Testosterone Boosters

Dietary supplements claiming to boost testosterone or enhance sexual performance are often explored and inquired about by athletes. However, these products come with concerns. Many of the ingredients are created in factories, making them unnatural, and lack scientific evidence regarding their safety and efficacy, even if the products are labeled as “herbal” or “all natural” (Campbell et al., 2013).

The Food and Drug Administration (FDA) holds dietary supplement manufacturers responsible for truth in labeling and safety of all dietary supplement products that enter the consumer market. Unfortunately, these companies may not list each product ingredient on the supplement facts panel, can make false or exaggerated claims, and/or add harmful ingredients. Due to the unregulated nature of supplements, there is little data regarding the products as a whole, including the ingredients, use of proprietary blends, and marketing claims (Willoughby, Spillane, & Schwarz, 2014).

Testosterone boosters and sexual enhancement products have a higher risk of containing harmful ingredients that are not listed on the label, compared to other supplement categories. For example, phosphodiesterase type 5 (PDE5) inhibitors are pharmaceutical medications used to treat erectile dysfunction. PDE5 inhibitors have been found in testosterone boosting and sexual enhancement supplements, but have not been listed on the product label. In 2013, researchers tested sexual performance supplements to determine if they were adulterated with PDE5 inhibitors or other undeclared ingredients. The marketing for all 54 tested supplements claimed they did not contain synthetic substances. However, 81% of the tested products contained one or more synthetic PDE5 inhibitor or similar ingredient, undisclosed to the consumer (Campbell et al., 2013).

Taking dietary supplements that “boost testosterone” have proven ineffective in reducing fat mass, as well as increasing total body or muscle mass. Instead, products making these claims come with a lot of unknowns and dangers (Willoughby et al., 2014).

Consumers are made to believe that testosterone levels and muscle mass will increase with the use of dietary supplements claiming to be testosterone boosters. Manufacturers even state that their product is scientifically proven to work. When in reality, they often contain dietary ingredients that have not been tested for efficacy or safety.

Tribulus terrestris (TT) is a popular herbal ingredient found in testosterone boosting supplements. TT is associated with claims of boosting testosterone and correcting erectile function. Physically-active men are the target market for products containing TT (Pokrywka, 2014). Similarly, TT allegedly improves plasma testosterone levels and increases skeletal muscle growth (Antonio, Uelmen, Rodriguez, & Earnest, 2000). The use of dietary supplements with TT has shown no substantiated benefits in human studies. As with most dietary ingredients, there is a lack of evidence-based information regarding the effectiveness and safety of TT use in sport (Pokrywka, 2014). The consumer should be aware that many herbal/all-natural ingredients claiming to boost testosterone levels or provide other anabolic effects have limited scientific support.

Drug Free Sport believes that food should be the first option for fueling when athletes are looking to reach performance goals. Dietary supplements are poorly regulated by the FDA, with manufacturers loosely following the FDA’s guidelines. Supplement companies market their products how they wish, often place unlabeled ingredients in the bottle, and make false claims. Appropriately-timed meals and snacks, on the other hand, have been proven to aid in weight reduction and achieving sports performance goals.

If you are thinking about taking any dietary supplement, please visit Drug Free Sport AXIS™ to learn more about your options to make an informed decision. 

References:

Antonio, J., Uelmen, J., Rodriguez, R., & Earnest, C. (2000). The effects of tribulus terrestris on body composition and exercise performance in resistance-trained males. International Journal of Sport Nutrition and Exercise Metabolism, 10, 208-215.

Campbell, N., Clark, J.P., Stecher, V.J., Thomas, J.W., Callanan, A.C., Donnelly, B.F.,… Kaminetsky, J.C. (2013). Adulteration of purported herbal and natural sexual performance enhancement dietary supplements with synthetic phosphodiesterase type 5 inhibitors. International Society for Sexual Medicine, 10, 1842-1849.

Pokrywka, A., Obminski, Z., Malczewska-Lenczowska, J., Fijatek, Z., Turek-Lepa, E., & Grucza, R. (2014). Insights into supplements with tribulus terrestris used by athletes. Journal of Human Kinetics, 41, 99-105.

Qureshi, A., Naughton, D.P., & Petroczi, A. (2014). A systematic review on the herbal extract tribulus terrestris and the roots of its putative aphrodisiac and performance enhancing effect. Journal of Dietary Supplements, 11(1), 64-79.

