Dietary Supplements _ Ergogenic Aids

Dietary Supplements & Ergogenic Aids Fahma Sunarja Sport Dietitian Sports Medicine & Sports Science Singapore Sports Council Supplementation Practices Most visible example of sports nutrition  For some, this is sports nutrition  Practices vary with type & level of sport & supplement knowledge  On average ~50-80% using supplements  Supplementation Practices  Reasons offered for supplement use: – Compensate for less than adequate diet or lifestyle – Meet unusual nutrient demands induced by heavy exercise – Produce a direct performance enhancing effect  Can be separated into 2 types:   Dietary Supplements Nutritional ergogenic Aids Dietary Supplements Dietary Supplements   Contain nutrients in amounts similar to amounts contained in food, in a form that is practical or convenient e.g. sports drink & liquid meal supplement OR Contains large amounts of a nutrient specifically for the rapid treatment of an identified nutrient deficiency e.g. iron supplement Dietary Supplements Meet specific nutrient need & thus improve performance  Generally accepted by sports nutrition experts  Offer practical nutrition  To be used when the convenience or practical advantages justify the cost  Dietary Supplements Application  Sports Drink:   Fluid & carbohydrate replacement (5-8% carbohydrate) Sodium replacement (10-25 mmol/L) During prolonged training sessions Post training Competition Gatorade, 100 Plus, H-TWO-O, Pocari Sweat – Application:    – Examples  Dietary Supplements Application  Carbohydrate Gels:  60-70% carbohydrate in squeeze pack  ± other nutrients e.g. antioxidants, BCAA‟s, caffeine  Low sodium – Application:  Concentrated carbohydrate source during exercise  Post-exercise refueling – Examples:  Power Gel, Weider Jelly, Gu gel Dietary Supplements Application  Sports Bars:     – Application:    Chewy or Muesli style bars ~40-50g CHO & 5-10g protein per bar Generally low fat Often fortified with vitamins & minerals – Examples  Complements high energy diet Pre-event meal Post-exercise refueling Power Bar, Chewy Bar, Myoplex Bar Dietary Supplements Application  Liquid Meal Supplements:     – Application     50-70% carbohydrate, 20+% protein Low fat Fortified with vitamins & minerals Mix in water or milk Complements high energy diet Pre-event meal Post-exercise refueling Portable & familiar snack for travelling athlete – Examples  Ensure Plus, Myoplex, Enercal, Myogain Dietary Supplements Application  Multi Vitamin & Mineral/ Fe/ Ca: – Application  Single or multiple vitamins & minerals  Supplement – Examples to low energy/ restrictive diet  Supervised treatment of diagnosed deficiency  Insurance policy for travelling athlete  Centrum, Fefol, Caltrate Nutritional Ergogenic Aid Nutritional Ergogenic Aids   Contains nutrients or other substances in much larger amounts than amounts found in food Aims to produce drug like effects e.g.    Growth hormone stimulators Fat loss enhancers Immune function enhancement    Huge range of products & ingredients Generally rely on “scientific theories” and testimonials of performance claims Few supported by scientific trials Nutritional Ergogenic Aids  Why so popular: – Emotive claims – Expectation of immediate & significant results – Athlete endorsement – Expense  Evidence for performance enhancement: – Supporting scientific evidence of varying quality Nutritional Ergogenic Aids Claims often exaggerated & unsubstantiated  New products arrive regularly  Nutritional Ergogenic Aids Supported By Science Caffeine  Bicarbonate  Creatine  * Note: - performance enhancement limited to specific situations - considerable individual variability in response Creatine Creatine   Naturally occurring amino acid metabolite from diet & production within the body Creatine phosphate role in exercise metabolism... Short term energy production – Cr-P power system Creatine - Mechanism of Action     Helps regenerate ATP & CP Performance improvement in repetitive, short duration, high intensity exercise Claims of increases in muscle mass and strength with long term use Performance enhancement only identified if muscle creatine levels increased Grande, B.M. et al. Creatine Supplementation: Forms, Function, and Effects. Strength and Cond Journal. 