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INTRODUCTION Although vitamin D is intimately involved in bone metabolism, the relationship between vitamin D status, as measured by serum total 25-hydroxyvitamin D [25(OH)D] concentration, and bone mineral density (BMD) is weak, particularly in non-White populations. Measurement of bioavailable 25(OH)D has been suggested as a better indicator of vitamin D status than total 25(OH)D concentration. To date, the bioavailable 25(OH)D biomarker has been explored minimally in athletic populations. The purpose of this study was to investigate the relationship between total and bioavailable 25(OH)D concentrations and BMD in collegiate athletes. METHODS NCAA Division 1 basketball and swimming athletes served as study participants (n = 53; 28 females, 25 males; 28 basketball players, 25 swimmers). All participants completed dual energy x-ray absorptiometry (DXA) scans for analysis of BMD, blood draws for vitamin D measures, and diet/lifestyle questionnaires. RESULTS Overall, total 25(OH)D was 80.0 + 13.9 nmol/L and bioavailable 25(OH)D was 6.0 ± 1.9 nmol/L. There was strong disagreement between total 25(OH)D and bioavailable 25(OH)D concentrations (κ = -0.299; r = -0.129) (p = 0.100); 53% of total participants and 77% of Black participants were classified differently (low vs. normal vitamin D status) based on total and bioavailable 25(OH)D criteria. Black participants had significantly lower total 25(OH)D and higher bioavailable 25(OH)D concentrations than White participants (59.5 vs. 102.5 nmol/L and 7.9 vs. 5.4 nmol/L, respectively) (p < 0.001). Total 25(OH)D and total BMD were not correlated, but bioavailable 25(OH)D and total BMD demonstrated a positive correlation (r = 0.618, p < 0.01). CONCLUSIONS These results suggest that bioavailable 25(OH)D concentration may be a better clinical measure of vitamin D status than total 25(OH)D in collegiate athletes as related to BMD, particularly in Black athletes. Further research on the utility of the bioavailable 25(OH)D biomarker in athletes is needed.

Thyroid disease is common in the general population, especially in women, and also may be prevalent among athletes. Autoimmune disorders are the most common cause of thyroid disorders in countries with iodine-fortification programs; however, thyroid dysfunction can be brought on by nutritional factors, including insufficient energy intake and iodine, selenium, iron, and vitamin D deficiency. Additionally, strenuous exercise may be associated with transient alterations in thyroid hormones. While the development of thyroid related disorders has the potential to impact health and peak performance, typical clinical manifestations are highly variable, lack specificity, and are frequently confused with other health problems. The assessment process should focus on anthropometric changes, biochemical tests (thyroid panel), personal and family history, examination for appropriate signs and symptoms, and diet and environmental assessment that includes adequacy of energy, iodine, iron, selenium, and vitamin D intake/status along with excess stress and exposure to environmental contaminants and dietary goitrogens.

Some dietary supplements are recommended to athletes based on data that supports improved exercise performance. Other dietary supplements are not ergogenic per se, but may improve health, adaptation to exercise, or recovery from injury, and so could help athletes to train and/or compete more effectively. In this review, we describe several dietary supplements that may improve health, exercise adaptation, or recovery. Creatine monohydrate may improve recovery from and adaptation to intense training, recovery from periods of injury with extreme inactivity, cognitive processing, and reduce severity of or enhance recovery from mild traumatic brain injury (mTBI). Omega 3-fatty acid supplementation may also reduce severity of or enhance recovery from mTBI. Replenishment of vitamin D insufficiency or deficiency will likely improve some aspects of immune, bone, and muscle health. Probiotic supplementation can reduce the incidence, duration, and severity of upper respiratory tract infection, which may indirectly improve training or competitive performance. Preliminary data show that gelatin and/or collagen may improve connective tissue health. Some anti-inflammatory supplements, such as curcumin or tart cherry juice, may reduce inflammation and possibly delayed onset muscle soreness (DOMS). Beta-hydroxy beta-methylbutyrate (HMB) does not consistently increase strength and/or lean mass or reduce markers of muscle damage, but more research on recovery from injury that includes periods of extreme inactivity is needed. Several dietary supplements, including creatine monohydrate, omega 3-fatty acids, vitamin D, probiotics, gelatin, and curcumin/tart cherry juice could help athletes train and/or compete more effectively.

