ࡱ>    E@ Rbjbj ܖ$x x x x x x x 4 ttth,t L.FFFYg{ """"""$)R{FQx N UYN N Fx x FF)))N px Fx Fh)N  ))T+6˸Cx x nF| `Vt%D$0#&#8n x x x x n#x LY()TyFF G)" Professionalization of Exercise Physiologyonline ISSN 1099-5862 Vol 6 No 8 August 2003 ___________________________ Exercise and Sport Nutrition: A Balanced Perspective for Exercise Physiologists Richard B. Kreider, PhD, MX, EPC, FACSM, FASEP; Anthony L. Almada, MSc; Jose Antonio, PhD, FACSM; Craig Broeder, PhD, FNAASO; Conrad Earnest, PhD, FACSM; Lori Greenwood, PhD, ATC, LAT; Mike Greenwood, PhD, CSCS*D; Thomas Incledon, MS, RD, LD/LN, NSCA-CPT, CSCS, RPT; Douglas S. Kalman MS, RD, FACN; Chad Kerksick, MS, CSCS, ATC, EPC; Susan M. Kleiner, PhD, RD, FACN; Brian Leutholtz, PhD, FACSM; Lonnie M. Lowery, PhD; Ron Mendel, PhD; Christopher J. Rasmussen, MS, MX, CSCS, EPC; Jeffrey R. Stout, PhD, FACSM, CSCS; Joseph P. Weir, Ph.D., EPC, FACSM; Darryn S. Willoughby, Ph.D., FACSM, FASEP, EPC, CSCS, CNS; Tim N. Ziegenfuss, PhD, CSCS, EPC, FASEP Author Affiliations: Richard B. Kreider, PhD, MX, EPC, FACSM, FASEP Past-President of ASEP and Member of ASEP Board of Directors Professor and Chair Department of Health, Human Performance & Recreation Director of the Exercise & Sport Nutrition Laboratory & Center for Exercise, Nutrition & Preventive Health Research Baylor University  HYPERLINK "mailto:Richard_Kreider@baylor.edu" Richard_Kreider@baylor.edu Anthony L. Almada, MSc Chief Scientific Officer IMAGINutrition Former Co-founder and Chief Scientific Officer Experimental & Applied Sciences Jose Antonio, PhD, FACSM Senior Manager of Sports Science MET-Rx Craig Broeder, PhD, FNAASO Professor and Chair Department of Exercise Science St. Benedictine University Conrad Earnest, PhD, FACSM Director, Exercise Physiology Laboratory The Cooper Institute Lori Greenwood, PhD, ATC, LAT Associate Professor and Coordinator of the Graduate Athletic Training and Sports Medicine Program Department of Health, Human Performance & Recreation Exercise & Sport Nutrition Laboratory Center for Exercise, Nutrition & Preventive Health Research Baylor University Mike Greenwood, PhD, CSCS*D Member of ASEP Board of Directors Professor and Graduate Program Director & Research Coordinator Department of Health, Human Performance & Recreation Exercise & Sport Nutrition Laboratory Center for Exercise, Nutrition & Preventive Health Research Baylor University Thomas Incledon, MS, RD, LD/LN, NSCA-CPT, CSCS, RPT Director of Performance Research and Nutrition Athletes' Performance Douglas S. Kalman MS, RD, FACN Director, Nutrition & Applied Clinical Research Miami Research Associates Chad Kerksick, MS, CSCS, ATC, EPC Doctoral Research Associate Exercise & Sport Nutrition Laboratory Department of Health, Human Performance & Recreation Baylor University Susan M. Kleiner, PhD, RD, FACN Affiliate Assistant Professor Department of Medical History and Ethics School of Medicine University of Washington Lonnie M. Lowery, PhD Department Nutrition and Dietetics Kent State University Brian Leutholtz, PhD, FACSM Professor, Department of Health, Human Performance & Recreation Exercise & Sport Nutrition Laboratory Center for Exercise, Nutrition & Preventive Health Research Baylor University Ron Mendel, PhD President, Ohio Society of Exercise Physiology Lab Director, PinnacleInstitute of Health & Human Performance Christopher J. Rasmussen, MS, MX, CSCS, EPC Research Coordinator Exercise & Sport Nutrition Laboratory Department of Health, Human Performance & Recreation Baylor University Jeffrey R. Stout, PhD, FACSM, CSCS Chief Scientific Officer Vitalstate USA Joseph P. Weir, PhD, EPC, FACSM Member of ASEP Board of Directors Associate Professor and Research Coordinator Division of Physical Therapy Des Moines University-Osteopathic Medical Center Darryn S. Willoughby, Ph.D., FACSM, FASEP, EPC, CSCS, CNS President-Elect of ASEP and Member of ASEP Board of Directors Associate Professor of Exercise & Molecular Physiology Exercise Biochemistry and Molecular Biology Lab Department of Kinesiology Texas Christian University Tim N. Ziegenfuss, PhD, CSCS, EPC Member of ASEP Board of Directors Chief Scientific Officer PinnacleInstitute of Health & Human Performance Introduction Over the last year or so several articles have appeared in PEP online suggesting that exercise physiologists who conduct research on exercise and nutrition and/or recommend that their clients/athletes consume special diets or take nutritional supplements are quacks  ADDIN EN.CITE Boone200228610Boone, T.2002Exercise Physiology Quackery and Consumer FraudProfessionalization of Exercise Physiology-online5(5). Available: http://www.css.edu/users/tboone2/asep/ExercisePhysiologyQuackery.html5[1]. More recent articles suggested that: 1.) sport nutrition research is often flawed from an ethical and scientific perspective; 2.) it is unethical and/or unprofessional for exercise physiologists to conduct performance enhancement research (particularly if it is funded by a supplement company); 3.) it is unethical and/or unprofessional for exercise physiologists to consult with supplement companies; 4.) it is unethical for athletes to consume nutrients and/or take performance enhancement supplements because it is a form of cheating; 5.) exercise physiologists and professors who conduct research in this area and/or teach their students how to optimize training and/or performance through scientific application of training and nutrition are unethical and contributing to a win at all cost mentality; and, 6.) if exercise physiologists recommend that people take nutritional supplements they are in violation of the ASEP Code of Ethics and should therefore be sanctioned in some manner by ASEP  ADDIN EN.CITE Boone200328600Boone, T.2003Dietary "Sports" Supplements: The University Teacher’s Role in Teaching Values?Professionalization of Exercise Physiology online6(7). Available: http://www.css.edu/users/tboone2/asep/TeachingVALUES.html7Birnbaum200328630Birnbaum, L.2003Athletes: Our Role Models, Right?Professionalization of Exercise Physiology-online6(7). Available: http://www.css.edu/users/tboone2/asep/AthletesWhoCheat.htmlBirnbaum200328640Birnbaum, L.2003Supplements and Exercise PhysiologyProfessionalization of Exercise Physiology-online6(5). Available: http://www.css.edu/users/tboone2/asep/SupplementsANDExercisePhysiology.htmlBoone200228610Boone, T.2002Exercise Physiology Quackery and Consumer FraudProfessionalization of Exercise Physiology-online5(5). Available: http://www.css.edu/users/tboone2/asep/ExercisePhysiologyQuackery.html5Boone2003l28620Boone, T.2003lEthical Thinking: What Is It and Why Does It Matter?Professionalization of Exercise Physiology-online.6(6). Available: http://www.css.edu/users/tboone2/asep/EthicalThinkingANDexercisephysiology.htm6[1-5]. As leading researchers and educators in this area, we felt that it was time to provide our opinion on these articles. Although we have great respect for the authors and appreciate their commitment to ASEP and passion for the professionalization of exercise physiologists, it is our view that many of the comments made in these articles simply cannot be supported by the current scientific literature. Further, that much of the logic used to support these views is flawed. Members of ASEP should know that many leading sport nutrition researchers, ASEP members, and members of the ASEP Board of Directors (BOD) do not share these views. As an indication of this consensus, this paper is coauthored by a number of respected exercise physiology and sport nutrition professors, researchers, practitioners, and leading who have extensive experience working with athletes, teaching exercise physiology and sport nutrition, conducting research on dietary supplements, serving as consultants for nutrition companies, coordinating research and product development for nutrition companies, and/or educating the scientific and lay communities about the role of nutrition on exercise and performance. This list includes: the Past-President and President-Elect of ASEP; members of the ASEP Board of Directors; Certified Exercise Physiologists (EPC), Strength and Conditioning Specialists (CSCS), Certified Athletic Trainers (ATC), and registered dietitians (RD); Fellows of ASEP, the American College of Sports Medicine (ACSM), American College of Nutrition (ACN), and the North American Association for the Study of Obesity (NAASO); leaders of sport nutrition organizations; Chief Scientific Officers of leading supplement companies; and, a cofounder of a company founded on the principle of developing products based on science. While PEP Online provides an opportunity for exercise physiologists to raise issues relevant to the professional practice of exercise physiologists and sport nutrition is certainly a relevant issue for exercise physiologists, authors should be careful that the opinions are based on a thorough and comprehensive analysis of the literature so that unfounded conclusions are not made. It is our view that these articles have served to alienate exercise physiologists, divide ASEP members, and have reflected poorly upon ASEP within the broader scientific community due to a misrepresentation of available scientific literature. Consequently, we felt it was our responsibility to provide a more balanced perspective on the role of nutrition on exercise and performance. In our view, it is the professional responsibility of an exercise physiologist to be up to date on current literature so the students, clients, and/or athletes are provided the latest information so they can make an informed decision about whether to try a particular training/rehab program, diet, and/or nutritional supplement. Moreover, they should teach their students about legal and illegal performance enhancement aids used by athletes so they understand the potential physiological mechanisms of action, potential benefits, and/or possible risks and side effects in order to properly educate their clients/athletes. If a proposed nutrient or diet lacks scientific support, then it is the responsibility of the exercise physiologist to inform their students, clients, and/or athletes that there is little to no data supporting a proposed benefit. If outrageous claims are made by marketing arms of supplement companies, then the best course of action for an exercise physiologist is to conduct research, publish the research findings, and inform their students and the public that there is no data to support the claims made. We concur that not doing so would be unethical. However, in our view it is equally unethical to suggest there are no data supporting the health and/or ergogenic value of a diet strategy or nutrient when there are indeed data supporting its use. It is our experience that many exercise physiologists and nutritionists unintentionally mislead and confuse the public because they simply are not familiar with the available scientific data. The area of exercise nutrition is rapidly advancing. Thousands of articles are published every year investigating the role of nutrition and exercise on health, disease, and performance. There have been enormous advancements in our understanding how diet, exercise, and specific nutrients can promote health, well-being, helps in disease management, and/or improve performance and training adaptations. For this reason, many grant agencies like the National Institutes of Health have called for an increase in funding to assess the interaction of exercise and nutrition on health, disease, and performance. In our view, not being aware of the scientific literature and/or making blatantly inaccurate or false statements about the role of nutrition and exercise is as unethical as supplement companies making unsupported claims about their products. It is our view that although the articles by Boone and Birnbaum  ADDIN EN.CITE Boone200328600Boone, T.2003Dietary "Sports" Supplements: The University Teacher’s Role in Teaching Values?Professionalization of Exercise Physiology online6(7). Available: http://www.css.edu/users/tboone2/asep/TeachingVALUES.html7Birnbaum200328630Birnbaum, L.2003Athletes: Our Role Models, Right?Professionalization of Exercise Physiology-online6(7). Available: http://www.css.edu/users/tboone2/asep/AthletesWhoCheat.htmlBirnbaum200328640Birnbaum, L.2003Supplements and Exercise PhysiologyProfessionalization of Exercise Physiology-online6(5). Available: http://www.css.edu/users/tboone2/asep/SupplementsANDExercisePhysiology.htmlBoone200228610Boone, T.2002Exercise Physiology Quackery and Consumer FraudProfessionalization of Exercise Physiology-online5(5). Available: http://www.css.edu/users/tboone2/asep/ExercisePhysiologyQuackery.html5Boone2003l28620Boone, T.2003lEthical Thinking: What Is It and Why Does It Matter?Professionalization of Exercise Physiology-online.6(6). Available: http://www.css.edu/users/tboone2/asep/EthicalThinkingANDexercisephysiology.htm6[1-5] raise some important questions that should be openly discussed as the exercise physiology profession develops, they are misleading in that they do not present a current and/or comprehensive view of the role of nutrition on exercise, performance, and training. For example, these articles indicated that there are no data to support a recommendation that athletes need to supplement their normal diet with protein, amino acids, vitamins, minerals, or many other purported ergogenic aids and even if there were data supporting their use it is unethical to do so. Moreover, if an exercise physiologist suggested that there were data to support these views, then they are quacks and/or are supporting unethical behavior among athletes. As several members of ASEP who reviewed some of these papers and/or provided comments regarding these positions at the recent ASEP national meeting indicated, these views are simply not supported by hundreds of articles reporting health, performance, and/or training benefits of various nutritional strategies, macronutrients, micronutrients, and ergogenic aids. It is our view that authors should be more careful before suggesting that a large segment of researchers, exercise physiologists, athletes, and members of the general public are unethical. Boone and Birnbaum  ADDIN EN.CITE Boone200328600Boone, T.2003Dietary "Sports" Supplements: The University Teacher’s Role in Teaching Values?Professionalization of Exercise Physiology online6(7). Available: http://www.css.edu/users/tboone2/asep/TeachingVALUES.html7Birnbaum200328630Birnbaum, L.2003Athletes: Our Role Models, Right?Professionalization of Exercise Physiology-online6(7). Available: http://www.css.edu/users/tboone2/asep/AthletesWhoCheat.htmlBirnbaum200328640Birnbaum, L.2003Supplements and Exercise PhysiologyProfessionalization of Exercise Physiology-online6(5). Available: http://www.css.edu/users/tboone2/asep/SupplementsANDExercisePhysiology.htmlBoone200228610Boone, T.2002Exercise Physiology Quackery and Consumer FraudProfessionalization of Exercise Physiology-online5(5). Available: http://www.css.edu/users/tboone2/asep/ExercisePhysiologyQuackery.html5Boone2003l28620Boone, T.2003lEthical Thinking: What Is It and Why Does It Matter?Professionalization of Exercise Physiology-online.6(6). Available: http://www.css.edu/users/tboone2/asep/EthicalThinkingANDexercisephysiology.htm6[1-5] also question the ethics of athletes attempting to enhance exercise capacity by using performance-enhancing supplements. It is our view that suggesting it is unethical and/or cheating for an athlete to follow a performance enhancement diet and/or take legal nutritional supplements shown in research to be safe and effective doesnt make sense. A similar argument can be made suggesting its unethical for athletes to: 1.) use the latest training methods shown in research to improve strength, speed, endurance, and/or agility; 2.) seek more experienced coaching to improve performance of an athletic skill; 3.) use the most technologically advanced athletic equipment; 4.) use protective sports medicine equipment to reduce risk of injuries; and/or, 5.) live at altitude in hopes of enhancing endurance performance at sea level. Using this line of thinking, it would be unethical for an athlete to consume a high carbohydrate diet, carbohydrate load or drink coffee prior to competition, and/or use sports drinks during prolonged exercise to maintain hydration and performance. Furthermore, it would be unethical for an athlete to consult with a sport psychologist, sport nutritionist, strength and conditioning specialist, and/or exercise physiologist to undergo assessments to gauge training and/or performance progress. After all, not all athletes have access good coaching, can eat a good diet, have strength and conditioning coaches, have access to the most technologically advanced equipment and training facilities, and/or can afford to take performance enhancing supplements. Using this logic, fairness in sport could only be achieved if athletes were required to follow the same training program, had access to the same training facilities, lived in the same environment, ate the same diet at the same time of day, slept the same amount each night, and had the same genetic endowment. Moreover, it would be unethical for anyone to recommend participating in a potentially dangerous sport or recreational activity (actually hundreds of people die each year from traumatic and non-traumatic sudden death during exercise and/or while participating in recreation and sporting events) or a sport that wasnt always fun. Based on this logic, we should ban competitive and professional sport because sports shouldnt be that serious, athletes may not always be good role models to our youth, and/or participating in sport may not always impart proper values to our children. To us, this line of thinking makes little sense. Many of us have been athletes and have worked extensively with young athletes (Junior High and High School), college athletes, Olympic athletes, and professional athletes. Many of us have made presentations to numerous professional societies and coaching groups in the U.S. and abroad. There are many reasons why people participate in exercise programs and sport. Its not always fun to run, lift weights, participate in sprint and conditioning drills, and/or endlessly practice to become good at a sport. It also isnt always easy to eat a well-designed diet and/or time nutrient intake to optimize performance and recovery. However, these are key principles of preparing individuals to perform to their best capability. Some people dont feel the discipline required to train hard, eat right, and optimize performance is worth the time and energy. Others strive to be the best they can be even though they dont have the genetic endowment for a particular sport. Still others who have the genetic predisposition and talent for a particular sport seek to reach the heights of athletic performance by becoming a national class, world class, or professional athlete. Optimizing training through provision of well-timed nutrients and/or use of various nutritional supplements research has shown can help optimize performance and/or training adaptations (e.g., sports drinks, energy bars, carbohydrate gels, carbohydrate/protein supplements, creatine, caffeine, etc) is not cheating its smart training and preparation for competition. Application of performance enhancement nutritional strategies doesnt make it easier to train, it helps you train harder, recover faster from intense training, and may help reduce the incidence of overtraining. It helps optimize energy availability so you can exercise longer and/or at higher intensities. This is not a short-cut to training but a way to help the body tolerate higher levels of training. It is no different than applying the latest training principles to optimize performance. Athletes and coaches have many choices they can make about which training methods to employ, how much training is enough (or too much), how much rest the athlete needs to recover well, what type of diet to follow, and/or whether nutritional supplements can help them train and/or perform better. The exercise physiologist should help coaches and athletes base their decisions on available science. Some will listen to this advice while others will employ seemingly strange training techniques and methods. As long as athletes and coaches adhere to the rules of their sport, these decisions should not be viewed as unethical. To us, the question is not whether optimizing nutrition is ethical or not but what is the best way to help people optimize training adaptations, performance, and/or assist in the rehabilitation of injury or illness. Ultimately, this may help people see better results from training, improve exercise adherence, and help people achieve their training, rehabilitation, and/or performance goals. Such a multitude of training and performance enhancements calls for some distinctions regarding legitimacy. It is unfair to conclude that simply because there is no literature on one ergogenic approach, then subsequently all strategies are equally unsupportable or unethical. Blanket statements regarding all ergogenic endeavors are inappropriate as we should strive to only make conclusions based upon existing data not personal convictions. Some aspects of exercise augmentation provide substantially more published evidence than others. For example, not all sports supplements are technically nutritional in nature. Sports nutrition, per se, is a well-documented field of study that can be incongruent with sports supplements such as prohormones and many herbal substances. Supplements that are essential to human health (e.g. proteins/ EAAs, carbohydrates, fats, vitamins and minerals) or are common to humans dietary intake (e.g. creatine, caffeine) are historically nutrition per se, and typically have far more data to support or refute their potential. Conversely, hormonal and herbal preparations although legally dietary supplements - are more the realm of sports pharmacology. This does not preclude their investigation by exercise physiologists, but does make them a different entity, calling for a somewhat different educational background by those researching them. There is a significant body of research that has evaluated the role of exercise and nutrition on performance. This research has served as a cornerstone in the development and advancement of exercise physiology. However, as Boone and Birnbaum  ADDIN EN.CITE Boone200228610Boone, T.2002Exercise Physiology Quackery and Consumer FraudProfessionalization of Exercise Physiology-online5(5). Available: http://www.css.edu/users/tboone2/asep/ExercisePhysiologyQuackery.html5Boone200328600Boone, T.2003Dietary "Sports" Supplements: The University Teacher’s Role in Teaching Values?Professionalization of Exercise Physiology online6(7). Available: http://www.css.edu/users/tboone2/asep/TeachingVALUES.html7Boone2003l28620Boone, T.2003lEthical Thinking: What Is It and Why Does It Matter?Professionalization of Exercise Physiology-online.6(6). Available: http://www.css.edu/users/tboone2/asep/EthicalThinkingANDexercisephysiology.htm6Birnbaum200328630Birnbaum, L.2003Athletes: Our Role Models, Right?Professionalization of Exercise Physiology-online6(7). Available: http://www.css.edu/users/tboone2/asep/AthletesWhoCheat.htmlBirnbaum200328640Birnbaum, L.2003Supplements and Exercise PhysiologyProfessionalization of Exercise Physiology-online6(5). Available: http://www.css.edu/users/tboone2/asep/SupplementsANDExercisePhysiology.html[1-5] correctly point out, there is a significant amount of misinformation and marketing hyperbole about various training techniques, devices, nutritional strategies, and dietary supplements. But again, this is a large group of distinct ergogenic approaches. There have also been instances when quality research findings have been misrepresented or exaggerated in marketing materials. The answer is not to condemn all performance enhancement training techniques, devices, nutritional strategies, dietary supplements, ergogenic aids, and those who support the use of some of these techniques as unethical. The answer is to conduct research to determine whether there is a scientific basis to these purported aids and assist in educating the public about which ones are credible or not. Further, to recommend to researchers in this area that they incorporate safeguards in grant contracts regarding full publication rights, restrictions that data can only be described in marketing material after it has been published and/or presented at an appropriate scientific venue, disclose any conflicts of interest, and to inform the public if marketing materials describing results misrepresent the data. ASEP should not separate itself from one of the foundations of exercise physiology and/or condemn those who seek to determine the legitimate role of training and nutrition on performance. Rather, it should encourage the ethical conduct of research and dissemination of research so that its members and the general public can be appropriately informed as to the state of the science in this area. Moreover, it should call upon companies who sell training devices and/or nutritional supplements to develop research based products, to fund clinical trials to independently analyze the ergogenic value of their products, and to fully and accurately portray results of research findings in research publications and marketing material so that the public can make an informed decision about them. Finally, it should encourage exercise physiologists to stay current with the scientific literature and help interpret the literature for the scientific and lay public by writing scholarly reviews for academic journals, online publications, and/or fitness magazines so the public can be properly informed about the science that does or does not support various products. Exercise physiologists need to be on the frontier of applying the scientific principles of training and nutrition. This requires a current and up-to-date understanding of the literature. In fact, the current professional climate provides a real niche for the exercise physiologist in this regard. Turning down the role of sports nutrition/ergogenic aid researcher as unethical would not only further relinquish certain authority of the exercise physiologist to other professions, but would itself be irresponsible to the public. There is published opinion that sports nutritionists need as little as one to two courses in exercise science, even as they are expected to understand and explain the plethora of ergogenic aids and their marketing claims and be able to apply biochemistry principles and analyze research designs  ADDIN EN.CITE Clark20003085011138445100122000DecIdentifying the educational needs of aspiring sports nutritionists1522-4Clark, N.J Am Diet AssocCareer MobilityCommerce/educationDietetics/*educationExercise/physiologyExertion/physiologyHumanNutrition/*education*SpecialismSports Medicine/*education/standardshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11138445[6]. It has also been suggested that these health professionals assuming the role of [sports] nutrition educator have been underdeveloped in their interpretation and/ or participation in the scientific literature  ADDIN EN.CITE Manore2003308701252580310312003JanResearch and the dietetics profession: making a bigger impact108-12Department of Nutrition and Food Management, Oregon State University, Corvallis, USA.Manore, M. M.Myers, E. F.J Am Diet Assoc*Dietetics/standards/trendsEvidence-Based MedicineHumanNutritionNutrition Policy*ResearchSocietiesUnited Stateshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12525803Glore2001308601127169010122001FebShow me the science186Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73190, USA. stephen-glore@ouhsc.eduGlore, S.J Am Diet AssocDietetics/*education*Evidence-Based MedicineHuman*NutritionResearch/education/*methodshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11271690[7, 8]. Thus, the opportunities and need for interdisciplinary interaction to protect the public are clear. Exercise physiologists also need to know how to evaluate the scientific merit of articles and advertisements about exercise and nutrition products so they can separate marketing hype from scientifically based training and nutritional practices. In order to help educate ASEP members about sport nutrition, we have adapted several recent articles and chapters from Dr. Kreiders work regarding exercise, nutrition, and training. This paper provides an overview of: 1.) what are ergogenic aids and dietary supplements; 2.) how dietary supplements are legally regulated; 3.) how to evaluate the scientific merit of nutritional supplements; 4.) general nutritional strategies to optimize performance and enhance recovery; and, 5.) an overview of our current understanding of the ergogenic value weight gain, weight loss, and performance enhancement supplements. We have also categorized nutritional supplements into apparently effective, possibly effective, too early to tell, and apparently ineffective as well as describes our general approach to educating athletes about sport nutrition. While some exercise physiologists and nutritionists may not agree with all of our interpretations of the literature and/or categorization of a particular supplement, these interpretations are based on the current available scientific evidence and have been well received within the broader scientific community. Our hope is that ASEP members find this information useful in their daily practice and consultation with their clients. What is an Ergogenic Aid? An ergogenic aid is any training technique, mechanical device, nutritional practice, pharmacological method, or psychological technique that can improve exercise performance capacity and/or enhance training adaptations  ADDIN EN.CITE Leutholtz200116077Leutholtz, B. Kreider, R.B.2001Exercise and Sport Nutrition.Wilson, T.Temple, N.Nutritional Health.Totowa, NJHumana Press, Inc.207 – 239Williams199920631Williams, M. H.1999Nutrition for Health, Fitness, and SportDubuque, IAACB/McGraw-Hill[9, 10]. This includes aids that may help prepare an individual to exercise, improve the efficiency of exercise, and/or enhance recovery from exercise. Ergogenic aids may also allow an individual to tolerate heavy training to a greater degree by helping them recover faster or help them stay healthy during intense training. Although this definition seems rather straightforward, there is considerable debate regarding the ergogenic value of various nutritional supplements. Some exercise physiologists only consider a supplement ergogenic if studies show that the supplement significantly enhances exercise performance (e.g., helps you run faster, lift more weight, and/or perform more work during a given exercise task). On the other hand, some feel that if a supplement helps prepare an athlete to perform or enhances recovery from exercise, it has the potential to improve training adaptations and therefore should be considered ergogenic. In our view, one should take a broader view about the ergogenic value of supplements. While we are interested in determining the performance enhancement effects of a supplement on a single bout of exercise, we also realize that one of the goals of training is to help people tolerate training to a greater degree. People who tolerate training better usually experience greater gains from training over time. Consequently, employing nutritional practices that help prepare people to perform and/or enhance recovery from exercise should also be viewed as ergogenic. What are Dietary Supplements and How Are They Regulated? According to the Food and Drug Administration (FDA), dietary supplements were regulated in the same manner as food prior to 1994  ADDIN EN.CITE FDA200310950FDA2003Dietary Supplementshttp://www.cfsan.fda.gov/~dms/ds-faq.html[11]. Consequently, the manufacturing processes, quality, and labeling of supplements were monitored by FDA. However, many people felt that the FDA was too restrictive in regulating dietary supplements. As a result, Congress passed the Dietary Supplement Health and Education Act (DSHEA) in 1994 which placed dietary supplements in a special category of "foods". In October 1994, DSHEA was signed into law by President Clinton. The law defined a "dietary supplement" as a product taken by mouth that contains a "dietary ingredient" intended to supplement the diet. Dietary ingredients" may include vitamins, minerals, herbs or other botanicals, amino acids, and substances (e.g., enzymes, organ tissues, glandulars, and metabolites). Dietary supplements may also be extracts or concentrates from plants or foods. Dietary supplements are typically sold in the form of tablets, capsules, soft gels, liquids, powders, and bars. Products sold as dietary supplements must be clearly labeled as a dietary supplement. According to DSHEA, dietary supplements are not drugs. Dietary supplement ingredients that were sold prior to 1994 are therefore not required to be shown to be safe and/or effective in clinical trials prior to being approved for sale by the FDA. However, new dietary supplement ingredients introduced after 1994 must undergo pre-market review for safety data by the FDA before it can be legally sold. Supplement companies are responsible for determining that the dietary supplements it manufactures or distributes are safe and that any representations or claims made about them are substantiated by adequate evidence to show that they are not false or misleading. Because of this, DSHEA requires supplement manufacturers to include on the label that This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease". According to the 1994 Nutrition Labeling and Education Act (NELA), the FDA has the ability to review and approve health claims for dietary supplements and foods. However, since the law was passed, it has only reviewed a few claims. The delay in reviewing health claims of dietary supplements resulted in a law suit filed by Pearson & Shaw et al v. Shalala et al in 1993. After years of litigation, U.S. Court of Appeals for the District of Columbia Circuit ruled in 1999 that qualified health claims may now be made about dietary supplements with approval by FDA as long as the statements are truthful and based on science. Supplement companies wishing to make health claims about supplements can submit research evidence to the FDA for approval. Additionally, they must submit an Investigation of New Drug (IND) application to FDA if a research study on a nutrient is designed to treat an illness and/or medical affliction and/or the company hopes to one day obtain approval for making a qualified health claim if the outcome of the study supports the claim. Studies investigating structure and function claims, however, do not need to be submitted to the FDA as an IND. Manufacturers and distributors of dietary supplements are not currently required to record, investigate or forward to FDA any reports they receive on injuries or illnesses that may be related to the use of their products. However, the FDA and other groups have established phone hotlines and online adverse event monitoring systems to report problems they believe may be a result of taking dietary supplements. While these reports are unsubstantiated, can be influenced by media attention to a particular supplement, and do not necessarily show a cause and effect, they are used by the FDA to monitor trends and signals that may suggest a problem. Once a dietary supplement product is marketed, the FDA has the responsibility for showing that a dietary supplement is unsafe before it can take action to restrict the product's use or removal from the marketplace. The Federal Trade Commission (FTC) is responsible to make sure manufacturers are truthful regarding claims they make about dietary supplements. The FDA has the power to remove supplements from the market if it has sufficient scientific evidence to show the supplement is unsafe. Additionally, the FTC has the power to act against companies who make false and/or misleading marketing claims about a specific product. This includes acting against companies if the ingredients found in the supplement do not match label claims. While this does not ensure the safety of dietary supplements, it does provide a means for governmental oversight of the dietary supplement industry if adequate resources are provided to enforce DSHEA. Since inception of DSHEA, the FDA has required a number of supplement companies to submit evidence showing safety of their products and acted to remove a number of products sold as dietary supplements from sale in the U.S. due to safety concerns. Additionally, the FTC has acted against a number of supplement companies for misleading advertisements and/or structure and function claims. As can be seen, although some argue that the dietary supplement industry is unregulated and/or may have suggestions for additional regulation, manufacturers of dietary supplements must adhere to a number of federal regulations before a product can go to market. Further, they must have evidence that the ingredients sold in their supplements are generally safe if requested to do so by the FDA. For this reason, over the last 10-15 years, most quality supplement companies have employed a team of researchers (many of whom are MS or PhD prepared exercise physiologists) who help educate the public about nutrition and exercise, provide input on product development, conduct preliminary research on products, and/or assist in coordinating research trials conducted by independent research teams (e.g., university based researchers or clinical research sites). They also consult with marketing teams with the responsibility to ensure structure and function claims do not misrepresent results of research findings. This has increased job opportunities for exercise physiologists as well as enhanced opportunities for external funding for research groups interested in exercise nutrition research. While it is true that some companies use borrowed science, suppress negative findings, and/or exaggerate results from research studies, the trend in the nutrition industry is to develop scientifically sound supplements. This trend toward greater research support is the result of: 1.) attempts to honestly and accurately inform the public about results; 2.) efforts to have data to support safety and efficacy on products for FDA and the FTC; and/or, 3.) to provide scientific evidence to support advertising claims and increase sales. This trend is due in large part to greater scrutiny from the FDA and FTC as a result of increased consumer expectations and political pressure to ensure that companies sell quality products that have been shown to be safe and effective in clinical trials. In our experience, companies who adhere to these ethical standards prosper while those who do not struggle to adhere to FDA and FTC guidelines and lose consumer confidence. When this occurs, companies are often sued by consumers and/or are forced out of business because ultimately the consumer has the final word on whether a supplement or supplement company is credible or not. How to Evaluate Nutritional Ergogenic Aids When you evaluate the ergogenic value of a nutritional supplement or training device/method, we recommend that you go through a process of evaluating the validity and scientific merit of claims made. This can be accomplished by evaluating the theoretical rationale behind the supplement/technique and determining whether there is any well-controlled data showing the supplement/technique works. Training devices and supplements based on sound scientific rationale with supportive research showing effectiveness may be worth trying and/or recommending. However, those based on unsound scientific rationales and/or little to no data supporting the ergogenic value for people involved in intense training may not. The exercise physiologist should be a resource to help their clients interpret the scientific and medical research that may impact on their welfare and/or help them train more wisely. The following are the questions we recommend asking when evaluating the potential ergogenic value of a supplement. Does the theory make sense? Most supplements that have been marketed to improve health and/or exercise performance are based on theoretical applications derived from basic and/or clinical research studies. Based on these preliminary studies, a training device or supplement is often marketed to people proclaiming the benefits observed in these basic research studies. Although the theory may sound good, critical analysis of the theory often reveals flaws in scientific logic and/or that the claims made dont quite match up with the literature cited. If you do your homework, you can discern whether a supplement has been based on sound scientific evidence or not. To do so, we suggest you read reviews about the training method, nutrient, and/or supplement from researchers who have been intimately involved in this line of research and/or consult reliable references about nutritional and herbal supplements  ADDIN EN.CITE 10890US RDA Recommendations.Available: http://www.lifestyler.com/jr/rdachart.htmBeers199910901Beers, M.H.Berkow, R.1999The Merck ManualMerck Research Laboratories172001109112001PDR for Nutritional SupplementsMontvale, NJ.Medical Economics Co.2000109212000PDR for Herbal Medicines.Montvale, NJ.Medical Economics Co. Available: http://physician.pdr.net/physician/static.htm?path=controlled/searchpdrherbal.htm2Available: http://physician.pdr.net/physician/static.htm?path=controlled/searchpdrherbal.htm2002109302002The Natural Health Encyclopedia.Available: http://www.tnp.com/encyclopedia/Available: http://www.tnp.com/encyclopedia/Available: http://www.tnp.com/encyclopedia/[12-16]. We also suggest doing a search on the nutrient/supplement on the National Library of Medicines Pub Med Online  ADDIN EN.CITE 2002109402002National Library of Medicine/Pub Med.Available: (http://www.ncbi.nlm.nih.gov/PubMed/[17]. A quick look at these references will often help you know whether the theory is plausible or not. In my experience, proponents of ergogenic aids often overstate claims made about training devices and/or nutritional supplements while opponents of nutritional supplements and ergogenic aids are either unaware and/or ignorant of research supporting their use. The exercise physiologist has the responsibility to know the literature and/or search available data bases to know whether there is merit or not to a proposed ergogenic aid. Is there any scientific evidence supporting the ergogenic value? The next question suggest asking is whether there is any well-controlled data showing the proposed ergogenic aid works as claimed in athletes or people involved in training. The first place we look is the list of references cited in marketing material supporting their claims. We look to see if the abstracts or articles cited are general references or specific studies that have evaluated the efficacy of the nutrient/supplement. We then critically evaluate the abstracts and articles by asking a series of questions. Are the studies simply basic research done in animals/clinical populations or have the studies been conducted on athletes? Studies reporting improved performance in rats may be insightful but research conducted on athletes is much more convincing. Were the studies well controlled? For ergogenic aid research, the study should be a placebo controlled, double blind, and randomized clinical trail if possible. This means that neither the researchers nor the subjects were aware which group received the supplement or the placebo during the study and that the subjects were randomly assigned into the placebo or supplement group. At times, supplement claims have been based on poorly designed studies (i.e., small groups of subjects, no control group, use of unreliable tests, etc) and/or testimonials which may make interpretation much more difficult. Studies that are well controlled clinical trials provide stronger evidence as to the potential ergogenic value than those that are not well controlled. Do the studies report statistically significant results or are claims being made on non-significant means or trends reported? Appropriate statistical analysis of research results allows for an unbiased interpretation of data. Although studies reporting statistical trends may be of interest and lead researchers to conduct additional research, studies reporting statistically significant results are obviously more convincing. With this said, exercise physiologist must be careful not to commit type II statistical error (i.e., indicating that no differences were observed when a true effect was seen but not detected statistically). Since many studies on ergogenic aids (particularly in high level athletes) evaluate small numbers of subjects, results may not reach statistical significance even though large mean changes were observed. In these cases, additional research is warranted to further examine the potential ergogenic aid before conclusions can be made. Do the results of the studies cited match the claims made about the supplement? It is not unusual for marketing claims to greatly exaggerate the results found in the actual studies. Therefore, you should compare results observed in the studies to marketing claims. Reputable companies accurately report results of studies so that consumers can make informed decisions about whether to try a product or not. Were results of the study presented at a reputable scientific meeting and/or published in a peer-reviewed scientific journal? At times, claims are based on research that has either never been published or only published in an obscure journal. The best research is typically presented at respected scientific meetings and/or published in reputable peer-reviewed journals. Have the research findings been replicated at several different labs? The best way to know an ergogenic aid works is to see that results have been replicated in several studies preferably by a number of researchers. The most reliable ergogenic aids are those in which a number of studies, conducted at different labs, have reported similar results. Is the Supplement Legal and Safe? The final question we ask is whether the supplement is legal and/or safe. Some athletic associations have banned the use of various nutritional supplements (e.g., prohormones, ephedra, etc). Obviously, if the supplement is banned, the exercise physiologist should discourage its use. In addition, many supplements have not been studied for long-term safety. People who consider taking nutritional supplements should be well aware of the potential side effects so that they can make an informed decision regarding whether to use a supplement or not. Additionally, they should consult with a knowledgeable physician to see if there are any underlying medical problems that may contraindicate use. When evaluating the safety of a supplement, we suggest looking to see if any side effects have been reported in the scientific or medical literature. In particular, we suggest determining how long a particular supplement has been studied, the dosages evaluated, and whether any side effects were observed. We also recommend consulting the PDR for nutritional supplements and herbal supplements to see if any side effects have been reported and/or there are any known drug interactions. If no side effects have been reported in the scientific/medical literature, we generally will view the supplement as safe for the length of time and dosages evaluated. Classifying and Categorizing Supplements Dietary supplements may contain carbohydrate, protein, fat, minerals, vitamins, herbs, and/or various plant/food extracts. Supplements can generally be classified as convenience supplements (e.g., energy bars, meal replacement powders, ready to drink supplements) designed to provide a convenient means of meeting caloric needs and/or managing caloric intake, weight gain supplements, weight loss supplements, and performance enhancement supplements. Based on the above criteria, we generally categorize nutritional supplements into the following categories: Apparently Effective. Supplements that help people meet general caloric needs and/or the majority of research studies show is effective and safe. Possibly Effective. Supplements that initial studies support the theoretical rationale but that more research is needed to determine how the supplement may affect training and/or performance. Too Early To Tell. Supplements that the theory may make sense but there is insufficient research to support the use at this time. Apparently Ineffective. Supplements that the theoretical rationale makes little scientific sense and/or research has clearly shown to be ineffective. When exercise physiologists council people who train, they should first evaluate their diet and training program. They should make sure that the athlete is eating an energy balanced, nutrient dense diet and that they are training intelligently. This is the foundation to build a good program. Following this, we recommend that they generally only recommend supplements in category I. If someone is interested in trying supplements in category II, they should make sure that they understand that these supplements are more experimental and that they may or may not see the type of results claimed. We recommend discouraging people from trying supplements in category III because there isnt enough data available on whether they work or not. However, if someone wants to try one of these supplements, they should understand that although there is some theoretical rationale, there is little evidence to support use at this time. Obviously, we do not support athletes taking supplements in categories IV. We believe that this approach is a more scientifically supportable and balanced view than simply dismissing the use of all dietary supplements out of hand. General Dietary Guidelines for Active Individuals A well-designed diet that meets energy intake needs and incorporates proper timing of nutrients is the foundation upon which a good training program can be developed. Research has clearly shown that athletes that do not ingest enough calories and/or do not consume enough of the right type of macronutrients may impede training adaptations while athletes who consume a good diet can help the body adapt to training. Moreover, maintaining an energy deficient diet during training may lead to loss of muscle mass, increased susceptibility to illness, and increase prevalence of overreaching and/or overtraining. Incorporating good dietary practices as part of a training program is one way to help optimize training adaptations and prevent overtraining. The following overviews energy intake and major nutrient needs of active individuals. Energy Intake. The first component to optimize training and performance through nutrition is to ensure the athlete is consuming enough calories to offset energy expenditure  ADDIN EN.CITE Sherman199828667Sherman, W.M.Jacobs, K.A.Leenders, N.1998Carbohydrate metabolism during endurance exerciseKreider, R.B.Fry, A. C.O'Toole, M.L.Overtraining in SportChampaignHuman Kinetics Publishers289-308Leutholtz200116077Leutholtz, B. Kreider, R.B.2001Exercise and Sport Nutrition.Wilson, T.Temple, N.Nutritional Health.Totowa, NJHumana Press, Inc.207 – 239Berning199828657Berning, J.R.1998Energy intake, diet, and muscle wastingKreider, R.B.Fry, A.C.O'Toole, M.L.Overtraining in SportChampaignHuman Kinetics275-288Kreider199828671Kreider, R.B.Fry, A. C.O'Toole, M.L.1998Overtraining in SportChampaignHuman Kinetics Publishers[9, 18-20]. People who participate in a general fitness program (e.g., exercising 30 - 40 minutes per day, 3 times per week) can generally meet nutritional needs following a normal diet (e.g., 1,800 2,400 kcals/day or about 25 - 35 kcals/kg/day for a 50 80 kg individual) because their caloric demands from exercise are not too great (e.g., 200 400 kcals/session)  ADDIN EN.CITE Leutholtz200116077Leutholtz, B. Kreider, R.B.2001Exercise and Sport Nutrition.Wilson, T.Temple, N.Nutritional Health.Totowa, NJHumana Press, Inc.207 – 239[9]. However, athletes involved in moderate levels of intense training (e.g., 2-3 hours per day of intense exercise performed 5-6 times per week) or high volume intense training (e.g., 3-6 hours per day of intense training in 1-2 workouts for 5-6 days per week) may expend 600 1,200 kcals or more per hour during exercise  ADDIN EN.CITE Leutholtz200116077Leutholtz, B. Kreider, R.B.2001Exercise and Sport Nutrition.Wilson, T.Temple, N.Nutritional Health.Totowa, NJHumana Press, Inc.207 – 239Kreider1991288701844400111991MarPhysiological considerations of ultraendurance performance3-27Department of Health, Physical Education and Recreation, Old Dominion University, Norfolk, VA 23529-0196.Kreider, R. B.Int J Sport NutrAdaptation, PhysiologicalExercise/*physiologyHuman*NutritionPhysical Education and TrainingPhysical Endurance/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1844400[9, 21]. For this reason, their caloric needs may approach 50 80 kcals/kg/day (2,500 8,000 kcals/day for a 50 100 kg athlete). For elite athletes, energy expenditure during heavy training or competition may be enormous. For example, energy expenditure for cyclists to compete in the Tour de France has been estimated as high as 12,000 kcals/day (150 - 200 kcals/kg/d for a 60 80 kg athlete)  ADDIN EN.CITE Brouns198928680266374210 Suppl 11989MayEating, drinking, and cycling. A controlled Tour de France simulation study, Part II. Effect of diet manipulationS41-8Department of Human Biology, University of Limburg, Maastricht, The Netherlands.Brouns, F.Saris, W. H.Stroecken, J.Beckers, E.Thijssen, R.Rehrer, N. J.ten Hoor, F.Int J Sports MedAdult*BicyclingDietary Carbohydrates/metabolism*Drinking*EatingEnergy MetabolismEvaluation StudiesHumanMale*Sportshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2663742Brouns198928690266374110 Suppl 11989MayEating, drinking, and cycling. A controlled Tour de France simulation study, Part IS32-40Department of Human Biology, University of Limburg, Maastricht, The Netherlands.Brouns, F.Saris, W. H.Stroecken, J.Beckers, E.Thijssen, R.Rehrer, N. J.ten Hoor, F.Int J Sports MedAdult*Bicycling*Drinking*Eating*Energy MetabolismHumanMale*Sportshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2663741Kreider1991288701844400111991MarPhysiological considerations of ultraendurance performance3-27Department of Health, Physical Education and Recreation, Old Dominion University, Norfolk, VA 23529-0196.Kreider, R. B.Int J Sport NutrAdaptation, PhysiologicalExercise/*physiologyHuman*NutritionPhysical Education and TrainingPhysical Endurance/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1844400[21-23]. Additionally, caloric needs for large athletes (i.e., 100 150 kg) may range between 6,000 12,000 kcals/day depending on the volume and intensity of different training phases  ADDIN EN.CITE Kreider1991288701844400111991MarPhysiological considerations of ultraendurance performance3-27Department of Health, Physical Education and Recreation, Old Dominion University, Norfolk, VA 23529-0196.Kreider, R. B.Int J Sport NutrAdaptation, PhysiologicalExercise/*physiologyHuman*NutritionPhysical Education and TrainingPhysical Endurance/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1844400[21]. Although some exercise physiologists and nutritionists argue that athletes can meet caloric needs simply by consuming a well-balanced diet, it is often very difficult for larger athletes and/or athletes engaged in high volume/intense training to be able to eat enough food in order to meet caloric needs  ADDIN EN.CITE Kreider1991288701844400111991MarPhysiological considerations of ultraendurance performance3-27Department of Health, Physical Education and Recreation, Old Dominion University, Norfolk, VA 23529-0196.Kreider, R. B.Int J Sport NutrAdaptation, PhysiologicalExercise/*physiologyHuman*NutritionPhysical Education and TrainingPhysical Endurance/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1844400Berning199828657Berning, J.R.1998Energy intake, diet, and muscle wastingKreider, R.B.Fry, A.C.O'Toole, M.L.Overtraining in SportChampaignHuman Kinetics275-288Brouns198928690266374110 Suppl 11989MayEating, drinking, and cycling. A controlled Tour de France simulation study, Part IS32-40Department of Human Biology, University of Limburg, Maastricht, The Netherlands.Brouns, F.Saris, W. H.Stroecken, J.Beckers, E.Thijssen, R.Rehrer, N. J.ten Hoor, F.Int J Sports MedAdult*Bicycling*Drinking*Eating*Energy MetabolismHumanMale*Sportshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2663741Brouns198928680266374210 Suppl 11989MayEating, drinking, and cycling. A controlled Tour de France simulation study, Part II. Effect of diet manipulationS41-8Department of Human Biology, University of Limburg, Maastricht, The Netherlands.Brouns, F.Saris, W. H.Stroecken, J.Beckers, E.Thijssen, R.Rehrer, N. J.ten Hoor, F.Int J Sports MedAdult*BicyclingDietary Carbohydrates/metabolism*Drinking*EatingEnergy MetabolismEvaluation StudiesHumanMale*Sportshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2663742Leutholtz200116077Leutholtz, B. Kreider, R.B.2001Exercise and Sport Nutrition.Wilson, T.Temple, N.Nutritional Health.Totowa, NJHumana Press, Inc.207 – 239[9, 19, 21-23]. Maintaining an energy deficient diet during training often leads to significant weight loss (including muscle mass), illness, onset of physical and psychological symptoms of overtraining, and reductions in performance  ADDIN EN.CITE Kreider199828671Kreider, R.B.Fry, A. C.O'Toole, M.L.1998Overtraining in SportChampaignHuman Kinetics Publishers[20]. Nutritional analyses of athletes diets have revealed that many are susceptible to maintaining negative energy intakes during training. Susceptible populations include runners, cyclists, swimmers, triathletes, gymnasts, skaters, dancers, wrestlers, boxers, and athletes attempting to lose weight too quickly  ADDIN EN.CITE Berning199828657Berning, J.R.1998Energy intake, diet, and muscle wastingKreider, R.B.Fry, A.C.O'Toole, M.L.Overtraining in SportChampaignHuman Kinetics275-288[19]. Additionally, female athletes have been reported to have a high incidence of eating disorders  ADDIN EN.CITE Berning199828657Berning, J.R.1998Energy intake, diet, and muscle wastingKreider, R.B.Fry, A.C.O'Toole, M.L.Overtraining in SportChampaignHuman Kinetics275-288[19]. Consequently, it is important for the exercise physiologist working with athletes to ensure that athletes are well-fed and consume enough calories to offset the increased energy demands of training and maintain body weight. Although this sounds relatively simple, intense training often suppresses appetite and/or alters hunger patterns so that many athletes do not feel like eating  ADDIN EN.CITE Berning199828657Berning, J.R.1998Energy intake, diet, and muscle wastingKreider, R.B.Fry, A.C.O'Toole, M.L.Overtraining in SportChampaignHuman Kinetics275-288[19]. Some athletes do not like to exercise within several hours after eating because of sensations of fullness and/or a predisposition to cause gastrointestinal distress. Further, travel and training schedules may limit food availability and/or the types of food athletes are accustomed to eating. This means that care should be taken to plan meal times in concert with training as well as make sure athletes have sufficient availability of nutrient dense foods throughout the day for snacking between meals (e.g., drinks, fruit, carbohydrate/protein bars, etc)  ADDIN EN.CITE Berning199828657Berning, J.R.1998Energy intake, diet, and muscle wastingKreider, R.B.Fry, A.C.O'Toole, M.L.Overtraining in SportChampaignHuman Kinetics275-288Sherman199828667Sherman, W.M.Jacobs, K.A.Leenders, N.1998Carbohydrate metabolism during endurance exerciseKreider, R.B.Fry, A. C.O'Toole, M.L.Overtraining in SportChampaignHuman Kinetics Publishers289-308Leutholtz200116077Leutholtz, B. Kreider, R.B.2001Exercise and Sport Nutrition.Wilson, T.Temple, N.Nutritional Health.Totowa, NJHumana Press, Inc.207 – 239[9, 18, 19]. For this reason, sport nutritionists often recommend that athletes consume 4-6 meals per day and snack in between meals in order to meet energy needs. Use of nutrient dense energy bars and high calorie carbohydrate/protein supplements provides a convenient way for athletes to supplement their diet in order to maintain energy intake during training. Carbohydrate. The second component to optimizing training and performance through nutrition is to ensure that athletes consume the proper amounts of carbohydrate, protein and fat in their diet. Individuals engaged in a general fitness program can typically meet macronutrient needs by consuming a normal diet (i.e., 45-55% carbohydrate [3-5 grams/kg/day], 10-15% protein [0.8 1.0 gram/kg/day], and 25-35% fat [0.5 1.5 grams/kg/day]). However, athletes involved in moderate and high volume training need greater amounts of carbohydrate and protein in their diet to meet macronutrient needs. For example, in terms of carbohydrate needs, athletes involved in moderate amounts of intense training (e.g., 2-3 hours per day of intense exercise performed 5-6 times per week) typically need to consume a diet consisting of 55-65% carbohydrate (i.e., 5-8 grams/kg/day or 250 1,200 grams/day for 50 150 kg athletes) in order to maintain liver and muscle glycogen stores  ADDIN EN.CITE Sherman199828667Sherman, W.M.Jacobs, K.A.Leenders, N.1998Carbohydrate metabolism during endurance exerciseKreider, R.B.Fry, A. C.O'Toole, M.L.Overtraining in SportChampaignHuman Kinetics Publishers289-308Leutholtz200116077Leutholtz, B. Kreider, R.B.2001Exercise and Sport Nutrition.Wilson, T.Temple, N.Nutritional Health.Totowa, NJHumana Press, Inc.207 – 239[9, 18]. Research has also shown that athletes involved in high volume intense training (e.g., 3-6 hours per day of intense training in 1-2 workouts for 5-6 days per week) may need to consume 8-10 grams/day of carbohydrate (i.e., 400 1,500 grams/day for 50 150 kg athletes) in order to maintain muscle glycogen levels  ADDIN EN.CITE Sherman199828667Sherman, W.M.Jacobs, K.A.Leenders, N.1998Carbohydrate metabolism during endurance exerciseKreider, R.B.Fry, A. C.O'Toole, M.L.Overtraining in SportChampaignHuman Kinetics Publishers289-308Leutholtz200116077Leutholtz, B. Kreider, R.B.2001Exercise and Sport Nutrition.Wilson, T.Temple, N.Nutritional Health.Totowa, NJHumana Press, Inc.207 – 239[9, 18]. This would be equivalent to consuming 0.5 2.0 kg of spaghetti. Preferably, the majority of dietary carbohydrate should come from complex carbohydrates with a low to moderate glycemic index (e.g., grains, starches, fruit, maltodextrins, etc). However, since it is physically difficult to consume that much carbohydrate per day when an athlete is involved in intense training, many nutritionists and exercise physiologist recommend that athletes consume concentrated carbohydrate juices/drinks and/or consume high carbohydrate supplements to meet carbohydrate needs. While consuming this amount of carbohydrate is not necessary for the fitness minded individual who only trains 3-4 times per week for 30-60 minutes, it is essential for competitive athletes engaged in intense moderate to high volume training. Protein. There has been considerable debate regarding protein needs of athletes  ADDIN EN.CITE Lemon19922888014000087321992AugProtein requirements and muscle mass/strength changes during intensive training in novice bodybuilders767-75School of Biomedical Sciences, Kent State University, Ohio 44242.Lemon, P. W.Tarnopolsky, M. A.MacDougall, J. D.Atkinson, S. A.J Appl PhysiolAdultBody Weight/physiologyDietDietary Proteins/*pharmacologyDouble-Blind MethodEnergy MetabolismHumanMaleMuscles/anatomy & histology/innervation/*physiologyNitrogen/metabolism*Nutritional RequirementsOrgan Weight/physiologySupport, Non-U.S. Gov'tTomography, X-Ray Computed*Weight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1400008Tarnopolsky19882889033566366411988JanInfluence of protein intake and training status on nitrogen balance and lean body