Supplements Archives - Athletes Sanctuary

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Whether you’re running marathons, lifting weights, or participating in team sports, your bones bear the brunt of your intense physical activity and constant training regime. While we all know the importance of calcium and vitamin D for bone health, we often forget the roll magnesium has in bone health.

The Magnesium-Bone Connection

Research suggests 20% of individuals constantly consume lower quantities of magnesium than recommended. So why is magnesium so essential for athletes? The answer lies in the intricate relationship between magnesium and various bone-related processes:

Mineralisation: Magnesium is a cofactor for the enzymes responsible for bone mineralisation. It helps convert vitamin D into its active form, which is crucial for calcium absorption, the primary mineral in bones. Lower levels of magnesium are related to osteoporosis in menopausal women. One study, suggested 30–40% of women are deficient in magnesium.
Bone Density: Athletes often put their bones under repetitive stress. Magnesium plays a vital role in maintaining healthy bone density and structural integrity. Low levels can decrease bone density, making athletes more susceptible to fractures.
Bone Turnover: Magnesium helps regulate the balance between bone formation and bone resorption. This is crucial for athletes as it ensures their bones adapt to training demands without becoming brittle or porous.

For Athletes

Apart from its direct impact on bone health, magnesium offers several other benefits for athletes:

Muscle Function: Adequate levels are essential for proper muscle function. It helps muscles contract and relax, preventing cramps and promoting efficient performance.
Energy Metabolism: Magnesium is a co-factor for enzymes involved in ATP (adenosine triphosphate) production, the primary energy source for athletes during exercise.
Immune Support: Intense physical activity can temporarily weaken the immune system. Magnesium aids immune function, helping athletes recover from workouts and training stress.
Recovery and tightness: Magnesium helps with restless legs, tight muscles, headaches and insomnia.
Hormonal Balance: Magnesium helps reduce fluid retention, menstrual cramps, anxiety, mood swings and cravings related to the menstrual cycle

Meeting Your Needs

As an athlete, meeting your nutrition requirements to ensure optimal bone health and overall performance is crucial. Here are some dietary sources of magnesium to consider:

Nuts and Seeds: Almonds, peanuts, cashews and pumpkin seeds are excellent.
Dark Leafy Greens: Spinach and kale are a rich source to add to your diet.
Whole Grains: Choose whole grain options like brown rice and sourdough bread.
Legumes: Beans and lentils are magnesium-packed additions to your diet.
Cocoa and brewer’s yeast also contain magnesium.

Supplements can be considered in cases where dietary intake may fall short, but it’s always advisable to consult with a healthcare professional or sports nutritionist before taking any supplements.

Magnesium is an essential yet often overlooked mineral for bone health in athletes. From mineralisation to bone density and regulating bone turnover, magnesium is pivotal in maintaining strong, resilient bones, making it a crucial element in an athlete’s nutrition regimen. So, next time you plan your meal, don’t forget to include magnesium-rich foods to keep your bones strong and support your overall athletic performance.

Contact the Athlete Sanctuary and learn how we can help you increase your bone health, well-being, and performance.

References

Health Direct (2023).

Orchard TS, Larson JC, Alghothani N, Bout-Tabaku S, Cauley JA, Chen Z, LaCroix AZ, Wactawski-Wende J, Jackson RD.(2014). Magnesium intake, bone mineral density, and fractures: results from the Women’s Health Initiative Observational Study. American Journal Clinical Nutrition. 2014 Apr;99(4):926-33

Rondanelli, M., Faliva, M. A., Tartara, A., Gasparri, C., Perna, S., Infantino, V., & Peroni, G. (2021). An update on magnesium and bone health. Biometals, 34(4), 715-736.

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She founded the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate thirsts for knowledge and has two bachelor’s degrees and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes.

Kate Smyth- Sports Naturopath and Nutritionist

It can be difficult to know how to choose the best protein powder. Protein plays a vital role in any athlete’s eating plan. Irrespective of your chosen sport be that running, triathlon, swimming, team sports, cycling or lifting weights, athletes expend more energy than the average person. Athletes also need more nutrients to recover from intense training or competition.

Protein provides both structural and functional properties to all working cells in the body, making up approximately one sixth of your body weight. Protein helps strengthen muscle tissue, repair damage and is critical to building muscle mass. Protein and amino acids are also vital for healthy bones, cartilage, tendons, skin and blood as explained in our article on collagen and tendons.

But there are many more benefits to including adequate protein in your diet, especially as an athlete. Optimising protein intake as an athlete is vital and needs can vary significantly from that of a more sedentary person.

Benefits of adequate protein

Stable Blood Sugar – more energy and reduced fatigue
Less Cravings for Sweet and Snack Foods- better weight management and reduced energy fluctuations
Improved recovery after sessions and events
Muscle growth and reduced risk of muscle loss, leading to greater powder to weight ratio
Improved immune system, reduced downtime days and disruptions to training progress
Healthy bone maintenance and reduced risk of osteoporosis
Improved metabolism and fat burning capabilities- enabling of a lean physique
Aids injury repair and improved recovery time
Improved nerve function and muscle contraction
Reduced hunger through reducing ghrelin (the hunger hormone) leading to greater satiety

Good sources of dietary protein

Ideally, sources of protein are coming from whole, fresh foods such as lean meat and poultry, fish, eggs, dairy products such as yoghurt, milk and cheese, seeds and nuts, beans, legumes, tofu and some grains, such as quinoa or buckwheat.

