Supplements and
Exercise Physiology
Larry Birnbaum
Associate
Professor
Department
of Exercise Physiology
The College
of St. Scholastica
Duluth, MN
55811
NUTRITIONAL SUPPLEMENTS
proved to be a lively topic at the latest ASEP meeting in Sacramento, CA.
The discussions focused on the role of exercise physiologists with respect
to the use of supplements by various sectors of society. Should exercise
physiologists investigate the beneficial and adverse effects of specific supplements?
Should exercise physiologists promote the use of supplements that have been
shown to provide beneficial effects with minimal or no adverse effects?
Or should exercise physiologists function as consultants who relay current
research information to clientele who inquire about specific supplements?
Should ASEP issue a position statement on the use of supplements as other
organizations have done?
Reflecting upon
the discussions at the ASEP meeting, it seems there were primarily two positions
on the use of supplements, which reflect perspectives on the role of exercise
physiologists in our society. One perspective sees exercise physiologists
as sports medicine researchers and practitioners; the other as health care
providers. It is not difficult to understand why those exercise physiologists
advancing sports medicine advocate the use of supplements to enhance athletic
performance, provided the supplements have been shown to be safe and effective.
It is equally easy to see why the health care perspective would discourage
the use of supplements if they do not provide a health benefit, even if they
improve athletic performance. An exploration of these two perspectives
may clarify issues associated with supplements and help exercise physiologists
determine an appropriate role regarding the use of supplements.
I must be forthright
in my bias. I see exercise physiologists as health care practitioners;
however, I believe I understand the rationale of the sports medicine enthusiasts
and I do see a “gray zone” for certain supplements. Indeed, if taking
a supplement, in addition to a healthy diet, good training program and appropriate
sleep, will improve athletic performance, why not take it? As an athlete,
do I not want to be the best I can be? As a coach or spectator, don’t
I want the players to perform at their greatest potential? And, of course,
I want to win or I want my team to win. If this argument is pursued,
could it lead to rather extreme practices, such as genetically-engineered
athletes(1). After all, if we want to be our best, why stop at supplements?
Then again, if I was genetically engineered, I would not be achieving my true
potential, but rather an engineered potential. If I am taking a performance
enhancing supplement, am I guilty of biochemically engineering my potential?
Where do I draw the line? It is easy to make it black and white by
saying anything beyond a healthy diet, one in which all nutritional requirements
are met, is stepping over the line. Obviously, there are those who
would argue it is not that black and white.
For example, what
is the difference between increasing protein in my diet by eating more meat
or by taking protein supplements? I think that question puts us in
the “gray zone.” One could argue that meat is natural and protein supplements
are artificial, but what about the practices of our agricultural industry.
Our agricultural producers have been genetically engineering livestock and
produce for many years via breeding and, more recently, direct genetic intervention
(2). There are those who argue we should only eat organically grown
produce to maximize our health (i.e., don’t eat herbicides and pesticides).
These issues make the matter less than black and white.
Still, I believe
there are some points we can all agree upon. Taking any supplement
that carries a significant risk of causing harm should be discouraged, if
not banned. I doubt that any exercise physiologist would advocate the
use of anabolic steroids due to the adverse consequences associated with
these substances (3). Exercise physiologists should be able to provide
accurate information about supplements to clientele interested in them without
advocating their use. In doing so, exercise physiologists are providing
a useful service and avoiding possible litigation. I certainly hope
that all exercise physiologists would agree that children should be discouraged
from taking any supplements, although there is likely disagreement about
the age at which children become adults. I would caution the reader
to not confuse treating dietary deficiencies to restore health (e.g., give
iron for iron deficiency) with taking supplements to increase athletic performance.
At the risk of
putting words in the mouths of the sports medicine enthusiasts, I suspect
they would argue that there is nothing wrong with taking a supplement to
enhance athletic performance provided it does just that without any serious,
adverse consequences. In my view, the exercise physiologist should
always be an advocate for the health of the individual. From this perspective,
the question the exercise physiologist must pose is, “Does the supplement
improve health?” If not, then the role of the exercise physiologist
is to provide accurate information about the supplement and make clear to
the interested party that it does not promote health. Personally, I
do not think exercise physiologists should advocate the use of any performance
enhancing supplements to anyone, not even professional athletes. We
can provide information from a neutral position, unless the substance is
harmful. As health care practitioners we are obligated to caution clients
about any adverse effects associated with supplements. For persons
under the age of 18 (e.g., high school athletes), parents should receive
the same information given to their children, preferably at the same time.
Regarding research,
exercise physiologists should conduct studies on various supplements to determine
possible benefits and, more importantly, possible injury. Long term
studies should be included to evaluate potential harmful effects that may
occur after taking a supplement for several years. Ideally, these studies
should be funded independently, rather than by the manufacturers of the supplements
under study. Even the noblest of researchers struggles with objectivity
when funding is tied to results.
Finally, I would
like to touch on ethics. Two ethical issues come to mind with performance
enhancing supplements. First, there is a health issue. As health
care practitioners, exercise physiologists must first do no harm. If
there is any risk associated with taking something that is not needed for
health, it should not be taken. The health of the individual should
be first and foremost. This has to be ASEP’s position. If we
want to be respected by the general public, we must advocate health.
If we want to be trusted by the general public, we cannot advocate anything
that could compromise health or pose a risk to health. ASEP is the
only organization comprised solely of exercise physiologists, most of whom
provide some form of health care.
Second, is it
a form of cheating when athletes take one or more supplements that enhance
their performance? I think it is. I see it as the same as taking
stimulants to increase energy and/or prolong endurance. Sure, we can
level the playing field by allowing everyone to take the supplements, but
then what is the message? Win at any cost? What are we teaching
our children? What kind of behavior are we promoting in our society?
I see the recent scandals with CEOs (e.g., Enron) as directly related to
this issue. Yes, win at any cost, whether you have to lie with accounting
figures or take supplements. It is an attitude that is simply not healthy
for the individual or the society. I may be old-fashioned, but I would
love to see sports return to the days when playing sports was for fun, when
the athletes trained hard, ate healthy and loved to play the game.
The idea was to build strong bodies, strong minds, and community (i.e., teamwork).
This ideal was directly translated to society. Obscene salaries, drugs,
supplements, etc. have put a sour taste in my mouth for sports. It seems
winning is the only thing that matters any more. We’ve lost our way.
The issues surrounding
the supplement industry will be with us for a long time. I am one voice.
ASEP needs input from all exercise physiologists. Let’s keep the dialogue
going.
References
1. Bonsor,
Kevin. How Designer Children Will Work. [Online]. http://science.howstuffworks.com/designer-children.htm
2. Center
for Life Sciences and Department of Soil and Crop Sciences at Colorado State
University. What Are Transgenic Plants? [Online]. http://www.colostate.edu/programs/lifesciences/TransgenicCrops/what.html
3. Lovitch,
Scott. Anabolic Steroids: Cheating Through Chemistry. [Online].
http//www.hcs.harvard.edu/~hsr/99_hsr_webpage/hsr/winter97/steroid.html
