Minerals, trace elements, Vit. D and bone health

The impact of 1-year vitamin D supplementation on vitamin D status in athletes: a dose–response study

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Abstract

Background/Objectives:

To assess the prevalence of vitamin D deficiency in Dutch athletes and to define the required dosage of vitamin D3 supplementation to prevent vitamin D deficiency over the course of a year.

Subjects/Methods:

Blood samples were collected from 128 highly trained athletes to assess total 25(OH)D concentration. Of these 128 athletes, 54 male and 48 female athletes (18–32 years) were included in a randomized, double blind, dose–response study. Athletes with either a deficient (<50 nmol/l) or an insufficient (50–75 nmol/l) 25(OH)D concentration were randomly assigned to take 400, 1100 or 2200 IU vitamin D3 per day orally for 1 year. Athletes who had a total 25(OH)D concentration above 75 nmol/l at baseline continued with the study protocol without receiving vitamin D supplements. Serum total 25(OH)D concentration was assessed every 3 months, as well as dietary vitamin D intake and sunlight exposure.

Results:

Nearly 70% of all athletes showed an insufficient (50–75 nmol/l) or a deficient (<50 nmol/l) 25(OH)D concentration at baseline. After 12 months, serum 25(OH)D concentration had increased more in the 2200 IU/day group (+50±27 nmol/l) than the sufficient group receiving no supplements (+4±17 nmol/l; P<0.01) and the 1100 IU/day group (+25±23 nmol/l; P<0.05). Supplementation with 2200 IU/day vitamin D resulted in a sufficient 25(OH)D concentration in 80% of the athletes after 12 months.

Conclusions:

Vitamin D deficiency is highly prevalent in athletes. Athletes with a deficient or an insufficient 25(OH)D concentration can achieve a sufficient 25(OH)D concentration within 3 months by taking 2200 IU/day.

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References

  1. 1

    Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab 2011; 96: 53–58.

  2. 2

    Allison RJ, Close GL, Farooq A, Riding NR, Salah O, Hamilton B et al. Severely vitamin D-deficient athletes present smaller hearts than sufficient athletes. Eur J Prev Cardiol 2014; 22: 535–542.

  3. 3

    Close GL, Leckey J, Patterson M, Bradley W, Owens DJ, Fraser WD et al. The effects of vitamin D(3) supplementation on serum total 25[OH]D concentration and physical performance: a randomised dose–response study. Br J Sports Med 2013; 47: 692–696.

  4. 4

    Ducher G, Kukuljan S, Hill B, Garnham AP, Nowson CA, Kimlin MG et al. Vitamin D status and musculoskeletal health in adolescent male ballet dancers a pilot study. J Dance Med Sci 2011; 15: 99–107.

  5. 5

    Mowe M, Haug E, Bohmer T . Low serum calcidiol concentration in older adults with reduced muscular function. J Am Geriatr Soc 1999; 47: 220–226.

  6. 6

    Salles J, Chanet A, Giraudet C, Patrac V, Pierre P, Jourdan M et al. 1,25(OH)2-vitamin D3 enhances the stimulating effect of leucine and insulin on protein synthesis rate through Akt/PKB and mTOR mediated pathways in murine C2C12 skeletal myotubes. Mol Nutr Food Res 2013; 57: 2137–2146.

  7. 7

    Close GL, Russell J, Cobley JN, Owens DJ, Wilson G, Gregson W et al. Assessment of vitamin D concentration in non-supplemented professional athletes and healthy adults during the winter months in the UK: implications for skeletal muscle function. J Sports Sci 2013; 31: 344–353.

  8. 8

    Barker T, Schneider ED, Dixon BM, Henriksen VT, Weaver LK . Supplemental vitamin D enhances the recovery in peak isometric force shortly after intense exercise. Nutr Metab 2013; 10: 69.

  9. 9

    Wyon MA, Koutedakis Y, Wolman R, Nevill AM, Allen N . The influence of winter vitamin D supplementation on muscle function and injury occurrence in elite ballet dancers: a controlled study. J Sci Med Sport 2014; 17: 8–12.

