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Critical Reviews in Food Science and

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Nutritional Supplements to Increase Muscle Mass
Priscilla M. Clarkson a; Eric S. Rawson a
a
Department Exercise Science, University of Massachusetts, Amherst, MA.

Online Publication Date: 01 May 1999

To cite this Article: Clarkson, Priscilla M. and Rawson, Eric S. (1999) 'Nutritional
Supplements to Increase Muscle Mass', Critical Reviews in Food Science and
Nutrition, 39:4, 317 — 328
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Critical Reviews in Food Science and Nutrition, 39(4):317–328 (1999)

Nutritional Supplements to Increase Muscle Mass

Priscilla M. Clarkson* and Eric S. Rawson
Department Exercise Science, University of Massachusetts, Amherst, MA

Referee: Dr. Emily Haymes, Florida State University, Department of Nutrition, Food, and Movement Science, 216 Johnston Building,
Tallahassee, FL 32306–1490

* Correspondence to: Priscilla M. Clarkson, Department of Exercise Science, Totman Building, University of Massachusetts, Amherst,
MA 01003

ABSTRACT: Although nutritional supplements purported to increase muscle mass are widely available at health
food stores, gyms, by mail order, and over the Internet, many of these supplements have little or no data to support
their claims. This article reviews the theory and research behind popular nutritional supplements commonly
marketed as muscle mass builders. Included are the minerals chromium, vanadyl sulfate, and boron, the steroid
hormone dehydroepiandrosterone (DHEA), β-methyl-hydroxy-β-methylbutyrate (HMB), creatine, protein supple-
ments, and amino acids. Research has shown that chromium, vanadyl sulfate, and boron do not appear to be
effective in increasing lean body mass. The few studies examining DHEA have not supported the claim of
increased muscle gain. Preliminary work on HMB supports an anticatabolic effect, but only one human study is
currently available. Many studies reported increased body mass and several have reported increased lean body
mass following creatine ingestion. This weight gain is most likely water retention in muscle but could also be due
to some new muscle protein. Although athletes have a greater protein requirement than sedentary individuals, this
is easily obtained through the diet, negating the use of protein supplements. Studies on amino acids have not
supported their claim to increase growth hormone or insulin secretion. Nutritional supplements can be marketed
without FDA approval of safety or effectiveness. Athletes who choose to ingest these supplements should be
concerned with unsubstantiated claims, questionable quality control, and safety of long-term use.

KEY WORDS: muscle mass, chromium, vanadium, DHEA, HMB, creatine, protein, supplements.

I. INTRODUCTION Kovacs, at the same height as Arnold, weighed

Growth in the popularity of nutritional supple-
ments to increase muscle mass is perhaps a reac-
tion to the cultural standards of a more muscular
body type for males. In competitive bodybuild-
ing, which embraces the most extreme ideals as to
what constitutes the ideal male physique, the stan-
dards have moved forward at a fast pace. At the
turn of the century, Eugen Sandow, the first mod-
ern bodybuilder, boasted measurements of a 49″
chest and 18″ biceps. Arnold Schwarzenegger,
considered by many to be the greatest bodybuilder
of all time, claimed measurements of a 57″ chest
and 22″ biceps at a body weight of 240 lbs.1 In
contrast, a recent professional bodybuilder, Greg
over 300 lbs. for his first professional bodybuild-
ing contest and has a 65″ chest and 26″ biceps.2
Toys have also followed this muscular trend
in the image of the ideal man. G. I. Joe was first
launched in 1964 as a “fit and trim soldier”, but in
1976 Hasbro stopped making the figure. How-
ever, in 1992, after Operation Desert Storm,
Hasbro brought back G. I. Joe with a new super-
muscular body to compete with other action fig-
ures on the market.3 In the last 30 years, toy
figures have changed from the realistic-looking
soldier to the fantastic and often grotesque
superheros of today.4 Recently, Fisher-Price de-
veloped a “good-guy” line of action heros, the
Rescue Heros, who depict very muscular figures

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317
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of a firefighter, mountain ranger, scuba diver, and
construction worker.5 Even Mattel’s popular Ken
doll now appears very tight, muscular, and “bulked
out”.6
This trend for a supermuscular body as the
ideal body type for males has perhaps led to body
image dissatisfaction in some males, where they
perceive themselves as not being muscular enough
or big enough to meet a projected ideal.7 In a
sample of adolescent males, it was found that
about 36% were trying to gain weight.8 Recently,
Pope et al.9 described a disorder in muscular body-
builders where they perceived themselves as too
thin, too small, or too insufficiently muscular.
