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Hyun Chul Jung, Myong Won Seo, Sukho Lee, Sung Woo Jung and Jong Kook Song

The prevalence of vitamin D deficiency has become an important worldwide public health issue ( Holick & Chen, 2008 ). It is well recognized that vitamin D plays a key role in bone health ( Välimäki et al., 2004 ), muscle function ( Ceglia, 2008 ), and athletic performance ( Koundourakis et

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Kelly Pritchett, Robert C. Pritchett, Lauren Stark, Elizabeth Broad and Melissa LaCroix

The National Health and Nutrition Examination Survey III determined that vitamin D insufficiency (<75 nmol/L) affects over 77% of the population. According to the World Health Organization and the Endocrine Society serum 25(OH) vitamin D (25(OH)D) standards, vitamin D deficiency is defined as <50

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Matthew A. Wyon, Roger Wolman, Nicolas Kolokythas, Karen Sheriff, Shaun Galloway and Adam Mattiussi

A worldwide vitamin D deficiency has been frequently reported in the scientific literature over the past 20 years. 1 The majority of studies have focused on the adult population but the few studies that have used adolescent populations have reported similar deficiency and insufficiency rates. 2

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Kirsty A. Fairbairn, Ingrid J.M. Ceelen, C. Murray Skeaff, Claire M. Cameron and Tracy L. Perry

Vitamin D is a secosteroid hormone that may directly act on skeletal muscle ( Ceglia, 2008 ; Hamilton, 2010 ). Muscle function is impaired in severe vitamin D deficiency like rickets and osteomalacia ( Wharton & Bishop, 2003 ), and supplementation of between 420 and 8,570 IU/day for 3–6 months in

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Gal Dubnov-Raz, Netachen Livne, Raanan Raz, Avner H. Cohen and Naama W. Constantini

It is hypothesized that vitamin D insufficiency in athletes might negatively affect sport performance. The objective of this study was to examine the effect of vitamin D3 supplementation on physical performance of adolescent swimmers with vitamin D insufficiency. Fifty-three adolescent competitive swimmers with vitamin D insufficiency (serum 25-hydroxyvitamin-D concentrations (25(OH)D)<30ng/ml, mean 24.2 ± 4.8ng/ml) were randomized to receive 2,000IU/day of vitamin D3 or placebo for 12 weeks. Swimming performance at several speeds, arm-grip strength, and one-legged balance, were measured before and after supplementation. The age-adjusted changes in performance variables during the study were compared between groups. 25(OH) D concentrations at study end were significantly higher in the vitamin group compared with the placebo group (29.6 ± 6.5ng/ml vs. 20.3 ± 4.2ng/ml, p < .001), yet only 48% of the vitamin group became vitamin D sufficient with this dosing. No between-group differences were found in the changes of the performance variables tested. No significant differences in performance were found between participants that became vitamin D sufficient, and those who did not. No significant correlation was found between the change in serum 25(OH)D and ageadjusted balance, strength or swimming performance at study end. Vitamin D3 supplementation that raised serum 25(OH)D concentrations by a mean of 9.3ng/ml above placebo in adolescent swimmers with vitamin D insufficiency, did not improve physical performance more than placebo.

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Gal Dubnov-Raz, Netachen Livne, Raanan Raz, Daniel Rogel, Avner H. Cohen and Naama W. Constantini

Serum vitamin D concentrations (25[OH]D) are associated with physical performance in the general population, but few studies have been published in athletes. 80 competitive adolescent swimmers from both sexes were tested for serum 25(OH)D concentrations, grip strength, balance and swimming performance at several speeds. Spearman’s correlations were used to examine the associations between 25(OH)D concentrations and age-adjusted measures of performance. Performance parameters were also compared between vitamin D sufficient (n = 27), insufficient (25[OH]D ranging 20−29.9 ng/ml, n = 42), and deficient (25[OH]D < 20 ng/ml, n = 11) participants. No significant associations were found between serum 25(OH)D concentrations and any of the performance measures, with no significant differences found between vitamin D sufficient, insufficient and deficient participants. In competitive adolescent swimmers, serum vitamin D concentrations were not associated with strength, balance or swimming performance. Vitamin D insufficient/deficient swimmers did not have reduced performance.

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Pamela J. Magee, L. Kirsty Pourshahidi, Julie M. W. Wallace, John Cleary, Joe Conway, Edward Harney and Sharon M. Madigan

Background:

A high prevalence of vitamin D insufficiency/deficiency, which may impact on health and training ability, is evident among athletes worldwide. This observational study investigated the vitamin D status of elite Irish athletes and determined the effect of wintertime supplementation on status.

Methods:

Serum 25-hydroxyvitamin D [25(OH)D], calcium, and plasma parathyroid hormone were analyzed in elite athletes in November 2010 (17 boxers, 33 paralympians) or March 2011 (34 Gaelic Athletic Association [GAA] players). A subset of boxers and paralympians (n = 27) were supplemented during the winter months with either 5,000 IU vitamin D3/d for 10–12 weeks or 50,000 IU on one or two occasions. Biochemical analysis was repeated following supplementation.

Results:

Median 25(OH)D of all athletes at baseline was 48.4 nmol/L. Vitamin D insufficiency/deficiency (serum 25(OH)D <50 nmol/L) was particularly evident among GAA players (94%) due to month of sampling. Wintertime supplementation (all doses) significantly increased 25(OH)D (median 62.8 nmol/L at baseline vs. 71.1 nmol/L in April or May; p = .001) and corrected any insufficiencies/deficiencies in this subset of athletes. In contrast, 25(OH)D significantly decreased in those that did not receive a vitamin D supplement, with 74% of athletes classed as vitamin D insufficient/deficient after winter, compared with only 35% at baseline.

Conclusions:

This study has highlighted a high prevalence of vitamin D insufficiency/deficiency among elite Irish athletes and demonstrated that wintertime vitamin D3 supplementation is an appropriate regimen to ensure vitamin D sufficiency in athletes during winter and early spring.

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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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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.