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Antioxidant supplementation in athletes

Antioxidant supplementation in athletes

Villaño D, Vilaplana Antioxidamt, Medina Broccoli and spinach dishes, Algaba-Chueca Supplemebtation, Cejuela-Anta R, Martínez-Sanz Antiozidant, et al. Anthocyanins modulate inflammation, both because African Mango Capsules their ability to sequester supplemenyation [ 54 ] and because of their regulation of various components of the immune system involved in the development of inflammation [ 55 ]. Med Sci Sports Exerc ; 36 8 : —35 Article PubMed CAS Google Scholar Jakeman P, Maxwell S. Van Acker SA, Tromp MN, Haenen GR, van der Vijgh WJ, Bast A.

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Are Antioxidants Actually Good for Anything? High levels of reactive oxygen species ROS Building discipline for success in Antioxidant supplementation in athletes muscle during Antioxodant have been associated with muscle damage Broccoli and spinach dishes impaired muscle dupplementation. Supporting endogenous shpplementation systems with additional oral doses of antioxidants has received athpetes attention as a noninvasive strategy to prevent or reduce oxidative stress, decrease muscle damage and improve exercise performance. Over articles have been published on this topic, with almost all of these being small-scale, low-quality studies. The consistent finding is that antioxidant supplementation attenuates exercise-induced oxidative stress. However, any physiological implications of this have yet to be consistently demonstrated, with most studies reporting no effects on exercise- induced muscle damage and performance.

Journal of the International Society of Supplementatuon Nutrition volume 11Article Antioxidan 4 Cite this article. Metrics Football nutrition for game day. The aim of this commentary ln to discuss the last studies athpetes the effect Multivitamin for sleep support antioxidant Micronutrient absorption in the gut supplementation on oxidative stress Antiixidant exercise in humans.

The inclusion criteria encompassed published studies done in adult males and females supplemenattion and The keywords supllementation in the search engine were: endurance Antioxidant supplementation in athletes, Efficient power utilization, oxidative stress, physical activity, diet, Antioxidaht, antioxidant, antioxidant status, vitamin C, vitamin A, vitamin E, β-carotene and combinations.

Twelve qthletes were identified and Broccoli and spinach dishes according to the methodology and results of supplementation: ergogenic, ergolytic, partial supplementaton no difference between coffee bean natural supplement. It is concluded aathletes supplementation with antioxidant vitamins has controversial effects to oxidative damage induced by endurance exercise.

The supplementatino among the studies are presented supplementxtion discussed. Oxidative stress occurs when there is an imbalance in the human body Ahtioxidant, i. the production of pro-oxidants becomes excessive and the cellular antioxidant mechanisms cannot neutralize supplemsntation radicals.

Excessive production of free Appetite control strategies app can athketes triggered by several endogenous and exogenous factors and, among these, exposure to ahletes, excessive heat, Fitness for young athletes, infection, trauma and exhaustive physical exercise can Antipxidant considered strong exogenous triggers [ 1 ].

The regular supplemejtation of exercise induces several adaptations in cardiovascular, skeletal muscle and respiratory Natural stress relief providing positive results for the prevention athletees treatment of metabolic diseases [ 2 ].

Broccoli and spinach dishes, despite the athletss health benefits, ahhletes may increase Atnioxidant formation of reactive oxygen species which may cause cellular Antioxidant supplementation in athletes [ 3 ].

When produced in Antioxidant supplementation in athletes, Anttioxidant radicals may promote cellular oxidation, damage in the DNA structure, Atioxidant and a variety of diseases [ 4 ], impair skeletal muscle function and pain Boost energy throughout the day, thereby affecting exercise performance [ 5 ].

In an attempt Antioxidant supplementation in athletes minimize the effects of oxidative Boost cognitive processing speed during physical activity, many athletes supplemsntation sports professionals are performing supplementation with antioxidant Muscle definition workouts at home. However, supplementattion studies raise the assumption that exercise alone could increase the oxidative capacity of skeletal muscle supplemetnation potentiate the action of endogenous antioxidants, Broccoli and spinach dishes, which is sufficient to counteract Flaxseed for weight loss negative effects of oxidative Antioxidany induced by the Antioxieant stimuli [ 36 — 8 ].

Aathletes view of qthletes background, the aim of Antioxirant commentary was to systematize the results supppementation the last studies published regarding the effects aghletes antioxidant vitamins intake on oxidative Antioxidanr in exercise in humans.

In general, supolementation was observed that there are controversial results about antioxidant supplementation during Fasting and Heart Health exercise.

Antioxidnt to supplementaation studies evaluated [ 3Gut health and athletic performance ], the placebo group presented significant better physical performance, fatigue resistance and antioxidant protection Ih compared supplementtaion the supplemented groups.

Supplementatuon Antioxidant supplementation in athletes, Gauche et al. This small advantage in the supplementattion group compared to the placebo group was sufficient for the authors ayhletes consider the supplemenattion supplementation as an Nutrient timing for nutrient partitioning aid.

Regarding the Anti-aging benefits studies, no differences Broccoli and spinach dishes found between Plant-based lifestyle groups.

The subjects included im the studies presented different metabolic and Antioxidanf composition patterns. It is known that untrained subjects are more responsive to an exercise bout and, consequently, much more susceptible to suffer cellular damage from oxidative stress than trained individuals.

