dietary supplements risks and benefits seminar/braun fih medical seminar... · fih medical seminar...

FIH Medical Seminar

June 4, 2014 Speaker:

Hans Braun

Olympic Training Center Rhineland

German Sport University Cologne

Hans Braun - Dipl. Sportlehrer - Dipl. Oecotrophologe

- German Sport University Cologne – Institute of Biochemistry

- momentum – German Research Center of Elite Sports

- Olympic Training Center Rhineland

FIH Medical Seminar - June 4, 2014

Nutrition and Health in Elite Hockey Players

Dietary Supplements

Risks and Benefits

FIH Medical Seminar


Hans Braun



Top Athlete – Standardized Athlete?

Quelle: www.howardschatz.com

One Size does not fit all!

FIH Medical Seminar


Hans Braun



43 kg , 153 cm

~ 1800 kcal pro Tag

146 kg , 183 cm

~ 8000 kcal pro Tag

Top Athlete – Standardized Athlete?

FIH Medical Seminar


Hans Braun



http://www.london2012.com

Olympic Games London 2012

www.london2012.com London 2012 Men‘s High Jump

FIH Medical Seminar


Hans Braun



Dietary Supplements – Statements

Leading sport organizations (IOC, FIFA, IAAF, ACSM) recommend that :

athletes should ensure they have a

good diet before contemplating

supplement use

DS should not be used by

underage athletes

Maughan et al. (2007)

Supplement use requires individual assessment and advice by a qualified

sports nutrition professional and medical practitioner. Maughan et al. (2007)

individual nutrition consulting

young athletes ~18%

olympic athletes ~54%

dietary supplement use

young athletes ~80%

olympic athletes ~95% Braun et al. (2009)

FIH Medical Seminar


Hans Braun



Dietary Supplements - Risks and Benefits

• Introduction

• Prevalence of Dietary supplements

• Groups of Dietary supplements

– Sports Drinks

– Sport Gels & Sport Bars

– Protein & Protein Components

– Micronutrients

– Ergogenic Aids

– Contamination & Doping

• Summary

FIH Medical Seminar


Hans Braun



AIS Supplement Classification System www.ausport.gov.au

FIH Medical Seminar


Hans Braun



Reference Intake – Risk of Supplementation

FIH Medical Seminar


Hans Braun



Pilot Study – DS use and micronutrient intake

• April/May 2011 – 27 athletes (15,6 ± 2,1 years)

• No athlete reported nutrition consulting before

• 12 athletes (44%) used DS

• 16 different products (14 x vitamins/minerals, 1x amino acids, 1x protein powder + VitMin)

Athlet Nr. DS product Amount per week

1 Orthomol Sport 7

1 Am Sport Aminosäuren 70 g

1 Ferro Sanol 100mg 7

2 Biolectra Magnesium (365 mg) 6

3 Orthomol Sport 6

3 Cevitt Immun direct (C+Zink) 1

4 All Vital Zellschutz 17

4 All Vital Vitamin B Komplex 14

5 Ferro Sanol 100 mg 7

6 Champ Muscle 90 Protein Shake 15 g

7 Juice Plus Obst 3

7 Juice Plus Gemüse 4

8 Taxofit Eisen Plus Vitamin C (50mg + 50mg) 4

9 Magnesium 400 mg Kneipp 2

10 Magnesium Abtei 400 mg + C 80mg + E 12 mg 2

11 Magnesium, Kneipp Calcium 400mg + Mg 245mg + C 37 mg 7

11 Das gesunde plus Vitamin Sticks (Multivitamin) 7

12 Hämatopan 75 mg Eisen 7

FIH Medical Seminar


Hans Braun



0% 50% 100% 150% 200% 250% 300% 350%

Vit. A

Vit. D

Vit. E

Vit. B1

Vit. B2

Niacin

Pantothenic Acid

Vit. B6

Biotin

Folic Acid

Vit. B12

Vit. C

Potassium

Calcium

Magnesium

Iron

Zinc

Copper

Mangan

Fluoride

Iodine

Without DS

< 100% RDA

Vit. A 6

Vit. D 11

Vit. E 6

Vit. B1 3

Vit. B2 2

Niacin 1

Pantothenic Acid 6

Vit. B6 2

Biotin 3

Folic Acid 11

Vit. B12 6

Vit. C 2

Potassium 3

Calcium 4

Magnesium 2

Iron 6

Zinc 1

Copper 0

Mangan 3

Fluoride 12

Iodine 12


FIH Medical Seminar


Hans Braun



0% 100% 200% 300% 400% 500% 600% 700% 800% 900% 1000% 1100% 1200%

Vit. A

Vit. D

Vit. E

Vit. B1

Vit. B2

Niacin

Pantothenic Acid

Vit. B6

Biotin

Folic Acid

Vit. B12

Vit. C

Potassium

Calcium

Magnesium

Iron

Zinc

Copper

Mangan

Fluoride

Iodine

1542%

2896%


FIH Medical Seminar


Hans Braun



DS use leads to exceed nutrient intakes higher than suggested Upper Intake Levels

