Exercise Sport Nutrition.pdf

Exercise & Sport Nutrition: A Balanced

Perspective for Exercise Physiologists

Richard B. Kreider, PhD, MX, EPC, FACSM, FASEP; Anthony L. Almada, MSc; Jose Antonio, PhD,

FACSM; Craig Broeder, PhD, FNAASO; Conrad Earnest, PhD, FACSM; Lori Greenwood, PhD, ATC,

LAT; Mike Greenwood, PhD, CSCS*D; Thomas Incledon, MS, RD, LD/LN, NSCA-CPT, CSCS, RPT;

Douglas S. Kalman MS, RD, FACN; Chad Kerksick, MS, CSCS, ATC, EPC; Susan M. Kleiner, PhD, RD,

FACN; Brian Leutholtz, PhD, FACSM; Lonnie M. Lowery, PhD; Ron Mendel, PhD; Christopher J.

Rasmussen, MS, MX, CSCS, EPC; Jeffrey R. Stout, PhD, FACSM, CSCS; Joseph P. Weir, Ph.D., EPC,

FACSM; Darryn S. Willoughby, Ph.D., FACSM, FASEP, EPC, CSCS, CNS;

Tim N. Ziegenfuss, PhD, CSCS, EPC, FASEP

Author Affiliations:

Richard B. Kreider, PhD, MX, EPC, FACSM, FASEP

Past-President of ASEP and Member of ASEP Board of Directors

Professor and Chair

Department of Health, Human Performance & Recreation

Director of the Exercise & Sport Nutrition Laboratory &

Center for Exercise, Nutrition & Preventive Health Research

Baylor University

Richard_Kreider@baylor.edu

Anthony L. Almada, MSc

Chief Scientific Officer

IMAGINutrition

Former Co-founder and Chief Scientific Officer

Experimental & Applied Sciences

Jose Antonio, PhD, FACSM

Senior Manager of Sports Science

MET-Rx

Craig Broeder, PhD, FNAASO

Professor and Chair

Department of Exercise Science

St. Benedictine University

Conrad Earnest, PhD, FACSM

Director, Exercise Physiology Laboratory

The Cooper Institute

Lori Greenwood, PhD, ATC, LAT

Associate Professor and Coordinator of the Graduate Athletic Training and Sports Medicine Program