  10. 10

    Holick MF . Vitamin D status: measurement, interpretation, and clinical application. Ann Epidemiol 2009; 19: 73–78.

  11. 11

    Wyon MA, Wolman R, Nevill AM, Cloak R, Metsios GS, Gould D et al. Acute effects of vitamin D3 Supplementation on muscle strength in Judoka athletes: a randomized placebo-controlled, double-blind trial. Clin J Sport Med 2015; 26: 279–284.

  12. 12

    Dubnov-Raz G, Livne N, Raz R, Cohen AH, Constantini NW . Vitamin D Supplementation and Physical Performance in Adolescent Swimmers. Int J Sport Nutr Exerc Metab 2015; 25: 317–325.

  13. 13

    Gezondheidsraad Evaluation of Dietary Reference Values for Vitamin D. The Hague Health Council of the Netherlands: Hague, 2012.

  14. 14

    Gallagher JC, Sai A, Templin T 2nd, Smith L . Dose response to vitamin D supplementation in postmenopausal women: a randomized trial. Ann Intern Med 2012; 156: 425–437.

  15. 15

    Cashman KD, Wallace JM, Horigan G, Hill TR, Barnes MS, Lucey AJ et al. Estimation of the dietary requirement for vitamin D in free-living adults &gt;=64 y of age. Am J Clin Nutr 2009; 89: 1366–1374.

  16. 16

    Heaney RP, Davies KM, Chen TC, Holick MF, Barger-Lux MJ . Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr 2003; 77: 204–210.

  17. 17

    Halliday TM, Peterson NJ, Thomas JJ, Kleppinger K, Hollis BW, Larson-Meyer DE . Vitamin D status relative to diet, lifestyle, injury, and illness in college athletes. Med Sci Sports Exerc 2011; 43: 335–343.

  18. 18

    Clark M, Reed DB, Crouse SF, Armstrong RB . Pre- and post-season dietary intake, body composition, and performance indices of NCAA division I female soccer players. Int J Sport Nutr Exerc Metab 2003; 13: 303–319.

  19. 19

    Brouwer-Brolsma EM, Vaes AM, van der Zwaluw NL, van Wijngaarden JP, Swart KM, Ham AC et al. Relative importance of summer sun exposure, vitamin D intake, and genes to vitamin D status in Dutch older adults: The B-PROOF study. J Steroid Biochem Mol Biol 2015, e-pub ahead of print 11 August 2015 doi:10.1016/j.jsbmb.2015.08.008.

  20. 20

    Fitzgerald JS, Peterson BJ, Wilson PB, Rhodes GS, Ingraham SJ . Vitamin D status is associated with adiposity in male ice hockey players. Med Sci Sports Exerc 2015; 47: 655–661.

  21. 21

    Blum M, Dolnikowski G, Seyoum E, Harris SS, Booth SL, Peterson J et al. Vitamin D(3) in fat tissue. Endocrine 2008; 33: 90–94.

  22. 22

    Holick MF, Matsuoka LY, Wortsman J . Age, vitamin D, and solar ultraviolet. Lancet 1989; 2: 1104–1105.

  23. 23

    Mavroeidi A, O'Neill F, Lee PA, Darling AL, Fraser WD, Berry JL et al. Seasonal 25-hydroxyvitamin D changes in British postmenopausal women at 57 degrees N and 51 degrees N: a longitudinal study. J Steroid Biochem Mol Biol 2010; 121: 459–461.

  24. 24

    Dawson-Hughes B, Harris SS, Palermo NJ, Ceglia L, Rasmussen H . Meal conditions affect the absorption of supplemental vitamin D3 but not the plasma 25-hydroxyvitamin D response to supplementation. J Miner Res 2013; 28: 1778–1783.

  25. 25

    Siebelink E, Geelen A, de Vries JH . Self-reported energy intake by FFQ compared with actual energy intake to maintain body weight in 516 adults. Br J Nutr 2011; 106: 274–281.

