Module 7 lecture 1 Nutritional Ergogenic Aids Flashcards
Substances, products, or techniques that enhance physical performance
ergogenic aid
* Ergo = “work”
* Genic = “to generate”
Types of ergogenic aids
- nutritional
- physiological
- psychological
- biomechanical
- pharmacological
Any supplement, food product, or dietary manipulation that enhances work capacity or atheltic performance
nutritional ergogenic aid
Any priactice or substances that enhances the bodies various systems and thus improves athletic performance
physiological ergogenic aid
Any practice or treatment that changes mental state and thereby ehances sport performance
psychological ergogenic aid
Any device, piece of equipment or external product that can be used to improve athletic performance during practice or competition
biomehcanical ergogenic aid
Any substance or compound classified as a drug or hormonal agent that is used to imrpove work output and/or sport performance.
pharmacological ergogenic aid
What is considered a nutritional supplement?
Not all have an ergogenic effect though
* Vitamins
* Minerals
* Herbs or other botanicals
* Amino acids
* Other dietary substances
* Any concentrate, metabolite, constituent, extract, or combination of these ingredients.
What are the sales for the global dietary supplement market in 2019?
estimated at ~$124 Billion in sales worldwide
top supplements used by athletes
- Multivitamins
- Vitamin C
- Protein Products
- Sports Drinks
- Sports Bars
- Energy Drinks
Prevalence of dietary supplements used by athletes
58-62% of athletes use some type of dietary supplement
* 87% of high performance athletes taken at least 3 supplements within last 6 months
Government Regulation of Sport Supplements
Health Canada and the Canadian Food Inspection Agency are given the authority to limit the sale of products, including drugs, food products, natural health products, and health supplements through legislation
* responsible to protect the public
What code are athletes subject to in regards to ergogenic aids?
The World Anti-Doping Agency (WADA) which limits the use of numerous ergogenic aids to prevent
* cheating
* harm to athlete health.
* Athletes in most sports are governed by the WADA Code either directly or indirectly and those who violate it can be banned from competition
What is WADA?
The World Anti-Doping Agency is a foundation initiated by the International Olympic Committee
* Established to promote, coordinate and monitor the fight against drugs in sports.
* Develops the policies and procedures for limiting the use of performance enhancing drugs and other strategies.
Established to promote, coordinate and monitor the fight against drugs in sports.
world anti-doping agency WADA
Develops the policies and procedures for limiting the use of performance enhancing drugs and other strategies.
world anti-doping agency WADA
Positive drug tests can result in?
- Loss of scholarship
- Competition bans
- Stripping of medals
- Monetary fines
Safety Issues of ergogenic aids
- Supplements do not need to be proven safe or effective before entering the market
- Good manufacturing practices are difficult to implement, monitor and enforce
- Funding to investigate complaints about sport supplements is very limited and enforcement is challenging
Regulation of Nutritional Ergogenic Aids in Canada
regulation of nutritional ergogenic aids and supplements in Canada is very loose!
* Unapproved, ineffective products can still be sold!
* Even approved products are not risk free
How are conventional sport products typically regulated?
typically regulated as “foods” not “drugs,” and includes fluid replacement beverages, sport gels, protein powders, and meal replacement drinks
* Should have a Nutrition Facts Panel or nutrient information on the label
* Purdon of proof of efficacy is lower than that required for pharmaceutical products.
What sport products are regulated as dietary supplements or licensed natural health products?
Supplements, bars, gels, sport “beans,” tablets and capsules, amino acids preparations, energy drinks and vitamin-mineral enhanced waters
* Will have a Natural Health Product Number (NPN) or a Drug Identification Number (DIN) on the label if they are legally approved for sale in Canada
The prescription or use of a drug or NHP for a purpose that has either not been approved by Health Canada (drugs) OR is being used for a purpose that is not the stated condition of use (NHP)
off label use
* ex. Human Growth Hormone being taken to promote muscle gain in an otherwise healthy adult
* There can be no guarantees of safety or efficacy when a drug or NHP is used “off label.”
What are potential risks of approved products?
- Can be toxic if taken in excess
- Can interact with other supplements, medications and foods
Example of a human growth hormone taken as an ergogenic aido
omnitrope to promote muscle gain accretion
What is omnitrope licensed for sale for?
Omnitrope is licensed for sale in Canada for the treatment of HGH deficiencies, it is not licensed for use as an adjunct for sport training in athletes.
What is the WADA code about growth hormones?
Growth hormone is in the category of Anabolic Agents on the World Anti-Doping Agency (WADA) Prohibited
List and is prohibited at all times and for all levels of athletes, including elite, junior, and masters-level athletes.
What is off label use?
This unapproved use of an approved drug
problem of Undeclared Ingredients and Contamination
The addition of undeclared ingredients to seemingly harmless sport supplements is relatively common
* E.g. anabolic steroids added to “muscle gain” products
* This is a concern for elite athletes because undeclared ingredients in a supplement may lead to a positive doping test.
Ex. Jessica Hardy; banned from 2008 olympics, clenbuterol
Why Add Undeclared Ingredients?
Without the addition of an anabolic steroid there is no nutritional supplement that could achieve these outcomes! If the product doesn’t work, no one will buy it.
APS Nutrition Ultra Mass Stack; Trenbolone – a veterinary steroid
Ingestion of substances that unbeknownst to the athlete can cause a positive test for doping.