Department of Health, Human Performance & Recreation

Exercise & Sport Nutrition Laboratory

Center for Exercise, Nutrition & Preventive Health Research

Baylor University

Mike Greenwood, PhD, CSCS*D

Member of ASEP Board of Directors

Professor and Graduate Program Director & Research Coordinator

Department of Health, Human Performance & Recreation

Exercise & Sport Nutrition Laboratory

Center for Exercise, Nutrition & Preventive Health Research

Baylor University

Thomas Incledon, MS, RD, LD/LN, NSCA-CPT, CSCS, RPT

Director of Performance Research and Nutrition

Athletes' Performance

Douglas S. Kalman MS, RD, FACN

Director, Nutrition & Applied Clinical Research

Miami Research Associates

Chad Kerksick, MS, CSCS, ATC, EPC

Doctoral Research Associate

Exercise & Sport Nutrition Laboratory

Department of Health, Human Performance & Recreation

Baylor University

Susan M. Kleiner, PhD, RD, FACN

Affiliate Assistant Professor

Department of Medical History and Ethics

School of Medicine

University of Washington

Lonnie M. Lowery, PhD

Department Nutrition and Dietetics

Kent State University

Brian Leutholtz, PhD, FACSM

Professor, Department of Health, Human Performance & Recreation

Exercise & Sport Nutrition Laboratory

Center for Exercise, Nutrition & Preventive Health Research

Baylor University

Ron Mendel, PhD

President, Ohio Society of Exercise Physiology

Lab Director, Pinnacle Institute of Health & Human Performance

Christopher J. Rasmussen, MS, MX, CSCS, EPC

Research Coordinator

Exercise & Sport Nutrition Laboratory

Department of Health, Human Performance & Recreation

Baylor University

Jeffrey R. Stout, PhD, FACSM, CSCS

Chief Scientific Officer

Vitalstate USA

Joseph P. Weir, PhD, EPC, FACSM

Member of ASEP Board of Directors

Associate Professor and Research Coordinator

Division of Physical Therapy

Des Moines University-Osteopathic Medical Center

Darryn S. Willoughby, Ph.D., FACSM, FASEP, EPC, CSCS, CNS

President-Elect of ASEP and Member of ASEP Board of Directors

Associate Professor of Exercise & Molecular Physiology

Exercise Biochemistry and Molecular Biology Lab

Department of Kinesiology

Texas Christian University

Tim N. Ziegenfuss, PhD, CSCS, EPC

Member of ASEP Board of Directors

Chief Scientific Officer

Pinnacle Institute of Health & Human Performance

Submitted respectfully to:

Professionalization in Exercise Physiology Online

July 14, 2003

Introduction

Over the last year or so several articles have appeared in PEP online suggesting that exercise

physiologists who conduct research on exercise and nutrition and/or recommend that their clients/athletes

consume special diets or take nutritional supplements are quacks [1]. More recent articles suggested that:

1.) sport nutrition research is often flawed from an ethical and scientific perspective; 2.) it is unethical

and/or unprofessional for exercise physiologists to conduct performance enhancement research

(particularly if it is funded by a supplement company); 3.) it is unethical and/or unprofessional for

exercise physiologists to consult with supplement companies; 4.) it is unethical for athletes to consume

nutrients and/or take performance enhancement supplements because it is a form of cheating; 5.) exercise

physiologists and professors who conduct research in this area and/or teach their students how to optimize

training and/or performance through scientific application of training and nutrition are unethical and

contributing to a “win at all cost” mentality; and, 6.) if exercise physiologists recommend that people take

nutritional supplements they are in violation of the ASEP Code of Ethics and should therefore be

sanctioned in some manner by ASEP [1-5].

As leading researchers and educators in this area, we felt that it was time to provide our opinion on these

articles. Although we have great respect for the authors and appreciate their commitment to ASEP and

passion for the professionalization of exercise physiologists, it is our view that many of the comments

made in these articles simply cannot be supported by the current scientific literature. Further, that much

of the logic used to support these views is flawed. Members of ASEP should know that many leading

sport nutrition researchers, ASEP members, and members of the ASEP Board of Directors (BOD) do not

share these views. As an indication of this consensus, this paper is coauthored by a number of respected

exercise physiology and sport nutrition professors, researchers, practitioners, and leading who have

extensive experience working with athletes, teaching exercise physiology and sport nutrition, conducting

research on dietary supplements, serving as consultants for nutrition companies, coordinating research

and product development for nutrition companies, and/or educating the scientific and lay communities

about the role of nutrition on exercise and performance. This list includes: the Past-President and

President-Elect of ASEP; members of the ASEP Board of Directors; Certified Exercise Physiologists

(EPC), Strength and Conditioning Specialists (CSCS), Certified Athletic Trainers (ATC), and registered

dietitians (RD); Fellows of ASEP , the American College of Sports Medicine (ACSM), American College

of Nutrition (ACN), and the North American Association for the Study of Obesity (NAASO); leaders of

sport nutrition organizations; Chief Scientific Officers of leading supplement companies; and, a

cofounder of a company founded on the principle of developing products based on science. While PEP

Online provides an opportunity for exercise physiologists to raise issues relevant to the professional

practice of exercise physiologists and sport nutrition is certainly a relevant issue for exercise

physiologists, authors should be careful that the opinions are based on a thorough and comprehensive

analysis of the literature so that unfounded conclusions are not made. It is our view that these articles

have served to alienate exercise physiologists, divide ASEP members, and have reflected poorly upon

ASEP within the broader scientific community due to a misrepresentation of available scientific literature.

Consequently, we felt it was our responsibility to provide a more balanced perspective on the role of

nutrition on exercise and performance.

