Friday, October 28, 2011

Understanding Supplements

Nutritional supplements have evolved over the past decade into nearly a $30 billion industry.  Unbeknownst to many, it is also a much more loosely regulated industry than the rest of the food and beverage industry simply because it is classified as a supplement and not daily consumption is not considered a necessity like typical food sources.  Recently, certifying agencies have been formed to validate the purity and legitimacy of the supplement relative to what is listed on the nutrition label, but the nutrition label isn't where supplement companies make their big claims...that is on the front of the packaging.  You will always find somewhere on the supplement packaging this statement:

"These statements have not been evaluated by the Food and Drug Administration.  This product is not intended to diagnose, treat, cure or prevent any disease."

That statement paves the way and clears the supplement manufacturer to make virtually any claim they want as long as they have at least one experiment showing the efficacy of the product.  The experiment is not held to the same standards as a clinical trial, or an experiment that is published in a peer-reviewed journal.  Conversely, as long as one person used the product to receive the benefit that is advertised, then the manufacturer can make the claim.

So, with that said, I am going to give you facts and in some cases, my opinion, about some of the key supplements being used today.  All of my analysis is based on scientific peer-reviewed journals, and actual academic nutrition and human physiology.


In my opinion, this is probably one of the most widely misunderstood supplements on the market which is why I am listing it first.  I have had parents and athletes ask me if creatine is a steroid, a hormone, or protein.  People have questioned me for years about the legality of creatine.  Well, here are your answers...

Creatine is a naturally occurring compound of amino acids found in the body.    Our body naturally produces creatine when the appropriate amino acids are present.  We can also consume creatine in whole foods, specifically meats.  (The Greek word for meat is creas.)  Unfortunately, cooking meat quickly denatures the creatine and makes it unavailable for use in the body.  So, many athletes turn to creatine in one of its various forms (monohydrate and ethyl-esther just to name two) to saturate their muscles with creatine.  Why?

To understand why, you need a quick lesson in energy systems.  Here it is in a nutshell...  Your body needs ATP to cause muscle contractions.  Your body has three mechanisms for providing ATP to your muscles.  The quicker the replenishment of ATP, the more powerful the muscle contraction.  For big, powerful contractions like those needed for jumping and sprinting, your body relies on the "creatine-phosphate shuttle" energy system to regenerate ATP very rapidly.  But, the creatine phosphate system is like having a Lamborghini with a fuel tank the size of your coffee cup.  It will get going, and going fast, but it won't last very long.

So, with that knowledge, athletes want to get as much creatine in your body.  Using the metaphor above, they are trying to go from a coffee cup to two coffee cups for the size of the fuel tank.  Sure the tank is still small, but if you are racing someone, that small amount can make a difference in winning and losing.  So what does the research say?  Well, the majority of the research has shown that creatine supplementation does help in extending absolute power relative to not taking creatine.  So it works!  Well, maybe...  Other research has compared carbohydrate supplementation to creatine supplementation and has seen little to no benefit, and in a couple of studies the carbohydrate group outperformed the creatine group.

When you factor in the side effects and difficulty of properly loading up with creatine, it boils down to what the athlete is trying to accomplish.  Creatine requires regular consumption (3g - 5g daily for 30 consecutive days) to maximize saturation.  You can saturate quicker by doing a loading phase (5g, five times a day for seven days straight, then 3g - 5g a day maintenance), but the side effects of bloating, excessive urination, and gastro-intestinal distress can be quite uncomfortable (please be proud of me for not resorting to bathroom humor here!).  Creatine also inevitably involves weight gain because it bonds with a water molecule while in the body to help stabilize the compound.  I remember the first time I tried it, and completed the loading phase, I felt like the Stay-Puft marshmallow man from Ghostbusters.

So, my take on creatine is this...  It is presumed safe for adults, although no long term studies have been completed because very few people want to take it for extended periods of time.  I feel that as an off-season training aid to help develop strength and power, it does have a role.  But, for in-season performance, the weight gain offsets any benefits that creatine may have.  And no, it is not a steroid, and yes, it is perfectly legal.


Caffeine is the world's most readily available and frequently used supplements for sports performance and training.  Many of us don't think of caffeine as a supplement, but in the literal meaning of the word "supplement," caffeine is exactly that.  Caffeine is found in 63 different plants species around the world, and because of its use in a variety of foods, beverages, and medications it is consumed regularly by roughly 75% of the world's population in one of its myriad forms.  Couple that with the fact that it does possess mild to moderate addictive characteristics and some people view caffeine as the most widely used drug in the world.

