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Study aim: The aim of the study was to analyse the lifespan of Polish male Olympic medallists in comparison to the general male population. Material and methods: The study included 238 Polish male Olympic medallists who participated in the Olympic games in 1924–1992. Duration of life in relation to the general Polish population was assessed. The age of acquiring their first medal, type and number of medals won and sports discipline were taken into consideration. Results: Polish male Olympic medallists born before 1940 lived over 8 years longer in comparison to the general population (p < 0.0001, d = 0.689 and d = 0.750). Over 80% of them lived up to 65 years of age and over 40% up to 80. In the general population only Conclusions: Polish male Olympic medallists lived significantly longer than the general population of Polish men. The longevity of male Olympic medallists was affected by the age of acquiring their first medal and by the category of sport practised.

Manned spaceflight requires research in diverse areas, including neuropsychology and human physiology. For these subjects, the Lunares Analog Research Station was established in Pila, Poland. It allows testing of crew members under space-like conditions. One experiment, Lunar Expedition I, was performed on a group of 6 analogue astronauts over 14 days. All were studied for their subjective perception of time and also asked to carry out mission-specific activities, like digging or repairing a rover during an extravehicular activity (EVA). The aims of the study were to measure cardiorespiratory signals using ECG and impedance pneumography devices under those conditions; to evaluate the quality of the data and the level of motion artefacts; and to assess the subjects’ status and adaptation. We used our own prototype, Pneumonitor 2, that enables registering respiratory-related impedance curve, a single-lead ECG and 3-axis accelerometer signals. Due to problems with a detachment of electrodes, we ultimately collected 10 full registrations from 5 astronauts. All signals were pre-processed and annotated. The set of cardiorespiratory parameters, including heart and respiratory activity indicators, was calculated for 3 main states: at rest, doing squats and performing various activities during EVA. We compared the results with normative values collected from elite athletes. The considered parameters were found to be in the normal range, typically slightly worse than the average for the athletes. The physiological responses are in line with expectations. Impedance pneumography enables to measure quantitative parameters of breathing like tidal volume and may be used during dynamic conditions. Combined with the ECG signal provides an objective astronaut’s cardiorespiratory profile. One can use it to assess the adaptation and to plan the schedule of the mission. However, there is a need for development of a wearable electronic textile solution for the target electrodes, to deal with sweating occurring while wearing a three-layer EVA suit.

Exercise-induced respiratory symptoms describe acute airway narrowing that occurs as a result of exercise. It includes exercise-induced bronchoconstriction (EIB) and exercise-induced asthma (EIA) issues. To provide clinicians with practical guidelines, a multidisciplinary panel of stakeholders was convened to review the pathogenesis of EIB/EIA and to develop evidence-based guidelines for the diagnosis and treatment. Recommendations for the diagnosis and treatment of EIB were developed. High-intensity exercise in polluted environment (cold air, humidity, contamination, allergens) may increase the risk of EIB and asthma symptoms in athletes. Diagnostic procedures should include history taking, physical examination, atopy assessment and functional tests of the respiratory system. A strong recommendation was made for regular use of inhaled glucocorticosteroids and avoidance of short-acting β2-agonists as the only treatment. The treatment of asthma in athletes should always take into account current anti-doping regulations. This position paper reflects the currently available evidence.

Background: Athletes and coaches believe in the ergogenic effect of vitamin B12 (which results from enhanced erythropoiesis) and they often insist on its unjustified supplementation. Therefore, our study aimed to assess the vitamin B12 status in Polish elite athletes and its influence on red blood cell parameters. Methods: In total, 1131 blood samples were collected during six years from 243 track and field athletes divided into strength and endurance groups, as well as according to the declared use of vitamin B12 injections. Results: An average vitamin B12 concentration in all subjects was 739 &plusmn, 13 pg/mL, with no cases of deficiency. A weak but significant relationship was found between vitamin B12 and hemoglobin concentrations. A significant increase in hemoglobin appeared from very low vitamin B12 concentration and up to approx. 400 pg/mL, while hemoglobin did not significantly change from 700 pg/mL and onwards. Vitamin B12 injections were used by 34% of athletes, significantly more often by endurance than by strength athletes. In athletes who declared no use of injections, a higher concentration of vitamin B12 was observed in the endurance group. Conclusion: The main finding of the present study is the determination of the range of vitamin B12 concentration which may favor better hemoglobin synthesis in athletes. They should regularly monitor vitamin B12 concentration and maintain the range of 400&ndash, 700 pg/mL as it may improve red blood cell parameters. We might suggest application of a supplementation if necessary. Special attention is required in athletes with a vitamin B12 concentration below 400 pg/mL.

