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Why Your Efforts To Relieve Your Symptoms Aren’t Working (and what to do about it)

Nutritional Exercise Supplements

I’m often asked about supplements – do I need them, should I take them, what should I take?

supplements

Grab yourself a brew and have a read about nutritional supplements!

I’ve seen people in my local gym, along with my brother and husband who are well into their fitness, use a variety of supplements. Supplement use is not only rife in the gym culture, but also amongst athletes (Burke, 2017) and the Military.

Having been in the Army myself, I’ve seen how common supplement use is amongst British soldiers and even research has shown how prevalent it is, including when on Op tours (Boos et al., 2011; Casey et al., 2014).

Supplement use in the military is rife!

In this post I’ll talk about…

  1. Some common types of supplements;
  2. Risks and benefits – are they safe and effective;
  3. If you actually need to take supplements;
  4. A “Food First” approach;
  5. Protein and carbs;
  6. Overview of sodium bicarbonate, caffeine, nitrates and creatine
  7. Clean sport; and
  8. Some sources of support

Some common supplements

Supplements can include vitamins, minerals, sports/exercise supplements, meal replacements, herbs/botanicals, enzymes, hormones, fish oils, and pre- and probiotics.

Herbal supplements may sound like the natural and hence the safest option, but this isn’t the case. Another issue with herbal products is that they can also interact with medications.

Not all herbal supplements have standardised ingredients, so the amount of active substances they contain could vary, therefore you don’t know exactly what you’re getting.

Herbal remedies aren’t necessarily the safest option

Speak with your GP, Pharmacist or Dietitian if you’re unsure about nutritional supplements, such as checking need, doses, suitability and that they’re not going to interact with any prescription medications you may be currently taking.

Check with your doctor

I’ve seen a lot of people inadvertently taking excessive amounts of certain nutrients. Such as by taking a multivitamin & mineral supplement, as well as a “vitamin B complex” supplement and a cod liver oil. This resulting in “doubling up” on some nutrients, such as vitamins A and D and the B vitamins, which may be harmful.

There’s soooo many types of supplements and as such, this is a vast topic, so I can’t possibly cover everything (and bore you in the process!), so here’s a snapshot of some key points…

Minefield

It can be a minefield knowing what to take and when, especially as there’s so many supplements available. The UK supplement industry is worth millions, and appears to be continuing to grow (according to Mintel’s info on market trends (2016)).

It’s not just the UK industry that has an impact. Many people buy their supplements online, thus shopping from worldwide retailers, looking for cheaper options. But at what cost? Because how do you know who the seller is – are they reputable, how the product was made and handled, and if the product even works!

The supplement industry is poorly regulated and I find it worrying to think of all the people using these products and are willing, and/or oblivious to the risk they’re taking. I also detest the lack of morals by dodgy sellers wanting to cash in on this vast market.

Are they safe and effective?

For safety and to avoid wasting money, you need to do your research! Is it a genuine website, where you’ll actually get the product you paid for, if the products are free from contamination, safe to use, but also do they actually work!

Sometimes it’s hard to know what these supplements are, let alone if they work. It’s important to check Informed Sport (2017) to see if they’re certified and safe. Although just because it’s listed doesn’t mean it’s an effective sport supplement!

Do your research before using supplements

A product may have robust scientific evidence behind its effectiveness, but different people can respond differently to the same product (Burke, 2017).

A Sports Nutritionist or Dietitian can help you assess your need for supplement(s)

A qualified Dietitian or Nutritionist can help you – you can check the SENr website (The Sport & Exercise Nutrition Register) (2017a) to find a qualified sports nutrition professional.

They can help you by initially completing a “needs assessment” (i.e. weighing up if you actually need it, and the pros and cons of using a supplement), and then identifying the most appropriate supplement for you to try. However, the needs assessment may actually show that you don’t currently require any supplements.

