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The Effects of Exercise on Indirect Markers of Gut Damage and Permeability: A Systematic Review and Meta-analysis

Chantler, Sarah, Griffiths, Alex, Matu, Jamie, Davison, Glen, Jones, Ben, Deighton, Kevin (2020) The Effects of Exercise on Indirect Markers of Gut Damage and Permeability: A Systematic Review and Meta-analysis. Sports Medicine, . ISSN 0112-1642. E-ISSN 1179-2035. (doi:10.1007/s40279-020-01348-y) (KAR id:84317)



Exercise appears to cause damage to the endothelial lining of the human gastrointestinal tract and elicit a significant increase in gut permeability.


The aim of this review was to determine the effect of an acute bout of exercise on gut damage and permeability outcomes in healthy populations using a meta-analysis.


PubMed, The Cochrane Library as well as MEDLINE, SPORTDiscus and CINHAL, via EBSCOhost were searched through February 2019. Studies were selected that evaluated urinary (ratio of disaccharide/monosaccharide excretion) or plasma markers [intestinal Fatty Acid Binding Protein (i-FABP)] of gut permeability and gut cell damage in response to a single bout of exercise.


A total of 34 studies were included. A random-effects meta-analysis was performed, and showed a large and moderate effect size for markers of gut damage (i-FABP) (ES 0.81; 95% CI 0.63–0.98; n = 26; p < 0.001) and gut permeability (Disaccharide Sugar/Monosaccharide Sugar) (ES 0.70; 95% CI 0.29–1.11; n = 17; p < 0.001), respectively. Exercise performed in hot conditions (> 23 °C) further increased markers of gut damage compared with thermoneutral conditions [ES 1.06 (95% CI 0.88–1.23) vs. 0.66 (95% CI 0.43–0.89); p < 0.001]. Exercise duration did not have any significant effect on gut damage or permeability outcomes.


These findings demonstrate that a single bout of exercise increases gut damage and gut permeability in healthy participants, with gut damage being exacerbated in hot environments. Further investigation into nutritional strategies to minimise gut damage and permeability after exercise is required. PROSPERO database number (CRD42018086339).

Item Type: Article
DOI/Identification number: 10.1007/s40279-020-01348-y
Uncontrolled keywords: gut damage; endothelial lining
Subjects: G Geography. Anthropology. Recreation > GV Recreation. Leisure > Sports sciences
R Medicine > RC Internal medicine > RC1200 Sports medicine
R Medicine > RC Internal medicine > RC1235 Physiology of sports
Divisions: Divisions > Division of Natural Sciences > Sport and Exercise Sciences
Depositing User: Glen Davison
Date Deposited: 20 Nov 2020 22:07 UTC
Last Modified: 09 Dec 2022 02:21 UTC
Resource URI: (The current URI for this page, for reference purposes)

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