In our view, it is the professional responsibility of an exercise physiologist to be up to date on current

literature so the students, clients, and/or athletes are provided the latest information so they can make an

informed decision about whether to try a partic ular training/rehab program, diet, and/or nutritional

supplement. Moreover, they should teach their students about legal and illegal performance enhancement

aids used by athletes so they understand the potential physiological mechanisms of action, potential

benefits, and/or possible risks and side effects in order to properly educate their clients/athletes. If a

proposed nutrient or diet lacks scientific support, then it is the responsibility of the exercise physiologist

to inform their students, clients, and/or athletes that there is little to no data supporting a proposed benefit.

If outrageous claims are made by marketing arms of supplement companies, then the best course of action

for an exercise physiologist is to conduct research, publish the research findings, and inform their students

and the public that there is no data to support the claims made. We concur that not doing so would be

unethical. However, in our view it is equally unethical to suggest there are no data supporting the health

and/or ergogenic value of a diet strategy or nutrient when there are indeed data supporting its use. It is

our experience that many exercise physiologists and nutritionists unintentionally mislead and confuse the

public because they simply are not familiar with the available scientific data. The area of exercise

nutrition is rapidly advancing. Thousands of articles are published every year investigating the role of

nutrition and exercise on health, disease, and performance. There have been enormous advancements in

our understanding how diet, exercise, and specific nutrients can promote health, well-being, helps in

disease management, and/or improve performance and training adaptations. For this reason, many grant

agencies like the National Institutes of Health have called for an increase in funding to assess the

interaction of exercise and nutrition on health, disease, and performance. In our view, not being aware of

the scientific literature and/or making blatantly inaccurate or false statements about the role of nutrition

and exercise is as unethical as supplement companies making unsupported claims about their products.

It is our view that although the articles by Boone and Birnbaum [1-5] raise some important questions that

should be openly discussed as the exercise physiology pr ofession develops , they are misleading in that

they do not present a current and/or comprehensive view of the role of nutrition on exercise, performance,

and training. For example, these articles indicated that there are no data to support a recommendatio n

that athletes need to supplement their normal diet with protein, amino acids, vitamins, minerals, or many

other purported ergogenic aids and even if there were data supporting their use it is unethical to do so.

Moreover, if an exercise physiologist suggested that there were data to support these views, then they are

“quacks” and/or are supporting unethical behavior among athletes. As several members of ASEP who

reviewed some of these papers and/or provided comments regarding these positions at the recent ASEP

national meeting indicated, these views are simply not supported by hundreds of articles reporting health,

performance, and/or training benefits of various nutritional strategies, macronutrients, micronutrients, and

ergogenic aids. It is our view that authors should be more careful before suggesting that a large segment

of researchers, exercise physiologists, athletes, and members of the general public are unethical.

Boone and Birnbaum [1-5] also question the ethics of athletes attempting to enhance exercise capacity by

using performance-enhancing supplements. It is our view that suggesting it is unethical and/or cheating

for an athlete to follow a performance enhancement diet and/or take legal nutritional supplements shown

in research to be safe and effective doesn’t make sense. A similar argument can be made suggesting its

unethical for athletes to: 1.) use the latest training methods shown in research to improve strength, speed,

endurance, and/or agility; 2.) seek more experienced coaching to improve performance of an athletic skill;

3.) use the most technologically advanced athletic equipment; 4.) use protective sports medicine

equipment to reduce risk of injuries; and/or, 5.) live at altitude in hopes of enhancing endurance

performance at sea level. Using this line of thinking, it would be unethical for an athlete to consume a

high carbohydrate diet, carbohydrate load or drink coffee prior to competition, and/or use sports drinks

during prolonged exercise to maintain hydration and performance. Furthermore, it would be unethical

for an athlete to consult with a sport psychologist, sport nutritionist, strength and conditioning specialist,

and/or exercise physiologist to undergo assessments to gauge training and/or performance progress. After

all, not all athletes have access good coaching, can eat a good diet, have strength and conditioning

coaches, have access to the most technologically advanced equipment and training facilities, and/or can

afford to take performance enhancing supplements. Using this logic, fairness in sport could only be