While it is possible for elite athletes to reach their daily protein requirements through diet from unprocessed wholefood sources (and this is highly recommended for the majority of protein intake) athletes in high training loads, with requirements for lean muscle mass or when injured, may find protein powders (20-30 grams) beneficial when ingested straight after training. During this time the muscles are more receptive to uptake of amino acids. However, muscle repair continues for 24 hours and therefore regular protein intake throughout the day is important.

Protein supplements such as whey protein or vegan protein powders are practical, convenient when travelling, or in a smoothie as a mid-morning snack.

Best protein powders

A ‘complete protein’ refers to the building blocks of protein – amino acids. There are 20 amino acids that can form a protein, and 9 that the body cannot produce on its own. These are the essential amino acids and we need to be able to get them through diet, or supplementation. All amino acids are required for protein synthesis, and a lack of one or more amino acids may compromise the athlete’s ability to build muscle.

Leucine is the key amino acid linked to muscle building and recovery. Research suggests ingestion of 2.7 grams of leucine results in a robust stimulation of muscle protein synthesis. Research suggests powders containing the optimal ratio for the branch chain amino acids leucine, isoleucine, and valine in a 2:1:1 ratio in addition to the full amino acid profile are optimal for sports recovery and performance.

What type of protein powder is best?

There isn’t one type of protein powder that is better than others however some powders may be more suited to athletes depending on food preferences and intolerances, and health goals. Powders with minimal ingredients, natural flavors, a balanced and complete amino acid profile, and organic are suggested to be the healthiest. Some powders may provide added probiotics beneficial for gut health.

Popular protein powder options include:

Plant-based protein

Plant-based protein powders may include combinations of pea, hemp, soy, pumpkin seed, flax seed fava bean, potato, corn and brown rice protein. Plant based options are dairy, whey, casein and egg free. Leucine, lysine, and/or methionine are key amino acids for muscle-building capacity which may be reduced in plant-based powders.

Plant-based proteins could provide the same amount of leucine by adjusting the amount of protein ingested. Due to the greater leucine content of corn, 20 g of protein needs to be ingested to provide 2.7 g leucine, while the dietary protein dose of the other plant-based proteins would need to be increased to 33 g (potato), 37 g (brown rice), 38 g (pea), 40 g (soy), and 54 g (hemp).

Plant-based proteins that do meet the requirements for essential amino acids include soy (27%), brown rice (28%), pea (30%), corn (32%), and potato (37%). When plant-based proteins are combined (e.g. rice and pea) the amino acid profile can be enhanced.

Microalgae has received considerable attention in recent years due to their high protein content (similar to meat, egg, soybean, and milk), presence of other beneficial nutrients, and production that requires less water and land than other crops or animal foods. 48 g of microalgae protein is required to provide 2.7 grams of leucine. Plant-based options are often viewed as sustainable, easily digestible, and potentially cheaper.

Whey

Whey protein powder is dairy-derived and fairly quickly and easily digested and absorbed. When combined with resistance training, whey protein may help increase muscle mass, support growth, and speed so it’s a great choice for athletes. Whey is also high in branched-chain amino acids (BCAAs), which can help speed muscle recovery.

Of the animal-based proteins, whey protein has the highest essential amino acid content of 43%. Whey protein is available in concentrate, isolate, or hydrolysate form, although many supplements contain a combination of the three. Typically 25g of whey protein provides 2.7 g of leucine.

Although whey concentrate and isolate offer similar benefits, whey protein isolate (WPI) undergoes processing methods that result in a higher concentration of protein and lower amounts of fat, carbs, and lactose. WPI may be a better option for those who are limiting their consumption of fat, carbs, or lactose. Hydrolyzed whey protein powders have been partially broken down to ease digestion and speed absorption.

Casein

Casein protein powders are dairy based and keep you feeling fuller for longer as they are digested and absorbed more slowly making them a good option for muscle growth and enhancing sleep when ingested before bed. Casein has a slightly lower essential amino acid content (34%) than whey (43%). Casein’s larger molecule size can make it more difficult to digest for some individuals and may be linked to digestive symptoms.

Egg

Egg white protein is suitable for those who have an allergy or intolerance to dairy products is paleo friendly and has a higher amino acid content (32%) than many of the plant-based proteins. It is not as easily manufactured and therefore not as widely distributed or found in health food shops. Egg white typically provides 26 grams of protein in a 30-gram serve.

Collagen

As mentioned in our blog, collagen is great for bone, joint, and ligament health, and a 20-gram serving of collagen peptides contains 18 grams of protein, no carbohydrates, and no fat. Collagen has a different amino acid profile to protein powders and therefore can be added to your protein powder or taken before a workout for tissue repair.

If you would like to know how we can best support your sports nutrition goals. Make an appointment here.