EFSA USA

(11-14y; 15-17y) (14-18y)

Iron NA 45 mg

Magnesium 250 mg Supplement 350 mg Supplement

Zinc 18-22 mg 34 mg

Vitamine B6 15-20 mg 80 mg

3 athletes (99 mg, 111 mg, 121 mg)

3 athletes high dosage Mg products

2 athletes (19 mg, 38 mg)

1 athlete (163 mg)

EFSA, 2006


FIH Medical Seminar


Hans Braun



I. „Athletes eat more, therefore they have a higher micronutrient intake“

Specific situations – micronutrient requirement

FIH Medical Seminar


Hans Braun



0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

0 1000 2000 3000 4000 5000 6000 7000

Zin

c In

tak

e (

mg

/da

y)

Energy Intake (kcal/day)

Männer Frauen

male r= 0,90

female r= 0,85

10 mg/day

7 mg/day

< 100% RDA

(DACH)

m; 7%

w; 7%

male female

Zinc intake of athletes (n=375)

FIH Medical Seminar


Hans Braun



Niacine r = 0,90

Vitamin B2 r = 0,86

Pantothenic Acid r = 0,86

Biotin r = 0,84

Vitamin B1 r = 0,83

Vitamin B6 r = 0,83

Vitamin E r = 0,80

Folic Acid r = 0,76

Vitamin B12 r = 0,63

Vitamin C r = 0,52

Vitamin A r = 0,45

Vitamin D r = 0,17

Zinc r = 0,90

Iron r = 0,90

Copper r = 0,89

Potassium r = 0,87

Magnesium r = 0,74

Calcium r = 0,66

Fluoride r = 0,62

Iodine r = 0,61

Energy Intake (kcal/day) and dietary micronutrient intake (amount/day)

Dietary Micronutrient Intake in Athletes (n=303)

„Vitamin and mineral supplements are not needed, if adequate energy to

maintain body weight is consumed from a variety of foods. ACSM, Position Stand 2009

FIH Medical Seminar


Hans Braun




Athletes might be in risk:

- during weight reduction periods

- in periods with low energy intake (weight class sport, ski jumper…)

II. „gender specific differences“


FIH Medical Seminar


Hans Braun



0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0

0 1000 2000 3000 4000 5000 6000 7000

Iro

n In

tak

e (

mg

/da

y)

Energy Intake (kcal/day) Männer Frauen

male; r= 0,91

female; r= 0,85

< 100% RDA

m; 15%

w; 67%

12 mg/day

15 mg/day

male female

Iron intake of athletes (n=375)

FIH Medical Seminar


Hans Braun








Iron needs are higher for females than males

- Iron supplementation could be of benefit for some females with respect to iron

status

- Supplementation without medical diagnosis should be avoided

III. „Seasonal needs“


FIH Medical Seminar


Hans Braun



Vitamin D Status in young athletes (n=308)

Braun & de Marées,

2013 (unpublished)

FIH Medical Seminar


Hans Braun



17 ng/ml 19 20 20 20 27 26 35 40 31 21 16

0

10

20

30

40

50

60

70

Jan(n=17)

Feb(n=18)

Mar(n=27)

Apr(n=52)

May(n=29)

Jun(n=18)

Jul(n=11)

Aug(n=28)

Sep(n=28)

Oct(n=26)

Nov(n=33)

Dec(n=12)

Seru

m 2

5(O

H)D

(n

g/m

l)

- Aug & Sep; 25(OH)D < 20ng/ml (11%) and <32 ng/ml (47%) of athletes

- Nov bis Mai; 25(OH)D < 20ng/ml (58%) and <32 ng/ml (96%) of athletes

Braun & de Marées 2013 (unpublished)

Vitamin D Status in young athletes (n=308)

FIH Medical Seminar


Hans Braun








Iron needs are higher for females than males

- Iron supplementation could be of benefit for some females with respect to iron

status

- Supplementation without medical diagnosis should be avoided

III. „Seasonal needs“

- Vitamin D Status might be reduced due to season (endogenous synthesis

reduced in winter month)

