What is to
become of Sports Nutrition in 2010 or 2020?
Tommy Boone, PhD,
MPH, FASEP, EPC
Professor and
Chair
Director,
Exercise Physiology Laboratories
Department of
Exercise Physiology
The College of
St. Scholastica
Duluth, MN 55811
“At
least 50 companies are marketing irrationally-formulated supplement
products exclusively or primarily through chiropractors.” [1]
I
have taken the day off to stay home to write. I am typing from my black
chair in the living room. It is a comfortable position with a laptop on
a light blanket across my legs. Chahice, my 14 year-old-7-pound Yorke
is under the blanket sleeping next to my legs. Everything is good. Cool
air is coming in the open windows from across Lake Superior. So, why am
I writing an article about sports nutrition? Why not just let my head
fall back on the chair and take a nap? Why not write about something
else altogether? The answer is simple. I cannot because I am convinced
that what is happening to sports nutrition today is inappropriate and
unnecessary. If things continue as they have during the last several
years, it will be next to impossible to recognize the course as it once
was. Also, I am not sure that if left alone, recovery may be next to
impossible. Therefore, from my point of view the question is, “Why
aren’t exercise physiologists doing something about the invasion of the
sports supplement industry in the teaching, thinking, and research that
underpins sports nutrition?”
Just as the right
rationale for
studying anatomy and exercise physiology is imperative for all exercise
physiologists [2], it is equally important that the study of different
subjects is carried out rationally and scientifically. This was the
case years ago with sports nutrition, especially when physiology was at
the center of sports training. This is not the case with now. And, by
comparison, it is not the case with “applied kinesiology” or AK [1],
which is based on the “…notion that every organ dysfunction is
accompanied by a specific muscle weakness….” Similarly, proponents of
“contact reflex analysis” or CRA claim [1] that “…over a thousand
health problems can be diagnosed with a muscle test during which the
chiropractor’s finger or hand is placed on one of 75 ‘reflex points’ on
the patient’s body.” Perhaps, there was a time when chiropractic
nutrition made sense. This is no longer the case today, which causes me
to think about the future of sports nutrition. Does it make sense to
teach a course that is driven by sports supplements?
Since
it is common for chiropractors to use nutritional supplementation with
spinal manipulations, where are the scientific papers to support their
claims? While I have not exhausted my search on this topic, I am
convinced the literature on the subject is small and non-scientific.
So, what’s the deal? My answer is this: It is all about what the market
potential will yield in “dollars.” Sadly, life and a person’s career
are the products of the drive to make money even if it is based on
deception. Chiropractors who use questionable test procedures to make
dietary recommendations and then recommend dietary supplements are not
healthcare professionals. They are quacks. And, exercise physiologists
are also quacks if they use deception to promote their work in the
classroom or published articles. They are guilty of deceiving their
clients, students, and colleagues. Even if the exercise physiologists
believe their own pseudoscience, deception is still deception!
Regardless of whether the supplements are used in chiropractic work or
in athletics, it is wrong.
Unlike the sports
nutrition of
years ago, sports nutrition today is everybody’s game. And, for every
person who works for the supplement industry, it is a very profitable
game indeed and one that is going in the wrong direction. Too many
students and others now define sports nutrition in terms of ingesting
the right supplements, which raises the question: “In what context is
it ‘right’ to promote the power of supplements over sound nutrition?”
If you are a college teacher tied to consulting with the industry, if
you are an athlete who wants to be the best, or if you are a teacher
who is searching for the right answers, each has different agendas.
Which agenda is the right course of action remains to be determined. It
is very possible that I could be wrong in my views regarding sports
nutrition. I am very passionate about what I think is the right content
for students of sports nutrition.
