Bodybuilding supplement

Bodybuilding supplements are dietary supplements commonly used by those involved in bodybuilding, weightlifting, mixed martial arts, and athletics for the purpose of facilitating an increase in lean body mass. The intent is to increase muscle, increase body weight, improve athletic performance, and for some sports, to simultaneously decrease percent body fat so as to create better muscle definition. Among the most widely used are high protein drinks, branched-chain amino acids (BCAA), glutamine, arginine, essential fatty acids, creatine, HMB, whey protein, ZMA[1] and weight loss products.[2] Supplements are sold either as single ingredient preparations or in the form of "stacks" – proprietary blends of various supplements marketed as offering synergistic advantages. While many bodybuilding supplements are also consumed by the general public the frequency of use will differ when used specifically by bodybuilders. One meta-analysis concluded that – for athletes participating in resistance exercise training and consuming protein supplements for an average of 13 weeks – total protein intake up to 1.6 g/kg of body weight per day would result in an increase in strength and fat-free mass, but that higher intakes would not further contribute.[3]

History

Athletes in ancient Greece were advised to consume large quantities of meat and wine. A number of herbal concoctions and tonics have been used by strong men and athletes since ancient times across cultures to try to increase their strength and stamina.[4] In the 1910s, Eugen Sandow, widely considered to be the first modern bodybuilder in the West, advocated the use of dietary control to enhance muscle growth. Later, bodybuilder Earle Liederman advocated the use of "beef juice" or "beef extract" (basically, consomme) as a way to enhance muscle recovery. In 1950s with recreational and competitive bodybuilding becoming increasingly popular Irvin P. Johnson began to popularize and market egg-based protein powders marketed specifically at bodybuilders and physical athletes. The 1970s and 1980s marked a dramatic increase in the growth of the bodybuilding supplement industry, fueled by widespread use of modern marketing techniques and a marked increase in recreational bodybuilding.

In October 1994, the Dietary Supplement Health and Education Act (DSHEA) was signed into law in the USA. Under DSHEA, responsibility for determining the safety of the dietary supplements changed from government to the manufacturer and supplements no longer required approval from the U.S. Food and Drug Administration (FDA) before distributing product. Since that time manufacturers did not have to provide FDA with the evidence to substantiate safety or effectiveness unless a new dietary ingredient was added. It is widely believed that the 1994 DSHEA further consolidated the position of the supplement industry and lead to additional product sales.[5]

Controversy

Mislabeling and adulteration

While many of the claims are based on scientifically based physiological or biochemical processes, their use in bodybuilding parlance is often heavily colored by bodybuilding lore and industry marketing and as such may deviate considerably from traditional scientific usages of the terms. In addition, ingredients listed have been found at times to be different from the contents. In 2015, Consumer Reports reported unsafe levels of arsenic, cadmium, lead and mercury in several of the protein powders that were tested.[6]

In the United States, the manufacturers of dietary supplements do not need to provide the Food and Drug Administration with evidence of product safety prior to marketing.[7] As a result, the incidence of products adulterated with illegal ingredients has continued to rise.[7] In 2013, one-third of the supplements tested were adulterated with unlisted steroids.[8] More recently, the prevalence of designer steroids with unknown safety and pharmacological effects has increased.[9][10]

In 2015 a CBC investigative report found that protein spiking (the addition of amino acid filler to manipulate analysis) was not uncommon;[11] however, many of the companies involved challenged these claims.[12]

Health problems

The US FDA reports 50,000 health problems a year due to dietary supplements [13] and these often involve bodybuilding supplements.[14] For example, the "natural" best-seller Craze, 2012's "New Supplement of the Year" by bodybuilding.com, widely sold in stores such as Walmart and Amazon, was found to contain N,alpha-Diethylphenylethylamine, a methamphetamine analog.[15] Other products by Matt Cahill have contained dangerous substances causing blindness or liver damage, and experts say that Cahill is emblematic for the whole industry.[16]

Liver damage

The incidence of liver damage from herbal and dietary supplements is about 16–20% of all supplement products causing injury, with the occurrence growing globally over the early 21st century.[2] The most common liver injuries from weight loss and bodybuilding supplements involve hepatocellular damage with resulting jaundice, and the most common supplement ingredients attributed to these injuries are catechins from green tea, anabolic steroids, and the herbal extract, aegeline.[2]