Some track-and-field athletes implement special diets aiming to improve health and/or performance. An evidence-based approach to any diet is recommended to minimize the risks associated with unnecessary dietary restriction, which may potentially do more harm than good. Four prevalent diets are reviewed in this study: (a) gluten-free; (b) low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP); (c) vegetarian; and (d) fasting diets. Recently, gluten-free diets and low FODMAP diets have emerged as novel regimes thought to improve gastrointestinal health and reduce the risk of exercise-associated gastrointestinal symptoms. No direct beneficial outcomes have been associated with avoiding gluten for clinically healthy athletes. Indirectly, a gluten-free diet is associated with other dietary changes, particularly FODMAP reduction, which may improve adverse gastrointestinal symptoms. Vegetarian diets can optimally support athletic demands. However, attention is required to ensure adequate energy and intake of specific nutrients that are less abundant or less well absorbed from plant sources. Finally, fasting is a long-standing concept that is undertaken on a voluntary and obligatory basis. Despite limited supporting research, voluntary fasting is a popular alternative to conventional diets perceptually offering health and body composition benefits. Strict obligatory fasting guidelines likely require the implementation of tailored nutrition strategies to help athletes cope with athletic demands. Overall, a multitude of factors influence adherence to special diets. Even when adherence to a special diet is a necessity, education and advice from an accredited dietitian/nutritionist are recommended for track-and-field athletes to optimize nutrition for health and performance.

Nutrition assessment is a necessary first step in advising athletes on dietary strategies that include dietary supplementation, and in evaluating the effectiveness of supplementation regimens. Although dietary assessment is the cornerstone component of the nutrition assessment process, it should be performed within the context of a complete assessment that includes collection/evaluation of anthropometric, biochemical, clinical, and environmental data. Collection of dietary intake data can be challenging, with the potential for significant error of validity and reliability, which include inherent errors of the collection methodology, coding of data by dietitians, estimation of nutrient composition using nutrient food tables and/or dietary software programs, and expression of data relative to reference standards including eating guidance systems, macronutrient guidelines for athletes, and recommended dietary allowances. Limitations in methodologies used to complete anthropometric assessment and biochemical analysis also exist, as reference norms for the athlete are not well established and practical and reliable biomarkers are not available for all nutrients. A clinical assessment collected from history information and the nutrition-focused physical exam may help identify overt nutrient deficiencies but may be unremarkable in the well-trained athlete. Assessment of potential food-drug interactions and environmental components further helps make appropriate dietary and supplement recommendations. Overall, the assessment process can help the athlete understand that supplement intake cannot make up for poor food choices and an inadequate diet, while a healthy diet helps ensure maximal benefit from supplementation. Establishment of reference norms specifically for well-trained athletes for the nutrition assessment process is a future research priority.

With the increasing popularity of Hatha yoga, it is important to understand the energy cost and METs of yoga practice within the context of the American College of Sports Medicine (ACSM) and the American Heart Association (AHA) physical activity guidelines.This systematic review evaluated the energy cost and metabolic intensity of yoga practice including yoga asanas (poses/postures) and pranayamas (breath exercises) measured by indirect calorimetry. The English-speaking literature was surveyed via PubMed using the general terms "yoga" and "energy expenditure" with no date limitations.Thirteen manuscripts were initially identified with an additional four located from review of manuscript references. Of the 17 studies, 10 evaluated the energy cost and METs of full yoga sessions or flow through Surya Namaskar (sun salutations), eight of individual asanas, and five of pranayamas. METs for yoga practice averaged 3.3 ± 1.6 (range = 1.83-7.4 METs) and 2.9 ± 0.8 METs when one outlier (i.e., 7.4 METs for Surya Namaskar) was omitted. METs for individual asanas averaged 2.2 ± 0.7 (range = 1.4-4.0 METs), whereas that of pranayamas was 1.3 ± 0.3. On the basis of ACSM/AHA classification, the intensity of most asanas and full yoga sessions ranged from light (less than 3 METs) to moderate aerobic intensity (3-6 METs), with the majority classified as light intensity.This review suggests that yoga is typically classified as a light-intensity physical activity. However, a few sequences/poses, including Surya Namaskar, meet the criteria for moderate- to vigorous-intensity activity. In accordance with the ACSM/AHA guidelines, the practice of asana sequences with MET intensities higher than three (i.e.,10 min) can be accumulated throughout the day and count toward daily recommendations for moderate- or vigorous-intensity physical activity.

