Objectives. Introduction. Sports Nutrition: Sports Supplements 101 July 28, 2016

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1 Sports Nutrition: Sports Supplements 101 July 28, 2016 Britta Anderson D.O. Primary Care Sports Medicine Associate Team Physician Detroit Tigers Objectives Discuss brief introduction to sports supplements Introduce NSF Certified for Sport Review some of the most commonly used sports supplements Introduction Athletes and supplements are under more scrutiny than ever before More than ½ of American adults use dietary supplements In 2010 US Supplement Industry grew 4.4% reaching $28 billion in consumer sales US Food and Drug Administration 1

2 Introduction In the past 4 years, 1 in 2 inspections by FDA have seen significant manufacturing product violations 1 in 4 inspections have resulted in a warning letter Sports supplements have the highest noncompliance rate for any FDA regulated industry US Food and Drug Administration Introduction What s in your supplement? In 2004 the IOC found that 15% of 634 supplements tested from 13 countries contained steroid prohibited in sport None of which were declared on the label International Olympic Committee Introduction In 2012, 84 illegal products such as energy and muscle gain products were found to contain dangerous ingredients including steroids, stimulants, and hormones 2

3 NSF Certified for Sport How do we find safer supplements? National Sanitation Foundation (NSF) - Certified for Sport To meet the demands of athletes, coaches, and all those concerned about banned substances in sports supplements Recognized by MLB, MLBPA, NFL, NFLPA, PGA, LPGA, CPSDA, CCES and other anti-doping agencies and sports organizations NSF Certified for Sport NSF tests for approximately 200 athletic banned substances from WADA, NFL, and MLB prohibited substances lists NSF is recognized globally NSF product testing occurs annually for label claims Allows athletes and consumers to know that what is on the label is in the bottle NSF Certified for Sport How do we find safer supplements? Look for NSF certification on the label Research online at Download the Mobile App Call NSF consumer hotline:

4 NSF Certified for Sport Why are certified supplements safer? Banned Substance Screening Toxicology Review Label Claim Review Contaminant Review Facility Audits Ongoing Monitoring Supplements Protein Amino Acids Performance Enhancers Fat Burners Proteins - Whey Whey Protein A product of cheese Thus likely containing animal enzymes = not the best option for lacto-vegetarians 20% of the protein in milk Contains all essential amino acids Timing/Dose: 10-30g at least 30min prior to workout and/or 10-30g immediately after Ideal Use: When you want high levels of BCAAs and need fast absorption for the development of lean muscle mass g/kg/day of protein consumption Volek, Jeff. 25 Top Sports Supplements 4

5 Proteins - Casein Casein Long lasting protein 80% of total protein in milk Contains all essential amino acids Digestion Rate: slow Timing of Dose: Not recommended pre-workout 10-30g within1hr post workout Ideal use: has extended anabolic effects thus ideal when frequent ingestion of protein is not possible Slow release ideal for ingestion before bed Usually found in meal replacement Volek, Jeff. 25 Top Sports Supplements Protein Egg White Powder Egg White Protein Contains over 40 proteins Contains all essential AA Digestion Rate: Medium fast Slightly slower than whey Peaks minutes after ingestion Timing/Dose: 10-30g at least 45 min pre-workout 10-30g immediately post workout Ideal Use: excellent for lactose intolerant or allergies to milk or soy Also saves time from preparation of eggs or if you don t like the taste Protein - Soy Soy Vegetarian source Contains all essential AA Digestion Rate: Intermediate between whey and casein Timing/Dose: 10-30g 45 min pre-workout or 10-30g immediately post workout Ideal use: highest quality plant derived protein source Also good for those with milk or egg allergies 5

