Dietary Supplements Targeted
to Enhance Workouts and the
Health Implications
Matthew Vukovich, PhD FACSM
Department of Health and Nutritional Sciences
South Dakota State University
Dietary Supplements and
Ergogenic Aids • Dietary supplement
– a product intended to supplement the diet that bears or contains
one or more of the following dietary ingredients:
• a vitamin; a mineral; an herb or other botanical; an amino
acid;
• a dietary substance for use by man to supplement the diet
by increasing the total dietary intake; or
• a concentrate, metabolite, constituent, extract, or
combination of any ingredient described above
• Ergogenic Aid
– Any substance, process, or procedure that may, or is perceived
to, enhance performance through improved strength, speed,
response time, or the endurance of the athlete.
Supplement Use
• Practice varies with type and level of sports
nutrition practice
• Knowledge obtained from internet, discussion
boards, friends and coaches.
• 50% to 90% of athletes use dietary
supplements.
• Reasons for use – Improved performance
– More muscle
– Poor diet
– Meets additional demands of training.
Sports Supplement Categories
• Protein
• Pre-Workout
• During Workout
• Post-Workout
• Stacks
• Enhance Training & Performance
• Natural Testosterone Support
• Growth Hormones Boosters
Efficacy and Safety
• Factors complicating the discussion of efficacy and safety… – Individual versus multiple ingredients
– Content versus label claim
– Contaminates – intentional and unintentional
– Spiking
– Food, drug, supplement interaction
– Men and women
– Age of individual (young athletes versus master athletes)
– Studies funded by supplement companies.
Protein • Protein needs of athletes can be as high as 2 to 3 times the
RDA/RDI.
– 0.8 g/kg/day 2.4 g/kg/day
– Must consume adequate energy to support protein synthesis.
• Positive net protein balance occurs when protein is consumed
throughout the day.
• Protein consumed before exercise and after exercise produces the
same increase in net positive protein balance.
– Resistance training augments the increase in net protein balance
• Whey protein produces positive changes in testosterone, growth
hormone, and IGF-I, promoting a positive net protein balance.
– Not observed with soy protein.
• Whey proteins promote a greater rise in whole-body protein
synthesis than do casein proteins, the casein proteins attenuate
whole-body proteolysis; the result is a greater retention of protein
with casein than with whey.
Daily protein distribution - typical ? -
Total Protein
90 g
Cat
abol
ism
A
nabol
ism
10 g
maximum rate of protein synthesis
15 g 65 g
A skewed daily protein distribution fails
to maximize potential for muscle growth
Daily protein distribution - Optimal -
Cat
abol
ism
Ana
bol
ism
maximum rate of protein synthesis
30 g 30g 30 g
Total Protein
90 g
Repeated maximal stimulation of protein synthesis increase / maintenance of muscle mass
~ 1.3 g/kg/day
Protein Supplements
• Safety Concerns
– Consumer Reports – heavy metals
– Kidney – no health risks with normal renal
function.
– Bone – Improves bone density.
Pre-Workout Supplements
• Marketed to
– Increase energy, focus and endurance.
– Stimulants • Common ingredient is caffeine
• Dosages range from 50mg to 300mg per serving.
• May contain ephedrine, oxilofrine, or 1,3-dimethylamylamine
– Little to no support for other ingredients.
– Significant safety concerns.
Claims and Research • b-alanine -buffering agent - amino acid derivative increases muscle
carnosine content, considered rate limiting for carnosine formation.
– 5g/d for 4 weeks
• Betaine – derivative of glycine – metabolized to di-methylglycine
(DMG) and sarcosine –
– Proposed to stimulate lipolysis, reduce lactic acid, inhibit
lipogenesis, stimulate protein synthesis, stimulate GH & IGF-I
release, stimulate insulin receptor signaling.
– 1g to 9 g/day. Research does not support claims.
• Taurine – facilitates Ca2+ dependent excitation-contraction processes,
antioxidant.
– 5 g/day does not alter muscle taurine content or substrate
metabolism
• N-Acetyl Cysteine- antioxidant –
– chronic intakes of most antioxidants have a harmful effect on
performance.
Claims and Research • Citrullline – increases arginine concentration, increase NO reduces
lactate,
– 3 grams to 9 grams
– reduces time to exhaustion (ergolytic - hinders performance).
• BCAA - no acute affect at that dose.
• Huperzine A – promotes immune and nervous system function
memory Alzheimer’s disease.