27(1):62-68.2005 Creatine    Dietary sources of creatine (g/kg): – Milk 0.1 /Cod 3.0 /Tuna 4.0 /Beef 4.5 /Salmon 4.5 /Pork 5.0 /Herring 10 Dosage: – 5 days @ 4 x 5g = 20g – Thereafter maintenance @ 2g/ day Disadvantages – ~0.7-1.6kg increase in body mass – Expense Balsom, P.D et al. Creatine in humans with special reference to creatine supplementation. Sports Med. 18(4):268-280.1994 Creatine – Evidence   An increased in muscle creatine stores does appear to enhance performance in repeat bouts of high intensity exercise Significant increase in body mass Casey,A. et al. Does creatine supplementation play a role in skeletal muscle metabolism and performance? Am J Clin Nutr 72(2), 607S-617S.2000 Cox, GR. Et al. Acute creatine supplementation and performance duringfield test stimulating match play in elitefemale soccer players. Int J Sport Nutr Exerc Metab 12, 33-46. 2002 Kreider RB. Effects of protein and amino acids supplementation on athletic performance. Sportscience 3 (1). 1999 Racetta SB. Creatine supplementation and athletic performance. J Orthop Sports Ther 33(10), 615-21. 2003 Caffeine  Most widely used drug in the world Affects all body tissues in a variety of ways... – Muscle contractility – Stimulation of epinephrine – Increase in fat oxidation/glycogen sparing – Central nervous system stimulant - changing perception of effort  Caffeine and Performance   3-6 mg/kg body weight (1 hour pre-exercise) associated with performance improvements Performance enhancement in... – Increase endurance times – Increase resistance to fatigue – Increase adrenaline levels Graham, TE. Caffeine and exercise: Metabolism, endurance and performance. Sports Med. 31(11): 785-807, 2001 Spriet LL. Caffeine and Performance. Int J Sport Nutr. Suppl., S8499, 1995 Jackman, et al. Metabolic catecholamine, and endurance responses to caffeine during intense exercise. J Appl Physiol. 81(4): 165863, 1996 Caffeine – Variability of Responses  Metabolic and performance responses vary with individual – Variability reduced in trained subjects – Variability also depends on caffeine habituation – Responders & non-responders  Diuretic effect may impair post-exercise rehydration, but unlikely to affect fluid balance during exercise – Thermo-regulator during exercise Caffeine – Effects on CNS? Caffeine and CNS   Meta analysis study 21 out 44 studies – Caffeine abstinence – Use caffeine tablets  Results: – 6% reduction in RPE during constant exercise – Improved performance by 11% (time trial) Doherty M., Smith P.M., Effects of Caffeine Ingestion on RPE during and after exercise. Scand J Med Sci Sports 15:69-78, 2005 Caffeine supplementation???  Dosage – 3-6mg/ kg body mass in 60 min. pre-exercise – doses 7-9+ mg/ kg increased risk side effects:      Diuresis Anxiety & insomnia Cardiac arrhythmias Delerium & hallucinations GIT upset – Effectiveness influenced by:   Caffeine habituation Training status Intensity of exercise Dosage Caffeine – Food Source 1 cup brewed coffee = 85 mg  1 cup instant coffee = 45 mg  1 cup tea = 15 – 30 mg  1 can cola = 30 mg  No Doz tab = 100 mg  100 mg Guarana = 100 mg  1 tube Sports gel = 25 – 50 mg  Caffeine - Carbohydrate mix... Energy Drinks  Combination of glucose, caffeine, taurine, B group vitamins... – Variable caffeine content... 50-80mg – May be associated with ergogenic potential in endurance events but...  