SUPPLEMENTS & ERGOGENICS

Lona Sandon, M.Ed., R.D., L.D.Assistant Professor

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 A concentrate or combination of above

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 DOPING

Unaware 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

ANABOLICS

Increase ability to build muscle tissue Examples

Testosterone Anabolic-androgenic hormones Growth hormone – HGH HMB (Beta-hydroxy-beta-methyl butyrate)

Leucine metabolite Anticatabolic, minimize PRO breakdown Appears safe & effective at dose of 3 g/d

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 amino acids

Caffeine Coenzyme Q10 Energy bars Energy gels Ginseng Glycerol

L-carnitine Medium-chain

triglycerides (MCT) Pyruvate Sodium/electrolyte

tablets Sports beverages

NUTRITIONAL ERGOGENICS USED BY STRENGTH/POWER ATHLETES

Chromium Creatine Conjugated

linoleic acid Growth hormone Anabolic steroids

Protein powders Protein bars Medium-chain

triglycerides Beta-hydroxy-

beta-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 Supplementshttp://ods.od.nih.gov/

US Pharmacopeia http://www.usp.org/

Consumer Labshttp://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!

REFERENCES

Fink HH, Burgoon LA, Mikesky AE, eds. Practical Applications in Sports Nutrition. Sudbury, MA: Jones and Bartlett; 2012

Dunford 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.