Vitamin-mineral supplement use and nutritional status of athletes

Exploring the Relationship between Micronutrients and Athletic Performance: A Comprehensive Scientific Systematic Review of the Literature in Sports Medicine

The aim of this systematic review is twofold: (i) to examine the effects of micronutrient intake on athletic performance and (ii) to determine the specific micronutrients, such as vitamins, minerals, and antioxidants, that offer the most significant enhancements in terms of athletic performance, with the goal of providing guidance to athletes and coaches in optimizing their nutritional strategies. The study conducted a systematic search of electronic databases (i.e., PubMed, Web of Science, Scopus) using keywords pertaining to micronutrients, athletic performance, and exercise. The search involved particular criteria of studies published in English between 1950 and 2023. The findings suggest that vitamins and minerals are crucial for an athlete's health and physical performance, and no single micronutrient is more important than others. Micronutrients are necessary for optimal metabolic body's functions such as energy production, muscle growth, and recovery, which are all important for sport performance. Meeting the daily intake requirement of micronutrients is essential for athletes, and while a balanced diet that includes healthy lean protein sources, whole grains, fruits, and vegetables is generally sufficient, athletes who are unable to meet their micronutrient needs due to malabsorption or specific deficiencies may benefit from taking multivitamin supplements. However, athletes should only take micronutrient supplements with the consultation of a specialized physician or nutritionist and avoid taking them without confirming a deficiency.

Analysis of serum magnesium ions in dogs exposed to external stress: A pilot study

Magnesium ions (Mg²⁺) are essential for various enzymatic reactions in the body associated with energy production and activation of the muscles and nerves. Mg²⁺ is also involved in blood pressure regulation, maintenance of body temperature, and glucose metabolism. Although various factors including foods and physical conditions have been reported to change serum Mg²⁺ status in humans, serum Mg²⁺ in dogs exposed to external stress has been unclear. In this study, we examined serum levels of Mg²⁺ in dogs at different conditions using the guide dog candidates for the blind. Serum Mg²⁺ was decreased in winter and increased in summer. Guide dog candidates in an elementary class of the training showed markedly lower levels of serum Mg²⁺, compared with that of dogs in an advanced class. When healthy adult dogs were subjected to forced exercise using a treadmill, a significant reduction in serum Mg²⁺ levels was observed, particularly in winter. These findings suggest that serum levels of Mg²⁺ may be influenced by weather fluctuation such as air temperature, nervousness in unaccustomed situations, age, and physical stress induced by exercise. The results indicate that Mg²⁺ supplementation should be considered for working dogs, dogs moving or traveling to a new environment, and dogs during winter.

Prevalence of Dietary Supplement Use by Athletes: Systematic Review and Meta-Analysis

BACKGROUND

Dietary supplements (DSs) are commercially available products consumed as an addition to the usual diet and are frequently ingested by athletes.

OBJECTIVE

Our objective was to examine the prevalence of DS use by athletes.

DATA SOURCES

PubMed, Ovid MEDLINE, OVID Healthstar, and Cumulative Index to Nursing and Allied Health were searched for original research articles published up to August 2014. Search terms included specific sports, specific DSs, and other terms.

STUDY SELECTION

Studies were selected if they were written in English, involved athletes, and provided a quantitative assessment of the proportion of athletes using specific DSs. Percent of athletes using specific DSs.

SYNTHESIS OF DATA

Methodological quality of studies was assessed by three reviewers using an 8-point scale that included evaluations for sampling methods, sampling frame, sample size, measurement tools, bias, response rate, statistical presentation, and description of the participant sample. Where there were at least two investigations, meta-analysis was performed to obtain summary (pooled) prevalence estimates (SPEs) on (1) DS use prevalence by sport and sex, (2) DS use prevalence by elite versus non-elite athletic status, and (3) specific DS prevalence for all athletic groups combined. Meta-analyses included evaluations of homogeneity and publication bias.