Carbohydrate content & associated GIT problems Bicarbonate  Events of 3-7 minutes of maximal exercise are limited by build-up of excess H+ ions (anaerobic glycolysis) Bicarbonate dose 300mg/kg ( 50mg/kg every 15 mins) 1-3 hours pre-event may increase extracellular buffering capacity – e.g. rowing   Bicarbonate and Performance    Meta-analysis of 29 studies shows moderate positive effect of bicarbonate on “anaerobic events” Effects most likely with significant anaerobic contribution, and with adequate bicarbonate intake Often associated with GIT symptoms e.g. diarrhoea, flatulence, cramping – Consume with adequate water & divided doses Mc Naughton, LR. Sodium bicarbonate ingestion and its effects on anaerobic exercise of various durations. J Sports Sci 10(5):425-35, 1992 Bird, SR et al. The effect of sodium bicarbonate ingestion on 1500m racing time. J Sports Sci 13(5):399-403, 1995 Bicarbonate Acute Loading for a race • 0.3g/kg 60 –90 minutes before race • • • for a 70 kg male athlete = 21g/day for a 55 kg female athlete = 16.5g/day taken with large amount of water, 500 – 2000ml Burke L.M., Pyne D., Bicarbonate Loading to Enhance Training and Competition Performance. Int J of Sports Physiol and Performance, 2:93-97, 2007 Bicarbonate Serial Loading for a Race • Smaller doses over consecutive days before an event • Minimize the GI distress • 0.5g/kg over 5 days • for 70kg athlete = 35 /5 = 7g/ day • for 55kg athlete = 27.5/5 = 5.5 g/day • blood buffer level persist for at least 24hrs after the last dosage Burke L.M., Pyne D., Bicarbonate Loading to Enhance Training and Competition Performance. Int J of Sports Physiol and Performance, 2:93-97, 2007 Bicarbonate Chronic Loading for Training • Most recently use to support daily training rather than competition • 0.4g/kg/day, 3 days/week for 8 weeks • For 70 kg athlete = 28g/day = 4.6g x 6 doses/day • For 55kg athlete = 22g/day = 3.6g x 6 doses/day Burke L.M., Pyne D., Bicarbonate Loading to Enhance Training and Competition Performance. Int J of Sports Physiol and Performance, 2:93-97, 2007 Other Ergogenic Aids HMB     Metabolite of leucine, has anti-catabolic actions during resistance training May increase muscle mass and strength associated with resistance training Some gain in lean muscle mass in untrained individuals Dosage 3 g/day Kreider, RB. Effects of protein and amino acid supplementation on athletic performance. Sportscience 3 (1), 1999 Thomson, JS. HMB supplementation of resistance trained men. Asia Pac J Clin Nutr 13 (suppl), S59, 2004 Ransone,J et al. The effect of HMB on muscular strength and body composition in collegiate football players. J Strength Cond Res 17(1): 34-9, 2003 Glutamine    Major fuel for white blood cells and a precursor to protein synthesis. Strong evidence in clinical practices but insufficient evidence in athletes At increased stress level, promote tissue repair Krzywkowski, K et al. Effect of glutamine supplementation on exercise induced changes in lymphocyte function. Am J Physiol cell Physiol 281 (4): C1259-65, 2001 Antonio, J eta;. The effect of high dose glutamine ingestion on weightlifting performance. J Strength Cond Res 16(1): 157-60, 2002 Castell L. Glutamine supplementation in vitro and in vivo, in exercise and in immunodepression. Sports Med 33(5): 323-45, 2003 Arginine Participate in protein synthesis, detoxification of ammonia  Role in sports performance (?)  – Secretion of endogenous growth hormone – Involvement is synthesis of creatine  ? Dosage (3.5 – 5g daily) Campbell B I et al. The Ergogenic Potential of Arginine. J of Int Society of Sports Nutr 1(2): 35 – 38, 2004 BCAAs    Leucine, isoleucine and valine Claims to minimise central fatigue and decrease exercise-induced protein degradation Easily achieved by consuming protein rich foods Kreider, RB. Effect of protein and amino acid supplementation on athletic performance. Sportscience 3(1), 1999 Williams, MH. Facts and fallacies of purpoted ergogenic amino acid supplements. Clin Sports Med 18(3): 633-49, 1999 CLA (Conjugated Linoleic Acid)    Claims to promote fat loss, decreases catabolism and builds muscle Positive evidence in animal studies but not in human studies ? Dosage 3 g/day Rainer, L. Heiss, CJ. CLA: Health implications and effects on body composition. J Am Diet Assoc 104(6): 963-8, 2004 Kreider RB et al. Effects of CLA supplementation during resistance training on body composition, bone density, strength and selected hematological markers. J Strength Cond Res 16(3): 325-34, 2002 Zambell KL et al. CLA supplementation in humans: Effects on body composition and energy expenditure. Lipids 35(7): 777-82, 2000 Herbal Supplements