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Paraskevi Detopoulou and Vasilios Papamikos

Omega-3 fatty acids exert a plethora of physiological actions including triglycerides lowering, reduction of inflammatory indices, immunomodulation, anti- thrombotic effects and possibly promotion of exercise performance. Their use is widespread and for commonly ingested doses their side- effects are minimal. We report a case of a 60y amateur athlete who consumed about 20 g omega-3 fatty acids daily from supplements and natural sources for a year. After the intake of cortisone and antibiotics he presented duodenum ulcer and bleeding although he had no previous history of gastrointestinal problems. Although several animal data support gastro-protective effects of omega-3 fatty acids in the present case they were not able to prevent ulcer generation. The present observation may be explained by (i) the high dose of omega-3 fatty acids and their effect on bleeding, (ii) the fact that cortisone increases their oxidation and may render them proinflammatory, (iii) other antithrombotic microconstituents included in the consumed cod-oil and/or the diet of the subject and (iv) the differences in the coagulation and fibrinolytic systems of well- trained subjects. Further studies are needed to substantiate any possible interaction of cortisone and omega-3 fatty acids in wide ranges of intake.

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Eric S. Rawson, Mary P. Miles and D. Enette Larson-Meyer

may help athletes to train and/or compete more effectively without performance impediments. These supplements include creatine monohydrate, beta-hydroxy beta-methylbutyrate (HMB), omega-3 fatty acids, vitamin D, probiotics, gelatin, and anti-inflammatory supplements such as curcumin or tart cherry

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Dariush Sheikholeslami-Vatani, Slahadin Ahmadi and Hassan Faraji

, especially in older adults, are important. Some evidence suggests that fish oil–derived omega-3 fatty acids (n-3 polyunsaturated fatty acids) regulate apoptosis in various cells. Omega-3 has attracted much attention in terms of its potential for prevention of cancers, cardiovascular disease, rheumatoid

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Anni Heikkinen, Antti Alaranta, Ilkka Helenius and Tommi Vasankari

The aim of this study was to evaluate the frequency of dietary supplement (DS) use among elite Finnish athletes in 2002 and 2009. In 2009, the authors also wanted to examine the reasons for athletes’ DS use, whether athletes feel they have experienced benefits from their supplement use, and whether athletes had had an opportunity to consult dietary specialists. Cross-sectional studies were conducted in 2002 and 2009 among Finnish Olympic athletes. Data were collected using semistructured questionnaires, mainly in national team camps. The study population in 2002 was 446 athletes, and in 2009 it was 372. The number of DS users was high in both study years (81% in 2002 and 73% in 2009). Vitamin D consumption was low in both 2002 and 2009 (0.7% and 2.0%, respectively). An increase was found in consumption of omega-3 fatty acids between study years (11% in 2002 and 19% in 2009; p = .002), and their regular use nearly doubled (8% and 15%, p = .002). For vitamin and mineral users, the main reason for DS use was to prevent nutritional deficiencies, and for nutritional supplement users the main reason was recovery from exercise. Only 27% of all athletes and 30% of DS users had an opportunity to consult dietary specialists in 2009. This survey shows that supplementation rates among elite Finnish athletes are high and there may be over- and underuse of some micronutrient supplements. There is a need for professional nutritional counseling among national elite athletes.

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Timothy D. Mickleborough

Increased muscle oxidative stress and inflammatory responses among athletes have been reported consistently. In addition, it is well known that exhaustive or unaccustomed exercise can lead to muscle fatigue, delayed-onset muscle soreness, and a decrement in performance. Omega-3 polyunsaturated fatty acids (PUFAs) have been shown to decrease the production of inflammatory eicosanoids, cytokines, and reactive oxygen species; have immunomodulatory effects; and attenuate inflammatory diseases. While a number of studies have assessed the efficacy of omega-3 PUFA supplementation on red blood cell deformability, muscle damage, inflammation, and metabolism during exercise, only a few have evaluated the impact of omega-3 PUFA supplementation on exercise performance. It has been suggested that the ingestion of EPA and DHA of approximately 1–2 g/d, at a ratio of EPA to DHA of 2:1, may be beneficial in counteracting exercise-induced inflammation and for the overall athlete health. However, the human data are inconclusive as to whether omega-3 PUFA supplementation at this dosage is effective in attenuating the inflammatory and immunomodulatory response to exercise and improving exercise performance. Thus, attempts should be made to establish an optimal omega-3 fatty-acid dosage to maximize the risk-to-reward ratio of supplementation. It should be noted that high omega-3 PUFA consumption may lead to immunosuppression and prolong bleeding time. Future studies investigating the efficacy of omega-3 PUFA supplementation in exercise-trained individuals should consider using an exercise protocol of sufficient duration and intensity to produce a more robust oxidative and inflammatory response.

