A Guide to Empowering and Educating Your Athletes About Supplement Use

by: Leslie Bonci, M.P.H., R.D.
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Let’s face it, supplements are here to stay. The lure of Bigger, Stronger, and Faster is irresistible, and all the glossy ads and quick fixes draw athletes like magnets. A Blue Cross and Blue Shield survey of teens using performance enhancers estimates that at least 1 million adolescents have tried these products. A survey conducted by the NCAA estimates that approximately 60% of college athletes have or are currently using nutritional supplements. Certainly, you want to encourage and appropriately enable your athletes to perform to the best of their ability, in as safe a way as possible. Oftentimes the types of supplements, methods of use, or amount consumed may be more performance-impairing than performance-enhancing. This article will focus on the following points:

• What you need to know about supplements
• What to tell your athletes about supplements
• How to educate parents about supplement use

As we all know, our athletes are very impressionable. Your words carry a lot of weight, and can be used very effectively when it comes to talking to athletes about supplements. Use this power appropriately. It is very important to be aware of the following points when it comes to supplements.

• Young bodies may be more susceptible to the negative effects of supplements
• Young athletes may focus more on the supplement than what they eat or drink.
• More is not better, and is almost always worse
• Supplements are NOT a substitute for proper eating and hydration
• Natural and safe are not synonymous terms
• Supplements are not well-regulated and therefore there is no guarantee of purity or efficacy.
• Supplements are not just available in a pill, powder, or vial, but are now added to sports bars, sports drinks and even juices.
• What the label says and what is really in the product are not always the same
• Supplements can interact with each other
• Supplements can interact negatively with prescription medications

WHY ARE ATHLETES USING SUPPLEMENTS?
To properly educate your athletes about supplement use, it is important to understand why they are used. The most frequent reasons for use include:

• To boost performance
• To improve appearance
• To increase muscle mass
• To lose weight
• To improve health
• To increase energy

WHAT ARE THE MOST COMMONLY USED SUPPLEMENTS?
Breaking down supplement use into categories by effect, the most frequently used substances include:

• Anabolics: Muscle building/Weight gainers
• Thermogenic or Fat Burning
• Energy Boosters
• Herbals
• Vitamin/Mineral supplements

MUSCLE BUILDING SUPPLEMENTS:
• Protein powders
• Amino acid supplements
• Creatine
• Androstenedione
• Norandro
• DHEA
• Human Growth Hormone
• HMB
• Yohimbe
• Chromium
• GHB/GBL

Many athletes want to take protein powders to increase muscle mass. Your athletes need to know that the protein from a powder is not any better than that from a food. Some of these powders taste terrible and cost a fortune. Many are chockful of vitamins, minerals, herbs and glandular extracts. Athletes who take these powders for weight gain often find that by the time they drink a large volume of protein shake, they are too full to eat, and end up consuming fewer calories than they need. It is also important to remind your athletes that the maximum usable amount of daily protein (measured in grams) is equal to 1 x body weight in pounds. An athlete who weighs 180 pounds does not need more than 180 grams of protein a day. Some of these products contain 50 grams of protein per scoop.

Amino acid supplements are a very costly, inefficient way to get in the protein the body needs. Taking selective amino acids may result in imbalances, and they can also cause an upset stomach. When talking to your athletes, emphasize the fact these products are providing very little protein to the body.

Amino acids are measured in milligrams, whereas the unit of measure for protein is in grams. A milligram is 1/1000th of a gram, so a supplement that contains 10,000 milligrams of amino acids is only providing 10 grams of protein, the amount in a 10 ounce glass of milk, but with a much higher price tag!

Although creatine may be an effective supplement for some athletes, it is not one size fits all. Some athletes notice an increase in strength or size, or decreased effort when using creatine, while others may feel worse, or find that the added weight detracts from performance.

Any product which claims to boost testosterone levels should be avoided. The NCAA bans all of these, and for the high school athlete with intentions of participating in sports in college. DHEA, Androstenedione, Norandro, Human Growth Hormone, GHB, and GBL all fall into this category.

In addition, GHB and GBL can result in adverse health consequences including: coma, seizures and death, especially when combined with drugs and/or alcohol.

HMB may be effective in increasing muscle mass, but it is costly, does not replace food, and only works in combination with an intense strength training regimen.

Yohimbe is an herb that has no effect on boosting testosterone, but can cause kidney damage and increase blood pressure. Chromium has no effect on increasing muscle mass.

SUPPLEMENT EFFECT
Protein powder May replace other needed nutrients ( such as carbohydrate), often contains mega doses of herbs, vitamins, minerals, and other additives
Amino acid supplements Not efficiently utilized by the body and may upset the stomach
Creatine May be effective for select athletes, needs to be taken with carbohydrate
DHEA, Andro, Norandro, Human Growth Hormone, GHB/GBL All are banned in the NCAA
Can be dangerous.
HMB May be effective, but not many studies have been done
Yohimbe Dangerous

THERMOGENIC (“FAT BURNERS”)
Athletes who need to lose weight are always looking for the quick fix. Fat burners or weight loss supplements are very attractive, because taking a pill is a lot easier than exercise or cutting back on food. However, these products can be very harmful to the body, may be useless, or banned.

