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Ergogenic Aids - Dietary SupplementsErgogenic Aids - Dietary Supplements
Assembled by the Assembled by the
IHSA Sports Medicine Advisory IHSA Sports Medicine Advisory CommitteeCommittee
Ergogenic AidsErgogenic Aids
Any substance taken to enhance athletic Any substance taken to enhance athletic performance.performance.
These substances include dietary These substances include dietary supplements which may be legal or illegal.supplements which may be legal or illegal.
Dietary SupplementsDietary Supplements
Products intended to supplement the diet Products intended to supplement the diet that contain at least one dietary ingredient that contain at least one dietary ingredient to include:to include:– Vitamins Vitamins – MineralsMinerals– Herbs or other botanicalsHerbs or other botanicals– Amino acidsAmino acids– and substances such as enzymes, organ and substances such as enzymes, organ
tissues, glandulars, and metabolitestissues, glandulars, and metabolites
Dietary SupplementsDietary Supplements
These products are taken by mouth.These products are taken by mouth.
These products are found in many forms These products are found in many forms to include: to include: – TabletsTablets– CapsulesCapsules– SoftgelsSoftgels– GelcapsGelcaps– LiquidsLiquids– Powders Powders – BarsBars
Dietary Supplement Health and Dietary Supplement Health and Education Act 1994Education Act 1994
As a result of this act,dietary supplements As a result of this act,dietary supplements are no longer regulated as foods and are are no longer regulated as foods and are not subject to pre-market safety not subject to pre-market safety evaluations.evaluations.
Dietary Supplement Health and Dietary Supplement Health and Education Act 1994Education Act 1994
The product must be labeled as a dietary The product must be labeled as a dietary supplement.supplement.
Information on the product label must not Information on the product label must not represent the product as a conventional represent the product as a conventional food or a sole item of a meal or diet.food or a sole item of a meal or diet.
Dietary Supplement Health and Dietary Supplement Health and Education Act 1994Education Act 1994
Allows for product labeling claims as long Allows for product labeling claims as long as it does not diagnose, prevent, treat or as it does not diagnose, prevent, treat or cure a specific disease.cure a specific disease.
While the statements must be truthful and While the statements must be truthful and not misleading, there is not a not misleading, there is not a review/approval process by the FDA. review/approval process by the FDA.
Dietary Supplement Health and Dietary Supplement Health and Education Act 1994Education Act 1994
The manufacturer is responsible to ensure The manufacturer is responsible to ensure the product is safe.the product is safe.
Manufacturers/distributors are not Manufacturers/distributors are not required to record, investigate or forward required to record, investigate or forward to the FDA any reports of injuries or to the FDA any reports of injuries or illnesses that may be related to use of illnesses that may be related to use of their product.their product.
Anabolic Steroid Control Act of Anabolic Steroid Control Act of 20042004
Expands the definition of anabolic steroids Expands the definition of anabolic steroids to include any drug or hormonal to include any drug or hormonal substance, chemically and substance, chemically and pharmacologically related to testosterone. pharmacologically related to testosterone. (other than estrogens, progestins, (other than estrogens, progestins, corticosteroids, and corticosteroids, and dehydroepiandrosterone) dehydroepiandrosterone)
This includes androstenediol and This includes androstenediol and androstenedione.androstenedione.
General ConcernsGeneral Concerns
Without regulatory control there is a buyer Without regulatory control there is a buyer beware marketbeware market– Dietary supplement advertisements can Dietary supplement advertisements can
be misleading and deceptivebe misleading and deceptive– Claims of effectiveness may not be Claims of effectiveness may not be
crediblecredible– The concentration and quality of active The concentration and quality of active
ingredients can differ from product to ingredients can differ from product to productproduct
Green, 2001; Geyer, 2004Green, 2001; Geyer, 2004
Analysis of Dietary SupplementsAnalysis of Dietary Supplements
Study of 12 brandsStudy of 12 brands– 11/12 contained <90% or >110% of amount 11/12 contained <90% or >110% of amount
listed on labellisted on label– 5/12 contained at least one ingredient not 5/12 contained at least one ingredient not
listed on labellisted on label– 2/12 were missing at least one ingredient 2/12 were missing at least one ingredient listed listed
on labelon label
Study of 240 supplementsStudy of 240 supplements– 18.8% contained steroids or pro-hormones not 18.8% contained steroids or pro-hormones not
listed on labellisted on label
General ConcernsGeneral Concerns
Dietary supplements may adversely Dietary supplements may adversely interact with each other as well as interact with each other as well as prescription medications.prescription medications.
Dietary supplements are often utilized as a Dietary supplements are often utilized as a short cut to optimal nutritional practices. short cut to optimal nutritional practices.
Research ConcernsResearch Concerns
There is a lack of quality peer reviewed There is a lack of quality peer reviewed research on human subjects.research on human subjects.
The high dosages, utilized by athletes, The high dosages, utilized by athletes, have not been well studied.have not been well studied.
The long term side effects are not well The long term side effects are not well studied, if at all. studied, if at all.
