Effects of exercise on riboflavin requirements of young women

Nutritional intake of riboflavin (vitamin B2) and migraine: a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) 2001-2004

OBJECTIVES

Clinical studies demonstrate that supplemental riboflavin is an efficacious and low risk prophylactic treatment for migraine. However, background riboflavin intake of adults with migraine from nutritional sources has not been evaluated. This study aimed to evaluate riboflavin consumption of adults with migraine in the United States, and further investigate the relationship between nutritional riboflavin consumption and the prevalence of migraine among adults.

METHODS

This cross-sectional secondary analysis included 3439 participants ages 20-50 years old in the National Health and Nutrition Examination Survey from 2001 to 2004. Presence of migraine in the past three months was self-reported. Riboflavin intake was determined from one 24-hour recall interview. Odds ratios and 95% confidence intervals were calculated for riboflavin intake quartiles using an adjusted logistic regression model. Statistical significance was determined using an adjusted Wald test.

RESULTS

Results showed that mean dietary consumption of riboflavin fulfilled the Recommended Dietary Allowance for migraine and control groups. Dietary riboflavin intake was associated with the odds of migraine (pWald = 0.002), but no association was found for supplemental or total riboflavin consumption (pWald = 0.479 and 0.136). When stratified by gender, there was no association of dietary riboflavin with migraine in males (pWald = 0.423), but an association was observed in females (pWald = 0.014).

DISCUSSION

The RDA value for riboflavin was not relevant for assessing odds of migraine; however, differing odds of migraine were detected across dietary riboflavin consumption groups at levels above the RDA. Future riboflavin supplementation trials for migraine prophylaxis should consider measuring background dietary intake.

The Effect of a Single Bout of Exercise on Vitamin B2 Status Is Not Different between High- and Low-Fit Females

High-fitness individuals have been suggested to be at risk of a poor vitamin B2 (riboflavin) status due to a potentially higher vitamin B2 demand, as measured by the erythrocyte glutathione reductase (EGR) activation coefficient (EGRAC). Longer-term exercise interventions have been shown to result in a lower vitamin B2 status, but studies are contradictory. Short-term exercise effects potentially contribute to discrepancies between studies but have only been tested in limited study populations. This study investigated if vitamin B2 status, measured by EGRAC, is affected by a single exercise bout in females who differ in fitness levels, and that represents long-term physical activity. At baseline and overnight after a 60-min cycling bout at 70% V·O₂peak, EGR activity and EGRAC were measured in 31 young female adults, divided into a high-fit (V·O₂peak ≥ 47 mL/kg/min, N = 15) and low-fit (V·O₂peak ≤ 37 mL/kg/min, N = 16) group. A single exercise bout significantly increased EGR activity in high-fit and low-fit females (P_time = 0.006). This response was not affected by fitness level (P_time*group = 0.256). The effect of exercise on EGRAC was not significant (P_time = 0.079) and not influenced by EGR activity. The exercise response of EGRAC was not significantly different between high-fit and low-fit females (P_time*group = 0.141). Thus, a single exercise bout increased EGR activity, but did not affect EGRAC, indicating that vitamin B2 status was not affected. The exercise response on EGRAC and EGR did not differ between high-fit and low-fit females.

Dietary Reference Values for riboflavin

Following a request from the European Commission, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) derives dietary reference values (DRVs) for riboflavin. The Panel considers that the inflection point in the urinary riboflavin excretion curve in relation to riboflavin intake reflects body saturation and can be used as a biomarker of adequate riboflavin status. The Panel also considers that erythrocyte glutathione reductase activation coefficient is a useful biomarker, but has limitations. For adults, the Panel considers that average requirements (ARs) and population reference intakes (PRIs) can be determined from the weighted mean of riboflavin intake associated with the inflection point in the urinary riboflavin excretion curve reported in four intervention studies. PRIs are derived for adults and children assuming a coefficient of variation of 10%, in the absence of information on the variability in the requirement and to account for the potential effect of physical activity and the methylenetetrahydrofolate reductase 677TT genotype. For adults, the AR and PRI are set at 1.3 and 1.6 mg/day. For infants aged 7–11 months, an adequate intake of 0.4 mg/day is set by upward extrapolation from the riboflavin intake of exclusively breastfed infants aged 0–6 months. For children, ARs are derived by downward extrapolation from the adult AR, applying allometric scaling and growth factors and considering differences in reference body weight. For children of both sexes aged 1–17 years, ARs range between 0.5 and 1.4 mg/day, and PRIs between 0.6 and 1.6 mg/day. For pregnant or lactating women, additional requirements are considered, to account for fetal uptake and riboflavin accretion in the placenta during pregnancy or the losses through breast milk, and PRIs of 1.9 and 2.0 mg/day, respectively, are derived.