Siberian Ginseng (Eleutheroccocus senticosus)  Cordyceps (C.sinensis)  Ginseng (Panax Ginseng)  Siberian Ginseng Consider to be adaptogenic, helps the body find balance and adapt to stresses  Claims  – Improve immune support – Blood sugar regulation – Improvement in energy levels Siberian Ginseng  Evidence – 1g/d of powder for 6 wks, did not improved VO2 max, heart rate recovery from exercise in 30 athletes – 3.4ml extract for 6 wks in 10 elite distance runners, did not effect run time to exhaustion, heart rate, lactate production, oxygen consumption, RPE – Identified as Ciwujia in Endurox, unable to substantiate claims of increase fat utilisation and decrease blood lactate concentration Earnest CP etal (2004) Effects of a Commercial Herbal-Based Formula on Exercise Performance in Cyclist. Med Sci Sports Exerc. 36(3):504-509. Bucci LR (2000) Selected herbals and human exercise performance. Am J Clin Nutr 72(2Suppl):624S-636S Siberian Ginseng Limited scientific evidence in improving human performance  Poor or inadequate experimental designs for studies investigating Siberian ginseng and physical performance  Cordyceps Cordyceps Dead body of a larva through which a fungal shoot sprouted  Claims  – Enhance endurance performance – Improves respiratory functions during exercise – Improves cellular energy production – Increases blood circulation Cordyceps 1993 World Games Stuttgart, Germany &1993, National Games Beijing  Broke 10,000m world record by 42sec  Broke 3,000m world record by 10sec  Beat the 1,500m world record by 2 sec   Ma Jun Ren, team coach credited team performance to Cordyceps Chinese herb used for generations as a lung Qi tonic Cordyceps  Evidence: – 2 wk ingestion fail to show positive changes in cycling performance – Cordyceps with Rhodiola did not enhance muscle tissue oxygen saturation – 5 wks of CordyMax Cs-4 has no effect on aerobic capacity or endurance enhancement in trained male cyclist Colson SN etal (2005) Cordyceps Sinesis and Rhodiola Rosea-Based Supplementation in Male Cyclist and its Effect on Muscle Tissue Oxygen Saturation. Journal of Strength Cond Res. 19(2): 358-363. Parcell AC etal (2004) Codyceps Sinesis (CordyMax Cs-4) supplementation does not improve endurance exercise performance. Int J Sport Nutr Exerc Metab. 14(2):236-242. Panax Ginseng Panax Ginseng     Known as Chinese or Korean Ginseng Available in many forms: whole roots, roots powder (white ginseng), steamed root powder (red ginseng), teas, etc Some controlled studies show improvement in performance Some commercial preparations may contained ephedrine which is banned by IOC Panax Ginseng Fundamental herb for improving energy levels for sports performance  Claims:  – Reduces exercise stress – Increases muscle strength – Improves heart function – Increases oxygen uptake – Increases mental alertness Panax Ginseng  Evidence: – 200mg extract for 12 wks improved aerobic capacity, reduce lactate production and heart rate in untrained individuals – 200mg extract for 9 wks in elite athletes did not show any significant differences – 2000mg extract for 4 wks in marathon runners, improved run to exhaustion, aerobic capacity, heart rate in older age group but not in younger age group Bucci LR (2000) Selected herbals and human exercise performance. Am J Clin Nutr 72(2Suppl):624S-636S Summary Assessing Nutritional Ergogenic Aids    Does it promise results that are too good to be true? They probably are! Is the application of the product specified? No product will assist all athletes in all situations! Is the product based only on an idea or case histories - regardless of which famous athlete swears by the advice or how „scientific‟ the theory sounds? Assessing Nutritional Ergogenic Aids     Has the product been scientifically tested and reported in a reputable journal? Is the product generally compatible with healthy nutrition guidelines Is the product supported by recognized nutrition authorities? Is it safe? Is it legal? Further info on Supplements www.ais.org.au  www.sda.org.au  www.supplementswatch.com  www.consumerlab.com  www.gssiweb.com 