Lack of effectiveness

In addition to being potentially harmful, some have argued that there is little evidence to indicate any benefit to using bodybuilding protein or amino acid supplements. A 2005 overview concluded that "[i]n view of the lack of compelling evidence to the contrary, no additional dietary protein is suggested for healthy adults undertaking resistance or endurance exercise".[17] In dispute of this, a 2017 meta-analysis concluded that for athletes participating in resistance exercise training and consuming protein supplements for an average of 13 weeks, total protein intake up to 1.6 g per kg body weight per day would result in an increase in strength and fat-free mass, i.e. muscle, but that higher intakes would not further contribute. The muscle mass increase was statistically significant but modest - averaging 0.3 for all trials and 1.0 to 2.0 kg, for protein intake ≥ 1.6 g/kg/day.[3]

Protein
Protein shakes, made from protein powder (center) and milk (left), are a common bodybuilding supplement.

Bodybuilders may supplement their diets with protein for reasons of convenience, lower cost (relative to meat and fish products), ease of preparation, and to avoid the concurrent consumption of carbohydrates and fats. Additionally, some argue that bodybuilders, by virtue of their unique training and goals, require higher-than-average quantities of protein to support maximal muscle growth.[18][19][20][21][22][23][24] However, there is no scientific consensus for bodybuilders to consume more protein than the recommended dietary allowance.[17][25] Protein supplements are sold in ready-to-drink shakes, bars, meal replacement products (see below), bites, oats, gels and powders. Protein powders are the most popular and may have flavoring added for palatability. The powder is usually mixed with water, milk or fruit juice and is generally consumed immediately before and after exercising or in place of a meal. The sources of protein are as follows and differ in protein quality depending on their amino acid profile and digestibility:

  • Whey protein contains high levels of all the essential amino acids and branched-chain amino acids. It also has the highest content of the amino acid cysteine, which aids in the biosynthesis of glutathione. For bodybuilders, whey protein provides amino acids used to aid in muscle recovery.[26] Whey protein is derived from the process of making cheese from milk. There are three types of whey protein: whey concentrate, whey isolate, and whey hydrolysate. Whey concentrate is 29–89% protein by weight whereas whey isolate is 90%+ protein by weight. Whey hydrolysate is enzymatically predigested and therefore has the highest rate of digestion of all protein types.[26]
  • Casein protein (or milk protein) has glutamine, and casomorphin.[26]
Shaker Bottle commonly used to mix supplements. Often has mesh or a metal whisk inside to breakdown lumps in the mixture.

Some nutritionists have suggested that higher calcium excretion may be due to a corresponding increase in protein-induced calcium absorption in the intestines.[27][28][29]

Amino acids

Some bodybuilders believe that amino acid supplements may benefit muscle development, but consumption of such supplements is unnecessary in a diet that already includes adequate protein intake.[30]

Prohormones

Prohormones are precursors to hormones and are most typically sold to bodybuilders as a precursor to the natural hormone testosterone. This conversion requires naturally occurring enzymes in the body. Side effects are not uncommon, as prohormones can also convert further into DHT and estrogen. To deal with this, many supplements also have aromatase inhibitors and DHT blockers such as chrysin and 4-androstene-3,6,17-trione. To date most prohormone products have not been thoroughly studied, and the health effects of prolonged use are unknown. Although initially available over the counter, their purchase was made illegal without a prescription in the US in 2004, and they hold similar status in many other countries. They remain legal, however, in the United Kingdom and the wider European Union. Their use is prohibited by most sporting bodies.

Creatine
Main article: Creatine supplements

Creatine is an organic acid naturally occurring in the body that supplies energy to muscle cells for short bursts of energy (as required in lifting weights) via creatine phosphate replenishment of ATP. A number of scientific studies have shown that creatine can improve strength,[31] energy,[32] muscle mass, and recovery times. In addition, recent studies have also shown that creatine improves brain function.[33] and reduces mental fatigue.[34] Unlike steroids or other performance-enhancing drugs, creatine can be found naturally in many common foods such as herring, tuna, salmon, and beef.

Creatine increases what is known as cell volumization by drawing water into muscle cells, making them larger. This intracellular retention should not be confused with the common myth that creatine causes bloating (or intercellular water retention).

