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Lee KM, Gallucci AR, Forsse JS, Chapman-Lopez TJ, Torres R, de Souza LC, Heileson JL, Funderburk LK. The relationship between serum vitamin D, bone mineral density, and injury in collegiate acrobatics and tumbling athletes. Nutr Health 2024:2601060241292398. [PMID: 39469990 DOI: 10.1177/02601060241292398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/30/2024]
Abstract
Background: Medical staff for indoor aesthetic sports such as acrobatics and tumbling (A&T) is often concerned with athletes' bone mineral density (BMD), serum vitamin D (SvD), and associated injury risks. Aim: To evaluate the relationship between BMD, SvD, and injury among A&T athletes. Methods: 42 (19 tops, 23 bases) female A&T athletes aged 19.6 (±1.17) years participated. Two samples of SvD were taken. Injury and BMD data were provided by support staff. Bivariate and multivariate analysis assessed relationships between and among variables. Results: Participants experienced a decrease in SvD (6.093 ± 10.973). Spine BMD was significantly higher in bases compared to tops (p = 0.039). BMD and SvD did not differ based on injuries sustained. Conclusion: Relationships between SvD, BMD, and injury were not identified. Positional differences in BMD may be related to the demands of each role. Participants possessed low SvD and high BMDs, which may provide useful information for medical staff.
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Affiliation(s)
- Katherine M Lee
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX, USA
| | - Andrew R Gallucci
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX, USA
| | - Jeffrey S Forsse
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX, USA
| | - Tomas J Chapman-Lopez
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX, USA
| | - Ricardo Torres
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX, USA
| | | | - Jeffery L Heileson
- Nutrition Services Department, Walter Reed National Military Medical Center, Bethesda, MD, USA
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2
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Khatri S, Albright JA, Byrne RA, Quinn M, Zhu AS, Arcand PH, Daniels AH, Owens BD. Association of Vitamin D Deficiency With Distal Biceps Injury: A Retrospective Analysis of 336,320 Patients. Sports Health 2024:19417381241273453. [PMID: 39189103 DOI: 10.1177/19417381241273453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND This study explores the association between vitamin D deficiency and distal biceps tendon injuries, illustrating that, although vitamin D deficiency is associated with prolonged hospital stays and various musculoskeletal problems, its connection to distal biceps tendon injuries is unknown. HYPOTHESIS Vitamin D deficiency is associated with an elevated risk of distal biceps injury but not with increased rates of subsequent surgery or revision surgery. STUDY DESIGN Case-control study. LEVEL OF EVIDENCE Level 3. METHODS A 1:1 matched retrospective comparative study of 336,320 vitamin-D-deficient patients was performed using PearlDiver data (between January 1, 2011 and October 31, 2018). Cohorts, with a mean age of 55.7 ± 13.2 years, underwent multivariate logistic regression to calculate distal biceps tendon injury and surgical repair incidence according to age and sex, while controlling for demographics and comorbidities. RESULTS The 1-year incidence of distal biceps tendinopathy in vitamin-D-deficient patients was 118 per 100,000 person-years (95% CI) compared with 44.3 per 100,000 person-years in matched controls. Male patients with vitamin D deficiency were at a greater risk for distal biceps tendinopathy after 1 and 2 years (adjusted odds ratio [aOR] = 2.81, 2.08-3.83; aOR = 2.80, 2.21-3.56). Female patients were also at a greater risk after both years (aOR = 1.69, 1.27-2.27; aOR = 1.57, 1.26-1.96). Vitamin D deficiency was not associated with an elevated risk of surgical repair or revision surgery. CONCLUSION In a nationwide cohort, a diagnosis of vitamin D deficiency elevated the risk of distal biceps tendinopathy but did not raise the rate of surgical repair or revision. As a result, prevention strategies in the form of vitamin supplementation should be increased for athletes.Clinical Relevance: These findings emphasize the clinical relevance of monitoring vitamin D levels in patients at risk for musculoskeletal injuries, and providing adequate care to those involved in high-demand physical activities.Strength of Recommendation: B.
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Affiliation(s)
- Surya Khatri
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - J Alex Albright
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Rory A Byrne
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Matthew Quinn
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
- Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Angela S Zhu
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | | | - Alan H Daniels
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
- Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Brett D Owens
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
- Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island
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Shoemaker ME, Dicks ND, Northrup MJ, Daughters SW, Krings TN, Barry AM. Evaluation of Nutrition and Performance Parameters in Division 1 Collegiate Athletes. Nutrients 2024; 16:1896. [PMID: 38931251 PMCID: PMC11206669 DOI: 10.3390/nu16121896] [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: 05/21/2024] [Revised: 06/10/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Testing and evaluating athletes is necessary and should include performance, body composition, and nutrition. The purpose of this study was to report assessments of dietary intake, V˙O2max, and body composition in D1 collegiate athletes and examine relationships between these assessments. METHODS Dietary intake was assessed with 3-day recalls and compared to recommendations, and body composition was assessed via bioelectrical impedance analysis (BIA) (n = 48). V˙O2max was evaluated using a graded exercise test (GXT) with a verification bout (n = 35). Reliability between "true" V˙O2max and verification was determined. Correlations and regressions were performed. RESULTS Energy, carbohydrate, and micronutrient intake was lower than recommendations. Mean V˙O2max was 47.3 and 47.4 mL·kg-1·min-1 for GXT and verification, respectively. While correlations were apparent among dietary intake, V˙O2max, and body composition, percent fat-free mass (%FFM) predicted 36% of V˙O2max. CONCLUSIONS Collegiate athletes are not meeting energy and carbohydrate recommendations and exceed fat recommendations. Vitamin D and magnesium were low in all sports, and iron and calcium were low in females. V˙O2max ranged from 35.6 to 63.0 mL·kg-1·min-1, with females below average and males meeting typical values for their designated sport. Assessing D1 athletes can provide guidance for sports dietitians, coaches, and strength and conditioning specialists to track and monitor nutrition in athletes.
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Affiliation(s)
- Marni E. Shoemaker
- School of Health and Consumer Sciences, South Dakota State University, Brookings, SD 57007, USA; (M.J.N.); (S.W.D.); (T.N.K.); (A.M.B.)
| | - Nathan D. Dicks
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58102, USA;
| | - Megan J. Northrup
- School of Health and Consumer Sciences, South Dakota State University, Brookings, SD 57007, USA; (M.J.N.); (S.W.D.); (T.N.K.); (A.M.B.)
| | - Seth W. Daughters
- School of Health and Consumer Sciences, South Dakota State University, Brookings, SD 57007, USA; (M.J.N.); (S.W.D.); (T.N.K.); (A.M.B.)
| | - Taylor N. Krings
- School of Health and Consumer Sciences, South Dakota State University, Brookings, SD 57007, USA; (M.J.N.); (S.W.D.); (T.N.K.); (A.M.B.)
| | - Allison M. Barry
- School of Health and Consumer Sciences, South Dakota State University, Brookings, SD 57007, USA; (M.J.N.); (S.W.D.); (T.N.K.); (A.M.B.)
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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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5
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Influences of Vitamin D and Iron Status on Skeletal Muscle Health: A Narrative Review. Nutrients 2022; 14:nu14132717. [PMID: 35807896 PMCID: PMC9268405 DOI: 10.3390/nu14132717] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 12/02/2022] Open
Abstract
There is conflicting evidence of the roles vitamin D and iron have in isolation and combined in relation to muscle health. The purpose of this narrative review was to examine the current literature on the roles that vitamin D and iron have on skeletal muscle mass, strength, and function and how these nutrients are associated with skeletal muscle health in specific populations. Secondary purposes include exploring if low vitamin D and iron status are interrelated with skeletal muscle health and chronic inflammation and reviewing the influence of animal-source foods rich in these nutrients on health and performance. PubMed, Scopus, SPORT Discus, EMBAE, MEDLINE, and Google Scholar databases were searched to determine eligible studies. There was a positive effect of vitamin D on muscle mass, particularly in older adults. There was a positive effect of iron on aerobic and anaerobic performance. Studies reported mixed results for both vitamin D and iron on muscle strength and function. While vitamin D and iron deficiency commonly occur in combination, few studies examined effects on skeletal muscle health and inflammation. Isolated nutrients such as iron and vitamin D may have positive outcomes; however, nutrients within food sources may be most effective in improving skeletal muscle health.
