Vitamin B12 Status and Optimal Range for Hemoglobin Formation in Elite Athletes

Gut microbiome composition: link between sports performance and protein absorption?

BACKGROUND

Sufficient protein intake is essential for adequate physical condition and athletic performance. However, numerous factors can influence the absorption of consumed protein, including timing, type of protein intake, and gut microbiota. In the present study, elite male water polo players consumed a plant-based, vegan protein supplement with (n = 10) or without (n = 10) pre- and probiotics daily during the 31-day study period.

METHODS

We determined the anthropometric characteristics and body composition, dietary habits, gut microbiota composition, and blood parameters of the players at the beginning and at the end of the study. Body composition parameters were analyzed using the InBody 970 bioimpedance analyzer. Gut microbiome composition was determined from stool samples by metagenome sequencing. Paired and unpaired t-tests were used to determine differences between body composition and blood parameters within the groups and between the two groups at the two different sampling times. The Wilcoxon test was used to determine the change in bacterial composition during the study. Correlations between changes in body composition, blood parameters, and taxonomic groups were analyzed using a linear correlation calculation.

RESULTS

Skeletal muscle mass (p < 0.001), body cell mass (p = 0.002), arm circumference (p = 0.003), and protein mass (p < 0.001) increased, while body fat mass (p = 0.004) decreased significantly in the intervention group which consumed pre- and probiotics in addition to protein supplement. Activated acetate (reductive TCA cycle I) and propionate (pyruvate fermentation to propanoate I) pathways correlated positively with increased skeletal muscle mass (p < 0.01 and p < 0.05), and the relative abundance of butyrate-producing species showed a significant positive correlation with changes in body fat mass in the intervention group (p < 0.05). These correlations were not observed in the control group without the intake of pre- and probiotics.

CONCLUSIONS

The composition of the gut microbiota may influence protein absorption and therefore body composition and consequently physical condition and sports performance.

Exercise testing for young athletes

With increasing competitiveness across the sporting landscape, there is a need for more research into monitoring and managing the young athlete, as the needs of a young athlete are vastly different to those of an older athlete who is already established in their respective sport. As the age of sports specialisation seems to decrease, exercise testing in the younger cohort of athletes is crucial for safety and long-term success. This article provides a comprehensive summary of available testing and monitoring methods that can be used to assist young athletes as they mature and attempt to excel in their chosen sport.

Considerations for the Consumption of Vitamin and Mineral Supplements in Athlete Populations

Vitamins and minerals are of fundamental importance to numerous human functions that are essential to optimise athlete performance. Athletes incur a high turnover of key vitamins and minerals and are therefore dependent on sufficient energy intake to replenish nutrient stores. However, many athletes are poor at servicing their energy replenishment needs, especially female athletes, and although a 'food first approach' to meeting nutrient requirements is the primary goal, it may be important for some athletes to consider a vitamin and/or mineral supplement to meet their daily needs. When working to determine if an athlete requires vitamin or mineral supplements, practitioners should use a robust framework to assess the overall energy requirements, current dietary practices and the biological and clinical status of their athletes. Of note, any supplementation plan should account for the various factors that may impact the efficacy of the approach (e.g. athlete sex, the nutrient recommended dietary intake, supplement dose/timing, co-consumption of other foods and any food-drug interactions). Importantly, there are numerous vitamins and minerals of key importance to athletes, each having specific relevance to certain situations (e.g. iron and B vitamins are significant contributors to haematological adaptation, calcium and vitamin D are important to bone health and folate is important in the female athlete); therefore, the appropriate supplement for a given situation should be carefully considered and consumed with the goal to augment an athlete's diet.

Iron Status and Physical Performance in Athletes

Iron is an important mineral in the body, essential for muscle function and oxygen transport. Adequate levels of iron in the blood are necessary for athletes, as iron-deficiency anemia can reduce physical performance. Several studies have investigated iron status and supplementation in iron-deficient athletes, and determined how physical strain can change iron balance and markers related to iron status. The question of how to influence and optimize iron status, as well as other markers that can affect iron metabolism, has been less thoroughly investigated. Therefore, the aim of this review is to take a closer look at the importance of iron values, iron markers, and factors that can change iron metabolism for physical performance and the extent to which physical performance can be influenced in a positive or negative way. A systematic search of the PubMed database was performed, with the use of « iron» or «iron deficiency» or «hemoglobin» AND «athletes» AND «athletic performance» as a strategy of the search. After the search, 11 articles were included in the review after the application of inclusion and exclusion criteria. Major findings include that iron supplementation had the best effect in athletes with the lowest iron status, and effects on physical performance were mostly achieved in those who were originally in a deficit. Iron supplementation could be beneficial for optimal erythropoietic response during altitude training, even in athletes with normal iron stores at baseline, but should be performed with caution. Alteration of the hepcidin response can affect the use of existing iron stores for erythropoiesis. Energy intake, and the amount of carbohydrates available, may have an impact on the post-exercise hepcidin response. Optimal vitamin D and B12 levels can possibly contribute to improved iron status and, hence, the avoidance of anemia.