Creatine is sold in a variety of forms, including creatine monohydrate and creatine ethyl ester, amongst others. Though all types of creatine are sold for the same purposes, there are subtle differences between them, such as price and necessary dosage.

In The New Encyclopedia of Modern Bodybuilding, 2nd ed., author Arnold Schwarzenegger states:

Creatine monohydrate is regarded as a necessity by most bodybuilders. Creatine monohydrate is the most cost-effective dietary supplement in terms of muscle size and strength gains. … There is no preferred creatine supplement, but it is believed that creatine works best when it is consumed with simple carbohydrates. This can be accomplished by mixing powdered creatine with grape juice, lemonade, or many high glycemic index drinks.[35]

Some studies have suggested that consumption of creatine with protein and carbohydrates can have a greater effect than creatine combined with either protein or carbohydrates alone.[36]

β-Hydroxy β-methylbutyrate
Main article: Beta-Hydroxy beta-methylbutyric acid

When combined with an appropriate exercise program, dietary supplementation with β-hydroxy β-methylbutyrate (HMB) has been shown to dose-dependently augment gains in muscle hypertrophy (i.e., the size of a muscle),[37][38] muscle strength,[37][39][40] and lean body mass,[37][39][40] reduce exercise-induced skeletal muscle damage,[note 1][37][38][40] and expedite recovery from high-intensity exercise.[37][41] HMB is believed to produce these effects by increasing muscle protein synthesis and decreasing muscle protein breakdown by various mechanisms, including activation of the mechanistic target of rapamycin (mTOR) and inhibition of the proteasome in skeletal muscles.[39][42]

The inhibition of exercise-induced skeletal muscle damage by HMB is affected by the time that it is used relative to exercise.[37][41] The greatest reduction in skeletal muscle damage from a single bout of exercise appears to occur when calcium HMB is ingested 1–2 hours prior to exercise.[41]

Meal replacement products

Meal replacement products (MRPs) are either pre-packaged powdered drink mixes or edible bars designed to replace prepared meals. MRPs are generally high in protein, low in fat, have a low to moderate amount of carbohydrates, and contain a wide array of vitamins and minerals.

The majority of MRPs use whey protein, casein (often listed as calcium caseinate or micellar casein), soy protein, and/or egg albumin as protein sources. Carbohydrates are typically derived from maltodextrin, oat fiber, brown rice, and/or wheat flour. Some MRPs also contain flax oil powder as a source of essential fatty acids.

MRPs can also contain other ingredients, such as creatine monohydrate, glutamine peptides, L-glutamine, calcium alpha-ketoglutarate, additional amino acids, lactoferrin, conjugated linoleic acid, and medium-chain triglycerides.

A sub-class of MRPs is colloquially known as "weight gainers", which are meal replacement products with a higher carbohydrate:protein ratio. Whereas a MRP will typically have a 0.25-2:1 carbohydrate:protein ratio, a weight gainer might have a ratio in the order of 3-5:1.

Thermogenic products

A thermogenic is a broad term for any supplement that the manufacturer claims will cause thermogenesis, resulting in increased body temperature, increased metabolic rate, and consequently an increased rate in the burning of body fat and weight loss. Until 2004 almost every product found in this supplement category comprised the "ECA stack": ephedrine, caffeine and aspirin. However, on February 6, 2004 the Food and Drug Administration (FDA) banned the sale of ephedra and its alkaloid, ephedrine, for use in weight loss formulas. Several manufacturers replaced the ephedra component of the "ECA" stack with bitter orange or citrus aurantium (containing synephrine) instead of the ephedrine.

