Athletes and Supplements

Christie Aschwanden, writing in Slate magazine, tells Olympic, and other athletes to stop taking supplements. Her article is very well written, with a plethora of links to provide background.

She begins by recounting the story of American swimmer Jessica Hardy who tested positive for a banned substance and missed the Olympics and World Championships in 2008. Hardy insisted she had not taken anything illegal.

What Hardy had taken was something called Arginine Extreme, a nutritional supplement made by AdvoCare, a multi-level marketing outfitthat describes itself as a health and wellness company and was one of her sponsors. Though clenbuterol is not listed on the ingredients list, tests presented by Hardy’s defense team showed that the Arginine Extreme supplements did, in fact, contain the drug. (AdvoCare disputes the evidence and denies wrongdoing.) During her arbitration hearing, Hardy convinced the World Anti-Doping Agency that she’d inadvertently ingested clenbuterol via a contaminated supplement, and she received only a one-year suspension instead of the usual two-year ban.

She then moves to the battles between the FDA and supplement manufacturers.

Supplements are risky thanks in part to a piece of legislation passed in 1994 called the Dietary Supplements and Health Education Act. The DSHEA essentially deregulated dietary supplements, including vitamins, herbs, protein shake mixes, nutritional supplements, and other powders and pills that millions of people of all levels of athletic ability might take to improve their health. Most people assume that if a product is available on store shelves, it must be OK. But supplements are not required to be evaluated or proven safe or effective before they’re sold. New rules finalized in 2007 gave the FDA power to regulate the manufacturing and packaging of supplements, but the agency’s ability to police supplement companies remains limited by DSHEA. Its chief author and most powerful advocate is Sen. Orrin Hatch, whose home state of Utah is home to much of the U.S. supplement industry. Hatch, who attributes his good health to the supplements he takes each day, fought a recent amendment to increase the FDA’s ability to regulate the industry.

FDA investigations have repeatedly found safety problems with supplements, including dangerous ingredients—everything from diet pills containing a drug previously pulled from the market due to safety concerns to body-building supplements packed with anabolic steroids. These are hardly isolated cases. A 2004 study found that 18 percent of nutritional supplements purchased in the United States contained undeclared anabolic androgenic steroids. The FDA has also warned consumers about supplements laced with dangerous levels of selenium and chromium. In 2009, college baseball player Jareem Gunter told a Senate hearing that he’d ended up in the hospital with liver failure after taking a body-building supplement, and late last year, the Army set up a probe to investigate whether body-building supplements containing dimethylamylamine, or DMAA, a stimulant that can narrow blood vessels and arteries, were involved in the deaths of two soldiers and liver and kidney damage in others.

Along with the honesty and quality assurance problems in the manufacturing process, there is little if any evidence that the supplements provide any benefit to athletes.

When studies do appear to support supplement companies’ claims, they are usually small and at best can offer only hints of efficacy, not definitive proof. As I learned first-hand during my earnest attempt to study the effects of beer on running, even seemingly robust study designs can lead you to a dodgy conclusion. My study could have easily been interpreted to show that beer made women better runners, but as a participant of the study, I discovered problems in the standard protocols that might not have been apparent otherwise. A series of reports published July 19 in BMJ found “a striking lack of evidence to support claims about improved performance and recovery” made by products aimed at athletes like sports drinks and supplements and concluded that it is “virtually impossible for the public to make informed choices about the benefits and harms of advertised sports products.”

It’s not just an American problem. In Canada, supplements are not regulated but they are popular.

Despite the scarcity of evidence, athletes continue to take supplements at high rates. A 2009 study estimated that 85 percent of elite track and field athletes took supplements, and 87 percent of Canadian athletes who participated in a survey published this year reported taking dietary supplements in the previous six months.

Coaches and athletes are not skilled in dietary science and are easily swayed by big claims from manufacturers. The difference between success and failure at an elite level is miniscule and participants are looking for any legal way to get an edge on the competition. This leaves them open to many types of quackery.

There is much more to Aschwanden’s article. Read it and at least some of the links. With luck, you’ll never take a supplement again.

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