The ABCs of Supplements for Athletes

Dietary supplements are used by athletes for various reasons including good health, management of nutrient deficiencies, performance enhancement or other indirect benefits to support hard training, to manipulation of physique, to help with recovery from injury, to alleviate muscle pain and to enhance mood. However, not all supplements are shown to achieve what it claims to help with.

There is an abundance of information on dietary supplements found in advertising and on the internet. Most of the claims found on the internet about these supplements are not backed by science. Many of which are unrealistic and even impossible. Even if they state that they use journals to support their claims, most are inappropriately extrapolated. Claims that the manufacturers make are apparently difficult to regulate. As the supplements is not regulated and tested for safety, retailers have the enormous freedom in making marketing claims.

Nutrition Plan X uses scientific studies to help you sieve out whether there is scientific evidence in the benefits that the supplements claim to have. It is important for you to understand the basics before diving into the specific dietary supplements.

Dietary supplement is "A food, food component, nutrient or non-food compound that is purposefully ingested in addition to the habitually consumed diet with the aim of achieving a specific health and/or performance benefit" ~IOC consensus statement~

The different forms of supplements

There are various forms of supplements available in the market. They include:

Functional Foods

Foods enriched/fortified with additional nutrients or components outside what they usually contain. For example, fortifying salt with iodine. It includes Protein Fortified Food (PFP).

Formulated Foods and Sports Foods

Products that provide energy and nutrients in a more convenient form compared to the usual foods for either general nutrition support (e.g. liquid meal replacements) or for targeted use around training and during competition time (e.g. sports drinks, sports gels, sports bars).

Sports foods and formulated foods are consumed to provide nutrients that help with performance such as to provide fuel for the muscle or brain.

Not every Sports Foods and Formulated Foods are equally used for a certain scenario specified in many media articles. For example, most media articles may identify sports drinks as a means to replenish fluid & electrolytes. But within the sports drinks category, there are certain beverages that are used for certain scenarios. For example, isotonic drinks are more for scenarios where you need to replenish fluid and electrolyte losses.

Single nutrients and other single components from food or herbal products

These are usually provided in isolated or concentrated forms. For example, whey protein powder, casein powder, iron supplements, Omega-3 supplements, etc.

Multi- ingredient products containing various combinations of nutrients and components from food or herbal products

These are also usually provided in concentrated forms or in pills. For example, multi-vitamins, etc.

Supplements

How should supplements be used?

Supplements should be:

• batch-tested,

• used only during certain situations,

• assessed for its effectiveness

• monitored in terms of dosage

• whether there may be a problem with the combination of supplements consumed.
  

Note: Not all supplements can directly enhance performance.

There are safety concerns such as the presence of stated ingredients or hidden ingredients that are toxic and prohibited. There was a report that showed that out of the 634 supplements tested that were found globally, 94 supplements contained anabolic steroids which can cause a positive result on a drug test. None of these supplements gave any indication that they contained steroids compounds. The possible supplement contamination and the risk of taking a mislabeled supplement may cause a threat to your athlete career as you undergo drug/ anti-doping tests and a threat to your health in the long run.

Why should we have batch-tested Supplements?

Supplements can contain prohibited substances listed on the World Anti-doping Agency (WADA)'s Prohibited List which results in an antidoping rule violation. Athletes and competitive individuals who are competing under the World Anti-doping Code are subjected to urine and blood testing.

You may think that supplements that are "natural" or "regulated" are safe but ingredients in supplements are not regulated. The supplement can be cross contaminated with the prohibited substances, or the prohibited substances are not listed in ingredients list. A study reported that ~15% of more than 600 products found around the world contained undeclared prohormones. Even commonly consumed supplements such as Vitamin C, Multivitamins and minerals have been found to contain prohibited substances.

To minimize the risk of having a positive doping test, you should choose supplements that are batch-tested as these substances may not be listed in the product labels. By getting batch-tested supplements, you will be able to consume products that are considered to be 'low risk' of containing prohibited substances. Although it does not guarantee that a product is entirely safe, it helps you to manage the risk.

Situations of use

All supplements target a range of situations and scenarios for them to be used. So, there are different approaches to assessing their effectiveness and potency.

Scenarios include:

Deficiencies that are medically diagnosed by the Doctors

Single or multi-nutrient supplements are usually aimed to correct nutrient deficiencies. Usually prescribed when you are unable to prevent or treat the suboptimal nutrient status with food. For example, when you are found to be diagnosed to be iron-deficiency anemia, the doctor would usually prescribe iron supplements to you.

When you are found to be deficient in one or more nutrients, it may lead to an impairment of sports performance either directly or by reducing your ability to optimally train or by weakening your immunity or by increasing the risk of injury.

Times where it is impractical for you to consume food to meet your nutrition goals

Reasons include:

• issues around preparation or storage of recovery/ post-training snacks,

• ease of consuming food due to training schedules,

• gut comfort during training/ competition or

• unable to meet nutrient requirements within your energy budget.

For example, immediately after key workouts/resistance exercises, you would need to consume rapidly digestible protein-rich foods to help with muscle gains. Protein supplements and certain Protein Fortified Foods (PFP) may be used as an alternative as it may contain whey protein which is a rapidly digestible protein.

Times where you are unable to replenish fluid & electrolytes losses

While water can hydrate you during rest days and short training sessions, it is unable to replenish fluids losses during prolonged exercise in the hot and humid climate and during scenarios where you are sweating profusely. As sweat contains water and electrolytes, you would need to replenish fluid and electrolytes when you sweat a lot. You would then use isotonic drinks to replenish fluids and electrolytes.

Most media articles may identify sports drinks as a means to replenish fluid & electrolytes. But within the sports drinks category, there are certain beverages that are used for certain scenarios. For example, isotonic drinks are more for scenarios where you need to replenish fluid and electrolyte losses while sports drinks with higher carbohydrates are more for refueling in a cold weather.

Common Side effects of Supplements

They vary according to the type of supplements and occur especially when used outside the optimal protocol. Side effects may also occur when you are consuming other supplements at the same time as the benefits of other supplements may counteract with each other.

For example:

1. Iron supplements without prescription

Taking supplements when you have adequate iron stores can result in symptoms such as vomiting, diarrhoea, abdominal pain. It can develop to haemochromatosis and liver failure.

2. Supplementing Bicarbonate on your own

Bicarbonate may cause gastrointestinal distress when consumed which impairs performance rather than improving it. For example, many athletes experience diarrhea, bloating, cramps an hour after consuming sodium bicarbonate in large doses.

3. Supplementing Caffeine on your own

When you excessively take caffeine, you might experience nausea, anxiety, fast heart rate and insomnia which outweighs the performance benefits. There is a report that very large doses of caffeine can be fatal. This was caused by miscalculation of the dosage of caffeine.

Think carefully whether you should use dietary supplements and whether the possible benefits outweigh the risks of getting a doping offence which might end your career.

For the athlete's support groups such as Coaches, when you provide your athlete with supplements, please take note that it can end your career if the supplement given contains prohibited substances and it can affect the athlete's performance if you do not know when to take and dosage of the supplement. You may not know whether there is a possible supplement contamination and the supplement that you give to your athlete is a mislabeled supplement with prohibited substances. So, try not to "self-diagnose" your athlete.

Key Points

• Dietary Supplements can play a small role in your nutrition plan

• Only a few supplements can directly enhance performance.

• It will take considerable effort and expert knowledge to identify what is appropriate and how to incorporate them into your sports nutrition plan. Book a slot with us for a consult. We provide credible, evidence-based information regarding the appropriateness, efficacy and dosage for the use of sports food and supplements.

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