Vitamin D deficiency is endemic in the general population; however, there is much to be learned about the vitamin D status of athletes. Purpose: The purposes of this study were to assess the prevalence of vitamin D insufficiency in collegiate athletes and to determine whether 25(OH)D concentrations are related to vitamin D intake, sun exposure, body composition, and risk for illness or athletic injury. Methods: 25(OH) vitamin D concentrations were measured in 41 athletes (18 men/23 women, 12 indoor/29 outdoor athletes) throughout the academic year. Dietary intake and lifestyle habits were assessed via questionnaire, bone density was measured by dual energy x-ray absorptiometry, and injury and illness were documented as part of routine care. Results: The 25(OH)D concentrations changed across time (P = 0.001) and averaged 49.0 ± 16.6, 30.5 ± 9.4, and 41.9 ± 14.6 ng·mL-1 (mean ± SD) in the fall, winter, and spring, respectively, and were higher in outdoor versus indoor athletes in the fall (P < 0.05). Using 40 ng·mL-1 as the cutoff for optimal status, 75.6%, 15.2%, and 36.0% of athletes had optimal status in the fall, winter, and spring, respectively. 25(OH)D concentrations were significantly (P < 0.05) correlated with multivitamin intake in the winter (r = 0.39) and tanning bed use in the spring (r = 0.48); however, status was otherwise not related to intake, lifestyle factors, or body composition. 25(OH)D concentrations in the spring (r = -0.40, P = 0.048) was correlated with frequency of illness. Conclusions: Our results suggest that collegiate athletes can maintain sufficient status during the fall and spring but would benefit from supplementation during the winter to prevent seasonal decreases in 25(OH)D concentrations. Results further suggest that insufficient vitamin D status may increase risk for frequent illness. Future research is needed to identify whether vitamin D status influences injury risk during athletic training or competition

While it is well recognized that vitamin D is necessary for optimal bone health, emerging evidence is finding that adequate vitamin D intake reduces risk for conditions such as stress fracture, total body inflammation, infectious illness, and impaired muscle function. Studies in athletes have found that vitamin D status is variable and is dependent on outdoor training time (during peak sunlight), skin color, and geographic location. Although research has found that athletes generally do not meet the U.S. dietary reference intake for vitamin D, inadequate endogenous synthesis is the most probable reason for insufficient/deficient status. Given the recent findings, it is imperative that sports dietitians and physicians routinely assess vitamin D status and make recommendations to help athletes achieve a serum 25(OH)D concentration of >or=32 and preferably >or=40 ng.mL(-1). Further research is needed to determine the effect of vitamin D status on injury, training, and performance in athletes.