mass187-93Department of Physical Education and Pediatrics, McMaster University, Hamilton, Ontario, Canada.Tarnopolsky, M. A.MacDougall, J. D.Atkinson, S. A.J Appl PhysiolAdolescentAdultBody CompositionBody Weight/*drug effectsComparative StudyDietary Proteins/*pharmacologyHumanIsometric ContractionMaleNitrogen/*metabolism*Physical Education and TrainingPhysical EnduranceSupport, Non-U.S. Gov'tUrea/urinehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3356636Tarnopolsky19922890014740767351992NovEvaluation of protein requirements for trained strength athletes1986-95Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.Tarnopolsky, M. A.Atkinson, S. A.MacDougall, J. D.Chesley, A.Phillips, S.Schwarcz, H. P.J Appl PhysiolAdultBody Composition/physiologyCreatine Kinase/metabolismDiet*Dietary Proteins/administration & dosageElbow/physiologyFeces/chemistryHumanLeucine/metabolismMaleNitrogen/metabolismNutritional RequirementsSupport, Non-U.S. Gov'tWeight Lifting/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1474076Tarnopolsky19992891010678685261999NovProtein and physical performance533-7Department of Neurology/Neurological Rehabilitation, McMaster University Medical Center, Hamilton, Ontario, Canada. tarnopol@fhs.mcmaster.caTarnopolsky, M. A.Curr Opin Clin Nutr Metab CareAgingComparative Study*Dietary Proteins/administration & dosageExerciseFemaleHumanMaleNutritional Requirements*Physical EnduranceSex Characteristicshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10678685Kreider1999. Available: http://www.sportsci.org/jour/9901/rbk.html1460Kreider, R. B.1999. Available: http://www.sportsci.org/jour/9901/rbk.htmlEffects of protein and amino acid supplementation on athletic performanceSportscience31[24-28]. Initially, it was recommended that athletes do not need to ingest more than the RDA for protein (i.e., 0.8 to 1.0 g/kg/d for children, adolescents and adults). However, research over the last decade has indicated that athletes engaged in intense training need to ingest about 1.5 2 times the RDA of protein in their diet (1.5 to 2.0 g/kg/d) in order to maintain protein balance  ADDIN EN.CITE Lemon19922888014000087321992AugProtein requirements and muscle mass/strength changes during intensive training in novice bodybuilders767-75School of Biomedical Sciences, Kent State University, Ohio 44242.Lemon, P. W.Tarnopolsky, M. A.MacDougall, J. D.Atkinson, S. A.J Appl PhysiolAdultBody Weight/physiologyDietDietary Proteins/*pharmacologyDouble-Blind MethodEnergy MetabolismHumanMaleMuscles/anatomy & histology/innervation/*physiologyNitrogen/metabolism*Nutritional RequirementsOrgan Weight/physiologySupport, Non-U.S. Gov'tTomography, X-Ray Computed*Weight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1400008Tarnopolsky19882889033566366411988JanInfluence of protein intake and training status on nitrogen balance and lean body mass187-93Department of Physical Education and Pediatrics, McMaster University, Hamilton, Ontario, Canada.Tarnopolsky, M. A.MacDougall, J. D.Atkinson, S. A.J Appl PhysiolAdolescentAdultBody CompositionBody Weight/*drug effectsComparative StudyDietary Proteins/*pharmacologyHumanIsometric ContractionMaleNitrogen/*metabolism*Physical Education and TrainingPhysical EnduranceSupport, Non-U.S. Gov'tUrea/urinehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3356636Tarnopolsky19922890014740767351992NovEvaluation of protein requirements for trained strength athletes1986-95Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.Tarnopolsky, M. A.Atkinson, S. A.MacDougall, J. D.Chesley, A.Phillips, S.Schwarcz, H. P.J Appl PhysiolAdultBody Composition/physiologyCreatine Kinase/metabolismDiet*Dietary Proteins/administration & dosageElbow/physiologyFeces/chemistryHumanLeucine/metabolismMaleNitrogen/metabolismNutritional RequirementsSupport, Non-U.S. Gov'tWeight Lifting/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1474076Tarnopolsky19992891010678685261999NovProtein and physical performance533-7Department of Neurology/Neurological Rehabilitation, McMaster University Medical Center, Hamilton, Ontario, Canada. tarnopol@fhs.mcmaster.caTarnopolsky, M. A.Curr Opin Clin Nutr Metab CareAgingComparative Study*Dietary Proteins/administration & dosageExerciseFemaleHumanMaleNutritional Requirements*Physical EnduranceSex Characteristicshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10678685Kreider1999. Available: http://www.sportsci.org/jour/9901/rbk.html1460Kreider, R. B.1999. Available: http://www.sportsci.org/jour/9901/rbk.htmlEffects of protein and amino acid supplementation on athletic performanceSportscience31[24-28]. If an insufficient amount of protein is obtained from the diet, an athlete will maintain a negative nitrogen balance which can increase protein catabolism and slow recovery. Over time, this may lead to lean muscle wasting and training intolerance  ADDIN EN.CITE Kreider199828671Kreider, R.B.Fry, A. C.O'Toole, M.L.1998Overtraining in SportChampaignHuman Kinetics PublishersLeutholtz200116077Leutholtz, B. Kreider, R.B.2001Exercise and Sport Nutrition.Wilson, T.Temple, N.Nutritional Health.Totowa, NJHumana Press, Inc.207 – 239[9, 20]. For people involved in a general fitness program, protein needs can generally be met by ingesting 0.8 1.0 grams/kg/day of protein. It is generally recommended that athletes involved in moderate amounts of intense training consume 1 1.5 grams/kg/day of protein (50 225 grams/day for a 50 150 kg athlete) while athletes involved in high volume intense training consume 1.5 2.0 grams/kg/day of protein (75 300 grams/day for a 50 150 kg athlete)  ADDIN EN.CITE Kreider200028920Kreider, R.B.Kleiner, S.M.2000Protein supplements for athletes: need vs. convenienceYour Patient & Fitness14612-18[29]. This protein need would be equivalent to ingesting 3 11 servings of chicken or fish per day for a 50 150 kg athlete  ADDIN EN.CITE Kreider200028920Kreider, R.B.Kleiner, S.M.2000Protein supplements for athletes: need vs. convenienceYour Patient & Fitness14612-18[29]. Although smaller athletes typically can ingest this amount of protein in their normal diet, larger athletes often have difficulty consuming this much dietary protein. Additionally, a number of athletic populations have been reported to be susceptible to protein malnutrition (e.g., runners, cyclists, swimmers, triathletes, gymnasts, dancers, skaters, wrestlers, boxers, etc). Therefore, care should be taken to ensure that athletes consume a sufficient amount of quality protein in their diet in order to maintain nitrogen balance (e.g., 1.5 - 2 grams/kg/day). However, it should be noted that not all protein is the same. Proteins differ based on the source that the protein was obtained, the amino acid profile of the protein, and the methods of processing or isolating the protein  ADDIN EN.CITE Bucci20001347Bucci, LR Unlu, LM2000Proteins and amino acid supplements in exercise and sportDriskell, JA Wolinsky, IEnergy-Yielding Macronutrients and Energy Metabolism in Sports NutritionBoca Raton, FLCRC Press191-212</MDL></Cite></EndNote>[30]. These differences influence availability of amino acids and peptides that have been reported to possess biological activity (e.g., -lactalbumin, -lactoglobulin, glycomacropeptides, immunoglobulins, lactoperoxidases, lactoferrin, etc). Additionally, the rate and metabolic activity of the protein  ADDIN EN.CITE Bucci20001347Bucci, LR Unlu, LM2000Proteins and amino acid supplements in exercise and sportDriskell, JA Wolinsky, IEnergy-Yielding Macronutrients and Energy Metabolism in Sports NutritionBoca Raton, FLCRC Press191-212[30]. For example, different types of proteins (e.g., casein and whey) are digested at different rates which directly affect catabolism and anabolism  ADDIN EN.CITE Bucci20001347Bucci, LR Unlu, LM2000Proteins and amino acid supplements in exercise and sportDriskell, JA Wolinsky, IEnergy-Yielding Macronutrients and Energy Metabolism in Sports NutritionBoca Raton, FLCRC Press191-212Boirie1997870http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=9405716Boirie, Y.Dangin, M.Gachon, P.Vasson, M. P.Maubois, J. L.Beaufrere, B.Slow and fast dietary proteins differently modulate postprandial protein accretionAdultAmino Acids/bloodCaseins/metabolismDietary Proteins/*metabolismHumanIntestinal AbsorptionLeucine/metabolismMilk Proteins/metabolism*Postprandial PeriodProteins/*metabolismSupport, Non-U.S. Gov'tLaboratoire de Nutrition Humaine, Universite Clermont Auvergne, Centre de Recherche en Nutrition Humaine, BP 321, 63009 Clermont-Ferrand Cedex 1, France.9405716Proc Natl Acad Sci U S A1997942614930-5.Boirie2001840Boirie, Y.Gachon, P.Cordat, N.Ritz, P.Beaufrere, B.Differential insulin sensitivities of glucose, amino acid, and albumin metabolism in elderly men and womenAdultAge FactorsAgedAging/*physiologyAmino Acids/blood/*metabolismBlood Glucose/metabolismBody Mass IndexCarbon IsotopesFemaleGlucose/*metabolismGlucose Clamp TechniqueHomeostasisHumanInfusions, IntravenousInsulin/administration & dosage/*blood/*pharmacologyLeucine/bloodMaleProteins/metabolismSerum Albumin/*metabolismLaboratoire de Nutrition Humaine, Universite d'Auvergne, Institut National de la Recherche Agronormique and Centre de Recherche en Nutrition Humaine, 63009 Clermont-Ferrand, France. boirie@clermont.inra.fr11158022http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11158022 http://jcem.endojournals.org/cgi/content/full/86/2/638 http://jcem.endojournals.org/cgi/content/abstract/86/2/638J Clin Endocrinol Metab2001862638-44.Boirie1996830http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=8997229Boirie, Y.Gachon, P.Corny, S.Fauquant, J.Maubois, J. L.Beaufrere, B.Acute postprandial changes in leucine metabolism as assessed with an intrinsically labeled milk proteinAdministration, OralAdultCarbon RadioisotopesHumanInjections, IntravenousLeucine/administration & dosage/*metabolismMaleMilk Proteins/*metabolism*Postprandial PeriodSupport, Non-U.S. Gov'tTritiumLaboratoire de Nutrition Humaine, Universite Clermont Auvergne, Clermont-Ferrand, France.8997229Am J Physiol19962716 Pt 1E1083-91.[30-33]. Therefore, care should be taken not only to make sure the athlete consumes enough protein in their diet but also that the protein is high quality. The best dietary sources of low fat and high quality protein are light skinless chicken, fish, egg white and skim milk (casein and whey)  ADDIN EN.CITE Bucci20001347Bucci, LR Unlu, LM2000Proteins and amino acid supplements in exercise and sportDriskell, JA Wolinsky, IEnergy-Yielding Macronutrients and Energy Metabolism in Sports NutritionBoca Raton, FLCRC Press191-212[30]. The best sources of high quality protein found in nutritional supplements is whey, colostrum, casein, milk proteins and egg protein  ADDIN EN.CITE Bucci20001347Bucci, LR Unlu, LM2000Proteins and amino acid supplements in exercise and sportDriskell, JA Wolinsky, IEnergy-Yielding Macronutrients and Energy Metabolism in Sports NutritionBoca Raton, FLCRC Press191-212Kreider200028920Kreider, R.B.Kleiner, S.M.2000Protein supplements for athletes: need vs. convenienceYour Patient & Fitness14612-18[29, 30]. Although some athletes may not need to supplement their diet with protein and some exercise physiologists may not think that protein supplements are necessary, suggestions that it is unethical for an exercise physiologist to recommend that some athletes supplement their diet with protein in order to meet dietary protein needs and/or provide essential amino acids following exercise in order to optimize protein synthesis is clearly not supported by the literature. Fat. The dietary recommendations of fat intake for athletes are similar to or slightly greater than those recommended for non-athletes in order to promote health. Maintenance of energy balance, replenishment of intramuscular triacylglycerol stores and adequate consumption of essential fatty acids are of greater importance among athletes and allow for somewhat increased intake  ADDIN EN.CITE Venkatraman20003088010910295327 Suppl2000JulDietary fats and immune status in athletes: clinical implicationsS389-95Department of Physical Therapy, Exercise and Nutrition Sciences, Sports Medicine Institute, University at Buffalo, NY 14214, USA. jtv@acsu.buffalo.eduVenkatraman, J. T.Leddy, J.Pendergast, D.Med Sci Sports ExercAntioxidants/pharmacology*Dietary Fats/administration & dosageExercise/*physiologyGene Expression RegulationHumanImmunity, Cellular/immunologyImmunocompetenceInfectionInflammationLipoproteins/*bloodLymphocyte SubsetsPhysical Endurance/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10910295[34]. This depends on the athletes training state and goals. For example, higher-fat diets appear to maintain circulating testosterone concentrations better than low-fat diets  ADDIN EN.CITE Dorgan19963089089424076461996DecEffects of dietary fat and fiber on plasma and urine androgens and estrogens in men: a controlled feeding study850-5Division of Cancer Prevention and Control, National Cancer Institute, Bethesda, MD 20892-7326, USA. dorganj@dcpcepn.nci.nih.govDorgan, J. F.Judd, J. T.Longcope, C.Brown, C.Schatzkin, A.Clevidence, B. A.Campbell, W. S.Nair, P. P.Franz, C.Kahle, L.Taylor, P. R.Am J Clin NutrAdultAndrogens/*bloodBody Weight/physiologyCross-Sectional StudiesDietary Fats/*pharmacologyDietary Fiber/*pharmacologyEstradiol/bloodEstrogens/*bloodEstrone/bloodHumanMaleMiddle AgeSex Hormone-Binding Globulin/analysisTestosterone/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8942407Hamalainen19833090062985071831983MarDecrease of serum total and free testosterone during a low-fat high-fibre diet369-70Hamalainen, E. K.Adlercreutz, H.Puska, P.Pietinen, P.J Steroid Biochem*Dietary Fats*Dietary FiberHumanKineticsMaleMiddle AgeRadioimmunoassay/methodsTestosterone/*bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6298507Reed19873091035587256451987MayDietary lipids: an additional regulator of plasma levels of sex hormone binding globulin1083-5Reed, M. J.Cheng, R. W.Simmonds, M.Richmond, W.James, V. H.J Clin Endocrinol MetabAdultCholesterol/bloodDietary Fats/administration & dosage/*pharmacologyHumanMaleMiddle AgeSex Hormone-Binding Globulin/*metabolismTestosterone/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3558725[35-37]. This has relevance to the documented testosterone suppression which can occur during volume-type overtraining  ADDIN EN.CITE Fry19983092098435638561998DecPituitary-adrenal-gonadal responses to high-intensity resistance exercise overtraining2352-9Human Performance Laboratories, University of Memphis, Memphis, Tennessee 38152, USA.Fry, A. C.Kraemer, W. J.Ramsey, L. T.J Appl PhysiolAdultEnkephalin, Methionine/analogs & derivatives/bloodEpinephrine/bloodExercise/*physiologyHumanHuman Growth Hormone/bloodHydrocortisone/bloodMalePhysical Education and TrainingPituitary-Adrenal System/*physiologyProtein Precursors/bloodTestis/*physiologyTestosterone/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9843563[38]. Generally, it is recommended that athletes consume a moderate amount of fat (approximately 30% of their daily caloric intake), while increases up to 50% of kcal can be safely ingested by athletes during regular high-volume training  ADDIN EN.CITE Venkatraman20003088010910295327 Suppl2000JulDietary fats and immune status in athletes: clinical implicationsS389-95Department of Physical Therapy, Exercise and Nutrition Sciences, Sports Medicine Institute, University at Buffalo, NY 14214, USA. jtv@acsu.buffalo.eduVenkatraman, J. T.Leddy, J.Pendergast, D.Med Sci Sports ExercAntioxidants/pharmacology*Dietary Fats/administration & dosageExercise/*physiologyGene Expression RegulationHumanImmunity, Cellular/immunologyImmunocompetenceInfectionInflammationLipoproteins/*bloodLymphocyte SubsetsPhysical Endurance/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10910295[34]. For athletes attempting to decrease body fat, however, it has been recommended that they consume 0.5 to 1 g/kg/d of fat  ADDIN EN.CITE Leutholtz200116077Leutholtz, B. Kreider, R.B.2001Exercise and Sport Nutrition.Wilson, T.Temple, N.Nutritional Health.Totowa, NJHumana Press, Inc.207 – 239[9]. The reason for this is that some weight loss studies indicate that people who are most successful in losing weight and maintaining the weight loss are those who ingest less than 40 g/d of fat in their diet  ADDIN EN.CITE Miller199728930934741421101997OctA meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention941-7George Washington University Medical Center, Washington DC 20052, USA.Miller, W. C.Koceja, D. M.Hamilton, E. J.Int J Obes Relat Metab DisordAdultBody CompositionCombined Modality TherapyComparative Study*Diet, Reducing*ExerciseHumanObesity/physiopathology/*prevention & controlSupport, Non-U.S. Gov'tWeight Loss/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9347414Miller200125370http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11547893Miller, W. C.Effective diet and exercise treatments for overweight and recommendations for interventionBehavior TherapyComorbidityDiet Therapy/adverse effects/*methodsDiet, Fat-RestrictedDiet, ReducingDietary Carbohydrates/therapeutic useDietary Fats/therapeutic useDietary Proteins/therapeutic useEnergy IntakeExercise Therapy/adverse effects/*methodsGallbladder Diseases/complications/etiologyHealth BehaviorHumanObesity/complications/*therapyOsteoarthritis/complications/etiologyProgram EvaluationSupport, Non-U.S. Gov'tExercise Science Programs, The George Washington University Medical Center, Washington, DC 20052, USA. wmiller@gwu.edu115478932001Sports Med3110717-24[39, 40] although this is not always the case  ADDIN EN.CITE Pirozzo20033093012760443422003MayShould we recommend low-fat diets for obesity?83-90School of Population Health, University of Queensland, Brisbane, Australia.Pirozzo, S.Summerbell, C.Cameron, C.Glasziou, P.Obes Revhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12760443[41]. Certainly, the type of dietary fat (e.g. n-6 versus n-3; saturation state) is a factor in such research and could play an important role in any discrepancies  ADDIN EN.CITE Hu200130940112934672012001FebTypes of dietary fat and risk of coronary heart disease: a critical review5-19Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA. Frank.hu@channing.harvard.eduHu, F. B.Manson, J. E.Willett, W. C.J Am Coll NutrAnimalCholesterol/bloodCoronary Disease/*etiology/prevention & controlDietDietary Fats/*administration & dosage/classificationEggsFatty Acids, Omega-3/administration & dosage/therapeutic useFatty Acids, Unsaturated/administration & dosage/therapeutic useFish Oils/administration & dosage/therapeutic useHumanMeta-AnalysisNutrition PolicyNuts/therapeutic usePhytotherapyRisk FactorsUnited Stateshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11293467Vessby200330950125446561412003FebDietary fat, fatty acid composition in plasma and the metabolic syndrome15-9Vessby, B.Curr Opin Lipidolhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12544656[42, 43]. Strategies to help athletes manage dietary fat intake include teaching them which foods contain various types of fat so that they can make better food choices and how to how to count fat grams  ADDIN EN.CITE Leutholtz200116077Leutholtz, B. Kreider, R.B.2001Exercise and Sport Nutrition.Wilson, T.Temple, N.Nutritional Health.Totowa, NJHumana Press, Inc.207 – 239Berning199828657Berning, J.R.1998Energy intake, diet, and muscle wastingKreider, R.B.Fry, A.C.O'Toole, M.L.Overtraining in SportChampaignHuman Kinetics275-288[9, 19]. Strategic Eating and Refueling. In addition to the general nutritional guidelines described above, research has also demonstrated that timing and composition of meals consumed may play a role in optimizing performance, training adaptations, and preventing overtraining  ADDIN EN.CITE Sherman199828667Sherman, W.M.Jacobs, K.A.Leenders, N.1998Carbohydrate metabolism during endurance exerciseKreider, R.B.Fry, A. C.O'Toole, M.L.Overtraining in SportChampaignHuman Kinetics Publishers289-308Leutholtz200116077Leutholtz, B. Kreider, R.B.2001Exercise and Sport Nutrition.Wilson, T.Temple, N.Nutritional Health.Totowa, NJHumana Press, Inc.207 – 239Kreider19991440http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10091274Kreider, R. B.Dietary supplements and the promotion of muscle growth with resistance exerciseAnabolic Steroids/metabolismBoron/administration & dosage/pharmacologyChromium/administration & dosage/pharmacologyCreatine/administration & dosage/pharmacologyDietary Carbohydrates/administration & dosage/pharmacologyDietary Proteins/administration & dosage/pharmacology*Dietary SupplementsGlutamine/administration & dosage/pharmacologyHumanLeucine/administration & dosage/pharmacologyMuscle, Skeletal/drug effects/*growth & developmentNutritionPrasterone/administration & dosage/pharmacologyProteins/biosynthesisTestosterone/metabolismValerates/administration & dosage/pharmacologyVanadium Compounds/administration & dosage/pharmacologyWeight Lifting/*physiologyDepartment of Human Movement Sciences and Education, University of Memphis, Tennessee, USA. kreider.richard@coe.memphis.edu10091274Sports Med199927297-110.Kreider200128947Kreider, R.B.2001Nutritional Considerations of OvertrainingStout, J.R. Antonio, J.Sport Supplements: A Complete Guide to Physique and Athletic EnhancementBaltimore, MDLippincott, Williams & Wilkins199-208[9, 18, 44, 45]. In this regard, it takes about 4 hours for carbohydrate to be digested and begin to be stored as muscle and liver glycogen. Consequently, pre-exercise meals should be consumed about 4 to 6 h before exercise  ADDIN EN.CITE Sherman199828667Sherman, W.M.Jacobs, K.A.Leenders, N.1998Carbohydrate metabolism during endurance exerciseKreider, R.B.Fry, A. C.O'Toole, M.L.Overtraining in SportChampaignHuman Kinetics Publishers289-308[18]. This means that if an athlete trains in the afternoon, breakfast is the most important meal to top off muscle and liver glycogen levels. Research has also indicated that ingesting a light carbohydrate and protein snack 30 to 60 min prior to exercise (e.g., 50 g of carbohydrate and 5 to 10 g of protein) serves to increase carbohydrate availability toward the end of an intense exercise bout  ADDIN EN.CITE Carli19922189013141746431992Changes in the exercise-induced hormone response to branched chain amino acid administration272-7Istituto di Fisiologia Umana, Universita di Siena, Italy.Carli, G.Bonifazi, M.Lodi, L.Lupo, C.Martelli, G.Viti, A.Eur J Appl Physiol Occup PhysiolAdultAmino Acids, Branched-Chain/*pharmacologyCorticotropin/bloodExercise/*physiologyGrowth Hormone/bloodHormones/*bloodHumanHydrocortisone/bloodMaleProlactin/bloodRunningSex Hormone-Binding Globulin/metabolismSupport, Non-U.S. Gov'tTestosterone/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1314174Cade199112050http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=1761010Cade, J. R.Reese, R. H.Privette, R. M.Hommen, N. M.Rogers, J. L.Fregly, M. J.Dietary intervention and training in swimmersAdultBiological MarkersCreatine Kinase/chemistry*DietDrinkingExercise/physiologyFemaleHumanLactate Dehydrogenase/bloodMaleMilk Proteins/pharmacologyMuscles/enzymology/*injuries*Physical Education and TrainingSwimming/*injuriesDepartment of Medicine, University of Florida College of Medicine, Gainesville.17610101991Eur J Appl Physiol Occup Physiol633-4210-5[46, 47]. This also serves to increase availability of amino acids and decrease exercise-induced catabolism of protein  ADDIN EN.CITE Cade199112050http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=1761010Cade, J. R.Reese, R. H.Privette, R. M.Hommen, N. M.Rogers, J. L.Fregly, M. J.Dietary intervention and training in swimmersAdultBiological MarkersCreatine Kinase/chemistry*DietDrinkingExercise/physiologyFemaleHumanLactate Dehydrogenase/bloodMaleMilk Proteins/pharmacologyMuscles/enzymology/*injuries*Physical Education and TrainingSwimming/*injuriesDepartment of Medicine, University of Florida College of Medicine, Gainesville.17610101991Eur J Appl Physiol Occup Physiol633-4210-5Carli19922235013141746431992Changes in the exercise-induced hormone response to branched chain amino acid administration272-7Istituto di Fisiologia Umana, Universita di Siena, Italy.Carli, G.Bonifazi, M.Lodi, L.Lupo, C.Martelli, G.Viti, A.Eur J Appl Physiol Occup PhysiolAdultAmino Acids, Branched-Chain/*pharmacologyCorticotropin/bloodExercise/*physiologyGrowth Hormone/bloodHormones/*bloodHumanHydrocortisone/bloodMaleProlactin/bloodRunningSex Hormone-Binding Globulin/metabolismSupport, Non-U.S. Gov'tTestosterone/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1314174Kreider19991440http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10091274Kreider, R. B.Dietary supplements and the promotion of muscle growth with resistance exerciseAnabolic Steroids/metabolismBoron/administration & dosage/pharmacologyChromium/administration & dosage/pharmacologyCreatine/administration & dosage/pharmacologyDietary Carbohydrates/administration & dosage/pharmacologyDietary Proteins/administration & dosage/pharmacology*Dietary SupplementsGlutamine/administration & dosage/pharmacologyHumanLeucine/administration & dosage/pharmacologyMuscle, Skeletal/drug effects/*growth & developmentNutritionPrasterone/administration & dosage/pharmacologyProteins/biosynthesisTestosterone/metabolismValerates/administration & dosage/pharmacologyVanadium Compounds/administration & dosage/pharmacologyWeight Lifting/*physiologyDepartment of Human Movement Sciences and Education, University of Memphis, Tennessee, USA. kreider.richard@coe.memphis.edu10091274Sports Med199927297-110.[44, 46, 47]. When exercise lasts more than one hour, athletes should ingest glucose/electrolyte solution (GES) drinks in order to maintain blood glucose levels, help prevent dehydration, and reduce the immunosuppressive effects of intense exercise  ADDIN EN.CITE Sherman199828667Sherman, W.M.Jacobs, K.A.Leenders, N.1998Carbohydrate metabolism during endurance exerciseKreider, R.B.Fry, A. C.O'Toole, M.L.Overtraining in SportChampaignHuman Kinetics Publishers289-308Nieman19972895092091846611997JulCarbohydrate supplementation affects blood granulocyte and monocyte trafficking but not function after 2.5 h or running153-9Department of Health, Appalachian State University, Boone, NC 28608, USA. niemandc@appstate.eduNieman, D. C.Fagoaga, O. R.Butterworth, D. E.Warren, B. J.Utter, A.Davis, J. M.Henson, D. A.Nehlsen-Cannarella, S. L.Am J Clin NutrAdultBeveragesBlood Glucose/drug effectsCarbohydrates/metabolism/*pharmacologyDouble-Blind MethodFemaleGranulocytes/*drug effects/immunologyHumanHydrocortisone/bloodImmune System/*drug effectsMaleMiddle AgeMonocytes/*drug effects/immunologyOxygen Consumption/drug effectsPhagocytosis/drug effectsRunning/*physiologySupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9209184Nieman199828960964409541998Influence of carbohydrate on the immune response to intensive, prolonged exercise64-76Department of Health, Leisure, and Exercise Science, Appalachian State University, Boone, NC 28608, USA.Nieman, D. C.Exerc Immunol RevCarbohydrates/metabolism/*physiology*ExerciseHumanImmune System/*immunologyImmunosuppressionSupport, Non-U.S. Gov'tTime Factorshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9644095Nieman199928970100912722721999FebExercise and immune function. Recent developments73-80Department of Health and Exercise Science, Appalachian State University, Boone, North Carolina, USA. niemandc@appstate.eduNieman, D. C.Pedersen, B. K.Sports MedAgedBacterial InfectionsComparative StudyDietary Carbohydrates/administration & dosageDietary SupplementsExercise/*physiologyHumanImmunity/*immunologyImmunologic SurveillanceKiller Cells, Natural/immunologyNeutrophils/immunologyNutritionPhysical Endurance/physiologyRisk FactorsSports/physiologyT-Lymphocytes, Helper-Inducer/immunologyTime FactorsVirus DiseasesWalking/physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10091272Burke2001289801128231712842001AprNutritional needs for exercise in the heat735-48Department of Sports Nutrition, Australian Institute of Sport, Leverrier Crescent, ACT, 2616, Bruce, Australia. louisse.burke@ausport.gov.auBurke, L. M.Comp Biochem Physiol A Mol Integr PhysiolBody WaterCarbohydrates/pharmacokineticsDehydration*Drinking*ExerciseGlycogen/metabolism*HeatHumanMuscle, Skeletal/metabolism*NutritionNutrition PolicySportshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11282317Burke19972899091276822911997MarNutrition for post-exercise recovery3-10Australian Institute of Sport, ACT, Australia.Burke, L. M.Aust J Sci Med SportDehydration/physiopathologyDietary Carbohydrates/administration & dosageExercise/*physiologyGlycogen/metabolismHumanLiver Glycogen/metabolismMuscle Fatigue/physiologyMuscle, Skeletal/metabolism*NutritionRehydration Solutionshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9127682Maughan19912900019251871211991JulFluid replacement and exercise stress. A brief review of studies on fluid replacement and some guidelines for the athlete16-31Department of Environmental and Occupational Medicine, University Medical School, Foresterhill, Aberdeen, Scotland.Maughan, R. J.Noakes, T. D.Sports MedAdaptation, PhysiologicalBeveragesBody Temperature Regulation/physiologyDietary Carbohydrates/administration & dosage/metabolismExercise/*physiologyHumanIntestinal AbsorptionPhysical Education and Training*SportsTemperature*Water-Electrolyte Balance/physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1925187[18, 48-53]. Following intense exercise, athletes should consume carbohydrate and protein (e.g., 1 g/kg of carbohydrate and 0.5 g/kg of protein) within 30 min after exercise as well as consume a high carbohydrate meal within two hours following exercise  ADDIN EN.CITE Leutholtz200116077Leutholtz, B. Kreider, R.B.2001Exercise and Sport Nutrition.Wilson, T.Temple, N.Nutritional Health.Totowa, NJHumana Press, Inc.207 – 239Kreider19991440http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10091274Kreider, R. B.Dietary supplements and the promotion of muscle growth with resistance exerciseAnabolic Steroids/metabolismBoron/administration & dosage/pharmacologyChromium/administration & dosage/pharmacologyCreatine/administration & dosage/pharmacologyDietary Carbohydrates/administration & dosage/pharmacologyDietary Proteins/administration & dosage/pharmacology*Dietary SupplementsGlutamine/administration & dosage/pharmacologyHumanLeucine/administration & dosage/pharmacologyMuscle, Skeletal/drug effects/*growth & developmentNutritionPrasterone/administration & dosage/pharmacologyProteins/biosynthesisTestosterone/metabolismValerates/administration & dosage/pharmacologyVanadium Compounds/administration & dosage/pharmacologyWeight Lifting/*physiologyDepartment of Human Movement Sciences and Education, University of Memphis, Tennessee, USA. kreider.richard@coe.memphis.edu10091274Sports Med199927297-110.Kreider200128947Kreider, R.B.2001Nutritional Considerations of OvertrainingStout, J.R. Antonio, J.Sport Supplements: A Complete Guide to Physique and Athletic EnhancementBaltimore, MDLippincott, Williams & Wilkins199-208[9, 44, 45]. This nutritional strategy has been found to accelerate glycogen resynthesis as well as promote a more anabolic hormonal profile that may hasten recovery  ADDIN EN.CITE Zawadzki19922901016017947251992MayCarbohydrate-protein complex increases the rate of muscle glycogen storage after exercise1854-9Department of Kinesiology, University of Texas, Austin 78712.Zawadzki, K. M.Yaspelkis, B. B., 3rdIvy, J. L.J Appl PhysiolBlood Glucose/metabolismDietary Carbohydrates/*administration & dosageDietary Proteins/*administration & dosageExercise/*physiologyGlycogen/metabolismHumanInsulin/bloodKineticsLactates/bloodLactic AcidMaleMuscles/*metabolismPhysical Endurance/physiologySupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1601794Tarnopolsky19972902093909588361997DecPostexercise protein-carbohydrate and carbohydrate supplements increase muscle glycogen in men and women1877-83Department of Medicine, McMaster University, Hamilton, Ontario, Canada L8S 4K1. tarnopol@mcmaster.caTarnopolsky, M. A.Bosman, M.Macdonald, J. R.Vandeputte, D.Martin, J.Roy, B. D.J Appl PhysiolAdultDietary Carbohydrates/*pharmacologyDietary Fats/pharmacologyDietary Proteins/*pharmacologyDouble-Blind MethodExercise/*physiologyFemaleGlycogen/*metabolismHumanKineticsMaleMuscle, Skeletal/*metabolismOxygen Consumption/drug effects/physiologyPhysical Endurance/physiologyPulmonary Gas Exchange/drug effects/physiologySex CharacteristicsSupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9390958Kraemer19982409097603528541998OctHormonal responses to consecutive days of heavy-resistance exercise with or without nutritional supplementation1544-55The Human Performance Laboratory, Ball State University, Muncie, Indiana 47306, USA. wkraemer@gw.bsu.eduKraemer, W. J.Volek, J. S.Bush, J. A.Putukian, M.Sebastianelli, W. J.J Appl PhysiolAdultBody CompositionCross-Over StudiesDietary CarbohydratesDietary ProteinsDouble-Blind MethodEnergy Intake*Food, FortifiedHormones/*bloodHumanHuman Growth Hormone/bloodHydrocortisone/bloodInsulin/bloodInsulin-Like Growth Factor I/metabolismMalePhysical EnduranceProlactin/bloodSex Hormone-Binding Globulin/metabolismSupport, Non-U.S. Gov'tTestosterone/bloodTime FactorsWeight Lifting/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9760352[54-56]. Finally, for 2 to 3 days prior to competition, athletes should taper training by 30 to 50% and consume 200 to 300 g/d of extra carbohydrate in their diet. This carbohydrate loading technique has been shown to supersaturate carbohydrate stores prior to competition and improve endurance exercise capacity  ADDIN EN.CITE Sherman199828667Sherman, W.M.Jacobs, K.A.Leenders, N.1998Carbohydrate metabolism during endurance exerciseKreider, R.B.Fry, A. C.O'Toole, M.L.Overtraining in SportChampaignHuman Kinetics Publishers289-308Leutholtz200116077Leutholtz, B. Kreider, R.B.2001Exercise and Sport Nutrition.Wilson, T.Temple, N.Nutritional Health.Totowa, NJHumana Press, Inc.207 – 239Kreider200128947Kreider, R.B.2001Nutritional Considerations of OvertrainingStout, J.R. Antonio, J.Sport Supplements: A Complete Guide to Physique and Athletic EnhancementBaltimore, MDLippincott, Williams & Wilkins199-208[9, 18, 45]. Thus, the type of meal and timing of eating are important factors in maintaining carbohydrate availability during training and potentially decreasing the incidence of overtraining. Vitamins. Vitamins are essential organic compounds which serve to regulate metabolic processes, energy synthesis, neurological processes, and prevent destruction of cells. There are two primary classifications of vitamins: fat and water soluble. The fat soluble vitamins include vitamins A, D, E, & K. The body stores fat soluble vitamins and therefore excessive intake may result in toxicity. Water soluble vitamins are B vitamins and vitamin C. Since these vitamins are water soluble, excessive intake of these vitamins are eliminated in urine. Table 1 describes RDA, proposed ergogenic benefit, and summary of research findings for fat and water soluble vitamins. Although research has demonstrated that specific vitamins may posses some health benefit (e.g., vitamin E, niacin, folic acid, vitamin C, etc), few have been reported to directly provide ergogenic value for athletes. However, some vitamins may help athletes tolerate training to a better degree by reducing oxidative damage (vitamin E, C) and/or help to maintain a healthy immune system during heavy training (vitamin C). Theoretically, this may help athletes tolerate heavy training leading to improved performance. The remaining vitamins reviewed appear to have little ergogenic value for athletes who consume a normal, nutrient dense diet. Since dietary analyses of athletes have found deficiencies in caloric and vitamin intake, many sport nutritionists recommend that athletes consume a low-dose one a day multivitamin and/or a vitamin enriched post-workout carbohydrate/protein supplement during periods of heavy training. The American Medical Association also recently evaluated the available medical literature and recommended that Americans consume a one-a-day low-dose multivitamin in order to promote general health. Suggestions that there is no benefit of vitamin supplementation for athletes and/or it is unethical for an exercise physiologist to recommend that their clients take a one-a-day multi-vitamin and/or suggest taking other vitamins that may reduce cholesterol levels (niacin), serve as antioxidants (Vitamin E), decrease risk to heart disease (niacin, Vitamin E), or may help maintain a health immune system (Vitamin C) is not consistent with current available literature. Minerals. Minerals are essential inorganic elements necessary for a host of metabolic processes. Minerals serve as structure for tissue, important components of enzymes and hormones, and regulators of metabolic and neural control. Some minerals have been found to be deficient in athletes or become deficient in response to training and/or prolonged exercise. When mineral status is inadequate, exercise capacity may be reduced. Dietary supplementation of minerals in deficient athletes has generally been found to improve exercise capacity. Additionally, supplementation of specific minerals in non-deficient athletes has also been reported to affect exercise capacity. Table 2 describes minerals that have been purported to affect exercise capacity in athletes. Of the minerals reviewed, several appear to possess health and/or ergogenic value for athletes under certain conditions. For example, calcium supplementation in athletes susceptible to premature osteoporosis may help maintain bone mass. There is also recent evidence that dietary calcium may help manage body composition. Iron supplementation in athletes prone to iron deficiencies and/or anemia has been reported to improve exercise capacity. Sodium phosphate loading has been reported to increase maximal oxygen uptake, anaerobic threshold, and improve endurance exercise capacity by 8 to 10%. Increasing dietary availability of salt (sodium chloride) during the initial days of exercise training in the heat has been reported to help maintain fluid balance and prevent dehydration. Finally, zinc supplementation during training has been reported to decrease exercise-induced changes in immune function. Consequently, somewhat in contrast to vitamins, there appear to be several minerals that may enhance exercise capacity and/or training adaptations for athletes under certain conditions. However, although ergogenic value has been purported for remaining minerals, there is little evidence that boron, chromium, magnesium, or vanadium affect exercise capacity or training adaptations in healthy individuals eating a normal diet. Suggestions that there is no benefit of mineral supplementation for athletes and/or it is unethical for an exercise physiologist to recommend that their clients take minerals that research has shown may affect health and/or performance is not consistent with current available literature. Water. The most important nutritional ergogenic aid for athletes is water. Exercise performance can be significantly impaired when 2% or more of body weight is lost through sweat. For example, when a 70-kg athlete loses more than 1.4 kg of body weight during exercise (2%), performance capacity is often significantly decreased. Further, weight loss of more than 4% of body weight during exercise may lead to heat illness, heat exhaustion, heat stroke, and possibly death  ADDIN EN.CITE Maughan19912900019251871211991JulFluid replacement and exercise stress. A brief review of studies on fluid replacement and some guidelines for the athlete16-31Department of Environmental and Occupational Medicine, University Medical School, Foresterhill, Aberdeen, Scotland.Maughan, R. J.Noakes, T. D.Sports MedAdaptation, PhysiologicalBeveragesBody Temperature Regulation/physiologyDietary Carbohydrates/administration & dosage/metabolismExercise/*physiologyHumanIntestinal AbsorptionPhysical Education and Training*SportsTemperature*Water-Electrolyte Balance/physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1925187[53]. For this reason, it is critical that athletes consume a sufficient amount of water and/or GES sports drinks during exercise in order to maintain hydration status. The normal sweat rate of athletes ranges from 0.5 to 2.0 L/h depending on temperature, humidity, exercise intensity, and their sweat response to exercise  ADDIN EN.CITE Maughan19912900019251871211991JulFluid replacement and exercise stress. A brief review of studies on fluid replacement and some guidelines for the athlete16-31Department of Environmental and Occupational Medicine, University Medical School, Foresterhill, Aberdeen, Scotland.Maughan, R. J.Noakes, T. D.Sports MedAdaptation, PhysiologicalBeveragesBody Temperature Regulation/physiologyDietary Carbohydrates/administration & dosage/metabolismExercise/*physiologyHumanIntestinal AbsorptionPhysical Education and Training*SportsTemperature*Water-Electrolyte Balance/physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1925187[53]. This means that in order to maintain fluid balance and prevent dehydration, athletes need to ingest 0.5 to 2 L/h of fluid in order to offset weight loss. This requires frequent ingestion of 6-8 oz of cold water or a GES sports drink every 5 to 15-min during exercise  ADDIN EN.CITE Maughan19912900019251871211991JulFluid replacement and exercise stress. A brief review of studies on fluid replacement and some guidelines for the athlete16-31Department of Environmental and Occupational Medicine, University Medical School, Foresterhill, Aberdeen, Scotland.Maughan, R. J.Noakes, T. D.Sports MedAdaptation, PhysiologicalBeveragesBody Temperature Regulation/physiologyDietary Carbohydrates/administration & dosage/metabolismExercise/*physiologyHumanIntestinal AbsorptionPhysical Education and Training*SportsTemperature*Water-Electrolyte Balance/physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1925187Brouns19982878095068021911998JanThe effect of different rehydration drinks on post-exercise electrolyte excretion in trained athletes56-60Department of Human Biology, Maastricht University, The Netherlands.Brouns, F.Kovacs, E. M.Senden, J. M.Int J Sports MedAdult*Beverages/analysisCaffeine/analysisCarbohydrates/analysisCross-Over StudiesElectrolytes/analysis/*urineExercise/*physiologyHumanMineral Waters/analysisSupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9506802Kovacs199928770102301693911999MarUrine color, osmolality and specific electrical conductance are not accurate measures of hydration status during postexercise rehydration47-53Department of Human Biology, Maastricht University, The Netherlands.Kovacs, E. M.Senden, J. M.Brouns, F.J Sports Med Phys FitnessAdultCross-Over StudiesDehydration/*urineElectric ConductivityExercise/*physiologyHumanMaleOsmolar ConcentrationSupport, Non-U.S. Gov'tUrine/chemistryhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10230169Kovacs200228730119936191212002MarEffect of high and low rates of fluid intake on post-exercise rehydration14-23Department of Human Biology at Maastricht University, The Netherlands.Kovacs, E. M.Schmahl, R. M.Senden, J. M.Brouns, F.Int J Sport Nutr Exerc MetabAdultBeveragesBicyclingBody Weight/physiologyCross-Over StudiesDehydration/blood/*therapy/urineDietary Carbohydrates/administration & dosageDrinkingElectrolytes/administration & dosageExercise/*physiologyExercise TestFluid Therapy/*methodsHumanKineticsMaleOsmolar ConcentrationPlasma VolumeSodium/analysis/metabolismUrination/*physiologyWater-Electrolyte Balancehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11993619Meyer199527850http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=8588794Meyer, L. G.Horrigan, D. J., Jr.Lotz, W. G.Effects of three hydration beverages on exercise performance during 60 hours of heat exposureAdultBody Temperature Regulation/*physiologyExercise/*physiologyHeart RateHeat Exhaustion/*physiopathologyHumanMaleOxygen Consumption*Rehydration SolutionsRespirationSkin TemperatureSupport, U.S. Gov't, Non-P.H.S.Environmental Physiology Division, Naval Aerospace Medical Research Laboratory, NAS Pensacola, FL 32508-1046, USA.8588794Aviat Space Environ Med199566111052-7.[53, 57-60]. Athletes and should not depend on thirst to prompt them to drink because people do not typically get thirsty until they have lost a significant amount of fluid through sweat. Additionally, athletes should weigh themselves prior to and following exercise training to ensure that they maintain proper hydration  ADDIN EN.CITE Maughan19912900019251871211991JulFluid replacement and exercise stress. A brief review of studies on fluid replacement and some guidelines for the athlete16-31Department of Environmental and Occupational Medicine, University Medical School, Foresterhill, Aberdeen, Scotland.Maughan, R. J.Noakes, T. D.Sports MedAdaptation, PhysiologicalBeveragesBody Temperature Regulation/physiologyDietary Carbohydrates/administration & dosage/metabolismExercise/*physiologyHumanIntestinal AbsorptionPhysical Education and Training*SportsTemperature*Water-Electrolyte Balance/physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1925187Brouns19982878095068021911998JanThe effect of different rehydration drinks on post-exercise electrolyte excretion in trained athletes56-60Department of Human Biology, Maastricht University, The Netherlands.Brouns, F.Kovacs, E. M.Senden, J. M.Int J Sports MedAdult*Beverages/analysisCaffeine/analysisCarbohydrates/analysisCross-Over StudiesElectrolytes/analysis/*urineExercise/*physiologyHumanMineral Waters/analysisSupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9506802Kovacs199928770102301693911999MarUrine color, osmolality and specific electrical conductance are not accurate measures of hydration status during postexercise rehydration47-53Department of Human Biology, Maastricht University, The Netherlands.Kovacs, E. M.Senden, J. M.Brouns, F.J Sports Med Phys FitnessAdultCross-Over StudiesDehydration/*urineElectric ConductivityExercise/*physiologyHumanMaleOsmolar ConcentrationSupport, Non-U.S. Gov'tUrine/chemistryhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10230169Kovacs200228730119936191212002MarEffect of high and low rates of fluid intake on post-exercise rehydration14-23Department of Human Biology at Maastricht University, The Netherlands.Kovacs, E. M.Schmahl, R. M.Senden, J. M.Brouns, F.Int J Sport Nutr Exerc MetabAdultBeveragesBicyclingBody Weight/physiologyCross-Over StudiesDehydration/blood/*therapy/urineDietary Carbohydrates/administration & dosageDrinkingElectrolytes/administration & dosageExercise/*physiologyExercise TestFluid Therapy/*methodsHumanKineticsMaleOsmolar ConcentrationPlasma VolumeSodium/analysis/metabolismUrination/*physiologyWater-Electrolyte Balancehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11993619Meyer199527850http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=8588794Meyer, L. G.Horrigan, D. J., Jr.Lotz, W. G.Effects of three hydration beverages on exercise performance during 60 hours of heat exposureAdultBody Temperature Regulation/*physiologyExercise/*physiologyHeart RateHeat Exhaustion/*physiopathologyHumanMaleOxygen Consumption*Rehydration SolutionsRespirationSkin TemperatureSupport, U.S. Gov't, Non-P.H.S.Environmental Physiology Division, Naval Aerospace Medical Research Laboratory, NAS Pensacola, FL 32508-1046, USA.8588794Aviat Space Environ Med199566111052-7.[53, 57-60]. The athlete should consume 3 cups of water for every pound lost during exercise in order adequately rehydrate themselves  ADDIN EN.CITE Maughan19912900019251871211991JulFluid replacement and exercise stress. A brief review of studies on fluid replacement and some guidelines for the athlete16-31Department of Environmental and Occupational Medicine, University Medical School, Foresterhill, Aberdeen, Scotland.Maughan, R. J.Noakes, T. D.Sports MedAdaptation, PhysiologicalBeveragesBody Temperature Regulation/physiologyDietary Carbohydrates/administration & dosage/metabolismExercise/*physiologyHumanIntestinal AbsorptionPhysical Education and Training*SportsTemperature*Water-Electrolyte Balance/physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1925187[53]. Athletes should train themselves to tolerate drinking greater amounts of water during training and make sure that they consume more fluid in hotter/humid environments. Preventing dehydration during exercise is one of the most effective ways to maintain exercise capacity. Finally, inappropriate and excessive weight loss techniques (e.g., cutting weight in saunas, wearing rubber suits, severe dieting, vomiting, using diuretics, etc) are extremely dangerous and should be prohibited. Exercise physiologists can play an important role in educating athletes and coaches about proper hydration methods and supervising fluid intake during training and competition. Dietary Supplements and Athletes Most of the work we do with athletes regarding sport nutrition is to teach them and their coaches how to structure their diet and time food intake to optimize performance and recovery. Dietary supplements can play a meaningful role in helping athletes consume the proper amount of calories, carbohydrate, and protein in their diet. However, they should be viewed as supplements to the diet, not replacements for a good diet. While it is true that most dietary supplements available for athletes have little scientific data supporting their potential role to enhance training and/or performance, it is also true that a number of nutrients and/or dietary supplements have been shown to help improve performance and/or recovery. This can help augment the normal diet to help optimize performance. Exercise physiologists must be aware of the current data regarding nutrition, exercise, and performance and be honest about educating their clients about results of various studies (whether pro or con). With the proliferation of information available about nutritional supplements to the consumer, the exercise physiologist, nutritionist, and nutrition industry lose credibility when they do not accurately describe results of various studies to the public. The following overviews several classifications of nutritional supplements that are often taken by athletes and categorizes them into apparently effective, possibly effective, too early to tell, and apparently ineffective supplements based on my interpretation of the literature. It should be noted that this analysis will primarily focus on whether the proposed nutrient has been found to affect exercise and/or training adaptations based on the current available literature. Additional research may reveal it may or may not possess ergogenic value which may then change its classification. It should be also noted that although there may be little ergogenic value to some nutrients, there may be some potential health benefits that may be helpful for some populations. Therefore, just because a nutrient does not appear to affect performance and/or training adaptations, that does not mean it may not have possible health benefits. Convenience Supplements Convenience supplements are meal replacement powders (MRPs), ready to drink supplements (RTDs), energy bars, and energy gels. They currently represent the largest segment of nutrition industry representing 50 75% of most companys sales. They are typically fortified with 33 50% of the RDA for vitamins and minerals and typically differ on the amount of carbohydrate, protein, and fat they contain. They may also differ based whether they are fortified with various nutrients purported to promote weight gain, enhance weight loss, and/or improve performance. Most people view these supplements as a high quality snacks and/or use them to help control caloric intake when trying to gain and/or lose weight. In our view, MRPs, RTDs, and energy bars/gels can provide a convenient way for people to meet specific dietary needs and/or serve as good alternatives to fast food. Use of these types of products can be particularly helpful in providing carbohydrate, protein, and other nutrients prior to and/or following exercise in an attempt to optimize nutrient intake when an athlete doesnt have time to sit down for a good meal. However, they should be used to improve dietary availability of macronutrients not as a replacement for a good diet. Care should also be taken to make sure they do not contain any banned or prohibited nutrients. Muscle Building Supplements The following provides an analysis of the literature regarding purported weight gain supplements and our general interpretation of how they should be categorized based on this information. Table 3 summarizes how we currently classify the ergogenic value of a number of purported performance-enhancing, muscle building, and fat loss supplements based on an analysis of the available scientific evidence. Apparently Effective Weight Gain Powders. One of the most common means athletes have employed to increase muscle mass is to add extra calories to the diet. Most athletes bulk up in this manner by consuming extra food and/or weight gain powders. Studies have consistently shown that simply adding an extra 500 1,000 calories per day to your diet will promote weight gain  ADDIN EN.CITE Kreider19991440http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10091274Kreider, R. B.Dietary supplements and the promotion of muscle growth with resistance exerciseAnabolic Steroids/metabolismBoron/administration & dosage/pharmacologyChromium/administration & dosage/pharmacologyCreatine/administration & dosage/pharmacologyDietary Carbohydrates/administration & dosage/pharmacologyDietary Proteins/administration & dosage/pharmacology*Dietary SupplementsGlutamine/administration & dosage/pharmacologyHumanLeucine/administration & dosage/pharmacologyMuscle, Skeletal/drug effects/*growth & developmentNutritionPrasterone/administration & dosage/pharmacologyProteins/biosynthesisTestosterone/metabolismValerates/administration & dosage/pharmacologyVanadium Compounds/administration & dosage/pharmacologyWeight Lifting/*physiologyDepartment of Human Movement Sciences and Education, University of Memphis, Tennessee, USA. kreider.richard@coe.memphis.edu10091274Sports Med199927297-110.Kreider1999. Available: http://www.sportsci.org/jour/9901/rbk.html1460Kreider, R. B.1999. Available: http://www.sportsci.org/jour/9901/rbk.htmlEffects of protein and amino acid supplementation on athletic performanceSportscience31[28, 44]. However, only about 30 50% of the weight gained on high calorie diets is muscle while the remaining amount of weight gained is fat. Consequently, increasing muscle mass by ingesting a high calorie can help you build muscle but the accompanying increase in body fat may not be desirable for everyone. Therefore, we typically do not recommend this type of weight gain approach. Creatine. In our view, the most effective nutritional supplement available to athletes to increase high intensity exercise capacity and muscle mass during training is creatine. Numerous studies have indicated that creatine supplementation increases body mass and/or muscle mass during training  ADDIN EN.CITE Williams199920651Williams, M. H.Kreider, R.Branch, J. D.1999Creatine: The power supplementChampaign, ILHuman Kinetics Publishers252[61] Gains are typically 2 5 pounds greater than controls during 4 12 weeks of training  ADDIN EN.CITE Kreider200321180127018152441-22003FebEffects of creatine supplementation on performance and training adaptations89-94Exercise and Sport Nutrition Laboratory, Center for Exercise, Nutrition and Preventive Health Research, Department of Health, Human Performance and Recreation, Baylor University, Waco, TX 76798-7313, USA. Richard_Kreider@baylor.eduKreider, R. B.Mol Cell Biochemhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12701815[62]. The gains in muscle mass appear to be a result of an improved ability to perform high intensity exercise enabling an athlete to train harder and thereby promote greater training adaptations and muscle hypertrophy  ADDIN EN.CITE Volek199920120Volek, J.S. Duncan, N.D. Mazzetti, S.A. Putukian, M. Gomez, A.L. Staron, R.S. Kraemer, W.J.1999Performance and muscle fiber adaptations to 12 weeks of creatine supplementation and heavy resistance training.Medicine & Science in Sports & Exercise315May, 1999Willoughby200120670Willoughby, D. S.Rosene, J.2001Effects of oral creatine and resistance training on myosin heavy chain expressionMed Sci Sports Exerc33101674-8111581551http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11581551Department of Kinesiology, Texas Christian University, Fort Worth, TX 76129; and Department of Kinesiology and Leisure Science, University of Hawaii, Honolulu, HI 96822.Willoughby200321500127830393562003JunEffects of oral creatine and resistance training on myogenic regulatory factor expression923-9Department of Kinesiology, Texas Christian University, Fort Worth 76129, USA. d.willoughby@tcu.eduWilloughby, D. S.Rosene, J. M.Med Sci Sports Exerchttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12783039[63-65]. The only clinically significant side effect reported from creatine supplementation has been weight gain  ADDIN EN.CITE Williams199920651Williams, M. H.Kreider, R.Branch, J. D.1999Creatine: The power supplementChampaign, ILHuman Kinetics Publishers252Kreider199924080100912742721999FebDietary supplements and the promotion of muscle growth with resistance exercise97-110Department of Human Movement Sciences and Education, University of Memphis, Tennessee, USA. kreider.richard@coe.memphis.eduKreider, R. B.Sports MedAnabolic Steroids/metabolismBoron/administration & dosage/pharmacologyChromium/administration & dosage/pharmacologyCreatine/administration & dosage/pharmacologyDietary Carbohydrates/administration & dosage/pharmacologyDietary Proteins/administration & dosage/pharmacology*Dietary SupplementsGlutamine/administration & dosage/pharmacologyHumanLeucine/administration & dosage/pharmacology*Muscle DevelopmentMuscle, Skeletal/drug effects/*growth & developmentNutritionPrasterone/administration & dosage/pharmacologyProteins/biosynthesisTestosterone/metabolismValerates/administration & dosage/pharmacologyVanadium Compounds/administration & dosage/pharmacologyWeight Lifting/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10091274Kreider200321180127018152441-22003FebEffects of creatine supplementation on performance and training adaptations89-94Exercise and Sport Nutrition Laboratory, Center for Exercise, Nutrition and Preventive Health Research, Department of Health, Human Performance and Recreation, Baylor University, Waco, TX 76798-7313, USA. Richard_Kreider@baylor.eduKreider, R. B.Mol Cell Biochemhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12701815Kreider200321170127018162441-22003FebLong-term creatine supplementation does not significantly affect clinical markers of health in athletes95-104Exercise and Sport Nutrition Laboratory, Department of Human Movement Sciences and Education, The University of Memphis, Memphis, TN, USA. Richard_Kreider@baylor.eduKreider, R. B.Melton, C.Rasmussen, C. J.Greenwood, M.Lancaster, S.Cantler, E. C.Milnor, P.Almada, A. L.Mol Cell Biochemhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12701816[61, 62, 66, 67] Although concerns have been raised about the safety and possible side effects of creatine supplementation  ADDIN EN.CITE Graham199913560Graham, A. S.Hatton, R. C.1999Creatine: a review of efficacy and safetyJ Am Pharm Assoc (Wash)396803-81010609446AdultClinical Trials*Creatine/administration & dosage/adverseeffects/metabolism/pharmacology*Dietary SupplementsDrug Contamination*ExerciseHumanKidney Diseases/chemically inducedMuscles/drug effectshttp://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10609446Genentech, Inc., South San Francisco, CA 94080, USA. graham.angie@gene.comJuhn199815080http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=9884794Juhn, M. S.Tarnopolsky, M.Potential side effects of oral creatine supplementation: a critical reviewCardiovascular System/drug effectsCreatine/*adverse effects/metabolism*Dietary SupplementsGastrointestinal System/drug effectsHumanLiver/drug effectsMusculoskeletal System/drug effectsDepartment of Family Medicine, University of Washington School of Medicine, Seattle, USA.9884794Clin J Sport Med199884298-304.[68, 69], recent long-term safety studies have reported no apparent side effects  ADDIN EN.CITE Taes200321420125438781822003FebCreatine supplementation does not affect kidney function in an animal model with pre-existing renal failure258-64Laboratory of Clinical Chemistry and. Renal Division, Department of Internal Medicine, University Hospital Ghent and. Department of Physiology and Physiopathology, Ghent University, Ghent, Belgium.Taes, Y. E.Delanghe, J. R.Wuyts, B.Van De Voorde, J.Lameire, N. H.Nephrol Dial Transplanthttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12543878Kreider200321170127018162441-22003FebLong-term creatine supplementation does not significantly affect clinical markers of health in athletes95-104Exercise and Sport Nutrition Laboratory, Department of Human Movement Sciences and Education, The University of Memphis, Memphis, TN, USA. Richard_Kreider@baylor.eduKreider, R. B.Melton, C.Rasmussen, C. J.Greenwood, M.Lancaster, S.Cantler, E. C.Milnor, P.Almada, A. L.Mol Cell Biochemhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12701816Schilling200118540http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11224803Schilling, B. K.Stone, M. H.Utter, A.Kearney, J. T.Johnson, M.Coglianese, R.Smith, L.O'Bryant, H. S.Fry, A. C.Starks, M.Keith, R.Stone, M. E.Creatine supplementation and health variables: a retrospective studyAdolescenceAdultAthletic Injuries/*etiologyBody Mass IndexCreatine/administration & dosage/*adverse effectsDietary ProteinsEnzyme-Linked Immunosorbent AssayFemaleHealth StatusHumanHydrocortisone/analysisMaleMuscle CrampMuscle, Skeletal/injuriesRetrospective StudiesSomatotropin/analysis*SportsSupport, Non-U.S. Gov'tTestosterone/analysisExercise Science, Appalachian State University, Boone, NC, USA.11224803Med Sci Sports Exerc2001332183-8.