Dietary Supplements:Hype or helpful?

Jeff Godin, Ph.D., CSCS, HFPD, CISSNFitchburg State College

Department of Exercise and Sport Science

Objectives

• Define dietary supplements.• Discuss safety issues and quality control.• Who uses supplements? - Trends in athletes.• Review some of the most popular dietary supplements

marketed to athletes.– Vitamins and Mineral supplements– Protein and specific amino acids– Beta alanine– Hydroxymethylbuterate (HMB)– Creatine– Resveratrol– Omega 3 FA

Dietary Supplements

• Definition

– Vitamins , minerals herbs and botanicals, amino acids, and other dietary substances intended to supplement the diet by increasing the total dietary intake, or as any concentrate, metabolite, constituent or combination of these ingredients.

• http://www.fda.gov/Food/DietarySupplements/default.htm

• Nutrition.gov

Dietary Supplements• Dietary Supplement Health and Education Act of 1994

• Was intended to increase the freedom of manufactures to market more products as dietary supplement and to provide information about their benefits to consumers

– Who are the supplement police protecting the public health interests?

• The net results is that the supplement industry is largely unregulated and any burden of proof rests on the FDA.

Dietary Supplements

• Keep these things in mind:

– Proof that a supplement works is not required.

– Proof that a supplement is safe is not required

– Health claims on labels must be “truthful and not misleading”. Basically as long as it doesn’t claim to prevent or cure a disease .

– There are no manufacturing standards or testing of products for purity.

• http://www.usp.org/USPVerified/dietarySupplements/

• http://www.Comsumerlabs.com

Dietary supplement usage by Division I athletes.

Froilan et al, 2004. In J Sports Nutr and Ex Metab

Reason for using supplements

Froilan et al, 2004. In J Sports Nutr and Ex Metab

Daily Vitamin Intake of Female Master Cyclists

Beshquetoor, et al. 2003, Int J Sports Nutr Ex Metab

Beshquetoor, et al. 2003, Int J Sports Nutr Ex Metab

Daily Mineral Intake of Female Master Cyclists

Are athletes deficient in the micronutrients?

• Of the 340 micronutrient entries generated from 17 micronutrients analyzed, all 20 subjects presented between 3 and 15 deficiencies each based on the Recommended Daily Allowances (RDA) value from food intake alone.

Misner (2006) J of the Int Soc Sports Nutr

How are the RDA’s Established?

RDA is set so that it is sufficient to meet the nutrient requirement of nearly all (98%) of healthy individuals.

Vitamin A (12,000 IU as naturalbeta-carotene, 3,000 as retinylacetate)

15,000 iu 300%

Vitamin C (750 mg as calciumascorbate and 250 mg as ascorbylpalmitate)

1000 mg 1667%

Vitamin D (as cholecalciferol) 400 iu 100%Vitamin E (400 IU as natural d-alpha, 130 IU as d-gamma and 70IU as d-beta tocopherols)

600 iu 2000%

Vitamin B1 (as thiamine HCl) 150 mg 10000%Vitamin B2 (as riboflavin) 17 mg 1000%Vitamin B3 (as niacin [non-flushing]) 100 mg 500%

Vitamin B6 (as pyridoxal 5’phosphate) 20 mg 1000%

Vitamin B9 (as folic acid) 800 mcg 200%

Vitamin B12 (as methylcobalamin) 600 mcg 10000%

Vitamin H (as biotin) 2 mg 666%Vitamin B5 (as calciumpantothenate) 250 mg 2500%

Calcium (as citrate, ascorbate,carbonate, pantothenate) 700 mg 70%

Iodine (as potassium iodide) 150 mcg 100%Magnesium (as magnesium oxide,magnesium chelate) 400 mg 100%

Zinc (as zinc citrate) 30 mg 200%

Recommendations for vitamin and mineral supplementation

• The National Academies of Sciences has established an upper limit for many vitamins and minerals that represents the highest level of a vitamin or mineral that can be taken without any risk of adverse effects.