Research has not been equally completed Research has not been equally completed on men, women and adolescents. on men, women and adolescents.
ProteinProtein
Background:Background:– Proteins are linked amino acids that Proteins are linked amino acids that
occur naturally in foodsoccur naturally in foods– Example foods that contain protein Example foods that contain protein
include: meats, fish, poultry, milk, include: meats, fish, poultry, milk, soybeanssoybeans
– Protein supplementation can include: Protein supplementation can include: powders, shakes and barspowders, shakes and bars
ProteinProtein
Claims include: Claims include: – Improved muscle growth and functionImproved muscle growth and function
Increased weight gainIncreased weight gain
Increased lean muscle massIncreased lean muscle mass
Increased strength/powerIncreased strength/power
ProteinProtein
Potential side effects:Potential side effects:– High protein intake may displace High protein intake may displace
carbohydrate in the diet possibly carbohydrate in the diet possibly affecting performanceaffecting performance
– Increased urinary calcium lossIncreased urinary calcium loss– Contribute to dehydrationContribute to dehydration– Due to the stress on the kidneys, Due to the stress on the kidneys,
individuals with kidney disease should individuals with kidney disease should avoid high protein dietsavoid high protein diets
ProteinProtein
Research findings:Research findings:– The protein requirement in athletes is The protein requirement in athletes is
higher than non-athletes.higher than non-athletes.– Most research studies do not support Most research studies do not support
supplementation as having a positive supplementation as having a positive effect on muscle size and function.effect on muscle size and function.
– Research may be affected by the fact Research may be affected by the fact that most athletes consume levels of that most athletes consume levels of protein that exceed recommended protein that exceed recommended amounts.amounts.
ProteinProtein
Legal status:Legal status:– Is a legal substanceIs a legal substance– Is not banned by sports governing Is not banned by sports governing
bodiesbodies
CreatineCreatine
Background:Background:– Naturally occurring compound derived Naturally occurring compound derived
from amino acids from amino acids – Found in meat and fish Found in meat and fish – Creatine supplementation can include: Creatine supplementation can include:
powder, candy gum, tablets and gelpowder, candy gum, tablets and gel
CreatineCreatine
Claims include:Claims include:– Increase lean body massIncrease lean body mass– Increase maximal energy Increase maximal energy
production/performance (short duration production/performance (short duration high intensity exercises – example high intensity exercises – example sprints)sprints)
– Delayed fatigue in workouts/competitionDelayed fatigue in workouts/competition– Improved recovery after Improved recovery after
workouts/competitionworkouts/competition
CreatineCreatine
Potential side effects:Potential side effects:– Increased body weight Increased body weight
Suspected to be from water weight Suspected to be from water weight – Gastrointestinal upsetGastrointestinal upset
Upset stomachUpset stomach
DiarrheaDiarrhea
NauseaNausea– Muscle cramping and strainsMuscle cramping and strains
CreatineCreatine
Potential side effects:Potential side effects:– DehydrationDehydration– Possible kidney effects/overloadPossible kidney effects/overload
CreatineCreatineResearch findings:Research findings:– Research is not unanimous; however, creatine Research is not unanimous; however, creatine
appears to be beneficial in short duration high appears to be beneficial in short duration high intensity exercise (sprints/football/volleyball)intensity exercise (sprints/football/volleyball)
– Has not been found to benefit aerobic exercise Has not been found to benefit aerobic exercise or oxygen carrying capacity (endurance or oxygen carrying capacity (endurance activities – example 800/1600 meter run)activities – example 800/1600 meter run)
– People with low to normal creatine stores People with low to normal creatine stores
respond better with supplementation than respond better with supplementation than those with normal to high storesthose with normal to high stores
CreatineCreatine
Legal status:Legal status:– Is a legal substanceIs a legal substance– Is not banned by sports governing Is not banned by sports governing
bodiesbodies
HMBHMB
Background:Background:– HMB is derived in the breakdown of the HMB is derived in the breakdown of the
essential amino acid leucineessential amino acid leucine– Found in some foods such as citrus fruit Found in some foods such as citrus fruit
and catfishand catfish– HMB is not an essential nutrientHMB is not an essential nutrient– The function of HMB is not fully The function of HMB is not fully
understoodunderstood
Thought to limit protein breakdown Thought to limit protein breakdown during activityduring activity
HMBHMB
Claims Include:Claims Include:– Increased muscle massIncreased muscle mass
Increased strengthIncreased strength– Enhancement of physical appearance Enhancement of physical appearance
HMBHMB
Potential Side Effects:Potential Side Effects:– There does not appear to be any side There does not appear to be any side
effects with short tem utilization of HMBeffects with short tem utilization of HMB– There is limited research on the side There is limited research on the side
effects of HMBeffects of HMB
HMBHMB
Research Findings:Research Findings:– Research is limited Research is limited – HMB supplementation may limit HMB supplementation may limit
exercise induced muscle exercise induced muscle damage/protein breakdown.damage/protein breakdown.
– While there has been some While there has been some improvement in strength and body improvement in strength and body composition the data is limited and composition the data is limited and further research is needed to determine further research is needed to determine any ergogenic benefit of HMB.any ergogenic benefit of HMB.
