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/