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit www.https://https://athletesanctuary.com.au/wp-content/uploads/2023/03/normatec-3-lower-body-system-thumb_720x-1.webp.com.au/wp-content/uploads/2020/05/Seed-Cycle-Blends-scaled-1.jpg.com.au

References

Athletic requirements for protein intake, Australian Institute of Sport- https://www.ais.gov.au/ . While athlete’s requirements have been widely debated, the Australian Institute of Sports has published this fact sheet on the Athletic Requirements for Protein Intake.

Campbell, B., Kreider, R. B., Ziegenfuss, T., La Bounty, P., Roberts, M., Burke, D., … & Antonio, J. (2007). International Society of Sports Nutrition position stand: protein and exercise. Journal of the international society of sports nutrition, 4(1), 1-7.

Witard, O. C., Garthe, I., & Phillips, S. M. (2019). Dietary protein for training adaptation and body composition manipulation in track and field athletes. International Journal of Sport Nutrition and Exercise Metabolism, 29(2), 165-174.https://journals.humankinetics.com/view/journals/ijsnem/29/2/article-p165.xml

Vitale, K., & Getzin, A. (2019). Nutrition and supplement update for the endurance athlete: review and recommendations. Nutrients, 11(6), 1289.https://www.mdpi.com/2072-6643/11/6/1289/htm

Bleakley S, Hayes M. Algal proteins: extraction, application, and challenges concerning production. Foods. 2017;6(5):33. doi: 10.3390/foods6050033.

The high demands of sports make athletes more vulnerable to illness, with 65% of athletes experiencing regular colds and infections. Zinc is a key nutrient required for immunity and keeping an eye out for low zinc symptoms, may just make the difference between being sick or great performances.

It can be so frustrating to put in many months of hard training only to be sidelined during a taper or on race day by heaving lungs, debilitating fatigue, and a pounding headache. Sports performance is materialised through consistency, akin to writing a book, one page at a time. Forced breaks from training due to illness detract from progress and drains confidence. Not all athletes rest when unwell and opt to “push through” the illness only to experience prolonged symptoms and more disruption to competition.

Building a robust immunity is all part of a holistic approach to coaching and training. So how do you minimise your risk of getting sick?

There are many nutrients that contribute to a healthy immune system as discussed previously.

Athletes may be more susceptible to being deficient in zinc because exercise, particularly strenuous and endurance exercise, increases zinc requirements, encourages zinc loss through sweating, and changes zinc transportation and metabolism.

In our opinion, zinc plays the most critical role in supporting athletes and immunity.

Zinc’s role in hormone control and immunity

Zinc regulates several crucial processes in both your innate and adaptive immune system. Being deficient in zinc can lead to athletes becoming more susceptible to respiratory illness, particularly in the colder months.

Apart from zinc’s well-established role in immunity, this mineral, contributes to protein structure, regulates gene expression, metabolism and is the second most abundant trace element in the body after iron. Zinc deficiency can impact an athlete through hormone dysregulation (testosterone, thyroid, and growth hormones to name a few) and may affect erectile function and fertility.

Zinc is essential to maintaining optimum performance due to its function in metabolism and healthy cell division – essential in repairing damaged tissues after you exercise.

Studies show being deficient in zinc can lead to a reduction in the number of fast-twitch muscle fibres and muscle mass and performance decline. For Masters Athletes this is of particular relevance as aging is also associated with sarcopenia, the age-related loss of muscle mass, muscle strength, and physical performance.

Zinc also helps maintain blood sugar control and assists with muscle contraction during exercise, glucose metabolism, and glycogen storage.

Zinc also plays an essential role in antioxidant production by increasing antioxidant activity and inhibiting free radical production that may damage tissues, impact liver function, and prevent muscle exhaustion.

Low zinc symptoms

Apart from recurrent colds and other infections, there are many low zinc symptoms.

*Anxiety and depression

*Hormone imbalances

*Poor concentration

*Stomach pain and gas

*Slow healing

*White spots on nails

*Skin issues and acne

*Loss of appetite

*Loss or change of smell

*Changes in taste

Zinc rich foods

The most concentrated sources of zinc are contained in animal products, particularly meat, seafood and dairy. Vegan and plant-based athletes may be more susceptible to zinc deficiency due to reduced dietary intake, lowered gastric acid (which is zinc-dependent) and higher phytate consumption. Phytates found in plant-based zinc-rich foods such as legumes can inhibit zinc absorption.

Soaking nuts and seeds and legumes prior to cooking is a great way to minimise this issue and allow for greater micronutrient absorption.

Iron absorption

The gastrointestinal tract plays an important role in maintaining total body zinc homeostasis by regulating zinc absorption and excretion. In order to boost your absorption, the addition of a probiotic may be beneficial.

In certain situations, zinc supplementation may be recommended. The amount ingested, supplement form, and the timing of zinc matters. Speak to a naturopath or nutritionist with an interest in sport before self-prescribing. You’ll definitely want to avoid zinc toxicity. High zinc levels can have a detrimental impact on your performance through anaemia, copper and iron deficiency and unpleasant gastrointestinal side effects.

Zinc testing

Serum blood testing is used by some conventional practitioners to determine zinc levels in the body. Keep in mind 60% of zinc is stored in muscle and 30% in bone therefore serum may not be the best measure of zinc homeostasis. A mineral test can be another alternative method of assessing zinc levels and is available through our clinic as explained here.

If you need help building a robust immune system, book an appointment with our naturopath.