Research has suggested that this disturbance in
body image in males may lead them to anabolic
steroid use.10 It is probably the case that males
who want to gain muscle mass first start with
nutritional supplements and, if these are ineffec-
tive, move on to drug use.
Muscle building supplements are available
for purchase on supermarket shelves and are often
advertised and available at weight-training cen-
ters, by mail order, and by ordering over the
Internet. This article reviews the theory and
research behind popular nutritional supplements
to enhance muscle mass: chromium, vanadyl sul-
fate, boron, dehydroepiandrosterone (DHEA),
β-hydroxy-β-methylbutyrate (HMB), creatine,
protein, and amino acids. Other similar reviews
are also available.11,12
II. CHROMIUM, VANADIUM AND BORON
A. Function and Purported Effects on
Muscle
Chromium, vanadium, and boron are miner-
als purported to increase muscle mass. Chromium
is essential for life, and the estimated safe and
adequate daily dietary intake, ESADDI, is 50 to
200 µg.13 Vanadium has not been deemed essen-
tial. A daily dietary intake of about 10 µg of
vanadium will probably meet any postulated
vanadium requirement.14 Vanadium deficiencies
in animals produce deleterious effects, but no
deficiencies in humans have been observed. Bo-
ron is an essential element for plant growth, but
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318
there is not sufficient information to establish a
requirement for humans.13,14 Boron intake is esti-
mated to range between 0.5 and 3.1 mg, and about
1 mg/d of boron may be needed.14
Both chromium and vanadium are thought to
potentiate insulin action and stimulate amino acid
uptake by cells.15,16 Based on evidence that chro-
mium supplements increase muscle mass and
growth in animals,17 it is thought that simulating
amino acid uptake with chromium will increase
protein synthesis and muscle mass in humans.
Recently, Rubin et al.,18 examining chromium
excretion with stable isotopes, found that increased
excretion with resistance exercise reflected an
increase in chromium absorption that may play a
role in increased muscle mass. Data suggesting
that vanadium has an anabolic effect on muscle
are derived from laboratory studies of cells and
studies of animal models.14 The exact function of
boron has not been identified but it is thought that
boron affects calcium and magnesium metabo-
lism and can influence membrane function.19
Boron was purported to increase muscle mass
based on data showing that it increased testoster-
one in post-menopausal women.20
B. Effects on Muscle Mass
Chromium is found in supplements in the
form of chromium picolinate, chromium nicoti-
nate, and chromium chloride, with chromium
picolinate being the most commercially available.
Evans21 first reported that chromium picolinate
increased lean tissue in young men who were
participating in a resistance-training program.
Untrained college students and trained football
players ingested 200 µg of chromium picolinate
or a placebo/d for 40 to 42 d. The subjects who
took chromium supplements gained significantly
more lean body mass compared with the placebo
group. However, lean body mass was estimated
from anthropometric measures, which are not
highly reliable, and the changes observed were
small so results could be influenced by measure-
ment error.
Four additional studies failed to confirm the
results of the Evans’ studies. Hasten and col-
leagues22 gave students participating in a weight
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training program either 200 µg of chromium
picolinate or a placebo for 12 weeks. There were
no differences in body weight gain for the males
on the chromium supplement or the placebo. How-
ever, females who took the chromium supple-
ment gained more body weight than the females
on the placebo, but lean body mass was not
assessed, so it is unknown if the increase in body
weight was due to increased muscle mass.
Clancy et al.23 gave chromium picolinate
(200 µg/d) supplements or placebos for 9 weeks
to college football players participating in a resis-
tance-training program. There was no difference
between the chromium supplement and the pla-
cebo on changes in skinfold measures and cir-
cumference measures or percent body fat and fat-
free mass (determined by hydrostatic weighing).
