A systematic review and meta-analysis of probiotic consumption and metabolic status of athletes

Abstract

Current evidence about the feasible effects of probiotic consumption on the metabolic status of athletes including lipid profile, fecal zonulin, and cortisol is debatable. Therefore, the present systematic reviewed and meta-analysis was aimed to clarify this inconclusiveness. Online databases (PubMed, Scopus, ISI Web of Science, and Cochrane’s library) were searched until May 2020. The overall effect was presented as weighted mean difference (WMD) or standard mean difference (SMD) and 95% confidence interval (CI) in a random-effects meta-analysis model. Publication bias was assessed using Egger’s and Begg’s statistics. A p-value <0.05 was considered as statistically significant. Cochrane Collaboration Risk of Bias Tool was used for quality assessment. Eleven RCTs (n = 398 participants) were considered as eligible. Probiotic consumption significantly decreased fecal zonulin (SMD = −0.63; 95% CI, −1.17 to −0.08; P = .02) with significant heterogeneity (I2 = 79.4%, P = .008). Also, serum triglyceride (WMD = −32.26 mg/dL; 95% CI, −60.44 to −4.08; P = .02) was reduced with high heterogeneity across the studies (I2 = 93.0%, P < .001). Subgroup analysis revealed that probiotic consumption did increase HDL-C among non-Asian studies. Also, serum triglyceride was higher when probiotics were consumed as food, among non-Asian population, and for less than 4 weeks. Probiotics may be beneficial to improve metabolic markers in athletes including fecal zonulin and serum triglyceride.