achieved if athletes were required to follow the same training program, had access to the same training

facilities, lived in the same environment, ate the same diet at the same time of day, slept the same amount

each night, and had the same genetic endowment. Moreover, it would be unethical for anyone to

recommend participating in a potentially dangerous sport or recreational activity (actually hundreds of

people die each year from traumatic and non-traumatic sudden death during exercise and/or while

participating in recreation and sporting events) or a sport that wasn’t always “fun”. Based on this logic,

we should ban competitive and professional sport because sports shouldn’t be that serious, athletes may

not always be good “role models” to our youth, and/or participating in sport may not always impart

proper “values” to our children. To us, this line of thinking makes little sense.

Many of us have been athletes and have worked extensively with young athletes (Junior High and High

School), college athletes, Olympic athletes, and professional athletes. Many of us have made

presentations to numerous professional societies and coaching groups in the U.S. and abroad. There are

many reasons why people participate in exercise programs and sport. It’s not always fun to run, lift

weights, participate in sprint and conditioning drills, and/or endlessly practice to become good at a sport.

It also isn’t always easy to eat a well-designed diet and/or time nutrient intake to optimize performance

and recovery. However, these are key principles of preparing individuals to perform to their best

capability. Some people don’t feel the discipline required to train hard, eat right, and optimize

performance is worth the time and energy. Others strive to be the best they can be even though they don’t

have the genetic endowment for a particular sport. Still others who have the genetic predisposition and

talent for a particular sport seek to reach the heights of athletic performance by becoming a national class,

world class, or professional athlete. Optimizing training through provision of well-timed nutrients and/or

use of various nutritional supplements research has shown can help optimize performance and/or training

adaptations (e.g., sports drinks, energy bars, carbohydrate gels, carbohydrate/protein supplements,

creatine, caffeine, etc) is not cheating – its smart training and preparation for competition. Application of

performance enhancement nutritional strategies doesn’t make it easier to train, it helps you train harder,

recover faster from intense training, and may help reduce the incidence of overtraining. It helps optimize

energy availability so you can exercise longer and/or at higher intensities. This is not a short-cut to

training but a way to help the body tolerate higher levels of training. It is no different than applying the

latest training principles to optimize performance. Athletes and coaches have many choices they can

make about which training methods to employ, how much training is enough (or too much), how much

rest the athlete needs to recover well, what type of diet to follow, and/or whether nutritional supplements

can help them train and/or perform better. The exercise physiologist should help coaches and athletes

base their decisions on available science. Some will listen to this advice while others will employ

seemingly strange training techniques and methods. As long as athletes and coaches adhere to the rules of

their sport, these decisions should not be viewed as unethical. To us, the question is not whether

optimizing nutrition is ethical or not but what is the best way to help people optimize training adaptations,

performance, and/or assist in the rehabilitation of injury or illness. Ultimately , this may help people see

better results from training, improve exercise adherence, and help people achieve their training,

rehabilitation, and/or performance goals.

Such a multitude of training and performance enhancements calls for some distinctions regarding

legitimacy. It is unfair to conclude that simply because there is no literature on one ergogenic approach,

then subsequently all strategies are equally unsupportable or unethical. Blanket statements regarding all

ergogenic endeavors are inappropr iate as we should strive to only make conclusions based upon existing

data – not personal convictions. Some aspects of exercise augmentation provide substantially more

published evidence than others. For example, not all sports supplements are technically nutritional in

nature. Sports nutrition, per se , is a well-documented field of study that can be incongruent with sports

supplements such as prohormones and many herbal substances. Supplements that are essential to human

health (e.g. proteins/ EAAs, carbohydrates, fats, vitamins and minerals) or are common to humans’

dietary intake (e.g. creatine, caffeine) are historically “nutrition” per se, and typically have far more data

to support or refute their potential. Conversely, hormonal and herbal preparations – although legally

“dietary supplements” - are more the realm of sports pharmacology. This does not preclude their

investigation by exercise physiologists, but does make them a different entity, calling for a somewhat

different educational background by those researching them.

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