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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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For myself, as a practitioner, I work half-time at a university, but also work two days a week for the Australian Rugby Union. It’s also facilitated an opportunity for me where, over the last year, I’ve worked closely with our integrity unit within the Australian Rugby Union to be able to develop a supplement policy that has helped to try and minimize the chances of this sort of issue occurring within rugby union.

When we talk supplementation, I think it’s really important that we have an appreciation of what actually we perceive to be a supplement. And I would presume, if I asked people in the audience if you’re taking any supplements at the moment, and we broke it down away from things like protein powders, creatine monohydrate, through to things like fish oils, vitamin and mineral supplements, I would presume there would be at least half the audience that are consuming some form of supplementation. Just a showing of hands—who’s taking some form of supplement—pill, powder, anything like that? Potentially if you’re taking it for a therapeutic reason—there you go.

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If I asked that question to a group of athletes, you’d find almost every single athlete would raise their hand.

Video: Sport supplements include a wide range of products, from protein shakes and creatine through to rehydration or electrolyte drinks, vitamins, and minerals. The target market ranges from elite athletes to weekend enthusiasts to budding young talent. But supplements are also produced for body builders with a greater focus on cosmetics than enhancing sporting performance. These Schwarzenegger gym bunnies have simulated a demand for supplements that may contain ingredients that are banned by the World AntiDoping Agency with little or no concern for drug testing. Athletes might say, “What’s the risk in that?” However, manufacturing of supplements is commonly sub-contracted to thirdparty manufacturers, who make a wide range of products for a wide range of brands. Whilst brand “B” may be respectable with the intention to be free of banned substances, traces of brand “A” may carry over if it was manufactured just before brand “B” and using the same equipment—bad news if brand “A” contained banned substances!

In addition, pressure on prices will encourage sourcing of raw ingredients from low-cost suppliers with low-cost quality control. Cross-contamination within a storage warehouse can then easily happen. More and more products are also using herbal ingredients, and the chemical makeup of these is often not understood. So, traces of banned substances can easily find their way into legitimate products, and urine samples containing one part per billion of contamination can lead to a positive drugs test, and careers left in tatters.

The answer is simple. Look for the Informed Sport, Informed Choice logo to guarantee a tested product.

Gary: Now, as you can see, that is actually a commercial presentation. It was prepared by Informed Sport, which are an independent testing body that will charge supplement 48 Keeping sport safe, fair and inclusive companies to analyse their products to confirm that they’re free of doping substances. I’m going to talk a little bit more in regards to Informed Sport. It’s very much something that’s new within the Australian market, has been around for a few more years within Europe and the U.S. And I think it’s very much a positive move, where we’re decreasing the potential of a doping offence through the use of products that are Informed Sport-certified. You don’t completely remove the risk, though.

There’s a whole range of issues that are raised in their film—one in regards to manufacture.

What we often don’t appreciate is that the majority of supplements that are produced within Australia come from just a couple of different paired blending facilities. So, if one company has contaminated products, it’s highly likely that other companies will also have contaminated products. The increased exposure to botanicals, herbal ingredients, can also carry an increased risk, whether or not they’re used in isolation or within these supplements, which carry many, many ingredients. And also, it’s a market that isn’t driven by science, but is driven by the consumer. What does the consumer want? We’ll provide it for them, because it is a commercial entity.

If you want a true definition in regards to a supplement, it’s “ a product which contains one or more purportedly active ingredients, derived from plant or animal sources, for the purposes of expanding dietary intake. It may range in presentation from a formulated food or drink to a pill, powder, fluid,

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Their perception of sports nutrition really is about sport supplementation. And while there is a small range of sport supplements that offer a true performance-enhancing benefit, you’re typically only looking at a one- to maybe three-percent improvement in performance, if it can actually be administered appropriately, that is, the right dose at the right time for the right athlete. The reality is that the vast majority of the benefit is going to actually come from the base meal plan that that athlete is working on, using their diet to be able to help support fuelling and recovery goals.

There is no question that athletes are interested in taking supplements. My university training, my academic training, taught me that, in general, people don’t need to take supplements. So, when I first moved down to the Australian Institute of Sport in 1996, and I carried over that ethos, then I was finding I wasn’t getting any buy-in from the athletes.

These guys want to take supplements.

Now, this is an assessment of dietary supplementation practices from the Western Australian Institute of Sport. It covers a range of different sports, including kayaking, swimming, hockey, athletic water polo, rowing, and netball, across both genders. Now, what you can see is that there’s about 90% of those athletes acknowledging some form of supplement use. It varies quite markedly between the sports, and while the rates of use might vary a little bit by gender, the big thing that differs between gender is the rationale for use.

But you can see kayakers, for example—and keep this in mind—the male kayakers are consuming, on average, eight different supplements on a daily basis. What sort of products 50 Keeping sport safe, fair and inclusive are they using? Well, you have your general vitamins and minerals, iron supplementation, which you could justify if an athlete had an iron deficiency, things like glucosamine, again, from a health perspective. And these tended to be the main products that were being used, products that might be prescribed according to health or a goal of being able to enhance their overall health. But you also see products like caffeine, creatine, mixed carbohydrate protein products, as well as protein-only-containing products, being very popular, but especially popular amongst the male athletes, because the males tend to be motivated by performance outcomes, the females being historically more motivated by health outcomes, but that’s starting to change, as well.