[67, 70, 71] and/or that creatine may lessen the incidence of injury during training  ADDIN EN.CITE Greenwood200321120127018142441-22003FebCreatine supplementation during college football training does not increase the incidence of cramping or injury83-8Human Performance Laboratory, Department of HPESS, Arkansas State University, Jonesboro, AR, USA.Greenwood, M.Kreider, R. B.Melton, C.Rasmussen, C.Lancaster, S.Cantler, E.Milnor, P.Almada, A.Mol Cell Biochemhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12701814Greenwood200213960Greenwood, MKreider, RBMelton, CRasmussen, CLancaster, SCantler, EMilnor, PAlmada, A2002Creatine supplementation during college football training does not increase the incidence of cramping or injury.Mol Cell BiochemIn PressWatsford200321490125806521712003FebCreatine supplementation and its effect on musculotendinous stiffness and performance26-33Human Movement Department, School of Leisure, Sport, and Tourism, University of Technology, Sydney, Australia 2070. mark.watsford@uts.edu.auWatsford, M. L.Murphy, A. J.Spinks, W. L.Walshe, A. D.J Strength Cond ResAdultBody Mass IndexCreatine/administration & dosage/*adverse effectsDietary Supplements/*adverse effectsElasticityHumanLegMaleMuscle Contraction/*drug effectsMuscle, Skeletal/drug effects/*physiologyTendons/drug effects/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12580652[72-74]. Consequently, supplementing the diet with creatine and/or creatine containing formulations seems to be a safe and effective method to increase muscle mass. (-hydroxy (-methylbutyrate (HMB). HMB is a metabolite of the amino acid leucine. Leucine and metabolites of leucine have been reported to inhibit protein degradation  ADDIN EN.CITE Nair19922151016408504161992JunEffect of leucine on amino acid and glucose metabolism in humans643-8Department of Medicine, College of Medicine, University of Vermont, Burlington.Nair, K. S.Matthews, D. E.Welle, S. L.Braiman, T.MetabolismAdultAmino Acids/*pharmacokineticsFemaleGlucose/*metabolismHormones/bloodHumanLeucine/metabolism/*pharmacologyLysine/pharmacokineticsMaleProteins/metabolismSupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1640850[75]. Supplementing the diet with 1.5 to 3 g/d of calcium HMB has been typically reported to increase muscle mass and strength particularly among untrained subjects initiating training  ADDIN EN.CITE Gallagher2000216701112885932122000DecBeta-hydroxy-beta-methylbutyrate ingestion, Part I: effects on strength and fat free mass2109-15Human Performance Laboratory, Ball State University, Muncie, IN 47306, USA.Gallagher, P. M.Carrithers, J. A.Godard, M. P.Schulze, K. E.Trappe, S. W.Med Sci Sports Exerc*Adipose TissueAdolescentAdultCreatine Kinase/bloodDouble-Blind MethodExercise/*physiologyHumanMaleMuscle ContractionMuscle, Skeletal/*drug effects/*physiologySupport, Non-U.S. Gov'tValerates/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11128859Gallagher2000216601112886032122000DecBeta-hydroxy-beta-methylbutyrate ingestion, part II: effects on hematology, hepatic and renal function2116-9Human Performance Laboratory, Ball State University, Muncie, IN 47306, USA.Gallagher, P. M.Carrithers, J. A.Godard, M. P.Schulze, K. E.Trappe, S. W.Med Sci Sports ExercAdolescentAdultBlood Chemical AnalysisDouble-Blind MethodExercise/*physiologyHumanKidney/*drug effects/*physiologyLipids/*bloodLiver/*drug effects/*physiologyMaleSupport, Non-U.S. Gov'tValerates/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11128860Nissen19962180089415348151996NovEffect of leucine metabolite beta-hydroxy-beta-methylbutyrate on muscle metabolism during resistance-exercise training2095-104Iowa State University, Ames 50011, USA.Nissen, S.Sharp, R.Ray, M.Rathmacher, J. A.Rice, D.Fuller, J. C., Jr.Connelly, A. S.Abumrad, N.J Appl PhysiolAdultBody Composition/physiologyBody Weight/drug effects/physiologyDietDietary Fats/pharmacologyDietary Proteins/pharmacologyEnergy Metabolism/drug effects/physiologyHumanLeucine/*metabolismMaleMethylhistidines/urineMuscle Proteins/metabolismMuscle, Skeletal/drug effects/*metabolism*Physical Education and TrainingValerates/*pharmacology*Weight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8941534Panton200021690109788531692000SepNutritional supplementation of the leucine metabolite beta-hydroxy-beta-methylbutyrate (hmb) during resistance training734-9Department of Education, East Tennessee State University, Johnson City, Tennessee 37614, USA. panton@etsu-tn.eduPanton, L. B.Rathmacher, J. A.Baier, S.Nissen, S.NutritionAdipose TissueAdultBody CompositionCohort StudiesCreatine Kinase/blood*Dietary SupplementsDouble-Blind Method*ExerciseFemaleHumanMalePlacebosSex CharacteristicsSupport, Non-U.S. Gov'tValerates/*administration & dosageWeight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10978853Slater200021700109661503022000AugBeta-hydroxy-beta-methylbutyrate (HMB) supplementation and the promotion of muscle growth and strength105-16Department of Physiology, Sports Science Sports Medicine Centre, Australian Institute of Sport, Canberra, Australian Capital Territory. gary_slater@sscc.gov.sgSlater, G. J.Jenkins, D.Sports MedAnimalAthletic Injuries/*prevention & controlChickensDietary SupplementsHumanMuscle DevelopmentMuscle, Skeletal/*drug effects/growth & development/injuriesOxidation-ReductionPeptide Hydrolases/metabolismPhysical Endurance/*drug effectsSheepSwineValerates/*pharmacologyWeight-Bearinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10966150Nissen2000217101091790513082000Augbeta-hydroxy-beta-methylbutyrate (HMB) supplementation in humans is safe and may decrease cardiovascular risk factors1937-45Iowa State University, Ames, USA.Nissen, S.Sharp, R. L.Panton, L.Vukovich, M.Trappe, S.Fuller, J. C., Jr.J NutrAdolescentAdultAgedAged, 80 and overBiological MarkersCardiovascular Diseases/*prevention & control*Dietary Supplements/adverse effectsDrug EvaluationEmotions/drug effectsExerciseFemaleHumanLiver Function TestsMaleMiddle AgePatient ComplianceRandom AllocationRisk FactorsValerates/adverse effects/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10917905[76-81] and the elderly  ADDIN EN.CITE Vukovich2001216301143552813172001JulBody composition in 70-year-old adults responds to dietary beta-hydroxy-beta-methylbutyrate similarly to that of young adults2049-52South Dakota State University, Brookings, SD 57007, USA. matthew_vukovich@sdstate.eduVukovich, M. D.Stubbs, N. B.Bohlken, R. M.J NutrAdipose TissueAgedAging/*physiologyBody Composition/*drug effectsDensitometry, X-RayDietary SupplementsDouble-Blind MethodFemaleHumanMaleMuscle, Skeletal/*drug effectsPlacebosSkinfold ThicknessSupport, Non-U.S. Gov'tTomography, X-Ray ComputedValerates/*pharmacology*Weight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11435528[82]. Gains in muscle mass are typically 0.5 to 1 kg greater than controls during 3 6 weeks of training. There is also recent evidence that HMB may lessen the catabolic effects of prolonged exercise  ADDIN EN.CITE Knitter200021680110075678942000OctEffects of beta-hydroxy-beta-methylbutyrate on muscle damage after a prolonged run1340-4Human Performance Laboratory, Iowa State University, Ames, Iowa 50011, USA.Knitter, A. E.Panton, L.Rathmacher, J. A.Petersen, A.Sharp, R.J Appl PhysiolAdultBody CompositionCreatine Kinase/bloodDietary SupplementsFemaleHumanLactate Dehydrogenase/bloodMaleMiddle AgeMuscle, Skeletal/*drug effects/physiology/physiopathologyOxygen Consumption/*drug effectsPlacebosRunning/*physiologyValerates/administration & dosage/blood/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11007567[83] and that there may be additive effects of co-ingesting HMB with creatine  ADDIN EN.CITE Jowko20012162011448573177-82001Jul-AugCreatine and beta-hydroxy-beta-methylbutyrate (HMB) additively increase lean body mass and muscle strength during a weight-training program558-66Institute of Sport and Physical Education, Biala Podlaska, Academy of Physical Education, Warsaw, Poland.Jowko, E.Ostaszewski, P.Jank, M.Sacharuk, J.Zieniewicz, A.Wilczak, J.Nissen, S.NutritionAdultAmino Acids/metabolismBlood Urea NitrogenBody Composition/*drug effectsCreatine/administration & dosage/*pharmacologyCreatine Kinase/antagonists & inhibitors/bloodCreatinine/blood/urineDietary SupplementsDouble-Blind MethodDrug SynergismElectric ImpedanceHumanMaleMuscle, Skeletal/*drug effects/metabolism/physiologyNitrogen/metabolismSupport, Non-U.S. Gov'tUrea/urineValerates/administration & dosage/*pharmacology*Weight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11448573O'Connor200321520126294644312003MarEffects of beta-hydroxy-beta-methylbutyrate and creatine monohydrate supplementation on the aerobic and anaerobic capacity of highly trained athletes64-8Institute of Sport and Exercise Science, James Cook University, Australia.O'Connor, D. M.Crowe, M. J.J Sports Med Phys FitnessAdministration, OralAdolescentAdultBody Weight/drug effectsCreatine/*administration & dosage*Dietary SupplementsExercise/*physiologyExercise TestFootball/*physiologyHumanLactic Acid/bloodMaleMuscle, Skeletal/drug effectsOxygen Consumption/drug effectsProspective StudiesTask Performance and AnalysisTreatment OutcomeValerates/*administration & dosagehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12629464[84, 85]. However, the effects of HMB supplementation in athletes are less clear. Most studies conducted on trained subjects have reported non-significant gains in muscle mass possibly due to a greater variability in response of HMB supplementation among athletes  ADDIN EN.CITE Kreider199921740106062122081999NovEffects of calcium beta-hydroxy-beta-methylbutyrate (HMB) supplementation during resistance-training on markers of catabolism, body composition and strength503-9Department of Human Movement Sciences & Education, The University of Memphis, TN 38152, USA. kreider.richard@coe.memphis.eduKreider, R. B.Ferreira, M.Wilson, M.Almada, A. L.Int J Sports MedAdultAnalysis of VarianceBiological MarkersBody Composition/*physiologyCalcium/administration & dosage*Dietary SupplementsEnergy Metabolism/*physiologyHumanLiver/enzymologyMaleMuscle, Skeletal/enzymology/*physiologyPhysical Education and Training/*methodsQuestionnairesSupport, Non-U.S. Gov'tValerates/*administration & dosagehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10606212Slater200121600115995061132001SepBeta-hydroxy-beta-methylbutyrate (HMB) supplementation does not affect changes in strength or body composition during resistance training in trained men384-96Sports Medicine Sports Science Division of the Singapore Sports Council, National Stadium, Singapore.Slater, G.Jenkins, D.Logan, P.Lee, H.Vukovich, M.Rathmacher, J. A.Hahn, A. G.Int J Sport Nutr Exerc MetabAdultAnalysis of VarianceBody Composition/*drug effects*Dietary SupplementsDouble-Blind MethodEnergy Metabolism/drug effects*ExerciseHumanMaleMuscle Contraction/*drug effectsPhysical Education and TrainingSupport, Non-U.S. Gov'tValerates/*therapeutic usehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11599506Ransone200321530125806531712003FebThe effect of beta-hydroxy beta-methylbutyrate on muscular strength and body composition in collegiate football players34-9College of Education, Oklahoma State University, Stillwater, Oklahoma 74078, USA. ransone@okstate.eduRansone, J.Neighbors, K.Lefavi, R.Chromiak, J.J Strength Cond ResAdipose Tissue/anatomy & histologyAdultBody Composition/*drug effectsCross-Over Studies*Dietary SupplementsDouble-Blind MethodFootball/*physiologyHumanMaleMuscle Contraction/*drug effectsMuscle, Skeletal/drug effects/*physiologyPhysical EnduranceValerates/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12580653[86-88] . Consequently, there is fairly good evidence showing that HMB may enhance training adaptations in individuals initiating training. However, additional research is necessary to determine whether HMB may enhance training adaptations in athletes. Possibly Effective Branched Chain Amino Acids (BCAA). BCAA supplementation has been reported to decrease exercise-induced protein degradation and/or muscle enzyme release (an indicator of muscle damage) possibly by promoting an anti-catabolic hormonal profile  ADDIN EN.CITE Kreider19991440http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10091274Kreider, R. B.Dietary supplements and the promotion of muscle growth with resistance exerciseAnabolic Steroids/metabolismBoron/administration & dosage/pharmacologyChromium/administration & dosage/pharmacologyCreatine/administration & dosage/pharmacologyDietary Carbohydrates/administration & dosage/pharmacologyDietary Proteins/administration & dosage/pharmacology*Dietary SupplementsGlutamine/administration & dosage/pharmacologyHumanLeucine/administration & dosage/pharmacologyMuscle, Skeletal/drug effects/*growth & developmentNutritionPrasterone/administration & dosage/pharmacologyProteins/biosynthesisTestosterone/metabolismValerates/administration & dosage/pharmacologyVanadium Compounds/administration & dosage/pharmacologyWeight Lifting/*physiologyDepartment of Human Movement Sciences and Education, University of Memphis, Tennessee, USA. kreider.richard@coe.memphis.edu10091274Sports Med199927297-110.Coombes200012520http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11125767Coombes, J. S.McNaughton, L. R.Effects of branched-chain amino acid supplementation on serum creatine kinase and lactate dehydrogenase after prolonged exerciseAdultAmino Acids, Branched-Chain/*administration & dosageAnalysis of VarianceCreatine Kinase/*bloodDiet*Dietary SupplementsExercise TestExercise Tolerance/physiologyExertion/*physiologyFollow-Up StudiesHumanIsoleucine/administration & dosageLactate Dehydrogenase/*bloodLeucine/administration & dosageMaleMuscle, Skeletal/*enzymology/pathologyOxygen Consumption/physiologyPhysical Endurance/physiologyTime FactorsValine/administration & dosageCentre for Human Movement, University of Tasmania, Launceston, Australia. Jeff.Coombes@utas.edu.au11125767J Sports Med Phys Fitness2000403240-6.Carli19922189013141746431992Changes in the exercise-induced hormone response to branched chain amino acid administration272-7Istituto di Fisiologia Umana, Universita di Siena, Italy.Carli, G.Bonifazi, M.Lodi, L.Lupo, C.Martelli, G.Viti, A.Eur J Appl Physiol Occup PhysiolAdultAmino Acids, Branched-Chain/*pharmacologyCorticotropin/bloodExercise/*physiologyGrowth Hormone/bloodHormones/*bloodHumanHydrocortisone/bloodMaleProlactin/bloodRunningSex Hormone-Binding Globulin/metabolismSupport, Non-U.S. Gov'tTestosterone/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1314174[44, 46, 89]. Theoretically, BCAA supplementation during intense training may help minimize protein degradation and thereby lead to greater gains in fat-free mass. There is some evidence to support this hypothesis. For example, Schena and colleagues  ADDIN EN.CITE Schena19922190014256426551992Branched-chain amino acid supplementation during trekking at high altitude. The effects on loss of body mass, body composition, and muscle power394-8Institute of Human Physiology, University of Verona, Italy.Schena, F.Guerrini, F.Tregnaghi, P.Kayser, B.Eur J Appl Physiol Occup PhysiolAdult*AltitudeAmino Acids, Branched-Chain/*administration & dosage*Body CompositionEnergy IntakeFemaleHumanIsoleucine/administration & dosageLeucine/administration & dosageMaleMuscles/*physiologyPlacebosValine/administration & dosage*Walkinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1425642[90] reported that BCAA supplementation (~10 g/d) during 21-days of trekking at altitude increased fat free mass (1.5%) while subjects ingesting a placebo had no change in muscle mass. Bigard and associates  ADDIN EN.CITE Bigard1996219308876349631996SepBranched-chain amino acid supplementation during repeated prolonged skiing exercises at altitude295-306Department de Physiologie Systemique, CERMA, Bretigny-sur-Orge, France.Bigard, A. X.Lavier, P.Ullmann, L.Legrand, H.Douce, P.Guezennec, C. Y.Int J Sport NutrAdult*AltitudeAmino Acids, Branched-Chain/*administration & dosage/bloodExercise/physiologyGlutamine/bloodHumanHuman Growth Hormone/bloodHydrocortisone/bloodInsulin/bloodMaleOxygen ConsumptionPhysical Endurance/*physiologySkiing/*physiologySupport, Non-U.S. Gov'tTryptophan/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8876349[91] reported that BCAA supplementation appeared to minimize loss of muscle mass in subjects training at altitude for 6-weeks. Finally, Candeloro and coworkers  ADDIN EN.CITE Candeloro19952195087099182041995Dec[Effects of prolonged administration of branched-chain amino acids on body composition and physical fitness]217-23Dipartimento di Medicina Sperimentale, Universita degli Studi di Roma Tor Vergata, Roma.Candeloro, N.Bertini, I.Melchiorri, G.De Lorenzo, A.Minerva EndocrinolAdultAmino Acids, Branched-Chain/*administration & dosage/*pharmacologyBody Composition/*drug effectsEnglish AbstractErgometryHand Strength/physiologyHumanLeucine/administration & dosage/pharmacologyMaleOxygen ConsumptionPhysical Fitness/*physiologyReference ValuesRespirationTime FactorsValine/administration & dosage/pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8709918[92] reported that 30 days of BCAA supplementation (14 grams/day) promoted a significant increase in muscle mass (1.3%) and grip strength (+8.1%) in untrained subjects. Although more research is necessary, these findings suggest that BCAA supplementation may have some impact on body composition. Essential Amino Acids (EAA). Recent studies have indicated that ingesting 3 to 6 g of EAA prior to  ADDIN EN.CITE Tipton200390601238816428412003JanAcute response of net muscle protein balance reflects 24-h balance after exercise and amino acid ingestionE76-89Metabolism Unit, Shriners Hospitals for Children, Galveston, Texas 77550, USA. ktipton@utmb.eduTipton, K. D.Borsheim, E.Wolf, S. E.Sanford, A. P.Wolfe, R. R.Am J Physiol Endocrinol MetabAmino Acids/analysis/bloodAmino Acids, Essential/*administration & dosageBlood Flow VelocityCarbon Isotopes/diagnostic useExercise/*physiologyFemaleGlycine/metabolismHumanInsulin/bloodKineticsLeg/blood supplyLeucine/metabolismMaleMuscle Proteins/biosynthesis/*metabolismMuscle, Skeletal/chemistryPhenylalanine/administration & dosage/diagnostic useSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Valine/metabolismhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12388164Wolfe2002907012368421132102002OctRegulation of muscle protein by amino acids3219S-24SUniversity of Texas Medical Branch and Shriners Burns Hospital, Department of Surgery, Galveston 77550, USA. rwolfe@utmb.eduWolfe, R. R.J NutrAmino Acids/*metabolism/pharmacokineticsAnimalHumanKineticsLegMuscle Proteins/biosynthesis/*metabolismMuscle, Skeletal/*metabolismNutritive ValueRadioisotope Dilution TechniqueSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12368421[93, 94] and or following exercise stimulates protein synthesis  ADDIN EN.CITE Rasmussen20001520Rasmussen, B. B.Tipton, K. D.Miller, S. L.Wolf, S. E.Wolfe, R. R.An oral essential amino acid-carbohydrate supplement enhances muscle protein anabolism after resistance exerciseAdministration, OralAmino Acids, Essential/administration & dosage/*pharmacologyAnalysis of VarianceCarbohydrates/administration & dosage/*pharmacologyDietary SupplementsExercise/*physiologyFemaleFemoral Artery/drug effects/metabolismFemoral Vein/drug effects/metabolismHumanInsulin/bloodLeg/blood supplyMaleMuscle Proteins/*drug effects/metabolismPhenylalanine/drug effects/metabolismRegional Blood Flow/drug effectsSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Time FactorsDepartment of Surgery, University of Texas Medical Branch and Metabolism Unit, Shriners Burns Institute, Galveston, Texas 77550, USA.10658002http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10658002 http://jap.physiology.org/cgi/content/full/88/2/386 http://jap.physiology.org/cgi/content/abstract/88/2/386J Appl Physiol2000882386-92.Tipton20011510Tipton, K. D.Rasmussen, B. B.Miller, S. L.Wolf, S. E.Owens-Stovall, S. K.Petrini, B. E.Wolfe, R. R.Timing of amino acid-carbohydrate ingestion alters anabolic response of muscle to resistance exerciseAdministration, OralAdultAmino Acids, Essential/*administration & dosageBiopsyBlood Flow Velocity/drug effectsCarbohydrates/*administration & dosageDeuteriumDietary SupplementsExertion/*physiologyFemaleHumanInfusions, IntravenousInsulin/bloodLegMaleMuscle, Skeletal/*drug effects/*metabolismPhenylalanine/administration & dosage/blood/pharmacokineticsProteins/biosynthesisRegional Blood Flow/drug effectsSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Time FactorsDepartment of Surgery, University of Texas Medical Branch, Galveston, Texas 77550, USA. ktipton@utmb.edu11440894http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11440894 http://ajpendo.physiology.org/cgi/content/full/281/2/E197 http://ajpendo.physiology.org/cgi/content/abstract/281/2/E197Am J Physiol Endocrinol Metab20012812E197-206.Rasmussen2002905012459885662002Oral and intravenously administered amino acids produce similar effects on muscle protein synthesis in the elderly358-62University of Southern California, Department of Kinesiology, University Park Campus, 3560 Watt Way, PED 107, Los Angeles, CA 90089-0652, USA. blakeras@usc.eduRasmussen, B. B.Wolfe, R. R.Volpi, E.J Nutr Health AgingAdministration, OralAgedAmino Acids/*administration & dosage/pharmacokineticsBiological AvailabilityBiological TransportBiopsyCatheters, IndwellingComparative Study*Enteral NutritionFemaleHumanInfusions, IntravenousMaleMuscle Proteins/*biosynthesisMuscle, Skeletal/*metabolism*Parenteral NutritionPhenylalanine/administration & dosage/pharmacokineticsSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12459885Miller20039020126185753532003MarIndependent and combined effects of amino acids and glucose after resistance exercise449-55Dairy Management, Inc, Rosemont, IL, USA.Miller, S. L.Tipton, K. D.Chinkes, D. L.Wolf, S. E.Wolfe, R. R.Med Sci Sports Exerchttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12618575Kobayashi200390301255634928432003MarReduced amino acid availability inhibits muscle protein synthesis and decreases activity of initiation factor eIF2BE488-98Department of Surgery, Shriners Burns Hospital, University of Texas Medical Branch, Galveston, Texas 77550, USA.Kobayashi, H.Borsheim, E.Anthony, T. G.Traber, D. L.Badalamenti, J.Kimball, S. R.Jefferson, L. S.Wolfe, R. R.Am J Physiol Endocrinol MetabAmino Acids/*bloodAnimalEukaryotic Initiation Factor-2B/*metabolismLegLeucine/metabolismMuscle Proteins/*biosynthesisMuscle, Skeletal/metabolismOsmolar ConcentrationPhenylalanine/metabolismRenal DialysisSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Swinehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12556349Wolfe2002907012368421132102002OctRegulation of muscle protein by amino acids3219S-24SUniversity of Texas Medical Branch and Shriners Burns Hospital, Department of Surgery, Galveston 77550, USA. rwolfe@utmb.eduWolfe, R. R.J NutrAmino Acids/*metabolism/pharmacokineticsAnimalHumanKineticsLegMuscle Proteins/biosynthesis/*metabolismMuscle, Skeletal/*metabolismNutritive ValueRadioisotope Dilution TechniqueSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12368421Borsheim200290801221788128342002OctEssential amino acids and muscle protein recovery from resistance exerciseE648-57Metabolism Unit, Department of Surgery, Shriners Hospital for Children/Galveston, University of Texas Medical Branch, Galveston, Texas 77550, USA.Borsheim, E.Tipton, K. D.Wolf, S. E.Wolfe, R. R.Am J Physiol Endocrinol MetabAdultBlood GlucoseCarbon Isotopes/diagnostic useDeuterium/diagnostic useExercise/*physiologyFemaleHumanInsulin/bloodLeucine/administration & dosage/blood/*pharmacokineticsMaleMuscle, Skeletal/drug effects/*metabolismNitrogen Isotopes/diagnostic usePhenylalanine/administration & dosage/blood/*pharmacokineticsProteins/biosynthesisSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Urea/administration & dosage/blood/pharmacokineticshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12217881Biolo19991490http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10331397Biolo, G.Williams, B. D.Fleming, R. Y.Wolfe, R. R.Insulin action on muscle protein kinetics and amino acid transport during recovery after resistance exerciseAdultAlanine/metabolismAmino Acids/blood/*metabolismBiological TransportBlood Flow VelocityExercise/*physiologyFemoral ArteryGlucose/metabolismHumanInsulin/administration & dosage/blood/*pharmacologyKineticsLeg/blood supplyLysine/metabolismMaleMuscle Proteins/biosynthesis/*metabolismMuscle, Skeletal/*metabolismSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Department of Internal Medicine, University of Texas Medical Branch, and the Shriners Burns Hospital, Galveston, USA.10331397Diabetes1999485949-57.[94-101]. Theoretically, this may enhance gains in muscle mass during training. To support this theory, a recent study by Esmarck and colleagues  ADDIN EN.CITE Esmarck20012196011507179535Pt 12001Aug 15Timing of postexercise protein intake is important for muscle hypertrophy with resistance training in elderly humans301-11Sports Medicine Research Unit, Bispebjerg Hospital, Denmark. bep01@bbh.hosp.dkEsmarck, B.Andersen, J. L.Olsen, S.Richter, E. A.Mizuno, M.Kjaer, M.J PhysiolAgedAged, 80 and overAging/*physiologyBlood Glucose/analysisCatecholamines/bloodDietary Proteins/*administration & dosage/pharmacologyDrug Administration ScheduleExercise/*physiologyHumanHypertrophyInsulin/bloodLegMaleMuscle Fibers/ultrastructureMuscle, Skeletal/anatomy & histology/*drug effects/*pathology/physiologyMyosin Heavy Chains/metabolismProtein Isoforms/metabolismSupport, Non-U.S. Gov'tTime Factors*Weight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11507179[102] found that ingesting EAA with carbohydrate immediately following resistance exercise promoted significantly greater training adaptations as compared to waiting until 2-hours after exercise to consume the supplement. Although more data is needed, there appears to be strong theoretical rationale and some supportive evidence that EAA supplementation may enhance protein synthesis and training adaptations. Glutamine. Glutamine is the most plentiful non-essential amino acid in the body and plays a number of important physiological roles  ADDIN EN.CITE Kreider19991440http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10091274Kreider, R. B.Dietary supplements and the promotion of muscle growth with resistance exerciseAnabolic Steroids/metabolismBoron/administration & dosage/pharmacologyChromium/administration & dosage/pharmacologyCreatine/administration & dosage/pharmacologyDietary Carbohydrates/administration & dosage/pharmacologyDietary Proteins/administration & dosage/pharmacology*Dietary SupplementsGlutamine/administration & dosage/pharmacologyHumanLeucine/administration & dosage/pharmacologyMuscle, Skeletal/drug effects/*growth & developmentNutritionPrasterone/administration & dosage/pharmacologyProteins/biosynthesisTestosterone/metabolismValerates/administration & dosage/pharmacologyVanadium Compounds/administration & dosage/pharmacologyWeight Lifting/*physiologyDepartment of Human Movement Sciences and Education, University of Memphis, Tennessee, USA. kreider.richard@coe.memphis.edu10091274Sports Med199927297-110.[44]. Glutamine has been reported to increase cell volume and stimulate protein  ADDIN EN.CITE Low1996219708734997492 ( Pt 3)1996May 1Responses of glutamine transport in cultured rat skeletal muscle to osmotically induced changes in cell volume877-85Department of Anatomy & Physiology, University of Dundee, UK. s.low@anatphys.dundee.ac.ukLow, S. Y.Taylor, P. M.Rennie, M. J.J Physiol4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid/pharmacology4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic Acid/pharmacologyAnimalCarrier Proteins/*metabolismCell Size/drug effectsCells, CulturedGlucose/metabolismGlutamine/*metabolism/pharmacologyInsulin/pharmacologyMuscle, Skeletal/drug effects/*metabolismNitrobenzenes/pharmacologyOsmolar ConcentrationRatsSupport, Non-U.S. Gov'tWater/metabolismbeta-Alanine/analogs & derivatives/metabolismhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8734997Rennie19962198088788642431996AugAmino acid transport in heart and skeletal muscle and the functional consequences869-73Department of Anatomy and Physiology, University of Dundee, Scotland, U.K.Rennie, M. J.Khogali, S. E.Low, S. Y.McDowell, H. E.Hundal, H. S.Ahmed, A.Taylor, P. M.Biochem Soc TransAmino Acid Transport SystemsAmino Acids/*metabolismAnimalBiological Transport, ActiveCarrier Proteins/metabolismCell SizeGlutamine/metabolism/pharmacologyHeart/drug effectsHumanIn VitroMuscle, Skeletal/cytology/*metabolismMyocardium/*metabolismSupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8878864Rennie19962199086424471264 Suppl1996AprGlutamine metabolism and transport in skeletal muscle and heart and their clinical relevance1142S-9SDepartment of Anatomy and Physiology, University of Dundee, Scotland, United Kingdom.Rennie, M. J.Ahmed, A.Khogali, S. E.Low, S. Y.Hundal, H. S.Taylor, P. M.J NutrAlanine/metabolismBiological TransportGlutamic Acid/metabolismGlutamine/*metabolism/therapeutic useHumanMuscle, Skeletal/*metabolismMyocardium/*metabolismSupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8642447[103-105] and glycogen synthesis  ADDIN EN.CITE Varnier19952200076535482692 Pt 11995AugStimulatory effect of glutamine on glycogen accumulation in human skeletal muscleE309-15Department of Anatomy and Physiology, University of Dundee, Scotland, United Kingdom.Varnier, M.Leese, G. P.Thompson, J.Rennie, M. J.Am J PhysiolAdolescentAdultAlanine/pharmacologyComparative StudyDrug CombinationsExertionFemaleGlutamine/*pharmacologyGlycine/pharmacologyGlycogen/*metabolismHumanMaleMuscle, Skeletal/*metabolismOxygen ConsumptionSodium Chloride/pharmacologySupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7653548[106]. Theoretically, glutamine supplementation prior to and/or following exercise (e.g., 6-10 g) may help to optimize cell hydration and protein synthesis during training leading to greater gains in muscle mass and strength  ADDIN EN.CITE Antonio19992201099161762411999FebGlutamine: a potentially useful supplement for athletes1-14Dept. of HPERLS, Human Performance Laboratory, University of Nebraska-Kearney, Kearney, NE 68849, USA.Antonio, J.Street, C.Can J Appl PhysiolAnimalBlood Glucose/metabolism*Dietary SupplementsGlutamine/*metabolism/*pharmacologyHumanImmune System/*drug effectsMuscle Proteins/metabolismMuscle, Skeletal/*metabolismSports/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9916176Kreider19991440http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10091274Kreider, R. B.Dietary supplements and the promotion of muscle growth with resistance exerciseAnabolic Steroids/metabolismBoron/administration & dosage/pharmacologyChromium/administration & dosage/pharmacologyCreatine/administration & dosage/pharmacologyDietary Carbohydrates/administration & dosage/pharmacologyDietary Proteins/administration & dosage/pharmacology*Dietary SupplementsGlutamine/administration & dosage/pharmacologyHumanLeucine/administration & dosage/pharmacologyMuscle, Skeletal/drug effects/*growth & developmentNutritionPrasterone/administration & dosage/pharmacologyProteins/biosynthesisTestosterone/metabolismValerates/administration & dosage/pharmacologyVanadium Compounds/administration & dosage/pharmacologyWeight Lifting/*physiologyDepartment of Human Movement Sciences and Education, University of Memphis, Tennessee, USA. kreider.richard@coe.memphis.edu10091274Sports Med199927297-110.[44, 107]. In support of this hypothesis, a recent study by Colker and associates  ADDIN EN.CITE Colker200022020Colker, C.M.2000Effects of supplemental protein on body composition and muscular strength in healthy athletic male adults.Curr Ther Res.61119-28[108] found that subjects who supplemented their diet with glutamine (5 grams) and BCAA (3 grams) enriched whey protein during training promoted about a 2 pound greater gain in muscle mass and greater gains in strength than ingesting whey protein alone. Although more data is needed, there appears to be a strong scientific rationale and some preliminary evidence to indicate that glutamine may help build muscle. Protein. As previously described, research has indicated that people undergoing intense training may need additional protein in their diet to meet protein needs (i.e., 1.5 2.0 grams/day). People who do not ingest enough protein in their diet may slow recovery and training adaptations  ADDIN EN.CITE Kreider19991440http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10091274Kreider, R. B.Dietary supplements and the promotion of muscle growth with resistance exerciseAnabolic Steroids/metabolismBoron/administration & dosage/pharmacologyChromium/administration & dosage/pharmacologyCreatine/administration & dosage/pharmacologyDietary Carbohydrates/administration & dosage/pharmacologyDietary Proteins/administration & dosage/pharmacology*Dietary SupplementsGlutamine/administration & dosage/pharmacologyHumanLeucine/administration & dosage/pharmacologyMuscle, Skeletal/drug effects/*growth & developmentNutritionPrasterone/administration & dosage/pharmacologyProteins/biosynthesisTestosterone/metabolismValerates/administration & dosage/pharmacologyVanadium Compounds/administration & dosage/pharmacologyWeight Lifting/*physiologyDepartment of Human Movement Sciences and Education, University of Memphis, Tennessee, USA. kreider.richard@coe.memphis.edu10091274Sports Med199927297-110.[44]. Protein supplements offer a convenient way to ensure that athletes consume quality protein in the diet and meet their protein needs. However, ingesting additional protein beyond that necessary to meet protein needs does not appear to promote additional gains in strength and muscle mass. The research focus over recent years has been to determine whether different types of protein (e.g., whey, casein, soy, milk proteins, colostrum, etc) and/or various biologically active protein subtypes and peptides (e.g., -lactalbumin, -lactoglobulin, glycomacropeptides, immunoglobulins, lactoperoxidases, lactoferrin, etc) have varying effects on the physiological, hormonal, and/or immunological responses to training. In addition, whether timing of protein intake may play a role in protein synthesis and training adaptations  ADDIN EN.CITE Rasmussen20001520Rasmussen, B. B.Tipton, K. D.Miller, S. L.Wolf, S. E.Wolfe, R. R.An oral essential amino acid-carbohydrate supplement enhances muscle protein anabolism after resistance exerciseAdministration, OralAmino Acids, Essential/administration & dosage/*pharmacologyAnalysis of VarianceCarbohydrates/administration & dosage/*pharmacologyDietary SupplementsExercise/*physiologyFemaleFemoral Artery/drug effects/metabolismFemoral Vein/drug effects/metabolismHumanInsulin/bloodLeg/blood supplyMaleMuscle Proteins/*drug effects/metabolismPhenylalanine/drug effects/metabolismRegional Blood Flow/drug effectsSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Time FactorsDepartment of Surgery, University of Texas Medical Branch and Metabolism Unit, Shriners Burns Institute, Galveston, Texas 77550, USA.10658002http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10658002 http://jap.physiology.org/cgi/content/full/88/2/386 http://jap.physiology.org/cgi/content/abstract/88/2/386J Appl Physiol2000882386-92.Tipton20011510Tipton, K. D.Rasmussen, B. B.Miller, S. L.Wolf, S. E.Owens-Stovall, S. K.Petrini, B. E.Wolfe, R. R.Timing of amino acid-carbohydrate ingestion alters anabolic response of muscle to resistance exerciseAdministration, OralAdultAmino Acids, Essential/*administration & dosageBiopsyBlood Flow Velocity/drug effectsCarbohydrates/*administration & dosageDeuteriumDietary SupplementsExertion/*physiologyFemaleHumanInfusions, IntravenousInsulin/bloodLegMaleMuscle, Skeletal/*drug effects/*metabolismPhenylalanine/administration & dosage/blood/pharmacokineticsProteins/biosynthesisRegional Blood Flow/drug effectsSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Time FactorsDepartment of Surgery, University of Texas Medical Branch, Galveston, Texas 77550, USA. ktipton@utmb.edu11440894http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11440894 http://ajpendo.physiology.org/cgi/content/full/281/2/E197 http://ajpendo.physiology.org/cgi/content/abstract/281/2/E197Am J Physiol Endocrinol Metab20012812E197-206.Rasmussen2002905012459885662002Oral and intravenously administered amino acids produce similar effects on muscle protein synthesis in the elderly358-62University of Southern California, Department of Kinesiology, University Park Campus, 3560 Watt Way, PED 107, Los Angeles, CA 90089-0652, USA. blakeras@usc.eduRasmussen, B. B.Wolfe, R. R.Volpi, E.J Nutr Health AgingAdministration, OralAgedAmino Acids/*administration & dosage/pharmacokineticsBiological AvailabilityBiological TransportBiopsyCatheters, IndwellingComparative Study*Enteral NutritionFemaleHumanInfusions, IntravenousMaleMuscle Proteins/*biosynthesisMuscle, Skeletal/*metabolism*Parenteral NutritionPhenylalanine/administration & dosage/pharmacokineticsSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12459885Miller20039020126185753532003MarIndependent and combined effects of amino acids and glucose after resistance exercise449-55Dairy Management, Inc, Rosemont, IL, USA.Miller, S. L.Tipton, K. D.Chinkes, D. L.Wolf, S. E.Wolfe, R. R.Med Sci Sports Exerchttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12618575Kobayashi200390301255634928432003MarReduced amino acid availability inhibits muscle protein synthesis and decreases activity of initiation factor eIF2BE488-98Department of Surgery, Shriners Burns Hospital, University of Texas Medical Branch, Galveston, Texas 77550, USA.Kobayashi, H.Borsheim, E.Anthony, T. G.Traber, D. L.Badalamenti, J.Kimball, S. R.Jefferson, L. S.Wolfe, R. R.Am J Physiol Endocrinol MetabAmino Acids/*bloodAnimalEukaryotic Initiation Factor-2B/*metabolismLegLeucine/metabolismMuscle Proteins/*biosynthesisMuscle, Skeletal/metabolismOsmolar ConcentrationPhenylalanine/metabolismRenal DialysisSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Swinehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12556349Wolfe2002907012368421132102002OctRegulation of muscle protein by amino acids3219S-24SUniversity of Texas Medical Branch and Shriners Burns Hospital, Department of Surgery, Galveston 77550, USA. rwolfe@utmb.eduWolfe, R. R.J NutrAmino Acids/*metabolism/pharmacokineticsAnimalHumanKineticsLegMuscle Proteins/biosynthesis/*metabolismMuscle, Skeletal/*metabolismNutritive ValueRadioisotope Dilution TechniqueSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12368421Borsheim200290801221788128342002OctEssential amino acids and muscle protein recovery from resistance exerciseE648-57Metabolism Unit, Department of Surgery, Shriners Hospital for Children/Galveston, University of Texas Medical Branch, Galveston, Texas 77550, USA.Borsheim, E.Tipton, K. D.Wolf, S. E.Wolfe, R. R.Am J Physiol Endocrinol MetabAdultBlood GlucoseCarbon Isotopes/diagnostic useDeuterium/diagnostic useExercise/*physiologyFemaleHumanInsulin/bloodLeucine/administration & dosage/blood/*pharmacokineticsMaleMuscle, Skeletal/drug effects/*metabolismNitrogen Isotopes/diagnostic usePhenylalanine/administration & dosage/blood/*pharmacokineticsProteins/biosynthesisSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Urea/administration & dosage/blood/pharmacokineticshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12217881Biolo19991490http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10331397Biolo, G.Williams, B. D.Fleming, R. Y.Wolfe, R. R.Insulin action on muscle protein kinetics and amino acid transport during recovery after resistance exerciseAdultAlanine/metabolismAmino Acids/blood/*metabolismBiological TransportBlood Flow VelocityExercise/*physiologyFemoral ArteryGlucose/metabolismHumanInsulin/administration & dosage/blood/*pharmacologyKineticsLeg/blood supplyLysine/metabolismMaleMuscle Proteins/biosynthesis/*metabolismMuscle, Skeletal/*metabolismSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Department of Internal Medicine, University of Texas Medical Branch, and the Shriners Burns Hospital, Galveston, USA.10331397Diabetes1999485949-57.[94-101]. Although more research is necessary in this area, research clearly indicates that protein needs of individuals engaged in intense training are elevated, that different types of protein have varying effects on anabolism and catabolism, that different types of protein subtypes and peptides have unique physiological effects, and that timing of protein intake may play an important role in optimizing protein synthesis following exercise. Therefore, it is simplistic and misleading to suggest that there is no data supporting contentions that athletes need more protein in their diet and/or there is no potential ergogenic value of incorporating different types of protein into the diet. Too Early to Tell (-ketoglutarate ((-KG). (-KG is an intermediate in the Krebs cycle that is involved in aerobic energy metabolism. There is some clinical evidence that (-KG may serve as an anticatabolic nutrient after surgery  ADDIN EN.CITE Wernerman199022030196906733586911990Mar 24Alpha-ketoglutarate and postoperative muscle catabolism701-3Department of Anaesthesiology and Intensive Care, St Goran's Hospital, Karolinska Institute, Stockholm, Sweden.Wernerman, J.Hammarqvist, F.Vinnars, E.LancetCholecystectomyDrug EvaluationGlutamine/*metabolismHumanKetoglutaric Acids/administration & dosage/*pharmacologyMuscle Proteins/*metabolismNitrogen/*urine*Parenteral Nutrition, TotalPostoperative PeriodRibosomes/metabolismSupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1969067Hammarqvist199022040212282121251990NovAlanyl-glutamine counteracts the depletion of free glutamine and the postoperative decline in protein synthesis in skeletal muscle637-44Department of Surgery, St. Goran's Hospital, Stockholm, Sweden.Hammarqvist, F.Wernerman, J.von der Decken, A.Vinnars, E.Ann SurgCholecystectomyComparative StudyFemaleGlutamine/metabolism/*therapeutic useHumanMaleMiddle AgeMuscles/*metabolism*Parenteral Nutrition, TotalPostoperative CarePostoperative PeriodSupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2122821[109, 110]. However, it is unclear whether (-KG supplementation during training may affect training adaptations. (-Ketoisocaproate (KIC). KIC is a branched-chain keto acid that is a metabolite of leucine metabolism. In a similar manner as HMB, leucine and metabolites of leucine are believed to possess anticatabolic properties  ADDIN EN.CITE Antonio200122051Antonio, J.Stout, J.R.2001Sport Supplements.Philadelphia, PALippincott, Williams and Wilkins.118-120[111]. There is some clinical evidence that KIC may spare protein degradation in clinical populations  ADDIN EN.CITE Mitch19812206074624286721981FebNitrogen sparing induced by leucine compared with that induced by its keto analogue, alpha-ketoisocaproate, in fasting obese man553-62Mitch, W. E.Walser, M.Sapir, D. G.J Clin InvestAdultAmino Acids/bloodComparative StudyFastingFemaleHumanInfusions, ParenteralKeto Acids/*administration & dosageLeucine/*pharmacologyMaleMiddle AgeNitrogen/*metabolism/urineObesity/*metabolismSupport, U.S. Gov't, P.H.S.Time FactorsUrea/urinehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7462428Van Koevering19922186017332472621 Pt 11992JanOxidation of leucine and alpha-ketoisocaproate to beta-hydroxy-beta-methylbutyrate in vivoE27-31Department of Animal Science, Iowa State University, Ames 50011.Van Koevering, M.Nissen, S.Am J PhysiolAnimalFemaleKeto Acids/*metabolismLeucine/*metabolismMaleOsmolar ConcentrationOxidation-ReductionSheepSwineValerates/*blood/urinehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1733247[112, 113]. Theoretically, KIC may help minimize protein degradation during training possibly leading to greater training adaptations. However, we are not aware of any studies that have evaluated the effects of KIC supplementation during training on body composition. Ecdysterones. Ecdysterones (also known as ectysterone, 20 Beta-Hydroxyecdysterone, turkesterone, ponasterone, ecdysone, or ecdystene) are naturally derived phytoecdysteroids (i.e., insect hormones). They are typically extracted from the herbs Leuza rhaptonticum sp., Rhaponticum carthamoides, or Cyanotis vaga. They can also be found in high concentrations in the herb Suma (also known as Brazilian Ginseng or Pfaffia). Research from Russia and Czechoslovakia conducted over the last 30 years indicates that ecdysterones may possess some potentially beneficial physiological effects in insects and animals  ADDIN EN.CITE Slama19962207086981145271996Jul 15Insect hormones in vertebrates: anabolic effects of 20-hydroxyecdysone in Japanese quail702-6Institute of Entomology, Czech Academy of Sciences, Praha, Czech Republic.Slama, K.Koudela, K.Tenora, J.Mathova, A.ExperientiaAnimalCoturnix/blood/*growth & developmentDietEcdysterone/administration & dosage/blood/*pharmacologyPlants/*chemistrySeeds/chemistrySex MaturationSupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8698114Slama197522090115660614821975AprInsect hormones and bioanalogues: their effect on respiratory metabolism in Dermestes vulpinus L. (Coleoptera)320-32Slama, K.Kodkoua, M.Biol BullAnimalColeoptera/growth & development/*metabolismEcdysterone/physiologyJuvenile Hormones/*physiologyLarvaMetamorphosis, Biological*Oxygen ConsumptionPupahttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1156606Tashmukhamedova198522220406341391985[Effect of phytoecdisteroids and anabolic steroids on liver mitochondrial respiration and oxidative phosphorylation in alloxan diabetic rats]37-9Tashmukhamedova, M. A.Almatov, K. T.Syrov, V. N.Sultanov, M. B.Abidov, A. A.Nauchnye Doki Vyss Shkoly Biol NaukiAnabolic Steroids/*therapeutic useAnimalCholestenones/therapeutic useDiabetes Mellitus, Experimental/*drug therapy/metabolismDrug Evaluation, PreclinicalEcdysterone/therapeutic useEnergy Metabolism/drug effectsEnglish AbstractMaleMethandrostenolone/therapeutic useMitochondria, Liver/*drug effects/metabolismOxidative Phosphorylation/drug effectsOxygen Consumption/drug effectsPlant Extracts/therapeutic useRatsTime Factorshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=4063413Syrov1984222306525371111984[Mechanism of the anabolic action of phytoecdisteroids in mammals]16-20Syrov, V. N.Nauchnye Doki Vyss Shkoly Biol NaukiAnimalCholestenones/pharmacologyComparative StudyDactinomycin/pharmacologyEcdysone/analogs & derivatives/pharmacologyEcdysterone/pharmacologyEnglish AbstractLiver/drug effects/metabolismMaleMetabolism/*drug effectsMicePhytosterols/*pharmacologyPolyribosomes/drug effects/metabolismProteins/biosynthesishttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6525371Kholodova200122110120355487332001May-JunPhytoecdysteroids: biological effects, application in agriculture and complementary medicine (as presented at the 14-th Ecdysone Workshop, July, 2000, Rapperswil, Switzerland)21-9Palladin Institute of Biochemistry, National Academy of Sciences of Ukraine, Kyiv.Kholodova, Y.Ukr Biokhim Zh*AgricultureAnimalEcdysteroids/*pharmacologyInsectshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12035548[114-118]. However, since most of the data on ecdysterones have been published in obscure journals, results are difficult to interpret. While future studies may find some ergogenic value of ecdysterones, it is our view that it is too early to tell whether phytoecdysteroids serve as a safe and effective nutritional supplement for athletes. Growth Hormone Releasing Peptides (GHRP) and Secretogues. Research has indicated that growth hormone releasing peptides (GHRP) and other non-peptide compounds (secretagogues) appear to help regulate growth hormone (GH) release  ADDIN EN.CITE Bowers199822260989370854121998DecGrowth hormone-releasing peptide (GHRP)1316-29Tulane University Medical School, New Orleans, Louisiana 70112, USA. rjabower@tmcpop.tmc.tulane.eduBowers, C. Y.Cell Mol Life SciAnimalHumanHypothalamus/*physiologyOligopeptides/*physiologyPituitary Gland/*physiologySupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9893708Camanni19982227094652891911998JanGrowth hormone-releasing peptides and their analogs47-72Department of Internal Medicine, University of Turin, Italy.Camanni, F.Ghigo, E.Arvat, E.Front NeuroendocrinolAnimalHumanReceptors, Somatotropin/drug effects/physiologySomatotropin-Releasing Hormone/chemistry/pharmacology/*physiologySupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9465289[119, 120]. These observations have served as the basis for development of nutritionally-based GH stimulators (e.g., amino acids, pituitary peptides, pituitary substances, macuna pruriens, broad bean, alpha GPC, etc). Although there is clinical evidence that pharmaceutical grade GHRPs and some non-peptide secretagogues can increase GH and IGF-1 levels at rest and in response to exercise, it is currently unknown whether any of these nutritional alternatives would increase GH and/or affect training adaptations. Isoflavones. Isoflavones are naturally occurring non-steroidal phytoestrogens that have a similar chemical structure as the ipriflavone (a synthetic flavonoid drug used in the treatment of osteoporosis)  ADDIN EN.CITE Messina200023270107578171022000AprSoyfoods, soybean isoflavones, and bone health: a brief overview63-8Department of Nutrition, Loma Linda University, Loma Linda, CA, USA.Messina, M.Messina, V.J Ren NutrAnimalBone Diseases/*prevention & controlBone and Bones/*physiologyFemale*FoodHuman*IsoflavonesJapan/epidemiologyOsteoporosis, Postmenopausal/epidemiology/prevention & controlSoybean ProteinsSoybeans/*chemistryhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10757817Messina2000232601105632636 Suppl 42000SepSoyfoods and soybean phyto-oestrogens (isoflavones) as possible alternatives to hormone replacement therapy (HRT)S71-2Nutrition Matters, Inc. Port Townsend, WA 98368, USA. markm@olympus.neMessina, M.Eur J CancerBreast Neoplasms/prevention & controlCoronary Disease/prevention & controlFemaleHormone Replacement Therapy/*methodsHumanIsoflavones/*therapeutic useMenopauseOsteoporosis/prevention & controlSoybean Proteins/*therapeutic usehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11056326de Aloysio19972332092724271141997AugBone density changes in postmenopausal women with the administration of ipriflavone alone or in association with low-dose ERT289-93Department of Obstetrics and Gynecology, University of Bologna, Italy.de Aloysio, D.Gambacciani, M.Altieri, P.Ciaponi, M.Ventura, V.Mura, M.Genazzani, A. R.Bottiglioni, F.Gynecol EndocrinolAdministration, CutaneousAlkaline Phosphatase/bloodBody Mass Index*Bone DensityBone RemodelingCreatinine/urineEstradiol/administration & dosage/therapeutic use*Estrogen Replacement TherapyFemaleHumanHydroxyproline/urineIsoflavones/*therapeutic use*Postmenopausehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9272427[121-123]. For this reason, soy protein (which is an excellent source of isoflavones) and isoflavone extracts have been investigated in the possible treatment of osteoporosis. Results of these studies have shown promise in preventing declines in bone mass in post-menopausal women as well as reducing risks to side effects associated with estrogen replacement therapy. More recently, the isoflavone extracts 7-isopropoxyisoflavone (ipriflavone) and 5-methyl-7-methoxy-isoflavone (methoxyisoflavone) have been marketed as powerful anabolic substances. These claims have been based on research described in patents filed in Hungary in the early 1970s  ADDIN EN.CITE 23330US Patent 3949085: Anabolic-weight-gain promoting compositions containing isoflavone derivatives and method using same. Available at http://www.delphion.com/details?pn=US0394908523340US Patent 4163746: Metabolic 5-methyl-isoflavone-derivatives, process for the preparation thereof and compositions containing the same. Available at: http://www.delphion.com/details?&pn=US04163746[124, 125]. Although the data presented in the patents are interesting, there is currently no peer-reviewed data indicating that isoflavone supplementation affects exercise, body composition, or training adaptations. Ornithine-(-ketoglutarate (OKG). OKG is another nutrient believed to possess anabolic/catabolic effect. Animal and clinical studies have suggested that patients administered OKG experienced improved protein balance  ADDIN EN.CITE 23330US Patent 3949085: Anabolic-weight-gain promoting compositions containing isoflavone derivatives and method using same. Available at http://www.delphion.com/details?pn=US0394908523340US Patent 4163746: Metabolic 5-methyl-isoflavone-derivatives, process for the preparation thereof and compositions containing the same. Available at: http://www.delphion.com/details?&pn=US04163746[124, 125]. Theoretically, OKG may provide some value for athletes engaged in intense training. A recent study by Chetlin and colleagues  ADDIN EN.CITE Chetlin200023350Chetlin, R.D.Yeater, R.A.Ullrich, I.H.Hornsby, W.G.Malanga, C.J.Byrner, R.W.2000The effect of ornithine alpha-ketoglutarate (OKG) on healthy, weight trained menJ Exerc Physiol Online34Available: www.css.edu/users/tboone2/asep/ChetlinV2.pdf[126] reported that OKG supplementation (10 grams/day) during 6-weeks of resistance training promoted greater gains in bench press. However, no significant differences were observed in squat strength, training volume, gains in muscle mass, or fasting insulin and growth hormone. Therefore, additional research is needed before conclusions can be drawn. Sulfo-Polysaccharides (Myostatin Inhibitors). Myostatin or growth differentiation factor 8 (GDF-8) is a transforming growth factor that has been shown to serve as a genetic determinant of the upper limit of muscle size and growth  ADDIN EN.CITE Gonzalez-Cadavid199830960984399495251998Dec 8Organization of the human myostatin gene and expression in healthy men and HIV-infected men with muscle wasting14938-43Division of Endocrinology, Charles R. Drew University, Los Angeles, CA 90059, USA. ncadavid@ucla.eduGonzalez-Cadavid, N. F.Taylor, W. E.Yarasheski, K.Sinha-Hikim, I.Ma, K.Ezzat, S.Shen, R.Lalani, R.Asa, S.Mamita, M.Nair, G.Arver, S.Bhasin, S.Proc Natl Acad Sci U S AAdultAnimalBase SequenceCHO CellsCattleChromosome Mapping*Chromosomes, Human, Pair 2Cloning, MolecularExons/geneticsHIV Infections/*genetics/physiopathologyHIV Wasting Syndrome/*genetics/physiopathologyHIV-1/*isolation & purificationHamstersHumanIntrons/geneticsMaleMiceMolecular Sequence DataMuscle, Skeletal/physiopathologySequence Analysis, DNASupport, U.S. Gov't, Non-P.H.S.Support, U.S. Gov't, P.H.S.Transforming Growth Factor beta/*geneticshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9843994[127]. Recent research has indicated that eliminating and/or inhibiting myostatin gene expression in mice  ADDIN EN.CITE McPherron199730970913982638766281997May 1Regulation of skeletal muscle mass in mice by a new TGF-beta superfamily member83-90Department of Molecular Biology and Genetics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.McPherron, A. C.Lawler, A. M.Lee, S. J.NatureAging/metabolismAmino Acid SequenceAnimalBody Weight/genetics/physiologyCHO CellsCloning, MolecularEmbryo/metabolismGene TargetingHamstersHomozygoteHumanHyperplasia/geneticsHypertrophy/geneticsIn Situ HybridizationMiceMice, Inbred C57BLMolecular Sequence DataMuscle, Skeletal/pathology/*physiologyPolymerase Chain ReactionProtein Sorting Signals/geneticsStem CellsSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Transforming Growth Factor beta/*chemistry/genetics/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9139826[128] and cattle  ADDIN EN.CITE McPherron199730980935647194231997Nov 11Double muscling in cattle due to mutations in the myostatin gene12457-61Department of Molecular Biology and Genetics, Johns Hopkins University School of Medicine, 725 North Wolfe Street, Baltimore, MD 21205, USA.McPherron, A. C.Lee, S. J.Proc Natl Acad Sci U S AAmino Acid SequenceAnimalCattleCloning, Molecular*Frameshift MutationMiceMolecular Sequence DataMuscle, Skeletal/*anatomy & histologyOrgan Weight/geneticsSequence AlignmentSequence AnalysisSpecies SpecificitySupport, Non-U.S. Gov'tTransforming Growth Factor beta/*geneticshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9356471Grobet19973100092881001711997SepA deletion in the bovine myostatin gene causes the double-muscled phenotype in cattle71-4Department of Genetics, Faculty of Veterinary Medicine, University of Liege, Belgium.Grobet, L.Martin, L. J.Poncelet, D.Pirottin, D.Brouwers, B.Riquet, J.Schoeberlein, A.Dunner, S.Menissier, F.Massabanda, J.Fries, R.Hanset, R.Georges, M.Nat GenetAmino Acid SequenceAnimalBase SequenceCattle/anatomy & histology/*genetics*Chromosome MappingDNA PrimersGenotypeHumanMale*Microsatellite RepeatsMolecular Sequence DataMuscle, Skeletal/*anatomy & histologyPhenotypePolymerase Chain ReactionSequence Alignment*Sequence DeletionSpecies SpecificitySupport, Non-U.S. Gov'tTransforming Growth Factor beta/biosynthesis/chemistry/*geneticshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9288100Kambadur1997310109314496791997SepMutations in myostatin (GDF8) in double-muscled Belgian Blue and Piedmontese cattle910-6AgResearch, Ruakura, Hamilton, New Zealand.Kambadur, R.Sharma, M.Smith, T. P.Bass, J. J.Genome ResAllelesAmino Acid SequenceAnimalCattle/*geneticsConserved SequenceDNA, ComplementaryFrameshift MutationGene Expression*Genes, StructuralHypertrophy/geneticsMiceMolecular Sequence DataMuscles/pathology/*ultrastructurePhenotypePolymerase Chain ReactionRNA/isolation & purificationSequence Analysis, DNASequence Homology, Amino AcidSpecies SpecificityTransforming Growth Factor beta/*geneticshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9314496[129-131] promotes marked increases in muscle mass during early growth and development. The result is that these animals experience what has been termed as a double-muscle phenomenon apparently by allowing muscle to grow beyond its normal genetic limit. In agriculture research, eliminating and/or inhibiting myostatin may serve as an effective way to optimize animal growth leading to larger, leaner, and a more profitable livestock yield. In humans, inhibiting myostatin gene expression has been theorized as a way to prevent or slow down muscle wasting in various diseases, speed up recovery of injured muscles, and/or promote increases in muscle mass and strength in athletes  ADDIN EN.CITE Ivey2000310401107809355112000NovEffects of age, gender, and myostatin genotype on the hypertrophic response to heavy resistance strength trainingM641-8Department of Kinesiology, College of Health and Human Performance, University of Maryland College Park 20742, USA.Ivey, F. M.Roth, S. M.Ferrell, R. E.Tracy, B. L.Lemmer, J. T.Hurlbut, D. E.Martel, G. F.Siegel, E. L.Fozard, J. L.Jeffrey Metter, E.Fleg, J. L.Hurley, B. F.J Gerontol A Biol Sci Med SciAdultAgedAging/*pathologyFemaleGenotypeHumanHypertrophyMaleMiddle AgeMuscle, Skeletal/*pathology*Physical Education and TrainingSex FactorsSupport, U.S. Gov't, P.H.S.Transforming Growth Factor beta/*geneticshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11078093[132]. While these theoretical possibilities may have great promise, research on the role of myostatin inhibition on muscle growth and repair is in the very early stages particularly in humans. There is some evidence that myostatin levels are higher in the blood of HIV positive patients who have experience muscle wasting and that myostatin levels negatively correlate with muscle mass  ADDIN EN.CITE Gonzalez-Cadavid199830960984399495251998Dec 8Organization of the human myostatin gene and expression in healthy men and HIV-infected men with muscle wasting14938-43Division of Endocrinology, Charles R. Drew University, Los Angeles, CA 90059, USA. ncadavid@ucla.eduGonzalez-Cadavid, N. F.Taylor, W. E.Yarasheski, K.Sinha-Hikim, I.Ma, K.Ezzat, S.Shen, R.Lalani, R.Asa, S.Mamita, M.Nair, G.Arver, S.Bhasin, S.Proc Natl Acad Sci U S AAdultAnimalBase SequenceCHO CellsCattleChromosome Mapping*Chromosomes, Human, Pair 2Cloning, MolecularExons/geneticsHIV Infections/*genetics/physiopathologyHIV Wasting Syndrome/*genetics/physiopathologyHIV-1/*isolation & purificationHamstersHumanIntrons/geneticsMaleMiceMolecular Sequence DataMuscle, Skeletal/physiopathologySequence Analysis, DNASupport, U.S. Gov't, Non-P.H.S.Support, U.S. Gov't, P.H.S.Transforming Growth Factor beta/*geneticshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9843994[127]. There is also evidence that myostatin gene expression may be fiber specific and that myostatin levels may be influenced by immobilization in animals  ADDIN EN.CITE Carlson199930990104445692772 Pt 21999AugSkeletal muscle myostatin mRNA expression is fiber-type specific and increases during hindlimb unloadingR601-6Department of Integrative Biology, Pharmacology, and Physiology, University of Texas Medical School at Houston, Houston, Texas 77030, USA.Carlson, C. J.Booth, F. W.Gordon, S. E.Am J PhysiolAnimalBody WeightEnergy Intake/physiologyFemaleGene Expression/physiologyHindlimb Suspension/*physiologyMiceMice, Inbred ICRMuscle Fibers/*metabolismMuscle, Skeletal/anatomy & histology/*metabolismMyosin Heavy Chains/metabolismOrgan WeightProtein Isoforms/metabolismRNA, Messenger/*metabolismSupport, U.S. Gov't, Non-P.H.S.Support, U.S. Gov't, P.H.S.Transforming Growth Factor beta/*geneticshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10444569[133]. Additionally, a recent study by Ivey and colleagues  ADDIN EN.CITE Ivey2000310401107809355112000NovEffects of age, gender, and myostatin genotype on the hypertrophic response to heavy resistance strength trainingM641-8Department of Kinesiology, College of Health and Human Performance, University of Maryland College Park 20742, USA.Ivey, F. M.Roth, S. M.Ferrell, R. E.Tracy, B. L.Lemmer, J. T.Hurlbut, D. E.Martel, G. F.Siegel, E. L.Fozard, J. L.Jeffrey Metter, E.Fleg, J. L.Hurley, B. F.J Gerontol A Biol Sci Med SciAdultAgedAging/*pathologyFemaleGenotypeHumanHypertrophyMaleMiddle AgeMuscle, Skeletal/*pathology*Physical Education and TrainingSex FactorsSupport, U.S. Gov't, P.H.S.Transforming Growth Factor beta/*geneticshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11078093[132] reported that female athletes with a less common myostatin allele (a genetic subtype that may be more resistant to myostatin) experienced greater gains in muscle mass during training and less loss of muscle mass during detraining. No such pattern was observed in men with varying amounts of training histories and muscle mass. These early studies suggest that myostatin may play a role in regulating muscle growth to some degree. Recently, some nutrition supplement companies have marketed sulfo-polysaccharides (derived from a sea algae called Cytoseira canariensis) as a way to partially bind the myostatin protein in serum. Although this theory is interesting and studies examining this hypothesis are underway, there is currently no published data supporting the use of sulfo-polysaccharides as a muscle building supplement. Smilax Officinalis (SO). SO is a compound which contains plant sterols purported to enhance immunity as well as provide an androgenic effect on muscle growth  ADDIN EN.CITE Leutholtz200116077Leutholtz, B. Kreider, R.B.2001Exercise and Sport Nutrition.Wilson, T.Temple, N.Nutritional Health.Totowa, NJHumana Press, Inc.207 – 239[9]. Some data supports the potential immune enhancing effects of SO. However, we are not aware of any data that show that SO supplementation increases muscle mass during training. Zinc/Magnesium Aspartate (ZMA). ZMA formulations have recently become a popular supplement purported to promote anabolism at night. The theory is based on studies suggesting that zinc and magnesium deficiency may reduce the production of testosterone and insulin like growth factor (IGF-1). ZMA supplementation has been theorized to increase testosterone and IGF-1 leading to greater recovery, anabolism, and strength during training. In support of this theory, Brilla and Conte  ADDIN EN.CITE Brilla200023360Brilla, L.R.Conte, V.2000Effects of a novel zing-magnesium formulation on hormones and strengthJ Exerc Physiol Online34Available: www.css.edu/users/tboone2/asep/BrillaV2.pdf[134] reported that a zinc-magnesium formulation increased testosterone and IGF-1 (two anabolic hormones) leading to greater gains in strength in football players participating in spring training. While these data are interesting, more research is needed to further evaluate the role of ZMA on body composition and strength during training before conclusions can be drawn. Apparently Ineffective Boron. Boron is a trace mineral proposed to increase testosterone levels and promote anabolism. Several studies have evaluated the effects of boron supplementation during training on strength and body composition alterations. These studies indicate that boron supplement (2.5 mg/d) appears to have no impact on muscle mass or strength  ADDIN EN.CITE Green1994233807889885102 Suppl 71994NovPlasma boron and the effects of boron supplementation in males73-7Department of Nutrition and Food Science, Auburn University, AL 36849.Green, N. R.Ferrando, A. A.Environ Health PerspectAdultBody Composition/drug effects/*physiologyBoron/administration & dosage/*bloodHumanMaleNutritional RequirementsPhysical Endurance/drug effects/physiologySupport, Non-U.S. Gov'tTestosterone/bloodWeight Lifting/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7889885Ferrando1993233908508192321993JunThe effect of boron supplementation on lean body mass, plasma testosterone levels, and strength in male bodybuilders140-9NASA, Johnson Space Center, Houston, TX 77058.Ferrando, A. A.Green, N. R.Int J Sport NutrAdult*Body Mass IndexBoron/*administration & dosage/blood*DietDouble-Blind MethodHumanMaleMuscles/*physiologySupport, Non-U.S. Gov'tTestosterone/*bloodWeight Lifting/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8508192[135, 136]. Chromium. Chromium is a trace mineral that is involved in carbohydrate and fat metabolism. Clinical studies have suggested that chromium may enhance the