Supplements

Supplements

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. Bodybuilding supplements may contain ingredients that are advertised to increase a person’s muscle, body weight, athletic performance, and decrease a person’s percent body fat for desired muscle definition. Among the most widely used are high protein drinkspre-workout blends, branched-chain amino acids (BCAA)glutaminearginineessential fatty acidscreatineHMBwhey proteinZMA, and weight loss products.[1][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.

History[edit]

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.[3]

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 the 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 the 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 the government to the manufacturer, and supplements no longer required approval from the U.S. Food and Drug Administration (FDA) before distributing the products. 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.[4]

Protein[edit]

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.[5][6][7][8][9][10][11][12] While the recommended dietary allowance is much less,[13] Harvard Medical School points out in Health Health Publishing that this RDA (recommended daily allowance) is “the minimum amount you need to keep from getting sick — not the specific amount you are supposed to eat every day.”[14] Protein supplements are sold in ready-to-drink health 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.[15] 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.[15]
  • Casein protein (or milk protein) has glutamine, and casomorphin.[15]
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.[16][17][18]

Amino acids[edit]

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.[19]

Prohormones[edit]

An androgen prohormone, or proandrogen, is a prohormone (or prodrug) of an anabolic-androgenic steroid (AAS). They can be prohormones of testosterone or of synthetic AAS, for example, nandrolone (19-nortestosterone). Dehydroepiandrosterone (DHEA), DHEA sulfate (DHEA-S), and androstenedione may all be considered proandrogens of testosterone.[20]

Since 2005, the use of steroid precursors (prohormones) has been illegal in the U.S.[21]

Creatine[edit]

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. Scientific studies have shown that creatine supplementation can increase the consumer’s strength,[22] energy during performance,[23] muscle mass, and recovery times after exercise. In addition, recent studies have also shown that creatine improves brain function.[24] and reduces mental fatigue.[25]

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.[26]

While generally considered safe, long-term or excessive consumption of creatine may have an adverse effect on the kidneys, liver, or heart and should be avoided if any pre-existing conditions affecting these organs exist.[27]

β-Hydroxy β-methylbutyrate[edit]

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),[28][29] muscle strength,[28][30][31] and lean body mass,[28][30][31] reduce exercise-induced skeletal muscle damage,[note 1][28][29][31] and expedite recovery from high-intensity exercise.[28][32] 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.[30][33]

The inhibition of exercise-induced skeletal muscle damage by HMB is affected by the time that it is used relative to exercise.[28][32] 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.[32]

Controversy[edit]

Mislabeling and adulteration[edit]

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 arseniccadmiumlead, and mercury in several of the protein powders that were tested.[34]

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.[35] As a result, the incidence of products adulterated with illegal ingredients has continued to rise.[35] In 2013, one-third of the supplements tested were adulterated with unlisted steroids.[36] More recently, the prevalence of designer steroids with unknown safety and pharmacological effects has increased.[37][38]

In 2015, a CBC investigative report found that protein spiking (i.e., the addition of amino-acid filler to manipulate analysis) was not uncommon;[39] however, many of the companies involved challenged these claims.[39]

Health problems[edit]

The US FDA reports 50,000 health problems a year due to dietary supplements[40] and these often involve bodybuilding supplements.[41] 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.[42]

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 and jaundice. The most common supplement ingredients attributed to these injuries are catechins from green teaanabolic steroids, and the herbal extractaegeline.[2] Other products by supplement designer and CEO of Driven Sports, Matt Cahill, have contained dangerous substances causing blindness or liver damage, and his pre-workout supplement Craze was found to contain illegal stimulants[43] that resulted in several athletes failing drug tests.[44]

Protein effectiveness[edit]

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”.[13]

