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What’s the “evidence” behind sports performance products?

Many advertisers of dietary supplements and other sports-related products make claims of enhanced performance and recovery, but a recent review found that the current evidence supporting these claims is mostly insufficient.

The dietary supplement and fitness industries are filled with sport drinks, powders, bars, pills, gels, footwear, clothing, and an array of devices all claiming to provide you with a competitive advantage, whether it be improved performance or enhanced recovery. With the ever-growing popularity of team and individual sports, professional and recreational athletes of all ages are an easy target for these claims. But how many of these claims are backed by evidence-based research?

A recent report now reviews the quality of evidence behind the claims of improved sports performance made by advertisers for a wide range of sports-related products, including sport drinks, supplements, footwear, and clothing. The team identified 431 performance-enhancing claims for 104 products advertised in more than 100 general, sport, and fitness magazines in the UK and U.S. for a single month in 2012. They found that more than half of the advertisements and their associated websites provided no evidence to support the claims of enhanced sports performance. Only 146 references were found, and only 74 of these met basic criteria for research quality and almost all of the 74 were found likely to be biased or lacking scientific objectivity. Only three studies were rated as “high” quality and probably unbiased. Such lack of evidence makes it very difficult for consumers to make well-informed decisions about using performance-enhancing sports products.

This review makes it clear that many of the claims made for sports and fitness products lack reliable evidence to support them and that more and better studies are needed to help inform consumers. In the meantime, consumers should be cautious when reading claims of enhanced performance and recovery and always remember that “true” evidence-based results mean that a substantial number of independent research studies have been performed, with findings that clearly support the claims made by advertisers. Presently, there is still no substitute for sound physical conditioning and nutrition practices.

For more information on dietary supplements and how to choose supplements safely, please visit Operation Supplement Safety (OPSS). For information on physical fitness and conditioning, please explore HPRC’s Physical Fitness domain. The original British Medical Journal open-access article is available online.

What is Tribulus terrestris?

What is Tribulus terrestris and why is it used in some dietary supplement products?

Tribulus terrestris is used as an ingredient in some dietary supplement products marketed as testosterone “boosters” and/or to enhance muscle strength. What is it and does it work? Read this OPSS FAQ about Tribulus terrestris to find out. Also, be sure to check the OPSS section often, as we add answers to other questions about ingredients in performance-enhancing and bodybuilding supplements. OPSS can help you learn how to choose supplements safely.

If you have a question about a particular dietary supplement ingredient or product, and you can’t find the answer on our website, please use our “Ask the Expert” button located on the OPSS home page.

What are Cheeba Chews?

Are Cheeba Chews legal? And what exactly are they? Read the OPSS FAQ to find out the answer.

Cheeba Chews are marketed as chocolate taffy, but they actually contain an illegal substance. Read the Operation Supplement Safety (OPSS) FAQ to find out more about these products and whether they are legal for members of the military community to consume. Be sure to check back often as we add answers to other questions and topics in the OPSS section of HPRC’s website.

DMAA products’ downward spiral

HPRC’s updated list of DMAA-containing products shows the impact of FDA’s announcement in April that dietary supplements containing DMAA are illegal.

Since we first posted our list of DMAA-containing dietary supplement products in December 2011, and especially since FDA’s announcement in April 2013, the number of products being manufactured with this ingredient has continued to decline. Our search does still occasionally turn up products with DMAA that were not on our previous lists: just six new products have been added since our last update in April 2013. Despite these additions, this update shows that about 80 dietary supplement products are apparently still being manufactured with DMAA, but note that many are by non-U.S. sources. Over the lifetime of this list 125 products have been discontinued or reformulated to exclude DMAA, including some of the most well-known ones. To the best of our knowledge and searching, 68 of these no longer appear for sale, even from distributor stock. You'll find our updated list of products containing DMAA here.

Dendrobium in dietary supplement products

 What is dendrobium, and why is it being used in dietary supplement products?

Dendrobium is being used as a dietary supplement ingredient in some pre-workout products marketed to enhance physical or athletic performance. What is it? And is it effective? Read this OPSS FAQ about dendrobium to find out. Be sure to check back often, as we add answers to other questions about ingredients in performance and weight-loss supplements and how to choose supplements safely.

If you have more questions about a particular dietary supplement ingredient or product, please use our “Ask the Expert” button located on the OPSS home page.

Here's how you shouldn't "spice" up your career!

HPRC Fitness Arena: Mind Tactics, Total Force Fitness

Synthetic drugs are laboratory-made substances marketed and sold as alternatives to illegal drugs such as marijuana, cocaine, and amphetamines. Although most are advertised as “all-natural,” they may have serious health effects and violate the Uniform Code of Military Justice (UCMJ). HPRC takes a look at two examples of synthetic drugs, their legal status, and how they can affect service members in “HPRC’s Answer: Synthetic Drugs of Abuse.”

What’s the story with carnitine?

Carnitine, a component that occurs naturally in red meat (and sometimes is added to dietary supplements and energy drinks), may help reduce complications associated with heart attacks, but new research suggests it also may contribute to heart disease.

Carnitine is a naturally occurring substance in the human body that helps cells use fat for energy. The liver and kidneys can produce carnitine from amino acids provided by the diet, but carnitine also comes from many foods, especially red meat, and is an ingredient in many dietary supplements and energy drinks.

