Are Sports Supplements Safe?

Written by Dr. Steve Chaney on . Posted in current health articles, Supplements and Health

Are There Any Sports Supplement Companies You Can Trust?

Author: Dr. Stephen Chaney

 

are sports supplements safe“Pump up your muscles”, “Explode your muscles”, “”Blast your fat”, “Annihilate your fat”, “Ramp up your energy”: The claims leap off the page of the ads for many sports and weight loss supplements.  But, are sports supplements safe?

The easiest way to ramp up your energy and annihilate your fat is to put amphetamines or other illegal stimulants in the supplement. The easiest way to pump up your muscles is to put steroids in the supplement. Unfortunately, there are always a few unscrupulous companies that are only too willing to do just that.

Well, the chickens have come home to roost. It’s been a bad few weeks for the sports supplement industry. It seems like every time you turned around there was another article about a sports supplement making fraudulent claims, containing illegal ingredients, or actually harming people. It makes you wonder whether you should just completely avoid sports supplements all together.

That would be unfortunate because sports supplements can help with hydration, endurance and recovery. They can help you maximize the benefits of your exercise program. Furthermore, there are a lot of reputable sports supplement companies out there. The problem is that there are a few “bad apples” in the industry, and the FDA is not really doing its job to protect the American consumer from their deceptive and dangerous products.

Even worse, when the FDA acts, major retail nutrition stores often drag their feet at actually removing the products from their shelves (https://healthtipsfromtheprofessor.com/are-dietary-supplements-safe/), and the unscrupulous manufacturers just switch to another equally dangerous stimulant.

It is, therefore, important for those of us who are nutrition educators to warn consumers like you about the dangerous products that are in the marketplace. The FDA will eventually act, but you need to know about those products now!

I have previously warned you about sports nutrition products containing the amphetamine-like stimulants DMAA (https://healthtipsfromtheprofessor.com/are-dietary-supplements-safe/), DEPEA (https://healthtipsfromtheprofessor.com/are-fat-burning-sports-supplements-safe/) and DMBA (https://healthtipsfromtheprofessor.com/supplements-to-avoid/). As you might guess from the names, these are all structurally related compounds. They have several other characteristics in common:

  • They are all synthetic amphetamine analogs.
  • The sports nutrition companies selling products with these ingredients tried to fool the public (and the FDA) by claiming that they were natural components of the herbal ingredients in their product.
  • None of them had ever been tested for safety and efficacy in humans. Some of them actually killed people before the FDA stepped in and banned them.

Amphetamine and amphetamine-like substances are popular in sports nutrition and weight loss products because they increase energy levels and speed up metabolism. Unfortunately, they also cause high blood pressure, arrhythmia, heart attacks and death.

Are Sports Supplements Safe?  Yes and No.

sports supplementsSports Supplements Containing a Form of Amphetamine

Yet another analog of DMAA called beta-methylphenethylamine (BMPEA) has appeared in the sports nutrition marketplace. It is an isomer of amphetamine that was first synthesized in the 1930’s. Because it is an analog of amphetamine, BMPEA is classified as a banned substance by the World Anti-Doping Agency. Unfortunately, its story is all too familiar.

The FDA first reported the presence of pharmacological doses of BMPEA in 43% of sports and weight loss supplements containing the herbal ingredient Acacia rigidula in 2012. The manufacturers claimed that the BMPEA in their products came from the Acacia rigidula even though there was no scientific evidence that it had ever been successfully extracted from Acacia rigidula.

BMPEA causes high blood pressure in animals and has never been tested for safety or efficacy in humans. Its close analog, DMAA, caused scores of deaths before the FDA finally banned it. However, the FDA did not warn consumers that supplements with the ingredient Acacia rigidula might contain BMPEA and might, therefore, be dangerous.

A group led by Dr. Pieter Cohen of Harvard University (Cohen et al, Drug Testing and Analysis, DOI: 10.1002/dta.1793, 2015) recently decided to analyze sports and weight loss supplements containing Acacia rigidula to see whether some companies had voluntarily removed DMPEA from their products over the last two years. One might hope that at least some of those companies might have been more motivated by protecting the health of their customers than by profit.