There is a debate over the independent effects of aerobic fitness and body fatness on mortality and disease risks.To determine whether a 25% energy deficit that produces equal change in body fatness leads to greater cardiometabolic benefits when aerobic exercise is included.Thirty-six overweight participants (16 males/20 females) (39 +/- 1 yr; 82 +/- 2 kg; body mass index = 27.8 +/- 0.3 kg x m2, mean +/- SEM) were randomized to one of three groups (n = 12 for each) for a 6-month intervention: control (CO, weight-maintenance diet), caloric restriction (CR, 25% reduction in energy intake), or caloric restriction plus aerobic exercise (CR + EX, 12.5% reduction in energy intake plus 12.5% increase in exercise energy expenditure). Food was provided during weeks 1-12 and 22-24. Changes in fat mass, visceral fat, VO2peak (graded treadmill test), muscular strength (isokinetic knee extension/flexion), blood lipids, blood pressure, and insulin sensitivity/secretion were compared.As expected, VO2peak was significantly improved after 6 months of intervention in CR + EX only (22 +/- 5% vs 7 +/- 5% in CR and -5 +/- 3% in CO), whereas isokinetic muscular strength did not change. There was no difference in the losses of weight, fat mass, or visceral fat and changes in systolic blood pressure (BP) between the intervention groups. However, only CR + EX had a significant decrease in diastolic BP (-5 +/- 3% vs -2 +/- 2% in CR and -1 +/- 2% in CO), in low-density lipoprotein (LDL) cholesterol (-13 +/- 4% vs -6 +/- 3% in CR and 2 +/- 4% in CO), and a significant increase in insulin sensitivity (66 +/- 22% vs 40 +/- 20% in CR and 1 +/- 11% in CO).Despite similar effect on fat losses, combining CR with exercise increased aerobic fitness in parallel with improved insulin sensitivity, LDL cholesterol, and diastolic BP. The results lend support for inclusion of an exercise component in weight loss programs to improve metabolic fitness.

The purposes of this study were to (a) determine whether structural differences in triceps surae muscle-tendon complex and walking economy exist between 14 African American and 19 Caucasian sedentary women and (b) determine whether muscle-tendon parameters are associated with walking economy. African American and Caucasian subjects were matched on body weight, height, and body composition. Muscle-tendon parameters were determined by magnetic resonance imaging and walking economy was evaluated at 4.8 km.h(-1). Medial gastrocnemius and total triceps surae muscle shape were different across ethnicity despite no ethnic differences in plantar flexion strength or in maximal cross-sectional area for any triceps surae muscles. African American women had shorter gastrocnemius muscles and longer tendons and performed walking more economically. Tendon length was the only variable related to walking economy. No ethnic differences were observed in walking economy after adjusting for tendon length. Data show gastrocnemius tendon length is related to level walking and longer gastrocnemius tendons may partly explain more economical walking in African American women. These preliminary findings indicate the structure of the muscle-tendon complex could be a factor partially accounting for reported ethnic differences in certain types of athletic-related performance.

An inverse relationship has been shown between running and cycling exercise economy and maximum oxygen uptake (VO2max). The purposes were: 1) determine the relationship between walking economy and VO2max; and 2) determine the relationship between muscle metabolic economy and muscle oxidative capacity and fiber type. Subjects were 77 premenopausal normal weight women. Walking economy (1/VO2max) was measured at 3 mph and VO2max during graded treadmill test. Muscle oxidative phosphorylation rate (OxPhos), and muscle metabolic economy (force/ATP) were measured in calf muscle using 31P MRS during isometric plantar flexion at 70 and 100% of maximum force, (HI) and (MI) respectively. Muscle fiber type and citrate synthase activity were determined in the lateral gastrocnemius. Significant inverse relationships (r from -0.28 to -0.74) were observed between oxidative metabolism measures and exercise economy (walking and muscle). Type IIa fiber distribution was inversely related to all measures of exercise economy (r from -0.51 to -0.64) and citrate synthase activity was inversely related to muscle metabolic economy at MI (r = -0.56). In addition, Type IIa fiber distribution and citrate synthase activity were positively related to VO2max and muscle OxPhos at HI and MI (r from 0.49 to 0.70). Type I fiber distribution was not related to any measure of exercise economy or oxidative capacity. Our results support the concept that exercise economy and oxidative capacity are inversely related. We have demonstrated this inverse relationship in women both by indirect calorimetry during walking and in muscle tissue by 31P MRS.