Instead of
concentrating
on sound eating habits for sports participation, some exercise
physiologists speak of nothing but this supplement and that supplement
as though sports by itself is rather meaningless without ingesting
something. Instead of these same individuals acknowledging the
weaknesses and pitfalls of ingesting supplements, their views are based
on showing that supplements work. This attitude that there is nothing
wrong with supplements cannot be good for young athletes or for sports
in the future. Exercise physiology is at the heart of this crisis in
sports. Failing to acknowledge that there is a difference today in
sports nutrition versus what is was just a few decades ago does not
speak well for the profession. I am afraid that what exercise
physiologists are experiencing today is the failure to appreciate that
the use of supplements is leading the profession down a very dangerous
path. As an exercise physiologist, I see this point driven home
everyday in numerous publications and throughout the Internet. If this
sounds oddly similar to you, think about the problems with medicine. If
you have not read the article [3] written by Shannon Brownlee, you must
do so. Here is a short paragraph:
“Today,
private
industry has
unprecedented leverage to dictate what doctors and patients know – and
don’t know – about the $160 billion worth of pharmaceuticals Americans
consume each year. This is an unsettling charge that many (if not a
majority) of doctors and academic researchers don’t want to
acknowledge. Once grasped, however, the full scope and consequences of
medical conflict of interest beget grave doubts about the veracity of
wide swaths of medical science.” [3, p. 2]
In other words, the
paid consultants of the supplement companies are paid employees of the
industry just as it is recognized that doctors who are consultants of
the pharmaceutical companies work for the companies. They are no longer
non-biased academics or professionals with academic training. They are
required to deliver for the companies; specifically, a business message
that sells products. If necessary (and probably, whenever possible),
they are ghostwriters to control what is published about the supplement
products. Why? Because they have a financial stake in the outcome of
the industry’s success, it is all about the bottom line. As a result,
today’s sports nutrition is using science to promote supplements. And,
without having looked critically at what has happened, exercise
physiologists have inadvertently supported the use of supplements.
However, they cannot continue to turn a blind eye to it. The impact of
supplements on athletes’ character and understanding of fair play is
just too important to not question it and do something about it.
Of
course, the industry does not want exercise physiologists to discuss or
investigate the role of paid consultants. After all, the industry is in
the business of making money. It is not an educational institution. It
is not hard to understand that impartiality just cannot exist when the
paid consultant is the researcher and the objective is to show that a
particular supplement works. Forget about open-mindedness or even
honesty. Does anyone actually think it is in the best interest of
exercise physiologists working for a corporate sponsor to conclude that
supplements do not work? In short, no one is going to bite the hand
that feeds it. That is why so few members of the supplement community
will stand up and fight the commercialization of sports nutrition? Not
a one of them is going to state that the exercise physiology connection
with the supplement industry is a threat to the integrity of the
profession.
Everyone has heard
the expression, “Hello, wake
up American.” How about this expression, “Hello, wake up exercise
physiologists.” As an exercise physiologist who has taught sports
nutrition for many years and as an exercise physiologist who has been
in the college classroom for nearly 40 years, I flatly disagree with
the negative influence of sports supplements on exercise physiology.
The sports nutritionist, whether an exercise physiologist or not, needs
to get over the idea that people cannot be bought. The failure to
acknowledge conflicts of interest has pinned some as “purchased.” They
are employees of the industry. So, what is a person to do about
deterring conflicts of interest in one’s own field of work? Maybe the
most anyone can do is talk about it or write about it. For certain,
there is something wrong when professionals fail to question the
potential for a conflict of interest when acting as a paid consultant
of any industry. Maybe it is a function of exercise physiologists not
having a professional code of conduct during the formative years under
sports medicine.
This issue is not
complicated. The fact is
this: Greed, pride, and ego are powerful forces to deal with. The
supplement industry is recognized as a pot of gold. The financial
support for research is enormous. This point is all too obvious with
the constant increase in products via the Internet and print-copy
publications. And, unfortunately, if you are an athlete today, you are
likely to have several performance-enhancers close by. Even the
children are using supplements. The impatience with regular physical
training and mental hard work has encouraged the alternative. Athletes
have been conditioned to believe that everyone can be a winner with
performance-enhancing substances and drugs. Athletes are not willing to
wait for natural growth spurts. Even their parents have become
promoters of supplements. It is all about appearance and winning. Of
course the marketers are happy. They have worked hard to promote their
products. The academics involved in the promotion of supplements are
happy, too. If the CEOs are happy, there is more money to travel to
conferences, sponsor websites, and build a reputation. After all, it is
the American dream. Everyone has the right to be happy! This is the
“new reality” of athletics and sports nutrition. It is difficult to
conceive how this reality has any positive benefits to it.
