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Zürcher SJ, Quadri A, Huber A, Thomas L, Close GL, Brunner S, Noack P, Gojanovic B, Kriemler S. Predictive Factors for Vitamin D Concentrations in Swiss Athletes: A Cross-sectional Study. Sports Med Int Open 2018; 2:E148-E156. [PMID: 30539132 PMCID: PMC6259462 DOI: 10.1055/a-0669-0791] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 07/13/2018] [Accepted: 07/18/2018] [Indexed: 12/15/2022] Open
Abstract
Vitamin D concentrations corresponding to 75 nmol/L 25(OH)D have been associated with maintained muscle function, growth and regeneration, optimal bone health and immunology in athletes. The objective of this study was to investigate the prevalence and predictors of insufficient 25(OH)D concentrations in athletes. Six hundred three Swiss athletes were assessed. 25(OH)D was analysed by high-performance liquid chromatography (HPLC). A standardized questionnaire was used to gather information about potential predictors for 25(OH)D concentrations; 50.5% showed insufficient 25(OH)D concentrations. Differences in predicted probability of insufficient 25(OH)D were found for those vitamin D supplemented (42%) versus not supplemented (52%), in those performing indoor (58%) versus outdoor sports (43%), and during the sun-deprived seasons of fall (49%), winter (70%) and spring (57%) compared with summer (17%). Higher BMI z-scores and age were associated with higher 25(OH)D concentrations. In conclusion, insufficient 25(OH)D concentrations were common among athletes especially at a younger age, among those not supplemented, in athletes who trained indoors, and during the sun-deprived seasons. Because the prevalence of insufficient 25(OH)D concentrations in this study was high, regular supplementation in athletes may be indicated, except perhaps during the summer season. Further research is needed to determine which 25(OH)D concentrations lead to optimal health and performance in athletes.
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Affiliation(s)
- Simeon Joel Zürcher
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
| | - Andrea Quadri
- Spital Bulach, Internal Medicine, Bulach, Switzerland
| | - Andreas Huber
- Kantonsspital Aarau, Labaratory Medicine, Aarau, Switzerland
| | - Lothar Thomas
- Klinikum der Johann-Wolfgang-Goethe Universität, Central laboratory for Clinical Chemistry and Hematology, Frankfurt am Main, Germany
| | - Graeme Leonard Close
- LJMU, Sports Science, Liverpool, United Kingdom of Great Britain and Northern Ireland
| | - Saskia Brunner
- Kantonsspital Aarau, Labaratory Medicine, Aarau, Switzerland
| | - Patrik Noack
- Medbase Abtwil, Swiss Olympic Medical Center, Abtwil, Switzerland
| | - Boris Gojanovic
- Hopital de la Tour, Swiss Olympic Medical Center, Meyrin, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
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The "Extreme Exercise Hypothesis": Recent Findings and Cardiovascular Health Implications. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2018; 20:84. [PMID: 30155804 PMCID: PMC6132728 DOI: 10.1007/s11936-018-0674-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
Abstract
PURPOSE OF REVIEW The "Extreme Exercise Hypothesis" is characterized by a U-shaped or reverse J-shaped, dose-response curve between physical activity volumes and cardiovascular health outcomes. In this review, we summarize recent findings that may support or refute the "Extreme Exercise Hypothesis." Furthermore, we discuss potential cardiovascular health implications of the cardiac anatomical, structural, contractility, and biomarker abnormalities that have been reported in some veteran endurance athletes. RECENT FINDINGS Emerging evidence from epidemiological studies and observations in cohorts of endurance athletes suggest that potentially adverse cardiovascular manifestations may occur following high-volume and/or high-intensity long-term exercise training, which may attenuate the health benefits of a physically active lifestyle. Accelerated coronary artery calcification, exercise-induced cardiac biomarker release, myocardial fibrosis, atrial fibrillation, and even higher risk of sudden cardiac death have been reported in athletes. There is primarily circumstantial evidence that supports the "Extreme Exercise Hypothesis." Subclinical and atherosclerotic coronary artery disease (CAD) as well as structural cardiovascular abnormalities and arrhythmias are present in some of the most active veteran endurance athletes and need appropriate clinical follow-up to reduce the risk for adverse cardiovascular outcomes. Future studies are warranted to establish the long-term cardiovascular health effects of these findings in veteran endurance athletes.
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Williams NC, Killer SC, Svendsen IS, Jones AW. Immune nutrition and exercise: Narrative review and practical recommendations. Eur J Sport Sci 2018; 19:49-61. [PMID: 29975589 DOI: 10.1080/17461391.2018.1490458] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Evidence suggests that periods of heavy intense training can result in impaired immune cell function, and whether this leaves elite athletes at greater risk of infections and upper respiratory symptoms (URS) is still debated. There is some evidence that episodes of URS do cluster around important periods of competition and intense periods of training. Since reducing URS, primarily from an infectious origin, may have implications for performance, a large amount of research has focused on nutritional strategies to improve immune function at rest and in response to exercise. Although there is some convincing evidence that meeting requirements of high intakes in carbohydrate and protein and avoiding deficiencies in nutrients such as vitamin D and antioxidants is integral for optimal immune health, well-powered randomised controlled trials reporting improvements in URS beyond such intakes are lacking. Consequently, there is a need to first understand whether the nutritional practices adopted by elite athletes increases their risk of URS. Second, promising evidence in support of efficacy and mechanisms of immune-enhancing nutritional supplements (probiotics, bovine colostrum) on URS needs to be followed up with more randomised controlled trials in elite athletes with sufficient participant numbers and rigorous procedures with clinically relevant outcome measures of immunity.
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Affiliation(s)
- Neil C Williams
- a Exercise and Health Research Group, Department of Sport Science, School of Science and Technology , Nottingham Trent University , Nottingham , UK
| | - Sophie C Killer
- b British Athletics, English Institute of Sport, National Performance Institute, Loughborough University , Loughborough , UK
| | | | - Arwel Wyn Jones
- d Lincoln Institute for Health, University of Lincoln , Lincoln , UK
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Amorim S, Teixeira VH, Corredeira R, Cunha M, Maia B, Margalho P, Pires J. Creatine or vitamin D supplementation in individuals with a spinal cord injury undergoing resistance training: A double-blinded, randomized pilot trial. J Spinal Cord Med 2018; 41:471-478. [PMID: 28901216 PMCID: PMC6055973 DOI: 10.1080/10790268.2017.1372058] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
PURPOSE Determine whether creatine or vitamin D supplementation improves muscle strength in individuals with spinal cord injury undergoing resistance training. METHODS Thirteen male and one female with spinal cord injury, from two Portuguese rehabilitation centers, were randomized to creatine (3g daily), vitamin D (25000 IU each two weeks) or placebo group in a double-blind design. All participants performed progressive resistance training during eight weeks. The outcome measures, obtained at baseline and after intervention, included: Sum of four skinfolds; Corrected arm muscle area; Seated medicine ball throw; Handgrip strength with dynamometer; Manual wheelchair slalom test and one repetition maximum for Chest press, Triceps, Pec deck and Lat pulldown. Vitamin D levels were obtained in all participants before and after intervention. RESULTS 71.4% of participants had deficit values of vitamin D. The corrected arm muscle area improved significantly (p<0.05) in creatine group relatively to the control group. There was a significant correlation (p<0.05) between the one repetition maximum Pec deck and levels of vitamin D. CONCLUSIONS Supplementation with creatine may improve muscle strength parameters in individuals with spinal cord injury. Vitamin D deficiency is highly prevalent in this population. It is recommended an initial screening of vitamin D levels at the beginning of the physical rehabilitation process.
