The effect of vitamin D supplementation on cardiorespiratory fitness and muscle strength in male adults undergoing basic military training

"Do probiotics mitigate GI-induced inflammation and perceived fatigue in athletes? A systematic review"

BACKGROUND

Fatigue and gastrointestinal (GI) distress are common among athletes with an estimated 30-90% of athletes participating in marathons, triathlons, or similar events experiencing GI complaints. Intense exercise can lead to increased intestinal permeability, potentially allowing members of the gut microbiota to permeate into the bloodstream, resulting in an inflammatory response and cascade of performance-limiting outcomes. Probiotics, through their capacity to regulate the composition of the gut microbiota, may act as an adjunctive therapy by enhancing GI and immune function while mitigating inflammatory responses. This review investigates the effectiveness of probiotic supplementation on fatigue, inflammatory markers, and exercise performance based on randomized controlled trials (RCTs).

METHODS

This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and PICOS (Population, Intervention, Comparison, Outcome, Study design) framework. A comprehensive search was conducted in Sportdiscus, PubMed, and Scopus databases, and the screening of titles, abstracts, and full articles was performed based on pre-defined eligibility criteria. Of the 3505 records identified, 1884 were screened using titles and abstracts, of which 450 studies were selected for full-text screening. After final screening, 13 studies met the eligibility criteria and were included for review. The studies contained 513 participants, consisting of 351 males and 115 females, however, two studies failed to mention the sex of the participants. Among the participants, 246 were defined as athletes, while the remaining participants were classified as recreationally active (n = 267). All trials were fully described and employed a double- or triple-blind placebo-controlled intervention using either a single probiotic strain or a multi-strain synbiotic (containing both pro- and pre-biotics).

RESULTS

This review assesses the effects of daily probiotic supplementation, ranging from 13 to 90 days, on physical performance and physiological markers in various exercise protocols. Ten studies reported improvements in various parameters, such as, enhanced endurance performance, improved anxiety and stress levels, decreased GI symptoms, and reduced upper respiratory tract infections (URTI). Moreover, despite no improvements in maximal oxygen uptake (VO2), several studies demonstrated that probiotic supplementation led to amelioration in lactate, creatine kinase (CK), and ammonia concentrations, suggesting beneficial effects on mitigating exercise-induced muscular stress and damage.

CONCLUSION

Probiotic supplementation, specifically at a minimum dosage of 15 billion CFUs daily for a duration of at least 28 days, may contribute to the reduction of perceived or actual fatigue.

Effects of vitamin D supplementation on muscle strength in middle-aged and elderly individuals: a retrospective, propensity score-matched study

Introduction

The aim of this study is to investigate the impact of vitamin D supplementation on the muscle strength of the elderly.

Methods

This retrospective, propensity score-matched study included 160 middle-aged and elderly individuals from a community in Beijing, China. The control group (n=110) received health education and lifestyle guidance, while the intervention group (n=50) was given oral vitamin D supplementation in addition to health education and lifestyle guidance. All participants underwent laboratory tests, muscle function, and physical function at baseline and follow-up.

Results

In the propensity score-matched cohort of 41 patients per group, the levels of serum calcium and 25-hydroxyvitamin D in both groups were improved significantly by the end of the study (p<0.05), with the intervention group showing a more significant improvement. The muscle strength of the left lower limb in the intervention group significantly increased after the intervention (p<0.05). The results also showed that the grip strength and pinch strength of the patients in both groups increased after the intervention, and the difference between the two groups was statistically significant (p<0.05).

Discussion

The findings of this study suggest that vitamin D supplementation, in conjunction with lifestyle guidance and health education, is beneficial for enhancing the upper and lower limb strength of patients.

Vitamin-D as a multifunctional molecule for overall well-being: An integrative review

Vitamin D is amongst the most important biomolecules to regularize and help in sustainable health, however, based on the studies, deficiency of this multifunctional vitamin is common. Vitamin D, besides playing a role in the form of vitamins, also acts as a multifunctional hormone (steroid). Vitamin D is synthesized inside the body through various steps starting from ultraviolet radiation exposure and comes from limited food sources, however, vitamin D-fortified food products are still among the major sources of vitamin D. Current review, focused on how vitamin D acts as a multifunctional molecule by effecting different functions in the body in normal or specific conditions and how it is important in fortification and how it can be managed from the available literature till date. During the Covid pandemic, people were aware of vitamin D and took supplementation, fortified foods, and sat under sunlight. As COVID prevalence decreases, people start forgetting about vitamin D. Vitamin D is very crucial for overall well-being as it has protective effects against a broad range of diseases as it can reduce inflammation, cancer cell growth and helps in controlling infection, increase metabolism, muscle, and bone strength, neurotransmitter expression, etc. Therefore, the present review is to provoke the population, and fulfillment of the vitamin D recommended dietary allowance daily must be confirmed.