It has been demonstrated that regular sport activity in children leads to physiological changes in the heart including increased left ventricular (LV) myocardial thickness and mass (LVM). The aim of the study was to establish the first specific normal values of LVM for child and adolescent athletes. Parasternal long-axis, 2D-guided echocardiographic measurements were obtained from a group of 791 Caucasian child athletes (age 5–18 years, 58.7% boys). For the preparation of normative data, LVM-for-lean body mass (LBM) reference curves were constructed using the LMS method. Then, a simple correlation plot was constructed to analyse the concordant and discordant indications of left ventricular hypertrophy (LVH), defined as LVM-for-LBM above the 95th percentile, according to the newly created and previously published normative data on LVM-for-LBM in the general population of children. Reference scatter plots of LVM-for-LBM for boys and girls in the analysed group of children practicing sports were presented, showing mean values of LVM and z-scores. The application to the studied group of reference centiles established for the general population of children would lead to false positive misclassification of increased LVH in 5.8% of the girls and 17.0% of the boys. We present the first specific normative data for LV mass in relation to lean body mass in Caucasian children and adolescents engaged in regular sport activities. The application of specific normative data for LV mass results in fewer false positive findings of left ventricular hypertrophy in this group than that of reference values for general paediatric population.

Intensive exercise modifies airway inflammation and infection susceptibility. We aimed to determine the effect of exercise on pro- and anti-inflammatory cytokine (TNF-α, IL-1ra, IL-10) and innate immunity protein (HSPA1, sCD14) levels in exhaled breath condensate (EBC) and nasal secretions of competitive athletes, non-exercising asthmatics and healthy controls (HC).The study group consisted of 15 competitive athletes (five speed skaters and ten swimmers) aged 15-25. The control groups comprised 10 mild-to-moderate asthmatics (AC) and seven HC. Athletes were assessed in- and off-training while asthmatics and controls at one time point. Nasal lavages and EBC were collected before and after a treadmill exercise challenge. Protein levels were assessed using ELISA.TNF-α levels in EBC were significantly higher in athletes than HC, but similar to asthmatic patients. In contrast, IL-1ra EBC concentrations were significantly lower in athletes than in HC, but again similar to asthmatics. Significant positive correlations were seen between baseline concentrations of TNF-α in EBC and fall in FEV1 following exercise challenge in athletes during training period (R=0.74, p0.01) and in asthmatics (R=0.64, p0.05). In nasal secretions, baseline IL-1ra levels were significantly higher in athletes and asthmatics than in HC. Exercise caused a slight, yet significant, increase in EBC HSPA1 in athletes (p=0.02). The exercise challenge did not considerably influence TNF-α, IL-1ra, HSPA1 and sCD14 in EBC or nasal secretions.Dysregulation of the TNF-α/IL-1ra balance in EBC and nasal secretions from athletes may reflect the presence of airway inflammation induced by repeated strenuous exercise.

Physical training is associated with changes in cardiac morphology called the “athlete’s heart”, which has not been sufficiently studied in children. The aim of the study was to analyze cardiac adaptation to exercise in pre-adolescent soccer players. Thirty-six soccer players (mean age 10.1 ± 1.4 years) and 24 non-athlete male controls (10.4 ± 1.7 years) underwent cardiac magnetic resonance. Measurements of myocardial mass, end-diastolic and end-systolic volume, stroke volume and ejection fraction for left and right ventricle (LV, RV) were performed. Additionally, left and right atrial (LA, RA) areas and volumes were analysed. Relative wall thickness (RWT) was calculated to describe the pattern of cardiac remodeling. Interventricular wall thickness and LV mass were significantly higher in athletes, but remained within the reference (6.9 ± 0.8 vs. 6.2 ± 0.9 mm/√m2, p = 0.003 and 57.1 ± 7.4 vs. 50.0 ± 7.1 g/m2, p = 0.0006, respectively) with no changes in LV size and function between groups. The RWT tended to be higher among athletes (p = 0.09) indicating LV concentric remodeling geometry. Soccer players had significantly larger RV size (p

