Effects of vitamin D3 supplementation on serum 25(OH)D concentration and strength in athletes: a systematic review and meta-analysis of randomized controlled trials

Qi Han, Xueyang Li, Qiushi Tan, Jing Shao, Muqing Yi, Qi Han, Xueyang Li, Qiushi Tan, Jing Shao, Muqing Yi

Abstract

Background: The purpose of this systematic review and meta-analysis is to investigate the effects of vitamin D3 supplementation on skeletal muscle strength in athletes. Vitamin D3 supplements or vitamin D3 fortified foods always have claims for bringing people health benefits including bone and muscle health. An up-to-date rigorous systematic review and meta-analysis is important to better understand the effect of vitamin D3 supplementation on muscle strength.

Methods: English written randomized controlled trials (RCTs) that looked at effects of vitamin D3 supplementation on muscle strength in healthy athletes were searched using three databases (PubMed, Embase and Cochrane Library). Serum 25(OH)D above 30 ng/mL is considered to be sufficient in this systematic review and meta-analysis.

Results: Five RCTs with 163 athletes (vitamin D3 n = 86, placebo n = 77) met inclusion criteria. Fourteen athletes were lost to follow-up and 149 athletes (vitamin D3 n = 80, placebo n = 69) were documented with complete result. Among athletes with baseline serum 25(OH)D values suggesting insufficiency, vitamin D3 daily dosage at 5000 IU for over 4 weeks led to a serum 25(OH)D concentration of 31.7 ng/mL. Athletes with sufficient serum 25(OH)D level at baseline were recruited in only one study, and the participants of which were assigned to either vitamin D3 at a daily dosage of 3570 IU or placebo for 12 weeks, their serum 25(OH)D sufficiency (VD: 37.2 ± 7.6 vs. 45.6 ± 7.6; PL: 38 ± 6.8 vs. 32 ± 8.4) was well maintained above the cut-off boundary. One repetition maximum Bench Press (1-RM BP) was not improved significantly (SMD 0.07, 95% CI: - 0.32 to 0.47, P = 0.72) and there was no significant increase in maximal quadriceps contraction (SMD -2.14, 95% CI: - 4.87 to 0.59, P = 0.12). Furthermore, there was no significant overall effect of vitamin D3 intervention on muscle strength in this meta-analysis (SMD -0.75, 95% CI: - 1.82 to 0.32, P = 0.17).

Conclusion: Although, serum 25(OH)D concentrations after supplementation reached sufficiency was observed, muscle strength did not significantly improve at this point of current meta-analysis. Additional well-designed RCTs with large number of participants examined for the effect of vitamin D3 supplementation on serum 25(OH)D concentrations, muscle strength in a variety of sports, latitudes and diverse multicultural populations are needed.

Keywords: 25(OH)D; Exercise; Muscle; Physical fitness; Strength and conditioning.

Conflict of interest statement

This review article does not recruit human subjects, and no intervention was applied to any subjects. Neither did we include any individual personal data nor information/documents. Therefore, consent for publication is not applicable for this article. Authors declare that there is no competing interest.

QH, QT, JS, MY and XL reached agreements on the proposal, delivery and outcomes of this study and have no conflicts of interest.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of search and selection process
Fig. 2
Fig. 2
Funnel plot for within study serum 25(OH)D difference between intervention and placebo for each trial at baseline. SE, standard error; MD, mean difference of serum 25(OH)D between intervention and placebo. Close 2013a included 2 different vitamin D3 dosage intervention groups in their study [28]
Fig. 3
Fig. 3
Cochrane risk of bias assessment. 2013a, 30 football and rugby athletes were recruited in reference ; 2013b, 10 soccer players were recruited in reference
Fig. 4
Fig. 4
Forest plot for vitamin D3 supplementation effects on serum 25(OH)D status
Fig. 5
Fig. 5
Sensitivity analysis for vitamin D3 supplementation effects on serum 25(OH)D status
Fig. 6
Fig. 6
Forest plot for vitamin D3 supplementation effects on muscle strength

