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Yuan, M., Tomlinson, V., Lara, R., Holliday, D., Chelala, C., Harada, T., et al

Bile Acid Malabsorption Bile acids are synthesized in the liver and released into the duodenum to facilitate, through their detergent properties, the solubilization and absorption of fatty acid and monoglycerides in the small intestine

JAMA 314 , 687699 (2015)

Athletes, especially endurance athletes, are at higher risk due to the intensity and duration of their workouts

This can be done by beginning with examining substances for which there are reports of their potential toxicity to the intestinal barrier and determining the degree of toxicity, monitoring the concentrations in the environment and various products of compounds toxic to the intestinal barrier, as well as limiting contact with substances that may cause intestinal leakage to doses that could be considered safe

When a compound average effect is only 2 kilograms over 12 weeks, many individual participants likely saw minimal to no change, while a smaller subset may have responded more strongly, pulling the average up