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Langley CK, Morse CI, Buffey AJ. The Prevalence of Low Vitamin D in Elite Para-Athletes: A Systematic Review. SPORTS MEDICINE - OPEN 2024; 10:96. [PMID: 39230661 PMCID: PMC11374943 DOI: 10.1186/s40798-024-00756-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 07/24/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND Vitamin D insufficiency (25OHD, 50-75 nmolˑl- 1) is a common issue within healthy adults and elite athletes and is associated with decreased musculoskeletal health and performance. However, few studies have identified the prevalence and risk factors associated with vitamin D insufficiency within elite Para-Athletes. METHODS An electronic search was completed on the 5th January 2023 and updated on the 21st June 2024, searching Web of Science, PubMed, Scopus, Cochrane Library and EASY (originally OpenGrey). To meet the eligibility criteria, retrieved studies were required to include at least one baseline measure of a vitamin D biomarker from elite Para-Athletes performing at national or international levels and therefore all quantitative study designs could be included. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist (8-item) for analytical cross-sectional studies. Data from the eligible studies was extracted and charted, with a supporting narrative synthesis. RESULTS The search strategy retrieved 3083 articles, of which ten studies met the inclusion criteria. In total there were n = 355 Para-Athletes, 69.6% of which comprised of males in the included studies. Across the ten included studies, n = 546 samples were taken from n = 355 Para-Athletes across different seasons and based upon the 25(OH)D insufficiency and deficiency thresholds set by each individual study 43.2% of the samples were considered insufficient and 28.1% deficient. During the winter months vitamin D insufficiency was at its most prevalent at 74.1%, compared to 57.1% in summer of the 25(OH)D samples measured in Para-Athletes. Wheelchair athletes who competed in indoor sports were also more susceptible to low vitamin D. CONCLUSION This review has highlighted that vitamin D insufficiency and deficiency is highly prevalent in elite level Para-Athletes, all year, across both summer and winter months. Therefore, this review highlights the need for education, treatment, and preventative measures in elite Para-Athletes throughout the year. REGISTRATION The following systematic review was prospectively registered through PROSPERO International prospective register of systematic reviews (PROSPERO registration ID number: CRD42022362149).
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Affiliation(s)
- Christina Kate Langley
- Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
- Manchester Institute of Sport, Manchester Metropolitan University, Manchester, UK
- University Academy 92 Ltd, Manchester, UK
| | - Christopher Ian Morse
- Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
- Manchester Institute of Sport, Manchester Metropolitan University, Manchester, UK
| | - Aidan John Buffey
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland.
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Abulafia O, Ashkenazi E, Epstein Y, Eliakim A, Nemet D. Characteristics of Vitamin D Concentration in Elite Israeli Olympic Athletes. Nutrients 2024; 16:2627. [PMID: 39203764 PMCID: PMC11357123 DOI: 10.3390/nu16162627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 08/04/2024] [Accepted: 08/06/2024] [Indexed: 09/03/2024] Open
Abstract
BACKGROUND The prevalence of vitamin D deficiency has been a growing concern in recent years. Vitamin D is important in many of the body's physiological systems, such as the musculoskeletal, cardiovascular and immune functions. A deficiency of vitamin D in athletes may negatively impact both muscle functions and recovery and, thus, affect performance and increase the risk of injury. Many studies assessed the prevalence of vitamin D deficiency in athletes; however, as of today, there are no official recommendations/protocols for screening vitamin D levels in athletes, and only a few studies were performed in male and female elite athletes (i.e., Olympic level), in different sport disciplines. METHOD We investigated the prevalence of vitamin D deficiency among athletes entering the Israeli Olympic team. A total of 761 samples of Vitamin D(OH)25 from 334 athletes were analyzed. For this analysis, we used the first test the athlete had performed when joining the Olympic team. The prevalence of vitamin D deficiency (<50 nmol/L, as defined by the Endocrine Society Committee) was investigated according to gender, types of sports and outdoor vs. indoor sports through the different seasons of the Israeli Olympic team athletes. RESULT Twenty-five athletes (7.5%) were diagnosed with vitamin D deficiency. One hundred and thirty-one athletes (39.2%) had insufficient levels of vitamin D (50-75 nmol/L). The highest incidence of vitamin D deficiency was found amongst gymnastics and combat sport athletes. A significant difference was also found in vitamin D concentration between seasons. Vitamin D average concentration in the winter was 74.1 nmol/L compared to 86.4 nmol/L in the Summer (p < 0.0005). CONCLUSIONS Due to the importance of vitamin D to athletic performance and the high prevalence of deficiency and insufficiency, we suggest careful and frequent monitoring of groups at risk, including elite athletes, especially in susceptible sports and during the winter. Future studies are necessary to investigate the effectiveness of Vitamin D supplementation in athletes with low baseline vitamin D levels.
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Affiliation(s)
- Ori Abulafia
- The Elite Sport Department of Israel, Wingate Institute, Netanya 4290200, Israel
- School of Public Health, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 69978, Israel
| | - Elya Ashkenazi
- Department of Pediatrics, Meir Medical Center, Kfar-Saba 4428164, Israel
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 69978, Israel
| | - Yoram Epstein
- School of Public Health, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 69978, Israel
- Faculty of Health Sciences, Department of Sport Therapy, Ono Academic College, Kiryat Ono 3133801, Israel
| | - Alon Eliakim
- Department of Pediatrics, Meir Medical Center, Kfar-Saba 4428164, Israel
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 69978, Israel
| | - Dan Nemet
- Department of Pediatrics, Meir Medical Center, Kfar-Saba 4428164, Israel
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 69978, Israel
- The Medical Department, Olympic Committee of Israel, Tel Aviv 69706, Israel
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Hollabaugh WL, Hymel A, Pennings JS, Clark DE, Soslow JH, Karpinos AR. Vitamin D Status and Cardiovascular Disease in College Athletes After SARS-CoV-2 Infection. Clin J Sport Med 2024:00042752-990000000-00211. [PMID: 38980665 DOI: 10.1097/jsm.0000000000001253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 06/10/2024] [Indexed: 07/10/2024]
Abstract
OBJECTIVE To evaluate the association between vitamin D status and CV disease after COVID-19 in college athletes. DESIGN Retrospective cohort study. SETTING National College Athletic Association Division-I college athletes from a single academic institution. PATIENTS A total of 157 athletes (60 female; median age: 20 years) from 9 sports with a positive SARS-CoV-2 test, cardiac magnetic resonance imaging (CMR), and vitamin D level. INDEPENDENT VARIABLES Serum 25-hydroxyvitamin D level (primary); age, sex (regression models). MAIN OUTCOMES MEASURES Differences in age, sex, race, ethnicity, myocarditis, pericarditis, and CMR metrics by vitamin D status were analyzed. Regression models were used to assess the relationship between vitamin D status and CMR metrics accounting for age and sex. RESULTS Low vitamin D (LVD) was found in 33 (21.0%) of athletes, particularly Black males (P < 0.001). Athletes with LVD had higher biventricular and lower mid-ventricular extracellular volumes, but these differences were not significant when corrected for age and sex. Athletes with LVD had higher left ventricle (LV) mass (P < 0.001) and LV mass index (P = 0.001) independent of age and sex. Differences in global circumferential strain were noted but are likely clinically insignificant. Vitamin D status did not associate with myocarditis and pericarditis (P = 0.544). CONCLUSIONS LVD is common in athletes, particularly in Black males. Although athletes with LVD had higher LV mass, cardiac function and tissue characterization did not differ by vitamin D status. Future studies are needed to determine if the differences in LV mass and LV mass index by vitamin D status are clinically significant. This study suggests that vitamin D status does not impact the development of myocarditis or pericarditis after COVID-19 infection.
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Affiliation(s)
- William L Hollabaugh
- Division of Sports Medicine, Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Alicia Hymel
- Division of Sports Medicine, Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jacquelyn S Pennings
- Division of Sports Medicine, Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
- Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Daniel E Clark
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, California
| | - Jonathan H Soslow
- Division of Cardiology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee; and
| | - Ashley R Karpinos
- Division of Sports Medicine, Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
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Han Q, Xiang M, An N, Tan Q, Shao J, Wang Q. Effects of vitamin D3 supplementation on strength of lower and upper extremities in athletes: an updated systematic review and meta-analysis of randomized controlled trials. Front Nutr 2024; 11:1381301. [PMID: 38860160 PMCID: PMC11163122 DOI: 10.3389/fnut.2024.1381301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 04/29/2024] [Indexed: 06/12/2024] Open
Abstract
Background Coaches and athletes are increasingly interested in understanding athletes' serum vitamin D levels, their impact on strength, physical performance, and athletic outcomes. Previous meta-analyses were reported with limited sample size and no significant overall effect was found. Hence, it is crucial to conduct a thorough and up-to-date systematic examination and meta-analysis to elucidate the potential advantages of supplementing with vitamin D3 in enhancing muscle strength for athletes. Methods We performed a thorough investigation, spanning three databases (PubMed, EBSCO, and Cochrane Library), seeking randomized controlled trials (RCTs) in all languages. These trials delved into the influence of vitamin D3 supplementation on the changes of pre- and post-intervention muscle strength in healthy athletes. Our systematic examination and meta-analysis took into account serum 25(OH)D levels exceeding 30 ng/mL as a marker of adequacy. Results Ten RCTs, comprising 354 athletes (185 in the vitamin D3 group and 169 in the placebo group), fulfilled the inclusion criteria. During the study, 36 athletes were lost to follow-up, leaving 318 athletes (166 in the vitamin D3 group and 152 in the placebo group) with documented complete results. In comparison with the placebo group, there is a significant increase between the changes of pre- and post-intervention serum 25(OH)D levels among athletes following a period of vitamin D3 supplementation (MD 14.76, 95% CI: 8.74 to 20.77, p < 0.0001). Overall effect of four strength measurements including handgrip, one repetition maximum Bench Press (1-RM BP), vertical jump, and quadriceps contraction was not significantly improved (SMD 0.18, 95% CI: -0.02 to 0.37, p = 0.08), but there was a significant increase in quadriceps contraction (SMD 0.57, 95% CI: 0.04 to 1.11, p = 0.04). Conclusion This updated meta-analysis indicates the potential benefits of vitamin D supplementation for enhancing muscle strength in athletes when analyzing its quantitatively synthesized effects. With limited available studies for the quantitative synthesis, it cannot warrant significant overall enhancements in muscle strength when athletes attain adequate serum 25(OH)D levels through supplementation.
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Affiliation(s)
- Qi Han
- Sports Nutrition Center, National Institute of Sports Medicine, Beijing, China
- Key Lab of Sports Nutrition, State General Administration of Sport of China, Beijing, China
- Sport Science College, Beijing Sport University, Beijing, China
- National Testing & Research Center for Sports Nutrition, Ministry of Science and Technology of the People’s Republic of China, Beijing, China
| | - Mai Xiang
- Sports Nutrition Center, National Institute of Sports Medicine, Beijing, China
- Key Lab of Sports Nutrition, State General Administration of Sport of China, Beijing, China
- Sport Science College, Beijing Sport University, Beijing, China
| | - Nan An
- Sports Nutrition Center, National Institute of Sports Medicine, Beijing, China
- Key Lab of Sports Nutrition, State General Administration of Sport of China, Beijing, China
- National Testing & Research Center for Sports Nutrition, Ministry of Science and Technology of the People’s Republic of China, Beijing, China
| | - Qiushi Tan
- Sports Nutrition Center, National Institute of Sports Medicine, Beijing, China
- Key Lab of Sports Nutrition, State General Administration of Sport of China, Beijing, China
- National Testing & Research Center for Sports Nutrition, Ministry of Science and Technology of the People’s Republic of China, Beijing, China
| | - Jing Shao
- Sports Nutrition Center, National Institute of Sports Medicine, Beijing, China
- Key Lab of Sports Nutrition, State General Administration of Sport of China, Beijing, China
- National Testing & Research Center for Sports Nutrition, Ministry of Science and Technology of the People’s Republic of China, Beijing, China
| | - Qirong Wang
- Sports Nutrition Center, National Institute of Sports Medicine, Beijing, China
- Key Lab of Sports Nutrition, State General Administration of Sport of China, Beijing, China
- National Testing & Research Center for Sports Nutrition, Ministry of Science and Technology of the People’s Republic of China, Beijing, China
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Molina-López J, Herrera-Quintana L, Vázquez-Lorente H, Planells E. Evolution of Vitamin D Status and Vitamin D Receptor Gene Expression Among Professional Handball Athletes During a Competitive Period. Relationship with Body Composition, Calcium, Magnesium and Phosphorous. Biol Trace Elem Res 2024; 202:1345-1355. [PMID: 37410265 PMCID: PMC10859345 DOI: 10.1007/s12011-023-03760-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/29/2023] [Indexed: 07/07/2023]
Abstract
INTRODUCTION A generalized risk of vitamin D deficiency exists worldwide affecting also professional and elite athletes. This study assesses the evolution of vitamin D status and vitamin D receptor (VDR) gene expression and their relationship with body composition, calcium (Ca), magnesium (Mg) and phosphorous (P) among professional handball athletes during a competitive period. METHODS A total of 26 male subjects were recruited: 13 professional handball athletes and 13 non-athlete controls. An observational follow-up study was conducted in 2 time points over a 16-week period. Nutritional intake, body composition, and routinary biochemical parameters were measured via 24-hours recall, bioimpedance and enzyme immunoassay, respectively. Ca and Mg were measured by flame atomic absorption spectrophotometry and P was determined with the colorimetric method of Fiske-Subbarow. 25-hydroxyvitamin-D (25(OH)D) levels and its forms (i.e., 25(OH)D3 and 25(OH)D2) were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS), whereas VDR gene expression was measured by quantitative real time-polymerase chain reaction (qRT-PCR). RESULTS A total of 54% of the athletes showed deficient vitamin D status. Moreover, a prevalence of insufficient vitamin D status in handball players affected 46% at baseline, reaching 61% after 16 weeks. Vitamin D showed no evolution during the competitive period and no differences between groups were observed (all p ≥ 0.05). Handball players increased the VDR expression, enhanced body composition, Ca and Mg levels at 16-weeks follow-up (all p < 0.05). VDR gene expression was positively related with body mass and body mass index at follow-up in athletes (all p ≤ 0.038; r ≥ 0.579) and with Ca at baseline in controls (p = 0.026; r = 0.648). Finally, 25(OH)D2 form was directly associated with P in athletes at 16 weeks of study (p = 0.034; r = 0.588). CONCLUSION Players of indoor team sports such as handball would be a population at risk of vitamin D deficiency. The 16-weeks competition improved VDR gene expression, body composition, Ca and Mg levels. The associations observed between VDR gene expression and the variables of the study evidenced the importance of this receptor as a marker involved in health status in handball athletes despite vitamin D - although in a deficient status -, Ca, Mg and P showed no remarkable changes during the competition period.