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6
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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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7
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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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8
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Kunces LJ, Keenan J, Schmidt CM, Schmidt MA. Molecular Deficits Relevant to Concussion Are Prevalent in Top-Ranked Football Players Entering the National Football League Draft. J Strength Cond Res 2021; 35:3139-3144. [PMID: 34533486 DOI: 10.1519/jsc.0000000000004131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Kunces, LJ, Keenan, J, Schmidt, CM, and Schmidt, MA. Molecular deficits relevant to concussion are prevalent in top-ranked football players entering the National Football League draft. J Strength Cond Res XX(X): 000-000, 2021-Characterization of blood variants in athletes entering the highly competitive contact environment of professional football can help us understand the risk for brain injury. When coupled with longitudinal follow-up of future concussion incidence and trajectory, it may provide additional insight into factors that influence brain injury. We observed the metabolic phenotype of collegiate football players entering the 2016 National Football League (NFL) draft. The principal aims were to characterize the molecular status of individual athletes and quantify the prevalence of athletes with multiple concurrent molecular deficits. Blood was taken from 30 elite American collegiate football players 7 weeks before the NFL scouting combine and 15 weeks before entering the NFL draft. Average results revealed suboptimal values in Omega-3 Index (avg ± std, 4.66 ± 1.16%), arachidonic acid:eicosapentaenoic acid fatty acid ratio (29.13 ± 10.78), homocysteine (11.4 ± 3.4 µmol·L-1), vitamin D (30 ± 11.4 ng·ml-1), and red blood cell magnesium (4.1 ± 0.8 mg·dl-1). Using sport-optimized reference ranges from previously published research, 10% presented with 3, 40% presented with 4, and 50% of athletes presented with 5 suboptimal values at once. We conclude molecular deficits in this cohort entering the NFL draft were common, with a significant number of athletes presenting with multiple suboptimal levels. The significant commonality of the suboptimal biomarkers is relevance to brain health and function. This data warrant extensive metabolic phenotyping and consideration of prophylactic precision nutrition countermeasures by the multidisciplinary staff for athletes entering contact environments.
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Affiliation(s)
- Laura J Kunces
- Onegevity Health, New York, New York; Thorne HealthTech, Summerville, South Carolina; EXOS, Phoenix, Arizona; and Advanced Pattern Analysis & Countermeasures Group, Boulder, Colorado
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9
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Holtzman B, Ackerman KE. Recommendations and Nutritional Considerations for Female Athletes: Health and Performance. Sports Med 2021; 51:43-57. [PMID: 34515972 PMCID: PMC8566643 DOI: 10.1007/s40279-021-01508-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 11/29/2022]
Abstract
Optimal nutrition is an important aspect of an athlete’s preparation to achieve optimal health and performance. While general concepts about micro- and macronutrients and timing of food and fluids are addressed in sports science, rarely are the specific effects of women’s physiology on energy and fluid needs highly considered in research or clinical practice. Women differ from men not only in size, but in body composition and hormonal milieu, and also differ from one another. Their monthly hormonal cycles, with fluctuations in estrogen and progesterone, have varying effects on metabolism and fluid retention. Such cycles can change from month to month, can be suppressed with exogenous hormones, and may even be manipulated to capitalize on ideal timing for performance. But before such physiology can be manipulated, its relationship with nutrition and performance must be understood. This review will address general concepts regarding substrate metabolism in women versus men, common menstrual patterns of female athletes, nutrient and hydration needs during different phases of the menstrual cycle, and health and performance issues related to menstrual cycle disruption. We will discuss up-to-date recommendations for fueling female athletes, describe areas that require further exploration, and address methodological considerations to inform future work in this important area.
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Affiliation(s)
- Bryan Holtzman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Kathryn E Ackerman
- Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, MA, USA. .,Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
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10
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Paradoxical Relationships between Serum 25(OH)D and Ferritin with Body Composition and Burnout: Variation by Sex and Sports Team. ENDOCRINES 2021. [DOI: 10.3390/endocrines2030030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Adequate serum vitamin D and iron levels are thought to influence physical training adaptations and mood positively. The primary purpose of this prospective, observational study was to investigate relationships between serum 25-OH vitamin D/25(OH)D and serum ferritin levels with body composition and athlete burnout symptoms. Seventy-three collegiate athletes (female: n = 49; male: n = 24) from indoor (swimming, basketball) and outdoor (soccer, cross-country) sports were tested pre-season and post-season for serum 25(OH)D and serum ferritin (nutrient biomarkers) via venipuncture; body composition (total lean mass, bone mineral density/BMD, and % body fat) via dual energy X-ray absorptiometry (DXA) scans; and athlete burnout symptoms (post-season) via the athlete burnout questionnaire (ABQ). When male and female cohorts were combined, significant correlations (Pearson’s r) were noted between pre-season serum 25(OH)D versus the change (∆: post-season minus pre-season) in both BMD (r = −0.34; p = 0.0003) and % body fat (r = −0.28; p = 0.015). Serum ferritin ∆ was significantly associated with lean mass ∆ (r = −0.34; p = 0.003). For burnout symptoms, serum 25(OH)D ∆ significantly explained 20.6% of the variance for devaluation of the sport in the male cohort only. Across time, serum 25(OH)D levels decreased while serum ferritin levels increased, non-significantly, in both males and females. Relationships between nutrient biomarkers and body composition were opposite of physiological expectations.
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11
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Podsiadło S, Skiba A, Kałuża A, Ptaszek B, Stożek J, Skiba A, Marchewka A. Influence of Nordic Walking Training on Vitamin D Level in the Blood and Quality of Life among Women Aged 65-74. Healthcare (Basel) 2021; 9:healthcare9091146. [PMID: 34574920 PMCID: PMC8471811 DOI: 10.3390/healthcare9091146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction. Demographic forecasts indicate the progressive aging process of societies in all countries worldwide. The extension of life span may be accompanied by deterioration of its quality resulting from a decrease in physical activity, mental or even social performance, and a deficit in certain chemical compounds responsible for proper functioning of the body. Aim. The aim of the study was to evaluate the influence of a 12-week Nordic walking (NW) training intervention on the level of vitamin D in the blood and quality of life among women aged 65–74 years. Materials and methods. The study comprised 37 women aged 65–74 (x = 68.08, SD = 4.2). The subjects were randomly assigned to 2 groups: experimental group (NW), which consisted of 20 women who underwent an intervention in the form of Nordic walking training for 12 weeks, and the control group (C), including 17 women who underwent observation. In the experimental group, training sessions were held 3 times a week for 1 h. At that time, the C group was not subject to any intervention. The SF−36 questionnaire was used to measure quality of life. Vitamin D was assessed based on the results of biochemical blood tests. The analysed parameters were assessed twice-before and after the completed intervention or observation. Results. Comparison of the results regarding trials 1 and 2 allowed to note statistically significant improvement in quality of life for all health components and factors in the NW group. Analysis of vitamin D levels demonstrated a statistically significant increase in the NW group. In group C, no significant changes in the analysed parameters were observed. Conclusions. Regularly undertaking Nordic walking training significantly influences the improvement of self-evaluation regarding the components of physical and mental health, as well as the concentration of vitamin D in women aged 65–74 years.
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Affiliation(s)
- Szymon Podsiadło
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Kraków, Poland; (A.S.); (A.K.); (J.S.); (A.S.); (A.M.)
- Correspondence:
| | - Agnieszka Skiba
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Kraków, Poland; (A.S.); (A.K.); (J.S.); (A.S.); (A.M.)
| | - Anna Kałuża
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Kraków, Poland; (A.S.); (A.K.); (J.S.); (A.S.); (A.M.)
| | - Bartłomiej Ptaszek
- Institute of Applied Sciences, University of Physical Education in Krakow, 31-571 Kraków, Poland;
| | - Joanna Stożek
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Kraków, Poland; (A.S.); (A.K.); (J.S.); (A.S.); (A.M.)
| | - Amadeusz Skiba
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Kraków, Poland; (A.S.); (A.K.); (J.S.); (A.S.); (A.M.)
| | - Anna Marchewka
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Kraków, Poland; (A.S.); (A.K.); (J.S.); (A.S.); (A.M.)
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12
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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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13
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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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14
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Stress Fractures of the Fifth Metatarsal in Athletes. J Am Acad Orthop Surg 2021; 29:507-517. [PMID: 33826553 DOI: 10.5435/jaaos-d-20-01060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 03/04/2021] [Indexed: 02/01/2023] Open
Abstract
Stress fractures of the fifth metatarsal (zones 2 and 3) remain a challenging clinical problem. It has been well established that nonsurgical treatment has unacceptably high nonunion and refracture rates. Surgical fixation remains the treatment of choice in the athletic cohort, and intramedullary screw fixation with a solid screw has been established as the most predictable means of achieving a successful outcome. Recently, the use of a plantar plate has also been advocated as has been shown in some studies to be more biomechanically advantageous. The use of bone grafting at the primary surgery and morphology and screw type are also important decisions to be made when treating these patients. This review will discuss our management of both primary fractures and refractures of the fifth metatarsal in athletes.