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit www.https://https://athletesanctuary.com.au/wp-content/uploads/2023/03/normatec-3-lower-body-system-thumb_720x-1.webp.com.au/wp-content/uploads/2020/05/Seed-Cycle-Blends-scaled-1.jpg.com.au

References

N. Walsh. Nutrition and Athlete Immune Health: New Perspectives on an Old Paradigm.
2019 Nov 6. doi: 10.1007/s40279-019-01160-3.
A. Venderley, W.Campbell. Vegetarian diets : nutritional considerations for athletes.
2006;36(4):293-305. doi: 10.2165/00007256-200636040-00002.
J.Hernández-Camacho, C. Vicente-García, D. Parsons, I. Navas-Enamorado. Zinc at the crossroads of exercise and proteostasis.
2020, 101529, ISSN 2213-2317. doi.org/10.1016/j.redox.2020.101529.
P. Trumbo, A. Yates, S. Schlicker, M. Poos. Dietary reference intakes: vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc.
2010 March.101(3):294-301. doi: 10.1016/S0002-8223(01)00078-5.
A. Baltaci, R. Mogulkoc, S. Baltaci. Review: The role of zinc in the endocrine system.
2019 Jan;32(1):231-239. PMID: 30772815.
P.Ranasinghe, S. Pigera, P. Galappatthy, G. Katulanda, & R. Constantine. Zinc and diabetes mellitus: understanding molecular mechanisms and clinical implications.
23(1), 44. doi.org/10.1186/s40199-015-0127-4
M. Hambidge, N. Krebs. Zinc metabolism and requirements.
2001;22(2):126-132 doi: 10.1177/156482650102200202

Is cramping cramping your style? In this article, we explain how cramping and hydration go hand in hand and what you can do to avoid issues.

Several factors contribute to cramping. Many athletes have increased their training intensity and volumes but possibly overlooked their nutritional needs to meet their supplementary training requirements.

Go back to the root cause

Dehydration may contribute to cramping in athletes along with imbalances in electrolytes and muscle fatigue.

There are a number of reasons why we may get more dehydrated. In the heat, we lose more sweat and are more prone to dehydration through both sodium and water loss. We also get dehydrated in winter. We often reduce our consumption of salads packed with magnesium-rich leafy vegetables over the cooler months and our natural inclination to drink fluids may also be reduced and our thirst mechanism sluggish over winter.

Coffee, alcohol, and some drugs (such as oral contraceptives) may also accelerate the excretion or reduce the absorption of water and electrolytes such as magnesium and calcium. Not all athletes realize they require 20% more magnesium than a sedentary person.

The adrenal gland churns through sodium, vitamin C, and magnesium when we are stressed. It is pretty rare to find a person who can honestly say they are stress-free, especially in the current environment.

How to stop cramping- a reminder of the basics

Increasing magnesium-rich foods such as spinach, broccoli, squash, peanuts, cashews, almonds, oats, brown rice and cocoa (quality chocolate can be beneficial!) pumpkin seeds, chia seeds, and yogurt may help reduce cramping in athletes. These foods may also ward off more advanced issues linked to magnesium deficiency such as fatigue, immune, bone, or cardiovascular issues.

Most athletes grossly underestimate their daily fluid needs when taking into account fluid losses from training. Endurance athletes are notorious for skipping hydration opportunities during a session (especially long-distance runners) despite large sweat losses. Many athletes are shocked at how many liters of fluid they lose in a single session and ignore the increased risk of nausea, vomiting, diarrhea, and other gastrointestinal problems due to dehydration. However, excessive fluid intake also causes issues such as hyponatremia (low sodium concentration in the blood). Therefore, knowing your sweat rate is the best way to determine how much you should be drinking during and post-exercise.

Calculating your sweat rate can be completed at home by following these simple steps:

1. Weigh yourself just before an intense one-hour session

2. Complete your session and record any fluids you had during the session

3. After your workout towel dry yourself

4. Weigh yourself again in the same clothing you had on for the session

5. The difference between the two weight measurements equates to the fluid lost per hour i.e. 1 liter = 1 kg of fluid lost. If you had fluids during your session deduct this amount i.e. 1kg of minus 200ml of fluid ingested during the run = 800ml of fluid lost.

Companies such as The Sweat Lab provide home-based sweat tests you can order online here

Post exercise rehydration

During recovery, you will continue to lose fluids through sweating and urination. Plan to replace 125-150% of this fluid deficit over the next 2-6 hours. Sip a small amount of fluids constantly over a few hours rather than sculling large amounts at once.

Make sure your daily total fluid intake includes both your exercise-associated requirements and physiological needs. Although we are led to believe 8 glasses is sufficient as a basic requirement, national health associations are now suggesting that 15.5 cups (3.7 liters) for men and 11.5 cups (2.7 liters) of fluids a day for women is more appropriate for adults living in temperate climates. Typically 20-30% of your hydration needs are obtained through water-containing foods and the remainder through liquids.

Athletes with a limited intake of dietary sodium (strictly whole foods diet) may benefit from adding a small pinch of sea salt to evening meals or drink bottles (except athletes with elevated blood pressure).