INTRODUCTION Periostin is a matricellular protein expressed by many tissues. Its release may be enhanced, among others, through mechanical stimulation of muscles and bones as well as by cytokines of allergic inflammation. OBJECTIVES Our aim was to assess periostin levels in serum and exhaled breath condensate (EBC) of professional athletes, asthmatics and healthy controls. We also sought to determine whether acute treadmill exercise influences serum and EBC periostin. METHODS Study groups included 9 competitive swimmers, 10 mild-to-moderate asthmatics and 7 healthy controls. Athletes were assessed twice (in- and off-training period) while asthmatics and controls in one time-point. Data on demographics, allergy symptoms and exercise load were acquired through Allergy Questionnaire for Athletes (AQUA) and International Physical Activity Questionnaire (IPAQ). Serum and EBC were collected before and after treadmill exercise challenge. RESULTS Baseline serum periostin in swimmers during training period was significantly higher (5- to 7-fold) than in asthmatics (P = .01) and controls (P < .05). In EBC, lowest periostin levels were seen in athletes in-training as compared with off-training period (P < .01) and with asthmatics (P < .03). Acute bout of exercise did not induce significant changes neither in serum nor in EBC periostin in any group. CONCLUSION Increased serum, but not EBC, periostin levels in competitive athletes are probably because of permanently increased exercise load leading to stimulation, injury and regeneration of musculoskeletal tissues. Periostin may be considered marker of long-term exercise overload after confirmation in larger groups.

Introduction Regular training modulates airway inflammation and modifies susceptibility to respiratory infections. The impact of exercise and ambient conditions on airway hyperreactivity and innate immunity has not been well studied. We aimed to assess exercise-related symptoms, lung function, airway hyperresponsiveness and innate immunity proteins in relation to meteorological conditions and exercise load in competitive athletes. Material and methods Thirty-six speed skaters were assessed during winter (WTP) and summer (STP) periods. The control group comprised 22 non-exercising subjects. An allergy questionnaire for athletes (AQUA) and IPAQ (International Physical Activity Questionnaire) were used to assess symptoms and exercise. Meteorological parameters were acquired from World Meteorological Organization resources. Serum innate immunity proteins were measured by ELISA. Results Exercise-associated respiratory symptoms were reported by 79.4% of skaters. Despite similar exercise load and lung parameters during both periods, positive methacholine challenge was more frequent during winter (p = 0.04). Heat shock protein HSPA1 and IL-1RA were significantly decreased during STP compared to WTP and controls. During WTP, IL-1RA was elevated in skaters reporting exercise-induced symptoms (p = 0.007). sCD14 was elevated in athletes versus controls in both periods (p < 0.05). HSPA1 was significantly higher in WTP compared to STP irrespective of presence of respiratory tract infections (RTIs). IL-1RA in WTP was elevated versus STP (p = 0.004) only in RTI-negative athletes. Serum IL-1RA negatively correlated with most meteorological parameters during WTP. Conclusions Ambient training conditions, but not training load, influence bronchial hyperreactivity and the innate immune response in competitive athletes assessed during winter. The protective effect of regular exercise against respiratory infections is associated with a shift in serum innate immunity proteins.

Background: The objective of this study is to check whether the type of sport is important for the development of the dual career in professional sport. Material/Methods: This study utilised the Chi-square test of the independence measurement model and student’s T test. It also analysed 7 scenarios. A final survey-list consisted of the 38 items of competences and it was completed by 243 young people who took part in this study; the sample included 151 (67.7%) athletes training individual disciplines and 72 (32.3%) team disciplines. Results: The statistically significant results between the groups are in terms of competence(scenarios 3 and 6). There were no statistically significant differences between the groups in terms of life experience. Conclusions: Results in both parts of the study confirmed the three hypotheses. It turned out that the type of sport does not affect the course of the dual career in professional athletes.

In addition to different injuries, infections are the most common reason for giving up training altogether or reducing its volume and intensity, as well as a lack of opportunities to participate in sports competitions. Nowadays, a slow but constant re‑emergence of pertussis, especially among teenagers and young adults, including athletes, can be observed. This paper describes an outbreak of pertussis among professional Polish shooters, focusing on the transmission of Bordetella pertussis infection between members of the national team, its influence on performance capacity and adverse event analysis. From 9 June, 2015 to 31 July, 2015, a total of 4 confirmed and suspected cases of pertussis were reported among members of the Polish Sport Shooting National Team, their relatives and acquaintances. Pertussis significantly decreased exercise performance of the first athlete, a 35-year-old woman, interrupted her training, and finally resulted in failure to win a medal or quota place. Pertussis also significantly decreased performance of the second athlete, a 25-year-old shooter. The other cases emerged in their families. Whooping cough is a real threat to athletes and should be prevented. Preventive measures include appropriate immunization, constant medical supervision, as well as early isolation, diagnostic tests and treatment of all infected sport team members. Regular administration of booster doses of the acellular pertussis vaccine (Tdpa) every 5 years seems reasonable.

