Ayudas Ergogenicas

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Ayudas Ergogénicas
Dr. Jorge Cancino L. PhD.

Avda. Pedro de Valdivia 1509
Providencia, Santiago
+56 2 2420 7100
www.finis terrae.cl
Ergogénico
• Ergo = trabajo
• Génico = generar
Toda condición que mejore

el rendimiento
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Ergolítico
• Ergo = trabajo
• lítico = destruir
Toda condición que empeore

el rendimiento
Ayudas ergogénicas vs
suplementos
• Creatina Vit-C
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Ayudas fisiológicas
• Auto infusión de sangre (Doping sanguíneo)
Farmacológicos
• Anfetaminas
• Hormonas
Doping
3
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Psicológicas
• Hipnosis
Biomecánicas
• Zapatillas
• Ropa
4
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Mecánicas
• Diseño de bicicletas
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El suplemento ideal tiene que ser:
Efectivo
Seguro
Legal
Suplementos Nutricionales para la

pérdida de peso.
• En 1992, la Administración de Alimentos y Drogas (
FDA ) de los Estados Unidos aprobó el Acta de
Suplementos Dietarios que permitió que dichos
suplementos fueran vendidos sin revisión de
EFECTIVIDAD.
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Los Quackery nutricionales

• El término “Quackery” significa curandería.
• Un Quackery nutricional está referido a la promoción fraudulenta de un
producto nutricional.
• Cómo reconocer fraudes nutricionales
• El producto promete rápidos resultados en salud y rendimiento físico
• Contiene ingredientes “secretos”
• Se publicita por casos anecdóticos o testimonios
• Habitualmente se involucran estrellas de cine o atletas en la publicidad
• Se oye muy bueno para ser verdad (promete lo imposible).
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Rev Andal Med Deporte. 2016;9(3):99–104
Revista Andaluza de
Medicina del Deporte
www.elsevier.es/ramd
Original
Consumo, características y perfil del consumidor de suplementos

nutricionales en gimnasios de Santiago de Chile
C. Jorquera Aguilera a , F. Rodríguez-Rodríguez b,∗ , M.I. Torrealba Vieira a ,
J. Campos Serrano a y N. Gracia Leiva a
a
Escuela de Nutrición y Dietética, Facultad de Medicina, Universidad Mayor, Santiago, Chile
b
Escuela de Educación Física, Laboratorio de Motricidad Humana, Facultad de Filosofía y Educación, Pontificia Universidad Católica de Valparaíso, Viña del Mar, Chile
información del artículo r e s u m e n
Historia del artículo: Introducción: Los deportistas son los principales consumidores de suplementos nutricionales; presentan
Recibido el 2 de junio de 2014 en general la utilización más alta. En Chile existe un creciente interés por consumir estos suplementos,
Aceptado el 27 de abril de 2015 sin tener mucho conocimiento de sus efectos.
Objetivos: Determinar el perfil del consumidor, quiénes lo recomiendan, los productos más usados y
Palabras clave: distinguir posibles diferencias de acuerdo al sexo, la finalidad de su uso y otras variables.
Suplementos nutricionales Métodos: Se aplica un cuestionario de 19 preguntas abiertas y cerradas a 446 voluntarios hombres y
Composición corporal
mujeres, asistentes a 6 gimnasios de la ciudad de Santiago de Chile durante el año 2013, pertenecientes
Ejercicio físico
a un grupo etario de entre 17 y 49 años de edad.
Resultados: Los hombres son los mayores consumidores de suplementos, lo cual aumenta de acuerdo
al tiempo de entrenamiento semanal que realizan. Ellos prefieren batidos proteicos con el objetivo de
aumentar su masa muscular. Las mujeres consumen principalmente vitaminas y agentes lipolíticos con
el objetivo de disminuir la masa grasa. Un alto porcentaje cree que el consumo de suplementos les ayuda
a cumplir sus objetivos.
Conclusión: Un número considerable de personas que asiste regularmente a los gimnasios consume
suplementos sin la orientación especializada y posiblemente sin tener que utilizarlos realmente, pero
es necesario regular el uso irracional y potencialmente inseguro de los suplementos nutricionales en
mejora del rendimiento físico.
© 2016 Consejerı́a de Turismo y Deporte de la Junta de Andalucı́a. Publicado por Elsevier España,
S.L.U. Este es un artı́culo Open Access bajo la licencia CC BY-NC-ND (http://creativecommons.org/
licencias/by-nc-nd/4.0/).
Consumption, characteristics, and profile: Consumers of nutritional

supplements in gymnasiums in Santiago, Chile
a b s t r a c t
Keywords: Introduction: Athletes are the principle consumers of nutritional supplements, and generally present the
Dietary supplements highest rate of usage. In Chile, there is a growing interest in consuming these supplements, although
Body composition there is little knowledge of their effects.
Physical exercise
Objectives: To determine the consumer profile, who recommends the usage of these nutritional supple-
ments, what the most used products are, and to distinguish possible differences in variables like sex, the
purpose of their use, and others.
Methods: A survey with 19 open and closed questions was given to 446 men and women volunteers,
Rev Andal
from between the ages of 17 and 49, who were participants M ed
from sixDeporte. 2016;9(3):99–104
gymnasiums in Santiago, Chile, in
2013.
Results: Men are the greatest consumers of supplements, and usage increases according to the amount
of time spent training every week. This group prefers protein shakes with the aim of increasing muscle
mass. Women principally consume vitamins and lipolytic agents with the aim of reducing fatty mass.
A high percentage believes that consuming supplements aids in meeting their goals.
∗ Autor para correspondencia.

Correos electrónicos: rodriguez.investigacion@gmail.com, fernando.rodriguez@ucv.cl (F. Rodríguez-Rodríguez).
http://dx.doi.org/10.1016/j.ramd.2015.04.004
1888-7546/© 2016 Consejerı́a de Turismo y Deporte de la Junta de Andalucı́a. Publicado por Elsevier España, S.L.U. Este es un artı́culo Open Access bajo la licencia CC BY-NC-ND
(http://creativecommons.org/licencias/by-nc-nd/4.0/).
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CONSUMO DE SUPLEMENTOS NUTRICIONALES EN GIMNASIOS, PERFIL DEL CONSUMIDOR Y CARACTERÍSTICAS DE SU USO
nasios pertenecen al rango de edad que va desde los 15 estar estudiando, consume algún tipo de SN. Sólo un
a los 30 años consumen SN. Es decir, aproximadamente 27,6% de los usuarios de gimnasios que declara estar
nueve de cada diez usuarios encuestados de gimnasios de trabajando consume algún tipo de SN. Un tercio (33,3%)
entre 15 y 30 años consumen SN. Aproximadamente, dos de los usuarios de gimnasios que se declaran inactivos
de cada cinco encuestados de gimnasios que pertenecen consumen algún tipo de SN. Sólo un 20% de los usuarios
al rango de edad que entre los 31 a 45 años consumen de gimnasios que se declararon pensionados consume
algún tipo de SN. Sólo un 17,2% de los usuarios de algún tipo de SN.
gimnasios que tienen más de 45 años consumen algún La aplicación del estadístico Chi Cuadrado entrega
tipo de SN. una asociación muy significativa entre las dos variables
La prueba de Chi Cuadrado entrega una asociación (p< 0,00). Es decir que el consumo de SN está muy aso-
muy significativa entre las dos variables (p< 0,00). Es ciado al tipo de ocupación de los usuarios de gimnasios.
decir, el consumo de SN se encuentra asociado al rango Objetivos del consumo de SN. La tabla 7 muestra
de edad de pertenencia de los mismos, siendo mayor el que los hombres tienen como principal objetivo el
consumo entre los jóvenes de 15 a 30 años y disminu- desarrollo muscular (69,4%), seguido por rendimiento
yendo a medida que aumenta el rango de edad. deportivo (17,9%), obtener energía (6,7%) y finalmente
Los datos de la tabla 6, nos permiten establecer que disminuir grasa corporal y salud (3%). Respecto a las
ocho de cada diez usuarios de gimnasios que declaran mujeres, la mayoría utiliza SN con el objetivo de dis-
TABLA 6
Consumo de suplementos nutricionales según tipo de educación del usuario

Rev Chil Nutr Vol. 38, Nº2, Junio 2011
CONSUMO DE SUPLEMENTOS NUTRICIONALES EN GIMNASIOS,

PERFIL DEL CONSUMIDOR Y CARACTERÍSTICAS DE SU USO
NUTRITIONAL SUPPLEMENT INTAKE IN GYMNASIUM,

CONSUMER PROFILE AND CHARATERISTICS OF THEIR USE
Fernando Rodríguez R. (1), Mirta Crovetto M. (2) Andrea González A. (2),

Nikol Morant C. (2), Francisco Santibáñez T. (2)
(1) Escuela de Educación Física, Facultad de Filosofía y Educación,

Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile.
(2) Nutrición y Dietética, Facultad de Ciencias de la Salud,
Universidad de Playa Ancha, Valparaíso, Chile.
TABLA 7
Clasificación del objetivo por el cual consume suplementos nutricionales, según sexo
ABSTRACT
Nowadays the great offer of dietary supplements (DS) in the market has led to a situation in which the use of these
products are not only acquired by sportspersons but also to a great population related with physical activity. The
main objective of our study was to know the characteristics of the DS consumers and to evaluate its consumption
through a survey previously validated and applied to 314 users (198 males and 116 females) from 6 gyms in Viña
del Mar. The results showed that more than half of the subjects consumed DS products (54.5%). Within male con-
sumers, a 69.4% use these products in order to increase muscular mass, while within women, a 62.2% consumed
them in order to diminish their body fat. There were 5 kinds of DS products consumed the most: Proteins (55.6%),
amino acids (25.9%), vitamins and minerals (25.1%), food substitutes (6.4%), caffeine (6.4%), and L-carnitine
(6.4%). The consumer profile is represented by young male individuals, those who follow a special diet, with long
practice in gym and who exercise several days a week. Much of consumers did not provide an adequate association
between DSN used and the purpose of consuming these supplements.
KEY WORDS: Nutritional supplement; exercise; sport; sport nutrition; performance.
Este trabajo fue recibido el 5 de Octubre de 2010 y aceptado para ser publicado el 7 de Abril de 2011.
INTRODUCCIÓN El crecimiento de la industria de gimnasios en Chile,

