Combined vit E and B2 may reduce stress fractures in female athletes, study finds

The awareness surrounding the prevalence of health issues in female athletes has been increasing in recent years, with concerns including hypothalamic amenorrhea and osteoporosis.

The American College of Sports Medicine has attributed this to the “female athlete triad” (FAT); a concept describing the interrelationship between energy availability, bone mineral density and menstrual function. This has recently been highlighted by the International Olympic Committee as a syndrome affecting many aspects of metabolic rate, immunity and physiological function.

As a result, the prevention of these conditions is vital due to the likely affect on athletic performance, as well as the risk of stress fractures specifically in track athletes.

Athletes at greatest risk of such injury are those with the C677T polymorphism in methylenetetrahydrofolate reductase (MTHFR)​; one in which increases blood homocysteine (Hcy) levels, thereby further increasing the risk of fracture. 

The researchers in the current study studied eleven female track and field athletes with this polymorphism over a period of 14 days, with the aim to observe the potential benefits of vitamin E and B2 supplementation in reducing this risk.

“The findings of this study may provide scientific evidence for developing nutritional management support by considering genetic polymorphisms as a decision-making factor for the healthcare of female athletes.”, ​conclude the researchers.

Vitamin function​

The participants were subject to three supplementation periods, each followed with a 14 day wash out, observing the effects of vitamin B2 and E individually as well as in combination.

It was found that circulating Hcy significantly decreased across all intervention types, but the reduction was most significantly observed in the group receiving the combination of vitamins.

Due to the vital role of B2 in the production of MTHFR, whichresults in the breakdown of Hcy, it is hypothesised these effects are due to B2 maximising the efficiency of this pathway.

The antioxidant potential of vitamin E has been widely documented, and thus, the observed synergy may result from enhanced circulating B vitamin levels due to the suppression of cell oxidation.

In addition, subsequent increases in serum folate levels may have reduced Hcy further, as a result of the critical role of folate in the conversion of Hcy to methionine.

Applications for athletes​

The lack of a control group to enable a causal relationship to be established reduces the validity of the results, highlighting the need for further randomised control trials utilising larger sample sizes and longer time frames. Additionally, although the diets of the athletes were controlled, significant confounders such as menstrual cycle and bone mineral density may have influenced the results collated in this study.

However, previous studies have highlighted the direct implications of increased Hcy levels on risk of stress fractures and abnormal bone metabolism. Thereby, the significant reductions in this study represent an interesting area of research into those with genetic polymorphisms that may increase risk further.

Source: Dietetics​
https://doi.org/10.3390/dietetics1030019​
“Short-Term Combined Intake of Vitamin B2 and Vitamin E Decreases Plasma Homocysteine Concentrations in Female Track Athletes.”​
Authors: A. Shinagawa, et al.