In contrast, a 2018 systematic review, meta-analysis and meta-regression concluded that, “Dietary protein supplementation significantly enhanced changes in muscle strength and size during prolonged RET in healthy adults.“ (RET is an abbreviation for resistance exercise training.)[45]

dietary supplement is a manufactured product intended to supplement a person’s diet by taking a pillcapsuletablet, powder, or liquid.[2] A supplement can provide nutrients either extracted from food sources, or that are synthetic (in order to increase the quantity of their consumption). The classes of nutrient compounds in supplements include vitaminsmineralsfiberfatty acids, and amino acids. Dietary supplements can also contain substances that have not been confirmed as being essential to life, and so are not nutrients per se, but are marketed as having a beneficial biological effect, such as plant pigments or polyphenols. Animals can also be a source of supplement ingredients, such as collagen from chickens or fish for example. These are also sold individually and in combination, and may be combined with nutrient ingredients. The European Commission has also established harmonized rules to help insure that food supplements are safe and appropriately labeled.[3]

Creating an industry estimated to have a value of $151.9 billion in 2021,[4] there are more than 50,000 dietary supplement products marketed in the United States,[5] where about 50% of the American adult population consumes dietary supplements. Multivitamins are the most commonly used product among types of dietary supplements.[6] The United States National Institutes of Health states that supplements “may be of value” for those who are nutrient deficient from their diet and receive approval from their medical provider.[7]

In the United States, it is against federal regulations for supplement manufacturers to claim that these products prevent or treat any disease. Companies are allowed to use what is referred to as “Structure/Function” wording if there is substantiation of scientific evidence for a supplement providing a potential health effect.[8] An example would be “_____ helps maintain healthy joints”, but the label must bear a disclaimer that the Food and Drug Administration (FDA) “has not evaluated the claim” and that the dietary supplement product is not intended to “diagnose, treat, cure or prevent any disease”, because only a drug can legally make such a claim.[8] The FDA enforces these regulations and also prohibits the sale of supplements and supplement ingredients that are dangerous, or supplements not made according to standardized good manufacturing practices (GMPs).

Definition

In the United States, the Dietary Supplement Health and Education Act of 1994 provides this description: “The Dietary Supplement Health and Education Act of 1994 (DSHEA) defines the term “dietary supplement” to mean a product (other than tobacco) intended to supplement the diet that bears or contains one or more of the following dietary ingredients: a vitamin, a mineral, an herb or other botanical, an amino acid, a dietary substance for use by man to supplement the diet by increasing the total dietary intake, or a concentrate, metabolite, constituent, extract, or combination of any of the aforementioned ingredients. Furthermore, a dietary supplement must be labeled as a dietary supplement and be intended for ingestion and must not be represented for use as conventional food or as a sole item of a meal or of the diet. In addition, a dietary supplement cannot be approved or authorized for investigation as a new drugantibiotic, or biologic, unless it was marketed as a food or a dietary supplement before such approval or authorization. Under DSHEA, dietary supplements are deemed to be food, except for purposes of the drug definition.”[9]

Per DSHEA, dietary supplements are consumed orally, and are mainly defined by what they are not: conventional foods (including meal replacements), medical foods,[10] preservatives or pharmaceutical drugs. Products intended for use as a nasal spray, or topically, as a lotion applied to the skin, do not qualify. FDA-approved drugs cannot be ingredients in dietary supplements. Supplement products are or contain vitaminsnutritionally essential mineralsamino acidsessential fatty acids and non-nutrient substances extracted from plants or animals or fungi or bacteria, or in the instance of probiotics, are live bacteria. Dietary supplement ingredients may also be synthetic copies of naturally occurring substances (for example: melatonin). All products with these ingredients are required to be labeled as dietary supplements.[11] Like foods and unlike drugs, no government approval is required to make or sell dietary supplements; the manufacturer confirms the safety of dietary supplements but the government does not; and rather than requiring risk–benefit analysis to prove that the product can be sold like a drug, such assessment is only used by the FDA to decide that a dietary supplement is unsafe and should be removed from market.[11]

Types

Vitamins

Pharmacies and supermarkets in the U.S. sell a large variety of vitamin dietary supplements.

