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HPRC Fitness Arena: Dietary Supplements
Vitamin E has been in the news lately, mostly regarding its use in preventing prostate cancer. Recent findings suggest it actually may increase prostate cancer risk instead. For additional information, read HPRC’s Answer about vitamin E and prostate cancer risk.
The Paleo Diet, also known as the Paleolithic or Caveman Diet, is based on the notion that by consuming what humans ate during the Paleolithic Era—wild animals, plants, eggs, tree nuts, vegetables, roots, fruits, and berries—we will be healthier, have lower disease risk, and live longer. Hunters/gatherers during that time had to rely on what was available and had no agriculture. But what are the implications of this type of diet for the athlete, let alone the average individual?
Foods that were grown and introduced after the Agricultural Revolution (roughly 10,000 years ago) are not allowed in the Paleo Diet. That means dairy and dairy products, grains, and legumes (beans, peas, and lentils) are excluded. Proponents of the Paleo Diet believe that we are “genetically programmed” to follow the diet of the hunters/gatherers. A specific book has been written for athletes who want to follow this diet, which accommodate athletes by allowing some carbohydrates: The authors present five stages of eating for the athlete to follow, based on the glycemic index (GI; how quickly food raises blood glucose levels). The stages are: (1) eating before exercise, (2) during exercise, (3) and 30 minutes after exercise, and (4) during post-exercise extended recovery and (5) long-term recovery. Low- to moderate-GI carbohydrates are recommended at least two hours prior to exercise. Sports drinks or high-GI carbohydrates are recommended for exercise lasting longer than 60 minutes. Immediately after exercise a recovery drink with carbohydrate and protein in a 4:1 to 5:1 ratio is recommended. Stage IV recovery foods (extended recovery) should be a 4:1 to 5:1 carbohydrate-to-protein ratio, with carbohydrates such as raisins, potatoes, sweet potatoes, and yams. Stage V recommends focusing on eating from the main Paleo Diet, with carbohydrates coming from fruits and vegetables. So one could argue that the Paleo Diet for Athletes is like most diets for athletes in that it requires carbohydrates. However, the Paleo Diet for Athletes is higher in protein and fat and lower in carbohydrates than what is recommended for athletes by most health professionals.
What we do know from scientific research is that carbohydrates provide the energy needed for endurance and resistance training, competitive athletic events, mental agility, and healthy living. Complex carbohydrates such as fruits, vegetables, whole-grain pasta, rice and grains, beans, and other legumes contribute to an overall healthy eating plan. By limiting consumption of some of these to only a brief time after exercise, the athlete runs the risk of not having enough fuel for the body, so the body will use protein for energy. Low-fat dairy products also contribute to a healthy lifestyle, providing much-needed calcium and vitamin D as well as probiotics. The Paleo Diet eliminates dairy entirely, even for athletes.
We also know from the scientific literature that during the post-exercise period, within roughly 30-45 minutes of exercise, eating a carbohydrate/protein snack, generally with a 3:1 carbohydrate-to-protein ratio, is essential to stimulate re-synthesis of muscle proteins and replenish glycogen (the storage form of carbohydrate). It doesn’t stop there: It is important to maintain glycogen levels in the muscle and liver to sustain all activities, especially over the course of several days. Eating high-carbohydrate snacks between training sessions is important to replenish glycogen stores. Carbohydrate intake recommendations for athletes are 6 to 10 g/kg body weight per day, or roughly 55% of daily calories from carbohydrates.
What’s the bottom line? Grains and dairy products are staples of modern-day society and provide essential nutrients to an overall healthy diet. By eliminating one or more food groups, you run the risk of missing important nutrients. And can we really eat as humans did during the Paleolithic era? Their life expectancy was about one quarter to one half of what ours is, and we benefit from research showing that eating a variety of foods over the course of time provides us with energy and the important vitamins and minerals needed to sustain us in daily activities and exercise.
A myriad of dietary supplements make their way to the market labeled as “healthy” for the public. However, many contain dangerous substances, including steroids, and consumers have no idea they are taking harmful substances. Supplement Safety Now, a public protection initiative, was founded by the U.S. Anti-Doping Agency to make sure over-the-counter supplements are safe for consumers. For more information, read more about this initiative.
