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Performance in a Pill? Introduction to Dietary Supplements

  • By Nutrition
  • Published Oct. 19, 2010
  • Updated Aug. 31, 2011 at 3:56 PM UTC

In this first installment of a new series, one of the top sports supplements experts invites you to learn everything you need to know about safe and effective nutritional supplementation for endurance.

Written by: Shawn Talbott, Ph.D.

Nearly 2,500 years ago, Hippocrates, the “father of modern medicine”, embraced the concept, “Let food be thy medicine and medicine be thy food.” Although we know that diet plays a role in five of the 10 leading causes of death (including coronary heart disease, stroke, certain cancers, Type II diabetes, and atherosclerosis), the advent of modern pharmaceutical therapy in the 19th century caused the “food as medicine” philosophy to fall into relative obscurity as a “quaint” concept among many healthcare professionals.

As endurance athletes, we’re concerned as much about health as we are about performance, so this “food first” approach is certainly something that we should be taking to heart. We know that diet is at least as important for optimal physical and mental performance as exercise training—but too few of us pay as much attention to our diets as we pay to choosing our next pair of running shoes.

Many of the athletes that I work with are looking for ways to “fix” the nutrition side of their performance, or looking to tweak their nutrition for a performance “edge” over their competition. This article is the first in a series, “Performance in a Pill?”, where I’ll explore the evidence for/against certain dietary supplements: some that might help us as endurance athletes, some that might not help, and others that might be downright dangerous or illegal (or both).

Herbal preparations have been used as medicinal agents and performance enhancers since time immemorial in all cultures the world over. Since 1994, however, with the passage of the Dietary Supplement Health and Education Act (DSHEA), millions of American consumers have readily and avidly embraced the use of food, dietary supplements, and herbal extracts for more than just basic nutrition. The past decade has seen the dietary supplement industry grow in size from almost zero to almost $25 billion in annual domestic sales with more $100 million in worldwide sales. Although estimates vary, approximately 50-60 percent of adults in the United States identify themselves as consumers of dietary supplements (close to 200 million Americans consume supplements, according to the FDA). Among endurance athletes, some studies suggest that as many as 90 percent of elite-level athletes are regular users of dietary supplements (and close to 100 percent of power athletes use supplements).

When considering any dietary supplement, we all face the often-daunting challenge of trying to determine whether or not a particular product meets our needs (or lives up to its claims). The broad definition of dietary supplements permits the use of a wide variety of plant constituents (roots, leaves, stems, etc.), vitamins, minerals, amino acids, and other ingredients that can have essential or nonessential bioactive constituents with associated health benefits (or risks). Endurance athletes tend to use dietary supplements either as preventive nutrition, where, for example, a daily multivitamin supplement is intended to provide nutritional “insurance”, or as ergogenic aids, or performance enhancers. For example, cordyceps and rhodiola are intended to improve oxygen utilization and boost endurance performance. Of course, consumers also use dietary supplements in myriad other ways to promote weight loss, to increase energy levels, and to treat specific diseases.

The Food and Drug Administration regulates dietary supplements in many of the same ways that it regulates conventional foods—but supplement products are required to carry the disclaimer, “This product is not intended to diagnose, treat, cure, or prevent any disease.” Like foods, but unlike drugs, dietary supplements do not require pre-marketing approval by the FDA, but the FDA has the authority to restrict sales and remove specific supplements from the market if they are shown to pose a public health risk. Because the scientific and medical evidence for the efficacy and safety of dietary supplements is highly variable in terms of both quantity and quality, it is very much a situation of “buyer beware” when it comes to choosing and using dietary supplements. However, by understanding the risks and benefits associated with use of these products, we can make an educated decision about which supplements are worth their cost to help with endurance, recovery, or general nutrition—and (perhaps more importantly) which others are best avoided.

This series of articles is intended to provide endurance athletes with a basis and background on which to make educated decisions about the appropriate use (or avoidance) of specific dietary supplements. The most important thing to realize is that dietary supplements are not panaceas or magic bullets that can counteract poor health habits; rather, they are supplements to a comprehensive lifestyle approach that also includes a balanced diet, regular physical training, stress management, adequate sleep, and other positive health practices.

Research studies of dietary supplements are often difficult to evaluate because of differences in the ingredients from study to study, incomplete description and analysis of the active ingredients, and variations in the dosing, duration, and population studied. Considering the large number of dietary supplements on the market, this series will focus on the supplements that are most likely to be of interest to endurance athletes and those that have a sufficient body of clinical evidence to evaluate.

Each article in this series will cover 3 main areas:

  • Claimst/theory behind the supplement (What is it supposed to do and how?)
  • Science (What does independent research say about this supplement?)
  • Recommendations (How might this supplement benefit you, the endurance athlete?)

I am generally a fairly “pro-supplement” kind of person, but I am also a staunch advocate of the idea that food and fitness must come first—so I won’t be pushing any magical pills or potions to make up for poor diet or lack of training. Thanks for starting this journey with me. I look forward to exploring the world of endurance supplements with you in the coming weeks.

About the Author: Shawn Talbott is multiple Ironman and ultramarathon finisher and a sports nutrition expert with a Ph.D. in nutritional biochemistry and a master’s degree in exercise science. He lives in Salt Lake City. For more information visit www.ShawnTalbott.com

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