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Affiliation(s)
- Jorge Molina-López
- Faculty of Education, Psychology and Sports Sciences, University of Huelva, Huelva, 21007, Spain
- Department of Physiology, School of Pharmacy. Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, 18071, Spain
| | - Lourdes Herrera-Quintana
- Department of Physiology, School of Pharmacy. Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, 18071, Spain
| | - Héctor Vázquez-Lorente
- Department of Physiology, School of Pharmacy. Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, 18071, Spain.
| | - Elena Planells
- Department of Physiology, School of Pharmacy. Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, 18071, Spain
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Chryssanthopoulos C, Souglis A, Tsalouhidou S, Hulton AT, Bogdanis GC, Petridou A, Philippou A, Maridaki M, Theos A. Dietary Intake of Soccer Players before, during and after an Official Game: Influence of Competition Level and Playing Position. Nutrients 2024; 16:337. [PMID: 38337622 PMCID: PMC10856869 DOI: 10.3390/nu16030337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
Physical demands in soccer differ according to league level and playing position and may influence nutritional requirements. This study examined the effect of competition level and playing position on dietary intake in male soccer players (SP). Diet was weighed and recorded by 123 SP for 3 days; before, on the day, and the day after an official match. SP in the Super League (SL, n = 33) division reported higher (p < 0.05) average three-day energy (195 ± 36 kJ/kg), carbohydrate (6.0 ± 1.1 g/kg), and protein (2.2 ± 0.5 g/kg) intakes compared to the intakes reported by SP in the 2nd (n = 30) (energy: 159 ± 31 kJ/kg; carbohydrate: 4.6 ± 1.2 g/kg; protein: 1.9 ± 0.4 g/kg), 3rd (n = 30) (energy: 153 ± 34 kJ/kg; carbohydrate: 4.5 ± 1.2 g/kg; protein: 1.7 ± 0.4 g/kg), and 4th (n = 30) (energy: 152 ± 36 kJ/kg; carbohydrate: 4.2 ± 1.2 g/kg; protein: 1.7 ± 0.5 g/kg) national leagues (mean ± SD). Furthermore, when data were analyzed by playing position (pooled data), wide midfielders reported higher (p < 0.05) energy (183 ± 33 kJ/kg), carbohydrate (5.4 ± 1.2 g/kg), and fat (1.5 ± 0.4 g/kg) intakes compared to central defenders (energy: 147 ± 37 kJ/kg; carbohydrate: 4.1 ± 1.1 g/kg; fat: 1.2 ± 0.4 g/kg). The dietary intake of SP may differ according to the playing position and competition level, possibly due to different metabolic demands in training and competition.
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Affiliation(s)
- Costas Chryssanthopoulos
- Department of Physical Education and Sport Science, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece (G.C.B.)
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Athanasios Souglis
- Department of Physical Education and Sport Science, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece (G.C.B.)
| | - Sofia Tsalouhidou
- Laboratory of Evaluation of Human Biological Performance, School of Physical Education and Sport Science at Thessaloniki, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece (A.P.)
| | - Andrew T. Hulton
- Department of Nutrition, Food and Exercise Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK;
| | - Gregory C. Bogdanis
- Department of Physical Education and Sport Science, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece (G.C.B.)
| | - Anatoli Petridou
- Laboratory of Evaluation of Human Biological Performance, School of Physical Education and Sport Science at Thessaloniki, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece (A.P.)
| | - Anastassios Philippou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Maria Maridaki
- Department of Physical Education and Sport Science, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece (G.C.B.)
| | - Apostolos Theos
- Section of Sports Medicine, Department of Community Medicine & Rehabilitation, Umeå University, 901 87 Umeå, Sweden
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Qiu J, Choi CY, Man GCW, He X, Yu M, Cao M, Wang Q, Ng JP, Yung PSH, Ong MTY. Serum vitamin D insufficiency is correlated with quadriceps neuromuscular functions in patients with anterior cruciate ligament injury: A preliminary study. Asia Pac J Sports Med Arthrosc Rehabil Technol 2024; 35:76-80. [PMID: 38292822 PMCID: PMC10827444 DOI: 10.1016/j.asmart.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 02/01/2024] Open
Abstract
Background This study aimed to investigate the correlations of serum vitamin D insufficiency with quadriceps neuromuscular function in patients with anterior cruciate ligament (ACL) injury. Methods A cross-sectional study was conducted. Eighteen patients with a primary, unilateral ACL injury who had insufficient serum vitamin D concentrations (<30 ng/ml) were recruited for the study. Bilateral quadriceps neuromuscular function, including maximal strength, the speed of rapid contraction, and inhibition, were measured on an isokinetic dynamometer with the hip and the knee joint flexion at 90° and 45°, respectively. Quadriceps strength was measured by maximal voluntary isometric contractions (MVIC); the speed of rapid contraction was quantified by the rate of torque development (RTD), which was divided into the early (RTD0-50) and the late phase (RTD100-200); quadriceps inhibition was quantified by the central activation ratio (CAR). Serum vitamin D concentration was quantitatively determined by serum 25(OH)D concentration measured by the 25(OH)D ELISA kit. The Spearman rank correlation analysis was used to examine the correlation between the vitamin D concentration and bilateral quadriceps MVIC, RTD0-50, RTD100-200, and CAR, respectively. Results The results of Spearman rank correlation analyses showed that the serum 25(OH)D concentration was significantly correlated with bilateral quadriceps MVIC (injured: r = 0.574, p = 0.013; uninjured: r = 0.650, p = 0.003) and RTD0-50 (r = 0.651, p = 0.003), and CAR (r = 0.662, p = 0.003) on the uninjured limb. However, no significant correlations were found between the serum 25(OH)D concentration and the other outcomes. Conclusions The serum vitamin D concentration correlates with quadriceps neuromuscular function in patients with ACL injury who had vitamin D insufficiency.
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Affiliation(s)
- Jihong Qiu
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Chi-Yin Choi
- Department of Orthopaedices and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Gene Chi-Wai Man
- Department of Orthopaedices and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Xin He
- Department of Orthopaedices and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Mingqian Yu
- Department of Orthopaedices and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Mingde Cao
- Department of Orthopaedices and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Qianwen Wang
- Department of Orthopaedices and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Jonathan Patrick Ng
- Department of Orthopaedices and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Patrick Shu-Hang Yung
- Department of Orthopaedices and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Michael Tim-Yun Ong
- Department of Orthopaedices and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
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Wyatt PB, Reiter CR, Satalich JR, O’Neill CN, Edge C, Cyrus JW, O’Connell RS, Vap AR. Effects of Vitamin D Supplementation in Elite Athletes: A Systematic Review. Orthop J Sports Med 2024; 12:23259671231220371. [PMID: 38188620 PMCID: PMC10768611 DOI: 10.1177/23259671231220371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 07/31/2023] [Indexed: 01/09/2024] Open
Abstract
Background Deficiency in vitamin D has been shown to increase the risk of injury. Purpose To synthesize current placebo-controlled randomized trials investigating the effect of vitamin D supplementation in elite athletes on (1) aerobic capacity; (2) anaerobic measures, such as strength, speed, and anaerobic power; (3) serum biomarkers of inflammation; and (4) bone health. Study Design Systematic review; Level of evidence, 1. Methods A literature search was conducted on November 30, 2022, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included were randomized, placebo-controlled studies of longer than 2 weeks on subjects with active participation in organized sport. Excluded were nonrandomized controlled trial study designs, vitamin D administration routes other than oral, studies that did not use vitamin D supplementation as the sole intervention, and studies with nonathletic or military populations. Results Out of 2331 initial studies, 14 studies (482 athletes) were included. Of the 3 studies that assessed aerobic capacity, 2 demonstrated significantly greater improvements in maximal oxygen uptake and physical working capacity-170 (P < .05) in supplemented versus nonsupplemented athletes. Measurements of anaerobic power and strength were consistently increased in supplemented groups compared with nonsupplemented groups in 5 out of the 7 studies that assessed this. Of the 6 studies that assessed sprint speed, 4 found no significant difference between supplemented and nonsupplemented groups. Aside from 1 study that found significantly lower interleukin-6 levels in supplemented athletes, measures of other inflammatory cytokines were not affected consistently by supplementation. The 4 studies that assessed markers of bone health were conflicting regarding benefits of supplementation. One study found demonstrated improvements in bone mineral density in response to supplementation (P = .02) compared with control whereas another found no significant difference between supplemented and nonsupplemented groups. However, in 3 other studies, serum biomarkers of bone turnover such as bone-specific alkaline phosphatase, parathyroid hormone, and N-terminal telopeptide appeared to be higher in subjects with lower serum vitamin D levels (P < .05). Conclusion Results of this systematic review indicated that the greatest benefit of vitamin D supplementation in elite athletes may be improving aerobic endurance, anaerobic power, and strength. More research is needed to determine the effect of vitamin D supplementation on bone health and injury risk in this population.
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Affiliation(s)
- Phillip B. Wyatt
- Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Charles R. Reiter
- Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - James R. Satalich
- Department of Orthopedic Surgery, Virginia Commonwealth University Health System, Richmond, Virginia, USA
| | - Conor N. O’Neill
- Department of Orthopedic Surgery, Virginia Commonwealth University Health System, Richmond, Virginia, USA
| | - Carl Edge
- Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - John W. Cyrus
- Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Robert S. O’Connell
- Department of Orthopedic Surgery, Virginia Commonwealth University Health System, Richmond, Virginia, USA
| | - Alexander R. Vap
- Department of Orthopedic Surgery, Virginia Commonwealth University Health System, Richmond, Virginia, USA
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Tuma C, Schick A, Pommerening N, Braun H, Thevis M. Effects of an Individualized vs. Standardized Vitamin D Supplementation on the 25(OH)D Level in Athletes. Nutrients 2023; 15:4747. [PMID: 38004144 PMCID: PMC10675819 DOI: 10.3390/nu15224747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
Vitamin D is crucial to the health and performance of athletes. Although the exact vitamin D requirements for athletes have not been established, maintaining a 25(OH)D level of at least 40 ng/mL is considered beneficial. This randomized controlled intervention study aimed to determine whether an individual loading dose formula for vitamin D supplementation is more effective than standardized supplementation and suitable enough for athletes to meet a target value of 40 ng/mL. In a 10-week supplementation study conducted during the winter months in Germany, 90 athletes with insufficient vitamin D levels (25(OH)D < 30 ng/mL) were randomly assigned to receive either a universal dose of 2000 IU/day of vitamin D or a loading dose of 4000 IU/day, followed by a maintenance dose of 1000 IU/day. The total 25(OH)D concentration was measured from dried blood spots at three time points: at baseline, at the computed date of 40 ng/mL, and after the 10-week period. Additionally, a vitamin-D-specific questionnaire was issued. On the day when 25(OH)D blood concentrations of 40 ng/mL were calculated to prevail, the individualized group had a significantly higher 25(OH)D level than the standardized group (41.1 ± 10.9 ng/mL vs. 32.5 ± 6.4 ng/mL, p < 0.001). This study demonstrated that the examined formula is suitable enough for athletes to achieve a 25(OH)D concentration of 40 ng/mL. This indicates that a personalized approach is more effective than a one-size-fits-all approach in restoring adequate vitamin D levels in athletes.
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Affiliation(s)
- Chiara Tuma
- Institute of Biochemistry/Center of Preventive Doping Research, German Sport University Cologne, 50933 Cologne, Germany (M.T.)
- German Research Centre of Elite Sports (Momentum), German Sport University Cologne, 50933 Cologne, Germany
| | - Arne Schick
- Institute of Biochemistry/Center of Preventive Doping Research, German Sport University Cologne, 50933 Cologne, Germany (M.T.)
| | - Nele Pommerening
- Institute of Biochemistry/Center of Preventive Doping Research, German Sport University Cologne, 50933 Cologne, Germany (M.T.)
| | - Hans Braun
- Institute of Biochemistry/Center of Preventive Doping Research, German Sport University Cologne, 50933 Cologne, Germany (M.T.)
- German Research Centre of Elite Sports (Momentum), German Sport University Cologne, 50933 Cologne, Germany
| | - Mario Thevis
- Institute of Biochemistry/Center of Preventive Doping Research, German Sport University Cologne, 50933 Cologne, Germany (M.T.)
- European Monitoring Center for Emerging Doping Agents, 50933 Cologne, Germany
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10
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Książek A, Zagrodna A, Lombardi G, Słowińska-Lisowska M. Seasonal changes in free 25-(OH)D and vitamin D metabolite ratios and their relationship with psychophysical stress markers in male professional football players. Front Physiol 2023; 14:1258678. [PMID: 37908338 PMCID: PMC10613696 DOI: 10.3389/fphys.2023.1258678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/03/2023] [Indexed: 11/02/2023] Open
Abstract
Introduction: Novel markers of vitamin D status are currently being investigated, including free 25-(OH)D (25-(OH)DF) and the vitamin D metabolite ratio (24,25-(OH)2D3:25-(OH)D3; VMR). The VMR may provide additional functional information on vitamin D metabolism in athletes. Therefore, the main objective of the current study was to evaluate 25-(OH)DF, bioavailable 25-(OH)D (25-(OH)DB), VMR, and psychophysical stress markers during different training periods over a half-season. The second aim was to assess the association between vitamin D binding protein (VDBP), total and free 25-(OH)D, VMRs, and psychophysical stress markers in professional football players. Moreover, we examined the relationship between 25-(OH)D3 and vitamin D metabolites (24,25-(OH)2D3, 3-epi-25-(OH)D3) to determine if training loads in different training periods influenced the vitamin D metabolome. Methods: Twenty professional football players were tested at six different time points across half a year (V1-June; V2-July; V3-August; V4-October; V5-December; V6-January). Results: Analyses indicated a significant seasonal rhythm for VDBP, and total 25-(OH)D (25-(OH)DT), 25-(OH)DB, 24,25-(OH)2D3, 3-epi-25-(OH)D3, 25-(OH)D3:24,25-(OH)2D3, and 24,25-(OH)2D3:25-(OH)D3 VMRs throughout the training period. No correlation was detected between 25-(OH)DT, 25-(OH)DB, 25-(OH)DF, vitamin D metabolites, VMRs, VDBP, and ferritin, liver enzymes (aspartate transaminase [AST] and alanine transaminase [ALT]), creatine kinase (CK), cortisol, testosterone, and testosterone-to-cortisol ratio (T/C) in each period (V1-V6). However, there was a strong statistically significant correlation between 25-(OH)D3 and 24,25-(OH)D3 in each training period. Conclusion: In conclusion, a seasonal rhythm was present for VDBP, 25-(OH)DT, 25-(OH)DB, vitamin D metabolites (24,25-(OH)2D3, 3-epi-25-(OH)D3), and VMRs (25-(OH)D3:24,25-(OH)2D3, 25-(OH)D3:3-epi-25-(OH)D3). However, no rhythm was detected for 25-(OH)DF and markers of psychophysical stress (ferritin, liver enzymes, CK, testosterone, cortisol, and T/C ratio). Moreover, the relationships between free and total 25-(OH)D with psychophysical stress markers did not demonstrate the superiority of free over total measurements. Furthermore, training loads in different training periods did not affect resting vitamin D metabolite concentrations in football players.
