Vitamin C for collagen synthesis in athletes -
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We would like to thank Esther Boelsma hospital Gelderse Vallei, Ede, the Netherlands for helping out find available rooms for performing the study; we would like to thank Bas Maresh and Myrthe Vestering for helping out and preparing the ultrasound protocols. We would also like to give thanks to Karin van den Brink who built the functional test package for this study with her expertise as sports physical therapist.
We would like to acknowledge Prof. HC Boshuizen for her advisory role in the statistical methods. This study was funded by the research fund of the Gelderse Vallei Hospital in Ede, the Netherlands, and by Rousselot Ghent, Belgium.
Rousselot supported the JUMPFOOD study by providing the intervention and placebo supplements and provided financial compensation for the execution of the study. Rousselot has however not been involved in the design of the study, nor will it be involved in the analysis of the data and publications.
Rousselot will have access to the manuscript. Department of Sports Medicine, SportsValley, Hospital Gelderse Vallei, Willy Brandtlaan 10, RP, Ede, The Netherlands. Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. You can also search for this author in PubMed Google Scholar. JZ, MM, and RV conceived of the idea, obtained funding for the study, and developed the intervention, together with RT and LD.
LD wrote the article, and together with RT and JZ developed the design of this trial. LD will recruit participants and is responsible for data acquisition. MM and RV provided advice on the study design. All authors read and approved the final manuscript. Hans Zwerver is a sports physician at Sports Valley in hospital Gelderse Vallei and also Extraordinary Professor of Sports and Exercise Medicine at the Center for Human Movement Sciences UMC-Groningen.
Rieneke Terink is the principal investigator. She received her PhD from Wageningen University on the topic: effect of exercise on nutritional status, and the stress and immune response. She currently works for Hospital Gelderse Vallei and Eat2Move, initiating new studies with a focus on nutrition, health, and exercise.
Marco Mensink is an assistant professor at the Wageningen University, department of Human Nutrition and Health, chairgroup Nutritional Biology. In his research he primarily focuses on the significance of nutrition and exercise to maintain or improve a persons' physical health and performance, in sports, but also during ageing.
Associate Prof. Robert-Jan de Vos is a sports physician at the Erasmus MC University Medical Center. He coordinates an academic tendon clinic and has a research line on the prevention and treatment of sports injuries with a specific focus on tendon injuries.
He recently supervised an RCT on the effectiveness of PTLE compared to eccentric exercises for athletes with Patellar Tendinopathy. Lotte van Dam will do the main implementation of the study as the executive researcher. She works as a junior researcher at Hospital Gelderse Vallei.
Correspondence to L. van Dam. Approval for study execution was provided by METC Oost-NL under the following number: NL For approval documents, see attached. Informed consent form is provided in Additional file 1. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Abstract Background Patellar tendinopathy PT is a common problem in jumping athletes. Trial registration ClinicalTrials.
gov NCT Registered on 7 June Administrative information Note: the numbers in curly brackets in this protocol refer to SPIRIT checklist item numbers. gov : NCT Trial registration number for medical ethical committee Oost-NL: NL Author details {5a} L van Dam 1,2 , R Terink 1 , M Mensink 2 , R de Vos 3 , J Zwerver 1,4 1 SportsValley, Department of Sports Medicine, Hospital Gelderse Vallei, Willy Brandtlaan 10, RP, Ede, the Netherlands.
wetenschapsbureau zgv. nl Role of sponsor {5c} Sponsor: The hospital supported the JUMPFOOD study by providing a financial compensation for the execution of the study.
The investigators will have the ultimate authority over any of these activities. Introduction Background and rationale {6a} Patellar tendinopathy PT is a tendon overuse injury that is clinically recognized by load-related pain localized at the inferior patellar pole [ 1 ].
Trial design {8} The JUMPFOOD study is a double-blinded, 2-armed randomized-controlled superiority trial RCT. Full size image. Methods: participants, interventions, and outcomes Study setting {9} The study will be performed and the data will be collected and handled at the Sports Medicine department of the Gelderse Vallei Hospital in Ede, The Netherlands.