6 Amino Acids BCAAs Glutamine Taurine Amino Acids - BCAA BCAAs Leucine, isoleucine, and valine Only AA s used directly by muscle as energy during exercise Leucine acts more like a hormone in that it activates muscle protein synthesis directly Study: compared to placebo, ingestion of 20g BCAA (10g am/10g pm) for 1 week prior to a damaging bout of exercise: decreased muscle soreness by 30% decreased markers of muscle damage by 22% improved muscle performance during recovery Howatson G, et al. Exercise Induced muscle damage is reduced in resistance-trained males by branched chain amino acids: a randomized, double-blind, placebo controlled study. J Int Soc Sports Nutr May 8;9(1):20 Amino Acids - BCAA Timing/Dose: some studies indicate consuming at least 2.5g of leucine per meal 4x/day Overall: 5-10g mixed in workout drink and/or immediately post workout Can also add a dose first thing in the morning if you are looking to build muscle Ideal Use: BCAA powder convenient to add to a pre-workout shake or liquid Research suggests BCAAs possibly effective for preventing muscle breakdown Insufficient evidence for athlete performance Zhang Y, Guo K, et al. Increasing dietary leucine intake reduces diet-induced obesity and improves glucose and cholesterol metabolism in mice via multi-mechanisms. Diebetes jun;56(6):

7 Amino Acids - Glutamine Glutamine Accounts for 60% of the free AA in muscle Catabolic states reduce glutamine Supplementation improves nitrogen balance and recovery It is a nitrogen transporter Minimize breakdown of muscle and improve protein metabolism Provides energy to immune cells and also acts as an immune enhancer Suggested to enhance glycogen levels Timing/Dose: Trouble getting absorbed because intestines use it as energy. 2-5g/day suggested Amino Acid - Taurine Helps in metabolism function Made famous by being featured in Red Bull 80mg caffeine = 1 cup of coffee Taurine = 1g Included in many pre-workout formulas Abundant in skeletal muscle and claimed to help increase cell volume Dose: greater than 1g likely needed Overall, evidence lacks effectiveness Performance Enhancers Creatine Beta-Alanine Nitric Oxide 7

8 PE - Creatine One of the most popular and more commonly used supplements Increase power and strength A natural substance that increases creatine phosphate in skeletal muscle Helps make ATP which provides energy for muscle contraction Helps extend the time muscles can exert maximal power Better for short burst exercise than endurance training PE - Creatine Scientific research is mixed Caution if history of kidney or liver damage Can cause water retention and dehydration Largest safety concern is contamination and quality of the product Contaminants are produced when making creatine products Dose: Loading Dose: 15-25g/day for 5 days Maintenance: 3-5g/day PE - Beta-Alanine Helps reduce acid buildup and fatigue Famous for producing a generalized tingling sensation throughout your body A non-essential betaamino acid Supplementing betaalanine will increase carnosine Carnosine helps decrease fatigue and increase total work capacity 8

9 PE Beta Alanine Carnosine is an antioxidant Muscles first line of defense vs. hydrogen ions during high-intensity exercise High Hydrogen can impact enzyme function H+ increases can cause muscle fatigue Good for short-to-medium duration high intensity muscle performance Exercise lasting longer than 60 seconds Best consumed pre-workout Dose: g/day for 4 weeks will increase carnosine PE Nitric Oxide Made and released by the cells that line your blood vessels When released, NO causes potent dilation of blood vessels Results in increased blood flow Research supports better function with impaired vascular function vs. athletes PE Nitric Oxide Large variety of preexercise NO formulas that claim to promote better vasodilatation and muscle pumps Most contain arginine Involved in the synthesis of NO Dose: high doses required to impact NO = 3 grams no established dosing regimen 9