Not a chance! Dr. Cohen and his colleagues tested 21 products containing Acacia rigidula and found that 11 of them (52%) contained BMPEA – some in amounts as high as 94 mg/serving.

Dr. Cohen was quoted as saying “More than two years after the FDA’s discovery [of BMPEA in sports supplements], the FDA has yet to warn consumers about the presence of an amphetamine isomer in supplements. This is really about the FDA and why the FDA is not enforcing the law. This is a great example of how the FDA could so easily move now and not wait like it did with DMAA, wait until strokes and heart attacks had become front page news.”

After Dr. Cohen’s article became front page news several Senators called on the FDA to ban BMPEA. A week later the FDA finally caved in and announced that BMPEA was not a legal ingredient and that any products listing it on the label must be withdrawn from market. A skeptic might note that this was a full two years after the FDA discovered the existence of products containing BMPEA. The FDA’s announcement also did not cover BMPEA-containing products listing only Acacia rigidula on the label – which made up most of the BMPEA-containing products identified by Dr. Cohen and his colleagues. As the old saying goes, the FDA action was “a day late and a dollar short”.

Sports Supplements Containing Steroids

sports supplements containing steroidsA week later the FDA issued a warning to consumers to stop using a product call Tri-Methyl Extreme because of reports of serious liver damage in people using it. The product contained the anabolic steroids methyl-stenbolone, MAX LMG (a non-methylated prohormone) and epistane.

There are two important take home lessons from this incident.

  • The product actually claimed that it contained anabolic steroids. Anabolic steroids are known to cause liver damage, heart attack and stroke, testicular cancer, infertility and mood disorders. It is hard to imagine why anyone would use a product that claimed to contain anabolic steroids. Unfortunately, some people are willing to do almost anything that will increase muscle mass and strength.
  • The FDA often only acts once a product has either seriously injured or actually killed people. I tend to agree with Dr. Cohen that it would be far preferable for the FDA to be proactive and warn consumers about products that have the potential to do harm.

Sports Supplements That Cause Cancer

As if that weren’t bad enough, at about the same time a paper was published reporting that use of muscle-building supplements by young men may increase their risk of testicular cancer by up to 177% (Li et al, British Journal of Cancer, DOI: 10.1038/bjc.2015.26).

The incidence of testicular germ cell cancer in men 15-39 years old has increased 1.6-fold between 1975 and 2011. The reason for that increase is not known, but the authors of British Journal of Cancer article noted that the use of performance-enhancing supplements in that group has also increased dramatically during the same time period.

A previous study of testicular cancer patients reported that a high percentage of them (~20%) had used performance-enhancing supplements, but no control group was included in that study. Thus, the authors of this study set out to carefully match testicular cancer patients with healthy men of the same age and demographics – something we scientists call a case-control study.

The study compared 356 testicular cancer patients age 18-55 from Connecticut and Massachusetts with 513 controls that were matched by age, race, education, tobacco and alcohol use, exercise level, injury to testes or groin, and family history of testicular cancer. The results were pretty scary.

  • Use of muscle building supplements increased the risk of testicular cancer by 65% compared to men who never used that kind of supplement.
  • For men who started using muscle building supplements before they were 25, the risk of developing testicular cancer increased by 121%.
  • For men who used muscle building supplements for more than 3 years, the risk increased to 156%.
  • For men who used more than 2 types of muscle building supplements, the risk increased to a whopping 177%. That’s almost double.

This study did not identify the actual ingredients that caused the increased testicular cancer risk, but with so many of the muscle-building supplements on the market containing dangerous and/or illegal ingredients it is perhaps not surprising that they might increase cancer risk. After all, this demographic (young males) is the group most likely to choose the “Monster Muscle Builder” products rather the less glamorous, but safer, sports supplements.

Sports Supplements That Mislead

sports supplements companies that misleadAt the same time that we were hearing about sports supplements with dangerous and illegal ingredients and sports supplements that may cause cancer, the Advertising Standards Authority (the British equivalent of the FTC) accused a British sports supplement company of making false and misleading ingredient claims. That’s a polite way of saying they were lying!