This publication is linked to the following EFSA Supporting Publications article: http://onlinelibrary.wiley.com/doi/10.2903/sp.efsa.2017.EN-1268/full

Changes in vitamin status of Indian Antarctic expeditioners during a one-month stay in Austral Summer

OBJECTIVE

Antarctic expeditioners face extremes of environmental conditions along with isolation which affect normal human activity at a polar station. Diets of polar expeditioners consist of products that have been kept in storage for more than a year. Processing and preservation adversely affect the nutritive value of the food products, especially water-soluble vitamins. This study was conducted to determine water-soluble vitamin status of Antarctic expeditioners consuming processed canned food.

METHODS

Twenty-two healthy male volunteers age 26 to 56 years (39.5+/-8.5, mean+/-SD) participated in the study. The study was conducted in 3 phases: at Goa, India (phase I), 48 hours after arriving in Antarctica (phase II) and after 1 month in Antarctica (phase III). Water-soluble vitamin status in erythrocytes was assessed at each phase with evaluation of riboflavin, thiamine, and pyridoxine status. Urinary N-methyl nicotinamide and methylmalonic acid (MMA) levels were measured to assess niacin and vitamin B(12) status. Blood plasma assays were used to assess ascorbic acid status.

RESULTS

No significant changes in riboflavin, thiamine, and pyridoxine status in erythrocytes and urinary excretion levels were observed after 1 month in Antarctica. Vitamin C levels decreased significantly (P<.001) after 1 month in Antarctica compared with basal values (1.31+/-0.076 mg/dL during phase I to 0.81+/-0.063 mg/dL during phase III). However, these levels were still within the normal reference range.

CONCLUSION

This study found no water-soluble vitamin deficiencies in participants consuming processed and canned food after 1 month in Antarctica.

The role of vitamins and minerals in energy metabolism and well-being

Physicians are frequently confronted with patients complaining of fatigue, tiredness and low energy levels. In the absence of underlying disease, these symptoms could be caused by a lack of vitamins and minerals. Certain risk groups like the elderly and pregnant women are well-recognized. Our aim was, therefore, to find out if other, less well-established groups might also be at risk. Thus, the objectives of this review are: to describe the inter-relationship between micronutrients, energy metabolism and well-being; identify risk groups for inadequate micronutrient intake; and explore the role of micronutrient supplementation in these groups. A review of the literature identified an important group at risk of inadequate micronutrient intake: young adults, often women, with a demanding lifestyle who are physically active and whose dietary behaviour is characterized by poor choices and/or regular dieting. Micronutrient supplementation can alleviate deficiencies, but supplements must be taken for an adequate period of time.

Vitamin and mineral status: effects on physical performance

Public health recommendations encourage the selection of a balanced diet and increasing physical activity to foster health and well-being. Whereas the adverse effects of restricted intakes of protein, fat, and carbohydrate on physical performance are well known, there is limited information about the impact of low intakes of vitamins and minerals on the exercise capacity and performance of humans. Physically active people generally consume amounts of vitamins and minerals consistent with the recommendations for the general public. However, when intakes are less than recommendations, some noticeable functional impairments occur. Acute or short-term marginal deficiencies, identified by blood biochemical measures of vitamin B status, had no impacts on performance measures. Severe deprivation of folate and vitamin B12 result in anemia and reduce endurance work performance. Evidence of vitamin A and E deficiencies in athletic individuals is lacking apparently because body storage is appreciable. In contrast to vitamins, marginal mineral deficiencies impair performance. Iron deficiency, with or without anemia, impairs muscle function and limits work capacity. Magnesium deprivation increases oxygen requirements to complete submaximal exercise and reduces endurance performance. Use of vitamin and mineral supplements does not improve measures of performance in people consuming adequate diets. Young girls and individuals participating in activities with weight classifications or aesthetic components are prone to nutrient deficiencies because they restrict food intake and specific micronutrient-rich foods. This information will be useful to professionals who counsel physically active people and scientific groups who make dietary recommendations to improve health and optimize genetic potential.