Fat Burners include: Ephedrine Synephrine
Caffeine L-carnitine
Hydroxycut Quercetin
Fat Trappers ( chitin) Dieter’s tea

Ephedra is a dangerous substance that is banned in the NCAA. It is a central nervous system stimulant that can be very stressful to the heart, especially in hot, humid conditions. Athletes need to be aware that the word ephedrine can be on a label as ephedra, Ma Huang, epitonin, or sida coridifolia. A product may say that it only has 20 milligrams of ephedra, but in reality it may have significantly more or less.

Synephrine, known as bitter orange, citrus aurantium, or zhi shi does not have a fat burning effect. Caffeine in an herbal form as guarana, mate, kola nut is present in several fat burners. Although it does not burn fat, it has a stimulatory effect, and is also a diuretic, causing fluid loss, and can be a diarrhetic, having a laxative effect.

Hydroxycut contains garcinia cambogia, which has not been shown to have a significant effect on body fat, but it also contains ephedra. L-carnitine, quercetin, and chitin are expensive, but useless for weight loss. Dieter’s tea contains herbal laxatives, so the only loss is fluid and electrolytes, not fat.

SUPPLEMENT EFFECT
Ephedra Dangerous
Synephrine No fat burning effect, but is usually in
products that contain ephedra
Caffeine In large doses can cause fluid and electrolyte loss
Garcinia cambogia Does not promote fat loss but is usually in
products that contain ephedra
L-carnitine, quercetin, chitin Has no effect on weightless
Dieter’s tea Fluid and electrolyte loss only, not body fat

ENERGY BOOSTING SUPPLEMENTS
Products labeled as energy boosters include those with caffeine, or ephedra, as well as ginseng. Caffeine and ephedra can both give a “buzz”, but the only thing that truly boost energy is getting in calories through food or fluid. Ginseng does not have performance enhancing effects, but may help to support a healthy immune system. I tell my athletes that I view supplements as the icing, but if you don’t eat the cake, you aren’t getting the full benefit.

HERBAL SUPPLEMENTS
Herbal supplements are an industy in and of themselves. There are many products available as pills, gelcaps, powders, extracts, and beverages. Although many are harmless, some herbs can cause allergic reactions, and can interfere with prescription medications. Certain herbs such as gingko, ginseng, and garlic have a blood thinning effect.

VITAMIN-MINERAL SUPPLEMENTS
Many athletes think that taking a vitamin -mineral supplement will offset poor eating. I always tell my athletes that a poor diet with supplements is a well-supplemented crappy diet! Athletes who take mega, ultra, high potency formulations are ending up with very expensive urine. If an athlete wants to take a supplement, they should take it daily, and should take a multivitamin-mineral formulation instead of individual supplements, unless prescribed.

HOW TO EDUCATE ATHLETES APPROPRIATELY
• Have a yearly team meeting with parents (for high school coaches) to discuss supplements
• Have a team meeting with the certified trainer, sports nutritionist, if available and/or team physician to discuss supplements, including the NCAA regulations for college athletes.
• Realize that what works for you may not work for them
• Gently discourage well-meaning parents from supplying supplements for their children.
• Do ask your athletes for an honest appraisal of current fueling and hydration practices, and use this information wisely when it comes to educating athletes about supplement use.
• Insist that your athletes fill out a supplement form, and update it if and when they try any new products. ( see sample form)
• Encourage your athletes to be truthful about what they take
• Ask athletes to bring in the labels from products.
• Ask athletes why they take the products and what they notice: benefits, side effects, no change, etc.
• Tell athletes that they should report any unusual side effects, and they should discontinue taking the supplement immediately!
• Remind athletes that the person selling the supplement is not always the best informed, and their job is to sell the product, which may not always be in the athlete’s best interest.
• Do emphasize responsibility!! Athletes should be responsible for what they are choosing to put into their bodies, and taking a supplement that could be harmful is acting irresponsibly.

THE BOTTOM LINE
All athletes are on the lookout for the magic bullet when it comes to maximizing performance, improving energy or changing body composition. We all want our athletes to be safe, not sorry, and certainly not harmed by any products they choose to use. The athlete who is informed, educated, and knows that someone else is keeping tabs will be more likely to be forthcoming with regards to supplement use. Keep an open door and an open mind, and keep yourself informed so you can better help your athletes.

Leslie Bonci is the Director of Sports Medicine Nutrition for the Department of Orthopedic Surgery and the Center for Sports Medicine at the University of Pittsburgh Medical Center. She is a registered dietitian with a Master’s degree in Public Health. Leslie is an Adjunct Assistant professor of Nutrition at the University of Pittsburgh. She is a media spokesperson for the American Dietetic Association, providing nutrition expertise in print, radio and television. Leslie serves as the nutritionist for the Pittsburgh Steelers, The University of Pittsburgh Athletic Department and also consults to local and national schools and universities, including The University of Notre Dame, and the University of Texas on topics such as eating disorders and sports nutrition. She also lectures on sports nutrition for the Gatorade Sports Science Institute’s Sports Nutrition network.

For further information contact Leslie Bonci at (412) 432-3674 or boncilj@msx.upmc.edu

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