Introduction
Athletes have a higher requirement of their bodies and it is no surprise that they need the nutrition to match. It is important not only to address common nutrient deficiencies that exist in the general population but also address areas where athletes are expected to have higher requirements such as protein and energy.
Also, there are a few important supplements that have been proven to improve performance, mental energy when exercising (ergogenic) and recovery. We shall review a few of them here.
Nutrition
Firstly, no supplement or compound will help if the foundational nutrition is not right. Eating a well balanced diet of >50% fruits and vegetables as well as wholesome non-processed foods and good dietary fats and proteins is worthwhile. Fasting between meals improves gut performance and adequate sleep and mindfulness is helpful.
Assessment
A regular assessment is important in athletes to get ahead of problems. Studies have shown that athletes seem to be lower in iron, magnesium and phosphorus; however these studies were in western populations; if you train overseas things might be different. The modern western diet is a constant state of flux and so it is important to be guided by your coach or nutrition practitioner.
Blood tests in the following areas can help determine what your needs may be.
Recommended Tests
Homocysteine
Homocysteine is involved in methylation; a series of chemical reactions involving B6, B12 and folate that help switch our genes on and off. High homocysteine reflects B12 and folate deficiency. High levels are associated with an increased risk of heart disease.
B12
Vitamin B12 is an important Vitamin for many bodily functions, such as brain health, blood cell production and proper nerve functioning. Vitamin B12 deficiency is a common condition. B12 helps with methylation. Active B12 is a more useful blood test than standard B12.
Red Blood Cell or RBC Folate
Folate is an essential vitamin for methylation, liver function, detoxification and nerves. It is commonly deficient, especially in the context of alcohol intake.
Zinc
Zinc is an essential mineral or metal. Soils in much of the world are deficient in Zinc. Low Zinc can be associated with oily skin and acne, low energy, low hormones. Zinc is essential for many pathways in the body. Often a deficiency is associated with white lines in the nails and a sluggish immune system.
Magnesium
Magnesium is a type of an electrolyte that is responsible for many important functions and processes in your body. Your body needs magnesium to help your muscles, nerves and heart work properly. Magnesium also helps control blood pressure and sugar.
Liver tests
Liver function tests help determine the health of your liver by measuring the levels of proteins, liver enzymes and bilirubin in your blood.
Thyroid Hormone Panel
The thyroid gland processes hormones that regulate your body’s metabolism (weight, temperature, energy). Thyroid blood tests are used to tell if your thyroid gland is functioning properly by measuring the amount of thyroid hormones in your body.
Testosterone
Testosterone is a male hormone. It is present in males (600-1000 ng/dL) and also females (circa 30-40 ng/dL) It is important for immune regulation, bone
and muscle health, mood, fat mobilisation, insulin reduction and body shape.
Cortisol
Cortisol is a stress hormone made by the adrenal gland. It surges to its highest level in the morning and reaches a level half of that in the afternoon. High levels of cortisol are associated with endocrine disorders whilst low levels may signify poor health. There are more accurate tests for cortisol that include taking repeat samples throughout the day.
Growth Hormone
IGF-1 is produced by the liver in response to Growth Hormone. It is a rough indicator of Growth Hormone activity. A youthful level is 300ng/mL and this declines over age. Growth Hormone is released by fasting, exercise, high protein and low carbohydrate meals and good sleep.
Female sex Hormones: Estradiol and Progesterone
There are three kinds of estrogen. Estrone is a weak estrogen from fat tissues, estradiol is the dominant form in fertile women and estriol is made in pregnancy. It is typical to measure Estradiol or E2, which is the the form of estrogen made mainly by the ovaries in women. E2 plays a key role in the development of the female reproductive system. In men, Estradiol plays an important role in counteracting testosterone. A normal range for men is between 20-40.
Vitamin D (25Hydroxy)
Vitamin D is important for strong and healthy bones and may prevent a number of diseases. Your body produces vitamin D when your skin is exposed to sunlight. It is customary to test for 25 hydroxy (25 OH) Vitamin D; however supplementation is usually with Vitamin D3, a precursor to 25OH. To make things confusing, the body then turns 25 OH vitamin D to 1, 25 vitamin D.
Common Sports Supplements
Creatine
Creatine is an amino acid found in protein and seafood. Creatine lives in our muscles and some of it is routinely broken down due to muscle metabolism; thus it has to be replaced each day. It is made in the liver or obtained from the diet.
Studies about creatine show:
- Creatine increases ATP, which is the energy molecule in cells.
- Creatine can be helpful for mitochondrial energy and brain cleanup
- Creatine is associated with better recovery from injury
- Creatine helps muscles retain water and so helps with training in the heat
- Creatine has some protective injury against brain injury such as concussion It provides 12-20% improvements in strength and power.
It is obtained from meat sources but is generally supplemented for weight lifting at 2.5-5g per day after a higher loading dose of 25-30g per day for a week.
It contains antioxidants which help cell recovery as well as arginine which helps blood flow. This can help brain function and mood.
Some people find that they get a few side effects when taking creatine; usually it’s fluid or weight gain, dizziness, muscle cramps etc.