– 0.2 mg to .8 mg ( 200 mcg to 800 mcg) – no improvement in
performance
• Piper Nigrum – Black Pepper – antioxidant, antimicrobial memory
Alzheimer’s disease
Caffeine’s Proven Effects – Increases lipid oxidation
– Spares muscle glycogen
– Increases time to fatigue
• Prolonged submaximal (> 90 min)
• Sustained high-intensity (20-60 min)
• Short-duration supra-max (1-5 min)
– Likely beneficial in endurance sports
– No clear benefit in stop-&-go and strength/power events
– ~2 to mg/kg dose
Caffeine in Endurance Events o Running
o 4.2-sec faster 1.5-km
o 1-3% faster 5-km
o 24-sec faster 8-km
o 50-sec faster 10-km military pack march
o No change in 21-km race
o Improved treadmill time-to-exhaustion in marathoners
o Cycling
o 3.5% higher mean power in 40km race
Pre-Workout Supplements
• Safety
– Increased heart rate, arrhythmias, and
blood pressure
– adolescents who sustained a recent TBI
while playing sports had higher odds of
recent energy drinks consumption than
abstainers (Ilie, 2016)
– Decreases fine motor control
During Workout/Training
• Strength/Power Athletes
– Same as pre-workout – energy
– Protein
• Endurance Athletes
– Carbohydrate – sports drinks, gels, etc.
– caffeine
Enhance Training &
Performance • Strength & Power
– Creatine
• Loading phase – 20 g/day for 3 days,
• Maintenance – 3g/day
• More effective in trained vs. recreational vs
untrained
• Performance improvements minimal
• Improves training adaptations
Enhance Training &
Performance • Endurance
– Various cocktail of ingredients with no
supportive research. • Caffeine, Ciwujia, DMG (n,n-dimethylglycine),
Ginseng, MCT (medium chain triglycerides), Cordyceps sinensis (extracted from non-toxic mushrooms) Rhodiola Rosea (arctic root or golden root)
– Various diet modifications • LCHF diets
• Paleo diets
• Train low– Low CHO training days
Cordyceps sinensis
• Considered one of the most valuable medicinal fungi
in the Orient.
• It is naturally distributed in the eastern extension area
of the Qinghai-Tibet plateau, at an altitude over 4000
m high.
• Parcell, et al. 2004 – 3g/d- 5-weeks
– 22 trained cyclists
– VO2peak, VT, time trial
– No effect on endurance capacity or performance
• Earnest, et al. 2004. – 14 days 3g/d to 1g/day – 17 competitive cyclists – VO2peak, TTE, peak
power, – No effect on
performance
Rhodiola rosea
• Also known as Arctic root,
Golden root, or Crenulin
• Found in mountain
regions of Siberia and
Tibet
• Has a reputation of…
– Stimulating the nervous
system
– Decreasing depression
– Enhancing work
performance
– Eliminating fatigue
– Preventing high altitude
sickness
• DeBock, 2004
– 200mg/d
– No acute effect on VO2
or TTF
– After 4wks – no effect on
VO2 or TTF
Adaptogens: Criteria for Defining
• Produces a non-specific response in an organism; i.e., an increases
in power of resistance against multiple stressors including physical,
chemical, or biological agents.
• Has a normalizing influence on physiology, irrespective of the
direction of change from physiological norms caused by the stressor
• Is capable of influencing normal body functions more than required
to gain non-specific resistance.
Echinacea Ginseng Rhodiola-rosea
Ribose Research
• Dunne, 2006 – 20g/d
– Rowers
– No affect on 2000m time
• Gallagher, 2001 – 20 g/d
– High-intensty cycling
– No affect on ATP or TAN
– No affect on performance
• Op’T Eijnde, 2001 – 16g/day
– No effect on isokinetic peak torque or power
• Kreider, 2003 – 10 g/d for 5 days
– 2, 30s Wingates
– No affect peak power, average power, torque, fatigue index, lactate, ammonia, glucose, or uric acid.
• Berardi, 2003 – 32 g over 36 hrs
– 6, 10s sprints
– ribose supplementation did not show reproducible increases in performance across all 6 sprints.
Anabolic Hormone “boosters”
• Focus is on building muscle and
increasing muscle protein synthesis.