BackgroundNormalization for body size is required for reliable left ventricular mass (LVM) evaluation, especially in children due to the large variability of body size. In clinical practice, the allometrically adjusted ratio of LVM to height raised to the power of 2.7 is often used. However, studies presenting normative LVM data for children recommend centile curves as optimal for the development of normative data. This study aimed to assess whether the allometrically adjusted LVM-to-height ratio can reliably reproduce the results of LVM normalization for height based on the centile curves method.MethodsLeft ventricular mass was computed for 464 boys and 327 girls, 5-18 years old, based on echocardiographic examination. Normalized data representing LVM for height were developed using the centile curves construction method and two variants of the allometrically adjusted ratio method: one variant with the allometric exponents specific to the study groups, and one variant with the universal exponent of 2.7. The agreement between the allometric methods and the centile curves method was analyzed using the concordance correlation coefficient, sensitivity, and specificity.ResultsFor both the specific allometric variant and the universal variant, the analysis of concordance has indicated high reproducibility compared to the centile curves method. The respective coefficient values were 0.9917 and 0.9916 for girls, and 0.9886 and 0.9869 for boys. The sensitivity and specificity test has also shown high agreement. However, for girls, the sensitivity was higher for the specific variant (100% vs. 90.9%).ConclusionThe results of the study show that allometric scaling of LVM for height can very reliably reproduce the results of LVM normalization for height based on the centile curves method. However, the analysis of sensitivity and specificity indicates greater agreement for the allometric normalization with the group-specific allometric exponents.

OBJECTIVE The aim of the study was to evaluate the safety and tolerance of influenza vaccines for the northern and southern hemispheres in Polish elite athletes participating in the Rio 2016 Olympics. DESIGN Prospective, observational, cohort study. SETTING Institutional level. PARTICIPANTS Ninety-seven athletes vaccinated only with the northern hemisphere vaccine; 98 athletes received the southern hemisphere vaccine alone, whereas 39 athletes were vaccinated with both vaccines. INTERVENTIONS The athletes were vaccinated with a trivalent, inactivated influenza vaccine recommended for the northern hemisphere 2015/2016 and then with the vaccine recommended for the southern hemisphere 2016. Athletes kept a diary of adverse events and effects (if any) on training for 6 days after vaccination. MAIN OUTCOME MEASURES The percentage of general and local adverse events, number of lost or modified training sessions. RESULTS Significantly more local adverse events (pain and redness) were found in the group immunized with the vaccine for the northern hemisphere. There were no differences in the frequency of general adverse events and influence on training between groups. Of total 273 athletes who had 1911 training days during 6 days after vaccination, 6 athletes (2.2%) lost 13 training days (0.7%) and 16 athletes (5.9%) had to modify 34 (1.7%) training days within first 2 days after vaccination. CONCLUSIONS Athletes tolerated influenza immunization well. If they are going to travel to the other hemisphere during the influenza season, the use of the second influenza vaccine should be advised. Athletes should anticipate modification of trainings for 2 days after vaccination.

Fitness level, fatigue and adaptation are important factors for determining the optimal training schedule and predicting future performance. We think that adding analysis of the mutual relationships between cardiac and respiratory activity enables better athlete profiling and feedback for improving training. Therefore, the main objectives were (1) to apply several methods for temporal causality analysis to cardiorespiratory data; (2) to establish causal links between the signals; and (3) to determine how parameterized connections differed across various subgroups. One hundred elite athletes (31 female) and a control group of 20 healthy students (6 female) took part in the study. All were asked to follow a protocol comprising two 5-min sessions of free breathing - once supine, once standing. The data were collected using Pneumonitor 2. Respiratory-related curves were obtained through impedance pneumography, along with a single-lead ECG. Several signals (e.g., tidal volume, instantaneous respiratory rate, and instantaneous heart rate) were derived and stored as: (1) raw data down-sampled to 25Hz; (2) further down-sampled to 2.5Hz; and (3) beat-by-beat sequences. Granger causality frameworks (pairwise-conditional, spectral or extended), along with Time Series Models with Independent Noise (TiMINo), were studied. The connections enabling the best distinctions were found using recursive feature elimination with a random forest kernel. Temporal causal links are the most evident between tidal volume and instantaneous heart rate signals. Predictions of the “effect” variable were improved by adding preceding “cause” samples, by medians of 20.3% for supine and 14.2% for standing body positions. Parameterized causal link structures and directions distinguish athletes from non-athletes with 83.3% accuracy on average. They may also be used to supplement standard analysis and enable classification into groups exhibiting different static and dynamic components during performance. Physiological markers of training may be extended to include cardiorespiratory data, and causality analysis may improve the resolution of training profiling and the precision of outcome prediction.