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Affiliation(s)
- Anna Książek
- Department of Biological and Medical Basis of Sport, Faculty of Physical Education and Sports, Wroclaw University of Health and Sport Sciences, Wroclaw, Poland
| | - Aleksandra Zagrodna
- Department of Biological and Medical Basis of Sport, Faculty of Physical Education and Sports, Wroclaw University of Health and Sport Sciences, Wroclaw, Poland
| | - Giovanni Lombardi
- Laboratory of Experimental Biochemistry and Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Athletics, Strength and Conditioning, Poznań University of Physical Education, Poznań, Poland
| | - Małgorzata Słowińska-Lisowska
- Department of Biological and Medical Basis of Sport, Faculty of Physical Education and Sports, Wroclaw University of Health and Sport Sciences, Wroclaw, Poland
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Carswell AT, O'Leary TJ, Swinton P, Jackson S, Tang JC, Oliver SJ, Izard RM, Walsh NP, Fraser WD, Greeves JP. Vitamin D Metabolites Are Associated With Musculoskeletal Injury in Young Adults: A Prospective Cohort Study. J Bone Miner Res 2023; 38:1453-1464. [PMID: 37526272 DOI: 10.1002/jbmr.4890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 07/06/2023] [Accepted: 07/26/2023] [Indexed: 08/02/2023]
Abstract
The relationship between vitamin D metabolites and lower body (pelvis and lower limb) overuse injury is unclear. In a prospective cohort study, we investigated the association between vitamin D metabolites and incidence of lower body overuse musculoskeletal and bone stress injury in young adults undergoing initial military training during all seasons. In 1637 men and 530 women (aged 22.6 ± 7.5 years; body mass index [BMI], 24.0 ± 2.6 kg/m- 2 ; 94.3% white ethnicity), we measured serum 25-hydroxyvitamin D (25(OH)D) and 24,25-dihydroxyvitamin D (24,25(OH)2 D) by high-performance liquid chromatography tandem mass spectrometry, and 1,25-dihydroxyvitamin D (1,25(OH)2 D) by immunoassay during week 1 of training. We examined whether the relationship between 25(OH)D and 1,25(OH)2 D:24,25(OH)2 D ratio was associated with overuse injury. During 12 weeks of training, 21.0% sustained ≥1 overuse musculoskeletal injury, and 5.6% sustained ≥1 bone stress injury. After controlling for sex, BMI, 2.4 km run time, smoking, bone injury history, and Army training course (Officer, standard, or Infantry), lower body overuse musculoskeletal injury incidence was higher for participants within the second lowest versus highest quartile of 24,25(OH)2 D (odds ratio [OR] = 1.62; 95% confidence interval [CI] 1.13-2.32; p = 0.009) and lowest versus highest cluster of 25(OH)D and 1,25(OH)2 D:24,25(OH)2 D (OR = 6.30; 95% CI 1.89-21.2; p = 0.003). Lower body bone stress injury incidence was higher for participants within the lowest versus highest quartile of 24,25(OH)2 D (OR = 4.02; 95% CI 1.82-8.87; p < 0.001) and lowest versus highest cluster of 25(OH)D and 1,25(OH)2 D:24,25(OH)2 D (OR = 22.08; 95% CI 3.26-149.4; p = 0.001), after controlling for the same covariates. Greater conversion of 25(OH)D to 24,25(OH)2 D, relative to 1,25(OH)2 D (ie, low 1,25(OH)2 D:24,25(OH)2 D), and higher serum 24,25(OH)2 D were associated with a lower incidence of lower body overuse musculoskeletal and bone stress injury. Serum 24,25(OH)2 D may have a role in preventing overuse injury in young adults undertaking arduous physical training. © 2023 Crown copyright and The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR). This article is published with the permission of the Controller of HMSO and the King's Printer for Scotland.
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Affiliation(s)
- Alexander T Carswell
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Thomas J O'Leary
- Army Health and Performance Research, Army HQ, Andover, UK
- Division of Surgery and Interventional Science, UCL, London, UK
| | - Paul Swinton
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - Sarah Jackson
- Army Health and Performance Research, Army HQ, Andover, UK
| | - Jonathan Cy Tang
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
- Departments of Endocrinology and Clinical Biochemistry, Norfolk and Norwich University Hospital, Norwich, UK
| | | | - Rachel M Izard
- Defence Science and Technology, Porton Down, Ministry of Defence, Salisbury, UK
| | - Neil P Walsh
- Faculty of Science, Liverpool John Moores University, Liverpool, UK
| | - William D Fraser
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
- Departments of Endocrinology and Clinical Biochemistry, Norfolk and Norwich University Hospital, Norwich, UK
| | - Julie P Greeves
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
- Army Health and Performance Research, Army HQ, Andover, UK
- Division of Surgery and Interventional Science, UCL, London, UK
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12
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Jones AW, Mironas A, Mur LAJ, Beckmann M, Thatcher R, Davison G. Vitamin D status modulates innate immune responses and metabolomic profiles following acute prolonged cycling. Eur J Nutr 2023; 62:2977-2990. [PMID: 37458775 PMCID: PMC10468936 DOI: 10.1007/s00394-023-03181-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 05/22/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE The influence of vitamin D status on exercise-induced immune dysfunction remains unclear. The aim of this study was to investigate the effects of vitamin D status (circulating 25(OH)D) on innate immune responses and metabolomic profiles to prolonged exercise. METHODS Twenty three healthy, recreationally active males (age 25 ± 7 years; maximal oxygen uptake [[Formula: see text]max] 56 ± 9 mL·kg-1·min-1), classified as being deficient (n = 7) or non-deficient n = 16) according to plasma concentrations of 25(OH)D, completed 2.5 h of cycling at 15% Δ (~ 55-60% [Formula: see text]max). Venous blood and unstimulated saliva samples were obtained before and after exercise. RESULTS Participants with deficient plasma 25(OH)D on average had lower total lymphocyte count (mean difference [95% confidence interval], 0.5 cells × 109 L [0.1, 0.9]), p = 0.013) and greater neutrophil:lymphocyte ratio (1.3 cells × 109 L, [0.1, 2.5], p = 0.033). The deficient group experienced reductions from pre-exercise to 1 h post-exercise (- 43% [- 70, - 15], p = 0.003) in bacterial stimulated elastase in blood neutrophils compared to non-deficient participants (1% [- 20, 21], p = 1.000) Multivariate analyses of plasma metabolomic profiles showed a clear separation of participants according to vitamin D status. Prominent sources of variation between groups were purine/pyrimidine catabolites, inflammatory markers (linoleic acid pathway), lactate and tyrosine/adrenaline. CONCLUSION These findings provide evidence of the influence of vitamin D status on exercise-induced changes in parameters of innate immune defence and metabolomic signatures such as markers of inflammation and metabolic stress.
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Affiliation(s)
- Arwel W Jones
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, UK.
- Respiratory Research@Alfred, Central Clinical School, Monash University, Melbourne, Australia.
| | - Adrian Mironas
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, UK
| | - Luis A J Mur
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, UK
| | - Manfred Beckmann
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, UK
| | - Rhys Thatcher
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, UK
| | - Glen Davison
- School of Sport and Exercise Sciences, Division of Natural Sciences, University of Kent, Canterbury, UK
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13
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Sist M, Zou L, Galloway SDR, Rodriguez-Sanchez N. Effects of vitamin D supplementation on maximal strength and power in athletes: a systematic review and meta-analysis of randomized controlled trials. Front Nutr 2023; 10:1163313. [PMID: 37841405 PMCID: PMC10570740 DOI: 10.3389/fnut.2023.1163313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 09/08/2023] [Indexed: 10/17/2023] Open
Abstract
Background Vitamin D is thought to be a powerful modulator of skeletal muscle physiology. However, available data on the effects of vitamin D supplementation on muscle function in athletes are limited and with mixed results. This meta-analysis therefore, aimed to quantitatively summarize the up-to-date literature assessing the effects of vitamin D supplementation on muscle strength and power in athletes. Methods Sport Discus, PubMed, Cochrane Library and Web of Science were searched to identify randomized controlled trials (RCTs) that used one-repetition maximum (1RM) tests to assess maximal strength, and vertical jump to assess muscle power in athletes. The Cochrane Risk of Bias tool was used to evaluate the included RCTs for sources of bias. The standardized mean difference (SMD) was used as the effect size, interpreted together with its 95% confidence intervals (CI). The effect sizes were calculated on the changes from baseline between vitamin D and placebo groups for maximal strength results by upper body and lower body, and for power results. Results Eleven RCTs involving 436 athletes were included. The results indicated that if baseline serum 25(OH)D concentration was < 75 nmol/L, the treatment had a small effect on upper body muscle strength [SMD 0.25, 95% CI: (-0.44, 0.95), p = 0.47] and on lower body muscle strength [SMD 0.26, 95% CI: (-0.13, 0.65), p = 0.19]; if the baseline serum 25(OH)D concentration was ≥ 75 nmol/L, the treatment had a trivial effect on muscle power [SMD 0.15, 95% CI: (-0.42, 0.72), p = 0.61]. Discussion This meta-analysis demonstrated that there is not a statistically significant effect of vitamin D supplementation on improving maximum strength and power, but highlights that further research is required addressing the key limitations in previous studies before definitive conclusions can be made.
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Affiliation(s)
- Marco Sist
- Faculty of Health Science and Sport, Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, United Kingdom
| | - Lu Zou
- AstraZeneca, London, United Kingdom
| | - Stuart D. R. Galloway
- Faculty of Health Science and Sport, Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, United Kingdom
| | - Nidia Rodriguez-Sanchez
- Faculty of Health Science and Sport, Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, United Kingdom
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14
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López-Jiménez A, Morán-Fagúndez L, Sánchez-Sánchez AM, Fernández-Pachón MS. The associations between anthropometric characteristics and nutritional parameters in male elite rugby union players. Int J Food Sci Nutr 2023; 74:707-718. [PMID: 37604816 DOI: 10.1080/09637486.2023.2246699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/28/2023] [Accepted: 08/06/2023] [Indexed: 08/23/2023]
Abstract
The objective was to analyse the associations between anthropometric characteristics and diet in male rugby players according to the playing position. A cross-sectional study was developed. The forwards had higher body weight (107 kg) and fat mass (FM; 12%) than the backs (87.8 kg and 8.47%, respectively) (p < 0.05). The quality of diet needs to improve (KIDMED value of 5.87 and 6.36 for forwards and backs, respectively). Nutritional imbalances, such as deficits in carbohydrates, fibre, calcium, magnesium and vitamin D, and excess of fats, saturated fatty acid, cholesterol and sugars were found. Carbohydrates and proteins intake were significant associated (p < 0.05) with a minor FM. Forwards with a KIDMED index of less than 8 had a significantly higher FM than those who maintained an optimal diet (p < 0.05). The diet of rugby players should be more in line with dietary recommendations and take into account the player position to optimise sports performance.
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Affiliation(s)
- Adrián López-Jiménez
- Departamento de Biología Molecular e Ingeniería Bioquímica, Área de Nutrición y Bromatología, Universidad Pablo de Olavide, Sevilla, Spain
| | - Luis Morán-Fagúndez
- Departamento de Biología Molecular e Ingeniería Bioquímica, Área de Nutrición y Bromatología, Universidad Pablo de Olavide, Sevilla, Spain
| | - Ana M Sánchez-Sánchez
- Departamento de Economía, Área de Estadística e Investigación Operativa, Métodos Cuantitativos e Historia Económica, Universidad Pablo de Olavide, Sevilla, Spain
| | - María-Soledad Fernández-Pachón
- Departamento de Biología Molecular e Ingeniería Bioquímica, Área de Nutrición y Bromatología, Universidad Pablo de Olavide, Sevilla, Spain
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15
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Gogojewicz A, Straburzyńska-Lupa A, Podgórski T, Frajtag P, Bibrowicz K, Śliwicka E. Assessment of the Dietary Intake and Nutritional Status of Polish Professional Futsal Players: A Descriptive Study-Do Futsal Players Require Nutritional Education? Nutrients 2023; 15:3720. [PMID: 37686752 PMCID: PMC10490003 DOI: 10.3390/nu15173720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/14/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
Futsal is a discipline with high training and nutritional requirements. Despite growing research interest in athletes' diet and nutritional status, no studies have examined Polish male futsal players. Therefore, the aim of this descriptive study was an assessment of the dietary intake and nutritional status in a selected group of futsal players. The study comprised 11 members of a top Polish futsal team (aged 26 ± 3.62 years). Dietary intake was assessed using a standardized 3-day food record. Body composition, total energy expenditure, physical fitness level, and concentrations of the biochemical indices of each participant were estimated. The energy availability in the diet was lower than recommended. Moreover, low consumption of carbohydrates was stated, as well as an inadequate intake of Vitamins E and D. Higher protein and cholesterol intake than recommended were also observed. To conclude, our results point to the need for educating athletes and coaches, particularly teaching about proper food choices, promoting quality foods, and, in some cases, using individual dietary plans to meet energy and nutrient needs. Nutrition education would help to improve their dietary and health habits and optimize their performance in sports training.
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Affiliation(s)
- Anna Gogojewicz
- Department of Food and Nutrition, Poznan University of Physical Education, 61-871 Poznań, Poland;
| | - Anna Straburzyńska-Lupa
- Department of Physical Therapy and Sports Recovery, Poznan University of Physical Education, 61-871 Poznań, Poland; (A.S.-L.); (P.F.)
| | - Tomasz Podgórski
- Department of Physiology and Biochemistry, Poznan University of Physical Education, 61-871 Poznań, Poland;
| | - Paulina Frajtag
- Department of Physical Therapy and Sports Recovery, Poznan University of Physical Education, 61-871 Poznań, Poland; (A.S.-L.); (P.F.)
| | - Karol Bibrowicz
- Department Science and Research Center of Body Posture, Kazimiera Milanowska College of Education and Therapy, 61-473 Poznań, Poland;
| | - Ewa Śliwicka
- Department of Physiology and Biochemistry, Poznan University of Physical Education, 61-871 Poznań, Poland;
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16
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Mieszkowski J, Brzezińska P, Stankiewicz B, Kochanowicz A, Zolodkiewicz K, Niespodziński B, Reczkowicz J, Kowalik T, Waldziński T, Antosiewicz J. Vitamin D Supplementation Influences Ultramarathon-Induced Changes in Serum Amino Acid Levels, Tryptophan/Branched-Chain Amino Acid Ratio, and Arginine/Asymmetric Dimethylarginine Ratio. Nutrients 2023; 15:3536. [PMID: 37630726 PMCID: PMC10459061 DOI: 10.3390/nu15163536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/06/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Exercise affects serum levels of amino acids and their metabolites, with important metabolic consequences. Since vitamin D impacts skeletal muscle protein degradation, we hypothesised that it would also impact exercise-induced changes in serum amino acid levels and the serum levels of arginine metabolites, influencing the body's ability to synthesise NO. Accordingly, we analysed the effect of a single high-dose vitamin D supplementation on the serum levels of various amino acids in ultramarathon runners. Thirty-five male amateur runners were assigned to the supplemented group, administered 150,000 IU vitamin D in vegetable oil 24 h before the run (n = 16), or the control (placebo) group (n = 19). Blood was sampled 24 h before, immediately after, and 24 h after the run. Changes in the serum levels of some amino acids were distinct in the two groups. The asymmetric dimethyl arginine levels were significantly decreased immediately after the run and increased 24 h later and were not affected by the supplementation. The symmetric dimethyl arginine levels were increased after the run in both groups but were lower in the supplemented group than in the placebo group 24 h after the run. The dimethylamine levels increased significantly in the supplemented group as compared to the placebo group. In conclusion, vitamin D impacts exercise-induced changes in serum amino acids and methylated arginine metabolites.
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Affiliation(s)
- Jan Mieszkowski
- Department of Gymnastics and Dance, Gdańsk University of Physical Education and Sport, 80-336 Gdańsk, Poland; (P.B.); (A.K.); (K.Z.)
