1. Dietary Supplements
Help or Hype?
Distribution of total supplement sales
- 40% vitamins
- 29% herbals & botanicals (ginkgo, echinacea, St. John’s Wort, ginseng, garlic)
- 10% sports nutrition
- 8% minerals
- 8% specialty supplements (melatonin, fish oil, amino acids, etc.)
- 5% meal supplements
Many people take dietary supplements (vitamins, minerals, herbs, amino acids, fatty
acids, enzymes, prohormones, etc.) In fact, it is estimated that 40-50% of U.S.
households purchase supplements, with total sales amounting to $13.9 billion in
1998.
More and more supplements are being added to food and beverage products as well.
Grocery store shelves are stocked with everything from protein bars packed with
creatine (purported to help bulk you up) to juices spiked with ginkgo biloba (purported
to boost your memory).
Students may choose to take supplements for many reasons: to help meet their
nutrient needs, achieve their fitness goals, promote optimal physical health, or
improve their emotional well-being There is accumulating scientific evidence that
many supplements do, in fact, offer these benefits. However, there is also a lot of
evidence that many supplements do not. Effective or not, most dietary supplements
are safe when taken in the recommended dose (meaning they will not harm you). But,
some supplements carry significant health risks of which you might not be aware.
Read on to learn…
· What you ABSOLUTELY must know before you buy any supplement.
· Whether or not you need to take a multi.
· If certain herbs can improve your energy, mood, memory, and/or sex drive.
· The truth about fat burners and muscle builders.
· Whether or not energy bars and drinks are worth your money.

2. Regulation of Dietary Supplements
What you absolutely need to know!
Unlike pharmaceutical drugs and food additives, dietary supplements are largely
unregulated by the FDA (Food and Drug Administration) for consumer protection.
This is largely due to heavy lobbying by the health food store industry, which led to
the passage of the Dietary Supplement Health and Education Act (DSHEA) in 1994.
Read on to learn how this act made the following legal…
· Supplements do not have to prove they work to be sold.
· Supplements do not have to prove they are safe to be sold.
· Supplement manufacturers can put “structure-function claims” on their labels,
so long as they don’t claim to “prevent” or “treat” a specific disease.
· Supplements do not have to be manufactured according to any standards.
Supplements do not have to prove they work to be sold.
Before drugs or food additives go on the market, hundreds of research studies must be
submitted to the FDA for review of the product’s efficacy. In fact, the average
evaluation of a new drug may take 15 years and cost $500 million! With dietary
supplements, manufacturers are simply required to notify the FDA (as a courtesy)
within 30 days of marketing their product. The FDA does not evaluate the research to
make sure that the product does what the manufacturer claims it does.
Supplements do not have to prove they are safe to be sold.
Before new drugs or food additives go on the market, extensive research proving safety
must be conducted by the manufacturer and then submitted to the FDA for evaluation
and approval. In other words, the "burden of proof" that a product is safe is placed on
the manufacturer.
With a new dietary supplement, however, manufacturers simply need to submit safety
data to the FDA 75 days before marketing it. The data need not be evaluated or
approved by the FDA, so the quality of research may be questionable. If the FDA
suspects that a product is unsafe and wants to take a product off the market, the FDA
has to prove it is unsafe. In other words, the "burden of proof" that a product is
unsafe is placed on the FDA.
Given the huge number of new dietary supplements added to the market each year
and the FDA’s limited resources, it is impossible for the FDA to finance and conduct
safety studies for all of these products. As a result, many potentially dangerous
products are sold over-the-counter to unsuspecting consumers.