En el mundo actual, al analizar la alimentación de 161
ha provocado un aumento en el número de personas
la población, ya no basta considerar únicamente los ali- que acuden regularmente a estos centros. La inserción
mentos, si no que se debe tener presente otras alternativas a este medio, predispone al individuo a consumir SN
cuando los requerimientos de nutrientes son elevados, por asesorías de profesionales, que muchas veces, no se
tales como los suplementos nutricionales (SN), los cuales encuentran debidamente capacitados para ejecutar esta
muchas veces son utilizados como complemento a la labor (3 - 5). Son pocos los estudios científicos que dan
dieta, sin mayor respaldo científico que justifique su uso cuenta del consumo de SN por la población cercana al
(1,2). Según el Reglamento Sanitario de los Alimentos, mundo de la actividad física (5). Nuestro país, no difiere
un SN, es un producto que ha sido elaborado para su- de esta realidad al no presentar estudios al respecto. La
plementar la dieta habitual de los individuos sanos, con escasez de información existente, dificulta la orientacio-
adición de uno o varios nutrientes y que se presenta en nes necesarias para abordar la problemática del uso, mal
diversos formatos. Estos productos, suelen estar acom- uso y abuso de los SN, por lo que el objetivo general
pañados de una propaganda comercial que los presentan de esta investigación, es conocer las características que
como sustancias milagrosas que contribuyen a diversos determinan el consumo de SN en gimnasios de la comuna
objetivos para mantener la salud. de Viña del Mar, evaluando su consumo mediante la
157 9
tricionista (14,2%) ó médico (9%). Una minoría declara consumía complejos de vitaminas y/o minerales. La
haber sido incentivado por la publicidad (4,5%), por el mayoría los consume con el objetivo de desarrollar masa
farmacéutico (2,2%) y el resto a través de “otro” tipo de muscular (32,6%) y disminuir grasa corporal (30,2%).
asesoría (4,5%). En mujeres la asesoría estuvo dada por
algún entrenador (37,8%), amigo (27%), nutricionista
Tan sólo una minoría lo consumía por salud (9,3%) y
para obtener energía (9,3%). A este tipo de SN se les ha
18/3/19
(13,5%) y médico (8,1%). Algunas fueron motivadas por atribuido un efecto protector de la salud, dado su poder
“otro” tipo de asesoría (8,1%) y en menor proporción a antioxidante, especialmente por la vitamina E, vitamina
través de la publicidad (5,4%). C y selenio. Otras vitaminas de este complejo, participan
La mayor cantidad de respuestas tanto en hombres en la producción de eritrocitos y síntesis proteica, así
como mujeres indicaron que la asesoría fue a través de como también en la reparación y mantenimiento de los
un entrenador (46,2%). tejidos, por lo que se podría fundamentar su consumo
Efectos esperados. Respecto al logro de los efectos con el objetivo de desarrollar masa muscular. Aún así,
esperados a través del consumo del SN (Tabla 9), la ma- existe controversia en la capacidad ergogénica de este
yoría de los encuestados (84,8%) respondieron si haber tipo de suplementos, debido a que para la mayoría de
logrado los efectos deseados, tanto hombres (85,8%) las vitaminas y minerales no se ha comprobado este
como mujeres (81,1%). Los individuos que declararon mecanismo de acción (11,12).
no haber logrado los efectos esperados representan la Del total de consumidores de SN como sustitutivos
minoría de los encuestados (15,2%). de comidas (6,4%), el mayor porcentaje lo consumía para
TABLA 8
Distribución del tipo de asesoría que incentivó el consumo de suplementos nutricionales según sexo
162 Artículo original Análisis del uso de suplementos nutricionales en gimnasios de la Región de Coquimbo, Chile
Rev Chil Nutr Vol. 38, Nº2, Junio 2011

Análisis del uso de suplementos nutricionales en gimnasios
CONSUMO DE SUPLEMENTOS NUTRICIONALES EN GIMNASIOS,
de la Región
PERFIL DEL CONSUMIDOR de Coquimbo, Chile
Y CARACTERÍSTICAS DE SU USO
Ignacio
NUTRITIONAL E. González Espinosa
SUPPLEMENT INTAKE
1
, Luis A. Cortez Huerta2, Andrés Pedreros Lobos3, Carlos Jorquera Aguilera4
IN GYMNASIUM,
Universidad Mayor. Santiago. Chile. Universidad Santo Tomás. Chile. Universidad Católica del Norte. Coquimbo. Chile. Universidad Mayor. Santiago. Chile.
1 2 3 4
CONSUMER PROFILE AND CHARATERISTICS OF THEIR USE
Fernando Rodríguez R. (1), Mirta Crovetto M. (2) Andrea González A. (2),

Nikol Morant C. (2), Francisco Santibáñez T. (2)
(1) Escuela de Educación Física, Facultad de Filosofía y Educación,

Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile.
Artículo original Análisis del uso de suplementos nutricionales en gimnasios de la Región de Coquimbo, Chile
(2) Nutrición y Dietética, Facultad de Ciencias de la Salud,
Universidad de Playa Ancha, Valparaíso, Chile.
Análisis del uso de suplementos nutricionales

