EDITORIAL
Exercise and Sport Sciences Reviews: 2019 Paper of
the Year
Editor’s note: The inaugural Paper of the Year for Exercise and
Sport Sciences Reviews was selected based on the significance
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and impact of the article. To read more about the award and the ar-
ticles selected for the other four journals published by the American
College of Sports Medicine, see https://www.multibriefs.com/
briefs/acsm/Active060220.htm.
EXERCISE AND THE MICROBIOME: EMERGING SCIENCE
AND FUTURE OUTLOOK
It is with warm congratulations and excitement that this
commentary is written in recognition of “Exercise and the gut
microbiome: a review of the evidence, potential mechanisms,
and implications for human health” being named Exercise and
Sport Sciences Reviews paper of the year for 2019 (1). This work
highlights the emerging science investigating the role of exer-
cise training in manipulating the gut microbiome.
Although the study of microbiology has been around for cen-
turies, only in the last few decades have scientists begun to ag-
gressively pursue the role of gut microbes in human health. It is
now widely accepted that these microorganisms play a powerful
role in human health outcomes, ranging from obesity and
diabetes to anxiety and depression. Although most of the re-
search focuses on diet, the growing niche of the exercise
microbiome deserves recognition. It has been shown by our
group and others that exercise alters the microbiome indepen-
dent of diet (2,3). Recently, our group has further shown that
exercise exerts strain level selection for microbes within the
host more robustly than genotype (4). In addition, studies have
shown that depletion of the microbiome via antibiotics or the
use of germ-free mice demonstrates a reduced exercise toler-
ance, suggesting that an intact microbiome is essential for exer-
cise capacity (5). Together, these studies illustrate not only the
immense independent impact exercise has on microbial commu-
nity structure but also that exercise tolerance is indeed depen-
dent on these microbes, highlighting a true symbiosis between
host and its microbiome.
One of the exciting highlights of Mailing et al. (1), as noted
in Figure 3, are the many proposed mechanisms by which
exercise can alter the gut microbiome. One of the most docu-
mented alterations is the favorable increase in butyrate concen-
trations (6), butyrate-producing microbes (2), and the activity of
butyryl CoA:acetate-CoA transferase (7). Butyrate is known for
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Exercise and Sport Sciences Reviews
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149
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being beneficial for colonocyte proliferation and differentia-
tion, which can help with inflammatory bowel disease–related
outcomes. Mailing et al. also address the importance of the
gut-immune interaction via gut-associated lymphoid tissue, or
GALT, the impact of exercise of gut permeability, bile acid cir-
culation, and metabolic flux. As the review highlights, all of
these mechanisms have the potential to influence host metab-
olism, and understanding how these systems act both inde-
pendently and interdependently will lead to meaningful
discoveries for human health. Future studies should focus on
the use of various -omic-based technologies to more accurately
measure and quantify microbial derived metabolic by-products
in systemic circulation. Only then can we truly link the microbiome
causally to systemic health outcomes. Finally, use of technol-
ogies to enhance taxonomic resolution to ascertain which spe-
cific species/strains of microbes change with exercise will
provide targets for therapeutic interventions. A known and
excellent example of this is Fecalibacterium prausnitzii. F.
prausnitzii has not only shown to be enhanced with exercise
training (2,7) and with insulin administration improving type
2 diabetes outcomes (8), but also is associated with lower
depression/anxiety scores on self-reported surveys (9). Given
that exercise has positive health benefits on type 2 diabetes and
mental health outcomes, making connections via the microbiome
is an exciting way to overlap complementary areas of study.
An additional exciting area is the notion that the microbiome
be considered a training adaptation. Accumulating evidence
suggests that if you maintain exercise training, you can main-
tain the beneficial changes to the microbiome. Allen et al.
(7), also from the Wood’s laboratory with Mailing et al., showed
that exercise increased butyrate levels as well as fecal acetate
and butyrate levels in lean and obese individuals. Interestingly,
although these changes were dependent on body mass index
status, short-chain fatty acid levels returned to normal when in-
dividuals returned to a sedentary state. Likewise, a recent article
by Hampton-Marcell et al. (10) reported that in swimmers, co-
inciding with the decrease in training volume, the microbial
community structure showed a significant decrease in overall
microbial diversity, a decrease in microbial community struc-
ture similarity, and a decrease in the proportion of the bacterial
genera Faecalibacterium and Coprococcus. These studies among a
few others show that exercise training is required to maintain
beneficial changes in the microbiome or they will revert back
to the original “seeded” communities. More research is needed
to understand the mechanisms that link both the timeline of
these changes after exercise interventions and the reversal of
these effects after detraining.
 Mailing et al. concludes, “Ultimately, we can imagine a fu-
ture of personalized microbiome-based lifestyle medicine, where
baseline gut microbiota, diet, and other host factors might help
predict which exercise program might be most effective for a
given individual.” We share in the excitement of this statement
and will continue to pursue this avenue of research with rigor.
For now, congratulations on a job well done and continued suc-
cess in moving this field forward!
Sara C. Campbell
Department of Kinesiology and Health
Rutgers University
New Brunswick, NJ
References
1. Mailing LJ, Allen JM, Buford TW, et al. Exercise and the gut microbiome: a
review of the evidence, potential mechanisms, and implications for human
health. Exerc. Sport Sci. Rev. 2019; 47:75–85.
2. Campbell SC, Wisniewski PJ, Noji M, et al. The effect of diet and exercise on in-
testinal integrity and microbial diversity in mice. PLoS One. 2016; 11:e0150502.
150 Exercise and Sport Sciences Reviews
Copyright © 2020 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
3. Allen JM, Miller MEB, Pence BD, et al. Voluntary and forced exercise dif-
ferentially alters the gut microbiome in C57BL/6J mice. J. Appl. Physiol.
2015; 118:1059–66.
4. Dowden RA, McGuinness LR, Wisniewski PJ, et al. Host genotype
and exercise exhibit species-level selection for members of the gut
bacterial communities in the mouse digestive system. Sci. Rep. 2020;
10:8984.
5. Hsu YJ, Chiu CC, Li YP, et al. Effect of intestinal microbiota on exercise
performance in mice. J. Strength Cond. Res. 2015; 29:552–8.
6. Matsumoto M, Inoue R, Tsukahara T, et al. Voluntary running exercise al-
ters microbiota composition and increases n-butyrate concentration in the
rat cecum. Biosci. Biotechnol. Biochem. 2008; 72:572–6.
7. Allen JM, Mailing LJ, Niemiro GM, et al. Exercise alters gut microbiota
composition and function in lean and obese humans. Med. Sci. Sports Exerc.
2018; 50:747–57.
8. Zhao L, Zhang F, Ding X, et al. Gut bacteria selectively promoted by dietary
fibers alleviate type 2 diabetes. Science. 2018; 359:1151–6.
9. Valles-Colomer M, Falony G, Darzi Y, et al. The neuroactive potential of
the human gut microbiota in quality of life and depression. Nat. Microbiol.
2019; 4:623–32.
10. Hampton-Marcell TJ, Eshoo TW, Cook MD, et al. Comparative analysis of
gut microbiota following changes in training volume among swimmers. Int.
J. Sports Med. 2020; 41:292–9.
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