3. Examples:
· Ephedra or Ma huang, a popular herbal supplement added to many weight loss
formulas for its stimulant and appetite-suppressing effects, has been linked with
over 1100 reports of adverse effects and 34 deaths since 1993. Yet anyone can get
this supplement over-the-counter without a doctor’s prescription or supervision.
· Many herbs can have dangerous interactions with drugs or other supplements.
But because their use is not supervised by a qualified clinician, consumers are not
aware of these interactions. For instance, St. John’s Wort, a popular (and
potentially helpful) herbal supplement for mild depression can interfere with the
action of HIV medications and birth control pills.
Supplement manufacturers can put “structure-function claims” on their labels, so long as they
don’t claim to “prevent” or “treat” a specific disease.
Structure-function claims can often be misleading. For example, carnitine is added to
many weight loss products with the claim: "promotes fat burning." This claim is
perfectly legal and somewhat true since it describes the function of carnitine in the
human body. Carnitine plays an essential role in transporting fatty acids into the part
of the cell responsible for producing energy. This implies that carnitine's function is to
“support or promote” fat burning.
But taking carnitine supplements does not speed up the fat burning process and it
does not cause weight loss. The healthy body knows how to synthesize carnitine and
already has all the carnitine it can use.
The manufacturer can make this misleading claim by including a simple disclaimer:
“This statement has not been evaluated by the FDA. This product is not intended to
diagnose, treat, cure, or prevent any disease.” In other words, the supplement can't
claim to "prevent" or "treat" obesity (a disease)--that would imply that the supplement
has drug-like actions. But, it can claim to "support" or "promote" fat burning.
In Winter 1999, due to complaints from the supplement industry and consumers, the FDA
relaxed its definition of what constitutes a “disease.” Now manufacturers can make claims about
“common conditions associated with the passage of life” such as pregnancy, menopause,
adolescence, and aging. This means supplements can claim to improve mild memory loss
associated with aging, but can't claim to treat real dementia or Alzheimer’s disease. They can
claim to ease the mood swings associated with PMS, but not treat clinical depression. Clearly
this is a very fine line!
Supplements do not have to be manufactured according to any standards.
Regardless of whether or not a supplement actually does what it claims to do, you
might not be getting what you think you are. Products may or may not contain the
right amount of the active ingredient that was used in research studies showing a
positive effect. And, even if the product label states that it has the right amount, it

4. may actually contain much less or none at all. Contaminants that are not listed on
the lable may also be present.
Several independent labs are testing products' contents and finding that several don’t
contain what is stated on the label. One company, www.consumerlab.com, analyzes
several brands of supplements for quality and purity and reports its findings on its
web site. For instance, in October and November 2000, ConsumerLab.com purchased
and tested 21 leading brands of St. John’s Wort and found that 1/3 either did NOT
contain the stated amount of the active ingredients or were contaminated with
unacceptable levels of cadmium (a toxic heavy metal).
When herbs and other supplements are added to foods and beverages, it’s even less
likely that the right amount of the active ingredient is present. For example, to get one
herbal dose of Siberian ginseng from Sobe Green Tea, you would have to drink 13-20
bottles. Ginseng is expensive, so many manufacturers may not add a therapeutic
dose to their products.
What's a person to do?
Given the limitations described above, it’s hard for consumers to know what (if
anything) to take. If you do decide to take supplements, be smart about it.
· Consult with a qualified health provider to determine if a product is safe and
effective for you.
· Choose a product that is manufactured by a major company that also produces
pharmaceutic drugs (and/or sells directly to health professionals). It is more likely
that these companies have existing good manufacturing practices (GMPs) in place
to ensure top quality products.
· Visit www.consumerlab.com and select one of the brands that passed its
independent lab tests.
· Check out the recommended websites on dietary supplements for more advice on
what and how much to take.
Vitamins & Minerals
Do you need a supplement?
If you are a healthy individual who usually eats an optimal diet (with enough calories
and enough servings from all the food groups), it is possible for you to get everything
you need without a supplement. If you regularly eat a fortified breakfast cereal or
other fortified products (like sports bars or shakes), it’s even easier. Many of these
foods supply 30-100% of the Daily Value for many nutrients.
Read on to learn…

5. · How foods can meet all of your vitamin and mineral needs.
· Who may need to take a supplement.
· How to choose the right multi for you.
The Food Guide Pyramid: A great guide for assuring adequate nutrient intake
The Food Pyramid separates foods into 6 groups. Each group provides a distinct array
of different nutrients. Check it out…
· Grains: Supply lots of complex carbohydrates, fiber, some protein, plus B
vitamins 1, 2, and 3 (thiamin, riboflavin, and niacin), as well as the minerals
magnesium and iron.
· Vegetables and fruits: Supply carbohydrate, fiber, vitamins A and C, folate,
potassium, and magnesium. Green leafy vegetables are also good sources of
vitamin K, iron, and calcium.
· Milk products: Supply protein and carbohydrate, plus calcium, riboflavin,
vitamin B12 and (if they are fortified) vitamins A and D.
· Meat, poultry, fish, legumes/beans, eggs, and nuts: Supply protein,
phosphorus, vitamin B6 and 12, iron, zinc, magnesium, niacin, and thiamin.
· Vegetable Oils: Supply essential fatty acids and vitamin E.
Who might not be getting enough from each of these food groups?
There are many situations in which students might not be getting enough servings
from all of the food groups to meet their nutrient needs. Below are some examples:
· Students who are strict vegetarians.
· Students who are allergic or intolerant to certain foods (like milk or wheat).
· Students who are restricting their calorie intake to lose weight
· Students who are following a rigid fad diet that does not include certain foods or
food groups.
· Students who don’t choose an optimal diet on a regular basis.
In each of these cases, a supplement may be a good idea. The hard part is how to
choose the right one.