• Testosterone – testosterone precursors
• Growth Hormone – GH secretagogues
• IGF-I – colostrum, deer antler velvet
Testosterone
Cholesterol
Pregnenolone
17-hydroxypregnenolone
Dehydroepiandrosterone (DHEA)
Progesterone
17-hydroxyprogesterone
Androstenedione
Androstenediol
Biosynthesis of Androgens
Cytochrome P450scc (desmolase)
17 α hydroxylase 17 α hydroxylase
3-βHSD
17 α hydroxylase
3-βHSD
C17 dehydrogenase/
17 α hydroxylase
3-βHSD
Estradiol
Aromatase
17βHSD 17βHSD
DHEA DHEA-S Androstenedione
Testosterone DHT
Estrone (E1)
Estradiol (E2)
Estriol (E3)
Androgen and Estrogen
Tainted Supplements
Such percentages are not comparable; instead they are provided as indications as to how difficult it is to ascertain or estimate the scale of this problem (Outram & Stewart, 2015).
Anabolic
Hormone
“boosters” • Safety
– Contaminated
products
– Hepatotoxicity
Danazol 17230-88-5 C22-H27-N-
O2
Fluoxymesterone 76-43-7 C20-H29-F-O3
Methandienone 72-63-9 C20-H28-O2
Methenolone 303-42-4 C27-H42-O3
Methyltestosterone 58-18-4 C20-H30-O2
Nandrolone 360-70-3 C28-H44-O3
Norethandrolone 52-78-8 C20-H30-O2
sexual enhancement, weight loss, and bodybuilding or athletic performance appeared to pose the greatest risk for patient harm due to product contamination with a pharmaceutical (Abe et al. 2015)
Efficacy and Safety
• Factors complicating the discussion of efficacy and safety… – Individual versus multiple ingredients
– Content versus label claim
– Contaminates – intentional and unintentional
– Spiking
– Food, drug, supplement interaction
– Men and women
– Age of individual (young athletes versus master athletes)
– Studies funded by supplement companies.
Content versus label claim • Gurley et al. (Am J Health Syst Pharm. 2000)
– 20 ephedrine containing products
– Content varied from 17% to 154% of label claim
• Cohen et al. (JAMA Internal Med. 2013) – Caffeine
– Content varied from 27% to 113% of label claim in 25% of products
• Garg et al. (J Nutr Health Aging, 2013)
– 14 products Vitamin D3
– 2 registered formulations: 90% & 97% of label claim
– 12 supplements varied between 8% and 201% of label claim
• Manning et al. (J Herb Pharacother, 2003)
– Green tea analyzed for catechin content
– Catechin content ranged from 9% to 48% of label claims.
• HyperDrive 3.0 (ALR Industries) • Ephedra Free Shredder (TBN Total Body Nutrition) • Fastin (Hi_Tech Pharmaceuticals) • Lean Pills (Line One Nutrition) • Ephedra Free Tummy Tuck (TBN Total Body Nutrition) • Methyl Drive 2.0 (ANS) • Drop Factor (MTS Nutrition) • Exile (AmericanMuscle Sports Nutrition Company) • China White 25 Ephedra (Cloma Pharma Laboratories) • Phenadrine (APS) • Hypercor (Kat-a-lyst Nutraceuticals) • MethylDrene 25 Ephedra Elite Stack (Cloma Pharma Laboratories) • Maimi Lean (Skyline Nutrition) • Eliminator X (Rok Hard Body Sports Nutrition)
FDA
• http://www.fda.gov/Food/DietarySupple
ments/ProductsIngredients/default.htm
• http://www.accessdata.fda.gov/scripts/sd
a/sdNavigation.cfm?filter=&sortColumn=
1a&sd=tainted_supplements_cder&page
=1
β-Alanine
• β-alanine
– An amino acid derivative
– Synthesized naturally in the liver
– Increases carnosine concentrations within
skeletal muscle
• Carnosine is a buffer during high intensity exercise – Short (30-60s) to long (1-2min) sprints
– Repeat sprints, Time to exhaustion, Peak power output, Anaerobic threshold
• BA + HIIT
• 6.4 g BA/PL for 3 wks
• 3.2 g BA/PL for 3 wks
• Increase in:
– VO2max
– TWD
– Training volume
– LMB
Smith et al, 2009
• 3 to 6 g of βA per day for 4 weeks can
elevate muscle carnosine content 60%
and 80% in 10 weeks.
• βA most likely works by delaying fatigue
through intra-muscular H+ buffering