High dose vitamin D supplementation decreases the risk of deficiency in male conscripts, but has no effect on physical performance-A randomized study

Purpose

Physical load during military training might increase the need for vitamin D; therefore, supplementation could be beneficial for 25(OH)D serum levels and physical performance.

Methods

One hundred and twelve male conscripts were randomized into two vitamin D oil capsule supplementation groups: 55 participants in the 600 IU group and 57 in the 4000 IU group with a follow-up period from July 2021 to May 2022. Physical fitness tests were performed in July, October and May. Hand grip strength tests were performed in July, October and January. Blood serum (25(OH)D), parathyroid hormone PTH), calcium and ionized calcium (i-Ca) values were measured in July, October, January and May.

Results

The 600 IU group had a lower (p < 0.001) value of 25(OH)D at all time points compared to the 4000 IU group, except at baseline. None of the subjects in the 600 IU group reached sufficient levels of 75 nmol/L of 25(OH)D in January and May. In May, 60% of participants in the 600 IU group and 30% in the 4000 IU group had 25(OH)D levels under 50 nmol/L. No significant differences in PTH or i-Ca values were found between the study groups at any time point. No significant differences at any time point were found in the physical fitness test or hand grip strength test between the groups.

Conclusion

A 10-month vitamin D supplementation with 4000 IU decreased the incidence of vitamin D deficiency (<75 nmol/L) in young, male army conscripts during wintertime, but no differences in physical performance were found compared to 600 IU supplementation.

Level of Evidence

Level I, Prospective randomized study.

Combined probiotics with vitamin D3 supplementation improved aerobic performance and gut microbiome composition in mixed martial arts athletes

Introduction

Mixed Martial Arts (MMA) is characterized as an interval sport in which the training program focuses on enhancing both aerobic and anaerobic capacities. Therefore, strategies targeting the intestinal microbiome may be beneficial for MMA athletes. Moreover, vitamin D supplementation may amplify the positive effects of certain bacterial strains. We previously demonstrated that the combined of probiotics and vitamin D3 supplementation improved the lactate utilization ratio, total work, and average power achieved during anaerobic tests in MMA. Therefore, this study aimed to investigate whether combined probiotic and vitamin D3 ingestion can modify the composition of the gut microbiome and epithelial cell permeability, influence the inflammatory response, and ultimately enhance aerobic capacity.

Methods

A 4-week clinical trial was conducted with 23 male MMA athletes randomly assigned to either the probiotic + vitamin D3 (PRO + VIT D) group or the vitamin D3 group (VIT D). The trial employed a double-blind, placebo-controlled design and involved measurements of serum inflammatory markers, gut microbiome composition, epithelial cell permeability, and aerobic performance.

Results

After 4-week of supplementation, we found a significantly lower concentration of calprotectin in the PRO + VIT D group (34.79 ± 24.38 mmol/L) compared to the value before (69.50 ± 46.91) supplementation (p = 0.030), augmentation of beta diversity after the intervention in the PRO + VIT D group (p = 0.0005) and an extended time to exhaustion to 559.00 ± 68.99; compared to the value before (496.30 ± 89.98; p = 0.023) after combined probiotic and vitamin D3 supplementation in MMA athletes. No effect was observed in the VIT D group.

Conclusion

Our results indicate that combined treatment of probiotics and vitamin D3 may cause alterations in alpha and beta diversity and the composition of the gut microbiota in MMA athletes. We observed an improvement in epithelial cell permeability and an extended time to exhaustion during exercise in MMA athletes following a 4-week combined probiotic and vitamin D3 treatment.

Severe deficiency of vitamin D has no negative effect on physical performance during military training

BACKGROUND

Decreased physical fitness and inferior physical performance are potentially life-threatening risk factors in a combat situation. To examine the effect of vitamin D on physical performance, a prospective study of young men conscripts in the Estonian Army was designed. The hypothesis of the study was that severe deficiency of vitamin D has a negative effect on physical performance.