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Affiliation(s)
- Samuel Amorim
- Faculdade de Desporto da Universidade do Porto (Portugal),Correspondence to: Samuel Amorim, Rua Maria Feliciana, n°31, 1°B. 4465–280, São Mamede Infesta, Portugal.
| | - Vitor Hugo Teixeira
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto (Portugal),Centro de Investigação em Actividade Física, Saúde e Lazer - Faculdade de Desporto da Universidade do Porto (Portugal)
| | - Rui Corredeira
- Faculdade de Desporto da Universidade do Porto (Portugal)
| | - Maria Cunha
- Centro de Reabilitação do Norte - Dr. Ferreira Alves (Portugal)
| | - Bruno Maia
- Centro de Reabilitação do Norte - Dr. Ferreira Alves (Portugal)
| | - Paulo Margalho
- Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais (Portugal)
| | - Joana Pires
- Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais (Portugal)
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105
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Biesalski Hans K, Jana T. Micronutrients in the life cycle: Requirements and sufficient supply. NFS JOURNAL 2018. [DOI: 10.1016/j.nfs.2018.03.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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106
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Abstract
Vitamin D is known to be important for calcium homeostasis and bone metabolism. It also has important direct effects on skeletal muscle. Unlike authentic vitamins, which cannot be synthesized in the body, vitamin D is produced in the skin using sunlight. Through its nuclear receptor (ie, vitamin D receptor) located throughout the body, including skeletal muscle, vitamin D initiates genomic and nongenomic pathways regulating multiple actions, including myocyte proliferation and growth. In some studies, vitamin D supplementation has been shown to increase muscle strength, particularly in people who are vitamin D deficient. Higher serum levels of vitamin D are associated with reduced injury rates and improved sports performance. In a subset of the population, vitamin D appears to play a role in muscle strength, injury prevention, and sports performance.
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Orysiak J, Mazur-Rozycka J, Fitzgerald J, Starczewski M, Malczewska-Lenczowska J, Busko K. Vitamin D status and its relation to exercise performance and iron status in young ice hockey players. PLoS One 2018; 13:e0195284. [PMID: 29630669 PMCID: PMC5891016 DOI: 10.1371/journal.pone.0195284] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 03/19/2018] [Indexed: 12/20/2022] Open
Abstract
Objectives The aim was to examine the association between serum vitamin D concentration and isometric strength of various muscle groups, vertical jump performance, and repeated sprint ability in young ice hockey players. The secondary aim was to determine the association between vitamin D deficiency and indices of iron status. Methods Fifty male ice hockey players (17.2±0.9 years) participated in this cross-sectional study. Exercise performance was evaluated using isometric strength measures of upper and lower extremities, vertical jump performance and repeated sprint ability (RSA). Blood samples were collected for the determination of serum 25-hydroxyvitamin D (25(OH)D) and multiple indicies of iron status. Results The mean serum 25(OH)D concentration was 30.4 ng·ml-1 and ranged from 12.5 to 91.4 ng·ml-1. Eleven participants (22%) had vitamin D deficiency and 20 athletes (40%) had vitamin D insufficiency. Serum 25(OH)D concentration was not positively correlated with isometric muscle strength, vertical jump performance, or RSA after adjusting for age, training experience, fat mass, fat free mass and height. Serum 25(OH)D concentration was not associated with indices of iron status. Conclusion Vitamin D insufficiency is highly prevalent in ice hockey players, but 25(OH)D concentration but it is not associated with exercise performance or indices of iron status.
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Affiliation(s)
- Joanna Orysiak
- Department of Nutrition Physiology and Dietetics, Institute of Sport – National Research Institute, Warsaw, Poland
| | - Joanna Mazur-Rozycka
- Central Institute For Labour Protection – National Research Institute (CIOP- PIB), Department of Ergonomics, Warsaw, Poland
| | - John Fitzgerald
- Department of Kinesiology and Public Health Education, University of North Dakota, Grand Forks, North Dakota, United States of America
| | - Michal Starczewski
- Department of Physiology, Institute of Sport – National Research Institute, Warsaw, Poland
| | | | - Krzysztof Busko
- Department of Anatomy and Biomechanics, Kazimierz Wielki University, Bydgoszcz, Poland
- * E-mail:
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Abstract
There is no clear evidence that vitamin D effectively improves physical capacity in high-level athletes. The aim of this study was to confirm that vitamin D supplementation of soccer players during eight-week high-intensity training would have a significant effect on their aerobic capacity. The subjects were divided into two groups: the experimental one that was supplemented with vitamin D (SG, n = 20), and the placebo group (PG, n = 16), not supplemented with vitamin D. All the players were subjected to the same soccer training described as High-Intensity Interval Training (HIIT). The data of the vitamin D level, PWC170, lactate threshold (LT) were collected just before and after the intervention. A significant increase in vitamin D concentration (119%) was observed in the supplemented group, while the non-supplemented group showed a decrease of 8.4%. The studied subjects improved VO2max results by 20% in the SG, and by 13% in the PG. The improvement in velocity at the LT was similar in both groups. Results of this study show that vitamin D can have a positive, though moderate, effect on aerobic performance in players subjected to high-intensity training in the form of small-sided games for 8 weeks.
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109
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Blue MN, Trexler ET, Hirsch KR, Smith-Ryan AE. A profile of body composition, omega-3 and vitamin D in National Football League players. J Sports Med Phys Fitness 2018; 59:87-93. [PMID: 29498249 DOI: 10.23736/s0022-4707.18.08122-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Body composition (percent body fat [%BF]), omega-3 fatty acids, and vitamin D (VitD) status are important components of an athlete's individual physiological profile, as each measure has potential to influence performance, inflammation, and injury recovery. The purpose of this study was to characterize %BF, omega-3, and VitD in a subset of professional football athletes. Secondary analyses investigated changes in %BF, omega-3, and VitD, throughout a competitive season, and evaluated the relationship between physiological variables, race, and injury prevalence. METHODS Forty-two professional football players (age: 24.0±2.4 years; height: 186.8±5.9 cm; weight: 108.8±19.4 kg) volunteered to participate. A-mode ultrasonography measured %BF and the percentage of highly unsaturated fatty acid content comprised of omega-3s was determined by an omega-3 bloodspot test. VitD levels and injury prevalence were obtained from the team athletic trainer. RESULTS Omega-3 was moderately correlated with VitD (R=0.397, P=0.030). Throughout the season there was a significant decrease in omega-3 percentage (∆=-2.47±5.48%, P=0.030), no change in body composition (∆=0.26±1.97%, P=0.482) and a significant increase in VitD (∆=9.03±19.46 ng/mL, P=0.015). VitD was significantly higher in white athletes (48.00±13.73 ng/mL) than black athletes (27.09±9.28 ng/mL; P<0.001) and athletes of other races (23.33±4.73 ng/mL; P=0.004). CONCLUSIONS Throughout the season, %BF was maintained, VitD levels increased, and omega-3 decreased. White athletes had significantly higher VitD levels than athletes of all other races. There were no differences in the physiological variables between injury severity categories. The results from the current study provides support for the potential importance of VitD and omega-3 supplementation for professional football athletes.