Oxidative Stress and Performance after Training in Professional Soccer (European Football) Players

Vitamins, hormones, free radicals, and antioxidant substances significantly influence athletic performance. The aim of this study was to evaluate whether these biological mediators changed during the season and if this was associated with the rate of improvement in performance after training, assessed by means of a standardized test. Professional male soccer players took part in the study. Two evaluations were performed: the first in the pre-season period and the second at the mid-point of the official season, after about 6 months of intensive training and weekly matches. Blood levels of vitamins D, B12, and folic acid, testosterone and cortisol, free radicals, and antioxidant substances were measured. Two hours after breakfast, a Yo-Yo test was performed. The relationships between the biological mediators and the rate of improvement after training (i.e., the increase in meters run in the Yo-Yo test between the pre-season and mid-season periods) were evaluated by means of a linear mixed models analysis. Results: Eighty-two paired tests were performed. The athletes showed better performance after training, with an increase in the meters run of about 20%. No significant relationships between the vitamin and hormone values and the gain in the performance test were observed. Plasmatic levels of free radicals increased significantly, as did the blood antioxidant potential. An indirect relationship between oxidative stress and the improvement in performance was observed (free radicals β ± SE: = -0.33 ± 0.10; p-value = 0.001), with lower levels of oxidative stress being associated with higher levels of performance in the Yo-Yo test. Monitoring the measures of oxidative stress could be a useful additional tool for coaches in training and/or recovery programs tailored to each player.

Soy-Based Tempeh Rich in Paraprobiotics Properties as Functional Sports Food: More Than a Protein Source

To date, there has been no recent opinion that explores tempeh as a functional food that can improve sports performance. Hence, this opinion article aims to elaborate on recent findings on the potential effect on sports performance of soy-based tempeh. This opinion paper presents updated evidence based on literature reviews about soy-based tempeh and its relationship with sports performance. The paraprobiotic role of Lactobacillus gasseri for athletes has been found to restore fatigue and reduce anxiety. This is achieved by increasing protein synthesis activity in eukaryotic initiation factor-2 (EIF2) signaling known as an adaptive pathway for integrated stress response. In addition, these paraprobiotics prevent down-regulation associated with the oxidative phosphorylation gene, thereby contributing to the maintenance of mitochondrial function and recovery from fatigue. The authors believe that this opinion article will encourage researchers to continue to evolve soybean-based tempeh food products and increase the performance of athletes by consuming soy-based foods.

Exploring the Relationship between Micronutrients and Athletic Performance: A Comprehensive Scientific Systematic Review of the Literature in Sports Medicine

The aim of this systematic review is twofold: (i) to examine the effects of micronutrient intake on athletic performance and (ii) to determine the specific micronutrients, such as vitamins, minerals, and antioxidants, that offer the most significant enhancements in terms of athletic performance, with the goal of providing guidance to athletes and coaches in optimizing their nutritional strategies. The study conducted a systematic search of electronic databases (i.e., PubMed, Web of Science, Scopus) using keywords pertaining to micronutrients, athletic performance, and exercise. The search involved particular criteria of studies published in English between 1950 and 2023. The findings suggest that vitamins and minerals are crucial for an athlete's health and physical performance, and no single micronutrient is more important than others. Micronutrients are necessary for optimal metabolic body's functions such as energy production, muscle growth, and recovery, which are all important for sport performance. Meeting the daily intake requirement of micronutrients is essential for athletes, and while a balanced diet that includes healthy lean protein sources, whole grains, fruits, and vegetables is generally sufficient, athletes who are unable to meet their micronutrient needs due to malabsorption or specific deficiencies may benefit from taking multivitamin supplements. However, athletes should only take micronutrient supplements with the consultation of a specialized physician or nutritionist and avoid taking them without confirming a deficiency.

