What would you risk for $1 million? The difference between Olympic gold or silver may only be a tenth of a point, but to an athlete it may mean millions of dollars in prize money and product endorsements. Athletes and their coaches are always looking for that extra edge to make them number one and will sacrifice most anything to be on top. This means risking health complications due to unknown side effects, losing amateur standing within their sport, and ruining their reputation. No harm, no foul, if you don’t get caught. Right?Many athletes are often willing to take the risk if it means enhanced performance.
Upon completes of this lecture and readings, you will be able to make recommendations to athletes about the use of a variety of supplements and why they may or may not be helpful and harmful. You will also understand how supplements are regulated and be able to access website resources for dietitians and athletes regarding supplement use.
Athletes turn to supplements for a number of reasons. But ultimately what most are looking for is that extra edge or boost in performance.
The questions listed here are a starting point for evaluating supplements. If evidence is lacking to respond to these questions, the user should be skeptical and reconsider.
Supplement use is quite common among athletes. You should always be sure to gather supplement use information when working with athletes. Other concerns of supplements is that the amount of active ingredient is known to vary from batch to batch and is not always consistent with the label. In addition, dietary supplements have been found to contain prescription drugs and illegal substances. This can be dangerous to your health and your athletic career. Unknowingly and inadvertent ingestion of illegal substances will still get you thrown off the bench and out of the game. It is best to just avoid supplements with this type of potential. There is almost a 1 in 4 chance that the sports supplement you buy at your local nutrition store is contaminated with illegal substances according to a study published by the International Olympic Committee (IOC) laboratory in Cologne, Germany. Whether contamination is intentional or unintentional, the risk is real. Athletes in all sports must understand the risk of being found guilty of illegal substance use when taking supplements that are not regulated for content, safety, or efficacy. Even if the athlete unknowingly ingests an illegal substance, they are considered guilty and will lose their right to compete.
Here are some tips for counseling athletes taking supplements.First and foremost, do on simply dismiss their use. Find out why the athlete is taking the supplement and what they think it will do for them. Investigate the supplement and then discuss with the athlete any safety concerns and potential for effectiveness. Be unbiased and open minded but keep a healthy sense of skepticism about you. Lastly, check out adds in popular fitness magazines to see what your athletes may be seing.
Hormone releasers are just as it sounds. They help release hormones that may lead to greater muscle mass.The three listed are claimed to promote increases in growth hormone but the research is lacking.
Some helpful web sites to book mark are the Office of Dietary Supplements, US Pharmacopeia, and Consumer Labs. Several others are listed in your text in table 9.10
OBJECTIVES List & state rational & purported benefits of supplements Explain regulations & labeling practices for supplements Analyze the available research on dietary supplements Provide practical advice to athletes Recognize supplements known to be harmful Describe how various supplements might work State resources available for dietitians and athletes to evaluate supplements and ergogenic aids
WHY ATHLETES USE SUPPLEMENTS Improve health Improve strength & power Gain or lose weight Burn fat Enhance energy Correct nutrient deficiencies Improve performance
WHAT IS AN ERGOGENIC AID? Ergo = “work” Genic = “to generate” Anything that helps to improve an athletes ability to perform better Run faster Lift heavier Go longer
TYPES OF ERGOGENIC AIDS Physiological – improves functioning of body systems Ex: enhances strength training, bicarbonate buffers blunt effects of lactic acid, blood doping increases oxygen carrying capacity Biomechanical – any equipment or devices that aids in performance Ex: joint wraps/braces, body suits for swimming, lighter wheels in cycling
TYPES OF ERGOGENIC AIDS Psychological – mental strategies for overcoming performance anxieties Ex:visualization training, lucky socks, preparation rituals Pharmacological – drugs used for the purpose of enhancing exercise performance Ex:steroids, hormones, painkillers, amphetamines
TYPES OF ERGOGENIC AIDS Nutritional - includes foods, supplements, special dietary practices Ex: caffeine, creatine, amino acids, sports gels, CHO loading
WHAT ARE DIETARY SUPPLEMENTS?Dietary Supplement Health & Education Act (DSHEA) of 1994 established definition: Not a food, or used as a food item Must include at least one of the following: Vitamin Mineral Herb or other botanical Amino acid Dietary substance to supplement diet