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Clemens von Schacky, Maximilian Kemper, Robert Haslbauer and Martin Halle

The Omega-3 Index is defined as erythrocyte eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and represents an individual’s status in these two marine omega-3 fatty acids. A target range of 8 to 11% has been suggested, because values below predispose to cardiovascular events, especially sudden cardiac death, as well as to suboptimal brain function, like prolonged reaction times or even depression. Compared with the general population, elite athletes have an increased incidence of sudden death. The Omega-3 Index has not yet been investigated in elite athletes. In an exploratory approach, we determined the Omega-3 Index in 106 consecutive German national elite winter endurance athletes presenting for preparticipation screening, using a well-established analytical procedure (HS-Omega-3 Index). Surprisingly, only one athlete had a value within the target range, but all others had values <8%. We conclude that we have identified a deficiency of EPA and DHA in these elite athletes. This deficiency presents a potential option for prevention of cardiovascular events such as sudden cardiac death, and improving aspects of brain function. It will be important to scrutinize our finding by more thorough epidemiologic studies and appropriate intervention trials.

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Christopher Rosimus

The body composition of a squash player may affect athletic performance as carrying excessive body fat may increase injury risk and impair agility and speed. This case study outlines the effect of a nutritional intervention on body composition, vitamin D status, and physical performance of a female squash player. A structured, 6-week, moderate energy–restricted diet (70–78% of estimated energy requirement of 2,300 kcal) was implemented with weekly support. A daily supplement of vitamin D, omega-3 fatty acids, and a multivitamin and whey protein was used. Full blood count, vitamin D status, body composition, and physical performance assessments were carried out at baseline and Week 6 of intervention. Body composition changes were measured using the BOD POD™ and skinfold calipers. Body fat was 23% at baseline and 22% at Week 6. Mean sum of eight skinfolds was 127.4 ± 2.2 mm at baseline and 107.3 ± 0.4 mm at Week 6. Lean body mass-to-fat mass ratio improved from 3.4 at baseline to 3.7 at Week 6. The greatest increments compared with baseline in serum markers were 25-hydroxyvitamin D3 (68%), ferritin (31%), eosinophils (20%), and triglycerides (16%). All physical performance measures improved, with reactive strength index (4.8%), and on-court repeated speed (6.0%) showing the greatest improvements from baseline. This intervention demonstrates that structured energy restriction alongside appropriately structured strength and conditioning training is an effective way to gradually reduce the body fat and improve the body composition of a female athlete.

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Leyre Gravina, Frankie F. Brown, Lee Alexander, James Dick, Gordon Bell, Oliver C. Witard and Stuart D.R. Galloway

Omega-3 fatty acid (n-3 FA) supplementation could promote adaptation to soccer-specific training. We examined the impact of a 4-week period of n-3 FA supplementation during training on adaptations in 1RM knee extensor strength, 20-m sprint speed, vertical jump power, and anaerobic endurance capacity (Yo-Yo test) in competitive soccer players. Twenty six soccer players were randomly assigned to one of two groups: n-3 FA supplementation (n-3 FA; n = 13) or placebo (n = 13). Both groups performed two experimental trial days. Assessments of physical function and respiratory function were conducted pre (PRE) and post (POST) supplementation. Training session intensity, competitive games and nutritional intake were monitored during the 4-week period. No differences were observed in respiratory measurements (FEV1, FVC) between groups. No main effect of treatment was observed for 1RM knee extensor strength, explosive leg power, or 20 m sprint performance, but strength improved as a result of the training period in both groups (p < .05). Yo-Yo test distance improved with training in the n-3 FA group only (p < .01). The mean difference (95% CI) in Yo-Yo test distance completed from PRE to POST was 203 (66–340) m for n-3 FA, and 62 (-94–217) m for placebo, with a moderate effect size (Cohen’s d of 0.52). We conclude that 4 weeks of n-3 FA supplementation does not improve strength, power or speed assessments in competitive soccer players. However, the increase in anaerobic endurance capacity evident only in the n-3 FA treatment group suggests an interaction that requires further study.

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Dana M. Lis, Daniel Kings and D. Enette Larson-Meyer

result in a reduction of energy intake or of specific nutrients including omega-3 fatty acids, iron, zinc, calcium, vitamin D, iodine, and vitamin B12. These nutrients are less abundant in plant foods or are less well absorbed from plant compared with animal sources. Energy in Vegetarian Track

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Ronald J. Maughan, Louise M. Burke, Jiri Dvorak, D. Enette Larson-Meyer, Peter Peeling, Stuart M. Phillips, Eric S. Rawson, Neil P. Walsh, Ina Garthe, Hans Geyer, Romain Meeusen, Luc van Loon, Susan M. Shirreffs, Lawrence L. Spriet, Mark Stuart, Alan Vernec, Kevin Currell, Vidya M. Ali, Richard G.M. Budgett, Arne Ljungqvist, Margo Mountjoy, Yannis Pitsiladis, Torbjørn Soligard, Uğur Erdener and Lars Engebretsen

intake recommendations Omega 3-fatty acids (about 2 g/day) Improved cognitive processing; decreased risk/enhanced recovery from mTBI; increased muscle protein synthesis; reduced symptoms of or enhanced recovery from muscle-damaging exercise (e.g., DOMS). Improved cognitive processing following omega 3