Probiotics, immunity and exercise: a review

Exerc Immunol Rev. 2009;15:107-26.


Nutritional practices that promote good health and optimal athletic performance are of interest to athletes, coaches, exercise scientists and dietitians. Probiotic supplements modulate the intestinal microbial flora and offer promise as a practical means of enhancing gut and immune function. The intestinal microbial flora consists of diverse bacterial species that inhabit the gastrointestinal tract. These bacteria are integral to the ontogeny and regulation of the immune system, protection of the body from infection, and maintenance of intestinal homeostasis. The interaction of the gut microbial flora with intestinal epithelial cells and immune cells exerts beneficial effects on the upper respiratory tract, skin and uro-genital tract. The capacity for probiotics to modulate perturbations in immune function after exercise highlight their potential for use in individuals exposed to high degrees of physical and environment stress. Future studies are required to address issues of dose-response in various exercise settings, the magnitude of species-specific effects, mechanisms of action and clinical outcomes in terms of health and performance.

Publication types

  • Review

MeSH terms

  • Animals
  • Clinical Trials as Topic
  • Cross-Over Studies
  • Diarrhea / epidemiology
  • Diarrhea / prevention & control
  • Double-Blind Method
  • Exercise / physiology*
  • Female
  • Gastric Mucosa / microbiology
  • Homeostasis
  • Humans
  • Immune System / drug effects*
  • Immunity, Cellular / drug effects
  • Intestinal Absorption
  • Intestinal Mucosa / cytology
  • Intestinal Mucosa / immunology
  • Intestinal Mucosa / microbiology
  • Lymphoid Tissue / drug effects
  • Lymphoid Tissue / immunology
  • Male
  • Mucins / metabolism
  • Probiotics / pharmacology
  • Probiotics / therapeutic use*
  • Randomized Controlled Trials as Topic
  • Respiratory Tract Infections / epidemiology
  • Respiratory Tract Infections / prevention & control
  • Stress, Physiological / immunology
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / prevention & control
  • Yogurt / microbiology
  • Young Adult


  • Mucins