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Vitamin/mineral supplements are often used by athletes as ergogenic aids to improve performance. This paper reviews studies of the prevalence, patterns, and explanations for vitamin/mineral supplement use among athletes. Fifty-one studies provided quantitative prevalence data on 10,274 male and female athletes at several levels of athletic participation in over 15 sports. The overall mean prevalence of athletes’ supplement use was 46%. Most studies reported that over half of the athletes used supplements (range 6% to 100%), and the larger investigations found lower prevalence levels. Elite athletes used supplements more than college or high school athletes. Women used supplements more often than men. Varying patterns existed by sport. Athletes appear to use supplements more than the general population, and some take high doses that may lead to nutritional problems. Sport nutritionists should include a vitamin/mineral supplement history as part of their dietary assessment so they can educate athletes about vitamin/mineral supplements and athletic performance.

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.

The relationship among the enzyme activities of cardiac markers, the antioxidant defense system, and erythrocyte membrane malonyldialdehyde (MDA) levels related to vitamin-mineral supplementation in swim exercise was investigated. Swimmers aged 11–13 years were divided into 2 separate groups as control and vitamin-mineral supplemented. Swimmers participated in a monthly swimming program (4 times/wk) and swam approximately 2–2.5 km/d. Cardiac markers such as creatine kinase (CK), creatine kinase-MB (CK-MB), glutamic oxaloacetic transaminase [GOT (AST)], lactate dehydrogenase (LDH), and antioxidant enzymes such as superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) activities in post-training samples were found to be significantly (p < .05) higher than in pre-training samples. Except for GOT (AST), the activity increases in CK, CK-MB, and LDH in female and male supplemented groups were significantly (p < .05) lower than those of control groups during the 1-month period of swim training. Antioxidant enzyme activity increases in the male vitamin-mineral group were significantly (p < .05) higher when compared with the other groups. Post-training MDA levels were significantly (p < .001) higher than pre-training MDA levels in the control groups, whereas no significant (p > .05) differences were found between the vitamin-mineral supplemented groups. Vitamin-mineral supplementation was found to attenuate cardiac and muscle damage markers while also enhancing antioxidant levels and reducing membrane LPO levels in response to 1 month of swim training.

The effect of vitamin and mineral supplementation was studied over 7 to 8 months of training and competition in 82 athletes from four sports: basketball, gymnastics, rowing, and swimming. Matched subgroups were formed and a double-blind design used, with subgroups being given either the supplementation or a placebo. All athletes were monitored to ensure that the recommended daily intakes (RDI) of vitamins and minerals were provided by diet alone. Sport-specific and some common tests of strength as well as aerobic and anaerobic fitness were performed. Coaches' assessment of improvement was also obtained. The only significant effect of supplementation was observed in the female basketball players, in which the supplementation was associated with increased body weight, skinfold sum, and jumping ability. A significant increase in skinfold sum was also demonstrated over the whole group as a result of supplementation. In general, however, this study provided little evidence of any effect of supplementation to athletic performance for athletes consuming the dietary RDIs.

Blood indicators of eight vitamins ( ${\text{B}}_1$ , ${\text{B}}_2$ , ${\text{B}}_6$ , 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 ${\text{B}}_1$ , ${\text{B}}_6$ , ${\text{B}}_{\mathrm{l2}}$ , and folate status all increased but there were no significant effects of supplementation on ${\text{B}}_2$ , 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 ${\text{B}}_2$ 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.

This study compared the dietary intakes of supplementing (SA) and non-supplementing athletes (NSA). Twenty-five female master athletes (mean age = 50.4 yr) participated in the study (SA = 16, NSA = 9). Four-day diet records were analyzed using Nutritionist V. Statistical significance (p < .005) was determined by independent t tests. No significant differences were observed in intakes of kilocalories (SA = 2079 ± 628 kcals, NSA = 2001 ± 435 kcals), protein (SA = 104 ± 75 g, NSA = 84 ± 35 g), fat (SA = 65 ± 39 g, NSA = 61 ± 22 g), or carbohydrates (SA = 269 ± 112 g, NSA = 277 ± 43 g). Mean intakes exceeded Dietary Reference Intake (DRI) guidelines for all micro-nutrients except calcium and vitamin E (NSA = 79% and 87% of DRI, respectively). SA had significantly greater total intakes than NSA for calcium (p = .0001), magnesium (p = .004), vitamin C (p = .003), and vitamin E (p = .001). Results suggest that female master athletes may rely on dietary supplements rather than nutrient-dense food choices to provide daily nutritional needs.

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.

The influences of gender, ethnicity, and sport of varsity athletes on their vitamin/mineral supplementation habits were examined. Subjects included 145 females and 266 males from 22 varsity teams; 80% were Caucasian; 12% African American; and 8% Combined-Other. Over half of the subjects took supplements. Males were more likely than females to give "too expensive" as a reason for not taking supplements, and "improve athletic performance" and "build muscle" as reasons for taking supplements. The most common supplement was multivitamins plus minerals. Females were more likely to take calcium and iron, and males vitamins B ₁₂ and A. African Americans were the most likely to take vitamin A. Males were more likely to get supplement information from nutritionists/dietitians and self, and females from family members or friends and physicians or pharmacists. Football players were more likely to get supplement information from nutritionists/dietitians, and males in other sports from coaches/trainers. There were some differences in vitamin/mineral supplement habits of the athletes by gender, ethnicity, and sport.

The supplementation practices of elite athletes in Singapore were studied using an anonymous questionnaire. Information was sought on not only the type of supplements used but also dosage, rationale for use, and other factors that might influence supplement use including selected demographic parameters and sources of information relating to supplements. Data was collected from 160 athletes across a spectrum of 30 sports. Use of supplements was widespread, with 77% of respondents acknowledging use of at least 1 product. Respondents ingested a total of 59 different supplements, with each athlete using on average 3.6 ± 0.3 different products. Sports drinks, caffeine, vitamin C, multivitamin/mineral supplements, and essence of chicken were some of the most commonly ingested products, confirming that while vitamin/mineral supplements are popular, sports supplements and traditional/herbal preparations were also well accepted. Respondents preferred to source information pertaining to supplements from “significant others” and other readily accessible sources. A small number of respondents acknowledged the use of International Olympic Committee (IOC) banned or restricted substances, highlighting the need for athletes to consult sports medicine professionals with specialist knowledge of dietary supplements in advance of initiating any supplementation regime.