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15
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Valtueña J, Aparicio-Ugarriza R, Medina D, Lizarraga A, Rodas G, González-Gross M, Drobnic F. Vitamin D Status in Spanish Elite Team Sport Players. Nutrients 2021; 13:nu13041311. [PMID: 33921150 PMCID: PMC8071574 DOI: 10.3390/nu13041311] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/09/2021] [Accepted: 04/14/2021] [Indexed: 11/16/2022] Open
Abstract
Low vitamin D is usual; however, data are limited for elite team players. The aim was to investigate the vitamin D levels in Football Club Barcelona (FCB) first division players of six sport modalities. Ninety-five elite male players (27.3 ± 4.6 y) belonging to FCB provided data for vitamin D throughout a season. In this study, 25(OH)D was measured in serum by chemiluminescent immunoassay. Outdoor/indoor training and supplementation were also considered. Total mean 25(OH)D concentrations were 91.9 ± 23.1 nmol/L in all players, with higher mean levels among supplemented players (94.7 ± 24.3 nmol/L). Around 25% of the team players were below optimal levels (<75 nmol/L), but none were below 50 nmol/L. Caucasian, supplemented football and handball players had the highest mean vitamin D concentrations over the whole year, whereas basketball players (indoor training) had the lowest ones. The highest rate of vitamin D insufficiency was found in spring (40%). A positive significant effect was observed for the interaction between indoor/outdoor training and supplementation with 25(OH)D concentrations (p < 0.05). Those team players training outdoors with supplementation had higher total vitamin D concentrations than those with indoors training and/or supplementation. A positive interaction of outdoor training with supplementation exists to determine 25(OH)D concentrations in team players.
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Affiliation(s)
- Jara Valtueña
- ImFine Research Group, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (J.V.); (R.A.-U.)
| | - Raquel Aparicio-Ugarriza
- ImFine Research Group, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (J.V.); (R.A.-U.)
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Daniel Medina
- Medical Services FC Barcelona, 08970 Barcelona, Spain; (D.M.); (A.L.); (G.R.); (F.D.)
| | - Antonia Lizarraga
- Medical Services FC Barcelona, 08970 Barcelona, Spain; (D.M.); (A.L.); (G.R.); (F.D.)
| | - Gil Rodas
- Medical Services FC Barcelona, 08970 Barcelona, Spain; (D.M.); (A.L.); (G.R.); (F.D.)
| | - Marcela González-Gross
- ImFine Research Group, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (J.V.); (R.A.-U.)
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-910677980
| | - Franchek Drobnic
- Medical Services FC Barcelona, 08970 Barcelona, Spain; (D.M.); (A.L.); (G.R.); (F.D.)
- GIRSANE-CAR (Centre d’Alt Rendiment Sant Cugat del Vallès), 08173 Sant Cugat del Vallès, Spain
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16
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Wilson-Barnes SL, Hunt JEA, Mendis J, Williams EL, King D, Roberts H, Lanham-New SA, Manders RJF. The relationship between vitamin D status, intake and exercise performance in UK University-level athletes and healthy inactive controls. PLoS One 2021; 16:e0249671. [PMID: 33798240 PMCID: PMC8018647 DOI: 10.1371/journal.pone.0249671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 03/23/2021] [Indexed: 12/18/2022] Open
Abstract
The potential ergogenic effects of vitamin D (vitD) in high performing athletes has received considerable attention in the literature and media. However, little is known about non-supplemented university athletes and students residing at a higher latitude. This study aimed to investigate the effects of vitD (biochemical status and dietary intake) on exercise performance in UK university athletes and sedentary students. A total of 34 athletes and 16 sedentary controls were studied during the spring and summer months. Serum vitD status and sunlight exposure were assessed using LC-MS/MS and dosimetry, respectively. Muscular strength of the upper and lower body was assessed using handgrip and knee extensor dynamometry (KE). Countermovement jump (CMJ) and aerobic fitness were measured using an Optojump and VO2max test, respectively. Statistical analysis was performed using paired/ independent t-tests, ANCOVA and Pearson/ Spearman correlations, depending on normality. VitD status increased significantly over the seasons, with athletes measuring higher status both in spring (51.7±20.5 vs. 37.2±18.9 nmol/L, p = 0.03) and summer (66.7±15.8 vs 55.6±18.8 nmol/L, p = 0.04) when compared to controls, respectively. Notably, 22% of the subjects recruited were vitD deficient during the spring term only (<25nmol/L, n 9). Subjects with 'insufficient' vitD status (<50nmol/L) elicited significantly lower CMJ when contrasted to the vitD 'sufficient' (>50nmol/l) group (p = 0.055) and a lower VO2 max (p = 0.05) in the spring and summer term (p = 0.05 and p = 0.01, respectively). However, an ANCOVA test showed no significant difference detected for either CMJ or VO2max following adjustments for co-variates. In conclusion, we provide novel information on the vitD status, dietary intake, physical fitness and sunlight exposure of UK young adults across two separate seasons, for which there is limited data at present.
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Affiliation(s)
- Saskia L. Wilson-Barnes
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Julie E. A. Hunt
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Jeewaka Mendis
- Surrey Clinical Research Centre, Surrey Clinical Trials Unit, NIHR Research Design Service SE, Guildford, Surrey, United Kingdom
| | - Emma L. Williams
- Division of Women’s, Children’s and Clinical Support, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - David King
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Harry Roberts
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Susan A. Lanham-New
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Ralph J. F. Manders
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom
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17
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Abstract
Proximal fifth metatarsal fractures are common in the athlete and can be a source of significant, temporary disability and missed playing time. The pattern of fracture can vary, and the type of fracture leads to a significantly different prognosis and treatment. Jones fractures of the fifth metatarsal are particularly common and difficult to treat in the athlete, can have recurrence and refracture, and require expertise to heal. Intramedullary screw fixation is currently the preferred method of fixation. Most other (non-Jones fractures and os vesalianum) proximal fifth metatarsal fractures can be treated successfully without surgery.
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Affiliation(s)
- David A Porter
- Methodist Sports Medicine/TOS, Department of Orthopedics, Indiana University, Purdue University, 201 Pennsylvania Parkway, Suite 100, Carmel, IN 46280, USA; Wabash College.
| | - Jeff Klott
- Department of Orthopedics, Indiana University, 46280, USA
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18
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Abstract
Vitamin D Deficiency in Sports Abstract. A deficiency in vitamin D is very common in the general population as well as in athletes. The aim of this overview is to assess the level of knowledge about the importance of vitamin D for athletes. A deficiency in vitamin D is present in up to 90 % of athletes. Risk groups are young athletes, female athletes, athletes with a limitation such as paraplegia, vegetarians, athletes with a resorption disorder such as celiac disease, athletes training and competing indoors (e.g. ice hockey, basketball, boxing, rhythmic gymnastics), and older athletes. Dark skin pigmentation, the use of sunscreen, the time of day of the training (early morning, late evening) and the geographical location influence the risk for a deficiency in vitamin D. Exposure to the sun and a balanced diet are often not enough to prevent a vitamin D deficiency.
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Affiliation(s)
- Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, St. Gallen
- Institut für Hausarztmedizin, Universität Zürich, Zürich
| | | | - Pantelis T Nikolaidis
- Exercise Physiology Laboratory, Nikaia, Griechenland
- School of Health and Caring Sciences, University of West Attica, Athen, Griechenland
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19
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Weber AE, Bolia IK, Korber S, Mayfield CK, Lindsay A, Rosen J, McMannes S, Romano R, Tibone JE, Gamradt SC. Five-Year Surveillance of Vitamin D Levels in NCAA Division I Football Players: Risk Factors for Failed Supplementation. Orthop J Sports Med 2021; 9:2325967120975100. [PMID: 33553450 PMCID: PMC7841681 DOI: 10.1177/2325967120975100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 07/29/2020] [Indexed: 12/31/2022] Open
Abstract
Background Monitoring vitamin D levels in athletes and determining their response to supplementation in cases of deficiency is thought to be necessary to modulate the risks associated with vitamin D deficiency. Hypothesis/Purpose To report the results of a 5-year-long surveillance program of vitamin D in the serum of football players on a National Collegiate Athletic Association (NCAA) Division I team and to examine whether factors including age, body mass index (BMI), race, position played, and supplement type would affect the response to 12-month oral vitamin D replacement therapy in athletes with deficiency. We hypothesized that yearly measurements would decrease the proportion of athletes with vitamin D insufficiency over the years and that the aforementioned factors would affect the response to the supplementation therapy. Study Design Cohort study; Level of evidence, 3. Methods We measured serum 25(OH)D levels (25-hydroxyvitamin D) in 272 NCAA Division I football players from our institution annually between 2012 and 2017. Athletes with insufficient vitamin D levels (<32 ng/mL) received supplementation with vitamin D3 alone or combined vitamin D3/D2. The percentage of insufficient cases between the first 2 years and last 2 years of the program was compared, and yearly team averages of vitamin D levels were calculated. Associations between player parameters (age, BMI, race, team position, supplement type) and failed supplementation were evaluated. Results The prevalence of vitamin D insufficiency decreased significantly during the study period, from 55.5% in 2012-2013 to 30.7% in 2016-2017 (P = .033). The mean 25(OH)D level in 2012 was 36.3 ng/mL, and this increased to 40.5 ng/mL in 2017 (P < .001); however, this increase was not steady over the study period. Non-Hispanic athletes and quarterbacks had the highest average 25(OH)D levels, and Black players and running backs had the lowest overall levels. There were no significant differences in age, BMI, race, or playing position between athletes with and without failed vitamin D supplementation. Athletes receiving vitamin D3 alone had a more successful rate of conversion (48.15%) than those receiving combined vitamin D3/D2 (22.22%; P = .034). Conclusion To decrease the prevalence of vitamin D deficiency in football players, serum vitamin D measurements should be performed at least once a year, and oral supplementation therapy should be provided in cases of deficiency. Black players might be at increased risk of vitamin D insufficiency. Oral vitamin D3 may be more effective in restoring vitamin D levels than combined vitamin D3/D2 therapy.