Who will take informed consent? Additional consent provisions for collection and use of participant data and biological specimens {26b} Additional blood samples will be obtained to be stored for use in future studies evaluating the pathobiology of PT.
Interventions Explanation for the choice of comparators {6b} All participants will receive education and advice with regard to load management and criteria-based PTLE. PTLE progressive tendon loading exercises All participants will receive criteria-based PTLE consisting of 4 stages within the limits of pain for 24 weeks.
Criteria for discontinuing or modifying allocated interventions {11b} Participants can withdraw from the study at any time for any reason if they wish to do so without any consequences. Strategies to improve adherence to interventions {11c} Before the start of the intervention, participants will receive an elaborative explanation about the supplement and the exercise program.
Relevant concomitant care permitted or prohibited during the trial {11d} Pain relieving medication should preferably not be used, but when participants experience pain with a VAS score of 7 or higher, with a duration of at least 24 h, the use of pain medication will be allowed.
Provisions for post-trial care {30} If participants still experience symptoms after completion of the study, we will advise them to contact the general practitioner for a referral to a sports medicine physician.
Outcomes {12} Primary outcome measure VISA-P questionnaire The primary outcome measure of the JUMPFOOD study is the change of the validated and disease-specific VISA-P score over 24 weeks, which will be compared between the supplement and placebo groups.
Functional tests Functional tests Functional tests will be performed to determine the pain rating on a visual analogue scale VAS and to determine flexibility and strength.
Imaging Imaging Ultrasound Hitachi Aloka Arietta machine, with 18—5 Hz linear echo probe, in B mode 25 fps, in Doppler 19 fps, Tokyo, Japan of the patellar tendon will be performed by an experienced musculoskeletal radiologist, or under the supervision of an experienced musculoskeletal radiologist.
Tendon stiffness Patellar tendon stiffness will be assessed using myotonometric measurements with the MyotonPRO device Myoton Ltd, Tallinn, Estonia. Nutrition A 3-Day Food Record 3DFR will be recorded at the start and at the end of the intervention period by the use of the validated TRAQQ app of Wageningen University [ 40 , 41 ].
Questionnaires Multiple questionnaires will be given at baseline, at 12 weeks, and at 24 weeks. Other outcomes Weekly logbooks Data on compliance to the training program, mean pain score during the exercises, and sport-specific training load will be registered on a weekly basis.
Participant timeline {13} Participants will be recruited from April until May Table 1 Schematic diagram of the JUMPFOOD study Full size table.
Assignment of interventions: allocation Sequence generation {16a} Participants will be randomly assigned to either the intervention or the control group using a block randomization with blocks of 8 participants. Implementation {16c} The allocation list containing supplement numbers linked to participant numbers is in possession of the executive researcher, who will allocate participants to participant numbers during enrolment.
Assignment of interventions: blinding Who will be blinded {17a} All participants, care providers, outcome assessors, and data analysts will be kept blind to the assignment of the type of intervention. Procedure for unblinding if needed {17b} The executive researcher will receive the code of the independent randomization person identifying which treatment the participant receives in case of an emergency in which a participant will have to be unblinded.
Data collection and management Plans for assessment and collection of outcomes {18a} Each researcher involved in this study will be trained in the study requirements; standardized measurement of height, weight, and fat percentage; how to handle the myotonometer, caliper, UTC, OptoGait, Castor, and questionnaires; how to prepare the supplements; and how to explain everything and guide the participants during study participation.
Data management {19} Data collection will be performed using the electronic data capture system Castor. Confidentiality {27} Personal data of the participants that will be collected during the present study will be handled confidentially and coded, in compliance with the General Data Protection Regulation GDPR Dutch: Algemene Verordening Gegevensbescherming, AVG.