- Faculty of Physical Education and Sport, Charles University, 162 52 Prague, Czech Republic
| | - Paulina Brzezińska
- Department of Gymnastics and Dance, Gdańsk University of Physical Education and Sport, 80-336 Gdańsk, Poland; (P.B.); (A.K.); (K.Z.)
| | - Błażej Stankiewicz
- Department of Theory and Methodology of Physical Education and Sport, Faculty of Health Sciences and Physical Education, Kazimierz Wielki University, 85-064 Bydgoszcz, Poland; (B.S.); (T.K.)
| | - Andrzej Kochanowicz
- Department of Gymnastics and Dance, Gdańsk University of Physical Education and Sport, 80-336 Gdańsk, Poland; (P.B.); (A.K.); (K.Z.)
| | - Katarzyna Zolodkiewicz
- Department of Gymnastics and Dance, Gdańsk University of Physical Education and Sport, 80-336 Gdańsk, Poland; (P.B.); (A.K.); (K.Z.)
| | - Bartłomiej Niespodziński
- Department of Biomedical Basis of Physical Education, Faculty of Health Sciences and Physical Education, Kazimierz Wielki University, 85-064 Bydgoszcz, Poland;
| | - Joanna Reczkowicz
- Department of Bioenergetics and Physiology of Exercise, Medical University of Gdańsk, 80-211 Gdańsk, Poland;
| | - Tomasz Kowalik
- Department of Theory and Methodology of Physical Education and Sport, Faculty of Health Sciences and Physical Education, Kazimierz Wielki University, 85-064 Bydgoszcz, Poland; (B.S.); (T.K.)
| | - Tomasz Waldziński
- Faculty of Health Sciences, University of Lomza, 14 Akademicka Street, 18-400 Lomza, Poland;
| | - Jędrzej Antosiewicz
- Department of Bioenergetics and Physiology of Exercise, Medical University of Gdańsk, 80-211 Gdańsk, Poland;
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Illidi CR, Romer LM, Johnson MA, Williams NC, Rossiter HB, Casaburi R, Tiller NB. Distinguishing science from pseudoscience in commercial respiratory interventions: an evidence-based guide for health and exercise professionals. Eur J Appl Physiol 2023; 123:1599-1625. [PMID: 36917254 PMCID: PMC10013266 DOI: 10.1007/s00421-023-05166-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/19/2023] [Indexed: 03/16/2023]
Abstract
Respiratory function has become a global health priority. Not only is chronic respiratory disease a leading cause of worldwide morbidity and mortality, but the COVID-19 pandemic has heightened attention on respiratory health and the means of enhancing it. Subsequently, and inevitably, the respiratory system has become a target of the multi-trillion-dollar health and wellness industry. Numerous commercial, respiratory-related interventions are now coupled to therapeutic and/or ergogenic claims that vary in their plausibility: from the reasonable to the absurd. Moreover, legitimate and illegitimate claims are often conflated in a wellness space that lacks regulation. The abundance of interventions, the range of potential therapeutic targets in the respiratory system, and the wealth of research that varies in quality, all confound the ability for health and exercise professionals to make informed risk-to-benefit assessments with their patients and clients. This review focuses on numerous commercial interventions that purport to improve respiratory health, including nasal dilators, nasal breathing, and systematized breathing interventions (such as pursed-lips breathing), respiratory muscle training, canned oxygen, nutritional supplements, and inhaled L-menthol. For each intervention we describe the premise, examine the plausibility, and systematically contrast commercial claims against the published literature. The overarching aim is to assist health and exercise professionals to distinguish science from pseudoscience and make pragmatic and safe risk-to-benefit decisions.
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Affiliation(s)
- Camilla R Illidi
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montréal, QC, Canada
| | - Lee M Romer
- Division of Sport, Health and Exercise Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Michael A Johnson
- Exercise and Health Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, Nottinghamshire, UK
| | - Neil C Williams
- Exercise and Health Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, Nottinghamshire, UK
| | - Harry B Rossiter
- Institute of Respiratory Medicine and Exercise Physiology, Division of Respiratory and Critical Care Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, CDCRC Building, Torrance, CA, 90502, USA
| | - Richard Casaburi
- Institute of Respiratory Medicine and Exercise Physiology, Division of Respiratory and Critical Care Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, CDCRC Building, Torrance, CA, 90502, USA
| | - Nicholas B Tiller
- Institute of Respiratory Medicine and Exercise Physiology, Division of Respiratory and Critical Care Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, CDCRC Building, Torrance, CA, 90502, USA.
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Baart AM, Slotegraaf AI, Gobes-de Punder IE, Mensink M, Wardenaar F, de Vries JH, Klein Gunnewiek JM, Balvers MG, Terink R. Efficacy and utility of a tool for both measurement of vitamin B6, B12, D, folate and iron status and assessment of diet quality in athletes. J Nutr Sci 2023; 12:e87. [PMID: 37528835 PMCID: PMC10388442 DOI: 10.1017/jns.2023.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 08/03/2023] Open
Abstract
NutriProfiel® is a tool to measure micronutrient status and to assess diet quality. It consists of measurement of micronutrient status in blood and a short food frequency questionnaire (FFQ) ('Eetscore-FFQ'). Based on the results, individuals receive a dietary advice. In this study, we evaluated the application of NutriProfiel in athletes ('NutriProfiel-Sport') by assessing the coverage of nutrient intake of the Eetscore-FFQ (part 1) and by evaluating athlete's dietary behaviour after using NutriProfiel-Sport and their satisfaction with this tool (part 2). For part 1, data of 419 athletes were used. We evaluated the coverage of nutrient intake of the Eetscore-FFQ using first and second MOMents (MOM1 and MOM2) sum scores of food items in the questionnaire. Forty-eight athletes were involved in part 2. They gave blood samples for micronutrient status measurement and were asked to complete the Eetscore-FFQ at baseline and after 3 months, as well as a questionnaire on their satisfaction with NutriProfiel-Sport. Results showed that for most nutrients, MOM1 and MOM2 scores were above 80 %, meaning that nutrient intake was sufficiently covered by the Eetscore-FFQ. No difference in diet quality was observed between baseline and after 3 months. Nevertheless, a majority of athletes reported the NutriProfiel-Sport results and advice as useful. On a scale from 0 to 10, NutriProfiel-Sport was graded with a mean (±sd) score of 7⋅6 (±0⋅8). In conclusion, NutriProfiel-Sport is a potential valuable and appreciated tool for athletes and the Eetscore-FFQ as part of this tool sufficiently covers nutrient intake in athletes.
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Affiliation(s)
- A. Mireille Baart
- Sports Valley, Department of Sports Medicine, Gelderse Vallei Hospital, Ede, The Netherlands
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Anne I. Slotegraaf
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
- Clinical Chemistry and Haematology Laboratory, Gelderse Vallei Hospital, Ede, The Netherlands
- Nutrition and Healthcare Alliance, Ede, The Netherlands
| | - Inge E. Gobes-de Punder
- Sports Valley, Department of Sports Medicine, Gelderse Vallei Hospital, Ede, The Netherlands
| | - Marco Mensink
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Floris Wardenaar
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Jeanne H.M. de Vries
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | | | - Michiel G.J. Balvers
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
- Clinical Chemistry and Haematology Laboratory, Gelderse Vallei Hospital, Ede, The Netherlands
| | - Rieneke Terink
- Sports Valley, Department of Sports Medicine, Gelderse Vallei Hospital, Ede, The Netherlands
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West S, Monteyne AJ, van der Heijden I, Stephens FB, Wall BT. Nutritional Considerations for the Vegan Athlete. Adv Nutr 2023; 14:774-795. [PMID: 37127187 PMCID: PMC10334161 DOI: 10.1016/j.advnut.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/19/2023] [Accepted: 04/27/2023] [Indexed: 05/03/2023] Open
Abstract
Accepting a continued rise in the prevalence of vegan-type diets in the general population is also likely to occur in athletic populations, it is of importance to assess the potential impact on athletic performance, adaptation, and recovery. Nutritional consideration for the athlete requires optimization of energy, macronutrient, and micronutrient intakes, and potentially the judicious selection of dietary supplements, all specified to meet the individual athlete's training and performance goals. The purpose of this review is to assess whether adopting a vegan diet is likely to impinge on such optimal nutrition and, where so, consider evidence based yet practical and pragmatic nutritional recommendations. Current evidence does not support that a vegan-type diet will enhance performance, adaptation, or recovery in athletes, but equally suggests that an athlete can follow a (more) vegan diet without detriment. A clear caveat, however, is that vegan diets consumed spontaneously may induce suboptimal intakes of key nutrients, most notably quantity and/or quality of dietary protein and specific micronutrients (eg, iron, calcium, vitamin B12, and vitamin D). As such, optimal vegan sports nutrition requires (more) careful consideration, evaluation, and planning. Individual/seasonal goals, training modalities, athlete type, and sensory/cultural/ethical preferences, among other factors, should all be considered when planning and adopting a vegan diet.
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Affiliation(s)
- Sam West
- Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Alistair J Monteyne
- Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Ino van der Heijden
- Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Francis B Stephens
- Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Benjamin T Wall
- Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom.
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20
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Liu MC, Weng PW, Chen SC, Liu TH, Huang HW, Huang CT, Yang CT, Mishra VK, Yang MT. Immunologic, Anti-Inflammatory, and Anti-Muscle Damage Profile of Supplemented Vitamin D 3 in Healthy Adults on Strenuous Endurance Exercise. BIOLOGY 2023; 12:biology12050657. [PMID: 37237471 DOI: 10.3390/biology12050657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/19/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023]
Abstract
Reportedly, strenuous endurance exercise can depress the immune system and induce inflammation and muscle damage. Therefore, this double-blinded, matched-pair study aimed to investigate the impact of vitamin D3 supplementation on immune response (leukocyte, neutrophil, lymphocyte, CD4+, CD8+, CD19+, and CD56+ counts), inflammatory profile (TNF-α and IL-6), muscle damage (CK and LDH levels), as well as aerobic capacity after strenuous endurance exercise in 18 healthy men taking 5000 IU of vitamin D3 (n = 9) or placebo (n = 9) daily for 4 weeks. Total and differential blood leukocyte counts, levels of cytokines, and muscle damage biomarkers were determined before, immediately after, and 2, 4, and 24 h after exercise. The IL-6, CK, and LDH levels were significantly lower in vitamin D3 group at 2, 4, and 24 h post exercise (p < 0.05). Maximal and average heart rates during exercise were also significantly lower (p < 0.05). In the vitamin D3 group, the CD4+/CD8+ ratio after 4 weeks of supplementation was only significantly lower at post-0 than at baseline and significantly higher at post-2 than at baseline and post-0 (all p < 0.05). Taken together, 5000 IU of daily vitamin D3 supplementation for 4 weeks exhibited positive effects in terms of increased blood 25(OH)D levels, CD4+/CD8+ ratio (immune response), and aerobic capacity while inhibiting inflammatory cytokines and CK and LDH (muscle damage) in people performing strenuous endurance exercise.
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Affiliation(s)
- Ming-Che Liu
- School of Dental Technology, Taipei Medical University, Taipei 110301, Taiwan
- Clinical Research Center, Taipei Medical University Hospital, Taipei 110301, Taiwan
- Department of Urology, Taipei Medical University Hospital, Taipei 110301, Taiwan
- Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Research Center of Urology and Kidney, Taipei Medical University, Taipei 110301, Taiwan
| | - Pei-Wei Weng
- School of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Department of Orthopaedics, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- International Ph.D. Program in Biomedical Engineering, Taipei Medical University, Taipei 110301, Taiwan
| | - Sheng-Chang Chen
- School of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Ting-Hao Liu
- Center for General Education, Taipei Medical University, Taipei 110301, Taiwan
| | - Hsiang-Wei Huang
- Department of Medical Education, E-DA Hospital, Kaohsiung 824005, Taiwan
| | - Chang-Ti Huang
- Graduate Institute of Medical Sciences, Taipei Medical University, Taipei 110301, Taiwan
| | - Cheng-Tse Yang
- Graduate Institute of Medical Sciences, Taipei Medical University, Taipei 110301, Taiwan
| | | | - Ming-Ta Yang
- Clinical Research Center, Taipei Medical University Hospital, Taipei 110301, Taiwan
- Center for General Education, Taipei Medical University, Taipei 110301, Taiwan
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21
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Bârsan M, Chelaru VF, Râjnoveanu AG, Popa ȘL, Socaciu AI, Bădulescu AV. Difference in Levels of Vitamin D between Indoor and Outdoor Athletes: A Systematic Review and Meta-Analysis. Int J Mol Sci 2023; 24:ijms24087584. [PMID: 37108748 PMCID: PMC10147028 DOI: 10.3390/ijms24087584] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 04/11/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
Vitamin D, its importance in different processes taking place in the human body, the effects of abnormal levels of this hormone, either too low or too high, and the need for supplementation have been extensively researched thus far. Variances in exposure to sunlight can cause vitamin D levels to fluctuate. Indoor activity can be a factor for these fluctuations and can lead to a decrease in vitamin D levels. We conducted a systematic review and meta-analysis aiming to identify whether indoor compared to outdoor training has a significant influence on vitamin D levels; we also performed subgroup analyses and multivariate meta-regression. The type of training has an impact on vitamin D levels that is influenced by multiple cofounders. In a subgroup analysis not considering cofounders, the mean serum vitamin D was 3.73 ng/mL higher in outdoor athletes, a difference which barely fails to achieve significance (p = 0.052, a total sample size of 5150). The indoor-outdoor difference is only significant (clinically and statistically) when considering studies performed exclusively on Asian athletes (a mean difference of 9.85 ng/mL, p < 0.01, and a total sample size of 303). When performing the analyses within each season, no significant differences are observed between indoor and outdoor athletes. To control for multiple cofounders (the season, latitude, and Asian/Caucasian race) simultaneously, we constructed a multivariate meta-regression model, which estimated a serum vitamin D concentration lower by 4.446 ng/mL in indoor athletes. While a multivariate model suggests that outdoor training is associated with slightly higher vitamin D concentrations when controlling for the season, latitude, and Asian/Caucasian race, the type of training has a numerically and clinically small impact. This suggests that vitamin D levels and the need for supplementation should not be decided based on training type alone.
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Affiliation(s)
- Maria Bârsan
- Department of Occupational Medicine, 'Iuliu Hațieganu' University of Medicine and Pharmacy Cluj-Napoca, 400347 Cluj-Napoca, Romania
| | - Vlad-Florin Chelaru
- Faculty of Medicine, 'Iuliu Hațieganu' University of Medicine and Pharmacy Cluj-Napoca, 400347 Cluj-Napoca, Romania
| | - Armand-Gabriel Râjnoveanu
- Department of Occupational Medicine, 'Iuliu Hațieganu' University of Medicine and Pharmacy Cluj-Napoca, 400347 Cluj-Napoca, Romania
| | - Ștefan Lucian Popa
- 2nd Medical Department, 'Iuliu Hațieganu' University of Medicine and Pharmacy Cluj-Napoca, 400347 Cluj-Napoca, Romania
| | - Andreea-Iulia Socaciu
- Department of Occupational Medicine, 'Iuliu Hațieganu' University of Medicine and Pharmacy Cluj-Napoca, 400347 Cluj-Napoca, Romania
| | - Andrei-Vlad Bădulescu
- Faculty of Medicine, 'Iuliu Hațieganu' University of Medicine and Pharmacy Cluj-Napoca, 400347 Cluj-Napoca, Romania
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22
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Miyamoto H, Kawakami D, Hanafusa N, Nakanishi T, Miyasaka M, Furutani Y, Ikeda Y, Ito K, Kato T, Yokoyama K, Arakawa S, Saito M, Furusho T, Matsuura T, Ochi S. Determination of a Serum 25-Hydroxyvitamin D Reference Ranges in Japanese Adults Using Fully Automated Liquid Chromatography-Tandem Mass Spectrometry. J Nutr 2023; 153:1253-1264. [PMID: 36806449 DOI: 10.1016/j.tjnut.2023.01.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/11/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Despite an increasing interest in vitamin D status, a reference range of the nutrient has not been fully established. This is partly due to a paucity of standardized measuring systems with high throughput. In addition, the range may vary by populations and may change with modernization of lifestyles. OBJECTIVES This study aims to calculate the current reference concentration of 25-hydroxyvitamin D (25(OH)D) among healthy people living in an urban area in Japan. METHODS A newly developed fully automated liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) system was used to measure serum 25(OH)D concentrations. Reproducibility was assessed by measuring standardized samples. Accuracy was validated by comparing with commercially available immunoassays. Then, mass screening was conducted targeting participants who received medical checkups in Tokyo from April 2019 to March 2020, and the reference ranges were calculated. RESULTS The coefficients of variations of interoperator and interday reproducibility were 4.1%-8.5% and 3.7%-8.0% for 25-hydroxyvitamin D2 (25(OH)D2) and 4.7%-7.0% and 4.0%-6.9% for 25-hydroxyvitamine D3, respectively. The measured total 25(OH)D concentrations correlated well with those measured by immunoassays. In total, 5518 participants were measured for 25(OH)D concentrations, among whom 98% showed inadequate concentrations (<30 ng/mL). The reference ranges of total 25(OH)D for female, male, and total participants were 7-30 ng/mL, 5-27 ng/mL, and 6-29 ng/mL, respectively. After excluding those with abnormal renal and liver function, the range was 6-30 ng/mL. CONCLUSIONS The high prevalence of vitamin D insufficiency among seemingly healthy population may be attributed to lifestyle characteristics of people living in urban areas of Japan, including spending less time outdoors and lower intake of traditional foods. Longitudinal follow-up and mass screenings targeting different population will help elucidate reasons for discrepancies between official guidelines and the observed concentrations, to which the well-validated measurement system is essential.
