The new term here in the US is Sports Supplements but the story remains the same.

The desire to find a supplement that will produce bigger, leaner, muscles more quickly. A supplement that will allow muscles to work longer. A pill that can provide you more energy to train harder. What is more American than wanting to perform better? The Anabolic Steroid Control Act, passed in 1990, which outlawed steroids, apparently sent many athletes looking for an alternative. These athletes received help in their search when Congress passed the Dietary Supplement Health Education Act (DSHEA) in 1994. DSHEA states that dietary supplements are not drugs and therefore, not subject to FDA regulation. This left the supplement industry to regulate itself. The era of legal performance enhancing supplements had arrived. The supplement industry would give athletes the safe steroid-like alternatives they were looking for.

Energy supplements would be provided. Weight loss or weight gain supplements recommended and everyone would be able to reach their maximum goals. It started with creatine monohydrate. Next came the androgen steroid precursors - supplements like DHEA and androstenedione, androstenediol and norandrostenedione. Ephedra, caffeine, and guarana became the booster supplements to provide more energy or to facilitate weight loss. However, harmful side effects occurred. There have been over 80 known deaths attributed to ephedra alone. What followed next was the banning of these supplements by major sport organizations like the International Olympic Committee, the NCAA, the Amateur Athletic Union and many others. Unfortunately, the use of potentially harmful supplements continues.

David Schardt, associate nutritionist at the Center for Science in the Public Interest, knew what went wrong, “The labels are often misleading, incomplete, and not a guide to using the product.” Larry Bowers, professor and director of the athletic testing and toxicology laboratory at the Sports Medicine Identification Laboratory at Indiana University Medical Center knew even more. His laboratory was frequently asked to test performance enhancing supplements and found that what is on the label is not what is in the bottle. “Since there is no regulatory oversight of the compounds and there’s no one checking to see what’s in it, it could be anything.” How many times have we heard a professional athlete say he did not know the supplement he was taking contained ephedra or a steroid. It is because you cannot rely on the label to tell what is actually in many of these supplements.

A recent survey of athletes and fitness regulars who took a performance-enhancing supplement revealed that 97% knew they caused harmful side effects or worse. However, the majority of athletes believed the performance claims made by the manufacturers and believed the claims were based on actual data. This is clearly not the case. The other reason people take these supplements is because they want results and they believe performance-enhancing supplements are the answer. The time has come for health care professionals and fitness professionals to convince our clients that the best route to building muscle is the old fashioned way: eat a healthy diet and make a commitment to training.

The fitness equipment industry has provided us with the best training equipment ever seen. We have more qualified fitness professionals than ever before to instruct clients on how to use the equipment safely and how to avoid injury. But we must practice what we preach. The commitment to what we know is right must be stronger than the desire to please.

Health care professionals learned this lesson the hard way. We have created antibiotic resistant organisms simply because we gave our patients what they wanted when we knew an antibiotic was really not needed. The fitness industry professionals must not make that same mistake. Do not fall prey to the outrageous claims we hear every day about bodybuilding and performance-enhancing supplements. The data to support their use is simply non-existent and the sports supplement industry is not reliable.

As doctors, we are learning that our patients want to prevent disease by proper diet, nutrition and exercise. We do recommend safe, efficacious vitamins, minerals and phytonutrients that are not harmful and can prevent illness and disease. However, we do not recommend trendy quick fixes that have yet to be proven as safe. Quick fixes will not extend the quality of lives in medicine, nor will it in the fitness business.

John P. Mamana MD
CEO American Health Sciences

References:
Eichner ER: What Athletes are using and why. The Physician and Sports Medicine 25:4 Apr. 1997

Phys Med Rehabil Clin N Am. 2000 Nov 11(4): 949-60. Pecci, MA. Lombardo, JA.

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