In particular, they disallowed claims that:

  • CLA builds lean muscle and attacks fat stores, promotes fat loss, improves mood and focus and boosts energy.
  • Acetyl-L-Carnitine aids weight loss, burns fat, boosts energy, improves mental performance, and improves focus.

There were more claims they disallowed (click here for the complete report) (http://www.asa.org.uk/Rulings/Adjudications/2015/4/Protein-World-Ltd/SHP_ADJ_288571.aspx#.VS2VbJOk9RN), but I included those two because you’ve probably seen similar claims for those ingredients on this side of the Atlantic. Those claims are just as bogus in the United States as they are in England.

How To Choose A Sports Supplement Company You Can Trust

safe sports supplementsBy now you are probably convinced that you should never use a sports supplement product again. However, as I said above good sports supplements properly used can improve hydration, endurance, recovery and the results you obtain from your exercise program. Here are the questions to ask.  Are sports supplements safe?  They can be.   Which sports nutrition products can you trust? Here are some simple guidelines to help you choose a trustworthy sports supplement company.

  • Avoid the hyped claims. If the supplement makes claims like “Get ripped fast”, “Intense Energy”. “Extreme Energy”, “Eviscerate fat”, “Makes fat cells self-destruct” or “boosts testosterone”, you should run the other direction.
  • Ignore testimonials. The placebo effect is close to 50% for things like energy, and if an athlete “thinks” they have more energy every time they work out, they will get stronger.
  • Look for published clinical studies showing that the product is safe and effective. Those clinical studies should be published in peer-reviewed scientific journals. If the company just cites their own “studies” or “white papers”, ignore them. They may look impressive, but they have not been peer reviewed. You have no idea whether they are accurate.
  • I could tell you to look for rigorous quality control standards, but every company claims they have excellent quality controls. Instead I will tell you to look for supplements that are used by medal winning Olympic athletes. Why Olympic athletes? That is because Olympic athletes are more rigorously drug tested than any other athlete. They absolutely cannot afford to have any stimulants, steroids or other banned substances in their body at any time. They need products that are pure, safe and effective.
  • Finally, avoid products with artificial ingredients. While the risks associated with artificial sweeteners, artificial flavors and artificial colors are not as great as the risks associated with stimulants and steroids, they are still ingredients to be avoided. We simply do not know the long term health consequences of artificial ingredients.

 

The Bottom Line

  • There are a few bad apples in every barrel, and the sports supplement industry is no exception. Are sports supplements safe?  Over one two-week period lately we have learned:
  • Over 50% of sports nutrition products labeled as containing an innocuous sounding herbal ingredient were actually found to contain an amphetamine isomer called BMPEA that has been banned by the World Anti-doping Agency. After years of dragging its feet, the FDA finally banned some of the products containing BMPEA, but left many others on the market. As the old saying goes, the FDA was “a day late and a dollar short”.
  • Even though they are extremely dangerous, new sports supplements with anabolic steroids keep popping up online. Once again, the FDA has had to warn consumers not to use a new muscle building supplement containing steroids because several people using that supplement suffered severe liver damage.
  • A study reported that young men who use muscle building supplements may increase their risk of testicular cancer by up to 177%.
  • The British equivalent of our FTC has told a British sports supplement manufacturer that it must stop making false and misleading claims about ingredients like CLA and acetyl-L-carnitine. That is noteworthy because some sports supplement companies in the US make very similar claims for the same ingredients.
  • You shouldn’t necessarily avoid sports supplements because of a few bad apples. Good sports supplements properly used can improve hydration, endurance, recovery and the results you obtain from your exercise program. There are a few simple guidelines that can help you choose the good sports supplement companies and avoid the bad ones:
  • Avoid the hyped claims.
  • Ignore testimonials.
  • Look for published clinical studies showing that the product is safe and effective.
  • Look for supplements that are used by medal winning Olympic athletes. That’s because Olympic athletes absolutely need products that are pure, safe and effective.
  • Avoid products with artificial ingredients.

 

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

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Should You Avoid Sugar Completely?

Posted October 24, 2017 by Dr. Steve Chaney

Is It The Sugar, Or Is It The Food?