Dietary recommendations and athletic menstrual dysfunction

Exercise-induced or athletic menstrual dysfunction (amenorrhoea, oligomenorrhoea, anovulation, luteal phase deficiency, delayed menarche) is more common in active women and can significantly affect health and sport performance. Although athletic amenorrhoea represents the most extreme form of menstrual dysfunction, other forms can also result in suppressed estrogen levels and affect bone health and fertility. A number of factors, such as energy balance, exercise intensity and training practices, bodyweight and composition, disordered eating behaviours, and physical and emotional stress levels, may contribute to the development of athletic menstrual dysfunction. There also appears to be a high degree of individual variation with respect to the susceptibility of the reproductive axis to exercise and diet-related stresses. The dietary issues of the female athlete with athletic menstrual dysfunction are similar to those of her eumenorrhoeic counterpart. The most common nutrition issues in active women are poor energy intake and/or poor food selection, which can lead to poor intakes of protein, carbohydrate and essential fatty acids. The most common micronutrients to be low are the bone-building nutrients, especially calcium, the B vitamins, iron and zinc. If energy drain is the primary contributing factor to athletic menstrual dysfunction, improved energy balance will improve overall nutritional status and may reverse the menstrual dysfunction, thus returning the athlete to normal reproductive function. Because bone health can be compromised in female athletes with menstrual dysfunction, intakes of bone-building nutrients are especially important. Iron and zinc are typically low in the diets of female athletes if meat products are avoided. Adequate intake of the B vitamins is also important to ensure adequate energy production and the building and repair of muscle tissue. This review briefly discusses the various factors that may affect athletic menstrual dysfunction and two of the proposed mechanisms: the energy-drain and exercise-intensity hypotheses. Because energy drain can be a primary contributor to athletic menstrual dysfunction, recommendations for energy and the macro- and micronutrients are reviewed. Methods for helping the female athlete to reverse athletic menstrual dysfunction are discussed. The health consequences of trying to restrict energy intake too dramatically while training are also reviewed, as is the importance of screening athletes for disordered eating. Vitamins and minerals of greatest concern for the female athlete are addressed and recommendations for intake are given.

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.

Micronutrients: interaction between physical activity, intakes and requirements

The present literature review examines the following questions: (a) What is the evidence that micronutrient requirements are increased in physically active people? (b) Is there an association between physical activity and micronutrient intake? (c) Are there any significant differences between indices of micronutrient status between physically active and inactive people? The available data suggest that micronutrient requirements are increased in physically active people because of increased losses through sweat, urine and faeces, and an increased need for defence against free radicals. However the evidence is controversial, and it is not possible to make any quantitative estimations. Micronutrient requirements in moderately active people are not likely to be very much above the levels recommended for the general population. The intake of micronutrients increases with increasing energy intake. Therefore, physically highly active people (athletes) have higher micronutrient intakes than untrained subjects. However, moderate physical activity does not necessarily affect daily micronutrient intake. The available indices of micronutrient status do not support the belief that micronutrient status is compromised in highly trained athletes, even without use of dietary supplements. Hence, there are no reasons to believe that the situation would be different in people who are only moderately active. The results suggest that micronutrient status is adequate for health and functional performance in physically active people who follow a normal, mixed Western diet.

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.

Nutrition in the exercising elderly

When making nutrition recommendations to the exercising elderly population, four important areas should be taken into consideration: (1) the changing needs that occur with age; (2) the changing needs that occur with exercise; (3) the presence of any chronic illnesses or diseases; and (4) whether one is exercising for fitness, recreation, or competition. For the most part, these four areas have been researched separately, and recommendations for elderly athletes need to be synthesized from this information. The nutrients for which food consumption is often inadequate and has the largest impact on the exercising elderly population include vitamin B6, vitamin B12, calcium, and vitamin D. The exercising elderly population needs to be aware of their bodies changing needs with exercise and should focus on maintaining energy balance while selecting a wide variety of foods high in complex carbohydrates. When adequate dietary intakes cannot be obtained, supplementation with a multivitamin of no more than 100% of the RDA is recommended.

Current knowledge concerning optimum nutritional status of riboflavin, niacin and pyridoxine

The term 'optimum nutrition' has evolved from a perceived need to base recommendations for nutrient intakes firmly in the context of function. It follows that 'optimum nutritional status' for individual nutrients should be defined in terms of biochemical or physiological markers having some functional value but also showing an appropriate relationship to nutrient intake. The present short review considers the current position regarding such markers for riboflavin, pyridoxine and niacin. It is concluded that whilst there are several biochemical measures which respond to changes in intake of each of these vitamins, no single measure is wholly satisfactory as a marker of optimum status.

Diet and athletic performance

Inadequate diet inhibits optimal performance in otherwise well-trained athletes. Controversy exists regarding specific dietary requirements, particularly in the areas of protein and vitamin/mineral supplementation. This article reviews energy substrate utilization, provides an overview of nutrient requirements during exercise, discusses ergogenic aids, and where possible, makes specific dietary recommendations for athletes.