Recibido: 18.07.2017
Aceptado: 14.03.2018
Resumen en gimnasios
de la Región de Coquimbo, ChileABSTRACT Lahas ciencia de la nutrición actualmente es considerada un componente crucial para la mejora de la salud y del rendimiento
Nowadays the great offer of dietary supplements (DS) in the marketdeportivo.
ledEltousoa de suplementos
situation nutricionales
in which (SN) ha
the use ofaumentado
these considerablemente en los últimos años. Estudios evidencian
que en gimnasios, existe un alto consumo de productos que carecen de evidencia científica y que pueden poner en riesgo la
products are not only acquired by sportspersons but also to a greatsalud
population related with physical activity. The
de la población. El objetivo del estudio fue analizar el uso de SN en usuarios de una cadena de gimnasios de la Región de
main objective of our study was to know the 2characteristics of the DS consumers
Coquimbo, and to
Chile durante evaluate
el año itseste
2016, para consumption
fin se aplicó una encuesta previamente validada a 359 usuarios (191 hombres
Ignacio E. González
through aEspinosa
1
, Luis A. validated
survey previously Cortez Huerta , Andrés
and applied Pedreros
to 314 Lobos
users (198y 168
3
, Carlos
mujeres)
males anden116Jorquera
cuatro sedes Aguilera
females) de from
4
una cadena
6 gymsde gimnasios
in Viñade la Región de Coquimbo. La edad media de la muestra fue de
Ignacio E. González Espinosa, et al. 28±10,1 años,
Universidad Mayor. Santiago. Chile. 2Universidad Santo Tomás. Chile. 3Universidad Católica del Norte. Coquimbo.
1
Chile. el
4 consumo de SN fue del 43,2%. El principal objetivo de uso de SN fue aumentar masa muscular (32%), los SN
Universidad Mayor. Santiago. Chile.
del Mar. The results showed that more than half of the subjects consumed DS products (54.5%). Within male con-
Palabras clave: más consumidos fueron proteína de suero de leche (72,9%), aminoácidos de cadena ramificada (21,9%) y glutamina (9,7%).
sumers, a 69.4% use these products in order to increase
Medicina deportiva.muscular
Nutrición De mass,
los 26while within
diferentes tiposwomen, a 62.2% elconsumed
de SN consumidos, 50% se clasificó como tipo C (existe poca evidencia acerca de sus efectos
them in order to diminish their body fat. There
deportiva.were 5 kinds
Proteína of
de suero DS beneficiosos).
de products Las variables;
consumed thehoras de entrenamiento
most: y quien recomienda el uso de SN mostraron significancia estadística para
Proteins (55.6%),
Al detallar esta información, se detectó 26 tipos diferentes de SN Tabla 4. Caracterización de objetivos del consumo de SN, fuente de leche. Rendimiento deportivo. el uso de SN. Esta información respalda la importancia de asesoría nutricional especializada en esta población, con el fin de
consumidos por los encuestados, donde los más consumidos por información o recomendación para el consumo amino acids
de SN (25.9%), vitamins and minerals
y percepción (25.1%), food substitutes (6.4%), caffeine (6.4%), and L-carnitine
Dopaje en el deporte. evitar el uso de productos inefectivos y/o que puedan perjudicar su salud.
el total de la muestra fueron la proteína de suero de leche (72,9%), (6.4%). The consumer profile is represented by young male individuals, those who follow a special diet, with long
de la eficacia de su uso en relación a objetivos.
aminoácidos ramificados (21,9%), glutamina (9,7%), agentes lipolíticos
practice in gym and who exercise several days a week. Much of consumers did not provide an adequate association
Características Total Hombres
between DSNMujeres
used and the purpose of consuming these supplements.
(9%) y multivitamínicos (7,1%). Al analizar la información por sexo, los n (%) n (%)
KEY WORDS:nNutritional
(%)
supplement; exercise; sport; sport nutrition; performance.
hombres preferían en orden decreciente la proteína de suero de leche
Analysis of the use of nutritional supplements in gyms in Coquimbo,
(80,2%), los aminoácidos ramificados (27,1%) y la glutamina (11,5%), Objetivo de consumo de SN
Este trabajo fue recibido el 5 de Octubre de 2010 y aceptado Chile
para ser publicado el 7 de Abril de 2011.
mientras que las mujeres consumían preferentemente proteína de Aumentar masa muscular 84 (31,6) 52 (33,1) 32 (29,4)
Summary
suero de leche (61%), los aminoácidos de cadena ramificada (13,6%) y Mejorar la recuperación 56 (21,1) 38 (24,2) 18 (16,5)
agentes lipolíticos (13,6%) (Tabla 3). Disminuir la grasa corporal 38 (14,3) Recibido: 18 (16,5) Resumen
20 (12,7) 18.07.2017 Nutritional science is a crucial component for improving health and sports performance. The use of nutritional supplements
Aceptado: 14.03.2018 (NS) has increased considerably in recent years. Studies show high consumption of nutritional supplements that lack scientific
Los principales objetivos por los cuales consumían SN en el total Obtener energía 33 (12,4) 17 (10,8) 16 (14,7) La ciencia de la nutrición actualmente es considerada un componente crucial para la mejora de la salud y del rendimiento
evidence and could be putting the health of the population at risk. The objective was to analyze the use of NS in clients of a
de la muestra fueron aumentar masa muscular (31,6%), mejorar la recu- Mejorar rendimiento deportivo 26 (9,8) 18 (11,5) 8 (7,3) deportivo. El uso de suplementos nutricionales (SN) ha aumentado
INTRODUCCIÓN El crecimientoconsiderablemente
de la industria
gymnasium franchise
en los
deúltimos
in the Coquimbo
años. Estudios
gimnasios
Region ofen Chile
evidencian
Chile,
during 2016. Was applied to 359 clients (191 men and 168 women) a
que en gimnasios, existe un alto consumo de productos que carecen deaumento
evidencia científica y que pueden poner en riesgo la in the Coquimbo Region. The median age of the sample
peración (21,1%) y disminuir la grasa corporal (14,3%), encontrándose Mejorar la salud 20 (7,5) 6En
(3,8)el mundo actual, al analizar la alimentación de
14 (12,8) ha provocado
previously
salud de la población. El objetivo del estudio fue analizar elpopulation
un
uso de SN en
validated survey en el locations
in four número ofde personas
a gymnasium franchise
la población, ya no basta considerar únicamente los ali- que acuden wasusuarios
28±10.1de
regularmente a
unaand
years
estos
cadena
43.2%deofgimnasios
centros. the
La
de la Región
population
inserción had usedde NS. The main goal of the NS users was to increase muscle
resultados similares en hombres y mujeres (Tabla 4). Otro 9 (3,4) 6 (3,8) 3 (2,8) Coquimbo, Chile durante el año 2016, para este fin se aplicó una encuesta previamente validada a 359 usuarios (191 hombres
Key words: mass (32%); the most commonly used NSs were whey protein (72.9%), branched-chain amino acids (21.9%), and glutamine
Respecto a las fuentes de información que refirieron utilizar los en- Total 266 (100) mentos,
157 (100)si no que
109 se debe
(100) tener
y 168 presente
mujeres) otrassedes
en cuatro alternativas
de unamedicine.
Sports cadena de a gimnasios
este medio,
Sports de la
(9.7%). predispone
OfRegión ofal
NS individuo
de Coquimbo.
the 26 types La edad50%
consumed, a consumir
mediaarede SN
la muestra
classified fue C,
as type dethat is, there exists little evidence regarding their benefits.
cuando los requerimientos 28±10,1 deaños, el consumo
nutrientes sondeelevados,
SN fue delsciences.
nutrition 43,2%. ElWhey
principal
por objetivo
asesorías
Two dede uso de SN
profesionales,
variables showed fue aumentar
que
statistical masa for
muchas
significance muscular
veces,
the use (32%),
no NS:los
ofse SN of training, and the person who had recommended the
hours
cuestados a la hora de escoger un SN, se destacan: entrenador (34,1%), Recomienda consumo de SN
tales comoPalabras clave: más consumidos
los suplementos nutricionales fueron proteína
(SN), los de suero
protein.
cuales de leche
Athletic perfor-(72,9%),
encuentranNS toaminoácidos
the user. This
debidamente deinformation
cadena ramificada
capacitados supports (21,9%)
para y glutamina
theejecutar
importance of (9,7%).
esta specialized nutritional assessment for the population to avoid
amigo (17,7%) y otro (15,9%). Si se analiza de acuerdo al sexo, destaca Entrenador Medicina36
56 (34,1) deportiva.
(35) Nutrición
20 (32,8) De los 26 diferentes tipos de SN consumidos, el 50% se clasificó como tipo
mance. Doping in sports. ineffective and harmful products.C (existe poca evidencia acerca de sus efectos
muchas
deportiva. Proteínaveces sondeutilizados
de suero como
beneficiosos). complemento
Las variables; horas deaentrenamiento
la labor (3 - recomienda
y quien 5). Son pocos el usolos
de SNestudios
mostraron científicos
significanciaque dan para
estadística
Amigo 29 (17,7) dieta,
21 (20,4)
sin mayor 8 (13,1) el uso
respaldo de SN. Esta
científico queinformación
justifique respalda
su usola importancia
cuentadedel asesoría
consumonutricional
de SN especializada en esta población,
por la población cercana conalel fin de
leche. Rendimiento deportivo.
Tabla 3. Suplementos nutricionales consumidos según sexo y clasi- Otro 26 (15,9) (1,2).
14 (13,6)
Dopaje en el 12 (19,7)
deporte. evitar el uso de productos inefectivos y/o que puedan perjudicar su salud.
ficación según sistema ABCD del Instituto Australiano del Deporte. Según el Reglamento Sanitario de los Alimentos, mundo de la actividad física (5). Nuestro país, no difiere
Profesional de la salud 25 (15,2)
un12SN,
(11,7)
es un 13 (21,3) que ha sido elaborado para su-
producto de esta realidad al no presentar estudios al respecto. La
Suplementos Total Hombres Mujeres Clasificación Internet 19 (11,6)
15 (14,6) la dieta
plementar 4 (6,6)
habitual de los individuos sanos, con escasez de información existente, dificulta la orientacio-
nutricionales n (%) n (%) n (%) ABCD Vendedor de SN 9 (5,5)
5 (4,9)de uno 4o(6,6)
adición varios nutrientes y que se presenta en nes necesarias para abordar la problemática del uso, mal
Total 164 (100) diversos
103 (100)formatos.
61 (100)
Proteínas de 113 (72,9) 77 (80,2) 36 (61) A Analysis
Estos of
productos, the
suelen use of nutritional
estar acom-
Correspondencia:
supplements
uso y abuso
Ignacio González
de los SN, porin lo
gyms
que elinobjetivo
Coquimbo,
general
Percepción de eficacia de uso de SN pañados de una propaganda comercial que los presentan deEspinosa
esta investigación, es conocer las características que
suero de leche Chile E-mail: igonzaleze@santotomas.cl
Aminoácidos de 34 (21,9) 26 (27,1) 8 (13,6) C Si 141 (90,9) como sustancias
93 (96,9) milagrosas que contribuyen
48 (81,4) a diversos determinan el consumo de SN en gimnasios de la comuna
Summary
cadena ramificada No 14 (9) objetivos
3 (3,1) para11mantener
(18,6) la salud. de Viña del Mar, evaluando su consumo mediante la
Glutamina 15 (9,7) 11 (11,5) 4 (6,8) B Nutritional science is a crucial component for improving health and sports performance. The use of nutritional supplements
289
Agentes lipolíticos 14 (9) 6 (6,3) 8 (13,6) C
Arch Med Deporte
(NS) has increased considerably in recent years. Studies show high consumption of nutritional 2018;35(6):
supplements that lack scientific
evidence and could be putting the health of the population at risk. The objective was to analyze the use of NS in clients of a
157
Multivitamínico 11 (7,1) 5 (5,2) 6 (10,2) A que en el caso de los hombres, el 35% consumía SN recomendado porgymnasium franchise in the Coquimbo Region of Chile during 2016. Was applied to 359 clients (191 men and 168 women) a
Comidas líquidas 9 (5,8) 2 (2,1) 7 (11,9) A su entrenador, seguido de un 20,4% que fue recomendado por un amigopreviously validated survey in four locations of a gymnasium franchise in the Coquimbo Region. The median age of the sample
Pre-entreno 7 (4,5) 7 (7,3) 0 (0) C population was 28±10.1 years and 43.2% of the population had used NS. The main goal of the NS users was to increase muscle
y 14,6% que obtuvo la información de internet. Por su parte, las mujeres
Key words: mass (32%); the most commonly used NSs were whey protein (72.9%), branched-chain amino acids (21.9%), and glutamine
Cafeína 5 (3,2) 3 (3,1) 2 (3,4) A en orden decreciente, consumían SN indicado por entrenador,
Sports profesio-(9.7%). Of the 26 types of NS consumed, 50% are classified as type C, that is, there exists little evidence regarding their benefits.
medicine. Sports
Creatina 5 (3,2) 5 (5,2) 0 (0) A nutrition
nal de la salud y “otro” con 32,8%, 21,3% y 19,7% sciences. Whey
respectivamente. CabeTwo variables showed statistical significance for the use of NS: hours of training, and the person who had recommended the
protein. Athletic perfor- NS to the user. This information supports the importance of specialized nutritional assessment for the population to avoid
Espirulina 5 (3,2) 2 (2,1) 3 (5,1) C mencionar que solo un 15,2% del total de encuestados, refirió consumirineffective and harmful products.
mance. Doping in sports.
Té verde 4 (2,6) 1 (1) 3 (5,1) C SN indicados por un profesional de la salud (Tabla 4).
Ganador de peso 3 (1,9) 3 (3,1) 0 (0) C Al clasificar los 26 diferentes tipos de SN consumidos por los en-
Proteínas (Carne) 3 (1,9) 2 (2,1) 1 (1,7) C cuestados según el programa de suplementación deportiva del Instituto
Omega 3 3 (1,9) 2 (2,1) 1 (1,7) B Australiano del Deporte se encontró que un 30,8% se clasifica como
Vitamina C 3 (1,9) 2 (2,1) 1 (1,7) B tipo A (la evidencia respalda su uso en situaciones específicas del de-
Proteínas (Caseína)
Colágeno
3 (1,9)
3 (1,9)
2 (2,1)
1 (1)
1 (1,7)
2 (3,4)
C
C
porte), un 15,4% como tipo B (falta mayor investigación), un 50% como
tipo C (existe poca evidencia acerca de sus efectos beneficiosos) y un
10
Correspondencia: Ignacio González Espinosa
Proteínas (Vegetales) 2 (1,3) 1 (1) 1 (1,7) C 3,8% como tipo D (Prohibido o con alto riesgo de contaminación con
E-mail: igonzaleze@santotomas.cl
Bebida energética 2 (1,3) 2 (2,1) 0 (0) C sustancias que podrían conducir a una prueba positiva de sustancias
Características Total Hombres Mujeres
(9%) y multivitamínicos (7,1%). Al analizar la información por sexo, los n (%) n (%) n (%)
hombres preferían en orden decreciente la proteína de suero de leche
(80,2%), los aminoácidos ramificados (27,1%) y la glutamina (11,5%), Objetivo de consumo de SN
mientras que las mujeres consumían preferentemente proteína de
suero de leche (61%), los aminoácidos de cadena ramificada (13,6%) y
Aumentar masa muscular
Mejorar la recuperación
84 (31,6)
56 (21,1)
52 (33,1)
38 (24,2)
18/3/19
32 (29,4)
18 (16,5)
agentes lipolíticos (13,6%) (Tabla 3). Disminuir la grasa corporal 38 (14,3) 20 (12,7) 18 (16,5)
Los principales objetivos por los cuales consumían SN en el total Obtener energía 33 (12,4) 17 (10,8) 16 (14,7)
de la muestra fueron aumentar masa muscular (31,6%), mejorar la recu- Mejorar rendimiento deportivo 26 (9,8) 18 (11,5) 8 (7,3)
peración (21,1%) y disminuir la grasa corporal (14,3%), encontrándose Mejorar la salud 20 (7,5) 6 (3,8) 14 (12,8)
resultados similares en hombres y mujeres (Tabla 4). Otro 9 (3,4) 6 (3,8) 3 (2,8)
Respecto a las fuentes de información que refirieron utilizar los en- Total 266 (100) 157 (100) 109 (100)
cuestados a la hora de escoger un SN, se destacan: entrenador (34,1%), Recomienda consumo de SN
amigo (17,7%) y otro (15,9%). Si se analiza de acuerdo al sexo, destaca Entrenador 56 (34,1) 36 (35) 20 (32,8)
Amigo 29 (17,7) 21 (20,4) 8 (13,1)
Tabla 3. Suplementos nutricionales consumidos según sexo y clasi- Otro 26 (15,9) 14 (13,6) 12 (19,7)
ficación según sistema ABCD del Instituto Australiano del Deporte.
Profesional de la salud 25 (15,2) 12 (11,7) 13 (21,3)
Suplementos Total Hombres Mujeres Clasificación Internet 19 (11,6) 15 (14,6) 4 (6,6)
nutricionales n (%) n (%) n (%) ABCD Vendedor de SN 9 (5,5) 5 (4,9) 4 (6,6)
Total 164 (100) 103 (100) 61 (100)
Proteínas de 113 (72,9) 77 (80,2) 36 (61) A
suero de leche Percepción de eficacia de uso de SN
Aminoácidos de 34 (21,9) 26 (27,1) 8 (13,6) C Si 141 (90,9) 93 (96,9) 48 (81,4)
cadena ramificada No 14 (9) 3 (3,1) 11 (18,6)
Glutamina 15 (9,7) 11 (11,5) 4 (6,8) B
Agentes lipolíticos 14 (9) 6 (6,3) 8 (13,6) C
Multivitamínico 11 (7,1) 5 (5,2) 6 (10,2) A que en el caso de los hombres, el 35% consumía SN recomendado por
Comidas líquidas 9 (5,8) 2 (2,1) 7 (11,9) A su entrenador, seguido de un 20,4% que fue recomendado por un amigo
Pre-entreno 7 (4,5) 7 (7,3) 0 (0) C y 14,6% que obtuvo la información de internet. Por su parte, las mujeres
Cafeína 5 (3,2) 3 (3,1) 2 (3,4) A en orden decreciente, consumían SN indicado por entrenador, profesio-
Creatina 5 (3,2) 5 (5,2) 0 (0) A nal de la salud y “otro” con 32,8%, 21,3% y 19,7% respectivamente. Cabe
Espirulina 5 (3,2) 2 (2,1) 3 (5,1) C mencionar que solo un 15,2% del total de encuestados, refirió consumir
Té verde 4 (2,6) 1 (1) 3 (5,1) C SN indicados por un profesional de la salud (Tabla 4).
Ganador de peso 3 (1,9) 3 (3,1) 0 (0) C Al clasificar los 26 diferentes tipos de SN consumidos por los en-
Proteínas (Carne) 3 (1,9) 2 (2,1) 1 (1,7) C cuestados según el programa de suplementación deportiva del Instituto
Omega 3 3 (1,9) 2 (2,1) 1 (1,7) B Australiano del Deporte se encontró que un 30,8% se clasifica como
Vitamina C 3 (1,9) 2 (2,1) 1 (1,7) B tipo A (la evidencia respalda su uso en situaciones específicas del de-
Proteínas (Caseína) 3 (1,9) 2 (2,1) 1 (1,7) C porte), un 15,4% como tipo B (falta mayor investigación), un 50% como
Colágeno 3 (1,9) 1 (1) 2 (3,4) C tipo C (existe poca evidencia acerca de sus efectos beneficiosos) y un
Proteínas (Vegetales) 2 (1,3) 1 (1) 1 (1,7) C 3,8% como tipo D (Prohibido o con alto riesgo de contaminación con
Bebida energética 2 (1,3) 2 (2,1) 0 (0) C sustancias que podrían conducir a una prueba positiva de sustancias
Guaraná 2 (1,3) 0 (0) 2 (3,4) C ilícitas) (Tabla 3).
Vitaminas complejo B 2 (1,3) 1 (1) 1 (1,7) A Cabe mencionar que los participantes refirieron invertir en prome-
Arginina 2 (1,3) 2 (2,1) 0 (0) C dio 72±65 USD mensuales en la compra de SN, no existiendo diferencias
Aumentador de la 1 (0,6) 1 (1) 0 (0) D significativas en el monto invertido por sexo.
producción de En cuanto a la percepción de la efectividad del consumo de SN
testosterona
en relación a los objetivos, en la Tabla 4 se observa que el 96,9% de los
Magnesio 1 (0,6) 0 (0) 1 (1,7) A
hombres y el 81,4% de las mujeres declaran que el consumo de SN les
Calcio 1 (0,6) 0 (0) 1 (1,7) A permitió alcanzar sus objetivos.
L-carnitina 1 (0,6) 0 (0) 1 (1,7) B En relación a la alimentación, el 59,9% de los encuestados refirió
Total 254 164 90 seguir un plan de alimentación en función de sus objetivos de en-
292 Arch Med Deporte 2018;35(6):
THE AIS SPORTS