REGULATION OF SUPPLEMENTS Can be marketed without proof of safety, efficacy, & quality Products containing new ingredients must notify the FDA, but do not require prior approval Manufacturer responsible for safety but not required to prove safety or efficacy
REGULATION OF SUPPLEMENTS “Facts” panel required All ingredients must be listed May include health, nutrient content, or structure/function claims on label Cannot claim to cure or treat disease
REGULATION OF SUPPLEMENTS(CONTINUED) FDA does not have the resources to monitor labeling claims closely Types of claims allowed:1. Nutrient content - “good source of calcium”2. Health – must be one of the FDA approved statements : “soluble fiber lowers cholesterol”3. Structure/function – unauthorized statements: “calcium builds strong bones”
SUPPLEMENT MARKETING Federal Trade Commission monitors marketing claims Common marketing techniques Product endorsements by celebrities & athletes Testimonials Scientific breakthrough claims: Unpublished “clinical” studies Used in foreign country – “known in Europe for years” False or untested structure/function claims
SAFETY OF SUPPLEMENTS Safety, potency, & identity of ingredients may be unknown Good Manufacturing Practices – GMPs Voluntary quality control program & procedures within the industry
SAFETY OF SUPPLEMENTS Look for USP seal 2003 guidelines for quality, purity, ingredients, & manufacturing standards Voluntary participation Buy from well- known companies
EVALUATING SUPPLEMENTS Is there scientific research to back the claims? Are the claims physiologically plausible? Is it safe? Is it effective? What is the cost? What are the ingredients? Consider the risk-benefit ratio
MORE ABOUT SUPPLEMENTS Use is common among athletes ~ 60% Amount of active ingredient varies greatly & not always consistent with labeling Sometimes contain illegal substances or Rx drugs
COUNSELING ATHLETES ON SUPP. Do not simply dismiss use Understand athletes goals & reasons for supp. use Discuss safety & effectiveness of use Explain physiological mechanisms, potential side effects, & conditions for appropriate use Provide unbiased information Be an open-minded skeptic Stay up on supps by reading fitness magazines & visiting supp stores
WHAT IS DOPING? “Practice of enhancing performance using foreign substances or other artificial means” (Fink, Burgoon, Mikesky, p. 267) Growing problem in competitive & professional sports Oversight agencies WADA – World Anti-doping Agency USADA – US Anti-doping Agency
INADVERTENT DOPINGUnaware of ingesting the substance Causes: Don’t know what is on the banned substance list Unrecognizable name on ingredients list Not included on the ingredient list, sometimes intentionally Product contaminated during production
COMMON DOPING AGENTS Anabolics Prohormones and hormone releasers Fat reducers Anticatabolics Vitamins and minerals
PROHORMONES Claim to increase production of anabolic hormones Androstenedione; “Andro” Testosterone precursor May increase estrogen & risk for cancer Decreases HDL cholesterol Banned & illegal to market DHEA (dehydroepiandrosterone) Testosterone & estrogen precursor Poor efficacy if any
HORMONE-RELEASER Ornithine and arginine Clonidine
FAT REDUCERS Modes of action: Decrease appetite Increase fat breakdown for energy Block absorption of ingested fats Caffeine – CNS stimulant, reduce sense of fatigue L-carnitine CLA (conjugate linoleic acid) Ephedrine – banned, risk of stroke/death, ↑ BP Commonly used by endurance athletes & those in aesthetic sports
ANTI-CATABOLICS Intended to help preserve lean body mass Examples Glutamine Branched chain amino acids Leucine Whey protein Commonly used by body builders
NUTRITIONAL ERGOGENICS USED BY ENDURANCE ATHLETES Branched chain L-carnitine amino acids Medium-chain Caffeine triglycerides (MCT) Coenzyme Q10 Pyruvate Energy bars Sodium/electrolyte Energy gels tablets Ginseng Sports beverages Glycerol
NUTRITIONAL ERGOGENICS USED BY STRENGTH/POWER ATHLETES Chromium Protein powders Creatine Protein bars Conjugated linoleic Medium-chain acid triglycerides Growth hormone Beta-hydroxy-beta- Anabolic steroids methyl butyrate
FIND THE RESEARCH MEDLINE/PubMed: Includes research/professional journals in the medical field CINAHL: Includes research/professional journals in nursing and allied health fields Sport Discus: Database that includes general media sources involving sport
WEB SITES Office of Dietary Supplements http://ods.od.nih.gov/ US Pharmacopeia http://www.usp.org/ Consumer Labs http://www.consumerlab.com/
SUMMARY Sports nutritionist must be aware of supplement use Most athletes use or have tried supplements Supplements are not tested for purity, safety, efficacy Supplements do not require FDA approval Supplements may contain banned substances Voluntary GMP and USP guidelines are used by some manufacturers FDA & FTC have limited resources to address abuse in the industry Buyer beware!
REFERENCESFink HH, Burgoon LA, Mikesky AE, eds. Practical Applications in Sports Nutrition. Sudbury, MA: Jones and Bartlett; 2012Dunford M, Smith M. Dietary supplements and ergogenic aids. In: Dunford M, ed. Sports Nutrition: A Practice Manual for Professionals, 4th ed. American Dietetic Association; 2006.