The effect of exercise on the riboflavin status of adult men

Six sedentary to moderately active men with biochemical signs of riboflavin deficiency were studied under metabolic ward conditions to examine the effects of physical activity on riboflavin status. All participants were subjected to additional exercise (EXER) for an 18 d period between two maintenance (M1 and M2) periods (16 and 13 d respectively) of habitual physical activity. Energy balance and riboflavin intake were maintained throughout the study. Riboflavin status, as judged by a significant reduction in erythrocyte glutathione reductase (EC 1.6.4.2) activation coefficient (EGR-AC), improved on changing from home (1.53 (SD 0.14)) to period M1 (1.36 (SD 0.21)) diets. The exercise period, however, resulted in a significant deterioration in riboflavin status (1.57 (SD 0.31)) which persisted in the subsequent period M2 (1.54 (SD 0.15)). There was a concomitant fall in the urinary excretion of riboflavin only in the EXER period, when results were expressed as a percentage of the dietary intake of riboflavin. These results suggest an increased demand for the vitamin for selective biochemical functions during exercise. However, the energy cost of walking (treadmill 4 km/h), 50 W and 100 W work-loads (bicycle ergometer) as well as delta mechanical efficiency (DME) did not change during the three metabolic periods. The urinary excretion of riboflavin was inversely related to DME (r -0.49; P < 0.05) and directly correlated with haemoglobin levels (r 0.63; P < 0.005). The present study suggests that riboflavin status further deteriorates during a short period of increased physical activity in individuals whose riboflavin status is marginal.

Vitamin supplementation and physical exercise performance

Vitamins, just as minerals and trace elements, meet with great interest in the world of sports because of their supposed role in enhancing physical performance. Of the 13 compounds now considered as vitamins, most water-soluble vitamins and vitamin E are involved in mitochondrial energy metabolism. The influence of vitamin supplementation on mitochondrial metabolism is largely unknown. The principal argument for vitamin supplementation is the assumed increased vitamin requirement of athletes. Theoretically, an increased requirement can be caused by decreased absorption by the gastrointestinal tract, increased excretion in sweat, urine and faeces, increased turnover, as well as biochemical adaptation to training. Of course, a marginal low vitamin status can simply be the consequence of a long-term inadequate intake. However, considering the RDAs there are no indications that long-term vitamin intake among athletes is insufficient. Neither are there indications that vitamin excretion or turnover is increased in athletes. However, it is very likely that the (apparently) increased requirement is the consequence of biochemical adaptation to training and does not indicate a decreased intake. Although a marginal vitamin status, induced by inadequate vitamin intake, may have a negative effect on performance, there is no evidence to support the view that this occurs in trained athletes. Moreover, vitamin supplementation in athletes with an adequate vitamin status has no effect on physical working capacity. Possibly, exceptions have to be made for the use of vitamin E at high altitudes and for the use of vitamin C and multiple B-vitamin supplements in hot climates.

Vitamin and mineral supplementation to athletes

Vitamin and mineral supplements are frequently used by competitive and recreational athletes. Dietary deficiencies of most vitamins are not very common among athletes except in those who restrict their food intake in order to maintain body weight. Vitamins most likely to be deficient in the diet are folate, B6, B12, and E. Biochemical evidence of vitamin deficiencies in some athletes have been reported for thiamine, riboflavin, and B6. When the diet is deficient, vitamin supplements may improve performance but are not likely to be effective if the dietary intake is adequate. Some female athletes' diets are low in calcium, iron, and zinc. Low calcium intake may reduce peak bone mass in young women. Iron deficiency may impair performance and needs to be corrected with an iron supplement. Zinc supplements that exceed the RDA interfere with the absorption of copper and lower HDL-cholesterol.

Riboflavin intakes and status of morbidly obese females during the first postoperative year following gastroplasty

Eighteen women participated in a prospective study to assess the need for supplemental riboflavin after gastroplasty. Three groups of five patients received either a placebo or 0.6 or 1.2 mg riboflavin daily for up to 12 months, except during months 4 and 7 when all participants were given a "one-a-day" supplement containing 1.7 mg riboflavin. Dietary intakes of riboflavin decreased from 1.43 +/- 0.17 mg before the operation to 0.70 +/- 0.07 mg at 3 months, and then increased to 1.02 +/- 0.17 mg by 6 months. Even at 12 months, only 33% of the subjects had dietary intakes greater than or equal to 1.2 mg. All those with total intakes less than or equal to 1.7 mg at 3 months had impaired riboflavin status, as indicated by an erythrocyte gluthatione reductase activity coefficient greater than 1.40 and an erythrocyte riboflavin concentration less than 372 nmol/L. In contrast, 62% of the same subjects had urinary riboflavin excretion in the acceptable range. Supplemental intake of 1.7 mg riboflavin appeared to prevent tissue depletion in all subjects.

