Lecture 7: Nutritional Ergogenic Aids

In this lecture we will:

1. Critically review main nutritional supplements for exercise performance

2. Identify potential exercise-specific nutritional needs in that supplementation

has strong/weak basis
v Nutritional ergogenic aids: definition

Non-pharmacological ergogenic aids: substances, foods, or training methods that enhance energy
production, use or recovery thus providing athletes with a competitive advantage over ‘typical’ routines

NO GENETICAL OR SURGICAL
MANIPULATION
v Drugs vs. nutritional supplements

DRUGS
Substances intended to diagnose, treat or prevent disease. They
must pass clinical trials before being released to the public and the
tests need to prove each drug is safe, performing just as the
manufacturer claims. Drugs and food are independently regulated.

The general rule is that drugs are considered unsafe until they
are proven safe.

NUTRITONAL SUPPLEMENTS
Substances taken orally for supplementing the diet. Considered as
food. Self-regulated by the manufacturer, little proof is required to
demonstrate their effectiveness and safety.

The general rule for supplements is that they’re considered

safe until they are proven unsafe.
v Nutritional ergogenic aids: focus on evidence-based supplements

The benefit of most dietary supplements is still under debate because their effectiveness is
often not strongly supported or even not scientifically proven at all

Jeukendrup et al. (2010). Sports Nutrition

v Evidence-based recommendations: evidence categories

Available at http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf

Garber et al. (2011). MSSE

v Nutritional ergogenic aids: main purposes

ALTER BODY WEIGHT AND

COMPOSITION
ENHANCE ENERGY
PRODUCTION

FACILITATE
RECOVERY
v Nutritional ergogenic aids: body weight and composition
Fat oxidation

• There are many nutrition supplements on the market that claim to increase fat oxidation

• Examples include caffeine, carnitine, hydroxycitric acid (HCA), chromium, conjugated

linoleic acid (CLA), guarana, citrus aurantium, Asian ginseng, cayenne pepper, coleus
forskholii, glucomannan, green tea, psyllium and pyruvate

• Is there any nutrional supplement effectively increasing fat oxidation

v Nutritional ergogenic aids: body weight and composition
Fat oxidation

Examples include caffeine, carnitine, hydroxycitric acid (HCA), chromium, conjugated

linoleic acid (CLA), guarana, citrus aurantium, Asian ginseng, cayenne pepper, coleus
forskholii, glucomannan, green tea, psyllium and pyruvate

There is little or no evidence that these particular supplements actually increase fat oxidation
during exercise compared with non-supplemented (normal) fat oxidation
v Nutritional ergogenic aids: body weight and composition
Fat oxidation

The only highly effective way to increase fat oxidation is through exercise training, although it is
still unclear what the best specific training regimen is to get the largest chronic reduction in body fat
v Nutritional ergogenic aids: body weight and composition
Increasing muscle mass

Whey: The liquid material obtained when milk is coagulated during the process
of cheese production

There appears to be specific advantage to the consumption of isolated whey protein in close
temporal proximity to the performance of resistance exercise. This is likely due to the high essential
amino acid content as well as the rapid pattern of delivery of amino acids provided by whey

Is it strictly needed to take whey supplements beyond the amount of whey found in regular foods
v Nutritional ergogenic aids: body weight and composition
Increasing muscle mass

Regular foods can provide the necessary amount of whey protein (> 1.5-1.7 g per kg per day)
to maximize increases in muscle mass

• Examples of foods rich in whey protein

Milk Cottage and Ricotta cheese Yogurt

v Nutritional ergogenic aids
Increasing muscle mass and performance (energy production)

Creatine: Nitrogen-containing organic compound that facilitates recycling of adenosine triphosphate

(ATP), the energy currency of the cell, via donation of phosphate groups. The supplement creatine
monohydrate is similar or identical to endogenous creatine produced in the liver, kidneys, and pancreas

• Food-derived rich sources of creatine provide

relatively little amounts of creatine (< 6 g per
kg)

• The body synthesizes only about 1 to 2 g of

creatine daily, primarily in the kidneys, liver,
and pancreas, from the amino acids arginine,
glycine, and methionine
v Nutritional ergogenic aids
Increasing muscle mass and performance (energy production)

• Few dietary supplements have shown much advantage in promoting muscle growth aside from
creatine

• A number of studies have shown that creatine supplementation (5 to 10 g per day) during a period of
resistance exercise training can enhance the gains in fat free mass and strength compared with no
supplementation
Tarnopolsky et al. (2001). MSSE
v Nutritional ergogenic aids
Increasing muscle mass and performance (energy production)

• Effects of 12 weeks of creatine supplementation plus heavy resistance training on changes in (A) body
mass (BM), fat-free body mass (FFM) and body fat, (B) muscular strength (squat and bench press), and
(C) cross-sectional areas of muscle fiber types

Volek et al. (1999). MSSE

v Nutritional ergogenic aids
Increasing muscle mass and performance (energy production)

CREATINE SUPPLEMENTATION
• Body mass generally increases between ⁓0.5 and ⁓2.4 kg with creatine supplementation.