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Affiliation(s)
- Alexander E Weber
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, California, USA
| | - Ioanna K Bolia
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, California, USA
| | - Shane Korber
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, California, USA
| | - Cory K Mayfield
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, California, USA
| | - Adam Lindsay
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, California, USA
| | - Jared Rosen
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, California, USA
| | - Sean McMannes
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, California, USA
| | - Russ Romano
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, California, USA
| | - James E Tibone
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, California, USA
| | - Seth C Gamradt
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, California, USA
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20
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Ammerman BM, Ling D, Callahan LR, Hannafin JA, Goolsby MA. Prevalence of Vitamin D Insufficiency and Deficiency in Young, Female Patients With Lower Extremity Musculoskeletal Complaints. Sports Health 2020; 13:173-180. [PMID: 33301353 DOI: 10.1177/1941738120953414] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Low levels of vitamin D have well-known impacts on bone health, but vitamin D also has a more global role throughout many tissues, including skeletal muscle. The high prevalence of hypovitaminosis D and the vast physiological features of vitamin D have led researchers to examine the influence of vitamin D on physical performance and injury. Because of the critical role of vitamin D in maintaining musculoskeletal health and function, a high rate of hypovitaminosis D among female patients with a variety of musculoskeletal issues could be of high clinical relevance. HYPOTHESIS There is a high prevalence of low vitamin D in female patients with both acute and overuse sports-related issues of both soft tissue and bone. STUDY DESIGN Prospective cohort study. LEVEL OF EVIDENCE Level 3. METHODS Female patients, aged 16 to 40 years, presenting with lower extremity injury diagnosed within the past 4 weeks, no use of multivitamin or vitamin D supplement, and no history of malabsorption syndrome met the inclusion criteria. Vitamin D levels were assessed and categorized as normal (≥32 ng/mL) and low, which includes insufficient (20.01-31.9 ng/mL) and deficient (≤20 ng/mL). RESULTS Of the 105 patients enrolled, 65.7% had low vitamin D. Within the low vitamin D cohort, 40.6% were deficient and 59.4% were insufficient. Injuries were grouped into overuse or acute with 74 overuse injuries and 31 acute injuries, exhibiting low vitamin D prevalence of 60.8% and 77.4%, respectively. Patients with ligamentous/cartilaginous injuries exhibited the highest percentage of low vitamin D (76.5%), followed by those with patellofemoral-related complaints (71.0%), muscle/tendon injuries (54.6%), and bone stress injuries (45.5%). In univariable analysis, older age, non-White race, less physical activity, less high-intensity interval training days, less endurance training days, and more rest days showed an association with low vitamin D, but none showed an independent association in multivariable analysis. CONCLUSION The prevalence of low vitamin D in female patients with various musculoskeletal complaints was high. Clinicians should evaluate for low vitamin D in both acute and overuse injuries. CLINICAL RELEVANCE In addition to screening, this study suggests that clinicians should evaluate for low vitamin D levels beyond bone stress injuries in the setting of acute and overuse injuries.
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Affiliation(s)
| | - Daphne Ling
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York
| | - Lisa R Callahan
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York.,Women's Sports Medicine Center, Hospital for Special Surgery, New York, New York
| | - Jo A Hannafin
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York.,Women's Sports Medicine Center, Hospital for Special Surgery, New York, New York
| | - Marci A Goolsby
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York.,Women's Sports Medicine Center, Hospital for Special Surgery, New York, New York
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21
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Micronutrient deficiency in athletes and inefficiency of supplementation: Is low energy availability a culprit? PHARMANUTRITION 2020. [DOI: 10.1016/j.phanu.2020.100229] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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22
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Lawley R, Syrop IP, Fredericson M. Vitamin D for Improved Bone Health and Prevention of Stress Fractures: A Review of the Literature. Curr Sports Med Rep 2020; 19:202-208. [PMID: 32516190 DOI: 10.1249/jsr.0000000000000718] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Vitamin D is a vital nutrient and hormone needed for many essential functions in overall health. There is growing literature examining the role of vitamin D not only in the general population but also in athletes. The most predominantly studied area of vitamin D pertains to bone health. Recently, there has been increased investigation into the relationship of vitamin D and stress fractures, including genetic polymorphisms, levels of 25-hydroxyvitamin D, and bioavailable vitamin D. This review will address the most recent developments of vitamin D research and its important role in bone health in athletes.
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Affiliation(s)
| | - Isaac P Syrop
- Columbia University College of Physicians and Surgeons, New York, NY
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23
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Choi JT, Yoshida B, Jalali O, Hatch GF. Malnutrition in Orthopaedic Sports Medicine: A Review of the Current Literature. Sports Health 2020; 13:65-70. [PMID: 32639180 DOI: 10.1177/1941738120926168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
CONTEXT Malnutrition is well-studied in various aspects of the orthopaedic literature, most commonly in relation to arthroplasty, spine surgery, and trauma. However, the management of nutritional deficiencies is commonly overlooked among orthopaedic sports medicine providers. The purpose of this article is to analyze the available sports medicine literature to review the associations between malnutrition and the management of orthopaedic sports medicine patients from a treatment and performance standpoint. EVIDENCE ACQUISITION PubMed was searched for relevant articles published from 1979 to 2019. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 4. RESULTS Few studies exist on the implications of macronutrient deficiencies specific to orthopaedic sports medicine procedures. Interestingly, micronutrient disorders-namely, hypovitaminosis D and iron deficiency-have been well studied and may lead to worse postoperative outcomes, injury rates, and athletic performance. Nutritional supplementation to correct such deficiencies has been shown to mitigate these effects, though further study is required. CONCLUSION Nutritional deficiencies are highly prevalent in orthopaedic sports medicine patients, and practitioners should be aware of their potential effects on treatment and performance outcomes. Management of such deficiencies and their effect on surgical patients remain an area of potential future research. Future studies are warranted in order to explore the potential therapeutic role of nutritional supplementation to prevent complications after common orthopaedic sports medicine procedures, improve athletic performance, and reduce injury rates.
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Affiliation(s)
- Jihoon T Choi
- Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Brandon Yoshida
- Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Omid Jalali
- Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - George F Hatch
- Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California
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Fields JB, Gallo S, Worswick JM, Busteed DR, Jones MT. 25-Hydroxyvitamin D, Vitamin D Binding Protein, Bioavailable 25-Hydroxyvitamin D, and Body Composition in a Diverse Sample of Women Collegiate Indoor Athletes. J Funct Morphol Kinesiol 2020; 5:E32. [PMID: 33467248 PMCID: PMC7739241 DOI: 10.3390/jfmk5020032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 12/24/2022] Open
Abstract
Women athletes are at higher risk for bone diseases; yet, information on vitamin D status ((25(OH)D), vitamin D binding protein (VDBP), and bioavailable 25(OH)D is limited. Collegiate athletes (n = 36) from volleyball (WVB), basketball (WBB), and track and field (WTF) were measured for (25(OH)D), VDBP, and bioavailable 25(OH)D; body composition and bone mineral density (BMD); and skin pigmentation. Participants self-reported daily vitamin D intake and sun exposure. One-way analysis of variance analyzed mean differences in measures across sports. Linear regression examined relationships between 25(OH)D; VDBP; bioavailable 25(OH)D; and whole body, hip, and spine BMD. Participants' (mean ± SD, 19.4 ± 1.4 years, 172.75 ± 8.21 cm, 70.9 ± 13.2 kg, and 22.9 ± 4.1% body fat) overall mean 25(OH)D was 70.5 ± 32.25 nmol/L, and 28% of participants were deemed inadequate and 61% below thresholds identified as sufficient for athletes. Although WBB athletes consumed higher (p = 0.007) dietary vitamin D (760.9 ± 484.2 IU/d) than WVB (342.6 ± 257.8) and WTF (402.3 ± 376.4) athletes did, there were no differences across sport in serum 25(OH)D. WVB and WTF had higher bioavailable 25(OH)D than WBB. No relationships existed between vitamin D status and body composition. Vitamin D inadequacy was identified among 1/3 of women indoor sport athletes. Consistent monitoring of vitamin D status and diet are recommended to sustain athlete health and sport performance.