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Affiliation(s)
- Hiroyasu Miyamoto
- Department of Laboratory Medicine, The Jikei University School of Medicine, Minato City, Tokyo, Japan; Department of Central Clinical Laboratory, The Jikei University Hospital, Minato City, Tokyo, Japan; Department of International Food and Agricultural Science, Faculty of International Agriculture and Food Studies, Tokyo University of Agriculture, Setagaya City, Tokyo, Japan
| | - Daisuke Kawakami
- Analytical & Measuring Instruments Division, Shimadzu Corporation, Kyoto city, Kyoto, Japan; Analytical Business Unit, Shimadzu Europa GmbH, Duisburg, Germany
| | - Nobuhiro Hanafusa
- Analytical & Measuring Instruments Division, Shimadzu Corporation, Kyoto city, Kyoto, Japan
| | - Tsuyoshi Nakanishi
- Analytical & Measuring Instruments Division, Shimadzu Corporation, Kyoto city, Kyoto, Japan
| | - Masaki Miyasaka
- Department of Laboratory Medicine, The Jikei University School of Medicine, Minato City, Tokyo, Japan
| | - Yutaka Furutani
- Department of Laboratory Medicine, The Jikei University School of Medicine, Minato City, Tokyo, Japan
| | - Yuichi Ikeda
- Department of Central Clinical Laboratory, The Jikei University Hospital, Minato City, Tokyo, Japan
| | - Kyoko Ito
- Centre for Preventive Medicine, The Jikei University School of Medicine, Minato City, Tokyo, Japan
| | - Tomohiro Kato
- Centre for Preventive Medicine, The Jikei University School of Medicine, Minato City, Tokyo, Japan
| | - Keitaro Yokoyama
- Harumi Toriton Clinic of The Jikei University Hospital, Chuo City, Tokyo, Japan; Department of Health Science, The Graduate School, The Jikei University School of Medicine, Tokyo, Japan
| | - Shoutaro Arakawa
- Department of Orthopedics, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Mitsuru Saito
- Department of Orthopedics, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Tadasu Furusho
- Department of International Food and Agricultural Science, Faculty of International Agriculture and Food Studies, Tokyo University of Agriculture, Setagaya City, Tokyo, Japan
| | - Tomokazu Matsuura
- Department of Laboratory Medicine, The Jikei University School of Medicine, Minato City, Tokyo, Japan
| | - Sae Ochi
- Department of Laboratory Medicine, The Jikei University School of Medicine, Minato City, Tokyo, Japan.
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23
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Feng C, Song X, Chalamaiah M, Ren X, Wang M, Xu B. Vitamin D Fortification and Its Effect on Athletes' Physical Improvement: A Mini Review. Foods 2023; 12:foods12020256. [PMID: 36673348 PMCID: PMC9857868 DOI: 10.3390/foods12020256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/08/2022] [Accepted: 12/22/2022] [Indexed: 01/09/2023] Open
Abstract
Poor vitamin D status is a widespread problem regardless of age and sex, emphasizing the necessity of new food sources to improve vitamin D levels. Currently, approximately 60% of dietary vitamin D consumption occurs via fortified foods. Vitamin D insufficiency (50-90%) is widespread according to age and region, despite different levels of sunlight exposure. The food industry must identify more effective strategies to increase normal dietary vitamin D intake and improve overall health. Strategies for vitamin D fortification include bioaddition, wherein a vitamin D-rich food source is added to staple foods during processes. These bioadditive strategies expand the range of vitamin D-containing foods and appeal to different preferences, cultures, and economic statuses. In several countries, vitamin D deficiency places athletes at a high risk of disease susceptibility. Due to low sun exposure, athletes in countries with higher and lower levels of sunlight have similar risks of vitamin D deficiency. In this review, we summarize recent technical advances to promote vitamin D utilization by humans during sports activities and in relation to the normal practices of athletes.
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Affiliation(s)
- Cong Feng
- Department of Physical Education, Jiangsu University, Zhenjiang 212013, China
| | - Xinjie Song
- School of Biological and Chemical Engineering, Zhejiang University of Science and Technology, Hangzhou 310023, China
- Correspondence:
| | - Meram Chalamaiah
- Department of Agricultural, Food and Nutritional Science (AFNS), 4-10 Ag/For Centre, University of Alberta, Edmonton, AB T6G 2P5, Canada
| | - Xiaofeng Ren
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
| | - Mingxing Wang
- Department of Business Administration, School of Business, Yeungnam University, Gyeongsan 38541, Republic of Korea
| | - Baoguo Xu
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
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24
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Harju T, Gray B, Mavroedi A, Farooq A, Reilly JJ. Prevalence and novel risk factors for vitamin D insufficiency in elite athletes: systematic review and meta-analysis. Eur J Nutr 2022; 61:3857-3871. [PMID: 35882673 PMCID: PMC9596536 DOI: 10.1007/s00394-022-02967-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 07/18/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND PURPOSE Vitamin D insufficiency may be common among elite athletes, but prevalence is unclear, and some potentially important risk factors are uncertain. The present study aimed to (a) estimate the prevalence of vitamin D insufficiency in elite athletes, and (b) examine differences in prevalence between the sexes, and between adults and adolescents, from recent studies which used a contemporary definition of insufficiency. METHODS Four databases (Web of Science, SPORTDiscus, PubMed, and Sports Medicine and Education Index) were searched for studies in elite athletes. Literature selection, data extraction, and risk of bias assessment were conducted independently by two researchers. Vitamin D insufficiency was defined as 25(OH)D < 50 nmol/L. Meta-analysis was conducted, using R software x64 4.0.2, to provide estimates of prevalence of insufficiency for adults and adolescents, and to examine between-sex differences in risk of insufficiency. RESULTS From the initial 943 literature search hits, 51 studies were eligible with 5456 participants, 33 studies in adults (12/33 in winter and spring), 15 studies in adolescents (6/15 in winter and spring) and 3 studies with age of study participants not given. Prevalence of vitamin D insufficiency from meta-analysis was 30% (95% CI 22-39%) in adults and prevalence was higher, though not significantly so, at 39% (95% CI 25-55%) in adolescents. Differences in the prevalence of insufficiency between the sexes for the eight studies which provided within-study comparisons was not significant (RR = 1.0; 95% CI 0.79-1.26). Evidence quality was moderate. CONCLUSIONS Prevalence of vitamin D insufficiency (≤ 50 nmol/L) in elite athletes is high, suggesting a need for greater attention to prevention and treatment. Prevalence estimates in the present study are conservative due to a relative lack of studies in winter. While there was no evidence of higher risk among women than men in the present study, there was less evidence on women.
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Affiliation(s)
- Tilda Harju
- University of Strathclyde School of Psychological Sciences & Health, Glasgow, Scotland
| | - Blair Gray
- University of Strathclyde School of Psychological Sciences & Health, Glasgow, Scotland
| | - Alexandra Mavroedi
- University of Strathclyde School of Psychological Sciences & Health, Glasgow, Scotland
| | - Abdulaziz Farooq
- FIFA Medical Centre of Excellence, Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - John Joseph Reilly
- University of Strathclyde School of Psychological Sciences & Health, Glasgow, Scotland.
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25
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Lozano-Berges G, Matute-Llorente Á, Gómez-Bruton A, González-Agüero A, Vicente-Rodríguez G, Casajús JA. Do Serum 25-Hydroxyvitamin D Concentrations Affect Body Composition, Physical Fitness, Bone Strength and Bone Biomarkers in Female Children and Adolescent Football Players? A One-Season Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15394. [PMID: 36430113 PMCID: PMC9697430 DOI: 10.3390/ijerph192215394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/17/2022] [Accepted: 11/19/2022] [Indexed: 06/16/2023]
Abstract
The aim was to compare changes in body composition, physical fitness, and bone biomarkers in female children and adolescent football players with different Vitamin D levels. Twenty-two players were classified into two groups according to 25(OH)D concentrations: 11 with deficient/insufficient 25(OH)D levels (IVD; <30 ng/mL) and 11 with sufficient 25(OH)D levels (SVD; ≥30 ng/mL). Body composition parameters were measured using dual-energy X-ray absorptiometry and a peripheral quantitative computed tomography scanner. The following physical fitness tests were applied: maximal isometric knee extension (MIF), long jump, 30-m sprint, and 20-m shuttle run test (VO2max). Electrochemiluminescence immunoassays were used to analyze bone biomarkers and 25(OH)D. All variables were registered at the beginning and the end of the football season. The increase in subtotal bone mineral density (BMD) was higher in players with SVD than those with IVD (p = 0.030). Only players with SVD improved their MIF of the left leg (p = 0.005); whereas, only players with IVD decreased their 30-m sprint performance (p = 0.007) and VO2max (p = 0.046). No significant between- and within-group differences were found for bone biomarkers. SVD might cause an extra improvement of subtotal BMD in female children and adolescent football players. Moreover, it seems that the 25(OH)D concentration could be an important parameter for physical fitness improvement in this population.
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Affiliation(s)
- Gabriel Lozano-Berges
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, 22001 Huesca, Spain
- Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain
| | - Ángel Matute-Llorente
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, 22001 Huesca, Spain
- Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain
| | - Alejandro Gómez-Bruton
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, 22001 Huesca, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain
| | - Alex González-Agüero
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, 22001 Huesca, Spain
- Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain
| | - Germán Vicente-Rodríguez
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, 22001 Huesca, Spain
- Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain
| | - José A. Casajús
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain
- Faculty of Health Sciences (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain
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Griffis CE, Pletta AM, Mutschler C, Ahmed AE, Lorimer SD. Proportion of Navy Recruits Diagnosed With Symptomatic Stress Fractures During Training and Monetary Impact of These Injuries. Clin Orthop Relat Res 2022; 480:2111-2119. [PMID: 35901437 PMCID: PMC9555899 DOI: 10.1097/corr.0000000000002304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 06/09/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Lower extremity stress fractures result in lost time from work and sport and incur costs in the military when they occur in service members. Hypovitaminosis D has been identified as key risk factor in these injuries. An estimated 33% to 90% of collegiate and professional athletes have deficient vitamin D levels. Other branches of the United States military have evaluated the risk factors for stress fractures during basic training, including vitamin D deficiency. To the best of our knowledge, a study evaluating the correlation between these injuries and vitamin D deficiency in US Navy recruits and a cost analysis of these injuries has not been performed. Cutbacks in military medical staffing mean more active-duty personnel are being deferred for care to civilian providers. Consequently, data that previously were only pertinent to military medical providers have now expanded to the nonmilitary medical community. QUESTIONS/PURPOSES We therefore asked: (1) What proportion of US Navy recruits experience symptomatic lower extremity stress fractures, and what proportion of those recruits had hypovitaminosis vitamin D on laboratory testing? (2) What are the rehabilitation costs involved in the treatment of lower extremity stress fractures, including the associated costs of lost training time? (3) Is there a cost difference in the treatment of stress fractures between recruits with lower extremity stress fractures who have vitamin D deficiency and those without vitamin D deficiency? METHODS We retrospectively evaluated the electronic medical record at Naval Recruit Training Command in Great Lakes, IL, USA, of all active-duty males and females trained from 2009 until 2015. We used ICD-9 and ICD-10 diagnosis codes to identify those diagnosed with symptomatic lower extremity stress fractures. Data collected included geographic region of birth, preexisting vitamin D deficiency, vitamin D level at the time of diagnosis, medical history, BMI, age, sex, self-reported race or ethnicity, hospitalization days, days lost from training, and the number of physical therapy, primary care, and specialty visits. To ascertain the proportion of recruits who developed symptomatic stress fractures, we divided the number of recruits who were diagnosed with a stress fracture by the total number who trained over that span of time, which was 204,774 individuals. During the span of this study, 45% (494 of 1098) of recruits diagnosed with a symptomatic stress fracture were female and 55% (604 of 1098) were male, with a mean ± SD age of 24 ± 4 years. We defined hypovitaminosis D as a vitamin D level lower than 40 ng/mL. Levels less than 40 ng/mL were defined as low normal and levels less than 30 ng/mL as deficient. Vitamin D levels were obtained at the discretion of the individual treating provider without standardization of protocol. Cost was defined as physical therapy visits, primary care visits, orthopaedic visits, diagnostic imaging costs, laboratory costs, hospitalizations, if applicable, and days lost from training. Diagnostic studies and laboratory tests were incorporated as indirect costs into initial and follow-up physical therapy visits. Evaluation and management code fee schedules for initial visits and follow-up visits were used as direct costs. We obtained these data from the Centers for Medicare & Medicaid Services website. Per capita cost was calculated by taking the total cost and dividing it by the study population. Days lost from training is based on a standardized government military salary of recruits to include room and board. RESULTS We found that 0.5% (1098 of 204,774) of recruits developed a symptomatic lower extremity stress fracture. Of the recruits who had vitamin D levels drawn at the time of stress fracture, 95% (416 of 437 [95% confidence interval (CI) 94% to 98%]; p > 0.99) had hypovitaminosis D (≤ 40 ng/mL) and 82% (360 of 437 [95% CI 79% to 86%]; p > 0.99) had deficient levels (≤ 30 ng/mL) on laboratory testing, when evaluated. The total treatment cost was USD 9506 per recruit. Days lost in training was a median of 56 days (4 to 108) for a per capita cost of USD 5447 per recruit. Recruits with deficient vitamin D levels (levels ≤ 30 ng/mL) incurred more physical therapy treatment costs than did those with low-normal vitamin D levels (levels 31 to 40 ng/mL) (mean difference USD 965 [95% CI 2 to 1928]; p = 0.049). CONCLUSION The cost of lost training and rehabilitation associated with symptomatic lower extremity stress fractures represents a major financial burden. Screening for and treatment of vitamin D deficiencies before recruit training could offer a cost-effective solution to decreasing the stress fracture risk. Recognition and treatment of these deficiencies has a role beyond the military, as hypovitaminosis and stress fractures are common in collegiate or professional athletes. LEVEL OF EVIDENCE Level III, prognostic study.