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Affiliation(s)
- Malia N Blue
- Laboratory of Applied Physiology, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA.,Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
| | - Eric T Trexler
- Laboratory of Applied Physiology, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA.,Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
| | - Katie R Hirsch
- Laboratory of Applied Physiology, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Abbie E Smith-Ryan
- Laboratory of Applied Physiology, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA - .,Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
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Hightower JM, Dalessandri KM, Pope K, Hernández GT. Low 25-Hydroxyvitamin D and Myofascial Pain: Association of Cancer, Colon Polyps, and Tendon Rupture. J Am Coll Nutr 2017; 36:455-461. [DOI: 10.1080/07315724.2017.1320951] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | - Karl Pope
- University of California Berkeley, School of Public Health, Berkeley, California, USA
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Wardenaar F, Brinkmans N, Ceelen I, Van Rooij B, Mensink M, Witkamp R, De Vries J. Micronutrient Intakes in 553 Dutch Elite and Sub-Elite Athletes: Prevalence of Low and High Intakes in Users and Non-Users of Nutritional Supplements. Nutrients 2017; 9:nu9020142. [PMID: 28212284 PMCID: PMC5331573 DOI: 10.3390/nu9020142] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Revised: 01/23/2017] [Accepted: 02/09/2017] [Indexed: 11/21/2022] Open
Abstract
This study investigated whether athletes meet micronutrient recommendations and whether the adequacy of their intake is related to the use of dietary supplements, sport nutrition products or a combination. Micronutrient intakes of 553 Dutch (sub-) elite athletes were assessed using web-based 24-h dietary recalls with accompanying nutritional supplement questionnaires. In the majority of both users and non-users of dietary supplements, vitamin D intake was below the estimated average requirement (AR) if supplements were not included in the analysis. Including dietary supplements improved vitamin D intake, but still a part of the athletes, both men and women, reported an intake below the AR. Non-users of dietary supplements were particularly at risk for low intakes of vitamins B1, B2, B3 and vitamins A, C and selenium. Mean iron intake was reported below the AR in a substantial group of women, both users and non-users. The use of sport nutrition products contributed only slightly to micronutrient intake. A small prevalence of athletes using dietary supplements showed intakes of some micronutrients above the Upper Level. In conclusion, both users and non-users of nutritional supplements reported inadequate intake of micronutrients. For most micronutrients, use of nutritional supplements does not completely compensate for intakes below AR. Athletes should consider making better food choices and the daily use of a low-dosed multivitamin supplement.
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Affiliation(s)
- Floris Wardenaar
- HAN University of Applied Sciences, Sports and Exercise Studies, 6525 AJ Nijmegen, The Netherlands.
| | - Naomi Brinkmans
- HAN University of Applied Sciences, Sports and Exercise Studies, 6525 AJ Nijmegen, The Netherlands.
| | - Ingrid Ceelen
- HAN University of Applied Sciences, Sports and Exercise Studies, 6525 AJ Nijmegen, The Netherlands.
| | - Bo Van Rooij
- HAN University of Applied Sciences, Sports and Exercise Studies, 6525 AJ Nijmegen, The Netherlands.
| | - Marco Mensink
- Division of Human Nutrition, Wageningen University, 6700 EV Wageningen, The Netherlands.
| | - Renger Witkamp
- Division of Human Nutrition, Wageningen University, 6700 EV Wageningen, The Netherlands.
| | - Jeanne De Vries
- Division of Human Nutrition, Wageningen University, 6700 EV Wageningen, The Netherlands.
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Abstract
Shin pain is a common complaint in adolescent athletes. The term "shin splints" has historically been applied to these patients. Shin splints, more often than not, refers to a stress reaction of the tibia from overuse. Overuse injuries occur when repetitive microtrauma to the bone exceeds the biologic healing potential. Diagnosis is based on typical history and physical examination findings. Plain radiographs and advanced imaging are rarely necessary but can provide valuable prognostic information. Treatment consists of adequate rest and exercise modification. Time to return to sport depends on injury location and severity. Stress fractures have long-term implications on bone health, so modifiable risk factors should be addressed. It is important for primary care physicians to understand the significance of these injuries. [Pediatr Ann. 2017;46(1):e29-e32.].
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Vitamin D and Weight Cycling: Impact on Injury, Illness, and Inflammation in Collegiate Wrestlers. Nutrients 2016; 8:nu8120775. [PMID: 27916879 PMCID: PMC5188430 DOI: 10.3390/nu8120775] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 10/26/2016] [Accepted: 11/18/2016] [Indexed: 01/05/2023] Open
Abstract
This study explored the link between vitamin D status and frequency of skin infections, inflammation, and injury in college wrestlers during an academic year. Methods: Serum 25-hydroxyvitamin D (25(OH)D) (n = 19), plasma cytokine (TNF-α, IL-6, IL-10) (n = 18) concentrations, and body weight/composition were measured and injury/illness/skin infection data were collected in fall, winter, and spring. Results: In the fall, 74% of wrestlers had vitamin D concentrations <32 ng/mL which increased to 94% in winter and spring. Wrestlers lost an average of 3.4 ± 3.9 kg (p < 0.001) during the season with corresponding decreases in fat mass and increases in lean mass (p < 0.01). An inverse association between 25(OH)D concentrations and total body mass and body fat percentage was observed at all-time points (p < 0.01). Concentrations of cytokines were highly variable among individuals and did not change across time (p > 0.05). Correlations between vitamin D status, cytokines, or frequency of illness, injury, or skin infections were not observed. Conclusions: A high prevalence of vitamin D insufficiency (<32 ng/mL) and deficiency (<20 ng/mL) was observed in wrestlers and was associated with higher adiposity. It remains unclear if higher vitamin D status would reduce injury, illness, and skin infection risk.