Willoughby, D.S., Spillane, M., & Schwarz, N. (2014). Heavy resistance training and supplementation with the alleged testosterone booster NMDA has on effect on body composition, muscle performance, and serum hormones associated with the hypothalamo-pituitary-gonadal axis in resistance-trained males. Journal of Sports Science and Medicine, 13, 192-199.

Medical Marijuana, Medical Exception?

State Marijuana Laws in 2016 (Post-Election)

Image Source: governing.com 

Here's what you should know as of the November 8 election:

• There are now eight states that have passed laws permitting recreational use of marijuana: Maine, California, Massachusetts, Nevada, Colorado, Washington, Oregon, and Alaska. 

• Medical marijuana is now legal in 28 states and Washington, D.C. after ballot measures passed in North Dakota, Arkansas, Florida, and Montana. 

• Federally, marijuana is still classified as a Schedule I drug by the Drug Enforcement Administration (DEA). 

• Because of the DEA's imposed status, doctors can only "recommend" marijuana to patients. Federal law prohibits medical professionals from prescribing the drug. 

• Rates of marijuana use in states that have legalized marijuana in some form have increased exponentially compared to those that have not. (Source, page 5)

• The average THC concentrations in cannabis have continued to increase, while the medicinal, non-psychoactive ingredient, cannabidiol (CBD), has not. (Source) 

What this means for athletes:

• Marijuana is still prohibited/banned in sport or considered a drug of abuse. 

• Drug-testing sanctions for marijuana-positive tests, as designated by each sport organization, still apply in states where marijuana has been legalized. 

• Marijuana's cannabinoids are stored in fat. The increasing potency of THC in marijuana means it can take longer for the drug to be metabolized and cleared from the body. (READ: Using marijuana over the holidays, and hoping for clean urine upon returning to practice is probably not the best idea.)

• There are NO medical exceptions (MEs) or therapeutic use exemptions (TUEs) for marijuana in sport. Athletes will not be granted a ME or TUE, even if a doctor has "prescribed" marijuana.

Other athlete-health implications to consider:

• Legalization of marijuana in Colorado has shown an increase in alcohol consumption—separately from the increase in marijuana-infused beers and wines on the market. (Source, page 26)

• Post-legalization of marijuana: DUI cases related to driving while high, and traffic fatalities where the driver tested positive for marijuana have increased in Washington State and Colorado, respectively. (Source, pages 17-18)

Share your thoughts with us on social media (#EducateDrugFreeSport) or request a speaker on marijuana to educate your athletes!

Risk Level Rating System: A Deeper Look

Contributed by Anna Filardo, MS
Education Program Manager, Drug Free Sport

Drug Free Sport AXIS™ staff review dietary supplements according to the ingredients listed on the product’s supplement facts panel, marketing claims, and related scam warnings or FDA recalls. After our research and evaluation process, a risk level is assigned as Level 1, 2, or 3. There is no Risk Level 0 because Drug Free Sport does not test dietary supplements.

Due to limitations on regulatory oversight of the dietary supplement industry, there can be no guarantees that a product does not contain banned ingredients without testing each individual item. Unfortunately, supplement companies may intentionally or unintentionally contaminate/adulterate products that end up on the market. For these reasons, the risk level rating system cannot guarantee that a product will not cause a positive drug test. For zero risk, athletes are advised to avoid dietary supplements altogether and focus on food as fuel.

Drug Free Sport AXIS serves as a helpful tool in determining supplement safety for athletes, and provides sports nutrition handouts and recipes as alternatives. For a detailed explanation of the different Risk Levels assigned through the Drug Free Sport AXIS Dietary Supplement Inquiry tool, please keep reading. 

Risk Level I:

•  The supplement facts panel does not list banned ingredients or ingredients related to a banned drug class. 
• Product webpage and/or the product label’s marketing is not related to a banned drug class. Example: testosterone is a banned substance; dietary supplements that claim to boost testosterone (and otherwise do not list banned substances) will not be assigned a Risk Level 1.
• Seen as the “safest” risk level. Remember—there is no guarantee that a dietary supplement company did not contaminate/adulterate the product, which in turn could cause a positive drug test.
• Specific to Collegiate Sports: A Risk level 1 does not indicate whether or not the product is permissible for direct distribution to athletes. Permissible items are typically determined by compliance officers on campus according to NCAA bylaws.
• Watch this webinar for more information on NCAA Permissibility of Dietary Supplements.