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Affiliation(s)
- Jennifer B. Fields
- Frank Pettrone Center for Sports Performance, George Mason University, Fairfax, VA 22030, USA; (J.B.F.); (S.G.); (D.R.B.)
- School of Kinesiology, George Mason University, Manassas, VA 20110, USA;
| | - Sina Gallo
- Frank Pettrone Center for Sports Performance, George Mason University, Fairfax, VA 22030, USA; (J.B.F.); (S.G.); (D.R.B.)
- Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA
| | - Jenna M. Worswick
- School of Kinesiology, George Mason University, Manassas, VA 20110, USA;
| | - Deanna R. Busteed
- Frank Pettrone Center for Sports Performance, George Mason University, Fairfax, VA 22030, USA; (J.B.F.); (S.G.); (D.R.B.)
| | - Margaret T. Jones
- Frank Pettrone Center for Sports Performance, George Mason University, Fairfax, VA 22030, USA; (J.B.F.); (S.G.); (D.R.B.)
- School of Kinesiology, George Mason University, Manassas, VA 20110, USA;
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Żebrowska A, Sadowska-Krępa E, Stanula A, Waśkiewicz Z, Łakomy O, Bezuglov E, Nikolaidis PT, Rosemann T, Knechtle B. The effect of vitamin D supplementation on serum total 25(OH) levels and biochemical markers of skeletal muscles in runners. J Int Soc Sports Nutr 2020; 17:18. [PMID: 32272973 PMCID: PMC7144051 DOI: 10.1186/s12970-020-00347-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 03/25/2020] [Indexed: 01/01/2023] Open
Abstract
Background The beneficial adaptation of skeletal muscle function to strenuous exercise is partially attributable to the improvement of vitamin D status. The present study aimed to evaluate the effects of a 3-week vitamin D supplementation on serum 25(OH)D levels and skeletal muscle biomarkers (i.e. troponin, myoglobin, creatine kinase and lactic dehydrogenase) of endurance runners. Methods A double-blind placebo-controlled study design was used and vitamin D supplementation was compared to a non-treatment control group. Twenty-four runners, competitors of the ultra-marathons held during the National Running Championships, were randomly assigned into two groups supplemented with the dose of 2000 IU vitamin D or placebo for three weeks. All subjects participated in three exercise protocols: (a) incremental exercise test (to determine the maximum oxygen uptake and the intensity of eccentric exercise), (b) eccentric exercise before and (c) after two dietary protocols. Venous blood samples were drawn at rest, immediately after the exercise and after 1 h and 24 h of recovery in order to estimate serum 25(OH)D levels, skeletal muscle biomarkers, proinflammatory cytokines and tumor necrosis factor-alpha (TNF-α) levels. A two-way ANOVA was used to test main effects and their interactions and Pearson correlation coefficients were analyzed to determine the effects of inter-variable relationships. Results Significant differences between pre- and post-intervention in baseline 25(OH)D levels were observed (34.9 ± 4.7 versus 40.3 ± 4.9 ng/ml, p = 0.02) in supplemented group. A higher post intervention 25(OH)D level was observed after vitamin D diet compared to placebo (40.3 ± 4.9 versus 31.8 ± 4.2 ng/mL, respectively; p < 0.05). The vitamin D supplementation decreased post-exercise (TN max) and 1 h post-exercise troponin (p = 0.004, p = 0.03, respectively), 1 h post-exercise myoglobin concentration (p = 0.01) and TNF-α levels(p < 0.03). 24 h post exercise creatine kinase activity was significantly lower in supplemented group compared to placebo (p < 0.05). A negative correlation was observed between post exercise 25(OH)D levels and myoglobin levels (r = − 0.57; p = 0.05), and 25(OH)D levels and TNFα (r = − 0.58; p = 0.05) in vitamin D supplemented group. Conclusions Three weeks of vitamin D supplementation had a positive effect on serum 25(OH)D levels in endurance trained runners and it caused a marked decrease in post-exercise biomarkers levels. We concluded that vitamin D supplementation might play an important role in prevention of skeletal muscle injuries following exercise with eccentric muscle contraction in athletes.
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Affiliation(s)
- Aleksandra Żebrowska
- Institute of Sport Sciences, Academy of Physical Education in Katowice, Mikołowska Street 72a, 40-065, Katowice, Poland
| | - Ewa Sadowska-Krępa
- Institute of Sport Sciences, Academy of Physical Education in Katowice, Mikołowska Street 72a, 40-065, Katowice, Poland
| | - Arkadiusz Stanula
- Institute of Sport Sciences, Academy of Physical Education in Katowice, Mikołowska Street 72a, 40-065, Katowice, Poland
| | - Zbigniew Waśkiewicz
- Institute of Sport Sciences, Academy of Physical Education in Katowice, Mikołowska Street 72a, 40-065, Katowice, Poland.,Department of Sport Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University (Sechenov University), 119435, Moscow, Russia
| | - Olga Łakomy
- Institute of Sport Sciences, Academy of Physical Education in Katowice, Mikołowska Street 72a, 40-065, Katowice, Poland
| | - Eduard Bezuglov
- Department of Sport Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University (Sechenov University), 119435, Moscow, Russia
| | | | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland. .,Medbase St. Gallen Am Vadianplatz, Vadianstrasse 26, 9001, St. Gallen, Switzerland.
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Sagayama H, Kondo E, Tanabe Y, Ohnishi T, Yamada Y, Takahashi H. Bone mineral density in male weight-classified athletes is higher than that in male endurance-athletes and non-athletes. Clin Nutr ESPEN 2020; 36:106-110. [DOI: 10.1016/j.clnesp.2020.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/27/2019] [Accepted: 01/13/2020] [Indexed: 01/26/2023]
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Wilson‐Barnes SL, Hunt JEA, Lanham‐New SA, Manders RJF. Effects of vitamin D on health outcomes and sporting performance: Implications for elite and recreational athletes. NUTR BULL 2020. [DOI: 10.1111/nbu.12413] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- S. L. Wilson‐Barnes
- Department of Nutritional Sciences Faculty of Health and Medical Sciences School of Biosciences and Medicine University of Surrey Guildford UK
| | - J. E. A. Hunt
- Department of Nutritional Sciences Faculty of Health and Medical Sciences School of Biosciences and Medicine University of Surrey Guildford UK
| | - S. A. Lanham‐New
- Department of Nutritional Sciences Faculty of Health and Medical Sciences School of Biosciences and Medicine University of Surrey Guildford UK
| | - R. J. F. Manders
- Department of Nutritional Sciences Faculty of Health and Medical Sciences School of Biosciences and Medicine University of Surrey Guildford UK
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Williams K, Askew C, Mazoue C, Guy J, Torres-McGehee TM, Jackson III JB. Vitamin D3 Supplementation and Stress Fractures in High-Risk Collegiate Athletes - A Pilot Study. Orthop Res Rev 2020; 12:9-17. [PMID: 32161507 PMCID: PMC7051810 DOI: 10.2147/orr.s233387] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 02/07/2020] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Vitamin D is paramount to bone health and little is known about vitamin D's role in the prevention of stress fractures in high-risk athletes. This study consists of a prospective, cross-sectional analysis accompanied by a retrospective review for control comparison of vitamin D3 supplementation in high-risk athletes. Our hypothesis is that supplemental vitamin D3 treatment will decrease the occurrence of stress fractures in high-risk collegiate athletes. MATERIALS AND METHODS A total of 118 NCAA Division I athletes were recruited from 6 high-risk collegiate teams. Blood draws in August and February established baseline 25(OH)D levels. Subjects with serum 25(OH)D <30 ng/mL were supplemented with 50,000 IU of vitamin D3/week for 8 weeks. Treated subjects were re-tested to ensure serum 25(OH)D levels rose to sufficient status. All enrolled subjects were monitored for the development of stress fractures. A 5-year retrospective chart review of athletes from the same sports teams was conducted to determine the incidence of any reported stress fractures in the past. RESULTS Prospective: 112 of the 118 enrolled subjects were tested in August. Sixty-one demonstrated vitamin D sufficiency (40.2 ng/mL ±8.28) and 51 were either insufficient or deficient (22.7 ng/mL ±4.89). Of the 118 enrolled subjects, 104 were tested in February. Fifty-six demonstrated vitamin D sufficiency (40.7 ng/mL ±9.47) and 48 were insufficient or deficient (21.6 ng/mL ±5.87). Two stress fractures were diagnosed amongst our cohort of 118 student athletes (1.69%). Retrospective: 34 stress fractures were diagnosed in 453 subjects from 01/2010-05/2015 (7.51%). Amongst our athletic teams, the cross-country team specifically demonstrated a statistically significant decrease in stress fracture incidence (p<0.05). We also found a statistically significant reduction in stress fracture incidence amongst the current overall cohort compared to our retrospective cohort (p<0.05). CONCLUSION In our population, almost half of the tested athletes proved to be vitamin D deficient. Hypovitaminosis D was prevalent throughout the winter months compared with the summer. With vitamin D3 supplementation, the stress fracture rate in our overall cohort demonstrated a statistically significant decrease from 7.51% to 1.65% (p=0.009).