• Most of the increase in body mass is explained by augmented muscle mass

• It remains unclear how much of the muscle mass gain occurs from:

§ the anabolic effect of creatine on muscle tissue synthesis

§ osmotic retention of intracellular water from increased creatine stores
§ other factors

§ Unlike protein (whey) supplementation, creatine supplementation facilitates higher

training intensity from early stages, thus increasing the exercise stimuli for muscle
protein synthesis
v Nutritional ergogenic aids
Increasing muscle mass and performance (energy production)

ADDED EFFECTS OF CREATINE SUPPLEMENTATION

• 6 weeks of creatine supplementation (0.1 g/kg/day) in addition to whey supplementation
(1.2 g/kg/day) increases lean mass and strength compared with whey alone or placebo

Burke et al. (2001). Int J Sports Nutr & Ex Metab

Selected studies showing increase in exercise performance following creatine monohydrate supplementation
CREATINE SUPPLEMENTATION AND EXERCISE PERFORMANCE
High-intensity, repetitive anaerobic efforts of short duration are generally improved with creatine
supplementation
CREATINE SUPPLEMENTATION AND EXERCISE PERFORMANCE
• Creatine supplementation does not improve exercise performance that mainly depends on aerobic
metabolism (involving prolonged cardiovascular work)

• It also exerts little or no effects on isometric (without movement) muscular strength or dynamic
muscle force measured during a brief single movement
v Nutritional ergogenic aids: body weight and composition
Increasing muscle mass and performance (energy production)
RECOMMENDED CREATING LOADING (fast and slow) PROTOCOLS
• To expedite “creatine load” skeletal muscle, ingest 20 g of creatine monohydrate daily for 6 days;
switch to a reduced dosage of 2 g per day to keep levels elevated for up to 28 days

• Supplementing 3 g of creatine daily for 28 days achieves the same effects in a longer period of time

• Creatine supplementation along with a carbohydrate-containing

drink increases creatine uptake and storage in skeletal muscle

• Augmented creatine storage with a creatine plus carbohydrate

likely results from insulin-mediated glucose absorption by skeletal
muscle, which also facilitates transport of creatine into muscle
fibers

Green et al. (1996). Am J Physiol

CREATINE SUPPLEMENTATION AND DAILY CAFFEINE
• Some evidence in the 1990s indicated that the short-term (1-week) effects of creatine
supplementation on strength is abolished with concomitant caffeine consumption (5 mg per kg
body mass)

• The average coffee may contain 60-90 mg of caffeine

• According to this evidence, athletes were recommended to refrain from daily caffeine-containing
foods to preserve creatine’s ergogenic effects
Vandenberghe et al. (1996). J Appl Physiol
CREATINE SUPPLEMENTATION AND ACUTE CAFFEINE CONSUMPTION

• Acute (single) caffeine consumption (6 mg per kg body mass) after a

week of creatine supplementation slightly improves high-intensity
repeated exercise performance

Chia-Yun Lee et al. (2011). Eur J Appl Physiol

 Is performance improved more with creatine than with protein supplementation

Post-exercise (within 60 min) carbohydrate (50 g) + protein (10 g) given over a period of 2 months
of resistance exercise training, resulted in similar strength gains when compared to training with
post-exercise consumption of creatine (10 g + 50 g of carbohydrate)
Jeukendrup (2010). Sports Nutrition. From lab to kitchen

Does carbohydrate supplementation (or high-carbohydrate diets) eventually

provide all the additional effects of creatine supplementation
v Nutritional ergogenic aids: enhancing energy production

CAFFEINE AND ENHANCED PERFORMANCE (ENERGY PRODUCTION)

• Drinking 2.5 cups of coffee (150 to 220 mg of caffeine) 1 hour before exercising extends
endurance in strenuous aerobic exercise under laboratory and field conditions, as it also
does in repeated exercise bouts in high-intensity team sports
Kach et al. (2008). Sports and Exercise Nutrition
v Nutritional ergogenic aids: enhancing energy production

CAFFEINE AND ENHANCED PERFORMANCE (ENERGY PRODUCTION)

Costill et al. (1978). MSSE Macintosh et al. (1995). Can J Appl Physiol
v Nutritional ergogenic aids: enhancing energy production
CAFFEINE AND ENHANCED PERFORMANCE (ENERGY PRODUCTION)

