by Tim Curry, MS ACSM-RCEP

What supplements should I take?

When you walk through almost any grocery store, convenience store, or pharmacy you’ll often find a wide variety of supplements to choose from. These options include standard vitamins and minerals as well as sport-focused aids claiming performance enhancement properties. How do you know which ones actually work? What risks are there in taking supplements? How should you choose an option that’s right for you? These are a few of the questions we’ll cover in this three-part series on supplements. 

Before we begin, be aware that the information found in this article is for educational purposes only. As with any aspect of your health, speak with the appropriate healthcare professional prior to making adjustments to your healthcare routine. This is especially true for changes to diet and exercise as they can have a drastic impact on pre-existing conditions. 

Let's start with the basics

Consider what’s in a name. You’ll see many terms used to describe the benefits of various pills, powders, and drinks. Instead of trying to decipher industry jargon of the ever-expanding selection of supplement options, let’s focus on the terms used in the research and by field experts:

  • Supplements - Used to correct a dietary deficiency that is present and could be caused by various reasons. 
    • This includes vitamins and minerals, as well asmacronutrients (carbs, fats, and proteins). 
  • Ergogenic aids - Specifically marketed or intended to improve the performance of some aspect of our physical fitness.

Now that we are all on the same page with these terms let’s dive into the details.

What supplements do I need?

You should be pleased to know that overall, when it comes to dietary deficiencies related to major vitamins and minerals, we are doing well as a nation. The most recent National Health and Nutrition Examination Survey’s Nutrition Report shows that as a whole there is no specific area where we are lacking, with the understanding that there’s still plenty of room for improvement. For example, it points out that certain populations have growing issues with certain vitamins or minerals. For more information on this, check out the executive summary, or you can take a deep dive into the entire report

You may be wondering whether you should be concerned with dietary deficiency yourself. It’s always a good idea to discuss this type of question with a registered dietitian or physician. If you have specific signs or symptoms present they can order specific blood tests in order to assess your current status. The most common recommendation regarding supplementation is to only add in supplements to correct a known deficiency. 

Are there other methods to prevent dietary deficiency without turning to supplements? The answer is yes! There’s a simple and effective approach you can start today! Aim to eat a well-rounded, healthy diet. New dietary fads can muddy the waters on what this actually means. For your health, this means lots of fruits and veggies, lean meats, whole grains, and healthy fats. In this regard, there is one diet approach that stands above the rest: the Mediterranean diet. It’s generally easy to follow and incorporates the healthy nutrients we want while reducing (but not banning) less healthful items we might over-indulge in. Established research on the positive overall health outcomes attributed to the Mediterranean diet means it’s recommended for almost everyone including generally healthy individuals, cardiac patients, cancer patients, diabetics, and more. This is one of the best-supported dietary changes you can make if you’re looking to improve your dietary intake. 

What about ergogenic aids?

There are many great questions we can discuss here. As athletes, we’re often focused on our performance, but what, if any ergogenic aids are necessary? When do we cross the line from legal aids to illegal doping? What are the health risks of taking an ergogenic aid? 

We’ll get into the topics of risk later but let's start with the basics, what should you take? Before we even discuss the philosophical questions of taking performance enhancement aids let’s start with the data. When incorporating something to enhance our performance, we’d prefer if it’s actually effective at its claim. A recent review of all the scientific research literature on sports supplementation, including ergogenic aids, published by the International Society of Sports Nutrition found that only eleven of fifty different ergogenic aid ingredients had strong evidence to support both their efficacy and safety. The rest had limited, mixed, or no evidence. So what did they find that worked?

It may not be a surprise that caffeine, appropriate carbohydrate and protein ingestion, and hydration (water and sports drinks) all show clear performance-enhancing effects, but these aren’t what most of us think of as “ergogenic aids”. So what about the pills and powders we see on shelves? The data shows some potential to including what the authors call the most effective choice: creatine monohydrate. However, before you race off to the store it’s important to ask yourself whether this actually applies to you and the demands of your sport. Creatine monohydrate shows improvements in increasing high-intensity exercise capacity (ex. all-out sprinting) and lean body mass gains. If you’re a road cyclist or mountain biker neither of these is particularly helpful to our heavily aerobic sport. Should you choose to use it you will also need to research what the most effective protocol is for the results you want. This can be a lot of work! Effective use of ergogenic aids isn’t as straightforward as buying what sounds good and following what the package says. 

Ok, but should I use them?

This is a question only you can answer, but here are a couple of things to consider:

  • Is it safe for you? Lack of regulation is a significant concern in this area of nutrition. As such the best advice if you are considering an ergogenic aid is to consult with the appropriate medical professional to eliminate or reduce harm to your health. 

  • Is it legal for your sport and goals? If you’re competing it’s important to check with the governing body as to what is and isn’t allowed. It’s also important to be aware of the lack of regulation on these products, which we’ll discuss in a later part of this series. If you consume a product that’s tainted with something that is illegal it will still count as a positive doping test even though you didn't mean to consume it; as we saw in 2019 with Enduro World Cup racers Richie Rude and Jared Graves.

  • How do you feel about it? While consuming increased carbs and water to support performance is almost never an issue of morality, specifically consuming additional substances for the express purpose of enhancing performance is not as clear cut. On this topic, you have to make up your own mind based on what you believe is morally right. It can be helpful to explore a bit about how we make ethical choices. This PBS Crash Course video playlist offers tons of excellent options to help. If you don’t want to go through all of the videos I would recommend starting with an overview of philosophy, and learning about egoism, relativism, utilitarianismvirtue ethics, and contractarianism. Learning a bit more about how you judge what is morally right or wrong can help you answer this question for yourself. 

Learn more about how to safely promote improved sports performance through easy and effective dietary approaches by checking out any of the courses below. In the next part of this series, we’ll examine the regulation and risks of using supplements when it comes to sports. 

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