Chapter 27:

Ergogenic Aids and the Female Athlete

Jacalyn J. Robert-McComb, Ph.D., FACSM

Shannon L. Jordan, M.S.

Texas Tech University

Health, Exercise, & Sports Science

Learning Objectives

Discuss potential reasons female athletes take supplements

Highlight likely supplements female athletes take

Describe the ergogenic and ergolytic effects of these supplements

Discuss standard dosages

What is an Ergogenic Aid and Why Do Women Take Them?

Ergogenic aids are items or substances which enhance performance.

Collegiate female athletes report taking supplements for the following reasons:

to improve health; to compensate for an inadequate diet; and to gain more energy.

According to Kristiansen, et al. (2005) and Froiland, et al. (2004), Female athletes use energy drinks and Female athletes use energy drinks and

carbohydrate/meal replacement products the carbohydrate/meal replacement products the most. most.

Protein products, amino acids, creatine, fat Protein products, amino acids, creatine, fat burners, caffeine, multivitamins, iron, and burners, caffeine, multivitamins, iron, and calcium are some of the most frequently calcium are some of the most frequently used products. used products.

Protein and Amino Acids

Most common forms:

Powders

Bars

Meal Replacers

Amino Acids

Listed Reasons Why Females Take Protein Supplements (Kristiansen, 2005)

For enhanced recovery

The taste

To provide Energy

To meet nutritional needs

For enhanced performance

To develop greater muscle strength

‘I Don’t Know’

Forms of ProteinSoy Protein vs. Milk Protein

Soy protein

Lacks the essential amino acids, lysine, and methionine; also contains less branch chained amino acids than milk proteins.

Milk protein

Casein protein is a milk protein as is whey protein.

Net protein synthesis is higher with casein protein than with soy protein.

Casein protein has a higher biological value because the slow release property keeps the amino acids from being released rapidly and degraded in the liver into urea (Luiking, Deutz, Jake, et al., 2005).

Whey protein is considered rapid release when compared to Casein (slow release preferred).

Glutamine

Commonly a component of weight-gain products (a small % of female athletes take this supplement).

Claims:

Enhance protein Synthesis

Offset immunosuppression

However, no long term studies substantiating these claims or ruling out adverse effects

CarnitineSynthesized from lysine and methionine.

Most healthy humans synthesize carnitine

Athletes take L-Carnitine for:

Weight loss purposes

Increased muscle mass

Enhanced β-oxidation

Enhanced recovery from high intensity

exercise.

L-Carnitine (an isomer )Findings

Effective weight loss agent for obese subjects, however, findings were inconclusive for non-obese subjects (Karlic & Lohninger, 2004).

Research findings have shown that athletes who have taken L-carnitine to enhance recovery from exercise have :

Decreased creatine kinase

Decreased Catabolism of purines

Decreased free radical formation

Decreased reported muscle soreness

L-Carnitine Dosage

Available as a prescription or OTC

Daily recommendations are 2-3.5g/d

Amounts in excess of 4g/d may result in gastric distress

A lethal dose (LD) of 630g/d for humans has been determined from animal studies (Calfee & Lohniger, 2004)

CreatineComposed of:

Arginine (non-essential amino acid)

Glycine (non-essential amino acid)

Methionine (essential amino acid)

Average Daily Requirement is 2g/d.

Body produces 1-2g/d.

Best sources of dietary creatine are meat and fish

Vegetarian athletes may have lower muscle creatine stores.

Fat Burners and Energy Supplements

The following supplements will be highlighted:

Chinese Ginseng

Siberian Ginseng

Ephedra (Ma Huang)

Bitter Orange

Caffeine

Creatine Supplementation Benefits

And Recommended DosageOptimum usage is for sports with a high percentage of ATP-PC system utilization.

No effects have been found on submaximal efforts

No effects have been found for aerobic endurance activities

Dosage

Loading phase: 5g/d, 4 X’s/d up to 7 days

Maintenance phase: 2g/d for 3 months

Increases muscle creatine stores 10-25%

When creatine is taken with carbohydrates absorption is enhanced.

When creatine is taken with caffeine absorption is inhibited.