Risk Level II:

• Ingredients listed on the label have limited scientific evidence regarding the safety, purity, or effects on the body. The ingredient may not be specifically banned, but has a possibility to be detrimental to the athlete’s health.
• The marketing for the product makes claims related to a banned drug class. Example: a product that claims to boost testosterone (and otherwise  may not list banned substances) is a Risk Level 2.
• Specific to organizations that prohibit caffeine: Caffeine or sources of caffeine (green tea, guarana, white tea, etc.) are listed on the label. Caffeine is banned (for specific sport organizations) under the stimulants drug class when urinary concentrations exceed 15 mcg/mL.
• There is no way for us to know what amount of caffeine will cause a positive drug test due to many factors: metabolic rate, other food/drink consumed, age, gender, weight, height, etc.
• There are ingredients listed on the label related to a banned drug class. The ingredient is not strictly banned, but is similar to a banned substance. Example: raspberry ketones may share a similar chemical structure to synephrine, a strictly banned stimulant. Therefore, a product listing raspberry ketones (and no other banned substances) would be categorized as a Risk Level 2.

Risk Level III:

• Ingredients listed are strictly banned. 
• The product has been cited for contamination/adulteration issues with banned substances, or has been recalled by the FDA.

The Drug Free Sport AXIS risk level rating system is a tool to assist athletes and athletic staff to make informed decisions regarding the use of dietary supplements for sports performance. Ultimately, athletes consume dietary supplements at their own risk.

To have a dietary supplement reviewed by our team, login and submit an inquiry to Drug Free SportAXIS. 

Drug Free Sport’s Community Investment – Showing Up Where It Matters

From our employees using their athletic careers to benefit the lives of Midwestern youth, to financially investing in certified athletic trainers to receive continuing education, you can count on Drug Free Sport’s commitment to philanthropy in 2017 and the years to come.

Here are a few ways that Drug Free Sport has shown up over the past year:

 

Boys & Girls Club of Greater Kansas City:
Drug Free Sport has supported youth sports development in many capacities. Philosophically, we understand that many habits and traits are learned in childhood, which can lead to helping kids make good decisions in life. Additionally, several studies have shown that youth sports help young boys and girls develop leadership skills and confidence, which can translate into positive influence in the boardroom and beyond.

Drug Free Sport’s COO, Chris Guinty, sits on the Boys & Girls Clubs of Greater Kansas City’s Board of Directors. Drug Free Sport has also sponsored a summer league T-ball team, tying into Major League Baseball’s RBI (Reviving Baseball in the Inner Cities) initiative. Dane Jensen, Assistant Director of Collector Training and Development, served as a coach for the kids (pictured above).

Drug Free Sport Continuing Education Awards:
High school and collegiate certified athletic trainers are on the front lines of combating drug abuse and affirming proper drug/supplement education. We aim to validate and encourage their work by offering multiple $1,000 continuing education awards to qualified athletic trainers. In June, we provided two collegiate and one high school certified athletic trainers with these awards. A group of certified athletic trainers, a former award winner, Drug Free Sport staff members and the Greater Kansas City Community Foundation came together to review the impressive body of candidates. This year’s award applications will begin in late December, with selected applicants announced in Spring 2017. 

"Shortly after graduating with my master's degree, I became a Division II head athletic trainer at a university that had been competing in intercollegiate athletics for nearly one hundred years, and had never administered an institutionalized drug test. It became apparent to us that Drug Free Sport could help us not only administer proper drug testing, but would also help our university with the most important aspect, education for our student-athletes. The Drug Free Sport Continuing Education Award has helped our university become more diverse in how we can educate our student-athletes and how we can close the gap on preventing drug use in collegiate athletics. Drug testing is just one small piece of the puzzle that any company can help provide. But, the educational tools that Drug Free Sport provides our university stand above the rest and have gone a long way in how we educate and prevent drug use in our student-athletes. We are proud to partner with Drug Free Sport and are proud of the work that their entire team does to help impact our student-athletes." – Heath Duncan, 2016 Drug Free Sport Continuing Education Award Winner; Head Athletic Trainer, Alderson Broaddus University (pictured above)

Careers in Sports Panel:

Our team members will often help those aspiring to careers in sport business by speaking on their life experiences at local events . A unique opportunity was presented in September, when we were asked to speak on a panel with ESPN’s Stephen A. Smith via the Team WallStreet organization.  The panel on careers in sports was a charity fundraiser for Kansas City-area youth. Vice President of Professional Sports Drug Testing, J.D. Matheus, addressed the crowd on his experiences as a student-athlete and matriculation into professional sports.