effects of insulin particularly in diabetic populations. Since insulin is an anti-catabolic hormone and has been reported to affect protein synthesis, chromium supplementation has been theorized to serve as an anabolic nutrient. Theoretically, this may increase anabolic responses to exercise. Although some initial studies reported that chromium supplementation increased gains in muscle mass and strength during training particularly in women  ADDIN EN.CITE Evans198923580Evans, G.W.1989The effect of chromium picolinate on insulin controlled parameters in humansInt Biosc Med Res11163-180Hasten1992235701299504241992DecEffects of chromium picolinate on beginning weight training students343-50Dept. of Kinesiology, Louisiana State University, Baton Rouge 70803-7101.Hasten, D. L.Rome, E. P.Franks, B. D.Hegsted, M.Int J Sport NutrAdultComparative StudyDouble-Blind MethodFemaleHumanMalePicolinic Acids/*pharmacologyPlacebosSex CharacteristicsWeight Gain/*drug effects*Weight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1299504Grant19972352092689552981997AugChromium and exercise training: effect on obese women992-8Department of Kinesiology and Health Education, University of Texas at Austin 78712, USA.Grant, K. E.Chandler, R. M.Castle, A. L.Ivy, J. L.Med Sci Sports ExercAdolescentAdultBlood Glucose/metabolismCoronary Disease/prevention & controlDiabetes Mellitus, Non-Insulin-Dependent/prevention & control*Exercise TherapyFemale*Food, FortifiedHumanInsulin/metabolismIron Chelating Agents/*pharmacology/therapeutic useNicotinic Acids/*pharmacology/therapeutic useObesity/physiopathology/*therapyPicolinic Acids/*pharmacology/therapeutic useRisk FactorsSupport, Non-U.S. Gov'tWeight GainWeight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9268955[137-139], most well-controlled that have been conducted since then have reported no benefit in healthy individuals taking chromium (200-800 mcg/d) for 4 to 16-weeks during training  ADDIN EN.CITE Campbell19992349098871108611999JanEffects of resistance training and chromium picolinate on body composition and skeletal muscle in older men29-39Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, and Veterans Affairs Geriatric Research, Education, and Clinical Center, Little Rock, Arkansas 72205, USA. campbellwaynew@exchange.uams.eduCampbell, W. W.Joseph, L. J.Davey, S. L.Cyr-Campbell, D.Anderson, R. A.Evans, W. J.J Appl PhysiolAgedBody Composition/drug effects/*physiologyCreatine/urineDietEnergy Metabolism/physiologyHumanIron Chelating Agents/*pharmacologyMaleMiddle AgeMuscle, Skeletal/drug effects/metabolism/*physiologyPhysical Fitness/*physiologyPicolinic Acids/*pharmacologySkinfold ThicknessSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Weight Lifting/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9887110Walker199823500986160730121998DecChromium picolinate effects on body composition and muscular performance in wrestlers1730-7Department of Health & Sport Sciences, University of Oklahoma, Norman, USA.Walker, L. S.Bemben, M. G.Bemben, D. A.Knehans, A. W.Med Sci Sports ExercAdolescentAdultAnaerobic Threshold/drug effectsAnalysis of VarianceBlood Glucose/analysisBody Composition/*drug effectsDiet*Dietary SupplementsDouble-Blind MethodEnergy Metabolism/drug effectsFollow-Up StudiesHumanInsulin/bloodMaleMuscle Contraction/drug effectsMuscle, Skeletal/*drug effects/metabolismOxygen Consumption/drug effectsPhysical Endurance/drug effectsPicolinic Acids/administration & dosage/*therapeutic usePlacebosRunning/physiologySupport, Non-U.S. Gov'tWeight Lifting/physiologyWrestling/education/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9861607Livolsi200123430117103991522001MayThe effect of chromium picolinate on muscular strength and body composition in women athletes161-6Division of Kinesiology and Health Promotion, California State University-Fullerton, 92634-9480, USA.Livolsi, J. M.Adams, G. M.Laguna, P. L.J Strength Cond ResAdolescentAdultBaseball/*physiologyBody Composition/*drug effectsBody WeightDietary SupplementsFemaleHumanIron Chelating Agents/*pharmacologyMuscle, Skeletal/*drug effectsPicolinic Acids/*pharmacology/urineSupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11710399Volpe200123440115060572042001AugEffect of chromium supplementation and exercise on body composition, resting metabolic rate and selected biochemical parameters in moderately obese women following an exercise program293-306Department of Nutrition, University of Massachusetts, Amherst 01003, USA. volpe@nutrition.umass.eduVolpe, S. L.Huang, H. W.Larpadisorn, K.Lesser,, IIJ Am Coll NutrAdult*Basal MetabolismBlood Glucose/analysisBlood Proteins/metabolism*Body CompositionC-Peptide/bloodCholesterol/bloodChromium/*administration & dosage/blood/urineDietDietary SupplementsDouble-Blind Method*ExerciseFastingFemaleGlucagon/bloodHumanInsulin/bloodIron/blood/urineLipids/bloodMiddle AgeObesity/*therapyPatient CompliancePlacebosSupport, Non-U.S. Gov'tSupport, U.S. Gov't, Non-P.H.S.Zinc/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11506057Hallmark19962354087753662811996JanEffects of chromium and resistive training on muscle strength and body composition139-44Department of Kinesiology, University of Maryland, College Park, USA.Hallmark, M. A.Reynolds, T. H.DeSouza, C. A.Dotson, C. O.Anderson, R. A.Rogers, M. A.Med Sci Sports ExercAdult*Body CompositionChromium/*pharmacologyDouble-Blind MethodHumanMaleMuscle, Skeletal/*drug effectsWeight Lifting/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8775366Lukaski19962353086446936361996JunChromium supplementation and resistance training: effects on body composition, strength, and trace element status of men954-65US Department of Agriculture, Agricultural Research Service, Grand Forks Human Nutrition Research Center, ND, USA.Lukaski, H. C.Bolonchuk, W. W.Siders, W. A.Milne, D. B.Am J Clin NutrAdultAnthropometryBody Composition/*drug effects/physiologyCeruloplasmin/analysisChromium/administration & dosage/blood/*pharmacologyCopper/bloodDensitometry, X-RayDouble-Blind MethodExercise/*physiologyFerritin/bloodFood, FortifiedHumanMaleMuscle Contraction/*drug effects/physiologyMuscle, Skeletal/drug effects/physiologyPatient ComplianceTrace Elements/*bloodZinc/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8644693Clancy1994235508054959421994JunEffects of chromium picolinate supplementation on body composition, strength, and urinary chromium loss in football players142-53Department of Exercise Science, University of Massachusetts, Amherst 01003.Clancy, S. P.Clarkson, P. M.DeCheke, M. E.Nosaka, K.Freedson, P. S.Cunningham, J. J.Valentine, B.Int J Sport NutrAdultAnthropometryBody Composition/*drug effectsChromium/*urineDietFootball/*physiologyHumanMaleMuscles/*drug effects/physiologyPhysical Education and TrainingPicolinic Acids/*pharmacologySupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8054959[140-146]. Consequently, it appears that although chromium supplementation may have some therapeutic benefits for diabetics, chromium does not appear to be a muscle-building nutrient for athletes. Conjugated Linoleic Acids (CLA). Animal studies indicate that adding CLA to dietary feed decreases body fat, increases muscle and bone mass, has anti-cancer properties, enhances immunity, and inhibits progression of heart disease  ADDIN EN.CITE Pariza19992375010630598522 Suppl1999DecConjugated linoleic acid and the control of cancer and obesity107-10Food Research Institute, Department of Food Microbiology and Toxicology, University of Wisconsin-Madison, 53706-1187, USA. mwpariza@facstaff.wisc.eduPariza, M. W.Park, Y.Cook, M. E.Toxicol SciAnimalLinoleic Acid/chemistry/*pharmacologyModels, MolecularNeoplasms, Experimental/*prevention & controlProtein Structure, Secondaryhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10630598Pariza2000237601063295622312000JanMechanisms of action of conjugated linoleic acid: evidence and speculation8-13Food Research Institute, Department of Food Microbiology, University of Wisconsin-Madison, 53706, USA. mwpariza@facstaff.wisc.eduPariza, M. W.Park, Y.Cook, M. E.Proc Soc Exp Biol MedAnimalAnticarcinogenic AgentsArteriosclerosis/prevention & controlBody Composition/drug effectsDrug DesignLinoleic Acids/chemistry/*pharmacologyMolecular ConformationRatsSupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10632956Pariza200123770114128934042001JulThe biologically active isomers of conjugated linoleic acid283-98Department of Food Microbiology and Toxicology, Food Research Institute, University of Wisconsin-Madison, 53706, USA. mwpariza@facstaff.wisc.eduPariza, M. W.Park, Y.Cook, M. E.Prog Lipid ResAdipocytes/metabolismAnimalAntineoplastic Agents/therapeutic useCattleDairy ProductsHumanInsulin/metabolismLinoleic Acids/chemistry/*metabolism/therapeutic useLipids/metabolismLiver/*metabolismMammary Neoplasms, Experimental/drug therapyMeatMiceMuscle, Skeletal/metabolismProtein Isoforms/biosynthesis/chemistry/metabolismRatshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11412893[147-149]. Consequently, CLA supplementation in humans has been suggested to help manage body composition, delay loss of bone, and provide health benefit. Although animal studies are impressive  ADDIN EN.CITE DeLany199923790101984002764 Pt 21999AprConjugated linoleic acid rapidly reduces body fat content in mice without affecting energy intakeR1172-9Pennington Biomedical Research Center, Louisiana State University, Baton Rouge 70808, Louisiana, USA. delanyjp/@mhs.pbrc.eduDeLany, J. P.Blohm, F.Truett, A. A.Scimeca, J. A.West, D. B.Am J PhysiolAdipose Tissue/*drug effectsAnimalBody Composition/drug effectsBody Weight/drug effectsDose-Response Relationship, DrugEating/*drug effectsInsulin/bloodLeptinLinoleic Acid/chemistry/*pharmacologyLiver/drug effects/pathologyMaleMiceMice, Inbred AKRProteins/analysisSpleen/drug effects/pathologySupport, Non-U.S. Gov'tTime FactorsVacuoles/ultrastructurehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10198400DeLany200023780109634691942000AugChanges in body composition with conjugated linoleic acid487S-493SPennington Biomedical Research Center, Baton Rouge, Louisiana 70808, USA. delanyjp@pbrc.eduDeLany, J. P.West, D. B.J Am Coll NutrAdipose Tissue/*drug effects/metabolismAnimalBody Composition/*drug effectsBody Weight/drug effectsDietary Fats, Unsaturated/*administration & dosage/pharmacologyDose-Response Relationship, DrugEnergy Metabolism/drug effectsLinoleic Acid/chemistry/*pharmacologyMaleMiceMice, Inbred AKROxidation-ReductionTime Factorshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10963469Park19972381092709773281997AugEffect of conjugated linoleic acid on body composition in mice853-8Department of Food Microbiology and Toxicology, University of Wisconsin-Madison 53706, USA.Park, Y.Albright, K. J.Liu, W.Storkson, J. M.Cook, M. E.Pariza, M. W.Lipids3T3 CellsAdipocytes/enzymologyAdipose Tissue/enzymologyAnimalBody Composition/*drug effectsBody Weight/drug effectsCarnitine O-Palmitoyltransferase/metabolismCorn Oil/administration & dosageDietDietary Fats/administration & dosage/*pharmacologyFemaleGlycerol/metabolismLinoleic Acids/administration & dosage/*pharmacologyLipolysis/drug effectsLipoprotein Lipase/antagonists & inhibitorsLiver/enzymologyMaleMiceMice, Inbred ICRMuscles/enzymologySupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9270977[150-152] and a some studies suggests benefit at some but not all dosages  ADDIN EN.CITE Blankson20002382011110851130122000DecConjugated linoleic acid reduces body fat mass in overweight and obese humans2943-8Scandinavian Clinical Research AS, N-2027 Kjeller, Norway.Blankson, H.Stakkestad, J. A.Fagertun, H.Thom, E.Wadstein, J.Gudmundsen, O.J NutrAdipose Tissue/*drug effectsAdultAgedBody Composition/*drug effectsDensitometry, X-RayDose-Response Relationship, DrugDouble-Blind MethodFemaleHumanLinoleic Acid/administration & dosage/*pharmacologyMaleMiddle AgeObesity/*drug therapy/prevention & controlQuestionnairesSupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11110851Gaullier2002238301255805037112002NovClinical trial results support a preference for using CLA preparations enriched with two isomers rather than four isomers in human studies1019-25Scandinavian Clinical Research, 2027 Kjeller, Norway. j-m@scr.noGaullier, J. M.Berven, G.Blankson, H.Gudmundsen, O.Lipidshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12558050[153, 154], most studies conducted on humans show little to no effect on body composition or muscle growth. ADDIN EN.CITE Zambell200023840109418793572000JulConjugated linoleic acid supplementation in humans: effects on body composition and energy expenditure777-82U.S. Department of Agriculture/Western Human Nutrition Research Center, University of California, Davis 95616, USA.Zambell, K. L.Keim, N. L.Van Loan, M. D.Gale, B.Benito, P.Kelley, D. S.Nelson, G. J.LipidsAdultBody Composition/*drug effectsBody Weight/drug effectsCalorimetryCapsulesDietary SupplementsEnergy Metabolism/*drug effectsFemaleHumanLinoleic Acids/administration & dosage/*pharmacologyPlacebosPlant Oilshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10941879Kreider200223850121739451632002AugEffects of conjugated linoleic acid supplementation during resistance training on body composition, bone density, strength, and selected hematological markers325-34Exercise and Sport Nutrition Laboratory, Department of Human Movement Sciences and Education, University of Memphis, Tennessee 38152, USA. richard_kreider@baylor.eduKreider, R. B.Ferreira, M. P.Greenwood, M.Wilson, M.Almada, A. L.J Strength Cond ResAdultBlood Cell Count*Blood Chemical AnalysisBody Composition/*drug effectsBone Density/*drug effectsDensitometry, X-Ray*Dietary SupplementsDouble-Blind MethodExercise/*physiologyHumanMaleMuscle ContractionMuscle, Skeletal/*physiologyPhysical FitnessSupport, Non-U.S. Gov'tWeight Liftingalpha-Linolenic Acid/adverse effects/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12173945[155, 156] Gamma Oryzanol (Ferulic Acid). Gamma oryzanol is a plant sterol theorized to increase anabolic hormonal responses during training  ADDIN EN.CITE Wheeler1991238601844993121991JunGamma oryzanol-plant sterol supplementation: metabolic, endocrine, and physiologic effects170-7Medical Department, Ross Laboratories, Columbus, OH 43216.Wheeler, K. B.Garleb, K. A.Int J Sport NutrAbsorptionAnimal*DietHumanHypothalamo-Hypophyseal System/drug effectsPhenylpropionates/*administration & dosage/adverseeffects/metabolism/pharmacologyPhytosterols/*administration & dosage/adverseeffects/metabolism/pharmacologyRisk FactorsSports/physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1844993[157]. Although data are limited, one study reported no effect of 0.5 g/d of gamma oryzanol supplementation on strength, muscle mass, or anabolic hormonal profiles during 9-weeks of training  ADDIN EN.CITE Fry1997238709407258741997DecThe effects of gamma-oryzanol supplementation during resistance exercise training318-29Exercise and Sport Science Laboratories, University of Memphis, TN 38152, USA.Fry, A. C.Bonner, E.Lewis, D. L.Johnson, R. L.Stone, M. H.Kraemer, W. J.Int J Sport NutrAdultBlood Pressure/drug effectsCalcium/bloodCholesterol/bloodExercise/*physiologyHeart Rate/drug effectsHormones/bloodHumanHydrocortisone/bloodLipoproteins, HDL Cholesterol/bloodMagnesium/bloodMalePhenylpropionates/*administration & dosageSerum Albumin/metabolismSupport, Non-U.S. Gov'tTestosterone/bloodTriglycerides/blood*Weight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9407258[158]. Anabolic Steroids & Prohormones. Testosterone and growth hormone are two primary hormones in the body that serve to promote gains in muscle mass (i.e., anabolism) and strength while decreasing muscle breakdown (catabolism) and fat mass  ADDIN EN.CITE Yarasheski1994242507925547221994Growth hormone effects on metabolism, body composition, muscle mass, and strength285-312Metabolism Division, Washington University School of Medicine, St. Louis, Missouri.Yarasheski, K. E.Exerc Sport Sci RevAdultAnimalBody Composition/*drug effectsExercise/physiologyFemaleGrowth Hormone/*pharmacology/therapeutic useHumanInsulin-Like Growth Factor I/physiologyMaleMetabolism/*drug effectsMuscles/*drug effects/physiologySupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7925547Lukas19932428084803761421993FebCurrent perspectives on anabolic-androgenic steroid abuse61-8Alcohol and Drug Abuse Research Center, McLean Hospital, Belmont, MA 02178.Lukas, S. E.Trends Pharmacol SciAnabolic Steroids/*adverse effectsAndrogens/*adverse effectsAnimalDoping in Sports/*statistics & numerical dataHumanSubstance-Related Disorders/*epidemiologySupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8480376Wagner19912429016861201241991OctEnhancement of athletic performance with drugs. An overview250-65College of Pharmacy, University of Nebraska Medical Center, Omaha.Wagner, J. C.Sports MedAdrenergic beta-Antagonists/adverse effectsAnabolic Steroids/adverse effectsDiuretics/adverse effects*Doping in Sports/prevention & controlHumanNarcotics/adverse effectsPhysical Education and TrainingSubstance-Related Disorders/epidemiology/*etiology/prevention & controlUnited States/epidemiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1686120Limbird19852432039674791111985JanAnabolic steroids in the training and treatment of athletes25-30Limbird, T. J.Compr TherBody Composition/drug effectsChemistryHuman*Physical Education and Training*SportsSteroids/adverse effects/*pharmacologyTestosterone/pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3967479Kuhn20022435012017555572002Anabolic steroids411-34Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North Carolina 27710, USA. ckuhn@duke.eduKuhn, C. M.Recent Prog Horm Res*Anabolic Steroids/administration & dosage/pharmacologyAndrogens/administration & dosageAndrostenedione/administration & dosageAnimalBiomechanicsCentral Nervous System/drug effects/physiologyDose-Response Relationship, DrugHumanMaleMuscles/anatomy & histology/drug effects/physiologySportshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12017555[159-163]. Testosterone also promotes male sex characteristics (e.g., hair, deep voice, etc)  ADDIN EN.CITE Kuhn20022435012017555572002Anabolic steroids411-34Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North Carolina 27710, USA. ckuhn@duke.eduKuhn, C. M.Recent Prog Horm Res*Anabolic Steroids/administration & dosage/pharmacologyAndrogens/administration & dosageAndrostenedione/administration & dosageAnimalBiomechanicsCentral Nervous System/drug effects/physiologyDose-Response Relationship, DrugHumanMaleMuscles/anatomy & histology/drug effects/physiologySportshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12017555[163]. Low level anabolic steroids are often prescribed by physicians to prevent loss of muscle mass for people with various diseases and illnesses  ADDIN EN.CITE Smart19952458011362415951995MayOther therapies for wasting7-8, 12Smart, T.GMHC Treat IssuesAcquired Immunodeficiency Syndrome/*drug therapyAnabolic Steroids/pharmacology/*therapeutic useCannabidiol/pharmacologyFemaleHumanKetotifen/pharmacology/*therapeutic useMaleMarijuana SmokingNational Institutes of Health (U.S.)Quality of LifeTetrahydrocannabinol/therapeutic useTumor Necrosis Factor/antagonists & inhibitorsWeight Gain/drug effectsrather than body fat. Several possible alternatives to the approved drugsfor AIDS-related wasting are discussed. Ketotifen, an antihistamineapproved in Europe, is a TNF inhibitor. Anabolic steroids are testosteronederivatives designed to increase strength and muscle. Although there areanecdotal reports of success with these steroids, their long-term safetyand efficacy have yet to be established in placebo-controlled studies. Anongoing study at Mt. Sinai shows a statistically significant effect onlean body mass in the first twelve men to complete the study.Dehydroepiandrosterone (DHEA) is a hormone produced by the adrenal gland.Although its role in the body is poorly understood; it may haveimmunologic effects, and appears to influence metabolism. There have beenno studies of DHEA's effect on weight or body composition in people withAIDS-related wasting. A study combining ketotifen and oxymetholone, theoral anabolic steroid, was presented at the Ninth International AIDSConference. Preliminary data from a study combining ketotifen andoxymetholone showed that 18 out of 22 patients gained an average of 11.4pounds after treatment of an average of 3.9 weeks. Finally, a trial ofsmoked marijuana versus the oral drug marinol for AIDS-related wastingsyndrome may be canceled. The Drug Enforcement Administration (DEA) andthe National Institute of Drug Abuse (NIDA) rejected the CommunityConsortium of San Francisco's proposal to obtain officially sanctionedcannabis.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11362415Casaburi20012459011462075337 Suppl2001JulSkeletal muscle dysfunction in chronic obstructive pulmonary diseaseS662-70Division of Respiratory and Critical Care Physiology, Harbor-UCLA Research and Education Institute, Torrance, CA 90502, USA. casaburi@ucla.eduCasaburi, R.Med Sci Sports ExercAndrogens/adverse effects/therapeutic use*Exercise TherapyExercise ToleranceFemaleHumanLung Diseases, Obstructive/complications/*physiopathology/rehabilitationMaleMuscle, Skeletal/*physiopathologyMuscular Diseases/etiology/physiopathology/therapySex FactorsTestosterone/therapeutic usehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11462075Hayes200124600113442298652001MayRecombinant human growth hormone and recombinant human insulin-like growth factor I diminish the catabolic effects of hypogonadism in man: metabolic and molecular effects2211-9Divisions of Endocrinology, Nemours Children's Clinic, Baptist Medical Center, Jacksonville, Florida 32207, USA.Hayes, V. Y.Urban, R. J.Jiang, J.Marcell, T. J.Helgeson, K.Mauras, N.J Clin Endocrinol MetabAdultBody Composition/drug effectsCarbohydrates/metabolismEnergy Metabolism/drug effectsGrowth Hormone/adverse effects/*therapeutic useHumanHypogonadism/*drug therapy/metabolismInsulin Like Growth-Factor-Binding Protein 4/geneticsInsulin-Like Growth Factor I/adverse effects/*therapeutic useLipids/metabolismMaleMuscle, Skeletal/drug effects/physiologyProteins/metabolismRNA, Messenger/analysisRecombinant Proteins/therapeutic useSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Testosterone/bloodTransforming Growth Factor beta/geneticshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11344229Newshan200124610112318651232001MarThe use of anabolic agents in HIV disease141-4Yonkers General Hospital, Yonkers, New York, USA. marcandgayle@msn.comNewshan, G.Leon, W.Int J STD AIDSAnabolic Steroids/administration & dosage/contraindications/*therapeuticuseAndrogens/contraindications/therapeutic useClinical TrialsDepressive Disorder/drug therapy/etiologyDrug Therapy, CombinationFatigue/drug therapy/etiologyFemaleHIV Infections/*complicationsHormone Replacement TherapyHumanMaleSex Disorders/drug therapy/etiologySex Hormones/therapeutic usehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11231865Tenover199824620103325631231998OctAndrogen replacement therapy to reverse and/or prevent age-associated sarcopenia in men419-25Department of Medicine, Emory University School of Medicine, Atlanta, GA 30329, USA.Tenover, J. S.Baillieres Clin Endocrinol MetabAgedAging/drug effects/*pathology/physiologyBody Composition/drug effects/physiology*Hormone Replacement TherapyHumanMaleMuscle, Skeletal/drug effects/pathology/*physiopathologyTestosterone/blood/pharmacology/*therapeutic usehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10332563Bross199824630103325591231998OctAndrogen effects on body composition and muscle function: implications for the use of androgens as anabolic agents in sarcopenic states365-78Division of Endocrinology, Metabolism and Molecular Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90049, USA.Bross, R.Casaburi, R.Storer, T. W.Bhasin, S.Baillieres Clin Endocrinol MetabAnabolic Steroids/*pharmacology/therapeutic use*Body Composition/drug effectsFemaleHumanHypogonadism/drug therapyMaleMuscles/drug effects/pathology/*physiologyTestosterone/blood/*physiologyWasting Syndrome/drug therapyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10332559Casaburi199824640103325621231998OctRationale for anabolic therapy to facilitate rehabilitation in chronic obstructive pulmonary disease407-18Division of Respiratory and Critical Care Physiology and Medicine, Harbor-UCLA Medical Center, Torrance 90509, USA.Casaburi, R.Baillieres Clin Endocrinol MetabAgedExercise Tolerance/*drug effects*Hormone Replacement TherapyHumanHuman Growth Hormone/therapeutic useLung Diseases, Obstructive/drug therapy/*rehabilitationMaleMuscle, Skeletal/*physiopathologyNutrition Disorders/physiopathologySupport, Non-U.S. Gov'tTestosterone/pharmacology/*therapeutic usehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10332562Johansen19992465010208142281141999Apr 14Anabolic effects of nandrolone decanoate in patients receiving dialysis: a randomized controlled trial1275-81Department of Medicine, San Francisco General Hospital, University of California, USA. johanse@itsa.ucsf.eduJohansen, K. L.Mulligan, K.Schambelan, M.JamaAdultAnabolic Steroids/administration & dosage/*therapeutic useBlood Chemical Analysis*Body Composition/drug effectsDensitometry, X-RayDouble-Blind MethodExercise TestFemaleHumanInjections, IntramuscularKidney Failure, Chronic/physiopathology/*therapyMaleMiddle AgeMusculoskeletal Physiology/drug effectsNandrolone/administration & dosage/*analogs & derivatives/therapeutic useNutrition Assessment*Quality of LifeRegression Analysis*Renal DialysisSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10208142Sattler199924660101997668441999AprEffects of pharmacological doses of nandrolone decanoate and progressive resistance training in immunodeficient patients infected with human immunodeficiency virus1268-76Department of Medicine, University of Southern California School of Medicine, Los Angeles County-University of Southern California Medical Center, Los Angeles 90033, USA.Sattler, F. R.Jaque, S. V.Schroeder, E. T.Olson, C.Dube, M. P.Martinez, C.Briggs, W.Horton, R.Azen, S.J Clin Endocrinol MetabAdultAnabolic Steroids/*therapeutic useBody Composition/drug effectsEnergy Intake*ExerciseHIV Wasting Syndrome/*drug therapy/metabolismHumanMaleMiddle AgeMuscles/physiopathologyNandrolone/*analogs & derivatives/therapeutic useSupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10199766Beiner19992467099344112711999Jan-FebThe effect of anabolic steroids and corticosteroids on healing of muscle contusion injury2-9Yale University School of Medicine, Department of Orthopaedics and Rehabilitation, New Haven, Connecticut 06520-8071, USA.Beiner, J. M.Jokl, P.Cholewicki, J.Panjabi, M. M.Am J Sports MedAnabolic Steroids/*pharmacology/therapeutic useAnimalAnti-Inflammatory Agents, Steroidal/*pharmacology/therapeutic useAthletic Injuries/*drug therapyDisease Models, AnimalEthics, MedicalMaleMethylprednisolone/*pharmacology/therapeutic useMuscle WeaknessMuscle, Skeletal/drug effects/*injuries/physiologyNandrolone/*analogs & derivatives/pharmacology/therapeutic useRatsRats, WistarWound Healing/*drug effectshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9934411Ferreira199824680967444211411998JulThe influence of 6 months of oral anabolic steroids on body mass and respiratory muscles in undernourished COPD patients19-28Respiratory Division of Federal University of Sao Paulo, Brazil.Ferreira, I. M.Verreschi, I. T.Nery, L. E.Goldstein, R. S.Zamel, N.Brooks, D.Jardim, J. R.ChestAdministration, OralAgedAnabolic Steroids/administration & dosage/*therapeutic useAnthropometryArm/anatomy & histologyAspiration/physiologyBody Constitution*Body Mass IndexDouble-Blind MethodExercise TestExercise TherapyExercise Tolerance/drug effectsHumanLung Diseases, Obstructive/*drug therapy/physiopathology/rehabilitationMaleMuscle Contraction/drug effectsMuscle, Skeletal/anatomy & histology/drug effectsNutrition Disorders/*physiopathologyProspective StudiesRespiratory Muscles/*drug effects/physiopathologyStanozolol/administration & dosage/therapeutic useSupport, Non-U.S. Gov'tTestosterone/administration & dosage/therapeutic useThigh/anatomy & histologyTime FactorsWeight Gainhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9674442Bhasin19972469090242278221997FebTestosterone replacement increases fat-free mass and muscle size in hypogonadal men407-13Division of Endocrinology, Metabolism, and Molecular Medicine, Charles R. Drew University of Medicine, Los Angeles, California 90059, USA.Bhasin, S.Storer, T. W.Berman, N.Yarasheski, K. E.Clevenger, B.Phillips, J.Lee, W. P.Bunnell, T. J.Casaburi, R.J Clin Endocrinol MetabAdultBody Composition/*drug effectsBody WeightHumanHypogonadism/*drug therapy/*pathologyMaleMiddle AgeMuscles/drug effects/*pathology/physiopathologyOrgan WeightSupport, U.S. Gov't, P.H.S.Testosterone/blood/*therapeutic usehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9024227[164-175]. It is well known that athletes have experimented with large doses of anabolic steroids in an attempt to enhance training adaptations, increase muscle mass, and/or promote recovery during intense training  ADDIN EN.CITE Yarasheski1994242507925547221994Growth hormone effects on metabolism, body composition, muscle mass, and strength285-312Metabolism Division, Washington University School of Medicine, St. Louis, Missouri.Yarasheski, K. E.Exerc Sport Sci RevAdultAnimalBody Composition/*drug effectsExercise/physiologyFemaleGrowth Hormone/*pharmacology/therapeutic useHumanInsulin-Like Growth Factor I/physiologyMaleMetabolism/*drug effectsMuscles/*drug effects/physiologySupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7925547Lukas19932428084803761421993FebCurrent perspectives on anabolic-androgenic steroid abuse61-8Alcohol and Drug Abuse Research Center, McLean Hospital, Belmont, MA 02178.Lukas, S. E.Trends Pharmacol SciAnabolic Steroids/*adverse effectsAndrogens/*adverse effectsAnimalDoping in Sports/*statistics & numerical dataHumanSubstance-Related Disorders/*epidemiologySupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8480376Wagner19912429016861201241991OctEnhancement of athletic performance with drugs. An overview250-65College of Pharmacy, University of Nebraska Medical Center, Omaha.Wagner, J. C.Sports MedAdrenergic beta-Antagonists/adverse effectsAnabolic Steroids/adverse effectsDiuretics/adverse effects*Doping in Sports/prevention & controlHumanNarcotics/adverse effectsPhysical Education and TrainingSubstance-Related Disorders/epidemiology/*etiology/prevention & controlUnited States/epidemiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1686120Limbird19852432039674791111985JanAnabolic steroids in the training and treatment of athletes25-30Limbird, T. J.Compr TherBody Composition/drug effectsChemistryHuman*Physical Education and Training*SportsSteroids/adverse effects/*pharmacologyTestosterone/pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3967479Kuhn20022435012017555572002Anabolic steroids411-34Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North Carolina 27710, USA. ckuhn@duke.eduKuhn, C. M.Recent Prog Horm Res*Anabolic Steroids/administration & dosage/pharmacologyAndrogens/administration & dosageAndrostenedione/administration & dosageAnimalBiomechanicsCentral Nervous System/drug effects/physiologyDose-Response Relationship, DrugHumanMaleMuscles/anatomy & histology/drug effects/physiologySportshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12017555[159-163]. Research has generally shown that use of anabolic steroids and growth hormone during training can promote gains in strength and muscle mass  ADDIN EN.CITE Ferrando200324480125198778812003JanDifferential anabolic effects of testosterone and amino acid feeding in older men358-62Departments of Surgery, University of Texas Medical Branch, Galveston, Texas 77550, USA. aferrand@utmb.eduFerrando, A. A.Sheffield-Moore, M.Paddon-Jones, D.Wolfe, R. R.Urban, R. J.J Clin Endocrinol MetabAgedAging/*physiologyAmino Acids/*pharmacologyAnabolic Steroids/*pharmacologyComparative StudyCysteine Endopeptidases/metabolismDouble-Blind MethodFasting/metabolismHumanKineticsMaleMultienzyme Complexes/metabolismMuscle Proteins/metabolismSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Testosterone/*analogs & derivatives/*pharmacologyUbiquitin/metabolismhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12519877Meeuwsen2002244901184581410912002JanMuscle strength and tibolone: a randomised, double-blind, placebo-controlled trial77-84Department of Geriatric Medicine, University Medical Centre, Utrecht, The Netherlands.Meeuwsen, I. B.Samson, M. M.Duursma, S. A.Verhaar, H. J.BjogAdministration, OralAndrogen Antagonists/*therapeutic useBody Mass IndexDouble-Blind MethodEstrogen Receptor Modulators/*therapeutic useExercise/physiologyFemaleHand Strength/physiologyHumanIsometric Contraction/physiologyMiddle AgeMuscle, Skeletal/*drug effects/physiologyNorpregnenes/*therapeutic usePostmenopause/drug effects/physiologySupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11845814King19992450010359391281211999Jun 2Effect of oral androstenedione on serum testosterone and adaptations to resistance training in young men: a randomized controlled trial2020-8Department of Health and Human Performance, Iowa State University, Ames 50011, USA. dsking@iastate.eduKing, D. S.Sharp, R. L.Vukovich, M. D.Brown, G. A.Reifenrath, T. A.Uhl, N. L.Parsons, K. A.JamaAdministration, OralAdultAnalysis of VarianceAndrostenedione/administration & dosage/metabolism/*pharmacologyBiopsy, NeedleBody CompositionDietary SupplementsDouble-Blind MethodEstrogens/bloodExercise/*physiologyHumanLipids/bloodLiver Function TestsMaleMuscle Fibers/pathologyMuscle, Skeletal/*drug effects/pathologyNutrition AssessmentSupport, Non-U.S. Gov'tTestosterone/*bloodTransaminases/metabolismhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10359391Bross199824510103325591231998OctAndrogen effects on body composition and muscle function: implications for the use of androgens as anabolic agents in sarcopenic states365-78Division of Endocrinology, Metabolism and Molecular Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90049, USA.Bross, R.Casaburi, R.Storer, T. W.Bhasin, S.Baillieres Clin Endocrinol MetabAnabolic Steroids/*pharmacology/therapeutic use*Body Composition/drug effectsFemaleHumanHypogonadism/drug therapyMaleMuscles/drug effects/pathology/*physiologyTestosterone/blood/*physiologyWasting Syndrome/drug therapyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10332559Carter19952452085566981141995NovEffect of anabolic hormones and insulin-like growth factor-I on muscle mass and strength in elderly persons735-48John L. McClellan Memorial Veterans Hospital, Little Rock, Arkansas, USA.Carter, W. J.Clin Geriatr MedAdrenergic beta-Agonists/therapeutic useAgedGrowth Hormone/therapeutic useHormones/adverse effects/*therapeutic useHumanInsulin-Like Growth Factor I/therapeutic useMuscle Weakness/*drug therapy/metabolism/prevention & controlMuscles/drug effectsTestosterone/therapeutic usehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8556698Yarasheski1994245307925547221994Growth hormone effects on metabolism, body composition, muscle mass, and strength285-312Metabolism Division, Washington University School of Medicine, St. Louis, Missouri.Yarasheski, K. E.Exerc Sport Sci RevAdultAnimalBody Composition/*drug effectsExercise/physiologyFemaleGrowth Hormone/*pharmacology/therapeutic useHumanInsulin-Like Growth Factor I/physiologyMaleMetabolism/*drug effectsMuscles/*drug effects/physiologySupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7925547Soe1989245402922825151101989Mar 6[The effect of anabolic androgenic steroids on muscle strength, body weight and lean body mass in body-building men]610-3Soe, M.Jensen, K. L.Gluud, C.Ugeskr LaegerAdultAnabolic Steroids/*pharmacologyBiomechanicsBody ConstitutionBody Surface AreaBody Weight/*drug effectsEnglish Abstract*ExerciseHumanMaleMuscles/*drug effects*SportsSupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2922825Griggs1989245502521699392 Pt 11989FebRandomized controlled trial of testosterone in myotonic dystrophy219-22Department of Neurology, University of Rochester School of Medicine and Dentistry, NY 14642.Griggs, R. C.Pandya, S.Florence, J. M.Brooke, M. H.Kingston, W.Miller, J. P.Chutkow, J.Herr, B. E.Moxley, R. T., 3rdNeurologyAcne Vulgaris/chemically inducedAdolescentAdultAgedClinical TrialsDouble-Blind MethodHumanMaleMiddle AgeMuscles/physiopathologyMyotonic Dystrophy/*drug therapy/physiopathologyRandom AllocationSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Testosterone/adverse effects/*analogs & derivatives/therapeutic usehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2521699Crist19832456068330345421983FebEffects of androgenic-anabolic steroids on neuromuscular power and body composition366-70Crist, D. M.Stackpole, P. J.Peake, G. T.J Appl PhysiolAdultAnabolic Steroids/*pharmacologyAndrogens/*pharmacologyBody Composition/*drug effectsDouble-Blind MethodFemaleHumanMaleMuscles/*drug effects/physiologyNeuromuscular Junction/*physiologySupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6833034Ward1973245704590143541973WinterThe effect of an anabolic steroid on strength and lean body mass277-82Ward, P.Med Sci SportsAdipose TissueAdolescentAdultBody Composition/*drug effectsClinical Trials*ExertionHumanMaleMethandrostenolone/*pharmacologyMuscle Contraction/drug effectsPhysical Education and TrainingSpirometrySports Medicinehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=4590143[159, 169, 176-183]. However, a number of potentially life threatening adverse effects of steroid abuse have been reported including liver and hormonal dysfunction, hyperlipidemia (high cholesterol), increased risk to cardiovascular disease, and behavioral changes (i.e., steroid rage)  ADDIN EN.CITE Varriale199924240104170381971999JulAcute myocardial infarction associated with anabolic steroids in a young HIV-infected patient881-4Division of Cardiology, Cabrini Medical Center, New York, New York 10003, USA.Varriale, P.Mirzai-tehrane, M.Sedighi, A.PharmacotherapyAdultAnabolic Steroids/*adverse effects/therapeutic useCase ReportHIV Infections/*complicationsHumanMaleMiddle AgeMuscular Diseases/etiology/prevention & controlMyocardial Infarction/*chemically inducedhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10417038Kibble1987243103315401691987SepAdverse effects of anabolic steroids in athletes686-92Department of Pharmacy Services, Kaiser Foundation Hospital, Redwood City, CA.Kibble, M. W.Ross, M. B.Clin PharmAggression/drug effectsAnabolic Steroids/administration & dosage/*adverse effects/pharmacologyCardiovascular Diseases/chemically inducedEndocrine Diseases/chemically inducedFemaleHumanLiver Diseases/chemically inducedMaleMuscles/physiologySpermatogenesis/drug effects*SportsWeight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3315401King19992450010359391281211999Jun 2Effect of oral androstenedione on serum testosterone and adaptations to resistance training in young men: a randomized controlled trial2020-8Department of Health and Human Performance, Iowa State University, Ames 50011, USA. dsking@iastate.eduKing, D. S.Sharp, R. L.Vukovich, M. D.Brown, G. A.Reifenrath, T. A.Uhl, N. L.Parsons, K. A.JamaAdministration, OralAdultAnalysis of VarianceAndrostenedione/administration & dosage/metabolism/*pharmacologyBiopsy, NeedleBody CompositionDietary SupplementsDouble-Blind MethodEstrogens/bloodExercise/*physiologyHumanLipids/bloodLiver Function TestsMaleMuscle Fibers/pathologyMuscle, Skeletal/*drug effects/pathologyNutrition AssessmentSupport, Non-U.S. Gov'tTestosterone/*bloodTransaminases/metabolismhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10359391Gruber200024700106018316912000Psychiatric and medical effects of anabolic-androgenic steroid use in women19-26Biological Psychiatry Laboratory, McLean Hospital, Belmont, MA 02478, USA. biopsych@mclean.orgGruber, A. J.Pope, H. G., Jr.Psychother PsychosomAdolescentAdultAgedAnabolic Steroids/*adverse effectsAndrogens, Synthetic/*adverse effectsEating Disorders/*chemically induced/diagnosisFemaleGender IdentityHumanMental Disorders/*chemically induced/diagnosisMiddle AgePsychiatric Status Rating ScalesSportsSubstance-Related Disorders/diagnosisSupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10601831Lamb19842471063675011211984Jan-FebAnabolic steroids in athletics: how well do they work and how dangerous are they?31-8Lamb, D. R.Am J Sports MedAdministration, OralAnabolic Steroids/adverse effects/*pharmacologyAnimalBody Composition/drug effectsBody Weight/drug effects*Doping in SportsErythropoiesis/drug effectsFemaleHumanInjections, IntramuscularLiver Diseases/chemically inducedMaleMuscles/drug effectsTesticular Diseases/chemically inducedVirilism/chemically inducedhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6367501Salke19852472040797431761985DecLeft ventricular size and function in body builders using anabolic steroids701-4Salke, R. C.Rowland, T. W.Burke, E. J.Med Sci Sports ExercAdultAnabolic Steroids/*pharmacologyBody WeightComparative StudyEchocardiographyHeart/anatomy & histology/*drug effects/physiologyHeart Ventricle/anatomy & histology/drug effects/physiologyHumanMale*Sports*Weight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=4079743[178, 184-188]. Some of the adverse effects associated with the use of these agents are irreversible, particularly in women  ADDIN EN.CITE Kibble1987243103315401691987SepAdverse effects of anabolic steroids in athletes686-92Department of Pharmacy Services, Kaiser Foundation Hospital, Redwood City, CA.Kibble, M. W.Ross, M. B.Clin PharmAggression/drug effectsAnabolic Steroids/administration & dosage/*adverse effects/pharmacologyCardiovascular Diseases/chemically inducedEndocrine Diseases/chemically inducedFemaleHumanLiver Diseases/chemically inducedMaleMuscles/physiologySpermatogenesis/drug effects*SportsWeight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3315401[185]. For this reason, anabolic steroids have has been banned by most sport organizations and should be avoided unless prescribed by a physician to treat an illness. Prohormones (androstenedione, 4-androstenediol, 19-nor-4-androstenedione, 19-nor-4-androstenediol, 7-keto DHEA, and DHEA, etc) are naturally derived precursors to testosterone or other anabolic steroids. Prohormones have become popular among body builders because they believe they are natural boosters of anabolic hormones. Consequently, a number of over-the-counter supplements contain prohormones. While there is a strong theoretical rationale that prohormones may increase testosterone levels, there is virtually no evidence that these compounds affect training adaptations in younger men with normal hormone levels. In fact, most studies indicate that they do not affect testosterone and that some may actually increase estrogen levels and reduce HDL-cholesterol  ADDIN EN.CITE Broeder20002400011074738160202000Nov 13The Andro Project: physiological and hormonal influences of androstenedione supplementation in men 35 to 65 years old participating in a high-intensity resistance training program3093-104The Human Performance Lab, East Tennessee State University, Box 70654, Johnson City, TN 37614-0654, USA. broeder@etsu.eduBroeder, C. E.Quindry, J.Brittingham, K.Panton, L.Thomson, J.Appakondu, S.Breuel, K.Byrd, R.Douglas, J.Earnest, C.Mitchell, C.Olson, M.Roy, T.Yarlagadda, C.Arch Intern MedAdultAgedAndrost-5-ene-3 beta,17 beta-diol/*therapeutic useAndrostenedione/*therapeutic useBody CompositionDiet*Dietary SupplementsEstradiol/blood*ExerciseHumanLipids/bloodMaleMiddle AgeSupport, Non-U.S. Gov'tTestosterone/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11074738Ballantyne200024130106836012512000FebThe acute effects of androstenedione supplementation in healthy young males68-78Department of Kinesiology, McMaster University, Hamilton, Ontario L8S 4K1.Ballantyne, C. S.Phillips, S. M.MacDonald, J. R.Tarnopolsky, M. A.MacDougall, J. D.Can J Appl PhysiolAdultAnalysis of VarianceAndrostenedione/administration & dosage/blood/*pharmacologyCross-Over Studies*Dietary SupplementsDouble-Blind MethodEstradiol/bloodExercise/*physiologyHumanLuteinizing Hormone/bloodMaleReference ValuesSex Hormones/*bloodSupport, Non-U.S. Gov'tTestosterone/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10683601Brown199924040106011788761999DecEffect of oral DHEA on serum testosterone and adaptations to resistance training in young men2274-83Exercise Biochemistry Laboratory, Department of Health and Human Performance, Iowa State University, Ames, Iowa 50011, USA.Brown, G. A.Vukovich, M. D.Sharp, R. L.Reifenrath, T. A.Parsons, K. A.King, D. S.J Appl PhysiolAdaptation, Physiological/*drug effectsAdministration, OralAdultAnthropometryDietDouble-Blind MethodGlucose Tolerance TestHistocytochemistryHormones/bloodHumanInsulin/bloodMaleMuscle, Skeletal/enzymology/physiology*Physical Education and TrainingPrasterone/*pharmacologySupport, Non-U.S. Gov'tTestosterone/*bloodWeight Lifting/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10601178King19992406010359391281211999Jun 2Effect of oral androstenedione on serum testosterone and adaptations to resistance training in young men: a randomized controlled trial2020-8Department of Health and Human Performance, Iowa State University, Ames 50011, USA. dsking@iastate.eduKing, D. S.Sharp, R. L.Vukovich, M. D.Brown, G. A.Reifenrath, T. A.Uhl, N. L.Parsons, K. A.JamaAdministration, OralAdultAnalysis of VarianceAndrostenedione/administration & dosage/metabolism/*pharmacologyBiopsy, NeedleBody CompositionDietary SupplementsDouble-Blind MethodEstrogens/bloodExercise/*physiologyHumanLipids/bloodLiver Function TestsMaleMuscle Fibers/pathologyMuscle, Skeletal/*drug effects/pathologyNutrition AssessmentSupport, Non-U.S. Gov'tTestosterone/*bloodTransaminases/metabolismhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10359391van Gammeren200223880122972081892002SepEffects of norandrostenedione and norandrostenediol in resistance-trained men734-7University of Florida, Center for Exercise Science, Gainesville 32611, USA. darinvg@ufl.eduvan Gammeren, D.Falk, D.Antonio, J.NutritionAdultAndrostenediols/administration & dosage/*pharmacologyAndrostenedione/administration & dosage/*analogs &derivatives/*pharmacologyBody Composition/*drug effectsDensitometry, X-Ray/methodsDietary SupplementsDouble-Blind MethodHumanMaleTreatment Outcome*Weight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12297208Brown200223910117446539212002JanAcute hormonal response to sublingual androstenediol intake in young men142-6Exercise Biochemistry Laboratory, Department of Health and Human Performance, Iowa State University, Ames, Iowa 50011, USA.Brown, G. A.Martini, E. R.Roberts, B. S.Vukovich, M. D.King, D. S.J Appl PhysiolAdministration, SublingualAdultAndrost-5-ene-3 beta,17 beta-diol/administration &dosage/blood/*pharmacologyBody Composition/drug effectsCyclodextrinsDietEstradiol/bloodExcipientsHormones/*bloodHumanMaleSupport, Non-U.S. Gov'tTestosterone/bloodWeight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11744653Van Gammeren200123950114174308452001MayThe effects of supplementation with 19-nor-4-androstene-3,17-dione and 19-nor-4-androstene-3,17-diol on body composition and athletic performance in previously weight-trained male athletes426-31University of Nebraska, Human Performance Laboratory, Kearney, NE 68849, USA.Van Gammeren, D.Falk, D.Antonio, J.Eur J Appl PhysiolAdultAndrostenediols/administration & dosage/*pharmacologyAndrostenedione/administration & dosage/analogs &derivatives/*pharmacologyBody Composition/*drug effectsDrug Administration ScheduleHumanMale*Physical Education and Training*Weight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11417430Pipe200123960114031141122001AprEffects of testosterone precursor supplementation on intensive weight training126University of Ottawa Heart Institute, Ontario, Canada.Pipe, A.Clin J Sport MedAdultAgedAndrost-5-ene-3 beta,17 beta-diol/*pharmacologyAndrostenedione/blood/*pharmacologyBody Composition/drug effectsDoping in SportsEstradiol/bloodEstrone/bloodHumanLipids/bloodMaleMiddle AgeMuscle, Skeletal/*drug effects/physiologyPrasterone/bloodSex Hormone-Binding Globulin/analysisTestosterone/bloodWeight Lifting/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11403114[178, 189-195]. Consequently, although there may be some potential applications for older individuals to replace diminishing androgen levels, it appears that prohormones have no training value. Since prohormones are steroid-like compounds, most athletic organizations have banned their use. Use of nutritional supplements containing prohormones will result in a positive drug test for anabolic steroids. Use of supplements knowingly or unknowingly containing prohormones have been believed to have contributed to a number of recent positive drug tests among athletes. Consequently, care should be taken to make sure that any supplement an athlete considers taking does not contain prohormone precursors particularly if their sport bans and tests for use of such compounds. Tribulus Terrestris. Tribulus terrestris (also known as puncture weed/vine or caltrops) is a plant extract that has been suggested to stimulate leutinizing hormone (LH) which stimulates the natural production of testosterone  ADDIN EN.CITE Antonio200122051Antonio, J.Stout, J.R.2001Sport Supplements.Philadelphia, PALippincott, Williams and Wilkins.118-120[111]. Consequently, Tribulus has been marketed as a supplement that can increase testosterone and promote greater gains in strength and muscle mass during training. Several recent studies have indicated that Tribulus supplementation appears to have no effects on body composition or strength during training  ADDIN EN.CITE Brown200124150117256947152001SepEffects of androstenedione-herbal supplementation on serum sex hormone concentrations in 30- to 59-year-old men293-301Exercise Biochemistry Laboratory, Department of Health and Human Performance, Iowa State University, Ames, IA, USA.Brown, G. A.Vukovich, M. D.Martini, E. R.Kohut, M. L.Franke, W. D.Jackson, D. A.King, D. S.Int J Vitam Nutr ResAdjuvants, Immunologic/*therapeutic useAdultAge FactorsAnalysis of VarianceAndrostenedione/*therapeutic use*Dietary SupplementsDouble-Blind MethodHumanMaleMiddle Age*PhytotherapyPlant Preparations/*therapeutic usePrasterone/*therapeutic useSex Hormones/*bloodSupport, Non-U.S. Gov'tTestosterone/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11725694Antonio200024180108613391022000JunThe effects of Tribulus terrestris on body composition and exercise performance in resistance-trained males208-15Human Performance Laboratory, University of Nebraska, Kearney, NE 68849-3101, USA.Antonio, J.Uelmen, J.Rodriguez, R.Earnest, C.Int J Sport Nutr Exerc MetabAdultAffect/drug effectsAnalysis of VarianceBody Composition/*drug effects*Dietary Supplements*ExerciseHumanMalePlants, MedicinalSaponins/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10861339[196, 197]. Vanadyl Sulfate (Vanadium). In a similar manner as chromium, vanadyl sulfate is a trace mineral that has been found to affect insulin-sensitivity and may affect protein and glucose metabolism  ADDIN EN.CITE Antonio200122051Antonio, J.Stout, J.R.2001Sport Supplements.Philadelphia, PALippincott, Williams and Wilkins.118-120[111]. For this reason, vanadyl sulfate has been purported to increase muscle mass and strength during training. Although there may be some clinical benefits for diabetics, vanadyl sulfate supplementation does not appear to have any effect on strength or muscle mass during training in non-diabetic individuals  ADDIN EN.CITE Fawcett1996242008953340641996DecThe effect of oral vanadyl sulfate on body composition and performance in weight-training athletes382-90School of Pharmacy, University of Otago, Dunedin, New Zealand.Fawcett, J. P.Farquhar, S. J.Walker, R. J.Thou, T.Lowe, G.Goulding, A.Int J Sport NutrAdministration, OralAdultAnthropometryBody Composition/*drug effectsDensitometry, X-RayDouble-Blind Method*ExertionFemaleHumanHypoglycemic Agents/administration & dosage/*pharmacologyMaleSupport, Non-U.S. Gov'tVanadium Compounds/administration & dosage/*pharmacology*Weight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8953340Fawcett19972421091401418041997AprOral vanadyl sulphate does not affect blood cells, viscosity or biochemistry in humans202-6School of Pharmacy, University of Otago, Dunedin, New Zealand.Fawcett, J. P.Farquhar, S. J.Thou, T.Shand, B. I.Pharmacol ToxicolAdultBlood Cell CountBlood Cells/*drug effectsBlood Chemical AnalysisBlood Pressure/drug effectsBlood Viscosity/*drug effectsBody Weight/drug effectsFemaleHematocritHumanHypoglycemic Agents/administration & dosage/*pharmacologyMaleSupport, Non-U.S. Gov'tVanadium Compounds/administration & dosage/*pharmacology*Weight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9140141[198, 199]. Weight Loss Supplements Although exercise and proper diet remain the best way to promote weight loss and/or manage body composition, a number of nutritional approaches have been investigated as possible weight loss methods (with or without exercise). The following overviews the major types of weight loss products available and discusses whether any available research supports their use. See Table 3 for a summary. Apparently Effective Low Calorie Diet Foods & Supplements. Most of the products in this category represent low fat/carbohydrate, high protein food alternatives  ADDIN EN.CITE Kreider200224730Kreider, R.B.2002New weight-control optionsFunctional Foods & NutraceuticalsJuly/August34-42[200]. They typically consist of pre-packaged food, bars, MRP, or RTD supplements. They are designed to provide convenient foods/snacks to help people follow a particular low calorie diet plan. In the scientific literature, diets that provide less than 1000 calories per day are known as very low calorie diets (VLCDs). Pre-packaged food, MRPs, and/or RTDs are often provided in VLCD plans to help people cut calories. In most cases, VLCD plans recommend behavioral modification and that people start a general exercise program. Research on the safety and efficacy of people maintaining VLCDs generally indicate that they can promote weight loss. For example, Hoie et al  ADDIN EN.CITE Hoie19932474083836361711993JanReduction of body mass and change in body composition on a very low calorie diet17-20Norsk Legesenter, Oslo, Norway.Hoie, L. H.Bruusgaard, D.Thom, E.Int J Obes Relat Metab DisordAdolescentAdultAgedBody Composition/physiologyBody Mass Index*Diet, ReducingEnergy Intake/*physiologyFemaleHumanMaleMiddle AgeObesity/*diet therapyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8383636[201] reported that maintaining a VLCD for 8-weeks promoted a 27 lbs (12.6%) loss in total body mass, a 21 lbs loss in body fat (23.8%), and a 7 lbs (5.2%) loss in lean body mass in 127 overweight volunteers. Bryner and colleagues  ADDIN EN.CITE Bryner199924750102048261821999AprEffects of resistance vs. aerobic training combined with an 800 calorie liquid diet on lean body mass and resting metabolic rate115-21Department of Human Performance and Applied Exercise Science, West Virginia University, Morgantown 26506, USA.Bryner, R. W.Ullrich, I. H.Sauers, J.Donley, D.Hornsby, G.Kolar, M.Yeater, R.J Am Coll NutrAdipose TissueAdult*Basal Metabolism*Body CompositionBody Mass Index*Energy Intake*ExerciseFemaleFood, FormulatedHumanMaleOxygen ConsumptionSolutions*Weight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10204826[202] reported that addition of a resistance training program while maintaining a VLCD (800 kcal/d for 12-weeks) resulted in a better preservation of lean body mass and resting metabolic rate compared to subjects maintaining a VLCD while engaged in an endurance training program. Kern and coworkers  ADDIN EN.CITE Kern199424760817222430751994MayCombined use of behavior modification and very low-calorie diet in weight loss and weight maintenance325-8Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California 90048.Kern, P. A.Trozzolino, L.Wolfe, G.Purdy, L.Am J Med Sci*Behavior TherapyBody Mass Index*Body WeightCombined Modality Therapy*Diet, ReducingFemaleFollow-Up StudiesHumanMaleMiddle AgeObesity/physiopathology/*rehabilitation/therapyTime Factors*Weight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8172224[203] reported that a medically supervised weight loss program involving behavioral modification and VLCD promoted a 51 lbs weight loss and that 61% of subjects maintained at least 50% of the weight loss at 12 and 18 months follow-up. Recent studies indicate that high protein/low fat VLCDs may be better than high carbohydrate/low fat diets in promoting weight loss  ADDIN EN.CITE Baba199925080http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10578211Baba, N. H.Sawaya, S.Torbay, N.Habbal, Z.Azar, S.Hashim, S. A.High protein vs high carbohydrate hypoenergetic diet for the treatment of obese hyperinsulinemic subjectsBasal MetabolismBody CompositionCholesterol/bloodDietary Carbohydrates/*administration & dosageDietary Fats/administration & dosageDietary Proteins/*administration & dosageEnergy IntakeEnergy MetabolismHumanHyperinsulinemia/blood/complications/*diet therapyLipoproteins, HDL Cholesterol/bloodLipoproteins, LDL Cholesterol/bloodMaleObesity/blood/complications/*diet therapySupport, Non-U.S. Gov'tTriglycerides/bloodWeight LossDepartment of Food Technology and Nutrition and the Division of Endocrinology, American University of Beirut, Beirut, Lebanon. nahla@aub.edu.lb10578211Int J Obes Relat Metab Disord199923111202-6.Skov199925090http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10375057Skov, A. R.Toubro, S.Ronn, B.Holm, L.Astrup, A.Randomized trial on protein vs carbohydrate in ad libitum fat reduced diet for the treatment of obesityAdolescentAdultBody CompositionComparative Study*Diet, Fat-RestrictedDietary Carbohydrates/*administration & dosageDietary Proteins/*administration & dosageFemaleHumanLipids/bloodMaleMiddle AgeObesity/*diet therapy/urinePatient Acceptance of Health CarePatient ComplianceSupport, Non-U.S. Gov't*Weight LossResearch Department of Human Nutrition, The Royal Veterinary and Agricultural University, Copenhagen, Denmark.10375057Int J Obes Relat Metab Disord1999235528-36.Toubro199825100http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=9469978Toubro, S.Astrup, A. V.[A randomized comparison of two weight-reducing diets. Calorie counting versus low-fat carbohydrate-rich ad libitum diet]Comparative Study*Diet, Fat-Restricted*Diet, ReducingDietary Carbohydrates/administration & dosageDietary Fats/administration & dosageEnergy IntakeEnglish AbstractFemaleFollow-Up StudiesHumanMaleObesity/*diet therapyWeight LossForskningsinstitut for Human Ernaering, Den Kongelige Veterinaer- og Landbohojskole, Frederiksberg. st@kvl.dk9469978Ugeskr Laeger19981606816-20.Miller200125110http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11547893Miller, W. C.Effective diet and exercise treatments for overweight and recommendations for interventionBehavior TherapyComorbidityDiet Therapy/adverse effects/*methodsDiet, Fat-RestrictedDiet, ReducingDietary Carbohydrates/therapeutic useDietary Fats/therapeutic useDietary Proteins/therapeutic useEnergy IntakeExercise Therapy/adverse effects/*methodsGallbladder Diseases/complications/etiologyHealth BehaviorHumanObesity/complications/*therapyOsteoarthritis/complications/etiologyProgram EvaluationSupport, Non-U.S. Gov'tExercise Science Programs, The George Washington University Medical Center, Washington, DC 20052, USA. wmiller@gwu.edu115478932001Sports Med3110717-24Aoyama200025120http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10793303Aoyama, T.Fukui, K.Takamatsu, K.Hashimoto, Y.Yamamoto, T.Soy protein isolate and its hydrolysate reduce body fat of dietary obese rats and genetically obese mice (yellow KK)Adipose Tissue/*drug effectsAnimalBlood Glucose/metabolismBody Composition/drug effectsCaseins/administration & dosageCholesterol/bloodDietary Fats/administration & dosageEnergy IntakeEnergy Metabolism/drug effectsMaleMiceMice, ObeseNitrogen/metabolismObesity/*diet therapy/prevention & controlProtein Hydrolysates/administration & dosage/blood/*pharmacologyRandom AllocationRatsRats, Sprague-DawleySoybean Proteins/administration & dosage/blood/*pharmacologySpecific Pathogen-Free OrganismsTriglycerides/bloodWeight Loss/*drug effectsDepartment of Novelty Materials, Research Institute, Fuji Oil Co., Ltd., Izumisano, Osaka, Japan. aoyama@hkc.fujioil.co.jp10793303Nutrition2000165349-54.[40, 204-207]. The reason for this is that typically when people lose weight about 40-50% of the weight loss is muscle which decreases resting energy expenditure. Increasing protein intake during weight loss helps preserve muscle mass and resting energy expenditure to a better degree than high carbohydrate diets  ADDIN EN.CITE Reaven200025130http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11122785Reaven, G. M.Diet and Syndrome XCoronary Disease/*diet therapy*DietDietary Carbohydrates/administration & dosageDietary Fats/administration & dosageFatty Acids, Unsaturated/*administration & dosage/therapeutic useHumanHypercholesterolemia/*diet therapy*Insulin ResistanceLipoproteins, LDL Cholesterol/drug effectsWeight Loss/physiologyDivision of Cardiovascular Medicine, Falk CVRB, Stanford Medical Center, 300 Pasteur Drive, Stanford, CA 94305, USA.11122785Curr Atheroscler Rep200026503-7.