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Affiliation(s)
- Kevin Williams
- University of South Carolina School of Medicine, Department of Orthopaedic Surgery, Columbia, SC, USA
| | - Christian Askew
- University of South Carolina School of Medicine, Department of Orthopaedic Surgery, Columbia, SC, USA
| | - Christopher Mazoue
- University of South Carolina School of Medicine, Department of Orthopaedic Surgery, Columbia, SC, USA
| | - Jeffrey Guy
- University of South Carolina School of Medicine, Department of Orthopaedic Surgery, Columbia, SC, USA
| | | | - J Benjamin Jackson III
- University of South Carolina School of Medicine, Department of Orthopaedic Surgery, Columbia, SC, USA
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Seasonal variation in vitamin D status, bone health and athletic performance in competitive university student athletes: a longitudinal study. J Nutr Sci 2020; 9:e8. [PMID: 32166023 PMCID: PMC7054308 DOI: 10.1017/jns.2020.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Vitamin D deficiency has been commonly reported in elite athletes, but the vitamin D status of UK university athletes in different training environments remains unknown. The present study aimed to determine any seasonal changes in vitamin D status among indoor and outdoor athletes, and whether there was any relationship between vitamin D status and indices of physical performance and bone health. A group of forty-seven university athletes (indoor n 22, outdoor n 25) were tested during autumn and spring for serum vitamin D status, bone health and physical performance parameters. Blood samples were analysed for serum 25-hydroxyvitamin D (s-25(OH)D) status. Peak isometric knee extensor torque using an isokinetic dynamometer and jump height was assessed using an Optojump. Aerobic capacity was estimated using the Yo-Yo intermittent recovery test. Peripheral quantitative computed tomography scans measured radial bone mineral density. Statistical analyses were performed using appropriate parametric/non-parametric testing depending on the normality of the data. s-25(OH)D significantly fell between autumn (52·8 (sd 22·0) nmol/l) and spring (31·0 (sd 16·5) nmol/l; P < 0·001). In spring, 34 % of participants were considered to be vitamin D deficient (<25 nmol/l) according to the revised 2016 UK guidelines. These data suggest that UK university athletes are at risk of vitamin D deficiency. Thus, further research is warranted to investigate the concomitant effects of low vitamin D status on health and performance outcomes in university athletes residing at northern latitudes.
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Fields JB, Payne DC, Gallo S, Busteed DR, Jones MT. Vitamin D Status Differs by Sex, Sport-Season, and Skin Pigmentation among Elite Collegiate Basketball Players. Sports (Basel) 2019; 7:sports7110239. [PMID: 31752086 PMCID: PMC6915602 DOI: 10.3390/sports7110239] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 10/26/2019] [Accepted: 11/08/2019] [Indexed: 12/29/2022] Open
Abstract
Vitamin D plays a key role in bone health, musculoskeletal function, and sport performance. Collegiate athletes competing in indoor sports may be at greater risk of vitamin D deficiency due to limited outdoor time. Therefore, the purpose was to assess 25-hydroxyvitamin D (25(OH)D) concentrations among collegiate men and women basketball (MBB, WBB) athletes. National Collegiate Athletic Association Division I men (MBB, n = 11) and women (WBB, n = 9) were tested during the off-season (T1; July) and pre-season (T2; October). Measurements included serum 25(OH)D; skin pigmentation, bone mineral density, and daily sun exposure (self-reported). Paired t-tests determined changes in 25(OH)D by sport-season and sex. Pearson correlations examined relationships between outcome variables. MBB athletes (mean ± SD; 19.6 ± 1.3 years) showed a reduction in 25(OH)D (T1: 64.53 nmol·L−1 ± 11.96) (T2: 56.11 nmol·L−1 ± 7.90) (p = 0.001). WBB (20.1 ± 1.1 years) had no change in 25(OH)D (T1: 99.07 nmol·L−1 ± 49.94. T2: 97.56 nmol·L−1 ± 36.47, p = 0.848). A positive association between 25(OH)D and skin pigmentation was observed (r = 0.47, p = 0.038). 25(OH)D was inversely correlated with lean body mass (LBM), body mass (BM), and bone mineral density (BMD), while a positive association was seen between 25(OH)D and skin pigmentation. In summary, 25(OH)D insufficiency was prevalent amongst male collegiate basketball athletes, with 25(OH)D levels being lower in the pre-season (October) than the off-season (July). Furthermore, darker skin pigmentation significantly correlated with 25(OH)D, indicating that individuals with darker skin tones may be at a greater risk of insufficiency/deficiency. More research is needed to examine the relationships between 25(OH)D and bone health in athletes.
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Affiliation(s)
- Jennifer B. Fields
- Frank Pettrone Center for Sports Performance, George Mason University, Fairfax, VA 22030, USA
- School of Kinesiology, George Mason University, Manassas, VA 20110, USA
| | - Daniel C. Payne
- School of Kinesiology, George Mason University, Manassas, VA 20110, USA
| | - Sina Gallo
- Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA
| | - Deanna R. Busteed
- Frank Pettrone Center for Sports Performance, George Mason University, Fairfax, VA 22030, USA
| | - Margaret T. Jones
- Frank Pettrone Center for Sports Performance, George Mason University, Fairfax, VA 22030, USA
- School of Kinesiology, George Mason University, Manassas, VA 20110, USA
- Correspondence:
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Rockwell M, Hulver M, Eugene E. Vitamin D Practice Patterns in National Collegiate Athletic Association Division I Collegiate Athletics Programs. J Athl Train 2019; 55:65-70. [PMID: 31729892 DOI: 10.4085/1062-6050-21-19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
CONTEXT Vitamin D status has been associated with performance, health, and well-being in athletic populations. The measurement of vitamin D status via 25-hydroxyvitamin D [25(OH)D] testing has increased in the general population, as has vitamin D supplement use. It is unclear if similar patterns exist in collegiate athletics programs. OBJECTIVE To describe the clinical care related to the prevention, evaluation, and treatment of vitamin D deficiency and insufficiency used by sports medicine providers with National Collegiate Athletic Association (NCAA) Division I programs. DESIGN Cross-sectional study. SETTING Population-based online survey. PATIENTS OR OTHER PARTICIPANTS All NCAA Division I head athletic trainers. MAIN OUTCOME MEASURE(S) Information related to 25(OH)D testing, vitamin D supplementation, vitamin D-related protocols and procedures, and characteristics of athletic programs and participants. RESULTS We received 249 responses (72% response rate). Use of 25(OH)D testing was described by 68% of participants, with the most common indicators being health status/history (78%) and injury status/history (74%). One-fifth of participants stated that vitamin D testing was conducted as screening (without a specific cause or indication). Target blood vitamin D concentrations were highly variable. A range of 8 to 1660 annual vitamin D blood tests was reported at a cost of <$50 (8%), $51 to $100 (51%), $101 to $150 (20%), and >$150 (10%). Forty-two percent of programs covered the cost of vitamin D supplements. More than half of the participants indicated that vitamin D blood testing and supplements were not a good use of program funds. In comparison with Football Championship Subdivision programs, Football Bowl Subdivision programs were more likely to conduct vitamin D testing and pay for vitamin D supplements, and their providers were more likely to believe that testing and supplements were a good use of program funds. CONCLUSIONS A great deal of variability was present in vitamin D-related clinical practices among NCAA Division I athletics programs, which reflects existing contradictions and uncertainty in research, recommendations, and guidelines. Knowledge of current practice patterns is important in evaluating and establishing best practices, policies, and procedures for sports medicine and sports nutrition professionals in the collegiate setting.
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Affiliation(s)
- Michelle Rockwell
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg.,Center for Transformative Research on Health Behaviors, Virginia Tech Fralin Biomedical Research Institute, Roanoke
| | - Matthew Hulver
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg.,Center for Transformative Research on Health Behaviors, Virginia Tech Fralin Biomedical Research Institute, Roanoke
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Moon AS, Boudreau S, Mussell E, He JK, Brabston EW, Ponce BA, Momaya AM. Current concepts in vitamin D and orthopaedic surgery. Orthop Traumatol Surg Res 2019; 105:375-382. [PMID: 30858042 DOI: 10.1016/j.otsr.2018.12.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 12/07/2018] [Accepted: 12/19/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Vitamin D plays an important role in the musculoskeletal system of the human body. Here, we review the most current literature on vitamin D as it relates to orthopaedic surgery and the musculoskeletal system, focusing largely on non-fracture applications. MATERIALS AND METHODS A literature review was performed on the basic science of vitamin D metabolism, epidemiology of vitamin D levels, role of vitamin D within the musculoskeletal system, and the correlation of vitamin D with injuries and orthopaedic surgical outcomes. RESULTS The existing literature suggests vitamin D plays multiple roles in the musculoskeletal system. Recent research has shed light on the importance of vitamin D in the setting of soft tissue healing and recovery in addition to affecting postoperative outcomes after common orthopaedic procedures. CONCLUSIONS Given the widespread prevalence of vitamin D deficiency, orthopaedic surgeons should be aware of the current evidence regarding clinical implications in patients with musculoskeletal complaints.
