Vitamin D Practice Patterns in National Collegiate Athletic Association Division I Collegiate Athletics Programs

Abstract

Context Vitamin D status has been associated with performance, health, and well-being in athletic populations. The measurement of vitamin D status via 25-hydroxyvitamin D [25(OH)D] testing has increased in the general population, as has vitamin D supplement use. It is unclear if similar patterns exist in collegiate athletics programs. Objective To describe the clinical care related to the prevention, evaluation, and treatment of vitamin D deficiency and insufficiency used by sports medicine providers with National Collegiate Athletic Association (NCAA) Division I programs. Design Cross-sectional study. Setting Population-based online survey. Patients or Other Participants All NCAA Division I head athletic trainers. Main Outcome Measure(s) Information related to 25(OH)D testing, vitamin D supplementation, vitamin D–related protocols and procedures, and characteristics of athletic programs and participants. Results We received 249 responses (72% response rate). Use of 25(OH)D testing was described by 68% of participants, with the most common indicators being health status/history (78%) and injury status/history (74%). One-fifth of participants stated that vitamin D testing was conducted as screening (without a specific cause or indication). Target blood vitamin D concentrations were highly variable. A range of 8 to 1660 annual vitamin D blood tests was reported at a cost of <$50 (8%), $51 to $100 (51%), $101 to $150 (20%), and >$150 (10%). Forty-two percent of programs covered the cost of vitamin D supplements. More than half of the participants indicated that vitamin D blood testing and supplements were not a good use of program funds. In comparison with Football Championship Subdivision programs, Football Bowl Subdivision programs were more likely to conduct vitamin D testing and pay for vitamin D supplements, and their providers were more likely to believe that testing and supplements were a good use of program funds. Conclusions A great deal of variability was present in vitamin D–related clinical practices among NCAA Division I athletics programs, which reflects existing contradictions and uncertainty in research, recommendations, and guidelines. Knowledge of current practice patterns is important in evaluating and establishing best practices, policies, and procedures for sports medicine and sports nutrition professionals in the collegiate setting.

Five-Year Surveillance of Vitamin D Levels in NCAA Division I Football Players: Risk Factors for Failed Supplementation

“…The literature has not established a standard vitamin D dosing regimen. 30 A common approach is to treat with 50,000 IU of vitamin D2 or D3 weekly for 6 to 8 weeks, followed by 800 IU of vitamin D3 daily, based on the guidelines by the Endocrine Society. 15 Based on our results, the prevalence of vitamin D insufficiency was relatively high in the returning athletes (supplemented), which highlights the need for optimization of the vitamin D supplementation protocol.…”

“…42 Significant variation has been reported in the practice patterns for the diagnosis and treatment of vitamin D deficiency among NCAA Division I athletes. 30 Previous studies in high-level athletes showed an association between vitamin D insufficiency and increased risk of stress fractures, hormonal imbalance (testosterone, cortisol, and parathyroid hormone), infection, and elevated blood pressure. 4,5,8,11,26,35,36,40 In collegiate football players, an association was found between vitamin D insufficiency and inability to maintain glucose homeostasis, and the same authors reported an inverse relationship between serum 25(OH)D levels and hepatic lipid content in these athletes.…”

“…There has been increased awareness of vitamin D insufficiency in athletes during the past decade. 18,30 Reported factors that increase the risk of vitamin D insufficiency in football players include Black race and male sex. 3,33,44 In terms of therapy, oral vitamin D supplementation has been shown to successfully raise levels of 25(OH)D in high-level athletes.…”

Changes in Nutrient Biomarkers, Body Composition, and Burnout Symptoms in Collegiate Athletes across a Season

“…The trend towards precision medicine [1] has fueled a more individualized approach towards precision athletic health and training. Assessing nutrient biomarkers, as a potential driver of favorable adaptations in muscle strength [2], performance [3], and mood [4], has fast become standardized practice in elite athlete screenings [5][6][7]. However, the development of normative values which promote health and peak performance, in the context of both sex and sport, remain to be elucidated.…”

“…Blood nutrient biomarkers which reflect vitamin D [6,[8][9][10][11][12][13] and iron [3,5,7,[14][15][16] status are commonly measured in athletes, particularly collegiate athletes [6,7,[9][10][11][12]14]. Vitamin D (typically assessed as serum 25-OH vitamin D measurement) has emerged as a potential ergogenic aid [2], reducing muscle damage [17], stress fractures [18], and frequent illness [13].…”