BackgroundTo assess left ventricular hypertrophy, actual left ventricular mass (LVM) normalized for body size has to be compared to the LVM normative data. However, only some published normative echocardiographic data have been produced separately for girls and boys; numerous normative data for the pediatric population are not sex-specific. Thus, this study aimed to assess whether the LVM normative data should be developed separately for girls and boys practicing sports.MethodsLeft ventricular mass was computed for 331 girls and 490 boys, 5-19 years old, based on echocardiography. The effect of sex on the relationship between LVM and body size was evaluated using a linear regression model. Seven sets of the LVM normative data were developed, using different methodologies, to test concordance between sex-specific and non-specific normative data. Every set consisted of normative data that was sex-specific and non-specific. Upon these normative data, for every study participant, seven pairs of LVM z-scores were calculated based on her/his actual LVM. Each pair consisted of z-scores computed based on sex-specific and non-specific normative data from the same set.ResultsThe regression lines fitted to the data points corresponding to LVM of boys had a higher slope than of girls, indicating that sex affects the relationship between LVM and body size. The mean differences between the paired LVM z-scores differed significantly from 0. The percentage of discordant indications, depending on the normalization method, ranged from 66.7% to 100% in girls and from 35.4% to 50% in boys. Application of the LVM normative data that were not sex-specific made relative LVM underestimated in girls and overestimated in boys.ConclusionThe LVM normative data should be developed separately for girls and boys practicing sports. Application of normative data that are not sex-specific results in an underestimation of relative LVM in girls and overestimation in boys.

Training of elite athletes requires regular physiological and medical monitoring to plan the schedule, intensity and volume of training, and subsequent recovery. In sports medicine, ECG-based analyses are well established. However, they rarely consider the correspondence of respiratory and cardiac activity. Given such mutual influence, we hypothesize that athlete monitoring might be developed with causal inference and that detailed, time-related techniques should be preceded by a more general, time-independent approach that considers the whole group of participants and parameters describing whole signals. The aim of this study was to discover general causal paths among cardiac and respiratory variables in elite athletes in two body positions (supine and standing), at rest. ECG and impedance pneumography signals were obtained from 100 elite athletes. The mean HR, the RMSSD, its natural logarithm, the mean respiratory rate, the breathing activity coefficients, and the resulting breathing regularity were estimated. Several causal discovery frameworks were applied: generalized correlations, CAM, FGES, GFCI, and two Bayesian network learning algorithms: Hill-Climbing and Tabu. The main, still mild, rules best supported by data are: for supine - tidal volume causes heart activity variation, which causes HR, which causes respiratory timing; and for standing - normalized respiratory activity variation causes average heart activity. The presented approach allows data-driven and time-independent analysis of elite athletes as a particular population, without considering prior knowledge. However, the results seem to be consistent with the medical background. Causality inference is an interesting mathematical approach to the analysis of biological responses, which are complex. One can use it to profile athletes and plan appropriate training., Comment: Accepted for publication on September 25, 2018; 24 pages; 16 figures; 3 tables; 68 references

BACKGROUND Application of normative data for echocardiographic measurements to children practicing sports may lead to false positive findings. The aim of the study was to define the normative data of basic echocardiographic measurements for this group and to compare them to the previously published normative data for the pediatric population. METHODS Parasternal long-axis 2D-guided echocardiographic measurements were obtained from a group of 791 child athletes (ages 5-18 years). According to the methodology presented previously by Pettersen et al. (2008), the regression equations for basic cardiac dimensions against body surface area were derived and individual Z-scores values were computed, using both Pettersen's equations and newly derived ones. RESULTS Z-scores computed based on Pettersen's equations were found to differ significantly from those based on the new equations, for all the analyzed parameters (p