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Abstract
CONTEXT The health of the skeletal system is important for athletes young and old. From the early benefits of exercise on bones to the importance of osteoporosis prevention and treatment, bone health affects the ability to be active throughout life. EVIDENCE ACQUISITION PubMed articles dating from 1986 to 2016 were used for the review. Relevant terms such as keywords and section titles of the article were searched and articles identified were reviewed for relevance to this article. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Levels 1 through 4 evidence included. RESULTS There is strong evidence that exercise benefits bone health at every age and is a critical factor in osteoporosis prevention and treatment. Vitamin D, calcium, and hormones play vital roles in ensuring optimal bone health. When there is an imbalance between exercise and nutrition, as seen in the female athlete triad, bone health is compromised and can lead to bone stress injuries and early osteoporosis. Both of these can lead to morbidity and lost time from training and competition. Thus, early recognition and appropriate treatment of the female athlete triad and other stress fracture risk factors are vital to preventing long-term bone health problems. CONCLUSION To optimize bone health, adequate nutrition, appropriate weightbearing exercise, strength training, and adequate calcium and vitamin D are necessary throughout life.
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115
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Vitamin D deficiency in individuals with a spinal cord injury: a literature review. Spinal Cord 2016; 55:428-434. [DOI: 10.1038/sc.2016.155] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 09/28/2016] [Accepted: 10/06/2016] [Indexed: 11/08/2022]
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Cialdella-Kam L, Kulpins D, Manore MM. Vegetarian, Gluten-Free, and Energy Restricted Diets in Female Athletes. Sports (Basel) 2016; 4:E50. [PMID: 29910298 PMCID: PMC5968895 DOI: 10.3390/sports4040050] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 10/02/2016] [Accepted: 10/08/2016] [Indexed: 12/15/2022] Open
Abstract
Female athletes who follow a diet that fails to meet energy and nutrient needs are at risk for musculoskeletal injuries, menstrual disturbances, and poor sports performance. Common nutritional concerns for the female athlete include low energy availability (EA) (i.e., energy intake from food remaining for metabolic processes after accounting for energy expended during exercise) and inadequate dietary intakes (i.e., not meeting sports nutrition guidelines) of carbohydrates, protein, essential fatty acids (EFAs), B-vitamins, calcium, iron, and vitamin D. Low EA and the associated nutrient deficiencies are more common in athletes who compete in weight-sensitive sports (i.e., aesthetic, gravitational, and weight category sports) because low body fat and mass confer a competitive advantage. Other athletes at risk for energy and nutrient deficits include athletes following a vegetarian or gluten-free diet (GFD). Careful dietary planning can help an athlete meet energy and nutrient needs. This review covers the nutrition issues associated with low EA and special diets (i.e., vegetarian and GFD) and describes strategies to help female athletes meet their energy and nutrient needs.
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Affiliation(s)
- Lynn Cialdella-Kam
- School of Medicine, Department of Nutrition, Case Western Reserve University, WG 48, 2109 Aldebert Rd., Cleveland, OH 44106-4954, USA.
| | - Danielle Kulpins
- School of Medicine, Department of Nutrition, Case Western Reserve University, WG 48, 2109 Aldebert Rd., Cleveland, OH 44106-4954, USA.
| | - Melinda M Manore
- School of Biological and Population Sciences, Nutrition and Exercise Science, Oregon State University, 103 Milam Hall, Corvallis, OR 97331, USA.
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Krzywanski J, Mikulski T, Krysztofiak H, Mlynczak M, Gaczynska E, Ziemba A. Seasonal Vitamin D Status in Polish Elite Athletes in Relation to Sun Exposure and Oral Supplementation. PLoS One 2016; 11:e0164395. [PMID: 27732653 PMCID: PMC5061377 DOI: 10.1371/journal.pone.0164395] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 09/23/2016] [Indexed: 11/19/2022] Open
Abstract
Vitamin D does not only influence the musculoskeletal health and mineral homeostasis but it also affects cardiovascular, endocrine, nervous, immune and mental functions, thus it is of considerable importance for both physically active people and elite athletes. However, vitamin D deficiency is common worldwide and results from inadequate endogenous skin synthesis (insufficient ultraviolet B exposure) and diet. To improve the vitamin D status elite athletes often travel to lower latitude during winter. The aim of the study was to evaluate the seasonal vitamin D status in Polish elite athletes according to the sun exposure and oral supplementation. Serum concentration of 25-hydroxyvitamin D (25(OH)D) was measured in the years 2010–2014 in 409 elite athletes, who were divided into the following groups: OUTD—outdoor sports, represented by track and field athletes, who trained in Poland; IND—weightlifters, handball and volleyball players who trained indoors in Poland; SUN—track and field athletes who trained during Polish winter in lower latitude with high sunshine exposure; SUPL—track and field athletes who trained in Poland, had an inadequate vitamin D status (25(OH)D < 30 ng/ml) and were supplemented orally. Inadequate Vitamin D status was observed in 80% of OUTD and 84% of IND athletes in winter, whereas in summer the values amounted to 42% and 83%, respectively. The athletes exposed to sun in winter had significantly higher vitamin D concentration than OUTD group. Oral supplementation improved vitamin D concentration by 45%, whereas winter sun exposure caused its increase by 85%. Except for a few summer months an inadequate status of vitamin D was found in the majority of Polish elite athletes, with the deficiency level being similar to the one observed in non-athletic population. The most serious deficiency was observed in indoor disciplines. Adequate vitamin D status can be achieved by both increased sun exposure, especially in winter, and oral supplementation. Athletes should therefore routinely assess their vitamin D status and be educated how to approach their sunlight exposure, diet and supplementation.
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Affiliation(s)
| | - Tomasz Mikulski
- Department of Applied Physiology, Mossakowski Medical Research Centre PAS, Warsaw, Poland
| | - Hubert Krysztofiak
- Department of Applied Physiology, Mossakowski Medical Research Centre PAS, Warsaw, Poland
- * E-mail:
| | - Marcel Mlynczak
- Warsaw University of Technology, Faculty of Mechatronics, Institute of Metrology and Biomedical Engineering, Warsaw, Poland
| | | | - Andrzej Ziemba
- Department of Applied Physiology, Mossakowski Medical Research Centre PAS, Warsaw, Poland
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Todd JJ, McSorley EM, Pourshahidi LK, Madigan SM, Crowe W, Laird EJ, Healy M, McNeilly A, Magee PJ. Oral spray wintertime vitamin D 3 supplementation has no impact on inflammation in Gaelic footballers. Scand J Med Sci Sports 2016; 27:1300-1307. [PMID: 27704631 DOI: 10.1111/sms.12785] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2016] [Indexed: 12/25/2022]
Abstract
Vitamin D inadequacy [total 25(OH)D <50 nmol/L] is widespread in athletes. The biologically active metabolite, 1,25-dihydroxyvitamin D, may be involved in regulating inflammation although in vitro findings have not been consistently replicated in human intervention trials. This study, conducted at a latitude of 55°N, aimed to assess inflammatory biomarkers in Gaelic footballers before and after a wintertime vitamin D3 intervention. Samples from a 12-week double-blind, randomized, placebo-controlled trial, in which 42 Gaelic footballers received 3000 IU (75 μg) vitamin D3 daily or placebo via oral spray solutions, were analysed for a range of inflammatory biomarkers. Cytokines (interleukin-8 and tumor necrosis factor-α), cathelicidin and high sensitivity C-reactive protein were quantified by multiplex assay, enzyme-linked immunosorbent assay and clinical biochemistry, respectively. White blood cell, lymphocyte, and neutrophil concentrations were determined by full blood profile. Data on total 25-hydroxyvitamin D, measured by LC-MS/MS, were available from the previous study. Vitamin D3 supplementation significantly increased mean total 25-hydroxyvitamin D concentrations from 47 to 84 nmol/L (P = 0.006); yet this had no effect on white blood cell count (P = 0.699), lymphocyte (P = 0.694), neutrophil (P = 0.594), interleukin-8 (P = 0.334), tumor necrosis factor-α (P = 0.587), cathelicidin (P = 0.745) or high sensitivity C-reactive protein concentration (P = 0.621) compared to placebo. 12-weeks vitamin D3 supplementation did not impact the immune profile of Gaelic footballers. This is likely because biomarkers were within their respective normal range or at a concentration similar to that of the general population at baseline. Future studies are encouraged to use inflammation as their primary outcome measure and recruit athletes at risk of compromised immunity.