Urinary chromium excretion before supplementa-
tion and for the placebo group throughout the
study was low and undetectable. However, uri-
nary chromium excretion for the chromium supple-
mented group significantly increased at 4 weeks
and remained elevated throughout the study. Chro-
mium stores were probably adequate and extra
ingested chromium was excreted into the urine.
Another study24 using virtually the same study
design as the Clancy et al.23 study but with
untrained males also found no benefit of chro-
mium supplements on fat-free mass determined
by hydrostatic weighing. In a well-controlled
study, Lukaski and colleagues25 examined the
effect of 8 weeks of chromium chloride, chro-
mium picolinate, or a placebo in untrained men
who started a resistance training program. The
two types of chromium supplements similarly in-
creased urinary chromium excretion and had no
effect on body composition assessed by anthro-
pometry and Dual X-ray Absorbtiometry (DEXA).
In the only study to evaluate vanadium supple-
ments and muscle gain, subjects ingested 0.5 mg/
kg/d of vanadyl sulfate or placebo for 12 weeks
during a weight training program, and the results
showed no beneficial effect on body composition
as assessed by anthropometric measures or DEXA
scans.26 The only study of boron effects on muscle
mass in males examined the effect of 2.5 mg/
boron or placebo for 7 weeks in bodybuilders and
found no difference between groups in fat-free
body mass (determined by hydrostatic weighing),
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total testosterone level, and strength over the
course of the 7 weeks.27
III. DEHYDROPEPIANDROSTERONE
(DHEA)
A. Function and Purported Effects on
Muscle
DHEA is an androgen steroid secreted from
the adrenal glands and is converted into testoster-
one and estrogen in the body.28 However, DHEA
is available as a nutritional supplement because it
is naturally found in wild yams.29 As a precursor
of anabolic hormones, it is thought that DHEA
ingestion will increase the concentration of test-
osterone and thereby increase muscle mass.28
Dehennin et al.30 reported that supplemented
DHEA of 50 mg in healthy men resulted in some
conversion of DHEA to the biologically active
androgen, testosterone, in the blood.
Only a few studies of DHEA in humans are
available. Because DHEA levels in the blood
decline with age,31 studies have focused on supple-
menting older individuals with DHEA. Morales
et al.32 found a significant but small increase
in androgens in the blood of older women but
not older men (40 to 70 years old) after taking
100 mg/d of DHEA for 6 months. In another
study of older women, 1600 mg/d for 4 weeks
resulted in a significant increase in androgens in
the blood.33
B. Effects on Muscle Mass
Welle et al.34 administered 1600 mg/d of
DHEA for 4 weeks to healthy men (mean age 26
years). There was a ninefold increased in plasma
DHEA, but there was no effect on body weight or
lean body mass, assessed by total body water and
total body potassium. Also, there was no effect of
DHEA on energy or protein metabolism. The
researchers concluded that DHEA was not an
important regulator of energy or protein metabo-
lism in humans. In another study of healthy men
(mean age 24 years), Nestler et al.35 found that
1600 mg/d of DHEA for 1 month increased serum
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androgen levels and decreased fat mass (assessed
by hydrostatic weighing) with no change in body
weight, thus suggesting an increase in lean mass.