Being frequent travelers, the elite athletes are advised to undergo an influenza vaccination. The aim of the study was to describe the antibody response to repeated trivalent, inactivated, split influenza vaccine, of different antigenic content, recommended for the Northern and the Southern Hemisphere, administered to sportsmen before the Olympic Games in Brasil in 2016. Fourteen athletes were included in the study. For both A/California/7/209/pdm09 A/H1N1/ antigen and A/Switzerland/971593/2013/A/H3N2/ antigen, higher seroconversion rates were obtained after the first than the second vaccination (10.2 vs. 1.5 and 10.6 vs. 3.0, respectively; p < 0.05 both). Conversion rates for B/Phuket/3073/2013, B/Brisbane/60/2008, and A/HongKong/4801/2014/A/H3N2/ antigens were lower. Nonetheless, the protection rate was greater than 70% for all antigens contained in both vaccines. The proportion of individuals demonstrating a high level of both protection rate and response rate was greater after the first than the second vaccination. We conclude that the immunological response after influenza vaccination is good in elite athletes and remains so after a second influenza vaccination required due to a different vaccine composition recommended for different hemispheres.

Introduction Exercise-induced respiratory symptoms are often reported by professional athletes, but asthma and allergy are underdiagnosed. Few studies used standardized questionnaires combined with clinical assessment to investigate asthma and allergy among athletes. Objectives Assessment of the prevalence of allergy and asthma symptoms among Polish professional athletes and confronting it with clinical data. Methods Two hundred twenty-two Olympic athletes participated in the project being part of the Global Allergy and Asthma European Network (GA2LEN) Olympic study. Allergy and asthma status was determined using Allergy Questionnaire for Athletes (AQUA), spirometry, reversibility test, methacholine challenge and skin prick testing. Final diagnosis was established by an allergist. Results At least one exercise-induced asthma (EIA) symptom was reported by 28.4% athletes, and finally asthma diagnosis was established in 11.3% while only 5.9% of athletes had history of asthma. Reversibility test was positive in 36% of athletes finally diagnosed with asthma. Allergic rhinitis (AR) symptoms were reported by 27%, and the diagnosis was confirmed in 21% of athletes while only 9% had previously diagnosed AR. No significant differences in frequency of asthma and AR were observed between endurance and non-endurance athletes. Conclusions High prevalence of exercise-induced respiratory symptoms among top athletes is not reflected by asthma diagnosis. As it was expected, our data confirm that – in diagnosis of EIA – lung function testing alone is not useful, whereas reversibility tests are of limited value.

Vitamin D does not only influence the musculoskeletal health and mineral homeostasis but it also affects cardiovascular, endocrine, nervous, immune and mental functions, thus it is of considerable importance for both physically active people and elite athletes. However, vitamin D deficiency is common worldwide and results from inadequate endogenous skin synthesis (insufficient ultraviolet B exposure) and diet. To improve the vitamin D status elite athletes often travel to lower latitude during winter. The aim of the study was to evaluate the seasonal vitamin D status in Polish elite athletes according to the sun exposure and oral supplementation. Serum concentration of 25-hydroxyvitamin D (25(OH)D) was measured in the years 2010–2014 in 409 elite athletes, who were divided into the following groups: OUTD—outdoor sports, represented by track and field athletes, who trained in Poland; IND—weightlifters, handball and volleyball players who trained indoors in Poland; SUN—track and field athletes who trained during Polish winter in lower latitude with high sunshine exposure; SUPL—track and field athletes who trained in Poland, had an inadequate vitamin D status (25(OH)D < 30 ng/ml) and were supplemented orally. Inadequate Vitamin D status was observed in 80% of OUTD and 84% of IND athletes in winter, whereas in summer the values amounted to 42% and 83%, respectively. The athletes exposed to sun in winter had significantly higher vitamin D concentration than OUTD group. Oral supplementation improved vitamin D concentration by 45%, whereas winter sun exposure caused its increase by 85%. Except for a few summer months an inadequate status of vitamin D was found in the majority of Polish elite athletes, with the deficiency level being similar to the one observed in non-athletic population. The most serious deficiency was observed in indoor disciplines. Adequate vitamin D status can be achieved by both increased sun exposure, especially in winter, and oral supplementation. Athletes should therefore routinely assess their vitamin D status and be educated how to approach their sunlight exposure, diet and supplementation.