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Jonathan M. Peake

Ascorbic acid or vitamin C is involved in a number of biochemical pathways that are important to exercise metabolism and the health of exercising individuals. This review reports the results of studies investigating the requirement for vitamin C with exercise on the basis of dietary vitamin C intakes, the response to supplementation and alterations in plasma, serum, and leukocyte ascorbic acid concentration following both acute exercise and regular training. The possible physiological significance of changes in ascorbic acid with exercise is also addressed. Exercise generally causes a transient increase in circulating ascorbic acid in the hours following exercise, but a decline below pre-exercise levels occurs in the days after prolonged exercise. These changes could be associated with increased exercise-induced oxidative stress. On the basis of alterations in the concentration of ascorbic acid within the blood, it remains unclear if regular exercise increases the metabolism of vitamin C. However, the similar dietary intakes and responses to supplementation between athletes and nonathletes suggest that regular exercise does not increase the requirement for vitamin C in athletes. Two novel hypotheses are put forward to explain recent findings of attenuated levels of cortisol postexercise following supplementation with high doses of vitamin C.

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Sheila A. Kopp-Woodroffe, Melinda M. Manore, Christine A. Dueck, James S. Skinner and Kathleen S. Matt

Chronic energy deficit is one of the strongest factors contributing to exercise-induced menstrual dysfunction. In such cases, macro- and micronutrient intakes may also be low. This study presents the results of a diet and exercise training intervention program, designed to reverse athletic amenorrhea, on improving energy balance and nutritional status in 4 amenorrheic athletes. The 20-week program provided a daily sport nutrition supplement and 1 day of rest/week. The intervention improved self-reported energy intake (El) and balance in all participants. The program increased protein intakes for the 3 athletes with a protein deficit to within the recommended levels for active individuals. Micronutrient intakes increased, as did serum concentrations of vitamin B12, folate, zinc, iron, and ferritin. These results indicate that some amenorrheic athletes have poor nutritional status due to restricted Els and poor food selections. A sport nutrition supplement may improve energy balance and nutritional status in active amenorrheic women.

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Richard D. Telford, Edward A. Catchpole, Vicki Deakin, Alan C. McLeay and Ashley W. Plank

Blood indicators of eight vitamins (B1, B2, B6, C, E, A, B,12 folate) and six minerals (Cu, Mg, Zn, Ca, P, Al) were measured in 86 athletes before and after a 7- to 8-month period of training. During this period half consumed a multivitamin/mineral supplement and a matched group look a placebo, Following the supplementation period, Mood biochemical indicators of B1, B6, Bl2, and folate status all increased but there were no significant effects of supplementation on B2, C, E, and A, or on the blood levels of any of the minerals. The supplementation had no effect on red or while cell counts or on hemoglobin levels. Irrespective of the supplementation, some blood measures varied according to sex, females evidencing significantly higher values than males for vitamins C, E, copper, magnesium, and aluminum, with B2 being higher in males. It is concluded that 7 to 8 months of multivitamin/mineral supplementation increased the blood nutritional status of some vitamins but did not affect any blood mineral levels, and that some blood nutritional indicators may vary according to sex.

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Satya S. Jonnalagadda, Dan Benardot and Marian Nelson

The nutrient intakes and dietary practices of elite, U.S. national team, artistic female gymnasts (n = 33) were evaluated using 3-day food records. The gymnasts' reported energy intake was 34.4 kcal/kg (total 1,678 kcal/day), which was 20% below the estimated energy requirement. The contributions of protein, fat, and carbohydrate to total energy intake were 17%, 18%, and 66%, respectively. All reported vitamin intakes, except vitamin E, were above the RDA. The reported mineral intakes, especially calcium, zinc, and magnesium, were less than 100% of the RDA. The overall nutrient densities of the subjects' diets were higher than expected. Eighty-two percent of the gymnasts reported taking nonprescription vitamin and mineral supplements, and 10% reported taking prescription vitamin and mineral supplements. Forty-eight percent of the gymnasts reported being on a self-prescribed diet. Compared to NHANES III, the reported nutrient intake of these gymnasts was different from that of the average U.S. adolescent female. In summary, certain key nutrients such as calcium, iron, and zinc should be given more attention to prevent nutrient deficiencies and subsequent health consequences.

