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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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What you see now, I’m sure it’s exactly the scenario with youth in Wales, there are specific sport supplement stores popping up everywhere. The one that I find particularly interesting though, where do you think I’ve taken that photo?

Woolworths. A whole aisle allocated to sport supplementation. Now the reality is if we look at the top section, where does the person at the supplement store, the retailer at the supplement store, where do they get their sports nutrition information from?

The reps, exactly.

54 Keeping sport safe, fair and inclusive So is there a conflict of interest there or what? So I have concerns about that, and I classically see the situation where I have an athlete that I’m working with and we’ve decided we’re going to use a little whey protein isolate for them. And they call me up a day later, and say, I’ve got this whey protein isolate, but they got me this fantastic pre-trainer, also this testosterone booster as well. You’re going to go back to the shop, you’re going to take your testosterone booster back and you’re going to ask for your money back.

The scary thing is, where does the person who gets their supplements from Woolworth’s where do they get their information from? “Price check aisle 3.” The other thing that we find is absolute penetration of supplementation and supplement sponsorship within sport. This is an example of a range of different professional sports that have sponsorship arrangements with one single supplement company. I don’t want to bore you but there’s also another page there showing another group there. And again, you can see that connection. A junior elite athlete looking up to the professional team and seeing these guys choking down these products in and around the training environment. And again, it’s very, very easy to make the connection that that product is going to help me to get to where I want to be.

The reality is those products need to taste nice as well and it’s very, very easy to be able to make that transition.

You will find it’s been raised earlier in the day, I guess the pressure that’s coming from society. We’ve long had an appreciation for the pressures, societal pressures for the young female athlete to be very thin. We see exactly the same situation but perhaps in the opposite direction for the junior elite athlete who’s aspiring to put on muscle mass to increase strength and to look aesthetically more appealing. With the presence of things like muscle dysmorphia, there’s a constant drive to get bigger, and the perception of self that you’re quite small.

We know with those individuals that are suffering from muscle dysmorphia, they’re more likely to consume supplements that are also more likely to transition then into using anabolic agents.

Now what I want to be able to give you here is a balanced approach to this. As a sports dietician, I’m a real advocate for appropriate use of sports supplements. I work with an elite sport environment and the professional teams that I work with typically have arrangements with supplement companies that might allocate 80 to $100,000 retail of product per annum to put around them. Now granted, I’d be happy to be able to make use of whole foods in many of those situations but the club isn’t going to give me $100,000 worth of Woolworth’s vouchers. And so that’s the environment that I work with in. But again, I want to try and give you a balanced approach, this is not just a hack out on supplements.

Cons associated with supplementation, a mode of marketing emphasizing pseudo-science. I find this is an absolute classic one. It was in the 80s where the supplement industry was still a little bit of a wild west and it really tells a story in regards to a research Play by the Rules https://www.youtube.com/watch?v=50QBwi11ncE study where they had a group of post-menopausal females who were deficient in boron.

When they gave them a boron supplement, they found this, “Boron supplementation markedly elevates the serine concentrations of estradiol and testosterone.” What did the supplement manufacturers think of that? ‘Hello’. If I produce a boron supplement, I can use the information from that study to be able to suggest that my supplement increases blood testosterone levels.

Well surprise, surprise, when you look at the target audience of this supplement, that is a 20 year old male who’s not boron deficient, taking a boron supplement does what to their blood testosterone levels? Absolutely nothing. Did the product work? No it didn’t.

Now I want to show you this video, it’s from the U.S. but it absolutely has context within Australia. The issues are the same and I think it’s also important to recognize that given the issues with—well it’s perhaps not quite the same at the moment, but the strength of the Aussie dollar, that we have absolute penetration of U.S. products within the Australian marketplace. Because of that strength of the Aussie dollar, those U.S. products can come within the Australian marketplace and compete price-wise. And that’s really changed the supplement industry within their country.

Video: Why do you believe that you need dietary supplements? Do you think that they give you a performance edge? Do you use them because you think everyone else uses them?

Do you think they just work? How careful are you when you choose one? How much do you really know about the dietary supplements that you might use?

56 Keeping sport safe, fair and inclusive Unlike drugs, the FDA does not evaluate dietary supplements for safety or effectiveness before they’re sold. So you can’t count on the FDA alone to protect you from unsafe or tainted products. You need to be an informed consumer. Let’s explore.

Here’s a fictional product that contains features found on actual products marketed as dietary supplements. Let’s look at this product together. Products may make promises that are too good to be true. Keep in mind this is a profit-driven industry. Supplement companies want you to buy their products. Do you really believe the promises made here?

This says clinical trials prove this supplement is effective, but who designed and conducted the study? Have you seen the study? Just so you know, studies conducted by the companies themselves are more likely to find positive results than studies conducted by independent organizations.

Are you swayed by endorsements by famous athletes? Most athletes endorse products after they’ve become successful so the product probably played no part in their success.

Remember, endorsements are a business arrangement between an athlete and the supplement company.

And what about the ingredients? A supplement facts label identifies this product as a dietary supplement but beware, there are products containing undeclared prescription medications or steroids that are sold as dietary supplements. We have seen them online, in health food stores, in drugstores, even in grocery stores. A wolf in sheep’s clothing may be hiding among legitimate dietary supplements. Can you tell the difference? Look closer.

