Abstract

The probiotic industry continues to grow in both usage and the diversity of products available. Scientific evidence supports clinical use of some probiotic strains for certain gastrointestinal indications. Although much less is known about the impact of probiotics in healthy populations, there is increasing consumer and scientific interest in using probiotics to promote physical and psychological health and performance. Military men and women are a unique healthy population that must maintain physical and psychological health in order to ensure mission success. In this narrative review, we examine the evidence regarding probiotics and candidate probiotics for physical and/or cognitive benefits in healthy adults within the context of potential applications for military personnel. The reviewed evidence suggests potential for certain strains to induce biophysiological changes that may offer physical and/or cognitive health and performance benefits in military populations. However, many knowledge gaps exist, effects on health and performance are generally not widespread among the strains examined, and beneficial findings are generally limited to single studies with small sample sizes. Multiple studies with the same strains and using similar endpoints are needed before definitive recommendations for use can be made. We conclude that, at present, there is not compelling scientific evidence to support the use of any particular probiotic(s) to promote physical or psychological performance in healthy military personnel. However, plausibility for physical and psychological health and performance benefits remains, and additional research is warranted. In particular, research in military cohorts would aid in assessing the value of probiotics for supporting physical and psychological health and performance under the unique demands required of these populations.

Highlights

  • INTRODUCTIONReadiness, and performance (defined as the ability to meet mission demands) are important measures within the military

  • Health, readiness, and performance are important measures within the military

  • The desire to optimize individual performance has been reported as a driving factor for service members to take dietary supplements, and significantly more military personnel are using dietary supplements than the general population (69% compared to 50%, respectively) [4,5,6,7]

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Summary

INTRODUCTION

Readiness, and performance (defined as the ability to meet mission demands) are important measures within the military. This review was conducted to assess the current body of evidence regarding the impact of probiotics in healthy adults on outcomes directly relevant to health and performance of military personnel, and to identify knowledge gaps where further research is needed to establish probiotic efficacy in this population. Increases in time to exhaustion have been reported with both multi-stain and single-strain products [35, 39], and, in one study, Lactobacillus plantarum PS128 supplementation reduced oxidative stress and improved performance during a triathlon [36]. Hao et al performed a systematic review on 13 clinical trials, performing meta-analysis on 12 (3,270 participants) ranging from children to older adults, taking Bifidobacterium, Lactobacillus, and Streptococcus probiotics [13] Both groups concluded that the evidence presented supports probiotic benefit for reducing numbers of URTI episodes, duration, and related work absences [13, 52].

Study design Probiotic administration
Study design
Study design Probiotic manipulation
Findings
CONCLUSION
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