HMBHMB
Legal Status:Legal Status:– Is a legal substanceIs a legal substance
Androstenedione - DHEAAndrostenedione - DHEA
Background:Background:– Weak anabolic-androgenic steroid Weak anabolic-androgenic steroid
hormones produced by the gonads and hormones produced by the gonads and adrenal glands adrenal glands
– Is a precursor to testosteroneIs a precursor to testosterone– Used by athletes based on the Used by athletes based on the
effectiveness of testosteroneeffectiveness of testosterone
Androstenedione - DHEAAndrostenedione - DHEA
Claims include:Claims include:– Increase muscle size/massIncrease muscle size/mass– Increase lean body massIncrease lean body mass– Increase muscle strength Increase muscle strength
Androstenedione - DHEAAndrostenedione - DHEA
Potential side effects:Potential side effects:– Dependent on the dosage and Dependent on the dosage and
testosterone levels the potential side testosterone levels the potential side effects are the same as anabolic-effects are the same as anabolic-androgenic steroidsandrogenic steroids
Androstenedione - DHEAAndrostenedione - DHEA
Potential side effects: Potential side effects: – Due to increased estrogen levels males Due to increased estrogen levels males
are associated with gynecomastia are associated with gynecomastia (breast become bigger) as well as other (breast become bigger) as well as other feminizing side effectsfeminizing side effects
– Increased cardiovascular disease Increased cardiovascular disease riskrisk
– Liver damage/cancerLiver damage/cancer
Androstenedione - DHEAAndrostenedione - DHEA
Potential side effects:Potential side effects:– Women risk virilization (male Women risk virilization (male
secondary sex characteristics)secondary sex characteristics)– Children have been associated with Children have been associated with
premature growth plate closure premature growth plate closure leading to diminished height as well leading to diminished height as well as virilization (male secondary sex as virilization (male secondary sex characteristics)characteristics)
Androstenedione - DHEAAndrostenedione - DHEA
Research Findings:Research Findings:– Do not support the notion that Do not support the notion that
testosterone concentration increased testosterone concentration increased with supplementation with supplementation
– Not shown to increase muscle Not shown to increase muscle size/strength or be an ergogenic aid size/strength or be an ergogenic aid
Androstendione - DHEAAndrostendione - DHEA
Legal Status: AndrostenedioneLegal Status: Androstenedione– Is a illegal substanceIs a illegal substance
Legal status: DHEALegal status: DHEA– Is a legal substanceIs a legal substance– Is banned by the IOC, NCAA, Is banned by the IOC, NCAA,
USCO/USADAUSCO/USADA
Dietary SupplementsDietary SupplementsThis presentation highlights only a few of the This presentation highlights only a few of the several dietary supplements available.several dietary supplements available.
Remember quality research is lacking on the Remember quality research is lacking on the effectiveness and side effects of dietary effectiveness and side effects of dietary supplements.supplements.
As shown, utilization of dietary supplements is a As shown, utilization of dietary supplements is a buyer beware market as you are not guaranteed buyer beware market as you are not guaranteed to get the ingredients that you purchased or you to get the ingredients that you purchased or you may get ingredients that you do not want.may get ingredients that you do not want.
Alternatives to SupplementationAlternatives to Supplementation
Appropriate diet and nutritional practices.Appropriate diet and nutritional practices.
Appropriate weight training and Appropriate weight training and conditioning.conditioning.
Appropriate rest and recovery.Appropriate rest and recovery.
Appropriate goal setting.Appropriate goal setting.
Reliable resourcesReliable resources
National Institute on Drug Abuse National Institute on Drug Abuse www.nida.nih.govwww.nida.nih.govNational Center for Drug-Free Sport National Center for Drug-Free Sport www.drugfreesport.comwww.drugfreesport.comWorld Anti-Doping Agency World Anti-Doping Agency www.wada-ama.orgwww.wada-ama.orgInternational Olympic Committee (IOC) International Olympic Committee (IOC) www.olympic.orgwww.olympic.orgNational Collegiate Athletic Association (NCAA) National Collegiate Athletic Association (NCAA) www.ncaa.orgwww.ncaa.orgTaylor Hooten Foundation Taylor Hooten Foundation www.taylorhooten.orgwww.taylorhooten.orgFDA Center for Food Safety and Applied Nutrition FDA Center for Food Safety and Applied Nutrition www.cfsan.fda.govwww.cfsan.fda.govNIH Office of Dietary Supplements NIH Office of Dietary Supplements www.ods.od.nih.govwww.ods.od.nih.govNational Center for Complementary & Alternative Medicine National Center for Complementary & Alternative Medicine www.nccam.nih.govwww.nccam.nih.govTufts Nutrition Navigator (Critical review of supplement web Tufts Nutrition Navigator (Critical review of supplement web sites) sites) www.navigator.tufts.eduwww.navigator.tufts.eduUnited States Anti-Doping Agency United States Anti-Doping Agency www.usantidoping.org/www.usantidoping.org/