A vitamin is an organic compound required by an organism as a vital nutrient in limited amounts.[12] An organic chemical compound (or related set of compounds) is called a vitamin when it cannot be synthesized in sufficient quantities by an organism and must be obtained from the diet. The term is conditional both on the circumstances and on the particular organism. For example, ascorbic acid (vitamin C) is a vitamin for anthropoid primates, humansguinea pigs and bats, but not for other mammals. Vitamin D is not an essential nutrient for people who get sufficient exposure to ultraviolet light, either from the sun or an artificial source, as they synthesize vitamin D in skin.[13] Humans require thirteen vitamins in their diet, most of which are actually groups of related molecules, “vitamers”, (e.g. vitamin E includes tocopherols and tocotrienols, vitamin K includes vitamin K1 and K2). The list: vitamins A, C, D, E, K, Thiamine (B1), Riboflavin (B2), Niacin (B3), Pantothenic Acid (B5), Vitamin B6, Biotin (B7), Folate (B9) and Vitamin B12. Vitamin intake below recommended amounts can result in signs and symptoms associated with vitamin deficiency. There is little evidence of benefit when vitamins are consumed as a dietary supplement by those who are healthy and have a nutritionally adequate diet.[14]

The U.S. Institute of Medicine sets tolerable upper intake levels (ULs) for some of the vitamins. This does not prevent dietary supplement companies from selling products with content per serving higher than the ULs. For example, the UL for vitamin D is 100 µg (4,000 IU),[15] but products are available without prescription at 10,000 IU.

Minerals

Minerals are the exogenous chemical elements indispensable for life. Four minerals – carbonhydrogenoxygen, and nitrogen – are essential for life but are so ubiquitous in food and drink that these are not considered nutrients and there are no recommended intakes for these as minerals. The need for nitrogen is addressed by requirements set for protein, which is composed of nitrogen-containing amino acids. Sulfur is essential, but for humans, not identified as having a recommended intake per se. Instead, recommended intakes are identified for the sulfur-containing amino acids methionine and cysteine. There are dietary supplements that provide sulfur, such as taurine and methylsulfonylmethane.

The essential nutrient minerals for humans, listed in order by weight needed to be at the Recommended Dietary Allowance or Adequate Intake are potassiumchlorinesodiumcalciumphosphorusmagnesiumironzincmanganesecopperiodinechromiummolybdenumselenium and cobalt (the last as a component of vitamin B12). There are other minerals which are essential for some plants and animals, but may or may not be essential for humans, such as boron and silicon. Essential and purportedly essential minerals are marketed as dietary supplements, individually and in combination with vitamins and other minerals.

Although as a general rule, dietary supplement labeling and marketing are not allowed to make disease prevention or treatment claims, the U.S. FDA has for some foods and dietary supplements reviewed the science, concluded that there is significant scientific agreement, and published specifically worded allowed health claims. An initial ruling allowing a health claim for calcium dietary supplements and osteoporosis was later amended to include calcium supplements with or without vitamin D, effective January 1, 2010. Examples of allowed wording are shown below. In order to qualify for the calcium health claim, a dietary supplement must contain at least 20% of the Reference Dietary Intake, which for calcium means at least 260 mg/serving.[16]

  • “Adequate calcium throughout life, as part of a well-balanced diet, may reduce the risk of osteoporosis.”
  • “Adequate calcium as part of a healthful diet, along with physical activity, may reduce the risk of osteoporosis in later life.”
  • “Adequate calcium and vitamin D throughout life, as part of a well-balanced diet, may reduce the risk of osteoporosis.”
  • “Adequate calcium and vitamin D as part of a healthful diet, along with physical activity, may reduce the risk of osteoporosis in later life.”