Inadvertent Doping
* E.g. creatine supplement containing undeclared anabolic steroids
causes of inadvertant doping
- Ignorance of what substances are banned.
- Names in ingredients list are not recognized.
- Manufacturer may not list all ingredients.
- Product could be contaminated
Strict Liability
The principle of Strict Liability is a cornerstone of the WADA code and asserts that:
* Athletes are responsible for any prohibited substance that may be found in their sample; and
* Athletes who test positive for a prohibited substance, may face sanctions regardless of how the prohibited substance got into their body.
Ex. Silken Laumann, rower, Canada; lost gold medals; OC cold remedy 1995
What is NEA?
nutritional ergogenic aids
Why might people believe that natural is better?
involves a range of ideas
* belief that nature is pure and inherently superior to humans
* beliefs affect the decisions people make about their health
Athlete health concerns with NEA
- cardiovascular issues
- renal isses
- hepatic issues
- seizures
- medication interactions
- Exceeding micronutrient ULs
Cardiovascular issues with NEA
Hypertension, cardiac issues and death have all been associated with dietary supplement use
Renal Issues with NEA
Kidney damage can occur, especially with supplements that contain herbs
Hepatic Issues with NEA
~20% of drug induced liver injuries are from dietary supplements
Seizure issues with NEA
Acute neurotoxicity can occur after ingestion of dietary supplements with sympathomimetic properties
(e.g. Yohimbe Extract)
Medication Interactions with NEA
Athletes are not always truthful with healthcare providers when discussing supplements. There can be potential interactions between supplemental ingredients and medications
What is UL?
Tolerable Upper Limits (UL) are the highest level of nutrient intake that is likely to pose no risk of adverse health effects for almost all individuals in the general population.
* As intake increases above the UL, the risk of adverse effects increases.
What NEAs are less of a concern with exceeding ULs?
Excess intake of the water soluble vitamins is less of a concern because generally excess is excreted in the urine
* In some instances, supplementation with certain water soluble vitamins can be toxic
Water-Soluble Vitamins with ULs
- vitamin C
- thiamin (B1)
- riboflavin (B2)
- Niacin (B3)
- Pantothenic Acid (B5)
- Vitamin B6
- Biotin
- Vitamin B12
- Folic Acid
What types of NEAs are more of a concern with ULs?
Fat soluble vitamins as well as minerals are not as easily cleared by the body and can become toxic at high levels
* Vitamins A,D,E,K
* minerals
Symptoms of UL toxicity
include but are not limited to:
* changes to vision
* bone and joint pain
* skin changes
* muscle weakness
* diarrhea
* increased risk of bleeding
* skin flushing
* heart arrythmias
WADA prohibited at all times list
- anabolic agents
- Peptide hormones, growth factors, related substances, or mimetics
- Beta-2 agonists
- Hormone and metabolic modulators
- Diuretics or masking agents
WADA prohibited in competition list
- stimulants
- narcotics
- cannabinoids
- glucocorticoids
Additional Resources about NEAs
- NIH Office of Dietary Supplements
- Medline Plus for Herbs and Supplements
- Natural Medicines Database
Position of Canadian Centre for Ethics in Sport on NEAs
“The CCES believes that the use of most supplements poses an unacceptable risk for athletes and their athletic career. Ultimately, athletes are responsible for any prohibited substance that may be found in their sample; this is known as strict liability.
* If athletes who use supplements test positive for a prohibited substance, this can result in a violation being declared, regardless of how the prohibited substance got into their body. Serious sanctions may be imposed.”
Flow diagram for use of supplements
Starts off with nutrient deficiency in insufficiency and move through it.
obligation to protect the public when offering nutrition recommendations.
Jurisprudence
Why is jurisprudence important?
The use of dietary supplements is an ever-changing and ever- challenging aspect of sports nutrition. Sports dietitians should be open-minded skeptics and take great care to consider the pros and the cons of recommending or appearing to recommend nutritional ergogenic aids to athletes.
* There are some supplements that are safe but not effective.
* There also may be some supplements that are effective but not safe, and these pose serious risk-benefit questions that ultimately can only be answered by the athlete.
Red flags with supplements
- Big claims
- Promise quick and unrealistic results
- “Alternatives” to prescription drugs
- Proprietary blends
Recommendations for 3rd party supplement testing
- Certifying program and labs accredited to International Standard Organization (ISO)17065
- Certifying program controls their certification mark
- Impartiality and written conflict of interest policies
- Methods to revoke certification and inform consumers
- Complaint and appeals process for clients
- Program certifies against NSF/ANSI 173 (NSF/ANSI 173 is the standard for evaluating dietary supplements)
Testing programs that certify ingredients, batches of products, and/or manufacturing facilities
3rd Party testing
* Athletes or athletic staff can send samples to independent labs for testing
NSF Certified for Sport
- Products do not contain any of approximately 270+ substances banned by major athletic organizations.
- The contents of the supplement actually match what is printed on the label.
- There are no unsafe levels of contaminants in the tested products.
- The product is manufactured at a facility that is GMP registered and audited twice annually for quality and safety by NSF International.
What to look for in order to make informed choices
- Certified finished products – full manufacturing audit and regularly tested for a wide variety of WADA banned substances
- Certified raw ingredients – full manufacturing audit and every batch is pre-market tested for a wide variety of WADA banned substances
- Certified sites – assurance that facilities are equipped with adequate critical control procedures
organizations that help practitioners and athletes identify supplements that meet strict quality controlled standards
3rd party testing