6. Ten tips for choosing a multi
So, you've decided to take vitamin and mineral supplements. How do you filter
through all the products out there and choose the best one (or ones) for you? Here are
some suggestions:
1. Keep it simple. Choose one single multi vs. many separate individual
tablets.
In general, nutrients are absorbed best from foods, in the presence of other nutrients
that favor their absorption. Taken in pure concentrated form, high amounts of
individual nutrients can interfere with the absorption of other nutrients. For example,
zinc hinders copper absorption, iron hinders zinc, calcium hinders iron, very high
levels of beta-carotene may interfere with the absorption of other disease-fighting
carotenoids, and so on.
The same it true of amino acid supplements. Amino acids compete with one another
for absorption. When you eat protein-rich foods, you consume all the amino acids
together in the right proportion. If you take high doses of single amino acids, however,
you may be interfering with the absorption of other amino acids and thus impairing
protein synthesis. That’s why it’s better to get nutrients from whole food sources
when possible.
To get the right proportion of different nutrients and to minimize adverse interactions,
choose one simple multi. You'll save yourself a lot of money and also the trouble of
having to remember to take lots of pills!
Look for a multi that contains both vitamins and minerals.
● Make sure it has 100% of the following ten vitamins and two minerals:
thiamin (vitamin B1)
riboflavin (vitamin B2)
niacin (vitamin B3)
pyridoxine (vitamin B6)
cobalamin (vitamin B12)
folic acid
vitamin C
vitamin D

7. vitamin E
zinc
copper
● It should also have at least 30% (25 mcg) of vitamin K, at least 120 mcg of
chromium, and 100 mg of magnesium.
● Women should look for a multi with 100% (18 mg) of iron.
● Men don’t need any extra iron and should look for a multi with 0 mg or no more
than 10 mg.
2. Avoid excesses. Choose a multi that supplies nutrients in amounts smaller
than, equal to, or very close to the recommended Daily Value (DV).
Remember, this is a supplement. You may already be getting close to (or more than)
100% of most vitamins and minerals from the foods in your diet. There is no need to
supplement with an additional 100% unless specifically recommended by a health
care professional.
Some students think that if a little of something is good, more must be better. This is
NOT TRUE! Megadoses of certain vitamins and most minerals are harmful and can
result in toxic reactions. It’s not possible to reach toxic doses through eating whole
foods. But it is definitely possible to reach toxic doses with supplements.
Check out the examples below:
· Too much B6 (which a lot of women might be taking for its purported PMS
benefits) can lead to neurological damage.
· Too much iron can impair calcium and zinc absorption, contribute to
constipation, may increase the risk for heart disease, and can be toxic for students
with hemochromatosis (a genetic defect that causes iron overload).
· Too much zinc (which a lot of students may take to fight off colds) may actually
depress immune function and lower the "good cholesterol" in your blood.
Some formulas may supply more than 100% DV of some nutrients. This is okay so
long as a daily dose does not exceed the upper limit (UL) for any nutrient. The UL is
the level above which toxic effects may occur. See From A to Zinc for a listing of all
the vitamins' and minerals' upper limits.
3. Consider a separate supplement for calcium if your diet is lacking.
Most multis don’t contain enough of this mineral because it is too big and bulky to fit
into a single pill.