See also
  • Glycocarn
  • Instant breakfast
  • Protein bar
  • Protein

Notes
  1. The effect of HMB on skeletal muscle damage has been assessed in studies using four different biomarkers of muscle damage or protein breakdown: serum creatine kinase, serum lactate dehydrogenase, urinary urea nitrogen, and urinary 3-methylhistidine.[37][40][41] When exercise intensity and volume are sufficient to cause skeletal muscle damage, such as during long-distance running or progressive overload, HMB supplementation has been demonstrated to attenuate the rise in these biomarkers by 20–60%.[37][41]

References
  1. Cruz-Jentoft AJ (May 2017). "Beta-hydroxy-beta-methyl butyrate (HMB): From experimental data to clinical evidence in sarcopenia". Current Protein & Peptide Science. 18 (7): 668–672. doi:10.2174/1389203718666170529105026. PMID 28554316. HMB is widely used as an ergogenic supplement by young athletes.
  2. Navarro, V; Khan, I; Björnsson, E; Seeff, L. B; Serrano, J; Hoofnagle, J. H (2016). "Liver Injury from Herbal and Dietary Supplements". Hepatology. 65 (1): 363–373. doi:10.1002/hep.28813. PMC 5502701. PMID 27677775.
  3. Morton RW, Murphy KT, McKellar SR, Schoenfeld BJ, Henselmans M, Helms E, Aragon AA, Devries MC, Banfield L, Krieger JW, Phillips SM (2017). "A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults". Br J Sports Med. 52 (6): bjsports–2017–097608. doi:10.1136/bjsports-2017-097608. PMC 5867436. PMID 28698222.
  4. Dalby A., Food in the Ancient World A-Z, Routledge (2008) pp. 203
  5. Higgins, Michael (June 1999). "Hard to Swallow: While federal law shut the door on regulation of dietary supplements, marketing hype may be leading the popular aids up courthouse steps". ABA Journal. 85 (6): 60–63.JSTOR 27840828
  6. "Are protein shakes the weight-loss magic bullet? - The Globe and Mail". Theglobeandmail.com. Retrieved December 11, 2015.
  7. "Body-building Products and Hidden Steroids: Enforcement Barriers". Food and Drug Administration.
  8. Spike in Harm to Liver Is Tied to Dietary Aids, The New York Times, December 21, 2013.
  9. Joseph, Jan; Parr, Maria (2015). "Synthetic Androgens as Designer Supplements". Current Neuropharmacology. 13 (1): 89–100. doi:10.2174/1570159X13666141210224756. PMC 4462045. PMID 26074745.
  10. Rocha, Tiago; Amaral, Joana S.; Oliveira, Maria Beatriz P.P. (2016). "Adulteration of Dietary Supplements by the Illegal Addition of Synthetic Drugs: A Review". Comprehensive Reviews in Food Science and Food Safety. 15: 43–62. doi:10.1111/1541-4337.12173. hdl:10198/15401.
  11. "Marketplace: Some protein powders fail fitness test - Health - CBC News". Cbc.ca. Retrieved December 11, 2015.
  12. "Marketplace: Some protein powders fail fitness test - Health - CBC News". Cbc.ca. Retrieved December 14, 2015.
  13. Offit, Paul A.; Erush, Sarah (December 14, 2013). "Skip the Supplements". The New York Times.
  14. Tainted Body Building Products, FDA, December 17, 2010.
  15. "Popular sports supplements contain meth-like compound". USA Today. October 25, 2013. Cohen said researchers informed the FDA in May about finding the new chemical compound in Craze. The team found the compound — N,alpha-diethylphenylethylamine — has a structure similar to methamphetamine, a powerful, highly addictive, illegal stimulant drug. They believe the new compound is likely less potent than methamphetamine but greater than ephedrine.
  16. Sports supplement designer has history of risky products, USA Today, September 27, 2013.
  17. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients), 2005, 661
  18. Journal of Sports Sciences, 2004, 22, 65–79 Protein and amino acids for athletes
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  33. Rae, C.; Digney, A. L.; McEwan, S. R.; Bates, T. C. (2003). "Oral creatine monohydrate supplementation improves brain performance: A double-blind, placebo-controlled, cross-over trial". Proceedings of the Royal Society B. 270 (1529): 2147–50. doi:10.1098/rspb.2003.2492. PMC 1691485. PMID 14561278.