• It is generally hard to exceed this limit with natural foods.

• Deficiencies are rare despite not receiving appropriate RDA.

• Receiving more than the RDA has not been shown to improve physical performance.

• But…..

– Athletes that are trying to lose weight, or have difficulty obtaining a balanced diet because of personal preferences, may benefit by a daily vitamin and mineral supplement.

• The is no reason to buy a supplement that has more 100% RDA for any particular vitamin or mineral.

Recommendations for vitamin and mineral supplementation

Caffeine

• Caffeine is the most widely used drug is Europe and America.

• Caffeine was recently removed from the IOC banned list.

• Main sources: coffee beans, tea leaves, cocoa beans, and cola nuts.

• Caffeine is easily absorbed after ingestion and peak levels are observed after 60 minutes.

• Half life has been reported to be between 2 and 10 hours.

Caffeine

• Effects in endurance Exercise– Early studies showed that ingestion 1hour before

exercise increase plasma FA concentration and improved performance.

– 3 – 6 mg per kg bw yields an improvement in exercise time to exhaustion of 10 – 20 % while exercising around intensities of 85% VO2max.

– Jeukendrup and Martin estimated that during 40k time trail, a cyclist may improve performance by 55-84 seconds.

Caffeine

• Effects in Maximal Exercise

– Ingestion of 6 mg/kg bw increased exercise time to exhaustion at 100% VO2max.

– Not related to glycogen sparing, may be due enhanced recruitment of muscle fibers or enhance glycolysis.

• Effects on Supramaximal Exercise

– This area has not been thoroughly studied, however the limited number of studies that are available suggest that there is a potential benefit.

Caffeine

• Effects on Cognitive Functioning– In one study, 2-3 mg/ kg bw increased measures

of cognitive functioning (attention, psychomotor skills, and memory)

• Effects of caffeine Dosage– A few studies have investigated the effects of

different dosages on endurance performance. The researchers concluded that 3 mg/kg bw improved endurance and greater amounts elicited no further improvements.

Caffeine

• Effects in Habitual Users

– Habitual users have markedly different metabolic responses to caffeine.

– However, this difference does not seem to have an impact on the observed improvements in performance.

– Furthermore, withdrawal from caffeine had no effect on the performance after caffeine ingestion prior to exercise.

Caffeine

• Mechanism of Caffeine Action– Caffeine increases lipolysis and spares muscle glycogen– Caffeine increase excitability of the muscle fibers– Caffeine influences signal transduction from the brain to

motor neuron

• Side Effects– GI distress, headaches, tachycardia, restlessness,

irritability, tremor, elevated BP.– Caffeine is a diuretic at rest. However, during exercise the

action of the catecholamines counteract the diuretic effect.

Acid Buffers

• Intracellular buffer – Carnosine

– Beta Alanine and Histadine = Carnosine

– Preliminary animal research indicates that carnosine can prevent muscle acidosis.

– Cross-sectional studies indicate that sprinters, weight lifters, and other athletes that accumulate acid during training or competition have higher levels of carnosine.

Beta-alanine and Carnosine

• Theory

– Beta-alanine may increase intramuscular stores of carnosine, which can serve as an antioxidant or as a buffer of hydrogen ions, reducing acidity, and increasing the lactate threshold

– Beta-alanine may also form another peptide, anserine, which may function as an antioxidant in muscles

Beta-alanine and Carnosine

• Main research findings

– Supplementation increases muscle carnosine

– Research findings are equivocal relative to ergogenic effects on anaerobic-type exercise performance• Improved performance cycling @ 110% VO2max

• No effect on 400-meter run time

– No ergogenic effect on aerobic-endurance• No effect on maximal aerobic power

– Generally data supports that BA supplementation increase the ability to perform repeated bouts of hard work.