SUPPLEMENT
FRAMEWORK
11
18/3/19
4 of 8
Group A
Overview of Sub-categories Examples

category
Evidence level: Sports foods Sports drink

Strong scientific Specialised products used to provide a convenient Sports gel
evidence for use in source of nutrients when it is impractical to
specific situations consume everyday foods. Sports confectionery
in sport using Sports bar
evidence-based
protocols. Electrolyte
supplement
Isolated protein
Use within supplement
Supplement Mixed macronutrient
Programs: supplement (Bar,
Permitted for use powder, liquid meal)
by identified Medical supplements Iron supplement
athletes according
to Best Practice Supplements used to prevent or treat clinical issues Calcium supplement
Protocols. including diagnosed nutrient deficiencies.
Multivitamin
Should be used within a larger plan under the
supplement
expert guidance of a Medical
Practitioner/Accredited Sports Dietitian. Vitamin D supplement
Probiotics
Performance supplements Caffeine
Supplements/ingredients that can support or
B-alanine
enhance sports performance.
Best used with an individualised and event-specific Bicarbonate
protocol, with the expert guidance of an Accredited Beetroot juice/Nitrate
Sports Dietitian.
Creatine
Glycerol
5 of 8
Group B
Overview of Sub-categories Examples

category
Evidence Level: Food polyphenols Cherries, berries and

Emerging scientific Food compounds that may have bioactivity black currants
support, deserving of including antioxidant and anti-inflammatory
further research. properties. May be consumed in food forms
Quercitin, ECGC,
Considered for use by (whole or concentrate) or as isolated extracts.
epicatechins & others
athletes under a
research protocol or
case-managed
Other Collagen support
monitoring situation.
Compounds that attract interest for potential products
benefits to body function, integrity and/or Carnitine
Use within metabolism.
Supplement HMB
Programs:
Ketone supplements
Considered for use by
identified individual Fish oils
athletes within Phosphate
research or clinical
monitoring situations. Curcumin
Sick Pack Zinc lozenges and
Note that some of the Multi-ingredient approach to moderate duration Vitamin C
products currently and severity of respiratory tract infections.
listed in Group B have
been included due to Best used with advice from an appropriate
their historic interest Medical Practitioner/Accredited Sports Dietitian.
by Key Stakeholders.
Amino Acids BCAA/Leucine
The Evidence Map Constituents of protein which may have effects
approach will better when taken in isolation, or may be consumed
define the scientific individually by an athlete to fortify an existing
food/supplement that is lacking in this amino Tyrosine
support for these
products in specific acid.
sporting situations. Antioxidants Vitamin C & E
Compounds often found in foods that protect
against oxidative damage from free-radical
chemicals.
N-acetyl cysteine
12
18/3/19
6 of 8
Group C
Overview of category Subcategories Examples
Evidence Level: Category A and B products See list for Category A

Scientific evidence not used outside approved and B products.
supportive of benefit protocols.
amongst athletes OR no The rest The AIS Supplement
research undertaken to Framework no longer
If you can’t find an ingredient/
guide an informed opinion. names Group C
product in Groups A, B or D, it
probably deserves to be here. supplements or
Use within Supplement supplement ingredients
Programs: in this top line layer of
Not advocated for use by information. This avoids
athletes within Supplement the perception that these
Programs. supplements are special.
May be permitted for use by

identified athletes where
there is specific approval
from, or reporting to, a
Sports Supplement Panel.
7 of 8
Group D
Overview of category Subcategories Examples

Use within AIS system
Evidence level: Stimulants Ephedrine
Banned or at high risk of Consult WADA list for all Strychnine
contamination with examples:
substances that could lead Sibutramine
https://www.wada-ama.org/
to a positive doping test. Methylhexanamine
(DMAA)
Use within Supplement 1,3-dimethylbutylamine
Programs: (DMBA)
Not be used by athletes. Other herbal stimulants
Prohormones and hormone DHEA
boosters
Androstenedione
Consult WADA list for all
examples: 19-norandrostenione/ol
https://www.wada-ama.org/ Other prohormones
Tribulus terrestris and
other testosterone
boosters*
Maca root powder*
GH releasers and “Peptides” Technically, while these
Consult WADA list for all are sometimes sold as
examples: supplements (or have
https://www.wada-ama.org/ been described as such)
they are WADA banned
drugs.
Beta-2 agonists Higenamine

