Effect of a Sliding Scale Vitamin D Supplementation Protocol on 25(OH)D Status in Elite Athletes with Spinal Cord Injury

Recent studies suggest that a substantial proportion of elite athletes with SCI (spinal cord injury) have insufficient 25(OH)D status which may be associated with decreased muscle strength. This study: 1) examined the effects of a 16-week sliding scale Vitamin D supplementation protocol on 25(OH)D concentration and 2) determined whether subsequent 25(OH)D status impacts muscle performance in elite athletes with SCI. Thirty-four members of the US Olympic Committee Paralympic program, and the Canadian Wheelchair Sports Association from outdoor sports participated. Serum 25(OH)D concentrations, lifestyle and dietary factors were assessed during the Winter and Spring. Participants were assigned a 16-week sliding scale vitamin D3 (cholecalciferol) (KleanAthlete Brand) supplementation protocol based on initial 25(OH)D levels. Participants with deficient 25(OH)D (\u3c50 nmol/L) status received 50,000 IU/wk. for 8 wks., and participants with insufficient status (50-75 nmol/L) received 35,000 IU/week for 4 weeks followed by a maintenance dosage of 15,000 IU/wk. Participants with sufficient status (\u3e75nmol/L) received the maintenance dosage of 15,000 IU/wk. 25 (OH)D concentrations increased significantly after supplementation (p \u3c.001; 66.3 + 24.3 nmol/L; 111.3 + 30.8 nmol/L) for Winter and Spring, respectively. 26% of athletes had sufficient 25(OH)D concentrations prior to supplementation, and 91% had sufficient concentrations post supplementation. 62% of participants improved handgrip strength post supplementation. No change in 20-meter wheelchair sprint performance time was observed. The 16-week sliding scale supplementation protocol used in the current study is effective for achieving sufficient vitamin D concentrations during the winter months in elite athletes with SCI

The Effects of Acute Post Exercise Consumption of Two Cocoa-Based Beverages with Varying Flavanol Content on Indices of Muscle Recovery Following Downhill Treadmill Running

Dietary flavanols have been associated with reduced oxidative stress, however their efficacy in promoting recovery after exercise induced muscle damage is unclear. This study examined the effectiveness of acute consumption of cocoa-flavanols on indices of muscle recovery including: subsequent exercise performance, creatine kinase, muscle tenderness, force, and self-perceived muscle soreness. Eight endurance-trained athletes (VO2max 64.4 ± 7.6 mL/kg/min) completed a downhill running protocol to induce muscle soreness, and 48-h later completed a 5-K (kilometer) time trial. Muscle recovery measurements were taken at PRE, 24 h-POST, 48 h-POST, and POST-5K. Participants consumed 1.0 g of carbohydrate per kilogram of body weight of a randomly assigned beverage (CHOC: 0 mg flavanols vs. CocoaCHOC: 350 mg flavanols per serving) immediately after the downhill run and again 2 h later. The same protocol was repeated three weeks later with the other beverage. An ANOVA revealed no significant difference (p = 0.97) between trials for 5 K completion time (CHOC 1198.3 ± 160.6 s, CocoaCHOC 1195.5 ± 148.8 s). No significant difference was found for creatine kinase (CK) levels (p = 0.31), or muscle soreness (p = 0.21) between groups over time. These findings suggest that the acute addition of cocoa flavanols to low-fat chocolate milk offer no additional recovery benefits

Effects of Pre-Exercise Ice Slurry Ingestion on Physiological and Perceptual Measures in Athletes with Spinal Cord Injuries