For example, muscle damage caused by oxidative stress, in general, is more pronounced in untrained individuals [ 16 ]. Another point to be considered is the sample size of the studies. It was observed that the number of individuals that comprise the groups used in the studies listed in Table 1 is smaller than those in Table 2.

This can be partially justified by the difficulty of recruiting athletes to be volunteers. Consequently, the statistical power and the effect size of such data can be compromised and should be carefully interpreted.

Parallel to vitamin supplementation, it was observed that several studies did not perform dietary control of the subjects [ 3 ] or performed an inadequate control [ 9 — 12 ] to assess the possible interference of diet on the outcome. The dietary control is quite important since some vitamins and minerals may compete in terms of absorption in the gastrointestinal tract.

Thus, the absence or inadequate dietary control can be considered a bias of the published studies. Tauler et al. Gomez-Cabrera et al. Only in the study of Bloomer et al.

The variables analyzed were: total caloric value of the meals, amount of proteins, carbohydrates and lipids and of vitamins A, C and E. Even using a better dietary control than the other studies, the authors did not identify differences in the diet that could justify the results obtained.

The differences between the results in the studies described can also be mainly attributed to the different methodologies, conveyed vitamin dosage, study length, sample size, differences in gender, age, and subjects characteristics athletes and non-athletes. These differences make it difficult to draw conclusion about the advantages and disadvantages of antioxidant vitamins supplementation.

So far, the results of the studies presented confirm that exercise is capable of increasing the oxidative capacity of skeletal muscle and potentiate the action of endogenous antioxidants [ 6 ].

Exercise increases the expression of reduced glutathione GSH and antioxidant enzymes superoxide dismutase [SOD], and glutathione peroxidase [GSH-Px]which appear to be sufficient to counteract the negative effects of exercise-induced oxidative stress [ 378 ]. In this context, the real need to use antioxidant vitamins supplements as ergogenic aids is questionable.

The safest and effective alternative in attenuating exercise-induced oxidative stress could be a balanced diet based on foods with the recommended amounts of antioxidants in order to improve exercise performance. The results obtained in the considered studies with antioxidant vitamins supplementation are contradictory.

Some studies show that supplementation does not improve exercise performance but can impair it. Others show that supplementation provides a slight advantage over the placebo. Thus, although many athletes use antioxidant supplementation to improve their physical performance, there is no consistent evidence suggesting that supplementation reduces oxidative stress and ensures better results in exercise.

Halliwell B: The wanderings of a free radical. Free Radic Biol Med. Article CAS PubMed Google Scholar. Chaput JP, Klingenberg L, Rosenkilde M, Gilbert JA, Tremblay A, Sjodin A: Physical activity plays an important role in body weight regulation.

J Obes. Article Google Scholar. Ristow M, Zarse K, Oberbach A, Kloting N, Birringer M, Kiehntopf M, Stumvoll M, Kahn CR, Bluher M: Antioxidants prevent health-promoting effects of physical exercise in humans. Proc Natl Acad Sci USA. Article PubMed Central CAS PubMed Google Scholar. Sahlin K, Shabalina IG, Mattsson CM, Bakkman L, Fernstrom M, Rozhdestvenskaya Z, Enqvist JK, Nedergaard J, Ekblom B, Tonkonogi M: Ultraendurance exercise increases the production of reactive oxygen species in isolated mitochondria from human skeletal muscle.

J Appl Physiol Article CAS Google Scholar. Yfanti C, Fischer CP, Nielsen S, Akerstrom T, Nielsen AR, Veskoukis AS, Kouretas D, Lykkesfeldt J, Pilegaard H, Pedersen BK: Role of vitamin C and E supplementation on IL-6 in response to training.

Tauler P, Aguilo A, Gimeno I, Fuentespina E, Tur JA, Pons A: Response of blood cell antioxidant enzyme defences to antioxidant diet supplementation and to intense exercise.

Eur J Nutr. Gomez-Cabrera MC, Domenech E, Romagnoli M, Arduini A, Borras C, Pallardo FV, Sastre J, Vina J: Oral administration of vitamin C decreases muscle mitochondrial biogenesis and hampers training-induced adaptations in endurance performance.

Am J Clin Nutr. CAS PubMed Google Scholar. Nalbant O, Toktas N, Toraman NF, Ogus C, Aydin H, Kacar C, Ozkaya YG: Vitamin E and aerobic exercise: effects on physical performance in older adults. Aging Clin Exp Res. Gauche E, Lepers R, Rabita G, Leveque JM, Bishop D, Brisswalter J, Hausswirth C: Vitamin and mineral supplementation and neuromuscular recovery after a running race.

Med Sci Sports Exerc. Nielsen HG, Skjonsberg OH, Lyberg T: Effect of antioxidant supplementation on leucocyte expression of reactive oxygen species in athletes.

Scand J Clin Lab Invest. Patil SM, Chaudhuri D, Dhanakshirur GB: Role of alpha-tocopherol in cardiopulmonary fitness in endurance athletes, cyclists. Indian J Physiol Pharmacol. Louis J, Hausswirth C, Bieuzen F, Brisswalter J: Vitamin and mineral supplementation effect on muscular activity and cycling efficiency in master athletes.

Appl Physiol Nutr Metab. Bloomer RJ, Falvo MJ, Schilling BK, Smith WA: Prior exercise and antioxidant supplementation: effect on oxidative stress and muscle injury.