Ultimately,
it boils down to a major problem for society, the subject of sports
nutrition, and exercise physiologists. While it should be self-evident,
I am afraid it is not. There are just too many young people and others
with muscle dysmorphia [4]. That is, even if a young person looks fine
and performs well, the market is always arguing that more is better.
How can anyone really be happy with less, right? This kind of thinking
is hugely problematic in all walks of life. Frankly, it seems that
either arrogance or ignorance is the standard rule of thumb. Surely I
am confused and misled by what I have read and experienced or am I?
Much of my thinking this morning is influence by the early morning news
of young children choking themselves to experience some sort of a high.
These are usually 8 or 14 years olds who do not smoke or use drugs. The
high risk of dying does not seem real to them. Everyone is doing it or
at least that is what they think.
Arguably, much of
what I
have written will fall on deaf ears. The sports nutrition “industry”
has not even begun exploiting every human creature it can get its grips
into. The chemical cocktails of the future will make what is common
today look like aspirins. University labs around the world will
undoubtedly have “certified sports supplement specialist” who will be
paid by the industry to promote their products. Exercise physiologists
with an interest in sports nutrition will be talented, forward-looking
investors with new cars, clothes, and jewelry. They will be investors
not researchers in the true sense of the word. As the most vocal
faculty members in the department, they will be acknowledged as experts
in the field. Their research will be used to market the industry’s
products. They will be the force behind the commercialization of
academics. Discoveries in new product development will be attributed to
them. The focus on increasing the exercise physiology body of knowledge
will change from its traditional views to the profit motive. The
expense of new equipment will only increase. Hence, the laboratories
that do the supplement research will have stock in the several
different companies within the industry. Directors will receive money
for their supervision of the industry’s dollars and the purchase of
equipment to do more of their work.
The question of
integrity
and the role of professionalism will take a back seat to big
laboratories. Students will come to believe that it is okay to cheat a
little on the statistics. Faculty will sit in first class plane seats
flying from one place to another rather than teaching their students.
Book publishing companies that partner with the industry’s dollar will
publish biased books (much like today’s obvious advertisements). The
partnership will effectively market products for the industry. Today’s
beliefs and values about academics, teaching, and research will differ
little from traditional business ideals. The tendency to support the
industry will be so strong that the ethical advancement of exercise
physiology research will be severely affected. Rather than publishing
new ideas and statistically driven data, decisions will be based first
on how it affects the industry and, then whether it has academic value.
Non-positive results will be pushed under the rug or retested until the
desired results are found that favor the supplement industry.
Most
notably a significant problem will be the university researcher who is
hired by the industry who also teaches sports nutrition. A conflict of
interest develops between the faculty member’s duties as the teacher of
students (and athletes) and as the person who believes in the product
and is a paid consultant of the industry. Even today this is not a
hypothetical case. Will it get worse in 2020 and especially in 2030 if
something isn’t done about it soon? You bet it will. It is already
moving that way with great speed. At the heart of the problem is the
industry and the vulnerability of the human race. The sole purpose of
the industry’s investment in academics is to secure its credibility or
(at least, the appearance of credibility) that it doesn’t have. It is
also a means to establishing a more secure marketing base from which
young college students will get hooked on performance-enhancers. This
interaction among the three is crucial to the success of the business
strategies aimed at commanding big bucks.
Exercise physiology
can only be a healthcare profession if its members recognize the
intrinsic ethic of doing what is right for the right reasons. Promoting
or selling sports supplements is not the way of exercise physiology.