8. Why is calcium so important?
Calcium is vital for maximizing your bone density. You only build bone up to the age
of about 25 years. After that, it stabilizes until around 40 and then starts to decline
(especially after menopause in women). If you don’t have much bone built up, you’re
at risk for significant losses that can lead to broken bones later in life.
How much calcium do you need?
● College students younger than 20 years old need 1300 mg /day.
● Adults 20-50 years old need 1000 mg /day.
● Adults over 50 need 1200 mg / day.
● Women who are not menstruating need 1500 mg. These women are at
especially high risk for bone loss because they are not producing as much
estrogen, a hormone which is vital for bone health. If you are a woman who has
not menstruated for 3 months or longer, consult a clinician in the Ashe Center's
Women’s Health Service immediately. You can schedule an appointment online
here.
How do you know if you're getting enough?
Each of the following foods provides about 300 mg (or 30% of the DV) for calcium.
1 cup (8 oz.) of milk, calcium fortified soy milk, or calcium fortified orange juice.
1 carton (6-8 oz.) of yogurt
1 ½ oz. of cheese
1 cup pudding, custard, or flan
6 sardines with bones (the bones contain calcium)
1 Power Bar (or other sports bar that provides about 30% DV)
1 cup Total cereal (or other breakfast cereal with about 30% DV)
How many servings of these foods do you usually eat each day?
NOTE: If you usually eat 3 or more of these foods every day (4 or more if you
are younger than 20 or older than 50), you're likely meeting your calcium
needs. You don't need a supplement. If you don't usually get this much, read
on...

9. Each of the following foods provides about 100 mg (or 10% of the DV) for calcium.
½ cup cottage cheese
½ cup cream soup
½ cup ice milk, frozen yogurt, or ice cream
1 cup dried beans or peas
2 oz. (1/2 can) canned fish with bones (salmon, mackerel)
½ cup tofu processed with calcium
¼ cup almonds
½ cup bok choy or turnip greens
1 cup broccoli, kale, or mustard greens
5 figs
2 corn tortillas
1 Tbsp. black strap molasses
2 Tbsp. nonfat cream cheese
How many servings of these foods do you usually eat each day?
If you are not meeting your need with food sources, it's a good idea to supplement
with the difference. For example, if you need 1000 mg and are only getting 700 mg,
you should supplement with the difference of 300 mg per day.
Calcium carbonate (which is in Tums, Caltrate, and Viactiv chews) or calcium citrate
(which is in Citracal) are generally good supplement sources. Avoid sources made
from bone meal, oyster shell, and dolomite, as they are more likely to be contaminated
with heavy metals from the manufacturing process.
Avoid taking more than 500 mg of calcium at one time, and avoid taking a calcium
supplement at the same time as a multi with iron. Calcium and iron interfere with
each other.
4. Consider higher doses of antioxidants from foods and/or a supplement.
What are antioxidants?

10. Antioxidants are substances that protect the body from oxidative damage (toxic
reactions with oxygen). Oxygen is vital to life, but at the same time, it has the
potential to cause a lot of damage in the body. Oxygen can react with cell membranes,
genetic material, and other body compounds to form very unstable molecules called
“free radicals.” Left unchecked, these free radicals exert a domino-like effect in the
body, as each reacts with other compounds to become more stable. Over time, high
amounts of oxidative damage may contribute to aging, heart disease, cancer, as well
as other degenerative diseases.
Antioxidants are protective because they get oxidized themselves so that the body's
cells and tissues are spared. In a way, antioxidants are like bodyguards; they jump in
front of the bullet to protect the person they are guarding from harm.
Our bodies have their own antioxidant defense systems to protect themselves from
the constant influx of oxygen we breathe everyday. These natural defense systems
may weaken with age or they may get stronger with regular physical activity. Certain
vitamins and minerals in our diet can also serve as antioxidants. For example,
vitamins C and E, beta-carotene, and selenium all protect our bodies from oxidative
damage.
How much of these substances offers optimal protection?
Some experts believe that antioxidants in higher amounts than the RDA
(Recommended Dietary Allowance) may be beneficial.
● Vitamin C RDA = 75 mg for women, 90 mg for men (an extra 35 mg if you
smoke); but several experts recommend 200-500 mg to saturate your body.
● Vitamin E RDA = about 30 IU; but several experts recommend 100-400 IU.
● Beta Carotene: There is no RDA or specific recommendation. However, the RDA
for vitamin A is 2300-3000 IU for women and men respectively, and beta carotene
can be converted to vitamin A in the body.
Should you supplement with these?
It’s actually fairly easy to get the higher amounts of beta carotene and vitamin C from
foods. Consider the following points:
· One 8 oz. glass of orange juice has about 100 mg vitamin C. Add just two more
½ cup servings of vitamin C-rich fruits and vegetables (like broccoli, sweet red bell
pepper, chili peppers, citrus fruits, kiwi, berries, or melon) and you’re at your goal
of 200-300 mg for the day.
· Just 3/4 cup cooked carrots provides 15,875 IU of beta carotene (which can be
converted to 2643 IU, or 100% of the RDA for vitamin A). Other deep orange,
yellow, or red colored fruits and vegetables and dark leafy greens are also rich
sources of beta carotene.