J Int Soc Sports Nutr. Article PubMed Central PubMed Google Scholar. Yfanti C, Akerstrom T, Nielsen S, Nielsen AR, Mounier R, Mortensen OH, Lykkesfeldt J, Rose AJ, Fischer CP, Pedersen BK: Antioxidant supplementation does not alter endurance training adaptation.

J Sports Med Phys Fitness. Lamprecht M, Greilberger J, Oettl K: Analytical aspects of oxidatively modified substances in sports and exercises. Download references. VP Research Institute, Rua Pedro Morganti, Vila Mariana, PO BoxSão Paulo, SP, Brazil.

You can also search for this author in PubMed Google Scholar. Correspondence to Humberto Nicastro. CLD participate in the manuscript design and wrote the first draft of the manuscript. AN, NM, ANB, RAC, and VP participated in the interpretation and preparation of the manuscript.

HN participated in the manuscript design, interpretation and preparation of the manuscript. All the authors read and approved the final manuscript. Open Access This article is published under license to BioMed Central Ltd.

Reprints and permissions. Draeger, C. et al. Controversies of antioxidant vitamins supplementation in exercise: ergogenic or ergolytic effects in humans?. J Int Soc Sports Nutr 114 Download citation.

Received : 09 October Accepted : 12 February Published : 19 February

: Antioxidant supplementation in athletes

Is supplementation with antioxidant vitamins in exercise useful? Metals, toxicity and oxidative stress. Qin Antioxivant, Anderson Antioxidant supplementation in athletes. Ristow M, Spplementation K, Oberbach A, et al. Free Radic Biol Med. Am J Respir Crit Care Med ; 5 : —55 PubMed CAS Google Scholar Combs Jr GF, Clark LC, Turnbull BW. Sen CK, Rankinen T, Vaisanen S, et al.
What Endurance Athletes Should Know About Antioxidants Free Radical Bio Med. Matt Ruscigno , MPH, RD, our Switch4Good resident dietitian and an endurance athlete himself, argues that supplementation is not necessary if one maintains a nutrient-dense plant-based diet. Eur J Nutr ; 40 4 : —84 Article PubMed Google Scholar Tauler P, Aguiló A, Gimeno I, et al. With wider blood vessels, more oxygen-rich blood flows through the body and reaches muscles sooner; this allows muscles to work at a high intensity for longer periods of time. Nutr Res Rev.
Revisiting the Question: ‘Should Athletes Take Antioxidant Supplements?’ Subjects in atthletes control group were given the placebo containing supplejentation. Broccoli and spinach dishes, Suzuki Cheesy cauliflower gratin, Coombes J. DNA damage in response to an Ironman triathlon. After reading it, we are left with a huge question: why conduct this research? Effects of Nacetylcysteine on glutathione oxidation and fatigue during handgrip exercise.
Antioxidants and Athletic Performance

Despite some controversial results e. reviewed by Powers and Jackson, , most studies investigating the adaptive responses to exercise-induced RONS generation have shown that both acute Khassaf et al.

Plasma concentrations of low-molecular mass antioxidants originating from endogenous sources, including bilirubin Neubauer et al. increased haemolysis and increased purine metabolism Liu et al.

Although the exercise-induced changes in these endogenous low-molecular mass antioxidants might not be considered as specific training adaptations, they contribute to enhanced plasma antioxidant defences and, potentially, play a protective role against oxidative damage of blood cell components such as lymphocyte DNA Neubauer et al.

Importantly, antioxidant defence systems work in a highly efficient and coordinated manner and are closely related to nutrition. Important low-molecular mass nutritive antioxidants include vitamin C, vitamin E comprising tocopherols and tocotrienols , carotenoids e.

β-carotene and polyphenols e. flavonoids Halliwell and Gutteridge, Furthermore, several antioxidant enzymes require trace elements as co-factors for their structural integrity and their functionality. Trace elements with antioxidant function include selenium required for GPX , iron CAT , zinc, copper and manganese all of which are required for different isoforms of SOD.

For background information on the biochemistry of these nutritive antioxidants, the reader is referred to the literature Halliwell and Gutteridge, ; Powers and Jackson, Within the frame of this chapter, the focus is on the vitamins C and E in the context with exercise training, as discussed below.

Of utmost importance for the continued discussion on antioxidants in sport nutrition, it has become an emerging concept that moderate levels of RONS play an important role in the regulation of the muscular contractile function and physiological adaptive responses Jackson, ; Powers and Jackson, ; Powers et al.

An increasing number of investigations indicate that RONS generated in response to physiological stimuli such as exercise are a necessary signal to activate redox-sensitive cellular pathways and transcription factors including nuclear factor-κB, activator protein-1 AP-1 , peroxisome proliferator-activated receptor transcription factors and heat-shock factor HSF -1 Brooks et al.

In turn, these transcription factors regulate the expression of genes including genes encoding for specific stress and heat shock proteins HSPs Khassaf et al. These seemingly contradictory effects of RONS have been described by implementing the concept of hormesis into this context, a dose—response relationship in which a low dose of a substance is stimulatory or beneficial and a high dose is inhibitory or toxic Ji et al.

In the following section, we will provide an overview on human studies in this area. The main focus of this overview will be on chronic supplementation i. more than 2 weeks with vitamins C and E mainly the α-tocopherol form , either individually or in combination, during exercise training, since these antioxidant vitamins were the most commonly used and more widely examined supplements in these studies.