  34. Watanabe, Airi; Kato, Nobumasa; Kato, Tadafumi (2002). "Effects of creatine on mental fatigue and cerebral hemoglobin oxygenation". Neuroscience Research. 42 (4): 279–85. doi:10.1016/S0168-0102(02)00007-X. PMID 11985880.
  35. Schwarzenegger, Arnold; Bill Dobbins (1998). The New Encyclopedia of Modern Bodybuilding, 2nd ed. New York: Simon & Schuster Paperbacks. pp. 764–5. ISBN 978-0-684-85721-3.
  36. Green AL, Hultman E, Macdonald IA, Sewell DA, Greenhaff PL (November 1996). "Carbohydrate ingestion augments skeletal muscle creatine accumulation during creatine supplementation in humans". Am. J. Physiol. 271 (5 Pt 1): E821–6. doi:10.1152/ajpendo.1996.271.5.E821. PMID 8944667.
  37. Momaya A, Fawal M, Estes R (April 2015). "Performance-enhancing substances in sports: a review of the literature". Sports Med. 45 (4): 517–531. doi:10.1007/s40279-015-0308-9. PMID 25663250. Wilson et al. [91] demonstrated that when non-resistance trained males received HMB pre-exercise, the rise of lactate dehydrogenase (LDH) levels reduced, and HMB tended to decrease soreness. Knitter et al. [92] showed a decrease in LDH and creatine phosphokinase (CPK), a byproduct of muscle breakdown, by HMB after a prolonged run. ... The utility of HMB does seem to be affected by timing of intake prior to workouts and dosage [97].
  38. Wu H, Xia Y, Jiang J, Du H, Guo X, Liu X, Li C, Huang G, Niu K (September 2015). "Effect of beta-hydroxy-beta-methylbutyrate supplementation on muscle loss in older adults: a systematic review and meta-analysis". Arch. Gerontol. Geriatr. 61 (2): 168–175. doi:10.1016/j.archger.2015.06.020. PMID 26169182.
  39. Brioche T, Pagano AF, Py G, Chopard A (April 2016). "Muscle wasting and aging: Experimental models, fatty infiltrations, and prevention". Mol. Aspects Med. 50: 56–87. doi:10.1016/j.mam.2016.04.006. PMID 27106402. In conclusion, HMB treatment clearly appears to be a safe potent strategy against sarcopenia, and more generally against muscle wasting, because HMB improves muscle mass, muscle strength, and physical performance. It seems that HMB is able to act on three of the four major mechanisms involved in muscle deconditioning (protein turnover, apoptosis, and the regenerative process), whereas it is hypothesized to strongly affect the fourth (mitochondrial dynamics and functions). Moreover, HMB is cheap (~30– 50 US dollars per month at 3 g per day) and may prevent osteopenia (Bruckbauer and Zemel, 2013; Tatara, 2009; Tatara et al., 2007, 2008, 2012) and decrease cardiovascular risks (Nissen et al., 2000). For all these reasons, HMB should be routinely used in muscle-wasting conditions especially in aged people. ... 3 g of CaHMB taken three times a day (1 g each time) is the optimal posology, which allows for continual bioavailability of HMB in the body (Wilson et al., 2013).
  40. Luckose F, Pandey MC, Radhakrishna K (2015). "Effects of amino acid derivatives on physical, mental, and physiological activities". Crit. Rev. Food Sci. Nutr. 55 (13): 1793–1807. doi:10.1080/10408398.2012.708368. PMID 24279396. HMB, a derivative of leucine, prevents muscle damage and increases muscle strength by reducing exercise-induced proteolysis in muscles and also helps in increasing lean body mass. ... The meta analysis studies and the individual studies conducted support the use of HMB as an effective aid to increase body strength, body composition, and to prevent muscle damage during resistance training.
  41. Wilson JM, Fitschen PJ, Campbell B, Wilson GJ, Zanchi N, Taylor L, Wilborn C, Kalman DS, Stout JR, Hoffman JR, Ziegenfuss TN, Lopez HL, Kreider RB, Smith-Ryan AE, Antonio J (February 2013). "International Society of Sports Nutrition Position Stand: beta-hydroxy-beta-methylbutyrate (HMB)". J. Int. Soc. Sports. Nutr. 10 (1): 6. doi:10.1186/1550-2783-10-6. PMC 3568064. PMID 23374455.
  42. Brook MS, Wilkinson DJ, Phillips BE, Perez-Schindler J, Philp A, Smith K, Atherton PJ (January 2016). "Skeletal muscle homeostasis and plasticity in youth and ageing: impact of nutrition and exercise". Acta Physiol (Oxf). 216 (1): 15–41. doi:10.1111/apha.12532. PMC 4843955. PMID 26010896.
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