And again, if we look at the main reason why they’re consuming these products, we see that issue in regards to enhancing of health, boosting immunity—the scary ones are things like peer recommendation. These guys are seeking information from fellow athletes, where they know that Johnny is taking product X. Johnny is the current national champion, and it’s very easy to make the connection between Johnny’s success as an athlete with taking

–  –  –

Where are these guys sourcing their information from?

Now, you need to keep in mind, this is from a state academy of sport, where the athletes have access to sports science, sports medicine support, as part of their scholarship. The great thing to know is that those guys that are in that environment are getting their information primarily from sources that you would classify as being well-informed.

And so, the athlete can make an informed opinion. They’re getting it from allied health professionals. They’re getting it from a dietician. They’re getting it from an exercise physiologist. But you’re also finding, even with these guys, that they’re getting information from less reputable sources.

The coach can be a fantastic person for being able to provide guidance in regards to technical issues. But a coach is not an expert in regards to sport supplementation. Neither is a doctor. The “self”—obviously, that’s a Google search. Using other athletes, family, and friends—Mum and Dad are always well-intending, but Mum might not necessarily be the best source of sport supplement information.

Thankfully, along our journey that we’ve had in recent weeks, there has been lots of information actually come up in the media. This came out of one of the Sydney papers, and it explored the issue in regards to education of athletes, teenage athletes, in regards to caffeine use. And I guess we have this decision to make. Do we bury our head in the sand and pretend like it doesn’t exist? Or do we look at actually educating these athletes? And I see analogies associated, I guess, with sex education. We can stick our head in the sand and pretend that it doesn’t happen. It will continue. And I think it’s the same situation in regards to supplementation.

But this isn’t an isolated event. Children competing in an under-12 hockey team drinking Red Bull cans to get an edge—it gives you wings, apparently. A group of 12- to 14-year-old swimmers in the Gold Coast recently suffered from strong withdrawals and side effects, including stomach cramps, to a vitamin pill juice plus that they were put on by their coach.

In an elite private school within Brisbane, recently, our dietician gave a talk, and one of the first questions asked by one of the boys was how to source and use protein supplements.

That’s perceived connection between a protein supplement and performance, or protein supplement and gains in muscle mass.

And it continues on. A Western Australian private school sent a letter to parents informing them of how to buy their sons on the rowing team creatine or protein powder.

Private schools contact the Western Australia Institute of Sport to source information about creatine, protein powders, and a banned substance to help their athletes boost 52 Keeping sport safe, fair and inclusive performance. And a senior swimmer was encouraging a junior swimmer on a national team to make use of No-doz, which is effectively a 100-mg caffeine tablet, similar to a serve of coffee.

Now, on the other side of that, you have Steve Lawrence, who is the head of the Western Australian Institute of Sport, that is defending the approach they’ve taken, that is, facilitating athletes being able to make informed opinions in regards to their supplementation practices, because I personally believe if you don’t provide that education for them, they will still take those products, but they will be unguarded and uninformed in regards to how to appropriately use those products. His statement—”we know, in swimming, parents buying supplements for their kids is endemic. In fact, it is in most junior sports.” And I’d suggest, from what I’ve seen with sub-elite athletes that I work with, that that certainly is the case, as well.

This is a big issue. We’ve done an educational approach. We’ve said, “Let’s not ignore what’s out there. Let’s show people what they do and how to do it,” so again, allowing people to make informed opinions. He said while he does not condone or encourage the use of caffeine tablets like No-doz in children under 18, they would rather inform their school-age athletes of the methodology of using caffeine safely.

This isn’t a one-off case. These are examples internationally. 91% of elite junior athletes in Germany have used at least one supplement in the last month. About 2/3 are seeking information, usually from the media, Internet, coaches, and fellow athletes—that is, not reputable sources of information—potentially getting misinformation and getting adverse effects associated. Almost 90% are unaware that supplementation can have adverse effects.

And I’ll show you some examples.

These are not inert substances, and used inappropriately, they can have adverse effects.

3/4 are unaware of the problem of supplement contamination, which I will again raise with you. And the majority of athletes don’t know the supplement’s active ingredients, the mechanism of action, potential side effects, or recommended dosage, as a consequence not really knowing how to utilize these products effectively.

Recognizing the issues at hand, my professional organization, Sports Dieticians of Australia, have released a position statement just recently. You can get that off the SDA website. And just a small excerpt from that—

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” diet.

And that’s the cold, hard truth. Even those products that do work—you’re talking about maybe a 1, 2, or 3 percent performance enhancement. Getting training right, or getting diet right, you’re going to influence performance by 10 to 20 percent. Adolescent athletes and their support personnel—it’s key that we include the support personnel, because that’s where they’re getting their information from. Or as we’ve alluded to, the reality is, for a 12-year-old child, the food they get access to, potentially the supplements they get access to, is totally dictated by Mom and Dad. So, we need to make sure that they’re incorporated into the overall education process, and the same thing with the coach. They should be aware of the risks associated with dietary supplementation.

Organizations involved with adolescent athletes should develop guidelines to regulate supplement use.

So, why have these products become so popular of late? I’ve been a bit of a gym junkie since I was about 18 years of age, and I think back to supplementation then, before I really ventured down my academic pathway. And there was this mystique associated with products. There was this small stash of products in the back of the shop at the gym, the gym where all the body builders hung out. Wow, this stuff must have steroid-like effects. Amazing!

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