References

    1. Paxton GA, Teale GR, Nowson CA, Mason RS, McGrath JJ, Thompson MJ, Siafarikas A, Rodda CP, Munns CF. Australian and New Zealand Bone and Mineral Society.; Osteoporosis Australia. Vitamin D and health in pregnancy, infants, children and adolescents in Australia and New Zealand: A position statement. Med J Aust. 2013;198:142–143. doi: 10.5694/mja11.11592.
    1. Cherniack EP, Levis S, Troen BR. Hypovitaminosis D: a widespread epidemic. Geriatrics. 2008;63:24–30.
    1. Winzenberg T, Jones G. Vitamin D and bone health in childhood and adolescence. Calcif Tissue Int. 2013;92:140–150. doi: 10.1007/s00223-012-9615-4.
    1. Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr. 2008;87:1080S–1086S. doi: 10.1093/ajcn/87.4.1080S.
    1. Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr. 2006;84:18–28. doi: 10.1093/ajcn/84.1.18.
    1. Tomlinson PB, Joseph C, Angioi M. Effects of vitamin D supplementation on upper and lower body muscle strength levels in healthy individuals. A systematic review with meta-analysis. J Sci Med Sport. 2015;18:575–580. doi: 10.1016/j.jsams.2014.07.022.
    1. Thacher TD, Clarke BL. Vitamin D insufficiency. Mayo Clin Proc. 2011;86:50–60. doi: 10.4065/mcp.2010.0567.
    1. DeLuca HF. Overview of general physiologic features and functions of vitamin D. Am J Clin Nutr. 2004;80:1689S–1696S. doi: 10.1556/AAlim.33.2004.4.10.
    1. Yoshizawa T, Handa Y, Uematsu Y, Takeda S, Sekine K, Yoshihara K, Kawakami T, Arioka K, Sato H, Uchiyama Y, et al. Mice lacking the vitamin D receptor exhibit impaired bone formation, uterine hypoplasia and growth retardation after weaning. Nat Genet. 1997;16:391–396. doi: 10.1038/ng0897-391.
    1. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM, Endocrine Society Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96:1911–1930. doi: 10.1210/jc.2011-0385.
    1. Institute of Medicine . Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press; 2011.
    1. Ogan D, Pritchett K. Vitamin D and the athlete: risks, recommendations, and benefits. Nutrients. 1856;2013:5. doi: 10.3390/nu5061856.
    1. Holick MF. Vtamin D is not as toxic as was once thought: a historical and an up-to-date perspective. Mayo Clin Proc. 2015;90:561–564. doi: 10.1016/j.mayocp.2015.03.015.
    1. Francesca MT, Paola C, Marta AS, Francesco P, Giuseppe M. Impact of Western and Mediterranean diets and vitamin D on muscle fibers of sedentary rats. Nutrients. 2018;10:231. doi: 10.3390/nu10020231.
    1. Oku Yuno, Tanabe Rieko, Nakaoka Kanae, Yamada Asako, Noda Seiko, Hoshino Ayumi, Haraikawa Mayu, Goseki-Sone Masae. Influences of dietary vitamin D restriction on bone strength, body composition and muscle in rats fed a high-fat diet: involvement of mRNA expression of MyoD in skeletal muscle. The Journal of Nutritional Biochemistry. 2016;32:85–90. doi: 10.1016/j.jnutbio.2016.01.013.
    1. Chang E, Kim Y. Vitamin D decreases adipocyte lipid storage and increases NAD-SIRT1 pathway in 3T3-L1 adipocytes. Nutrition. 2016;32:702–708. doi: 10.1016/j.nut.2015.12.032.
    1. Farrokhyar F, Tabasinejad R, Dao D, Peterson D, Ayeni OR, Hadioonzadeh R, Bhandari M. Prevalence of vitamin D inadequacy in athletes: a systematic-review and meta-analysis. Sports Med. 2015;45:365–378. doi: 10.1007/s40279-014-0267-6.
    1. Holick MF. The vitamin D epidemic and its health consequences. J Nutr. 2005;135:2739S–2748S. doi: 10.1093/jn/135.11.2739S.
    1. Nykjaer A, Dragun D, Walther D, Vorum H, Jacobsen C, Herz J, Melsen F, Christensen EI, Willnow TE. An Endocytic pathway essential for renal uptake and activation of the steroid 25-(OH) vitamin D. Cell. 1999;96:507–515. doi: 10.1016/S0092-8674(00)80655-8.
    1. Orysiak J, Mazur-Rozycka J, Fitzgerald J, Starczewski M, Malczewska-Lenczowska J, Busko K. Vitamin D status and its relation to exercise performance and iron status in young ice hockey players. PLoS One. 2018;13:e0195284. doi: 10.1371/journal.pone.0195284.
    1. Chiang CM, Ismaeel A, Griffis RB, Weems S. Effects of vitamin D supplementation on muscle strength in athletes a systematic review. J Strength Cond Res. 2017;31:566. doi: 10.1519/jsc.0000000000001518.
