Performance for a Price? Part 1

Are you a “weekend warrior” looking for a nutritional edge? Chances are you enhance your weekend sports activities during the week with a couple workouts at the gym, or maybe you lift weights or participate in a basketball, softball or soccer league.

In the old days, athletes trained hard, took vitamins and minerals, got plenty of sleep, and mentally prepared for competition. Now, to get that additional edge, an increasing number of athletes, including those in high school, are turning to sports supplements.

Doctors and nutritional experts are beginning to warn athletes about potential long-term side effects. “It is of concern to doctors that the use of performance-enhancing supplements among adolescents and young adults is on the rise and doctors know little about the critical application of such supplements,” said Dr. Bernd Wollschlager, a family practice physician in Miami who specializes in herbal medicine. “Such supplements might enhance endurance, but the untrained ‘weekend warrior’ can face muscle injuries or bone damage by exercising beyond his or her endurance limit.”

Over the last five years, the nutritional supplement industry has exploded in popularity, growing at a 10-percent annual rate. Revenue estimates show that supplements will become a $12 billion industry this year, according to the Supplement Research Institute.

One of the most popular additives to sports supplements is creatine, said Rehan Jalali, president of the Supplement Research Foundation in Costa

Mesa, Calif.

“Studies show creatine improves athletic performance and enhances energy in muscle tissue. It allows you to exercise a little longer to sustain performance. It is the most effective supplement in use since the 1960s,” Jalali said.

Creatine protects muscles by drawing water inside muscle cells. “It increases body water by 15 percent,” he said. “It also reduces lactic acid, which naturally builds up in overworked muscles and leads to cramping.”

But Dr. Lyle Lundblad, president of the Midwest Institute of Urology in Minneapolis, warns that it may not be good for all muscles. One side effect with creatine is erectile dysfunction in some men. “A lot depends how much is taken and how long it takes to get out of the system,” he said.

Lundblad estimates about 10 percent to 20 percent of his patients have supplement-related erection or virility problems. “Creatine suppresses testosterone production,” he said.

Health professionals agree that adolescents under age 18 should not use creatine.

“There is rampant use of creatine in high schools,” Jalali said. “It increases performance, but we don’t have specific studies on this age group so I don’t recommend adolescents use it. Kids are better off getting on a diet program. They should drink mixes with protein powders, and nutrients and take base supplements like vitamins and minerals.”

A number of other groups are warning that use of creatine by teen-agers may be dangerous. Blue Cross and Blue Shield Association’s Healthy

Competition Foundation said anecdotal evidence from physicians, coaches, trainers and athletes indicate a link between creatine use and several adverse reactions, including cramping, diarrhea, nausea, dizziness, dehydration, muscle strain, high blood pressure, incontinence, and abnormal liver and kidney functions.

According to Blue Cross and Blue Shield, a large number of high school seniors are using creatine monohydrate with little or no scientific evidence of its safety. One state high school federation in New Jersey is expected to recommend this year that its 440 members discourage athletes from using such diet supplements as androstenedione and creatine.

“Because there is a lack of [Food and Drug Administration] oversight, we are seeing an increasing trend of younger individuals having problems with these body-building supplements,” Lundblad said. “Most kids think it is OK to use these supplements because they are sold in stores.”

Another popular sport supplement that can be found on the shelves is androstenedione, a hormone that many athletes believe can be converted into the muscle-building male sex hormone testosterone. Andro achieved fame in 1998 when St. Louis Cardinals’ slugger Mark McGwire admitted he used it during his record-breaking 70-home run season.

But in a 1999 study, androstenedione did not increase the serum testosterone concentrations and there was no increased muscle strength or muscle size, according to the Journal of the American Medical Association. The study also found andro increased the risk of pancreatic cancer, Wollschlager said.

“Everyone should avoid all andro products,” Jalali said. “It seems to enhance testosterone levels, but the JAMA study questions this. It also enhances estrogen levels, which can have negative effects on men, such as water retention and breast formation.”

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