Sports Nutritional Supplements Survey: what the nutrition experts take

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Rich Kreider, Ph.D., is associate professor and assistant department chairperson in the Department of Human Movement Sciences and Education at the University of Memphis in Tennessee. Along with Paul Greenhaff at the University of Nottingham in England and Eric Hultman at Huddinge University Hospital in Sweden, Kreider is considered one of the world's leading experts on the effects of creatine-monohydrate supplementation in both strength and endurance athletes. He has published extensively in peer-reviewed journals and is an advisor to the University of Memphis athletic teams. Here's how he replied to our questions:
'I do take nutritional supplements - but only when I am training hard. During periods of strenuous strength training, I take Phosphagain (a creatine plus amino-acid supplement) once or twice per day (in the morning and/or at night) or Phosphagen HP (a creatine-glucose combination), usually after a workout. I can't take too much, because I put on weight fast!
'I use EAS products, mainly because they are quality supplements, and we usually have them left over from our research studies. I have also used AminoFuel and RipFuel from Twinlabs.

For triathlon training and competition, I take Phosphagain or Aminofuel once or twice per day. Before each race, I carbo-load for three to four days with 100 to 150 grams of maltodextrin and take Phosphagen HP (5 grams creatine + 35 grams glucose) three times a day for three to four days. I also load with sodium phosphate (4 to 8 grams per day of PhosFuel from Twinlabs) for three to four days before competitions. On race day, I have a light carbohydrate meal and take Phosphagain about three to four hours before the start. I also take two grams of sodium phosphate each hour until one hour before race time. About 90 minutes before the race, I also drink a strong cup of coffee for caffeine.

'I have also used BCAA (branched-chain amino acid)/glutamine capsules (three to six grams before and after workouts) but more recently have just taken Phosphagain or AminoFuel before workouts, since they also have BCAA and glutamine.

'I usually will try things if studies from our lab or others show effectiveness. I may serve as a my own lab rat to see if I notice an effect. If I think something has enough scientific rationale for usage, I will usually give it a try.'
Liz Applegate, Ph.D., is the nutrition editor of Runner's World magazine, a sports nutritionist on the faculty of the University of California-Davis, and the author of the popular book Power Foods. She was a pro triathlete for many years and now competes in bike races, works out with a swim team, and completes over 50 pull-ups a day! Here's what she had to say:
'I use a multi-vitamin with minerals and take this every other day. I also ingest 500 mg of vitamin C and 400 IU of vitamin E every other day. I also use sports drinks and bars, but I don't take creatine or anything else along those lines. I take the multi-vitamin capsule, C, and E every other day rather than every day because my diet is pretty good - and I just don't like taking supplements.'
Dr. E. Randy Eichner, M.D., follows the nutritional-supplement research as closely as any mortal, is team physician for the University of Oklahoma, and has published widely in scientific journals on a variety of nutritional topics. Taking a slightly more sceptical view of supplements, he said:
'Hope for magic springs eternal in the human breast (and beast). Ask an audience of 100 scientists/physicians whether they take antioxidant supplements, and 60 or 70 will raise their hands. Ask them whether they prescribe the same for their patients, and most hands go down. Why? Because the science supporting the supplement use is not in, or is in but weak. At this point in time, taking supplements is based more on personality than wisdom. Those who take vitamin E, for instance, take it not because they are sure it works but because they can't think of any reason not to.

'As for me, by nature, I wait for the science. So I don't take supplements. Here's how I view it: creatine may work for repeated, explosive bouts, although many studies now coming out are negative. At least it seems safe.

