Supplements

Dear Parents,

On behalf of the RV Sports Medicine Department, we are taking this opportunity to communicate with you about a very important topic, sports supplementation. We believe it is important for us to be proactive by increasing you, and your child's awareness and knowledge of this issue.

The use of sports supplementation is one of the fastest growing trends, yet least discussed issues, in all levels of sports today. Sport supplementation is a multi-billion dollar industry that has targeted your sons and daughters as a primary consumer. Sport supplements come in all shapes, sizes, flavors and forms. In the United States, the only guidelines the supplement industry needs to follow are those within the Hatch Act. According to the Hatch Act, in order for any supplement to be legal it only needs to be found in a compound that exists in nature. We feel it is imperative for you to know these same natural compounds are not subject to FDA testing or regulation, leaving their effectiveness and safety in question.

As a department, the sports medicine staff and team physician discourage any of our athletes from partaking in the use of any form of supplementation. The scientific literature on these supplements has focused on adults, not adolescents. This same literature shows some supplements seem to be safe (e.g. whey protein), others (e.g. androstenedione (Andro) and dehydroepiandrosterone (DHEA) may have serious side effects, which include, but are not limited to: liver abnormalities; lowering HDL/LDL cholesterol ratio; testicular atrophy; breast enlargement in men; prostate hypertrophy; mood swings; excessive hair growth in women; and in adolescents, premature closure of growth plates.

Nothing is more important to athletic performance than proper nutrition. A properly balanced diet, rich in protein, carbohydrates, fats, vitamins, minerals, and water, provides the body with the nutrients needed to perform. We encourage our athletes to maintain a properly balanced diet, which will enable them to reach their full genetic potential.

We would encourage you to become actively aware of sports supplements and use of any form of supplementation. If you like to speak to someone about this issue, please call Jim McHugh or Tami Osterhout at 609-267-0830 ext. 3285.

What is a dietary Supplement?

The Dietary Supplement Health and Education Act, of 1994 (DSHEA) established a formal definition of "dietary supplement" using several criteria. A dietary supplement:

• Is a product (other than tobacco) that is intended to supplement the diet that bears or contains one or more of the following dietary ingredients: a vitamin, a mineral, an herb or other botanical, an amino acid, a dietary substance for use by man to supplement the diet by increasing the total daily intake, or a concentrate, metabolite, constituent, extract, or combinations of these ingredients.
• Is intended for ingestion in pill, capsule, tablet, or liquid form.
• Is not represented for use as a conventional food or as the sole item of a meal or diet.

Supplements are also defined as products, which have the following properties: Contains nutrients in amounts similar to the level specified by the recommended dietary allowances to intakes (RDA/RDIs) and similar to amounts found in food (Burke and Read, 1993). Provides a convenient or practical means of ingesting nutrients especially in a sports setting. Allows or aids in achievement of known physiologic or nutritional requirements of an athlete. Contains nutrients in large amounts for use in reversing a known nutritional deficiency.

How prevalent is the use of supplements in the United States?

Dietary supplements are widely available through many commercial sources including health food stores, grocery stores, pharmacies, and by mail. A review of literature on the use of vitamins and minerals among athletes showed that athletes in general use supplements more often than 35-40% of the general population who use supplements and the 20-25% of the adolescents who use supplements (Sobal and Marquart, 1994). Elite athletes had a mean supplement use of 59% and college athletes had a mean supplement use of 43%. Multivitamins were the most frequent type of nutritional supplements. The second most frequent was vitamin C, followed by iron, B-complex vitamins, vitamin E, calcium, and vitamin A. Iron supplements were used more frequently by women athletes and often in very high amounts (Sobal and Marquart, 1994). According to another study more than 50% of elite women distance runners, non-elite women marathon runners and Ironman tri-athletes of both sexes used vitamin and mineral supplements (Haymes, 1991). Supplement use is most prevalent in sports emphasizing muscle size such as weight lifting or body building (Burke, Gollan, Read, 1991).

Why do athletes use dietary supplements?

Athletes have used supplements for many reasons. Sobal and Marquart (1994) have suggested that athletes have used supplements to improve performance through increased endurance, muscular strength/power, recovery from heavy workouts, and to prevent illness when the severe exertions related to sport may increase the chances of illness.

What are the possible hazards of using unregulated supplements?

Some athletes may be misled by strong, false claims of some products currently on the market. To deter false claims the FDA has mandated that all the nutrients in dietary supplements be listed on the labels (since July 1995). Some herbal products and nutritional supplements may contain banned substances such as ephedrine or androstendione. In 1989 there were 32 deaths from using L-Tryptophan amino acid. Some athletes may believe that certain foods and supplements enhance performance. These products may provide certain psychological effects because of the placebo effect rather than the physiological effects. When the use of these substances replaces a balanced nutritional program it can cause serious health consequences (Source: ADA). Many popular fad diets supply large amounts of saturated fat and cholesterol which are associated with cardiovascular disease. Some diets that are low in carbohydrates are not appropriate for athletes because of problems with secondary dehydration. Almost all the popular fad diets are nutritionally inadequate. Low calorie diets can not meet the training needs of athletes and promote loss of lean body mass and depletion of carbohydrate stores (Berning and Steen, 1991). Many substances are banned by the NCAA and student athletes who use them may lose their eligibility to compete!

How can I decide if a nutritional supplement is acceptable to take?

Student athletes should take every precaution to ensure that they are not taking any substance that will prevent them from participation, or that may result in a positive drug test. The American Dietetic Association (ADA) offers the following:

1. Beware of claims that the products being advertised will produce rapid results.
2. Beware of claims for products that seem unreasonably distorted e.g "25 lbs of muscle in one month."
3. Be cautious about oversimplified conclusions that come from a complex scientifically designed study.
4. Be aware of recommendations that have been taken from one study that supports the sale of the product.
5. Remember that dramatic statements do not usually come from well-designed accurately reported research findings.
6. Be alert to lists that divide food into "good" and "bad" substances.
7. Be cautious about recommendations that focus only on selling the product.
8. Be aware of recommendations that are taken from studies that have been published without peer review.
9. Be aware of studies that present recommendations from studies that have not compared different reactions among individuals or groups

Student athletes should always check with the Sports Medicine staff or team physician, and check the NCAA banned drug list before using any substance.