In some cases where magnesium depletion is significant, a magnesium supplement and adequate electrolytes may be beneficial. As with all supplements, it is best to speak with a health professional to avoid the pitfalls of self-prescribing such as gastrointestinal issues and interactions. Athletes with a history of iron or zinc deficiency should be mindful of magnesium forms. Magnesium citrate is often found in supplements as it is well absorbed and specific to muscles however long-term use may interfere with the carrier protein (ceruloplasmin) and contribute to future mineral insufficiency.

Five quick tips for boosting your overall fluid intake:

1. Keep a pot of warm herbal tea or lemon and ginger in your workspace and sip continuously

2. Enjoy a cup of bone broth, miso or soup as a snack or with dinner.

3. Increase your fluid through foods. Enjoy more “wet” dishes such as soups, casseroles or Vietnamese style Pho bowls and enjoy snacks with high water content such as cucumbers, watermelon, oranges and apples.

4. Add warming herbs and spices such as cinnamon and turmeric to your favourite smoothies or juices (made with room temperature water or warm milk and fresh fruits instead of frozen).

5. Stick to a hydration plan during training sessions and keep a record of total intake daily in your training app or journal.

About the Author Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit www.https://https://athletesanctuary.com.au/wp-content/uploads/2023/03/normatec-3-lower-body-system-thumb_720x-1.webp.com.au/wp-content/uploads/2020/05/Seed-Cycle-Blends-scaled-1.jpg.com.au

Supplementation by athletes can be a minefield to navigate for the unwary. Whilst there may be significant value in taking additional nutrients, most of us share the view that it should always be a ‘food first’ policy. Maintaining a balanced nutrient–dense diet, is the key foundation for sports performance regardless of the level of competition.

Foods ingested in their natural format contain a package of bioavailable nutrients that help the body absorb key nutrients in ratios that are more easily assimilated than many supplements, and no volume of supplements can make-up for a poor diet. Athletes undertaking regular hard training sessions, may however benefit from taking supplements to maintain nutrient sufficiency and to maintain optimal health.

Supplementation by athletes should ideally focus on only high-quality supplements that are more likely to contain nutrients in beneficial ratios and bioavailable forms. Unfortunately, supplements may not contain all the active ingredients and compounds found in nature. Poor quality (and often cheaper) supplements may contain artificial forms of nutrients that are more difficult for the body to absorb. Retail products may also be formulated in doses below the therapeutic range required for health benefits. The storage and manufacturing processes of some supplements may also be questionable. Investigations of cheaper supplements such as fish oil may be rancid! Supplementation by athletes does have its place. It just isn’t practical to expect anyone to eat 2 buckets of spinach a day! Some nutrients are difficult to obtain purely from food sources when an athlete has high demands, digestion issues, illness, dietary restrictions or nutrient depletion. Iron, iodine, vitamin C and vitamin B12 are just some of the nutrients that fall into this category.

A 2015 study showed up to 70% of athletes use some form of supplement. This study by Outram and Stewart (2015) also revealed between 10-15% of supplements contained banned substances and over 80% did not contain what the label said. Competing athletes are typically aware of known banned substances but some are unaware of the considerable risk of accidental or inadvertent doping through using supplements.

If you are taking supplements and likely to be drug tested either in or out of competition in the future, the general guidelines below may be helpful. Some athletes are currently not in competition but still need to be aware there is no guarantee that taking “at risk” supplements will be out of your system when testing and competition resume.

Avoid imports
Imported supplements purchased online may sometimes appear to be cheaper but come at a huge cost to your sporting career. There are a number of issues to consider. Product quality can be difficult to ascertain due to being produced under different standards and labelling laws from those imposed on us from the Therapeutic Goods Association (TGA) in Australia. All ingredients may not be listed on the label of an imported product and this may put athletes at significant risk of testing positive to a banned substance. In the USA, dietary supplements are classified as a subcategory of food, exempting manufacturers from providing pre-market evidence of product safety and efficacy. The U.S. Food and Drug Administration (FDA) cannot inspect supplements until after the products have entered the marketplace and some disreputable manufacturers have spiked products with drugs such as anabolic steroids and amphetamines.

Know your banned substances
Always check labels and know the banned substance list for your specific sport both in and out of competition. The list of banned drugs and substances can be found on the ASADA website and substances can be checked here. If you are likely to be competing internationally, it would be wise to also look at the WADA guidelines here. Just because the substance does not appear on the prohibited list, does not mean it is 100% ok to ingest. The rules change frequently and supplements and other over the counter drugs may have different names from what appears on the list. Substances such as Bupropion, caffeine, nicotine and phenylephrine are included in the WADA 2020 Monitoring Program and their status may change at any time. If in doubt, avoid the substance.

Health foods and natural products
Some health food products and herbal medicines should still be avoided even if they are not on the banned list if you are unable to be assured of their purity and quality. For example, maca powder taken to support hormone function, energy and sports performance is one natural food product that is at risk of contamination. Tribulus is another product to be weary of. The Australian Institute of Sport (AIS) states “these products do not appear on the WADA list and are thus not specifically banned. However, they are often found in multi-ingredient products that contain banned ingredients or are at high risk of being contaminated. Therefore, they are not recommended for use.” See the AIS Supplement Group D list here .