HUNTER, G. R., R. L. WEINSIER, J. P. MCCARTHY, D. E. LARSON-MEYER, and B. R. NEWCOMER. Hemoglobin, muscle oxidative capacity, and V2max in African-American and Caucasian women. Med. Sci. Sports Exerc., Vol. 33, No. 10, 2001, pp. 1739–1743. Purpose: The purpose of this paper was to determine whether differences in hemoglobin (Hb) and muscle aerobic capacity exist between African-American (AA) and Caucasian (CA) premenopausal women and to determine whether Hb and aerobic capacity of the muscle are associated with the racial differences in maximum oxygen uptake (V2max). Methods: 43 AA and 46 CA sedentary premenopausal women were subjects. Percent body fat was determined by four-compartment model, leg lean tissue by dual energy x-ray absorptiometry, V2max during a graded exercise test, aerobic capacity of the calf muscle by 31P magnetic resonance spectroscopy, and serum Hb by the cyanide method. Results: AA women had reduced V2max (AA 29.3 ± 3.0 vs CA 33.6 ± 5.6 mL·kg−1 bdw−1·min, P < 0.01), reduced muscle aerobic capacity (AA 24.3 ± 5.8 vs CA 21.3 ± 4.8 s, P = 0.01, where lower values indicate higher aerobic capacity), and reduced Hb (AA 11.8 ± 1.3 vs CA 12.9 ± 0.8 g·dL−1, P < 0.01). The racial difference in V2max persisted whether the values were unadjusted or adjusted for fat-free mass or leg lean tissue. Multiple regression analysis revealed that both Hb and muscle aerobic capacity were related to V2max after adjusting for each other, race, and either fat-free mass or leg lean tissue. Being AA was associated with reduced V2max in mL O2·kg leg lean tissue−1.min−1 (zero-order simple Pearson-product correlation −0.60, P < 0.01). When multiple regression was used, the correlation between race and V2max decreased but persisted (−0.40

Aging is associated with loss of endurance; however, aging is also associated with decreased fatigue during maximal isometric contractions. The aims of this study were to examine the relationship between age and walking endurance (WE) and maximal isometric fatigue (MIF) and to determine which metabolic/fitness components explain the expected age effects on WE and MIF. Subjects were 96 pre-menopausal women. Oxygen uptake (walking economy) was assessed during a 3-mph walk; aerobic capacity and WE by progressive treadmill test; knee extension strength by isometric contractions, MIF during a 90-s isometric plantar flexion (muscle metabolism measured by 31P MRS). Age was related to increased walking economy (low VO2, r = −0.19, P < 0.03) and muscle metabolic economy (force/ATP, 0.34, P = 0.01), and reduced MIF (−0.26, P < 0.03). However, age was associated with reduced WE (−0.28, P < 0.01). Multiple regression showed that muscle metabolic economy explained the age-related decrease in MIF (partial r for MIF and age −0.13, P = 0.35) whereas walking economy did not explain the age-related decrease in WE (partial r for WE and age −0.25, P < 0.02). Inclusion of VO2max and knee endurance strength accounted for the age-related decreased WE (partial r for WE and age = 0.03, P > 0.80). In premenopausal women, age is related to WE and MIF. In addition, these results support the hypothesis that age-related increases in metabolic economy may decrease MIF. However, decreased muscle strength and oxidative capacity are related to WE.

We have previously shown that Achilles tendon length is related to walking economy on the flat, presumably because of increased stretch-shortening cycle elastic energy savings. In addition, greater walking economy in African American (AA) women compared to European American (EA) women is explained by longer Achilles tendons in AA women. The purposes of this study were to determine whether economy while walking up a grade and during isometric plantar flexion, two tasks expected to produce proportionately less energy savings from elastic savings are different between AA and EA women. We evaluated walking economy at 4.8 km/h at 0 and 2.5% grade in 48 AA and 48 EA premenopausal women. Plantar flexor muscle metabolic economy (force/ATP) was also evaluated using (31) phosphate magnetic resonance spectroscopy ((31)P-MRS). AA women walked on the flat more economically (net VO(2), AA 8.3 and EA 8.9 ml kg(-1) min(-1), P = 0.04). No significant ethnic differences were observed while walking up a 2.5% grade or in (31)P-MRS determined plantar flexor muscle metabolic economy. These data support our previous study's suggestion that AA women are more economical while walking on the flat. On the other hand, in activities in which stretch-shortening cycle elastic energy savings would be expected to be reduced (grade walking and isometric force production), no differences in economy during grade walking or isometric force production were observed suggesting that biomechanical, i.e. stretch-shortening cycle elastic energy savings differences rather biochemical differences contribute to the better flat walking economy observed in AA women.

