Gut-muscle axis
Significance of gut microbiota in post-exercise recovery and exercise adaptation
DOI:
https://doi.org/10.12775/QS.2026.59.72739Keywords
gut microbiota, gut-muscle axis, exercise recovery, skeletal muscle, probiotics, short-chain fatty acids, sports medicine, inflammationAbstract
Background. The gut microbiota is increasingly recognized as a metabolically and immunologically active system that may influence skeletal muscle physiology, recovery kinetics and adaptation to training. The gut-muscle axis integrates microbial metabolites, intestinal barrier integrity, immune regulation, substrate metabolism and neuromuscular function.
Aim. The aim of this evidence-based review was to critically synthesize current biomedical literature on the role of gut microbiota in post-exercise recovery and exercise adaptation, with emphasis on sports medicine, metabolism, microbiology and immunology.
Material and methods. A structured narrative review with systematic evidence prioritization was performed. PubMed/MEDLINE, PubMed Central and ClinicalTrials.gov were screened for systematic reviews, meta-analyses, randomized controlled trials, controlled intervention studies, mechanistic translational studies and registered trials published mainly between January 2020 and April 2026.
Results. Evidence supports a biologically plausible relationship between gut microbiota and skeletal muscle function. Regular physical activity is associated with altered gut microbial diversity and enrichment of taxa involved in short-chain fatty acid production. Probiotic and synbiotic trials suggest possible benefits for gastrointestinal tolerance, inflammatory tone and selected recovery biomarkers, including creatine kinase, but the overall certainty remains limited by strain heterogeneity, small sample sizes, dietary confounding and inconsistent endpoints.
Conclusions. The gut-muscle axis is a promising translational framework in sports medicine. However, microbiota-targeted interventions should currently be interpreted as adjunctive and investigational rather than routine performance or recovery therapies. Future trials should standardize diet, training load, probiotic strain identity, metagenomic assessment and clinically relevant recovery outcomes.
References
1. Marttinen M, Ala-Jaakkola R, Laitila A, Lehtinen MJ. Gut microbiota, probiotics and physical performance in athletes and physically active individuals. Nutrients. 2020;12(10):2936. doi: https://doi.org/10.3390/nu12102936.
2. Porepp ODSC, et al. Effect of probiotic supplementation on gut microbiota and sport performance in athletes and physically active individuals: a systematic review. J Diet Suppl. 2024;21(5):660-676. doi: https://doi.org/10.1080/19390211.2023.2293842.
3. Heimer M, Teschler M, Schmitz B, Mooren FC. Health benefits of probiotics in sport and exercise - Non-existent or a matter of heterogeneity? A systematic review. Front Nutr. 2022;9:804046. doi: https://doi.org/10.3389/fnut.2022.804046.
4. Min L, Ablitip A, Wang R, Luciana T, Wei M, Ma X. Effects of exercise on gut microbiota of adults: a systematic review and meta-analysis. Nutrients. 2024;16(7):1070. doi: https://doi.org/10.3390/nu16071070.
5. Teglas T, Radak Z. Probiotic supplementation for optimizing athletic performance: current evidence and future perspectives for microbiome-based strategies. Front Nutr. 2025;12:1572687. doi: https://doi.org/10.3389/fnut.2025.1572687.
6. Sales KM, Reimer RA. Unlocking a novel determinant of athletic performance: the role of the gut microbiota, short-chain fatty acids, and biotics in exercise. J Sport Health Sci. 2023;12(1):36-44. doi: https://doi.org/10.1016/j.jshs.2022.09.002.
7. Allen JM, Mailing LJ, Niemiro GM, Moore R, Cook MD, White BA, et al. Exercise alters gut microbiota composition and function in lean and obese humans. Med Sci Sports Exerc. 2018;50(4):747-757. doi: https://doi.org/10.1249/MSS.0000000000001495.
8. Hawley JA, Forster SC, Giles EM. Exercise, the gut microbiome and gastrointestinal diseases: therapeutic impact and molecular mechanisms. Gastroenterology. 2025;169(1):48-62. doi: https://doi.org/10.1053/j.gastro.2025.01.224.
9. Mohr AE, Jäger R, Carpenter KC, Kerksick CM, Purpura M, Townsend JR, et al. The athletic gut microbiota. J Int Soc Sports Nutr. 2020;17:24. doi: https://doi.org/10.1186/s12970-020-00353-w.
