Wednesday, May 9, 2012

Supplement Series Part 2: How to Evaluate Ergogenic Aids

Last week I listed a variety of commercial sport food supplements that athletes often use to provide fluid, energy, and electrolytes. Using these types of products correctly leads to relatively little risk with respect to safety and legality for the athlete. However, another category of supplements poses huge issues: ergogenic aids. Ergogenic aids are defined as any external influence created to enhance sport performance. So, while this can mean anything from an oral product to those spiffy new running shoes, today I'm going to focus on the powders and pills that so many athletes know and experiment with. So, going forward, any time I use the word "supplement" in this post, I'll be referring to ergogenic aids in the form of powders, pills, capsules, or tablets (also known as dietary supplements).

The Nutrition Business Journal estimated that sales of all nutritional supplements (including vitamins and minerals) in the United States in 2010 was somewhere around $28.7 billion. Supplements sales have steadily increased 6-7% per year since 2009, which is higher than the 5% growth the industry saw yearly from 2000-2009. Sales were highly driven by dietary supplements such as vitamin D, probiotics, fish oil, and CoQ10.

With the multitude of products on the market today, how do you know if what you're taking is safe (won't affect your short- and long-term health), effective (actual does what it claims to do), and legal (doesn't contain banned substances for your sport)? Before I go any further, let me be clear on one point: If you are under the age of 18, you should not be taking ANY ergogenic aidsThe long-term effects of most supplements on growing athletes has either not been studied or is unfavorable. So, until you are 18, don't even think about it! 

Under the Dietary Supplement Health and Education Act of 1994 (DSHEA), "the dietary supplement or dietary ingredient manufacturer is responsible for ensuring that a dietary supplement or ingredient is safe before it is marketed. The FDA is responsible for taking action against any unsafe dietary supplement product after it reaches the market" []. Did you read that correctly? The manufacturers of dietary supplements can essentially put anything they want on the market without prior approval or testing. The FDA will only monitor that supplement if people complain/file grievances. Does that sound backwards to anyone else? The FDA also states that manufacturers have to provide a truthful label, with all ingredients listed on that label. However, we know from countless studies that this often is not the case, leading to many positive drug tests in athletes who thought they were taking one thing, but actually were ingesting something quite different. In addition, claims can be made on the label based on the manufacturer's interpretation of the scientific literature, but these are often misleading. For example, a claim made on the label could be based on studies done on mice taking doses too high for human consumption.

While some companies do follow good manufacturing practices (GMPs), too many others do not. In a study conducted by the International Olympic Committee, of 634 supplements tested from 13 different countries, 94 supplements (14.8%) contained prohibited substances. Another 10% showed possible presence of steroids. That means that 1 out of every 4 supplements contained prohibited substances. Products that tested positive were from all over the world.

As an athlete, it is your job to know what you can and cannot take. Sports governing bodies (i.e. the NCAA, IOC, etc.) publish lists of banned substances every year. That means if you test positive for those, you are done competing. Note that they don't list specific supplements that contain the banned supplements, which is why working with a sports dietitian is so important. Saying "I didn't know" is not a good defense. Note also that just because a product is "Natural" does not equate to safe. 

Safety and legality aside, also realize that supplement companies do not have to prove a supplement's effectiveness or potency before placing it on the market. That means you could be ingesting mainly flour with a little caffeine for effect (a common ingredient included in pills so athletes feel like the supplement is "doing something").

How do you evaluate the safety & effectiveness of supplements?
Meet with a registered sports dietitian, who is qualified to assess your supplements. You can also check out the National Institute of Health Office of Dietary Supplements website to do your own research.

How do you assure the quality of your supplements?
Look for NSF-certified products. NSF International ( are products that are certified to be clean. Go here and you can actually search by supplement name to determine if it is NSF-certified. You can also check as well as . However, realize that even when using certified products, you are still risking a positive drug test. Any product can be contaminated since there is nothing in place to prevent this.

If you choose to take a supplement, make sure you do not take more than the recommended dose (sometimes even this dose is unnecessarily high). If you are in college, semi-pro, or pro sports, inform your team sports dietitian, sports doc, or athletic trainer about what you are taking. If you are feel you are having a reaction to the supplement such as headache, upset stomach, dehydration, etc., stop taking the product immediately!

Come back next week for Supplement Series Part 3. I'll discuss the 5 most common ergogenic aids and evaluate their effectiveness with respect to athletic performance.

Be Extraordinary,


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