A surprisingly high prevalence of vitamin D insufficiency and deficiency has recently been reported worldwide. Although very little is known about vitamin D status among athletes, a few studies suggest that poor vitamin D status is also a problem in athletic populations. It is well recognized that vitamin D is necessary for optimal bone health, but emerging evidence is finding that vitamin D deficiency increases the risk of autoimmune diseases and nonskeletal chronic diseases and can also have a profound effect on human immunity, inflammation, and muscle function (in the elderly). Thus, it is likely that compromised vitamin D status can affect an athlete’s overall health and ability to train (i.e., by affecting bone health, innate immunity, and exercise-related immunity and inflammation). Although further research in this area is needed, it is important that sports nutritionists assess vitamin D (as well as calcium) intake and make appropriate recommendations that will help athletes achieve adequate vitamin D status: serum 25(OH)D of at least 75 or 80 nmol/L. These recommendations can include regular safe sun exposure (twice a week between the hours of 10 a.m. and 3 p.m. on the arms and legs for 5–30 min, depending on season, latitude, and skin pigmentation) or dietary supplementation with 1,000–2,000 IU vitamin D3 per day. Although this is significantly higher than what is currently considered the adequate intake, recent research demonstrates these levels to be safe and possibly necessary to maintain adequate 25(OH)D concentrations.

Purpose: This study evaluated whether lowering IMCL stores via 3-d consumption of very-low-fat (LFAT) diet impairs endurance performance relative to a moderate-fat diet (MFAT), and whether such a diet unfavorably alters lipid profiles. Methods: Twenty-one male and female endurance-trained runners followed a controlled diet and training regimen for 3 d prior to consuming either a LFAT (10% fat) or MFAT (35% fat) isoenergetic diet for another 3 d in random crossover fashion. On day 7, runners followed a glycogen normalization protocol (to equalize glycogen stores) and then underwent performance testing (90-min preload run at 62 +/- 1% V[spacing dot above]O2max followed by a 10-km time trial) on the morning of day 8. Muscle biopsies obtained from vastus lateralis before and after performance testing were analyzed for IMCL (via electron microscopy) and glycogen content (via enzymatic methodology). Results: Despite approximately 30% lower IMCL (0.220 +/- 0.032% LFAT, 0.316 +/- 0.049% MFAT; P = 0.045) and approximately 22% higher muscle glycogen stores at the start of performance testing (P = 0.10), 10-km performance time was not significantly different following the two diet treatments (43.5 +/- 1.4 min LFAT vs 43.7 +/- 1.2 min MFAT). However, LFAT produced less favorable lipid profiles (P < 0.01) by increasing fasting triglycerides (baseline = 84.9 +/- 8.6; LFAT = 118.7 +/- 10.0 mg[middle dot]dL-1) and the total cholesterol:HDL cholesterol ratio (baseline = 3.42 +/- 0.13:1; LFAT = 3.75 +/- 0.20:1), whereas MFAT lowered triglycerides (baseline = 97.5 +/- 12.2; MFAT = 70.9 +/- 7.1 mg[middle dot]dL-1) and the total cholesterol:HDL cholesterol ratio (baseline = 3.47 +/- 0.18:1; MFAT = 3.33 +/- 0.14:1). Conclusion: The results suggest that reducing IMCL via 3-d consumption of a LFAT diet does not impair running performance lasting a little over 2 h (compared with 3-d consumption of a MFAT diet plus 1-d glycogen normalization), but that even short-term consumption of a LFAT diet may unfavorably alter serum lipids, even in healthy, endurance-trained runners.