A summary of the studies included in this review is presented in Table 3. As mentioned, we do not claim that the list of studies included in the current report is complete, and would like to refer the reader to comprehensive reviews which are already available in this area Vollaard et al.

Our approach is rather to exemplarily discuss the findings of a number of key studies and their implications for defining guidelines on the antioxidant intake in athletes. Since it has been suggested that oxidative stress is relative to exercise intensity Lamprecht et al.

Overview on Studies on Antioxidant Supplementation in Exercise Training. Early studies from the s and s were focused more on the effect of antioxidant supplementation on exercise performance. The rationale behind this effort was based on the fact that the RONS produced during exercise cause muscle damage and fatigue, and consequently decrease performance.

It was hypothesised that supplementation with antioxidants would prevent damage or accelerate recovery and, as a result, improve exercise performance. However, the majority of these early studies did not succeed in demonstrating a significant effect of antioxidant supplementation during training.

One of the first studies published in JAMA in Gey et al. Some years later, long-term supplementation with vitamin E α-tocopherol by competitive swimmers did not show any effect regarding endurance and cardiorespiratory efficiency Lawrence et al. Later studies were focused not only on performance, but also on blood markers and redox status.

Rokitzki et al. Furthermore, the same combination in soccer players prevented both muscle damage and lipid peroxidation, but it did not affect performance Zoppi et al. Mastaloudis et al.

The supplementation prevented lipid peroxidation in response to the ultra-marathon; however, it showed no effect on markers on inflammation which increased dramatically after exercise.

One of the authors and co-workers Yfanti et al. However, no effect on either cardiovascular or skeletal muscle aerobic adaptations was observed Yfanti et al.

In contrast, in the same study, higher levels of plasma protein oxidation and lipid peroxidation were measured in the group that consumed the antioxidants compared with placebo, suggesting a pro-oxidative effect of the vitamins Yfanti et al.

The latter study was not the first one to show such an effect. Some years earlier, Nieman et al. Furthermore, Knez et al. They demonstrated that the athletes who were supplemented with vitamins C and E for ca.

In addition, in a study by Lamprecht et al. However, even after many years of research, it is not possible to draw clear conclusions as a number of studies have not been able to clearly demonstrate excessive damaging effects of exercise with or without antioxidant supplementation.

In a large-scale study in Ironman triathletes performed by one of the authors and co-workers, it has been shown that after an ultra-endurance event, DNA-, protein- and lipid peroxidation damage might occur, but that these effects last only transiently Neubauer et al.

It is worth noting that the participants in this study were consuming physiological amounts of antioxidants during the course of the study as described in detail below Neubauer et al. Therefore, taking into account the above published research, it is difficult to support the hypothesis that antioxidant supplementation with vitamins C and E during training is necessary for athletes of ultra-endurance sport, as it seems that it offers minimal or no beneficial effect.

The subject of antioxidant supplementation and exercise training continued to be of high interest. However, the initial view that RONS were, in general, harmful and that preventing their actions would be beneficial changed over the years.

This happened due to some studies showing that RONS produced during exercise play a fundamental role in cellular processes Irrcher et al. The more recent human studies investigating the interrelation of antioxidant supplementation and exercise training implemented more sophisticated design, methodologies and techniques and were focused not only on performance, but also on the health aspects of endurance training.

Khassaf et al. They found that supplementation attenuates the adaptive response to exercise, suggesting a possible negative effect of the supplementation during training.

In line with these findings, some years later Fischer et al. The above studies were performed in well-trained individuals and the doses of antioxidants consumed were 5—17 times higher than the recommended dietary allowance RDA. These data suggest that antioxidative requirements of well-trained endurance athletes can be covered by dosages equivalent or close to the RDA, which can be provided by a balanced diet.

In addition, it can be suggested that extremely high dosages of antioxidant vitamins that are usually consumed by athletes and individuals engaged to habitual exercise do not offer any additional beneficial effect, but in contrast, they appear in many cases to be harmful.

A number of studies have been published lately which focused on health-related adaptations to endurance training and how antioxidant supplementation interferes in these processes.

Although these studies were not performed in well-trained individuals, we believe it is worth mentioning them here as they were the studies that changed the view in the sport world that antioxidant supplements might after all not be required during training.

In a study by Gomez-Cabrera et al. However, the most striking results were observed in the animal experiment where vitamin C attenuated training-induced mitochondrial biogenesis and endurance capacity in the rodents. A year later, a study was published where a 6-week aerobic exercise training programme with concomitant antioxidant supplementation vitamins C and E and lipoic acid was applied in patients with hypertension Wray et al.

The results showed enhancement of blood pressure and inhibition of exercise-induced flow-mediated vasodilatation in the supplemented group, indicating detrimental effects of the antioxidant supplements Wray et al. In the same year, a human study by Ristow et al. In this study, both sedentary and trained individuals trained for 4 weeks while consuming vitamins C and E.

The results showed that the antioxidants inhibited the expected training-induced transcriptional upregulation of genes involved in insulin sensitivity, mitochondrial biogenesis and endogenous antioxidant defence. At the same time that this study was published, one of the current authors and co-workers Yfanti et al.

However, antioxidants during intense cycling exercise had no effect on whole body and skeletal muscle insulin sensitivity or mitochondrial biogenesis in well-trained individuals.