GinsengReported Benefits:

Improved Mood

Improve Performance

Increase Alertness

Increase Fat Utilization

Two Main Types of Ginseng:

Chinese Ginseng (Panax ginseng)

Siberian Ginseng (Eleutherococcus ginseng)

Chinese GinsengReported Benefits (Bucci, 2000; Winterstein & Storrs, 2001)

Improves Strength

Improves aerobic capacity

Requires at least 8 weeks of supplementation with athletic training to see benefits.

Recommended Dosage:

1-2g/d

Varies based on powder vs. root extract

Chinese GinsengReported Side Effects (Bucci, 2000; Winterstein & Storrs, 2001):

Sleeplessness

Nervousness

Hypertension

Dermatological problems

Morning diarrhea

Euphoria

Rx Drug Interactions:

Phenelzine (A monoamine oxidase inhibitor)

Siberian Ginseng

Distant relative to Chinese ginseng

Contains different compounds than Chinese ginseng

Previous studies were not conducted well and are unreliable

The few well-designed studies have failed to show an ergogenic benefit (Winterstein & Storrs, 2001).

EphedraContains ephedrine and other alkaloids

Sympathomimetic

α and β-agonistic properties

Facilitates catecholamine release

Stimulates the CNS

Uses:

Energy Booster

Fat Burner

Athletic Performance Booster

Ephedra

Also called Ma Huang

Studies often pair ephedra with caffeine

Legality of ephedra is still being determined

May be banned by various athletic governing bodies

Ephedra Research Findings

Many studies also involve caffeine, therefore, the effects due to ephedra are hard to separate from caffeine (Shekelle, et al. 2003).

Studies without caffeine do not support the claim of enhanced athletic performance (Calfee, 2006; Bucci, 2000)

Claims of weight loss have been substantiated, although many of those studies also contained caffeine (Powers, 2001; Shekelle, et al., 2003).

Side Effects of Ephedra (Calfee, 2006; Powers, 2001; Shekelle, et al., 2003 ; Winterstein & Storrs, 2001).

Headache

Tremors

Hypertension

Arrhythmias

Insomnia

Nervousness

Increased heart rate

Note: It has also linked to several deaths!

Bitter Orange: A Replacement for Ephedra

Citrus aurantium

Common ingredient in many “Ephedra Free” fat burners

Contains synephrine

Similar effects as ephedra

Commonly paired with caffeine (Bucci, 2000)

CaffeineVarsity female athletes listed these reasons for taking caffeine:

Enhanced Performance

More Energy

Increased alertness

Taste

Listed forms Taken:

Beverages

Tablets

Energy Bars, Drinks, and Gels

Chocolate

Caffeine: Mode of Action (Graham, 2003)

Chemical structure resembles adenosine

Binds to adenosine receptors

Stimulates release of epinephrine

Direct mode of action on muscle function

•Causes sarcoplasmic reticulum to release more calcium

Caffeine has been reported to:

Enhance β-oxidation

Spare Muscle Glycogen

Sustain Muscle Force Longer

Caffeine and Performance

High Intensity Exercise (Doherty, et al., 2004):

Lower Perceived Exertion

Increased Glycolytic Performance*

Increased Blood Lactate*

* Not all studies have shown increased performance in glycolytic activities and blood lactate (Greer et al., 1998)

Endurance Exercise:

Main concept id that of fatty acid moblization and glycogen sparing

Prolongs Endurance Exercise **

** Mechanism behinds enhanced endurance performance not completely understood

Caffeine: Adverse Effects

Mild Diuretic

Dehydration not likely if athlete is properly hydrating

Tachycardia with Exercise

Increased Blood Pressure

Gastrointestinal Distress

Habituation/Addiction

There are also effects when discontinuing use:

Headache

Fatigue

Possible Flu-like Symptoms

(Ghram, 2 001; Mangus & Trowbridge, 2005)

Caffeine: Dosage

Caffeine paired with ephedra is potentially harmful and should be avoided (Powers, 2001; Mangus & Trowbridge, 2005 ).

Dosage:

Endurance Exercise:

3-5mg/kg

Since most beverages are variable in the amounts contained, tablets are probably the most effective method.

Anabolic-androgenic Steroids (AAS)

AAS are synthetic derivatives of testosterone.