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Affiliation(s)
- Clare E Griffis
- Naval Medical Center Portsmouth, Portsmouth, VA, USA
- Captain James A. Lovell Federal Health Care Center, North Chicago, IL, USA
| | - Aileen M Pletta
- Naval Special Warfare Center, San Diego, CA, USA
- Captain James A. Lovell Federal Health Care Center, North Chicago, IL, USA
| | - Christian Mutschler
- Navy Medicine Readiness and Training Command Camp Pendleton, Oceanside, CA, USA
| | - Anwar E Ahmed
- Uniformed Service University of the Health Sciences/Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MS, USA
| | - Shannon D Lorimer
- Naval Medical Center Portsmouth, Portsmouth, VA, USA
- Captain James A. Lovell Federal Health Care Center, North Chicago, IL, USA
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Masson W, Barbagelata L, Falconi M, Arenaza DPD. Association between physical activity and coronary artery calcification estimated by computed tomography: A systematic review. CLÍNICA E INVESTIGACIÓN EN ARTERIOSCLEROSIS 2022:S0214-9168(22)00130-9. [DOI: 10.1016/j.arteri.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/03/2022] [Accepted: 10/05/2022] [Indexed: 11/11/2022]
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Crescioli C. Vitamin D, exercise, and immune health in athletes: A narrative review. Front Immunol 2022; 13:954994. [PMID: 36211340 PMCID: PMC9539769 DOI: 10.3389/fimmu.2022.954994] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/22/2022] [Indexed: 11/23/2022] Open
Abstract
Vitamin D exerts important extra-skeletal effects, exhibiting an exquisite immune regulatory ability, affecting both innate and adaptive immune responses through the modulation of immunocyte function and signaling. Remarkably, the immune function of working skeletal muscle, which is fully recognized to behave as a secretory organ with immune capacity, is under the tight control of vitamin D as well. Vitamin D status, meaning hormone sufficiency or insufficiency, can push toward strengthening/stabilization or decline of immune surveillance, with important consequences for health. This aspect is particularly relevant when considering the athletic population: while exercising is, nowadays, the recommended approach to maintain health and counteract inflammatory processes, “too much” exercise, often experienced by athletes, can increase inflammation, decrease immune surveillance, and expose them to a higher risk of diseases. When overexercise intersects with hypovitaminosis D, the overall effects on the immune system might converge into immune depression and higher vulnerability to diseases. This paper aims to provide an overview of how vitamin D shapes human immune responses, acting on the immune system and skeletal muscle cells; some aspects of exercise-related immune modifications are addressed, focusing on athletes. The crossroad where vitamin D and exercise meet can profile whole-body immune response and health.
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Książek A, Zagrodna A, Słowińska-Lisowska M, Lombardi G. Relationship Between Metabolites of Vitamin D, Free 25-(OH)D, and Physical Performance in Indoor and Outdoor Athletes. Front Physiol 2022; 13:909086. [PMID: 35874521 PMCID: PMC9304810 DOI: 10.3389/fphys.2022.909086] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
The potential effects of vitamin D in athletes have received considerable attention in the literature. However, little is known about vitamin D metabolites and their association with physical performance in athletes. Therefore, the aim of our study was to determine the relationship between metabolites of vitamin D, vitamin D binding protein (VDBP), free, bioavailable 25-(OH)D, and physical fitness tests in athletes. A total of 40 indoor and outdoor players (16 judoists and 24 football players) participated in the study. Vitamin D metabolites (25-(OH)D, 24,25-(OH)2D3, 3-epi-25-(OH)D3, and 1,25-(OH)2D) were assessed using LM-MS/MS. Free 25-(OH)D concentration was evaluated by calculation using serum albumin and VDBP levels. Athletic performance was assessed using handgrip and vertical jump. Our study showed a significant correlation between vitamin D metabolites and handgrip strength and vertical jump variables in indoor players. It demonstrated a significant association between 3-epi-25-(OH)D3 and vertical jump parameters in outdoor players. The results of our study showed relationship between free, bioavailable 25-(OH)D, and vertical jump variables in indoor players. In conclusion, we provide novel information on the vitamin D metabolites and athletic performance in athletes. Based on the results of our study, we concluded that vitamin D metabolites might be involved in skeletal muscle function in relation to athletic performance.
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Affiliation(s)
- Anna Książek
- Department of Biological and Medical Basis of Sport, Faculty of Physical Education and Sports, Wroclaw University of Health and Sport Sciences, Wroclaw, Poland
- *Correspondence: Anna Książek,
| | - Aleksandra Zagrodna
- Department of Biological and Medical Basis of Sport, Faculty of Physical Education and Sports, Wroclaw University of Health and Sport Sciences, Wroclaw, Poland
| | - Małgorzata Słowińska-Lisowska
- Department of Biological and Medical Basis of Sport, Faculty of Physical Education and Sports, Wroclaw University of Health and Sport Sciences, Wroclaw, Poland
| | - Giovanni Lombardi
- Laboratory of Experimental Biochemistry & Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milano, Italy
- Department of Athletics, Strength and Conditioning, Poznań University of Physical Education, Poznań, Poland
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Ip TST, Fu SC, Ong MTY, Yung PSH. Vitamin D deficiency in athletes: Laboratory, clinical and field integration. Asia Pac J Sports Med Arthrosc Rehabil Technol 2022; 29:22-29. [PMID: 35847194 PMCID: PMC9256943 DOI: 10.1016/j.asmart.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 05/12/2022] [Accepted: 06/07/2022] [Indexed: 11/28/2022] Open
Abstract
Vitamin D deficiency is highly prevalent in athletes. Increased utilisation and storage depletion may be key contributing factor. We found a higher prevalence of vitamin D inadequacy (deficiency/ insufficiency) in power than endurance sport athletes, which may be related to vitamin D utilisation and reserve in skeletal muscles.
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Affiliation(s)
- Tina Shuk-Tin Ip
- Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region
| | - Sai-Chuen Fu
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Michael Tim-Yun Ong
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Patrick Shu-Hang Yung
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong Special Administrative Region
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Dietary vitamin D intake in low ultraviolet irradiation seasons is associated with a better nutritional status of vitamin D in Korean adults according to the 2013-2014 National Health and Nutrition Examination Survey. Nutr Res 2022; 105:53-65. [DOI: 10.1016/j.nutres.2022.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/04/2022] [Accepted: 06/05/2022] [Indexed: 11/23/2022]
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Stojanović E, Radovanović D, Hew-Butler T, Hamar D, Jakovljević V. Vitamin D in Basketball Players: Current Evidence and Future Directions. Sports Health 2022; 14:377-388. [PMID: 34085865 PMCID: PMC9112709 DOI: 10.1177/19417381211019343] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
CONTEXT Despite growing interest in quantifying and correcting vitamin D inadequacy in basketball players, a critical synthesis of these data is yet to be performed to overcome the low generalizability of findings from individual studies. OBJECTIVE To provide a comprehensive analysis of data in basketball pertaining to (1) the prevalence of vitamin D inadequacy; (2) the effects of vitamin D supplementation on 25-hydroxyvitamin D [25(OH)D] concentration (and its association with body composition), bone health, and performance; and (3) crucial aspects that warrant further investigation. DATA SOURCES PubMed, MEDLINE, ERIC, Google Scholar, SCIndex, and ScienceDirect databases were searched. STUDY SELECTION After screening, 15 studies were included in the systematic review and meta-analysis. STUDY DESIGN Systematic review and meta-analysis. LEVEL OF EVIDENCE Level 3. DATA EXTRACTION The prevalence of vitamin D inadequacy, serum 25(OH)D, body composition, stress fractures, and physical performance were extracted. RESULTS The pooled prevalence of vitamin D inadequacy for 527 basketball players in 14 studies was 77% (P < 0.001; 95% CI, 0.70-0.84). Supplementation with 4000 IU/d and 4000 IU/wk (absolute mean difference [AMD]: 25.39 nmol/L; P < 0.001; 95% CI, 13.44-37.33), as well as 10,000 IU/d (AMD: 100.01; P < 0.001; 95% CI, 70.39-129.63) vitamin D restored 25(OH)D to normal concentrations. Body composition data revealed inverse correlations between changes in serum 25(OH)D (from pre- to postsupplementation) and body fat (r = -0.80; very large). Data concerning positive impacts of vitamin D supplementation on bone health and physical performance remain sparse. CONCLUSION The high proportion of vitamin D inadequacy underscores the need to screen for serum 25(OH)D in basketball players. Although supplementation restored vitamin D sufficiency, the beneficial effects on bone health and physical performance remain sparse. Adiposity can modulate 25(OH)D response to supplementation.
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Affiliation(s)
- Emilija Stojanović
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
- Faculty of Medical Sciences, Department of Physiology, University of Kragujevac, Kragujevac, Serbia
| | | | - Tamara Hew-Butler
- Faculty of Exercise and Sport Science, Division of Kinesiology, Health and Sport Studies, Wayne State University, Detroit, Michigan
| | - Dušan Hamar
- Faculty of Physical Education and Sport, Department of Sports Kinanthropology, Comenius University in Bratislava, Bratislava, Slovakia
| | - Vladimir Jakovljević
- Faculty of Medical Sciences, Department of Physiology, University of Kragujevac, Kragujevac, Serbia
- Department of Human Pathology, Moscow State Medical University IM Sechenov, Moscow, Russia
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Brzeziański M, Migdalska-Sęk M, Czechowska A, Radzimiński Ł, Jastrzębski Z, Brzeziańska-Lasota E, Sewerynek E. Correlation between the Positive Effect of Vitamin D Supplementation and Physical Performance in Young Male Soccer Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5138. [PMID: 35564532 PMCID: PMC9101676 DOI: 10.3390/ijerph19095138] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/17/2022] [Accepted: 04/21/2022] [Indexed: 02/01/2023]
Abstract
The aim of this study was to determine whether supplementation with vitamin D during eight weeks of high-intensity training influences muscle power and aerobic performance in young soccer players. A total of 25 athletes were divided into two groups: the supplemented group (GS; n = 12; vitamin D 20,000 IU, twice a week) and the non-supplemented group (GN; n = 13). A set of measurements, including sprint tests, explosive power test, maximal oxygen uptake (VO2max), and serum 25(OH)D concentration, were obtained before (T1) and after (T2) the intervention. A significant group x time interaction was found in the 25(OH)D serum levels (p = 0.002; ES = 0.36, large). A significant improvement in VO2max was found in the TG (p = 0.0004) and the GS (p = 0.031). Moreover, a positive correlation between 25(OH)D and VO2max (R = 0.4192, p = 0.0024) was calculated. The explosive power tests revealed insignificant time interactions in the average 10-jump height and average 10-jump power (p = 0.07, ES = 0.13; p = 0.10, ES = 0.11, respectively). A statistically insignificant trend was observed only in the group-by-time interaction for the sprint of 10 m (p = 0.05; ES = 0.15, large). The present study provides evidence that vitamin D supplementation has a positive but trivial impact on the explosive power and locomotor skills of young soccer players, but could significantly affect their aerobic performance.
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Affiliation(s)
- Michał Brzeziański
- Department of Endocrine Disorders and Bone Metabolism, Medical University of Lodz, 90-752 Lodz, Poland; (M.B.); (E.S.)
- Academic Laboratory of Three-Dimensional Anthropometry, Medical University of Lodz, 92-213 Lodz, Poland
| | - Monika Migdalska-Sęk
- Department of Biomedicine and Genetics, Medical University of Lodz, 92-213 Lodz, Poland;
| | - Aleksandra Czechowska
- Academic Laboratory of Movement and Human Physical Performance, Medical University of Lodz, 92-213 Lodz, Poland
| | - Łukasz Radzimiński
- Department of Physiology and Biochemistry, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland; (Ł.R.); (Z.J.)
| | - Zbigniew Jastrzębski
- Department of Physiology and Biochemistry, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland; (Ł.R.); (Z.J.)
| | - Ewa Brzeziańska-Lasota
- Department of Biomedicine and Genetics, Medical University of Lodz, 92-213 Lodz, Poland;
| | - Ewa Sewerynek
- Department of Endocrine Disorders and Bone Metabolism, Medical University of Lodz, 90-752 Lodz, Poland; (M.B.); (E.S.)
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Şenışık S, Köyağasıoğlu O, Denerel N. Vitamin D levels on sports injuries in outdoor and indoor athletes: a cross-sectional study. PHYSICIAN SPORTSMED 2022; 50:164-170. [PMID: 34402729 DOI: 10.1080/00913847.2021.1969217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Having vitamin D levels within normal limits is important for bone and muscle health and its deficiency may increase the risk of injury. The aim of this cross-sectional study was to investigate whether vitamin D levels are different in indoor and outdoor athletes and its levels increase the risk of injury. MATERIAL AND METHODS Serum vitamin D levels were measured in Caucasian adolescent athletes, who admitted to the sports medicine polyclinic due to a routine health check or injury. The study was carried out at 38°26' north latitude in İzmir between June and September 2019. After the physical examination of the injured athletes, the diagnoses were made accompanied by the findings obtained by imaging methods in cases of necessity. RESULTS A total of 256 athletes, including swimmers (n = 87), basketball players (n = 104), and football (n = 65) players aged 13.2 (± 2.2) years, were investigated. The average serum vitamin D (25(OH)D) level in athletes was 29.2 (±10.0) ng/mL (6.0-66.0 ng/mL). Forty-six of all athletes (18%) had vitamin D deficiency, with a mean value of 15.7 (±4.0) ng/mL, and 93 of them (36.3%) had vitamin D deficiency with a mean value of 25.2 (±2.4) ng/mL. While vitamin D levels were significantly higher in football players (32 ng/mL) than in other athletes (p < 0.05), it was similar in basketball players (27 ng/mL) and swimmers (26 ng/mL) (p > 0.05). Vitamin D levels (26 ng/mL) of the injured athletes were significantly lower than those of the non-injured athletes (30 ng/mL) (p = 0.001). Bone injuries were significantly related to Vitamin D levels (p < 0.001) but not with muscle injuries (p > 0.05). CONCLUSION Frequency of vitamin D deficiency and insufficiency is higher in indoor athletes andis especially associated with risk of bone injuries . In order to examine the effect of vitamin D level on bone mineral density, comprehensive prospective studies are required.