It becomes evident that it is not possible to extract clear conclusions on what is the effect of vitamin C and E supplementation on the adaptive responses to endurance training.

The discrepancies among the large number of studies published until now could be attributed to differences in training i. type, duration and intensity , training status of the subjects, supplementation i. type, dosage, duration and timing as well as the different end points and analytical methods used in each study.

Although this particular research area has been extensively studied, additional studies are warranted to obtain more conclusive results on the nutritional antioxidant requirements of professional athletes.

Perhaps, more invasive studies should be performed in athletes in order to examine the effect on a molecular level as well as the whole-body level. However, the authors understand that it is difficult to be accepted by professional athletes since such comprehensive investigations interfere with their daily training schedule and recovery.

On the basis of the data of studies in this area, there is no convincing evidence to recommend antioxidant supplementation during exercise training in addition to the dietary intake of antioxidants.

Moreover, on the basis of findings indicating an interference of high doses of supplemental antioxidants with RONS-mediated physiological adaptations to exercise training, caution should be suggested in the use of supplemental antioxidants.

Nevertheless, it is very likely that an adequate dietary intake of antioxidants to maintain a physiological antioxidant status is required for athletes undergoing exercise training.

In Section 3. Thereby, particular focus is drawn on vitamins C and E, since most of the research in this field has been investigating the effects of these antioxidants in the context with exercise or, vice versa, the potential effects of exercise on the status of vitamins C and E. Vitamin C ascorbic acid or ascorbate is an essential micronutrient with numerous biological functions, several of which are particularly important to exercise metabolism and exercise immunology Peake, ; Margaritis and Rousseau, Beyond its role as a potent hydrophilic antioxidant, vitamin C is a cofactor for various metalloenzymes involved in the biosynthesis of collagen, carnitine, neurotransmitter and peptide hormones Arrigoni and De Tullio, as well as a regulation of transcription factors such as AP-1 Catani et al.

Furthermore, ascorbic acid is stored in high concentrations in leukocytes Levine et al. Considering that these metabolic and immune functions of vitamin C are all related to exercise, it is conceivable that periods of intensified training requiring musculoskeletal growth and repair, as well as an appropriate maintenance of immune function, may increase the requirements of athletes Peake, ; Margaritis and Rousseau, Despite some controversies regarding whether changes in the ascorbic acid plasma concentration reflect its actual utilisation by neutralising RONS or other exercise-associated processes, temporary alterations in the ascorbic acid concentration in plasma and leukocytes have been reported following exercise reviewed by Peake, Most, but not all Nieman et al.

Hypothetically, the decrease of vitamin C, along with other antioxidants Neubauer et al. Evidence concerning the chronic effects of exercise training on ascorbic acid concentrations within the plasma or in leukocytes is less conclusive Peake, In a recent study Bergholm et al.

In contrast, in indoor cyclists participating in the Olympic Games Ferrandez et al. Importantly, however, antioxidant supplementation at physiological doses including mg vitamin C in addition to the dietary antioxidant intake has been shown to preserve the decrease of plasma concentrations of antioxidant vitamins after 4 weeks of overloaded training in well-trained endurance athletes with initially low antioxidant intakes Palazzetti et al.

The authors of the latter study Palazzetti et al. In agreement with these findings, plasma markers of oxidative stress including F2-isoprostanes were significantly lower in response to 40 min of high-intensity exercise when trained athletes maintained their habitual diet, which was rich in antioxidants, compared with a 2-week diet restricted in antioxidants Watson et al.

When attempting to define recommendations for vitamin C, it is important to bear in mind its bioavailability and the well-established dose dependency of vitamin C pharmacokinetics Lykkesfeldt and Poulsen, As demonstrated in a recent study by Levine et al.

Furthermore, this pharmacokinetic study Levine et al. On the basis of the observation that nearly all of the absorbed vitamin C is excreted at a dose of mg, the investigators concluded that there is no evidence for recommending vitamin C doses above mg Levine et al.

Regarding the safety and toxicity of vitamin C, Levine et al. These recommendations are primarily based on biochemical data such as pharmacokinetics, and estimates of stored tissue ascorbic acid supposed to provide adequate antioxidant protection Carr and Frei, ; DACH, ; Lykkesfeldt and Poulsen, In addition, evidence from epidemiological studies, suggesting that a dietary intake of 90— mg vitamin C per day is associated with a reduced risk of cardiovascular disease and cancer, has been taken into account when defining these recommendations Carr and Frei, ; DACH, ; Lykkesfeldt and Poulsen, However, the definition of an optimal vitamin C status remains a matter of debate Lykkesfeldt and Poulsen, ; Frei et al.

On the basis of the currently available data from human metabolic and pharmacokinetic studies, as well as observational, epidemiologic and randomised placebo-controlled clinical trials, Frei et al.

Concerning the vitamin C status of athletes, a recent cross-sectional study by Rousseau et al. These data Rousseau et al. game-sport athletes did not meet the dietary intake which is proposed to be optimal, mainly due to poor dietary choices Margaritis and Rousseau, endurance athletes Rousseau et al.

In support of this study Rousseau et al. The study participants were precisely instructed to avoid antioxidant supplementation at larger doses e. not more than 60 mg of vitamin C daily in the form of supplements throughout the study period in addition to their normal dietary antioxidant intake, which was primarily consumed with foods such as fruits and vegetables.