Author: Dr. Stephen Chaney

 

Should we avoid sugar completely?  Almost every expert agrees that Americans should cut down on the amount of sugar we are consuming. However, for some people this has become a “sugar phobia”. They have sworn that “sugar shall never touch their lips”. Not only do they avoid sugar sweetened sodas and junk food, but they also have become avid label readers. They scour the label of every food they see and reject foods they find any form of sugar listed as an ingredient. Is this degree of sugar avoidance justified?

 

Should We Avoid Sugar to Keep it From Killing Us?

 

Let me add some perspective:

  • If you just take studies about the dangers of sugar at face value, sugar does, indeed, look dangerous. Excess sugar consumption is associated with increased risk of obesity, diabetes, and heart disease. However, when you look a little closer, you find that most of these studies have been done by looking at the correlation of each of these conditions with sugar sweetened beverage consumption (sodas and fruit juices).

A few studies have looked at the correlation of obesity and disease with total “added sugar” consumption. However, 71.6% of added sugar in the American diet comes from sugar sweetened beverages and junk food. None of the studies have looked at the sugar from healthy foods like fruits, vegetables, and whole grains. That’s because there is ample evidence that these foods decrease the risk of obesity, diabetes, and heart disease.

  • For example, if apples had a nutrition label, it would list 16 grams of sugar in a medium 80 calorie apple, which corresponds to about 80% of the calories in that apple. The sugar in an apple is about the same proportion of fructose and glucose found in high fructose corn syrup. Apples are not unique. The nutrition label would read about the same on most other fruits. Does that mean you should avoid sugar from all fruits? I think not.

Avoid Sugar or Avoid Certain Foods

 

avoid sugar from junk foodsThe obvious question is: “Why are the same sugars, in about the same amounts, unhealthy in sodas and healthy in fruits?” Let’s go back to those studies I just mentioned—the ones that are often used to vilify sugars. They are all association studies, the association of sugar intake with obesity and various diseases.

The weakness of association studies is the association could be with something else that is tightly correlated with the variable (sugar intake) that you are measuring. Could it be the food that is the problem, not the sugar?

If we look at healthy foods (fruits, vegetables, whole grains) they are chock full of vitamins, minerals, phytonutrients, fiber, and (sometimes) protein. Fiber and protein slow the absorption of sugar into the bloodstream. As a result, blood sugar levels rise slowly and are sustained at relatively low levels for a substantial period of time.

In sodas there is nothing to slow the absorption of blood sugar. You get rapid rise in blood sugar followed by an equally rapid fall. The same is true of junk foods consisting primarily of sugar, refined flour and/or fat.  Avoid sugar from those types of foods.

Another consideration is something called caloric density. Here is a simple analogy. I used to explain the concept of caloric density to medical students in my teaching days. There are about the same number of calories in a 2-ounce candy bar and a pound of apples (around 278 in the 2-ounce candy bar and 237 in a pound of apples). You can eat a 2-ounce candy bar and still be hungry. If you eat a pound of apples you are done for a while. In this example, the 2-ounce candy bar had a high caloric density (a lot of calories in a small package). Perhaps a more familiar terminology would be the candy bar was just empty calories.

Are Sodas and Junk Foods Killing Us?

avoid sugar from candyPutting all that together, you can start to understand why the foods the sugars are in are more important than the sugars themselves. When you consume sugars in the form of sugar sweetened beverages or sugary junk foods, your appetite increases. We don’t know for sure whether it is the intense sweetness of those foods, the rapid increase and fall in blood sugar, or the high caloric density (lots of calories ina small package) that makes us hungrier. It doesn’t matter. We crave more food, and it isn’t usually fruits, vegetables, and complex carbohydrates we crave. It’s more junk. That sets in motion a predictable sequence of events.