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Affiliation(s)
- Seçkin Şenışık
- Department of Sports Medicine, Ege University Faculty of Medicine, İzmir, Turkey
| | - Ogün Köyağasıoğlu
- Department of Sports Medicine, Kayseri City Training and Research Hospital, Kayseri, Turkey
| | - Nevzad Denerel
- Health Team Sports Medicine Clinic, Nicosia, Turkish Republic of North Cyprus
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Zhai LL, Chen CX, Zhan CH, You GW, Chen QL, Tang ZG. Analysis of serum 25-hydroxyvitamin D levels involves taking into account several confounding factors. Eur J Clin Nutr 2022; 76:1349-1350. [PMID: 35149832 DOI: 10.1038/s41430-022-01098-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Lu-Lu Zhai
- Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Chun-Xi Chen
- Department of Pediatrics, Xishui People's Hospital, Huanggang, China
| | - Chun-Hua Zhan
- Department of Infectious Diseases, Xishui People's Hospital, Huanggang, China
| | - Guo-Wen You
- Department of Infectious Diseases, Xishui Maternal and Child Health Hospital, Huanggang, China
| | - Qing-Lin Chen
- Department of Gastroenterology, Xishui Maternal and Child Health Hospital, Huanggang, China
| | - Zhi-Gang Tang
- Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
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Hollabaugh WL, Meirick PJ, Matarazzo CP, Burston AM, Camery ME, Ferrill-Moseley KA, Bley JA, Pennings JS, Fitch RW, Tanner SB, Karpinos AR. Evaluation of a Vitamin D Screening and Treatment Protocol Using a Seasonal Calculator in Athletes. Curr Sports Med Rep 2022; 21:53-62. [PMID: 35120051 DOI: 10.1249/jsr.0000000000000934] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
ABSTRACT Vitamin D is important in musculoskeletal health, and low serum vitamin D concentration is common in athletes. This study implemented a vitamin D screening and supplementation protocol in a cohort of National Collegiate Athletic Association Division I athletes using summer 25-hydroxyvitamin D concentration and a seasonal variation calculator to achieve sufficient vitamin D concentration year-round. After implementation of the Vitamin D Protocol, there was a nonsignificant difference in athletes with sufficient winter vitamin D concentrations (72.6%) compared with summer vitamin D concentrations (66.1%) (P = 0.40). The Seasonal Variation Calculator predicted winter vitamin D concentrations (8 ± 18 ng·mL-1) higher than actual winter vitamin D concentrations (P < 0.01). While most athletes (78%) believed vitamin D was important for athletic performance, athlete compliance to the Vitamin D Protocol was inconsistent. In the future, adjustment of vitamin D screening and supplementation protocols may help athletes achieve sufficient vitamin D status year-round.
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Affiliation(s)
- William L Hollabaugh
- Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN
| | | | - Chris P Matarazzo
- Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN
| | - Alda M Burston
- Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN
| | - Megan E Camery
- Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN
| | - Kimberly A Ferrill-Moseley
- Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN
| | - Jordan A Bley
- Department of Epidemiology, Vanderbilt University Medical Center, Nashville, TN
| | | | | | - S Bobo Tanner
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
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Changes of 25(OH)D Concentration, Bone Resorption Markers and Physical Performance as an Effect of Sun Exposure, Supplementation of Vitamin D and Lockdown among Young Soccer Players during a One-Year Training Season. Nutrients 2022; 14:nu14030521. [PMID: 35276883 PMCID: PMC8838295 DOI: 10.3390/nu14030521] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/18/2022] [Accepted: 01/21/2022] [Indexed: 12/10/2022] Open
Abstract
The main purpose of this research was to demonstrate the changes in 25(OH)D concentration, bone resorption markers, and physical fitness along the one-year training season in young soccer players. A total of 24 young soccer players (age: 17.2 ± 1.16 years, mass: 70.2 ± 5.84, height: 179.1 ± 4.26 cm) were tested at four different time points across one year (T1—September 2019; T2—December 2019; T3—May 2020; T4—August 2020). After T2 (during COVID-19 lockdown), players were divided into a supplemented (GS) group and a placebo group (GP). Variables such as 25(OH)D, calcium (Ca), phosphorus (P), parathyroid hormone (PTH), aerobic capacity, speed, and explosive power were measured. Analyses performed for all participants indicated significant changes in all selected blood markers and running speed. The highest values in 25(OH)D were noted during summertime in T1 and T4. After individuals were split into two groups, a two-factorial ANOVA demonstrated a significant time interaction for 25(OH)D, Ca, P, PTH, 30 m sprint, and counter-movement jump. Significant time x group effect was calculated for aerobic capacity. This study confirmed that 25(OH)D concentration varies between four seasons, with the greatest decreases in the low sunlight periods. Vitamin D supplementation did not cause a preventive and long-lasting effect of increasing the 25(OH)D concentration in the young soccer players.
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Zhou H, He YR, Liu L, Zhu ZQ. OUP accepted manuscript. Oncologist 2022; 27:e99. [PMID: 35305108 PMCID: PMC8842460 DOI: 10.1093/oncolo/oyab017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/19/2021] [Indexed: 11/15/2022] Open
Affiliation(s)
- Hong Zhou
- Department of General Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, People's Republic of China
| | - Yi-Ren He
- Department of General Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, People's Republic of China
| | - Liu Liu
- Department of General Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, People's Republic of China
| | - Zhi-Qiang Zhu
- Department of General Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, People's Republic of China
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Araujo P, Méndez-Dávila C. Challenges Ahead for a Rational Analysis of Vitamin D in Athletes. Front Nutr 2021; 8:712335. [PMID: 34820410 PMCID: PMC8606642 DOI: 10.3389/fnut.2021.712335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/07/2021] [Indexed: 11/13/2022] Open
Abstract
Vitamin D is an essential vitamin for the normal formation of bones and calcium absorption. It is synthesized into our body through sunlight exposure and obtained by consuming foods rich in vitamin D (e.g., fatty fish, eggs yolk, dairy products). Its benefits on the health and performance of athletes are well documented. This article outlines some analytical challenges concerning the analytical quantification of vitamin D for its optimal intake, namely, a comprehensive study of the variability of the assay before categorizing any method as the golden standard, assurance of sample comparability to draw meaningful correlations, revision of the intake guidance based on appropriate statistical power analysis, and the implementation of rational strategies for preventing the underlying mechanism of preanalytical factors. Addressing these challenges will enable the effective management of vitamin D in the sports sector.
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Affiliation(s)
- Pedro Araujo
- Feed and Nutrition Group, Norwegian Institute of Marine Research, Bergen, Norway
| | - Cioly Méndez-Dávila
- Department of Rheumatology, University Hospital 12 de Octubre, Madrid, Spain
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Most A, Dörr O, Nef H, Hamm C, Bauer T, Bauer P. Influence of 25-Hydroxy-Vitamin D Insufficiency on Maximal Aerobic Power in Elite Indoor Athletes: A Cross-Sectional Study. SPORTS MEDICINE-OPEN 2021; 7:74. [PMID: 34648100 PMCID: PMC8517059 DOI: 10.1186/s40798-021-00363-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 09/21/2021] [Indexed: 11/21/2022]
Abstract
Background The impact of vitamin D on musculoskeletal health is well-established, although its influence on physical performance is unclear. Therefore, we conducted this study to evaluate the impact of 25-hydroxy-vitamin D (25-OH vitamin D) concentrations with maximal aerobic power of professional indoor athletes.
Results A total of 112 male professional athletes were included in this cross-sectional study, consisting of 88 handball and 24 ice hockey players. The maximal aerobic power was assessed with a standardized cycling ergometer test. Athletes were assigned to two groups according to their 25-OH vitamin D status: insufficient (< 30 ng/mL) and sufficient (≥ 30 ng/mL). Thirty-four players (30.4%) displayed insufficient (21.9 ± 5.9 ng/mL) and 78 (69.6%) sufficient 25-OH vitamin D concentrations (41.6 ± 8.6 ng/mL). Athletes with sufficient levels achieved a higher maximal aerobic power (3.9 ± 0.9 vs. 3.5 ± 0.8 W/kg, p = 0.03) compared to those with insufficient levels. Conclusions There is a high prevalence of 25-OH vitamin D insufficiency in professional indoor athletes, even in summer. Insufficient 25-OH vitamin D concentrations were associated with lower maximal aerobic power in male professional indoor athletes. Further, the 25-OH vitamin D concentration was identified as the only independent predictor of maximal aerobic power in these athletes, highlighting the impact of 25-OH vitamin D on physical performance. Therefore, 25-OH vitamin D concentrations of ≥ 30 ng/mL should be maintained to ensure optimal physical performance in these athletes. Supplementary Information The online version contains supplementary material available at 10.1186/s40798-021-00363-1.
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Affiliation(s)
- Astrid Most
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Klinikstrasse 33, 35392, Giessen, Germany.
| | - Oliver Dörr
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Klinikstrasse 33, 35392, Giessen, Germany
| | - Holger Nef
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Klinikstrasse 33, 35392, Giessen, Germany
| | - Christian Hamm
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Klinikstrasse 33, 35392, Giessen, Germany.,Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - Timm Bauer
- Department of Cardiology, Internal Intensive Care, General Internal Medicine, Sana Klinikum, Offenbach, Germany
| | - Pascal Bauer
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Klinikstrasse 33, 35392, Giessen, Germany
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Rockwell MS, Kostelnik SB, McMillan RP, Lancaster M, Larson-Meyer DE, Hulver MW. An Association between Bioavailable 25-Hydroxyvitamin D and Bone Mineral Density in a Diverse Cohort of Collegiate Athletes. Med Sci Sports Exerc 2021; 54:371-376. [PMID: 34652336 DOI: 10.1249/mss.0000000000002807] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Although vitamin D is intimately involved in bone metabolism, the relationship between vitamin D status, as measured by serum total 25-hydroxyvitamin D [25(OH)D] concentration, and bone mineral density (BMD) is weak, particularly in non-White populations. Measurement of bioavailable 25(OH)D has been suggested as a better indicator of vitamin D status than total 25(OH)D concentration. To date, the bioavailable 25(OH)D biomarker has been explored minimally in athletic populations. The purpose of this study was to investigate the relationship between total and bioavailable 25(OH)D concentrations and BMD in collegiate athletes. METHODS NCAA Division 1 basketball and swimming athletes served as study participants (n = 53; 28 females, 25 males; 28 basketball players, 25 swimmers). All participants completed dual energy x-ray absorptiometry (DXA) scans for analysis of BMD, blood draws for vitamin D measures, and diet/lifestyle questionnaires. RESULTS Overall, total 25(OH)D was 80.0 + 13.9 nmol/L and bioavailable 25(OH)D was 6.0 ± 1.9 nmol/L. There was strong disagreement between total 25(OH)D and bioavailable 25(OH)D concentrations (κ = -0.299; r = -0.129) (p = 0.100); 53% of total participants and 77% of Black participants were classified differently (low vs. normal vitamin D status) based on total and bioavailable 25(OH)D criteria. Black participants had significantly lower total 25(OH)D and higher bioavailable 25(OH)D concentrations than White participants (59.5 vs. 102.5 nmol/L and 7.9 vs. 5.4 nmol/L, respectively) (p < 0.001). Total 25(OH)D and total BMD were not correlated, but bioavailable 25(OH)D and total BMD demonstrated a positive correlation (r = 0.618, p < 0.01). CONCLUSIONS These results suggest that bioavailable 25(OH)D concentration may be a better clinical measure of vitamin D status than total 25(OH)D in collegiate athletes as related to BMD, particularly in Black athletes. Further research on the utility of the bioavailable 25(OH)D biomarker in athletes is needed.
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Affiliation(s)
- Michelle S Rockwell
- Fralin Life Sciences Institute, Virginia Tech, Blacksburg, VA Department of Family and Community Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA Department of Human Nutrition, Foods, and Exercise, Blacksburg, VA The Metabolism Core at Virginia Tech, Blacksburg, VA
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Leitch BA, Wilson PB, Ufholz KE, Roemmich JN, Orysiak J, Walch TJ, Short SE, Fitzgerald JS. Vitamin D Awareness and Intake in Collegiate Athletes. J Strength Cond Res 2021; 35:2742-2748. [PMID: 31373981 DOI: 10.1519/jsc.0000000000003240] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
ABSTRACT Leitch, BA, Wilson, PB, Ufholz, KE, Roemmich, JN, Orysiak, J, Walch, TJ, Short, SE, and Fitzgerald, JS. Vitamin D awareness and intake in collegiate athletes. J Strength Cond Res 35(10): 2742-2748, 2021-Poor vitamin D status is a risk factor for negative health and performance outcomes in athletes, but little is known about how athletes' awareness and beliefs about vitamin D affect their consumption of vitamin D. This observational study investigated awareness of vitamin D for health and performance among collegiate athletes and evaluated the association of vitamin D awareness with its dietary intake. Fifty-two female and 29 male Division I collegiate athletes completed an online vitamin D awareness and dietary intake questionnaire between November 1, 2015, and January 30, 2016. Median intake of vitamin D was 330 International Units (IU), which is below the recommended daily allowance (RDA) of 600 IU, but was greater in male athletes (693 IU) than female athletes (263 IU, p < 0.01). The RDA for vitamin D was met by 62% of men and 30% of women. Athletes responded that vitamin D "probably" or "definitely" will play a role in their health (88.9%) and athletic performance (71.6%). However, only 23.4 and 28.4% of athletes reported concern for their vitamin D levels or believed that they were at risk for deficiency, respectively. Results showed small-to-moderate, positive correlations (r = 0.28-0.495, p < 0.05) between aspects of vitamin D awareness and vitamin D intake, particularly with supplemental forms of vitamin D. Given the lack of awareness concerning risk of vitamin D deficiency, and the links between aspects of vitamin D awareness and vitamin D intake, nutritional education programs designed to increase vitamin D awareness in athletes may be an effective strategy to reduce deficiency.
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Affiliation(s)
- Bennett A Leitch
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, North Dakota
| | - Patrick B Wilson
- Human Movement Sciences, Old Dominion University, Norfolk, Virginia
| | - Kelsey E Ufholz
- USDA, Agricultural Research Service, Grand Forks Human Nutrition Research Center, Grand Forks, North Dakota; and
| | - James N Roemmich
- USDA, Agricultural Research Service, Grand Forks Human Nutrition Research Center, Grand Forks, North Dakota; and
| | - Joanna Orysiak
- Department of Nutrition Physiology and Dietetics, Institute of Sport, National Research Institute, Warsaw, Poland
| | - Tanis J Walch
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, North Dakota
| | - Sandra E Short
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, North Dakota
| | - John S Fitzgerald
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, North Dakota
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Zamir A, Ben-Zeev T, Hoffman JR. Manipulation of Dietary Intake on Changes in Circulating Testosterone Concentrations. Nutrients 2021; 13:3375. [PMID: 34684376 PMCID: PMC8538516 DOI: 10.3390/nu13103375] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 12/22/2022] Open
Abstract
Elevations in the circulating concentration of androgens are thought to have a positive effect on the anabolic processes leading to improved athletic performance. Anabolic-androgenic steroids have often been used by competitive athletes to augment this effect. Although there has been concerted effort on examining how manipulating training variables (e.g., intensity and volume of training) can influence the androgen response to exercise, there has been much less effort directed at understanding how changes in both macronutrient and micronutrient intake can impact the androgen response. Thus, the focus of this review is to examine the effect that manipulating energy and nutrient intake has on circulating concentrations of testosterone and what the potential mechanism is governing these changes.
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Affiliation(s)
| | | | - Jay R. Hoffman
- Department of Physical Therapy, Faculty of Health Sciences, Ariel University, 40700 Ariel, Israel; (A.Z.); (T.B.-Z.)
