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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Does Protein Supplement Timing Matter?

Posted May 15, 2018 by Dr. Steve Chaney

How Do You Gain Muscle Mass & Lose Fat Mass?

Author: Dr. Stephen Chaney

 

protein supplement timingMost of what you read about protein supplements on the internet is wrong. That is because most published studies on protein supplements:

  • Are very small
  • Are not double blinded.
    • Both the subjects and the investigators knew who got the protein supplement.
  • Are done by individual companies with their product.
    • You have no idea which ingredients are in their product are responsible for the effects they report.
    • You have no idea how their product compares with other protein products.
    • There is no standardization with respect to the amount or type of protein or the addition of non-protein ingredients.

Because of these limitations there is a lot of misleading information on the benefits of protein supplements timing and maximal benefit. Let’s start by looking at why people use protein supplements. Let’s also look at what is generally accepted as true with respect to the best supplement timing.

There are 4 major reasons people consume protein supplements:

  • Enhance the muscle gain associated with resistance training: In this case, protein supplements are customarily consumed concurrently with the workout.
  • Preserve muscle and accelerate fat loss while on a weight loss diet: In this case, protein supplements are customarily consumed with meals or as meal replacements.
  • Provide a healthier protein source. In this case, protein supplements are customarily consumed with meals in place of meat protein.
  • Prevent muscle loss associated with aging or illness. There is no customary pattern associated with this use of protein supplements.

How good are the data supporting the customary timing of protein supplementation? The answer is: Not very good. The timing is based on a collection of weak studies which do not always agree with each other.

The current study  (J.L. Hudson et al, Nutrition Reviews, 76: 461-468, 2018 ) was designed to fill this void in our knowledge. It is a meta-analysis that compares all reasonably good studies that have looked at the effect of protein supplement timing on weight gain or loss, lean muscle mass gain, fat loss, and the ratio of lean muscle mass to fat mass.

How Was The Study Done?

The authors started by doing a literature search of all studies that met the following criteria:

  • The study was a randomized control trial with parallel design. This means that study contained a control group. It does not mean that the investigators or subjects were blinded with respect to which subjects used a protein supplement and which did not.
  • The subjects were engaged in resistance training.
  • The study lasted 6 weeks or longer.
  • Reliable methods were used to measure body composition (lean muscle mass and fat mass).
  • The subjects were healthy and at least 19 years old.
  • There was no restriction on the food the subjects consumed.

The authors started with 2074 published studies and ended up with 34 that met all their criteria. They then separated the studies into two groups – those in which the protein supplements were used with meals and those in which the protein supplements were used between meals.

Both groups were diverse.

  • Group 1 included subjects who consumed their protein supplement with their meal and those who consumed their protein supplement as a meal replacement.
  • Group 2 included subjects who consumed their protein supplement concurrent with exercise (usually immediately after exercise) and those who consumed their protein supplement at a fixed time of day not associated with exercise.

Does Protein Supplement Timing Matter?

 

protein supplement timing workoutsBecause the individual studies were very diverse in the way they were designed, the authors could not calculate a reliable estimate of how much lean muscle mass was increased or fat mass was decreased. Instead, they calculated the percentage of studies showing an increase in lean muscle mass or a decrease in fat mass.

When the authors compared protein supplements consumed with meals versus protein supplements consumed between meals:

  • Weight gain was observed in 56% of the studies of protein supplementation with meals compared to 72% of the studies of protein supplementation between meals. In other words, protein supplements consumed with meals were less likely to lead to weight gain than protein supplements consumed between meals.
  • An increase in lean muscle mass was observed in 94% of the studies of protein supplementation with meals compared to 90% of the studies of protein supplementation between meals. In other words, timing of protein supplementation did not matter with respect to increase in muscle mass.
  • A loss of fat mass was observed in 87% of the studies of protein supplementation with meals compared to 59% of the studies of protein supplementation between meals. In other words, protein supplements consumed with meals were more likely to lead to loss of fat mass.
  • An increase in the ratio of lean muscle mass to fat mass was observed in 100% of the studies of protein supplementation with meals compared to 87% of the studies of protein supplementation between meals. In short, protein supplements consumed with meals were slightly more likely to lead to an increase in the ratio of lean muscle mass to fat mass.

The following seem to suggest protein supplement timing matters:

The authors pointed out that their findings were consistent with previous studies showing that when protein supplements are consumed with a meal they displace some of the calories that otherwise would have been consumed. Simply put, people naturally compensate by eating less of other foods.

