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

Food Assistance Programs and Mississippi Farmers Markets

At a time when money is tight everywhere, things are particularly tough in Mississippi. The budget problems and high rates of unemployment that challenge other states are compounded in Mississippi by alarmingly high rates of obesity. One of the main causes of this dangerous health issue is that Mississippi’s poorest people have very little access to fresh fruits, vegetables, and other local farm products, despite recent growth in farmers markets across the state. Without access to healthy foods, this vulnerable population is left with unhealthy food alternatives that contribute to unhealthy weight gain. Barriers at the local, state and national level have either limited or entirely blocked the use of federal Supplemental Nutrition Assistance Program (SNAP formerly known as food stamps) benefits at Mississippi farmers markets. In addition, federal funding for the Women Infants and Children (WIC) farmers market voucher programs in Mississippi has remained stagnant in recent years. Thus, the poorest Mississippians are unable to use their government benefits to purchase healthy food, and are forced to resort to less healthy alternatives. This is a serious problem requiring immediate action by our elected officials and government agencies

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

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

Carbohydrate, protein and fat metabolism during exercise after oral carnitine supplementation in humans

Twenty non-vegetarian active males were pair-matched and randomly assigned to receive 2 g L-Carnitine L-tartrate (LC).d-1 or placebo for 2 weeks. Subjects exercised for 90 min at 70% O2max following 2 days of a prescribed diet (mean ± SD: 13.6 ± 1.6 MJ, 57% carbohydrate, 15% protein, 26% fat, 2% alcohol) before and after supplementation. Results indicated no change in carbohydrate oxidation, nitrogen excretion, branched-chain amino acid oxidation, or plasma urea during exercise between the beginning and end of supplementation in either group. Following 2 weeks LC supplementation the plasma ammonia response to exercise tended to be suppressed (0 vs. 2wk at 60 min exercise: 97 ± 26 vs. 80 ± 9; and 90 min exercise: 116 ± 47 vs. 87 ± 25 µmol.L-1), with no change in the placebo group. The data indicate that 2 weeks of LC supplementation does not affect fat, carbohydrate and protein contribution to metabolism during prolonged moderate intensity cycling exercise. However, the tendency towards suppressed ammonia accumulation indicates that oral LC supplementation may have the potential to reduce the metabolic stress of exercise or alter ammonia production/removal which warrants further investigation

Effects of exercise intensity and altered substrate availability on cardiovascular and metabolic responses to exercise after oral carnitine supplementation in athletes

The effects of 15 d of supplementation with L-carnitine L-tartrate (LC) on metabolic responses to graded-intensity exercise under conditions of altered substrate availability were examined. Fifteen endurance-trained male athletes undertook exercise trials after a 2-d high-carbohydrate diet (60% CHO, 25% fat) at baseline (D0), on Day 14 (D14), and after a single day of high fat intake (15% CHO, 70% fat) on Day 15 (D15) in a double-blind, placebo-controlled, pair-matched design. Treatment consisted of 3 g LC (2 g L-carnitine/d; n = 8) or placebo (P, n = 7) for 15 d. Exercise trials consisted of 80 min of continuous cycling comprising 20-min periods at each of 20%, 40%, 60%, and 80% VO2peak. There was no significant difference between whole-body rates of CHO and fat oxidation at any workload between D0 and D14 trials for either the P or LC group. Both groups displayed increased fat and reduced carbohydrate oxidation between the D14 and D15 trials (p less than .05). During the D15 trial, heart rate (p less than .05 for 20%, 40%, and 60% workloads) and blood glucose concentration (p less than .05 for 40% and 60% workloads) were lower during exercise in the LC group than in P. These responses suggest that LC may induce subtle changes in substrate handling in metabolically active tissues when fatty-acid availability is increased, but it does not affect whole-body substrate utilization during short-duration exercise at the intensities studied

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

Risk of Low Energy Availability in National and International Level Paralympic Athletes: An Exploratory Investigation