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Gilic B, Kosor J, Jimenez-Pavon D, Markic J, Karin Z, Domic DS, Sekulic D. Associations of Vitamin D Levels with Physical Fitness and Motor Performance; A Cross-Sectional Study in Youth Soccer Players from Southern Croatia. BIOLOGY 2021; 10:biology10080751. [PMID: 34439983 PMCID: PMC8389772 DOI: 10.3390/biology10080751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/31/2021] [Accepted: 08/02/2021] [Indexed: 12/16/2022]
Abstract
Simple Summary Vitamin D is a fat-soluble prohormone crucial for bone mineralization, muscle contractility, and neurological conductivity. It is theorized that Vitamin D plays an important role in sport performances, especially in young athletes. In this study we examined the associations of levels of 25-hydroxyvitamin D (25(OH)D) with physical fitness and motor-performance achievements in youth soccer players from Southern Croatia. Participants were tested on physical fitness, motor performance and vitamin D at the end of the winter period, when levels of vitamin D are known to be lowest due to low exposure to sunlight. Results showed that deficiency of 25(OH)D was widespread among youth soccer players living in Southern Croatia. Low 25(OH)D levels were associated with lower results in fitness tests (i.e., tests of energetic capacities), but there was no correlation between 25(OH)D levels and the results in motor performance tests (i.e., skill tests). Our results support the theory of the association between vitamin D and energetic capacities of athletes, but there is no evidence on association between vitamin D and skill-based capacities. Abstract Vitamin D level is known to be a factor potentially influencing physical fitness, but few studies have examined this phenomenon among youth athletes. We aimed to evaluate the associations of vitamin D levels (as measured by 25-hydroxyvitamin D concentrations—25(OH)D) with various physical fitness and motor performance tests in youth football (soccer) players. This cross-sectional study included a total of 52 youth soccer players (15.98 ± 2.26 years old) from Southern Croatia. The participants were evaluated at the end of the winter period and data were collected of anthropometric measures (body mass and body height), vitamin D status (25(OH)D levels), physical fitness tests (sprints of 10 and 20 m, 20 yards test, the countermovement jump, the reactive strength index (RSI)) and motor performance tests (the soccer-specific CODS, the soccer-specific agility, and static balance). Among the studied players, 54% had 25(OH)D insufficiency/deficiency, showing a lack of 25(OH)D is widespread even in youth athletes living at a southern latitude. The 25(OH)D level was correlated with sprint 20 m, 20 yards tests, and RSI, showing a greater role of 25(OH)D in physical fitness tests where energetic capacity is essential than in sport-related motor performance tests where skills are crucial. Our results support the idea that vitamin D can play a determinant role in physical fitness tests with a clear physiological component, but is not crucial in motor performance tests related to specific sports where skills are a key component. Future studies should investigate the effects of vitamin D supplementation on the performance in physical fitness and motor performance tests among youth athletes.
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Affiliation(s)
- Barbara Gilic
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia;
- Faculty of Kinesiology, University of Zagreb, 10000 Zagreb, Croatia
| | - Jelena Kosor
- Department of Pediatrics, University Hospital of Split, 21000 Split, Croatia; (J.K.); (J.M.)
| | - David Jimenez-Pavon
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, 11519 Cadiz, Spain;
- Biomedical Research and Innovation Institute of Cadiz (INiBICA) Research Unit, Puerta del Mar University Hospital University of Cadiz, 11009 Cadiz, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), 28001 Madrid, Spain
| | - Josko Markic
- Department of Pediatrics, University Hospital of Split, 21000 Split, Croatia; (J.K.); (J.M.)
- School of Medicine, University of Split, 21000 Split, Croatia
| | - Zeljka Karin
- Teaching Institute of Public Health of Split Dalmatian County, 21000 Split, Croatia;
| | - Daniela Supe Domic
- Department of Medical Laboratory Diagnostics, University Hospital of Split, 21000 Split, Croatia;
- Department of Health Studies, University of Split, 21000 Split, Croatia
| | - Damir Sekulic
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia;
- Correspondence:
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Liu W, Hu J, Fang Y, Wang P, Lu Y, Shen N. Vitamin D status in Mainland of China: A systematic review and meta-analysis. EClinicalMedicine 2021; 38:101017. [PMID: 34308318 PMCID: PMC8283334 DOI: 10.1016/j.eclinm.2021.101017] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/13/2021] [Accepted: 06/21/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Low vitamin D (VitD) status is becoming a global health issue. Previous heterogenous results are urging a meta-analysis to delineate a panorama of VitD conditions in the general population in Mainland of China. METHODS We performed a systematic review and meta-analysis by searching PubMed, Web of Science, EMBASE, China National Knowledge Infrastructure, WanFang, and VIP databases up to June 4, 2021. The inclusion criteria were as follows: (1) original articles or dissertations focused on VitD status of people in Mainland of China; and (2) studies were population-based, cross-sectional, or longitudinal cohort with baseline data. The outcomes were serum 25(OH)D concentration and the prevalence of low VitD status. Low VitD status included VitD deficiency (< 30 nmol/L) and VitD inadequacy (< 50 nmol/L). Data were estimated by Hierarchical Bayesian methods. All included studies were cross-sectional or longitudinal cohort studies about VitD status of people in Mainland of China. (Registration: PROSPERO CRD42021226130). FINDINGS A total of 105 eligible studies including 234,519 subjects were included. In adults, the overall mean 25(OH)D concentration was 44.3 nmol/L (95% Credible Interval [CrI]: 39.8-48.7). The pooled prevalence of VitD deficiency and inadequacy was 20.7% (95% CrI: 11.9-32.9) and 63.2% (95% CrI: 53.5-72.3), respectively. In children and adolescents, the overall mean 25(OH)D concentration was 52.2 nmol/L (95% CrI: 46.7-57.5). The pooled prevalence of VitD deficiency and inadequacy was 23.0% (95% CrI: 8.9-44.3) and 46.8% (95% CrI: 37.2-56.6), respectively. Specially, we identified that the prevalence of VitD inadequacy increased with age in populations with age ≤ 18 years and ≥ 60 years. INTERPRETATION Low VitD status is prominent in general population of Mainland of China, especially for adults. FUNDING National Major Scientific and Technological Special Project for "Significant New Drugs Development" (2017ZX09304022).
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Affiliation(s)
- Wenhua Liu
- Clinical Research Center,Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Jing Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, HUST, Wuhan, China
| | - Yuanyuan Fang
- Department of Neurology, Tongji Hospital,Tongji Medical College, HUST, Wuhan, China
| | - Peng Wang
- Institute and Department of Infectious Disease, Tongji Hospital, Tongji Medical College, HUST, Wuhan, China
| | - Yanjun Lu
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, HUST, Wuhan, China
| | - Na Shen
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, HUST, Wuhan, China
- Corresponding author.
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Stojanović E, Jakovljević V, Scanlan AT, Dalbo VJ, Radovanović D. Vitamin D 3 supplementation reduces serum markers of bone resorption and muscle damage in female basketball players with vitamin D inadequacy. Eur J Sport Sci 2021; 22:1532-1542. [PMID: 34240659 DOI: 10.1080/17461391.2021.1953153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This study aimed to investigate the effect of vitamin D3 supplementation at a dose of 4,000 IU/day for 6 weeks on serum levels of: 25-hydroxyvitamin D [25(OH)D], bone turnover [osteocalcin and carboxy-terminal telopeptides of crosslinks of type I collagen (CTx-I)], and muscle damage [lactate dehydrogenase (LDH) and creatine kinase (CK)] in middle adolescent (15-18 years) and late-adolescent to early adulthood (19-30 years) female basketball players with inadequate vitamin D status. Participants (N=24) were randomly assigned in a double-blind manner into a vitamin D or placebo group. Data were analyzed using separate 2×2x2 mixed ANOVAs with one within-subjects factor (time) and two between-subjects factors (condition and age). When a significant interaction was observed, the intra-group changes were assessed using paired t tests and Hedge's g. Paired t-tests comparing intra-group changes in the vitamin D condition revealed a non-significant large improvement in 25(OH)D (p = 0.06; g = 0.86), non-significant small decreases in CTx-I (p = 0.13; g = -0.22) and CK (p = 0.07; g = -0.26), as well as a significant moderate decrease in LDH (p = 0.004; g = -0.74). Paired t-tests comparing intra-group changes in the placebo condition revealed a significant moderate decline in 25(OH)D (p <0.001; g = -0.77), as well as significant small increases in CTx-I (p = 0.04; g = 0.47) and CK (p = 0.04; g = 0.36). Vitamin D3 supplementation at 4,000 IU/day could be effective in reducing bone resorption and muscle damage in female basketball players with inadequate baseline vitamin D, irrespective of age.
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Affiliation(s)
- Emilija Stojanović
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia.,Faculty of Medical Sciences, Department of Physiology, University of Kragujevac, Kragujevac, Serbia
| | - Vladimir Jakovljević
- Faculty of Medical Sciences, Department of Physiology, University of Kragujevac, Kragujevac, Serbia.,Department of Human Pathology, Moscow State Medical University IM Sechenov, Moscow, Russia
| | - Aaron T Scanlan
- Human Exercise and Training Laboratory, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Vincent J Dalbo
- Human Exercise and Training Laboratory, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
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Jakobsen MM, Nygaard RH, Hojbjerg JA, Larsen JB. The association between vitamin D status and overuse sport injuries: A systematic review and meta‐analysis. TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Marie Munk Jakobsen
- Department of Clinical Biochemistry Aarhus University Hospital Aarhus Denmark
| | - Rie Harboe Nygaard
- Department of Clinical Biochemistry Aarhus University Hospital Aarhus Denmark
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Relationships between Vitamin D and Selected Cytokines and Hemogram Parameters in Professional Football Players-Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137124. [PMID: 34281061 PMCID: PMC8297090 DOI: 10.3390/ijerph18137124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 06/28/2021] [Accepted: 07/01/2021] [Indexed: 12/20/2022]
Abstract
Vitamin D affects both innate and adaptive immunity. Most of the effects of vitamin D on innate immunity are anti-inflammatory. In monocytes/macrophages, vitamin D suppresses the production of the inflammatory cytokines TNF-alpha, IL-1beta, IL-6, and IL-8. Therefore, the aim of our study was to investigate the relationship between 25(OH)D concentration and selected cytokines—IL-6, TNF-α, and IL-1β, which are hemogram parameters for professional football players. We enrolled 41 Polish premier league soccer players. The mean age, career duration, and VO2max were, respectively: 22.7 ± 5.3 years, 14.7 ± 4.5 years, and 55.8 ± 4.0 mL/kg/min. Serum levels of 25(OH)D were measured by electrochemiluminescence (ECLIA) using the Elecsys system (Roche, Switzerland). Serum levels of IL-6, IL-1β, and TNF-α were measured by ELISA (R&D Systems, Minneapolis). Blood count with smear was measured on a Sysmex XT-4000i analyzer (Sysmex Corporation, Japan). Our study showed decreased serum 25(OH)D levels in 78% of the professional players. We found a significant negative correlation between 25(OH)D levels and TNF-α and LYMPH (%). The results also demonstrated a statistically significant positive correlation between vitamin D levels and NEUTH (%), NEUTH (tys/µL), and EOS (tys/µL). Based on the results of our study, we concluded that football players from Poland are not protected against vitamin D insufficiency in winter months. Moreover, vitamin D deficiency may be associated with an increased pro-inflammatory risk in well-trained athletes.
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Fredericson M, Kussman A, Misra M, Barrack MT, De Souza MJ, Kraus E, Koltun KJ, Williams NI, Joy E, Nattiv A. The Male Athlete Triad-A Consensus Statement From the Female and Male Athlete Triad Coalition Part II: Diagnosis, Treatment, and Return-To-Play. Clin J Sport Med 2021; 31:349-366. [PMID: 34091538 DOI: 10.1097/jsm.0000000000000948] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 04/23/2021] [Indexed: 02/02/2023]
Abstract
ABSTRACT The Male Athlete Triad is a medical syndrome most common in adolescent and young adult male athletes in sports that emphasize a lean physique, especially endurance and weight-class athletes. The 3 interrelated conditions of the Male Athlete Triad occur on spectrums of energy deficiency/low energy availability (EA), suppression of the hypothalamic-pituitary-gonadal axis, and impaired bone health, ranging from optimal health to clinically relevant outcomes of energy deficiency/low EA with or without disordered eating or eating disorder, functional hypogonadotropic hypogonadism, and osteoporosis or low bone mineral density with or without bone stress injury (BSI). Because of the importance of bone mass acquisition and health concerns in adolescence, screening is recommended during this time period in the at-risk male athlete. Diagnosis of the Male Athlete Triad is best accomplished by a multidisciplinary medical team. Clearance and return-to-play guidelines are recommended to optimize prevention and treatment. Evidence-based risk assessment protocols for the male athlete at risk for the Male Athlete Triad have been shown to be predictive for BSI and impaired bone health and should be encouraged. Improving energetic status through optimal fueling is the mainstay of treatment. A Roundtable on the Male Athlete Triad was convened by the Female and Male Athlete Triad Coalition in conjunction with the 64th Annual Meeting of the American College of Sports Medicine in Denver, Colorado, in May of 2017. In this second article, the latest clinical research to support current models of screening, diagnosis, and management for at-risk male athlete is reviewed with evidence-based recommendations.
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Affiliation(s)
- Michael Fredericson
- Division of Physical Medicine & Rehabiilitation, Stanford University, Stanford, California
| | - Andrea Kussman
- Division of Physical Medicine & Rehabiilitation, Stanford University, Stanford, California
| | - Madhusmita Misra
- Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Michelle T Barrack
- Department of Family and Consumer Sciences, California State University, Long Beach, Long Beach, California
| | - Mary Jane De Souza
- Department of Kinesiology and Physiology Penn State University, University Park, Pennsylvania
| | - Emily Kraus
- Division of Physical Medicine & Rehabiilitation, Stanford University, Stanford, California
| | | | - Nancy I Williams
- Department of Kinesiology and Physiology Penn State University, University Park, Pennsylvania
| | | | - Aurelia Nattiv
- Department of Family Medicine, University of California, Los Angeles, Los Angeles, California
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Yoon S, Kwon O, Kim J. Vitamin D in athletes: focus on physical performance and musculoskeletal injuries. Phys Act Nutr 2021; 25:20-25. [PMID: 34315203 PMCID: PMC8342187 DOI: 10.20463/pan.2021.0011] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 06/28/2021] [Indexed: 12/30/2022] Open
Abstract
PURPOSE The aim of this review was to discuss the effects of vitamin D on physical performance and musculoskeletal injuries in athletes and provide information on the field applications of vitamin D. METHODS A systematic review was conducted to identify studies on vitamin D in athletes that assessed serum vitamin D levels, vitamin D and physical performance, vitamin D and musculoskeletal injuries, and practical guidelines for supplementation of vitamin D. RESULTS Several studies reported that a high proportion of athletes had vitamin D insufficiency or deficiency. Low serum levels of vitamin D in athletes were more pronounced in winter than in other seasons, and indoor athletes had lower serum vitamin D levels than outdoor athletes. Low vitamin D levels have been demonstrated to have negative effects on muscle strength, power, and endurance; increase stress fractures and other musculoskeletal injuries; and affect acute muscle injuries and inflammation following high-intensity exercises. Therefore, periodic assessment and monitoring of vitamin D levels are necessary in athletes; the recommended serum level of 25(OH)D is > 32 ng/mL and the preferred level is > 40 ng/mL (-1). In those with low levels of vitamin D, exposure to sunlight and an improved diet or supplements may be helpful. Particularly, 2000-6000 IU of supplemental vitamin D3 can be consumed daily. CONCLUSION Vitamin D is a potential nutritional factor that can significantly affect physical performance and musculoskeletal injuries in athletes. The importance and role of vitamin D in athletes should be emphasized, and the current levels of vitamin D should be assessed. Therefore, it is essential to periodically evaluate and monitor serum vitamin D levels in athletes.
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Affiliation(s)
- Sewoon Yoon
- Division of Sports Science, College of Health Science, University of Suwon, Hwaseong, Republic of Korea
| | - Ohkyu Kwon
- Department of Physical Education, College of Education, Daegu Catholic University, Gyeongsan, Republic of Korea
| | - Jooyoung Kim
- Office of Academic Affairs, Konkuk University, Chungju, Republic of Korea
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