Statistical methods Statistical methods for primary and secondary outcomes {20a} Statistical analyses will be performed with SPSS software Version 27, IBM, Armonk, NY, USA. Interim analyses {21b} Not applicable, as this trial has no DMC, the duration of recruitment is manageable and there are no potentially serious outcomes.
Methods for additional analyses e. Methods in analysis to handle protocol non-adherence and any statistical methods to handle missing data {20c} Consistent with the CONSORT statement, an intention-to-treat analysis will be performed.
Plans to give access to the full protocol, participant-level data, and statistical code {31c} We plan to write at least one scientific paper about the results from the JUMPFOOD study. Oversight and monitoring Composition of the coordinating center and trial steering committee {5d} Principal Investigator: Design and conduct of JUMPFOOD.
Preparation of protocol and revisions. Preparation of investigators brochure IB and CRFs [Case Report Forms]. Organizing steering committee meetings. Managing CTO [Clinical Trials Office].
Publication of study reports. Steering committee SC : Design and agreement of final protocol. Budget administration. Executive researcher: Design and conduct of JUMPFOOD.
Organizing and steering committee meetings weekly. Study planning. Organization of test days. Provide annual risk report to ethics committee METC-OOST.
SUSAR [Serious unexpected suspected adverse events] reporting to METC-OOST. Responsible for trial master file.
Organization of central serum sample collection. Data manager. Follow-up of participants. Randomization person: Randomization. Independent expert: Answering questions related to study. Composition of the data monitoring committee, its role and reporting structure {21a} Not applicable.
Adverse event reporting and harms {22} All adverse events reported spontaneously by the participant or observed by the investigator or his staff will be recorded.
Frequency and plans for auditing trial conduct {23} Auditing trials are not conducted as this is a single-center study with low risk for the participants. Plans for communicating important protocol amendments to relevant parties e.
Dissemination plans {31a} We plan to publish at least one scientific paper about the results of the JUMPFOOD study. Discussion Despite the high prevalence of PT among athletes and its potential impact on sports participation, management of patellar tendinopathy remains challenging.
Trial status Protocol version: 1 Date: 28— Start date recruitment: 01— End date recruitment: 01— Availability of data and materials {29} Persons who have access to the final dataset are the research team members, the principal investigator, the project leader, and the executive researcher, as well as Rousselot.
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Article PubMed Google Scholar Sterne JA, White IR, Carlin JB, Spratt M, Royston P, Kenward MG, et al. Article CAS PubMed PubMed Central Google Scholar Download references. Acknowledgements We would like to thank Esther Boelsma hospital Gelderse Vallei, Ede, the Netherlands for helping out find available rooms for performing the study; we would like to thank Bas Maresh and Myrthe Vestering for helping out and preparing the ultrasound protocols.
Funding This study was funded by the research fund of the Gelderse Vallei Hospital in Ede, the Netherlands, and by Rousselot Ghent, Belgium. Author information Authors and Affiliations Department of Sports Medicine, SportsValley, Hospital Gelderse Vallei, Willy Brandtlaan 10, RP, Ede, The Netherlands L.
van Dam, R. Mensink Erasmus MC University Medical Center, Rotterdam, The Netherlands R. de Vos Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands J. Zwerver Authors L. van Dam View author publications.
View author publications. Ethics declarations Ethics approval and consent to participate {24} Approval for study execution was provided by METC Oost-NL under the following number: NL Consent for publication {32} Informed consent form is provided in Additional file 1. Competing interests {28} The authors declare that they do not have competing interests.
Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Supplementary Information.
Additional file 1. Informed consent form. Rights and permissions Open Access This article is licensed under a Creative Commons Attribution 4. About this article. Cite this article van Dam, L. Vitamin C Vit C , also known as ascorbic acid, was one of the first vitamins isolated and discovered back in the early s.
Can you guess which vitamins came before C? Vitamin C is an antioxidant and necessary for the growth, development, and repair of all body tissues including blood vessels, cartilage, muscle, and collagen in bones. The RDA recommended daily allowance is a guideline for how much C we need, and most references will suggest the following:.