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Kentz S. Willis, Nikki J. Peterson and D. Enette Larson-Meyer

A surprisingly high prevalence of vitamin D insufficiency and deficiency has recently been reported worldwide. Although very little is known about vitamin D status among athletes, a few studies suggest that poor vitamin D status is also a problem in athletic populations. It is well recognized that vitamin D is necessary for optimal bone health, but emerging evidence is finding that vitamin D deficiency increases the risk of autoimmune diseases and nonskeletal chronic diseases and can also have a profound effect on human immunity, inflammation, and muscle function (in the elderly). Thus, it is likely that compromised vitamin D status can affect an athlete’s overall health and ability to train (i.e., by affecting bone health, innate immunity, and exercise-related immunity and inflammation). Although further research in this area is needed, it is important that sports nutritionists assess vitamin D (as well as calcium) intake and make appropriate recommendations that will help athletes achieve adequate vitamin D status: serum 25(OH)D of at least 75 or 80 nmol/L. These recommendations can include regular safe sun exposure (twice a week between the hours of 10 a.m. and 3 p.m. on the arms and legs for 5–30 min, depending on season, latitude, and skin pigmentation) or dietary supplementation with 1,000–2,000 IU vitamin D3 per day. Although this is significantly higher than what is currently considered the adequate intake, recent research demonstrates these levels to be safe and possibly necessary to maintain adequate 25(OH)D concentrations.

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Rachel A. Hildebrand, Bridget Miller, Aric Warren, Deana Hildebrand and Brenda J. Smith

Increasing evidence indicates that compromised vitamin D status, as indicated by serum 25-hydroxyvitamin D (25-OH D), is associated with decreased muscle function. The purpose of this study was to determine the vitamin D status of collegiate athletes residing in the southern U.S. and its effects on muscular strength and anaerobic power. Collegiate athletes (n = 103) from three separate NCAA athletic programs were recruited for the study. Anthropometrics, vitamin D and calcium intake, and sun exposure data were collected along with serum 25-OH D and physical performance measures (Vertical Jump Test, Shuttle Run Test, Triple Hop for Distance Test and the 1 Repetition Maximum Squat Test) to determine the influence of vitamin D status on muscular strength and anaerobic power. Approximately 68% of the study participants were vitamin D adequate (>75 nmol/L), whereas 23% were insufficient (75–50 nmol/L) and 9%, predominantly non-Caucasian athletes, were deficient (<50 nmol/L). Athletes who had lower vitamin D status had reduced performance scores (p < .01) with odds ratios of 0.85 on the Vertical Jump Test, 0.82 on the Shuttle Run Test, 0.28 on the Triple Hop for Distance Test, and 0.23 on the 1 RM Squat Test. These findings demonstrate that even NCAA athletes living in the southern US are at risk for vitamin D insufficiency and deficiency and that maintaining adequate vitamin D status may be important for these athletes to optimize their muscular strength and power.

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Sun H. Kim and Carl L. Keen

An excessive use of vitamin/mineral supplements is considered by many to be a common health problem. We surveyed 1,355 adolescent boys and girls attending athletic high schools in Korea for their usage patterns of vitamin/mineral supplements. The usage rate of the vitamin/mineral supplements was 35.8%. The most favored supplements were vitamin C, multivitamins, and calcium. The reasons most cited for taking supplements were "to recover from fatigue," and "to maintain health." Vitamin and mineral intakes occurred over a wide range; mean intake values were typically higher than the Korean RDA. Vitamins B , B12 and C were consumed in very high amounts at 29.7,17.9 and 11.1 times the Korean RDA, respectively. When the intakes of nutrients from supplements and diet were combined, it was observed that the intakes of niacin, folic acid, vitamin C, and iron exceeded levels that have been proposed as upper safe limits. The above data underscore the need to provide sound nutritional education to athletic adolescents and their coaches with respect to the use of vitamin/ mineral supplements and the links between adequate diet, good health, and physical performance.