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Affiliation(s)
- J J Todd
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland
| | - E M McSorley
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland
| | - L K Pourshahidi
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland
| | | | - W Crowe
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland
| | - E J Laird
- School of Biochemistry and Immunology, Trinity College, Dublin, Ireland
| | - M Healy
- Department of Biochemistry, Central Pathology Laboratory, St. James's Hospital, Dublin, Ireland
| | - A McNeilly
- Sport and Exercise Sciences Research Institute, University of Ulster, Jordanstown, Northern Ireland
| | - P J Magee
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland
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Effect of 12-Week Vitamin D Supplementation on 25[OH]D Status and Performance in Athletes with a Spinal Cord Injury. Nutrients 2016; 8:nu8100586. [PMID: 27669288 PMCID: PMC5083975 DOI: 10.3390/nu8100586] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 09/14/2016] [Accepted: 09/17/2016] [Indexed: 12/17/2022] Open
Abstract
(1) BACKGROUND: studies with able-bodied athletes showed that performance might possibly be influenced by vitamin D status. Vitamin D seems to have a direct impact on neuromuscular function by docking on vitamin D receptors in the muscle tissue. Additionally, a high prevalence of vitamin D deficiency was shown not only in infants and in the elderly but also in healthy adults and spinal cord injured individuals. Therefore, the aim of our study was to investigate whether a vitamin D dose of 6000 IU daily over 12 weeks would be sufficient to increase vitamin D status in indoor wheelchair athletes to a normal or optimal vitamin D level and whether vitamin D deficiency is associated with an impairment in muscle performance in these individuals; (2) METHODS: vitamin D status was assessed in indoor elite wheelchair athletes in order to have a baseline measurement. If vitamin D status was below 75 nmol/L, athletes were supplemented with 6000 IU of vitamin D daily over 12 weeks. A vitamin D status over 75 nmol/L was supplemented with a placebo supplement. Vitamin D status, as well as a Wingate test and an isokinetic dynamometer test, were performed at baseline and after six and 12 weeks; (3) RESULTS: 20 indoor elite wheelchair athletes participated in this double-blind study. All of these athletes showed an insufficient vitamin D status at baseline and were, therefore, supplemented with vitamin D. All athletes increased vitamin D status significantly over 12 weeks and reached an optimal level. Wingate performance was not significantly increased. Isokinetic dynamometer strength was significantly increased but only in the non-dominant arm in isometric and concentric elbow flexion; (4) CONCLUSION: a dose of 6000 IU of vitamin D daily over a duration of 12 weeks seems to be sufficient to increase vitamin D status to an optimal level in indoor wheelchair athletes. It remains unclear, whether upper body performance or muscle strength and vitamin D status are associated with each other.
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Brännström A, Yu JG, Jonsson P, Åkerfeldt T, Stridsberg M, Svensson M. Vitamin D in relation to bone health and muscle function in young female soccer players. Eur J Sport Sci 2016; 17:249-256. [PMID: 27633075 DOI: 10.1080/17461391.2016.1225823] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The present work investigated serum vitamin D (25(OH)D) status in relation to bone and muscle qualities and functions in 19 female soccer players (13-16 years) resident at northern latitude with very low sun exposure (∼32-36 h/month) during winter season (late January to early March). Serum 25(OH)D, parathyroid hormone and bone turnover markers osteocalcin (OC) and beta carboxy-terminal collagen cross-links (β-Ctx), as well as body composition and muscle performance were examined. Hormones were tested using routine laboratory methods. Fat mass, lean mass, and bone mineral density in whole body, as well as femur and lumbar spine were evaluated with dual-energy X-ray absorptiometry. Muscle performance was assessed through isokinetic knee extension and flexion, countermovement jump, and sprint running. 25(OH)D was low (50.5 ± 12.8 nmol l-1), whereas the values of bone turnover markers were markedly high (OC: 59.4 ± 18.6 µg l-1; β-Ctx: 1075 ± 408 ng l-1). All bone and muscle measurements were normal or above normal. 25(OH)D was not significantly correlated with most of the parameters of bone and muscle quality or function, except the knee extension time to peak torque (r = -0.50, p = .03). In conclusion, the level of vitamin D is markedly low in adolescent female soccer players during the winter in Sweden. However, vitamin D levels did not significantly correlate with measures of bone and muscle except a moderate correlation in time to peak torque in the knee extensors. The practical implication of low vitamin D levels in young growing female athletes remains unclear.
