Chapter 27:
Ergogenic Aids and the Female Athlete
Jacalyn J. Robert-McComb, Ph.D., FACSM
Shannon L. Jordan, M.S.
Texas Tech University
Health, Exercise, & Sports Science
Learning Objectives
Discuss potential reasons female athletes take supplements
Highlight likely supplements female athletes take
Describe the ergogenic and ergolytic effects of these supplements
Discuss standard dosages
What is an Ergogenic Aid and Why Do Women Take Them?
Ergogenic aids are items or substances which enhance performance.
Collegiate female athletes report taking supplements for the following reasons:
to improve health; to compensate for an inadequate diet; and to gain more energy.
According to Kristiansen, et al. (2005) and Froiland, et al. (2004), Female athletes use energy drinks and Female athletes use energy drinks and
carbohydrate/meal replacement products the carbohydrate/meal replacement products the most. most.
Protein products, amino acids, creatine, fat Protein products, amino acids, creatine, fat burners, caffeine, multivitamins, iron, and burners, caffeine, multivitamins, iron, and calcium are some of the most frequently calcium are some of the most frequently used products. used products.
Protein and Amino Acids
Most common forms:
Powders
Bars
Meal Replacers
Amino Acids
Listed Reasons Why Females Take Protein Supplements (Kristiansen, 2005)
For enhanced recovery
The taste
To provide Energy
To meet nutritional needs
For enhanced performance
To develop greater muscle strength
‘I Don’t Know’
Forms of ProteinSoy Protein vs. Milk Protein
Soy protein
Lacks the essential amino acids, lysine, and methionine; also contains less branch chained amino acids than milk proteins.
Milk protein
Casein protein is a milk protein as is whey protein.
Net protein synthesis is higher with casein protein than with soy protein.
Casein protein has a higher biological value because the slow release property keeps the amino acids from being released rapidly and degraded in the liver into urea (Luiking, Deutz, Jake, et al., 2005).
Whey protein is considered rapid release when compared to Casein (slow release preferred).
Glutamine
Commonly a component of weight-gain products (a small % of female athletes take this supplement).
Claims:
Enhance protein Synthesis
Offset immunosuppression
However, no long term studies substantiating these claims or ruling out adverse effects
CarnitineSynthesized from lysine and methionine.
Most healthy humans synthesize carnitine
Athletes take L-Carnitine for:
Weight loss purposes
Increased muscle mass
Enhanced β-oxidation
Enhanced recovery from high intensity
exercise.
L-Carnitine (an isomer )Findings
Effective weight loss agent for obese subjects, however, findings were inconclusive for non-obese subjects (Karlic & Lohninger, 2004).
Research findings have shown that athletes who have taken L-carnitine to enhance recovery from exercise have :
Decreased creatine kinase
Decreased Catabolism of purines
Decreased free radical formation
Decreased reported muscle soreness
L-Carnitine Dosage
Available as a prescription or OTC
Daily recommendations are 2-3.5g/d
Amounts in excess of 4g/d may result in gastric distress
A lethal dose (LD) of 630g/d for humans has been determined from animal studies (Calfee & Lohniger, 2004)
CreatineComposed of:
Arginine (non-essential amino acid)
Glycine (non-essential amino acid)
Methionine (essential amino acid)
Average Daily Requirement is 2g/d.
Body produces 1-2g/d.
Best sources of dietary creatine are meat and fish
Vegetarian athletes may have lower muscle creatine stores.
Fat Burners and Energy Supplements
The following supplements will be highlighted:
Chinese Ginseng
Siberian Ginseng
Ephedra (Ma Huang)
Bitter Orange
Caffeine
Creatine Supplementation Benefits
And Recommended DosageOptimum usage is for sports with a high percentage of ATP-PC system utilization.
No effects have been found on submaximal efforts
No effects have been found for aerobic endurance activities
Dosage
Loading phase: 5g/d, 4 X’s/d up to 7 days
Maintenance phase: 2g/d for 3 months
Increases muscle creatine stores 10-25%
When creatine is taken with carbohydrates absorption is enhanced.
When creatine is taken with caffeine absorption is inhibited.