[208]. These findings and others indicate that VLCDs (typically using MRPs and/or RTDs as a means to control caloric intake) can be effective particularly as part of an exercise and behavioral modification program. Most people appear to maintain at least half of the initial weight lost for 1-2 years but tend to regain most of the weight back within 2-5 years. Therefore, although these diets may help people lose weight on the short-term, it is essential people who use them follow good diet and exercise practices in order to maintain the weight loss. Ephedra, Caffeine, and Silicin. Thermogenics are supplements designed to stimulate metabolism thereby increasing energy expenditure and promote weight loss. They typically contain the ECA stack of ephedra alkaloids (e.g., Ma Haung, 1R,2S Nor-ephedrine HCl, Sida Cordifolia), caffeine (e.g., Gaurana, Bissey Nut, Kola) and aspirin/salicin (e.g., Willow Bark Extract). More recently, other potentially thermogenic nutrients have been added to various thermogenic formulations. For example, thermogenic supplements may also contain synephrine (e.g., Citrus Aurantum, Bitter Orange), calcium & sodium phosphate, thyroid stimulators (e.g., guggulsterones, L-tyrosine, iodine), cayenne & black pepper, and ginger root. A significant amount of research has evaluated the safety and efficacy of EC and ECA type supplements. Studies show that use of synthetic or herbal sources of ephedrine and caffeine (EC) promote about 2 lbs of extra weight loss per month while dieting (with or without exercise) and that EC supplementation is generally well tolerated in healthy individuals  ADDIN EN.CITE Boozer200224980120327412652002MayHerbal ephedra/caffeine for weight loss: a 6-month randomized safety and efficacy trial593-604New York Obesity Research Center, St Luke's-Roosevelt Hospital and Columbia University, New York 10025, USA.Boozer, C. N.Daly, P. A.Homel, P.Solomon, J. L.Blanchard, D.Nasser, J. A.Strauss, R.Meredith, T.Int J Obes Relat Metab DisordBlood Glucose/analysisBlood Pressure/drug effectsBody CompositionBody WeightCaffeine/administration & dosage/adverse effects/*therapeutic useCholesterol/bloodCola/adverse effectsDietary SupplementsElectrocardiography, Ambulatory*Ephedra/adverse effects/chemistryEphedra sinica/adverse effectsEphedrine/administration & dosage/adverse effects/*therapeutic useHeart Rate/drug effectsHumanLipoproteins, HDL Cholesterol/bloodLipoproteins, LDL Cholesterol/bloodPatient CompliancePlacebosPlant Preparations/administration & dosage/adverse effects/*therapeuticuseProspective StudiesSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Triglycerides/blood*Weight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12032741Boozer200124990113196272532001MarAn herbal supplement containing Ma Huang-Guarana for weight loss: a randomized, double-blind trial316-24Obesity Research Center, St Luke's-Roosevelt Hospital Center and Department of Medicine, Columbia University College of Physicians and Surgeons, New York 10025, USA. cnb7@columbia.eduBoozer, C. N.Nasser, J. A.Heymsfield, S. B.Wang, V.Chen, G.Solomon, J. L.Int J Obes Relat Metab DisordAdultAnthropometryBlood PressureCaffeine/*administration & dosage*Dietary SupplementsDouble-Blind MethodDrug CombinationsDrugs, Chinese Herbal/*administration & dosageFemaleHeart RateHumanMaleMiddle AgeObesity/*prevention & controlSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Theobromine/*administration & dosageTheophylline/*administration & dosageTriglycerides/blood*Weight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11319627Boozer200225000120327412652002MayHerbal ephedra/caffeine for weight loss: a 6-month randomized safety and efficacy trial593-604New York Obesity Research Center, St Luke's-Roosevelt Hospital and Columbia University, New York 10025, USA.Boozer, C. N.Daly, P. A.Homel, P.Solomon, J. L.Blanchard, D.Nasser, J. A.Strauss, R.Meredith, T.Int J Obes Relat Metab DisordBlood Glucose/analysisBlood Pressure/drug effectsBody CompositionBody WeightCaffeine/administration & dosage/adverse effects/*therapeutic useCholesterol/bloodCola/adverse effectsDietary SupplementsElectrocardiography, Ambulatory*Ephedra/adverse effects/chemistryEphedra sinica/adverse effectsEphedrine/administration & dosage/adverse effects/*therapeutic useHeart Rate/drug effectsHumanLipoproteins, HDL Cholesterol/bloodLipoproteins, LDL Cholesterol/bloodPatient CompliancePlacebosPlant Preparations/administration & dosage/adverse effects/*therapeuticuseProspective StudiesSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Triglycerides/blood*Weight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12032741Boozer200125010113196272532001MarAn herbal supplement containing Ma Huang-Guarana for weight loss: a randomized, double-blind trial316-24Obesity Research Center, St Luke's-Roosevelt Hospital Center and Department of Medicine, Columbia University College of Physicians and Surgeons, New York 10025, USA. cnb7@columbia.eduBoozer, C. N.Nasser, J. A.Heymsfield, S. B.Wang, V.Chen, G.Solomon, J. L.Int J Obes Relat Metab DisordAdultAnthropometryBlood PressureCaffeine/*administration & dosage*Dietary SupplementsDouble-Blind MethodDrug CombinationsDrugs, Chinese Herbal/*administration & dosageFemaleHeart RateHumanMaleMiddle AgeObesity/*prevention & controlSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Theobromine/*administration & dosageTheophylline/*administration & dosageTriglycerides/blood*Weight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11319627Molnar2000250201112620824122000DecSafety and efficacy of treatment with an ephedrine/caffeine mixture. The first double-blind placebo-controlled pilot study in adolescents1573-8Department of Paediatrics, University of Pecs, Hungary. dmolnar@apacs.pote.huMolnar, D.Torok, K.Erhardt, E.Jeges, S.Int J Obes Relat Metab DisordAdipose TissueAdolescentApolipoproteins B/bloodBlood PressureBody CompositionCaffeine/*administration & dosage/adverse effects/therapeutic useDouble-Blind MethodElectric ImpedanceEnergy IntakeEphedrine/*administration & dosage/adverse effects/therapeutic useFemaleHeart RateHumanMaleObesity/diet therapy/*drug therapy/physiopathologyPlacebosSubstance Withdrawal SyndromeSupport, Non-U.S. Gov'tWeight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11126208Molnar199325030838418117 Suppl 11993FebEffects of ephedrine and aminophylline on resting energy expenditure in obese adolescentsS49-52Department of Paediatrics, University Medical School of Pecs, Hungary.Molnar, D.Int J Obes Relat Metab DisordAdolescentAminophylline/*pharmacology/therapeutic useBasal Metabolism/drug effectsBody Temperature Regulation/drug effectsChildEnergy Metabolism/*drug effectsEphedrine/*pharmacology/therapeutic useFemaleHumanMaleObesity/drug therapy/*metabolismSupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8384181Greenway20012504012120105232001AugThe safety and efficacy of pharmaceutical and herbal caffeine and ephedrine use as a weight loss agent199-211Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, Louisiana 70808, USA. greenwfl@pbrc.eduGreenway, F. L.Obes RevAminophylline/adverse effects/therapeutic useAnimalCaffeine/adverse effects/*therapeutic useEphedrine/adverse effects/*therapeutic useHumanObesity/*drug therapy*Plant PreparationsTheophylline/adverse effects/therapeutic use*Weight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12120105Greenway20002505011152061662000DecThe effect of an herbal dietary supplement containing ephedrine and caffeine on oxygen consumption in humans553-5Pennington Biomedical Research Center, Baton Rouge, Louisiana 70808, USA. greenwfl@pbrc.eduGreenway, F. L.Raum, W. J.DeLany, J. P.J Altern Complement MedCaffeine/*metabolism/pharmacologyCross-Over Studies*Dietary Supplements/analysisDouble-Blind MethodEphedrine/*metabolism/pharmacologyFemaleHumanObesity/*drug therapy/metabolismOxygen Consumption/*drug effectsPlant Extracts/*metabolism/pharmacologySupport, Non-U.S. Gov'tWeight Loss/*drug effectshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11152061Greenway19992506010574509761999NovPharmaceutical cost savings of treating obesity with weight loss medications523-31Pennington Biomedical Research Center, Baton Rouge, LA 70808-4124, USA. greenwfl@mhs.pbrc.eduGreenway, F. L.Ryan, D. H.Bray, G. A.Rood, J. C.Tucker, E. W.Smith, S. R.Obes ResAdolescentAdultAppetite Depressants/*therapeutic useCaffeine/therapeutic useCardiovascular Diseases/etiology/prevention & control*Drug CostsEphedrine/therapeutic useFemaleFenfluramine/therapeutic useHumanHyperlipidemia/drug therapy/etiologyHypertension/drug therapy/etiologyMaleMazindol/therapeutic useMiddle AgeObesity/complications/*drug therapy/economicsObesity in Diabetes/drug therapyPhentermine/therapeutic useRisk FactorsWeight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10574509Greenway19992507010440593741999JulDouble-blind, randomized, placebo-controlled clinical trials with non-prescription medications for the treatment of obesity370-8Pennington Biomedical Research Center, Baton Rouge, LA 70808-4124, USA. greenfl@mhs.pbrc.eduGreenway, F.Herber, D.Raum, W.Morales, S.Obes ResAdolescentAdultAgedAppetite Depressants/administration & dosage/*therapeutic useBenzocaine/administration & dosage/*therapeutic useComparative StudyDelayed-Action Preparations/administration & dosage/therapeutic useDose-Response Relationship, DrugDouble-Blind MethodDrug Therapy, CombinationDrugs, Non-Prescription/administration & dosage/*therapeutic useEphedrine/administration & dosage/*therapeutic useFemaleHumanMaleMiddle AgeObesity/*drug therapyPhenylpropanolamine/administration & dosage/*therapeutic useSupport, Non-U.S. Gov'tWeight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10440593[209-216]. For example, Boozer et al  ADDIN EN.CITE Boozer200124990113196272532001MarAn herbal supplement containing Ma Huang-Guarana for weight loss: a randomized, double-blind trial316-24Obesity Research Center, St Luke's-Roosevelt Hospital Center and Department of Medicine, Columbia University College of Physicians and Surgeons, New York 10025, USA. cnb7@columbia.eduBoozer, C. N.Nasser, J. A.Heymsfield, S. B.Wang, V.Chen, G.Solomon, J. L.Int J Obes Relat Metab DisordAdultAnthropometryBlood PressureCaffeine/*administration & dosage*Dietary SupplementsDouble-Blind MethodDrug CombinationsDrugs, Chinese Herbal/*administration & dosageFemaleHeart RateHumanMaleMiddle AgeObesity/*prevention & controlSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Theobromine/*administration & dosageTheophylline/*administration & dosageTriglycerides/blood*Weight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11319627[210] reported that 8-weeks of ephedrine (72 mg/d) and caffeine (240 mg/d) supplementation promoted a 9 lbs loss in body mass and a 2.1 % loss in body fat with minor side effects. Molnar and associates  ADDIN EN.CITE Boozer200224980120327412652002MayHerbal ephedra/caffeine for weight loss: a 6-month randomized safety and efficacy trial593-604New York Obesity Research Center, St Luke's-Roosevelt Hospital and Columbia University, New York 10025, USA.Boozer, C. N.Daly, P. A.Homel, P.Solomon, J. L.Blanchard, D.Nasser, J. A.Strauss, R.Meredith, T.Int J Obes Relat Metab DisordBlood Glucose/analysisBlood Pressure/drug effectsBody CompositionBody WeightCaffeine/administration & dosage/adverse effects/*therapeutic useCholesterol/bloodCola/adverse effectsDietary SupplementsElectrocardiography, Ambulatory*Ephedra/adverse effects/chemistryEphedra sinica/adverse effectsEphedrine/administration & dosage/adverse effects/*therapeutic useHeart Rate/drug effectsHumanLipoproteins, HDL Cholesterol/bloodLipoproteins, LDL Cholesterol/bloodPatient CompliancePlacebosPlant Preparations/administration & dosage/adverse effects/*therapeuticuseProspective StudiesSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Triglycerides/blood*Weight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12032741[209] reported that overweight children treated for 20 weeks with ephedrine and caffeine observed a 14.4% loss in body mass and a 6.6% decrease in body fat with no differences in side effects. Interestingly, Greenway and colleagues  ADDIN EN.CITE Greenway19992506010574509761999NovPharmaceutical cost savings of treating obesity with weight loss medications523-31Pennington Biomedical Research Center, Baton Rouge, LA 70808-4124, USA. greenwfl@mhs.pbrc.eduGreenway, F. L.Ryan, D. H.Bray, G. A.Rood, J. C.Tucker, E. W.Smith, S. R.Obes ResAdolescentAdultAppetite Depressants/*therapeutic useCaffeine/therapeutic useCardiovascular Diseases/etiology/prevention & control*Drug CostsEphedrine/therapeutic useFemaleFenfluramine/therapeutic useHumanHyperlipidemia/drug therapy/etiologyHypertension/drug therapy/etiologyMaleMazindol/therapeutic useMiddle AgeObesity/complications/*drug therapy/economicsObesity in Diabetes/drug therapyPhentermine/therapeutic useRisk FactorsWeight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10574509[215]reported that EC supplementation was a more cost-effective treatment for reducing weight, cardiac risk, and LDL cholesterol than several weight loss drugs (fenfluramine with mazindol or phentermine). Finally, Boozer and associates  ADDIN EN.CITE Boozer200224980120327412652002MayHerbal ephedra/caffeine for weight loss: a 6-month randomized safety and efficacy trial593-604New York Obesity Research Center, St Luke's-Roosevelt Hospital and Columbia University, New York 10025, USA.Boozer, C. N.Daly, P. A.Homel, P.Solomon, J. L.Blanchard, D.Nasser, J. A.Strauss, R.Meredith, T.Int J Obes Relat Metab DisordBlood Glucose/analysisBlood Pressure/drug effectsBody CompositionBody WeightCaffeine/administration & dosage/adverse effects/*therapeutic useCholesterol/bloodCola/adverse effectsDietary SupplementsElectrocardiography, Ambulatory*Ephedra/adverse effects/chemistryEphedra sinica/adverse effectsEphedrine/administration & dosage/adverse effects/*therapeutic useHeart Rate/drug effectsHumanLipoproteins, HDL Cholesterol/bloodLipoproteins, LDL Cholesterol/bloodPatient CompliancePlacebosPlant Preparations/administration & dosage/adverse effects/*therapeuticuseProspective StudiesSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Triglycerides/blood*Weight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12032741[209] reported that 6-months of herbal EC supplementation promoted weight loss with no clinically significant adverse effects in healthy overweight adults. Less is known about the safety and efficacy of synephrine, thyroid stimulators, cayenne/black pepper and ginger root. Despite these findings, the Food and Drug Administration (FDA) and the medical community have warned against use of ephedra containing supplements. In fact, the FDA has attempted to ban sale of supplements containing ephedra since the mid 1990s and a number of sport organizations prohibit the use of ephedra or ephedrine during competition (even from cold medicines). The rationale has been based on reports to adverse event monitoring systems and in the media suggesting a link between intake of ephedra and a number of severe medical complications (e.g., high blood pressure, elevated heart rate, arrhythmias, sudden death, heat stroke, etc)  ADDIN EN.CITE Bent200326220http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12639079Bent, S.Tiedt, T. N.Odden, M. C.Shlipak, M. G.The relative safety of ephedra compared with other herbal productsComparative StudyEphedra/*adverse effectsFemaleHumanPhytotherapy/*adverse effectsPlant Components/*adverse effectsProduct Surveillance, PostmarketingRiskSafetySupport, U.S. Gov't, Non-P.H.S.Support, U.S. Gov't, P.H.S.Osher Center for Integrative Medicine at the University of California, San Francisco, and San Francisco Veterans Affairs Medical Center, San Francisco, 111-A1, 4150 Clement Street, San Francisco, California 94121, USA. bent@itsa.ucsf.edu12639079Ann Intern Med20031386468-71.Fleming200026650http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11117982Fleming, G. A.The FDA, regulation, and the risk of strokeAppetite Depressants/*adverse effectsDietary Supplements/*adverse effectsDrug Approval/*legislation & jurisprudenceDrugs, Chinese Herbal/*adverse effectsEphedrine/*adverse effectsFemaleHumanIntracranial Hemorrhages/*chemically inducedNasal Decongestants/adverse effectsPhenylpropanolamine/*adverse effectsProduct Surveillance, PostmarketingUnited StatesUnited States Food and Drug Administration11117982N Engl J Med2000343251886-7.[217, 218]. Although results of available clinical studies do not show these types of adverse events, anyone contemplating taking thermogenic supplements should carefully consider the potential side effects, discuss possible use with a knowledgeable physician, and be careful not exceed recommended dosages. Possibly Effective High Fiber Diets. One oldest and most common methods of suppressing the appetite is to eat a high fiber diet. Ingesting high fiber foods (fruits, vegetables) or fiber supplements increase the feeling of fullness (satiety). They typically allow you to feel full while ingesting fewer calories. Theoretically, maintaining a high fiber diet may serve to help decrease the amount of food you eat. In addition, high fiber diets/supplements have also been purported to help lower cholesterol and blood pressure as well as help diabetics manage glucose and insulin levels. Some of the research conducted on high fiber diets indicates that they provide some benefit, particularly in diabetic populations. For example, Raben et al  ADDIN EN.CITE Raben1997247709082633159101997Mar 3[Spontaneous weight loss in young subjects of normal weight after 11 weeks of unrestricted intake of a low-fat/high-fiber diet]1448-53Den Kgl. Veterinaer- og Landbohojskole, Forskningsinstitut for Human Ernaering, Frederiksberg.Raben, A.Jensen, N. D.Marckmann, P.Sandstrom, B.Astrup, A. V.Ugeskr LaegerAdultBody Mass Index*Diet, Fat-RestrictedDietary Fiber/*administration & dosageEnergy IntakeEnglish AbstractFemaleHumanMaleSupport, Non-U.S. Gov'tTime Factors*Weight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9082633[219] reported that subjects maintaining a low fat/high fiber diet for 11 weeks lost about 3 lbs of weight and 3.5 lbs of fat. Other studies report either no significant effects or modest amounts of fat loss. High fiber/low fat diets have also been found to help reduce cholesterol. Consequently, although maintaining a low fat / high fiber diet may have some health benefits, they do not appear to promote a significant amount of weight or fat loss. Calcium. Research has indicated that calcium modulates 1,25-diydroxyvitamin D which serves to regulate intracellular calcium levels in fat cells  ADDIN EN.CITE Zemel200226870Zemel, M., Thompson, W.Zemel, P.Nocton, A.Milstead, A.Morris, K.Campbell, P.2002Dietary calcium and dairy products accelerate weight and fat-loss during energy restriction in obese adultsClin Nutri75Zemel200326750http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12733746Zemel, M. B.Role of dietary calcium and dairy products in modulating adiposityDepartment of Nutrition, The University of Tennessee, Nutrition Institute, Knoxville, Tennessee 37996, USA. mzemel@utk.edu12733746Lipids2003382139-46.Zemel200326760http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12514303Zemel, M. B.Mechanisms of dairy modulation of adiposityAdipocytes/*drug effects/metabolismAnimalCalcium, Dietary/*therapeutic use*Dairy ProductsGuinea PigsHumanMiceMice, TransgenicObesity/*diet therapyProteins/*drug effectsDepartment of Nutrition, The University of Tennessee, Knoxville 37996, USA. mzemel@utk.edu12514303J Nutr20031331252S-256S.Zemel200326840http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12514303Zemel, M. B.Mechanisms of dairy modulation of adiposityAdipocytes/*drug effects/metabolismAnimalCalcium, Dietary/*therapeutic use*Dairy ProductsGuinea PigsHumanMiceMice, TransgenicObesity/*diet therapyProteins/*drug effectsDepartment of Nutrition, The University of Tennessee, Knoxville 37996, USA. mzemel@utk.edu12514303J Nutr20031331252S-256S.[220-222]. Increasing dietary availability of calcium reduces 1,25-diydroxyvitamin D and promotes reductions in fat mass in animals  ADDIN EN.CITE Zemel200226870Zemel, M., Thompson, W.Zemel, P.Nocton, A.Milstead, A.Morris, K.Campbell, P.2002Dietary calcium and dairy products accelerate weight and fat-loss during energy restriction in obese adultsClin Nutri75Zemel200326750http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12733746Zemel, M. B.Role of dietary calcium and dairy products in modulating adiposityDepartment of Nutrition, The University of Tennessee, Nutrition Institute, Knoxville, Tennessee 37996, USA. mzemel@utk.edu12733746Lipids2003382139-46.Zemel200326760http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12514303Zemel, M. B.Mechanisms of dairy modulation of adiposityAdipocytes/*drug effects/metabolismAnimalCalcium, Dietary/*therapeutic use*Dairy ProductsGuinea PigsHumanMiceMice, TransgenicObesity/*diet therapyProteins/*drug effectsDepartment of Nutrition, The University of Tennessee, Knoxville 37996, USA. mzemel@utk.edu12514303J Nutr20031331252S-256S.Zemel200326840http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12514303Zemel, M. B.Mechanisms of dairy modulation of adiposityAdipocytes/*drug effects/metabolismAnimalCalcium, Dietary/*therapeutic use*Dairy ProductsGuinea PigsHumanMiceMice, TransgenicObesity/*diet therapyProteins/*drug effectsDepartment of Nutrition, The University of Tennessee, Knoxville 37996, USA. mzemel@utk.edu12514303J Nutr20031331252S-256S.[220-222]. Dietary calcium has been shown to suppress fat metabolism and weight gain during periods of high caloric intake  ADDIN EN.CITE Zemel20007240http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10834935Zemel, M. B.Shi, H.Greer, B.Dirienzo, D.Zemel, P. C.Regulation of adiposity by dietary calciumAdipocytes/cytology/*drug effects/enzymology/metabolismAdultAnimalBlood Glucose/analysisBody Temperature/drug effectsCalcium/*metabolismCalcium, Dietary/administration & dosage/*pharmacology/therapeutic useCells, CulturedDairy ProductsEnergy IntakeEnergy Metabolism/drug effectsFatty Acid Synthetase Complex/genetics/metabolismFemaleHumanInsulin/bloodLipolysis/*drug effectsMaleMiceMice, TransgenicObesity/blood/diet therapy/metabolismParathyroid Hormones/antagonists & inhibitors/pharmacologyProteins/genetics/metabolismSupport, Non-U.S. Gov'tVitamin D/antagonists & inhibitors/pharmacologyWeight Gain/drug effectsDepartment of Nutrition, The University of Tennessee, Knoxville, Tennessee 37996-1900, USA. mzemel@utk.edu10834935Faseb J20001491132-8.Zemel200226800http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11999543Zemel, M. B.Regulation of adiposity and obesity risk by dietary calcium: mechanisms and implicationsAdipocytes/drug effects/metabolism*Adipose Tissue*Body CompositionCalcitriol/administration & dosage/physiologyCalcium/physiologyCalcium, Dietary/*administration & dosageDairy ProductsEnergy IntakeFatty Acids/metabolismFeces/chemistryHumanObesity/*prevention & controlProteins/metabolismRisk FactorsWeight LossThe University of Tennessee, Knoxville 37996, USA. mzemel@utk.edu11999543J Am Coll Nutr2002212146S-151S.Zemel200226870Zemel, M., Thompson, W.Zemel, P.Nocton, A.Milstead, A.Morris, K.Campbell, P.2002Dietary calcium and dairy products accelerate weight and fat-loss during energy restriction in obese adultsClin Nutri75[220, 223, 224]. Further, increasing calcium intake has been shown to increase fat metabolism and preserve thermogenesis during caloric restriction  ADDIN EN.CITE Zemel20007240http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10834935Zemel, M. B.Shi, H.Greer, B.Dirienzo, D.Zemel, P. C.Regulation of adiposity by dietary calciumAdipocytes/cytology/*drug effects/enzymology/metabolismAdultAnimalBlood Glucose/analysisBody Temperature/drug effectsCalcium/*metabolismCalcium, Dietary/administration & dosage/*pharmacology/therapeutic useCells, CulturedDairy ProductsEnergy IntakeEnergy Metabolism/drug effectsFatty Acid Synthetase Complex/genetics/metabolismFemaleHumanInsulin/bloodLipolysis/*drug effectsMaleMiceMice, TransgenicObesity/blood/diet therapy/metabolismParathyroid Hormones/antagonists & inhibitors/pharmacologyProteins/genetics/metabolismSupport, Non-U.S. Gov'tVitamin D/antagonists & inhibitors/pharmacologyWeight Gain/drug effectsDepartment of Nutrition, The University of Tennessee, Knoxville, Tennessee 37996-1900, USA. mzemel@utk.edu10834935Faseb J20001491132-8.Zemel200226800http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11999543Zemel, M. B.Regulation of adiposity and obesity risk by dietary calcium: mechanisms and implicationsAdipocytes/drug effects/metabolism*Adipose Tissue*Body CompositionCalcitriol/administration & dosage/physiologyCalcium/physiologyCalcium, Dietary/*administration & dosageDairy ProductsEnergy IntakeFatty Acids/metabolismFeces/chemistryHumanObesity/*prevention & controlProteins/metabolismRisk FactorsWeight LossThe University of Tennessee, Knoxville 37996, USA. mzemel@utk.edu11999543J Am Coll Nutr2002212146S-151S.Zemel200226870Zemel, M., Thompson, W.Zemel, P.Nocton, A.Milstead, A.Morris, K.Campbell, P.2002Dietary calcium and dairy products accelerate weight and fat-loss during energy restriction in obese adultsClin Nutri75[220, 223, 224]. In support of this theory, Davies and colleagues  ADDIN EN.CITE Davies200026880http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11134120Davies, K. M.Heaney, R. P.Recker, R. R.Lappe, J. M.Barger-Lux, M. J.Rafferty, K.Hinders, S.Calcium intake and body weightAdultAgedAged, 80 and overBody Mass IndexBody Weight/*drug effectsCalcium, Dietary/*administration & dosage/therapeutic useCross-Sectional StudiesDouble-Blind MethodFemaleHumanMiddle AgeOsteoporosis/prevention & controlSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Osteoporosis Research Center, Creighton University, Omaha, Nebraska 68131, USA.11134120J Clin Endocrinol Metab200085124635-8.[225] reported that dietary calcium was negatively correlated to weight and that calcium supplementation (1,000 mg/d) accounted for an 8 kg weight loss over a 4 yr period. Additionally, Zemel and associates  ADDIN EN.CITE Zemel200226870Zemel, M., Thompson, W.Zemel, P.Nocton, A.Milstead, A.Morris, K.Campbell, P.2002Dietary calcium and dairy products accelerate weight and fat-loss during energy restriction in obese adultsClin Nutri75[220] reported that supplemental calcium (800 mg/d) or high dietary intake of calcium (1,200 1,300 mg/d) during a 24-week weight loss program promoted significantly greater weight loss (26-70%) and dual energy x-ray absorptiometer (DEXA) determined fat mass loss (38-64%) compared to subjects on a low calcium diet (400-500 mg/d). These findings and others suggest a strong relationship between calcium intake and fat loss. Phosphates. The role of sodium and calcium phosphate on energy metabolism and exercise performance has been studied for decades  ADDIN EN.CITE Kreider199930837Kreider, R.B.1999Phosphorus in exercise and sportDriskell, J.A. Wolinsky, I.Macroelements, Water, and ElectrolytesBoca RatonCRC Press29-46[226]. These studies have revealed that sodium phosphate supplementation appears to possess ergogenic properties particularly in endurance exercise events  ADDIN EN.CITE Kreider199226890http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=1299483Kreider, R. B.Miller, G. W.Schenck, D.Cortes, C. W.Miriel, V.Somma, C. T.Rowland, P.Turner, C.Hill, D.Effects of phosphate loading on metabolic and myocardial responses to maximal and endurance exerciseAdultBicyclingDouble-Blind MethodEchocardiographyExercise/*physiologyHeart/drug effects/*physiologyHematocritHemodynamicsHemoglobins/metabolismHumanMaleMetabolism/*drug effectsOxygen ConsumptionPhosphates/*administration & dosage/blood/pharmacologyPhysical Endurance/*physiologyPlacebosRandom AllocationDept. of HPER, Old Dominion University, Norfolk, VA 23529-0196.1299483Int J Sport Nutr19922120-47.Kreider199026900http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=2355823Kreider, R. B.Miller, G. W.Williams, M. H.Somma, C. T.Nasser, T. A.Effects of phosphate loading on oxygen uptake, ventilatory anaerobic threshold, and run performanceAnaerobic Threshold/*drug effectsErythrocytes/metabolismGlycolysis/drug effectsHumanOxygen Consumption/*drug effectsPhosphates/metabolism/*pharmacologyRespiration/*drug effects*RunningSupport, Non-U.S. Gov'tDepartment of Health, Physical Education and Recreation, Human Performance Laboratory, Old Dominion University, Norfolk, VA 23529-0196.2355823Med Sci Sports Exerc1990222250-6.[227, 228]. More recently, phosphate supplementation has also been suggested to affect energy expenditure. For example, Kaciuba-Uscilko and colleagues  ADDIN EN.CITE Kaciuba-Uscilko199326920http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=8123890Kaciuba-Uscilko, H.Nazar, K.Chwalbinska-Moneta, J.Ziemba, A.Kruk, B.Szczepanik, J.Titow-Stupnicka, E.Bicz, B.Effect of phosphate supplementation on metabolic and neuroendocrine responses to exercise and oral glucose load in obese women during weight reductionAdultBlood Glucose/metabolismBlood Pressure/drug effectsCatecholamines/bloodExercise/*physiologyFemaleGlucose/*pharmacologyGlucose Tolerance TestHeart Rate/drug effectsHumanInsulin/bloodObesity/blood/diet therapy/*metabolismOxygen Consumption/drug effectsPhosphates/*pharmacologyWeight Loss/*physiologyDepartment of Applied Physiology, Polish Academy of Sciences, Warsaw.8123890J Physiol Pharmacol1993444425-40.[229] reported that phosphate supplementation during a 4-week weight loss program increased resting metabolic rate (RMR) and respiratory exchange ratio (suggesting greater carbohydrate utilization and caloric expenditure) during submaximal cycling exercise. In addition, Nazar and coworkers  ADDIN EN.CITE Nazar199626910http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=8807564Nazar, K.Kaciuba-Uscilko, H.Szczepanik, J.Zemba, A. W.Kruk, B.Chwalbinska-Moneta, J.Titow-Stupnicka, E.Bicz, B.Krotkiewski, M.Phosphate supplementation prevents a decrease of triiodothyronine and increases resting metabolic rate during low energy dietAdult*Body WeightDiet, ReducingDouble-Blind MethodEnergy IntakeEnergy MetabolismFemaleHumanMiddle AgeObesity/blood/*diet therapyOxygen Consumption/physiologyPhosphates/*administration & dosageTriiodothyronine/*bloodDepartment of Applied Physiology, Polish Academy of Sciences, Warsaw, Poland.8807564J Physiol Pharmacol1996472373-83.[230] reported that phosphate supplementation during an 8-week weight loss program increased RMR by 12-19% and prevented a normal decline in thyroid hormones. Although the rate of weight loss was similar in this trial, results suggest that phosphate supplementation may influence metabolic rate possibly by affecting thyroid hormones. Consequently, it is possible that phosphate could serve as a potential thermogenic nutrient in non-ephedrine based supplements. Additional research is necessary to test this hypothesis. Green Tea Extract. Green tea is one of the more interesting herbal supplements that has recently been suggested to affect weight loss. Green tea contains high amounts of caffeine and catechin polyphenols. Research suggests that catechin polyphenols possess antioxidant properties  ADDIN EN.CITE Nakagawa199926930http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10552751Nakagawa, K.Ninomiya, M.Okubo, T.Aoi, N.Juneja, L. R.Kim, M.Yamanaka, K.Miyazawa, T.Tea catechin supplementation increases antioxidant capacity and prevents phospholipid hydroperoxidation in plasma of humansAdultAntioxidants/*pharmacologyCatechin/blood/*pharmacologyChromatography, High Pressure LiquidDietary SupplementsHumanMalePhosphatidylcholines/*bloodPlant Extracts/pharmacologyReference Values*TeaTime FactorsLaboratory of Biodynamic Chemistry, Tohoku University Graduate School of Life Science and Agriculture, Sendai 981-8555, Japan.10552751J Agric Food Chem199947103967-73.[231]. In addition, green tea has also been theorized to increase energy expenditure by stimulating brown adipose tissue thermogenesis. In support of this theory, Dulloo et al  ADDIN EN.CITE Dulloo200026940http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10702779Dulloo, A. G.Seydoux, J.Girardier, L.Chantre, P.Vandermander, J.Green tea and thermogenesis: interactions between catechin-polyphenols, caffeine and sympathetic activityAnimalBody Temperature Regulation/*drug effectsBrown Fat/drug effects/*metabolismCaffeine/*pharmacologyCatechin/pharmacologyCentral Nervous System Stimulants/*pharmacologyEphedrine/pharmacologyMaleNorepinephrine/metabolismObesity/*metabolismOxygen ConsumptionPhenols/pharmacologyPlant Extracts/pharmacologyPolymers/pharmacologyRatsRats, Sprague-DawleySupport, Non-U.S. Gov'tSympathectomySympathetic Nervous System/drug effects/physiology*TeaTissue CultureInstitute of Physiology, University of Fribourg, Fribourg, Switzerland. abdul.dulloo@unifr.ch10702779Int J Obes Relat Metab Disord2000242252-8.Dulloo199926950http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10584049Dulloo, A. G.Duret, C.Rohrer, D.Girardier, L.Mensi, N.Fathi, M.Chantre, P.Vandermander, J.Efficacy of a green tea extract rich in catechin polyphenols and caffeine in increasing 24-h energy expenditure and fat oxidation in humansAdipose Tissue/*drug effects/metabolismAdultCaffeine/*pharmacologyCatechin/*pharmacologyCentral Nervous System Stimulants/*pharmacologyCircadian RhythmEnergy Metabolism/*drug effectsHumanLipids/metabolismMaleObesity/urineOxidation-ReductionPlant Extracts/pharmacologySupport, Non-U.S. Gov't*TeaDepartment of Physiology, Faculty of Medicine, University of Geneva. abdul.dulloo@unifr.ch10584049Am J Clin Nutr19997061040-5.[232, 233] reported that green tea supplementation in combination with caffeine (e.g., 50 mg caffeine and 90 mg epigallocatechin gallate taken 3-times per day) significantly increased 24-hour energy expenditure and fat utilization in humans. The thermogenic effects of green tea supplementation were much greater than when an equivalent amount of caffeine was evaluated suggesting a synergistic effect. Theoretically, increases in energy expenditure may help individuals lose weight and/or manage body composition. Calcium Pyruvate. Calcium Pyruvate is supplement that hit the scene about five or six years ago with great promise. The theoretical rationale was based on studies from the early 1990s that reported that calcium pyruvate supplementation (16 25 g/d with or without dihydroxyacetone phosphate [DHAP]) promoted fat loss in overweight/obese patients following a medially supervised weight loss program  ADDIN EN.CITE Stanko199627070http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=8910097Stanko, R. T.Arch, J. E.Inhibition of regain in body weight and fat with addition of 3-carbon compounds to the diet with hyperenergetic refeeding after weight reductionAdipose TissueAdult*Body CompositionDietDihydroxyacetone/administration & dosage/*therapeutic useElectric Impedance*Energy IntakeEnergy MetabolismFemaleHumanLongitudinal StudiesMaleMiddle AgeNitrogen/metabolismObesity/physiopathology/*therapyProteins/metabolismPyruvic Acid/administration & dosage/*therapeutic useSupport, U.S. Gov't, P.H.S.*Weight LossDepartment of Medicine, Montefiore University Hospital, University of Pittsburgh Medical Center, PA 15213-2582, USA.8910097Int J Obes Relat Metab Disord19962010925-30.Stanko199227060http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=1550057Stanko, R. T.Tietze, D. L.Arch, J. E.Body composition, energy utilization, and nitrogen metabolism with a severely restricted diet supplemented with dihydroxyacetone and pyruvateAdultBasal Metabolism*Body Composition*Diet, ReducingDihydroxyacetone/*therapeutic use*Energy MetabolismFemaleHumanLeucine/metabolismMiddle AgeNitrogen/*metabolismObesity/diet therapy/*therapyPyruvates/*therapeutic usePyruvic AcidSupport, U.S. Gov't, P.H.S.Weight LossClinical Nutrition Unit, Montefiore University Hospital, Pittsburgh, PA 15213.1550057Am J Clin Nutr1992554771-6.Stanko199427010http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=8310996Stanko, R. T.Reynolds, H. R.Hoyson, R.Janosky, J. E.Wolf, R.Pyruvate supplementation of a low-cholesterol, low-fat diet: effects on plasma lipid concentrations and body composition in hyperlipidemic patientsAdipose Tissue/drug effectsBody Composition/*drug effectsBody Mass IndexCholesterol, Dietary/administration & dosageDietary Fats/*administration & dosageFemaleHumanHyperlipidemia/blood/*diet therapy/drug therapyLipids/*bloodLipoproteins, HDL Cholesterol/bloodLipoproteins, LDL Cholesterol/bloodLongitudinal StudiesMaleMiddle AgePyruvates/pharmacology/*therapeutic usePyruvic AcidSupport, U.S. Gov't, P.H.S.Triglycerides/bloodWeight Loss/drug effectsDepartment of Medicine, Montefiore University Hospital, Pittsburgh, PA 15213-2582.8310996Am J Clin Nutr1994592423-7.[234-236]. Although the mechanism for these findings was unclear, the researchers speculated that it might be related to appetite suppression and/or altered carbohydrate and fat metabolism. Since calcium pyruvate is very expensive, several studies have attempted to determine whether ingesting smaller amounts of calcium pyruvate (6-10 g/d) affect body composition in untrained and trained populations. Results of these studies are mixed. Kalman and colleagues  ADDIN EN.CITE Kalman199926970http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10355844Kalman, D.Colker, C. M.Wilets, I.Roufs, J. B.Antonio, J.The effects of pyruvate supplementation on body composition in overweight individualsAdultBody Composition/*drug effectsBody Weight/*drug effectsDietary SupplementsDouble-Blind MethodEnergy Metabolism/drug effectsExerciseFemaleHumanMalePlacebosPyruvic Acid/*administration & dosagePeak Wellness, Greenwich, Connecticut 06830, USA.10355844Nutrition1999155337-40.[237] reported that calcium pyruvate supplementation (6 g/d for 6-weeks) significantly decreased body weight (-1.2 kg), body fat (-2.5 kg), and percent body fat (-2.7%). However, Stone and colleagues  ADDIN EN.CITE Stone199926960http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10362452Stone, M. H.Sanborn, K.Smith, L. L.O'Bryant, H. S.Hoke, T.Utter, A. C.Johnson, R. L.Boros, R.Hruby, J.Pierce, K. C.Stone, M. E.Garner, B.Effects of in-season (5 weeks) creatine and pyruvate supplementation on anaerobic performance and body composition in American football playersAdolescentAnaerobiosisBody Composition/*drug effectsBody WeightCreatine/*administration & dosage*Dietary SupplementsExertion/*drug effectsHumanMaleMuscle ContractionMuscle, Skeletal/drug effects/physiologyPlacebosPyruvic Acid/*administration & dosageExercise Science Department, Appalachian State University, Boone, NC 28608, USA.10362452Int J Sport Nutr199992146-65.[238] reported that pyruvate supplementation did not affect hydrostatically determined body composition during 5-weeks of in-season college football training. These findings indicate that although there is some supportive data indicating that calcium pyruvate supplementation may enhance fat loss when taken at high doses (6-16 g/d), there is no evidence that ingesting the doses typically found in pyruvate supplements (0.5 2 g/d) has any affect on body composition. Too Early to Tell Gymnema Sylvestre. Gymnema Sylvestre is a relatively new supplement. It is purported to affect glucose and fat metabolism as well as inhibit sweet cravings. In support of these contentions, some recent data have been published by Shigematsu and colleagues  ADDIN EN.CITE Shigematsu200124860114115672462001JunEffect of administration with the extract of Gymnema sylvestre R. Br leaves on lipid metabolism in rats713-7Biosci. Textile Technol., Shinshu University, Ueda, Nagano, Japan. noshigematsu@fancl.co.jpShigematsu, N.Asano, R.Shimosaka, M.Okazaki, M.Biol Pharm BullAngiosperms/*chemistryAnimalBody WeightCholesterol/*bloodDietary Fats/metabolismDietary Proteins/metabolismFeces/chemistryFeeding BehaviorMaleOrgan WeightPhosphatidylcholine-Sterol O-Acyltransferase/bloodPlant Extracts/*pharmacologyPlant Leaves/*chemistryRatsRats, WistarTriglycerides/*bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11411567Shigematsu200124870114115522462001JunEffect of long term-administration with Gymnema sylvestre R. BR on plasma and liver lipid in rats643-9Biosci. Textile Technol., Shinshu University, Ueda, Nagano, Japan. noshigematsu@fancl.co.jpShigematsu, N.Asano, R.Shimosaka, M.Okazaki, M.Biol Pharm BullAngiosperms/*chemistryAnimalDietary Fats/administration & dosageFeeding BehaviorLiver/*drug effects/metabolismMaleOrgan WeightPlant Extracts/*pharmacologyRatsRats, WistarTriglycerides/blood/*metabolismhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11411552[239, 240] indicating that short and long-term oral supplementation of gymnema sylvestre in rats fed normal and high-fat diets may have some positive effects on fat metabolism, blood lipid levels, and/or weight gain/fat deposition. Although these findings are interesting, we are aware of no published studies that have evaluated the effects of gymnema sylvestre supplementation on lipid metabolism or body composition in humans. Consequently, more research is needed before conclusions can be drawn. Chitosan. Chitosan has been marketed as a weight loss supplement for several years. It is purported to inhibit fat absorption and lower cholesterol. Several animal studies report decreased fat absorption, increased fecal fat content, and/or lower cholesterol following chitosan feedings  ADDIN EN.CITE Gallaher200224880123567852152002OctA glucomannan and chitosan fiber supplement decreases plasma cholesterol and increases cholesterol excretion in overweight normocholesterolemic humans428-33Department of Food Science and Nutrition, University of Minnesota, St. Paul, Minnesota 55108, USA. dgallahe@che.umn.eduGallaher, D. D.Gallaher, C. M.Mahrt, G. J.Carr, T. P.Hollingshead, C. H.Hesslink, R., Jr.Wise, J.J Am Coll NutrAdolescentAdultBody WeightChitin/*administration & dosage/analogs & derivativesCholesterol/*blood/*metabolismDietary Fats/administration & dosageDietary Fiber/*administration & dosageDietary SupplementsEnergy IntakeFeces/chemistryFemaleHumanLipoproteins, HDL Cholesterol/bloodLipoproteins, LDL Cholesterol/bloodMaleMannans/*administration & dosageMiddle AgeObesity/*metabolismSupport, Non-U.S. Gov'tTriglycerides/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12356785Gallaher20002489011053517130112000NovCholesterol reduction by glucomannan and chitosan is mediated by changes in cholesterol absorption and bile acid and fat excretion in rats2753-9Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN, USA.Gallaher, C. M.Munion, J.Hesslink, R., Jr.Wise, J.Gallaher, D. D.J NutrAnalysis of VarianceAnimalAnticholesteremic Agents/administration & dosage/*pharmacologyBile Acids and Salts/*metabolismCathartics/administration & dosage/*pharmacologyChitin/administration & dosage/*analogs & derivatives/pharmacologyCholesterol, Dietary/*pharmacokineticsFats/*metabolismFeces/chemistryIntestinal Absorption/drug effectsLiver/*drug effects/metabolismMaleMannans/administration & dosage/*pharmacologyRatsRats, WistarSupport, Non-U.S. Gov'tWeight Gain/drug effectshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11053517Chiang200024900108794656452000MayEffect of dietary chitosans with different viscosity on plasma lipids and lipid peroxidation in rats fed on a diet enriched with cholesterol965-71Department of Food Science, National Taiwan Ocean University, Keelung, ROC. chiangmt@wfd.ntou.edu.twChiang, M. T.Yao, H. T.Chen, H. C.Biosci Biotechnol BiochemAnimalAnticholesteremic Agents/*chemistry/metabolismChitin/*analogs & derivatives/*chemistry/metabolismCholesterol/*analysis*Cholesterol, DietaryDietary SupplementsFeces/chemistryGlucosephosphate Dehydrogenase/analysis*Lipid PeroxidationLipids/analysis/*bloodLiver/chemistryRandom AllocationRatsRats, Sprague-DawleySupport, Non-U.S. Gov'tThiobarbituric Acid Reactive Substances/metabolismViscosityhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10879465Tai2000249101109229723112000NovEffect of chitosan on plasma lipoprotein concentrations in type 2 diabetic subjects with hypercholesterolemia1703-4Tai, T. S.Sheu, W. H.Lee, W. J.Yao, H. T.Chiang, M. T.Diabetes CareAnticholesteremic Agents/*therapeutic useBlood Glucose/metabolismChitin/*analogs & derivatives/therapeutic useComparative StudyDiabetes Mellitus, Non-Insulin-Dependent/*blood/complications/drug therapyHumanHypercholesterolemia/*bloodHypoglycemic Agents/therapeutic useLipoproteins/*bloodPlacebosTriglycerides/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11092297[241-244]. However, the effects in humans appear to be less impressive. For example, although there is some data suggesting that chitosan supplementation may lower blood lipids in humans, ADDIN EN.CITE Wuolijoki199924930104203922151999JunDecrease in serum LDL cholesterol with microcrystalline chitosan357-61Finn-Medi Research Ltd., Department of Pharmacological Sciences, University of Tampere, Finland.Wuolijoki, E.Hirvela, T.Ylitalo, P.Methods Find Exp Clin PharmacolAdultAnticholesteremic Agents/*pharmacologyBody Weight/drug effectsChitin/adverse effects/*analogs & derivatives/pharmacologyDouble-Blind MethodFemaleHumanLipids/bloodLipoproteins, HDL Cholesterol/bloodLipoproteins, LDL Cholesterol/*bloodObesity/bloodTriglycerides/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10420392[245] other studies report no effects on fecal fat content  ADDIN EN.CITE Guerciolini20012494011399783962001JunComparative evaluation of fecal fat excretion induced by orlistat and chitosan364-7F. Hoffmann-La Roche, Palo Alto, California, USA.Guerciolini, R.Radu-Radulescu, L.Boldrin, M.Dallas, J.Moore, R.Obes ResAdolescentAdultAnti-Obesity Agents/*pharmacologyAnticholesteremic Agents/*pharmacologyChitin/analogs & derivatives/*pharmacologyComparative StudyDietary Fats/*pharmacokineticsFeces/*chemistryFemaleHumanIntestinal Absorption/drug effectsLactones/*pharmacologyLipids/analysisMaleMiddle AgeSupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11399783[246]or body composition alterations  ADDIN EN.CITE Pittler199924960103694935351999MayRandomized, double-blind trial of chitosan for body weight reduction379-81Department of Complementary Medicine, School of Postgraduate Medicine and Health Sciences, University of Exeter, United Kingdom.Pittler, M. H.Abbot, N. C.Harkness, E. F.Ernst, E.Eur J Clin NutrAdolescentAdultChitin/administration & dosage/adverse effects/*analogs &derivatives/therapeutic useDouble-Blind MethodFemaleHumanMaleMiddle AgeObesity/*drug therapyPlacebosSupport, Non-U.S. Gov't*Weight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10369493Ho200124970113612304212001JanIn the absence of dietary surveillance, chitosan does not reduce plasma lipids or obesity in hypercholesterolaemic obese Asian subjects006-10Department of Endocrinology, Singapore General Hospital, Singapore.Ho, S. C.Tai, E. S.Eng, P. H.Tan, C. E.Fok, A. C.Singapore Med JAdultAnticholesteremic Agents/administration & dosage/*therapeutic useBody WeightChitin/administration & dosage/analogs & derivatives/*therapeutic useCholesterol/bloodDietDouble-Blind MethodFemaleHumanHypercholesterolemia/blood/*drug therapyLife StyleLipids/*bloodLipoproteins, HDL Cholesterol/bloodMaleObesity/blood/*drug therapyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11361230[247, 248] when administered to people following their normal diet. It seems that people may be prone to eat more when they know they are taking a fat blocking supplement in a similar way people tend to eat more when the consume low-fat foods. Whether chitosan may promote greater amounts of fat loss when people are put on a controlled diet is unclear. Non-Ephedra Containing Thermogenics. Since the safety of ephedra supplements has come into question, a number of supplement companies have been looking for alternatives to ephedra such as Citrus Aurantum or Bitter Orange (synephrine), thyroid stimulators, and various herbs and peppers (cayenne, black pepper, ginger root, etc)  ADDIN EN.CITE Kreider200224730Kreider, R.B.2002New weight-control optionsFunctional Foods & NutraceuticalsJuly/August34-42[200]. Of these, Citrus Aurantum (synephrine) appears to have the most promise  ADDIN EN.CITE Penzak200127080http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11583473Penzak, S. R.Jann, M. W.Cold, J. A.Hon, Y. Y.Desai, H. D.Gurley, B. J.Seville (sour) orange juice: synephrine content and cardiovascular effects in normotensive adultsAdultAnalysis of VarianceBeverages/*analysisCardiovascular System/*drug effectsCitrus/*chemistryCross-Over StudiesFemaleHemodynamics/drug effects/physiologyHumanMalePlant Extracts/analysis/pharmacologySynephrine/*analysis/chemistry/*pharmacologyVasoconstrictor Agents/*analysis/chemistry/*pharmacologyDepartment of Pharmacy Practice, Mercer University, Southern School of Pharmacy, Atlanta, Georgia 30341-4155, USA.11583473J Clin Pharmacol200141101059-63.Moro200027090http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10930716Moro, C. O.Basile, G.Obesity and medicinal plantsAnti-Obesity Agents/*therapeutic useHumanObesity/*drug therapy*PhytotherapyPlant Preparations/*therapeutic use*Plants, MedicinalDepartment of Pharmaceutical and Toxicological Chemistry, Study University of Naples Federico II, via D. Montesano 49, 80131, Naples, Italy.10930716Fitoterapia200071 Suppl 1S73-82.[249, 250]. Some studies suggest that synephrine may increase metabolism without significantly affecting heart rate and blood pressure. However, it is unclear whether dietary supplementation of Citrus Aurantum may enhance weight loss. A number of thyroid stimulating supplements have also been marketed. Most contain nutrients (e.g., guggulsterones, 3, 5-Diiodo-L-Thyronine, etc.) believed to enhance the conversion of triidiothyronine (T3) to thyroxin (T4) or increase availability of T2 (diidiothyronine) or T3 which would theoretically increase basal metabolic rate (resting caloric expenditure) and promote weight loss  ADDIN EN.CITE Cavallo199027100http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=2076860Cavallo, E.Armellini, F.Zamboni, M.Vicentini, R.Milani, M. P.Bosello, O.Resting metabolic rate, body composition and thyroid hormones. Short term effects of very low calorie dietAdult*Basal Metabolism*Body Composition*Diet, ReducingEnergy IntakeFemaleHumanObesity/blood/*physiopathologyThyrotropin/*bloodThyroxine/*bloodTriiodothyronine/*bloodWeight LossInstitute of Clinica Medica, University of Verona, Italy.2076860Horm Metab Res19902212632-5.Goglia200227120http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12418548Goglia, F.Silvestri, E.Lanni, A.Thyroid hormones and mitochondriaAnimalEnergy Metabolism/*physiologyHumanMitochondria/*physiologyThyroid Hormones/*physiologyFacolta de Scienze, Universita degli Studi del Sannio, Benevento, Italy. goglia@unisannio.it12418548Biosci Rep200222117-32.[251, 252]. However, while thyroid medications can effectively increase metabolic rate  ADDIN EN.CITE Wilson198127110http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=7275465Wilson, J. H.Lamberts, S. W.The effect of triiodothyronine on weight loss and nitrogen balance of obese patients on a very-low-calorie liquid-formula dietAdultBody WeightCreatinine/urine*Diet, Reducing/adverse effectsFemaleHumanMaleMiddle AgeNitrogen/*metabolismObesity/*diet therapy/metabolismThyroid Hormones/bloodTriiodothyronine/administration & dosage/*pharmacology72754651981Int J Obes53279-82[253], it is unclear whether these supplements can promote weight loss. Additionally, several of these types of supplements have been recently pulled by the FDA due to adverse health outcomes reported among people using these types of supplements particularly if they also contain usnic acid. Phosphatidyl Choline (Lecithin). Choline is considered an essential nutrient that is needed for cell membrane integrity and to facilitate the movement of fats in and out of cells. It is also a component of the neurotransmitter acetylcholine and is needed for normal brain functioning, particularly in infants. For this reason, phosphatidyl choline (PC) has been purported as a potentially effective supplement to promote fat loss as well as improve neuromuscular function. There is some data from animal studies that supports the potential value of PC as a weight loss supplement  ADDIN EN.CITE Rama Rao200127130http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11469557Rama Rao, S. V.Sunder, G. S.Reddy, M. R.Praharaj, N. K.Raju, M. V.Panda, A. K.Effect of supplementary choline on the performance of broiler breeders fed on different energy sourcesAbdomen/anatomy & histologyAdipose Tissue/metabolismAnimalAnimal FeedChickens/metabolism/*physiologyCholine/administration & dosage/*pharmacology*Dietary SupplementsEggs/standardsFemaleFertilityLiver/*metabolismMaleOryza sativa/metabolismOviposition/*drug effectsReproductionZea mays/metabolismProject Directorate on Poultry, Rajendranagar, Hyderabad, India. pdpoult@ap.nic.in11469557Br Poult Sci2001423362-7.[254]. There has also been some interest in determining the potential ergogenic value of choline supplementation during endurance exercise  ADDIN EN.CITE Buchman200027140http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11194530Buchman, A. L.Awal, M.Jenden, D.Roch, M.Kang, S. H.The effect of lecithin supplementation on plasma choline concentrations during a marathonAdultCholine/*bloodDietary SupplementsFemaleHumanMaleMiddle AgePhosphatidylcholines/*administration & dosage*RunningDivision of Gastroenterology and Hepatology, Northwestern University, Chicago, Illinois 60611, USA. a-buchman@northwestern.edu11194530J Am Coll Nutr2000196768-70.Buchman199927150http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10613411Buchman, A. L.Jenden, D.Roch, M.Plasma free, phospholipid-bound and urinary free choline all decrease during a marathon run and may be associated with impaired performanceAdultCholine/*blood/*urineFemaleHumanMaleMiddle AgePhospholipids/*bloodRunning/*physiologyDivision of Gastroenterology, Hepatology and Nutrition, University of Texas Houston Health Science Center, USA.10613411J Am Coll Nutr1999186598-601.[255, 256]. However, it is currently unclear whether PC supplementation affects body composition in humans. Betaine. Betaine is a compound that is involved in the metabolism of choline and homocysteine. A number of studies have evaluated the effects of betaine feedings on liver metabolism, fat metabolism, and fat deposition in animals  ADDIN EN.CITE Garcia Neto200027160http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11055856Garcia Neto, M.Pesti, G. M.Bakalli, R. I.Influence of dietary protein level on the broiler chicken's response to methionine and betaine supplementsAdipose TissueAnimalBetaine/*administration & dosageBody CompositionChickens/*physiologyDietDietary Proteins/*administration & dosageDietary SupplementsEnergy IntakeEnergy MetabolismLipids/analysisLiver/anatomy & histologyMaleMethionine/*administration & dosageMuscle Proteins/metabolismMuscle, Skeletal/anatomy & histology/metabolismProteins/analysisSupport, Non-U.S. Gov'tSupport, U.S. Gov't, Non-P.H.S.Tibia/chemistryWeight GainDepartment of Poultry Science, The University of Georgia, Athens 30602, USA.11055856Poult Sci200079101478-84.Overland199927170http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10461993Overland, M.Rorvik, K. A.Skrede, A.Effect of trimethylamine oxide and betaine in swine diets on growth performance, carcass characteristics, nutrient digestibility, and sensory quality of porkAnimal*Animal FeedBetaine/*pharmacologyBody Composition/*drug effects*DigestionFemaleHousing, AnimalLipids/bloodLipotropic Agents/*pharmacologyMaleMeat Products/*standardsMethylamines/*pharmacologyOxidants/*pharmacologyRandom AllocationSupport, Non-U.S. Gov'tSwine/*growth & developmentDepartment of Animal Science, Agricultural University of Norway, As. margareth.overland@ihf.nlh.no10461993J Anim Sci19997782143-53.[257, 258]. There has also been interest in determining whether betaine supplementation may help lower homocysteine levels which has recently been identified as a marker of risk to heart disease  ADDIN EN.CITE Schwab200227180http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12399266Schwab, U.Torronen, A.Toppinen, L.Alfthan, G.Saarinen, M.Aro, A.Uusitupa, M.Betaine supplementation decreases plasma homocysteine concentrations but does not affect body weight, body composition, or resting energy expenditure in human subjectsAdultBetaine/blood/*pharmacologyBlood Pressure/drug effectsBody Composition/*drug effectsBody Weight/*drug effectsDietDietary SupplementsEnergy IntakeEnergy Metabolism/*drug effectsExertion/drug effectsFemaleFolic Acid/bloodHomocystine/*bloodHumanLipoproteins/bloodLipotropic Agents/blood/*pharmacologyMaleMiddle AgeSupport, Non-U.S. Gov'tDepartment of Clinical Nutrition, University of Kuopio, Kuopio, Finland. ursula.schwab@uku.fi12399266Am J Clin Nutr2002765961-7.[259]. For this reason, betaine supplements have been marketed as a supplement designed to promote heart health as well as a weight loss. Although the potential theoretical rationale of betaine supplementation is interesting, it is currently unclear whether betaine supplementation may serve as an effective weight loss supplement in humans. Coleus Forskohlii (Forskolin). Forskolin is another relatively new weight loss supplement. Forskolin is a plant native to India that has been used for centuries in traditional Ayurvedic medicine primarily to treat skin disorders and respiratory problems  ADDIN EN.CITE Ammon198527210http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=3006108Ammon, H. P.Muller, A. B.Forskolin: from an ayurvedic remedy to a modern agentAdenylate Cyclase/antagonists & inhibitorsCyclic AMP/metabolism/physiologyForskolin/history/*pharmacology/therapeutic useHemodynamics/drug effectsHistory of Medicine, AncientHuman*Medicine, AyurvedicTime Factors3006108Planta Med19856473-7.Ammon198427220http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=6090960Ammon, H. P.Muller, A. B.Effect of forskolin on islet cyclic AMP, insulin secretion, blood glucose and intravenous glucose tolerance in ratsAnimalBlood Glucose/*metabolismCyclic AMP/*metabolismDiterpenes/*pharmacologyFemaleForskolinGlucose Tolerance TestInsulin/*secretionIslets of Langerhans/*metabolismMaleRatsRats, Inbred Strains6090960Naunyn Schmiedebergs Arch Pharmacol19843264364-7.[260, 261]. A considerable amount of research has evaluated the physiological and potential medical applications of forskolin over the last 25 years. Forskolin has been reported to reduce blood pressure, increase the hearts ability to contract, help inhibit platelet aggregation, improve lung function, and aid in the treatment of glaucoma  ADDIN EN.CITE de Souza198327230http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=6345959de Souza, N. J.Dohadwalla, A. N.Reden, J.Forskolin: a labdane diterpenoid with antihypertensive, positive inotropic, platelet aggregation inhibitory, and adenylate cyclase activating propertiesAdenylate Cyclase/*metabolismAnimalAntihypertensive Agents/*pharmacologyCardiotonic Agents/*pharmacologyCatsChemistryDiterpenes/isolation & purification/*pharmacologyDogsEnzyme Activation/drug effectsForskolinGuinea PigsHeart/drug effectsHemodynamics/drug effectsHumanPlatelet Aggregation/*drug effectsRatsStructure-Activity Relationship6345959Med Res Rev198332201-19.Ammon198527210http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=3006108Ammon, H. P.Muller, A. B.Forskolin: from an ayurvedic remedy to a modern agentAdenylate Cyclase/antagonists & inhibitorsCyclic AMP/metabolism/physiologyForskolin/history/*pharmacology/therapeutic useHemodynamics/drug effectsHistory of Medicine, AncientHuman*Medicine, AyurvedicTime Factors3006108Planta Med19856473-7.Ammon198427220http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=6090960Ammon, H. P.Muller, A. B.Effect of forskolin on islet cyclic AMP, insulin secretion, blood glucose and intravenous glucose tolerance in ratsAnimalBlood Glucose/*metabolismCyclic AMP/*metabolismDiterpenes/*pharmacologyFemaleForskolinGlucose Tolerance TestInsulin/*secretionIslets of Langerhans/*metabolismMaleRatsRats, Inbred Strains6090960Naunyn Schmiedebergs Arch Pharmacol19843264364-7.[260-262]. With regard to weight loss, forskolin has been reported to increase cyclic AMP and thereby stimulate fat metabolism  ADDIN EN.CITE Litosch198227250http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=6288010Litosch, I.Saito, Y.Fain, J. N.Forskolin as an activator of cyclic AMP accumulation and secretion in blowfly salivary glands3',5'-Cyclic-Nucleotide Phosphodiesterase/metabolismAnimalCalcium/metabolismComparative StudyCyclic AMP/*metabolismDiptera/*metabolismDiterpenes/*pharmacologyForskolinIn VitroSalivary Glands/drug effects/metabolism/secretionSerotonin/pharmacologyStimulation, ChemicalSupport, U.S. Gov't, P.H.S.6288010Biochem J19822041147-51.Litosch198227260http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=6289066Litosch, I.Hudson, T. H.Mills, I.Li, S. Y.Fain, J. N.Forskolin as an activator of cyclic AMP accumulation and lipolysis in rat adipocytes3',5'-Cyclic-Nucleotide Phosphodiesterase/metabolismAdenylate Cyclase/*metabolismAdipose Tissue/cytology/drug effects/*metabolismAnimalCell Membrane/metabolismCyclic AMP/*metabolismDiterpenes/*pharmacologyEnzyme Activation/drug effectsFemaleForskolinHypothyroidism/metabolismIn VitroLipolysis/*drug effectsMaleRatsRats, Inbred StrainsSupport, U.S. Gov't, P.H.S.6289066Mol Pharmacol1982221109-15.Seamon198127240http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=6267587Seamon, K. B.Padgett, W.Daly, J. W.Forskolin: unique diterpene activator of adenylate cyclase in membranes and in intact cellsAdenylate Cyclase/*metabolismAnimalBrain/enzymologyCyclic AMP/metabolismDiterpenes/*pharmacologyEnzyme Activation/drug effectsFluorides/pharmacologyForskolinGuanine Nucleotides/pharmacologyHormones/pharmacologyMaleManganese/pharmacologyMembranes/enzymologyRatsSupport, U.S. Gov't, P.H.S.Tissue Distribution6267587Proc Natl Acad Sci U S A19817863363-7.[263-265]. Theoretically, forskolin may therefore serve as an effective weight loss supplement. In support of this theory, Sabinsa Corporation (the principle source for Forskolin in the U.S.) reported that forskolin supplementation (250 mg of a 10% forskolin extract taken twice daily for 8-weeks) administered in an open label manner to six overweight females promoted a 7.25 lbs loss in body weight and a 7.7% decrease bioelectrical impedance (BIA) determined body fat  ADDIN EN.CITE Badmaev2001272710Badmaev, V.Majeed, M.Conte, A.A.Parker, J.E.2001Diterpene forskolin (Coleus forskohlii, Benth.): A possible new compound for reduction of body weight by increasing lean body massPiscataway, NJSabinsa CorporationAvailable: http://www.forslean.com/clinical_studies.html[266]. Although this was not a placebo controlled double blind study and BIA is not the most accurate method of assessing body composition, these preliminary findings provide some support to contentions that forskolin supplementation may promote fat loss. Another recent study suggested that supplementing the diet with coleus forskohlii in overweight women helped maintain weight and was not associated with any clinically significant adverse events  ADDIN EN.CITE Kreider200227280Kreider, R.B.Henderson, S.Magu, B.Rasmussen, C.Lancaster, S.Kerksick, C.Smith, P.Melton, C.Cowan, P.Greenwood, M.Earnest, C.Almada, A.Milnor, P.2002Effects of coleus forskohlii supplementation on body composition and markers of health in sedentary overweight females.FASEB JLB59[267]. Additional research is needed before conclusions can be drawn. Dehydroepiandrosterone (DHEA) and 7-Keto DHEA. Dehydroepiandrosterone (DHEA) and its sulfated conjugate DHEAS represent the most abundant adrenal steroids in circulation  ADDIN EN.CITE Ebeling199427300http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=7911183Ebeling, P.Koivisto, V. A.Physiological importance of dehydroepiandrosteroneBreast Neoplasms/metabolismCardiovascular Diseases/bloodFemaleHumanInsulin Resistance/physiologyMaleMenopause/metabolismObesity/metabolismPrasterone/blood/*physiologyReference ValuesSecond Department of Medicine, Helsinki University Hospital, Finland.7911183Lancet199434389111479-81.[268]. Although, DHEA is considered a weak androgen, it can be converted to the more potent androgens testosterone and dihydrotestosterone in tissues. In addition, DHEAS can be converted into androstenedione and testosterone. DHEA levels have been reported to decline with age in humans  ADDIN EN.CITE Denti199727310http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=9225839Denti, L.Pasolini, G.Sanfelici, L.Ablondi, F.Freddi, M.Benedetti, R.Valenti, G.Effects of aging on dehydroepiandrosterone sulfate in relation to fasting insulin levels and body composition assessed by bioimpedance analysisAdolescentAdultAgedAged, 80 and overAging/*blood/*physiologyAnthropometry*Body CompositionDehydroepiandrosterone Sulfate/*bloodElectric Impedance*FastingFemaleHumanInsulin/*bloodMaleMiddle AgeSex CharacteristicsSkinfold ThicknessDepartment of Geriatrics, University of Parma, Italy.9225839Metabolism1997467826-32.[269]. The decline in DHEA levels with aging has been associated with increased fat accumulation and risk to heart disease  ADDIN EN.CITE De Pergola199627320http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=8968856De Pergola, G.Zamboni, M.Sciaraffia, M.Turcato, E.Pannacciulli, N.Armellini, F.Giorgino, F.Perrini, S.Bosello, O.Giorgino, R.Body fat accumulation is possibly responsible for lower dehydroepiandrosterone circulating levels in premenopausal obese womenAdipose Tissue/radiographyAdultAndrostenedione/bloodAnthropometryBody ConstitutionBody Mass IndexFemaleHumanInsulin/bloodLinear ModelsObesity/*bloodPrasterone/*blood*PremenopauseSex Hormone-Binding Globulin/analysisSkinTestosterone/bloodTomography, X-Ray ComputedVisceraInstitute of Medical Clinic, Endocrinology and Metabolic Diseases, School of Medicine, University of Bari, Policlinco di Bari, Italy.8968856Int J Obes Relat Metab Disord199620121105-10.