Westside (KC) Back-To-School Backpack/School Supplies Event:
Drug Free Sport headquarters lie on Kansas City’s Westside, a historic area rich in culture and development. Within the neighborhood, there is a frequent need for proper school supplies for children. Drug Free Sport continued its support of its neighborhood by donating to buy more than 30 padlocks for student lockers. Additionally, the team showed up to distribute backpacks and school supplies to kids of all school ages alongside members of the Kansas City, MO Police Department. “Working at the Westside Back-to-School event in the backpack room was very rewarding,” said Michael McCabe, Sport Drug Testing Program Manager. “The moments that brought the most joy were the looks of excitement on each kid’s face, knowing the work that we were doing would make it a little bit easier to head back to school.”

In all of our involvements, we often get as much (if not more) out of the experiences than the communities that we serve.

- Gene Willis, Director of Marketing

A Case to Choose Natural Food Over Dietary Supplements

Dietary supplements make up for a lack of nutrition, right? Wrong! Many health goals are met by eating whole, natural food, not by consuming dietary supplements. Athletes report many reasons for consuming dietary supplements. A popular one: “it’s hard to eat healthy; I don’t have time to cook, because my sport takes up a lot of my time.”  However, a deeper look into the food habits of athletes reflects missed meals or snacks, high fat and/or low carbohydrate intake, inadequate total calorie intake, the use of recovery shakes as meal replacements, or an emphasis on supplement intake before food.

The athlete may say:

• I'm tired all day.
• I can't maintain my weight.
• Eating healthy is expensive.
• I think I need more protein.
• I'm so hungry at night.
• I tend to eat more sweets after dinner.

A proper nutrition plan and healthy food choices can address many of the concerns commonly brought forward by athletes.

Research supports that adequate food for performance can:

• Increase energy.
• Improve performance.
• Increase speed, stamina, & endurance.
• Improve mental focus.
• Decrease recovery time.
• Improve mood & sleep.
• Reduce the risk of injury, cramping, & muscle pulls.
• Increase muscle mass.
• Decrease fat mass.

The comparisons below illustrate how whole food combinations actually provide more nutrition than dietary supplements.

Clearly, food is a better bang for your buck! The risk of contamination/adulteration in dietary supplements is eliminated, and you receive more nutritive value from food than dietary supplements. Working with a sports dietitian is highly recommended to help individualize your unique food fueling strategies to reach performance goals. Drug Free Sport AXIS™ also provides a growing "Athlete Recipe Box" with athlete-friendly recipes that require little time, taste great, and are easy to prepare.  

Troubleshooting Drug Free Sport AXIS

Drug Free Sport AXIS™ (AXIS) is everything the Resource Exchange Center/REC was, and more. Over the next year, AXIS will evolve and expand to address a wider range of topics pertinent to athlete health and wellness. However, we understand that a new name may come with some questions and confusion.  The purpose of this post is to outline some common questions and provide solutions to help you troubleshoot the new platform.

Best Practices for Logging in and Using Drug Free Sport AXIS for Dietary Supplement Inquiries:

1. Visit drugfreesport.com/axis and bookmark this webpage.
2. Login to AXIS using your designated sport organization’s password.
3. From the homepage, go to the “Dietary Supplement Inquiry” box—this is the picture of a water bottle.
4. If this is your FIRST time logging in you will need to enter all necessary information. Entries are confidential and used only to communicate our findings to a valid email address. We do not send personal information to schools/sports organizations. If you already HAVE an account, simply select the “Use an existing account” button to enter your email address—make sure everything is spelled correctly!
5. You will then receive an email from axis@drugfreesport.com. This email will directly link you into your AXIS account.  IMPORTANT TIME-SAVING TIP: SAVE THIS EMAIL IN A SAFE FOLDER IN YOUR INBOX FOR FUTURE DIETARY SUPPLEMENT INQUIRIES. DOING THIS WILL SAVE YOU TIME & ALLOW YOU TO ACCESS YOUR ACCOUNT 24/7 ON ANY DEVICE.
6. Follow the directions on the Dietary Supplement Inquiry Dashboard to enter and send supplements for review. NOTE: You MUST press the orange “Send Inquiry” button to deliver your message to our team. If you do not receive a confirmation email regarding supplement inquiry submission, you have not sent your products to our team!