No dose-response relationship
• The figure shows the effects of pre-exercise
caffeine on endurance time of well-trained
male cyclists. Subjects received a placebo or a
capsule containing 5, 9, or 13 mg of caffeine
per kg of body mass 1 hour before cycling at
80% of maximal power output

• All caffeine trials improved exercise

performance by 24%. No greater benefit
occurred above 5 mg of caffeine per kg of
body mass

Pasman et al. (1995). Int J Sports Med

v Nutritional ergogenic aids: enhancing energy production

Habitual coffee drinkers

• The ergogenic effects on endurance occur less for caffeine in coffee than for an
equivalent dose from a caffeine capsule in water

• Beneficial effects do not consistently occur among habitual caffeine users

• Athletes must consider “caffeine tolerance” before assuming it provides a consistent

benefit to all persons. From a practical standpoint, individuals should omit caffeine-
containing foods and beverages 4 to 6 days before competition to optimize
caffeine’s potential for ergogenic effects

Jeukendrup et al. (2010). Sports Nutrition

v Nutritional ergogenic aids: enhancing energy production
EPHEDRINE SUPPLEMENTATION AND ENHANCED PERFORMANCE
(ENERGY PRODUCTION)

The ephedra plant contains the active component ephedrine,

a potent amphetamine-like alkaloid compound with sympathomimetic effects

Based on an analysis of existing data, including commissioning a safety study by an

independent research group, the Food and Drug Administration (FDA) announced in April,
2004 a ban on ephedra, the first time this federal agency has banned a dietary supplement
v Nutritional ergogenic aids: enhancing energy production
EPHEDRINE SUPPLEMENTATION AND ENHANCED PERFORMANCE
(ENERGY PRODUCTION)

• Double-blind, placebo-controlled studies using 0.8–1.0 mg ephedrine per

kg of body mass, either alone or combined with caffeine, produced small
but statistically significant effects on endurance performance and
anaerobic power output (Wingate test)

• Improved 1500-m running performance with no reported side effects by

male athletes who receive 2.5 mg of ephedrine per kg of body mass
compared to carbohydrate (maltodextrin) placebo 90 minutes before the
all-out run trial

• Ergogenic effects are commonly attributed to central nervous system

effects rather than to improved metabolism

Kach et al. (2008). Sports and Exercise Nutrition

 v Nutritional ergogenic aids: enhancing energy production

CARBOHYDRATE SUPPLEMENTATION AND ENHANCED PERFORMANCE (ENERGY PRODUCTION)

Carbohydrate drinks Gels

DEVELOPED IN LECTURE 5

• Consumption of high amounts of carbohydrates is needed to store and replenish all or a

substantial portion of the glycogen that is used during prolonged (high-intensity) exercise

• The specific characteristics of exercise (duration, intensity, modality) will determine the
most appropriate type (combination) of carbohydrates
v Nutritional ergogenic aids: enhancing energy production
OTHER NUTRITIONAL SUPPLEMENTS CLAIMED TO ENHANCE PERFORMANCE
(ENERGY PRODUCTION)

• Coenzyme Q10 (aerobic metabolism)

• Pyruvate (aerobic metabolism)

• Medium-chain triacylglycerols

• Inosine (aerobic and anaerobic metabolism)

• …

The effectiveness of these and other nutritional supplements to enhance performance remains to be
strongly and consistently demonstrated by high-quality scientific studies
Recovery and exercise performance
Recovery (sleep) and exercise performance

Kirschen et al. (2018). Clin J Sport Med

v Nutritional ergogenic aids: facilitating recovery

EXAMPLES OF NUTRITIONAL SUPPLEMENTS CLAIMED TO IMPROVE SLEEP

• Sedative herbs (e.g., Valerian)

• Tryptophan

• Melatonin

• Magnesium

• …

Overall, scientific evidence reveals none, inconclusive or little to mild effects of nutritional
supplements on some aspect of sleep
v Nutritional ergogenic aids: facilitating recovery

• The effect of high- and low-glycemic index carbohydrate–based meals ingested 4 h before
bedtime on sleep quality. The effect of the timing of high-GI meals (4 h compared with 1 h) on
sleep quality was also determined

• Twelve healthy men (aged 18-35 y) were administered standard, isocaloric (767 kcal; 90.4% of
energy as carbohydrate) meals of either Mahatma rice (low glycemic index = 50) or Jasmine rice
(high glycemic index = 100) 4 h before their usual bedtime. On another testing day, the high-GI
meal was given 1 h before bedtime.