[270]. Since DHEA is a naturally occurring compound, it has been suggested that dietary supplementation of DHEA may help maintain DHEA availability, maintain and/or increase testosterone levels, reduce body fat accumulation, and/or reduce risk to heart disease as one ages  ADDIN EN.CITE De Pergola199627320http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=8968856De Pergola, G.Zamboni, M.Sciaraffia, M.Turcato, E.Pannacciulli, N.Armellini, F.Giorgino, F.Perrini, S.Bosello, O.Giorgino, R.Body fat accumulation is possibly responsible for lower dehydroepiandrosterone circulating levels in premenopausal obese womenAdipose Tissue/radiographyAdultAndrostenedione/bloodAnthropometryBody ConstitutionBody Mass IndexFemaleHumanInsulin/bloodLinear ModelsObesity/*bloodPrasterone/*blood*PremenopauseSex Hormone-Binding Globulin/analysisSkinTestosterone/bloodTomography, X-Ray ComputedVisceraInstitute of Medical Clinic, Endocrinology and Metabolic Diseases, School of Medicine, University of Bari, Policlinco di Bari, Italy.8968856Int J Obes Relat Metab Disord199620121105-10.Ebeling199427300http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=7911183Ebeling, P.Koivisto, V. A.Physiological importance of dehydroepiandrosteroneBreast Neoplasms/metabolismCardiovascular Diseases/bloodFemaleHumanInsulin Resistance/physiologyMaleMenopause/metabolismObesity/metabolismPrasterone/blood/*physiologyReference ValuesSecond Department of Medicine, Helsinki University Hospital, Finland.7911183Lancet199434389111479-81.[268, 270]. Although animal studies have generally supported this theory, the effects of DHEA supplementation on body composition in human trials have been mixed. For example, Nestler and coworkers  ADDIN EN.CITE Nestler198827330http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=2961787Nestler, J. E.Barlascini, C. O.Clore, J. N.Blackard, W. G.Dehydroepiandrosterone reduces serum low density lipoprotein levels and body fat but does not alter insulin sensitivity in normal menAdipose Tissue/*drug effectsAdultAndrogens/bloodAndrostenedione/bloodBody Composition/*drug effectsCholesterol/bloodDehydroepiandrosterone SulfateHumanInsulin/*pharmacologyLipids/bloodLipoproteins, LDL/*bloodLipoproteins, LDL Cholesterol/bloodMaleMuscles/drug effectsPrasterone/analogs & derivatives/blood/*pharmacologySupport, U.S. Gov't, P.H.S.Division of Endocrinology and Metabolism, Medical College of Virginia/Virginia Commonwealth University, Richmond 23298.2961787J Clin Endocrinol Metab198866157-61.[271] reported that DHEA supplementation (1,600 mg/d for 28-d) in untrained healthy males promoted a 31% reduction in percentage of body fat. However, Vogiatzi and associates  ADDIN EN.CITE Vogiatzi199627340http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=8769361Vogiatzi, M. G.Boeck, M. A.Vlachopapadopoulou, E.el-Rashid, R.New, M. I.Dehydroepiandrosterone in morbidly obese adolescents: effects on weight, body composition, lipids, and insulin resistanceAdolescentAdultAndrogens/bloodBody Weight/*drug effectsDouble-Blind MethodFemaleHuman*Insulin ResistanceLipids/*bloodMaleObesity, Morbid/*drug therapy/*pathology/physiopathologyPrasterone/blood/*therapeutic useSupport, U.S. Gov't, P.H.S.Department of Pediatrics, New York Hospital-Cornell University Medical College, New York, USA.8769361Metabolism19964581011-5.[272] reported that DHEA supplementation (40 mg/d for 8 wks) had no effect on body weight, percent body fat, or serum lipid levels in obese adolescents. More recently, 7-keto DHEA has been marketed as a potentially more effective form of DHEA. 7-keto DHEA is a precursor to DHEA that is believed to possess lypolytic properties. Although data are limited, Kalman and colleagues and coworkers  ADDIN EN.CITE Kalman200027360Kalman, D.S.Colker, C.M.Swain, M.A.Torina, G.C.Shi, Q.2000A randomized double-blind, placebo-controlled study of 3-acetyl-7-oxo-dehydroepiandrosterone in healthy overweight adultsCurr Thera61435-442[273] reported that 7-keto DHEA supplementation (200 mg/d) during 8-weeks of training promoted a greater loss in body mass and fat mass while increasing T3. No significant effects were observed on thyroid stimulating hormone (TSH), T4, or other hormones. Although more research is needed, these findings provide some support to contentions that 7-keto DHEA may serve as an effective weight loss supplement. However, additional research is needed before definitive conclusions can be made. Psychotropic Nutrients/Herbs. This is a relatively new type of weight loss supplement category. Psychotropic nutrients/herbs often contain things like St. Johns Wart, Kava, Ginkgo Biloba, Ginseng, and L-Tyrosine. They are believed to serve as naturally occurring antidepressants, relaxants, and mental stimulants. The theoretical rationale regarding weight loss is that they may help people fight depression or maintain mental alertness while dieting. Although a number of studies support potential role as naturally occurring psychotropics or stimulants, the potential value in promoting weight loss is unclear. Apparently Ineffective Chromium. Interest in chromium as a potential body composition modifier emanated from studies suggesting that chromium may enhance insulin sensitivity/glucose disposal in diabetics. Initial studies reported that chromium supplementation during resistance training improved fat loss and gains in lean body mass  ADDIN EN.CITE Evans198923580Evans, G.W.1989The effect of chromium picolinate on insulin controlled parameters in humansInt Biosc Med Res11163-180Hasten1992235701299504241992DecEffects of chromium picolinate on beginning weight training students343-50Dept. of Kinesiology, Louisiana State University, Baton Rouge 70803-7101.Hasten, D. L.Rome, E. P.Franks, B. D.Hegsted, M.Int J Sport NutrAdultComparative StudyDouble-Blind MethodFemaleHumanMalePicolinic Acids/*pharmacologyPlacebosSex CharacteristicsWeight Gain/*drug effects*Weight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1299504Grant19972352092689552981997AugChromium and exercise training: effect on obese women992-8Department of Kinesiology and Health Education, University of Texas at Austin 78712, USA.Grant, K. E.Chandler, R. M.Castle, A. L.Ivy, J. L.Med Sci Sports ExercAdolescentAdultBlood Glucose/metabolismCoronary Disease/prevention & controlDiabetes Mellitus, Non-Insulin-Dependent/prevention & control*Exercise TherapyFemale*Food, FortifiedHumanInsulin/metabolismIron Chelating Agents/*pharmacology/therapeutic useNicotinic Acids/*pharmacology/therapeutic useObesity/physiopathology/*therapyPicolinic Acids/*pharmacology/therapeutic useRisk FactorsSupport, Non-U.S. Gov'tWeight GainWeight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9268955[137-139]. However, recent studies using more accurate methods of assessing body composition have mostly reported no effects on body composition in healthy non-diabetic individuals  ADDIN EN.CITE Campbell19992349098871108611999JanEffects of resistance training and chromium picolinate on body composition and skeletal muscle in older men29-39Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, and Veterans Affairs Geriatric Research, Education, and Clinical Center, Little Rock, Arkansas 72205, USA. campbellwaynew@exchange.uams.eduCampbell, W. W.Joseph, L. J.Davey, S. L.Cyr-Campbell, D.Anderson, R. A.Evans, W. J.J Appl PhysiolAgedBody Composition/drug effects/*physiologyCreatine/urineDietEnergy Metabolism/physiologyHumanIron Chelating Agents/*pharmacologyMaleMiddle AgeMuscle, Skeletal/drug effects/metabolism/*physiologyPhysical Fitness/*physiologyPicolinic Acids/*pharmacologySkinfold ThicknessSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Weight Lifting/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9887110Walker199823500986160730121998DecChromium picolinate effects on body composition and muscular performance in wrestlers1730-7Department of Health & Sport Sciences, University of Oklahoma, Norman, USA.Walker, L. S.Bemben, M. G.Bemben, D. A.Knehans, A. W.Med Sci Sports ExercAdolescentAdultAnaerobic Threshold/drug effectsAnalysis of VarianceBlood Glucose/analysisBody Composition/*drug effectsDiet*Dietary SupplementsDouble-Blind MethodEnergy Metabolism/drug effectsFollow-Up StudiesHumanInsulin/bloodMaleMuscle Contraction/drug effectsMuscle, Skeletal/*drug effects/metabolismOxygen Consumption/drug effectsPhysical Endurance/drug effectsPicolinic Acids/administration & dosage/*therapeutic usePlacebosRunning/physiologySupport, Non-U.S. Gov'tWeight Lifting/physiologyWrestling/education/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9861607Livolsi200123430117103991522001MayThe effect of chromium picolinate on muscular strength and body composition in women athletes161-6Division of Kinesiology and Health Promotion, California State University-Fullerton, 92634-9480, USA.Livolsi, J. M.Adams, G. M.Laguna, P. L.J Strength Cond ResAdolescentAdultBaseball/*physiologyBody Composition/*drug effectsBody WeightDietary SupplementsFemaleHumanIron Chelating Agents/*pharmacologyMuscle, Skeletal/*drug effectsPicolinic Acids/*pharmacology/urineSupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11710399Volpe200123440115060572042001AugEffect of chromium supplementation and exercise on body composition, resting metabolic rate and selected biochemical parameters in moderately obese women following an exercise program293-306Department of Nutrition, University of Massachusetts, Amherst 01003, USA. volpe@nutrition.umass.eduVolpe, S. L.Huang, H. W.Larpadisorn, K.Lesser,, IIJ Am Coll NutrAdult*Basal MetabolismBlood Glucose/analysisBlood Proteins/metabolism*Body CompositionC-Peptide/bloodCholesterol/bloodChromium/*administration & dosage/blood/urineDietDietary SupplementsDouble-Blind Method*ExerciseFastingFemaleGlucagon/bloodHumanInsulin/bloodIron/blood/urineLipids/bloodMiddle AgeObesity/*therapyPatient CompliancePlacebosSupport, Non-U.S. Gov'tSupport, U.S. Gov't, Non-P.H.S.Zinc/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11506057Hallmark19962354087753662811996JanEffects of chromium and resistive training on muscle strength and body composition139-44Department of Kinesiology, University of Maryland, College Park, USA.Hallmark, M. A.Reynolds, T. H.DeSouza, C. A.Dotson, C. O.Anderson, R. A.Rogers, M. A.Med Sci Sports ExercAdult*Body CompositionChromium/*pharmacologyDouble-Blind MethodHumanMaleMuscle, Skeletal/*drug effectsWeight Lifting/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8775366Lukaski19962353086446936361996JunChromium supplementation and resistance training: effects on body composition, strength, and trace element status of men954-65US Department of Agriculture, Agricultural Research Service, Grand Forks Human Nutrition Research Center, ND, USA.Lukaski, H. C.Bolonchuk, W. W.Siders, W. A.Milne, D. B.Am J Clin NutrAdultAnthropometryBody Composition/*drug effects/physiologyCeruloplasmin/analysisChromium/administration & dosage/blood/*pharmacologyCopper/bloodDensitometry, X-RayDouble-Blind MethodExercise/*physiologyFerritin/bloodFood, FortifiedHumanMaleMuscle Contraction/*drug effects/physiologyMuscle, Skeletal/drug effects/physiologyPatient ComplianceTrace Elements/*bloodZinc/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8644693Clancy1994235508054959421994JunEffects of chromium picolinate supplementation on body composition, strength, and urinary chromium loss in football players142-53Department of Exercise Science, University of Massachusetts, Amherst 01003.Clancy, S. P.Clarkson, P. M.DeCheke, M. E.Nosaka, K.Freedson, P. S.Cunningham, J. J.Valentine, B.Int J Sport NutrAdultAnthropometryBody Composition/*drug effectsChromium/*urineDietFootball/*physiologyHumanMaleMuscles/*drug effects/physiologyPhysical Education and TrainingPicolinic Acids/*pharmacologySupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8054959[140-146]. For example, Walker and colleagues  ADDIN EN.CITE Walker199823500986160730121998DecChromium picolinate effects on body composition and muscular performance in wrestlers1730-7Department of Health & Sport Sciences, University of Oklahoma, Norman, USA.Walker, L. S.Bemben, M. G.Bemben, D. A.Knehans, A. W.Med Sci Sports ExercAdolescentAdultAnaerobic Threshold/drug effectsAnalysis of VarianceBlood Glucose/analysisBody Composition/*drug effectsDiet*Dietary SupplementsDouble-Blind MethodEnergy Metabolism/drug effectsFollow-Up StudiesHumanInsulin/bloodMaleMuscle Contraction/drug effectsMuscle, Skeletal/*drug effects/metabolismOxygen Consumption/drug effectsPhysical Endurance/drug effectsPicolinic Acids/administration & dosage/*therapeutic usePlacebosRunning/physiologySupport, Non-U.S. Gov'tWeight Lifting/physiologyWrestling/education/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9861607[141] reported that chromium supplementation (200 (g/d for 14-weeks) did not affect body composition alterations during training in healthy wrestlers. Likewise, Lukaski et al  ADDIN EN.CITE Lukaski19962353086446936361996JunChromium supplementation and resistance training: effects on body composition, strength, and trace element status of men954-65US Department of Agriculture, Agricultural Research Service, Grand Forks Human Nutrition Research Center, ND, USA.Lukaski, H. C.Bolonchuk, W. W.Siders, W. A.Milne, D. B.Am J Clin NutrAdultAnthropometryBody Composition/*drug effects/physiologyCeruloplasmin/analysisChromium/administration & dosage/blood/*pharmacologyCopper/bloodDensitometry, X-RayDouble-Blind MethodExercise/*physiologyFerritin/bloodFood, FortifiedHumanMaleMuscle Contraction/*drug effects/physiologyMuscle, Skeletal/drug effects/physiologyPatient ComplianceTrace Elements/*bloodZinc/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8644693[145] reported that 8-weeks of chromium supplementation during resistance training did not affect strength or DEXA determined body composition changes. Therefore, chromium supplementation does not appear to promote fat loss. Conjugated Linoleic Acids (CLA). CLA is a term used to describe a group of positional and geometric isomers of linoleic acid that contain conjugated double bonds. Adding CLA to the diet has been reported to possess significant health benefits in animals  ADDIN EN.CITE Pariza19992375010630598522 Suppl1999DecConjugated linoleic acid and the control of cancer and obesity107-10Food Research Institute, Department of Food Microbiology and Toxicology, University of Wisconsin-Madison, 53706-1187, USA. mwpariza@facstaff.wisc.eduPariza, M. W.Park, Y.Cook, M. E.Toxicol SciAnimalLinoleic Acid/chemistry/*pharmacologyModels, MolecularNeoplasms, Experimental/*prevention & controlProtein Structure, Secondaryhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10630598MacDonald200027370http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10759137MacDonald, H. B.Conjugated linoleic acid and disease prevention: a review of current knowledgeAnimal*AntioxidantsArteriosclerosis/*prevention & controlDairy Products/analysisHumanImmunityLinoleic Acid/analysis/*therapeutic useMeat/analysisNeoplasms/*prevention & controlDairy Farmers of Canada, Montreal, Quebec.10759137J Am Coll Nutr2000192 Suppl111S-118S.[147, 274]. In terms of weight loss, CLA feedings to animals have been reported to markedly decrease body fat accumulation  ADDIN EN.CITE Pariza2000237601063295622312000JanMechanisms of action of conjugated linoleic acid: evidence and speculation8-13Food Research Institute, Department of Food Microbiology, University of Wisconsin-Madison, 53706, USA. mwpariza@facstaff.wisc.eduPariza, M. W.Park, Y.Cook, M. E.Proc Soc Exp Biol MedAnimalAnticarcinogenic AgentsArteriosclerosis/prevention & controlBody Composition/drug effectsDrug DesignLinoleic Acids/chemistry/*pharmacologyMolecular ConformationRatsSupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10632956Pariza19992375010630598522 Suppl1999DecConjugated linoleic acid and the control of cancer and obesity107-10Food Research Institute, Department of Food Microbiology and Toxicology, University of Wisconsin-Madison, 53706-1187, USA. mwpariza@facstaff.wisc.eduPariza, M. W.Park, Y.Cook, M. E.Toxicol SciAnimalLinoleic Acid/chemistry/*pharmacologyModels, MolecularNeoplasms, Experimental/*prevention & controlProtein Structure, Secondaryhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10630598Park19972374092709773281997AugEffect of conjugated linoleic acid on body composition in mice853-8Department of Food Microbiology and Toxicology, University of Wisconsin-Madison 53706, USA.Park, Y.Albright, K. J.Liu, W.Storkson, J. M.Cook, M. E.Pariza, M. W.Lipids3T3 CellsAdipocytes/enzymologyAdipose Tissue/enzymologyAnimalBody Composition/*drug effectsBody Weight/drug effectsCarnitine O-Palmitoyltransferase/metabolismCorn Oil/administration & dosageDietDietary Fats/administration & dosage/*pharmacologyFemaleGlycerol/metabolismLinoleic Acids/administration & dosage/*pharmacologyLipolysis/drug effectsLipoprotein Lipase/antagonists & inhibitorsLiver/enzymologyMaleMiceMice, Inbred ICRMuscles/enzymologySupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9270977[147, 148, 152]. Consequently, CLA has been marketed as a health and weight loss supplement since the mid 1990s. Although basic research in animals is very promising, the effect of CLA supplementation in humans is less clear. There are some data suggesting that CLA supplementation may modestly promote fat loss and/or increases in lean mass  ADDIN EN.CITE Lowery199827450Lowery, L.M.Appicelli, P.A.Lemon. P.W.R.1998Conjugated linoleic acid enhances muscle size and strength gains in novice bodybuildersMed Sci Sports Exerc305S182Riserus200127440http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11477497Riserus, U.Berglund, L.Vessby, B.Conjugated linoleic acid (CLA) reduced abdominal adipose tissue in obese middle-aged men with signs of the metabolic syndrome: a randomised controlled trialAdipose Tissue/*anatomy & histologyAdultBlood Glucose/analysisBody Constitution/*physiologyCardiovascular Diseases/*diet therapy/prevention & controlHumanInsulin/bloodLinoleic Acid/*administration & dosage/therapeutic useLipids/bloodMaleMiddle AgeObesity/blood/*diet therapy/physiopathologyRisk FactorsSupport, Non-U.S. Gov'tClinical Nutrition Research Unit, Department of Public Health and Caring Sciences/Geriatrics, Faculty of Medicine, Uppsala University, Uppsala, Sweden. ulf.riserus@geriatrik.uu.se11477497Int J Obes Relat Metab Disord20012581129-35.Riserus200227430http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12196420Riserus, U.Arner, P.Brismar, K.Vessby, B.Treatment with dietary trans10cis12 conjugated linoleic acid causes isomer-specific insulin resistance in obese men with the metabolic syndromeAdultAgedBody CompositionDouble-Blind MethodHumanHyperlipidemia/*chemically induced*Insulin ResistanceIsomerismLeptin/bloodLinoleic Acid/*adverse effects/chemistryLipoproteins/bloodMaleMetabolic Syndrome X/*drug therapyMiddle AgeObesity in Diabetes/*drug therapySupport, Non-U.S. Gov'tDepartment of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden. ulf.riserus@pubcare.uu.se12196420Diabetes Care20022591516-21.Riserus200227420http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12370214Riserus, U.Basu, S.Jovinge, S.Fredrikson, G. N.Arnlov, J.Vessby, B.Supplementation with conjugated linoleic acid causes isomer-dependent oxidative stress and elevated C-reactive protein: a potential link to fatty acid-induced insulin resistanceAdultAgedAnti-Obesity Agents/chemistry/*pharmacologyBiological Markers/analysisBlood Glucose/analysisC-Reactive Protein/*analysisCytokines/analysisDouble-Blind MethodF2-Isoprostanes/analysisHumanInflammation/metabolismInsulin ResistanceIsomerismKineticsLinoleic Acids/chemistry/*pharmacologyLipid PeroxidationLipoproteins, VLDL/analysisMaleMetabolic Syndrome X/blood/drug therapy/*metabolismMiddle Age*Oxidative StressSupport, Non-U.S. Gov'tTriglycerides/analysisDepartment of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden. ulf.riserus@pubcare.uu.se12370214Circulation2002106151925-9.Blankson200027410http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11110851Blankson, H.Stakkestad, J. A.Fagertun, H.Thom, E.Wadstein, J.Gudmundsen, O.Conjugated linoleic acid reduces body fat mass in overweight and obese humansAdipose Tissue/*drug effectsAdultAgedBody Composition/*drug effectsDensitometry, X-RayDose-Response Relationship, DrugDouble-Blind MethodFemaleHumanLinoleic Acid/administration & dosage/*pharmacologyMaleMiddle AgeObesity/*drug therapy/prevention & controlQuestionnairesSupport, Non-U.S. Gov'tScandinavian Clinical Research AS, N-2027 Kjeller, Norway.11110851J Nutr2000130122943-8.Thom200127400http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11725826Thom, E.Wadstein, J.Gudmundsen, O.Conjugated linoleic acid reduces body fat in healthy exercising humansAdipose Tissue/*anatomy & histology/drug effectsAdultBody ConstitutionBody Weight/*physiologyComparative StudyExercise/*physiologyFemaleHumanLinoleic Acid/*pharmacologyMalePlacebosReference ValuesSupport, Non-U.S. Gov'tPAREXEL Norway AS, 1 Lillestrom. erling.thom@parexel.com11725826 abstract.J Int Med Res2001295392-6.[275-280]. However, other studies indicate that CLA supplementation (1.7 to 12 g/d for 4-weeks to 6-months) has limited to no effects on body composition alterations in untrained or trained populations  ADDIN EN.CITE Von Loeffelholz199927473Von Loeffelholz, C.Von Loeffelholz, B.A.Von Loeffelholz, B.Jahreis, G.1999Influence of conjugated linoleic acid (CLA) supplementation on body composition and strength in bodybuildersSymposium: Vitamine und ZusatzstoffeJena (Thhr.)7238-243Beuker199927463Beuker, F.Haak, H.Schwietz, H.1999CLA and body stylingSymposium: Vitamine und ZusatzstoffeJena (Thhr.)7229-237Lowery199827450Lowery, L.M.Appicelli, P.A.Lemon. P.W.R.1998Conjugated linoleic acid enhances muscle size and strength gains in novice bodybuildersMed Sci Sports Exerc305S182Blankson200027410http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11110851Blankson, H.Stakkestad, J. A.Fagertun, H.Thom, E.Wadstein, J.Gudmundsen, O.Conjugated linoleic acid reduces body fat mass in overweight and obese humansAdipose Tissue/*drug effectsAdultAgedBody Composition/*drug effectsDensitometry, X-RayDose-Response Relationship, DrugDouble-Blind MethodFemaleHumanLinoleic Acid/administration & dosage/*pharmacologyMaleMiddle AgeObesity/*drug therapy/prevention & controlQuestionnairesSupport, Non-U.S. Gov'tScandinavian Clinical Research AS, N-2027 Kjeller, Norway.11110851J Nutr2000130122943-8.Zambell200023730109418793572000JulConjugated linoleic acid supplementation in humans: effects on body composition and energy expenditure777-82U.S. Department of Agriculture/Western Human Nutrition Research Center, University of California, Davis 95616, USA.Zambell, K. L.Keim, N. L.Van Loan, M. D.Gale, B.Benito, P.Kelley, D. S.Nelson, G. J.LipidsAdultBody Composition/*drug effectsBody Weight/drug effectsCalorimetryCapsulesDietary SupplementsEnergy Metabolism/*drug effectsFemaleHumanLinoleic Acids/administration & dosage/*pharmacologyPlacebosPlant Oilshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10941879Medina200027480http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10941880Medina, E. A.Horn, W. F.Keim, N. L.Havel, P. J.Benito, P.Kelley, D. S.Nelson, G. J.Erickson, K. L.Conjugated linoleic acid supplementation in humans: effects on circulating leptin concentrations and appetiteAdipose Tissue/anatomy & histologyAdultAppetite/*drug effectsBlood Glucose/metabolismDietary SupplementsFemaleHumanInsulin/bloodLactates/bloodLeptin/*bloodLinoleic Acids/administration & dosage/*pharmacologySupport, Non-U.S. Gov'tSupport, U.S. Gov't, Non-P.H.S.Support, U.S. Gov't, P.H.S.Department of Cell Biology and Human Anatomy, School of Medicine, University of California, Davis 95616, USA.10941880Lipids2000357783-8.Kreider200223850121739451632002AugEffects of conjugated linoleic acid supplementation during resistance training on body composition, bone density, strength, and selected hematological markers325-34Exercise and Sport Nutrition Laboratory, Department of Human Movement Sciences and Education, University of Memphis, Tennessee 38152, USA. richard_kreider@baylor.eduKreider, R. B.Ferreira, M. P.Greenwood, M.Wilson, M.Almada, A. L.J Strength Cond ResAdultBlood Cell Count*Blood Chemical AnalysisBody Composition/*drug effectsBone Density/*drug effectsDensitometry, X-Ray*Dietary SupplementsDouble-Blind MethodExercise/*physiologyHumanMaleMuscle ContractionMuscle, Skeletal/*physiologyPhysical FitnessSupport, Non-U.S. Gov'tWeight Liftingalpha-Linolenic Acid/adverse effects/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12173945[155, 156, 275, 279, 281-283]. The reason for the discrepancy in research findings has been suggested to be due to differences in purity and the specific isomer studied. For instance, early studies in humans showing no effect used CLA that contained all 24 isomers. Today, most labs studying CLA use 50-50 mixtures containing the trans-10,cis-12 and cis-9,trans-11 isomers, the former of which being recently implicated in positively altering body composition. In our view, although CLA supplementation may have promise to promote general health, additional research is needed to determine if specific isomers of CLA may affects body composition in humans before conclusions can be made. Garcinia Cambogia (HCA). HCA is a nutrient that has been hypothesized to increase fat oxidation by inhibiting citrate lyase and lipogenesis  ADDIN EN.CITE Jena200224780117545365012002Jan 2Chemistry and biochemistry of (-)-hydroxycitric acid from Garcinia10-22Human Resource Development, Central Food Technological Research Institute, Mysore 570 013, India.Jena, B. S.Jayaprakasha, G. K.Singh, R. P.Sakariah, K. K.J Agric Food ChemAnimalAnti-Obesity Agents/chemistry/metabolism/pharmacologyCitrates/*chemistry/*metabolism/pharmacologyClusiaceae/*chemistryEnergy Intake/drug effectsEnzyme Inhibitors/chemistry/metabolism/pharmacologyFruit/chemistryHumanLipids/*metabolismWeight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11754536[284]. Theoretically, this may lead to greater fat burning and weight loss over time. Although there is some evidence that HCA may increase fat metabolism in animal studies, there is little to no evidence showing that HCA supplementation affects body composition in humans. For example, Ishihara et al  ADDIN EN.CITE Ishihara20002484011110858130122000DecChronic (-)-hydroxycitrate administration spares carbohydrate utilization and promotes lipid oxidation during exercise in mice2990-5Laboratory of Nutrition Chemistry, Division of Applied Life Sciences, Graduate School of Agriculture, Kyoto University, Kyoto 606-8502, Japan.Ishihara, K.Oyaizu, S.Onuki, K.Lim, K.Fushiki, T.J NutrAdministration, OralAnimalAnti-Obesity Agents/administration & dosage/*pharmacologyBasal Metabolism/drug effectsCarbohydrates/*metabolismCitrates/administration & dosage/*pharmacologyComparative StudyDietary SupplementsEnergy Metabolism/drug effectsFatty Acids, Nonesterified/analysisFruit/chemistryGlycogen/analysisLipids/*metabolismMaleMiceMuscle, Skeletal/metabolismOxygen Consumption/*drug effectsPhysical Endurance/*drug effectsRunningSwimmingTime Factorshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11110858[285] reported that HCA supplementation spared carbohydrate utilization and promoted lipid oxidation during exercise in mice. However, Kriketos and associates  ADDIN EN.CITE Kriketos199924850104907892381999Aug(-)-Hydroxycitric acid does not affect energy expenditure and substrate oxidation in adult males in a post-absorptive state867-73Center for Human Nutrition, University of Colorado Health Sciences Center, Denver 80262, USA.Kriketos, A. D.Thompson, H. R.Greene, H.Hill, J. O.Int J Obes Relat Metab DisordAdipose Tissue/metabolismAdultAnti-Obesity Agents/*pharmacologyCitrates/*pharmacologyCross-Over StudiesDouble-Blind MethodEnergy Metabolism/*drug effectsExerciseFastingHumanMaleObesity/enzymology/*metabolismOxidation-Reductionhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10490789[286] reported that HCA supplementation (3 g/d for 3-days) did not affect resting or post-exercise energy expenditure or markers of lipolysis in healthy men. Likewise, Heymsfield and coworkers  ADDIN EN.CITE Heymsfield1998248309820262280181998Nov 11Garcinia cambogia (hydroxycitric acid) as a potential antiobesity agent: a randomized controlled trial1596-600Department of Medicine, Obesity Research Center, St Luke's-Roosevelt Hospital, Columbia University College of Physicians and Surgeons, New York, NY 10025, USA. sbh2@columbia.eduHeymsfield, S. B.Allison, D. B.Vasselli, J. R.Pietrobelli, A.Greenfield, D.Nunez, C.JamaAdultAnti-Obesity Agents/*therapeutic useBody CompositionBody Mass IndexCitrates/*therapeutic useDouble-Blind MethodFemaleHumanMaleObesity/drug therapyPlant Extracts/*therapeutic useSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Weight Losshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9820262[287] reported that HCA supplementation (1.5 g/d for 12-weeks) while maintaining a low fat/high fiber diet did not promote greater weight or fat loss than subjects on placebo. Finally, Mattes and colleagues  ADDIN EN.CITE Mattes20002479011134690711-22000Oct 1-15Effects of (-)-hydroxycitric acid on appetitive variables87-94Department of foods and Nutrition, Purdue University, 212 Stone Hall, West Lafayette, IN 47907-1264, USA. mattesr@cfs.purdue.eduMattes, R. D.Bormann, L.Physiol BehavAdolescentAdultAgedAnti-Obesity Agents/*pharmacologyAppetite/*drug effectsBody Composition/drug effectsBody Weight/drug effectsCitrates/*pharmacologyDouble-Blind MethodEating/drug effects/physiology/psychologyEnergy Metabolism/drug effectsFemaleHumanMaleMiddle AgeSupport, Non-U.S. Gov'tWeight Loss/*drug effectshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11134690[288] reported that HCA supplementation (2.4 g/d for 12-weeks) did not affect appetite, energy intake, or weight loss. These findings suggest that HCA supplementation does not appear to promote fat loss in humans. L-Carnitine. Carnitine serves as an important transporter of fatty acids from the cytosol into the mitochondria of the cell. Theoretically, increasing cellular levels of carnitine would thereby enhance transport of fats into the mitochondria and fat metabolism. For this reason, L-carnitine has been one of the most common nutrients found in various weight loss supplements. Over the years, a number of studies have been conducted on the effects of L-carnitine supplementation on fat metabolism, exercise capacity and body composition. Although there is some data showing that L-carnitine supplementation may be beneficial for some patient populations, most well controlled studies indicate that L-carnitine supplementation does not affect muscle carnitine content, fat metabolism, and/or weight loss in overweight or trained subjects  ADDIN EN.CITE Brass200027490http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10919968Brass, E. P.Supplemental carnitine and exerciseCarnitine/administration & dosage/analogs &derivatives/biosynthesis/*metabolism/physiology/urineCoenzyme A/metabolismDietary Supplements/adverse effects/*standardsExercise/*physiologyFatty Acids/metabolismFemaleHumanMaleMuscle Contraction/physiologyMuscle, Skeletal/*metabolism/physiologyOxygen Consumption/physiologyHarbor-UCLA Medical Center, Torrance, CA 90274, USA.10919968Am J Clin Nutr2000722 Suppl618S-23S.[289]. For example, Villani et al  ADDIN EN.CITE Villani200027500http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10861338Villani, R. G.Gannon, J.Self, M.Rich, P. A.L-Carnitine supplementation combined with aerobic training does not promote weight loss in moderately obese womenAdipose Tissue/drug effectsAdultAnalysis of VarianceBasal Metabolism/drug effectsBody CompositionCarnitine/administration & dosage/*therapeutic useDouble-Blind Method*ExerciseFemaleHumanMiddle AgeObesity/drug therapy/*therapyPremenopauseSupport, Non-U.S. Gov'tWalkingWeight Loss/*drug effectsDepartment of Human Biology and Movement Science, Royal Melbourne Institute of Technology, Melbourne, Victoria, 3083, Australia.10861338Int J Sport Nutr Exerc Metab2000102199-207.[290] reported that L-carnitine supplementation (2 g/d for 8-weeks) did not affect weight loss, body composition, or markers of fat metabolism in overweight women. Herbal Diuretics. This is a new type of supplement recently marketed as a natural way to promote weight loss. There is limited evidence that taraxacum officinale, verbena officinalis, lithospermum officinale, equisetum arvense, arctostaphylos uva-ursi, arctium lappa and silene saxifraga infusion may affect diuresis in animals  ADDIN EN.CITE Grases199427510http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=7860196Grases, F.Melero, G.Costa-Bauza, A.Prieto, R.March, J. G.Urolithiasis and phytotherapyAnimalFemale*PhytotherapyRatsRats, WistarUrinary Calculi/*therapyDepartment of Chemistry, University of Balearic Islands, Palma de Mallorca, Spain.78601961994Int Urol Nephrol265507-11Grases199427520http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=7870230Grases, F.Llompart, I.Conte, A.Coll, R.March, J. G.Glycosaminoglycans and oxalocalcic urolithiasisCalcium Oxalate/*metabolismComparative StudyFemaleGlycosaminoglycans/*urineHumanMaleMethylene Blue/analogs & derivativesPhotometry/methodsSupport, Non-U.S. Gov'tUrinary Calculi/chemistry/*urineDepartment of Chemistry, University of Balearic Islands, Palma de Mallorca, Spain.78702301994Nephron684449-53[291, 292]. Two studies presented at the 2001 American College of Sports Medicine meeting  ADDIN EN.CITE Dolan200127530Dolan, R.L.Crosby, E.C.Leutkemeir, M.J.Barton, R.G.Askew, E,W.2001The effects of diuretics on resting metabolic rate and subsequent shifts in respiratory exchange ratiosMed Sci Sports Exerc33S163Crosby200127540Crosby, E.C.Dolan, R.L.Benson, J.E.Leutkemeir, M.J.Barton, R.G.Askew, E.W.2001Herbal diuretic induced dehydration and resting metabolic rateMed Sci Sports Exerc33S163[293, 294] indicated that although herbal diuretics promoted a small amount of dehydration (about 0.3% in one day), they were not nearly as effective as a common diuretic drug (about 3.1% dehydration in one day). Consequently, although more research is needed, the potential value of herbal diuretics as a weight loss supplement appears limited. Performance Enhancement Supplements A number of nutritional supplements have been proposed to enhance exercise performance. Some of these nutrients have been described above. Table 3 categorizes the proposed ergogenic nutrients into apparently safe and effective, possibly effective, too early to tell, and apparently ineffective. Weight gain supplements purported to increase muscle mass may also have ergogenic properties if they also promote increases in strength. Similarly, some sports may benefit from reductions in fat mass. Therefore, weight loss supplements that help athletes manage body weight and/or fat mass may also posses some ergogenic benefit. The following describes which supplements may or may not affect performance that were not previously described. Based on this analysis, Table 4 summarizes the general nutritional recommendations for athletes and which dietary supplements may help power and endurance athletes. Apparently Effective Water and Sports Drinks. Preventing dehydration during exercise is one of the keys of maintaining exercise performance (particularly in hot/humid environments). People engaged in intense exercise or work in the heat need to frequently ingest water or sports drinks (e.g., 1-2 cups every 10 15 minutes). The goal should be not to lose more than 2% of body weight during exercise (e.g., 180 lbs x 0.02 = 3.6 lbs). Sports drinks contain salt and carbohydrate. Studies show that ingestion of sports drinks during exercise in hot/humid environments can help prevent dehydration and improve endurance exercise capacity  ADDIN EN.CITE Burke200127560http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11282317Burke, L. M.Nutritional needs for exercise in the heatBody WaterCarbohydrates/pharmacokineticsDehydration*Drinking*ExerciseGlycogen/metabolism*HeatHumanMuscle, Skeletal/metabolism*NutritionNutrition PolicySportsDepartment of Sports Nutrition, Australian Institute of Sport, Leverrier Crescent, ACT, 2616, Bruce, Australia. louisse.burke@ausport.gov.au11282317Comp Biochem Physiol A Mol Integr Physiol20011284735-48.[295]. Consequently, frequent ingestion of water and/or sports drinks during exercise is one of the easiest and most effective ergogenic aids. Carbohydrate. General nutritional needs were discussed earlier. However, one of the best ergogenic aids available for active people is carbohydrate. Athletes and active individuals should consume a diet high in carbohydrate (e.g., 55 65% of calories or 5-8 grams/kg/day) in order to maintain muscle and liver carbohydrate stores  ADDIN EN.CITE Leutholtz200116077Leutholtz, B. Kreider, R.B.2001Exercise and Sport Nutrition.Wilson, T.Temple, N.Nutritional Health.Totowa, NJHumana Press, Inc.207 – 239[9]. Additionally, ingesting a small amount of carbohydrate and protein 30-60 minutes prior to exercise and use of sports drinks during exercise can increase carbohydrate availability and improve exercise performance. Finally, ingesting carbohydrate and protein immediately following exercise can enhance carbohydrate storage and protein synthesis  ADDIN EN.CITE Leutholtz200116077Leutholtz, B. Kreider, R.B.2001Exercise and Sport Nutrition.Wilson, T.Temple, N.Nutritional Health.Totowa, NJHumana Press, Inc.207 – 239[9]. Creatine. Earlier we indicated that creatine supplementation is one of the best supplements available to increase muscle mass and strength during training. However, creatine has also been reported to improve exercise capacity in a variety of events  ADDIN EN.CITE Kreider200321180127018152441-22003FebEffects of creatine supplementation on performance and training adaptations89-94Exercise and Sport Nutrition Laboratory, Center for Exercise, Nutrition and Preventive Health Research, Department of Health, Human Performance and Recreation, Baylor University, Waco, TX 76798-7313, USA. Richard_Kreider@baylor.eduKreider, R. B.Mol Cell Biochemhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12701815[62]. This is particularly true when performing high intensity, intermittent exercise such as multiple sets of weight lifting, repeated sprints, and/or exercise involving sprinting and jogging (e.g., soccer)  ADDIN EN.CITE Kreider200321180127018152441-22003FebEffects of creatine supplementation on performance and training adaptations89-94Exercise and Sport Nutrition Laboratory, Center for Exercise, Nutrition and Preventive Health Research, Department of Health, Human Performance and Recreation, Baylor University, Waco, TX 76798-7313, USA. Richard_Kreider@baylor.eduKreider, R. B.Mol Cell Biochemhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12701815[62]. Although studies evaluating the ergogenic value of creatine on endurance exercise performance are mixed, endurance athletes may also theoretically benefit in several ways. For example, increasing creatine stores prior to carbohydrate loading (i.e., increasing dietary carbohydrate intake before competition in an attempt to maximize carbohydrate stores) has been shown to improve the ability to store carbohydrate  ADDIN EN.CITE Derave200112850Derave, W. Op'T Eijinde, B. Richter, E.A. Hespel, P.2001Combined creatine and protein supplementation improves glucose tolerance and muscle glycogen accumulation in humans.Abstracts of 6th Internationl Conference on Guanidino Compounds in Biology and MedicineSeptember 3, 2001Nelson200117000http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11445755Nelson, A. G.Arnall, D. A.Kokkonen, J.Day,Evans, J.Muscle glycogen supercompensation is enhanced by prior creatine supplementationDepartment of Kinesiology, Louisiana State University, Baton Rouge, LA 70803; Department of Physical Therapy, Northern Arizona University, Flagstaff, AZ 86011; Division of Physical Education and Division of Math and Science, Brigham Young University-Hawaii, Laie, HI 96762.11445755Med Sci Sports Exerc20013371096-1100.Op 't Eijnde200117270http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11147785Op 't Eijnde, B.Urso, B.Richter, E. A.Greenhaff, P. L.Hespel, P.Effect of oral creatine supplementation on human muscle GLUT4 protein content after immobilizationAdministration, OralAdultCasts, SurgicalCreatine/metabolism/*pharmacologyDouble-Blind MethodFemaleGlycogen/metabolismHuman*Immobilization/adverse effectsLegMaleMonosaccharide Transport Proteins/*metabolismMuscle, Skeletal/drug effects/*metabolismMuscular Atrophy/etiology/rehabilitationPhysical Education and TrainingSupport, Non-U.S. Gov'tWeight LiftingFaculty of Physical Education and Physiotherapy, Exercise Physiology and Biomechanics Laboratory, Katholieke Universiteit Leuven, Belgium.11147785Diabetes200150118-23.[296-298]. Further, coingesting creatine with carbohydrate has been shown to optimize creatine and carbohydrate loading  ADDIN EN.CITE Green199613610http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=8944667Green, A. L.Hultman, E.Macdonald, I. A.Sewell, D. A.Greenhaff, P. L.Carbohydrate ingestion augments skeletal muscle creatine accumulation during creatine supplementation in humansAdenosine Diphosphate/metabolismAdenosine Triphosphate/metabolismAdministration, OralAdultAnalysis of VarianceCreatine/administration & dosage/*metabolism/pharmacokinetics*Dietary CarbohydratesFood, FortifiedHumanMaleMuscle, Skeletal/*metabolismPhosphocreatine/metabolismReference ValuesSupport, Non-U.S. Gov'tDepartment of Physiology and Pharmacology, University Medical School, Queen's Medical Center, Nottingham, United Kingdom.8944667Am J Physiol19962715 Pt 1E821-6.[299]. Most endurance athletes also perform interval training (sprint or speed work) in an attempt to improve anaerobic threshold. Since creatine has been reported to enhance interval sprint performance, creatine supplementation during training may improve training adaptations in endurance athletes  ADDIN EN.CITE Nelson200017020http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11072779Nelson, A. G.Day, R.Glickman-Weiss, E. L.Hegsted, M.Kokkonen, J.Sampson, B.Creatine supplementation alters the response to a graded cycle ergometer testAdultCreatine/*administration & dosageExercise/*physiologyExercise Test/methodsFemaleHeart Rate/drug effectsHumanMaleOxygen Consumption/drug effectsRespiration/drug effectsDepartment of Kinesiology, Louisiana State University, Baton Rouge 70803, USA. anelso@lsu.edu11072779Eur J Appl Physiol200083189-94.Nelson199717030Nelson, A. G.Day, R. Glickman-Weiss, E. L.Hegsted, M.Sampson, B.1997Creatine supplementation raises anaerobic threshold.FASEB Journal11A5891997[300, 301]. Finally, many endurance athletes lose weight during their competitive season. Creatine supplementation during training may help people maintain weight. Sodium Phosphate. We previously mentioned that sodium phosphate supplementation may increase resting energy expenditure and therefore could serve as a potential weight loss nutrient. However, most research on sodium phosphate has actually evaluated the potential ergogenic value. A number of studies indicated that sodium phosphate supplementation (e.g., 1 gram taken 4 times daily for 3-6 days) can increase maximal oxygen uptake (i.e., maximal aerobic capacity) and anaerobic threshold by 5-10%  ADDIN EN.CITE Kreider199027610http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=2355823Kreider, R. B.Miller, G. W.Williams, M. H.Somma, C. T.Nasser, T. A.Effects of phosphate loading on oxygen uptake, ventilatory anaerobic threshold, and run performanceAnaerobic Threshold/*drug effectsErythrocytes/metabolismGlycolysis/drug effectsHumanOxygen Consumption/*drug effectsPhosphates/metabolism/*pharmacologyRespiration/*drug effects*RunningSupport, Non-U.S. Gov'tDepartment of Health, Physical Education and Recreation, Human Performance Laboratory, Old Dominion University, Norfolk, VA 23529-0196.2355823Med Sci Sports Exerc1990222250-6.Cade198427600Cade, R.Conte, M.Zauner, C.Mars, D.Peterson, J.Lunne, D.Hommen, N.Packer, D.1984Effects of phosphate loading on 2,3 diphosphoglycerate and maximal oxygen uptakeMed Sci Sports Exerc16263-268Kreider199227570http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=1299483Kreider, R. B.Miller, G. W.Schenck, D.Cortes, C. W.Miriel, V.Somma, C. T.Rowland, P.Turner, C.Hill, D.Effects of phosphate loading on metabolic and myocardial responses to maximal and endurance exerciseAdultBicyclingDouble-Blind MethodEchocardiographyExercise/*physiologyHeart/drug effects/*physiologyHematocritHemodynamicsHemoglobins/metabolismHumanMaleMetabolism/*drug effectsOxygen ConsumptionPhosphates/*administration & dosage/blood/pharmacologyPhysical Endurance/*physiologyPlacebosRandom AllocationDept. of HPER, Old Dominion University, Norfolk, VA 23529-0196.1299483Int J Sport Nutr19922120-47.Kreider199027610http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=2355823Kreider, R. B.Miller, G. W.Williams, M. H.Somma, C. T.Nasser, T. A.Effects of phosphate loading on oxygen uptake, ventilatory anaerobic threshold, and run performanceAnaerobic Threshold/*drug effectsErythrocytes/metabolismGlycolysis/drug effectsHumanOxygen Consumption/*drug effectsPhosphates/metabolism/*pharmacologyRespiration/*drug effects*RunningSupport, Non-U.S. Gov'tDepartment of Health, Physical Education and Recreation, Human Performance Laboratory, Old Dominion University, Norfolk, VA 23529-0196.2355823Med Sci Sports Exerc1990222250-6.Cade198427600Cade, R.Conte, M.Zauner, C.Mars, D.Peterson, J.Lunne, D.Hommen, N.Packer, D.1984Effects of phosphate loading on 2,3 diphosphoglycerate and maximal oxygen uptakeMed Sci Sports Exerc16263-268Kreider199227570http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=1299483Kreider, R. B.Miller, G. W.Schenck, D.Cortes, C. W.Miriel, V.Somma, C. T.Rowland, P.Turner, C.Hill, D.Effects of phosphate loading on metabolic and myocardial responses to maximal and endurance exerciseAdultBicyclingDouble-Blind MethodEchocardiographyExercise/*physiologyHeart/drug effects/*physiologyHematocritHemodynamicsHemoglobins/metabolismHumanMaleMetabolism/*drug effectsOxygen ConsumptionPhosphates/*administration & dosage/blood/pharmacologyPhysical Endurance/*physiologyPlacebosRandom AllocationDept. of HPER, Old Dominion University, Norfolk, VA 23529-0196.1299483Int J Sport Nutr19922120-47.Stewart199027620Stewart, I.McNaughton, L.Davies, P.Tristram, S.1990Phosphate loading and the effects of VO2max in trained cyclistsRes Quart6180-84[227, 228, 302, 303]. These finding suggest that sodium phosphate may be highly effective in improving endurance exercise capacity. Other forms of phosphate (i.e., calcium phosphate, potassium phosphate) do not appear to possess ergogenic value. Sodium Bicarbonate (Baking Soda). During high intensity exercise, acid (H+) and carbon dioxide (CO2) accumulate in the muscle and blood. One of the ways you get rid of the acidity and CO2 is to buffer the acid and CO2 with bicarbonate ions. The acid and CO2 are then removed in the lungs. Bicarbonate loading (e.g., 0.3 grams per kg taken 60-90 minutes prior to exercise or 5 grams taken 2 times per day for 5-days) has been shown to be an effective way to buffer acidity during high intensity exercise lasting 1-3 minutes in duration  ADDIN EN.CITE McNaughton199927640http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10483803McNaughton, L.Backx, K.Palmer, G.Strange, N.Effects of chronic bicarbonate ingestion on the performance of high- intensity workAcid-Base Equilibrium/drug effectsAdultAnaerobic Threshold/*drug effectsBicarbonates/*pharmacologyBlood Gas AnalysisElectrolytes/bloodExercise/*physiologyExercise TestHumanHydrogen-Ion ConcentrationLactic Acid/bloodOxygen Consumption/drug effectsSupport, Non-U.S. Gov'tSports Science, Kingston University, Kingston upon Thames, Surrey, UK.10483803Eur J Appl Physiol Occup Physiol1999804333-6.Applegate199927650http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10362455Applegate, E.Effective nutritional ergogenic aidsAmino Acids/administration & dosageAntioxidants/administration & dosageCaffeine/administration & dosageCreatine/administration & dosageDietary Carbohydrates/administration & dosageDietary Proteins/administration & dosage*Dietary Supplements*Energy MetabolismExercise/*physiologyHumanSodium Bicarbonate/administration & dosageNutrition Department, University of California - Davis, 1 Shields Avenue, Davis, CA 95616, USA.10362455Int J Sport Nutr199992229-39.Kronfeld199427660http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=7996286Kronfeld, D. S.Ferrante, P. L.Grandjean, D.Optimal nutrition for athletic performance, with emphasis on fat adaptation in dogs and horsesAdaptation, PhysiologicalAnimal*Animal NutritionDietary Fats/*administration & dosageDogs/*physiologyGlycogen/metabolismHorses/*physiologyHumanLactates/blood*Physical Conditioning, AnimalSportsSupport, Non-U.S. Gov'tDepartment of Animal Science, Virginia Polytechnic Institute and State University, Blacksburg 24061-0306.7996286J Nutr199412412 Suppl2745S-2753S.Kraemer199527670http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=8605517Kraemer, W. J.Gordon, S. E.Lynch, J. M.Pop, M. E.Clark, K. L.Effects of multibuffer supplementation on acid-base balance and 2,3- diphosphoglycerate following repetitive anaerobic exercise2,3-Diphosphoglycerate*Acid-Base EquilibriumAdultAnaerobiosisBicarbonates/*administration & dosageBicyclingBuffersCarnosine/*administration & dosageDiphosphoglyceric Acids/*bloodExercise/*physiologyHumanMalePhosphates/*administration & dosageSupport, Non-U.S. Gov'tCenter for Sports Medicine, Pennsylvania State University, University Park 16802, USA.8605517Int J Sport Nutr199554300-14.[304-307]. This can improve exercise capacity in events like the 400 - 800 m run or 100 200 m swim  ADDIN EN.CITE Matson1993308408388767311993MarEffects of sodium bicarbonate ingestion on anaerobic performance: a meta-analytic review2-28School of Kinesiology & Physical Education, University of Northern Colorado, Greeley 80639.Matson, L. G.Tran, Z. V.Int J Sport NutrAnaerobiosisBicarbonates/administration & dosage/blood/*pharmacologyExercise/*physiologyHumanHydrogen-Ion ConcentrationLactates/bloodLactic AcidSodium/administration & dosage/*pharmacologySodium Bicarbonatehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8388767[308]. Although bicarbonate loading can improve exercise, some people have difficulty with their stomach tolerating bicarbonate as it may cause gastrointestinal distress. Caffeine. Caffeine is a naturally derived stimulant found in many nutritional supplements typically as Gaurana, Bissey Nut, or Kola. Caffeine can also be found in coffee, tea, soft drinks, energy drinks, and chocolate. Studies indicate that ingestion of caffeine (e.g., 3-9 mg/kg taken 30 90 minutes before exercise) can spare carbohydrate use during exercise and thereby improve endurance exercise capacity  ADDIN EN.CITE Graham200127680http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11897887Graham, T. E.Caffeine, coffee and ephedrine: impact on exercise performance and metabolismCaffeine/metabolism/*pharmacology*Coffee/metabolismDietary SupplementsEnergy Metabolism*Exercise/physiologyHumanOxygen ConsumptionSupport, Non-U.S. Gov'tDepartment of Human Biology and Nutritional Sciences, University of Guelph Guelph, ON.11897887Can J Appl Physiol200126SupplS103-19.Applegate199927690http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10362455Applegate, E.Effective nutritional ergogenic aidsAmino Acids/administration & dosageAntioxidants/administration & dosageCaffeine/administration & dosageCreatine/administration & dosageDietary Carbohydrates/administration & dosageDietary Proteins/administration & dosage*Dietary Supplements*Energy MetabolismExercise/*physiologyHumanSodium Bicarbonate/administration & dosageNutrition Department, University of California - Davis, 1 Shields Avenue, Davis, CA 95616, USA.10362455Int J Sport Nutr199992229-39.[305, 309]. People who drink caffeinated drinks regularly, however, appear to experience less ergogenic benefits from caffeine  ADDIN EN.CITE Tarnopolsky198927700http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=2674593Tarnopolsky, M. A.Atkinson, S. A.MacDougall, J. D.Sale, D. G.Sutton, J. R.Physiological responses to caffeine during endurance running in habitual caffeine usersAdultCaffeine/administration & dosage/*pharmacologyFood HabitsHumanLegMaleMuscles/drug effectsPhysical Endurance/*drug effects*RunningSupport, Non-U.S. Gov'tDepartment of Pediatrics, Physical Education and Medicine, McMaster University, Hamilton, Ontario, Canada.2674593Med Sci Sports Exerc1989214418-24.[310]. Additionally, some concern has been expressed that ingestion of caffeine prior to exercise may contribute to dehydration although recent studies have not supported this concern  ADDIN EN.CITE Armstrong200227710http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12187618Armstrong, L. E.Caffeine, body fluid-electrolyte balance, and exercise performanceAdultBody Fluids/*drug effectsCaffeine/*pharmacologyCentral Nervous System Stimulants/*pharmacologyExercise/*physiologyFemaleHumanMaleSupport, Non-U.S. Gov'tWater-Electrolyte Balance/*drug effectsDepartments of Kinesiology, Nutritional Sciences, and Physiology & Neurobiology, University of Connecticut, Storrs, CT 06269-1110, USA.12187618Int J Sport Nutr Exerc Metab2002122189-206.Graham200127720http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11583104Graham, T. E.Caffeine and exercise: metabolism, endurance and performanceCaffeine/adverse effects/*metabolismCentral Nervous System Stimulants/adverse effects/*metabolismExercise/*physiologyFemaleHumanMalePhysical Endurance/*physiologySupport, Non-U.S. Gov'tHuman Biology and Nutritional Sciences, University of Guelph, Ontario, Canada. terrygra@uoguelph.ca115831042001Sports Med3111785-807Falk199027730http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=2383801Falk, B.Burstein, R.Rosenblum, J.Shapiro, Y.Zylber-Katz, E.Bashan, N.Effects of caffeine ingestion on body fluid balance and thermoregulation during exerciseAdultBody Temperature Regulation/*drug effectsCaffeine/adverse effects/blood/*pharmacology*ExerciseHumanMaleOxygen Consumption/drug effectsRespiration/drug effectsSweating/drug effectsWater-Electrolyte Balance/*drug effectsFaculty of Health Sciences, McMaster University, Hamilton, Ont., Canada.2383801Can J Physiol Pharmacol1990687889-92.[311-313]. Caffeine doses above 9 mg/kg can result in urinary caffeine levels that surpass the doping threshold for many sport organizations. Suggestions that there is no ergogenic value to caffeine supplementation is not supported by the preponderance of available scientific studies. Possibly Effective Post-Exercise Carbohydrate and Protein. Ingesting carbohydrate and protein following exercise enhances carbohydrate storage and protein synthesis. Theoretically, ingesting carbohydrate and protein following exercise may lead to greater training adaptations. In support of this theory, Esmarck and coworkers  ADDIN EN.CITE Esmarck200127740http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11507179Esmarck, B.Andersen, J. L.Olsen, S.Richter, E. A.Mizuno, M.Kjaer, M.Timing of postexercise protein intake is important for muscle hypertrophy with resistance training in elderly humansAgedAged, 80 and overAging/*physiologyBlood Glucose/analysisCatecholamines/bloodDietary Proteins/*administration & dosage/pharmacologyDrug Administration ScheduleExercise/*physiologyHumanHypertrophyInsulin/bloodLegMaleMuscle Fibers/ultrastructureMuscle, Skeletal/anatomy & histology/*drug effects/*pathology/physiologyMyosin Heavy Chains/metabolismProtein Isoforms/metabolismSupport, Non-U.S. Gov'tTime Factors*Weight LiftingSports Medicine Research Unit, Bispebjerg Hospital, Denmark. bep01@bbh.hosp.dk11507179J Physiol2001535Pt 1301-11.[314] found that ingesting carbohydrate and protein immediately following exercise doubled training adaptations in comparison to waiting until 2-hours to ingest carbohydrate and protein. Additionally, Tarnopolsky and associates  ADDIN EN.CITE Tarnopolsky200127750http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11740297Tarnopolsky, M. A.Parise, G.Yardley, N. J.Ballantyne, C. S.Olatinji, S.Phillips, S. M.Creatine-dextrose and protein-dextrose induce similar strength gains during trainingAdultAnthropometryAspartate Aminotransferases/bloodBlood Urea NitrogenBody WeightComparative StudyCreatine/analysis/*pharmacologyCreatine Kinase/bloodCreatinine/urineDietary Proteins/*pharmacologyDouble-Blind MethodExercise/*physiologyGlucose/*pharmacologyHumanMaleMuscle Fibers/metabolismMuscle, Skeletal/chemistry/*drug effects/metabolismPhysical Education and Training/methodsSupport, Non-U.S. Gov'tDepartment of Medicine (Neurology and Neurological Rehabilitation), Rm. 4U4, McMaster University Medical Center, 1200 Main Street W., Hamilton, Ontario, Canada, L8N 3Z5. tarnopol@mcmaster.ca11740297Med Sci Sports Exerc200133122044-52.[315] reported that post-exercise ingestion of carbohydrate with protein promoted as much strength gains as ingesting creatine with carbohydrate during training. These findings underscore the importance of post-exercise carbohydrate and protein ingestion. Glutamine. As described above, glutamine has been shown to influence protein synthesis and help maintain the immune system. Theoretically, glutamine supplementation during training should enhance gains in strength and muscle mass as well as help athletes tolerate training to a better degree. Although there is some evidence that glutamine supplementation with protein can improve training adaptations, more research is needed to determine the ergogenic value in athletes. Essential Amino Acids (EAA). Ingestion of 3-6 grams of EAA following resistance exercise has been shown to increase protein synthesis  ADDIN EN.CITE Tipton200390601238816428412003JanAcute response of net muscle protein balance reflects 24-h balance after exercise and amino acid ingestionE76-89Metabolism Unit, Shriners Hospitals for Children, Galveston, Texas 77550, USA. ktipton@utmb.eduTipton, K. D.Borsheim, E.Wolf, S. E.Sanford, A. P.Wolfe, R. R.Am J Physiol Endocrinol MetabAmino Acids/analysis/bloodAmino Acids, Essential/*administration & dosageBlood Flow VelocityCarbon Isotopes/diagnostic useExercise/*physiologyFemaleGlycine/metabolismHumanInsulin/bloodKineticsLeg/blood supplyLeucine/metabolismMaleMuscle Proteins/biosynthesis/*metabolismMuscle, Skeletal/chemistryPhenylalanine/administration & dosage/diagnostic useSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Valine/metabolismhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12388164Wolfe2002907012368421132102002OctRegulation of muscle protein by amino acids3219S-24SUniversity of Texas Medical Branch and Shriners Burns Hospital, Department of Surgery, Galveston 77550, USA. rwolfe@utmb.eduWolfe, R. R.J NutrAmino Acids/*metabolism/pharmacokineticsAnimalHumanKineticsLegMuscle Proteins/biosynthesis/*metabolismMuscle, Skeletal/*metabolismNutritive ValueRadioisotope Dilution TechniqueSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12368421Rasmussen20001520Rasmussen, B. B.Tipton, K. D.Miller, S. L.Wolf, S. E.Wolfe, R. R.An oral essential amino acid-carbohydrate supplement enhances muscle protein anabolism after resistance exerciseAdministration, OralAmino Acids, Essential/administration & dosage/*pharmacologyAnalysis of VarianceCarbohydrates/administration & dosage/*pharmacologyDietary SupplementsExercise/*physiologyFemaleFemoral Artery/drug effects/metabolismFemoral Vein/drug effects/metabolismHumanInsulin/bloodLeg/blood supplyMaleMuscle Proteins/*drug effects/metabolismPhenylalanine/drug effects/metabolismRegional Blood Flow/drug effectsSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Time FactorsDepartment of Surgery, University of Texas Medical Branch and Metabolism Unit, Shriners Burns Institute, Galveston, Texas 77550, USA.10658002http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10658002 http://jap.physiology.org/cgi/content/full/88/2/386 http://jap.physiology.org/cgi/content/abstract/88/2/386J Appl Physiol2000882386-92.Tipton20011510Tipton, K. D.Rasmussen, B. B.Miller, S. L.Wolf, S. E.Owens-Stovall, S. K.Petrini, B. E.Wolfe, R. R.Timing of amino acid-carbohydrate ingestion alters anabolic response of muscle to resistance exerciseAdministration, OralAdultAmino Acids, Essential/*administration & dosageBiopsyBlood Flow Velocity/drug effectsCarbohydrates/*administration & dosageDeuteriumDietary SupplementsExertion/*physiologyFemaleHumanInfusions, IntravenousInsulin/bloodLegMaleMuscle, Skeletal/*drug effects/*metabolismPhenylalanine/administration & dosage/blood/pharmacokineticsProteins/biosynthesisRegional Blood Flow/drug effectsSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Time FactorsDepartment of Surgery, University of Texas Medical Branch, Galveston, Texas 77550, USA. ktipton@utmb.edu11440894http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11440894 http://ajpendo.physiology.org/cgi/content/full/281/2/E197 http://ajpendo.physiology.org/cgi/content/abstract/281/2/E197Am J Physiol Endocrinol Metab20012812E197-206.Rasmussen2002905012459885662002Oral and intravenously administered amino acids produce similar effects on muscle protein synthesis in the elderly358-62University of Southern California, Department of Kinesiology, University Park Campus, 3560 Watt Way, PED 107, Los Angeles, CA 90089-0652, USA. blakeras@usc.eduRasmussen, B. B.Wolfe, R. R.Volpi, E.J Nutr Health AgingAdministration, OralAgedAmino Acids/*administration & dosage/pharmacokineticsBiological AvailabilityBiological TransportBiopsyCatheters, IndwellingComparative Study*Enteral NutritionFemaleHumanInfusions, IntravenousMaleMuscle Proteins/*biosynthesisMuscle, Skeletal/*metabolism*Parenteral NutritionPhenylalanine/administration & dosage/pharmacokineticsSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12459885Miller20039020126185753532003MarIndependent and combined effects of amino acids and glucose after resistance exercise449-55Dairy Management, Inc, Rosemont, IL, USA.Miller, S. L.Tipton, K. D.Chinkes, D. L.Wolf, S. E.Wolfe, R. R.Med Sci Sports Exerchttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12618575Kobayashi200390301255634928432003MarReduced amino acid availability inhibits muscle protein synthesis and decreases activity of initiation factor eIF2BE488-98Department of Surgery, Shriners Burns Hospital, University of Texas Medical Branch, Galveston, Texas 77550, USA.Kobayashi, H.Borsheim, E.Anthony, T. G.Traber, D. L.Badalamenti, J.Kimball, S. R.Jefferson, L. S.Wolfe, R. R.Am J Physiol Endocrinol MetabAmino Acids/*bloodAnimalEukaryotic Initiation Factor-2B/*metabolismLegLeucine/metabolismMuscle Proteins/*biosynthesisMuscle, Skeletal/metabolismOsmolar ConcentrationPhenylalanine/metabolismRenal DialysisSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Swinehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12556349Wolfe2002907012368421132102002OctRegulation of muscle protein by amino acids3219S-24SUniversity of Texas Medical Branch and Shriners Burns Hospital, Department of Surgery, Galveston 77550, USA. rwolfe@utmb.eduWolfe, R. R.J NutrAmino Acids/*metabolism/pharmacokineticsAnimalHumanKineticsLegMuscle Proteins/biosynthesis/*metabolismMuscle, Skeletal/*metabolismNutritive ValueRadioisotope Dilution TechniqueSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12368421Borsheim200290801221788128342002OctEssential amino acids and muscle protein recovery from resistance exerciseE648-57Metabolism Unit, Department of Surgery, Shriners Hospital for Children/Galveston, University of Texas Medical Branch, Galveston, Texas 77550, USA.Borsheim, E.Tipton, K. D.Wolf, S. E.Wolfe, R. R.Am J Physiol Endocrinol MetabAdultBlood GlucoseCarbon Isotopes/diagnostic useDeuterium/diagnostic useExercise/*physiologyFemaleHumanInsulin/bloodLeucine/administration & dosage/blood/*pharmacokineticsMaleMuscle, Skeletal/drug effects/*metabolismNitrogen Isotopes/diagnostic usePhenylalanine/administration & dosage/blood/*pharmacokineticsProteins/biosynthesisSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Urea/administration & dosage/blood/pharmacokineticshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12217881Biolo19991490http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10331397Biolo, G.Williams, B. D.Fleming, R. Y.Wolfe, R. R.Insulin action on muscle protein kinetics and amino acid transport during recovery after resistance exerciseAdultAlanine/metabolismAmino Acids/blood/*metabolismBiological TransportBlood Flow VelocityExercise/*physiologyFemoral ArteryGlucose/metabolismHumanInsulin/administration & dosage/blood/*pharmacologyKineticsLeg/blood supplyLysine/metabolismMaleMuscle Proteins/biosynthesis/*metabolismMuscle, Skeletal/*metabolismSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Department of Internal Medicine, University of Texas Medical Branch, and the Shriners Burns Hospital, Galveston, USA.10331397Diabetes1999485949-57.