GinsengReported Benefits:
Improved Mood
Improve Performance
Increase Alertness
Increase Fat Utilization
Two Main Types of Ginseng:
Chinese Ginseng (Panax ginseng)
Siberian Ginseng (Eleutherococcus ginseng)
Chinese GinsengReported Benefits (Bucci, 2000; Winterstein & Storrs, 2001)
Improves Strength
Improves aerobic capacity
Requires at least 8 weeks of supplementation with athletic training to see benefits.
Recommended Dosage:
1-2g/d
Varies based on powder vs. root extract
Chinese GinsengReported Side Effects (Bucci, 2000; Winterstein & Storrs, 2001):
Sleeplessness
Nervousness
Hypertension
Dermatological problems
Morning diarrhea
Euphoria
Rx Drug Interactions:
Phenelzine (A monoamine oxidase inhibitor)
Siberian Ginseng
Distant relative to Chinese ginseng
Contains different compounds than Chinese ginseng
Previous studies were not conducted well and are unreliable
The few well-designed studies have failed to show an ergogenic benefit (Winterstein & Storrs, 2001).
EphedraContains ephedrine and other alkaloids
Sympathomimetic
α and β-agonistic properties
Facilitates catecholamine release
Stimulates the CNS
Uses:
Energy Booster
Fat Burner
Athletic Performance Booster
Ephedra
Also called Ma Huang
Studies often pair ephedra with caffeine
Legality of ephedra is still being determined
May be banned by various athletic governing bodies
Ephedra Research Findings
Many studies also involve caffeine, therefore, the effects due to ephedra are hard to separate from caffeine (Shekelle, et al. 2003).
Studies without caffeine do not support the claim of enhanced athletic performance (Calfee, 2006; Bucci, 2000)
Claims of weight loss have been substantiated, although many of those studies also contained caffeine (Powers, 2001; Shekelle, et al., 2003).
Side Effects of Ephedra (Calfee, 2006; Powers, 2001; Shekelle, et al., 2003 ; Winterstein & Storrs, 2001).
Headache
Tremors
Hypertension
Arrhythmias
Insomnia
Nervousness
Increased heart rate
Note: It has also linked to several deaths!
Bitter Orange: A Replacement for Ephedra
Citrus aurantium
Common ingredient in many “Ephedra Free” fat burners
Contains synephrine
Similar effects as ephedra
Commonly paired with caffeine (Bucci, 2000)
CaffeineVarsity female athletes listed these reasons for taking caffeine:
Enhanced Performance
More Energy
Increased alertness
Taste
Listed forms Taken:
Beverages
Tablets
Energy Bars, Drinks, and Gels
Chocolate
Caffeine: Mode of Action (Graham, 2003)
Chemical structure resembles adenosine
Binds to adenosine receptors
Stimulates release of epinephrine
Direct mode of action on muscle function
•Causes sarcoplasmic reticulum to release more calcium
Caffeine has been reported to:
Enhance β-oxidation
Spare Muscle Glycogen
Sustain Muscle Force Longer
Caffeine and Performance
High Intensity Exercise (Doherty, et al., 2004):
Lower Perceived Exertion
Increased Glycolytic Performance*
Increased Blood Lactate*
* Not all studies have shown increased performance in glycolytic activities and blood lactate (Greer et al., 1998)
Endurance Exercise:
Main concept id that of fatty acid moblization and glycogen sparing
Prolongs Endurance Exercise **
** Mechanism behinds enhanced endurance performance not completely understood
Caffeine: Adverse Effects
Mild Diuretic
Dehydration not likely if athlete is properly hydrating
Tachycardia with Exercise
Increased Blood Pressure
Gastrointestinal Distress
Habituation/Addiction
There are also effects when discontinuing use:
Headache
Fatigue
Possible Flu-like Symptoms
(Ghram, 2 001; Mangus & Trowbridge, 2005)
Caffeine: Dosage
Caffeine paired with ephedra is potentially harmful and should be avoided (Powers, 2001; Mangus & Trowbridge, 2005 ).
Dosage:
Endurance Exercise:
3-5mg/kg
Since most beverages are variable in the amounts contained, tablets are probably the most effective method.
Anabolic-androgenic Steroids (AAS)
AAS are synthetic derivatives of testosterone.