Consult WADA list for all
examples:
Other Colostrum – not

Consult WADA list for all recommended by WADA
examples: due to the inclusion of
growth factors within its
composition.
*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.
13
18/3/19
Ayudas ergogénicas
aeróbicas
14
18/3/19
Qué suplemento podría ayudar en la economía de carrera?
nutrients
Review
Effects of Beetroot Juice Supplementation on
Cardiorespiratory Endurance in Athletes.
A Systematic Review
Raúl Domínguez 1 , Eduardo Cuenca 2 , José Luis Maté-Muñoz 1 , Pablo García-Fernández 1 ,
Noemí Serra-Paya 2 , María Carmen Lozano Estevan 1 , Pablo Veiga Herreros 1
and Manuel Vicente Garnacho-Castaño 2, *
1 College of Health Sciences, University Alfonso X El Sabio University, Madrid 29651, Spain;
rdomiher@uax.es (R.D.); jmatmuo@uax.es (J.L.M.-M.); pablgafe@uax.es (P.G.-F.);
mloza@myuax.com (M.C.L.E.); pveigher@uax.es (P.V.H.)
2 Tecnocampus, College of Health Sciences, University of Pompeu Fabra, Mataró-Maresme,
Barcelona 08302 Spain; educuen@hotmail.com (E.C.); nserra@tecnocampus.cat (N.S.-P.)
* Correspondence: mgarnacho@escs.tecnocampus.cat
Received: 21 October 2016; Accepted: 30 December 2016; Published: 6 January 2017
Abstract: Athletes use nutritional supplementation to enhance the effects of training and achiev
nutrients improvements in their athletic performance. Beetroot juice increases levels of nitric oxide (NO), whic
serves multiple functions related to increased blood flow, gas exchange, mitochondrial biogenes
and efficiency, and strengthening of muscle contraction. These biomarker improvements indicate th
Review supplementation with beetroot juice could have ergogenic effects on cardiorespiratory enduranc
Effects of Beetroot Juice Supplementation on that would benefit athletic performance. The aim of this literature review was to determine the effec
of beetroot juice supplementation and the combination of beetroot juice with other supplemen
Cardiorespiratory Endurance in Athletes. on cardiorespiratory endurance in athletes. A keyword search of DialNet, MedLine, PubMe
Scopus and Web of Science databases covered publications from 2010 to 2016. After excludin
A Systematic Review reviews/meta-analyses, animal studies, inaccessible full-text, and studies that did not supplemen
with beetroot juice and adequately assess cardiorespiratory endurance, 23 articles were selecte
Raúl Domínguez 1 , Eduardo Cuenca 2 , José Luis Maté-Muñoz 1 , Pablo García-Fernández 1 , for analysis. The available results suggest that supplementation with beetroot juice can improv
Noemí Serra-Paya 2 , María Carmen Lozano Estevan 1 , Pablo Veiga Herreros 1 cardiorespiratory endurance in athletes by increasing efficiency, which improves performance a
and Manuel Vicente Garnacho-Castaño 2, * various distances, increases time to exhaustion at submaximal intensities, and may improve th
1 College of Health Sciences, University Alfonso X El Sabio University, Madrid 29651, Spain; cardiorespiratory performance at anaerobic threshold intensities and maximum oxygen uptak
rdomiher@uax.es (R.D.); jmatmuo@uax.es (J.L.M.-M.); pablgafe@uax.es (P.G.-F.); (VO2max ). Although the literature shows contradictory data, the findings of other studies lead us t
mloza@myuax.com (M.C.L.E.); pveigher@uax.es (P.V.H.) hypothesize that supplementing with beetroot juice could mitigate the ergolytic effects of hypoxia o
2 Tecnocampus, College of Health Sciences, University of Pompeu Fabra, Mataró-Maresme, cardiorespiratory endurance in athletes. It cannot be stated that the combination of beetroot juic
Barcelona 08302 Spain; educuen@hotmail.com (E.C.); nserra@tecnocampus.cat (N.S.-P.) with other supplements has a positive or negative effect on cardiorespiratory endurance, but it
* Correspondence: mgarnacho@escs.tecnocampus.cat possible that the effects of supplementation with beetroot juice can be undermined by interactio
with other supplements such as caffeine.
Abstract: Athletes use nutritional supplementation to enhance the effects of training and achieve Keywords: nutrition; sport; exercise; nitric oxide; physical activity
improvements in their athletic performance. Beetroot juice increases levels of nitric oxide (NO), which
serves multiple functions related to increased blood flow, gas exchange, mitochondrial biogenesis
and efficiency, and strengthening of muscle contraction. These biomarker improvements indicate that 1. Introduction
supplementation with beetroot juice could have ergogenic effects on cardiorespiratory endurance
Cardiorespiratory endurance is defined as a health-related component of physical fitness tha
that would benefit athletic performance. The aim of this literature review was to determine the effects
relates to the ability of the circulatory and respiratory systems to supply fuel during sustained physic
of beetroot juice supplementation and the combination of beetroot juice with other supplements
activity and to eliminate fatigue products after supplying fuel [1]. Cardiorespiratory endurance is
on cardiorespiratory endurance in athletes. A keyword search of DialNet, MedLine, PubMed,
performance factor in all sports in which adenosine triphosphate (ATP) is resynthesized, mainly b
Scopus and Web of Science databases covered publications from 2010 to 2016. After excluding aerobic metabolism or oxidative processes that produce energy. In these sports, the expended effo
reviews/meta-analyses, animal studies, inaccessible full-text, and studies that did not supplement typically lasts longer than five minutes, primarily depending on the metabolic level of the oxidativ
with beetroot juice and adequately assess cardiorespiratory endurance, 23 articles were selected
for analysis. The available results suggest that supplementation with beetroot juice can improve Nutrients 2017, 9, 43; doi:10.3390/nu9010043 www.mdpi.com/journal/nutrien
cardiorespiratory endurance in athletes by increasing efficiency, which improves performance at
various distances, increases time to exhaustion at submaximal intensities, and may improve the
cardiorespiratory performance at anaerobic threshold intensities and maximum oxygen uptake
(VO2max ). Although the literature shows contradictory data, the findings of other studies lead us to
hypothesize that supplementing with beetroot juice could mitigate the ergolytic effects of hypoxia on
cardiorespiratory endurance in athletes. It cannot be stated that the combination of beetroot juice
with other supplements has a positive or negative effect on cardiorespiratory endurance, but it is
possible that the effects of supplementation with beetroot juice can be undermined by interaction
Keywords: nutrition; sport; exercise; nitric oxide; physical activity

15
1. Introduction
Review
18/3/19
Effects of Beetroot Juice Supplementation on
A Systematic Review
and Manuel Vicente Garnacho-Castaño 2, *
1 College of Health Sciences, University Alfonso X El Sabio University, Madrid 29651, Spain;
rdomiher@uax.es (R.D.); jmatmuo@uax.es (J.L.M.-M.); pablgafe@uax.es (P.G.-F.);
2 Tecnocampus, College of Health Sciences, University of Pompeu Fabra, Mataró-Maresme,
Nutrients 2017, 9, 43 Barcelona 08302 Spain; educuen@hotmail.com
3 of 18 (E.C.); nserra@tecnocampus.cat (N.S.-P.)
* Correspondence: mgarnacho@escs.tecnocampus.cat
Nutrients 2017, 9, 43 3 of 18
Abstract: Athletes use nutritional supplementation to enhance the effects of training and achiev
improvements in their athletic performance. Beetroot juice increases levels of nitric oxide (NO), whic
serves multiple functions related to increased blood flow, gas exchange, mitochondrial biogenes
and efficiency, and strengthening of muscle contraction. These biomarker improvements indicate th
supplementation with beetroot juice could have ergogenic effects on cardiorespiratory enduranc
that would benefit athletic performance. The aim of this literature review was to determine the effec
NO3- Nitrato of beetroot juice supplementation and the combination of beetroot juice with other supplemen
on cardiorespiratory endurance in athletes. A keyword search of DialNet, MedLine, PubMe
NO2- Nitrito Scopus and Web of Science databases covered publications from 2010 to 2016. After excludin
NO Oxido nítrico reviews/meta-analyses, animal studies, inaccessible full-text, and studies that did not supplemen
with beetroot juice and adequately assess cardiorespiratory endurance, 23 articles were selecte
for analysis. The available results suggest that supplementation with beetroot juice can improv
cardiorespiratory endurance in athletes by increasing efficiency, which improves performance a
various distances, increases time to exhaustion at submaximal intensities, and may improve th
cardiorespiratory performance at anaerobic threshold intensities and maximum oxygen uptak
(VO2max ). Although the literature shows contradictory data, the findings of other studies lead us t
hypothesize that supplementing with beetroot juice could mitigate the ergolytic effects of hypoxia o
cardiorespiratory endurance in athletes. It cannot be stated that the combination of beetroot juic
with other supplements has a positive or negative effect on cardiorespiratory endurance, but it
possible that the effects of supplementation with beetroot juice can be undermined by interactio
1. Introduction
relates to the ability of the circulatory and respiratory systems to supply fuel during sustained physic
activity and to eliminate fatigue products after supplying fuel [1]. Cardiorespiratory endurance is
performance factor in all sports in which adenosine triphosphate (ATP) is resynthesized, mainly b
nutrients
aerobic metabolism or oxidative processes that produce energy. In these sports, the expended effo
typically lasts longer than five minutes, primarily depending on the metabolic level of the oxidativ

Review
Figure
Figure 1. 1. Pathway
Pathway ofof nitric
nitric oxide (NO)
oxide (NO) production
production from
from beetroot
beetroot juice
juice supplementation.
supplementation. Nitrate
Nitrate
(NO(NO)3−is
3
) is reduced toto nitrite
reduced (NO2−) ) by
nitrite (NO
2 byanaerobic
anaerobicbacteria
bacteriain inthe
theoral
oralcavity
cavityand
and
Effects of Beetroot Juice Supplementation
Nutrients 2017, 9, 43; doi:10.3390/nu9010043
then
thento to
NO NO in the
in the
on
www.mdpi.com/journal/nutrien
stomach. NO3 3 and

stomach. NO − −
remaining NO22 are absorbed from the intestine into the circulation, which can
and remaining NO are absorbed from the intestine into the circulation, which can
become bioactive NO in tissues and blood. NO induces several physiological functions improving
become bioactive NO in tissues and blood. NO induces several physiological functions improving A Systematic Review
skeletal muscle function and, consequently, increasing cardiorespiratory performance.
skeletal muscle function and, consequently, increasing cardiorespiratory performance.
NO induces several physiological mechanisms that influences O2 utilization during contraction
In addition, a potent signaling molecule that
skeletal muscle. Physiological mechanisms for NO2affects cell function inand many Manuelbody
− reduction are facilitated by hypoxic conditions, tissues,
Vicente NO is
Garnacho-Castaño 2, *
endogenously produced by synthesizing nitric oxide from L-arginine oxidation.