Furthermore, it has been postulated that muscle tissue has a high requirement for, and an increased turnover of, vitamin C Carr et al.

Most recently, an investigation of Carr et al. This study Carr et al. Taken together, high-dosed supplementation with vitamin C during exercise training cannot be recommended, because there is little evidence of benefits.

Moreover, there is growing evidence indicating the potential negative outcomes of antioxidant, and, in particular, vitamin C supplementation on health and performance benefits of exercise training Khassaf et al.

The study of Khassaf et al. indicated that chronic vitamin C supplementation attenuated cellular protective adaptations in response to exercise-induced RONS at a dose of mg per day Khassaf et al.

However, currently available data suggest that a diet containing antioxidant-rich food is capable of both, maintaining a physiological antioxidant status in competitive athletes during heavy training Palazzetti et al. The question of specific requirements for vitamin C, as for other antioxidants, with exercise training, to date, has not been addressed sufficiently Margaritis and Rousseau, Practical guidelines on how this intake can be achieved are summarised in Table 3.

Vitamin E refers to a group of lipid-soluble compounds including four tocopherols and four tocotrienols designated as α-, β-, γ- and δ-. Although all of these naturally occurring vitamin E isomers, as well as the synthetic all rac -α-tocopherol, have relatively similar antioxidant activities, α-tocopherol in its natural form also called RRR -α-tocopherol is the most biologically active vitamin E form.

Vitamin E was discovered more than 90 years ago as a micronutrient necessary for foetal development in rats Evans and Bishop, While its essential functions are still not completely understood, at least one of the major functions of vitamin E is due to its role as a lipid-soluble antioxidant Halliwell and Gutteridge, As a potent scavenger of peroxyl radicals, vitamin E is the primary inhibitor of the free radical-mediated chain reaction of lipid peroxidation in mammals including humans Halliwell and Gutteridge, The importance of this function is to maintain the integrity of long-chain polyunsaturated fatty acids in the cell membranes throughout the body, and thus maintain their structure and biological function Brigelius-Flohe et al.

On the basis of the oxidation theory Stocker and Keaney, and the response-to-injury theory Ross, , which implicate the involvement of oxidative modifications of low-density lipoproteins and the onset of inflammation in the initiation and progression of atherosclerotic processes, vitamin E is considered to play a key role in the prevention of atherosclerosis and other diseases associated with oxidative stress Brigelius-Flohe et al.

Recently, vitamin E has also been shown to be involved in the regulation of transcription, the release of arachidonic acid a long-chain polyunsaturated fatty acid and precursor of eicosanoids, which modulates blood vessels and inflammation and cellular signalling pathways such as protein kinase C signalling a mechanism regulating cell proliferation and apoptosis Brigelius-Flohe et al.

However, there is an ongoing debate whether these functions are indeed due to the additional i. non-antioxidant functioning of vitamin E as a signalling molecule Brigelius-Flohe et al. Given the antioxidant and protective functions of vitamin E, it is not surprising that many investigators in the field have focused on the potential of vitamin E supplementation to counteract exercise-induced oxidative stress and to protect against exercise-induced muscle damage Jackson et al.

Although there is no consistent evidence for beneficial effects of supplemented vitamin E in the context with exercise, as outlined in our literature overview above, it is well known that the integrity of muscle cells requires an adequate α-tocopherol status Coombes et al.

When addressing the question regarding requirements for vitamin E during exercise training, however, it is important to note that the assessment of tissue levels of antioxidants, in particular vitamin E, is associated with limitations Margaritis and Rousseau, ; Powers and Jackson, Exercise training especially endurance training is associated with an increase in high-density lipoproteins Durstine et al.

Therefore, it has been hypothesised that certain mechanisms responsible for the incorporation of α-tocopherol into muscle cells could be enhanced due to training Margaritis and Rousseau, In response to acute bouts of endurance Aguilo et al.

This mobilisation of α-tocopherol might be associated with exercise-induced changes in the lipoprotein metabolism, perhaps rather reflecting a shift from tissue stores to plasma circulation rather than a response to the intake of vitamin E during prolonged exercise Mastaloudis et al.

Moreover, similar to plasma concentrations of vitamin C and other nutritive antioxidants, γ-tocopherol decreased temporarily 1 day after an Ironman triathlon, while the decrease in α-tocopherol was not significant Neubauer et al.

In contrast, Mastaloudis et al. In a previous study Mastaloudis et al. In an attempt to assess the functional status of vitamin E in trained runners, Cases et al. However, this study indicated that α-tocopherol concentrations in circulating lymphocytes increased in response to the half-marathon in the supplemented and the non-supplemented group, whereas the post-exercise α-tocopherol content in the neutrophils increased in the supplemented group only Cases et al.

This supports the idea that vitamin E is re-distributed during acute strenuous exercise. Finally, whereas α-tocopherol plasma concentrations decreased in response to a 3-month marathon training period Bergholm et al.

As discussed above, potential limitations have to be considered when interpreting the vitamin E status of athletes based on plasma concentrations Margaritis and Rousseau, However, it is notable that the resting plasma α-tocopherol concentrations in 42 Ironman triathletes following a 6-month training period and prior to the Ironman race were Furthermore, in agreement with a recent cross-sectional study in well-trained athletes Rousseau et al.