METHODS

All conscripts (N.=410) entering 10-month military service in July 2015 at the Kuperjanov Battalion were asked to participate. Initially, a total of 98 conscripts volunteered to participate. A prospective longitudinal study with a 10-month follow-up period was performed. The Army Physical Fitness Test (APFT) was performed three times, and hand grip strength, and blood serum values of 25(OH)D, parathyroid hormone (PTH) and calcium (Ca) were measured four times.

RESULTS

A significant decrease in the levels of 25(OH)D compared with baseline values were found, with a lowest mean value of 31.9 nmol/L in March 2016 (P<0.001). No significant differences were found in serum Ca levels. In March 2016, PTH was significantly higher in the severe deficiency group (<25 nmol/L of 25(OH)D) (P=0.02). No significant differences were found in terms of the APFT or hand grip strength between conscripts with severe deficiency of 25(OH)D or values >25 nmol/L. The main finding of the present study was that severe 25(OH)D deficiency was common among male conscripts during the winter season but had no negative effect on physical performance in terms of the APFT test and hand grip strength test.

CONCLUSIONS

Severe vitamin D deficiency during the winter season is common but has no negative effect on physical performance in young, physically active men in military service.

Vitamin D Supplementation Has No Impact on Cardiorespiratory Fitness, but Improves Inflammatory Status in Vitamin D Deficient Young Men Engaged in Resistance Training

Data on the effect of vitamin D (Vit-D) supplementation on cardiorespiratory fitness (VO2max) are conflicting. A possible source of discrepancies in the literature is the heterogeneity in baseline Vit-D status among participants in previous studies. The main objectives of the present study were to assess the impact of Vit-D supplementation on VO2max and inflammatory status in Vit-D deficient young healthy men. Participants (n = 39, baseline serum Vit-D level < 50 nmol/L) were quasi-randomly assigned to one of the two groups, which, in a double-blind manner, supplemented their diet daily with either Vit-D (8000 IU; VD) or placebo (PLC) and concomitantly performed a 12-week supervised resistance training program. During the 12-week intervention, serum Vit-D concentrations increased 3.9-fold (p < 0.001) in the VD group while no changes occurred in the PLC group. Baseline VO2max did not differ in the two groups and remained unchanged during the intervention. Serum interleukin-10/tumour necrosis factor alpha ratio increased significantly (30%, p = 0.007; effect size 0.399) in VD but not in PLC group. In conclusion, 12-week Vit-D supplementation increases serum 25(OH)D levels and improves inflammatory status, but has no impact on VO2max in Vit-D deficient young men engaged in resistance training.

Lactobacillus plantarum PS128 Improves Physiological Adaptation and Performance in Triathletes through Gut Microbiota Modulation

A triathlon is an extremely high-intensity exercise and a challenge for physiological adaptation. A triathlete's microbiome might be modulated by diet, age, medical treatments, lifestyle, and exercise, thereby maintaining aerobiosis and optimum health and performance. Probiotics, prebiotics, and synbiotics have been reported to have health-promoting activities (e.g., immunoregulation and cancer prevention). However, few studies have addressed how probiotics affect the microbiota of athletes and how this translates into functional activities. In our previous study, we found that Lactobacillus plantarum PS128 could ameliorate inflammation and oxidative stress, with improved exercise performance. Thus, here we investigate how the microbiota of triathletes are altered by L. plantarum PS128 supplementation, not only for exercise performance but also for possible physiological adaptation. The triathletes were assigned to two groups: an L. plantarum 128 supplement group (LG, 3 × 10¹⁰ colony-forming units (CFU)/day) and a placebo group (PG). Both groups continued with their regular exercise training for the next 4 weeks. The endurance performance, body composition, biochemistries, blood cells, microbiota, and associated metabolites were further investigated. PS128 significantly increased the athletes' endurance, by about 130% as compared to the PG group, but there was no significant difference in maximal oxygen consumption (VO₂max) and composition between groups. The PS128 supplementation (LG) modulated the athlete's microbiota with both significant decreases (Anaerotruncus, Caproiciproducens, Coprobacillus, Desulfovibrio, Dielma, Family_XIII, Holdemania, and Oxalobacter) and increases (Akkermansia, Bifidobacterium, Butyricimonas, and Lactobacillus), and the LG showed lower diversity when compared to the PG. Also, the short-chain fatty acids (SCFAs; acetate, propionate, and butyrate) of the LG were significantly higher than the PG, which might be a result of a modulation of the associated microbiota. In conclusion, PS128 supplementation was associated with an improvement on endurance running performance through microbiota modulation and related metabolites, but not in maximal oxygen uptake.