therefore, NO (vasodilator) is produced in those parts of muscle that are consuming or in need of more 1 CollegeThe molecule
of Health Sciences,hasUniversity Alfonso X El Sabio University, Madrid 29651, Spain;
important
O2. This hemodynamic
mechanism would and metabolic
allow local functions
blood flow [16,17], beingto a O
to adapt major vasodilator
2 requirement that can(R.D.);
rdomiher@uax.es
providing increase
within jmatmuo@uax.es (J.L.M.-M.); pablgafe@uax.es (P.G.-F.);
blood flow to muscles [18] and promote oxygen transfer in the muscle. 2Additional
skeletal muscle an adequate homogeneous distribution. This physiological response could be positive physiological
Tecnocampus, College of Health Sciences, University of Pompeu Fabra, Mataró-Maresme,
benefits
in terms of NO include
of muscle improved
function, mitochondrial
although it would not efficiency and
explain a glucose
reduced O2 uptake in muscle
cost Barcelona
during exercise
08302 [19]
Spain; and
[15].
educuen@hotmail.com (E.C.); nserra@tecnocampus.cat (N.S.-P.)
Nutrients 2017, 9, 43
enhanced muscle contraction and relaxation processes
Another probable mechanism is related to NO [20]. Other researchers
2− and NO as regulators of cellular O have reported
* Correspondence: that NO5 of 18
mgarnacho@escs.tecnocampus.cat
2 utilization [15].
can act as an immunomodulator [21] and stimulates gene expression and mitochondrial
In addition, a potent signaling molecule that affects cell function in many body tissues, NO is Received: 21 Octoberbiogenesis [22]. 30 December 2016; Published: 6 January 2017
2016; Accepted:
Given the positive effects of beetroot juice, which are induced
endogenously produced by synthesizing nitric oxide from by means ofAbstract: NO, this
L‐arginine oxidation. The molecule has supplement
Athletes has
Table 2. Summary of studies that have evaluated the performance or metabolic responses after supplementation protocol with beet juice. use nutritional supplementation to enhance the effects of training and achiev
been proposed as part of the therapeutic approach in people with chronic
important hemodynamic and metabolic functions [16,17], being a major vasodilator that can increase obstructive
improvements pulmonary
in their athletic performance. Beetroot juice increases levels of nitric oxide (NO), whic
Reference Participants
blood
disease
Experimental
flow
[23], to muscles
hypertension
Conditions
[18]
[24],and
Supplementation heartpromote
failureoxygen
[25] andtransfer
Variables insulinin the muscle.
resistance [26]. serves Results
Additional multiple functions related to increased blood flow, gas exchange, mitochondrial biogenes
physiological
Protocol
M (n: 5) and W
benefits of
These findingsNO include improved mitochondrial efficiency and
reflect the importance of supplementation with NO3 and efficiency, and strengthening of muscle contraction. These biomarker improvements indicate th
glucose uptake in muscle [19] and
or nitrate salts to increase
EC1: enhanced muscle contraction and relaxation processes [20]. Other researchers have reported that NO
beet juice, EC1: beet juice (8 mmol supplementation
Performance: Last mile 1.1: faster EC1 vs. withEC2beetroot
(5%), juice could have ergogenic effects on cardiorespiratory enduranc
[12] (n: 6), trained the placebo
EC2: bioavailability ofnitrate)
NO(90inminorder to influence
before)
Test 5 km:muscle function
Performance, HR, RPE improving exercise performance, mainly
RPE: 1 mile: lower
thatin EC1
wouldvs. EC2
benefit athletic performance. The aim of this literature review was to determine the effec
athletes can act as an immunomodulator [21] and stimulates gene expression and mitochondrial biogenesis
in aerobic metabolism [27]. Therefore, supplementation with beetroot juice may
of beetroot
Performance in test
have
4 km: Time:juice
an ergogenic
lowersupplementation
in EC1 vs. EC2 and the combination of beetroot juice with other supplemen
[22]. Given the positive effects of beetroot juice, which are induced by means of NO, this supplement
effect in athletes [9], especially with respect to cardiorespiratory endurance. onHowever,
(6.27 ± 0.35 vs. 6.45 ± 0.42 min), the
cardiorespiratory assumption
Power: endurance
Higher in EC1 in athletes. A keyword search of DialNet, MedLine, PubMe
has been proposed as part of the therapeutic approach in vs.people EC2 (292 ±with
44
Scopus chronic
vs. 279 51 W),
±and Web obstructive
W/VO : Higher indatabases covered publications from 2010 to 2016. After excludin
of 2Science
M, competitive that the beetroot
EC1: beet juice, juice
EC1:supplementation
500 mL beet juice improves performance
Tests 4 km and 16 km: respiratory in cardiorespiratory endurance under
EC1 vs. EC2 (93 ± 17 vs. 83 ± 9 W/L/min), Performance
[27]
cyclists (n: 9)
pulmonary disease [23], hypertension [24], heart failure [25] and insulin resistance [26].
EC2: placebo
(6.2 mmol nitrate)
parameters, performance reviews/meta-analyses,
test of 16 km: Time: animal
lower in EC1 vs. EC2 (26.9 ± 1.8 vs. studies, inaccessible full-text, and studies that did not supplemen
(120 min before)
27.7 ± 2.1 min), with
Power:beetroot juice
Higher in EC1 vs.and adequately
EC2 (247 ± 44 assess cardiorespiratory endurance, 23 articles were selecte
vs. 233 ± 43 W), W/VO2 : Higher in EC1 vs. EC2 (69 ± 3
for analysis. The available results suggest that supplementation with beetroot juice can improv
vs. 64 ± 6 W/L/min)
cardiorespiratory endurance in athletes by increasing efficiency, which improves performance a
Study A: 4 min test: VO2 : decreases in EC1 vs. EC2
Study A: EC1: 140 mL Study A: kayaking incremental test: (46.87 ± 2.56 vs.various distances,
47.83 ± 2.77 mL/kg/min), increases
Economy:time to exhaustion at submaximal intensities, and may improve th
beet juice (4.8 mmol Test 10 min (10 min + 5 min LT1 improved EC1 vs. EC2 (189.67 ± 8.17 vs.performance at anaerobic threshold intensities and maximum oxygen uptak
cardiorespiratory
M, national level
EC1: beet juice, nitrate) (150 min before), LT2) + 4 min test: respiratory 193.90 ± 8.17 mL/kg/km). Study B: Test 500 m: Time:
[29] athletes kayak
EC2: placebo Study B: EC1: 140 mL beet parameters, lactate, performance improved EC1 vs. (VOEC22max ). Although
(114.6 the+literature
+ 1.5 s vs. 116.7 2.2 s), shows contradictory data, the findings of other studies lead us t
(n: 5)
juice (9.6 mmol nitrate) (test 4 min), HR, RPE. Study B: Test hypothesize
Rowing often partially 100–400 m:that supplementing
increases in EC1 vs. with beetroot juice could mitigate the ergolytic effects of hypoxia o
(150 min before) 500 m EC2 (108 + 2 vs. cardiorespiratory
105 + 2 strokes), Partial endurance
speed 100–400in m:athletes. It cannot be stated that the combination of beetroot juic
increases in EC1 vs. EC2 (4.40 + 0.03 vs. 4.30 + 0.05 m/s)
with other supplements has a positive or negative effect on cardiorespiratory endurance, but it
Test 30 min at 45% MAP + 30 min at Respiratory parameters VO2 at 45% MAP: lower in EC1
M, trained 65% MAP + test 10 km: respiratory possible
vs. EC2 (1.93 ± 0.05 that
vs. 2.0 ± 0.07the effects
L/min), VO2of supplementation
at 65% with beetroot juice can be undermined by interactio
EC1: beet juice, EC1: beet juice 140 mL
[30] cyclists-triathletes
EC2: placebo (8 mmol nitrate) (6 days)
parameters, lactate, glucose, with
MAP: lower in EC1 vs.other supplements
EC2 (2.94 ± 0.10 vs. such as caffeine.
(n: 13) performance (test to exhaustion at 3.1 ± 0.09 L/min), Performance (test 10 km):
80% VO2max ), HR, RPE improvement in EC1 vs. EC2 (953 ± 21 vs. 965 ± 21 s)
EC1: 280 mL of beet juice Test 20 min (10 min to 10 min
M, trained EC1: beet juice, Respiratory parameters: 70% VO2max : oxygen
[31] (6.5 mmol nitrate) for 50% + 70% VO2max ):
athletes (n: 13) EC2: placebo consumption decrease in EC1 (3%)
7 days. EC2: Control respiratory parameters
EC1: 500 mL beet juice Performance: last 10 miles: lower time in EC1 vs. EC2,
M, trained EC1: beet juice, Test 50 miles: respiratory
[32] (6.2 mmol nitrate) W/VO2 : higher1.inIntroduction
EC1 vs. EC2 (67.4 ± 5.5 vs.
cyclists (n: 8) EC2: placebo parameters, lactate, performance
(150 min before) 65.3 ± 4.8 W/L/min)
Test 40 min [20 min at 50% VO2max
Respiratory parameters: RER: greater in EC1 vs. EC2 at
+ 20 min at 70% VO2max ] + time to relates
50% VO2max (0.89 tovs.
± 0.03 the ability
0.86 ± 0.06)ofand
thetest
circulatory
to and respiratory systems to supply fuel during sustained physic
EC1: 450 mL beet juice
M, trained EC1: beet juice, exhaustion at 90% VO2max : exhaustion (1.04 ± 0.06 vs.
activity 1.01to
and 0.06), Performance
± eliminate fatigue(testproducts after supplying fuel [1]. Cardiorespiratory endurance is
[33] (5 mmol nitrate) (115 min
athletes (n: 16) EC2: placebo respiratory parameters, to exhaustion at 90% VO2max ): time increases in EC1 vs.
EC2 (185 ± 122performance factor in all Higher
sportsinin which adenosine triphosphate (ATP) is resynthesized, mainly b
before)
performance (test to exhaustion at s vs. 160 ± 109 s), Max lactate:
90% VO2max ), lactate, HR, RPE aerobic
EC1 vs. EC2 (8.80 ± 2.10metabolism or oxidative processes that produce energy. In these sports, the expended effo
vs. 7.90 ± 2.30 mmol/L)
typically lasts longer than five minutes, primarily depending on the metabolic level of the oxidativ
Nutrients 2017, 9, 43; doi:10.3390/nu9010043 www.mdpi.com/journal/nutrien
16
18/3/19
The performance benefits are particularly seen

during all-out exercise lasting 5-30 min.
S38 A. M. J
(a) 1.6 therefore the creation of a nitrate-depleted beetroot ju

placebo that was used first in the study of Lansley et
End-exercise Vo 2 (L/minute)
Sports Med (2014) 44 (Suppl 1):S35–S45

1.5
[46]. In that study, nine healthy subjects consumed 0.5
DOI 10.1007/s40279-014-0149-y beetroot juice/day (6.2 mmol of nitrate) or the same
REVIEW ARTICLE
ume of placebo (\0.005 mmol of nitrate) for 6 days
1.4
. completed treadmill and knee-extension exercise tests
days 4–6. The oxygen cost of treadmill walking
1.3 moderate-intensity treadmill running were significa
Dietary Nitrate Supplementation and * Exercise *# Performance *#
reduced. During high-intensity running, beetroot ju
1.2 Baseline supplementation resulted in an enhanced exercise tolera
Andrew M. Jones Placebo
S38 – A. M. Jones
of 15 % (7.5 ± 1.7, 7.6 ± 1.5, and 8.7 ± 1.8 min
NO3
0.0 pre-supplemented control, placebo, and beetroot ju
BL 2.5 hours 5 days 15 days
conditions, respectively). The time to exhaustion du
(a) 1.6 therefore the creation of a nitrate-depleted beetroot juice
incremental knee-extension exercise was also significa
placebo that (b) 360was used first in the study of Lansley et* #al.
End-exercise Vo 2 (L/minute)
longer following nitrate supplementation (8.2 ±