11. On the other hand, it’s much more difficult to get the higher amounts of vitamin E
from food sources alone.
· Vitamin E is found in high amounts in vegetable oils, nuts, seeds, and wheat
germ.
· But, you would have to consume 6 cups of canola oil or 3.5 cups of shelled
sunflower seeds to get 400 IU of vitamin E.
Bottom Line:
· It may be reasonable to take a separate vitamin E supplement (and vitamin C if
you are not eating several servings of fruit and vegetables every day).
· Don’t exceed the upper limit of 2000 mg for vitamin C or about 1200 IU for
vitamin E. Harmful effects can occur beyond these limits.
· Rely on food for beta carotene. Supplements of beta carotene have been linked
with increased risk of lung cancer in one recent study with smokers. High doses
may interfere with other disease-fighting carotenoids found in whole foods.
5. Look for a supplement with the USP lettering. These are usually the
cheaper, generic store-brands. Or consult www.consumerlab.com for a listing of
quality products.
Supplements may or may not be packaged in a capsule that will dissolve in your
body. In 1997, Tufts University tested a variety of supplements for dissolvability and
found that a few expensive, big name brands failed miserably. If a company puts
“USP” on its label, it is legally responsible to the FDA for meeting the standards set
forth by the United States Pharmacopeia.
The United States Pharmacopeia (USP) conducts a variety of tests on supplements to
ensure the following:
- Disintegration (how fast a tablet breaks down into small pieces or at least into a
mushy mass so that its ingredients can proceed to dissolve).
- Strength or potency, (whether the amount of the vitamin or mineral in the tablet
actually is the amount claimed on the label)
- Purity (the pill hasn’t degraded during production or been contaminated by
bacteria, heavy metal, or other undesirable substances).
NOTE: USP dissolution test does not apply to supplements that are sustained-release
or timed-release, only immediate release.

12. 6. Don’t be fooled by marketing ploys.
· Statements like “release-assured,” “laboratory-tested,” “quality and potency
guaranteed,” and “scientifically blended” carry little, if any, legal weight if not
accompanied by the USP seal.
· In most cases, “natural” vitamins are no better than synthetic. The one
exception is natural vitamin E (d-alpha tocopherol), which appears to be slightly
better retained and used by the body than synthetic E (dl-alpha tocopherol). By
contrast, folic acid (synthetic form) is more bioavailable than folate (the natural
form found in foods).
· In theory, chelated minerals may be better absorbed. Because they are sitting
inside an amino acid “claw,” they are protected from substances in foods that can
bind them. But, it may not be worth the extra cost. Chelated calcium, for
example, is absorbed 5-10% better than ordinary calcium, but it costs five times as
much.
7. Be sure to check the expiration date.
8. Take it on a full stomach.
· Some nutrients are better absorbed when your digestive tract is geared up to
handle food. Also, food slows the movement of the nutrients through the digestive
tract, allowing more time for them to dissolve and be absorbed.
· Unless your doctor or pharmacist says otherwise, it’s a good rule of thumb to
wait a few hours between taking any prescription medication and taking a multi,
since some nutrients could interfere with the drug, and vice versa.
9. Put your supplement in perspective.
Some students believe “I don’t need to worry about how I eat, I took my supplements
this morning.” Taking supplements does not make up for a lousy diet. Supplements
can’t cancel out the damaging effect of a fast food diet high in saturated fat and
sodium. And, they aren’t packaged with fiber and the disease-fighting phytochemicals
that only plant foods (like vegetables, fruits, whole grains, nuts and beans) provide. In
addition, they are not the magical cure to sleep deprivation, lack of exercise, and
excessive stress.
10. Aim to eat like the Food Pyramid and supplement a healthy lifestyle with
a multi.
Muscle Builders
You’re reading the latest issue of your favorite fitness magazine; and, cover-to-cover,
you see ads for all kinds of supplements promising to “erupt your anabolic drive,”
“dramatically increase protein synthesis,” and “pack on pounds of lean mass…fast!”

