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«Transcript of the Safeguarding the Integrity of Sport Forum May 2015 A production of Play by the Rules In cooperation with © Play by the Rules 2015 ...»

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Again, we’ve got the issue within Australia, how much context does this have within the Australian marketplace? Well the reality is the strength of the Australian dollar has meant that there is a significant amount of products from overseas within the Australian marketplace. We were kind of isolated for a long period of time and it wasn’t until things like Jack 3D, if you guys have heard of that before, it was a very popular as pre-training supplement that contained DMAA in it which is a banned stimulant. And that was, I guess, the first time when one of our athletes could go down to our local health food store or supplement store, pick up a product off the supplement shelf and it’d have within it a banned doping substance that was actually on the ingredient list.

Are there particular products that are more likely to result in a positive doping test?

Absolutely. Those pro hormones, products that are claiming to enhance blood testosterone levels, for example, typically contain added amounts or are more likely to contain anabolic agents that are not, obviously, on the label.

More recently, this was an investigation that was just published this year, an analysis of 30 different diet supplements having their components assessed through chemical analysis to see if they contained any banned substances. And despite them not being on the label, the vast majority of them contained anabolic agents, things like testosterone, DHEA for example, stanizol, that would result in a positive doping test. Again this is out of the U.S., does it have context within the Australian marketplace, I believe so.

60 Keeping sport safe, fair and inclusive On the video that I showed you before, you might have remembered seeing an ingredient called geranium oil. Geranium oil is the natural term used for the DMAA, the banned stimulant. Again, this is information that was just released this year where 12 or 14 pretraining supplements, the products that people would consume before exercise to hype them up, if you like, contained DMBA, which is effectively a derivative of DMAA, again, which would result in a positive doping test.

Potential side effects, again, I’ve mentioned before these are not inert substances. An example of a body builder over a three day period consuming 7 ½ grams of caffeine in an attempt to cut up presenting with a grand mal seizure at a hospital, 7 ½ grams of caffeine, that’s equivalent of about 75 cups of coffee over a three day period. I like my coffee but I don’t like it that much.

Yohimbine, which is a product that supposedly enhances blood testosterone levels. Again, a person presenting to accident and emergency with vomiting and loss of consciousness.

AAKG, which is quite often used in these pre-training products, again, presenting to A&E as a consequence, nausea and vomiting and loss of consciousness.

And some information out of the U.S. looking at 15 of the most common protein supplements, divvying out three serves a day and then assessing those products for contamination of heavy metals and they found out that five of those 15 contained amounts of heavy metals that were above levels considered safe for human consumption.

On the opposite effect, appropriate use of antioxidant supplementation and the perception that an antioxidant supplement like vitamin C, like vitamin E, couldn’t have any detrimental effects. The reality is, there’s some quite compelling research showing now that even 1000 milligrams of vitamin C a day, I’m sure there’s some people in the audience that are taking that, suppressing training adaptations. Your body gets exposed to free radicals when you do exercise. As a consequence, your body wants to up-regulate its own antioxidant defence

–  –  –

That culture of quick fix, classic example of what might be used in marketing strategy for a weight gain protein supplement, this was supposedly over 16 weeks. I’d be gobsmacked if it occurred over 16 months. And again, that perception, giving people that perception that they can achieve that in such a short period of time and when they don’t achieve that by themselves through training and diet because it’s just not physiologically possible, they start to look at other options.

The tainted public perception, this is an interesting one for mine because I worked with George Gregan for a number of years as a Brumby’s athlete as well as the captain of the Wallaby’s. And he explained one day in a media interview his use of caffeine, which I’d educated him on so that we looked at maximizing his performance and minimizing the adverse effects, that we used No-Doz as a means of being able to achieve that caffeine. Why did we use that? Because it’s got a very defined amount of caffeine and it’s a very, very small volume. And he did everything exactly in line with what I’d recommended. But it provides that perception—now if he’d taken that as coffee, do you think there would have been a different perception in regards to his use of caffeine?

I’m certainly guilty of using caffeine to enhance my cognitive function when it’s on the decline in the afternoons. But again, it comes back to that perception and we’ve looked at other ways of being able to get around that because while I’m providing George with that information to optimize his performance as a Wallaby, would I be providing the same advice to a 12 year old rugby athlete? Of course not.

What are the potential values associated with strategic use of supplementation under the guidance of an informed health care professional like myself? Obviously, it has valid application clinically. If an athlete is diagnosed with an iron deficiency, anaemia, it’s absolutely appropriate that they should be given an iron supplement to help resolve that issue.

Practical nutrition support within the sporting context, I’ve already alluded to earlier in the presentation that carbohydrate ingestion during exercise of longer than 60 minutes can enhance exercise performance. Now by rights, that could be via a bowl of rice, it’s just particularly difficult to get access to that bowl of rice on the bike. And that’s where products such as sports drinks, gels, sports bars might offer a practical alternative to be able to achieve that nutrition support.

There’s absolute recognition that appropriateness of some dietary supplements when provided in the correct amount and right time with the right athlete, can enhance exercise performance. There’s very clear evidence that creatine monohydrate supplementation can enhance recovery within an exercise session that is characterized by repeats bouts of high 62 Keeping sport safe, fair and inclusive intensity work. The rugby union athletes that I work with are a classic example, the creatine enhances recovery within the session and allows them to do more work at the back end of the exercise session.

