Most athletes and coaches understand the important role that naturally occurring anti-inflammatory fatty acids play in recovery from intensive training. This is not necessarily a case of more being better. Much like a construction site with too many bricks and not enough mortar, having high quantities of EPA/DHA without having the essential B and E Vitamins bioavailable will not build anything. Just as intense, functional training will stress many different systems in the body, recovery from such training will require an equally diverse set of micronutrients to facilitate the process of rebuilding everything, from muscle fibers to bone to neurons. Omega-3 fatty acids are not in and of themselves a magical potion for recovery; the body needs an array of micronutrients in order to utilize these fatty acids to assist in recovery and development.

Folate

Folate, or folic acid, is a water-soluble B vitamin, with a singular enzyme cofactor role in mediating the transfer of one-carbon units. This notably includes a prominent action in nucleic acid metabolism, amino acid metabolism, immune function and inflammatory response, all of which are of additional importance in the healing continuum.

Folate has commonplace application pre-pregnancy in the prevention of neural tube defects and other neurologic anomalies, though a body of more recent work has documented that folic acid can enhance neurologic growth and repair mechanisms even in the adult patient. This has particular implications for use in neurosurgery, spine surgery, and common peripheral neurodecompressive procedures such as carpal tunnel release. These same mechanisms are believed to account for the documented effect of folic acid in protecting against falls in studies of balance in the elderly.

So what relevance does this have to the athlete? These studies imply that an athlete whose training places great stress on the Central Nervous System, weightlifters in particular, could benefit from ensuring that they have adequate levels of folate. While we cannot go so far as to say that increased levels of folate will mean an increased capacity for a weightlifter to fire their motor neurons and explode a barbell off of the ground, it is relatively safe to imply that a deficiency in folate will hinder an athlete’s healing capacity to some extent.

Supplemental folate increased from typical daily intake, and optimized for the athlete will support:
∙Best immune function and wound healing response
∙Potential for neural repair and re-growth
Folate intake recommended for the athlete: 400-1000 mcg/day
RDA: 400mcg/day, with a tolerable upper limit of 800-1000mcg/day.

Vitamin E

The term vitamin E actually describes at least twelve discreet compounds, though of these, the tocopherols, and alpha-tocopherol in particular, are those with greatest nutritional significance in humans. The topic of vitamin E and recovery is of some controversy. Together, the best available literature addressing vitamin E and wound healing leads to several possible conclusions: 1) systemic vitamin E may have a negative impact on surgical wounds as secondary to its lysosomal-stabilizing properties, 2) vitamin A may have a role in mitigating some of these potentially adverse effects, and 3) hydrophilic and hydrophobic preparations of vitamin E may have distinct effects as related to healing.

While the studies on the matter are inconclusive, it appears that vitamin E may have more negative effects then positive in a surgical setting. Primary among these negative effects is an increased risk of bleeding. Unlike some of our other examples, it is more difficult to use studies looking at how micronutrient sufficiency affects healing with vitamin E. While the increased risk of bleeding this can have deadly consequences in traumatic injury or surgery, most athletes do a comparatively minimal amount of bleeding in training and competition.

Post-operatively or post injury, vitamin E and naturally affiliated compounds (DHA and EPA) can have strong beneficial recovery and anti-inflammatory effects that are extensively documented. The dose levels of these compounds that are likely to be of greatest merit are such that an independent source is required (ie, liquid purified fish oil, or gel tab preperations with a strategically balanced mix of vitamin E, DHA, EPA, and other omega compounds). The dosing regimen will vary greatly depending on the specifics of each preparation. The most potentant supplementary source is found in naturally fermented cod liver oil. However, there are many available sources of fish or krill oil that can also provide a beneficial source of EPA/DHA.
Recommended vitamin E intake for the athlete: 7.5mg/day; Increase dose post-training or competition using cod liver/fish/krill oil preparation containing vitamin E forms in conjunction with naturally related DHA and EPA.

The 7.5mg low-dose regimen is sufficient to mitigate the low short-term potential for deficiency issues, while simultaneously absolutely minimizing potential for adverse anti-platelet of coagulation concerns attributed to higher-dose supplemental vitamin E programs.

An increased, dedicated post-procedure regimen will provide additional potential recovery benefit, though requires sufficiently large doses such that an independent supplemental source is needed (as outlined above).
RDA: 15 mg/day (22.4 IU/day). Established tolerable upper limits are 1000 mg/day (1500 IU/day). However, a meta-analysis of 135,967 patients enrolled in a total of 19 clinical trials by Miller ER demonstrated that vitamin E supplementation of over 400 IU/day was significantly linked to an increase in all cause mortality.

Timing of Vitamin and Mineral Support Programs

The pre-event time frames for a targeted supplement optimization program that includes the recommendations made in this series will vary considerably based upon the nature and magnitude of the training being planned, the athlete’s diet, compounding medical issues, sleep, and other stressors. In general, a high level nutritional stringency should be maintained.
Since athletes are constantly subjecting their bodies to significant amounts of training stress, the athlete’s body is in a never-ending state of adaptation to increasingly greater and greater stress demands. For competitive athletes training for a specific event and following a periodized training program, the increased need for additional nutritional supplementation will coincide with the increased demands of training. We recommend that athletes and coaches pay particular attention to micronutrient consumption during the beginning of any training cycle, as this will be typically be the time that the athlete’s unconditioned body will have the hardest time recovering from training.

Simply put, due to the high stress from training and the small margin for error between defeat and victory, athletes have less wiggle room for suboptimal nutrition than other people. The goal of supplemental optimization of micronutrients is fostering the complete healing as rapidly as possible, with the greatest quality of healed tissue (biomechanics and cellular), and with the least amount of scarring to achieve optimal performance.

Conclusion

It is well accepted that ideal nutrition is often critical to proper recovery and increased performance of an athlete. This includes appropriate protein and lipid intake, carbohydrate intake, and other macro-nutritional factors, as well as the broad and often more complex micro-nutritional factors that are discussed as the focus of this work. Abundant nutritional information characterizing the role for vitamins and minerals in the support of muscular and other types of tissue healing have been scientifically evolving for at least the past 40 years. Even so, this body of information has been scattered widely over time and is most often found in other aspects of healing, such as surgery and trauma rather than athletics. However, once this body of knowledge is properly organized, aligned, integrated and applied to the specific goals of training and sport recovery, a compelling basis and strategy for the use of optimal levels of vitamins and mineral support becomes apparent.
While real whole foods provide the best and most bioavailable forms of every nutrient and micronutrient, it may be hard, regardless of how well athletes eat, for them to consume and digest the above average quantities of vitamins and minerals the best research into healing would suggest as optimal. While food quality and quantity will always have primacy, athletes and coaches should be cognizant of micronutrients functions and their requirements so that they know when and how to properly supplement.