What if improving your gut health could improve your physical performance and exercise capacity? For those who are already dealing with gut related issues, wouldn’t it be nice to have a simple solution that would actually improve how our gut functions? Well, the great news is that evidence has demonstrated that both of those things are possible.

We’re at an exciting point in medicine as advanced lab testing allows us to have a breakdown of what types of bacteria are present in our microbiome, effectively telling us who the neighbors are in the neighborhood. Even newer technologies allow us to answer the questions of how and what are the neighbors in the neighborhood doing? We can know, “Are they able to carry out their jobs?”, “Does it appear that there is a lot of conflict (inflammation) in the neighborhood?”, “Have some of the neighbors started to overgrow their living spaces (dysbiosis)?”. Once we understand this information, this informs a true personalized health approach. Let’s move on to how exercise and gut health affect one another.      

First, is it possible that we could selectively target improving digestion and the microbiome, and expect that an athlete could become a more elite version of themselves? Let’s begin with the pancreas and its role in digestion. If an athlete has insufficient pancreatic function, they’re unlikely to be able to create the building blocks of energy production. There are ways, through targeted digestive support and supplementation, to improve digestive function. We want to also consider short chain fatty acid status (SCFAs), as SCFAs are a fuel source for intestinal cells. They also regulate absorption of nutrients and are involved in insulin sensitivity and energy regulation [1]. Endurance athletes commonly deal with “runner’s stomach”, where the lining of the intestines are altered, leading to poor nutrient absorption, and many times, leading to potential food allergy/sensitivity issues [2]. We can improve both the SCFA production and the gut lining integrity, by using targeted nutritional approaches. Lastly, research suggests that the “neighbors in the neighborhood” can also affect exercise capacity.  Certain differences have been found in elite athletes vs. others, which specifically allow for longer duration of higher intensity workout, seemingly as a result of their gut metabolism [3].  There are numerous examples of ways that the microbiome can be affected through specific nutrition, sleep, lifestyle, and stress management decisions.        

Now, looking at this in the opposite direction, for those who are dealing with active medical problems, can we improve our gut health by implementing an exercise routine? Publications have shown that exercise programs can actually improve your pancreatic function, resolve fatty pancreas issues, and thus, increase overall digestive capacity [4,5].  Exercise has been shown to provide the “fuel” for the intestines, by increasing the three main types of short chain fatty acids [6].  While diet is still looked at as the most influential factor in the diversity of the microbes in your gut, exercise also proves to be an important factor as well. Prior comparisons between athletes and high BMI individuals demonstrate an incredible contrast, with athletes having much higher proportions of certain types of bacteria (i.e. Faecalibacterium, Akkermansia) and improved diversity [7], but are these things potentially modifiable? Are you stuck with what you have, or can you impact the gut “neighborhood”? The answer is that not only is the microbiome potentially modifiable, but the metabolites from the members of the microbiome can change. More specifically, by adding an exercise program, there is evidence that this can alter levels of gut metabolites that are linked to energy production and cardiovascular health (PAG, TMAO).

To summarize, exercise clearly demonstrates an association with gut health.  Whether you’re an athlete who wants to improve your performance, or if you’re someone who is considering whether exercise will improve your gut health, we see the benefit on both sides.  Our team at Index Health offers functional medicine trained, board certified physicians, teamed up with expert nutritionists and advanced lab testing.  We get you the right information, coupled with the right plan, to help you achieve real progress.

Take control of your gut health with Index!


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2.     ter Steege, R.W.F. and Kolkman, J.J. (2012), Review article: the pathophysiology and management of gastrointestinal symptoms during physical exercise, and the role of splanchnic blood flow. Aliment Pharmacol Ther, 35: 516-528.

3.     Scheiman J, Luber JM, Chavkin TA, et al. Meta-omics analysis of elite athletes identifies a performance-enhancing microbe that functions via lactate metabolism. Nat Med. 2019;25(7):1104-1109.

4.     Kiker, Dustin MD1; Pieper, Alexander2; Fourment, Chris MD3; Ritter, Timothy E. MD3 Fatty Pancreas as a Reversible Cause of Exocrine Pancreatic Insufficiency: A Case Series, American Journal of Gastroenterology: October 2018 - Volume 113 - Issue - p S738

5.     Tahtacı M, Algın O, Karakan T, et al. Can pancreatic steatosis affect exocrine functions of pancreas?. Turk J Gastroenterol. 2018;29(5):588-594.

6.     Allen, Jacob M; Mailing, Lucy J.; Niemiro, Grace M.; Moore, Rachel; Cook, Marc D.3; White, Bryan A.; Holscher, Hannah D; Woods, Jeffrey A. Exercise Alters Gut Microbiota Composition and Function in Lean and Obese Humans, Medicine & Science in Sports & Exercise: April 2018 - Volume 50 - Issue 4 - p 747-757.

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Exercise and associated dietary extremes impact on gut microbial diversity

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Nugent H, Fanning A, Melgar S, Falvey EC, Holmes E, Cotter PD, O’Sullivan O, Molloy MG, Shanahan F. 2018. A prospective metagenomic and metabolomic analysis of the impact of exercise and/or whey protein supplementation on the gut microbiome of sedentary adults. mSystems 3:e00044-18.