Practical Guidelines for Using Pre- and Probiotics in Sports

Prebiotics are dietary substances (primarily consisting of non-starch polysaccharides and oligosaccharides) that are not digested and absorbed in the upper parts of the gastrointestinal tract but are fermented by the microflora of the human large intestine, stimulating its growth and activity.

Probiotics are live microorganisms that provide benefits to the host when administered in adequate amounts.

In the work of D.B. Pyne and colleagues (2015), a scheme (Fig. 6) is presented showing the sequence of actions by athletes and coaches when using probiotic dietary supplements. In the sports community, a number of practical principles have been established regarding the effective use of probiotics. This includes selecting products from reputable companies based on detailed medical and pharmaceutical information (reviewing relevant literature, official instructions, indications, contraindications, side effects).

A probiotic product is part of an athlete’s overall nutrition plan, evaluated in terms of nutritional value and compatibility with other macro-, micro-, and pharmacological nutrients. Some probiotics may contain significant amounts of energy and carbohydrates, which should be considered in daily diet planning. Attention should also be paid to product expiration dates to avoid consuming expired probiotics and the presence of potentially harmful and/or banned substances in sports (Prohibited List WADA‒2018). Given the wide variety of probiotic products available (see below), athletes should choose the most suitable ones.

The adequate selection of probiotic products is often hampered by the insufficient preparation of many coaches and sports doctors (knowledge of microorganism strains, pharmacokinetics, pharmacodynamics of probiotics, etc.). Therefore, regular training courses and certification of sports specialists should pay serious attention to this issue.

Probiotic dietary supplements are appropriate at all stages of the annual macrocycle (preparatory, competitive, recovery) and can transition smoothly from one to another due to the recommended long duration of use of such nutrients. The best source of knowledge for using probiotics is systematic reviews and meta-analyses based on randomized double-blind placebo-controlled and diet-controlled studies. However, due to the clear lack of such studies, even personal experience and the experience of other specialists can be useful. Nutritional training concerning all other nutrients is a mandatory part of the practical use of probiotics. Regimens, doses, and combinations of probiotics with other components of the daily diet should be tested well before competitions. By the competitive season, the athlete should have a ready-made diet plan where the probiotic product occupies a specific place in the nutrition plan.

Probiotic food supplements at all stages of use must be well packaged, stored, and used in accordance with the conditions specified in the instructions (especially in extreme temperature conditions). The practical use of probiotics should begin at least 14 days before major training camps or competitions to achieve an adequate degree of intestinal colonization by microorganisms.

This is particularly important if upcoming camps or competitions are held in countries where the risk of gastrointestinal diseases is high (Shaw M.T. et al., 2010). During this period, it is advisable to develop a separate plan with a doctor and coach to prevent gastrointestinal disturbances and to monitor the athlete’s condition daily. Probiotics should be taken daily at the same time of day (e.g., during breakfast).