Supplementation by athletes -Consider certified
Common sports supplements such as magnesium, probiotics, vitamin C, protein powders, creatinine etc. are now being batch tested and certified. Human and Supplement Testing Australia (HASTA) is an Australian commercial product testing organisation for WADA and has a certification scheme. Certifying a product involves not just multiple batch testing, but verification of the manufacturing quality controls that are in place and site inspections. If a product has been “HASTA Certified” it means that every batch has been tested for over 200 WADA prohibited substances.

Informed Sport also conduct supplementation testing on international sports nutrition brands. You can read more about the Informed Sport certification process here and HASTA process here

The same supplements should not be more expensive than usual just because they are batch tested.

Are there any guarantees?
No. Supplements screened by Hasta and Informed Sport cannot offer a 100% guarantee that an athlete will not test positive, but they are significantly less risky than other supplements. As batch testing is very expensive, limited supplements are available despite some manufacturers having large product ranges. If you have purchased a Hasta certified product, always check your supplement bottle has been batch tested. If your supplement does not come with a Hasta certificate, you are unable to safely assume it has been batch tested.

Are certified products better quality?
Unfortunately no. Companies that can afford to undertake the rigorous and expensive certification process may have some products included. Smaller companies that produce high quality products, may not be on the list. Just because a product is certified, does not mean they are suitable for you. Athletes still need to choose supplements with bioavailable forms of nutrients and take sufficient amounts to reach therapeutic levels and health benefits. There are Hasta certified products from reputable companies that I recommend frequently but it may be difficult for an athlete to choose suitable options if they just scroll through the list of supplement options.

Therefore, if you are a competing athlete, we suggest always checking with a qualified practitioner before self-prescribing any supplement, even if it appears to be batch tested or packaged as ‘food grade’ at the health food shop. Batch tested supplements are available through the Athlete Sanctuary.

We hope you found this information useful. If you would like further guidance with your supplementation protocol or health concerns, please get in touch.

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit www.https://https://athletesanctuary.com.au/wp-content/uploads/2023/03/normatec-3-lower-body-system-thumb_720x-1.webp.com.au/wp-content/uploads/2020/05/Seed-Cycle-Blends-scaled-1.jpg.com.au

Choosing the best collagen for tendon repair can be challenging. There are so many to choose from. All collagen powders are not created equal. Understanding the different forms and their sources can be helpful when making your decision. Keep in mind collagen can be helpful in the repair of tendons, bones and ligaments, improving skin elasticity and gut health.

Recent studies have helped to fine-tune dosage recommendations and nutrient combinations to enhance its effectiveness. As the quality and volume of collagen produced by our body reduces with age, master athletes may benefit from consistent supplementation.

What does collagen do?

Collagen is a major structural protein and building block made within your body. Collectively, collagen comprises 30% of the body’s protein as amino-acids, specifically glycine, proline, hydroxyproline and arginine. Collagen provides structure and acts like glue to your skin, hair, skeleton, tendons, muscles, ligaments, corneas, teeth and blood vessels. Hydrolysed collagen is similar to gelatin but structurally varies. Collagen contains tri peptides whereas gelatin contains simple amino acid chains. Peptide chains within collagen act as signalling molecules to fibroblasts which increase collagen, elastin and hyaluronic production. They also signal anti-inflammatory agents and increase the production of antioxidants.

There are 29 different types of collagen, all with slightly different roles but 80 – 90 % of the collagen in the body consists of types I, II, and III. Together all forms serve the same purpose; to help tissues withstand stretching. Although all forms are essential in the body, research tends to focus on types I-III when it comes to athletes. Let’s explore these three types in a little more detail.

Type I forms the reinforcing rods in bone, cartilage, tendons, teeth and connective tissue and is the most dominant form within the body making up 90% of all collagen. It is also the collagen that forms scar tissue and skin.

Type II (also known as hyaline or articular cartilage) is the major collagen in elastic cartilage and is the gel like substance designed to provide cushioning and allow joints to absorb shock. Its rigid macromolecules provide the strength and compressibility that allow it to resist large deformations in shape during movement.

Type III supports the structure of muscles, organs, and arteries.

Collagen and vitamin C for repair – the research evidence

Recent studies have also shown the combination of 500mg of vitamin C and between 5 – 15 grams of collagen is beneficial when taken one hour before exercise. Positive results do not appear to be dose dependent when within this range. Several studies including a study from the AIS (Australia Institute of Sport) showed significant improvements in achilles tendon injuries when taken for three to six months.

A 2017 study also demonstrated significant improvements in activity-related joint pain in 139 athletes, positive changes to ankle function and pain following supplementation for sprains. Collagen also reduces the risk of subsequent sprains for 3 months after supplementation.

Most collagen powders on the market are derived from shellfish, beef, chicken or pork. As a general recommendation, better quality collagen supplements are derived from grass-fed animals or wild-caught seafood. Vegans should be aware plants do not make collagen. There are currently no clinical trials that support bone broth as a reliable source of collagen peptides.

Vitamin C

Vitamin C converts proline and glycine to hydroxyproline. Pre-clinical studies have also shown vitamin C has the potential to accelerate bone healing after a fracture, increased type I synthesis, and reduce oxidative stress.