  26. 26

    Faul F, Erdfelder E, Lang AG, Buchner AG . *Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007; 39: 175–191.

  27. 27

    Cashman KD, Seamans KM, Lucey AJ, Stocklin E, Weber P, Kiely M et al. Relative effectiveness of oral 25-hydroxyvitamin D3 and vitamin D3 in raising wintertime serum 25-hydroxyvitamin D in older adults. Am J Clin Nutr 2012; 95: 1350–1356.

  28. 28

    Farrokhyar F, Tabasinejad R, Dao D, Peterson D, Ayeni OR, Hadioonzadeh R et al. Prevalence of Vitamin D inadequacy in athletes: a systematic-review and meta-analysis. Sports Med 2014; 45: 365–378.

  29. 29

    Constantini NW, Arieli R, Chodick G, Dubnov-Raz G . High prevalence of vitamin D insufficiency in athletes and dancers. Clin J Sport Med 2010; 20: 368–371.

  30. 30

    Hamilton B, Grantham J, Racinais S, Chalabi H . Vitamin D deficiency is endemic in Middle Eastern sportsmen. Public Health Nutr 2010; 13: 1528–1534.

  31. 31

    Bescos Garcia R, Rodriguez Guisado FA . Low levels of vitamin D in professional basketball players after wintertime: relationship with dietary intake of vitamin D and calcium. Nutr Hosp 2011; 26: 945–951.

  32. 32

    Galan F, Ribas J, Sanchez-Martinez PM, Calero T, Sanchez AB, Munoz A . Serum 25-hydroxyvitamin D in early autumn to ensure vitamin D sufficiency in mid-winter in professional football players. Clin Nutr 2012; 31: 132–136.

  33. 33

    Cashman KD, Fitzgerald AP, Kiely M, Seamans KM . A systematic review and meta-regression analysis of the vitamin D intake-serum 25-hydroxyvitamin D relationship to inform European recommendations. Br J Nutr 2011; 106: 1638–1648.

  34. 34

    Cashman KD, Hill TR, Lucey AJ, Taylor N, Seamans KM, Muldowney S et al. Estimation of the dietary requirement for vitamin D in healthy adults. Am J Clin Nutr 2008; 88: 1535–1542.

  35. 35

    Melamed ML, Michos ED, Post W, Astor B . 25-hydroxyvitamin D levels and the risk of mortality in the general population. Arch Internal Med 2008; 168: 1629–1637.

  36. 36

    Durup D, Jorgensen HL, Christensen J, Schwarz P, Heegaard AM, Lind B . A reverse J-shaped association of all-cause mortality with serum 25-hydroxyvitamin D in general practice: the CopD study. J Clin Endocrinol Metab 2012; 97: 2644–2652.

  37. 37

    Vieth R . Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr 1999; 69: 842–856.

  38. 38

    EFSA Panel on Dietetic Products NaAN.. Scientific opinion on the tolerable upper intake level of vitamin D. EFSA J 2012; 10: 2813–2858.

  39. 39

    MacLaughlin J, Holick MF . Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest 1985; 76: 1536–1538.

  40. 40

    Hulshof MO KFAM, van Rossum CTM, Buurma-Rethans EJM, Brants HAM, Drijvers JJMM et al. Resultaten van de Voedselconsumptiepeiling 2003 Zeist 2003.

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Acknowledgements

We thank all the students and Lucy Okma for assisting during the tests.

Author information

Correspondence to L C P G M de Groot.

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Competing interests

The project is funded by DSM, Food Specialties (Delft, The Netherlands) and the Dutch Olympic Committee (NOC)*Dutch Sports Federation (NSF) (Arnhem, The Netherlands). EMP Backx, M Tieland, M Mensink, LJ van Loon and CPMG de Groot have no conflicts of interest. K Maase is a researcher with Unit Elite Sports, Netherlands Olympic Committee*Netherlands Sports Confederation (NOC*NSF). AK Kies is a researcher with DSM Food Specialties.

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