Athletes with spinal cord injuries (SCI) have an impaired ability to thermoregulate during exercise, leading to an increased core temperature (Tcore) due to a decrease in sweat response. Elevated core temperature may result in premature onset of fatigue and decreased athletic performance. Therefore, precooling techniques that decrease Tcore before exercise may increase the storage capacity for metabolic heat production, thereby improving exercise performance. The purpose of this study was to investigate the effects of pre-exercise ice slurry ingestion as a precooling method in elite athletes with SCI during a match simulation. Employing a field-based, counterbalanced-design, subjects were administered 6.8 g/kg of room temperature (PLB) or ice slurry (IS) beverage during a 20 minute precooling period, before engaging in a 50 and 60 minute on-court training session on day 1 and 2, respectively. Physiological measures, including Tcore and heart rate, and perceptual measures including gastrointestinal and thermal comfort, and rating of perceived exertion, were monitored throughout precooling (minutes 10, 20) and exercise (minutes 10-60). IS had a large effect on Tcore at the midpoint of exercise on day 1 (minute 30) (ES = 0.73) and 2 (minute 40) (ES = 1.17). Independent samples T-tests revealed significant differences in the perception of thermal comfort between IS and PLB at the midpoint of exercise on both day 1 (minute 30) (P = 0.04) and 2 (minute 40) (P = 0.05), indicating that IS helped subjects to feel cooler during exercise. In conclusion, pre-exercise ice slurry ingestion provides an effective means for delaying an increase in Tcore in athletes with SCI

Energy and Nutrient Issues in Athletes with Spinal Cord Injury: Are They at Risk for Low Energy Availability?

Low energy availability (LEA) and nutrient intake have been well studied in able-bodied athletes, but there is a lack of research examining these issues amongst athletes with spinal cord injury (SCI). To date, there have been no studies that have examined energy availability (EA) amongst this population. Furthermore, athletes with SCI may experience unique challenges around nutrition that may increase their risk of LEA. This review will evaluate the literature and assess whether this population is at risk for LEA. Due to the limited research on this topic, sedentary individuals with SCI and para athletes were also included in this review. Review of the current literature suggests that athletes with SCI may be at an increased risk for LEA. While research examining EA and risk of LEA in athletes with SCI is lacking, the number of athletes with SCI continues to increase; therefore, further research is warranted to assess nutrient and energy needs and their risk to this population

Vitamin D and the Athlete: Risks, Recommendations, and Benefits

Vitamin D is well known for its role in calcium regulation and bone health, but emerging literature tells of vitamin D’s central role in other vital body processes, such as: signaling gene response, protein synthesis, hormone synthesis, immune response, plus, cell turnover and regeneration. The discovery of the vitamin D receptor within the muscle suggested a significant role for vitamin D in muscle tissue function. This discovery led researchers to question the impact that vitamin D deficiency could have on athletic performance and injury. With over 77% of the general population considered vitamin D insufficient, it’s likely that many athletes fall into the same category. Research has suggested vitamin D to have a significant effect on muscle weakness, pain, balance, and fractures in the aging population; still, the athletic population is yet to be fully examined. There are few studies to date that have examined the relationship between vitamin D status and performance, therefore, this review will focus on the bodily roles of vitamin D, recommended 25(OH)D levels, vitamin D intake guidelines and risk factors for vitamin D insufficiency in athletes. In addition, the preliminary findings regarding vitamin D’s impact on athletic performance will be examined

Multiple Stress Fractures and Low Energy Availability in Female Recreational Runners

Low energy availability (LEA) is the underlying factor for Relative Energy Deficiency in Sport which includes a facet of bone health. Stress fractures (SF) are common injuries among runners. The prevalence of coexisting LEA and multiple SF in recreational runners is unknown. PURPOSE: The purpose is 1) to assess the prevalence of multiple SF and risk of LEA among recreational female runners 2) to compare current eating disorders, body weight dissatisfaction, and restrictive eating behaviors between females with a history of SF and those with ≤ 1 SF. METHODS: Female noncompetitive, recreational runners (running \u3e 10 miles/week, 18-25 years old) completed an online survey that included the Disordered Eating Screening Assessment (DESA-6) and Low Energy Availability in Females Questionnaire (LEAF-Q). RESULTS: 458 females qualified and divided into two groups ≤ 1 lifetime stress fractures (≤ 1 SF) (n=309) and ≥ 2 lifetime stress fractures (≥ 2 SF) (n=149). The prevalence of females at risk of LEA by the LEAF-Q was significantly higher in the ≥ 2 SF group at 85% compared to 49% in the ≤ 1 SF group (p=0.01). 14% (n = 21) of the ≥ 2 SF group reported secondary amenorrhea compared to 6% (n=19) in the ≤ 1 SF group (p=2=7.96) Intentionally restricting specific foods, food groups, or the amount of food consumed to lose weight (p=2=36.30) and currently having an eating disorder ( p=2=73.70) were significantly different between the ≤ 1 SF group and the ≥ 2 SF group. However, fear of weight gain in the off-season (p=0.59, 2=0.29) and weight dissatisfaction in the past three months (p=0.21, 2=1.55) were not different between the two groups. CONCLUSION: Those with ≥ 2 SF were highly identified as at risk of LEA by the LEAF-Q. Despite the two groups reporting similar levels of fear of weight gain and weight dissatisfaction, the ≥ 2 SF group restricted food suggesting they acted upon the fear. They also reported having secondary amenorrhea and currently having an eating disorder

