Elite athletes with higher vitamin D show healthier lipid profiles

By Vijay Kumar MalesuReviewed by Susha Cheriyedath, M.Sc.Jun 23 2026

In a large cohort of professional male athletes, higher vitamin D status tracked with lower atherogenic lipid markers, raising new questions about metabolic health beyond training alone.

Study: Vitamin D Status and Atherogenic Lipid Profiles, Including Lipoprotein(a), in Elite Athletes. Image Credit: Vink Fan / Shutterstock

In a recent study published in the journal Nutrients,  researchers in Germany investigated the association between serum 25-hydroxyvitamin D concentrations and atherogenic lipid parameters, including lipoprotein(a), in male professional athletes.

Background

Did you know that even highly trained athletes can develop unfavorable lipid profiles that may influence long-term cardiovascular health? Vitamin D is very important for bone health, modulation of inflammatory responses, and metabolism, but some studies have linked lower vitamin D levels to less favorable lipid profiles. However, these results vary because obesity, physical inactivity, chronic illness, and medication use can influence both vitamin D status and lipid metabolism. 

About the Study

The researchers conducted a single-center, cross-sectional registry study of male professional athletes who underwent routine preseason sports cardiology evaluations at the University Hospital of Giessen from 2014 to 2026. The inclusion criteria for the study were male athletes aged 18-39 years with a recorded serum 25-hydroxyvitamin D level. Athletes with known cardiovascular, metabolic, or systemic disease, or those taking regular medications, were excluded.

The study evaluated 773 professional athletes from handball, basketball, ice hockey, and soccer. All participants underwent standardized assessments, including physical examinations, blood pressure measurements, electrocardiography, and echocardiography. Information regarding training history and weekly training volume was collected through standardized questionnaires.

Serum 25-hydroxyvitamin D, parathyroid hormone, lipid metrics, lipoprotein(a), glycated hemoglobin, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, C-reactive protein, and calcium were analyzed from blood samples that were collected at least 3 hours after eating during routine screening; fasting was not routinely required, so lipid measurements were treated as non-fasting and underwent standardized laboratory testing methods.

Vitamin D levels were analyzed as continuous variables and divided into three categories: (<30, 30-50, >50 ng/mL). The associations were examined with detailed statistical analyses, including subgroup analyses, correlation analyses, and multiple regression models controlling for age, body mass index, type of sport, season, training characteristics, assessment year, and exercise performance.

Study Results

The study included 773 male professional athletes with a mean age of 25.5 years. Participants represented different team sports, including handball, basketball, ice hockey, and soccer. The average blood level of 25-hydroxyvitamin D was 34.25 ng/mL. Higher levels of vitamin D were found between June and October than during November and May, likely due to seasonal differences in ultraviolet exposure.

Participants were categorized according to the vitamin D levels for further evaluation. A total of 477 athletes had sufficient vitamin D levels, while 296 had insufficient levels. When grouped by vitamin D status, athletes with sufficient vitamin D had a more favorable blood lipid profile than those with insufficient vitamin D.

Athletes with sufficient vitamin D had lower low-density lipoprotein concentrations than those with insufficient vitamin D (95.08 versus 101.06 mg/dL). They also had lower triglyceride concentrations compared to athletes with inadequate levels (96.11 versus 105.96 mg/dL). Concentrations of lipoprotein(a) also differed significantly between groups, although values were skewed and partly affected by assay detection limits. 

Concentrations of high-density lipoprotein were not significantly different. Total cholesterol showed only a trend toward lower values in athletes with sufficient vitamin D.

Participants with sufficient vitamin D showed higher peak exercise performance, lower parathyroid hormone levels, and slightly higher calcium levels than participants with insufficient vitamin D. Age, body mass index, and training history were comparable between the groups.

Further analysis divided participants into three vitamin D categories: <30 ng/mL, 30-50 ng/mL, and>50 ng/mL. Increasing vitamin D concentrations were associated with progressively lower total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels. There was a significant difference between groups of participants based on lipoprotein(a) distributions by vitamin D level categories; however, the lipoprotein(a) concentrations did not improve systematically across vitamin D categories.

Correlative analysis of the participants revealed that higher vitamin D levels were associated with lower total cholesterol, low-density lipoprotein cholesterol, triglycerides, lipoprotein(a), glycated hemoglobin, and parathyroid hormone levels, while also positively correlating with calcium levels and higher peak exercise performance. There were no significant correlations between vitamin D and age, body mass index, C-reactive protein levels, and training volume.

Following multivariable analysis, it was concluded that higher levels of vitamin D were independently associated with lower total cholesterol levels, low-density lipoprotein cholesterol levels, triglyceride levels, and lipoprotein(a) levels.

Results showed that for every 1 ng/mL increase in vitamin D, low-density lipoprotein cholesterol was 0.19 mg/dL lower and lipoprotein(a) was 1.1% lower. No independent association was found between vitamin D and high-density lipoprotein cholesterol levels.

Conclusion

The study found that higher serum 25-hydroxyvitamin D concentrations were independently associated with a more favorable atherogenic lipid profile in male professional athletes. Athletes with higher vitamin D levels generally exhibited lower concentrations of low-density lipoprotein cholesterol, triglycerides, and lipoprotein(a), even after accounting for age, body mass index, training-related factors, sport discipline, assessment year, and seasonal variation.

Higher vitamin D levels were also associated with higher peak exercise performance and lower parathyroid hormone levels, but the study cannot determine whether vitamin D directly influences performance or lipid levels.

As the cross-sectional design of this study prohibits making causal conclusions, these results raise the possibility that vitamin D status may be an important metabolic correlate of cardiovascular risk-related lipid parameters in elite athletes.

The findings should be interpreted as exploratory because vitamin D supplementation, dietary intake, body composition, ultraviolet exposure, and other lifestyle-related factors were not systematically assessed.

The authors also noted that multiple statistical comparisons were performed without formal adjustment and that the exclusive inclusion of male professional athletes limits generalizability to female athletes, recreational athletes, and non-athletic populations.

Further research is needed to clarify these relationships in populations with fewer lifestyle-related confounding factors.

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