Further studies are needed to verify the results of
Nestler et al.35 However, studies of obese subjects
given DHEA have not proven promising in alter-
ing body composition.36
IV. CREATINE
A. Function and Purported Effects on
Muscle
Creatine is synthesized endogenously in the
liver, pancreas, and kidney from the amino acids
arginine, glycine, and methionine.37 It is then trans-
ported against a concentration gradient to tissues
such as skeletal muscle where it can be utilized.38
Approximately 95% of creatine in the body is
stored in skeletal muscle, with as much as 70%
existing in its phosphorylated form.37
Creatine phosphate (phosphocreatine) donates
its phosphate to ADP, rephosphorylating it to
ATP, thus increasing available energy.39 Also,
during ATP hydrolysis hydrogen ions (H+) are
produced. When ADP is rephosphorylated to ATP,
H+ are consumed, which helps to maintain the
normal pH of the cell. In resting vertebrate muscle
there is typically a sufficient amount of creatine
phosphate to supply energy for several minutes.39
However, under more demanding conditions, such
as sprinting, the supply only lasts for a few sec-
onds.39 Creatine is also ingested in the diet through
various meats and fishes, which contain about 5 g
of creatine per kg of uncooked meat.40
B. Effects on Muscle Mass
Harris et al.41 demonstrated that ingestion of
approximately 20 g of creatine for 2 or more days
resulted in a significant increase in muscle creat-
ine and creatine phosphate levels. Although cre-
atine is typically considered a nutritional supple-
ment to enhance performance of short-term intense
exercise, it is also used by athletes to increase
muscle mass.42 Recently, the National Strength
and Conditioning Association reported the results
of a survey distributed at a creatine symposium
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320
held at its national conference. Coaches and train-
ers who responded claimed that 86% of their
athletes take creatine, and 88% of these
respondents reported a visual increase in muscle,
as well as increased strength and body
mass.42
Several investigations have reported increases
in body mass ranging from 1 to 3 kg after
taking 20 to 30 g/d of creatine for about 5 d.43–54
Some investigators, however, have reported no
differences in body mass following supplementa-
tion. 55–61 Individual responses to creatine
supplementation can vary substantially. For ex-
ample, creatine uptake and changes in body mass
are greater in vegetarians,41,43 and vegetarians have
lower levels of serum creatine, which may indi-
cate lower muscle creatine levels.62 Also, females
have higher levels of muscle creatine and older
individuals have decreased levels of muscle cre-
atine phosphate.63,64 Initial creatine status may
significantly affect an individual’s response to
supplementation.
The increased body mass and muscle mass
observed following creatine ingestion may be due
to increased protein or increased water in muscle,
or both. Early studies that examined creatine and
its role in protein synthesis showed that creatine
supplied in vitro can increase the rate of myosin
heavy chain and actin formation.65–68 These inves-
tigators suggested that increased creatine concen-
tration may be the biochemical signal to increase
protein synthesis and muscle hypertrophy. More
current work in animals69 and preliminary work
in humans70 appear to support this. In fact, in their
preliminary study Ziegenfuss et al.70 demonstrated
an improved nitrogen status and increased cross-
sectional area of the thigh using [15N] glycine and
magnetic resonance imaging, respectively, after
5 d of supplementation. However, it is unlikely
that subjects can synthesize 3.0 kg of new protein
tissues in 5 d. The most likely explanation then is
an increase in water retention, which is supported
by the work of Hultman et al.,71 who found a
significant decrease in urine volume during creat-
ine loading. Using bioelectrical impedance tech-
niques, Ziegenfuss et al.70 also showed that creat-
ine supplementation produced an increase in total
body water.
