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  • Author: Laurel M. Wentz x
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Laurel M. Wentz, Pei-Yang Liu, Jasminka Z. Ilich and Emily M. Haymes

Background:

High rates of vitamin D deficiency have been reported in athletes. The purpose of this study was to evaluate the associations between vitamin D with bone health and parathyroid hormone (PTH) concentrations in female runners who trained at 30.4° degrees north.

Methods:

Serum 25-hydroxyvitamin D (25(OH) D), PTH, body composition, and bone mineral density (BMD) were measured in 59 female runners, aged 18–40 years. Stress fracture history, training duration and frequency were evaluated by questionnaire. As per National Endocrine Society cut-offs, serum vitamin D ranges were: 25(OH)D < 50 nmol/L for deficient; 50–75 nmol/L for insufficient; and ≥ 75 nmol/L for sufficient status.

Results:

Mean serum 25(OH)D concentrations were 122.6 ± 63.9 nmol/L, with 18.6% of subjects in the deficient (5.1%) or insufficient (13.5%) range. No significant differences were observed between sufficient and deficient/insufficient subjects for BMD, PTH, history of stress fractures, or demographic data.

Conclusions:

The majority of distance runners maintained sufficient vitamin D status, suggesting that training outdoors in latitude where vitamin D synthesis occurs year-round reduces the risk for vitamin D deficiency. Data do not support the indiscriminate supplementation of outdoor athletes in southern latitudes without prior screening.

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Laurel Wentz, Pei-Yang Liu, Jasminka Z. Ilich and Emily M. Haymes

Purpose:

To compare female runners with and without a history of stress fractures to determine possible predictors of such fractures.

Methods:

27 female runners (age 18–40 yr) who had had at least 1 stress fracture were matched to a control sample of 32 female runners without a history of stress fractures. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (iDXA). Subjects answered questionnaires on stress-fracture history, training, menstrual status, and diet.

Results:

No significant differences were found in menstrual characteristics, diet and dairy intake, or bone measurements. Weekly servings of milk during middle school significantly predicted BMD at the femur (p = .010), femoral neck (p = .002), Ward’s triangle (p = .014), and femoral shaft (p = .005). Number of menstrual cycles in the previous year predicted femoral-neck BMD (p = .004). Caffeine intake was negatively associated with BMD of the femur (p = .010), femoral neck (p = .003), trochanter (p = .038), and femoral shaft (p = .035). Weekly hours of training were negatively associated with total-body BMD (p = .021), total-body bone mineral content (p = .028), and lumbar-spine BMD (p = .011). Predictors for stress fractures included the number of years running, predominantly running on hard ground, irregular menstrual history, low total-body BMD, and low current dietary calcium intake when controlling for body-mass index (Nagelkerke R 2 = .364).

Conclusions:

Servings of milk during middle-school years were positively correlated with hip BMD, although current calcium intake, low BMD, irregular menstrual history, hard training surface, and long history of training duration were the most important predictors of stress fractures.

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David C. Nieman, Giuseppe Valacchi, Laurel M. Wentz, Francesca Ferrara, Alessandra Pecorelli, Brittany Woodby, Camila A. Sakaguchi and Andrew Simonson

This double-blinded, placebo controlled, randomized crossover trial investigated the influence of 2-week mixed flavonoid versus placebo supplementation on oxinflammation markers after a 75-km cycling time trial in 22 cyclists (42.3 ± 1.7 years). Blood samples were collected before and after the 2-week supplementation, and then 0 hr, 1.5 hr, and 21 hr post 75-km cycling (176 ± 5.4 min, 73.4 ±2.0% maximal oxygen consumption). The supplement provided 678-mg flavonoids with quercetin (200 mg), green tea catechins (368 mg, 180-mg epigallocatechin gallate), and anthocyanins (128 mg) from bilberry extract, with caffeine, vitamin C, and omega-3 fatty acids added as adjuvants. Blood samples were analyzed for blood leukocyte counts, oxinflammation biomarkers, including 4-hydroxynonenal, protein carbonyls, and peripheral blood mononuclear mRNA expression for cyclooxygenease-2 and glutathione peroxidase. Each of the blood biomarkers was elevated postexercise (time effects, all ps < .01), with lower plasma levels for 4-hydroxynonenal (at 21-hr postexercise) in flavonoid versus placebo (interaction effect, p = .008). Although elevated postexercise, no trial differences for the neutrophil/lymphocyte ratio (p = .539) or peripheral blood mononuclear mRNA expression for cyclooxygenease-2 (p = .322) or glutathione peroxidase (p = .839) were shown. Flavonoid supplementation prior to intensive exercise decreased plasma peroxidation and oxidative damage, as determined by 4-hydroxynonenal. Postexercise increases were similar between the flavonoid and placebo trials for peripheral blood mononuclear mRNA expression for cyclooxygenease-2 and the nuclear factor erythroid 2-related factor 2 related gene glutathione peroxidase (NFE2L2). The data support the strategy of flavonoid supplementation to mitigate postexercise oxidative stress in endurance athletes.