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