RESULTS

A total of 159 unique studies met the review criteria. Methodological quality was generally low with an average ± standard deviation of 43 ± 16% of available rating points. There was low homogeneity for SPEs when compiled by sport, athletic status, and/or specific DSs. Contributing to the lack of homogeneity were differences in studies' objectives and types of assessments used (e.g., dietary surveys, interviews, questionnaires). Despite these limitations, the data generally indicated that elite athletes used DSs much more than their non-elite counterparts. For most DSs, use prevalence was similar for men and women except that a larger proportion of women used iron while a larger proportion of men used vitamin E, protein, and creatine. No consistent change in use over time was observed because even the earliest investigations showed relatively high use prevalence.

CONCLUSION

It was difficult to generalize regarding DS use by athletes because of the lack of homogeneity among studies. Nonetheless, the data suggested that elite athletes used dietary supplements far more than their non-elite counterparts; use was similar for men and women with a few exceptions; use appeared to change little over time; and a larger proportion of athletes used DSs compared with the general US population. Improvements in study methodology should be considered in future studies especially (1) defining DSs for participants; (2) querying for very specific DSs; (3) using a variety of reporting timeframes (e.g., daily, 2-6 times/week, 1 time/week and <1 time/week); (4) reporting the sampling frame, number of individuals solicited, and number responding; (5) reporting characteristics of volunteers (and non-volunteers, if available); and (6) using similar methods on several occasions to examine possible temporal trends among athletes.

Reduction of plasma lactate elevation and proteinuria by a complex dietary supplement in swimmers during over-loading training

Endurance training aiming at eliciting further increase of physical performance of competitive athletes demands serious time and intensity constraints. In addition, very high intensity training could lead to "over-loading" frequently associated with increased concentration of plasma lactate after maximum intensity exercise and proteinuria. We hypothesized that a newly available complex dietary (CD) supplement by providing the necessary substances and cofactors for increased tissue metabolism would reduce the increase in plasma lactate concentration and proteinuria after maximum intensity exercise in swimmers undergoing high intensity training and exercise (70 km/week, for 6 weeks) period. Subjects involved in the investigation were junior swimmers (n = 10). Data were collected four times during the third macrocycle of training; 1st: before, 2nd: after 10 days and 3rd: 14 days after withdrawal of CD-supplement, whereas 4th: after 10 days of placebo treatment. The study was a double-blinded random controlled investigation. In the first period, plasma lactate concentration was 8.4 +/- 2.1 mmol/l, whereas protein level in the urine was 8.9 +/- 5.8 mg/l. After use of CD-supplement plasma lactate concentration significantly decreased to 5.5 +/- 1.9 mmol/l and proteinuria decreased to 1.3 +/- 2.1 mg/l (p<0.05). Importantly, the intensity and the volume of the training did not change during the observation period. Thus, use of CD-supplement significantly reduced the increase in plasma lactate and proteinuria after maximum intensity exercise in athletes (swimmers) undergoing high endurance training despite maintained training load. We propose that the special components of CD-supplement support the mechanisms responsible for lactate elimination and reduction of protein catabolism and/or increase of protein reabsorption. These adaptations are likely to allow the athletes to undergo higher intensity training resulting in greater performance.

Dietary behaviour of German adults differing in levels of sport activity

OBJECTIVE

To analyse the dietary behaviour of persons engaging in different levels of sport activity.

DESIGN

A cross-sectional survey analysis.

SETTING

A population-based sample of German adults.

SUBJECTS

A total of 1756 men and 2254 women participating in the German National Health Interview and Examination Survey and the integrated German Nutrition Survey 1998.

RESULTS

Among both genders, the median micronutrient intakes of active persons were more preferable than those of sedentary persons when German current reference values were used as a criterion. The median nutrient densities were also higher in the diet of active persons, especially those of vitamin E, calcium, magnesium, and among women also those of folate and vitamin C. On average, active persons consumed higher amounts of fruit/vegetable juice, drinking water, milk products (including cheese) and fruits. Active men additionally consumed higher amounts of vegetables and vegetable fat. The contribution of dietary supplements to the total nutrient intake was 3%, on average, for active men and women. Compared with sedentary persons, this contribution was significantly higher for vitamins, and among men also for calcium and magnesium.

CONCLUSION

There was no indication of an impaired micronutrient intake of active and moderately active persons compared with sedentary persons.