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Affiliation(s)
- Andrew S Moon
- Tufts University School of Medicine, Boston, MA, USA; Department of Orthopaedics, The University of Alabama at Birmingham, 951 18th St. S, 35205 Birmingham, AL, USA
| | - Sellers Boudreau
- Department of Orthopaedics, The University of Alabama at Birmingham, 951 18th St. S, 35205 Birmingham, AL, USA
| | - Eric Mussell
- Department of Orthopaedics, The University of Alabama at Birmingham, 951 18th St. S, 35205 Birmingham, AL, USA
| | - Jun Kit He
- Department of Orthopaedics, The University of Alabama at Birmingham, 951 18th St. S, 35205 Birmingham, AL, USA.
| | - Eugene W Brabston
- Department of Orthopaedics, The University of Alabama at Birmingham, 951 18th St. S, 35205 Birmingham, AL, USA
| | - Brent A Ponce
- Department of Orthopaedics, The University of Alabama at Birmingham, 951 18th St. S, 35205 Birmingham, AL, USA
| | - Amit M Momaya
- Department of Orthopaedics, The University of Alabama at Birmingham, 951 18th St. S, 35205 Birmingham, AL, USA
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Aydın CG, Dinçel YM, Arıkan Y, Taş SK, Deniz S. The effects of indoor and outdoor sports participation and seasonal changes on vitamin D levels in athletes. SAGE Open Med 2019; 7:2050312119837480. [PMID: 30886717 PMCID: PMC6415475 DOI: 10.1177/2050312119837480] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 02/21/2019] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Nowadays, people tend to spend more time in the closed areas and benefit less from sunlight. In this study, we examined the results of vitamin D measurements of athletes from different disciplines in different months and aimed to determine if the synthesis of vitamin D decreases or not according to exercise environment and month. METHODS The study was conducted in participants aged 5-52 years. A total of 555 elite-level sportsmen who were admitted to our Sports Medicine Clinic in the study participated in this study. Indoor and outdoor environmental and seasonal effects on the measurements in different months were statistically evaluated. Independent-samples test and definitive statistics were used for statistical analyses and a p-value less than 0.05 has been considered significant. RESULTS The study group consisted of 229 male and 326 female athletes. The serum 25-hydroxyvitamin D concentration was observed; 120 (21.6%) athletes have severe serum vitamin D deficiency (<11-20 ng/mL). Vitamin D levels were not significantly different from outdoor athletes (393; 70.8%). Winter measurements of vitamin D levels were significantly lower than those measured in autumn (p = 0.000). CONCLUSION Increasing vitamin D levels are very important especially in participating athletes and additional supplements are recommended whenever necessary. Gender and indoor/outdoor sports participation showed no statistically significant outcomes on vitamin D levels. However, winter season had a negative effect on vitamin D levels. Therefore, adequate precautions should be taken to increase vitamin D, especially during winter, to maintain the best performance of the athletes.
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Affiliation(s)
- Canan Gönen Aydın
- Department of Sports Medicine, Baltalimani Metin Sabanci Bone and Joint Diseases Education and Research Hospital, Istanbul, Turkey
| | - Yaşar Mahsut Dinçel
- Department of Orthopaedic and Traumatology, Baltalimani Metin Sabanci Bone and Joint Diseases Education and Research Hospital, Istanbul, Turkey
| | - Yavuz Arıkan
- Department of Orthopaedic and Traumatology, Baltalimani Metin Sabanci Bone and Joint Diseases Education and Research Hospital, Istanbul, Turkey
| | - Süleyman Kasım Taş
- Department of Orthopaedic and Traumatology, Baltalimani Metin Sabanci Bone and Joint Diseases Education and Research Hospital, Istanbul, Turkey
| | - Serdar Deniz
- Malatya Public Health Directorate, Malatya, Turkey
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Sikora-Klak J, Narvy SJ, Yang J, Makhni E, Kharrazi FD, Mehran N. The Effect of Abnormal Vitamin D Levels in Athletes. Perm J 2019; 22:17-216. [PMID: 30005732 DOI: 10.7812/tpp/17-216] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Vitamin D is a lipophilic prohormone integral to musculoskeletal, autoimmune, oncologic, cardiovascular, and mental health. Of particular importance to the orthopedic surgeon is the role of vitamin D in the regulation of bone mass, muscle strength, and physical performance. Although vitamin D-related skeletal pathologies are rare in industrialized nations, emerging research in the field has shown that most American adults have inadequate levels of vitamin D. Even among athletes, there is a high prevalence of vitamin D deficiency, which may place competitors at risk of stress fractures, illness, and delayed muscle recovery. Adequately identifying vitamin D-deficient individuals in need of supplementation is important to help optimize performance and prevent future injury. The goal of this review is to describe the epidemiology of vitamin D deficiency and its effects on athletic performance and musculoskeletal health. Future double-blinded studies of vitamin D supplementation in athletes are needed. We recommend treating athletes who have insufficient or deficient vitamin D levels.
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Affiliation(s)
- Jakub Sikora-Klak
- Orthopedist for the University of California, San Diego Health System.
| | - Steven J Narvy
- Orthopedist at the Providence Little Company of Mary Medical Center in Torrance, CA.
| | - Justin Yang
- Orthopedist at the Sunset Medical Center in Los Angeles, CA.
| | - Eric Makhni
- Orthopedist at the Kerlan-Jobe Orthopaedic Clinic in Los Angeles, CA.
| | | | - Nima Mehran
- Orthopedist at the Sunset Medical Center in Los Angeles, CA.
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Jerome SP, Sticka KD, Schnurr TM, Mangum SJ, Reynolds AJ, Dunlap KL. 25(OH)D levels in trained versus sedentary university students at 64° north. Int J Circumpolar Health 2018; 76:1314414. [PMID: 28452288 PMCID: PMC5497540 DOI: 10.1080/22423982.2017.1314414] [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] [Indexed: 02/04/2023] Open
Abstract
PURPOSE 25-hydroxyvitamin D (25[OH]D) deficiency is associated with compromised bone mineralisation, fatigue, suppressed immune function and unsatisfactory skeletal muscle recovery. We investigated the risk of 25(OH)D insufficiency or deficiency in endurance athletes compared to sedentary non-athletes living at 64° north. METHODS University student-athletes (TS) and sedentary students (SS) volunteered to participate in this study. TS engaged in regular exercise while SS exercised no more than 20 minutes/week. Metabolic Equivalent of Task (MET) scores for participants were determined. Vitamin D intake was assessed using the National Cancer Institute's 24-hour food recall (ASA24). Fasting plasma 25(OH)D levels were quantified via enzyme-linked immunosorbent assay. RESULTS TS reported higher activity levels than SS as assessed with MET-minutes/week and ranking of physical activity levels (p < 0.05). The reported mean daily intake of vitamin D was higher in TS compared to SS (p < 0.05) while 25(OH)D plasma levels were lower in TS than in SS (p < 0.05). In total, 43.8% of the TS were either insufficient (31.3%) or deficient (12.5%) in 25(OH)D, while none of the SS were insufficient and 13.3% were deficient. CONCLUSION TS are at increased risk of 25(OH)D insufficiency or deficiency compared to their sedentary counterparts residing at the same latitude, despite higher vitamin D intake.
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Affiliation(s)
- Scott P Jerome
- a Department of Chemistry and Biochemistry , University of Alaska Fairbanks , Fairbanks , AK , USA
| | - Kendra D Sticka
- a Department of Chemistry and Biochemistry , University of Alaska Fairbanks , Fairbanks , AK , USA.,b College of Health , University of Alaska Anchorage , Anchorage , AK , USA
| | - Theresia M Schnurr
- a Department of Chemistry and Biochemistry , University of Alaska Fairbanks , Fairbanks , AK , USA.,c Novo Nordisk Research Foundation Center for Basic Metabolic Research , University of Copenhagen , Copenhagen , Denmark
| | - Sally J Mangum
- d Department of Family Medicine , Pacific Northwest University of Health Sciences , Yakima , WA , USA
| | - Arleigh J Reynolds
- e Department of Veterinary Medicine , University of Alaska Fairbanks , Fairbanks , AK , USA
| | - Kriya L Dunlap
- a Department of Chemistry and Biochemistry , University of Alaska Fairbanks , Fairbanks , AK , USA.,f Institute of Arctic Biology , University of Alaska Fairbanks , Fairbanks , AK , USA
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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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Abstract
UNLABELLED Fifth metatarsal fractures, otherwise known as "Jones" fractures, occur commonly in athletes and nonathletes alike. While recent occurrence in the popular elite athlete has increased public knowledge and interest in the fracture, this injury is common at all levels of sport. This review will focus on all three types of Jones fractures. The current standard for treatment is operative intervention with intramedullary screw fixation. Athletes typically report an acute episode of lateral foot pain, described as an ache. Radiographic imaging with multiple views of the weightbearing injured foot are needed to confirm diagnosis. If these images are inconclusive, further magnetic resonance imaging (MRI) or computed tomography (CT) is used. Nonoperative treatment is not commonly used as the sole treatment, except when following reinjury of a stable screw fixation. While screw selection is still controversial, operative treatment with intramedullary screw fixation is the standard approach. Technical tips on screw displacement are provided for Torg (types I, II, III) fractures, cavovarus foot fractures, recurrent fractures, revision surgery, occult fractures/high-grade stress reactions, and Jones' variants. Excellent clinical outcomes can be expected in 80% to 100% of patients when using the intramedullary screw fixation to "fit and fill" the medullary canal with threads across the fracture site. Most studies show the timing for return to sports with optimal healing to be seven to twelve weeks after fixation. LEVEL OF EVIDENCE Level V, expert opinion.