In the same year, the European Food Safety Authority also approved a dietary supplement health claim for calcium and vitamin D and the reduction of the risk of osteoporotic fractures by reducing bone loss.[17] The U.S. FDA also approved Qualified Health Claims (QHCs) for various health conditions for calcium, selenium and chromium picolinate.[18] QHCs are supported by scientific evidence, but do not meet the more rigorous “significant scientific agreement” standard required for an authorized health claim. If dietary supplement companies choose to make such a claim then the FDA stipulates the exact wording of the QHC to be used on labels and in marketing materials. The wording can be onerous: “One study suggests that selenium intake may reduce the risk of bladder cancer in women. However, one smaller study showed no reduction in risk. Based on these studies, FDA concludes that it is highly uncertain that selenium supplements reduce the risk of bladder cancer in women.”[19]

Proteins and amino acids

Protein-containing supplements, either ready-to-drink or as powders to be mixed into water, are marketed as aids to people recovering from illness or injury, those hoping to thwart the sarcopenia of old age,[20][21] to athletes who believe that strenuous physical activity increases protein requirements,[22] to people hoping to lose weight while minimizing muscle loss, i.e., conducting a protein-sparing modified fast,[23] and to people who want to increase muscle size for performance and appearance. Whey protein is a popular ingredient,[21][24][25] but products may also incorporate caseinsoypeahemp or rice protein. A meta-analysis found a moderate degree of evidence in favor of whey protein supplements use as a safe and effective adjunct to an athlete’s training and recovery, including benefits for endurance, average power, muscle mass, and reduced perceived exercise intensity.[26]

According to US and Canadian Dietary Reference Intake guidelines, the protein Recommended Dietary Allowance (RDA) for adults is based on 0.8 grams protein per kilogram body weight. The recommendation is for sedentary and lightly active people.[27][28][29] Scientific reviews can conclude that a high protein diet, when combined with exercise, will increase muscle mass and strength,[30][31][32] or conclude the opposite.[33] The International Olympic Committee recommends protein intake targets for both strength and endurance athletes at about 1.2–1.8 g/kg body mass per day.[22] One review proposed a maximum daily protein intake of approximately 25% of energy requirements, i.e., approximately 2.0 to 2.5 g/kg.[28]

The same protein ingredients marketed as dietary supplements can be incorporated into meal replacement and medical food products, but those are regulated and labeled differently from supplements. In the United States, “meal replacement” products are foods and are labeled as such. These typically contain protein, carbohydrates, fats, vitamins and minerals. There may be content claims such as “good source of protein”, “low fat” or “lactose free”.[34] Medical foods, also nutritionally complete, are designed to be used while a person is under the care of a physician or other licensed healthcare professional.[35][10] Liquid medical food products – for example, Ensure – are available in regular and high protein versions.

Proteins are chains of amino acids. Nine of these proteinogenic amino acids are considered essential for humans because they cannot be produced from other compounds by the human body and so must be taken in as food. Recommended intakes, expressed as milligrams per kilogram of body weight per day, have been established.[27] Other amino acids may be conditionally essential for certain ages or medical conditions. Amino acids, individually and in combinations, are sold as dietary supplements. The claim for supplementing with the branched chain amino acids leucine, valine and isoleucine is for stimulating muscle protein synthesis. A review of the literature concluded this claim was unwarranted.[36] In elderly people, supplementation with just leucine resulted in a modest (0.99 kg) increase in lean body mass.[37] The non-essential amino acid arginine, consumed in sufficient amounts, is thought to act as a donor for the synthesis of nitric oxide, a vasodilator. A review confirmed blood pressure lowering.[38] Taurine, a popular dietary supplement ingredient with claims made for sports performance, is technically not an amino acid. It is synthesized in the body from the amino acid cysteine.[39]

Blaine

Blaine is a city in Anoka county in the State of Minnesota. The population was 57,186 at the 2010 census.[5] The city is located mainly in Anoka County, and is part of the Minneapolis–Saint Paul metropolitan area.

 

Interstate Highway 35W, U.S. Highway 10, and Minnesota State Highway 65 are three of the main routes in the city.

Until 1877, Blaine was part of the city of AnokaMinnesota. Phillip Laddy, a native of Ireland, is recognized as the first settler in Blaine and settled near a lake that now bears his name, Laddie Lake, in 1862. Laddy died shortly after his arrival and his survivors moved on to Minneapolis. Another early settler was the Englishman George Townsend, who lived for a short time near what would today be Lever St. and 103rd Ave.