Magnesium-creatine supplementation effects on body water

This study evaluated magnesium-creatine (MgCre) supplementation on body water and quadriceps torque. Maltodextran (Placebo), Mg oxide plus Cre (MgO-Cre), and Mg-creatine chelate (MgC-Cre) at 800 mg Mg and 5 g Cre per day were used for 2 weeks in 35 subjects in a random assignment, blinded study. Pre-post measures were completed with bioimpedance to determine total body water (TBW), extracellular water (ECF), and intracellular water (ICF), and an isokinetic device at 180 degrees per second for knee extension peak torque (T), total work (W), and power (PWR). Body weights increased for both treatment groups, MgO-Cre Delta 0.75 kg (P <.05) and MgC-Cre Delta 0.4 kg (P =.07). Significant pre-post differences (P <.05) were noted only for MgC-Cre in ICW (26.29 v 28.01 L) and ECW (15.75 v 14.88 L). MgC-Cre had significant peak T (Nm) increase (124.5 v135.8, P <.05), while MgO-Cre (116.4 v 124.9, P =.06) and placebo (119.8 v 123.7, P =.343) did not. Both treatment groups had increased PWR (P <.05). MgC-Cre affects cellular fluid compartments. The peak torque changes were significant only in the MgC-Cre group, which had increases in ICW that may infer more muscular creatine due to its osmotic effect, and with increased cellular hydration, perhaps increased protein synthesis.

Plasma changes in micronutrients following a multivitamin and mineral supplement in healthy adults

OBJECTIVE

To estimate the micronutrient (riboflavin, folate, vitamin C, vitamin B(12), iron, zinc and copper) bioavailability in healthy adults from a multi-micronutrient dietary supplement to assess the possible influence on it by the tablet disintegration properties and by the relative intestinal permeability of subject.

METHODS

The bioavailability of seven micronutrients from a single brand of multi-micronutrient dietary supplement was measured on two separate occasions in the presence of a standardized test meal in 15 healthy adult subjects. Each subject visited the Metabolic Research Unit on four separate randomized occasions for an absorption test. One test measured the intestinal permeability. The other three tests measured the postprandial changes in plasma or serum concentrations after consuming a test meal alone (control:placebo effect), or the test meal with either whole or crushed and powdered dietary supplements. 15 healthy Caucasian adult volunteers, aged 42 +/- 14 years.

RESULTS

The 12 hour-post-dose AUC for riboflavin, folate and vitamin C (whole and crushed tablet), and that for vitamin B(12) (only for the crushed tablet treatment) and iron (only for the whole tablet treatment) were all significantly (p < 0.001) higher than after a test meal alone. In contrast there was no significant increase in the AUC after supplement intake for zinc and copper. Neither the form of the supplement for all micronutrients tested nor intestinal permeability of the subject for riboflavin, folate, vitamin C, iron, zinc and copper influenced the postdose nutrient AUC. In contrast, for vitamin B(12) the intestinal permeability of the subject influenced significantly the nutrient AUC (p = 0.003).

CONCLUSION

Tablet disintegration characteristics of this dietary supplement did not limit absorption of these seven micronutrients. The intestinal permeability of subject was only positively correlated with the B(12) bioavailability. Results are suggestive of using multi-micronutrients dietary supplements as a vehicle to decrease the prevalence of multiple micronutrient deficiencies overall for vitamins in healthy adults.

Calcium deficiency modifies polyunsaturated fatty acid metabolism in growing rats

Fatty acid desaturase activities were determined in liver microsomes from calcium-deficient rats and compared to calcium-sufficient ones. The calcium-deprived diet (0.5 g/kg) administered for 60 d caused a 30% inhibition in the delta5 desaturase activity and a 45-55% decrease in delta6 and delta9, respectively, facts that cannot be attributed to a reduction in food intake. In vitro addition of calcium, ethyleneglycol-bis(Beta-aminoethyl ether)N,N-tetraacetic acid, and/or cytosol fractions from control or calcium-deficient rats to microsomes from both groups of animals indicates that the reduced desaturase capacities would be the consequence of an indirect effect of calcium deprivation. The present work shows that the reduced unsaturated fatty acid biosynthesis might be the result of modifications in the physicochemical properties of microsomal membranes. Such changes could also be derived from the inhibition of phospholipase A2 activity induced by calcium deficiency.