Supplements are just that – they can supplement your diet

They’re convenient but not the solution to an unhealthy diet. You need to get the basics right first (SENr, 2017b), and if there are any “gaps”, or a “Food First” approach isn’t cutting it or practical, then a supplement can be added.

Get the basics right first

“A time and a place” for supplements

From my training and work, I know what a serious matter supplement use is, and have been trying to help my husband, brother, and clients understand this and promote a “Food First” approach.

Food First approach

A “Food First” approach is a cheaper and safer option that can improve your overall diet. There’s a time and place for supplements, but only once a needs assessment has been completed.

Times when a supplement may be required include:

  1. Nutritional inadequacy/deficiency
  2. Unable to get the nutrient in adequate amounts from your diet and
  3. Issues such as poor appetite and/or motivation to prepare some food after your exercise session, or
  4. Unable to access suitable foods/drinks

Protein and carbohydrate

Most gym-goers and people that are into keeping fit are aware of, and many use, a protein supplement (- a powder, bar, ready-made shake, gel).

Check out my High Protein Foods Vs Protein Supps blog.

However, you may not necessarily need to take it. People often believe “more is more” – I see this a lot with guys wanting to “get massive”.

An average UK adult easily exceeds the recommended daily amount of protein (BNF, 2012; NDNS, 2012; NHS, 2017). Therefore, the average gym-goer or even athlete, may not necessarily require extra protein in their diet. It may be more of a case of altering the type, timing and dose to help achieve a better outcome.

The same is true of carbohydrates. However, a less active individual will need a lower total carbohydrate intake, and excessive intake can lead to weight gain. A diet and exercise assessment would need to be completed before recommendations could be made.

There is a vast amount of evidence behind the use of protein and carbohydrates for exercise performance, and beyond the scope of this blog!

Get tailored advice from a qualified sport Nutritionist or Dietitian

(Rather than blanket advice which may not be most appropriate for you as an individual)!

Overview of some other performance supplements

Sodium Bicarbonate

Theory: Blood can become acidic due to hard exercise (which can increase fatigue), so the body produces “buffers” to neutralise it

Benefit: Taken before exercise it can help the body to buffer, and in turn, help reduce fatigue (Burke, 2017). Best for short duration, high intensity exercise

Risk: Potentially tummy upset

Caffeine

Theory: Caffeine is a stimulant and increases alertness

Benefit: Appears to reduce perception of effort or pain (and hence improve performance (IOC, 2016)). For high intensity exercise, and skill sports such as shooting and golf (Burke, 2017).

Risk: Includes sleep disturbances, increased heart rate and tremors, and very large doses are toxic (Dietitians of Canada, Academy of Nutrition & Dietetics and ACSM, 2016)

Nitrates

Theory: Nitrate intake can lead to increases in nitric oxide production, which improves blood flow

Benefit: Taken as food, increases your fruit and veg intake! Nitrates may improve high intensity exercise performance and recovery

Risk: Beetroot juice can discolour urine and faeces, but is not harmful. Beetroot/beetroot juice may be an issue for those that suffer with IBS.

Although not a risk, but the more fit you are, the less effective it is (McMahon et al., 2017).

Creatine

Theory: Phosphocreatine (PCr) is an energy source stored in the muscles, and therefore if creatine is taken, then it can boost the amount of PCr and thus improve performance (IOC, 2016)

Benefit: Supplementation could improve performance during repeated bouts of high intensity exercise

Risk: Can include gastrointestinal discomfort (Dietitians of Canada, Academy of Nutrition & Dietetics and ACSM, 2016), and weight gain (- therefore may not be appropriate for weight category sports such as boxing, or aesthetic sports such as figure skating, gymnastics, bodybuilding)

Clean Sport

Another important factor to consider, even if you are at the start of your career as an athlete, is if the substance is on the banned list. WADA’s (World Anti-Doping Agency) role includes education and monitoring of compliance to it rules/code – making sure athletes are not taking banned substances (-they have a prohibited list which is routinely updated (WADA, 2017)).