– 1.6 g/ 4x day

Protein Supplementation

• General requirement are .8 g/kg body weight• For athletes - 1.2 – 2.0 g/kg body weight• The extra protein accounts for what be would

oxidized during exercise or use for muscle repair.• The timing of the protein intake is extremely

important.• Protein before, during and after exercise has

been shown to enhance recovery.• The actual amount that is need to elicit these

effects is surprisingly low.

Protein Supplementation During Exercise

Saunders et al. (2004). Med Sci Sports Ex

Protein Supplementation During Exercise

Saunders et al. (2004). Med Sci Sports Ex

Protein Supplementation During Exercise

Saunders et al. (2004). Med Sci Sports Ex

Protein Supplementation After Exercise

Beradi et al. 2006, Med Sci Sports Ex

Essential AA and exercise

Essential AA and recovery

• Borsheim et al., 2002

Kammer et al. Journal of the International Society of Sports Nutrition 2009 6:11 doi:10.1186/1550-2783-6-11

Hydroxy-Methylbutyrate (HMB)

3g/day of HMB for six weeks exerts a protective effect during a prolonged endurance run of 20 k.

Knitter et al. 2002 J Appl Physiol

Hydroxy-Methylbutyrate (HMB)

Lamboley et al. 2007, Int J Sport Nutri Ex Metab

Creatine

• Creatine is found naturally in animal foods, especially meat

• Creatine may also be synthesized by the liver and kidney

Food g/Kg

Milk 0.1

Tuna 4.0

Salmon 4.5

Beef 4.5

Pork 5.0

Loading phase

Fast protocol: 20-30 grams/day for 5-7 days

Slow protocol: 3 grams/day for 30 days

Maintenance phase

2-5 grams/day

Recommended Protocol

Creatine Supplementation (20g/day for 5 days) with and without Carbohydrate (360g)

Adapted from Green, A., et al. ACTA Physiol Scand, 1996.

Creatine supplementation:Effect on the ATP-PCr energy system

• An ergogenic effect has been reported for numerous exercise tasks dependent on PCr

– Maximal force in isometric contraction

– Strength and endurance in isotonic tests

– Muscular force and endurance in isokinetic tests

– Maximal cycle ergometer performance from 6-30 seconds

– Sprint run, swim, and cycle performance from 5-100 meters or up to 30 seconds duration

• These findings may be applicable to sports such as weightlifting, cycle, swim and run sprints, and soccer

Creatine supplementation:Effect on the Lactic Acid energy system

• Fewer studies are available, but research findings suggest an enhancement effect in some events where athletes maximize power output from 30 to 150 seconds

• Some beneficial effects noted in a 300-meter run

• No beneficial effects in 100-meter swimming

• Additional research is merited

Creatine supplementation:Effect on the Oxygen energy system

• There is very little theoretical support

• Possible adverse effects– Weight gain

• Some theories include:

– Enhanced performance in events with short sprints

– Enhanced interval training

Creatine Supplementation: Effect on 6-kilometer cross-country run

• In a well designed Swedish study, 18 habitually active males consumed either a placebo or creatine (20 g/day for 6 days). ‘

• They ran a 6K terrain run on a forest trail before and after supplementation

• Major findings: Creatine supplementation significantly

– Increased body mass 0.9 kg

– Impaired run performance (pre = 23.36; post = 23.79)

Creatine Supplementation:

• Increase in body water weight

Creatine Supplementation Effect On Training For Aerobic Endurance

• Creatine supplementation has been shown to improve performance in interval run repeats of 300 and 1000 meters. Theoretically, if creatine supplementation could help an athlete train more effectively at shorter distances, conceivably performance in longer distances might eventually be improved.