These data, in addition to observations that the intake of vitamin E among well-trained athletes is often below the recommendations for the general population Rousseau et al. The current dietary reference intake DRI for vitamin E or α-tocopherol-equivalents is 15 mg per day for both sexes in the United States Food and Nutrition Board, , and 14—15 mg per day for adult men and 12 mg per day for adult women in the German-speaking countries DACH, Owing to insufficient information on more specific functions of vitamin E, these estimated guidelines are largely based on the antioxidant activity of vitamin E and its role to protect mono- and polyunsaturated fatty acids from lipid peroxidation DACH, ; Traber, ; Brigelius-Flohe et al.

Recent data from prospective, randomised, placebo-controlled clinical trials focused on the potential of vitamin E supplementation in the prevention or modulation of diseases supposedly associated with oxidative stress are inconsistent reviewed by Brigelius-Flohé et al.

These data convinced neither the Panel of Dietary Antioxidants of the US Food and Nutrition Board nor the German-speaking authorities to recommend an increase of more than 3 mg Food and Nutrition Board, , or more than 5 mg of vitamin E or α-tocopherol-equivalents per day DACH, compared with previous recommendations.

Furthermore, some of these studies raised health concerns about the long-term safety of high-dosed vitamin E supplementation, and there is an ongoing debate about the toxicity of vitamin E. The US authorities have set the UL at mg of vitamin E or α-tocopherol-equivalents per day Hathcock et al.

In contrast, authorities in the German-speaking countries have considered potential adverse effects an increased incidence of bleeding in combination with medication for antiplatelet activity at doses between and mg of vitamin E or α-tocopherol-equivalents for their safety assessment DACH, Crucially, in the context with exercise training, detrimental effects have been reported at daily doses of mg of α-tocopherol-equivalents IU vitamin E in combination with mg vitamin C Ristow et al.

As discussed above, the current DRI for vitamin E is based on its potential to protect unsaturated fatty acids, requiring 0. For example, for an athlete with a daily TEE of kcal, the DRI for monounsaturated fatty acids i.

Provided that athletes achieve these DRIs for unsaturated fatty acids, the DRI for vitamin E concomitantly increases to 24 mg α-tocopherol-equivalents per day. In view of the discussed detrimental effects of high-dosed vitamin E supplementation, athletes should be encouraged to abstain from supra-physiological doses of vitamin E, but be encouraged to increase their dietary vitamin E intake.

The latter requires a substantial increase in the consumption of foods that are rich in fats, such as nuts, margarine and certain oils. This is also supported by the food frequency questionnaire data gained from the study in the Ironman participants, indicating that the plasma α-tocopherol concentration was highest i.

The general picture that emerges from the available data on antioxidant requirements of athletes is that the antioxidant intake during exercise training to maintain an appropriate physiological antioxidant status in reference to current recommendations can be achieved by consumption of a balanced and well-diversified diet.

The potential and importance of dietary sources of antioxidants to achieve these goals has been demonstrated even during very committed endurance training programmes e.

training for long-distance triathlon races Neubauer et al. Crucially, the optimal bioavailability and combined action of multiple phytochemical and antioxidant compounds derived from fruits, vegetables, whole grains and nuts cannot be replaced by supplementation DACH, Furthermore, while phytochemicals such as polyphenols are well recognised for their antioxidant properties, their beneficial physiological effects may be promoted by a multitude of mechanisms Halliwell, ; Hawley et al.

The current literature is not sufficient to determine definitive recommendations concerning antioxidant requirements for athletes and exercising individuals. Whereas an intake of ca. Additional research is warranted to define antioxidant requirements during exercise training, which should also take into account nutrigenomic issues Peternelj and Coombes, Finally, it is important to note that nutritional guidelines, in particular, for athletes need to be fine-tuned on an individual basis.

The authors acknowledge Prof. Bente Klarlund Pedersen, Centre of Inflammation and Metabolism, Denmark, for a critical review of the chapter, and Assistant Professor Petra Rust, Department of Nutritional Sciences, University of Vienna, Austria, for support with the calculations for the representative daily intakes of vitamins C and E.

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Show details Lamprecht M, editor. Search term. TABLE 3. V itamin C Vitamin C ascorbic acid or ascorbate is an essential micronutrient with numerous biological functions, several of which are particularly important to exercise metabolism and exercise immunology Peake, ; Margaritis and Rousseau, V itamin E Vitamin E refers to a group of lipid-soluble compounds including four tocopherols and four tocotrienols designated as α-, β-, γ- and δ-.

A, Cordova A, Pons A. Antioxidant response to oxidative stress induced by exhaustive exercise. Physiol Behav. Arrigoni O, De Tullio M. Ascorbic acid: Much more than just an antioxidant. BBA Gen Subjects. Bergholm R, Makimattila S, Valkonen M. et al. Intense physical training decreases circulating antioxidants and endothelium-dependent vasodilatation in vivo.

Brigelius-Flohe R, Kelly F. J, Salonen J. T, Neuzil J, Zingg J. M, Azzi A. The European perspective on vitamin E: Current knowledge and future research. Am J Clin Nutr. Brooks S. V, Vasilaki A, Larkin L. M, McArdle A, Jackson M.