I’ve already alluded to the performance benefits associated with caffeine and as a performance focused nutrition professional, caffeine is probably the substance that I use the most with the athletes that I work with. But it’s always trialled in training and we always start with a very minimal dose and then increase right up thereafter because we certainly know now through research, the amount of caffeine you need to enhance exercise performance is much, much less than we’d known previously.

Changing acid base status, whether that be using things like bicarbonate supplementation or beta alanine, again, there’s compelling research for the potential value of that within specific sports. And again, even within a specific sport, trialling it with the athlete in training to confirm that they tolerate it and have a perception of enhanced exercise performance.

Through to simple things like manipulation of carbohydrate intake during exercise, or certainly in the last five to 10 years, the use of protein supplementation, if any of you guys go to a commercial gym, it seems like it’s unanimous amongst every single person that goes into the gym whether or not they’re trying to lose weight, gain weight, enhance fitness, they need to take their whey protein shake after every exercise.

And then the power of the placebo, or making the athletes that you work with have the perception that we’re doing everything we possibly can to be a cutting edge program. To use an example, here this is the game day supplementation practices potentially and all athletes might not be consuming your products, in preparation for a game for Rugby Union athletes. So we reinforce the importance of their actual dietary intake, manipulation of their carbohydrate intake so their muscle glycogen stores are optimized in preparation for a game.

We look at a nitrate rich supplement, there’s research to suggest that they can enhance running economy, for example. For the Queensland Reds, the start of the super rugby season, can still be played in hot environments and we know through research that we did in advance of Beijing that using a sports drink slushy can help decrease body temperature to roundabout the same amount as going into a hydrotherapy or plunge pool. You’ll be glad to know that we don’t actually go down to the 7-11 and get a slushy, we do specifically use a sports drink slushy.

The strategic use of caffeine in preparation for the game, we know that caffeine levels reach their peak within 60 to 90 minutes of consumption so we’ll have that prior to the warm up.

Supporting the use of carbohydrate during exercise and then potentially, for those guys that feel like they need an additional top up for the second half of the game, using things like caffeinated gum and the reason why we use caffeinated gum over a No-Doz is because the caffeine gets into the bloodstream about twice as quick when it gets absorbed through the oral cavity as opposed to being absorbed through the stomach.

Play by the Rules But again, every single one of those strategies is used in isolation in the trial matches and in training for every single athlete to make sure that we optimize the strategy for them. Now that’s again, at an elite level. Would I advocate that for a school athlete? Absolutely not.

So our summary there, supplements are very efficiently effectively promoted within the marketplace, very, very emotive of marketing and the reason why they’re so popular and it’s an ever-expanding environment, they’re likely distract attention away from a food first philosophy to performance nutrition strategies and certainly within the Australian Rugby Union, we’ve taken that food first philosophy. The reality is athletes have access to a much wider range of products domestically and internationally and as a consequence, when they’re travelling internationally for training or competition, they need to have an appreciation of the increased risk associated with the acquisition of products perhaps overseas.

The risks associated with supplement use are very real, whether that be from a doping perspective but also from an adverse event potential but when used as part of an integrated meal plan that is giving absolute consideration to the person’s food and fluid intake, specific supplements can make a valuable contribution to overall performance success of the athlete. But it’s not really going to do anything if it’s used in isolation. The expert guidance of a sports nutrition professional is strongly recommended.

So while athletes might have this perception in regards to sports nutrition, the reality is it should be like this, trying to focus absolutely in regards to a meal plan where the energy density of the meal plan adjusts, increases and decreases to reflect training loans.

When they’ve got that box ticked, they start to explore the potential use of sports foods, that is, foods that provide macronutrients, carbohydrates, fats, proteins, similar to what they might be able to achieve through whole food but in a convenient package.

And when they’ve ticked that box, and only then, should they be considering exploration of those few products – the nutritional ergogenic aids - the caffeine, the creatine, etc, that might add that one or two percent.

64 Keeping sport safe, fair and inclusive Because of the issues at hand, a number of sporting organizations have now developed supplement policies that form part of their high performance agreement. A small excerpt from the Australian Rugby Union, one that I’ve developed over the last year – the ARU acknowledges the use of supplements in rugby and is committed to establishing best practice protocols for the use of supplements based on the core principles of player safety, evidence based science and compliance with a wider prohibited list.

There is no expectation or requirement that any individual associated with rugby must use supplements - and we don’t have any squad prescription for products, it is always something that is discussed with the individual athlete because it also means we need to give consideration of their dietary intake as well.

The ARU approves of the appropriate use of supplements to support a nutrition program and promotes the food first message which is that a person is more likely to benefit from a health and performance focused, outcome driven meal plan which should be established with an accredited practicing dietician.

And finally, some links for you where you can go to for more information, the supplement 411 if you a Google search for that, you’ll find the USADA videos. There’s also some excellent information on the ASADA website. Sports Dieticians Australia provide a wide range of valuable resources in regards to supplementation that are free to access. The Australian Institute of Sport and Nutrition program and their supplementation framework is an excellent resource to explore and also, the Informed Sport Program.

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