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Affiliation(s)
- André Brännström
- a Department of Community Medicine and Rehabilitation , Sports Medicine Unit, Umeå University , Umeå , Sweden
| | - Ji-Guo Yu
- a Department of Community Medicine and Rehabilitation , Sports Medicine Unit, Umeå University , Umeå , Sweden
| | - Per Jonsson
- b Department of Surgical and Perioperative Sciences, Division of Orthopaedics , Umeå University , Umeå , Sweden
| | - Torbjörn Åkerfeldt
- c Department of Medical Sciences , Section of Clinical Chemistry, Uppsala University , Uppsala , Sweden
| | - Mats Stridsberg
- c Department of Medical Sciences , Section of Clinical Chemistry, Uppsala University , Uppsala , Sweden
| | - Michael Svensson
- a Department of Community Medicine and Rehabilitation , Sports Medicine Unit, Umeå University , Umeå , Sweden
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Vitamin D Status and Supplementation Practices in Elite Irish Athletes: An Update from 2010/2011. Nutrients 2016; 8:nu8080485. [PMID: 27517954 PMCID: PMC4997398 DOI: 10.3390/nu8080485] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 08/03/2016] [Accepted: 08/03/2016] [Indexed: 12/29/2022] Open
Abstract
Vitamin D deficiency is a global health concern that is prevalent in Ireland. The vitamin D status of elite Irish athletes following implementation of a revised supplementation policy in 2010/2011 has not been explored to date. This study aimed to assess the vitamin D status of elite Irish athletes participating in high-profile sports and establish if equatorial travel, supplementation and/or sunbed use predict vitamin D status. Across Ireland, blood samples (n = 92) were obtained from cricketers (n = 28), boxers (n = 21) and women’s rugby sevens players (n = 43) between November 2013 and April 2015. Total 25-hydroxyvitamin D (25(OH)D) concentrations were quantified using LC-MS/MS. Parathyroid hormone and adjusted calcium concentrations were measured by clinical biochemistry. Athletes completed a questionnaire that queried equatorial travel, supplementation and sunbed use. Vitamin D sufficiency (25(OH)D >50 nmol/L) was evident in 86% of athletes. Insufficiency (31–49 nmol/L) and deficiency (<30 nmol/L) was present in only 12% and 2% of athletes respectively. On average, athletes from all sport disciplines were vitamin D sufficient and 25% reported vitamin D supplementation which was a significant positive predictor of vitamin D status, (OR 4.31; 95% CI 1.18–15.75; p = 0.027). Equatorial travel and sun bed use were reported in 47% and 16% of athletes respectively however these factors did not predict vitamin D status (both p > 0.05). Although different cohorts were assessed, the overall prevalence of vitamin D insufficiency/deficiency was 55% in 2010/2011 compared with only 14% in 2013/2015. Targeted supplementation is highly effective in optimising vitamin D status, negating the need for blanket-supplementation in elite cohorts.
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Backx EMP, Tieland M, Maase K, Kies AK, Mensink M, van Loon LJC, de Groot LCPGM. The impact of 1-year vitamin D supplementation on vitamin D status in athletes: a dose–response study. Eur J Clin Nutr 2016; 70:1009-14. [DOI: 10.1038/ejcn.2016.133] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 05/23/2016] [Accepted: 06/24/2016] [Indexed: 11/09/2022]
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Lawrence DW, Sharma B. A review of the neuroprotective role of vitamin D in traumatic brain injury with implications for supplementation post-concussion. Brain Inj 2016; 30:960-8. [DOI: 10.3109/02699052.2016.1147081] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Kanikarla-Marie P, Jain SK. 1,25(OH)2D3 inhibits oxidative stress and monocyte adhesion by mediating the upregulation of GCLC and GSH in endothelial cells treated with acetoacetate (ketosis). J Steroid Biochem Mol Biol 2016; 159:94-101. [PMID: 26949104 PMCID: PMC4825694 DOI: 10.1016/j.jsbmb.2016.03.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 02/29/2016] [Accepted: 03/01/2016] [Indexed: 01/10/2023]
Abstract
BACKGROUND There is a significantly higher incidence of cardiovascular disease (CVD) among type 1 diabetic (T1D) patients than among non-diabetic subjects. T1D is associated with hyperketonemia, a condition with elevated blood levels of ketones, in addition to hyperglycemia. The biochemical mechanism by which vitamin D (VD) may reduce the risk of CVD is not known. This study examines whether VD can be beneficial in reducing hyperketonemia (acetoacetate, AA) induced oxidative stress in endothelial cells. METHODS HUVEC were pretreated with 1,25(OH)2D3, and later exposed to the ketone body acetoacetate. RESULTS The increases in ROS production, ICAM-1 expression, MCP-1 secretion, and monocyte adhesion in HUVEC treated with AA were significantly reduced following treatment with 1,25(OH)2D3. Interestingly, an increase in glutathione (GSH) levels was also observed with 1,25(OH)2D3 in ketone treated cells. The effects of 1,25(OH)2D3 on GSH, ROS, and monocyte-endothelial adhesion were prevented in GCLC knockdown HUVEC. This suggests that 1,25(OH)2D3 inhibits ROS, MCP-1, ICAM-1, and adherence of monocytes mediated by the upregulation of GCLC and GSH. CONCLUSION This study provides evidence for the biochemical mechanism through which VD supplementation may reduce the excess monocyte adhesion to endothelium and inflammation associated with T1D.
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Affiliation(s)
- Preeti Kanikarla-Marie
- Departments of Pediatrics and Biochemistry & Molecular Biology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA
| | - Sushil K Jain
- Departments of Pediatrics and Biochemistry & Molecular Biology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA.
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Todd JJ, McSorley EM, Pourshahidi LK, Madigan SM, Laird E, Healy M, Magee PJ. Vitamin D 3 supplementation using an oral spray solution resolves deficiency but has no effect on VO 2 max in Gaelic footballers: results from a randomised, double-blind, placebo-controlled trial. Eur J Nutr 2016; 56:1577-1587. [PMID: 27015912 PMCID: PMC5486642 DOI: 10.1007/s00394-016-1202-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 03/07/2016] [Indexed: 12/18/2022]
Abstract
PURPOSE Vitamin D inadequacy is a global health concern in athletes as well as the general population. Whilst the role of vitamin D in skeletal health is well defined, there remains uncertainty over whether vitamin D supplementation has an added benefit beyond bone health. METHODS This randomised placebo-controlled trial in healthy male and female Gaelic footballers (n = 42) investigated the effect of vitamin D3 supplementation [3000 IU (75 µg) daily for 12 weeks, via an oral spray solution] on VO2 max which was the primary outcome measure. Secondary outcomes included skeletal muscle and lung function. RESULTS Supplementation significantly increased total 25-hydroxyvitamin D concentrations compared to the placebo group (mean ± SD change from baseline, 36.31 ± 32.34 vs. 6.11 ± 23.93 nmol/L, respectively; P = 0.006). At baseline, 50 and 22 % of footballers presented with vitamin D insufficiency (31-49 nmol/L) and deficiency (<30 nmol/L), respectively. Total 25-hydroxyvitamin D concentration did not significantly correlate with any measure of physical performance. Analysis of covariance (ANCOVA) models demonstrated that vitamin D supplementation over 12 weeks had no significant effect on VO2 max (P = 0.375), vertical jump height (P = 0.797), left and right handgrip strength (P = 0.146 and P = 0.266, respectively), forced vital capacity (P = 0.573) or forced expiratory volume at 1 s (P = 0.665), after adjusting for confounders. The high prevalence of vitamin D inadequacy observed in this cohort of collegiate Gaelic footballers supports the need for vitamin D supplementation during wintertime to avoid being at risk of poor bone health. CONCLUSIONS Twelve-week daily supplementation with 3000 IU (75 µg) vitamin D3 successfully resolved deficiency but did not have any significant effect on VO2 max, skeletal muscle or lung function.
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Affiliation(s)
- Joshua J Todd
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, UK
| | - Emeir M McSorley
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, UK
| | - L Kirsty Pourshahidi
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, UK
| | - Sharon M Madigan
- Irish Institute of Sport, Sports Campus Ireland, Abbotstown, Dublin 15, UK
| | - Eamon Laird
- Institute of Molecular Medicine, Trinity College, Dublin, UK
| | - Martin Healy
- Department of Medicine, Trinity Centre for Health Science St. James's Hospital, Dublin, UK
| | - Pamela J Magee
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, UK.