10. Dorelli B, Gallè F, De Vito C, Duranti G, Iachini M, Zaccarin M, et al. Can physical activity influence human gut microbiota composition independently of diet? A systematic review. Nutrients. 2021;13(6):1890. doi: https://doi.org/10.3390/nu13061890.
11. Cullen JMA, Shahzad S, Dhillon J. A systematic review on the effects of exercise on gut microbial diversity, taxonomic composition, and microbial metabolites: identifying research gaps and future directions. Front Physiol. 2023;14:1292673. doi: https://doi.org/10.3389/fphys.2023.1292673.
12. Shirkoohi NM, Mohammadi H, Gallaly DQ, Djafarian K. The effects of probiotic supplementation on body composition, recovery following exercise-induced muscle damage, and exercise performance: a systematic review and meta-analysis of clinical trials. Physiol Rep. 2025;13(8):e70288. doi: https://doi.org/10.14814/phy2.70288.
13. Ghaffar T, Ubaldi F, Volpini V, Giombini A, et al. The role of gut microbiota in different types of physical activity and their intensity: systematic review and meta-analysis. Sports. 2024;12(8):221. doi: https://doi.org/10.3390/sports12080221.
14. Hughes RL, Holscher HD. Fueling gut microbes: a review of the interaction between diet, exercise, and the gut microbiota in athletes. Adv Nutr. 2021;12(6):2190-2215. doi: https://doi.org/10.1093/advances/nmab077.
15. Bonomini-Gnutzmann R, Plaza-Díaz J, Jorquera-Aguilera C, Rodríguez-Rodríguez A, Rodríguez-Rodríguez F. Effect of intensity and duration of exercise on gut microbiota in humans: a systematic review. Int J Environ Res Public Health. 2022;19(15):9518. doi: https://doi.org/10.3390/ijerph19159518.
16. Chen Y, Yang K, Xu M, Zhang Y, Weng X, Luo J, Li Y, Mao YH. Dietary patterns, gut microbiota and sports performance in athletes: a narrative review. Nutrients. 2024;16(11):1634. doi: https://doi.org/10.3390/nu16111634.
17. Xu Y, et al. The gut-muscle axis: a comprehensive review of the interplay between physical activity and gut microbiota in the prevention and treatment of muscle wasting disorders. Front Microbiol. 2025;16:1695448. doi: https://doi.org/10.3389/fmicb.2025.1695448.
18. Grosicki GJ, Fielding RA, Lustgarten MS. Gut microbiota contribute to age-related changes in skeletal muscle size, composition, and function: biological basis for a gut-muscle axis. Calcif Tissue Int. 2018;102(4):433-442. doi: https://doi.org/10.1007/s00223-017-0345-5.
19. Scheiman J, Luber JM, Chavkin TA, MacDonald T, Tung A, Pham LD, 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. doi: https://doi.org/10.1038/s41591-019-0485-4.
20. Aragón-Vela J, et al. Impact of exercise on gut microbiota in obesity. Nutrients. 2021;13(11):3999. doi: https://doi.org/10.3390/nu13113999.
21. Mokarrami A, Capacci A, Trio B, Merra G, Della Morte Canosci D. Relationship between gut-microbiota and sport activity. Cent Eur J Sport Sci Med. 2024;45(1):25-53. doi: https://doi.org/10.18276/cej.2024.1-03.
22. Kim HJ, et al. Microbiota influences host exercise capacity via regulation of skeletal muscle glucose metabolism. Mol Cells. 2023;46:745-757. doi: https://doi.org/10.14348/molcells.2023.2181.
23. Finderle J, Schleicher VS, Schleicher LMS, Krsek A, Braut T, Baticic L. Exercise-induced modulation of the gut microbiota: mechanisms, evidence, and implications for athlete health. Gastrointest Disord. 2026;8(1):1. doi: https://doi.org/10.3390/gidisord8010001.
24. Liu Y, et al. Gut microbiota and exercise: probiotics to modify the composition and roles of the gut microbiota in the context of 3P medicine. Microb Ecol. 2025. doi: https://doi.org/10.1007/s00248-025-02529-w.
25. Zhang X, Li Y, Zhang F, Zhou G. Exercise and diet reshape athletes' gut microbiota: countering health challenges in athletes. Life. 2025;15(12):1812. doi: https://doi.org/10.3390/life1512181
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Natalia Powęska, Julita Papińska, Jakub Buziak, Magdalena Lengier, Małgorzata Świderska, Patrycja Małyszek, Franciszek Cezary Pastuszak, Szymon Świstak, Szymon Zych, Julia Pielacha
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 141
Number of citations: 0