[93-101]. Theoretically, ingestion of EAA after exercise should enhance gains in strength and muscle mass during training. While there is sound theoretical rationale, it is currently unclear whether following this strategy would lead to greater training adaptations and/or whether EAA supplementation would be better than simply ingesting carbohydrate and a quality protein following exercise. Branched Chain Amino Acids (BCAA). Ingestion of BCAA (e.g., 6-10 grams per hour) with sports drinks during prolonged exercise would theoretically improve psychological perception of fatigue (i.e., central fatigue). Although there is strong rationale, the effects of BCAA supplementation on exercise performance is mixed with some studies suggesting an improvement and others showing no effect  ADDIN EN.CITE Kreider199924080100912742721999FebDietary supplements and the promotion of muscle growth with resistance exercise97-110Department of Human Movement Sciences and Education, University of Memphis, Tennessee, USA. kreider.richard@coe.memphis.eduKreider, R. B.Sports MedAnabolic Steroids/metabolismBoron/administration & dosage/pharmacologyChromium/administration & dosage/pharmacologyCreatine/administration & dosage/pharmacologyDietary Carbohydrates/administration & dosage/pharmacologyDietary Proteins/administration & dosage/pharmacology*Dietary SupplementsGlutamine/administration & dosage/pharmacologyHumanLeucine/administration & dosage/pharmacology*Muscle DevelopmentMuscle, Skeletal/drug effects/*growth & developmentNutritionPrasterone/administration & dosage/pharmacologyProteins/biosynthesisTestosterone/metabolismValerates/administration & dosage/pharmacologyVanadium Compounds/administration & dosage/pharmacologyWeight Lifting/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10091274[66]. More research is needed before conclusions can be drawn. Calcium (-HMB. HMB supplementation has been reported to improve training adaptations in untrained individuals initiating training as well as help reduce muscle breakdown in runners. Theoretically, this should enhance training adaptations in athletes. However, most studies show little benefit of HMB supplementation in athletes. Glycerol. Ingesting glycerol with water has been reported to increase fluid retention  ADDIN EN.CITE Wagner199927820http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=9972189Wagner, D. R.Hyperhydrating with glycerol: implications for athletic performanceDehydration/*prevention & controlDrinking/physiologyExercise/*physiologyFemaleGlycerol/pharmacology/*therapeutic useHeat Stress Disorders/prevention & controlHumanMaleOsmolar ConcentrationSports/*physiologyExercise and Sports Science Department, Vanguard University of Southern California, Costa Mesa 92626, USA.9972189J Am Diet Assoc1999992207-12.[316]. Theoretically, this should help athletes prevent dehydration during prolonged exercise and improve performance particularly if they are susceptible to dehydration. Although studies indicate that glycerol can significantly enhance body fluid, studies are mixed on whether it can improve exercise capacity  ADDIN EN.CITE Inder199827830http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=9710867Inder, W. J.Swanney, M. P.Donald, R. A.Prickett, T. C.Hellemans, J.The effect of glycerol and desmopressin on exercise performance and hydration in triathletesAdultBlood Glucose/analysisBody Water/*drug effectsDesmopressin/*pharmacologyExercise/*physiologyGlucagon/bloodGlycerol/*pharmacologyHumanInsulin/bloodMaleOxygen ConsumptionRenal Agents/*pharmacologySupport, Non-U.S. Gov'tSweatingDepartment of Endocrinology, Christchurch Hospital, New Zealand.9710867Med Sci Sports Exerc19983081263-9.Montner199627840http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=8775573Montner, P.Stark, D. M.Riedesel, M. L.Murata, G.Robergs, R.Timms, M.Chick, T. W.Pre-exercise glycerol hydration improves cycling endurance timeAdultBicycling/*physiologyBody Temperature/drug effectsCross-Over StudiesDouble-Blind MethodExercise/*physiologyFemaleGlycerol/*pharmacologyHeart Rate/drug effectsHumanMalePhysical Endurance/*physiology*Rehydration SolutionsSupport, U.S. Gov't, Non-P.H.S.Support, U.S. Gov't, P.H.S.Department of Medicine, Veterans Affairs Medical Center, Albuquerque, NM 87108, USA.8775573Int J Sports Med199617127-33.Meyer199527850http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=8588794Meyer, L. G.Horrigan, D. J., Jr.Lotz, W. G.Effects of three hydration beverages on exercise performance during 60 hours of heat exposureAdultBody Temperature Regulation/*physiologyExercise/*physiologyHeart RateHeat Exhaustion/*physiopathologyHumanMaleOxygen Consumption*Rehydration SolutionsRespirationSkin TemperatureSupport, U.S. Gov't, Non-P.H.S.Environmental Physiology Division, Naval Aerospace Medical Research Laboratory, NAS Pensacola, FL 32508-1046, USA.8588794Aviat Space Environ Med199566111052-7.Boulay199527860http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=7742773Boulay, M. R.Song, T. M.Serresse, O.Theriault, G.Simoneau, J. A.Bouchard, C.Changes in plasma electrolytes and muscle substrates during short-term maximal exercise in humansAdenosine Triphosphate/metabolismAdultBlood Glucose/analysisBlood Volume/physiologyBody WaterChlorides/bloodComparative StudyElectrolytes/*bloodExercise TestExertion/*physiologyGlycerol/bloodGlycogen/bloodHumanLactates/blood/metabolismMaleMuscle, Skeletal/*metabolismPotassium/bloodSodium/bloodSupport, Non-U.S. Gov'tPhysical Activity Sciences Laboratory, Laval University, Ste-Foy, Quebec.7742773Can J Appl Physiol199520189-101.Tikuisis199927810http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10194218Tikuisis, P.Ducharme, M. B.Moroz, D.Jacobs, I.Physiological responses of exercised-fatigued individuals exposed to wet-cold conditionsAdultBlood Glucose/metabolismBody Temperature*Body Temperature Regulation*ColdElectromyographyEnergy MetabolismExercise/*physiologyFatty Acids, Nonesterified/bloodGlycerol/bloodHormones/blood/secretionHumanMaleMuscle Fatigue/*physiologyMuscle, Skeletal/physiologyOxygen ConsumptionPhysical Fitness*RainSupport, Non-U.S. Gov'tTime FactorsDefence and Civil Institute of Environmental Medicine, Human Protection, and Performance, Toronto, Ontario, Canada M3M 3B9. Peter.Tikuisis@dciem.dnd.ca10194218J Appl Physiol19998641319-28.Jimenez199927800http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10367716Jimenez, C.Melin, B.Koulmann, N.Allevard, A. M.Launay, J. C.Savourey, G.Plasma volume changes during and after acute variations of body hydration level in humansAdultBlood Proteins/metabolismBlood Volume/*physiologyBody Temperature Regulation/physiologyDehydration/*physiopathologyEvans Blue/pharmacokineticsExertion/physiologyGlycerolHeatHematocritHemoglobinsHumanMaleOsmolar ConcentrationPosture/physiologyRandom AllocationVehiclesWater-Electrolyte Balance/*physiologyUnite de Bioenergetique et Environnement, Centre de Recherches du Service de Sante des Armees Emile Parde, La Tronche, France.10367716Eur J Appl Physiol Occup Physiol19998011-8.Magal200327760http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12544649Magal, M.Webster, M. J.Sistrunk, L. E.Whitehead, M. T.Evans, R. K.Boyd, J. C.Comparison of glycerol and water hydration regimens on tennis-related performanceAdultComparative StudyCross-Over StudiesDehydration/prevention & controlDouble-Blind MethodGlycerol/*therapeutic useHumanMalePlasma Volume*Rehydration SolutionsRunning/*physiology*Task Performance and AnalysisTennis/physiology*WaterSchool of Human Performance and Recreation, University of Southern Mississippi, Hattiesburg, MS, USA. meirmagal@cs.com12544649Med Sci Sports Exerc2003351150-6.[60, 317-322]. Ephedrine/Caffeine. Most research has evaluated the effects of ingesting ephedrine and caffeine (EC) supplements on weight loss. However, since ephedra and caffeine are stimulants and caffeine has been shown to have ergogenic properties, there has also been interest in the potential ergogenic value of EC. Recent research has shown that ingestion of low to moderate amounts of synthetic EC supplements generally improves endurance and high intensity exercise performance with no apparent adverse effects  ADDIN EN.CITE Bell200228220http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11828246Bell, D. G.McLellan, T. M.Sabiston, C. M.Effect of ingesting caffeine and ephedrine on 10-km run performanceAdultCaffeine/blood/*pharmacologyCatecholamines/bloodCentral Nervous System Stimulants/pharmacologyComparative StudyDrug Therapy, CombinationEphedrine/blood/*pharmacologyExertion/*drug effectsFemaleHeart Rate/drug effectsHumanLactic Acid/bloodMaleOxygen Consumption/drug effectsRunning/*physiology*Task Performance and AnalysisTime FactorsDefence and Civil Institute of Environmental Medicine, Toronto, Ontario, Canada. doug.bell@dciem.dnd.ca11828246Med Sci Sports Exerc2002342344-9.Bell200128240http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11474345Bell, D. G.Jacobs, I.Ellerington, K.Effect of caffeine and ephedrine ingestion on anaerobic exercise performanceAdultCaffeine/*pharmacologyCatecholamines/metabolismCentral Nervous System Stimulants/*pharmacologyDopamine/metabolismEnergy MetabolismEphedrine/*pharmacologyExercise/*physiologyHumanMalePhysical EnduranceDefence and Civil Institute of Environmental Medicine, Toronto, Ontario M3M 3B9, Canada. doug.bell@dciem.dnd.ca11474345Med Sci Sports Exerc20013381399-403.Bell200028260http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10766467Bell, D. G.Jacobs, I.McLellan, T. M.Zamecnik, J.Reducing the dose of combined caffeine and ephedrine preserves the ergogenic effectAdultCaffeine/*administration & dosageCentral Nervous System Stimulants/*administration & dosageDouble-Blind MethodDrug CombinationsEphedrine/*administration & dosage*ExerciseHumanMaleNausea/prevention & controlOxygen Consumption*Physical EnduranceDefence and Civil Institute of Environmental Medicine, Toronto, Ontario, Canada.10766467Aviat Space Environ Med2000714415-9.Bell199928270http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10223267Bell, D. G.Jacobs, I.Combined caffeine and ephedrine ingestion improves run times of Canadian Forces Warrior TestAdultAnalysis of VarianceCaffeine/blood/*pharmacologyCentral Nervous System Stimulants/blood/*pharmacologyDrug MonitoringDrug Therapy, CombinationEnergy Metabolism/drug effectsEphedrine/blood/*pharmacologyExercise TestHeart Rate/drug effectsHumanMale*Military PersonnelPhysical Endurance/*drug effectsPsychomotor Performance/*drug effects*RunningTime FactorsWeight-BearingDefence and Civil Institute of Environmental Medicine, Toronto, Ontario, Canada.10223267Aviat Space Environ Med1999704325-9.Bell199828280http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=9562293Bell, D. G.Jacobs, I.Zamecnik, J.Effects of caffeine, ephedrine and their combination on time to exhaustion during high-intensity exerciseAdultBlood Glucose/metabolismCaffeine/*administration & dosage/*pharmacologyCarbon Dioxide/physiologyDopamine/bloodDrug SynergismEphedrine/*administration & dosage/*pharmacologyEpinephrine/bloodExercise/*physiologyExercise TestFatty Acids, Nonesterified/bloodGlycerol/bloodHeart Rate/drug effects/physiologyHumanLactic Acid/bloodMaleMuscle Fatigue/*drug effects/physiologyNorepinephrine/bloodOxygen Consumption/drug effects/physiologyPhysical Fitness/physiologyRespiration/drug effectsTime FactorsDefence and Civil Institute of Environmental Medicine, North York, Ontario, Canada.9562293Eur J Appl Physiol Occup Physiol1998775427-33.[323-327]. However, it is unclear whether dietary supplements containing botanical ephedrine (i.e., ephedra) and caffeine (e.g., kola nut) have similar effects on performance. Further, since most sport organizations ban use of ephedrine and ephedra and concern has been raised regarding the safety of EC supplementation during intense exercise in hot/humid environments, the potential use in athletes appears limited. Too Early to Tell A number of supplements purported to enhance performance and/or training adaptation fall under this category. This includes the weight gain and weight loss supplements listed in Table 3 as well as the following supplements not previously described in this category. Medium Chain Triglycerides (MCT). MCTs are shorter chain fatty acids that can easily enter the mitochondria of the cell and be converted to energy through fat metabolism  ADDIN EN.CITE Jeukendrup199827950http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=9774203Jeukendrup, A. E.Saris, W. H.Wagenmakers, A. J.Fat metabolism during exercise: a review--part III: effects of nutritional interventionsBiological AvailabilityDietary Fats/administration & dosage/metabolismEnergy MetabolismExercise/*physiologyFastingFatigue/prevention & controlFatty Acids/pharmacokineticsGastric Emptying/physiologyGlycogen/metabolismHumanLipids/*metabolismMuscle, Skeletal/metabolismNutritionOxidation-ReductionSports/physiologyTriglycerides/administration & dosage/metabolismNutrition Research Center, Department of Human Biology, University Maastricht, The Netherlands.9774203Int J Sports Med1998196371-9.[328]. Studies are mixed as to whether MCTs can serve as an effective source of fat during exercise metabolism and/or improve exercise performance  ADDIN EN.CITE Goedecke199927930http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10036340Goedecke, J. H.Elmer-English, R.Dennis, S. C.Schloss, I.Noakes, T. D.Lambert, E. V.Effects of medium-chain triaclyglycerol ingested with carbohydrate on metabolism and exercise performance3-Hydroxybutyric Acid/bloodAdultBicycling/*physiologyBlood Glucose/analysisCarbon Dioxide/metabolismCarbon Radioisotopes/diagnostic useDietary Carbohydrates/*administration & dosage/metabolismDietary Fats/*administration & dosage/metabolismErgometryFatty Acids, Nonesterified/bloodGlucose/*administration & dosage/metabolismHumanInsulin/bloodLactates/bloodMaleOxidation-ReductionOxygen Consumption/physiologyPhysical Endurance/physiologyPsychomotor Performance/physiologyRadiopharmaceuticals/diagnostic useStomach/drug effectsSupport, Non-U.S. Gov'tTriglycerides/*administration & dosage/metabolismMRC/UCT Bioenergetics of Exercise Research Unit, University of Cape Town Medical School, Newlands, South Africa.10036340Int J Sport Nutr19999135-47.Calabrese199927940http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=9988780Calabrese, C.Myer, S.Munson, S.Turet, P.Birdsall, T. C.A cross-over study of the effect of a single oral feeding of medium chain triglyceride oil vs. canola oil on post-ingestion plasma triglyceride levels in healthy menAdministration, OralAdultCross-Over StudiesFatty Acids, Monounsaturated/*administration & dosageHumanMaleSingle-Blind MethodTriglycerides/*administration & dosage/*bloodBastyr University Research Institute, 14500 Juanita Dr. NE, Kenmore, WA 98028, USA. carlo@bastyr.edu9988780Altern Med Rev19994123-8.Angus200027910http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10642370Angus, D. J.Hargreaves, M.Dancey, J.Febbraio, M. A.Effect of carbohydrate or carbohydrate plus medium-chain triglyceride ingestion on cycling time trial performanceAdultBeveragesBicycling/*physiologyBlood Glucose/drug effectsDietary Carbohydrates/administration & dosage/metabolism/*pharmacologyDouble-Blind MethodExercise/*physiologyFats/metabolismFatty Acids, Nonesterified/bloodHeart Rate/drug effectsHumanInsulin/bloodLactic Acid/bloodMaleMolecular WeightOxidation-Reduction/drug effectsOxygen/metabolismSupport, Non-U.S. Gov'tTime FactorsTriglycerides/administration & dosage/chemistry/*pharmacologyExercise Physiology and Metabolism Laboratory, Department of Physiology, The University of Melbourne, Parkville, Victoria 3052, Australia.10642370J Appl Physiol2000881113-9.Jeukendrup199827980http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=9497182Jeukendrup, A. E.Thielen, J. J.Wagenmakers, A. J.Brouns, F.Saris, W. H.Effect of medium-chain triacylglycerol and carbohydrate ingestion during exercise on substrate utilization and subsequent cycling performance3-Hydroxybutyric Acid*BicyclingBlood Glucose/metabolismCalorimetryDietary Carbohydrates/*administration & dosage/adverse effectsDietary Fats/*administration & dosage/adverse effects*Energy MetabolismFatty Acids/bloodGastrointestinal System/drug effects/physiopathologyHumanHydroxybutyrates/bloodLactates/bloodMaleTriglycerides/*administration & dosage/adverse effectsDepartment of Human Biology, Nutrition Research Centre, Maastricht University, The Netherlands. A.Jenkendrup@hb.unimaas.nl9497182Am J Clin Nutr1998673397-404.Van Zyl199627990http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=8806933Van Zyl, C. G.Lambert, E. V.Hawley, J. A.Noakes, T. D.Dennis, S. C.Effects of medium-chain triglyceride ingestion on fuel metabolism and cycling performanceAdultEnergy Metabolism/*drug effectsExercise/*physiologyGlucose/metabolismHumanMaleOxygen Consumption/*physiologySupport, Non-U.S. Gov'tTask Performance and AnalysisTriglycerides/*pharmacologyLiberty Life Chair of Exercise and Sport Science, University of Cape Town Medical School, Observatory, South Africa.8806933J Appl Physiol19968062217-25.[329-333]. Ribose. Ribose is a 3-carbon carbohydrate that is involved in the synthesis of adenosine triphosphate (ATP) in the muscle (the useable form of energy). Clinical studies have shown that ribose supplementation can increase exercise capacity in heart patients  ADDIN EN.CITE Tullson199128060http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=1908187Tullson, P. C.Terjung, R. L.Adenine nucleotide synthesis in exercising and endurance-trained skeletal muscleAdenine Nucleotides/*biosynthesisAnimal*ExertionGlycine/pharmacokineticsMaleMuscle Proteins/biosynthesisMuscles/*metabolism*Physical Conditioning, Animal*Physical EnduranceRatsRibose/pharmacologySupport, U.S. Gov't, P.H.S.Department of Physiology, State University of New York Health Science Center, Syracuse 13210.1908187Am J Physiol19912612 Pt 1C342-7.Gross199128070http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=1904121Gross, M.Kormann, B.Zollner, N.Ribose administration during exercise: effects on substrates and products of energy metabolism in healthy subjects and a patient with myoadenylate deaminase deficiencyAMP Deaminase/*deficiencyAdolescentAdultAmmonia/bloodBlood Glucose/metabolismDrug Administration ScheduleEnergy Metabolism/*physiology*Exercise TestFatty Acids, Nonesterified/bloodHumanHypoxanthineHypoxanthines/bloodLactates/bloodLactic AcidMaleRibose/*administration & dosageMedizinische Poliklinik, Universitat Munchen, FRG.1904121Klin Wochenschr1991694151-5.Wagner199128080http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=1781401Wagner, D. R.Gresser, U.Kamilli, I.Gross, M.Zollner, N.Effects of oral ribose on muscle metabolism during bicycle ergometer in patients with AMP-deaminase-deficiencyAMP Deaminase/*deficiencyAdministration, OralAmmonia/bloodExercise TestHumanHypoxanthineHypoxanthines/bloodInosine/bloodLactates/bloodLactic AcidMuscles/*drug effects/metabolismMuscular Diseases/drug therapy/metabolismRibose/administration & dosage/*therapeutic useMedizinische Poliklinik, Universitat Munich, Germany.17814011991Adv Exp Med Biol383-5Pliml199228100http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=1354276Pliml, W.von Arnim, T.Stablein, A.Hofmann, H.Zimmer, H. G.Erdmann, E.Effects of ribose on exercise-induced ischaemia in stable coronary artery diseaseAgedCoronary Disease/physiopathology/*prevention & controlElectrocardiographyExercise TestHumanMaleMiddle AgeRibose/*therapeutic useSupport, Non-U.S. Gov'tDepartment of Medicine, Medizinische Klinik I, Klinikum Grosshadern, Germany.1354276Lancet19923408818507-10.Pauly200028120http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11150394Pauly, D. F.Pepine, C. J.D-Ribose as a supplement for cardiac energy metabolismAdenosine Triphosphate/biosynthesisAnimalCardiomegaly/physiopathologyCoronary Disease/physiopathology/prevention & control*Dietary SupplementsDisease Models, Animal*Energy MetabolismHeart/drug effects/physiologyHumanMuscle, Smooth/physiologyMyocardial Contraction/physiologyMyocardial Ischemia/*physiopathology/prevention & controlMyocardium/*metabolismOxidative StressRatsRibose/pharmacokinetics/*pharmacology/therapeutic useDivision of Cardiovascular Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA.11150394J Cardiovasc Pharmacol Ther200054249-58.[334-338]. For this reason, ribose has been suggested to be an ergogenic aid for athletes. Although more research is needed, most studies show no ergogenic value of ribose supplementation on exercise capacity in health untrained or trained populations  ADDIN EN.CITE Op 't Eijnde200128040http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11641371Op 't Eijnde, B.Van Leemputte, M.Brouns, F.Van Der Vusse, G. J.Labarque, V.Ramaekers, M.Van Schuylenberg, R.Verbessem, P.Wijnen, H.Hespel, P.No effects of oral ribose supplementation on repeated maximal exercise and de novo ATP resynthesisAdenine Nucleotides/pharmacologyAdenosine Triphosphate/*biosynthesisAdultAmmonia/bloodBlood Glucose/metabolismDietDouble-Blind MethodExercise/*physiologyHumanKnee/physiologyLactic Acid/bloodMaleMuscle, Skeletal/drug effects/metabolismOxygen Consumption/drug effectsPhysical Fitness/physiologyRibose/*pharmacologySupport, Non-U.S. Gov'tExercise Physiology and Biomechanics Laboratory, Department of Kinesiology, Faculty of Physical Education and Physiotherapy, Katholieke Universiteit Leuven, B-3001 Heverlee, Belgium.11641371J Appl Physiol20019152275-81.Berardi200328020http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12580655Berardi, J. M.Ziegenfuss, T. N.Effects of ribose supplementation on repeated sprint performance in menAdultBicycling/*physiologyCross-Over Studies*Dietary SupplementsDouble-Blind MethodExercise TestHumanMalePhysical Endurance/*drug effectsRibose/*administration & dosageSupport, Non-U.S. Gov'tApplied Physiology Laboratory, Eastern Michigan University, Ypsilanti, Michigan 48197, USA. jb@johnberardi.com12580655J Strength Cond Res200317147-52.Kreider200328010http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12660407Kreider, R. B.Melton, C.Greenwood, M.Rasmussen, C.Lundberg, J.Earnest, C.Almada, A.Effects of oral d-ribose supplementation on anaerobic capacity and selected metabolic markers in healthy malesExercise and Sport Nutrition Laboratory, Center for Exercise, Nutrition and Preventative Health, in the Department of Health, Human Performance and Recreation at Baylor University, Waco, TX 76798-7313.12660407Int J Sport Nutr Exerc Metab200313187-96.[339-341]. Apparently Ineffective Inosine. Inosine is a building block for DNA and RNA that is found in muscle. Inosine has a number of potentially important roles that may enhance training and/or exercise performance  ADDIN EN.CITE Hargreaves199828370http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=9572818Hargreaves, M.McKenna, M. J.Jenkins, D. G.Warmington, S. A.Li, J. L.Snow, R. J.Febbraio, M. A.Muscle metabolites and performance during high-intensity, intermittent exerciseAdenosine Triphosphate/analysis/metabolismAdultBiopsyCalcium/metabolismErgometryExertion/*physiologyGlycogen/metabolismHumanHydrogen-Ion ConcentrationHypoxanthine/metabolismInosine Monophosphate/metabolismLactic Acid/metabolismMaleMuscles/*metabolismOxygen Consumption/physiologyPhosphocreatine/metabolismSarcoplasmic Reticulum/physiologySupport, Non-U.S. Gov'tDepartment of Physiology, The University of Melbourne, Parkville, Australia.9572818J Appl Physiol19988451687-91.[342]. Although there is some theoretical rationale, available studies indicate that inosine supplementation has no apparent affect on exercise performance capacity  ADDIN EN.CITE Starling199628400http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=8883009Starling, R. D.Trappe, T. A.Short, K. R.Sheffield-Moore, M.Jozsi, A. C.Fink, W. J.Costill, D. L.Effect of inosine supplementation on aerobic and anaerobic cycling performance2,3-DiphosphoglycerateAdultCross-Over StudiesDiphosphoglyceric Acids/bloodDouble-Blind MethodExercise Test*Food, FortifiedHeart RateHuman*InosineLactic Acid/bloodMaleOxygen ConsumptionSupport, Non-U.S. Gov'tHuman Performance Laboratory, Ball State University, Muncie, IN 47306, USA.8883009Med Sci Sports Exerc19962891193-8.Williams199028450http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=2402214Williams, M. H.Kreider, R. B.Hunter, D. W.Somma, C. T.Shall, L. M.Woodhouse, M. L.Rokitski, L.Effect of inosine supplementation on 3-mile treadmill run performance and VO2 peakAdministration, OralAdultEfficiency/*drug effectsExertion/*drug effectsFemaleHumanInosine/administration & dosage/*pharmacologyMaleOxygen Consumption/*drug effects*RunningSupport, Non-U.S. Gov'tTime FactorsDepartment of Health, Physical Education and Recreation, College of Education, Old Dominion University, Norfolk, VA 23529-0196.2402214Med Sci Sports Exerc1990224517-22.McNaughton199928350http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10660865McNaughton, L.Dalton, B.Tarr, J.Inosine supplementation has no effect on aerobic or anaerobic cycling performance2,3-Diphosphoglycerate/bloodAnalysis of VarianceBicycling*Dietary SupplementsDouble-Blind Method*ExerciseHumanInosine/*administration & dosage/blood/urineMaleUric Acid/bloodSports Science Dept., Kingston University, Kingston upon Thames, Surrey, England.10660865Int J Sport Nutr199994333-44.[343-345]. Supplements to Promote General Health In addition to the supplements previously described, several nutrients have been suggested to help athletes stay healthy during intense training. For example, the American Medical Association recently recommended that all Americans ingest a daily low-dose multivitamin in order to ensure that people get a sufficient amount of vitamins and minerals in their diet. Although one-a-day vitamin supplementation has not been found to improve exercise capacity in athletes, it may make sense to take a daily vitamin supplement for health reasons. Glucosomine and chondroitin have been reported to slow cartilage degeneration and reduce the degree of joint pain in active individuals which may help athletes postpone and/or prevent joint problems  ADDIN EN.CITE Braham200331050125477423712003FebThe effect of glucosamine supplementation on people experiencing regular knee pain45-9; discussion 49Department of Human Movement and Exercise Science, University of Western Australia, Crawley, Western Australia 6009. Rebecca.Braham@med.monash.edu.auBraham, R.Dawson, B.Goodman, C.Br J Sports MedAdministration, OralAdultAgedAnalysis of VarianceArthralgia/physiopathology/*prevention & controlChronic DiseaseExercise Test/methodsFemaleGlucosamine/*administration & dosage/adverse effectsHuman*Knee JointMaleMiddle AgePain Measurement/methodshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12547742Vad2002310601219603232112002Exercise recommendations in athletes with early osteoarthritis of the knee729-39Cornell University Medical Center, New York, New York 10021, USA. VadV@HSS.EDUVad, V.Hong, H. M.Zazzali, M.Agi, N.Basrai, D.Sports MedAthletic Injuries/drug therapy/physiopathology/*rehabilitationHumanKnee Joint/physiologyOsteoarthritis, Knee/drug therapy/physiopathology/*rehabilitation*Physical Therapy TechniquesRange of Motion, Articularhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12196032[346, 347]. Vitamin C, glutamine, Echinacea, and zinc have been reported to enhance immune function  ADDIN EN.CITE Nieman200128550http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11897882Nieman, D. C.Exercise immunology: nutritional countermeasuresDietary Carbohydrates/administration & dosageDietary SupplementsExercise/*physiologyHumanImmune ToleranceNeutrophils/physiologyPhysical EndurancePhysical FitnessRespiratory Tract Infections/physiopathologySports/*physiologyDepartment of Health & Exercise Science, Appalachian State University, Boone, NC 28608, USA.11897882Can J Appl Physiol200126SupplS45-55.Gleeson200128560http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11897880Gleeson, M.Lancaster, G. I.Bishop, N. C.Nutritional strategies to minimise exercise-induced immunosuppression in athletesDietary Carbohydrates/administration & dosageDietary SupplementsExercise/*physiologyHumanImmune Tolerance/*physiology*NutritionSports/*physiologySchool of Sport and Exercise Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, England.11897880Can J Appl Physiol200126SupplS23-35.Gleeson200028570http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10893024Gleeson, M.Bishop, N. C.Elite athlete immunology: importance of nutritionDietary Carbohydrates/immunologyDietary Fats/immunologyDietary Proteins/immunologyExercise/*physiologyFood Habits/*physiologyHumanImmune Tolerance/*physiologyImmunity/*physiologyMinerals/immunology*SportsVitamins/immunologySchool of Sport and Exercise Sciences, University of Edgbaston, Birmingham, England. m.gleeson@bham.ac.uk10893024Int J Sports Med200021 Suppl 1S44-50.Nieman199928580http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10410840Nieman, D. C.Nutrition, exercise, and immune system functionCarbohydrates/metabolism/physiologyExercise/*physiologyExertion/physiologyHumanImmune System/*physiologyInfection/etiologyInflammation/etiology*Nutrition/physiologyRisk FactorsSports/*physiologyDepartment of Health, Leisure, and Exercise Science, Appalachian State University, Boone, North Carolina, USA. niemandc@appstate.edu10410840Clin Sports Med1999183537-48.[348-351]. Consequently, some sport nutritionists recommend that athletes who feel a cold coming on take these nutrients in order to enhance immune function  ADDIN EN.CITE Nieman200128550http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11897882Nieman, D. C.Exercise immunology: nutritional countermeasuresDietary Carbohydrates/administration & dosageDietary SupplementsExercise/*physiologyHumanImmune ToleranceNeutrophils/physiologyPhysical EndurancePhysical FitnessRespiratory Tract Infections/physiopathologySports/*physiologyDepartment of Health & Exercise Science, Appalachian State University, Boone, NC 28608, USA.11897882Can J Appl Physiol200126SupplS45-55.Gleeson200128560http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11897880Gleeson, M.Lancaster, G. I.Bishop, N. C.Nutritional strategies to minimise exercise-induced immunosuppression in athletesDietary Carbohydrates/administration & dosageDietary SupplementsExercise/*physiologyHumanImmune Tolerance/*physiology*NutritionSports/*physiologySchool of Sport and Exercise Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, England.11897880Can J Appl Physiol200126SupplS23-35.Gleeson200028570http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10893024Gleeson, M.Bishop, N. C.Elite athlete immunology: importance of nutritionDietary Carbohydrates/immunologyDietary Fats/immunologyDietary Proteins/immunologyExercise/*physiologyFood Habits/*physiologyHumanImmune Tolerance/*physiologyImmunity/*physiologyMinerals/immunology*SportsVitamins/immunologySchool of Sport and Exercise Sciences, University of Edgbaston, Birmingham, England. m.gleeson@bham.ac.uk10893024Int J Sports Med200021 Suppl 1S44-50.Nieman199928580http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10410840Nieman, D. C.Nutrition, exercise, and immune system functionCarbohydrates/metabolism/physiologyExercise/*physiologyExertion/physiologyHumanImmune System/*physiologyInfection/etiologyInflammation/etiology*Nutrition/physiologyRisk FactorsSports/*physiologyDepartment of Health, Leisure, and Exercise Science, Appalachian State University, Boone, North Carolina, USA. niemandc@appstate.edu10410840Clin Sports Med1999183537-48.[348-351]. Similarly, nutrients such as vitamins E and C may help restore overwhelmed anti-oxidant defenses exhibited by athletes and reduce the risk of numerous chronic diseases  ADDIN EN.CITE Lowery200131077Lowery, L.Berardi, J. M.Ziegenfuss, T.2001AntioxidantsAntonio, J.Stout, J.Sports SupplementsBaltimore, MDLippincott, Williams & Wilkins260-278[352]. Creatine, calcium -HMB, BCAA, and L-carnitine have been shown to help athletes tolerate heavy training periods  ADDIN EN.CITE Gomez200013480Gomez, A.L.Volek, J.S.Ratamess, N.A.Rubin, M.R. Wickham, R.B.Mazzetti, S.A.Doan, B.K.Newton, R.U.Kraemer, W.J.2000Creatine supplementation enhances body composition during short-term reisstance training overreaching.Journal of Strength and Conditioning Research143August, 2000French200113310French, D.N. Volek, J.S.Ratamess, N.A. Mazzetti, S.A.Rubin, M.R. Gomez, A.L.Wickham, R.B. Doan, B.K. McGuigan, M.R. Scheett, T.P. Newton, R.U. Dorofeyeva, E. Kraemer, W.J.2001The effects of creatine supplementation on resting serum hormonal concentrations during short-term resistance training overreaching.Med Sci Sports & Exerc335S203May, 2001Volek200220160http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11788381Volek, J. S.Kraemer, W. J.Rubin, M. R.Gomez, A. L.Ratamess, N. A.Gaynor, P.L-Carnitine L-tartrate supplementation favorably affects markers of recovery from exercise stressAdultBiological MarkersCarnitine/bloodCross-Over StudiesCytosol/metabolismDouble-Blind MethodExercise/*physiologyFree Radicals/metabolismHumanLactic Acid/bloodMagnetic Resonance ImagingMaleMuscle, Skeletal/pathology/physiopathologyPain/physiopathologyProteins/metabolismPurines/metabolismStress/*etiology/*metabolism/physiopathologySupport, Non-U.S. Gov'tTartrates/*pharmacologyHuman Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, Connecticut 06269, USA. jvolek@uconnvm.uconn.edu11788381Am J Physiol Endocrinol Metab20022822E474-82.Knitter200015400Knitter, A. E.Panton, L.Rathmacher, J. A.Petersen, A.Sharp, R.Effects of beta-hydroxy-beta-methylbutyrate on muscle damage after a prolonged runAdultBody CompositionCreatine Kinase/bloodDietary SupplementsFemaleHumanLactate Dehydrogenase/bloodMaleMiddle AgeMuscle, Skeletal/*drug effects/physiology/physiopathologyOxygen Consumption/*drug effectsPlacebosRunning/*physiologyValerates/administration & dosage/blood/*pharmacologyHuman Performance Laboratory, Iowa State University, Ames, Iowa 50011, USA.11007567http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11007567 http://jap.physiology.org/cgi/content/full/89/4/1340 http://jap.physiology.org/cgi/content/abstract/89/4/1340J Appl Physiol20008941340-4.Kreider199921780100912742721999FebDietary supplements and the promotion of muscle growth with resistance exercise97-110Department of Human Movement Sciences and Education, University of Memphis, Tennessee, USA. kreider.richard@coe.memphis.eduKreider, R. B.Sports MedAnabolic Steroids/metabolismBoron/administration & dosage/pharmacologyChromium/administration & dosage/pharmacologyCreatine/administration & dosage/pharmacologyDietary Carbohydrates/administration & dosage/pharmacologyDietary Proteins/administration & dosage/pharmacology*Dietary SupplementsGlutamine/administration & dosage/pharmacologyHumanLeucine/administration & dosage/pharmacology*Muscle DevelopmentMuscle, Skeletal/drug effects/*growth & developmentNutritionPrasterone/administration & dosage/pharmacologyProteins/biosynthesisTestosterone/metabolismValerates/administration & dosage/pharmacologyVanadium Compounds/administration & dosage/pharmacologyWeight Lifting/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10091274Candeloro19952195087099182041995Dec[Effects of prolonged administration of branched-chain amino acids on body composition and physical fitness]217-23Dipartimento di Medicina Sperimentale, Universita degli Studi di Roma Tor Vergata, Roma.Candeloro, N.Bertini, I.Melchiorri, G.De Lorenzo, A.Minerva EndocrinolAdultAmino Acids, Branched-Chain/*administration & dosage/*pharmacologyBody Composition/*drug effectsEnglish AbstractErgometryHand Strength/physiologyHumanLeucine/administration & dosage/pharmacologyMaleOxygen ConsumptionPhysical Fitness/*physiologyReference ValuesRespirationTime FactorsValine/administration & dosage/pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8709918Coombes200012520http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11125767Coombes, J. S.McNaughton, L. R.Effects of branched-chain amino acid supplementation on serum creatine kinase and lactate dehydrogenase after prolonged exerciseAdultAmino Acids, Branched-Chain/*administration & dosageAnalysis of VarianceCreatine Kinase/*bloodDiet*Dietary SupplementsExercise TestExercise Tolerance/physiologyExertion/*physiologyFollow-Up StudiesHumanIsoleucine/administration & dosageLactate Dehydrogenase/*bloodLeucine/administration & dosageMaleMuscle, Skeletal/*enzymology/pathologyOxygen Consumption/physiologyPhysical Endurance/physiologyTime FactorsValine/administration & dosageCentre for Human Movement, University of Tasmania, Launceston, Australia. Jeff.Coombes@utas.edu.au11125767J Sports Med Phys Fitness2000403240-6.Mero199921760104180712761999JunLeucine supplementation and intensive training347-58Department of Biology of Physical Activity, University of Jyvaskyla, Finland. mero@maila.jyu.fiMero, A.Sports Med*Dietary Supplements*Exercise/physiologyHumanLeucine/chemistry/metabolism/*pharmacology/*therapeutic useMuscle, Skeletal/drug effects/physiologyNutritional RequirementsPhysical Endurance/*drug effects/physiologyProteins/biosynthesis/metabolismSports Medicine*Weight Lifting/physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10418071Schena19922190014256426551992Branched-chain amino acid supplementation during trekking at high altitude. The effects on loss of body mass, body composition, and muscle power394-8Institute of Human Physiology, University of Verona, Italy.Schena, F.Guerrini, F.Tregnaghi, P.Kayser, B.Eur J Appl Physiol Occup PhysiolAdult*AltitudeAmino Acids, Branched-Chain/*administration & dosage*Body CompositionEnergy IntakeFemaleHumanIsoleucine/administration & dosageLeucine/administration & dosageMaleMuscles/*physiologyPlacebosValine/administration & dosage*Walkinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1425642[66, 89, 90, 92, 353-357]. Finally, omega-3 fatty acids, in supplemental form, are now endorsed by the American Heart Association for heart health in certain individuals  ADDIN EN.CITE Harris31080Harris, W.S.Appel, L.J.New guidelines focus on fish, fish oil, omega-3 fatty acidsAmerican Heart AssociationAmerican Heart Association2002November 11Available: http://www.americanheart.org/presenter.jhtml?identifier=3006624http://www.americanheart.org/presenter.jhtml?identifier=3006624[358]. This supportive supplement position stems from: 1.) an inability to consume cardio-protective amounts by diet alone; and, 2.) the mercury contamination sometimes present in whole-food sources of DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid) found in fatty fish. Consequently, prudent use of these types of nutrients at various times during training may help athletes stay healthy and/or tolerate training to a greater degree  ADDIN EN.CITE Kreider200128947Kreider, R.B.2001Nutritional Considerations of OvertrainingStout, J.R. Antonio, J.Sport Supplements: A Complete Guide to Physique and Athletic EnhancementBaltimore, MDLippincott, Williams & Wilkins199-208[45]. Summary Numerous nutritional and herbal products are marketed to promote weight gain, weight loss, and/or improve performance. Most have a theoretical basis for use but little data supporting safety and efficacy in athletes. A number are heavily marketed despite data indicating that they do not affect body composition, performance, and/or training adaptations at the dosages recommended. It is in these particular situations that unsupported claims explicitly or implicitly endorsed by exercise physiologists constitute fraud and/ or quackery. Prudent training, maintaining an energy balance and nutrient dense diet, proper timing of nutrient intake, and obtaining adequate rest are the cornerstones to enhancing performance and/or training adaptations. Use of a limited number of nutritional supplements that research has supported can help improve energy availability (e.g., sports drinks, carbohydrate, creatine, caffeine, etc) and/or promote recovery (carbohydrate, protein, essential amino acids, etc) can provide additional benefit in certain instances. The exercise physiologist should stay up to date regarding the role of nutrition on exercise so they can provide honest and accurate information to their students, clients, and/or athletes about the role of nutrition and dietary supplements on performance and training. Furthermore, the exercise physiologist should actively participate in exercise nutrition research; write unbiased scholarly reviews for journals and lay publications; help disseminate the latest research findings to the public so they can make informed decisions about appropriate methods of exercise, dieting, and/or whether various nutritional supplements can affect health, performance, and/or training; and, disclose any commercial or financial conflicts of interest during such promulgations to the public. Finally, exercise physiologists can challenge companies who sell exercise equipment and/or nutritional supplements to develop scientifically based products, conduct research on their products, and honestly market the results of studies so consumers can make informed decisions. To us, that is the ethical and proper position to take and certainly not that of quacks. Table 1. Proposed Nutritional Ergogenic Aids Vitamins NutrientRDA (mg/d)Proposed Ergogenic ValueSummary of Research Findings Vitamin AMales 1.0 Females 0.8Constituent of rhodopsin (visual pigment) and is involved in night vision. Some suggest that Vitamin A supplementation may improve sport vision. No studies have shown that Vitamin A supplementation improves exercise performance  ADDIN EN.CITE Williams1989290402507696301989Vitamin supplementation and athletic performance163-91Williams, M. H.Int J Vitam Nutr Res SupplEfficiency/drug effectsHumanPhysical Endurance/drug effects*SportsVitamins/administration & dosage/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=250769620002905011145214100122000DecPosition of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and athletic performance1543-56J Am Diet AssocAltitudeBody CompositionBody WeightDehydration/prevention & controlDietDietary SupplementsEnergy MetabolismExercise/physiologyHuman*NutritionPhysical Endurance/physiology*Sports/physiologyTemperaturehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=111452142000290601112886232122000DecJoint Position Statement: nutrition and athletic performance. American College of Sports Medicine, American Dietetic Association, and Dietitians of Canada2130-45Med Sci Sports ExercAltitudeBody CompositionBody WeightDehydration/prevention & controlDietDietary SupplementsEnergy MetabolismExercise/physiologyHuman*NutritionPhysical Endurance/physiology*Sports/physiologyTemperaturehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11128862[359-361]. Vitamin D0.01 Promotes bone growth and mineralization. Enhances calcium absorption. Supplementation with calcium may help prevent bone loss in osteoperotic populations. Co-supplementation with calcium may help prevent bone loss in athletes susceptible to osteoporosis  ADDIN EN.CITE Reid199629960896961731261996DecTherapy of osteoporosis: calcium, vitamin D, and exercise278-86Department of Medicine, University of Auckland, New Zealand.Reid, I. R.Am J Med SciBone DensityCalcium/*therapeutic useExerciseFemaleHumanMenopause/physiologyOsteoporosis/*therapyRandomized Controlled TrialsSupport, Non-U.S. Gov'tVitamin D/*therapeutic usehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8969617[362]. However, Vitamin D supplementation does not enhance exercise performance  ADDIN EN.CITE Williams1989290402507696301989Vitamin supplementation and athletic performance163-91Williams, M. H.Int J Vitam Nutr Res SupplEfficiency/drug effectsHumanPhysical Endurance/drug effects*SportsVitamins/administration & dosage/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=250769620002905011145214100122000DecPosition of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and athletic performance1543-56J Am Diet AssocAltitudeBody CompositionBody WeightDehydration/prevention & controlDietDietary SupplementsEnergy MetabolismExercise/physiologyHuman*NutritionPhysical Endurance/physiology*Sports/physiologyTemperaturehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=111452142000290601112886232122000DecJoint Position Statement: nutrition and athletic performance. American College of Sports Medicine, American Dietetic Association, and Dietitians of Canada2130-45Med Sci Sports ExercAltitudeBody CompositionBody WeightDehydration/prevention & controlDietDietary SupplementsEnergy MetabolismExercise/physiologyHuman*NutritionPhysical Endurance/physiology*Sports/physiologyTemperaturehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11128862[359-361]. Vitamin EMales 10.0 Females 8.0As an antioxidant, Vitamin E has been shown to help prevent the formation of free radicals during intense exercise and prevent the destruction of red blood cells, improving or maintaining oxygen delivery to the muscles during exercise. Some evidence suggests that it may reduce risk to heart disease or decrease incidence of recurring heart attack.Numerous studies show that Vitamin E supplementation can decrease exercise-induced oxidative stress  ADDIN EN.CITE Kumar19922987015889321111-21992AprDietary supplementation of vitamin E protects heart tissue from exercise-induced oxidant stress109-15School of Life Sciences, University of Hyderabad, India.Kumar, C. T.Reddy, V. K.Prasad, M.Thyagaraju, K.Reddanna, P.Mol Cell BiochemAnimalBody WeightExertion/*physiologyFemaleFood, FortifiedFree Radicals/*metabolismHeart/*physiologyLipid Peroxidation/physiologyMyocardium/metabolismOrgan WeightOxygen/*metabolismRatsRats, Inbred StrainsStress/metabolism/*physiopathologySuperoxide Dismutase/metabolismSupport, Non-U.S. Gov'tVitamin E/metabolism/*pharmacologyXanthine Oxidase/metabolismhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1588932Goldfarb19932988084507262521993FebAntioxidants: role of supplementation to prevent exercise-induced oxidative stress232-6Exercise and Sport Science Department, University of North Carolina, Greensboro 27412.Goldfarb, A. H.Med Sci Sports ExercAnimalAntioxidants/*administration & dosageAscorbic Acid/*administration & dosage/physiologyExercise/*physiologyForecastingHumanLipid Peroxidation/*drug effectsLiver/metabolismMuscles/metabolismMyocardium/metabolismSupport, Non-U.S. Gov'tVitamin E/*administration & dosage/physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8450726Ji19952989076287301861995JunOxidative stress during exercise: implication of antioxidant nutrients1079-86Department of Kinesiology and Interdepartmental Program of Nutritional Sciences, University of Wisconsin-Madison, USA.Ji, L. L.Free Radic Biol Med*Antioxidants*DietExercise/*physiologyGlutathioneHuman*Oxidative StressSulfhydryl CompoundsVitaminshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7628730Appell19972990091879671831997AprSupplementation of vitamin E may attenuate skeletal muscle immobilization atrophy157-60Institute for Sport Orthopedics, German Sport University, Cologne, Germany.Appell, H. J.Duarte, J. A.Soares, J. M.Int J Sports MedAnimalGlutathione/physiologyHindlimb SuspensionMuscle, Skeletal/*physiopathologyMuscular Atrophy/*physiopathologyOxidative Stress/*physiologyPhysical Conditioning, Animal/physiologyRatsRats, WistarReactive Oxygen Species/physiologyVitamin E/*administration & dosage/pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9187967Goldfarb199929910103644192431999JunNutritional antioxidants as therapeutic and preventive modalities in exercise-induced muscle damage249-66Department of Exercise and Sport Science, University of North Carolina-Greensboro, 27402-6169, USA.Goldfarb, A. H.Can J Appl PhysiolAnimalAntioxidants/*therapeutic useAscorbic Acid/therapeutic useCalcium/metabolism*Dietary SupplementsExercise/*physiologyFree Radical Scavengers/therapeutic useFree Radicals/antagonists & inhibitors/metabolismHomeostasis/physiologyHumanIsoflavones/therapeutic useMuscle, Skeletal/*drug effects/metabolism/pathologyOxidative Stress/physiologyPain/metabolism/pathologyVitamin E/therapeutic usebeta Carotene/therapeutic usehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10364419Avellini1999299201042571812321999JunEffect of exercise training, selenium and vitamin E on some free radical scavengers in horses (Equus caballus)147-54Istituto di Biochimica e Chimica Medica, Universita di Perugia, Italy.Avellini, L.Chiaradia, E.Gaiti, A.Comp Biochem Physiol B Biochem Mol BiolAnimalDietary SupplementsErythrocytes/drug effects/metabolismFree Radical Scavengers/*bloodGlutathione Peroxidase/bloodHorses/*bloodLymphocytes/enzymologyMaleMalondialdehyde/bloodMethemoglobin/metabolismOxidative Stress*Physical Conditioning, AnimalSelenium/*blood/pharmacologySupport, Non-U.S. Gov'tVitamin E/*blood/pharmacologytert-Butylhydroperoxidehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10425718Baskin200029930109519776182000AugEffects of dietary antioxidant supplementation on oxidative damage and resistance to oxidative damage during prolonged exercise in sled dogs886-91Department of Veterinary Clinical Sciences, Veterinary Teaching Hospital, The Ohio State University, Columbus 43210, USA.Baskin, C. R.Hinchcliff, K. W.DiSilvestro, R. A.Reinhart, G. A.Hayek, M. G.Chew, B. P.Burr, J. R.Swenson, R. A.Am J Vet ResAnimalAntioxidants/*administration & dosageDeoxyguanosine/analogs & derivatives/blood*Dietary SupplementsDogs/metabolism/*physiologyEnzyme-Linked Immunosorbent Assay/veterinaryFemaleLinear ModelsLipid Peroxides/bloodLipoproteins, LDL/bloodLipoproteins, VLDL/bloodLutein/administration & dosage/bloodMaleOxidative Stress/*physiologyPhysical Conditioning, Animal/*adverse effectsRegression AnalysisSupport, Non-U.S. Gov'tVitamin A/bloodVitamin E/administration & dosage/bloodbeta Carotene/administration & dosage/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10951977Schroder200129940119059594042001AugEffects of alpha-tocopherol, beta-carotene and ascorbic acid on oxidative, hormonal and enzymatic exercise stress markers in habitual training activity of professional basketball players178-84Sports Medicine Barcelona, Department of Nutrition, Spain. helmuts@teleline.esSchroder, H.Navarro, E.Mora, J.Galiano, D.Tramullas, A.Eur J NutrAdultAntioxidants/*administration & dosage/metabolismAscorbic Acid/administration & dosage/bloodBasketball/*physiologyCreatine Kinase/metabolism*Dietary SupplementsExercise/*physiologyHumanHydrocortisone/bloodLactate Dehydrogenase/metabolismLipid PeroxidationMaleOxidation-ReductionOxidative StressSingle-Blind MethodSupport, Non-U.S. Gov'tTestosterone/bloodalpha-Tocopherol/administration & dosage/bloodbeta Carotene/administration & dosage/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11905959[363-370]. However, most studies show no effects on performance at sea level. At high-altitudes, Vitamin E may improve exercise performance  ADDIN EN.CITE Tiidus19952986074812762011995JulVitamin E status and response to exercise training12-23Department of Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada.Tiidus, P. M.Houston, M. E.Sports MedAnimalAntioxidants/pharmacologyExercise/*physiologyExercise Tolerance/drug effects/physiologyHumanMuscle, Skeletal/drug effects/physiologyOxidative StressPhysical Conditioning, Animal/physiologySports/physiologyVitamin E/pharmacology/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7481276Williams1989297502507696301989Vitamin supplementation and athletic performance163-91Williams, M. H.Int J Vitam Nutr Res SupplEfficiency/drug effectsHumanPhysical Endurance/drug effects*SportsVitamins/administration & dosage/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2507696[359, 371]. Additional research is necessary to determine whether long-term supplementation may help athletes tolerate training to a better degree.Vitamin KMales 0.08 Females 0.06Important in blood clotting. There is also some evidence that Vitamin K may affect bone metabolism in post-menopausal women. Vitamin K supplementation (10 mg/d) in elite female athletes has been reported to increase calcium-binding capacity of osteocalcin and promoted a 15-20% increase in bone formation markers and a 20-25% decrease in bone resorption markers suggesting an improved balance between bone formation and resorption  ADDIN EN.CITE Craciun19982995098398451971998OctImproved bone metabolism in female elite athletes after vitamin K supplementation479-84Department of Biochemistry and Cardiovascular Research Institute, Maastricht University, The Netherlands.Craciun, A. M.Wolf, J.Knapen, M. H.Brouns, F.Vermeer, C.Int J Sports MedAdultBiological Markers/bloodBone ResorptionBone and Bones/*metabolism*Dietary SupplementsEstradiol/bloodExercise/*physiologyFemaleFollicle Stimulating Hormone/bloodHumanLuteinizing Hormone/bloodRunning/*physiologySupport, Non-U.S. Gov'tVitamin K/administration & dosage/*bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9839845[372].Thiamin (B1)Males 1.2 Females 1.1Coenzyme (thiamin pyrophosphate) in the removal of CO2 from decarboxylic reactions from pyruvate to acetyl CoA and in TCA. Supplementation is theorized to improve anaerobic threshold and CO2 transport. Deficiencies may decrease efficiency of energy systems. Dietary availability of thiamin does not appear to affect exercise capacity when athletes have a normal intake  ADDIN EN.CITE Reid199629960896961731261996DecTherapy of osteoporosis: calcium, vitamin D, and exercise278-86Department of Medicine, University of Auckland, New Zealand.Reid, I. R.Am J Med SciBone DensityCalcium/*therapeutic useExerciseFemaleHumanMenopause/physiologyOsteoporosis/*therapyRandomized Controlled TrialsSupport, Non-U.S. Gov'tVitamin D/*therapeutic usehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8969617Fogelholm1993299708508194321993JunLack of association between indices of vitamin B1, B2, and B6 status and exercise-induced blood lactate in young adults165-76Dept. of Applied Chemistry and Microbiology, University of Helsinki, Finland.Fogelholm, M.Ruokonen, I.Laakso, J. T.Vuorimaa, T.Himberg, J. J.Int J Sport NutrAdolescentAdultAspartate Aminotransferases/bloodDouble-Blind MethodEnzyme ActivationErythrocytes/enzymologyExercise/*physiologyFemaleGlutathione Reductase/bloodHumanLactates/*bloodLactic AcidMalePyridoxine/*administration & dosageRiboflavin/*administration & dosageSupport, Non-U.S. Gov'tThiamine/*administration & dosageTransketolase/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8508194[362, 373].Riboflavin (B2)Males 1.3 Females 1.7Constituent of flavin nucleotide coenzymes involved in energy metabolism. Theorized to enhance energy availability during oxidative metabolism. Dietary availability of riboflavin does not appear to affect exercise capacity when athletes have a normal intake  ADDIN EN.CITE Reid199629960896961731261996DecTherapy of osteoporosis: calcium, vitamin D, and exercise278-86Department of Medicine, University of Auckland, New Zealand.Reid, I. R.Am J Med SciBone DensityCalcium/*therapeutic useExerciseFemaleHumanMenopause/physiologyOsteoporosis/*therapyRandomized Controlled TrialsSupport, Non-U.S. Gov'tVitamin D/*therapeutic usehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8969617Fogelholm1993299708508194321993JunLack of association between indices of vitamin B1, B2, and B6 status and exercise-induced blood lactate in young adults165-76Dept. of Applied Chemistry and Microbiology, University of Helsinki, Finland.Fogelholm, M.Ruokonen, I.Laakso, J. T.Vuorimaa, T.Himberg, J. J.Int J Sport NutrAdolescentAdultAspartate Aminotransferases/bloodDouble-Blind MethodEnzyme ActivationErythrocytes/enzymologyExercise/*physiologyFemaleGlutathione Reductase/bloodHumanLactates/*bloodLactic AcidMalePyridoxine/*administration & dosageRiboflavin/*administration & dosageSupport, Non-U.S. Gov'tThiamine/*administration & dosageTransketolase/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8508194[362, 373]. Niacin (B3)Males 16 Females 14Constituent of coenzymes involved in energy metabolism. Theorized to blunt increases in fatty acids during exercise, reduce cholesterol, enhance thermoregulation, and improve energy availability during oxidative metabolism. Studies indicate that niacin supplementation (100 to 500 mg/d) can help decrease blood lipid levels and increase homocysteine levels in hypercholesteremic patients  ADDIN EN.CITE Urberg19882998031990882761988DecHypocholesterolemic effects of nicotinic acid and chromium supplementation603-6Department of Family Medicine, Wayne State University, Detroit, Michigan.Urberg, M.Benyi, J.John, R.J Fam PractCase ReportCholesterol/bloodChromium/administration & dosage/*therapeutic useDrug Therapy, CombinationFemaleHumanHypercholesterolemia/blood/*drug therapyMiddle AgeNiacin/administration & dosage/*therapeutic usehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3199088Thomas19962999090968565531996DecEffect of chromium nicotinic acid supplementation on selected cardiovascular disease risk factors297-305TADC-DPH-SP, US Army Personnel Command, Alexandria, VA, USA.Thomas, V. L.Gropper, S. S.Biol Trace Elem ResAdministration, OralAdultAgedBlood Glucose/analysis/*drug effectsCardiovascular Diseases/epidemiology/*prevention & controlChromium/administration & dosage/*pharmacology/therapeutic useCross-Over StudiesDiabetes Mellitus, Non-Insulin-Dependent/*blood/complications/drug therapyDouble-Blind MethodFemaleGlucose Tolerance TestHumanInsulin/bloodLipids/*bloodLipoproteins, HDL Cholesterol/bloodLipoproteins, LDL Cholesterol/bloodMaleMiddle AgeNiacin/administration & dosage/*pharmacology/therapeutic useRisk FactorsSupport, Non-U.S. Gov'tTriglycerides/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9096856Philipp19983000097329108251998Sep 1Effect of niacin supplementation on fibrinogen levels in patients with peripheral vascular disease697-9, A9Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey 08903-0019, USA.Philipp, C. S.Cisar, L. A.Saidi, P.Kostis, J. B.Am J CardiolAdultAntilipemic Agents/*administration & dosageAntioxidants/administration & dosageArterial Occlusive Diseases/*bloodComparative StudyDose-Response Relationship, DrugFemaleFibrinogen/*metabolismHemodynamics/drug effectsHumanIschemia/bloodLeg/blood supplyLipoproteins, HDL Cholesterol/bloodLipoproteins, LDL Cholesterol/bloodMaleMiddle AgeNiacin/*administration & dosageSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Warfarin/administration & dosagehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9732910Garg199930010105774381386 Pt 11999DecNiacin treatment increases plasma homocyst(e)ine levels1082-7Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA. garg_rehka@lilly.comGarg, R.Malinow, M.Pettinger, M.Upson, B.Hunninghake, D.Am Heart JAgedFemaleHomocystine/*blood/*drug effectsHumanMaleMiddle AgeNiacin/*pharmacologySupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10577438Alaswad19993002011122691111999JulCombination drug therapy for dyslipidemia44-9Mid America Heart Institute of Saint Luke's Hospital, USA.Alaswad, K.O'Keefe, J. H., Jr.Moe, R. M.Curr Atheroscler RepAnion Exchange Resins/administration & dosageAntilipemic Agents/*administration & dosageDrug Therapy, CombinationFish Oils/administration & dosageHumanHydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosageHyperlipidemia/blood/*drug therapyLipoproteins, LDL Cholesterol/bloodNiacin/administration & dosageSitosterols/administration & dosagehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11122691[374-378]. However, niacin supplementation (280 mg) during exercise has been reported to decrease exercise capacity by blunting the mobilization of fatty acids  ADDIN EN.CITE Murray19953003075649732771995JulPhysiological and performance responses to nicotinic-acid ingestion during exercise1057-62Exercise Physiology Laboratory, Gatorade Sports Science Institute, Barrington, IL 60010, USA.Murray, R.Bartoli, W. P.Eddy, D. E.Horn, M. K.Med Sci Sports ExercBlood Glucose/analysisExercise/*physiologyFatty Acids, Nonesterified/*bloodFemaleGrowth Hormone/bloodHumanHydrocortisone/bloodInsulin/bloodMaleNiacin/*pharmacologyOxygen Consumptionhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7564973[379]. Pyridoxine (B6)1.3Pyridoxine has been market as a supplement that will improve muscle mass, strength and aerobic power in the lactic acid and oxygen systems. It also may have a calming effect that has been linked to an improved mental strength.In well-nourished athletes, pyridoxine failed to improve aerobic capacity, or lactic acid accumulation  ADDIN EN.CITE Reid199629960896961731261996DecTherapy of osteoporosis: calcium, vitamin D, and exercise278-86Department of Medicine, University of Auckland, New Zealand.Reid, I. R.Am J Med SciBone DensityCalcium/*therapeutic useExerciseFemaleHumanMenopause/physiologyOsteoporosis/*therapyRandomized Controlled TrialsSupport, Non-U.S. Gov'tVitamin D/*therapeutic usehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8969617Fogelholm1993299708508194321993JunLack of association between indices of vitamin B1, B2, and B6 status and exercise-induced blood lactate in young adults165-76Dept. of Applied Chemistry and Microbiology, University of Helsinki, Finland.Fogelholm, M.Ruokonen, I.Laakso, J. T.Vuorimaa, T.Himberg, J. J.Int J Sport NutrAdolescentAdultAspartate Aminotransferases/bloodDouble-Blind MethodEnzyme ActivationErythrocytes/enzymologyExercise/*physiologyFemaleGlutathione Reductase/bloodHumanLactates/*bloodLactic AcidMalePyridoxine/*administration & dosageRiboflavin/*administration & dosageSupport, Non-U.S. Gov'tThiamine/*administration & dosageTransketolase/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8508194[362, 373]. (39-40). However, when combined with vitamins B1 and B12, it may increase serotonin levels and improve fine motor skills that may be necessary in sports like pistol shooting and archery  ADDIN EN.CITE Bonke1989300402507698301989Improvement of fine motoric movement control by elevated dosages of vitamin B1, B6, and B12 in target shooting198-204Bonke, D.Nickel, B.Int J Vitam Nutr Res SupplHumanPsychomotor Performance/*drug effectsPyridoxine/*pharmacologySportsThiamine/*pharmacologyVitamin B 12/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2507698Williams1989300502507696301989Vitamin supplementation and athletic performance163-91Williams, M. H.Int J Vitam Nutr Res SupplEfficiency/drug effectsHumanPhysical Endurance/drug effects*SportsVitamins/administration & dosage/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2507696Bonke1986300603964214381986Influence of vitamin B1, B6, and B12 on the control of fine motoric movements104-9Bonke, D.Bibl Nutr DietaBrain/physiologyComparative StudyHumanPsychomotor Performance/*drug effectsPyridoxine/*pharmacologyThiamine/*pharmacologyTime FactorsVitamin B 12/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3964214[359, 380, 381].Cyano-cobalamin (B12)2.4 mcg/d Cyanocobalamin is a coenzyme involved in the production of DNA and serotonin. DNA is important in protein and red blood cell synthesis. Theoretically it would increase muscle mass, the oxygen-carrying capacity of blood and decrease anxiety.In well-nourished athletes, no ergogenic effect has been reported. However, when combined with vitamins B1 and B6, cyanocobalamin has been shown to improve performance in pistol shooting  ADDIN EN.CITE Bonke1989300402507698301989Improvement of fine motoric movement control by elevated dosages of vitamin B1, B6, and B12 in target shooting198-204Bonke, D.Nickel, B.Int J Vitam Nutr Res SupplHumanPsychomotor Performance/*drug effectsPyridoxine/*pharmacologySportsThiamine/*pharmacologyVitamin B 12/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2507698Williams1989300502507696301989Vitamin supplementation and athletic performance163-91Williams, M. H.Int J Vitam Nutr Res SupplEfficiency/drug effectsHumanPhysical Endurance/drug effects*SportsVitamins/administration & dosage/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2507696Bonke1986300603964214381986Influence of vitamin B1, B6, and B12 on the control of fine motoric movements104-9Bonke, D.Bibl Nutr DietaBrain/physiologyComparative StudyHumanPsychomotor Performance/*drug effectsPyridoxine/*pharmacologyThiamine/*pharmacologyTime FactorsVitamin B 12/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3964214[359, 380, 381]. This may be due to increased levels of serotonin, a neurotransmitter in the brain, which may reduce anxiety.Folacin400Folic acid functions as a coenzyme in the formation of DNA and red blood cells. An increase in red blood cells could improve oxygen deliver to the muscles during exercise. Believed to be important to help prevent birth defects and may help increase homocysteine levels. Studies suggest that increasing dietary availability of folic acid during pregnancy can lower the incidence of birth defects in children  ADDIN EN.CITE Van Dyke200230100120883124462002JunFolic acid and prevention of birth defects426-9Division of Developmental Disabilities, The Children's Hospital of Iowa, Iowa City, USA. don-vandyke@uiowa.eduVan Dyke, D. C.Stumbo, P. J.Mary, J. B.Niebyl, J. R.Dev Med Child NeurolAbnormalities/*prevention & controlAbsorptionAdultDietary SupplementsDrug InteractionsFemaleFolic Acid/pharmacokinetics/*pharmacology/*therapeutic useHematinics/pharmacokinetics/*pharmacology/*therapeutic useHomocysteine/metabolismHumanInfant, NewbornNutritionPreconception CarePregnancyRisk FactorsSupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12088312Krishnaswamy2001301201150909985 Suppl 22001MayImportance of folate in human nutritionS115-24National Institute of Nutrition, Jamai-Osmania, Hyderabad-500007, India. icmrnin@ren.nic.inKrishnaswamy, K.Madhavan Nair, K.Br J NutrBiological AvailabilityBirth WeightCardiovascular Diseases/etiologyFemaleFolic Acid/administration & dosage/*physiologyFolic Acid Deficiency/complications/*epidemiologyHomocysteine/bloodHumanIndia/epidemiologyIntestinal AbsorptionLiver/embryology/metabolismMaleMeatNeoplasms/etiologyNeural Tube Defects/etiologyNutrition*Nutrition PolicyPregnancyPrevalence*Public HealthVegetableshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11509099Scholl20003015010799405715 Suppl2000MayFolic acid: influence on the outcome of pregnancy1295S-303SDepartment of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine, Stratford 08084, USA. scholl@umdnj.eduScholl, T. O.Johnson, W. G.Am J Clin Nutr*Dietary SupplementsFemaleFolic Acid/*administration & dosageHomocysteine/bloodHumanPregnancy*Pregnancy OutcomeSupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10799405Refsum2001301301150909885 Suppl 22001MayFolate, vitamin B12 and homocysteine in relation to birth defects and pregnancy outcomeS109-13Department of Pharmacology, University of Bergen, Armauer Hansens Hus, 5021 Bergen, Norway. helga.refsum@farm.uib.noRefsum, H.Br J NutrAbnormalities/etiology/prevention & controlDeficiency Diseases/*metabolism/prevention & control*Developing CountriesFemaleFolic Acid/administration & dosage/*metabolismFolic Acid Deficiency/complications/drug therapyHomocysteine/*metabolismHumanInfant, NewbornNeural Tube Defects/etiologyPregnancyPregnancy Complications/*metabolism/prevention & controlPregnancy OutcomeVitamin B 12/administration & dosage/*metabolismVitamin B 12 Deficiency/complications/drug therapyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11509098[382-385]. Additionally, that it may decrease homocysteine levels (a risk factor to heart disease)  ADDIN EN.CITE Mattson20023011012039451112002FebFolic acid and homocysteine in age-related disease95-111Laboratory of Neurosciences, Gerontology Research Center, National Institute on Aging, 5600 Nathan Shock Drive, Baltimore, MD 21224, USA. mattsonm@grc.nia.nih.govMattson, M. P.Kruman,, IIDuan, W.Ageing Res RevAbnormalities/etiologyAgedAging/*metabolismCardiovascular Diseases/metabolismCerebrovascular Accident/metabolismFemaleFolic Acid/*metabolismFolic Acid Deficiency/pathologyHomocysteine/*metabolismHumanMaleMental Disorders/metabolismNeoplasms/etiology/metabolismNeurodegenerative Diseases/metabolismSupport, U.S. Gov't, P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12039451Rader200230090121637131328 Suppl2002AugFolic acid fortification, folate status and plasma homocysteine2466S-2470SCenter for Food Safety and Applied Nutrition, Food and Drug Administration, Washington, DC 20204, USA. jrader@cfsan.fda.govRader, J. I.J NutrCohort StudiesFolic Acid/*administration & dosage/*bloodHomocysteine/*bloodHumanNeural Tube Defects/prevention & controlhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12163713Refsum2001301301150909885 Suppl 22001MayFolate, vitamin B12 and homocysteine in relation to birth defects and pregnancy outcomeS109-13Department of Pharmacology, University of Bergen, Armauer Hansens Hus, 5021 Bergen, Norway. helga.refsum@farm.uib.noRefsum, H.Br J NutrAbnormalities/etiology/prevention & controlDeficiency Diseases/*metabolism/prevention & control*Developing CountriesFemaleFolic Acid/administration & dosage/*metabolismFolic Acid Deficiency/complications/drug therapyHomocysteine/*metabolismHumanInfant, NewbornNeural Tube Defects/etiologyPregnancyPregnancy Complications/*metabolism/prevention & controlPregnancy OutcomeVitamin B 12/administration & dosage/*metabolismVitamin B 12 Deficiency/complications/drug therapyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11509098Lucock20003014011001804711-22000Sep-OctFolic acid: nutritional biochemistry, molecular biology, and role in disease processes121-38Academic Unit of Paediatrics and Obstetrics and Gynaecology, University of Leeds, D Floor, Clarendon Wing, Leeds General Infirmary, West Yorkshire, Leeds, LS2 9NS, United Kingdom.Lucock, M.Mol Genet MetabBiological Transport, ActiveCoenzymes/metabolismDietFemaleFolic Acid/administration & dosage/chemistry/*metabolismFood, FortifiedHomocysteine/metabolismHumanMolecular BiologyNeoplasms/etiology/prevention & controlNeural Tube Defects/etiology/prevention & controlNutritionPregnancyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11001804Krishnaswamy2001301201150909985 Suppl 22001MayImportance of folate in human nutritionS115-24National Institute of Nutrition, Jamai-Osmania, Hyderabad-500007, India. icmrnin@ren.nic.inKrishnaswamy, K.Madhavan Nair, K.Br J NutrBiological AvailabilityBirth WeightCardiovascular Diseases/etiologyFemaleFolic Acid/administration & dosage/*physiologyFolic Acid Deficiency/complications/*epidemiologyHomocysteine/bloodHumanIndia/epidemiologyIntestinal AbsorptionLiver/embryology/metabolismMaleMeatNeoplasms/etiologyNeural Tube Defects/etiologyNutrition*Nutrition PolicyPregnancyPrevalence*Public HealthVegetableshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11509099[383, 385-388]. In well-nourished and folate deficient athletes, folic acid did not improve exercise performance  ADDIN EN.CITE Williams1989300502507696301989Vitamin supplementation and athletic performance163-91Williams, M. H.Int J Vitam Nutr Res SupplEfficiency/drug effectsHumanPhysical Endurance/drug effects*SportsVitamins/administration & dosage/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2507696[359].Pantothenic Acids5-9Pantothenic acid acts as a coenzyme for Acetyl Coenzyme A (Acetyl CoA). This may benefit aerobic or oxygen energy systems.Research has reported no improvements in aerobic performance with Acetyl CoA supplementation, however, one study reported a decrease in lactic acid accumulation, without an improvement in performance  ADDIN EN.CITE Webster19983016096507317761998MayPhysiological and performance responses to supplementation with thiamin and pantothenic acid derivatives486-91Laboratory of Applied Physiology, School of Human Performance and Recreation, University of Southern Mississippi, Hattiesburg 39406, USA.Webster, M. J.Eur J Appl Physiol Occup PhysiolAdultBicycling/physiologyBlood Glucose/metabolismDouble-Blind MethodExercise/*physiologyExercise TestFatty Acids, Nonesterified/bloodHeart Rate/drug effectsHumanLactic Acid/bloodMaleOxygen Consumption/drug effectsPantetheine/administration & dosage/analogs & derivativesPantothenic Acid/*administration & dosagePulmonary Gas Exchange/drug effectsSupport, Non-U.S. Gov'tThiamine/*administration & dosage/analogs & derivativeshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9650731Williams1989301702507696301989Vitamin supplementation and athletic performance163-91Williams, M. H.Int J Vitam Nutr Res SupplEfficiency/drug effectsHumanPhysical Endurance/drug effects*SportsVitamins/administration & dosage/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2507696[359, 389].Beta CaroteneNoneServes as an antioxidant. Theorized to help minimize exercise-induced lipid perioxidation and muscle damage. Research indicates that beta carotene supplementation with or without other antioxidants can help decrease exercise-induced perioxidation. Over time, this may help athletes tolerate training. However, it is unclear whether antioxidant supplementation affects exercise performance  ADDIN EN.CITE Goldfarb199929910103644192431999JunNutritional antioxidants as therapeutic and preventive modalities in exercise-induced muscle damage249-66Department of Exercise and Sport Science, University of North Carolina-Greensboro, 27402-6169, USA.Goldfarb, A. H.Can J Appl PhysiolAnimalAntioxidants/*therapeutic useAscorbic Acid/therapeutic useCalcium/metabolism*Dietary SupplementsExercise/*physiologyFree Radical Scavengers/therapeutic useFree Radicals/antagonists & inhibitors/metabolismHomeostasis/physiologyHumanIsoflavones/therapeutic useMuscle, Skeletal/*drug effects/metabolism/pathologyOxidative Stress/physiologyPain/metabolism/pathologyVitamin E/therapeutic usebeta Carotene/therapeutic usehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10364419[367]. Vitamin CMales 90 Females 75Vitamin C is used in a number of different metabolic processes in the body. It is involved in the synthesis of epinephrine, iron absorption and is an antioxidant. Theoretically, it could benefit exercise performance by improving metabolism during exercise. There is also evidence that vitamin C may enhance immunity.In well-nourished athletes, Vitamin C supplementation does not appear to improve physical performance  ADDIN EN.CITE van der Beek19943021077065981361994DecThiamin, riboflavin and vitamin B6: impact of restricted intake on physical performance in man629-40TNO Nutrition and Food Research, Zeist, The Netherlands.van der Beek, E. J.van Dokkum, W.Wedel, M.Schrijver, J.van den Berg, H.J Am Coll NutrAdultDouble-Blind MethodEnergy Metabolism/physiologyErythrocytes/enzymologyExercise TestFlavin-Adenine Dinucleotide/bloodHumanLactates/bloodMaleMitochondria/metabolismOxygen Consumption/physiologyPhysical Fitness/*physiologyRiboflavin Deficiency/blood/*physiopathology/urineThiamine Deficiency/blood/*physiopathology/urineTime FactorsTransketolase/bloodVitamin B 6 Deficiency/blood/*physiopathology/urinehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7706598van der Beek19943022079631451341994AugCombinations of low thiamin, riboflavin, vitamin B6 and vitamin C intake among Dutch adults. (Dutch Nutrition Surveillance System)383-91Department of Human Nutrition, TNO Toxicology and Nutrition Institute, The Netherlands.van der Beek, E. J.Lowik, M. R.Hulshof, K. F.Kistemaker, C.J Am Coll NutrAdultAgedAlcohol DrinkingAscorbic Acid/*administration & dosageDietDietary Proteins/administration & dosageEnergy IntakeFemaleHumanMaleMiddle AgeNetherlandsNutritional RequirementsPyridoxine/*administration & dosageRiboflavin/*administration & dosageThiamine/*administration & dosagehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7963145van der Beek19883033032020954861988DecThiamin, riboflavin, and vitamins B-6 and C: impact of combined restricted intake on functional performance in man1451-62Department of Human Nutrition, TNO-CIVO Toxicology and Nutrition Institute, Zeist, The Netherlands.van der Beek, E. J.van Dokkum, W.Schrijver, J.Wedel, M.Gaillard, A. W.Wesstra, A.van de Weerd, H.Hermus, R. J.Am J Clin NutrAdultAscorbic Acid Deficiency/*physiopathologyBody CompositionDouble-Blind MethodHumanLactates/bloodLactic AcidMaleNutritional Requirements*Psychomotor PerformanceRiboflavin Deficiency/*physiopathologyThiamine Deficiency/*physiopathologyVitamin B 6 Deficiency/*physiopathologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3202095van der Beek19913029018953659 Spec No1991SummerVitamin supplementation and physical exercise performance77-90Department of Human Nutrition, TNO Toxicology and Nutrition Institute, Zeist, The Netherlands.van der Beek, E. J.J Sports SciAdaptation, PhysiologicalExercise/*physiologyHumanIntestinal AbsorptionMitochondria, Muscle/metabolismTask Performance and AnalysisVitamins/administration & dosage/*metabolismhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1895365[390-393]. However, there is some evidence that vitamin C supplementation following intense-exercise (e.g., 500 mg/d) may decrease the incidence of upper respiratory tract infections  ADDIN EN.CITE van der Beek19943021077065981361994DecThiamin, riboflavin and vitamin B6: impact of restricted intake on physical performance in man629-40TNO Nutrition and Food Research, Zeist, The Netherlands.van der Beek, E. J.van Dokkum, W.Wedel, M.Schrijver, J.van den Berg, H.J Am Coll NutrAdultDouble-Blind MethodEnergy Metabolism/physiologyErythrocytes/enzymologyExercise TestFlavin-Adenine Dinucleotide/bloodHumanLactates/bloodMaleMitochondria/metabolismOxygen Consumption/physiologyPhysical Fitness/*physiologyRiboflavin Deficiency/blood/*physiopathology/urineThiamine Deficiency/blood/*physiopathology/urineTime FactorsTransketolase/bloodVitamin B 6 Deficiency/blood/*physiopathology/urinehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7706598van der Beek19943022079631451341994AugCombinations of low thiamin, riboflavin, vitamin B6 and vitamin C intake among Dutch adults. (Dutch Nutrition Surveillance System)383-91Department of Human Nutrition, TNO Toxicology and Nutrition Institute, The Netherlands.van der Beek, E. J.Lowik, M. R.Hulshof, K. F.Kistemaker, C.J Am Coll NutrAdultAgedAlcohol DrinkingAscorbic Acid/*administration & dosageDietDietary Proteins/administration & dosageEnergy IntakeFemaleHumanMaleMiddle AgeNetherlandsNutritional RequirementsPyridoxine/*administration & dosageRiboflavin/*administration & dosageThiamine/*administration & dosagehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7963145van der Beek19883033032020954861988DecThiamin, riboflavin, and vitamins B-6 and C: impact of combined restricted intake on functional performance in man1451-62Department of Human Nutrition, TNO-CIVO Toxicology and Nutrition Institute, Zeist, The Netherlands.van der Beek, E. J.van Dokkum, W.Schrijver, J.Wedel, M.Gaillard, A. W.Wesstra, A.van de Weerd, H.Hermus, R. J.Am J Clin NutrAdultAscorbic Acid Deficiency/*physiopathologyBody CompositionDouble-Blind MethodHumanLactates/bloodLactic AcidMaleNutritional Requirements*Psychomotor PerformanceRiboflavin Deficiency/*physiopathologyThiamine Deficiency/*physiopathologyVitamin B 6 Deficiency/*physiopathologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3202095van der Beek19913029018953659 Spec No1991SummerVitamin supplementation and physical exercise performance77-90Department of Human Nutrition, TNO Toxicology and Nutrition Institute, Zeist, The Netherlands.van der Beek, E. J.J Sports SciAdaptation, PhysiologicalExercise/*physiologyHumanIntestinal AbsorptionMitochondria, Muscle/metabolismTask Performance and AnalysisVitamins/administration & dosage/*metabolismhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1895365Pedersen199930400106042105831999AugExercise and immune function: effect of ageing and nutrition733-42Copenhagen Muscle Research Centre, Denmark. bkp@rh.dkPedersen, B. K.Bruunsgaard, H.Jensen, M.Krzywkowski, K.Ostrowski, K.Proc Nutr Soc*AgingDietExercise/*physiologyHuman*Immunity*NutritionPhysical EnduranceSupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10604210Gleeson2000304101089302421 Suppl 12000MayElite athlete immunology: importance of nutritionS44-50School of Sport and Exercise Sciences, University of Edgbaston, Birmingham, England. m.gleeson@bham.ac.ukGleeson, M.Bishop, N. C.Int J Sports MedDietary Carbohydrates/immunologyDietary Fats/immunologyDietary Proteins/immunologyExercise/*physiologyFood Habits/*physiologyHumanImmune Tolerance/*physiologyImmunity/*physiologyMinerals/immunology*SportsVitamins/immunologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10893024Nieman2000304201089302621 Suppl 12000MayExercise immunology: future directions for research related to athletes, nutrition, and the elderlyS61-8Department of Health, Leisure, and Exercise Science, Appalachian State University, Boone, NC 28608, USA. niemandc@appstate.eduNieman, D. C.Int J Sports MedAged/*physiology*DietDietary SupplementsExercise/*physiologyHumanImmune Tolerance/physiologyImmunity/*physiology*Sportshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10893026Bishop199930430105414402831999SepNutritional aspects of immunosuppression in athletes151-76School of Sport and Exercise Sciences, University of Birmingham, Edgbaston, England.Bishop, N. C.Blannin, A. K.Walsh, N. P.Robson, P. J.Gleeson, M.Sports MedDiet/*adverse effectsDiet, Fat-Restricted/adverse effectsDiet, Protein-Restricted/adverse effectsDietary Carbohydrates/immunology/metabolismDietary Fats/immunology/metabolismDietary Proteins/immunology*ImmunosuppressionMinerals/immunologyOpportunistic InfectionsSports/*physiologySports MedicineSupport, Non-U.S. Gov'tVitamins/administration & dosage/immunologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10541440Shephard199830440964409341998Immunological hazards from nutritional imbalance in athletes22-48Faculty of Physical Education & Health, University of Toronto, Ontario.Shephard, R. J.Shek, P. N.Exerc Immunol RevAmino Acids/immunology/metabolismAnimalCarbohydrates/immunology/metabolismDiet, Fat-RestrictedEatingEnergy Metabolism/immunologyFats/immunology/metabolismFood HabitsHumanNutritional Status/*immunologyPeptides/immunology/metabolismProteins/immunology/metabolismSupport, Non-U.S. Gov'tVitamins/immunology/metabolismhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9644093[390-398]. Recommended Dietary Allowances (RDA) based on the 2002 Food & Nutrition Board, National Academy of Sciences-National Research Council recommendations. Table 2. Proposed Nutritional Ergogenic Aids Minerals NutrientRDA (mg/d)Proposed Ergogenic ValueSummary of Research Findings BoronNoneBoron has been marketed to athletes as a dietary supplement that may promote muscle growth during resistance training. The rationale was primarily based on an initial report that boron supplementation (3 mg/d) significantly increased (-estradiol and testosterone levels in post-menopausal women consuming a diet low in boron. Studies which have investigated the effects of 7-wks of boron supplementation (2.5 mg/d) during resistance training on testosterone levels, body composition, and strength have reported no ergogenic value  ADDIN EN.CITE Green1994233807889885102 Suppl 71994NovPlasma boron and the effects of boron supplementation in males73-7Department of Nutrition and Food Science, Auburn University, AL 36849.Green, N. R.Ferrando, A. A.Environ Health PerspectAdultBody Composition/drug effects/*physiologyBoron/administration & dosage/*bloodHumanMaleNutritional RequirementsPhysical Endurance/drug effects/physiologySupport, Non-U.S. Gov'tTestosterone/bloodWeight Lifting/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7889885Ferrando1993233908508192321993JunThe effect of boron supplementation on lean body mass, plasma testosterone levels, and strength in male bodybuilders140-9NASA, Johnson Space Center, Houston, TX 77058.Ferrando, A. A.Green, N. R.Int J Sport NutrAdult*Body Mass IndexBoron/*administration & dosage/blood*DietDouble-Blind MethodHumanMaleMuscles/*physiologySupport, Non-U.S. Gov'tTestosterone/*bloodWeight Lifting/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8508192[135, 136]. There is no evidence at this time that boron supplementation during resistance-training promotes muscle growth.Calcium1,200 for 15 years and older Involved in bone and tooth formation, blood clotting and nerve transmission. Stimulates fat metabolism. Diet should contain sufficient amounts especially in growing children/adolescents, female athletes, and post-menopausal women. Vitamin D needed to assist absorption.Calcium supplementation may be beneficial in populations susceptible to osteoperosis  ADDIN EN.CITE Grados200330450128147637032003JunEffects on bone mineral density of calcium and vitamin D supplementation in elderly women with vitamin D deficiency203-208Rheumatology Department, North Hospital Group, 80054 cedex 1, Amiens, FranceGrados, F.Brazier, M.Kamel, S.Duver, S.Heurtebize, N.Maamer, M.Mathieu, M.Garabedian, M.Sebert, J. L.Fardellone, P.Joint Bone Spinehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12814763Fogelholm200330460127978423382003Dairy products, meat and sports performance615-31The UKK Institute for Health Promotion Research, Tampere, Finland.Fogelholm, M.Sports Medhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12797842Prestwood20023047012739329462002Prevention and treatment of osteoporosis31-41Division of Geriatrics, University of Connecticut Center on Aging, University of Connecticut Health Center, Farmington, Connecticut, USA.Prestwood, K. M.Raisz, L. G.Clin CornerstoneAgedAlendronate/therapeutic useCalcitonin/therapeutic useCalcium/administration & dosageDietary SupplementsEstrogen Replacement TherapyEtidronic Acid/*analogs & derivatives/therapeutic useExerciseFemaleHumanMiddle AgeOsteoporosis/diet therapy/drug therapy/*prevention & controlSelective Estrogen Receptor Modulators/therapeutic useVitamin D/administration & dosagehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12739329Love200330480125747211212003Jan 9-22Dietary needs for bone health and the prevention of osteoporosis12-21St George's Hospital Medical School, London, UK.Love, C.Br J NursBone and Bones/*metabolismCalcium/deficiency/metabolismDeficiency Diseases/etiology/*prevention & controlDiet/*standardsDietary Supplements/standardsEstrogens, Non-Steroidal/metabolismFood Labeling/standardsHumanOsteoporosis/metabolism/*prevention & controlVitamin D/pharmacokineticsVitamin D Deficiency/etiology/metabolism/prevention & controlhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12574721[399-402]. Additionally, calcium supplementation has been shown to promote fat metabolism and help manage body composition  ADDIN EN.CITE Zemel200026780http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10834935Zemel, M. B.Shi, H.Greer, B.Dirienzo, D.Zemel, P. C.Regulation of adiposity by dietary calciumAdipocytes/cytology/*drug effects/enzymology/metabolismAdultAnimalBlood Glucose/analysisBody Temperature/drug effectsCalcium/*metabolismCalcium, Dietary/administration & dosage/*pharmacology/therapeutic useCells, CulturedDairy ProductsEnergy IntakeEnergy Metabolism/drug effectsFatty Acid Synthetase Complex/genetics/metabolismFemaleHumanInsulin/bloodLipolysis/*drug effectsMaleMiceMice, TransgenicObesity/blood/diet therapy/metabolismParathyroid Hormones/antagonists & inhibitors/pharmacologyProteins/genetics/metabolismSupport, Non-U.S. Gov'tVitamin D/antagonists & inhibitors/pharmacologyWeight Gain/drug effectsDepartment of Nutrition, The University of Tennessee, Knoxville, Tennessee 37996-1900, USA. mzemel@utk.edu10834935Faseb J20001491132-8.Zemel200126730http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11603653Zemel, M. B.Calcium modulation of hypertension and obesity: mechanisms and implicationsAdipose Tissue/drug effectsBlood Pressure/drug effectsCalcium/*metabolismCalcium, Dietary/*administration & dosage/therapeutic useHomeostasisHumanHypertension/drug therapy/*prevention & controlObesity/drug therapy/metabolism/*prevention & controlSodium Chloride, Dietary/adverse effectsVitamin D/*analogs & derivatives/*metabolismDepartment of Nutrition, University of Tennessee, Knoxville, USA. mzemel@utk.edu11603653J Am Coll Nutr2001205 Suppl428S-435S; discussion 440S-442S.Zemel200226870Zemel, M., Thompson, W.Zemel, P.Nocton, A.Milstead, A.Morris, K.Campbell, P.2002Dietary calcium and dairy products accelerate weight and fat-loss during energy restriction in obese adultsClin Nutri75Zemel200326750http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12733746Zemel, M. B.Role of dietary calcium and dairy products in modulating adiposityDepartment of Nutrition, The University of Tennessee, Nutrition Institute, Knoxville, Tennessee 37996, USA. mzemel@utk.edu12733746Lipids2003382139-46.Zemel200326760http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12514303Zemel, M. B.Mechanisms of dairy modulation of adiposityAdipocytes/*drug effects/metabolismAnimalCalcium, Dietary/*therapeutic use*Dairy ProductsGuinea PigsHumanMiceMice, TransgenicObesity/*diet therapyProteins/*drug effectsDepartment of Nutrition, The University of Tennessee, Knoxville 37996, USA. mzemel@utk.edu12514303J Nutr20031331252S-256S.Zemel200226800http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11999543Zemel, M. B.Regulation of adiposity and obesity risk by dietary calcium: mechanisms and implicationsAdipocytes/drug effects/metabolism*Adipose Tissue*Body CompositionCalcitriol/administration & dosage/physiologyCalcium/physiologyCalcium, Dietary/*administration & dosageDairy ProductsEnergy IntakeFatty Acids/metabolismFeces/chemistryHumanObesity/*prevention & controlProteins/metabolismRisk FactorsWeight LossThe University of Tennessee, Knoxville 37996, USA. mzemel@utk.edu11999543J Am Coll Nutr2002212146S-151S.[220-224, 403]. However, calcium supplementation provides no ergogenic effect on exercise performance.ChromiumMales 0.035 Females 0.025Chromium, commonly sold as Chromium Picolinate has been marketed with claims that the supplement will increase lean body mass and decrease body fat levels.Animal research indicates that chromium supplementation increases lean body mass and reduces body fat. Early research on humans reported similar results  ADDIN EN.CITE Hasten1992235701299504241992DecEffects of chromium picolinate on beginning weight training students343-50Dept. of Kinesiology, Louisiana State University, Baton Rouge 70803-7101.Hasten, D. L.Rome, E. P.Franks, B. D.Hegsted, M.Int J Sport NutrAdultComparative StudyDouble-Blind MethodFemaleHumanMalePicolinic Acids/*pharmacologyPlacebosSex CharacteristicsWeight Gain/*drug effects*Weight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1299504[138], however more recent, well-controlled studies reported that chromium supplementation (200 to 800 mcg/d) does not improve lean body mass or reduce body fat  ADDIN EN.CITE Kreider19991440http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10091274Kreider, R. B.Dietary supplements and the promotion of muscle growth with resistance exerciseAnabolic Steroids/metabolismBoron/administration & dosage/pharmacologyChromium/administration & dosage/pharmacologyCreatine/administration & dosage/pharmacologyDietary Carbohydrates/administration & dosage/pharmacologyDietary Proteins/administration & dosage/pharmacology*Dietary SupplementsGlutamine/administration & dosage/pharmacologyHumanLeucine/administration & dosage/pharmacologyMuscle, Skeletal/drug effects/*growth & developmentNutritionPrasterone/administration & dosage/pharmacologyProteins/biosynthesisTestosterone/metabolismValerates/administration & dosage/pharmacologyVanadium Compounds/administration & dosage/pharmacologyWeight Lifting/*physiologyDepartment of Human Movement Sciences and Education, University of Memphis, Tennessee, USA. kreider.richard@coe.memphis.edu10091274Sports Med199927297-110.Walker19986420http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=9861607Walker, L. S.Bemben, M. G.Bemben, D. A.Knehans, A. W.Chromium picolinate effects on body composition and muscular performance in wrestlersAdolescenceAdultAnaerobic Threshold/drug effectsAnalysis of VarianceBlood Glucose/analysisBody Composition/*drug effectsDiet*Dietary SupplementsDouble-Blind MethodEnergy Metabolism/drug effectsFollow-Up StudiesHumanInsulin/bloodMaleMuscle Contraction/drug effectsMuscle, Skeletal/*drug effects/metabolismOxygen Consumption/drug effectsPhysical Endurance/drug effectsPicolinic Acids/administration & dosage/*therapeutic usePlacebosRunning/physiologySupport, Non-U.S. Gov'tWeight Lifting/physiologyWrestling/education/*physiologyDepartment of Health & Sport Sciences, University of Oklahoma, Norman, USA.9861607Med Sci Sports Exerc199830121730-7.Campbell199912060Campbell, W. W.Joseph, L. J.Davey, S. L.Cyr-Campbell, D.Anderson, R. A.Evans, W. J.Effects of resistance training and chromium picolinate on body composition and skeletal muscle in older menAgedBody Composition/drug effects/*physiologyCreatine/urineDietEnergy Metabolism/physiologyHumanIron Chelating Agents/*pharmacologyMaleMiddle AgeMuscle, Skeletal/drug effects/metabolism/*physiologyPhysical Fitness/*physiologyPicolinic Acids/*pharmacologySkinfold ThicknessSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Weight Lifting/*physiologyDonald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, and Veterans Affairs Geriatric Research, Education, and Clinical Center, Little Rock, Arkansas 72205, USA. campbellwaynew@exchange.uams.edu9887110http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=9887110 http://jap.physiology.org/cgi/content/full/86/1/29J Appl Physiol199986129-39.Campbell200223410121876131222002JunEffects of resistive training and chromium picolinate on body composition and skeletal muscle size in older women125-35Department of Foods and Nutrition, Purdue University, West Lafayette, IN 47907, USA.Campbell, W. W.Joseph, L. J.Anderson, R. A.Davey, S. L.Hinton, J.Evans, W. J.Int J Sport Nutr Exerc MetabAgedAnalysis of VarianceBody Composition/*drug effectsDouble-Blind MethodFemaleHumanIron Chelating Agents/*administration & dosageMiddle AgeMuscle, Skeletal/*drug effectsObesity/*therapyPicolinic Acids/*administration & dosage/urineSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Time FactorsWeight Lifting/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12187613Volpe200123440115060572042001AugEffect of chromium supplementation and exercise on body composition, resting metabolic rate and selected biochemical parameters in moderately obese women following an exercise program293-306Department of Nutrition, University of Massachusetts, Amherst 01003, USA. volpe@nutrition.umass.eduVolpe, S. L.Huang, H. W.Larpadisorn, K.Lesser,, IIJ Am Coll NutrAdult*Basal MetabolismBlood Glucose/analysisBlood Proteins/metabolism*Body CompositionC-Peptide/bloodCholesterol/bloodChromium/*administration & dosage/blood/urineDietDietary SupplementsDouble-Blind Method*ExerciseFastingFemaleGlucagon/bloodHumanInsulin/bloodIron/blood/urineLipids/bloodMiddle AgeObesity/*therapyPatient CompliancePlacebosSupport, Non-U.S. Gov'tSupport, U.S. Gov't, Non-P.H.S.Zinc/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11506057Joseph199923470103378514851999MayEffect of resistance training with or without chromium picolinate supplementation on glucose metabolism in older men and women546-53Noll Physiological Research Center and Graduate Program in Physiology, The Pennsylvania State University, University Park, USA.Joseph, L. J.Farrell, P. A.Davey, S. L.Evans, W. J.Campbell, W. W.MetabolismAgedBlood Glucose/analysisC-Peptide/bloodDouble-Blind MethodFasting/bloodFemaleGlucose/*metabolismHumanInsulin/bloodMaleMiddle Age*Physical Education and TrainingPhysical Endurance/physiologyPicolinic Acids/*pharmacologySupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.Weight Lifting/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10337851Lukaski19962353086446936361996JunChromium supplementation and resistance training: effects on body composition, strength, and trace element status of men954-65US Department of Agriculture, Agricultural Research Service, Grand Forks Human Nutrition Research Center, ND, USA.Lukaski, H. C.Bolonchuk, W. W.Siders, W. A.Milne, D. B.Am J Clin NutrAdultAnthropometryBody Composition/*drug effects/physiologyCeruloplasmin/analysisChromium/administration & dosage/blood/*pharmacologyCopper/bloodDensitometry, X-RayDouble-Blind MethodExercise/*physiologyFerritin/bloodFood, FortifiedHumanMaleMuscle Contraction/*drug effects/physiologyMuscle, Skeletal/drug effects/physiologyPatient ComplianceTrace Elements/*bloodZinc/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8644693Hallmark19962354087753662811996JanEffects of chromium and resistive training on muscle strength and body composition139-44Department of Kinesiology, University of Maryland, College Park, USA.Hallmark, M. A.Reynolds, T. H.DeSouza, C. A.Dotson, C. O.Anderson, R. A.Rogers, M. A.Med Sci Sports ExercAdult*Body CompositionChromium/*pharmacologyDouble-Blind MethodHumanMaleMuscle, Skeletal/*drug effectsWeight Lifting/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8775366[44, 143-145, 404-407].IronMales 8 Females 18Iron supplements are used to increase aerobic performance in sports that use the oxygen system. Iron is a component of hemoglobin in the red blood cell, which is a carrier of oxygen.Most research shows that iron supplements do not appear to improve aerobic performance unless the athlete is iron-depleted and/or has anemia  ADDIN EN.CITE Fogelholm19923053015559061321992FebEffects of iron supplementation in female athletes with low serum ferritin concentration158-62Department of Nutrition, University of Helsinki, Finland.Fogelholm, M.Jaakkola, L.Lampisjarvi, T.Int J Sports MedAdolescentAdult*DietExercise/*physiologyFemaleFerritin/*bloodHemoglobins/metabolismHumanIron/*administration & dosageLactates/bloodLactic AcidOxygen ConsumptionRandom AllocationSupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1555906Klingshirn19923054015015682471992JulEffect of iron supplementation on endurance capacity in iron-depleted female runners819-24Department of Exercise Science, University of South Carolina, Columbia 29208.Klingshirn, L. A.Pate, R. R.Bourque, S. P.Davis, J. M.Sargent, R. G.Med Sci Sports ExercAdultAscorbic Acid/administration & dosageComparative StudyFemaleFerrous Compounds/*pharmacologyHumanIron/blood/deficiencyLactates/bloodOxygen ConsumptionPhysical Endurance/*drug effects*RunningSupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1501568Friedmann199930550101907662021999FebEffects of iron supplementation on total body hemoglobin during endurance training at moderate altitude78-85Department of Sports Medicine, University of Heidelberg, Germany. birgit_friedmann@ukl.uni-heidelberg.deFriedmann, B.Jost, J.Rating, T.Weller, E.Werle, E.Eckardt, K. U.Bartsch, P.Mairbaurl, H.Int J Sports MedAdult*AltitudeDouble-Blind MethodErythropoiesisExercise/*physiologyExercise TestHemoglobins/*analysisHuman*Iron, DietaryPhysical Endurance/*physiologySupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10190766Brutsaert200330560125404067722003FebIron supplementation improves progressive fatigue resistance during dynamic knee extensor exercise in iron-depleted, nonanemic women441-8Department of Anthropology, the State University of New York at Albany, 12222, USA. tbrutsae@csc.albany.eduBrutsaert, T. D.Hernandez-Cordero, S.Rivera, J.Viola, T.Hughes, G.Haas, J. D.Am J Clin NutrAdolescentAdultDietary SupplementsDouble-Blind MethodErythrocyte IndicesExercise/physiologyFemaleHumanIron/blood/*deficiencyIron, Dietary/*administration & dosageMiddle AgeMuscle Fatigue/*drug effectsOxygen ConsumptionPhysical Endurance/*drug effects/physiologyReceptors, Transferrin/blood/drug effectsSupport, Non-U.S. Gov'tTransferrin/*metabolismhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12540406[408-411]. MagnesiumMales 420 Females 320Activates enzymes involved in protein synthesis. Involved in ATP reactions. Serum levels decrease with exercise. Some suggest that magnesium supplementation may improve energy metabolism/ATP availability.Most well-controlled research indicates that magnesium supplementation (500 mg/d) does not affect exercise performance in athletes unless there is a deficiency  ADDIN EN.CITE Bohl200230570124874194262002Magnesium and exercise533-63University of Massachusetts, Department of Nutrition, Amherst 01003, USA.Bohl, C. H.Volpe, S. L.Crit Rev Food Sci NutrAdolescentAdultChildChild, PreschoolDietary SupplementsExercise/*physiologyFemaleHumanInfantLactation/physiologyMagnesium/administration & dosage/metabolism/*physiology*Magnesium Deficiency/complications/etiology/physiopathologyMaleMiddle Age*Nutrition PolicyNutritional RequirementsPregnancySports/physiologyUnited Stateshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12487419Lukaski2001305801189787926 Suppl2001Magnesium, zinc, and chromium nutrition and athletic performanceS13-22U.S. Department of Agriculture, Agricultural Research Service, Grand Forks Human Nutrition Research Center, Grand Forks, ND 58202-9034, USA.Lukaski, H. C.Can J Appl PhysiolChromium/pharmacology/*physiologyDietary SupplementsExercise/physiologyHumanMagnesium/pharmacology/*physiologyNutritional StatusSports/*physiologyZinc/pharmacology/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11897879Finstad200130590112520793332001MarThe effects of magnesium supplementation on exercise performance493-8School of Kinesiology, Lakehead University, Thunder Bay, Ontario, Canada.Finstad, E. W.Newhouse, I. J.Lukaski, H. C.McAuliffe, J. E.Stewart, C. R.Med Sci Sports ExercAdolescentAdultAntacids/*pharmacologyCross-Over Studies*Dietary SupplementsDouble-Blind MethodExercise TestFemaleHeart RateHumanMagnesium/bloodMagnesium Oxide/*pharmacologyOxygen Consumption*Physical EndurancePlacebosSupport, Non-U.S. Gov'tSupport, U.S. Gov't, Non-P.H.S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11252079Newhouse200030600109599301032000JulThe effects of magnesium supplementation on exercise performance195-200School of Kinesiology, Lakehead University, Thunder Bay, Ontario, Canada. Ian.Newhouse@Lakeheadu.CaNewhouse, I. J.Finstad, E. W.Clin J Sport MedCross-Over Studies*Dietary SupplementsExercise/*physiologyHumanMagnesium/administration & dosage/*pharmacologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10959930Tuttle1995306107670449521995JunEffect of acute potassium-magnesium aspartate supplementation on ammonia concentrations during and after resistance training102-9Department of Physical Education, Indiana State University, Terre Haute 47809, USA.Tuttle, J. L.Potteiger, J. A.Evans, B. W.Ozmun, J. C.Int J Sport NutrAdolescentAdultAmmonia/*bloodAnalysis of VarianceAscorbic Acid/administration & dosage/pharmacologyCross-Over StudiesDouble-Blind MethodExercise/*physiologyFood, FortifiedHumanLactates/bloodMalePotassium Magnesium Aspartate/administration & dosage/*pharmacologySupport, Non-U.S. Gov'thttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7670449McDonald1988306203285436531988MarIron, zinc and magnesium nutrition and athletic performance171-84Department of Nutrition and Internal Medicine, University of California, Davis.McDonald, R.Keen, C. L.Sports Med*ExertionHumanIron/*deficiencyMagnesium Deficiency/*metabolismZinc/*deficiencyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3285436[412-417].Phosphorus (Phosphate Salts)700 Phosphate has been studied for its ability to improve all three energy systems, primarily the oxygen system or aerobic capacity. Recent well-controlled research studies reported that sodium phosphate supplementation (4 g/d for 3-d) improved the oxygen energy system in endurance tasks  ADDIN EN.CITE Kreider199027610http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=2355823Kreider, R. B.Miller, G. W.Williams, M. H.Somma, C. T.Nasser, T. A.Effects of phosphate loading on oxygen uptake, ventilatory anaerobic threshold, and run performanceAnaerobic Threshold/*drug effectsErythrocytes/metabolismGlycolysis/drug effectsHumanOxygen Consumption/*drug effectsPhosphates/metabolism/*pharmacologyRespiration/*drug effects*RunningSupport, Non-U.S. Gov'tDepartment of Health, Physical Education and Recreation, Human Performance Laboratory, Old Dominion University, Norfolk, VA 23529-0196.2355823Med Sci Sports Exerc1990222250-6.Cade198427600Cade, R.Conte, M.Zauner, C.Mars, D.Peterson, J.Lunne, D.Hommen, N.Packer, D.1984Effects of phosphate loading on 2,3 diphosphoglycerate and maximal oxygen uptakeMed Sci Sports Exerc16263-268Kreider199227570http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=1299483Kreider, R. B.Miller, G. W.Schenck, D.Cortes, C. W.Miriel, V.Somma, C. T.Rowland, P.Turner, C.Hill, D.Effects of phosphate loading on metabolic and myocardial responses to maximal and endurance exerciseAdultBicyclingDouble-Blind MethodEchocardiographyExercise/*physiologyHeart/drug effects/*physiologyHematocritHemodynamicsHemoglobins/metabolismHumanMaleMetabolism/*drug effectsOxygen ConsumptionPhosphates/*administration & dosage/blood/pharmacologyPhysical Endurance/*physiologyPlacebosRandom AllocationDept. of HPER, Old Dominion University, Norfolk, VA 23529-0196.1299483Int J Sport Nutr19922120-47.Kreider199027610http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=2355823Kreider, R. B.Miller, G. W.Williams, M. H.Somma, C. T.Nasser, T. A.Effects of phosphate loading on oxygen uptake, ventilatory anaerobic threshold, and run performanceAnaerobic Threshold/*drug effectsErythrocytes/metabolismGlycolysis/drug effectsHumanOxygen Consumption/*drug effectsPhosphates/metabolism/*pharmacologyRespiration/*drug effects*RunningSupport, Non-U.S. Gov'tDepartment of Health, Physical Education and Recreation, Human Performance Laboratory, Old Dominion University, Norfolk, VA 23529-0196.2355823Med Sci Sports Exerc1990222250-6.Cade198427600Cade, R.Conte, M.Zauner, C.Mars, D.Peterson, J.Lunne, D.Hommen, N.Packer, D.1984Effects of phosphate loading on 2,3 diphosphoglycerate and maximal oxygen uptakeMed Sci Sports Exerc16263-268Kreider199227570http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=1299483Kreider, R. B.Miller, G. W.Schenck, D.Cortes, C. W.Miriel, V.Somma, C. T.Rowland, P.Turner, C.Hill, D.Effects of phosphate loading on metabolic and myocardial responses to maximal and endurance exerciseAdultBicyclingDouble-Blind MethodEchocardiographyExercise/*physiologyHeart/drug effects/*physiologyHematocritHemodynamicsHemoglobins/metabolismHumanMaleMetabolism/*drug effectsOxygen ConsumptionPhosphates/*administration & dosage/blood/pharmacologyPhysical Endurance/*physiologyPlacebosRandom AllocationDept. of HPER, Old Dominion University, Norfolk, VA 23529-0196.1299483Int J Sport Nutr19922120-47.Stewart199027620Stewart, I.McNaughton, L.Davies, P.Tristram, S.1990Phosphate loading and the effects of VO2max in trained cyclistsRes Quart6180-84[227, 228, 302, 303]. There appears to be little ergogenic value of other forms of phosphate (i.e., calcium phosphate, potassium phosphate). More research is needed to determine the mechanism for improvement. Potassium 2000An electrolyte that helps regulate fluid balance, nerve transmission, and acid-base balance. Some suggest excessive increases or decreases in potassium may predispose athletes to cramping. Although potassium loss during intense exercise in the heat has been anecdotal associated with muscle cramping, the etiology of cramping is unknown  ADDIN EN.CITE Morton200030720106941283222000FebCharacteristics and etiology of exercise-related transient abdominal pain432-8Discipline of Human Physiology, Faculty of Medicine and Health Sciences, The University of Newcastle, Callaghan, NSW, Australia. darren.morton@avondale.edu.auMorton, D. P.Callister, R.Med Sci Sports ExercAbdominal Pain/*etiology/physiopathologyAdultDiaphragm/pathology*ExerciseFemaleHumanIschemia/complicationsLigaments/pathologyMaleMuscle Cramp/*etiology/physiopathologyQuestionnairesSportsStresshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10694128Noakes199830730969442319 Suppl 21998JunFluid and electrolyte disturbances in heat illnessS146-9Department of Physiology, University of Cape Town Medical School and Sports Science Institute of South Africa, Newlands, Cape.Noakes, T. D.Int J Sports MedAthletic Injuries/etiology/physiopathologyBody Temperature Regulation/physiologyDehydration/complications/physiopathologyExercise/physiologyHeat Exhaustion/etiology/physiopathologyHeat Stress Disorders/*etiology/physiopathologyHeat Stroke/etiology/physiopathologyHumanMuscle Cramp/etiology/physiopathologyMuscle, Skeletal/innervation/physiopathologyNeural Pathways/physiologySpinal Cord/physiopathologyWater-Electrolyte Imbalance/*complications/physiopathologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9694423Schwellnus19973074092325531531997JunAetiology of skeletal muscle 'cramps' during exercise: a novel hypothesis277-85MRC/UCT Bioenergetics of Exercise Research Unit, University of Cape Town Medical School, Newlands, South Africa.Schwellnus, M. P.Derman, E. W.Noakes, T. D.J Sports SciElectromyographyExercise/*physiologyFatigue/*etiologyHumanMechanoreceptors/physiologyModels, TheoreticalMotor Neurons/physiologyMuscle Cramp/*etiology/physiopathologyMuscle Fatigue/*physiologyMuscle, Skeletal/*physiologyTemperatureWater-Electrolyte Balancehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9232553[418-420]. It is unclear whether potassium supplementation in athletes decreases the incidence of muscle cramping  ADDIN EN.CITE Sawka20003068010919961722 Suppl2000AugFluid and electrolyte supplementation for exercise heat stress564S-72SThermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, MA 01760-5007, USA.Sawka, M. N.Montain, S. J.Am J Clin NutrAdultAgedBody Temperature Regulation/physiologyCalcium Chloride/metabolismClimateCystic Fibrosis/physiopathologyDehydration/metabolism/physiopathology/prevention & controlDietary Supplements/*standardsExercise/*physiologyHeat Stress Disorders/*metabolism/physiopathology/prevention & controlHumanMagnesium Chloride/metabolismMalePotassium Chloride/metabolismSodium Chloride/metabolismSpinal Cord Injuries/physiopathologySweat/physiologyThirst/physiologyWater/*physiologyWater-Electrolyte Balance/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10919961Zorbas1998306909845480641-31998SummerDaily hyperhydration effect on electrolyte deficiency of endurance-trained subjects during prolonged hypokinesia259-73Hypokinetic Physiology Laboratory, Athens, Greece.Zorbas, Y. G.Yaroshenko, Y. Y.Kuznetsov, N. K.Matvedev, S. L.Biol Trace Elem ResAdultAnthropometryElectrolytes/*blood/*urine*ExerciseHumanHypokinesia/*physiopathologyMaleOxygen/metabolism*Water-Electrolyte Balancehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9845480McCutcheon19983070095616891411998AprSweating. Fluid and ion losses and replacement75-95Department of Pathobiology, Ontario Veterinary College, University of Guelph, Canada.McCutcheon, L. J.Geor, R. J.Vet Clin North Am Equine PractAnimalElectrolytes/administration & dosageFluid Therapy/methods/veterinaryHorses/*physiologyPhysical Conditioning, Animal/*physiologySweat/chemistrySweating/*physiologyWater-Electrolyte Balance/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9561689Whang19983071094528942411998JanElectrolyte & water metabolism in sports activities5-8Department of Medicine, John A Burns School of Medicine, University of Hawaii, Honolulu, USA.Whang, R.Compr TherBeverages/standardsBody Water/*metabolismChlorides/metabolismDietary SupplementsElectrolytes/*metabolismExercise/*physiologyHumanMagnesium/metabolismPotassium/metabolismSports/physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9452894[421-424]. No ergogenic effects reported.Selenium0.055 Selenium has been marketed as a supplement to increase aerobic exercise performance. Working closely with vitamin E and glutathione peroxidase (an antioxidant), Selenium may destroy destructive free radical production of lipids during aerobic exercise.Although selenium may reduce lipid peroxidation during aerobic exercise, improvements in aerobic capacity have not been demonstrated  ADDIN EN.CITE Tessier19953066077528662731995MarSelenium and training effects on the glutathione system and aerobic performance390-6Laboratoire de Recherche sur l'Entrainement, Biomecanique et Biologie de l'Exercice, Faculte des Sciences du Sport, Universite de Nice, France.Tessier, F.Margaritis, I.Richard, M. J.Moynot, C.Marconnet, P.Med Sci Sports ExercAdultAerobiosisAntioxidants/metabolismDouble-Blind MethodErythrocytes/enzymologyExercise/physiologyGlutathione/*bloodGlutathione Peroxidase/bloodGlutathione Reductase/bloodHumanMaleOxygen Consumption/drug effects/*physiologyPhysical Education and TrainingPhysical Endurance/*physiologyPlacebosReactive Oxygen Species/metabolismSelenium/blood/*pharmacologySupport, Non-U.S. Gov'tWork/physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7752866Margaritis19973067091768701111997AprEffects of endurance training on skeletal muscle oxidative capacities with and without selenium supplementation37-43Laboratoire de Biomecanique et Biologie de l'Exercice, Faculte des Sciences du Sport, Universite de Nice Sophia-Antipolis, France.Margaritis, I.Tessier, F.Prou, E.Marconnet, P.Marini, J. F.J Trace Elem Med BiolAdultAnalysis of VarianceCreatine Kinase/metabolismCytochrome-c Oxidase/metabolismDouble-Blind MethodFluorescent Antibody Technique, DirectGlutathione Peroxidase/metabolismHumanMaleMitochondria, Muscle/enzymologyMuscle Fibers/metabolismMuscle, Skeletal/drug effects/metabolism/*physiologyMyosin Heavy Chains/biosynthesisOxygen Consumption/*drug effectsPhysical Endurance/*physiology*Physical FitnessPlacebosSelenium/administration & dosage/*pharmacologySuccinate Dehydrogenase/metabolismSupport, Non-U.S. Gov'tVitamin E/bloodhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9176870[425, 426]. Sodium500An electrolyte that helps regulate fluid balance, nerve transmission, and acid-base balance. Increased dietary availability during intense training in the heat has been proposed to help maintain hydration, prevent hyponatremia, and reduce incidence of muscle cramping. During the first several days of intense training in the heat, a greater amount of sodium is lost in sweat. Additionally, prolonged ultraendurance exercise may decrease sodium levels leading to hyponatremia. Increasing salt availability during heavy training in the heat has been shown to help maintain fluid balance and prevent hyponatremia  ADDIN EN.CITE McCutcheon19983063095616891411998AprSweating. Fluid and ion losses and replacement75-95Department of Pathobiology, Ontario Veterinary College, University of Guelph, Canada.McCutcheon, L. J.Geor, R. J.Vet Clin North Am Equine PractAnimalElectrolytes/administration & dosageFluid Therapy/methods/veterinaryHorses/*physiologyPhysical Conditioning, Animal/*physiologySweat/chemistrySweating/*physiologyWater-Electrolyte Balance/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9561689Latzka199930640104108381831999JulWater and electrolyte requirements for exercise513-24Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA. wlatzka@natick-ccmail.army.milLatzka, W. A.Montain, S. J.Clin Sports MedCarbohydrates/metabolismDrinking BehaviorElectrolytes/*metabolismExercise/*physiologyHumanNutritional RequirementsSports/*physiologyWater/metabolism/*physiology*Water-Electrolyte Balancehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10410838Sawka20003065010919961722 Suppl2000AugFluid and electrolyte supplementation for exercise heat stress564S-72SThermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, MA 01760-5007, USA.Sawka, M. N.Montain, S. J.Am J Clin NutrAdultAgedBody Temperature Regulation/physiologyCalcium Chloride/metabolismClimateCystic Fibrosis/physiopathologyDehydration/metabolism/physiopathology/prevention & controlDietary Supplements/*standardsExercise/*physiologyHeat Stress Disorders/*metabolism/physiopathology/prevention & controlHumanMagnesium Chloride/metabolismMalePotassium Chloride/metabolismSodium Chloride/metabolismSpinal Cord Injuries/physiopathologySweat/physiologyThirst/physiologyWater/*physiologyWater-Electrolyte Balance/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10919961[421, 423, 427]. . VanadiumNoneVanadium may be involved in reactions in the body that produce insulin-like effects on protein and glucose metabolism. Due to the anabolic nature of insulin, this has brought attention to vanadium as a supplement to increase muscle mass, enhance strength and power.Limited research has shown that noninsulin-dependent diabetics may improve their glucose control, however there is no scientific proof that vanadyl sulfate has any effect on muscle mass, strength or power  ADDIN EN.CITE Fawcett19972421091401418041997AprOral vanadyl sulphate does not affect blood cells, viscosity or biochemistry in humans202-6School of Pharmacy, University of Otago, Dunedin, New Zealand.Fawcett, J. P.Farquhar, S. J.Thou, T.Shand, B. I.Pharmacol ToxicolAdultBlood Cell CountBlood Cells/*drug effectsBlood Chemical AnalysisBlood Pressure/drug effectsBlood Viscosity/*drug effectsBody Weight/drug effectsFemaleHematocritHumanHypoglycemic Agents/administration & dosage/*pharmacologyMaleSupport, Non-U.S. Gov'tVanadium Compounds/administration & dosage/*pharmacology*Weight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9140141Fawcett1996242008953340641996DecThe effect of oral vanadyl sulfate on body composition and performance in weight-training athletes382-90School of Pharmacy, University of Otago, Dunedin, New Zealand.Fawcett, J. P.Farquhar, S. J.Walker, R. J.Thou, T.Lowe, G.Goulding, A.Int J Sport NutrAdministration, OralAdultAnthropometryBody Composition/*drug effectsDensitometry, X-RayDouble-Blind Method*ExertionFemaleHumanHypoglycemic Agents/administration & dosage/*pharmacologyMaleSupport, Non-U.S. Gov'tVanadium Compounds/administration & dosage/*pharmacology*Weight Liftinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8953340[198, 199].ZincMales 11 Females 8Constituent of enzymes involved in digestion. Associated with immunity. Theorized to reduce incidence of upper respiratory tract infections in athletes involved in heavy training. Studies indicate that zinc supplementation (25 mg/d) during training minimized exercise-induced changes in immune function  ADDIN EN.CITE Gibson2002307501249264611 Suppl 32002Risk of suboptimal iron and zinc nutriture among adolescent girls in Australia and New Zealand: causes, consequences, and solutionsS543-52Department of Human Nutrition, University of Otago, Dunedin, New Zealand. rosalind.gibson@stonebow.otago.ac.nzGibson, R. S.Heath, A. L.Ferguson, E. L.Asia Pac J Clin NutrAdolescent*Adolescent NutritionAnemia, Iron-Deficiency/*epidemiology/prevention & controlAustralia/epidemiologyBiological AvailabilityDietary SupplementsFemaleHumanIntestinal AbsorptionIron, Dietary/*administration & dosage/pharmacokineticsNew Zealand/epidemiologyNutritional RequirementsPrevalenceZinc/*administration & dosage/*deficiency/pharmacokineticshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12492646Gleeson2001307601189788026 Suppl2001Nutritional strategies to minimise exercise-induced immunosuppression in athletesS23-35School of Sport and Exercise Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, England.Gleeson, M.Lancaster, G. I.Bishop, N. C.Can J Appl PhysiolDietary Carbohydrates/administration & dosageDietary SupplementsExercise/*physiologyHumanImmune Tolerance/*physiology*NutritionSports/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11897880Nieman2001307701189788226 Suppl2001Exercise immunology: nutritional countermeasuresS45-55Department of Health & Exercise Science, Appalachian State University, Boone, NC 28608, USA.Nieman, D. C.Can J Appl PhysiolDietary Carbohydrates/administration & dosageDietary SupplementsExercise/*physiologyHumanImmune ToleranceNeutrophils/physiologyPhysical EndurancePhysical FitnessRespiratory Tract Infections/physiopathologySports/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11897882Gleeson2000307801089302421 Suppl 12000MayElite athlete immunology: importance of nutritionS44-50School of Sport and Exercise Sciences, University of Edgbaston, Birmingham, England. m.gleeson@bham.ac.ukGleeson, M.Bishop, N. C.Int J Sports MedDietary Carbohydrates/immunologyDietary Fats/immunologyDietary Proteins/immunologyExercise/*physiologyFood Habits/*physiologyHumanImmune Tolerance/*physiologyImmunity/*physiologyMinerals/immunology*SportsVitamins/immunologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10893024Nieman199930790104108401831999JulNutrition, exercise, and immune system function537-48Department of Health, Leisure, and Exercise Science, Appalachian State University, Boone, North Carolina, USA. niemandc@appstate.eduNieman, D. C.Clin Sports MedCarbohydrates/metabolism/physiologyExercise/*physiologyExertion/physiologyHumanImmune System/*physiologyInfection/etiologyInflammation/etiology*Nutrition/physiologyRisk FactorsSports/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10410840Konig199830800964409241998Zinc, iron, and magnesium status in athletes--influence on the regulation of exercise-induced stress and immune function2-21Dept. of Rehabilitation, Prevention and Sports Medicine, Freiburg University Hospital, Germany.Konig, D.Weinstock, C.Keul, J.Northoff, H.Berg, A.Exerc Immunol RevAnimal*ExerciseHumanImmune System/*immunologyIron/*metabolismMagnesium/*metabolismMuscle, Skeletal/*physiopathologyNutritional StatusStress, MechanicalZinc/*metabolismhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9644092Cordova19953081075667451931995FallBehaviour of zinc in physical exercise: a special reference to immunity and fatigue439-45Department of Physiology and Biochemistry, University School of Physiotherapy, University of Valladolid, Soria, Spain.Cordova, A.Alvarez-Mon, M.Neurosci Biobehav RevAnimalExercise/*physiologyExertion/*physiologyFemaleHumanImmunity/*physiologyMaleMuscle Fatigue/*physiologyPhysical Conditioning, Animal/physiologyZinc/metabolism/*physiologyhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7566745Singh19943082079288507661994JunExercise-induced changes in immune function: effects of zinc supplementation2298-303Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814.Singh, A.Failla, M. L.Deuster, P. A.J Appl PhysiolAdultBlood Cell CountCopper/bloodDietDouble-Blind MethodExercise/*physiologyHumanHydrocortisone/bloodImmunity/*drug effects/*physiologyLactates/bloodLactic AcidLymphocytes/drug effects/immunology/physiologyMaleMitogens/diagnostic useNeutrophils/drug effects/immunology/physiologyRespiratory Burst/physiologySuperoxides/metabolismZinc/blood/*pharmacology/urinehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7928850[395, 428-434].Recommended Dietary Allowances (RDA) based on the 2002 Food & Nutrition Board, National Academy of Sciences-National Research Council recommendations. Table 3. Categorization of the Ergogenic Value of Performance Enhancement, Muscle Building, and Weight Loss Supplements Category Muscle Building SupplementsWeight Loss SupplementsPerformance EnhancementI.. Apparently Effective and Generally SafeWeight Gain Powders Creatine HMB (Untrained Individuals Initiating Training) Low calorie foods, MRPs and RTDs that help individuals maintain a hypocaloric diet Ephedra, caffeine, and salicin containing thermogenic supplements taken at recommended doses in appropriate populations Water & Sports Drinks Carbohydrate Creatine Sodium Phosphate Sodium Bicarbonate Caffeine Possibly EffectivePost-exercise carbohydrate & protein BCAA Essential Amino Acids (EAA) Glutamine Protein HMB (Trained Subjects) High fiber diets Calcium Phosphate Green Tea Extract Pyruvate/DHAP (at high doses) Post-exercise CHO/PRO Glutamine EAA BCAA HMB (Trained Subjects) Glycerol Low Doses of Ephedrine/CaffeineIII. Too Early To Tell(-ketoglutarate (-ketoisocaproate (KIC) Ecdysterones Growth Hormone Releasing Peptides (GHRP) and Secretogues HMB (Trained Athletes) Isoflavones Smilax Officinalis (SO) Sulfo-polysaccharides (Myostatin Inhibitors) Zinc/Magnesium Aspartate (ZMA) Appetite Suppressants & Fat Blockers (Gymnema Sylvestre, Chitosan) Thermogenics (Synephrine, Thyroid Stimulators, Cayenne Pepper, Black Pepper, Ginger Root) Lipolytic Nutrients (Phosphatidyl Choline, Betaine, Coleus Forskohlii, 7-keto DHEA) Psychotropic Nutrients/Herbs Medium Chain Triglycerides Ribose IV. Apparently Not Effective and/or Dangerous Boron Chromium Conjugated Linoleic Acids (CLA) Gamma Oryzanol (Ferulic Acid) Prohormones Tribulus Terrestris Vanadyl Sulfate (Vanadium) Yohimbine (Yohimbe) Chromium (non-diabetics) CLA HCA L-Carnitine Pyruvate (at low doses) Herbal Diuretics High doses of Ephedrine/Caffeine Inosine High doses of Ephedrine/Caffeine  Table 4. Summary of Performance Enhancement Nutrition Program for Athletes  General Recommendations Stress high carbohydrate, nutrient dense, and isoenergetic diet designed to maintain weight. Take a low-dose daily multi-vitamin (with iron for women). Taper training intensity and carbohydrate load before competition. Consume a pre-practice or pre-workout carbohydrate/protein snack 30-60 minutes before exercise. Consume plenty of water and sports drinks during exercise (particularly in the heat). Consume a post-practice carbohydrate/protein snack within 30 minutes of exercise. If you have to train in the morning, ingest an evening snack prior to going to bed. Only consider sport specific use of effective and legal ergogenic aids Potentially Effective Supplements for Strength/Power/Sprint Athletes Water/Sports Drinks Carbohydrate Creatine Bicarbonate Loading Sodium Phosphate Glycerol (to counteract dehydration) Potentially Effective Supplements for Endurance Athletes Water/Sports Drinks Carbohydrate Caffeine Sodium Phosphate Glycerol (to counteract dehydration) Creatine Possible Anticatabolic Nutrients Which May Help Athletes Tolerate Training Sports Drinks Carbohydrate Post-exercise carbohydrate, protein, EAA & glutamine Creatine HMB Possible Nutrients to Enhance the Immune System Post-exercise carbohydrate, protein, and EAA Vitamin C Zinc Glutamine Echinacea References  ADDIN EN.REFLIST 1. Boone, T., Exercise Physiology Quackery and Consumer Fraud. Professionalization of Exercise Physiology-online, 2002. 5(5). Available: http://www.css.edu/users/tboone2/asep/ExercisePhysiologyQuackery.html. 2. 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Neurosci Biobehav Rev, 1995. 19(3): p. 439-45. 434. Singh, A., M.L. Failla, and P.A. Deuster, Exercise-induced changes in immune function: effects of zinc supplementation. J Appl Physiol, 1994. 76(6): p. 2298-303.  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Kreider, PhDIT8K                           ! " # $ % & ' ( ) * + , - . / 0 1 2 3 4 5 6 7 8 9 : ; < = > ? @ A B C D E F G H I J  Oh+'0 ( D P \ ht|Muscular Development1MD Fat Loss ReviewtRichard B. Kreider, PhDichNormal ITm2mMicrosoft Word 10.0@G@=]G@2uߨV@2uߨVS6C  ՜.+,D՜.+,P  hp  RBK ConsultationslK Muscular Development Title P  0 T p x  _PID_HLINKS_AdHocReviewCycleID_EmailSubject _AuthorEmail_AuthorEmailDisplayName_PreviousAdHocReviewCycleID_ReviewingToolsShownOnceA `u$>@http://www.americanheart.org/presenter.jhtml?identifier=3006624;H;.http://www.forslean.com/clinical_studies.htmlw83http://www.css.edu/users/tboone2/asep/BrillaV2.pdfjm54http://www.css.edu/users/tboone2/asep/ChetlinV2.pdf} 2/http://www.delphion.com/details?&pn=US04163746O/.http://www.delphion.com/details?pn=US03949085d<,+http://www.sportsci.org/jour/9901/rbk.html90)$http://www.ncbi.nlm.nih.gov/PubMed/^&!http://www.tnp.com/encyclopedia/[G#Rhttp://physician.pdr.net/physician/static.htm?path=controlled/searchpdrherbal.htm *http://www.lifestyler.com/jr/rdachart.htm*http://www.cfsan.fda.gov/~dms/ds-faq.htmlARhttp://www.css.edu/users/tboone2/asep/EthicalThinkingANDexercisephysiology.htm(6)|1Lhttp://www.css.edu/users/tboone2/asep/SupplementsANDExercisePhysiology.htmln$<http://www.css.edu/users/tboone2/asep/AthletesWhoCheat.htmlBP"mailto:Richard_Kreider@baylor.edu%Fw: Article Submission to PEP OnlineeRichard_Kreider@baylor.eduEKreider, Richard B.Q~rei  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~                           ! 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