This product says it contains the ingredient 3-17 etiocholanotriene, the name gives it away as a steroid. Note the numbers and the –E-N-E ending. But the name does not properly describe a chemical structure. The manufacturer either has a poor understanding of basic chemistry or has made a deliberate attempt to confuse the consumer. But wait, this product is guaranteed to be steroid-free. What’s behind this guarantee? Has the product actually been tested be a reputable, independent, third party or is this just a decorative decal made up by the company? If there is certification from a third party testing agency, what did the testing program cover? Was this exact batch tested? It is important for you to learn all that you can about any testing program or guarantees made about a product.

What else is in this product? Let’s look at the all-natural energy blend. The word “natural” does not necessarily mean safe. After all, poison ivy is all-natural too. Some botanical ingredients may be safe when used as the whole plant but concentrated extracts of those same botanicals can have very different and sometimes negative effects. Are you familiar with the safety profiles of these botanical ingredients? What about the herbal ingredients in your supplements?

Speaking of herbal ingredients, let’s look at the geranium oil listed here as an ingredient.

Some companies list geranium oil on the label but then spike their product with synthetically produced methylxanthines, a stimulant prohibited in sport. The phrase “allnatural energy blend” may not mean what you think it does.

Play by the Rules Do you recognize DHEA on this label? It is spelled out as dehydroepiandrosterone. DHEA may be legally sold as a dietary supplement but it is prohibited in sport as an anabolic agent and can make you test positive.

What about proprietary blends? Only the total amount of the proprietary blend needs to be listed on the label, not the quantities of the individual ingredients. How much creatine are you getting here anyway? You can’t tell. And look at the energy blend, there are several ingredients here with stimulant effects but since you don’t know how much you’re getting, how can you be sure it’s safe for you?

Let’s step back a moment, are we giving this label too much credibility? We’re assuming that the label accurately reports what’s in the product yet some dietary supplements contain ingredients not listed on the label or contain different amounts than what is stated on the label. To combat this, some third party testing companies test for substances prohibited in sport and also conduct what’s known as label verification to make sure that the label and the contents match.

By law, supplement companies must comply with good manufacturing practices or GMP.

This product is GMP certified. Or is it? Has this company actually been audited? It’s very difficult to tell from the label which supplements have been produced according to the law.

Even so, many products are decorated with a stamp such as this one. You cannot rely on the label, you need to do your homework. This company has posted a warning on their product which is good in a way, but if you see a lengthy health warning, don’t you wonder what’s in it that can cause these side effects?

Companies are required to report to the FDA any serious adverse events or health problems associated with their products. Have you researched the adverse event reports for the supplements you use? And what about the company, is this company really committed to quality? Have you checked the FDA or FTC website to see if there have been any warning letters or enforcement actions against this company? Does this company have any criminal proceedings against them? Have you researched the company’s owners? What you find may surprise you.

So the question becomes, “What is actually in the bottle?” In this example, you can’t really tell. Is it worth the risk? There are steps that you can take to help you decide whether to assume the risk of using dietary supplements. You will find these on USADA’s website focused on dietary supplements. Don’t be the next positive doping test and don’t trade your money for health problems or false hopes of amazing results. Be an informed consumer when considering dietary supplements, it is ultimately your decision and it can be a risky one.

Gary: A whole lot of issues rise with that video, it is freely available on the USADA website and there’s also some really good resources for the Australian version for ASADA in regards to supplementation issues.

58 Keeping sport safe, fair and inclusive Second con, distraction of resources, whether they be financial or time. An example here of a financial constraint, two products, thankfully the top product doesn’t exist anymore, creatine monohydrate, it’s a supplement in which there’s a significant amount of research supporting its use and also some research suggesting that the co-ingestion of creatine with carbohydrate enhances the uptake into the muscles by about 60%. As a consequence, supplement companies produce products such as the myocytin which is effectively created with some carbohydrate added to it.

My concern again, and this comes down to the financial constraints, if you actually look at the cost of the creatine per 100 grams according to each of those different products, this product here, you’re paying $93.27 for 100 grams of creatine or you’re paying $6.99 for 100 grams of this creatine. It can be equally effective just to take this product and co-ingest it with your meals and snacks throughout the day.

Play by the Rules From a time perspective, it’s my belief that athletes only have a defined attention span for any one particular thing at a time and if they’re focusing their energies in regards to supplementation, especially if it’s inappropriate supplements, they can be better off focusing their time on recovering modalities or skill acquisition, for example.

Anti-doping violations, whether they be direct or indirect; so an example here, this is the attitude to doping amongst males and females of those that are consumers of nutritional supplements versus those that are not consumers of nutritional supplements.

And what you find is that doping incidents is about 22% among supplement users but only 6% among non-supplement users. And the take home message from that investigation was that athletes who engage in legal performance enhancing practices appear to embody an at-risk group that are more likely to dope into the future.

This is a highly publicized study that was commissioned by the international Olympic committee. They went and sourced out 634 supplements across Europe and the U.S. and they analysed them for the contamination of doping substances. Nothing on the list of ingredients that would suggest there was doping substances within them but they found on average, about 15% of the products that were tested contained sufficient amounts of doping substances to result in a positive doping test. Now you can see the incidents there is according to the country and again, perhaps that shouldn’t be surprising given the vast majority of supplements from each of those respective countries are going to come from just one or two different powder blending facilities.

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