Additional dietary intake of vitamin C-rich foods during rehabilitation may also be beneficial. Good sources include berries, red capsicum, broccoli, kiwi, guava, citrus, rosehip and indigenous foods such as camu camu, goji berry and Kakadu plum.

Other beneficial nutrients

Copper also plays a role in production as it activates an enzyme called lysyl oxidase that is required for maturation. Copper is found in beef liver, crab, oysters, sunflower and sesame seeds, cocoa powder, cashews, hazelnuts, peanuts, almonds and lentils.

Zinc helps with the production and activates a protein that re–models collagen during wound healing. Zinc is found in seafood, oysters, pepitas, nuts, poultry and meat.

Manganese activates enzymes such as pro–lidase that your cells use to make proline and gives collagen fibres their shape. Brown rice, oats, pineapple, peanuts, and pecans all contain manganese.

Amino Acids

Insufficient protein intake or overall energy intake impedes wound healing and increases inflammation to possibly deleterious levels. During the healing process, energy expenditure is increased, particularly if the injury is severe. Energy expenditure may increase between 15% – 50%, depending on the type and severity of the injury.

Given that muscle loss may begin from inactivity during an injury recovery phase within 36 hours and healing processes are heavily reliant on synthesis of collagen and other proteins, the importance of dietary protein should not be understated. If you are in the unfortunate position of being injured, protein intake of 2 grams/ kg of body weight per day is advocated.

Meat, poultry, seafood, dairy, legumes, and tofu are all excellent sources of amino acids. Plant-based athletes may combine protein sources to ensure all essential amino acids are available for protein synthesis.

In addition, specific foods rich in proline and glycine may be beneficial.

Proline is found in egg whites, wheat germ, dairy products, cabbage, asparagus, and mushrooms.

Glycine is found in the skin of pork or chicken and gelatin.

Making your own gelatin chews are an easy way to boost glycine intake.

Gelatin is what is used to set jelly and gummy lollies. Gelatin also contains proline, valine and glutamic acid.

Be wary of sugar! Sugar interferes with collagen’s ability to repair itself and degrades collagen. It is therefore a good idea to limit your consumption of added sugar and refined carbs when injured for several reasons.

Please remember the guidelines provided in this blog are general in nature. If you are injured, you may benefit from individualised nutritional guidance to help you get back on track. Make an appointment here

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit www.https://https://athletesanctuary.com.au/wp-content/uploads/2023/03/normatec-3-lower-body-system-thumb_720x-1.webp.com.au/wp-content/uploads/2020/05/Seed-Cycle-Blends-scaled-1.jpg.com.au

References

Clark, K. L., Sebastianelli, W., Flechsenhar, K. R., Aukermann, D. F., Meza, F., Millard, R. L., & Albert, A. (2008). 24-Week study on the use of collagen hydrolysate as a dietary supplement in athletes with activity-related joint pain. Current medical research and opinion, 24(5), 1485-1496.

Dressler, P., Gehring, D., Zdzieblik, D., Oesser, S., Gollhofer, A., & König, D. (2018). Improvement of functional ankle properties following supplementation with specific collagen peptides in athletes with chronic ankle instability. Journal of sports science & medicine, 17(2), 298.

Frankenfield, D. (2006). Energy expenditure and protein requirements after traumatic injury. Nutrition in Clinical Practice, 21(5), 430-437.

Lis, D. M., & Baar, K. (2019). Effects of Different Vitamin C–Enriched Collagen Derivatives on Collagen Synthesis. International Journal of sports nutrition and exercise metabolism, 29(5), 526-531.

Praet, S. F., Purdam, C. R., Welvaert, M., Vlahovich, N., Lovell, G., Burke, L. M., & Waddington, G. (2019). Oral supplementation of specific collagen peptides combined with calf-strengthening exercises enhances function and reduces pain in achilles tendinopathy patients. Nutrients, 11(1), 76.

Shaw, G., Lee-Barthel, A., Ross, M. L., Wang, B., & Baar, K. (2017). Vitamin C–enriched gelatin supplementation before intermittent activity augments collagen synthesis. The American Journal of clinical nutrition, 105(1), 136-143.

Zdzieblik, D., Oesser, S., Gollhofer, A., & König, D. (2017). Improvement of activity-related knee joint discomfort following supplementation of specific collagen peptides. Applied Physiology, Nutrition, and Metabolism, 42(6), 588-595.

Vitamin D deficiency has consequences well beyond bone health.

Vitamin D is gold.

Vitamin D is so important to the body, immune cells, brain, colon, breast, and other cells have the ability to also activate it locally when required. Although labelled a vitamin, calcitriol (bio-active vitamin D) acts more like a hormone within the body. It is involved in many essential functions well beyond bone health. Vitamin D is critical for inflammatory modulation, hormonal and immune functions as well as cardiovascular, mental health and pancreatic function. The active form of vitamin D interacts with receptors in the intestine, bone, brain, heart, immune cells and skeletal muscle. Vitamin D functions as a modulator of up to 1000 genes involved in cellular growth and protein synthesis.

Vitamin D plays an important role in an athlete’s health, training and performance.

Studies show it may even be necessary for optimal muscle function and performance as muscle performance is impaired by suboptimal vitamin D status. Deficiency induces atrophy of fast twitch muscle fibers, impairs calcium uptake and prolongs time to peak contractile tension and relaxation. Studies also show Vitamin D deficiency may delay rehabilitation from injury.

