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Markus Herrmann, Rima Obeid, Juergen Scharhag, Wilfried Kindermann, and Wolfgang Herrmann

This study aimed to compare the vitamin B12 and folate status of recreational endurance athletes and inactive controls by modern biomarkers. In 72 athletes (38 ± 7 y) and 46 inactive controls (38 ± 9 y) serum levels of vitamin B12, methylmalonic acid (MMA), holotranscobalamin II (holoTC), folate, and homocysteine (Hcy) were measured. Vitamin B12 and folate levels of both groups were comparable, but athletes had higher median (25.−75. percentile) MMA [242 (196 to 324) versus 175 (141 to 266) nmol/L] and holoTC concentrations [67 (52 to 93) versus 55 (45 to 70) pmol/L] than controls. Hcy was slightly lower in athletes [9.2 (7.2 to 12.6) versus 10.8 (8.9 to 12.9) nmol/L]. In controls, we found the following correlations: vitamin B12 and MMA (r = −0.38), vitamin B12 and holoTC (r = 0.51), MMA and holoTC (r = −0.36). In athletes, MMA did not correlate with vitamin B12 and holoTC. Our data suggests an altered vitamin B12 metabolism in recreational athletes that needs further investigation.

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Kathleen Woolf and Melinda M. Manore

The B-vitamins (thiamin, ribofavin, vitamin B-6) are necessary in the energy-producing pathways of the body, while folate and vitamin B-12 are required for the synthesis of new cells, such as the red blood cells, and for the repair of damaged cells. Active individuals with poor or marginal nutritional status for a B-vitamin may have decreased ability to perform exercise at high intensities. This review focuses on the B-vitamins and their role in energy metabolism and cell regeneration. For each vitamin, function related to physical activity, requirement, and status measures are given. Research examining dietary intakes and nutritional status in active individuals is also presented. Current research suggests that exercise may increase the requirements for ribofavin and vitamin B-6, while data for folate and vitamin B-12 are limited. Athletes who have poor diets, especially those restricting energy intakes or eliminating food groups from the diet, should consider supplementing with a multivitamin/mineral supplement.

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Jason T. Penry and Melinda M. Manore

Choline plays a central role in many physiological pathways, including neurotransmitter synthesis (acetylcholine), cell-membrane signaling (phospholipids), lipid transport (lipoproteins), and methyl-group metabolism (homocysteine reduction). Endurance exercise might stress several of these pathways, increasing the demand for choline as a metabolic substrate. This review examines the current literature linking endurance exercise and choline demand in the human body. Also reviewed are the mechanisms by which exercise might affect blood choline levels, and the links between methyl metabolism and the availability of free choline are highlighted. Finally, the ability of oral choline supplements to augment endurance performance is assessed. Most individuals consume adequate amounts of choline, although there is evidence that current recommendations might be insufficient for some adult men. Only strenuous and prolonged physical activity appears sufficient to significantly decrease circulating choline stores. Moreover, oral choline supplementation might only increase endurance performance in activities that reduce circulating choline levels below normal.

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Hans Braun, Judith von Andrian-Werburg, Wilhelm Schänzer, and Mario Thevis

respective RDA values ( 13 ) are presented in Table  4 . No player met the RDA for vitamin D, and a considerable group of participants stayed under the RDAs for vitamin B 12 (53%), folate (75%), vitamin A (53%), calcium (59%), phosphorus (38%), and iron (69%). Subjects showed a high interindividual

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Susan Heaney, Helen O’Connor, Janelle Gifford, and Geraldine Naughton


This study aimed to compare strategies for assessing nutritional adequacy in the dietary intake of elite female athletes.


Dietary intake was assessed using an adapted food-frequency questionnaire in 72 elite female athletes from a variety of sports. Nutritional adequacy was evaluated and compared using mean intake; the proportion of participants with intakes below Australian nutrient reference values (NRV), U.S. military dietary reference intakes (MDRI), and current sports nutrition recommendations; and probability estimates of nutrient inadequacy.


Mean energy intake was 10,551 ± 3,836 kJ/day with macronutrient distribution 18% protein, 31% fat, and 46% carbohydrate, consistent with Australian acceptable macronutrient distribution ranges. Mean protein intake (1.6 g · kg−1 · d−1) was consistent with (>1.2 g · kg−1 · d−1), and carbohydrate intake (4.5 g · kg−1 · d−1), below, current sports nutrition recommendations (>5 g · kg−1 · d−1), with 30% and 65% of individuals not meeting these levels, respectively. Mean micronutrient intake met the relevant NRV and MDRI except for vitamin D and folate. A proportion of participants failed to meet the estimated average requirement for folate (48%), calcium (24%), magnesium (19%), and iron (4%). Probability estimates of inadequacy identified intake of folate (44%), calcium (22%), iron (19%), and magnesium (15%) as inadequate.