Effect of physical activity on thiamine, riboflavin, and vitamin B-6 requirements

Because exercise stresses metabolic pathways that depend on thiamine, riboflavin, and vitamin B-6, the requirements for these vitamins may be increased in athletes and active individuals. Theoretically, exercise could increase the need for these micronutrients in several ways: through decreased absorption of the nutrients; by increased turnover, metabolism, or loss of the nutrients; through biochemical adaptation as a result of training that increases nutrient needs; by an increase in mitochondrial enzymes that require the nutrients; or through an increased need for the nutrients for tissue maintenance and repair. Biochemical evidence of deficiencies in some of these vitamins in active individuals has been reported, but studies examining these issues are limited and equivocal. On the basis of metabolic studies, the riboflavin status of young and older women who exercise moderately (2.5-5 h/wk) appears to be poorer in periods of exercise, dieting, and dieting plus exercise than during control periods. Exercise also increases the loss of vitamin B-6 as 4-pyridoxic acid. These losses are small and concomitant decreases in blood vitamin B-6 measures have not been documented. There are no metabolic studies that have compared thiamine status in active and sedentary persons. Exercise appears to decrease nutrient status even further in active individuals with preexisting marginal vitamin intakes or marginal body stores. Thus, active individuals who restrict their energy intake or make poor dietary choices are at greatest risk for poor thiamine, riboflavin, and vitamin B-6 status.

Essentiality of selenium in the human body: relationship with different diseases

In the present review different aspects related to the essential element selenium in the human organism are considered. A large number of human studies have been performed in order to improve knowledge on the influence of this element in the origin and development of several degenerative diseases. Selenium deficiencies among human beings as well as animals are being recognized worldwide to be related to a number of pathologies. This element has also the special characteristic that the range between its essential and toxic character is very close, and consequently daily dietary intake should be appropriately monitored in individuals. Nevertheless, nowadays there is still a lot of controversy about the optimum dietary level of this element in order to cure or to prevent the appearance of diseases such as cirrhosis, cancer, diabetes, or cardiovascular pathologies. Results obtained in several animal and epidemiological studies have indicated that Se could constitute a dietary factor with protective action against several degenerative diseases.

Nutritional needs of the female athlete

US women, including female athletes, are under ever increasing pressure to be thin ar thinner. this pressure to achieve and maintain a low body weight leads to potentially harmful patterns of long-term dieting or disordered eating, which can affect long-term health. Some of the health consequences of long-term energy restriction in female athletes may include poor energy and nutrient intakes, poor nutritional status, decreased RMR and total daily energy expenditure, increased psychological stress and risk for a clinical eating disorder, and increased risk for exercise-induced amenorrhea and osteoporosis. Female athletes participating in thin-build sports may be at risk for the disorders of the female athlete triad: disordered eating, amenorrhea, and osteoporosis. This triad of disorders can also produce severe health consequences that can influence present and future health. Strategies for helping active women get off the dieting "bandwagon" requires the identification of an appropriate and healthy body weight, good eating and exercise habits, and techniques for maintaining these habits throughout life.

Search for the competitive edge: a history of dietary fads and supplements

The premise and promise of ergogenic aid use is rooted in antiquity and is based upon superstition and ritualistic behavior of athletes who perceive that past performances were predicated upon unique dietary constituents or dietary manipulation. Accounts from ancient times recommended that athletes and soldiers preparing for battle consume specific animal parts to confer agility, speed or strength associated with that animal. Scientific understanding of the chemical and physiological nature of muscular work in the early 20th century was followed by ergogenic aid use by athletes and rationalized as "scientific" justification. Ergogenic aids such as alkaline salts, caffeine, carbohydrate and protein have been used by athletes with variable success. As nutritionists and exercise physiologists discovered and perfected the scientific understanding of metabolic reactions, athletes in turn experimented with the amount, form and timing of administration in the search for optimal performance. Anabolic steroids and blood doping enhance athletic performance, but health risks, ethics and sportsmanship contravene their use. Popularity and use of ergogenic aids often have preceded scientific substantiation of claims. Current products such as protein isolates and antioxidant nutrients commonly are used by athletes, and many ergogenic aids available today differ little from those used long ago.