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Lothar Rokitzki, Andree N. Sagredos, Friedrich Reuß, Michael Büchner and Josef Keul

The vitamin B6 status of 13 endurance athletes was determined by whole blood B6 (microbiological) and urine 4-pyridoxic acid (4-PA) (HPLC), serum vitamin B6 (pyridoxal, pyridoxol, pyridoxamin) (HPLC), and erythrocyte α- EGOT measurements with the aid of 7-day records. In addition, blood and serum samples and urine were collected before (Time A), directly after (Time B), and 2 hr after a marathon race (Time C). The total energy intake was 12,303 ± 3,464 Wday (34% fat, 48% carbohydrates, 14% protein). The vitamin B6 intake, serum concentrations, α-EGOT value, and 4-PA excretion were higher than the reference values at Time A. Only the vitamin B6 whole blood levels were below the normal level at Time A. The vitamin B, status of the athletes corresponded essentially to reference values obtained for untrained individuals. There was a mean loss of about 1 mg vitamin B6 as a result of the marathon race. Vitamin B6 supplementation does not appear necessary if a balanced diet is consumed.

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Gal Dubnov-Raz, Harri Hemilä, Avner H. Cohen, Barak Rinat, Lauryn Choleva and Naama W. Constantini

Observational studies identified associations between vitamin D insufficiency (serum 25(OH)D > 30ng·ml−1) and risk of upper respiratory infection (URI). Swimmers are highly prone to URIs, which might hinder their performance. The aim of this study was to examine if vitamin D3 supplementation reduces URI burden in vitamin D-insufficient swimmers. Fifty-five competitive adolescent swimmers with vitamin D insufficiency were randomized to receive vitamin D3 (2,000IU·d4) or placebo for 12 winter weeks. A URI symptom questionnaire was completed weekly. Serum 25(OH)D concentrations were measured by radio-immunoassay before and after supplementation. We used linear regression to examine the relation between the change in 25(OH)D concentrations during the trial, and the duration and severity of URIs. There were no between-group differences in the frequency, severity, or duration of URIs. Exploratory analyses revealed that in the placebo group only, the change in 25(OH)D concentrations during the trial was highly associated with the duration of URIs (r = −0.90,p > .001), and moderately associated with the severity of URIs (r = −0.65,p = .043). The between-group differences for duration were highly significant. Vitamin D3 supplementation in adolescent swimmers with vitamin D insufficiency did not reduce URI burden. However, larger decreases in serum 25(OH)D concentrations were associated with significantly longer and more severe URI episodes.

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Nina Rica Wium Geiker, Mette Hansen, Jette Jakobsen, Michael Kristensen, Rikke Larsen, Niklas R. Jørgensen, Birthe S. Hansen and Susanne Bügel

Impaired muscle function has been coupled to vitamin D insufficiency in young women and in elderly men and women. Those living at Northern latitudes are at risk for vitamin D insufficiency due to low sun exposure which may be more pronounced among elite swimmers because of their indoor training schedules. We aimed to examine vitamin D status among young elite swimmers and evaluate the association between vitamin D status and muscle strength. Twenty-nine swimmers, 12 female and 17 male (16–24 years) residing at latitude 55–56°N were studied in March and April. Blood samples were analyzed for serum 25-hydroxyvitamin D (s-25(OH)D) and hand-grip strength was measured as marker of muscle strength. Subjects´ vitamin D and calcium intake were assessed by food frequency questionnaire and sun exposure and training status by questionnaires. Mean (± SD) s-25(OH)D was 52.6 ± 18.3nmol/L among all swimmers. In 45% of the swimmers s-25(OH)D was below 50 nmol/L. Female swimmers had higher s-25(OH)D concentration than male swimmers (61.7 ± 17,5 nmol/L vs. 46.2 ± 16,5 nmol/L, p = .026). Among male swimmers, those with sufficient vitamin D status had higher hand grip strength than those with insufficient vitamin D status (50.6 ± 6.4 kg vs. 41.1 ± 7.8 kg, p = .02). Among Danish elite swimmers 45% had an insufficient vitamin D status during the spring; the prevalence being higher among male swimmers. Muscle strength was significantly higher in male swimmers with sufficient vitamin D status.