Troubleshooting Issues with Drug Free Sport AXIS:

• ISSUE: You signed up for AXIS as outlined above, but have not received an email to access your account.
• SOLUTION #1: Check your junk & spam folders—these are usually two different folders.
• SOLUTION #2: If the email is not in your junk OR spam, contact your organization’s IT department to allow emails to be received from axis@drugfreesport.com and the “@drugfreesport.com” suffix.
• SOLUTION #3: If you have done these things and are not receiving the email, please call Anna Filardo (Education Services Program Manager) at 816-285-1429 or the toll-free AXIS hotline at 877-202-0769.
• ISSUE: You submitted an inquiry over 48 hours* ago and have not heard anything back from us.
• SOLUTION #1: Check your account and ensure that you hit the orange “send inquiry” button on the “Inquiries” tab.
• SOLUTION #2: If you did, in fact, hit “send inquiry,” please email us at axis@drugfreesport.com and include your Inquiry ID# in the subject line.

*Please note: If you submitted an inquiry after 5:00pm CST on a Friday, you may not receive a response until Monday afternoon.     

• ISSUE: You don’t see the medication you are taking in the “Prescription Drug Inquiry” database.
• SOLUTION #1: Type in the generic name of the medication instead of the brand name. If absent, try the brand name in the search bar. If neither the generic nor the brand name of the medication is listed in the database, see Solution #2 below.
• SOLUTION #2: Submit the medication as a “Dietary Supplement Inquiry” to our staff. Enter the medication name in the “Supplement Name” box, “Create & Add to Inquiry,” click orange “Send Inquiry” button. We will have our expert Pharmacist research the medication and report the status of the medication back to you within 24-48 hours.

If you are experiencing additional challenges with Drug Free Sport AXIS, please contact us directly at axis@drugfreesport.com or 877-202-0769. 

To learn more about NCAA's rules on permissible vs. impermissible dietary supplements view this webinar recording. 

Anti-Inflammatory Nutrition

Contributed by: Anna Filardo, MS, CPT

Education Program Manager, Drug Free Sport

It’s no secret that athletes are prone to injury, especially those causing inflammation around ligaments, joints, tendons, bones, even the brain. Inflammation may occur in the brain after a concussion or hard impact with the head.  A common response to inflammation is to reach for over-the-counter anti-inflammatory medications such as Ibuprofen and Aspirin.

But, did you know certain foods have anti-inflammatory properties? Nutrition is fuel for the body— helping it to heal and grow. Focus on eating foods rich in omega-3 fatty acids, vitamins, fruits/veggies, whole grains and drinking adequate water. Think: Brightly colored, minimally processed, whole foods.

Recommended Anti-Inflammatory Foods to Eat:

• Omega 3 Fatty Acids, specifically DHA

  

  Image courtesy of Harvard Health Publications: Harvard Medical School

• Salmon
• Trout
• Walnuts
• Spinach
• Chia Seeds

• Vitamins C, D, & E
• Bell peppers
• Oranges
• Kale
• Cauliflower
• Brussels Sprouts
• Broccoli
• Dairy Products
• Nuts

• Whole Grains
• Whole wheat bread/pasta
• Brown rice
• Oatmeal

• Fruits/Veggies
• The darker the veggie, the better
• Berries

• Water

Foods to Avoid:

• Alcohol
• Caffeine
• Salty food
• Sweets/candy
• Fried food

The bottom line:  take care of your body, especially when recovering from injury. For best results, work with a Sports Dietitian to determine the proper type and amount of foods to consume to optimize your path to recovery. You can also visit Drug Free Sport AXIS (dfsaxis.com) and look under the “Sports Nutrition” section for athlete-friendly recipes and nutrition handouts.

Concussion Resources:

NCAA Concussion Fact Sheet for Coaches

NCAA Concussion Fact Sheet for Athletes

Medical Exceptions and TUE Procedures: What You Need to Know

"My prescription is a banned substance! Now what?"

It’s that time of year when athletes are returning to campus, the season is starting, and the banned drug list is hanging over everyone’s head. It’s also the time of year that Drug Free Sport receives many phone calls, emails, and online inquiries regarding banned medications and medical exception procedures.