1.5
[46]. In that study, nine healthy subjects consumed 0.5 l of 8.2 ± 0.9, and 8.5 ± 0.8 min for pre-supplemented c
beetroot juice/day 340 (6.2 mmol of nitrate) or the same vol- trol, placebo, and beetroot juice conditions, respective
ume of placebo (\0.005 mmol of nitrate) for 6 days and
Peak power (W)
! The Author(s) 2014. This article is published with open access at Springerlink.com The lack of effect of nitrate-depleted beetroot juice c
1.4
. completed treadmill 320 and knee-extension exercise tests on sumption on plasma [nitrite], blood pressure, the oxy
Abstract Dietary nitrate days is growing4–6.in popularity
The oxygen as a cost of bioactive
and other treadmill walking
nitrogen and
oxides in vivo, and cost
thereofis exercise, and exercise tolerance in this study p
1.3 sports nutrition supplement.moderate-intensity
This article reviews the treadmill
evi- growing scientificwere
running in the potential of this clearly
interest significantly ‘nitrate– to the nitrate content, per se, being chiefly resp
* * #
* #the potential of inorganic nitrate 300
dence base for to enhance sible for the physiological effects of beetroot ju
nitrite–NO’ pathway in physiology, dietetics, and medicine
reduced. During high-intensity
sports and exercise performance. Inorganic nitrate is
running, beetroot
[2–5]. It has been suggested
juice
Baseline Baseline that this alternative consumption.
pathway
1.2 present in numerous foodstuffs supplementation
and is abundant resulted inmay an enhanced
complement exercise tolerance pathway by
280 in green thePlacebo
L-arginine–NOS–NO
Placebo
leafy vegetables and beetroot.
–
of Following
15 % (7.5 ± 1.7,
ingestion, nitrate7.6 enabling
± 1.5, NO andproduction
8.7NO ±3– 1.8 min for of low oxygen
in conditions
NOis3 converted in the body to nitrite and stored and0circulated availability in which NOS activity (which is 3oxygen Effects on Exercise Performance
0.0 pre-supplemented Bcontrol, L placebo,
2 .5dependent)
hours 5 days and beetroot juice 1 5 days
BL 2.5 hours 5 days
in the blood. In conditions
15 days
of low oxygen availability, may be reduced [6].
nitrite can be converted intoconditions,
nitric oxide, which respectively).
is known to The time Time
In addition to exhaustion
to its generation byduring means of the NOS sys-
It is important to recognize that, while valuable scien
play a number of important incremental
roles in vascularknee-extension
and metabolic exercise
tem, body stores was also significantly
of nitrate and nitrite may also be increased
(b) 360 * # nitrate supplementation
control. Dietary Fig.
longer following
2 Influence
increases plasmaof acute and chronic through
exogenously dietary nitrate
the diet,supplementation
particularly through cally,thethe time to exhaustion or incremental tests used
nitrite concentration and reduces resting withblood
0.5 l/day ofnitrate
beetroot
pressure.
supplementation
juice
consumptionon a pulmonary
of green oxygen
(8.2uptake
± 0.9,
leafy vegetables such asthe
during early nitrate supplementation studies [39, 41, 42,
lettuce,
8.2 ± 0.9,also
Intriguingly, nitrate supplementation andreduces
submaximal 8.5 ±the0.8 min
exercise and b peak
spinach, forrocket,
pre-supplemented
power output achieved during
celery, cress, and beetroot, con- which typically
ramp 46] are tests of exercise capacity rather than exercise
incremental exercise. The nitrate condition is shown in filled symbols,
340 oxygen cost of submaximal trol, placebo,
exercise and can, andin beetroot
some juice over
contain conditions,
250 mg ([4 respectively).
mmol) nitrate per 100formance. g fresh ‘Real-world’ competitive sport typic
the placebo condition is shown in open symbols, and the non-
circumstances, enhance exercise tolerance and perfor- weight [2, 5, 7]. Ingested inorganic nitrate circulates in the that athletes complete a given distance in
Peak power (W)
The lack of effect

supplemented of nitrate-depleted
control condition is shown beetroot in grey symbols. juice Thecon-steady- requires
mance. The mechanisms that may be responsible _ for these plasma, and a portion (*25 %) is taken up by the salivary
sumption state VO
on plasma 2 during moderate-intensity
[nitrite], exercise
bloodconcentrated was reduced
pressure, thetheoxygen 2.5 h after shortest possible time. It is also important to note that
320 effects are reviewed and practical guidelines
nitrate for safe and
ingestion glands
and this was and
maintained after 5in and saliva
15 days [8].
of Commensal
cost of exercise, and exercise tolerance in bacteria
this effect size in time to exhaustion tests is considera
efficacious dietary nitrate supplementation are provided.
continued supplementation. facultative
The anaerobic
peak power outputstudy residing
was point
higher inthan
the crypts on the
surface ofse,theoftongue reduce nitrate to nitrite greater than in time trials. For example, a 15 % impro
clearly tothethe nitrate
other content,
conditions after perdays
15 being chiefly
supplementation. respon-
Values are[9, 10]. Some
300 mean ± SD. *Significantly of thedifferent
swallowed fromnitrite
the isnon-supplemented
reduced to NO in the ment in time to exhaustion following a given interven
acidic
1 Introduction sible forcontrol thecondition
physiological #effects of beetroot
(p \ 0.05); significantly different from the placebo
environment of the stomach, but a juice
substantial mightofbe expected to translate into a 1 % improvemen
amount
Baseline consumption. condition (p \ 0.05). BLnitrite entersVO
baseline, _ the systemic circulation, elevating thetime
2 oxygen uptake
plasma
trial performance over an equivalent duration [
280 Until relatively recently, it was believed that the ubiquitous
Placebo nitrite concentration ([nitrite]) [11, 12]. Following bolus
Although seemingly small, such an effect would be hig
NO3 physiological signaling molecule, nitric oxide (NO), was nitrate ingestion, plasma nitrate concentration ([nitrate])
–
meaningful in performance terms to an elite athlete.
0 generated solely through the Effectsthat
3 oxidation ofonLthe effectsinon
-arginine
Exercise efficiency
peaks after
a Performance are1–2 stillhmanifest,
and plasma albeit perhaps
[nitrite] peaks after 2–3 h,
Recognizing the importance of evaluating the influe
BL 2 .5 hours 5 days 1 5 days
reaction catalyzed by a family of NO lesssynthase (NOS) when
impressively, after normal
which both gradually
dietary nitrate fall, arriving
intake back at baseline
is not
Time enzymes, resulting in the endogenous productionrestricted.ofInterestingly,
nitrate values afterwas
there aboutno 24 h [13]. A variety
improvement in ramp of dietary
of enzymes and nitrate supplementation on exercise performan
(NO3-) and nitrite (NO2-) [1] It is important
(Fig. 1). However,toit recognize
is now that, including
proteins, while valuable scientifi-can subsequently
deoxyhemoglobin, Lansley et al. [48] asked nine club-level male cyc
test performance, relative to placebo, after 2.5 h or 5 days of
known that nitrate and nitrite can bethe
cally, reduced
time back
to to NO
exhaustion catalyze
or the one-electrontests
incremental reduction
used ofinnitrite to(mean
NO inVO _ 2max , 56 ml/kg per minute) to complete both
Fig. 2 Influence of acute and chronic dietary nitrate supplementation beetroot juice intake. bloodHowever,
and other tissuesthere [14–16].
were This significant
process is facilitated
with 0.5 l/day of beetroot juice on a pulmonary oxygen uptake during the earlyincreases
nitrate in supplementation
the peakinpower studies
output [39, 41, availability
42, 44, at(ischemiakm and a 16.1-km time trial on a cycle ergometer follow
conditions of and
low theoxygenpower output and
submaximal exercise and b peak power output achieved during
(&) ramp 46] are tests of exercise the acute consumption of 0.5 l of beetroot juice (6.2 m
A. M. Jones the GET comparedcapacitywith rather
placebo, than
afterpH 15 exercise
days per-
of beetroot
17
hypoxia) and low [17], enabling NO to be produced
incremental exercise. The nitrate condition is shown in filled symbols,
Sport and Health Sciences, College of Life and Environmental of nitrate) or nitrate-depleted beetroot juice as a place
the placebo condition is shown in open symbols, Sciences, University
and formance.
of Exeter, St.
the non- juice‘Real-world’
Luke’s Campus, supplementation competitive
where
(Fig.it 2).
is most required.sport Interestingly,
typicallythese conditions
(low partial exist inBecause
skeletal acute nitrate ingestion had previously been sho
Exeter EX1 2LU, UK
supplemented control condition is shown in grey symbols. The steady- requires that In addition
athletestocomplete
nitrate, a pressure
beetroot givenjuiceoxygen
muscle during exercise [18].
distance and pH) may
also contains in the other
e-mail: a.m.jones@exeter.ac.uk
compounds that Itmay be independently to reduce steady-state VO _ [44], the beverages were c
_ 2 during moderate-intensity exercise was reduced 2.5 h after
state VO shortest possible time. is also important to bioactive
note thatorthethat 2
18/3/19
100 g = 4 mMol o 250 mg
Peak es obtenido 2-3 horas luego

de la suplementación.
Efectos ergogénicos a los 150 min
luego de suplementación
Dosis recomendada 6 – 8 mMol
• Acute supplementation with beetroot juice may have an ergogenic effect on

reducing VO2 at less than or equal to VO2max intensity, while improving the
relationship between watts required and VO2 level , mechanisms that make it
possible to enable increase time-to-exhaustion at less than or equal to VO2max
intensity.
• In addition to improving efficiency and performance in various time trials or
increasing time-to-exhaustion at submaximal intensities, chronic
supplementation with beetroot juice may improve cardiorespiratory
performance at the anaerobic threshold and VO2max intensities.
• Apparently, the effects of supplementation with beetroot juice mi ght not have a
positive interaction with caffeine supplementation, mit igating th e effects of
beetroot juice intake on cardiorespiratory performance, however, more work is
needed to confirm the results of these investigations because the number of
studies analyzing the effects of the combination of beetroot juice with other
supplements, such as caffeine, is limited.
• Intake of beetroot juice should be initi ated within 90 min before athletic effort,
since the peak value of NO3− occurs within 2–3 h after ingestion. At least 6–8
mmol of NO3− intake is required, which can be increased in athlet es with a hi gh
level of training.
18
18/3/19
Sports Medicine (2019) 49 (Suppl 1):S25–S37

https://doi.org/10.1007/s40279-018-1005-2
REVIEW ARTICLE
From Paper to Podium: Quantifying the Translational Potential

of Performance Nutrition Research
Graeme L. Close1 · Andreas M. Kasper1 · James P. Morton1
Published online: 22 January 2019