And, being an exercise physiologist is more than being a sports
nutritionist. The profession of exercise physiology is based on a code
of ethics and standards of practice. Exercise physiologists must
declare to the public their willingness to do what is right by devoting
their work to a higher good. The exercise physiologist who is true to
the profession will not engage in unethical behaviors. Exercise
physiology cannot become a business no more so than medicine can. It
must be a profession, just as physical therapy, occupational therapy,
and nursing are healthcare professionals. Students from these
professionals have a right to expect from their teachers that they are
giving them honest, unbiased, and uninfluenced information. Exercise
physiology students deserve the same.
It is important to
add
that in 2020 or, perhaps, 2030, that should research continue as a
for-profit industry sponsorship of sports nutrition research (which is
very likely to be the case), the use of human subjects may very well
predispose to significant problems. As guinea pigs, the health and well
being of the subjects may be jeopardized. Gross [5] points out that,
“…investigators can be unduly influenced by a financial connection to
an industry sponsor, resulting in biased science.” Academics are no
different from other researchers. They will engage in the same negative
behaviors as medical doctors. It is only a matter of time. The funding
and/or consulting sources are already influencing some sports
nutritionists. This is exactly why there will be a significant increase
in conflicts of interest if exercise physiologists do not abide by
their Code of Ethics [6].
It is interesting
that the American
Academy of Audiology posted an “Advisory…” on its website in regards to
an upcoming convention [7]. In the members’ Ethical Practice Guidelines
on Financial Incentives from Hearing Instrument Manufacturers, it
reads: “Conflicts of interest are defined as incentives that cause, or
can appear to cause, a loss of independent judgment, a loss of
impartiality or a loss of objectivity.” Does any of this sound
familiar? Here is an organization doing what it can to prevent
conflicts of interest for ethical reasons. Exercise physiologists still
have their heads buried in the sand of ignorance and denial, which
reminds me of the fables now collected under the name of Aesop. One
fable in particular has great importance, both for a better
understanding of our present situation and what is likely to happen in
the near future. The titled of this fable is The Wolf and the Shepherd
[8]:
“A
wolf followed a
flock of sheep without doing them any
harm. At first the shepherd was fearful of it as an enemy and watched
it nervously. But, as the wolf kept on following without making any
attempt to harm them, he began to look upon it as more of a guardian
than an enemy to be wary of. As he needed to go into town one day, he
left the sheep with the wolf in attendance. The wolf, seeing his
opportunity, hurled himself at the sheep and tore most of them to
pieces. When the shepherd returned and saw the lost sheep he cried out:
‘It serves me right. How could I have entrusted my sheep to a wolf.’”
It
is the same with exercise physiologists: when you entrust sports
nutrition to greedy people it is natural that you will lose something
important.
References
1. Barrett, S. (2005). Dubious Chiropractic Nutrition. Canoe Network.
C-Health’s Alternative Medicine: A Skeptical Look. [Online]. http://www.canoe.ca/HealthAlternativeColumns/010622.html
2. Boone, T. (2003). Why Teach Anatomy? Professionalization of Exercise
Physiologyonline. 6:3 [Online]. http://www.asep.org/asep/asep/WhyTeachAnatomy.html
3. Brownlee, S. (2004). Doctors Without Borders. Washington Monthly.
[Online]. http://www.washingtonmonthly.com/features/2004/0404.brownless.html
4. Warren, J. (2005). The Steroid Generation. Digital Journal.com
[Online]. http://www.digitaljournal.com/print.html?id=4201
5. Gross, C.P. (2001). Financial Conflict of Interest and Medical
Research: Beware the Medical-Industrial Complex. The Journal of
Philosophy, Science, and Law. 1:December [Online]. http://www.psljournal.com/archives/newsedit/gross.cfm
6. American Society of Exercise Physiologists. (2005). ASEP Code of
Ethics. [Online]. http://www.asep.org/ethics.htm
7. American Academy of Audiology. (2005). Advisory: To Party or Not to
Party? That is the Question! [Online]. http://www.audiology.org/professional/ethics/adv-party.php
8. Temple, O. and Temple, R. (1998). The Complete Fables of AESOP. New
York, NY: Penguin Books. p. 170.