The UK Anti-Doping agency (UKAD) ensures WADA’s code is implemented and is dedicated to the culture of “clean sport” (UKAD, 2017a). “100% Me”(through UKAD) is about an athlete’s progress and success being solely down to their talent, hard work and dedication – clean and fair competition (UKAD, 2017b).

Like athletes, military personnel undergo drug testing – i.e. CDT (Compulsory Drug Testing), so it is essential that personnel also check Informed Sport. Informed Sport have a dedicated information section: http://www.informed-sport.com/armed-forces-education

5 Take home messages

1. Do you really need to use a supplement?

  • Can it be achieved through diet, good planning and advance preparation?

2. Is the product safe and actually contains what it states on the label?

3. Don’t be fooled by celebrity endorsement (or an amazing physique!)

  • They may not know exactly what the supplement is (!) and may not even use it!

4. If you do decide to use a supplement

5. ​Seek support from a qualified sport and exercise nutrition professional

Please feel free to drop me a line if you have any queries or comments.

 

Opinions all my own!

N.B. It is crucial to get your food and fluid intake right if you want to control your IBS symptoms, and if you want train harder, go faster and recover quicker from training sessions and competitions. Dietary requirements are highly individualised and there’s no ‘one size fits all’ approach. Working with a Registered Clinical & Sports Dietitian to develop a bespoke plan based on your unique requirements will help to ensure the most appropriate strategy and best results are achieved.

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new treatment or health care regimen, or before making any changes to your existing treatment, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

References and useful links
Boos et al. (2011). jramc.bmj.com/content/157/3/229 (Abstract only)
BNF. (2012). www.nutrition.org.uk/nutritionscience/nutrients-food-and-ingredients/protein.html?limit=1&start=2
Burke. (2017). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5371635/
​Casey et al. (2014) https://www.ncbi.nlm.nih.gov/pic/articles/pmc4189117/pdf/s00007114514001597a.pdf
Dietitians of Canada, Academy of Nutrition & Dietetics and ACSM (2016): noap-position-paper.aspx
Domínguez et al. (2017). Effects of beetroot juice supplementation on cardiorespiratory endurance in athletes: A systematic review. Nutrients, 9(1), 43-60.
EFSA. (2008). Opinion of the scientific panel on contaminants in the food chain on a request from the European Commission to perform a scientific risk assessment on nitrate in vegetables. EFSA Journal, 689, 1-79. doi: 10.2903/j.efsa.2008.689
Informed Sport. (2017). http://www.informed-sport.com​
IOC (2016): 1378_IOC_NutritionAthleteHandbook_1e.pdf
Jones. (2014). Dietary nitrate supplementation and exercise performance. Review article. Sports Medicine, 44(1), 35-45.
McMahon et al. (2017). The effect of dietary nitrate supplementation on endurance exercise performance in healthy adults: A systematic review and meta-analysis. Sports Medicine, 47(4), 735-756.
Mintel. (2016). ​http://www.mintel.com/press-centre/social-and-lifestyle/sports-nutrition-bulks-up-uk-market-sales-rise-by-27-in-two-years-as-one-in-four-brits-use-the-products
NDNS (National Diet & Nutrition Survey) (2012). www.ncbi.nlm.nih.gov/pmc/articles/PMC3328127/
NHS. (2017). www.nhs.uk/Livewell/Goodfood/Pages/reference-intakes-RI-guideline-daily-amounts-GDA.aspx
SENr. (2017a). www.senr.org.uk/
​SENr. (2017b). ​www.senr.org.uk/wp-content/uploads/SENr-Statement-updated-January-2017.pdf
UKAD. (2017a). ukad.org.uk
UKAD. (2017b). 100% Me. https://www.ukad.org.uk/education/athletes/
WADA. (2017). ​www.wada-ama.org/en/resources/science-medicine/prohibited-list-documents

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