10 PE - Arginine Conditionally-essential AA Physiological circumstance can impact body s ability to synthesis this AA Rate limiting AA in the synthesis of NO Research suggests it may help exercise efficiency and performance In one study healthy men who consumed 6g of arginine reduces amt of oxygen required to perform exercise and increased time to exhaustion by 26% during high intensity cycling Dose: High doses required to impact NO = > 3g Safe range is 1-4g Kraemer WJ, et. al. Androgenic responses to resistance exercise: effects of feeding and L-Carnitine. Med Sci Sports Exerc Jul;38(7): Fat Burners Green Tea Extract Raspberry Ketones Caffeine Fat Burners Green Tea Extract Green Tea is a great source of antioxidants Antioxidants = catechins Help support immune function, cardiovascular health, and fat loss EGCG (epigallocatechin gallate) is the predominant active ingredient responsible for green tea s thermogenic and fat burning effects The most active catechin Dose: enough extract to provide at least 270mg of EGCG Best fat burning potential is mg of ECGC/day Equals 4-5 cups of strongly brewed tea Effect depends on if user is highly resistant to caffeine Diepvens K, et al. (2007) Obesity and thermogenesis related to the consumption of caffeine, ephedrine, capsaicin, and green tea. Am J Physio Regul Integr Comp Physiol 292: R

11 Fat Burners Raspberry Ketones Aromatic compounds that chemically resemble capsaicin A chemical from red raspberries amongst other fruits Made famous after Dr. Oz television show, Raspberry Ketone: Miracle fat-burner in a bottle Studies on capsaicin indicate it promotes thermogenesis in a dose response manner by increasing epinephrine secretion Diepvens K, et al. (2007) Obesity and thermogenesis related to the consumption of caffeine, ephedrine, capsaicin, and green tea. Am J Physio Regul Integr Comp Physiol 292: R77-85 Raspberry Ketones In humans, several studies have reported capsaicin acutely increases energy expenditure, reduces food intake, enhances fat oxidation, and decreases body fat RK s may affect a hormone called adiponectin Adiponectin can increase the rate of fat burning and reduce appetite Not enough evidence to support use and provide proper dose Dose is variable based on user s age, health, and other conditions Fat Burning - Caffeine Most widely used stimulant drug in the world Found in many pre-exercise drinks and supplements Stimulates the CNS and increases alertness Also mildly elevates fat burning and metabolic rate Despite research, role of caffeine as a performance enhancing drug is still controversial Caffeine does not appear to benefit short term, high intensity exercise i.e.) sprinting Volek, J. PhD, RD: 25 Top Sports Supplements. Nutritionexpress.com 11

12 Fat Burning - Caffeine Caffeine can enhance performance in endurance sports Caffeine mobilizes fat stores and encourage working muscles to use fat as fuel Easily absorbed in stomach and intestine Peak blood levels in 1-2hrs IOC restricts use Approximately 1000mg of caffeine (about 8 cups of coffee) would be required to exceed the IOC limit Conclusion NSF Certified for Sport is a valuable resource for all members of a medical team NSF meets the demands of athletes, coaches, and medical staff concerned about the content of sports supplements and information on banned substances Do you research!! Resources Volek, J. PhD, RD: 25 Top Sports Supplements. Nutritionexpress.com US Food and Drug Administration International Olympic Committee Hoffman, J, et al. Effect of creatine and beta-alanine supplementation on performance and endocrine response in strength/power athletes. Int J Sport Nutr Exerc Metab Aug;16(4): Howatson G, et al. Exercise Induced muscle damage is reduced in resistancetrained males by branched chain amino acids: a randomized, double-blind, placebo controlled study. J Int Soc Sports Nutr May 8;9(1):20 Zhang Y, Guo K, et al. Increasing dietary leucine intake reduces diet-induced obesity and improves glucose and cholesterol metabolism in mice via multi-mechanisms. Diabetes jun;56(6): Kraemer WJ, et. al. Androgenic responses to resistance exercise: effects of feeding and L-Carnitine. Med Sci Sports Exerc Jul;38(7): Diepvens K, et al. (2007) Obesity and thermogenesis related to the consumption of caffeine, ephedrine, capsaicin, and green tea. Am J Physio Regul Integr Comp Physiol 292: R77-85 Raff M, et al. Conjugated linoleic acids reduce body fat in healthy postmenopausal women. J Nutr Jul;139(7):