Creatine Supplementation:Effect on body mass

• In general, research indicates increases in body mass, mainly as muscle tissue, in both males and females, including both trained and untrained

• Studies report increases in myosin and myonuclei concentration

Creatine supplementation: Safety

• Kidney and liver function

– Consuming recommended dose does not appear to increase health risks

– Those with liver or kidney disease may be at risk

• Gastrointestinal distress

– Large doses may cause nausea, vomiting and diarrhea

• Dehydration, muscle cramps and tears

– Appears to cause few problems with exercise in the heat

– Possibility of anterior compartment syndrome

• Overdoses and contaminants

– Creatine appears to be safe at 5 grams per day

– Some products may contain contaminants

Creatine supplementation:Medical applications

• Increased strength in some conditions

– Muscular dystrophy

– Patients with heart disease

– Injury to the spinal cord

• Facilitate rehabilitation from musculoskeletal injury

• Reduce the loss of muscle mass (sarcopenia) with aging

Resveratrol

Omega-3 fatty acids

• Alpha-linolenic fatty acid (omega-3)

– Flax seed

• Omega-3 fatty acids

– Eicosapentaenoic acid (EPA)

– Docosahexaenoic acid (DHA)

• Found mainly in fish

Omega-3 fatty acids:EPA and DHA

• Epidemiological research indicates populations that consume diets rich in fish have a lower incidence rate of CHD

• Theory underlying health effects of EPA and DHA

– Help to form eicosanoids (local hormones) that affect metabolism and gene expression

Omega-3 fatty acids:EPA and DHA

Experimental research has suggested a number of possible mechanisms underlying health benefits of omega-3 fatty acids

– Reduce serum triglycerides

– Increase HDL-cholesterol

– Prevent clot formation

– Decrease platelet aggregation

– Improve vascular tone

– Decrease blood viscosity

– Optimize blood pressure

– Promote anti-inflammatory activity

– Decrease abnormal heart rhythms

Omega-3 fatty acids:EPA and DHA

• Experimental research findings are equivocal regarding a cardio protective effect of omega-3 fatty acid supplementation

• Some reviews note that epidemiological evidence favors risk reduction, while experimental studies do not. People who eat more fish may engage in other healthy behaviors

• Conversely, several meta-analyses indicate eating more fish and omega-3 fatty acids lowers mortality from cardiovascular disease

Omega-3 fatty acids:AHA Scientific Statement

• Key points of the AHA statement on fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease

• Eat fish, particularly fatty fish, at least twice a week

• Eat plant foods rich in alpha-linolenic fatty acid

• Individuals who have high serum triglycerides may benefit from a fish oil supplement of 2-4 grams of EPA and DHA daily

Why are omega-3 fatty acids suggested to be ergogenic, and do they work?

• Theory as an ergogenic aid

– May increase blood flow and O2 delivery• RBC membrane less viscous; easier blood flow

• Produce eicosanoids that induce vasodilation

– May also increase secretion of human growth hormone

– One of the theories of the Zone Diet

Ergogenic effects of omega-3 fatty acids: Research findings

– Non peer-reviewed studies found improved performances with Eicomax, a sport dietary supplement

– Results from well-controlled, peer-reviewed scientific research indicate omega-3 fatty acids so not affect energy metabolism during exercise.

– Studies also report no ergogenic effect on aerobic endurance performance

– Some research suggests omega-3 fatty acids may help reduce bronchoconstriction in athletes with exercise-induced asthma

Final Thoughts

• Dietary supplements don’t make up for a poor diet.

• Dietary supplements won’t make up for poor or inconsistent training.

• Most athletes will benefit the most through the proper timing of nutrient intake during and after exercise to promote recovery.

• Some supplement may provides 1 -5% in performance, which could be the difference between a medal or no medal.

Final thoughts

EPO, Steroids, Stimulants, Ephedrine

Protein, Caffeine, carbohydrate, creatine, Beta Alanine, HMB, Glucosamine,

Prohormones

Polylactate

Pyruvate, Herbs, chromium, DHEA

Effectiveness+

Effectiveness-

Safety+

Safety-

The Balanced Diet and Nutrient Density

• The balanced diet

– Variety

– Moderation

Thank You!Questions???

Comments???

Jeff Godin, Ph.D., CSCS, HFPD, CISSN

Fitchburg State College

Department of Exercise and Sport Science

jgodin@fsc.edu