If you are an athlete or parent reading this, please note that it is inherently important to report all medications and supplements to the sports medicine staff at your organization or school. 

Prescription and Over-the-Counter medications can be checked using the Drug Free Sport AXIS™ (formerly the Resource Exchange Center/REC) medication database at drugfreesport.com/axis. By entering the brand or generic name of the medication, you can view the status of the medication as “banned” or “not banned” by your sports organization. 

If the medication registers the response “Drug Class Unassigned,” the medication is not yet categorized in our database. To check the status of this medication, navigate to the Dietary Supplement Inquiry page in the TOOLS menu bar and submit the medication to our AXIS team. A response will be provided within 24-48 hours and the medication will be added to the database. [Images below detail the process of of checking medications in the database and submitting an "unassigned" medication via the Dietary Supplement Inquiry form.]

From the Homepage, select the quick link box on the bottom right (shown above) titled 

"Prescription & Over-the- Counter Medication Database" to begin. 

In the database, simply start typing the name of the medication in the search bar. Once the medication 

appears in the auto-generated drop down menu, click and view the Medication Status in the gray box on the right. 

In this example, Adderall is Banned under the Stimulants drug class. 

If the Medication Status comes back as "Drug Class Unassigned," use the TOOLS menu bar 

shown with the arrow above to select "Dietary Supplement Inquiry" to send it to our team. 

To send the medication to the AXIS team, "Start a new inquiry" and type the name of the medication in the search bar. For example, "Acxion" as shown above. Select the green bar that reads "Don't see your supplement listed? Click here." and enter the medication information in the Supplement Name box. Add to inquiry and click "SEND" to receive a confirmation email that your inquiry has been received by our team.

Commonly, medications (such as those used to treat ADHD) come back as “banned” in the database. Sport organizations understand that some banned substances are warranted for treating specific medical conditions. In this case, each organization has a medical exception or Therapeutic Use Exemption (TUE) process that athletes and sports medicine personnel can follow to clear an athlete for competition. Before pursuing a medical exception or TUE, prescribing physicians should always consider alternative medications that do not contain banned substances, when appropriate for certain treatment plans.

Below are links for more information about the medical exception or TUE process for differing organizations. We have also shared additional insights and notes regarding the NCAA medical exception process specifically as you read on. 

NCAA

USATF

LPGA

PGA Tour: Page 36

World Surf League

For NCAA athletes, preapproval from the NCAA is only required if the medication or treatment plan aligns with the Peptide Hormones and Analogues or Anabolic Agents drug classes. Medical exceptions are NOT granted for any substances within the “Street Drugs” class, regardless of the possession of a medical prescription. All other banned drug classes do NOT require preapproval, but it is recommended to have all documentation in place prior to competition.

For medications that are banned under the Diuretics & Masking Agents, Beta-2 Agonists, and Alcohol/Beta Blockers (banned for rifle only) drug classes, the athletic department will maintain appropriate documentation in the student-athlete’s medical record in the event that the athlete tests positive for the prescribed substance. This documentation includes: the current diagnosis, medical history, course of treatment, and a current prescription/dosage for the medication.

Note: Many asthma medications are Beta-2 Agonists that appear as banned substances. However, the NCAA Banned Drug List states that “Beta-2 Agonists [are] permitted only by prescription and inhalation.” By this account, prescription inhalers such as albuterol are permitted with a current prescription documented in the student-athletes medical record.

For medications banned under the Stimulants drug class (such as those used to treat ADHD), the institution will need to maintain the same documentation as for the other drug classes, in addition to the ADHD Reporting Form that can be found here.  Again, this form and all other documentation do not need to be sent to the NCAA until the student-athlete tests positive on a NCAA drug test, at which time the institution may request an exception.

For additional questions about medical exceptions procedures for your institution or sport organization, please use the links provided above or email our Education Department at axis@drugfreesport.com.

NCAA "Approved" Supplements. Explaining the truth.

Contributed by Anna Filardo, MS, CPT 
Education Program Manager at Drug Free Sport, Inc.

MYTH: The NCAA approves dietary supplements.

Dietary supplement companies might advertise supplements as “NCAA Approved” on brand websites and packaging labels and persuade student-athletes to buy their product. This marketing effort may give sports medicine staff the perception that the supplement is safe and appropriate for their student-athletes. Many believe there is a list of NCAA “approved” dietary supplements— or that there is an approval process.