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Bakken A, Targett S, Bere T, Adamuz MC, Tol JL, Whiteley R, Wilson MG, Witvrouw E, Khan KM, Bahr R. Health conditions detected in a comprehensive periodic health evaluation of 558 professional football players. Br J Sports Med 2016; 50:1142-50. [PMID: 27012663 DOI: 10.1136/bjsports-2015-095829] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 01/02/2023]
Abstract
BACKGROUND Despite the widespread use of periodic health evaluation (PHE) to detect and prevent injury and illness in athletes, its effectiveness in detecting health conditions and relevant risk factors is still debated. AIM To assess health conditions detected by a comprehensive PHE in professional male football players and evaluate their consequences for participation clearance. METHODS A total of 558 professional football players in Qatar completed a PHE prior to the 2013 or 2014 seasons: history, general medical (including blood test), cardiovascular (12-lead ECG and echocardiography) and a musculoskeletal examination, including a specific test battery targeting lower extremity strength and flexibility. On the basis of the PHE, players were either cleared or not cleared for participation. RESULTS In 533 players (95.5%), at least one health condition was detected requiring treatment or follow-up. Vitamin D deficiency or insufficiency (≤30 ng/mL) was the most common medical condition (n=499, 89.4%), followed by hepatitis B non-immunity or infection (n=164, 29.4%). Cardiac screening identified 48 players (8.6%) with one or more abnormal findings (ECG (n=19, 3.4%) and echocardiography (n=14, 2.5%)). Musculoskeletal conditions were observed in 180 players (32.3%); injuries to or strength deficits of the hip/groin and thigh accounted for the largest proportion. Medical clearance was temporarily not given in 69 players (12.4%), while further examinations were being conducted. One player was disqualified from competitive football. CONCLUSIONS PHE revealed a high prevalence of health conditions requiring treatment or follow-up in professional footballers; however, only 12.4% of conditions impacted on final clearance for participation.
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Affiliation(s)
- Arnhild Bakken
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| | - Stephen Targett
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Tone Bere
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Department of Orthopaedics, Oslo University Hospital, Oslo, Norway
| | | | - Johannes L Tol
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar The Sports Physician Group, Department of Sports Medicine, St Lucas Andreas Hospital, Amsterdam, The Netherlands Amsterdam Center of Evidence Based Sports Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Rod Whiteley
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Mathew G Wilson
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK Research Institute of Sport and Exercise Sciences, University of Canberra, Australia
| | - Erik Witvrouw
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Karim M Khan
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Roald Bahr
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
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Flueck JL, Hartmann K, Strupler M, Perret C. Vitamin D deficiency in Swiss elite wheelchair athletes. Spinal Cord 2016; 54:991-995. [PMID: 26976532 DOI: 10.1038/sc.2016.33] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 01/15/2016] [Accepted: 02/12/2016] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN This is a retrospective analysis of total serum 25-hydroxyvitamin D (25[OH]D) in Swiss elite wheelchair athletes. OBJECTIVES The aim was to investigate the occurrence of vitamin D deficiency in Swiss elite wheelchair athletes over the whole year and to detect differences between winter and summer months, and between indoor and outdoor athletes. SETTING This study was conducted in Switzerland. METHODS A total of 164 blood samples from 72 Swiss elite wheelchair athletes (mean±s.d.: age 32±13 years) were analyzed for total serum 25[OH]D. All participants were members of the national team in their discipline. The following disciplines have been included: rugby, athletics, cycling, tennis, ski alpine, curling and basketball. According to general guidelines, insufficient vitamin D status was defined between 50 and 75 nmol l-1, deficiency below 50 nmol l-1 and severe deficiency below 27.5 nmol l-1. RESULTS In all, 73.2% of all samples showed an insufficiency/deficiency in vitamin D status. Total serum 25[OH]D was significantly higher during summer compared with winter months (69.5±21.4 nmol l-1 vs 51.5±21.9 nmol l-1; P<0.001). Indoor sports showed a higher amount of vitamin D insufficiency/deficiency (80.9%) than outdoor sports (70.1%), with a significantly higher 25[OH]D concentration in outdoor sports (P=0.042). CONCLUSION A high percentage of vitamin D deficiency was found among Swiss elite wheelchair athletes. Conclusively, we recommend supplementation with vitamin D-especially during winter-to prevent a deficiency and an impairment of performance.
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Affiliation(s)
- J L Flueck
- Institute of Sports Medicine, Swiss Paraplegic Centre Nottwil, Nottwil, Switzerland
| | - K Hartmann
- Institute of Sports Medicine, Swiss Paraplegic Centre Nottwil, Nottwil, Switzerland
| | - M Strupler
- Institute of Sports Medicine, Swiss Paraplegic Centre Nottwil, Nottwil, Switzerland
| | - C Perret
- Institute of Sports Medicine, Swiss Paraplegic Centre Nottwil, Nottwil, Switzerland
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Sprague S, Petrisor B, Scott T, Devji T, Phillips M, Spurr H, Bhandari M, Slobogean GP. What Is the Role of Vitamin D Supplementation in Acute Fracture Patients? A Systematic Review and Meta-Analysis of the Prevalence of Hypovitaminosis D and Supplementation Efficacy. J Orthop Trauma 2016; 30:53-63. [PMID: 26429406 DOI: 10.1097/bot.0000000000000455] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The objectives of this systematic review and meta-analyses are (1) to estimate the prevalence of hypovitaminosis D in fracture patients and (2) to summarize the available evidence on the efficacy of vitamin D supplementation in fracture patients. DATA SOURCES A comprehensive search of the MEDLINE, Embase, PubMed, and Cochrane Central Register of Controlled Trials databases was conducted. Conference abstracts from relevant meetings were also searched. STUDY SELECTION We included studies that investigate vitamin D insufficiency or examine the effect of vitamin D supplementation on 25-hydroxy-vitamin D (25(OH)D) serum levels in fracture patients. DATA EXTRACTION Two authors independently extracted data using a predesigned form. DATA SYNTHESIS We performed a pooled analysis to determine the prevalence of postfracture hypovitaminosis D and mean postfracture 25(OH)D levels. We present detailed summaries of each of the studies evaluating the impact of vitamin D supplementation. RESULTS The weighted pooled prevalence of hypovitaminosis D was 70.0% (95% confidence interval: 63.7%-76.0%, I = 97.7). The mean postfracture serum 25(OH)D was 19.5 ng/mL. The studies that evaluated the efficacy of vitamin D supplementation suggest that vitamin D supplementation safely increases serum 25(OH)D levels. Only 1 meeting abstract showed a trend toward reduced risk of nonunion after a single large loading dose of vitamin D. CONCLUSIONS This review found a high prevalence of hypovitaminosis D in fracture patients and that vitamin D supplementation at a range of doses safely increases 25(OH)D serum levels. To date, only 1 pilot study published as a meeting abstract has demonstrated a trend toward improved fracture healing with vitamin D supplementation. LEVEL OF EVIDENCE Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Sheila Sprague
