Boosting Calcium and Vitamin D Levels can Protect Athletes
By Dr. Brooke Pengel
Did you know…
- Vitamin D contributes to strong bones in young athletes?
- An estimated 60 percent of youth (50 million children) in the US suffer from low Vitamin D Levels?
- Low Vitamin D and a poor calcium intake can place athletes at risk for recurrent fractures and stress fractures?
Bone Health in Young Athletes
Calcium and Vitamin D are both important for strong bones. Bones and muscles in athletes are exposed to repetitive stress. Paying attention to Calcium and Vitamin D can have a role in protecting athletes from fractures and stress fractures. Vitamin D has also been shown to facilitate recovery of muscle strength, allowing for quicker recovery.
Calcium is found most readily in dairy products (milk, cheese, yogurt, ice cream etc.). Many adolescents, especially those who are dairy avoidant, have a diet that is lacking in needed calcium. Calcium is stored in the bone, providing the bone strength through a mineralized matrix. The body also needs calcium for many critical body functions. When dietary intake is poor, the body will take or “steal” the calcium from the stores in the bone, thus further contributing to poor bone density over time. Vitamin D promotes absorption of calcium, so even if calcium intake is good, a child can still be at risk for developing poor bone strength.
Vitamin D is difficult to find in the typical diet. Vitamin D is better known as our “sunshine vitamin.” The body is able to synthesize Vitamin D during the summer months when there is abundant exposure to sunlight. However, because of the fear over adverse effects of sun exposure, sunscreen is applied to the skin blocking up to 95% of Vitamin D. Athletes who train inside all year round may be especially at risk for Vitamin D deficiency. During the winter, even in sunny climates, Vitamin D is more difficult to obtain from the sun because of its latitude. Unfortunately, Vitamin D is not readily present in a typical diet, so it is common for Vitamin D levels to significantly decrease in the winter season. There is a simple screening blood test that can detect Vitamin D deficiency.
Young athletes would benefit from education on optimizing calcium and Vitamin D status. Children are in their prime bone-building years, as 90% of peak bone mass is typically achieved by 18 years of age. After approximately 25 years, peak bone mass is achieved and bone loss gradually occurs naturally with age. Therefore, the “bank” or “reserves” that are achieved by that age will need to sustain the individual throughout life.
What to do to boost Calcium and Vitamin D Levels
- Encourage a balanced healthy diet with quality sources of calcium. Adolescents typically need 4-6 servings of calcium-rich foods every day.
E.g., Small piece of cheese, cup of yogurt, 6 oz. milk
- If an athlete is dairy avoidant, consider calcium-fortified food and drinks.
E.g. Orange juice, cereals, almond milk
- Vitamin D status can be improved by a combination of diet, sun exposure and supplementation. Sources of dietary Vitamin D include salmon, fatty fish, egg yolks and fortified products such as milk, orange juice and cereal. These sources tend to have relatively nominal levels of Vit D.
- In the summer, allow short periods of time outside without sunscreen:
- 15-30 min between 10AM-3PM, at least 2 times per week. Dark skinned people require 3-5X longer exposure
- Expose most of the skin- e.g. shorts and t-shirt
- Aim for just enough exposure for the skin to be pink
- When there is concern over inadequate diet/sun exposure, consider giving a supplement. The amount to supplement for an adolescent is similar to adult requirements:
- Calcium: 500-1000mg per day (for higher dose, divide to 500 mg twice per day for better absorption).
- Vitamin D3: 400-1000 IUs per day. Vit D3 is most commonly recommended
- Screening for Vitamin D deficiency may be considered in the setting of recurrent fractures, stress fractures, or poor healing of bone injury.