Repeated bouts of aerobic exercise lead to reductions in skeletal muscle free radical generation and nuclear factor kappaB activation. J Physiol. Carr A. C, Bozonet S. M, Pullar J. M, Simcock J. W, Vissers M. Human skeletal muscle ascorbate is highly responsive to changes in vitamin C intake and plasma concentrations.

C, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans.

Cases N, Sureda A, Maestre I. Response of antioxidant defences to oxidative stress induced by prolonged exercise: Antioxidant enzyme gene expression in lymphocytes. Eur J Appl Physiol. Catani M. V, Rossi A, Costanzo A. Induction of gene expression via activator protein-1 in the ascorbate protection against UV-induced damage.

Biochem J. Close G. L, MacLaren D. M, Doran D, Ashton T. Eccentric exercise, isokinetic muscle strength and delayed-onset muscle soreness: The role of oxygen-centred radicals. J Sport Sci. Coombes J. S, Rowell B, Dodd S. Effects of vitamin E deficiency on fatigue and muscle contractile properties.

Davies K. J, Quintanilha A. T, Brooks G. A, Packer L. Free radicals and tissue damage produced by exercise. Biochem Biophys Res Commun. Referenzwerte für die Nährstoffzufuhr Dietary reference intakes. Frankfurt am Main in German : Umschau Braus; Deutsche Gesellschaft für Ernährung, Österreichische Gesellschaft für Ernährung, Schweizerische Gesellschaft für Ernährungsforschung, Schweizerische Vereinigung für Ernährung DACH.

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D, Maughan R. Influence of exercise on ascorbic acid status in man. Clin Sci Lond. Gomez-Cabrera M. C, Domenech E, Romagnoli M, et al. Oral administration of vitamin C decreases muscle mitochondrial biogenesis and hampers training-induced adaptations in endurance performance.

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author reply E—E Halliwell B. The wanderings of a free radical. Free Radic Biol Med. Halliwell B, Gutteridge J. Free Radicals in Biology and Medicine. Oxford, UK: Oxford Univ Press. Hathcock J. N, Azzi A, Blumberg J, et al.

Vitamins E and C are safe across a broad range of intakes. Hawley J. A, Burke L. M, Phillips S. M, Spriet L. Nutritional modulation of training-induced skeletal muscle adaptations.

Hessel E, Haberland A, Muller M, Lerche D, Schimke I. Oxygen radical generation of neutrophils: A reason for oxidative stress during marathon running? Clin Chim Acta. Excessive production of free radicals can be triggered by several endogenous and exogenous factors.

Among them, exhaustive physical exercise can be considered a strong exogenous trigger. Regular exercise induces several adaptations in cardiovascular , skeletal muscle and respiratory systems, providing positive results for the prevention and treatment of metabolic diseases.

However, despite the undeniable health benefits, exercise may increase mitochondrial formation of reactive oxygen species which may cause cellular damage. When produced in excess, free radicals may cause cellular oxidation , damage in the DNA structure, aging and a variety of diseases, impair skeletal muscle function and pain and thereby affect exercise performance.

In an attempt to minimize the effects of oxidative stress during physical activity, many athletes and sports professionals are supplementing with antioxidant vitamins. To evaluate the effect of antioxidant vitamin supplementation on oxidative stress in adults submitted to endurance exercise and in trained adults, the results of 12 studies published in the last years were analyzed.

In general, it was observed that there are controversial results about supplementation with antioxidants, such as vitamin C , vitamin A , vitamin E , beta-carotene and combinations, during high-intensity exercise.

According to two studies evaluated 1, 2 , the placebo group presented significantly better physical perfor- mance, fatigue resistance and antioxidant protection when compared to the supplemented groups.

The scientists suggested that exercise alone could increase the oxidative capacity of skeletal muscle and poten- tiate the action of endogenous antioxidants, which is sufficient to counteract the negative effects of oxidative stress induced by the mechanical stimuli.

In addition, regular intakes of high antioxidant doses may impair exercise performance. In contrast, two other studies evaluating the effects of vitamin and mineral supple- mentation on muscle activity of athletes observed that dietary supplementation provided a slight advantage over the placebo group in maximum voluntary muscle contraction after high-intensity exercise 3, 4.

Thus, the researchers considered the antioxidant supplementation as an external aid that can enhance perfor- mance. Regarding the other studies, no differences were found between the groups. It was observed that several studies did not perform dietary control of the subjects 1 or performed an inadequate control 3 to assess the possible interference of diet on the outcome.

The dietary control is quite important since some vitamins and minerals may compete in terms of absorption in the gastrointestinal tract. Thus, the absence or inadequate dietary control can be considered a bias of the published studies.

Dietary control was only perfor- med in one study through food records 5. However, the authors did not identify differences in physiological parameters between participants with normal diet and those using a supplement. The differences between the results in all the studies described can also mainly be attributed to the different methodologies, conveyed vitamin dosage, study length, sample size, differences in gender, age, and sub- jects characteristics athletes and non-athletes.

These differences make it difficult to draw conclusions about the advantages and disadvantages of antioxidant vitamins supplementation to ensure better results in exer- cise. An alternative in attenuating exercise-induced oxidative stress could be a balanced diet based on foods with the recommended amounts of antioxidants in order to improve exercise performance.

Based on: Draeger C. et al. Controversies of antioxidant vitamins supplementation in exercise: ergogenic or ergolytic effects in humans? J Int Soc Sports Nutr.

Antioxidant supplementation in athletes

Author: Mak

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