In contrast, the authors stated that previous studies have shown that when foods, especially liquid foods, are consumed as snacks (between meals), people are less likely to compensate by reducing the calories consumed in the next meal.

The others concluded: “Concurrently with resistance training, consuming protein supplements with meals, rather than between meals, may more effectively promote weight control and reduce fat mass without influencing improvements in lean [muscle] mass.”

What Are The Limitations Of The Study?

Meta-analyses such as this one, are only as good as the studies included in the meta-analysis. Unfortunately, most sports nutrition studies are very weak studies. Thus, this meta-analysis is a perfect example of the “Garbage In: Garbage Out (GI:GO)” phenomenon.

For example, let’s start by looking at what the term “protein supplement” meant.

  • Because the studies were done by individual companies with their product, the protein supplements in this meta-analysis:
    • Included whey, casein, soy, bovine colostrum, rice or combinations of protein sources.
    • Were isolates, concentrates, or hydrolysates.
    • Contained various additions like creatine, amino acids, and carbohydrate.
  • As I discuss in my book, Slaying the Food Myths, previous studies have shown that optimal protein and leucine levels are needed to maximize the increase in muscle mass and decrease in fat mass associated with resistance exercise. However, neither protein nor leucine levels were standardized in the protein supplements included in this meta-analysis.
  • Previous studies have shown that protein supplements that have little effect on blood sugar levels (have a low glycemic index) are more likely to curb appetite. However, glycemic index was not standardized for the protein supplements included in this meta-analysis.

protein supplement timing workout peopleIn short, the conclusions of this study might be true for some protein supplements, but not for others. We have no way of knowing.

We also need to consider the composition of the two groups.

  • Protein supplements used as meal replacements are more likely to decrease weight and fat mass than protein supplements consumed with meals. Yet, both were included in group 1.
  • Some studies suggest that protein supplements consumed concurrent with resistance exercise are more likely to increase muscle mass than protein supplements consumed another time of day. Yet, both are included in group 2. We also have no idea whether the meals with protein supplements in group 1 were consumed shortly after exercise or at an entirely different time of day.

This was the most glaring weakness of the study because it was completely avoidable. The authors could have grouped the studies into categories that made more sense.

In other words, there are multiple weaknesses that limit the predictive power of this study.

What Can We Learn From This Study?

Despite its many limitations, this study does remind us that protein supplements do have calories. This is of relatively little importance for people whose primary goal is to increase lean muscle mass.

However, most of us are using protein supplements to lose weight or to increase our lean mass to fat mass ratio. Simply put, we are either trying to lean out (shape up) or lose weight. And, we want to lose that weight primarily by getting rid of excess fat. For us, calories do matter. With that in mind:

  • If we are consuming a protein supplement immediately after exercise or between meals we probably should make a conscious effort to reduce our daily caloric intake elsewhere in our diet.
  • Alternatively, we could consume the protein supplement with a meal, but time the meal so it occurs shortly after exercise.

 

The Bottom Line:

 

A recent study looked at the optimal timing of protein supplements consumed by subjects who were engaged in resistance exercise. Specifically, the study compared protein supplements consumed with meals versus protein supplements consumed between meals on weight, lean muscle mass, fat mass, and the ratio of lean muscle mass to fat mass. The study reported:

  • Protein supplements consumed with meals were less likely to lead to weight gain than protein supplements consumed between meals.
  • Timing of protein supplementation did not matter with respect to increase in muscle mass.
  • Protein supplements consumed with meals were more likely to lead to loss of fat mass.
  • Protein supplements consumed with meals were slightly more likely to lead to an increase in the ratio of lean mass to fat mass.

The authors pointed out that their findings were consistent with previous studies showing that when a protein supplement was consumed with a meal it displaces some of the calories that would have been otherwise consumed. Simply put, people naturally compensate by eating less of other foods.

In contrast, the authors said that previous studies have shown that when foods, especially liquid foods, are consumed as snacks (between meals), people are less likely to compensate by reducing the calories consumed in the next meal.

As discussed in the article above, the study has major weaknesses. However, despite its many weaknesses, this study does remind us that protein supplements do have calories. This is of relatively little importance for people whose primary goal is to increase lean muscle mass.

However, for those of us who are using protein supplements to lose weight or to increase our lean mass to fat mass ratio, calories do matter.  With that in mind:

  • If we are consuming a protein supplement immediately after exercise or between meals we probably should make a conscious effort to reduce our daily caloric intake elsewhere in our diet.
  • Alternatively, we could consume the protein supplement with a meal, but time the meal so it occurs shortly after exercise.

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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