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HEALTH AND FITNESS: ASK THE COACH
Katharine McCoy
October 9, 2009
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Doesn't everybody wish that they had access to a personal coach for
their questions about training and fitness? Road Bike Action recently
caught up with Johnathan Edwards M.D. Dr. Edwards is a practicing
sports doctor and anesthesiologist in Las Vegas, Nevada. He has been a
sports doctor for American cyclists as well as in Europe. He is a USA
Cycling certified level 3 coach, has worked with athletes during the
Paris Dakar rally. As a former professional motocross racer and current
Cat 2 road racer, he understands the health and training needs of
cyclists of all levels.
I have stomach cramps and bloating when cycling long distances and everyone keeps telling me that I need to take probiotics found in yogurt. Is there any validity to this?
Many cyclists develop stomach pains and gastro-intestinal (GI) upset before, during and after cycling. There are many causes for GI upset, including dehydration, delayed gastric emptying, GERD, Irritable Bowel Syndrome (IBS), to just name a few. So be sure that you have ruled out some of these above named causes with your physician or other health provider. Now, we’ll consider the question at hand.
Probiotics are living micro-organisms that work by restoring the balance of intestinal bacteria. Probiotics, which means, "for life," have been used for centuries as natural health promoting foods. Just to give you an idea, your body contains about 4 pounds of bacteria in the stomach and intestines. These bacteria are very important part of the immune system as they influence the production of antibodies or immunoglobulins (Ig). Probiotics may help shorten the duration of colds in some studies. Only some probiotics of thousands have proven effective in clinical trials.
According to a recent New York Times article, there is a lot of marketing hype regarding the health benefits of yogurt and probiotics. As with many vitamins, no standard labeling requirement exists to help people make sense of probiotic products. The word “probiotic” on the label is not enough information to tell whether a given product will be effective for a particular health concern. Just as doctors prescribe specific antibiotics for certain diseases, specific probiotics are indicated in certain diseases.
A real life example is Fly V Australia’s Phil Zajicek (he beat Lance Armstrong and Levi Leipheimer in the tour of the Gila). He was diagnosed with Crohn’s disease in 2008 and he takes specific strains or types of probiotics to be help the symptoms of his disease. As for probiotics improving symptoms in Crohn’s, there is a strong amount of data that show by controlling bacterial colonies, Crohn’s symptoms improve (but do not go away). In addition, the data stating improvement in eczema and Crohn’s, point not only to a bacterial basis of control, but also control of the immune system. Bacterial colonies play a role in controlling immunoglobulin production (particularly in the GI tract, Ig A production). Thus, affecting immunoglobulin production can, in some way, affect tissue destruction, and this is well documented.
Some examples of probiotics are Lactobacillus (known as LGG), which comes in a number of strains. LGG is found in diet supplements as well as several milk products. But one must realize that Lactobacillus is just the bacterium and that many different subtypes or strains of LGG exist. Another effective species of probiotic’s are the Saccharomyces cerevisiae. As to which strain is right for the job is another story and requires a source or someone with knowledge about probiotics.
So what health problems can probiotics really help? After gathering of 12 “experts” at Yale University, the panel concluded that several probiotic strains could reduce diarrhea, including that associated with antibiotic use. They also suggested that certain probiotics may be useful for some types of irritable bowel syndrome (IBS). IBS is very common in cycling and is thought to be related to Crohn’s disease. The latest studies in the American Journal of Gastroenterology state that symptoms of IBS were improved with probiotic use (pain and gas which equates to bloating, a significant source of pain in patient with IBS).
There are many claims that probiotics help the immune system. The GI tract is an important part of the immune system, and studies show that intestinal bacteria play an essential role in immune defenses. For example, Crohn’s, eczema, and psoriasis are all immune related. However, some studies say there is no evidence that probiotics help the immune response and there are others with convincing evidence that they do; so the jury is still out on this one. For example, studies show that all Lactobacillus strains can reduce diarrhea, but certain strains are also effective in atopic eczema and psoriasis (skin disorders) and allergies in children (The Journal of Clinical Gastroenterology, 2008).
If you are interested in probiotics, first educate yourself about the different strains of probiotics and what they treat, and then look for products that list the specific strain on the label. The internet has many places to find studies and information on various probiotic strains. According to Dr. Anthony DiCarli, a GI specialist in New Smyrna Beach, Florida, “probiotics are expensive so realize that probiotics may help and may not. It will not hurt to try them, but one must be willing to spend the time, because results are not immediate. Consider to start with a product called Activia, because it is among the least expensive.”
Good luck,
Dr. Edwards
The author would like thank Dr. Anthony DiCarli for his advice preparing this article. He is a practicing Gastroenterologist in New Smyrna Beach, Florida who competes regularly in Ironman distance triathlons.
Neither the Author nor Dr. DiCarli has financial interest in Activia (Dannon) products.
The information provided in the ASK THE COACH column does not constitute formal medical advice. The information provided on this public web site is provided solely for general interest of the visitors to the site. Information in this column does not constitute medical advice nor establish a doctor-patient relationship with Dr. Johnathan Edwards. Readers of this column should not act upon any information contained in the web site without first seeking medical advice from their personal physician.
If you have your own question about health or training that you would like to ask a coach please send them to fitness@roadbikeaction.com
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