Studies that examined creatine ingestion dur-
ing 4 or more weeks of resistance training also
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reported changes in lean (or fat-free) mass.72–74
Using hydrostatic weighing, Earnest et al.72 found
a small (1.6 kg) but nonsignificant increase in fat-
free mass following 28 d of creatine ingestion of
20 g/d in strength-trained males and Vandenberghe
et al.73 demonstrated significant increases of 2 kg
and 2.6 kg in fat-free mass determined by hydro-
static weighing in untrained females following 5
and 10 weeks of training, respectively. Prior to
training, subjects in this study ingested a 20 g/d
creatine loading dose for 4 days followed by a
5 g/d creatine maintenance dose during the train-
ing. Most recently, Kreider et al.,74 using DEXA,
reported a significant increase in fat/bone-free
mass (2.4 kg) in football players following 28 d
of creatine supplementation of 15.75 g/d. These
results could be explained by the fact that subjects
ingesting creatine were able to exercise at a greater
training intensity due to increased initial creatine
phosphate levels or enhanced creatine phosphate
resynthesis between exercises.75
b-HYDROXY-b−METHYLBUTYRATE
(HMB)
A. Function and Purported Effects on
Muscle
HMB is produced in the body from the essen-
tial amino acid leucine via its metabolite
α-ketoisocaproate (KIC). Extrapolating from
available data from research on pigs, it is esti-
mated that humans produce 0.2 to 0.4 g HMB/d.76
In 1960, Hider et al.77 demonstrated that in rats
leucine and KIC have anticatabolic actions. Both
leucine and KIC may inhibit protein breakdown,
although this has not been clearly demonstrated
in healthy adults.78–80 Recently, based on a variety
of experiments in farm animals, attention has
turned to HMB as a potential compound that may
possess anticatabolic properties.81 Small amounts
of HMB are ingested directly in the diet through
foods such as grapefruit and catfish, although
typically foods do not account for a significant
source of HMB. It has been hypothesized that
HMB supplementation in humans can inhibit the
protein breakdown that occurs with intense resis-
tance training, leading to increased lean tissue
mass and muscle strength.76
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B. Effects on Muscle Mass
Data on HMB supplementation in humans
and changes in muscle mass are limited. Unlike
the rapidly growing body of literature regarding
creatine supplementation and muscle mass, there
is currently only one existing peer-reviewed pub-
lication examining HMB supplementation in hu-
mans.76 This article presented two experiments on
HMB supplementation during resistance-training.
In the first experiment, untrained subjects ingested
0, 1.5, or 3.0 g HMB/d for 3 weeks while partici-
pating in a standardized resistance-training rou-
tine 3 d/weeks. Each session was monitored by a
trained supervisor who adjusted the training load
to produce muscular failure after 3 to 5 repeti-
tions. Lean tissue determined by TOBEC tended
to increase in a dose-responsive manner with HMB
supplementation as the 0, 1.5, and 3.0 g HMB/d
groups gained 0.4, 0.8, and 1.2 kg, respectively. A
criticism of this investigation is that the 3.0 g
HMB/d group began the investigation with the
lowest lean body mass as well as the lowest
strength levels. This group possibly experienced
the greatest gains during training because they
were the most untrained.
In the second experiment of the Nissen et al.
study,76 subjects trained 6 d/weeks for 2 to 3 h/d
and were supplemented with 3.0 g HMB/d for
7 weeks. Although the subjects training history is
described only as “engaged in some form of
exercise program”, subjects in this group were
likely advanced because their strength was high,
with mean 1-Repetition Maximums (1-RM) of
315, 380, and 221 lb in the bench press, squat, and
hang clean, respectively. This experiment dem-
onstrated a significant increase in fat-free mass
using TOBEC in the HMB group on day 14 and
through day 39 of the study. However, by the
final day of the study fat-free mass was not sig-
nificantly different between groups. Bench press
strength was significantly increased following
supplementation, but there were no differences in
strength in the other two exercises. Although the
results of this investigation lend some support to
the hypothesis that HMB supplementation can
increase muscle mass during strength training,
the amount of weight gained during this study
was not great (HMB group = 2.6 kg; Placebo
group = 1.1 kg). Furthermore, unlike the first
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experiment, there were no dietary controls in the
second study.
VI. PROTEIN AND AMINO ACIDS
A. Function and Purported Effects on
Muscle
Many supplements containing protein pow-
ders and various amino acid combinations are
marketed for muscle gain. The recommended di-
etary allowance for protein intake is 0.8 g · kg–1 ·
d–1,13 but several studies have indicated that ath-
letes require a greater amount.82–85 Resistance
exercise increases protein synthesis and can cause
a negative nitrogen balance,86–88 which suggests a
need for increased protein in the diet. Selected
amino acids such as arginine and ornithine, histi-
dine, lysine, methionine, and phenylalanine are
purported to increase growth hormone,89–92 which
is thought to produce an anabolic effect in muscle.