13. There’s always an impressive before-and-after shot, and you’re intrigued. But, do
these impressive ads have scientific muscle to back up their heavy claims?
Read on to learn…
· How much protein and amino acids you really need to build muscle.
· If creatine is the magic bullet it is claimed to be.
· Whether or not andro and other pro-hormone supplements offer safe and
effective alternatives to anabolic steroids.
· What are the keys to achieving optimal muscle strength and mass?
· Is there a genetic limit to how much muscle you can gain?
Protein & Amino Acids
Creatine
What is it?
Creatine is comprised of three amino acids: arginine, glycine, and methionine. It can
be made in the body (primarily by the kidneys, but also by the liver and pancreas to
some extent) from these amino acids. Because it can be made in the body, there is no
dietary requirement for it. We synthesize about 1 gm/day.
Creatine is also a naturally occurring compound found in beef, poultry, and fish. We
consume creatine in our diet from these food sources (about 1 gm/day). Vegetarians
who do not eat these animal foods tend to have lower creatine levels than meat eaters.
Once creatine is taken up by the muscle, it can combine with phosphate, forming
creatine phosphate (CP). CP is a high energy compound stored in muscle that is used
during very short, very intense power activities which last only 2-30 seconds (like
weight lifting, sprinting, swinging a baseball bat, or slam-dunking a basketball). It's
claimed that taking creatine supplements will help you train harder and achieve
greater gains in muscular strength and size.
Does it work?
There is convincing evidence that creatine supplementation enhances recovery, and
thus improves performance, during repeated bouts of very intense power activities.
The physiological basis for creatine supplementation is similar to that of carbohydrate-
loading routinely practiced by endurance athletes (like long-distance runners and
cyclists). While carbohydrate loading increases stores of muscle glycogen (which
provides energy during endurance events), creatine supplementation increases stores
of CP (which provides energy during short bursts of high intensity exercise).
Supplementation with creatine has been shown to increase muscle CP stores by

14. approximately 20%. Because of increased stores, CP is less rapidly depleted and you
are able to maintain your high-energy performance longer during repeated bouts of
high intensity activity.
A common side effect of short-term creatine supplementation is increased body weight
(1.5-4.5 lb.). This is probably due to water retention (since water travels along with
creatine into muscles). But, over the long term, there may also be some increase in
protein synthesis and muscle mass due to increased training capacity. Because of the
fluid shifts that occur with creatine supplementation, it's important to drink plenty of
fluids while taking it. Click here for more tips on sensible creatine supplementation.
Should you add creatine to your training plan?
While there is good evidence supporting the positive effects of creatine, it's important
to remember that it's no magic bullet. Hard training, combined with adequate calories
from whole foods, is what builds muscle. Creatine supplements just give you a little
extra edge by maximizing your muscle CP stores, helping in recovery between sets,
and allowing you to keep training at a higher intensity.
It works best in people who have marginal creatine stores in their muscles (like
vegetarians). If you include a lot of meat, chicken, and fish in your diet, which most
power athletes do, your muscles are probably already saturated with creatine, and you
may see only minimal gains with supplementation. The average concentration of
creatine in muscle is approximately 120 mmol/kg and ranges from 90 to 160
mmol/kg. You cannot supersaturate creatine muscle stores above this level. Once
muscle capacity is reached, excess creatine taken from supplements is simply excreted
in the urine.
Is it safe?
This is an important question to ask yourself before taking any dietary supplement.
As for creatine, here's what we know about its safety:
· Taking supplements may suppress your body’s own creatine synthesis, but this
reverses when you stop taking it.
· Anecdotal information from athletic trainers suggests a relationship between
creatine supplements and muscle cramps, muscle spasms, and even pulled
muscles (possibly due to water retention, dehydration, or over-training), but this
has not been seen in scientific studies.
· Research studies done in the United States have only been short term (4 days to
two months), so the long term safety of taking creatine is unknown.
· There are increasing concerns about possible kidney stress and liver damage
with supplementation. In one case report, a 20 year old healthy man developed
acute nephritis (inflammation of the kidneys) after supplementing with 20 g of
creatine daily for four weeks. This exceeds the recommended dosage of 20 g for 5
days, followed by a maintenance dose of 3 g daily. People with pre-existing kidney