- *Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada;†Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada;‡Graduate Entry Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland; and§Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD
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Cassity EP, Redzic M, Teager CR, Thomas DT. The effect of body composition and BMI on 25(OH)D response in vitamin D-supplemented athletes. Eur J Sport Sci 2015; 16:773-9. [PMID: 26698109 DOI: 10.1080/17461391.2015.1125952] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Fat mass is inversely associated with vitamin D status, and athletes with the most adipose tissue may have the greatest risk for insufficient (25(OH)D 20-32 ng mL(-1)) or deficient (25(OH)D < 20 ng ml(-1)) status. The effects of fat and lean mass on 25(OH)D change in response to vitamin D supplementation have yet to be elucidated in athletes. In addition, vitamin D has a known role in bone health yet a link between short-term changes in 25(OH)D and bone turnover in indoor athletes have not yet been described. Thirty-two collegiate swimmers and divers (19 male, 13 female; 19 (1) years) participated in a 6-month randomized controlled trial and consumed either 4000 IU d(-1) of vitamin D3 (n = 19) or placebo (PLA; n = 13). Anthropometry and blood collection of 25(OH)D, bone-specific alkaline phosphatase (B-ALP) and N-terminal telopeptide (NTx) occurred at three time points. Dual-energy X-ray absorptiometry measured body composition analysis at baseline and endpoint. In the vitamin D group, BMI was negatively correlated with 6-month 25(OH)D change (R = -0.496; P = .03) and a stronger predictor of 25(OH)D change (P = .04) than ultraviolet B exposure and fat mass change. Athletes in the high bone turnover group showed significantly greater losses of 25(OH)D over 6-months compared to athletes in the low bone turnover group (P = .03). These results suggest athletes within the normal BMI category experience a diminished response to 4000 IU d(-1) of vitamin D3 supplementation, and periods of high bone turnover may be an additional risk factor for developing compromised vitamin D status in athletes.
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Affiliation(s)
- Evan P Cassity
- a Division of Pulmonary, Critical Care and Sleep Medicine , University of Kentucky , Lexington , KY , USA
| | - Maja Redzic
- b Department of Pharmacology and Nutritional Sciences , University of Kentucky , Lexington , KY , USA
| | - Cassidy R Teager
- c College of Health Sciences , University of Kentucky , Lexington , KY , USA
| | - D Travis Thomas
- c College of Health Sciences , University of Kentucky , Lexington , KY , USA
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Parnell JA, Wiens K, Erdman KA. Evaluation of congruence among dietary supplement use and motivation for supplementation in young, Canadian athletes. J Int Soc Sports Nutr 2015; 12:49. [PMID: 26677351 PMCID: PMC4681054 DOI: 10.1186/s12970-015-0110-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 12/10/2015] [Indexed: 11/10/2022] Open
Abstract
Background Dietary supplement use is endemic in young athletes; however, it is unclear if their choices are congruent with their motivation for supplementation and the established benefits of the dietary supplements. The aim of this study was to evaluate the relationships between dietary supplement use and self-reported rationale in young athletes. Methods Canadian athletes (n = 567; 11–25 years; 76 % club or provincial level, 24 % national or higher) completed a questionnaire designed to assess supplementation patterns and motivation for supplementation. Chi square tests examined associations between dietary supplements and self-reported rationale for use. Results Vitamin and mineral supplements, including vitamin-enriched water, were associated with several health- and performance- related reasons (p < 0.001). Branched chain amino acids (BCAA) and glutamine were linked to improving diet and immune function (p < 0.01), but were more strongly associated with performance reasons, as were performance foods (protein powder, sport bars, sport gels, etc.). Plant extracts and fatty acids were primarily associated with health reasons, particularly immune support (p < 0.001). Conclusions Congruencies exist between performance rationales and supplementation for common ergogenic aids, however, less so for vitamin and mineral supplements, vitamin-enriched water, and plant extracts. Incongruences were found between fatty acids, protein supplements, vitamin and mineral supplements, vitamin-enriched water, and plant extracts and health motivators for supplementation. Educational interventions are essential to ensure young athletes are using dietary supplements safely and effectively.
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Affiliation(s)
- Jill A Parnell
- Department of Physical Education and Recreation Studies, Mount Royal University, 4825 Mount Royal Gate SW, Calgary, Alberta T3E 6K6 Canada
| | - Kristin Wiens
- Department of Behavioral Health and Nutrition, University of Delaware, 026 North College Avenue, Newark, Delaware 19716 USA
| | - Kelly Anne Erdman
- Sport Medicine Centre, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1N4 Canada
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Dahlquist DT, Dieter BP, Koehle MS. Plausible ergogenic effects of vitamin D on athletic performance and recovery. J Int Soc Sports Nutr 2015; 12:33. [PMID: 26288575 PMCID: PMC4539891 DOI: 10.1186/s12970-015-0093-8] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 08/09/2015] [Indexed: 01/06/2023] Open
Abstract
The purpose of this review is to examine vitamin D in the context of sport nutrition and its potential role in optimizing athletic performance. Vitamin D receptors (VDR) and vitamin D response elements (VDREs) are located in almost every tissue within the human body including skeletal muscle. The hormonally-active form of vitamin D, 1,25-dihydroxyvitamin D, has been shown to play critical roles in the human body and regulates over 900 gene variants. Based on the literature presented, it is plausible that vitamin D levels above the normal reference range (up to 100 nmol/L) might increase skeletal muscle function, decrease recovery time from training, increase both force and power production, and increase testosterone production, each of which could potentiate athletic performance. Therefore, maintaining higher levels of vitamin D could prove beneficial for athletic performance. Despite this situation, large portions of athletic populations are vitamin D deficient. Currently, the research is inconclusive with regards to the optimal intake of vitamin D, the specific forms of vitamin D one should ingest, and the distinct nutrient-nutrient interactions of vitamin D with vitamin K that affect arterial calcification and hypervitaminosis. Furthermore, it is possible that dosages exceeding the recommendations for vitamin D (i.e. dosages up to 4000-5000 IU/day), in combination with 50 to 1000 mcg/day of vitamin K1 and K2 could aid athletic performance. This review will investigate these topics, and specifically their relevance to athletic performance.
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Affiliation(s)
- Dylan T Dahlquist
- UBC Environmental Physiology Laboratory, School of Kinesiology, University of British Columbia, Vancouver, BC Canada
| | - Brad P Dieter
- Providence Medical Research Center, Providence Sacred Heart Medical Center and Children's Hospital, Research Discovery Lab, Spokane, WA 99204 USA
| | - Michael S Koehle
- Simon Fraser University, Biomedical Physiology and Kinesiology (BPK), 8888 University Drive - Burnaby, Vancouver, BC V5A 1S6 Canada
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