- Dietary vitamin D intake does not compensate reduced synthesis


FIH Medical Seminar


Hans Braun



Dietary Supplements - Risks and Benefits

• Introduction

• Prevalence of Dietary supplements

• Groups of Dietary supplements

– Sports Drinks

– Sport Gels & Sport Bars

– Protein & Protein Components

– Micronutrients

– Ergogenic Aids

– Contamination & Doping

• Summary

FIH Medical Seminar


Hans Braun



Contamination & Doping

Geyer et al 2004

FIH Medical Seminar


Hans Braun




Geyer et al 2004

Follow up 2011/2012

597 products

17 countries + Internet

analysis of 43

anabolic steroids

4 products positive

Reduced risk of

contamination with anabolic

steroids

New risk with other

substances (e.g. Stimulants)

or faked products

FIH Medical Seminar


Hans Braun



Problem:

Methylhexanamine declared

under different names

• Geranamin,

• Forthan

• Floradrene

• Dimethylamylamine,

• Dimethylpentylamine,

• Pentylamin,

• 2-amino-4-methylhexane

1 31

123

283 320

0

50

100

150

200

250

300

350

2008 2009 2010 2011 2012

WADA Statistik für Methylhexanamin (Adverse Analytical Findings)


FIH Medical Seminar


Hans Braun




FIH Medical Seminar


Hans Braun



Doping Cases Sotschi 2014

Methylhexanamin Biathlon

Trimetazidine Skilanglauf

Methylhexanamin Eishockey

Methylhexanamin Bob

Pseudoephedrin Eishockey

N-ethyl-1-phenylbutan-2-amine Bob

Erythropoietin Skilanglauf

Dehydrochlormethyltestosteron Eishockey


FIH Medical Seminar


Hans Braun



Weight loss product and training booster with Stimulants

Nox Pump

Declared Ingredient:

Geranium Root Extract

Not declared:

Methylhexanamin

(15 mg/Kapsel)


FIH Medical Seminar


Hans Braun



LIDA Product: Meizitang

slimming product

Herbal diet capsules with sibutramine

(15 mg/capsule) not declared on the

label

50 h following a single administration

of the tea, sibutramine metabolites

were clearly detectable in a volunteer’s

urine and would have caused a failed

doping test.


FIH Medical Seminar


Hans Braun



14.07.2013

3 Sprinters positive for Oxilofrin www.spiegel.de


http://www.spiegel.de/

FIH Medical Seminar


Hans Braun




FIH Medical Seminar


Hans Braun



Supplement faked with the stimulant

Oxilofrin

(bought in July 2013)


FIH Medical Seminar


Hans Braun



Dietary supplement

Faked with Oxilofrin

(April 2014)


FIH Medical Seminar


Hans Braun



Neuroenhancer, adulterated with stimulant Oxilofrine

and other stimulants http://epiphanyd1.com/ online 09.09.2013


http://epiphanyd1.com/

FIH Medical Seminar


Hans Braun



The Food and Drug Administration (FDA) has found

o nearly 300 fraudulent products

o promoted mainly for weight loss, sexual enhancement, and bodybuilding

o containing hidden or deceptively labeled ingredients

• such as active ingredients in FDA-approved drugs

or their analogs (closely-related drugs)

• other compounds, such as novel synthetic steroids, that do not

qualify as dietary ingredients

www.fda.gov


FIH Medical Seminar


Hans Braun



Contamination & Health risk

FIH Medical Seminar


Hans Braun



http://www.fda.gov/Safety/Recalls/ucm375740.htm

Contamination & Health risk

FIH Medical Seminar


Hans Braun




What can athletes do?

Athletes are advised to take supplements only from “low-risk”

sources.

Germany (www.colognelist.com)

Netherlands (http://www.dopingautoriteit.nl/)

These Databases list supplements from companies, which perform

quality control for anabolic steroids and stimulants.

FIH Medical Seminar


Hans Braun



Summary

• Before contemplating supplement use, athletes should ensure to have a

healthy, balanced and sport specific diet.

• For implementation, individual nutritional assessment by a qualified sports

nutrition professional is advised.

• Evaluate DS use of your athletes. Why do they use them? What is really

necessary?

• The non-critical intake of micronutrient supplements should not be

underestimated and can lead to an intake higher than the upper intake level.

• Some athletes might benefit from micronutrient supplementation in some

situations.

• Supplements can be contaminated or faked with illegal substances and can

lead to a positive doping case.

• Supplements aggressively advertised for weight loss, reduction of fat mass,

increasing lean body mass, are of high risk.

• If supplements are necessary take them from low risk sources.

FIH Medical Seminar


Hans Braun



Hans Braun - Dipl. Sportlehrer - Dipl. Oecotrophologe

- German Sport University Cologne – Institute of Biochemistry

- momentum – German Research Center of Elite Sports

- Olympic Training Center Rhineland

FIH Medical Seminar - June 4, 2014

Nutrition and Health in Elite Hockey Players

Dietary Supplements

Risks and Benefits

dietary supplements risks and benefits seminar/braun fih medical seminar... · fih medical seminar...

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