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Affiliation(s)
- David A Porter
- 1 Methodist Sports Medicine/The Orthopedic Specialists, Indianapolis, IN, USA
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Vitale JA, Lombardi G, Cavaleri L, Graziani R, Schoenhuber H, Torre AL, Banfi G. Rates of insufficiency and deficiency of vitamin D levels in elite professional male and female skiers: A chronobiologic approach. Chronobiol Int 2017; 35:441-449. [PMID: 29231753 DOI: 10.1080/07420528.2017.1410828] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Vitamin D is essential for the maintenance and promotion of musculoskeletal health, for the functioning of the immune, cardiovascular and reproductive systems, and its main action is to keep calcium and phosphate plasmatic physiological concentrations at intestinal, renal and bony level. Vitamin D affects several parameters related to physical performance too and a particularly high percentage of vitamin D insufficiency and deficiency in professional athletes has been observed. Several variables are able to impair the synthesis of 25(OH)D in athletes, specifically both genetic and environmental factors, but the most probable explanation for the deficient/insufficient vitamin D levels is the insufficient ultraviolet B light (UVB) exposure during winter. To confirm this, the existence of a circannual rhythm of vitamin D in professional soccer players, highlighting a peak in summer and lowest values in winter regardless the period of the season, has been documented. Nonetheless, from what we are aware of, no other study adopted a chronobiologic approach to better understand and describe the circannual variations of serum 25(OH)D in other sport disciplines. Therefore, we studied serum vitamin D in a cohort of top-level professional skiers, during a period of three consecutive competitive seasons (2015, 2016 and 2017), in order to evaluate, with a rhythmometric approach, the vitamin D behavior along the year. The study population was composed by 152 professional Italian alpine skiers of FISI (Winter Sport Italian Federation), 63 females and 89 males (mean age: 24.1 ± 3.2 years) and a total of 298 blood drawings were carried out to determine plasma 25(OH)D. Vitamin D data were compared between genders and then processed with the population mean cosinor tests to evaluate the presence of a circannual rhythm, both for female and male athletes. In total, 77 skiers (50.7%) showed, at least once during the three competitive seasons, an insufficient level of 25(OH)D and other 45 subjects (29.6%) showed a deficient status; no differences were observed between genders (mean for females: 26.9 ± 8.1 ng/mL; mean for males: 27.4 ± 7.6 ng/mL). In addition, the rhythmometric analysis highlighted the existence of a significant circannual rhythm for both female and male professional skiers; the acrophases (Φ) occurred in July and both MESOR (M) and amplitude (A) were comparable between the two groups. Our data indicate that, despite the physical effort spent, vitamin D follows a classical season-associated rhythm with a peak in summer and a nadir in winter. Moreover, the percentage of insufficiency and deficiency is in line with that of the general population. In conclusion, our findings reinforce the hypothesis that there is no direct effect of physical activity on vitamin D metabolism and that the factors involved in the determination of vitamin D levels in the general population are valid also for athletes.
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Affiliation(s)
- Jacopo Antonino Vitale
- a Laboratory of Biological Structure Mechanics , IRCCS Istituto Ortopedico Galeazzi , Milano , Italia
| | - Giovanni Lombardi
- b Laboratory of Experimental Biochemistry & Molecular Biology , IRCCS Istituto Ortopedico Galeazzi , Milano , Italia
| | - Luca Cavaleri
- c Department of Biomedical Sciences for Health , Università degli Studi di Milano , Milan , Italia
| | - Rosa Graziani
- d Centro Diagnostico Alto-Lombardo (CEDAL) , Gallarate , Italia
| | - Herbert Schoenhuber
- e Sports Traumatology and Arthroscopic Surgery Unit , IRCCS Istituto Ortopedico Galeazzi , Milano , Italia
| | - Antonio La Torre
- c Department of Biomedical Sciences for Health , Università degli Studi di Milano , Milan , Italia
| | - Giuseppe Banfi
- b Laboratory of Experimental Biochemistry & Molecular Biology , IRCCS Istituto Ortopedico Galeazzi , Milano , Italia.,f Vita-Salute San Raffaele University , Milano , Italia
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39
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Mehran N, Schulz BM, Neri BR, Robertson WJ, Limpisvasti O. Prevalence of Vitamin D Insufficiency in Professional Hockey Players. Orthop J Sports Med 2016; 4:2325967116677512. [PMID: 28203589 PMCID: PMC5298407 DOI: 10.1177/2325967116677512] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background: Vitamin D is a fat-soluble hormone that plays a role in bone health, muscle function, and athletic performance. Studies have shown that low levels of vitamin D can lead to slower muscle recovery and function, increased rates of stress fractures, and even poorer athletic performance. Insufficient vitamin D levels have been demonstrated in professional basketball and football players, however, there have been no studies to date reviewing vitamin D insufficiency in professional hockey players. Purpose/Hypothesis: The purpose of this study was to perform a cross-sectional review to determine the prevalence of vitamin D deficiency and insufficiency in professional hockey players. The hypothesis was that there would be a high percentage of players with vitamin D insufficiency. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The preseason serum 25-hydroxy (OH) vitamin D laboratory test results of 105 professional hockey players were retrospectively reviewed. All players on 3 National Hockey League (NHL) teams were included. Player parameters evaluated included age, height, weight, body mass index, and 25(OH) vitamin D level. Players were divided into 4 groups based on serum vitamin D levels: deficient (<20 ng/mL), insufficient (20-31.9 ng/mL), sufficient (≥32 ng/mL), and ideal (≥40 ng/mL). Descriptive statistics were performed, in addition to 2-group and 3-group comparisons. Results: The average 25(OH) vitamin D level of 105 players was 45.8 ± 13.7 ng/mL (range, 24-108 ng/mL). No players in the study were considered deficient. A total of 14 players (13.3%) were considered insufficient, while 91 players (86.7%) were considered sufficient. However, only 68 players (64.8%) were considered ideal. When comparing groups, athletes with sufficient vitamin D levels were older than athletes with insufficient vitamin D levels (25.9 vs 23.1 years; P = .018). All other player parameters demonstrated no significant difference between groups. Conclusion: Despite playing a winter sport and spending a great deal of time training indoors, professional hockey players have low levels of vitamin D insufficiency.
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Affiliation(s)
- Nima Mehran
- Kerlan-Jobe Orthopaedic Clinic, Los Angeles, California, USA
| | - Brian M Schulz
- Kerlan-Jobe Orthopaedic Clinic, Los Angeles, California, USA
| | - Brian R Neri
- Sports Medicine Long Island, New Hyde Park, New York, USA
| | | | - Orr Limpisvasti
- Kerlan-Jobe Orthopaedic Clinic, Los Angeles, California, USA
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40
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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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41
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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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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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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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Neal S, Sykes J, Rigby M, Hess B. A review and clinical summary of vitamin D in regard to bone health and athletic performance. PHYSICIAN SPORTSMED 2015; 43:161-8. [PMID: 25797288 DOI: 10.1080/00913847.2015.1020248] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The large amount of scientific literature regarding vitamin D can be overwhelming and confusing. Some organizations have made specific guidelines and recommendations regarding optimal blood levels of vitamin D. In the sports medicine literature, new information about the effects of vitamin D on performance and bone health abound. Most of these articles seem to raise more questions than they answer. Are athletes at increased risk of vitamin D deficiency? Does vitamin D deficiency affect athletic performance? Should athletes be tested for deficiency? What is the optimal goal for vitamin D levels in athletes and is this different from the general population? The goal of this article is to provide clinical insight and clarity, both for those practicing in the primary care setting as well as for those taking care of athletes.
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Affiliation(s)
- Sara Neal
- Cone Health Family Medicine Residency and Primary Care Sports Medicine Fellowship , Greensboro, NC 27401 , USA
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