'Chromium is a sham. Protein supplements are also a sham, because most athletes, especially men, are already getting more protein than they need from their regular diets. Carnitine has struck out. The average female athlete may need more iron and zinc than she gets in her diet, but the average male athlete often needs less, and in any case, you don't really need iron unless you're anaemic.
'On antioxidants, I don't buy the vitamin-C story; the weight of scientific research says vitamin C does not prevent colds and at best merely cuts the symptoms of respiratory illness. Beta-carotene has now gone through the full 'arc of science' and has failed: a third controlled clinical trial just out in Lancet agrees with two others that beta-carotene pills are worthless, if not harmful (they may boost the risk of heart attack, at least in patients with coronary heart disease). No one should be taking beta-carotene pills. Vitamin E has not yet completed the full arc, but the studies finding 'benefit' are observational and flawed, because the vitamin-E takers have healthier lifestyles than non-takers (thus, the healthy lifestyles rather than vitamin E might be producing the increase in life expectancy). As you know, the full arc is completed only when the controlled clinical trials finally appear. Two are out on vitamin E, and they reach opposite conclusions on whether taking E supplements is a good idea, at least for preventing a second heart attack. Maybe the vitamin-E arc will be full when the Women's Health Study appears in a year or two (they are testing, in healthy women, 600 IU of vitamin E vs. placebo every other day).

'It's clear that antioxidants (and indeed, vitamins in general) do not enhance athletic performance. As for vitamin E promoting faster recovery and thus fostering harder training, most studies so far show only various rises or falls in 'markers of oxidative stress', whatever the heck that is. Few or no studies show that athletes on vitamin E recover faster functionally. So what about the question - 'To E or not to E?' Go ahead, if you can't resist, but keep it to 400 IU per day or less, and just because you pop a 'magic pill' don't feel free to indulge your bad health and dietary habits. In general, I think that athletes and non-athletes would be far, far better off if they would focus on food, not pills. Your readers should cut way back on animal fat and eat huge amounts of fruits, veggies, grains, seeds, and other vegetarian fare.

'All I take is one aspirin a day; the science is in and favourable - at least for men over the age of 50 - on that. Once or twice a year, I may take two or three vitamin-C pills in the early stages of a cold, in hopes of cutting symptoms. I do carbo-load for endurance events. I use caffeine, too, and the research shows it 'works' for runners, but it's a drug, not a nutrient. Many women may also want calcium supplements for bone health. The now-popular zinc supplements can be tricky: if you take too much for too long, you end up with a performance-sapping anaemia from copper deficiency.

'For those people who just can't wait for all the science to come in and want to supplement, I would recommend the following:
1. One multi-vitamin and mineral capsule a day, such as Centrum Silver (it's among the tops in vitamin E with 45 IU, so with it and a carefully-chosen diet, you can get at least 60 or so IU of vitamin E per day). Such a capsule will also help people get enough folic acid, which is soon to be the next heart-health craze (folic acid helps keep blood homocysteine levels low, which is good since high homocysteine is linked with heart disease; however, you can surely get all the folic acid you need from fruits and veggies). Centrum will also ensure that people get enough vitamin B12; this is especially important for older people, who may begin to malabsorb B12 from food. The Centrum caps also help with vitamin D, which is nice for those who live in sun-less places, especially during the winter,
2. A calcium supplement for women,
3. A vitamin-C pill, 500 mg a day, which I don't think will help but won't hurt, either, and
4. A vitamin-E pill, with no more than 100 IU 400 IU a day, which I doubt will help much (and in the long run, like beta-carotene, may even prove harmful, although I doubt it).'
Mel Cunningham Siff, Ph.D., recently rocked the athletic world with the publication of the third edition of his outstanding book SuperTraining, a volume which overturns tired, traditional views of training with provocative, exciting new methods. Siff is a senior lecturer at the University of Witwatersrand in Johannesburg, South Africa, and has presented papers internationally at conferences in sports science, physiology, physiotherapy, sports medicine, psychology, engineering, ergonomics, physical education, linguistics, and communication. A former weightlifter who earned university, provincial, and national awards in his sport, he was Chairman of the South African Universities Weightlifting Association for over 20 years and has received two meritorious service awards for contribution to sport. Siff has collaborated closely during the last decade with Dr. Yuri Verkhoshansky, the Russian sports scientist who guided many Soviet Olympic teams and won the 1988 Olympic-Year Gold Medal from his home country in recognition of his advancement of Soviet sport. This was Mel's interesting reply:
'I learned from my early Russian sources of the importance of resistance training in improving athletic performance in a variety of sports, as well as the utility of using ergogenic aids such as adaptogens. Over the years, I also experimented with Vitamin E (400 IU per day), Vitamin C, brewer's or torula *****, Casilan (the inevitable protein supplement), mineral supplements, l-lysine, PABA, so-called vitamin B15 (pangamic acid), digestive enzymes such as bromelain, papain and pectin, very dilute hydrochloric acid, kelp tablets, desiccated liver, dolomite, selenium, beta-carotene, lecithin, and many other substances which seem to keep the health shops in business. Further along the supplement road, I tested amino-acid supplements, whey protein, and chelated minerals. Gradually, I switched my attention from track & field to Olympic weightlifting, a very quantitative discipline in which it is relatively easy to assess the impact of any new supplements that one is taking. Together with my lifting colleagues, we experimented for years with the 'latest and the greatest'. I could not honestly say that we noticed any major differences in performance - with or without the supplements.