    1. Farrokhyar F, Sivakumar G, Savage K, Koziarz A, Jamshidi S, Ayeni OR, Peterson D, Bhandari M. Effects of vitamin D supplementation on serum 25-Hydroxyvitamin D concentrations and physical performance in athletes: a systematic review and meta-analysis of randomized controlled trials. Sports Med. 2017;47:2323. doi: 10.1007/s40279-017-0749-4.
    1. Tenforde AS, Sayres LC, Sainani KL, Fredericson M. Evaluating the relationship of calcium and vitamin D in the prevention of stress fracture injuries in the young athlete: a review of the literature. PM R. 2010;2:945–949. doi: 10.1016/j.pmrj.2010.05.006.
    1. Dahlquist DT, Dieter BP, Koehle MS. Plausible ergogenic effects of vitamin D on athletic performance and recovery. J Int Soc Sports Nutr. 2015;12:33. doi: 10.1186/s12970-015-0093-8.
    1. Moher D, Liberati A, Tetzlaff J, Douglas GA, for the PRISMA Group Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Int J Surg. 2010;8:336–341. doi: 10.1136/bmj.b2535.
    1. Review Manager (RevMan) [Computer program]. Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
    1. Jastrzebska M, Kaczmarczyk M, Jastrzebski Z. The effect of vitamin d supplementation on training adaptation in well trained soccer players. J Strength Cond Res. 2016;30:2648–2655. doi: 10.1519/JSC.0000000000001337.
    1. Close GL, Leckey J, Patterson M, Bradley W, Owens DJ, Fraser WD, Morton JP. The effects of vitamin D3 supplementation on serum total 25[OH]D concentration and physical performance: a randomised dose-response study. Br J Sports Med. 2013;47:692–696. doi: 10.1136/bjsports-2012-091735.
    1. Wyon MA, Wolman R, Nevill AM, Cloak R, Metsios GS, Gould D, Ingham A, Koutedakis Y. Acute effects of vitamin D3 supplementation on muscle strength in judoka athletes: a randomized placebo-controlled, double-blind trial. Clin J Sport Med. 2016;26:279–284. doi: 10.1097/JSM.0000000000000264.
    1. Jung HC, Seo MW, Lee S, Jung SW, Song JK. Correcting vitamin D insufficiency improves some, but not all aspects of physical performance during winter training in taekwondo athletes. Int J Sport Nutr Exerc Metab. 2018;28:635–643. doi: 10.1123/ijsnem.2017-0412.
    1. Fairbairn KA, Ceelen IJ, Skeaff CM, Cameron CM, Perry TL. Vitamin D3 supplementation does not improve Sprint performance in professional Rugby players: a randomised, placebo-controlled double blind intervention study. Int J Sport Nutr Exerc Metab. 2018;28:1–9. doi: 10.1123/ijsnem.2017-0157.
    1. Close GL, Russell J, Cobley JN, Owens DJ, Wilson G, Gregson W, Fraser WD, Morton JP. Assessment of vitamin D concentration in non-supplemented professional athletes and healthy adults during the winter months in the UK: implications for skeletal muscle function. J Sports Sci. 2013;31:344–353. doi: 10.1080/02640414.2012.733822.
    1. Holick MF, Matsuoka LY, Wortsman J. Age, vitamin D, and solar ultraviolet. Lancet. 1989;2:1104–1105. doi: 10.1016/S0140-6736(89)91124-0.
    1. Michael EA, Albert OG, Michael S, Russell FW, Scott AR. Am J Sports Med. 2013;41:461. doi: 10.1177/0363546513475787.
    1. Ziegler PJ, Nelson JA, Jonnalagadda SS. Nutritional and physiological status of U.S. National Figure Skaters. Int J Sport Nutr. 1999;9:345–360. doi: 10.1123/ijsn.9.4.345.
    1. Fitzgerald JS, Orysiak J, Wilson PB, Mazur-Rozycka J, Obminski Z. Association between vitamin D status and testosterone and cortisol in ice hockey players. Biol Sport. 2018;35:207–213. doi: 10.5114/biolsport.2018.74631.
    1. Fitzgerald JS, Peterson BJ, Warpeha JM, Johnson SC, Ingraham SJ. Association between vitamin D status and maximal-intensity exercise performance in junior and collegiate hockey players. J Strength Cond Res. 2015;29:2513–2521. doi: 10.1519/JSC.0000000000000887.
    1. Mehran N, Schulz BM, Neri BR, Robertson WJ, Limpisvasti O. Prevalence of vitamin D insufficiency in professional hockey players. Orthop J Sports Med. 2016;4:2325967116677512. doi: 10.1177/2325967116677512.
    1. Backx EM, Tieland M, Maase K, Kies AK, Mensink M, van Loon LJ, de Groot LC. The impact of 1-year vitamin D supplementation on vitamin D status in athletes: a dose-response study. Eur J Clin Nutr. 2016;70:1009–1014. doi: 10.1038/ejcn.2016.133.