B. Effects on Muscle Mass
Protein intake of about 2.0 g of protein ·
kg–1 · d–1 is required to maintain a positive nitro-
gen balance in strength-training athletes. Fern
et al.93 found that when strength-training athletes
consumed 3.3 g of protein · kg–1 · d–1 for 4 weeks,
whole body protein synthesis increased and sig-
nificantly more lean body mass was achieved
compared with ingesting 1.3 g of protein · kg–1 ·
d–1. However, other studies reported an increase
in amino acid oxidation with protein supplements,
suggesting that protein intake exceeded that needed
for muscle growth.84,85 Increasing protein intake
to 2.4 g of protein · kg–1 · d–1 did not increase
protein synthesis more than 1.4 g · kg–1 · d–1, but
did result in an increase in amino acid oxidation.94
Based on available research, resistance train-
ing athletes require about 1.4 to 1.8 g of protein ·
kg–1 · d–1, with beginning athletes in the first 2 to
3 weeks of training requiring the higher end of the
range and those adapted to training requiring the
lower end of the range.82–85 However, although
resistance-training athletes require more protein
than those who do not exercise, most athletes
ingest a large amount of calories, and their protein
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322
intake generally meets or exceeds the recom-
mended range for strength-trained athletes.
With respect to effects of selected amino
acids, Bucci et al.95,96 gave bodybuilders 40, 100,
or 170 mg/kg of L -ornithine and found no
increase in serum insulin but a significant in-
crease in growth hormone after the 170 mg/kg
dose only (about 12 g ornithine). Isidori et al.97
had subjects ingest 1.2 g L-lysine and 1.2 g
L-arginine and found that ingesting them together
but not alone produced an increase in growth
hormone and insulin.
Other studies have not supported these posi-
tive findings regarding growth hormone or insu-
lin using L-arginine, L-ornithine, and L-lysine
supplement (2 g/d each),98 2.4 g arginine/lysine,99
200 mg arginine/kg,100 or 1.85 g ornithine/ty-
rosine.99 Elite junior weightlifters who took a
supplement containing most amino acids during
1 weeks of training had no increase in resting or
exercise blood levels of growth hormone, test-
osterone, or cortisol.101 Suminski et al.102 found
that 1.5 g L-arginine and 1.5 g L-lysine produced
only a small, transient, and highly variable
increases in growth hormone at rest but not after
exercise. Thus, the weight of the data suggest that
manufacturer-recommended doses of amino acid
supplements (<4 g/serving) will not increase
growth hormone and alter body weight.
VII. SAFETY
Because nutritional supplements are not regu-
lated by the Food and Drug Administration, there
is no guarantee as to whether the ingredients on
the label are actually in the product. For example,
commercial preparations of the popular supple-
ment melatonin were found to have unidentified
impurities.29 Also, long-term safety of many of
these supplements is not known.
Chromium supplements appear to be safe at
the manufacturer-recommended doses, at least for
a short period of time. However, laboratory stud-
ies of cultured cells suggested that chromium
picolinate could accummulate in cells and cause
chromosome damage.103,104 The dosages were very
high and studies were of cultured cells so that
these results may not be meaningful for humans.105
Recently, Cerulli et al.106 described a case of a
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33-year-old woman who ingested 1200 to 2400 µg
per day of chromium picolinate and presented
with serious renal impairment and compromised
liver function.
Vanadium supplements of up to 13.5 mg
vanadium/d for 6 weeks or 9 mg for up to 16
months were not toxic, but larger doses produced
diarrhea, green tongue, gastrointestinal distur-
bances, and cramps.14 Boron side effects from
acute toxicity (>10 g) are nausea, vomiting, diar-
rhea, dermatitis, and lethargy;107 long-term ef-
fects are largely unknown.
