The effect of body composition and BMI on 25(OH)D response in vitamin D-supplemented athletes

Fat mass is inversely associated with vitamin D status, and athletes with the most adipose tissue may have the greatest risk for insufficient (25(OH)D 20-32 ng mL(-1)) or deficient (25(OH)D < 20 ng ml(-1)) status. The effects of fat and lean mass on 25(OH)D change in response to vitamin D supplementation have yet to be elucidated in athletes. In addition, vitamin D has a known role in bone health yet a link between short-term changes in 25(OH)D and bone turnover in indoor athletes have not yet been described. Thirty-two collegiate swimmers and divers (19 male, 13 female; 19 (1) years) participated in a 6-month randomized controlled trial and consumed either 4000 IU d(-1) of vitamin D3 (n = 19) or placebo (PLA; n = 13). Anthropometry and blood collection of 25(OH)D, bone-specific alkaline phosphatase (B-ALP) and N-terminal telopeptide (NTx) occurred at three time points. Dual-energy X-ray absorptiometry measured body composition analysis at baseline and endpoint. In the vitamin D group, BMI was negatively correlated with 6-month 25(OH)D change (R = -0.496; P = .03) and a stronger predictor of 25(OH)D change (P = .04) than ultraviolet B exposure and fat mass change. Athletes in the high bone turnover group showed significantly greater losses of 25(OH)D over 6-months compared to athletes in the low bone turnover group (P = .03). These results suggest athletes within the normal BMI category experience a diminished response to 4000 IU d(-1) of vitamin D3 supplementation, and periods of high bone turnover may be an additional risk factor for developing compromised vitamin D status in athletes.

Vitamin D status is related to intramyocellular lipid in older adults

Vitamin D and intramyocellular lipid (IMCL) both affect muscle function, but the relationship between vitamin D status and IMCL has not been established. To assess the relationship between vitamin D [measured as 25-hydroxy-vitamin-D (25(OH)D)] and IMCL, 20 community-dwelling adults between the ages of 65 and 85 were recruited. Serum 25(OH)D, and gastrocnemius IMCL and extramyocellular lipid (EMCL) were measured with magnetic resonance spectroscopy and fat ratio segmentation. A lifestyle questionnaire assessed physical activity. Muscle strength (1-repetition maximum) and physical function tests (timed up and go, timed sit to stand, four square step test, and gait speed) were also performed. Mean 25(OH)D was 37.9 ± 13.1 ng/mL with a range of 19-68 ng/mL. Soleus and gastrocnemius IMCL to water ratio was 1.04 ± 0.43 and 0.53 ± 0.22, respectively, but only gastrocnemius IMCL was correlated with 25(OH)D (R (2) = 0.39; p = 0.02). This relationship was independent of body mass index (p > 0.14), physical activity level (p > 0.08), and sex (p > 0.13). 25(OH)D did not correlate with EMCL (R (2) = 0.007; p = 0.78). The four square step test was the only performance or strength test correlated with 25(OH)D (R (2) = 0.26; p = 0.023). Muscle strength and physical function measures were not correlated with IMCL or EMCL. These data suggest that vitamin D status may influence gastrocnemius IMCL content independent of body mass and physical activity. Future studies should consider exploring whether vitamin D has an independent role in affecting muscle lipid metabolism and function.

The effects of season-long vitamin D supplementation on collegiate swimmers and divers

The purpose of this 6-month randomized, placebo-controlled trial was to determine the effect of season-long (September-March) vitamin D supplementation on changes in vitamin D status, which is measured as 25(OH) D, body composition, inflammation, and frequency of illness and injury. Forty-five male and female athletes were randomized to 4,000 IU vitamin D (n = 23) or placebo (n = 22). Bone turnover markers (NTx and BSAP), 25(OH)D, and inflammatory cytokines (TNF-alpha, IL-6, and IL1-β) were measured at baseline, midpoint, and endpoint. Body composition was assessed by DXA and injury and illness data were collected. All athletes had sufficient 25(OH)D (> 32 ng/ml) at baseline (mean: 57 ng/ml). At midpoint and endpoint, 13% and 16% of the total sample had 25(OH)D < 32 ng/ml, respectively. 25(OH)D was not positively correlated with bone mineral density (BMD) in the total body, proximal dual femur, or lumbar spine. In men, total body (p = .04) and trunk (p = .04) mineral-free lean mass (MFL) were positively correlated with 25(OH)D. In women, right femoral neck BMD (p = .02) was positively correlated with 25(OH)D. 25(OH)D did not correlate with changes in bone turnover markers or inflammatory cytokines. Illness (n = 1) and injury (n = 13) were not related to 25(OH)D; however, 77% of injuries coincided with decreases in 25(OH)D. Our data suggests that 4,000 IU vitamin D supplementation is an inexpensive intervention that effectively increased 25(OH)D, which was positively correlated to bone measures in the proximal dual femur and MFL. Future studies with larger sample sizes and improved supplement compliance are needed to expand our understanding of the effects of vitamin D supplementation in athletes.

Relationship between 25-hydoxyvitamin D, muscle strength, and incidence of injury in healthy adults: a systematic review

The purpose of this systematic review is to answer the following clinical questions in healthy adults: is vitamin D status related to (1) muscle strength? (2) or incidence of injury? A literature search was performed using Pubmed, SPORTDiscus, and Web of Science to capture relevant articles that have examined these outcomes. Inclusion criteria required studies to address at least one of the 2 questions stated above, enroll healthy human subjects with a mean age of 18 to 65 years of age, and include serum 25-hydoxyvitamin D measures. Study characteristics such as vitamin D status, study design, and study population were documented. Measured assessors and outcomes from all studies were extracted to answer at least one of the two questions. When applicable, data were used to compute effect sizes at a 95% confidence interval for comparisons across studies to answer the 2 questions. The results of these studies indicate a weak to moderate effect of higher 25-hydoxyvitamin D levels on greater muscle strength and reduced incidence of injury. Randomized controlled clinical trials examining these questions are scarce when compared with the popularity of vitamin D testing; therefore, future trials are necessary to advance our understanding and to clarify the effect vitamin D has on extraskeletal outcomes in healthy adults.