In sporty pregnant women, low vitamin D levels are linked to pre-eclampsia, gestational diabetes and adverse pregnancy outcomes. Vitamin D also plays a part in regulating insulin, blood sugar balance and thyroid hormones. Research shows that a deficiency of vitamin D is associated with a high risk of thyroid antibodies, which are found in individuals with autoimmune thyroid disorders.

Vitamin D is most commonly known in the athletic community for its influence on bone health and prevention of bone injury. Vitamin D influences bone health by upregulating expression of genes that enhance intestinal calcium absorption, and reabsorption by the kidneys along with increasing bone-building cell activity. Studies show calcium absorption significantly increases when vitamin D levels are sufficient. Calcium absorption is reduced to 10-15% with low vitamin D levels and stress fracture risk significantly increases.

Typically, 80% of our vitamin D is obtained from the sun and 20% from food sources.

Signs of Vitamin D deficiency

fatigue and tiredness
lower back pain
recurrent colds and infections and poor immunity
stress fractures
heaviness in the legs
recurrent injuries
muscle pain, weakness, poor muscle contraction and relaxation
mental health issues, low mood, seasonal sadness and depression
hormonal imbalances and PMS
anaemia and low iron
pale floating stool
photosensitivity

According to Sunsmart Australia, one-third of Australians are low in Vitamin D.

10 Reasons your vitamin D is low

Vitamin D can be made by our body when skin is exposed to sunlight through a complex activation process, however, what many people fail to realise is that this process doesn’t always occur efficiently or reach levels required for optimal health. Vitamin D production may vary depending on the time of day of sun exposure, season, cloud cover, smog, latitude, skin pigmentation, age, and sunscreen use.

We often see patients with low levels of vitamin D despite being out in the sun daily. There are several reasons why vitamin D levels drop despite sunlight exposure.

1. As vitamin D is fat-soluble and stored in fat cells, individuals with low body fat, may be disposed to vitamin D deficiency as their storage tank is smaller.

2. Activation and production of vitamin D are inhibited by magnesium deficiency, inflammation, and excessive use of sunscreen.

3. Individuals with any form of malabsorption issues, liver or kidney issues, coeliac’s disease, Crohn’s, vegans, and thyroid issues can be prone to deficiencies.

4. Anyone with a history of anaemia should also be aware of the bidirectional influence between iron and vitamin D. The activation of vitamin D in the kidneys requires iron-containing compounds ferredoxin reductase and ferredoxin. Iron deficiency may therefore contribute to the inactivation of vitamin D. Vitamin D deficiency may also be associated with higher hepcidin (a pro-inflammatory mediator) in the liver. Hepcidin will elevate ferritin stores and down-regulate intestinal absorption of iron from food and impair storage iron release. Hundreds of athletes have used our handy anaemia tool to help determine the likely risk of having low iron or anaemia.

5. Diets containing limited seafood, eggs or dairy such as vegan diets may also reduce vitamin D intake.

6. Insufficient direct UVB exposure (due to smog, cloud cover or latitude), early- or late-day training, indoor training, geographic location further away from the equator and sunscreen use (SPF of 15 lowers vitamin D synthesis capacity by 98%).

7. Disruption to the microbiota and gut inflammation may also affect the availability of vitamin D.

8. In addition some individuals may find it difficult to increase their vitamin D levels if they have low antioxidant status.

9. Medications such as anticonvulsants, corticosteroids, cimetidine, theophylline, statins or the weight loss drug orlistat.

PATHOLOGY TESTING

As a general guide, Osteoporosis Australia recommends most people should have levels of at least 50 nmol/L at the end of winter, which means people may have higher levels during summer (60-70 nmol/L). However, in order to maintain optimal health, athletes should aim for serum levels over 90 nmol/L ideally between 100 and 130 nmol/L.

Treatment

Daily sunlight exposure on your skin especially on large areas such as the back, chest, legs and arms (25-60 minutes in winter) without suntan cream, is a great way to keep levels topped up. Athletes living in southern states of Australia and New Zealand need 30 minutes of direct skin exposure (springtime) on large areas of skin such as back, arms, chest or legs closer to midday. Athletes living closer to the equator may require 15 minutes before 10 am. During this time avoid putting sunscreen on, then for the rest of the day, cover up. Lunchtime exercise with as much skin exposure as possible (within decency) is a great way to give yourself a vitamin D fix, especially in winter months.

Get tested biannually- before winter and again in spring.

Consume vitamin D-rich foods on a daily basis such as oily fish like cod, salmon, sardines or tuna, egg yolks, sun-dried mushrooms, and fortified milk, butter and fortified cereals. Some individuals may benefit from cod liver oil which also contains vitamin A and essential fatty acids.

When levels are low, take a quality supplement in the correct dosage range and a probiotic. Certain probiotics such as Lactobacillus rhamnosus LGG and Lactobacillus plantarum enhance levels synergistically.

Obtain adequate magnesium-rich foods such as spinach, pumpkin seeds, almonds, black beans, oyster mushrooms, avocado, figs, yogurt or kefir and banana. Chocolate also contains magnesium.

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