Salmon is commonly touted for its omega-3 fatty acids. HPRC recently received a question about what foods other than salmon are the best sources of omega-3 fatty acids. For a complete answer, including the recommended intakes from the American Heart Association, please see HPRC’s answer.
Many adverse events associated with dietary supplement use go unreported. HPRC has developed one page information resources on how to report adverse events. Warfighters and their families can follow the directions for reporting adverse events to MedWatch (FDA) and Natural Medicines Watch. In addition to these sites, Health care providers can follow step by step directions for reporting via AHLTA.
Apidexin is a weight-loss supplement that contains vitamin B12, chromax (a form of chromium), and a proprietary blend of various ingredients. One of the ingredients is guggul, which has been associated with side effects such as headaches, nausea, vomiting, diarrhea, skin reactions, and more. Other ingredients in Apidexin with known side effects are Irvingia gabonensis and DiCaffeine Malate. Both been associated with headaches and difficulty sleeping, and the latter also can increase heart rate and raise blood pressure. And keep in mind that there’s no data on how all of these ingredients might act together. For more detailed information, read HPRC’s Answer to a recent question about the side effects of Apidexin.
Looking for programs to help manage your weight? The Human Performance Resource Center just posted its new “Fighting Weight Strategies” page, where we have compiled a list of programs and resources, arranged by service, for maintaining overall health and body weight. You can find these helpful resources by going to the Fighting Weight Strategies page of HPRC’s website.
HPRC recently wrote about “The Lure of Jack3d” and answered a “Question from the Field” about . Jack3d is marketed as a pre-workout supplement and OxyElite Pro is marketed as a fat-burner product. Both contain the ingredient 1,3-dimethylamylamine (DMAA). Since we last wrote about both products, there have been new reports about DMAA.
Makers of Jack3d and OxyElite Pro claim that DMAA is a “natural constituent” of the geranium plant. DMAA was originally patented as a drug in the U.S. by Lilly in the 1940s. Since then, it has been identified on many product labels (especially on sport, energy, and weight-loss products) as being derived from geranium oil, stem, or extract, but review of the scientific literature has not substantiated this claim. To date, there is no credible scientific data that establishes the presence of methylhexanamine in geranium. Recently, the American Herbal Products Association announced that products containing DMAA (which can also be seen on labels as 1,3-dimethlypentlyamine, methylhexaneamine, or MHA, in addition to 1,3-dimethylamylamine) should be labeled as such and not as geranium oil or any part of the geranium plant. Health Canada has clarified that DMAA is a drug and must go through appropriate drug approval processes before it is used in any product. The United States Anti-Doping Agency (USADA) has long warned athletes about dietary supplements and more recently about the inclusion of methylhexaneamine in products under the guise of “geranium”; USADA has recently issued an advisory to athletes. There are questions about whether DMAA may be legally included in dietary supplements, since there is no credible evidence that it is present in geranium and it has not gone through the New Dietary Ingredient notification process with the Food and Drug Administration. Therefore, caution is advised when considering whether to use a product that contains this ingredient. Please be aware that such products may be sold in large retail nutrition outlets and on the Internet.
The United States Anti-Doping Agency (USADA) has issued an Athlete Advisory regarding methylhexaneamine, a prohibited stimulant. After reports that many athletes have tested positive for this stimulant, USADA is advising athletes to be cautious about taking supplements with methylhexaneamine, also referred to on labels as 1,3-dimethylamylamine (DMAA), dimethylpentylamine (DMP 4-methylhexan-2-amine), Geranamine, and geranium oil, extract, or stems and leaves. For more information, read the USADA Athletic Advisory.
If you are a healthcare provider, you may be interested in two new resources available on our website. One is “Guidelines for Taking a Comprehensive Dietary Supplement History” and the other is “How to Probe for Dietary Supplement Use and Report Adverse Events” [video]. Both of these helpful tools can be found on the website by clicking on the Dietary Supplements tab on the home page, then choosing Dietary Supplement Resources from the left-hand column, and then clicking on the Resources tab on the next window.