Do we need to put our vitamin c intake on watch? Deficiency is there for smokers, certain GI or cancer conditions, or those with a diet void of fruits and vegetables.
But, is it better to get vitamin C from food or a supplement? You probably already know the answer to this. Vitamin C from food is more natural and more useful because synthetic vitamins often contain isomers as a byproduct of the manufacturing. Isomers are like chemical imposters that can block the ability of the vitamin in question to function.
The knowledge about vitamin c was expedited mainly because of Scurvy — a deficiency in vitamin c. This disease was first discovered by sailors in the s. Alright, time for our in-house mad scientist, Dr. Cate is not only a mad scientist but also a biochemist and medical doctor.
Time to separate fact from falsehood. However, nearly every vitamin is needed for collagen synthesis! Optimizing a complex process like stimulating fibroblast cells — more on fibroblasts below — to make more collagen in all your collagenous tissues requires just about every nutrient there is.
We have scientific studies from the early 20th century proving that vitamin c helps collagen production. This data can be found in every basic physiology book known to man, such as the Textbook of Biochemistry with Clinical Correlations by Thomas M.
It seems like vitamin c gets most, if not all, of the attention when it comes to collagen. But, why? This aforementioned disease required significant research on vitamin c. Vitamin C helps turn the amino acids proline and lysine into the modified amino acids hydroxyproline and hydroxylysine.
These two modified amino acids are unique to collagen. For fibroblasts to do the heavy lifting of creating more collagen, they need enzymes, and one of those enzymes uses vitamin c.
As we learned above, since most of us are not vitamin c deficient, these enzymes have what they need to create more collagen. Goodness, this specific detail around collagen and C has shifted far and away from science and biology. No, you do not need vitamin c to absorb collagen. Harbin Clinic defines this nicely:.
Does your small intestine wait around for vitamin c before it absorbs a scoop of collagen powder with your morning coffee? Instead, we need healthy gut flora and healthy intestinal cells. Yes, you can take collagen and vitamin c together safely.
You can consume collagen and vitamins together safely because collagen is food! Collagen powders that add vitamin c will include anywhere from 50mg to 90mg of Vitamin C per serving 1 scoop. Hyaluronic Acid is another popular additive to pair with synthetic vitamin c. Are there dangers of adding vitamin c to collagen powder?
We believe so. And so does Dr. Cate adds a provoking thought to our million-dollar question. This is a lot of information. We know. But the topic certainly requires it.
Eric discovered collagen back in thanks to Charlie and been a believer since. As CMO, he's directly responsible for crafting the CB Supplements positioning, content, branding, and overall marketing direction.
She is a Board-certified Family Physician, biochemist trained at Cornell University, and New York Times Bestseller. New to collagen? Looking to buy a collagen supplement? Ready to up your existing collagen game?
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April 4, Cate's Takeaway.
Click name to Low glycemic grains affiliation. Nutritional strategies to improve connective tissue collagen synthesis have garnered significant interest, although synthezis scientific validity of these interventions Vitamin C for collagen synthesis in athletes behind their Vitamin C for collagen synthesis in athletes. This study was synthseis to atlhetes the effects of three forms of collagen on N-terminal peptide of procollagen and serum amino acid levels. A total of 10 recreationally active males completed a randomized double-blinded crossover design study consuming either placebo or 15 g of vitamin C—enriched gelatin or hydrolyzed collagen HCor gummy containing equal parts of gelatin and HC. Supplements were consumed 1 hr before 6 min of jump rope. Sports nutrition xollagen a decisive factor Vitamin C for collagen synthesis in athletes sports Pomegranate smoothie benefits and recovery. The forr between ideal training and adequate nutrition will help achieve a higher intensity work for a longer time. In the same way, respecting the rest periods and pairing them with adequate nutrition will aid supercompensation and sports adaptation. Bad nutrition facilitates injuries and fatigue. So, we must ingest it.
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