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Effect of Supplementation with Saccharomyces Boulardii on Academic Examination Performance and Related Stress in Healthy Medical Students: A Randomized, Double-Blind, Placebo-Controlled Trial

1
Department of Pharmacology and Toxicology, Medical University of Lodz, Żeligowskiego 7/9, 90-752 Łódź, Poland
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Department of Infectious Diseases and Hepatology, Medical University of Lodz, Kniaziewicza 1/5, 91-347 Łódź, Poland
3
Department of Pediatrics and Allergy, Copernicus Memorial Hospital in Łódź, Medical University of Lodz, Piłsudskiego 71, 90-329 Łódź, Poland
4
Oklahoma Medical Research Foundation, Aging and Metabolism Program, 825 NE 13th St, Oklahoma City, OK 73104, USA
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Department of Clinical Pharmacology, Medical University of Lodz, Kopcińskiego 22, 90-153 Łódź, Poland
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Department of Medical Biochemistry, Medical University in Lodz, Mazowiecka 6/8, 92-215 Łódź, Poland
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(5), 1469; https://doi.org/10.3390/nu12051469
Received: 25 March 2020 / Revised: 15 May 2020 / Accepted: 15 May 2020 / Published: 19 May 2020
(This article belongs to the Special Issue Role of Prebiotics and Probiotics in Health and Disease)
In recent years, bacterial probiotic dietary supplementation has emerged as a promising way to improve cognition and to alleviate stress and anxiety; however, yeast probiotics have not been tested. The aim of the present study was to determine whether 30-day supplementation with Saccharomyces boulardii enhances academic performance under stress and affects stress markers. The trial was retrospectively registered at clinicaltrials.gov (NCT03427515). Healthy medical students were randomized to supplement their diet with Saccharomyces boulardii CNCM I-1079 or placebo before sitting for an academic examination, which served as a model of stress. The grades of a final examination adjusted to subject knowledge tested in non-stressful conditions was used as a primary outcome measure. Psychometrically evaluated state anxiety, cortisol and metanephrine salivary levels, and pulse rate were tested at a non-stressful time point before the intervention as well as just before the stressor. Fifty enrolled participants (22.6 ± 1.4 years of age, 19 males) completed the trial in the Saccharomyces and placebo arms. Supplementation with Saccharomyces did not significantly modify examination performance or increase in state anxiety, salivary cortisol, and metanephrine. However, the intervention resulted in higher increase in pulse rate under stress as compared to placebo by 10.4 (95% CI 4.2–16.6) min−1 (p = 0.0018), and the effect positively correlated with increase in salivary metanephrine (Pearson’s r = 0.35, 95% CI 0.09–0.58, p = 0.012). An intention-to-treat analysis was in line with the per-protocol one. In conclusion, supplementation with Saccharomyces boulardii CNCM I-1079 appears largely ineffective in improving academic performance under stress and in alleviating some stress markers, but it seems to increase pulse rate under stress, which may hypothetically reflect enhanced sympathoadrenal activity. View Full-Text
Keywords: Saccharomyces boulardii; dietary supplementation; probiotic; academic examination; stress; anxiety; salivary cortisol; salivary metanephrine; pulse rate Saccharomyces boulardii; dietary supplementation; probiotic; academic examination; stress; anxiety; salivary cortisol; salivary metanephrine; pulse rate
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Karbownik, M.S.; Kręczyńska, J.; Kwarta, P.; Cybula, M.; Wiktorowska-Owczarek, A.; Kowalczyk, E.; Pietras, T.; Szemraj, J. Effect of Supplementation with Saccharomyces Boulardii on Academic Examination Performance and Related Stress in Healthy Medical Students: A Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients 2020, 12, 1469.

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