Adolescent female usage is estimated between 2-5% (Congeni & Miller, 2002; Faigenbaum et al., 1998).

Collegiate use may be higher (Evans, 2004)

Women typically have <10% the amount of testosterone of men (Evans, 2004).

Testosterone and AAS bind to androgen receptors inside the cytoplasm and are transported to the nucleus.

This leads to an increase of structural and contractile proteins.

(Congeni & Miller, 2002; Calfee & Fadale, 2006; Evans, 2004)

AAS: Ergogenic Effects

Anabolism

Anti-catabolism

Aggression

May lead to more intense training

Gains:

Muscle Hypertrophy

Strength Gains

Lean body Mass Increases(Congeni & Miller, 2002; Tokish, et al., 2004)

AAS: Adverse Effects

Virilizing Effects:

Hirsutism

Voice Deepening

Male-pattern Baldness

Enlargement of the Clitoris

Menstrual Irregularities

Reduced Breast Size

Continued…………

AAS: Adverse Effects Continued

Increased Blood Pressure

Left Ventricular Hypertrophy

Decreased HDL

Hepatic Abnormalities

Dermatological Problems

Psychological Effects

Mood swings

Aggression

Note: Some of these effects are irreversible! The adverse effects far outweigh the benefits for women (Congeni & Miller, 2002; Calfee & Fadale, 2006; Evans, 2004)

AAS: Withdrawal Symptoms and other Repercussions

Withdrawal Symptoms:

Depression and Anger (Congeni & Miller, 2002; Calfee & Fadale, 2006)

Injection Related Complications:

Inflammation from repeated use of injection site

Bacterial Infections

Infectious Diseases

Hepatitis B and C

HIV (Calfee & Fadale, 2006; Evans, 2004)

Multivitamins

Female athletes stated these reasons for taking multivitamins:

Meet Nutritional Needs

Boost Immune System

Boost Energy

Increased Alertness

Habit From Childhood

(Kristiansen, et al., 2005; Froiland, et al., 2004)

Many multivitamins marketed as performance vitamins include other herbal supplements.

Athletes, trainers, coaches, and medical Professionals need to be aware of the extra ingredients in the OTC (over the counter) multivitamins since multivitamins are not subject to FDA regulation.

Iron

Women in general tend to have more iron deficiency issues than men.

Possible causes of iron deficiency:

Underestimated Menstrual Blood Loss

Inadequate Dietary Intake

Increased Loss from Sweat

Gastrointestinal Blood Loss in Runners

Even slight anemia will negatively impact performance!

(Beard & Tobin , 2001; Nielsen & Nachtigall, 1998)

Iron Supplementation

Forms of Iron:

Different forms are absorbed differently

OTC products are unregulated

A Rx Multivitamin with Iron may be the appropriate route for a female athlete with an iron deficiency.

Athletic Performance has not been improved by supplementing non-anemic athletes with iron

Side Effects of Supplementing with Normal Ferritin Levels:

Gastrointestinal Distress

Constipation(Beard & Tobin , 2001; Nielsen & Nachtigall, 1998)

Calcium

Female athletes stated these reasons for taking calcium:

Strengthen Bones

Lactose Intolerance

Low Dietary Intake

Dietary protein should be monitored relative to calcium.

(Kristiansen, et al., 2005; Froiland, et al., 2004)

Calcium: Protein Ratio

Increased dietary protein may lower urinary pH and increase calcium excretion (Barzel & Massey, 1998).

Increased calcium intake can offset the elevated calcium losses (Dawson-hughes, 2003)

20:1 is the typical recommended ratio for a middle-aged woman (Heaney, 1998).

An athlete’s need may be different due to an increased protein consumption to maintain a positive nitrogen balance.

Use of the dietary journal is key to assess nutritional consumption information.

Summary

Many times athletes do not understand supplements, regulations, or how to read the labels on these supplements.

OTC supplements are unregulated by the FDA and the product may be adulterated with products not listed on the label, some of which may be banned by athletic governing bodies.

Athletes, coaches, trainers, and medical professionals should be well versed on brands, supplements, and regulations before recommending use of a product.

Always check the rules of your particular governing body for legality of the supplement in question!