25(OH)D Status of Elite Athletes with Spinal Cord Injury Relative to Lifestyle Factors

Background: Due to the potential negative impact of low Vitamin D status on performance-related factors and the higher risk of low Vitamin D status in Spinal Cord Injury (SCI) population, research is warranted to determine whether elite athletes with SCI have sufficient 25(OH)D levels. The purposes of this study were to examine: (1) the seasonal proportion of vitamin D insufficiency among elite athletes with SCI; and (2) to determine whether lifestyle factors, SCI lesion level, and muscle performance/function are related to vitamin D status in athletes with SCI. Methods: Thirty-nine members of the Canadian Wheelchair Sports Association, and the US Olympic Committee Paralympic program from outdoor and indoor sports were recruited for this study. Dietary and lifestyle factors, and serum 25(OH)D concentrations were assessed during the autumn (October) and winter (February/March). An independent t-test was used to assess differences in 25(OH)D status among seasons, and indoor and outdoor sports in the autumn and winter, respectively. Results: Mean ± SD serum 25(OH)D concentration was 69.6 ± 19.7 nmol/L (range from 30 to 107.3 nmol/L) and 67.4 ± 25.5 nmol/L (range from 20 to 117.3 nmol/L) in the autumn and winter, respectively. In the autumn, 15.4% of participants were considered vitamin D deficient (25(OH)D \u3c 50 nmol/L) whereas 51.3% had 25(OH)D concentrations that would be considered insufficient (\u3c80 nmol/L). In the winter, 15.4% were deficient while 41% of all participants were considered vitamin D insufficient. Conclusion: A substantial proportion of elite athletes with SCI have insufficient (41%–51%) and deficient (15.4%) 25(OH)D status in the autumn and winter. Furthermore, a seasonal decline in vitamin D status was not observed in the current study

Institutional Policy Changes Aimed at Addressing Obesity Among Mental Health Clients

BackgroundPeople with mental illness often experience unique barriers to healthy eating and physical activity. For these clients, interventions should focus on changes in the immediate environment to change behaviors. The purpose of this project was to implement and evaluate policy changes that would limit calorie intake and increase calorie expenditure of clients receiving mental health services. ContextThis intervention was implemented in a rural mental health system in the southeastern United States. Clients live in small group homes, where they are served breakfast, dinner, and a snack, and attend outpatient day treatment programs, where they are served lunch and can purchase snacks from vending machines. MethodsThis intervention included institutional policy changes that altered menus and vending machine options and implemented group walking programs. Primary outcome measures were changes in clients’ weight at 3 and 6 months after policy implementation. ConsequencesAt the 3-month follow-up, the median weight loss for overweight/obese clients (n = 45) was 1.4 kg. The 33 overweight/obese clients who were still in the group homes at the 6-month follow-up either maintained or continued to lose weight. InterpretationInstitutional policy changes aimed at improving dietary intake and physical activity levels among clients receiving mental health services can promote weight loss in overweight clients

Nutrition, Health and Athletic Performance

Optimal nutrition is fundamental for enhancing training, recovery and performance in sport. Therefore, research has aimed to determine the efficacy of appropriate intake of nutrients, fluids, and supplements and their role in exercise performance. The purpose of this Special Issue entitled “Nutrition, Health and Athletic Performance” is to highlight recent research examining aspects of sports nutrition and exercise performance. Manuscript submissions of original research, meta-analyses, or reviews of the scientific literature, which targets nutritional strategies to benefit performance and health, are welcome. Studies performed in humans are preferred given the applied nature of this issue