HEMOGLOBIN ANALYSIS AFTER OVERLOAD TRAINING IN ATHLETES

ABSTRACT Introduction: The cardiovascular system provides athletes with the proper conditions for blood circulation, ensuring the stability and normal metabolism of the body's internal environment during exercise. Objective: Investigate the effect of overload training on the hemoglobin of male taekwondo athletes. Methods: Twenty-one male taekwondo athletes (level 2 or higher) were selected and trained for four weeks, five days per week, with an initial load intensity of 60% of the maximum heart rate and a weekly intensity increase of 10%. Before training and on every weekend during training, hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), reticulocyte count (Ret) were checked, RBC volume distribution width (RDW), hemoglobin content distribution width (HDW), mean reticulocyte volume (MCVr), mean reticulocyte hemoglobin concentration (CHCMr), serum iron (Fe) and ferritin (Fer). Results: After four weeks of increasing load training, athletes showed a progressive and significant decrease in Hb (P<0.01), manifested as exercise-induced hypohemoglobin, and MCV, MCH, MCHC, CHCMr, HDW, and serum ferritin were significantly or extremely decreased(P<0.) 05, P<0.01); RDW increased significantly (P<0.05); Changes in Ret and serum iron showed no statistical significance (P>0.05). Correlation analysis found that hemoglobin concentration had the highest correlation with MCHC and CHCMr. Conclusion: Four-week incremental load training can induce exercise-induced hypohemoglobin in male taekwondo athletes, its changes being most correlated with MCHC and CHCMr, but without significant correlation with serum Fe, RDW, HDW, and MCV. Level of Evidence: Therapeutic Studies -Investigation of Outcomes.

Benefits of a plant-based diet and considerations for the athlete

Individuals may opt to follow a plant-based diet for a variety of reasons, such as religious practices, health benefits or concerns for animal or environmental welfare. Such diets offer a broad spectrum of health benefits including aiding in the prevention and management of chronic diseases. In addition to health benefits, a plant-based diet may provide performance-enhancing effects for various types of exercise due to high carbohydrate levels and the high concentration of antioxidants and phytochemicals found in a plant-based diet. However, some plant-based foods also contain anti-nutrional factors, such as phytate and tannins, which decrease the bioavailability of key nutrients, such as iron, zinc, and protein. Thus, plant-based diets must be carefully planned to ensure adequate intake and absorption of energy and all essential nutrients. The current narrative review summarizes the current state of the research concerning the implications of a plant-based diet for health and exercise performance. It also outlines strategies to enhance the bioavailability of nutrients, sources of hard-to-get nutrients, and sport supplements that could interest plant-based athletes.

Spectroscopic and computational insight into the conformational dynamics of hemoglobin in the presence of vitamin B12

Protein-ligand interactions play a significant role in all living organisms, thereby affecting the design and application of drugs and other biomaterials. The current study reports the binding of vitamin B12 to hemoglobin, employing optical spectroscopy and computational methods. It is observed that vitamin B12 quenched the intrinsic fluorescence of hemoglobin. The nature of quenching appears to be static according to the steady-state and time-resolved fluorescence measurements. The conformational changes of hemoglobin caused by vitamin B12 interactions were studied by synchronous fluorescence spectroscopy and protein secondary structure analyses. The synchronous fluorescence spectra indicate the tryptophan residue microenvironment change while no secondary structural change is observed from circular dichroism spectra and molecular dynamics (MD) simulation study. The computational molecular docking elucidated the probable binding of vitamin B12 at the active site of hemoglobin, whereas the stability of the hemoglobin-vitamin B12 complex was studied by MD simulation. The study might be helpful for the treatment of pernicious anemia, hereditary transcobalamin deficiency, and performance enhancement of elite athletes.

Exploring the Anthropometric, Cardiorespiratory, and Haematological Determinants of Marathon Performance

Aim

We aimed to investigate the main anthropometric, cardiorespiratory and haematological factors that can determine marathon race performance in marathon runners.

Methods

Forty-five marathon runners (36 males, age: 42 ± 10 years) were examined during the training period for a marathon race. Assessment of training characteristics, anthropometric measurements, including height, body weight (n = 45) and body fat percentage (BF%) (n = 33), echocardiographic study (n = 45), cardiopulmonary exercise testing using treadmill ergometer (n = 33) and blood test (n = 24) were performed. We evaluated the relationships of these measurements with the personal best marathon race time (MRT) within a time frame of one year before or after the evaluation of each athlete.