Those athletes who use DHEA or HMB
report few side effects, but adverse effects due to
long-term use have not been determined. 108
Although the desired effect of DHEA for males is
to increase testosterone levels, it may also in-
crease estrogen leading to irreversible gyneco-
mastia.29
No side effects have been documented fol-
lowing creatine ingestion, but the effects of long-
term supplementation remain unknown. Natural,
endogenous production of creatine by the liver is
reduced when exogenous creatine is available,109
but neither this effect has not been documented in
humans nor has it been determined how this would
affect liver function with long periods of supple-
mentation. There are anecdotal reports of muscle
pulls and cramps, but these have not been sub-
stantiated. Manufacturers recommend a creatine
loading phase of 20 g/d for 5 d followed by 2 to
5 g/d as a maintenance dose. However, it is pos-
sible that athletes are taking greater than the rec-
ommended dosage or using them in combination
with multiple other purported ergogenic aids. The
deaths of three collegiate wrestlers in the Fall of
1997 who were undergoing dangerous dehydra-
tion/rapid weight loss procedures raised questions
regarding the safety of creatine supplementation
because it was speculated that they may have
been using creatine. Although these athletes most
likely died of thermal stress and there has been no
evidence presented by the Food and Drug Admin-
istration (FDA) or the Centers for Disease
Control (CDC) that creatine was involved, it is
still unknown under what situations creatine
supplementation may be contraindicated or
inappropriate.
High-protein diets are not associated with risk,
other than increasing a loss of calcium from the
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body. Excessive dietary protein from foods with
high potential renal acid load will increase uri-
nary calcium loss.110 It was once thought that
high-protein diets could negatively affect kidney
function, but this has never been substantiated in
healthy young subjects.85 Because of the water
loss associated with urinary excretion of high
amounts of nitrogen, athletes on high-protein
diets should be sure to ingest sufficient fluid.
High amounts of selected amino acids are of con-
cern because they can cause several side effects,
ranging from mild conditions such as stomach
cramping and diarrhea to more serious effects
such as affecting the body’s absorption of other
amino acids and severe toxicities.85
VIII. CONCLUSION
Chromium supplements do not appear to be
effective in increasing lean body mass. At present
there is not sufficient information to suggest that
boron or vanadium supplements will increase
muscle mass in athletes, and large doses over a
period of time could prove harmful. DHEA has
not been tested adequately, and those available
studies do not support the claim for muscle gain.
Currently, little is known about HMB supplemen-
tation in humans. Although preliminary work may
support the anticatabolic effects of HMB, the
mechanism by which this may occur is not known.
Despite this, HMB continues to be a popular
nutritional supplement, and athletes can purchase
handbooks on HMB at many health food stores
where this supplement is typically sold.
Many studies have reported increases in body
weight from 1 to 3 kg after creatine ingestion for
periods as short as 5 to 6 d. There appears to be a
large intersubject variability in the response that
may be due to the individual’s creatine status
prior to supplementation. Whether the increase in
body mass is due to increases in muscle protein or
in water retention, or both, is not definitely known.
However, due to the rapid increase in weight
(<1 week) it is thought to be mostly a result of
water retention. Increased lean body mass with
creatine supplementation, compared with a pla-
cebo, during 4 or more weeks of resistance-train-
ing may be due to increased protein, but this has
not yet been documented.
323
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The protein requirement of weight-training
athletes is 1.4 to 1.8 g of protein · kg–1 · d–1, which
can be obtained through the diet without protein
supplements. Many “high-tech” protein supple-
ments on the market include a variety of additives
to boost weight gain. However, these products
have never been tested to evaluate their efficacy,
and it is unlikely they would be more effective
than adequate protein in the diet or an inexpen-
sive high-quality protein supplement like casein
(milk powder). Although several formulations of
amino acid supplements are purported to increase
growth hormone and insulin and create an ana-
bolic effect, studies have not confirmed this.
Overall, it appears that there is little scientific
documentation that most nutritional supplements
will increase muscle mass as purported. Despite
this, the sale of muscle-building products are big
business. For example, creatine reached sales of
$200 million in U.S. in 1997. Further research is
needed to document the efficacy of these supple-
ments, the mechanisms by which they produce
their effects, and the long-term safety.
Glossy advertisements for muscle gain prod-
ucts are enticing but often misleading or decep-
tive. These nutritional supplements can be mar-
keted without the FDA review of safety or
effectiveness. Many claims are unsubstantiated,
and the concentration of active ingredients can
differ markedly from product to product due to
the lack of regulatory control. The placebo effect
for most supplements is high, and because ath-
letes believe these supplements will enhance
weight gain, they may train harder or work more
efficiently. This will likely result in an initial
improvement in performance, but eventually many
supplements prove ineffective, a waste of money,
and may even be harmful.
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