Milk: Destroying the Myths

Milk is fattening. Milk is mucus-forming. Milk is hard to digest. Milk is bad for the heart. Milk is for kids.

Sports nutrition. Approaching the nineties

A sophisticated appreciation of the role of nutrition in athletic performance has been made possible by increasing knowledge of the physiology of exercise. The nutritional issues of training are of primary importance, since this occupies most of the athlete's effort. The nutritional support of an intense daily training programme includes an appropriately high energy intake, predominantly in the form of carbohydrate in order to continually replenish muscle glycogen stores. Recent review of the protein needs of athletes indicates that requirements may be substantially above those of sedentary subjects, to account for the oxidation of amino acids during exercise as well as the retention of nitrogen during periods of muscle building. However, these increased requirements are likely to be met by the generous protein intakes anticipated in a high energy diet. The same would seem to hold true for micronutrient considerations, although there is no evidence that vitamin requirements are considerably increased by exercise. Nevertheless, a high energy diet chosen from a sufficiently varied range of foods should allow micronutrient intakes well in excess of population recommended dietary intake levels. Current interest is focused on the mineral status of athletes, particularly that of iron and calcium. In the case of iron, there is a possibility that the increased level of loss by some endurance athletes will not be met by their usual dietary patterns. Screening for early signs of iron deficiency, and appropriate supplementation and dietary counselling seem warranted in high risk groups. Competition poses the challenge of identifying possible factors limiting performance, and taking steps to delay or reduce these. Of paramount importance is body temperature regulation through the maintenance of hydration levels. This issue has long been recognised, but recent studies of gastric emptying and the benefits of carbohydrate supplementation during exercise have caused an update of the advice to athletes regarding fluid intake during exercise. It now seems possible to simultaneously achieve fluid and carbohydrate requirements for endurance exercise within a wide range of choice of beverages containing up to 10% carbohydrate. Concern about the adequacy of carbohydrate fuel stores in endurance exercise situations is also well known. The recognition that training achieves various physiological adaptations to enhance the lifespan of fuel stores has taken away some of the attention previously focussed on carbohydrate-loading techniques.(ABSTRACT TRUNCATED AT 400 WORDS)

Physical training and fasting erythrocyte activities of free radical scavenging enzyme systems in sedentary men

Effects of 10 weeks of physical training on free radical scavenging enzyme systems in erythrocytes were investigated in 7 sedentary healthy male students. The training consisted of running over 5 km, 6 times/week. Their maximum oxygen uptake and 12 min walk-run performance increased significantly after training. Of the antioxidant enzyme systems examined in the erythrocytes, both catalase activity and concentration and total glutathione reductase (GR) activity also showed significant increases following the training. The erythrocyte GR activity coefficient also increased significantly. These results suggest that chronic aerobic exercise increases riboflavin requirements and has some positive effects on antioxidative processes.

Diets of Endurance Runners Competing in a 20-Day Road Race

In brief: The diets of 15 experienced male distance runners were evaluated during eight consecutive days in the middle portion of the 1982 Great Hawaiian Footrace, a 500-km, 20-day road race. The runners were free to eat and drink at will; each subject kept daily records of food and beverage intake (excluding water). The data showed that the runners' intake of specific nutrients usually met or exceeded the 1980 recommended dietary allowances. This suggests that supplementing a male endurance athlete's diet is not necessary.

Implications of nutritional status on human biochemistry, physiology, and health

Optimum nutrition is the level of intake that should promote the highest level of health. Although excess caloric intake will lead to obesity, a deficit in nutrition may result in a tissue depletion of essential nutrients that can lead to biochemical changes and eventually to clinical signs and symptoms. Nutrition requirements may differ according to sex, age, activity, or physiological state and can be influenced by drugs, smoking, alcohol, and other factors. With ever-increasing sedentary life styles and less physically demanding jobs, the resulting reduced caloric requirements have made it more difficult to make nutritionally sound food choices. Nutrition is the single most important component of preventive health care. Diet has been associated with cancer, heart disease, diabetes, stroke and hypertension, arteriosclerosis, and cirrhosis of the liver. The ability of the human to respond to stresses, such as altitude, heat, trauma, surgery, and infection can be influenced by nutritional status. Nutritional status is reflected in a variety of metabolic processes that provide the basis for a number of methods for its assessment.