Caffeine can be a very powerful ergogenic aid, meaning it assists in achieving greater physical performance.  Up until the 2004 Olympics, caffeine was actually fully banned by the World Anti-Doping Agency.   Caffeine has been shown to increase not only mental alertness and concentration, but also delay or inhibit the perception of fatigue which can be very useful in activities lasting more than 60 minutes.  Studies have shown that it helps your body utilize fat better during activity which also spares glycogen, a valuable source of energy in your muscle cells.  Furthermore, other studies have shown that it can mildly assist with muscle contractility, although its ability to assist the body in producing more force is highly questioned.

With such obvious benefits, it is clear to see why athletes, and fitness enthusiasts would value caffeine consumption during activity.  But just like most things in life, there is a cost and risk associated with caffeine use.  Over-consumption can quickly lead to gastrointestinal distress, but even more detrimental is the fact that caffeine is a powerful diuretic.  Hydration is the key component to an individual's ability to perform an activity at a high intensity.  A mere 2% decrease in body weight because of loss of water can equate to as much as a 20% decrease in athletic ability.  Since caffeine can purge the body of water, the use of caffeine as an ergogenic aid must be monitored very closely.

My opinion of caffeine varies by who I am talking to.  Youth athletes under the age of 13 don't need excess caffeine in their body as their thermoregulation (sweating) system in their body is not fully developed.  The risks simply don't outweigh any benefits.  For more mature individuals, caffeine usage is very subjective.  As a sports performance coach, I want to educate my athletes on intelligent use of ergogenic aids and supplements, and I do feel that caffeine can be highly useful.  With that said, though, I would prefer for all of my athletes to train properly first to prepare for competition, and only use caffeine in specific situations such as back to back games, our tournaments where due to the frequency of games, a slight neurological and muscular stimulant can make a tremendous difference.  For the fitness population, I generally encourage the use of a small doses of caffeine, but that is more because of the potential increased fat metabolism and the lifestyle of my clients.

Nitric Oxide

Not to be confused with Nitrous Oxide (N20), Nitric Oxide (NO) causes vasodilation in arteries and veins.  Because of that effect, it has been utilized in the medical industry to regulate and treat high blood pressure by relaxing and expanding the arterial walls.  Because of this characteristic, it has been actively marketed by supplement manufacturers with a wide variety of claims.  Typically aimed at individuals trying to gain muscle mass, nitric oxide supplementation allows the body to maintain the appearance of larger muscles while consuming the supplement.  As most men, and some women have noticed, when you lift heavy weights over the course of the workout your muscles slightly swell.  This is due to local vasodilation that allows increased blood flow to the working muscles, and is a natural response by the body.  Many people refer to this as the "muscle pump." 

Nitric oxide produces a similar result, but manufacturers have begun to make extraordinary claims about what NO can and cannot actually do.  The claims range from increased strength to increased muscle mass development to increased endurance, but none of this has been scientifically proven with any consistent validity.  The theory is that with expanded arteries, more nutrients can be delivered to the working muscles which will equate to one of the above claims.  The problems is that to-date not a single study has been able to prove those claims, including the claim that NO consumption promotes a positive nitrogen balance (which is a direct indicator of potential muscle growth).  In fact some studies have shown that aside from the muscle pump effect of consumption, there is no other positive effect that NO produces.

Recently, a new form of NO, whose chemical name has so many syllables that I won't even try to write it here, that is making the same claims as originally claimed by makers of NO supplements. Scientific studies have been completed using this new chemical based on NO, and the results are in...  No real benefit.  So, unless you are purely interested in the vanity aspect of the supplement, NO appears to have no real benefit to your athletic performance.

Branch Chain Amino Acids

Branch Chain Amino Acids (BCAA) are three amino acids that are members of the essential amino acid family meaning that we require the ingestion of the amino acids for proper health. Essential amino acids, unlike other amino acids, cannot by synthesized in body from other protein sources. The three amino acids, leucine, isoleucine, and valine, have been positively identified with enhancement for lean muscle mass, treatment in certain pathologies, and experimentally used to treat burn victims with some success.

From the research I have seen so far, I am a firm believer that the addition of BCAA, specifically leucine, presents a host of positive benefits from a sporting and fitness perspective. Leucine helps prevent muscle catabolism (breakdown) which happens on a daily basis, even with exercise. The root function for gaining muscle rests in the body's ability to produce more muscle growth than breakdown. If we slow the breakdown, then muscle growth becomes more significant. This was shown in a recent experiment where sedentary, elderly men were given BCAA. Aside from the supplement, nothing about the men's lifestyle change. The results of the experiment showed an increase in muscle mass for almost every participant.

Now although I would like to believe that BCAA is perfectly safe, and harmless for everyone to consume, I can not ethically state that children and teens should consume them because there is no research about the long term affects of consumption of BCAA. But, given the fact that the three amino acids are readily found in a number of other natural food sources, you can make your own choices on its safety.