Sometimes doctors use carnitine to treat certain heart conditions. Recent clinical trials suggest that carnitine supplements may help reduce many of the complications associated with heart attacks, such as chest pain and irregular heart rhythms.

But new research suggests that long-term consumption of dietary carnitine also may play a role in the development of atherosclerosis—“hardening of the arteries”—especially in people who eat red meat regularly. So what’s the bottom line? More research is needed to determine the risks and benefits associated with carnitine.

You can learn more about carnitine in HPRC’s Dietary Supplement Classification System.

FDA warns: DMAA in dietary supplements now illegal

FDA urges consumers to check all dietary supplement product labels to ensure they do not contain the illegal stimulant DMAA.

The Food and Drug Administration (FDA) has issued a Consumer Update warning of the potential dangers of DMAA, which was announced illegal in dietary supplements on 11 April 2013. DMAA is also referred to as dimethylamylamine and other names. This dietary supplement product ingredient has been used in many weight-loss, bodybuilding, and performance-enhancement products. FDA received numerous reports of illnesses and death from the use of products containing DMAA; commonly reported reactions include heart and nervous system problems as well as psychiatric disorders. DMAA has been the focus of conflicting information regarding whether or not it is a natural extract from geranium. FDA has now found “the information insufficient to defend the use of DMAA as an ingredient in dietary supplements.” Online, FDA also stated, "Dietary supplements containing DMAA are illegal and FDA is doing everything within its authority to remove these products from the market."

For more information, read the FDA Q&A on DMAA here.

FDA Warns Consumers about DMAA

FDA urges consumers to check all dietary supplement product labels to ensure they do not contain the illegal stimulant DMAA.

The Food and Drug Administration (FDA) has issued a Consumer Update warning of the potential dangers of DMAA, which was announced illegal on 12 April 2013. DMAA is also referred to as dimethylamylamine and other names. This dietary supplement product ingredient has been used in many weight-loss, bodybuilding, and performance-enhancement products. FDA received numerous reports of illnesses and death from the use of products containing DMAA; commonly reported reactions include heart and nervous system problems as well as psychiatric disorders. DMAA has been the focus of conflicting information regarding whether or not it is a natural extract from geranium. FDA has now found “the information insufficient to defend the use of DMAA as an ingredient in dietary supplements.” Online, FDA also stated, "Dietary supplements containing DMAA are illegal and FDA is doing everything within its authority to remove these products from the market."

For more information, read the FDA Q&A on DMAA here.

Energy drinks and adolescents – a risky combination

Energy drinks and adolescents can be a dangerous combination, especially because of the amounts of caffeine and other stimulants that may be in these products. Educating youth about potential risks is very important.

Energy drinks have been in the news lately, mostly due to media reporting on a group (doctors, researchers, scientists, and politicians) writing to the Food and Drug Administration (FDA) to express concern over the use of these drinks by adolescents. Much of the concern has to do with the amounts of caffeine in these drinks, among other issues. Energy drinks also may contain large amounts of other stimulants, including guarana, yohimbe, yerba mate, kola nut, methylsynephrine, Citrus aurantium (Bitter Orange), and Ma Huang (ephedra). Although listing the total amount of caffeine on the label would help, consumers should be aware that there are often other stimulants in energy drinks.

The American Academy of Pediatrics has written several articles over the last year about the potential risks associated with the adolescent population using energy drinks. One very recent article outlines the harmful effects of energy drinks on adolescents, including increased heart rate, high blood pressure, anxiety, digestive problems, sleep disturbances, and dehydration. The withdrawal effects after habitually consuming energy drinks is also an issue, as it can lead to headaches and attention problems. Also, the ingestion of energy drinks by adolescents who take prescription drugs for Attention Deficit Hyperactivity Disorder (ADHD) or who have eating disorders or diabetes is another topic of concern.

The amount of caffeine contained in energy drinks is not regulated, as the FDA does not regulate caffeine in foods or beverages, except that the maximum concentration for caffeine in cola beverages is 71 mg per 12 oz. The amount of caffeine in energy drinks ranges from 50 to more than 500 mg per can or bottle. The American Academy of Pediatrics recommends that children and teens drink no more than 100 mg of caffeine per day. To put that in perspective, an eight-ounce cup of coffee typically contains about 100 mg of caffeine (or more), and the most popular caffeine-containing sodas contain around 30 to 55 mg in a 12 oz. can. Not knowing how much caffeine and other stimulants are contained in energy drinks is a potential health threat.

Furthermore, the caffeine and other stimulants contained in the energy drinks, when combined with alcohol, can mask the symptoms of alcohol intoxication, potentially leading to risky behavior. The American Academy of Pediatrics advises parents and doctors to talk to children about the dangers of mixing alcohol and energy drinks, and the Centers for Disease Control and Prevention has a fact sheet on the potential risks.

Parents, educators, and healthcare professionals need to focus on educating adolescents about potential problems associated with consuming these high-stimulant products. Companies are heavily marketing their products by featuring athletic superstars, which causes children and adolescents to confuse energy drinks with sports drinks. Generally speaking, adolescents don’t need energy drinks, and they should be made aware of the potential dangers. It’s definitely a case of “buyer beware.”

Visit HPRC’s Operation Supplement Safety (OPSS) to access resources on the informed use of dietary supplements.

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