Results

The training age regarding long-distance running was 9 ± 7 years. Training volume was 70 (50-175) km/week. MRT was 4:02:53 ± 00:50:20 h. The MRT was positively associated with BF% (r = 0.587, p = 0.001). Among echocardiographic parameters, MRT correlated negatively with right ventricular end-diastolic area (RVEDA) (r = -0.716, p < 0.001). RVEDA was the only independent echocardiographic predictor of MRT. With regard to respiratory parameters, MRT correlated negatively with maximum minute ventilation indexed to body surface area (VEmax/BSA) (r = -0.509, p = 0.003). Among parameters of blood test, MRT correlated negatively with haemoglobin concentration (r = -0.471, p = 0.027) and estimated haemoglobin mass (Hbmass) (r = -0.680, p = 0.002). After performing multivariate linear regression analysis with MRT as dependent variable and BF% (standardised β = 0.501, p = 0.021), RVEDA (standardised β = -0.633, p = 0.003), VEmax/BSA (standardised β = 0.266, p = 0.303) and Hbmass (standardised β = -0.308, p = 0.066) as independent variables, only BF% and RVEDA were significant independent predictors of MRT (adjusted R² = 0.796, p < 0.001 for the model).

Conclusions

The main physiological determinants of better marathon performance appear to be low BF% and RV enlargement. Upregulation of both maximum minute ventilation during exercise and haemoglobin mass may have a weaker effect to enhance marathon performance.

Clinical Trial Registration

www.ClinicalTrials.gov, identifier NCT04738877.

Low Serum Vitamin E Level Associated with Low Hand Grip Strength in Community-Dwelling Adults: Korean National Health and Nutrition Examination Survey (KNHANES VII) 2016-2018

This study assessed the association between serum vitamin E levels and hand grip strength (HGS) in community-dwelling adults data of 1011 men aged 50 years and older and 1144 postmenopausal women were analyzed. Low HGS was defined as HGS below the sex-stratified median value. Proportion of low HGS was the greatest in the lowest quintile of serum vitamin E level (<10.51 mg/L, 57.1%), with a decreasing trend toward the highest vitamin E quintile (>17.81 mg/L, 43.6%; p < 0.001). A one-unit (mg/L) decrease in vitamin E levels was associated with lower HGS in men (adjusted beta coefficient −0.10, 95% confidence interval [CI] −0.18 to −0.02, p = 0.019), but not in women (−0.01, 95% CI −0.06 to 0.03, p = 0.550). Compared with the middle quintile (Q3; 12.59–14.69 mg/L), the lowest vitamin E quintile (Q1) was associated with elevated odds of low HGS (adjusted odds ratio [aOR]: 1.38, p = 0.045), independent of sociodemographic factors, health-related lifestyles, comorbidities, dietary intake, and cholesterol level. However, the odds of low HGS did not differ significantly in other vitamin E quintiles (Q2, aOR 1.12; Q4, aOR 1.38; Q5, aOR 1.12; p > 0.05). Individuals with the lowest quintile vitamin E level had elevated odds of low HGS independent of covariates, findings which merit further validation.

Elevated Plasma Vitamin B12 in Patients with Hepatic Glycogen Storage Diseases

Background: Hepatic glycogen storage diseases (GSDs) are inborn errors of metabolism affecting the synthesis or breakdown of glycogen in the liver. This study, for the first time, systematically assessed vitamin B₁₂ status in a large cohort of hepatic GSD patients. Methods: Plasma vitamin B₁₂, total plasma homocysteine (tHcy) and methylmalonic acid concentrations were measured in 44 patients with hepatic GSDs and compared to 42 healthy age- and gender-matched controls. Correlations of vitamin B₁₂ status with different disease markers of GSDs (including liver transaminase activities and triglycerides) as well as the vitamin B₁₂ intake were studied. Results: GSD patients had significantly higher plasma vitamin B₁₂ concentrations than healthy controls (p = 0.0002). Plasma vitamin B₁₂ concentration remained elevated in GSD patients irrespective of vitamin B₁₂ intake. Plasma vitamin B₁₂ concentrations correlated negatively with triglyceride levels, whereas no correlations were detected with liver transaminase activities (GOT and GPT) in GSD patients. Merging biomarker data of healthy controls and GSD patients showed a positive correlation between vitamin B₁₂ status and liver function, which suggests complex biomarker associations. A combined analysis of biomarkers permitted a reliable clustering of healthy controls versus GSD patients. Conclusions: Elevated plasma concentration of vitamin B₁₂ (irrespective of B₁₂ intake) is a common finding in patients with hepatic GSD. The negative correlation of plasma vitamin B₁₂ with triglyceride levels suggests an influence of metabolic control on the vitamin B₁₂ status of GSD patients. Elevated vitamin B₁₂ was not correlated with GOT and GPT in our cohort of GSD patients. Merging of data from healthy controls and GSD patients yielded positive correlations between these biomarkers. This apparent dichotomy highlights the intrinsic complexity of biomarker associations and argues against generalizations of liver disease and elevated vitamin B₁₂ in blood. Further studies are needed to determine whether the identified associations are causal or coincidental, and the possible impact of chronically elevated vitamin B₁₂ on GSD.