Protein (Whey, Casein, and Soy)

I saved protein for my last supplement because after caffeine, it probably the most widely used supplement in the United States.  Because of it s popularity, many forms of supplemental protein are available on the market.  Before getting into the various forms of protein, I simply want to say that I see absolutely no harm whatsoever in almost any form or type of moderate protein supplementation.  Key word there is moderate.  Over-consumption of any of the proteins I am about to describe will have various negative side effects.

Protein supplementation is generally considered safe for most populations, and when consumed at key times, can be a very powerful tool for recovery from a workout.  With that said, though, I always encourage my athletes and clients to consume the majority of their protein from food sources, not supplements.  But, supplements do have a role.  The primary role for protein supplementation is relative to timing.  For the first 45 minutes after a workout, the body has heightened levels of key hormones that when paired with proper nutrients, promote quicker recovery, better muscle anabolism (growth), and enhanced carbohydrate uptake to the muscles.  Because of this limited window, supplementation provides a vital role.

Whey Protein

Whey protein is derived from dairy and originally was a disposed by-product of making cheese.  Whey is probably the most utilized form of supplemental protein today for two reasons.  First, it is cheap and easy to produce and package.  It has a fairly long shelf-life making it desirable to manufacturers.  Secondly, it has the most rapid digestion rate of all of the proteins.  Whey protein can be broken down very quickly and therefore is very popular as post-workout protein choice.  Whey protein availability in the bloodstream peaks very quickly, approximately 1-2 hours after consumption.  This matches nicely with your body's hormonal response after a workout where your body releases certain anabolic (growth/recovery) hormones to assist in recover and protein synthesis. 

Whey protein can be found in various forms, liquid and powder, and as an isolate.  For the most part, as long as the overall quality of the protein is high, you generally don't receive much more benefit by consuming some of the more processed and expensive versions.  I personally buy the 5 pound bulk bag of powder.


Casein is derived, like whey, from dairy products.  Different than whey, casein contains more nutrients and has a different chemical structure than whey.  Casein is found in both cow and human milk which is why I tell almost all of my athletes that a big glass of chocolate milk is actually a phenomenal post-workout drink.  Also different from whey, casein is not strictly a protein, but contains some carbohydrates as well as calcium and phosphorus.  But, like whey, casein does contain essential amino acids.

The biggest and most important differentiation between casein and whey is that because of the more complicated structure and nutrient profile of casein, casein digest much more slowly because it actually gels in the stomach.  This slows digestion and results in a moderate extended release of nutrients over a longer period of time.  Because of this casein is not necessarily the best choice immediately after a workout where we want to deliver as many nutrients as possible as quickly as possible.  But, casein is a very good choice for smoothies and mid-day snacks because it will satiate you longer than whey protein.  Some fitness enthusiasts consume a small amount of casein prior to going to bed believing that the sustained released of amino acids through the night assists in recovery.  In theory, this does make sense, but to my knowledge no studies have been completed relative to that idea.

Soy Protein

Soy protein is derived from soybean or soya bean (shocker, huh?) and is a processed to have all of the fat and carbohydrates removed.  Although technically classified as a complete protein because all of the essential amino acids are present, the ratios of the amino acids vary greatly from what we typically see in the whey a casein choices.  Soy has come into recent popularity because of many supposed health benefits.  Then even more recently it has taken some bad press because of some supposed negative health issues related to over-consumption.  The key issue revolves around the fact that soy protein acts as a binder to estrogen receptors.  Over consumption in men results in a greater amount of estrogen production, which is generally not a good thing.  Over consumption in women has been correlated to increased risk of cancer, although the correlation is highly controversial and requires much more study to be considered a serious correlation. 

Soy is cheap and trendy which makes it popular in many "healthy" food choices.  Oddly, soy protein is also one of the most highly processed additives to most of these healthy choices.  In the health and fitness world, soy protein because of its insufficient amino acid ratio is not a first choice for most omnivores.  For vegans, vegetarians, etc, it is a very popular choice as it is 100% vegetable in its make-up.

One think to note from this analysis of protein is that the hands down best form of protein for your body is egg protein.  It has the ideal amino acid ratio that your body desires, but receives much less attention because it is more expensive and less stable than other protein choices and therefore can not be used in as many products as soy, casein, or whey.

Closing remarks...

On everything I have written about, recent is still being conducted.  What I wrote today is 99% fact with a little bit of intelligent opinion added.  It is up to you to arm yourself with this information and make sound intelligent decisions about any supplement that you or your child may consume.  With all of these supplements, there are no studies that involve children nor pregnant women for ethical reasons.  I personally have consumed every single supplement on this list, some of which I still utilize today for working out or athletic events.  Aside from an odd twitch here and there and my random losses of consciousness I have had no side effects...(that is a joke obviously.)

The key thing to remember is that these are supplements.  They are designed to added to a diet when you can't easily consume natural normal food.  Whenever possible, I always encourage my clients and athletes to consume actual food versus a supplement.  The natural nutrients of whole foods can and never will be fully matched by supplements.