    1. Guillemant J, Le HT, Maria A, Allemandou A, Pérès G, Guillemant S. Wintertime vitamin D deficiency in male adolescents: effect on parathyroid function and response to vitamin D3 supplements. Osteoporos Int. 2001;12:875–879. doi: 10.1007/s001980170040.
    1. He CS, Fraser WD, Tang J, Brown K, Renwick S, Rudland-Thomas J, Teah J, Tanqueray E, Gleeson M. The effect of 14 weeks of vitamin D3 supplementation on antimicrobial peptides and proteins in athletes. J Sports Sci. 2016;34:67–74. doi: 10.1080/02640414.2015.1033642.
    1. Lewis RM, Redzic M, Thomas DT. The effects of season-long vitamin D supplementation on collegiate swimmers and divers. Int J Sport Nutr Exerc Metab. 2013;23:431–440. doi: 10.1123/ijsnem.23.5.431.
    1. Shanely RA, Nieman DC, Knab AM, Gillitt ND, Meaney MP, Jin F, Sha W, Cialdella-Kam L. Influence of vitamin D mushroom powder supplementation on exercise-induced muscle damage in vitamin D insufficient high school athletes. J Sports Sci. 2014;32:670–679. doi: 10.1080/02640414.2013.847279.
    1. Nieman DC, Gillitt ND, Shanely RA, Dew D, Meaney MP, Luo B. Vitamin D2 supplementation amplifies eccentric exercise-induced muscle damage in NASCAR pit crew athletes. Nutrients. 2013;6:63–75. doi: 10.3390/nu6010063.
    1. Stephensen CB, Zerofsky M, Burnett DJ, Lin YP, Hammock BD, Hall LM, McHugh T. Ergocalciferol from mushrooms or supplements consumed with a standard meal increases 25- hydroxyergocalciferol but decreases 25-hydroxycholecalciferol in the serum of healthy adults. J Nutr. 2012;142:1246–1252. doi: 10.3945/jn.112.159764.
    1. Silk LN, Greene DA, Baker MK, Jander CB. Tibial bone responses to 6-month calcium and vitamin D supplementation in young male jockeys: a randomised controlled trial. Bone. 2015;8:554–561. doi: 10.1016/j.bone.2015.09.004.
    1. Storlie DM, Pritchett K, Pritchett R, Cashman L. 12-week vitamin D supplementation trial does not significantly influence seasonal 25(OH)D status in male collegiate athletes. Int J Health Nutr. 2011;2:8–13.
    1. Rene FC, Ivan H, Renata P, Leon S, Tonnie H, Rui Z, Nancy QL, Albert S, Miriam G, Mallya SM, John SA, Martin H. Differential Responses to Vitamin D2 and Vitamin D3 Are Associated With Variations in Free 25-Hydroxyvitamin D. Endocrinology. 2016;157:3420–3430. doi: 10.1210/en.2016-1139.
    1. Trang HM, Cole DE, Rubin LA, Pierratos A, Siu S, Vieth R. Evidence that vitamin D3 increases serum 25-hydroxyvitamin D more efficiently than does vitamin D2. Am J Clin Nutr. 1998;68:854–858. doi: 10.1093/ajcn/68.4.854.
    1. Jones G. Extrarenal vitamin D activation and interactions between vitamin D3, vitamin D2, and vitamin D analogs. Annu Rev Nutr. 2013;33:23–44. doi: 10.1146/annurev-nutr-071812-161203.
    1. Houghton LA, Vieth R. The case against ergocalciferol (vitamin D2) as a vitamin supplement. Am J Clin Nutr. 2006;84:694–697. doi: 10.1186/1476-511X-5-25.
    1. Armas LA, Hollis BW, Heaney RP. Vitamin D2 is much less effective than vitamin D3 in humans. J Clin Endocrinol Metab. 2004;89:5387–5391. doi: 10.1210/jc.2004-0360.
    1. Logan V, Gray A, Peddie M, Harper M, Houghton L. Long-term vitamin D3 supplementation is more effective than vitamin D2 in maintaining serum 25-hydroxyvitamin D status over the winter months. Br J Nutr. 2013;109:1082–1088. doi: 10.1017/S0007114512002851.
    1. Visser M, Deeg DJ, Lips P. Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and muscle mass (sarcopenia): the longitudinal aging study Amsterdam. J Clin Endocrinol Metab. 2003;88:5766–5772. doi: 10.1210/jc.2003-030604.
    1. Koundourakis NE, Androulakis NE, Malliaraki N, Margioris AN. Vitamin D and exercise performance in professional soccer players. PLoS One. 2014;9:e101659. doi: 10.1371/journal.pone.0101659.
    1. Sinha A, Hollingsworth KG, Ball S, Cheetham T. Improving the vitamin D status of vitamin D deficient adults is associated with improved mitochondrial oxidative function in skeletal muscle. J Clin Endocrinol Metab. 2013;98:E509–E513. doi: 10.1210/jc.2012-3592.
    1. Andresen CJ, Moalli M, Turner CH, Berryman E, Pero R, Bagi CM. Bone parameters are improved with intermittent dosing of vitamin D3 and calcitonin. Calcif Tissue Int. 2008;83:393. doi: 10.1007/s00223-008-9187-5.

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