Nutrition supplements are a multibillion-dollar industry, which might seem less surprising once you know that over 76 percent of all U.S. adults (170-plus million people) take at least one.
Last year, Americans spent more than $43 billion on supplements, with roughly $5.6 billion going toward sports-specific products.
Each year the number of new supplements seems to grow, but with so many on the market, how do we know which ones are safe, effective and worth the investment?
Let’s discuss how to be a smart supplement shopper and review some of the most popular sports products currently being used. But before we dig into the specifics, let’s cover the basics.
Defining supplements
Supplements are not always well-defined.
According to the Food and Drug Administration, they are vitamins, minerals, herbs, botanicals, amino acids and enzymes used to ensure nutritional adequacy or reduce the risk of disease.
In sports, we typically hear about ergogenic aids, which aim to increase muscle mass and improve speed and endurance. These might come in the form of function foods (foods enriched with additional nutrients), specially formulated foods, single nutrients or multi-ingredient products.
Either way, it is important to note that both supplements and ergogenic aids are not the same as drugs, which are intended to treat, prevent or cure disease and are regulated by the FDA.
Safety, efficacy, interactions
Because the FDA does not regulate supplements, they are not tested for effectiveness or safety by an overarching regulatory body.
Manufacturers are responsible for testing their products for safety before they hit the market, but many times consumers don’t have access to that information. Without data on the quality or type of safety testing for supplements, consumers might not know all the side effects or possible interactions with other medications.
When in doubt, err on the safe side and talk to a doctor or registered dietitian before starting a new supplement.
They’re not a replacement
As the name implies, supplements are not intended to replace a food group.
They are meant to complement the diet and make you whole where you might be lacking. Many times when we extract a nutrient from the food(s) it originated from, we often don’t see the same benefit, and that’s because there are many more advantages to consuming a whole food rather than just a single nutrient.
For example, many fruits contain antioxidants, a substance that is often extracted and given in high-dose pill forms, but when you eat a whole fruit, you also get vitamins, minerals and fiber, and together all of those things are healthier than just a single element.
More is not better
Finally, it’s important to remember that most vitamins, minerals and proteins are needed only in specific quantities by the body, so taking more will lead to benefits only if you were previously deficient (which most people in the U.S. are not).
Many people have the mindset that if taking one of something is good, then two will be better. This is not the case with supplements and can lead to overdoses, negative side effects and, in some cases, toxicity and death.
For most supplements, if you take more than you need, the excess will be excreted in your urine, but others get stored and can build up to toxic levels. To avoid having very expensive urine or potentially dangerous side effects, always contact your doctor or a registered dietitian before starting new supplements.
Becoming a smart consumer
Now that we have some general information about supplements, let’s talk about how you can pick the right ones for you.
First things first, set goals, do your research and be reasonable. As an athlete, do you need to improve speed, strength or endurance? Are you planning to run a marathon or are you starting a wrestling season?
Not all supplements are right for every sport and every athlete, so make sure you know what you are working toward before you buy something you don’t need.
Not sure where to start? Talking to a registered dietitian is a good idea. You also can look online for research, but be wary of your sources. Try to focus on non-commercial sites (such as NIH, FDA, USDA) rather than distributors or sellers who might be biased. Don’t fall for claims that are too good to be true or make outrageous promises. If a supplement offers a quick fix, it’s likely bogus.
As all athletes know, building muscle, speed and endurance takes time and hard work, so don’t fall for anything promising overnight results.
Let’s review supplements that have the best research to support their use:
Creatine (specifically, creatine monohydrate): Helps provide quick energy to muscles for short bursts of high-intensity activity; found naturally in meat, but not in high enough doses to see performance benefits.
- Research shows it’s most beneficial for high-intensity, intermittent, anaerobic exercise (such as weightlifting). It also might be beneficial for increasing muscle mass and thus strength gains. Less helpful for long-distance or endurance sports such as running.
- No negative health impacts are expected if 
taken at typical doses (loading dose of 20 g/day for 
up to 7 days and maintenance doses of 3-5 g/day for up to 12 weeks).
- Can cause weight gain (due to water retention), dehydration, diarrhea, nausea and muscle cramps if taken in excess.
Caffeine: Found naturally in coffee, tea and chocolate. Research shows it can reduce feelings of tiredness, pain and fatigue and in some studies improved performance in continuous and intermittent endurance/long-duration sports (such as running, soccer, basketball).
- Not recommended above 400-500 mg/day (for reference, one 8-ounce cup of coffee has about 95 mg).
- Side effects range from mild (insomnia, restlessness, nausea) to severe (vomiting, tachycardia — rapid heart rate, arrhythmia — abnormal heart beat, and even death) if doses reach or exceed 10-14 grams of pure caffeine.
- Never buy pure caffeine powder, and focus on natural sources such as coffee or tea.
Nitrates: Found naturally in foods such as beets and leafy greens.
- Nitrates enhance blood vessel dilation and thus blood flow throughout the body.
- From an exercise standpoint, it can help provide improved blood flow and oxygen supply to working muscles; can reduce time to exhaustion.
- Benefits likely apply to many athletes, but 
specifically mid and distance runners.
- Beet root juice (375-750 milliliters or about 12.5-25 fluid ounces), two to three hours before an event, or in powdered form 310-560 mg, two to three hours before exercise.
- No noted health concerns, but might cause gastrointestinal upset in some athletes.
Sodium bicarbonate (baking soda): Acts as an extracellular buffer, reducing feelings of fatigue.
- Most effective for activities lasting between 1-10 minutes.
- Can cause gastrointestinal distress — do not try on a big event or race day. Loading protocol should be 
practiced beforehand. Taking dose with a carbohydrate-rich meal can minimize GI upset.
- Possible doses: 0.2-0.4 grams per kilogram of body weight roughly one to two hours before exercise, or more consistent loading of three to four smaller doses for two to four days before an event.
Beta alanine: Acts as an intracellular buffer and reduces feelings of muscle fatigue.
- Most beneficial for sustained, high-intensity exercise.
- Dosing: About 65 milligrams per kilogram of body weight; recommend split dosing every three to four hours for 10-12 weeks.
- Generally recognized as safe, but can cause skin rashes or paraesthesia (tingling/numbness), which stop with cessation of taking the supplement.
Sarah Gilbert, MS, RD, LDN, is a registered dietitian with a master’s in nutrition from Boston University. Sarah is the nutrition coach for RPM Athlete Performance and helps athletes optimize performance and wellness and reduce risk of injury through nutrition. For more information, visit rpmathlete.com.