FACT:   

Image courtesy of NCAA

"There is no list of NCAA-approved supplement products.” [Quote and image from the 2016-17 NCAA Drug-Testing Program.] The NCAA has a food-first mindset: eat whole foods instead of using dietary supplements to achieve performance and recovery goals. Dietary supplements bring uncertainty to consumers. Due to minimal regulation or oversight by the Food and Drug Administration (FDA), supplement companies ARE NOT required to have pre-market approval of safety, efficacy, or purity of their products before selling them to consumers. So, there is no way for the NCAA (or any sport organization) to be 100% certain of what is in a dietary supplement.  

Drug Free Sport AXIS™ is the NCAA’s preferred tool to provide guidance on dietary supplements and assess for banned ingredients and misleading marketing.  The Drug Free Sport AXIS™ team’s role is to compare the NCAA banned substance list with the supplement facts and ingredient list on any dietary supplement. This process does not endorse or indicate any approval for the use of a dietary supplement.

A Risk Level 1 DOES NOT mean the dietary supplement is approved for NCAA athletes. Student-athletes consume dietary supplements at their own risk. Similarly, it is up to the institution to interpret the NCAA bylaw that pertains to the direct distribution of permissible nutritional supplements.

It is important for athletic departments and student-athletes to understand that a supplement categorized as a Risk Level 1 in the Drug Free Sport AXIS™ Dietary Supplement Inquiry resource DOES NOT make the dietary supplement permissible to directly supply to student-athletes. Drug Free Sport does not provide official interpretation of NCAA policies and bylaws.

Let’s recap:

• The NCAA does not approve the use of dietary supplements.
• Dietary supplements are only permissible under four categories and certain ingredients.
• A Drug Free Sport AXIS™ Risk Level 1 supplement assignment does not indicate that the dietary supplement is approved or permissible for use. 

To learn more about NCAA rules regarding dietary supplements or to ask specific questions on the topic, be sure to register for our upcoming webinar on September 14: NCAA Dietary Supplements: Approved, Permissible, or Banned?  The webinar will be presented by Mary Wilfert, Associate Director for the NCAA Sports Science Institute and Lara Gray, Director of Education for Drug Free Sport.

To submit a Dietary Supplement Inquiry on Drug Free Sport AXIS™ visit www.drugfreesport.com/axis

Key Lessons and Outcomes from Sport Exchange Summit 2016

To the day, we are a month after Drug Free Sport’s first “Sport Exchange Summit”, where we gathered thought leaders from sport to discuss the bigger issues that affect “the team behind the team”. For two days, we were inspired and challenged by calls to action to be full resources to the athletic communities that we serve.

A few highlights from this event that continue to resonate:

-         Drug Abuse in Sport: Students are returning to campuses around America right now, each bringing a new set of experiences with them from the summer months. Our presenters that discussed prescription drug abuse and new forms of marijuana consumption shared the risks and access that youth have to these substances. These aren’t the recreational drugs of old – they’re genetically charged, in many cases not prescribed, and widely accessible. Drug Free Sport offers educational options for many levels of sport on how to listen, consult and guide athletes who are experiencing these challenges during an age of experimentation.

-         Race/Diversity in Sport: It’s one of America’s hot topics right now. Sport brings together people of all walks of life, in its best, forming one unit for a greater good. However, there are differences that are to be acknowledges as we embrace the idea that athletes bring their life experiences to the field and court. Learning to listen, understand and embrace these differences, even when they are uncomfortable, is a mentally healthy approach to humanizing your team members.

-         Sport Staff Integration of Ideas: The Sport Exchange Summit brought together career paths that cross each other on campuses and in training centers , but that don’t often speak on a peer level. Throughout many presentations, leaders emphasized the importance of athletic trainers, team psychologists, dietitians, athletic administrations and others sharing ideas for the athletes that they support. It wasn’t lost on anyone in the room that each group often has their individual goals, especially as revenue and performance are frequently hand in hand. To quote Aristotle, “the whole is greater than the sum of its parts.” We need to remember that this is one of the reasons that so many professionals were drawn to a career in sports.  From visiting interns to Pro Football Hall of Famer Will Shields, this message resonated throughout the event and beyond.