High school athletes and nutritional supplements: a study of knowledge and use

Factors influencing nutritional supplement use by high school students were assessed. Comparisons were made between various groups of sports participants and non-sports participants. The Nutritional Supplement Use and Knowledge Scale was administered to 509 students. Mean supplement use score was 10.87 (SEM = 0.50, range 0-57). Mean knowledge score was 13.56 (SEM = 0.16, range 1-21). Significant relationships (p < .01) were obtained for supplement knowledge with use, and supplement use with gender. ANOVA found significant differences between supplement use by gender (p < .01), supplement use by sports category (p < .05), and knowledge scores by sports category (p < .01). Discriminant function analysis indicated knowledge, supplement use, and subscores for protein, vitamins/minerals, knowledge, supplement use, and subscores for protein, vitamins/minerals, and carbohydrates were best discriminators of sport group membership. Greater knowledge about supplements was associated with less use; hence, education about supplements can be a deterrent to use. This study may help coaches, athletic trainers, athletic directors, teachers, physicians, and parents identify nutritional misconceptions held by adolescents.

Micronutrients and exercise: anti-oxidants and minerals

Exercise has been shown to increase indirect measures of lipid peroxidation. However, exercise and training appear to augment the body's anti-oxidant defence system. Whether this augmented defence system can keep up with the increase in lipid peroxidation with exercise is not known. Iron depletion is experienced by many athletes, especially female endurance athletes and adolescents, but iron deficiency anaemia is rare. Iron depletion could affect the ability to train and recover from strenuous exercise, but this has not been examined. There is a concern that female athletes, especially adolescents, are not ingesting sufficient calcium, and this may affect the development of peak bone mass and increase the risk of bone fractures. Further research is needed on mineral and trace mineral intake and loss in athletes. It appears that most athletes have adequate status of chromium, zinc, phosphate and magnesium. Athletes who are restricting energy intake to achieve a low body mass (for example, endurance runners), may not have adequate vitamin or mineral status. More data are needed on vitamin/mineral status of athletes from underdeveloped countries. The general recommendation for athletes is that foods rich in anti-oxidants and minerals should be ingested rather than supplements.

Vitamin/mineral supplement use among athletes: a review of the literature

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.

Vitamin B6 and exercise

This paper presents an overview of vitamin B6 and exercise, including the role that vitamin B6 plays in gluconeogenesis and glycogenolysis and changes in vitamin B6 metabolism during exercise. The dietary vitamin B6 intakes of athletes are also reviewed. Most studies report that male athletes have adequate dietary intakes of vitamin B6, whereas some females, especially those with low energy intakes, appear to have low vitamin B6 intakes. Few studies have assessed the vitamin B6 status of nonsupplementing athletes using the recommended status criteria. The role that vitamin B6 may play in attenuating the rise in plasma growth hormone observed during exercise is also reviewed. Finally, recommendations are given for further research in the area of vitamin B6 and exercise.

Trace mineral requirements for athletes

This paper reviews information pertaining to zinc, copper, chromium, and selenium requirements of athletes. Exercise increases zinc loss from the body, and dietary intake for some athletes, especially females, may be inadequate. Blood copper levels are altered by exercise, but there is no information to suggest that copper ingestion or status is compromised in athletes. Studies have shown that urinary chromium excretion is increased by exercise, but whether this leads to an increased requirement is still unknown. There is concern that athletes may not ingest sufficient quantities of chromium; however, there are inadequate data to confirm this. The limited data that exist show that athletes do not have altered selenium status. There is no conclusive evidence that supplementation with any of these trace minerals will enhance performance. A diet containing foods rich in micronutrients is recommended. However, for those athletes concerned that their diets may not be sufficient, a multivitamin/mineral supplement containing no more than the RDA may be advised.