'Some of my fellow athletes began experimenting with anabolic steroids, and there was no doubt that this supplement made a huge difference to their performance, despite the fact that most of the medical profession asserted that this improvement was due to a placebo effect. It's interesting to note that they are now singing a different tune all these years later. Nevertheless, they still ignore our comments that anabolic-androgenic (AA) steroids are used quite successfully by distance athletes to improve their performances. Some of our local ex-ultramarathoners have admitted to me that they used AA steroids during their heyday, but the sports and medical authorities maintain that they are only useful in increasing strength and muscle bulk. Subsequently, I conducted a literature review and noted that AA steroids definitely enhance physiological processes that can improve endurance performance.

'I do believe that certain supplements improve immunity, such as sublingually placed zinc lozenges and very large doses of vitamin C. However, the evidence that every vegetable and fruit contains a variety of what are now called 'phytochemicals' has forced me to conclude that the use of isolated macro- and micro-nutrients probably lowers their efficacy, so I began to take all of my supplements together with the natural plants which contain them. It seems obvious that life evolved in a synergistic way with complex mixtures of biochemicals, not commercialized isolates, yet it is the latter which are claimed by various researchers to be the most important substances for achieving better health or greater athletic performance.

'Thus, I believe that if you are supplementing with vitamin C, it is probably more sensible to take it after or with a meal containing citrus fruit (to supply the various bioflavonoids) or green peppers. If you are taking beta-carotene, then one should do so in a meal with carrots or squash. Similarly, vitamin-B complex should accompany a meal of liver, whole grains and so on. This approach, which I might term 'natural-synthetic complexing,' is one which remains with me today. I choose to do so in this complexed manner in an attempt not to disrupt what the body has adapted to over the history of human development.'
Gary Green, M.D., is the co-author of the important paper 'Nutrition Supplements: Science vs. Hype' which appeared recently in The Physician and Sportsmedicine (vol. 25, no. 6, June 1997). Dr. Green is a clinical associate professor in the Department of Family Medicine at the University of California in Los Angeles. He said:
'Yes, I take a multi-vitamin and 1000 mg of Vitamin C per day. I do take some vitamin E because it's contained in the multi-vitamin, but not in huge doses. I take C for the antioxidant effects which, while certainly not proven, do hold some promise. I went to a lecture by Linus Pauling about 20 years ago in which he discussed the advantages of vitamin C. I began taking it then, because I have a firm policy which states, "I listen very seriously to anyone who has two more Nobel Prizes than I do"'. (Editor's note: Linus Pauling was the only winner of two unshared Nobel Prizes. He earned the Nobel Prize in chemistry in 1954 for his research into the nature of chemical bonding and the structures of complicated compounds such as antibodies. He was also awarded the Nobel Peace Prize in 1962 for his passionate advocacy of nuclear disarmament and ardent efforts to ban atmospheric testing of nuclear weapons. Pauling, who published several books and over 1,000 scientific papers, believed that large daily doses of vitamin C could extend life expectancy and reduce the risks of colds, cancer, and cardiovascular disease; the California scientist took about 18,000 mg of vitamin C per day, 300 times the RDA. Pauling died in 1994 at the age of 93.)
Owen Anderson

[mtex]

QUOTE 'Chromium is a sham. Protein supplements are also a sham, because most athletes, especially men, are already getting more protein than they need from their regular diets."

i must add, i dont agree that protein supps are a sham. this article makes some good points but i am not sure these so called experts now entirely what they are talking about.

Good article. Mel Siff knew his stuff. Unfortunately he died of a heart attack last year.