  • We overeat. Those excess calories are stored as fat and we become obese. [Note: The low carb enthusiasts will tell you our fat stores come from carbohydrates alone. That is incorrect. All excess calories, whether from protein, fat, or carbohydrate, are stored as fat.]
  • It’s not just the fat you can see (belly fat) that is the problem. Some of that fat builds up in our liver and muscles. This sets up an unfortunate sequence of metabolic events.
  • The fat stores release inflammatory cytokines into our bloodstream. That causes inflammation. Inflammation increases the risk of many diseases including heart disease and cancer.
  • The fat stores also cause our cells to become resistant to insulin. That reduces the ability of our cells to take up glucose, which leads to hyperglycemia and type 2 diabetes. [Note: The low carb enthusiasts will tell you carbohydrates cause type 2 diabetes. That is also incorrect. It is our fat stores that cause insulin resistance and type 2 diabetes. Our fat stores come from all excess calories, not just excess calories from carbohydrates.]
  • Insulin resistance also causes the liver to overproduce cholesterol and triglycerides and pump them into the bloodstream. That increases the risk of heart disease.
  • Sugar sweetened beverages and sugary junk foods also displace healthier foods from our diet. That leads to potential nutrient shortfalls that can increase our risk of many diseases.

However, none of this has to happen. The one thing that every successful diet has in common is the elimination of sodas, junk foods, fast foods and convenience foods. You should avoid sugar from those foods as much as possible. Once you eliminate those from your diet,you significantly enhance your chances of being at a healthy weight and being healthy long term.

 

What About Protein Supplements And Similar Foods?

Of course, the dilemma is what you, as an intrepid label reader, should do about protein supplements, meal replacement bars, or snack bars. They are supposed to be healthy, but the label lists one or more sugars. Even worse, the sugar content is higher than your favorite health guru recommends.  So, should you avoid sugar from supplements and the like?

In this case, a more useful concept is glycemic index, which is a measure of the effect of the food on your blood sugar levels. Healthy foods like apples may have a high sugar content, but they havea low glycemic index.

avoid sugar and consume protein to slow absorbptionThe same is true for the protein supplements and bars you are considering. Rather than looking at the sugar content, you should be looking for the term “low glycemic” on the label. That means there is enough fiber and protein in the food to slow the absorption of sugar into the bloodstream and stabilize your blood sugar levels.

What Does This Mean For You?

Don’t misunderstand me. I am not advocating for unlimited consumption of sugar. We should work on ways to avoid sugar or reduce the amount of sugar in our diet. On the other hand, we don’t need to become so strict that we and our family need to eat foods that taste like cardboard. We also don’t want to replace natural sugars with artificial sweeteners. I have warned about the dangers of artificial sweeteners previously.

We can go a long way towards reducing sugar by just eliminating sodas, other sugar sweetened beverages, junk foods, fast foods, convenience foods, and pastries from our diet. When considering fast foods and convenience foods, we should check the label for hidden sugar. For example, some Starbucks drinks are mostly sugar. When considering foods that are supposed to be healthy, we should look for the term “low glycemic” on the label.

So we don’t have to avoid sugar completely, but we should reduce sugar from sugar sweetened beverages and junk food.

 

The Bottom Line

 

We need to keep warnings about the dangers of sugar in perspective:

  • The studies showing that sugar consumption leads to obesity, diabetes, and heart disease have all been done with sodas and junk foods.
  • Many fruits have just as much sugar as a soda. They also contain about the same proportion of fructose and glucose as high fructose corn syrup. Yet we know fruits are good for us.
  • Diets rich in fruits, vegetables and whole grains decrease our risk of obesity, diabetes, and heart disease.
  • That is because the sugar in whole foods is generally present along with fiber and protein, which slows the absorption of sugar and prevents the blood sugar spikes we get with sodas and junk foods.
  • In the case of prepared foods like protein supplements, you should look for “low glycemic” on the label rather than sugar content. Low glycemic means that there is enough fiber and protein in the product to slow the absorption of sugar and prevent blood sugar spikes.
  • Don’t misunderstand me. I am not advocating for unlimited consumption of sugar. We should all work on ways to avoid sugar from junk foods or to reduce the amount of sugar in our diet. On the other hand, we don’t need to become so strict that we and our family need to eat foods that taste like cardboard. We also don’t want to replace natural sugars with artificial sweeteners.
  • We can go a long way towards reducing sugar by just eliminating sodas, other sugar sweetened beverages, junk foods, fast foods, convenience foods, and pastries from our diet. When considering fast foods and convenience foods, we should check the label for hidden sugar. When considering foods that are supposed to be healthy, we should look for the term “low glycemic” on the label.

For more details, read the article above.

 

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

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