-         Self-development. Each of the numerous attendees made an effort to travel to Kansas City, devoting at least two days toward continuing education. It’s important to take care of the people that take care of others – in this case, it’s self-maintenance. Please continue to take care of yourself and each other as this school year starts. We are a support system and a community. To continue these conversations that were started, join the conversations on Twitter using the #SportExchangeSummit hashtag. If you’re new to the event and didn’t attend, review the hashtag to see the great comments and content.

Drug Free Sport will offer continuing educational opportunities, including our free webinar on Tuesday, August 23 on marijuana trends. For more information, including how to register, click here: bit.ly/2aL2zRE 

Hydration 411

Water [n]: a transparent, odorless, tasteless liquid, a compound of hydrogen and oxygen, H2O. A need in life— especially when the weather is hot. Now that summer is in full swing and sport camps are gearing up, staying hydrated is extremely important. Proper hydration is crucial to keep your body moving, thinking, and performing to your highest potential.

Do you often find yourself reaching for water during practice or games; it’s probably because you are dehydrated. Read on to find tips and information about the importance of hydration as an athlete.  

*Graphic from U.S. Geological Survey

Water and the Body

The average human body is made up of 60% water. In fact, most of the body's organs are comprised on water.

• The brain and heart are approximately 73% water.
• 83% of the lungs are water.
• The skin is 64% water. 
• Muscles and kidneys are 79% water.
• Bones are even comprised of water, sitting at 31%.

No wonder our bodies cannot function properly when hydration is limited! Water is pivotal for performing at your capabilities.

Hydration

Hydration should not be forgotten when exercise, practice, or games end. Exercising in the heat without adequate fluid replacement is a sure way to cause dehydration and land you on the bench, watching your teammates practice or play.

               

“How much water is needed?”, you ask.

Well, that’s the million-dollar question. There is not a definite answer; in fact, total fluid needs and replacement protocols are quite specific to the individual. Sports dietitian, Nancy Clark, MS, RD, recommends that athletes:

·         Drink 2-3 mL of water per pound of body weight at least 4 hours before exercise, practice, or games.

·         Use your sweat rate to determine necessary water during exercise (see equation below).

·         Drink 50% more fluid than lost in sweat after exercise ends.

Graphic from the American College of Sports Medicine

Calculating your sweat rate is an important step to determine the amount of fluids you need every hour of exercise. Training with your individualized hydration protocol can not only delay fatigue, but also heighten energy and performance against your dehydrated competitors. For best results, work with a sports dietitian or certified athletic trainer familiar with personalized sweat rate calculations and hydration plans.

Hydration and Performance 

Water makes practice and games easier, and helps performance improve. When fluid is taken in the plasma, volume restores near the pre-exercise levels and assists to avoid adverse effects of dehydration on muscle strength, endurance, and coordination. In addition, pre-exercise hydration assists in improving thermoregulation, heat dissipation, and performance.    

Dehydration

Dehydration is shown when the amount of water (sweat) exiting the body exceeds the amount of water (or electrolytes) entering the body. The risk of dehydration greatly increases when practicing in hot, sunny, intense environments. Dehydration can be shown by a number of signs such as:

·         Thirst—first sign of dehydration

·         Headaches

·         Dry skin

·         Bright yellow urine (see urine color chart)

·         Difficulty concentrating

·         Increase in body temperature

·         Muscle cramps

·         Swollen fingers/toes

Dehydration and Performance

Dehydration can be detrimental to your performance, not only during practice and games but in the classroom/film room as well. Physical and mental performance is impaired when you’re dehydrated as little as 2% of your body weight. When dehydration reaches 5%, there is a 30% decline in performance. Endurance is also greatly impaired when severe dehydration sets in. The greatest danger is to the heart; plasma and blood volume fall, increasing blood thickness while lowering central venous pressure. This, in turn, causes difficulty when the body is trying to return blood to the heart. It is vital not only for exercise, but also for life.

Steps to take when dehydrated

1. Go to a cool or shaded area
2. Seek help from your sports medicine team
3. Drink clear fluids: water, electrolytes, pickle juice, etc.
4. Continue to drink these fluids until and after you are re-hydrated

Grab a water bottle and keep it by your side at all times! If drinking water is difficult for you, add flavors such a lemon, lime, or other fruit you enjoy. Athletes with high sweat rates should also consume fluids that replace electrolytes lost in sweat such as sodium and potassium. Challenge yourself and teammates to see who can meet their fluid needs each day. Drink up!