(1) Background: The purpose of this study was to examine the symptoms of low energy availability (LEA) and risk of relative energy deficiency in sport (RED-S) symptoms in para-athletes using a multi-parameter approach. (2) Methods: National level para-athletes (n = 9 males, n = 9 females) completed 7-day food and activity logs to quantify energy availability (EA), the LEA in Females Questionnaire (LEAF-Q), dual energy X-ray absorptiometry (DXA) scans to assess bone mineral density (BMD), and hormonal blood spot testing. (3) Results: Based on EA calculations, no athlete was at risk for LEA (females \u3c 30 kcal·kg−1 FFM·day−1; and males \u3c 25 kcal·kg−1 FFM·day−1; thresholds for able-bodied (AB) subjects). Overall, 78% of females were “at risk” for LEA using the LEAF-Q, and 67% reported birth control use, with three of these participants reporting menstrual dysfunction. BMD was clinically low in the hip (\u3c−2 z-score) for 56% of female and 25% of male athletes (4) Conclusions: Based on calculated EA, the risk for RED-S appears to be low, but hormonal outcomes suggest that RED-S risk is high in this para-athlete population. This considerable discrepancy in various EA and RED-S assessment tools suggests the need for further investigation to determine the true prevalence of RED-S in para-athlete populations

Differences in visceral adipose tissue and biochemical cardiometabolic risk markers in elite rugby union athletes of Caucasian and Polynesian descent

Polynesian individuals are leaner with greater musculature than Caucasians of an equivalent size, and this genetically different morphology provides a physique that is often compatible with success in a number of sports, including rugby union. Evidence indicates that Polynesians have greater stores of absolute and relative abdominal fat mass and this is known to confer cardiometabolic risk. The aims of this study were to (1) explore the relationship between ethnicity, visceral adipose tissue (VAT), and cardiometabolic disease risk markers in elite Caucasian and Polynesian rugby union athletes, and (2) assess the impact of a pre-season training programme on these markers. Twenty-two professional rugby union athletes of Caucasian (n = 11) and Polynesian (n = 11) descent underwent physique assessment via surface anthropometry, dual-energy X-ray absorptiometry, and magnetic resonance imaging before and after an 11-week pre-season. A fasted blood test was undertaken at both time points. Compared to Caucasians, at baseline Polynesians displayed significantly higher VAT (771 ± 609 cm3 vs 424 ± 235 cm3; p = 0.043), triglycerides (1.0 ± 0.9 mmol/L vs 0.6 ± 0.2 mmol/L; p = 0.050), and low-density lipoprotein cholesterol (3.1 ± 0.9 mmol/L vs 2.3 ± 0.7 mmol/L; p = 0.019). Similar changes were observed in both groups over the pre-season period in VAT and blood biochemical markers. Polynesian rugby union athletes were more likely than Caucasians to exhibit risk factors associated with cardiometabolic disease, such as elevated VAT and unfavourable lipid profiles. Further longitudinal research is required to identify and explain the short- and long-term risk of cardiometabolic disease in athletes of Polynesian descent

Longitudinal changes in body composition assessed using DXA and surface anthropometry show good agreement in elite Rugby Union athletes

Rugby union athletes have divergent body composition based on the demands of their on-field playing position and ethnicity. With an established association between physique traits and positional requirements, body composition assessment is routinely undertaken. Surface anthropometry and dual-energy X-ray absorptiometry (DXA) are the most common assessment techniques utilised, often undertaken synchronously. This study aims to investigate the association between DXA and surface anthropometry when assessing longitudinal changes in fat free mass (FFM) and fat mass (FM) in rugby union athletes. Thirty-nine elite male rugby union athletes (age 25.7 ± 3.1 years; stature 187.6 ± 7.7 cm; mass 104.1 ± 12.2 kg) underwent assessment via DXA and surface anthropometry multiple times over three consecutive international seasons. Changes in the lean mass index (LMI), an empirical measure to assess proportional variation in FFM, showed large agreement with changes in DXA FFM (r=0.54, SEE=1.5%,