• The participants underwent a familiarization night followed by 3 test nights in random order 1 wk
apart

Afaghi et al. (2007). Am J Clin Nutr

v Nutritional ergogenic aids: facilitating recovery

SLEEP ONSET
LATENCY
Afaghi et al. (2007). Am J Clin Nutr
v Nutritional ergogenic aids: facilitating recovery

EFFECTIVE NUTRITIONAL INTERVENTION TO IMPROVE SLEEP ONSET LATENCY

• Intake of carbohydrates with high glycemic index (e.g., white rice, bread, potatoes) may
promote sleep; however, they should be consumed more than 1 hr before bedtime, ideally
4 hrs before bedtime

• High carbohydrate diets generally improve sleep

• Hypocaloric diets should be avoided

• Caffeine and alcohol intake should be minimized

Jeukendrup et al. (2010). Sports Nutrition

v Nutritional ergogenic aids: facilitating recovery

Another nutritional factor involved with sleep quantity and quality may be hydration. In a
recent survey of sleep habits of athletes at the Australian Institute of Sport, a major reason for
sleep disturbances was getting up several times during the night to urinate. One reason for
this is the need for rehydration following afternoon or evening training sessions or
competition, possibly resulting in hyper-hydration in some individuals

Jeukendrup (2010). Sports Nutrition

v Nutritional ergogenic aids: facilitating recovery

NUTRITIONAL SUPPLEMENTS AND IMMUNE FUNCTION

• Numerous studies have shown that several aspects of immune function are depressed for
a period of time following a bout of prolonged strenuous exercise and this has been
suggested to provide a potential “open window” (between 3 and 72 hours, depending on
the immune measure) for disease causing micro-organisms

• Immunonutrition support for athletes has been a focus of research efforts of exercise
immunologists during the past 15 years

• Examples of supplements: zinc, n-3 polyunsaturated fatty acids (n-3 PUFAs), plant
sterols, antioxidants (e.g., vitamins C and E, beta-carotene, N-acetylcysteine, and
butylated hydroxyanisole), glutamine, bovine colostrum, probiotics, quercetin,
isoquercetin, epigallocatechin 3-gallate (EGCG), β-glucan and carbohydrate

• Except for carbohydrate, results have been generally disappointing

Jeukendrup et al. (2010). Sports Nutrition
 v Nutritional ergogenic aids: overall current conclusion
ENHANCE ENERGY
PRODUCTION

ALTER BODY
FACILITATE
WEIGHT AND
RECOVERY
COMPOSITION

According to currently available evidence, even those supplements consistently proven to induce beneficial
effects (compared with no supplementation) provide little to moderate improvements in athletes following an
appropriate diet for their sport discipline
v Nutritional ergogenic aids: potential risks

• The Dietary Supplements Health and Education Act 1994

(DSHEA) passed by the US Congress meant that nutritional
supplements that do not claim to diagnose, prevent or cure
disease are not subject to regulation by the Food and Drugs
Administration (FDA)

• Supplements are regulated in the same way as food ingredients

and are not subject to the stringent regulations that are applied
to the pharmaceutical industry. From this it follows that there is no
requirement to prove claimed benefits, no requirement to show
safety with acute or chronic administration, no quality assurance
and liberal labelling requirements
v Nutritional ergogenic aids: potential risks

• Some products have been shown to contain impurities (lead,

broken glass, animal feces, etc.) because of the failure of the
producers to observe good manufacturing practice

• The risk of gastrointestinal upset because of poor hygiene

during the production and storage of products is a concern to
athletes. This may be nothing more than a minor inconvenience or
it may cause the athlete to miss a crucial competition

• Some products do not to contain an effective dose of expensive

ingredients listed on the label, and in some cases, the active
ingredient is entirely absent and the product contains only
inexpensive materials. A rather sophisticated chemical analysis is
required to identify the contents of a supplement, so there is no
way for athletes to know what is in any of these products.
Harris et al. (2004). J Sports Sci
v Nutritional ergogenic aids: potential risks

• There are now numerous published studies to show that

contamination of dietary supplements with prohibited
substances is not uncommon. A wide range of stimulants,
steroids and other agents that are included on the World Anti-
Doping Agency’s prohibited list has been identified in otherwise
innocuous supplements..

• In some cases, the extraneous additions have actions that are

linked to the intended use of the product. Thus anabolic agents
have been found in supplements sold as muscle growth promoters,
stimulants in herbal tonics, and anorectic agents in herbal weight
loss supplements
v Nutritional ergogenic aids: potential risks

ANALYSIS OF DIETARY SUPPLEMENTS FOR ANABOLIC AGENTS

(COLOGNE DOPING LABORATORY)
v Nutritional ergogenic aids: potential risks

Because of the strict liability principle that applies in doping cases, inadvertent ingestion
of a prohibited substance through use of a contaminated dietary supplement does not
absolve the athlete of guilt. Athletes contemplating the use of dietary supplements should
consider very carefully whether the potential benefits outweigh the risks of a doping
offence that might bring an end to their career
 Many thanks for your attention

I am available if you have any question or comment