Beta Alanine
Beta alanine is an amino acid that is a vital precursor to carnosine. Carnosine accumulates in high levels in muscles and the brain where it is an antioxidant, pH buffer and helps muscle function. Carnosine neutralises lactic acid in the muscle.
Carnosine
Carnosine is most useful in high intensity bursts of activity (rowing).
It can cause tingling in some forms; it is best to take with sodium bicarbonate in a timed release
It is loaded for a few weeks at 3-6g per day.
Supplementation with Beta alanine has been shown to increase carnosine in muscles
It decreases fatigue in athletes and increases the muscle work
Caffeine
Caffeine is a well known molecule. Coffee itself has other beneficial compounds in it, owing to its properties as a bean. The exercise benefits of caffeine are broadly due to its effect on mental energy and alertness as well as its ability to break down fats. Caffeine has been used in athletics for over 100 years.
Caffeine helps with alertness and also neurotransmitters such as serotonin, adrenalin and dopamine.
Caffeine helps move fatty acids for use as energy and is shown to increase athletic performance in many studies.
Caffeine also helps people perform by acting as a exertion booster.
It should be remembered that caffeine is broken down differently depending on our genes. There are genetic tests, of CYP1A1 gene (AA, AC and CC) – the CC types often do not get an increase in energy out of caffeine.
Dosing of caffeine.
200mg per day (one espresso) for fat burning and 500mg for bodybuilding; it takes 20 days to get tolerant to the agitation.
Flavonoids (Blackcurrants)
It is well known that plants contain a number of biologically active compounds. Flavonoids are one such compound and are derived from roots, bark, fruits, leaves, vegetables, flowers, tea and wine.
They broadly have antioxidant, anti inflammatory and anti-cancer effects to name a few.
The effects of flavonoids are broad and include: an increase in fat oxidation and switching on genes in fat oxidation. Some studies show an increased blood flow as well.
Some people take them for enhanced recovery.
Collagen and bone broth soups
Collagen is a structural molecule in muscles and skin. When we workout, we need to rebuild these structures. When taken with vitamin C, collagen enhances recovery of microdamage in bones and tendons.It is a useful building block.
This is similar to how it is used within the beauty industry to give thicker and more healthy skin.
Studies show an increase in fat-free mass for those on collagen.
Collagen peptides, the bricks of collagen, have been shown to improve ankle instability
Collagen peptides have been shown to improve muscle soreness post-exercise.
Minerals and hydration
Minerals are naturally occurring metals that our body needs and are used in the dissolved state in the body. Many athletes are low in magnesium, as are the general public. Ensuring minerals like magnesium and sometimes potassium are replenished with a broad diet and sometimes hydration drinks helps optimise performance. Magnesium is a common constituent of workout powders.
Iron and Magnesium have the most evidence for use in sports; with rectifying any deficiencies otherwise recommended.
Heffernan et al (2019) state:
In conclusion, the current evidence suggests that 300–500 mg·day−1 for short term supplementation (~1–4 weeks) can have a positive influence on functional dynamic measures of muscle performance (CMJ, 1RM and fatigue resistance) and exercised-induced inflammation, DNA damage, cortisol and immunological blood markers, but no effect on isokinetic performance
Glutamine
Glutamine is an amino acid. It is related to Glutamate, which is an important neurotransmitter in the brain. Glutamine is typically used for gut repair, immune modulation but also has antioxidant and healing properties in the muscle which helps performance and recovery. It also helps with energy.
Glutamate stimulates the creation of glutathione which is the master antioxidant in the liver. After exercise, there are quite a few toxins to breakdown to enable recovery and so glutamate helps with this.
Athletes who train a lot often chew through their glutamine and studies show that it can be deficient over the long term in athletes.
A diet rich in glutamine was shown to improve physical performance.
Glutamine is anti-inflammatory and helps muscle cells become resistant to the accumulation of CK and LDH, markers of muscle fatigue.
When used with Alanine it helps cells retain sodium and thus helps with dehydration
L-alanine and L-glutamine combinations improve the ability of either to cross from the gut into the body.
Dietary patterns
Athletes are advised to discuss their nutrition with a dedicated trainer or nutritionist. Diet is a very important part of training and requires experienced and expert advice.
Many athletes choose to fast, which is fine so long as they manage calories.
Preworkout and postworkout diets have emerged. In general, protein is taken during or after a workout whilst preworkout often involves hydrating minerals (especially magnesium and potassium) as well as caffeine and good fats for fat burning. Some athletes will start the morning with black coffee and some fat (such as olive oil or coconut oil) and a mineral shot.
L carnitine helps fatty acid oxidation
Caffeine helps fatty acid oxidation
Coconut oil in an espresso will not break a fast
Summary of Tests
- Ferritin (for iron)
- Homocysteine
- Active B12
- Zinc
- Liver Function Tests
- Total Testosterone
- IGF-1
- Folate
- Thyroid Function Tests
- Cortisol
- Vitamin D
- Magnesium (500mg twice per day)
- Zinc picolinate (15-30mg twice per day)
- Iron (test and replace as needed)
- Collagen (~3g per day based on formulation)
- L carnitine
- Glutamate (as a powder)
- Caffeine (200-500mg, some will increase to 600mg)
- Creatine 5-10g
- Beta Alanine
- Flavonoids
References
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