Adolescent female usage is estimated between 2-5% (Congeni & Miller, 2002; Faigenbaum et al., 1998).
Collegiate use may be higher (Evans, 2004)
Women typically have <10% the amount of testosterone of men (Evans, 2004).
Testosterone and AAS bind to androgen receptors inside the cytoplasm and are transported to the nucleus.
This leads to an increase of structural and contractile proteins.
(Congeni & Miller, 2002; Calfee & Fadale, 2006; Evans, 2004)
AAS: Ergogenic Effects
Anabolism
Anti-catabolism
Aggression
May lead to more intense training
Gains:
Muscle Hypertrophy
Strength Gains
Lean body Mass Increases(Congeni & Miller, 2002; Tokish, et al., 2004)
AAS: Adverse Effects
Virilizing Effects:
Hirsutism
Voice Deepening
Male-pattern Baldness
Enlargement of the Clitoris
Menstrual Irregularities
Reduced Breast Size
Continued…………
AAS: Adverse Effects Continued
Increased Blood Pressure
Left Ventricular Hypertrophy
Decreased HDL
Hepatic Abnormalities
Dermatological Problems
Psychological Effects
Mood swings
Aggression
Note: Some of these effects are irreversible! The adverse effects far outweigh the benefits for women (Congeni & Miller, 2002; Calfee & Fadale, 2006; Evans, 2004)
AAS: Withdrawal Symptoms and other Repercussions
Withdrawal Symptoms:
Depression and Anger (Congeni & Miller, 2002; Calfee & Fadale, 2006)
Injection Related Complications:
Inflammation from repeated use of injection site
Bacterial Infections
Infectious Diseases
Hepatitis B and C
HIV (Calfee & Fadale, 2006; Evans, 2004)
Multivitamins
Female athletes stated these reasons for taking multivitamins:
Meet Nutritional Needs
Boost Immune System
Boost Energy
Increased Alertness
Habit From Childhood
(Kristiansen, et al., 2005; Froiland, et al., 2004)
Many multivitamins marketed as performance vitamins include other herbal supplements.
Athletes, trainers, coaches, and medical Professionals need to be aware of the extra ingredients in the OTC (over the counter) multivitamins since multivitamins are not subject to FDA regulation.
Iron
Women in general tend to have more iron deficiency issues than men.
Possible causes of iron deficiency:
Underestimated Menstrual Blood Loss
Inadequate Dietary Intake
Increased Loss from Sweat
Gastrointestinal Blood Loss in Runners
Even slight anemia will negatively impact performance!
(Beard & Tobin , 2001; Nielsen & Nachtigall, 1998)
Iron Supplementation
Forms of Iron:
Different forms are absorbed differently
OTC products are unregulated
A Rx Multivitamin with Iron may be the appropriate route for a female athlete with an iron deficiency.
Athletic Performance has not been improved by supplementing non-anemic athletes with iron
Side Effects of Supplementing with Normal Ferritin Levels:
Gastrointestinal Distress
Constipation(Beard & Tobin , 2001; Nielsen & Nachtigall, 1998)
Calcium
Female athletes stated these reasons for taking calcium:
Strengthen Bones
Lactose Intolerance
Low Dietary Intake
Dietary protein should be monitored relative to calcium.
(Kristiansen, et al., 2005; Froiland, et al., 2004)
Calcium: Protein Ratio
Increased dietary protein may lower urinary pH and increase calcium excretion (Barzel & Massey, 1998).
Increased calcium intake can offset the elevated calcium losses (Dawson-hughes, 2003)
20:1 is the typical recommended ratio for a middle-aged woman (Heaney, 1998).
An athlete’s need may be different due to an increased protein consumption to maintain a positive nitrogen balance.
Use of the dietary journal is key to assess nutritional consumption information.
Summary
Many times athletes do not understand supplements, regulations, or how to read the labels on these supplements.
OTC supplements are unregulated by the FDA and the product may be adulterated with products not listed on the label, some of which may be banned by athletic governing bodies.
Athletes, coaches, trainers, and medical professionals should be well versed on brands, supplements, and regulations before recommending use of a product.
Always check the rules of your particular governing body for legality of the supplement in question!
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