15. conditions, family history of kidney disease, and others who are at high risk (such
as people with diabetes) should avoid creatine supplements.
· Because long term safety data is not available, creatine can no longer be
distributed to athletes in the NCAA (National Collegiate Athletic Association). But,
unlike many other muscle builders, it is not a banned substance in the athletic
world.
· It is expensive and the benefits may not be worth it.
If you decide to try it, be sensible!
Manufacturers typically recommend a loading phase followed by a maintenance
phase. In the loading phase, the optimal amount required to increase creatine stores
to their maximal level is about 20 g/day for 5 days. To get 20 g of creatine from food,
you would have to eat about 10 pounds of steak! The 20 g should be divided into four,
5 g doses and taken every 3 to 4 waking hours. In the maintenance phase, one daily
dose of about 3 g is typically sufficient to maintain elevated levels of creatine in
muscle.
Don’t bother taking more than these recommended doses. Once your muscles are
loaded up, the excess creatine will just be excreted in your urine. And, more
importantly, the excess creatine in your body may cause damage to your liver or
kidneys.
Other tips for safe and effective creatine supplementation:
· Take each dose with food or beverage--preferably a carbohydrate-rich item that
has a high glycemic index (or high blood sugar response) plus some protein--to
enhance its uptake into muscle.
· Drink plenty of water (especially during the loading phase) to avoid dehydration,
prevent muscle cramping, and minimize any potential damage to your kidneys.
Remember, as muscle retains the ingested creatine, fluid is retained with it. This
leaves less fluid available for the other vital functions it serves in the body, such as
body temperature regulation (through sweating), particularly when exercising in
hot, humid conditions.
· Monitor your individual response. If you don't see any positive effects within a
few weeks (or if you experience any negative effects at all), stop taking it.
· Since we don't know the consequences of long-term supplementation, it's
probably a good idea to cycle on and off. In other words, take it for a few weeks or
months and then take a break for a few weeks or months.
· Don’t worry about a skipped dose. It takes 4 weeks for muscular creatine levels
to return to normal after supplementation stops.

16. Can Supplements Overcome Your Genes?
Dietary supplements are a multi-billion dollar industry that feeds on people's false
hopes and desperate efforts to achieve something that, for most people, is an
unrealistic body ideal. The amount of muscle you can put on and the amount of body
fat you can lose is restricted to a great extent by your genetics and your body type.
Further, to maximize what you CAN achieve (given the constraints of your genes) takes a lot of
work! It’s not as simple as just taking a supplement. To achieve your personal best requires a
balanced eating plan and a consistent physical activity program. It takes time, patience, and
effort to develop and implement these two things.
The models you see in fitness magazine ads didn’t get there by just taking the
supplements they are promoting. They got there with a combination of 1) genetic
endowment, 2) a very rigid eating plan (often unhealthfully rigid), 3) hours of hard
training every day (they probably are not students at UCLA if they have that much free
time), and in many cases 4) illegal anabolic steroids and/or surgical procedures like
liposuction and breast enhancement.
Consider this male model who is HUGE, weighing in at 250 lb, but is completely
shredded with only 3% body fat!
With this very low level of body fat, this much muscle mass is not possible to obtain
naturally without the help of illegal, dangerous anabolic steroids. There is a
physiological limit to how much lean muscle mass a man’s frame can hold, given a
certain percentage of body fat. In order for him to gain more lean muscle mass, he
would have to also gain more fat mass. Most men simply cannot be that BIG and be
that LEAN naturally.
Consider this female model, who is super lean, with only 12% body fat, but has
HUGE breasts. With this very low level of body fat, this much breast tissue is not
possible. After all breasts are made of fat!
The supplement industry is making lots of money; while consumers are getting more
and more obsessed about their weights, diets, and exercise regimens and more and
more frustrated, depressed, and angry because they are not able to achieve the
stunning results displayed in the ads. Worse yet, hundreds of thousands of
consumers are putting themselves at risk, conducting a large-scale experiment on
themselves with supplements that have questionable long-term safety.
Consider putting your time, energy, and money in better places. Attend a free nutrition
workshop through the Ashe Center, invest in a fitness pass or a couple of sessions with a
personal trainer through the Wooden Center, buy a new outfit that highlights your best
features. You’ll feel better and look better too!