Multisport: Nutritional Supplements – The Good, The Bad and The UGLY

Choosing Wisely and Safely

Written by: Kathy Zawadzki, CTS Certified Coach

Competitive athletes and recreational exercisers alike are using sports nutrition supplements with the hope that they will see improvements in muscle mass and strength, energy and endurance, and recovery after exercise. Using the right products in the right way, in the right amounts and in the right situations may help improve exercise performance, enhance adaptations to training and help promote a quicker recovery from training. But how does one know which product, and in what amount will do the trick?

Almost everywhere we look these days, one can find an advertisement for a product that will make you swim or run faster, or make you leaner and stronger. Products are marketed to help athlete’s clear lactate more effectively, or to store more creatine in the muscles, or build bigger and stronger muscles. The list goes on and on, but where does reality stop and marketing-hype begin??

For decades, the Food and Drug Administration (FDA) regulated dietary supplements as foods, in most circumstances, to ensure that they were safe and wholesome, and that their labeling was truthful and not misleading. Not so anymore. For the past ten years the Dietary Supplements Health and Education Act of 1994 (DSHEA) deregulated the industry and limited the FDA’s powers. Unlike drug products that must be proven safe and effective before marketing, there are no provisions in the law for FDA to "approve" dietary supplements for safety or effectiveness before they reach the consumer. Under DSHEA, the burden of proof has been shifted --once the product is marketed, the FDA has the responsibility for showing that a dietary supplement is "unsafe," before it can take action to restrict the product's use or removal from the marketplace.

So what can the manufacturers say their supplements can do? To be legal under DSHEA, a "nutritional support" statement must not be a "drug" claim. Manufactures may make claims that their products affect the structure or function of the body; however, products may not bear a claim that they can prevent, treat, cure or diagnose disease. For example, while a manufacturer cannot say an iron supplement cures anemia, they can say that iron is important in the synthesis of hemoglobin in red blood cells. You should never see express disease claims such as "prevents osteoporosis", or implied disease claims like "prevents bone fragility in postmenopausal women". What you will see are health-maintenance claims such as "maintains a healthy circulatory system" and other non-disease claims such as "for muscle enhancement," or "helps you relax”. These nutritional support statements must be followed by the phrase, “This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat or prevent disease.”

All of this leads to one major conclusion, BUYER BEWARE. If the claims sound too good to be true, most likely they are. Most athletes want to believe that there is a magic pill or potion that can help give them that extra edge and manufacturers use that to manipulate consumers. When trying to evaluate if a supplement can be beneficial, ask yourself the following questions to help evaluate the claims:

Is the person or company making the claims reputable? Is the only reason they are telling you about their product to sell you their product? Be aware of statements that promise to dramatically enhance performance or guarantee fast results. Is their “ad” based on personal testimonials rather than scientific evidence?

What evidence is supplied for the claims that are made? All claims should be supported with studies published in peer-reviewed, scientific journals. If you are uncertain, look up the study to be sure it is recent, and what the study actually investigated. Some “facts” get stretched or oversimplified to help support claims by manufacturers.

Doesn’t 'natural,' mean that a product is safe? Consumers can be misled if they assume this term assures wholesomeness, or that these food-like substances necessarily have milder effects, which makes them safer to use than drugs. The term "natural" on labels is not well defined and is sometimes used ambiguously to imply unsubstantiated benefits or safety. For example, many weight-loss products claim to be "natural" or "herbal" but this doesn't necessarily make them safe. (Ephedra is a natural ingredient that has led to over 155 reported deaths!)

So the big question is “Do athletes really need dietary supplements?” The answer is not completely clear, as some have been shown to enhance performance and recovery, while others are unsubstantiated. There is strong scientific evidence to support the ergogenic effect of carbohydrate and electrolyte products for use during and after training or competition including, Sports Drinks, Energy Gels and Bars, and Recovery Drinks. When choosing a product in these categories, make sure that you are buying from a reputable company and that you read the ingredients list carefully. These days there are many products with added ingredients that you may not need or that may not agree with your system.

