Level of Micronutrients in Elite Sports: Impact on Muscle Damage, Infections, Sleep Disorders and Fatigue

Summary: Muscle damage, recurrent and serious infections or exercise-induced fatigue especially to the end of the playing period in team sport or to the end of preparation for competition in endurance or single sport are the most common symptoms in elite sport demolishing optimal training results. Are micronutrient deficiencies responsible for these symptoms in elite sport. Methods: In 111 elite athletes [male: 50 – female: 61 / soccer: 21 – field hockey: 62 – Olympics: 19 – tennis: 5 motorsports (DTM-Formula1): 4] blood vitamin D, coenzymeQ10, vitamin B1-B2-B6-B12 and folic acid as well as selenium, ferrum and magnesium intraerythrocytary were determined. In all elite athletes the symptoms muscle damage, infections, sleeping disorder and fatigue were correlated. A Spearman-ranking coefficient of correlation, a chi-quadrat-test by Pearson and an independent t-test were used. Results: In 51, 3% of all elite athletes (N=57/111) a vitamin Ddeficiency (< 30 ng/ml), in 57% (N=61/107) a seleniumdeficiency (< 121 μg/l), in 70% (N=77/110) a coenzymeQ10deficiency (< 750 μg/l) and in 27,1% (N=19/70) a magnesium deficiency intraerythrocytary were established. In cases of young player (< 18) vitamin D and of young national player (U16-U21) ferrum intraerythrocytary compared to national A player were poorly supplied [vitamin D: 25,71 ± 9,58 ng/ml vs 35,87 ± 12,35 ng/ml (p=0,007) – ferrum: 407,13 ± 43,09 mg/l vs 460,29 ± 36,69 mg/l (p=0,018)]. Muscle damages (in 73% of all cases) significantly occurred in vitamin D deficiency [29,13 ± 9,38 ng/dl vs 36,27 ± 12,09 ng/dl, p=0,005] and in coenzymeQ10 deficiency [623,31 ± 226,31 μg/l vs 732,93 ± 408,19 μg/l, p=0,039] more frequently. Comparing the settings of vitamin D 40ng/ml [27,50 ± 7,85 ng/ml vs 46,31 ± 6,71 ng/ml, OR=4,53, p=0,007] muscle damage were observed 4,53 times more frequent in the lower group, whereas the settings of vitaminB1-(thiamine) < 50 μg/l vs > 50 μg/l [36,45 ± 7,01 μg/l vs 63,24 ± 24,33 ng/ml, OR=0,38, p=0,045] showed muscle damage in 62% less frequent in the lower group. No significances were observed in infection, sleeping disorder or fatigue. Conclusion: Independantly to the type of sports, except all bvitamines, deficiencies of essential vitamins and trace elements in elite sports were observed. Vitamin Das well as coenzymeQ10deficiencies and vitaminB1excess play an important and significant role developing muscle damages. Further studies preventing muscle damages, recurrent infections and fatigue by treating elite athletes with micronutrients to eradicate those deficiencies are necessary. Introduction Micronutrients vitamins and trace elements interact with each other. They are essential and are needed daily to optimally maintain all physiological body functions [1-2]. High training effort, tight schedule, unbalanced or incorrect diet, frequent travel and high psychological stress lead to a high consumption of these micronutrients during preparation, which in 12.9% of cases ends in injuries and in 9.2% in acute infections and leads to lack of training and cancellation of competitions [3-6]. In major events such as the Olympics, FIFA World Cup or IAAF, 9.6-14% of participants fail due to injury [5-13]. 5.4-8.9% of participants suffer from an acute infectious disease, twice as many in winters than in summer [5-13]. The most common acute infections occur in the upper respiratory tract (46%), 25% in the urogenital system, followed by 21% with gastrointestinal infections and 8% skin infections [5-13]. These infections could not be reduced by the "General guidelines for illness prevention in athletes" of the Olympic Committee [14]. For the competitive athlete, micronutrients play a major role in energy production, blood and bone health and antioxidant radical protection [1-2]. The group of B vitamins (thiamine, riboflavin, niacin, pyridoxine, folic acid, cobalamin), coenzyme Q10 and minerals (iron, magnesium, zinc, selenium) are necessary for the mitochondrial oxidation of carbohydrates and fatty acids to energy (ATP) in the respiratory chain and essential for the competitive athletes to maintain their immense energy expenditure [1-2]. For the high turnover of red blood cells (oxygen transport) the athlete needs cellular iron, vitaminB6, -B9 and -B12 [15]. Adequate calcium, magnesium, phosphate and vitamin D values ensure the maintenance of sufficient bone density and prevent stress fractures [15-17]. Various antioxidants (vitamin A-C-E, selenium, zinc) protect cells and muscle tissue from destruction training and competition-related free oxidative radicals, especially by optimizing the cellular selenium-dependent Glutathione peroxidase and zinc-dependent superoxide dismutase [15]. In taking isolated micronutrients (polyunsaturated fatty acids (PUFA), folic acid, calcium, and antioxidants) seems to reduce muscle injuries and infections [18]. The degree of fatigue a top athlete is highly related to the quality of sleep and stress level in competition [1920]. The determination of stress parameters (neurotransmitters: cortisol, serotonin, melatonin) from saliva and urine seem to give first indications of therapeutic impact [20]. Serotonin regulates pain and mood, while melatonin is responsible for sleep induction and is considered a powerful antioxidant for the brain. These neurotransmitters are dependent on their formation on specific Research Article Advances in Orthopedics and Sports Medicine AOASM-127 ISSN: 2641-6859 Received Date: July 18, 2020; Accepted Date: July 24, 2020; Published Date: August 10, 2020 Corresponding author: Klaus Erpenbach, Institut für medizinische Leistungsoptimierung und Trainingssteuerung, Marienstraße 1, 50374 Erftstadt, Germany. Email: info@im-lot.org