The study purpose was to determine the relationship: 1) of muscle metabolism to exercise performance and 2) of exercise performance to rate of weight gain.Eighty-three black and white premenopausal women were evaluated for maximum oxygen uptake (VO2max ), isometric quadriceps and triceps surae strength, and 31P magnetic resonance spectroscopy of calf muscle metabolic capacity. Rate of weight gain was determined 1 yr later. Multiple regression was used to model dependent variables.Muscle aerobic capacity and strength of the quadriceps muscle independently contributed to endurance time on the treadmill (ET) in one model (overall R = 0.47, P0.01), and VO2max and strength of the quadriceps muscle independently contributed to ET in another model (R = 0.85, P0.001). In models of muscle strength, maximum creatine kinase activity and maximum anaerobic glycolytic rate independently contributed to triceps surae strength, after adjusting for triceps surae cross-section area (R = 0.63, P0.001). In another model, maximum creatine kinase activity was related to quadriceps strength independent of leg lean tissue (R = 0.31, P0.05). Rate of weight gain was related to muscle metabolic economy (r = -0.25, = 0.04), quadriceps strength (r = -0.34, P0.01), VO2max (r = -0.22, = 0.04), and ET (r = -0.21, = 0.04). Rate of weight gain was modeled by muscle metabolic economy, VO2max, and quadriceps strength (R = 0.48, P0.01).Implications of findings are 1) greater strength and aerobic fitness-at the muscle and whole-body levels-improve endurance; 2) greater muscle anaerobic metabolism is associated with greater muscle strength, independent of muscle size; and 3) greater exercise endurance reduces weight gain.

We investigated the effects of creatine (Cr) supplementation on muscle strength and body composition during 13 weeks of training in female collegiate soccer players. Fourteen athletes were randomly assigned to receive either Cr supplementation (7.5 g, 2 times a day for 1 week and 5 g per day thereafter) or placebo dissolved in a fluid-replacement beverage. Baseline measurements were made 1–2 weeks before and at 5 and 13 weeks after beginning supplementation. The Cr group demonstrated greater improvements in bench press and full-squat maximal strength (the trial by group interaction) compared with the placebo group, which were significantly different between baseline and 5 weeks for the bench press and between 5 and 13 weeks for the full squat. Fat-and bone-free lean masses measured by dual-energy x-ray absorptiometry increased with training (main effect) but were not enhanced by Cr supplementation. These results suggest that female soccer players increase strength as well as lean tissue during off-season training. Cr supplementation, however, appears to be associated with significantly greater increases in muscle strength but not lean tissue.

Nutrition usually makes a small but potentially valuable contribution to successful performance in elite athletes, and dietary supplements can make a minor contribution to this nutrition programme. Nonetheless, supplement use is widespread at all levels of sport. Products described as supplements target different issues, including (1) the management of micronutrient deficiencies, (2) supply of convenient forms of energy and macronutrients, and (3) provision of direct benefits to performance or (4) indirect benefits such as supporting intense training regimens. The appropriate use of some supplements can benefit the athlete, but others may harm the athlete's health, performance, and/or livelihood and reputation (if an antidoping rule violation results). A complete nutritional assessment should be undertaken before decisions regarding supplement use are made. Supplements claiming to directly or indirectly enhance performance are typically the largest group of products marketed to athletes, but only a few (including caffeine, creatine, specific buffering agents and nitrate) have good evidence of benefits. However, responses are affected by the scenario of use and may vary widely between individuals because of factors that include genetics, the microbiome and habitual diet. Supplements intended to enhance performance should be thoroughly trialled in training or simulated competition before being used in competition. Inadvertent ingestion of substances prohibited under the antidoping codes that govern elite sport is a known risk of taking some supplements. Protection of the athlete's health and awareness of the potential for harm must be paramount; expert professional opinion and assistance is strongly advised before an athlete embarks on supplement use. Publisher PDF