Interpretation of dietary adequacy is complex and varies depending on whether the mean, proportion of participants below the relevant NRV, or statistical probability estimate of inadequacy is used. Further research on methods to determine dietary adequacy in athlete populations is required.

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Jennifer L. Krempien and Susan I. Barr

Energy intakes of adults with spinal cord injury (SCI) have been reported to be relatively low, with many micronutrients below recommended amounts, but little is known about the diets of athletes with SCI. The purpose of this cross-sectional, observational study was to assess energy intakes and estimate the prevalence of dietary inadequacy in a sample of elite Canadian athletes with SCI (n = 32). Three-day self-reported food diaries completed at home and training camp were analyzed for energy (kcal), macronutrients, vitamins, and minerals and compared with the dietary reference intakes (DRIs). The prevalence of nutrient inadequacy was estimated by the proportion of athletes with mean intakes below the estimated average requirement (EAR). Energy intakes were 2,156 ± 431 kcal for men and 1,991 ± 510 kcal for women. Macronutrient intakes were within the acceptable macronutrient distribution ranges. While at training camp, >25% of men had intakes below the EAR for calcium, magnesium, zinc, riboflavin, folate, vitamin B12, and vitamin D. Thiamin, riboflavin, calcium, and vitamin D intakes were higher at home than training camp. Over 25% of women had intakes below the EAR for calcium, magnesium, folate, and vitamin D, with no significant differences in mean intakes between home and training camp. Vitamin/mineral supplement use significantly increased men’s intakes of most nutrients but did not affect prevalence of inadequacy. Women’s intakes did not change significantly with vitamin/mineral supplementation. These results demonstrate that athletes with SCI are at risk for several nutrient inadequacies relative to the DRIs.

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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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Guadalupe Garrido, Anthony L Webster, and Manuel Chamorro

The article describes a study that evaluated the adequacy of 2 different menu settings in a group of elite adolescent Spanish soccer players. Five-day food intake was assessed on 2 occasions, while athletes were consuming a flexible “buffet-style” diet (B; n = 33) and a fixed “menu-style” diet (M; n = 29). For all principal meals of the day food weighing was performed, and snacks were recorded by self-report. M provided significantly higher total energy and carbohydrate intakes than B. Breakfast and snacks both provided more energy in M. Calories obtained from fat were excessive in both settings. Calcium and vitamin D were below recommendations in B but not in M. Fiber, magnesium, folate, vitamin A, and vitamin E intake fell below recommended values in both settings. M provided significantly greater quantities of magnesium and vitamins D and E. Both feeding options were far from optimal in satisfying current scientifically based recommendations for active adolescents.

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Robert A. Niekamp and Janine T. Baer

The purpose of this study was to determine the dietary adequacy of 12 collegiate cross-country runners during a competitive season. Four-day diet records were collected twice during the season and analyzed for total daily energy, macronutrients, vitamin A, vitamin C, thiamin, riboflavin, niacin, vitamin B6, folate, iron, magnesium, zinc, and calcium. Mean energy intake (3,248 ± 590 kcal) was not significantly different from estimated mean energy expenditure (3,439 ± 244 kcal). Week 8 mean prealbumin levels were within normal limits (26.8 ± 2.8 mg/dl). Mean daily CHO intake was 497 ± 134 g/day (61.2%). Three to four hours prior to competition a pre-race meal was consumed; it contained 82 ± 47 g CHO. Posteompetition CHO intake was delayed an average 2.5 hr; at that time approximately 2.6 ± 0.69 g CHO/kg body weight was consumed. The athletes appeared to demonstrate dietary adequacy with the exception of timing of posteompetition carbohydrate consumption.

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Emily M. Haymes

Vitamin and mineral supplements are frequently used by competitive and recreational athletes. Dietary deficiencies of most vitamins are not very common among athletes except in those who restrict their food intake in order to maintain body weight. Vitamins most likely to be deficient in the diet are folate, B6, B12, and E. Biochemical evidence of vitamin deficiencies in some athletes have been reported for thiamine, riboflavin, and B6. When the diet is deficient, vitamin supplements may improve performance but are not likely to be effective if the dietary intake is adequate. Some female athletes' diets are low in calcium, iron, and zinc. Low calcium intake may reduce peak bone mass in young women. Iron deficiency may impair performance and needs to be corrected with an iron supplement. Zinc supplements that exceed the RDA interfere with the absorption of copper and lower HDL-cholesterol.