Supplementing with a variety of vitamins and minerals is still controversial. It is important to point out that most research has shown no enhancement in athletic performance with vitamin and mineral supplementation, but there are definitely cases of decreased performance when there is a deficiency in a specific vitamin or mineral. Inadequate vitamin consumption can lead to sub optimal health and poor athletic performance. Think of an automobile and its need for oil. If there is not enough oil in the car, then the engine function may be compromised and it may even harm the engine in the long run. When oil levels are optimal, performance is optimal. However, if extra oil is added, it does nothing to enhance the performance of the engine. Therefore, if vitamin supplements are provided to eliminate a known vitamin deficiency, they will lead to better health and provide a foundation for better training and improved performance.

Typically, there is an increase in the use of vitamins and minerals that are involved in the metabolic pathways that are stressed during training and the theoretical increase in the requirement for certain vitamins and minerals. However, as an athlete you are going to be consuming more food than your sedentary counterparts. Along with the extra calories, come extra vitamins and minerals. For most active people, eating more food will cover the additional requirement for certain vitamins and minerals. This is assuming, however, that you are choosing a variety of wholesome foods. If you find your dietary choices are not always the best, supplementing with an antioxidant formula multi-vitamin would be recommended.

It is important to note that consuming a supplement that contains high amounts of a single micronutrient is more likely to cause adverse affects than a general multi-vitamin/mineral supplement. Micronutrients work in a delicate balance with each other to keep the body functioning normally, and they are vital to growth, maintenance and repair. It's a rare occasion that a micronutrient will work alone to accomplish a task--most work in concert with others. By taking a large amount of a single vitamin or mineral, you could interfere with how another nutrient works in the body.

If you choose to use dietary supplements, which are not regulated, I encourage you to look for products that have USP (United States Pharmacopeia) on the label. This not-for-profit, non-government organization has established state-of-the art standards to ensure quality products.

There is also The Dietary Supplement Verification Program (DSVP), which works to ensure that supplements contain the declared ingredients in the declared quantities. It helps to look for nationally known food and drug manufacturers who make their products under tight manufacturing controls, as well. Manufacturers who participate in this program agree to a number of guidelines including random off-the-shelf testing of products and bear the DSVP certification mark.

One major misconception by athletes is that they assume if a product is harmful, it will be immediately and completely removed from the marketplace. A product recall of a dietary supplement is voluntary and while many manufacturers do their best, a recall does not necessarily remove all harmful products from the marketplace. On Dec. 30, 2003, the FDA issued a consumer alert on the safety of dietary supplements containing ephedra. The alert advised consumers to immediately stop buying and using ephedra products. The principal active ingredient is ephedrine, which when chemically synthesized is regulated as a drug. There are on-going court proceedings by manufacturers challenging the FDA, so be aware that you may still find ephedra containing products on your store shelves.

But while most supplements are probably fairly benign, Consumer Reports has identified a dozen that according to government warnings, adverse-event reports, and top experts are too dangerous to be on the market. Some on their hit list include comfrey, kava, and androstenedione.

The FDA’s most recent crackdown came in March of 2004 when it sent a letter to companies that manufacture, market, and distribute products containing androstenedione, or "andro.” Andro acts like a steroid once it is metabolized by the body, and therefore, can pose similar kinds of health risks as steroids. A statement by FDA Commissioner Mark McClellan, Ph.D., M.D. illustrates the seriousness of the FDA’s actions: "Anyone who takes these products in sufficient quantities to build muscle or improve performance is putting himself or herself at risk for serious long-term and potentially irreversible health consequences. There is no proven safe substitute for hard work and training when it comes to improving athletic skill; we will do all we can to protect Americans against companies that seek to profit by trying to convince consumers otherwise.”

As athletes, you must remember that these products are called “supplements” for a reason. They are designed to supplement the diet, not replace the benefits of wholesome foods. The nutrients and other healthful compounds in foods work in a fine balance, which scientists are only beginning to understand. By striving for a well-balanced diet with a variety of fresh fruits and vegetables, you will take the first step in assuring your body will be getting a good balance of all the required nutrients your body needs.