© The Author(s) 2019
Abstract
Sport nutrition is one of the fastest growing and evolving disciplines of sport and exercise science, demonstrated by a 4-fold
increase in the number of research papers between 2012 and 2018. Indeed, the scope of contemporary nutrition-related
research could range from discovery of novel nutrient-sensitive cell-signalling pathways to the assessment of the effects of
sports drinks on exercise performance. For the sport nutrition practitioner, the goal is to translate innovations in research to
develop and administer practical interventions that contribute to the delivery of winning performances. Accordingly, step
one in the translation of research to practice should always be a well-structured critique of the translational potential of the
existing scientific evidence. To this end, we present an operational framework (the “Paper-2-Podium Matrix”) that provides
a checklist of criteria for which to prompt the critical evaluation of performance nutrition-related research papers. In con-
sidering the (1) research context, (2) participant characteristics, (3) research design, (4) dietary and exercise controls, (5)
validity and reliability of exercise performance tests, (6) data analytics, (7) feasibility of application, (8) risk/reward and (9)
timing of the intervention, we aimed to provide a time-efficient framework to aid practitioners in their scientific appraisal of
research. Ultimately, it is the combination of boldness of reform (i.e. innovations in research) and quality of execution (i.e.
ease of administration of practical solutions) that is most likely to deliver the transition from paper to podium.
Key Points
The field of sport nutrition has evolved substantially dur-

ing the last two decades and now encompasses a range of
research examining the effects of nutrient availability on
modulating cell-signalling pathways through to the more
traditional evaluations of ergogenic aids on performance.
The task of translating research to practical interven-
tions to implement in athletic populations has therefore
become highly complex, requiring a critical evaluation
From Paper to Podium: Quantifying the Translational Potential of of the translational
Performance potential of the research in question
Nutrition Research S27
as well as the feasibility of application with specific
athletes and sporting domains.
To this end, we present the Paper-to-Podium Matrix,
a nine-stage decision-making process to evaluate the
translational potential of performance nutrition-related
research according to traditional research design indices
and feasibility of application.
* Graeme L. Close
g.l.close@ljmu.ac.uk
1
Research Institute for Sport and Exercise Science, Liverpool
John Moores University, Liverpool L3 3AF, UK
Vol.:(0123456789)
Fig. 1 Translation of science to practice: a map of delivery towards an ‘increased potential’ to deliver improved performance outcomes
improved performance outcomes. In this model, the quality of (Quadrant 2). In contrast, continual improvements in the practical
research is ranked according to the degree of innovation and transla- application of existing science are likely to lead to improved per-
tional potential whilst practical application is ranked according to the formance outcomes (Quadrant 3). Finally, the pursuit of research-
development, delivery and ease of administration of practical strate- informed practice and development of research-active practitioners
gies. In the absence of developments in research and innovation or (who also possess the skill attributes outlined in Quadrant 3) along-
alterations to the practical application of the existing science, perfor- side continual improvements in quality of practical application may
mance remains as status quo (Quadrant 1). Developments in research deliver transformational improvements in performance outcomes
and innovation (especially research with translational potential) but (Quadrant 4). CHO carbohydrate
without concomitant changes to practical application merely lead to
whether the study is intended as ‘purely’ mechanistic (e.g.

elucidating novel molecular mechanisms regulating mus-
performance in the laboratory or field. Initial and careful
consideration of the research context therefore provides
19
cle adaptations) or, alternatively, does the research context the platform to further evaluate the translational potential
immediately lend itself to outcome measures of human to a specific sporting situation.
18/3/19
Table 1 The Paper-2-Podium (P-2-P) Matrix: an operational framework to evaluate the translational potential of performance nutrition research
S28
Score −2 −1 0 +1 +2
Research context Non-human cells and no exer- Non-human cells but exercise Human cell type in vitro study Human participants and exer- Human participants, exercise
cise condition (mechanistic condition (mechanistic (mechanistic study) cise performance measures performance measures and
study) study) (applied study) evaluation of mechanisms
(applied and mechanistic
study)
Research participants Levels of participants not Inappropriate age group or Inappropriate training status Close to appropriate train- The same training status for
reported training status for the con- of the participants for the ing status for the context the context required, e.g.
text required context required (with required. e.g. trained level elite level participants when
defined criteria) although in participants when wanting wanting to translate to elite
required age group to translate to elite athletes athletes (with defined criteria)
(with defined criteria), and and in required age group
in the required age group
Research design No control group and no Randomisation of participant Randomised cross-over trial Randomised cross over trial Randomised cross over trial
blinding of intervention. No allocation to treatment in with repeated measures or with repeated measures or with repeated measures or
consideration of sample size matched pairs design, inclu- matched groups design, matched groups design with matched groups and double-
sion of control group but no inclusion of control group single blind placebo- con- blind placebo- controlled
blinding of intervention. No but no blinding of interven- trolled conditions. Sample conditions. A priori sample
consideration of sample size tion. Sample size com- size commensurate with size calculation provided and
mensurate with previous previous research in the area justified
research in the area but no but no sample size calcula-
sample size calculations tions provided
provided
Dietary and exercise controls No reference to dietary or Methods of dietary and Methods of dietary and Dietary provision provided by Dietary provision provided by
exercise controls exercise control cited (but exercise control cited (but researchers, exercise control researchers, exercise control
limited to subject self- limited to subject self- cited, supported by relevant cited, supported by relevant
reporting) and no objective reporting) supported by objective data but limited objective data and representa-
data provided relevant objective data replication to real-world tive of real-world context
context
Validity and reliability No inclusion of familiarisation Inclusion of familiarisation Inclusion of familiarisation Inclusion of familiarisation Inclusion of familiarisation trial
trial or citation of reliability trial but no citation of reli- trial and citation of reliabil- trial and citation of reliabil- and citation of reliability data
data and measurement tool ability data or measurement ity data and measurement ity data and measurement and measurement tool error.
error. Exercise protocol not tool error. Exercise protocol tool error. Exercise protocol tool error. Exercise protocol Exercise protocol is represent-
representative of the relevant not representative of the rel- not representative of the rel- is representative of the ative of the relevant exercise
exercise modality nor valid evant exercise modality nor evant exercise modality nor relevant exercise modality modality and includes both
to real-world context valid to real-world context valid to real-world context but limited to a laboratory- laboratory- and field- based
based protocol that is not protocols that are applicable
valid to real-world context to real-world context
Data analytics Analytics not reported or Analytics reported but limited Analytics reported and appro- Analytics reported, appropri- Analytics reported, appropri-
performed to descriptive statistics priate significance or MBI ate significance or MBI tests ate significance or MBI tests
tests provided provided and effect sizes provided, effect sizes included
G. L. Close et al.
included and presentation of individual
responses to treatment inter-
vention if appropriate
Table 1 (continued)
From Paper to Podium: Quantifying the Translational Potential of Performance Nutrition Research
Score −2 −1 0 +1 +2
Having assessed the relevant paper from a research design perspective, the below criteria evaluate the feasibility of application in relation to the practitioner’s chosen sporting context
Feasibility of application Outside the budget constraints Could be within budget Within budget constraints, Cheap to implement, simple to Cheap to implement, extremely
of the organisation. Complex constraints but complex to reasonable to implement and implement and good chance simple to implement and min-
to implement, e.g. daily long implement and low chance some chance of compliance of compliance imal risk of non-compliance
term supplementation and of compliance
low chance of compliance
Risk/reward High risk in terms of anti- Minimal risk in terms of Minimal risk in terms of Minimal risk in terms of anti- Minimal risk in terms of anti-
doping violation or safety of anti-doping violation but no anti-doping violation and doping violation and safety doping violation and safety
the intervention. No safety safety data available. Poten- safety data available. Some data available. Low risk of data available. Solid evidence
data available. Potential to tial to impair performance potential side effects, e.g. GI side effects that may reduce of no side effects and optimal
impair performance through through high risk of adverse discomfort that may reduce performance. Optimal dose dose clear
high risk of adverse side side effects. Optimum dose performance. Optimal dose suggested but unclear
effects. Optimum dose not not stated or unknown suggested but unclear
stated or unknown
Timing of intervention Not age-appropriate. Time Age-appropriate for the Age-appropriate for the ath- Age-appropriate for the ath- Age-appropriate for the athlete.
available for dosing is not athlete. Time available for lete. Time available for dos- lete. Time available for dos- Time available for dosing is
suitable and/or is too close dosing is not suitable and/ ing is not considered optimal ing is not considered optimal considered optimal to be
to the major competition or is too close to the major but could be effective. Time but could be effective. Time effective. Time from the
to warrant testing the new competition to warrant test- from the major competition from the major competition major competition is also suf-
strategy ing the new strategy is not sufficient to warrant is sufficient to warrant test- ficient to warrant testing the
testing the new strategy ing the new strategy. new strategy
Scores Negative score 0 score—low positive Moderate to high positive
Exercise caution when apply- May be an appropriate study score
ing the data in practice to guide implementation An appropriate study to guide
although some caution is practice
needed
Where relevant, the P-2-P Matrix should be used alongside the supporting text in the paper to accommodate the nuances inherent to performance nutrition related research
GI gastrointestinal, MBI magnitude-based inference
S29
20
18/3/19
Sports Med (2018) 48:7–16

https://doi.org/10.1007/s40279-017-0776-1
CURRENT OPINION
Are the Current Guidelines on Caffeine Use in Sport Optimal

for Everyone? Inter-individual Variation in Caffeine
Ergogenicity, and a Move Towards Personalised Sports Nutrition
Craig Pickering1,2 • John Kiely1
Fue doping en altas dosis > 12 ug/ml entre 1984 – 2004

Es ampliamente usado en atletas.
Published online: 29 August 2017
Sus efectos ergogénicos se conocen hace más de 100 años

! The Author(s) 2017. This article is an open access publication
en actividades de resistencia y esfuerzos repetidos.

Abstract Caffeine use is widespread in sport, with a
Key Points
strong evidence base demonstrating its ergogenic effect.
Based on existing research, current guidelines recommend
There is substantial variation between individuals
Efectos: ingestion of 3–9 mg/kg approximately 60 min prior to
when it comes to the performance improvement seen
exercise. However, the magnitude of performance
- Antagonista receptor de adenosina following caffeine ingestion in sport.
enhancement following caffeine ingestion differs substan-
tially between individuals, with the spectrum of responses
These differences are mediated, in part, by genetic
- Aumento liberación NT y frecuencia disparo neuralvariation between individuals.
ranging between highly ergogenic to ergolytic. These
- Estimula liberación adrenalina

extensive inter-individual response distinctions are medi-
Knowledge of this variation could lead to the
ated by variation in individual genotype, environmental
development of improved caffeine usage guidelines
- Altera utilización sustrato energético.
factors, and the legacy of prior experiences partially
for athletes.
mediated via epigenetic mechanisms. Here, we briefly
- Disminuye la percepción de dolor
review the drivers of this inter-individual variation in caf-
feine response, focusing on the impact of common poly-
morphisms within two genes, CYP1A2 and ADORA2A.
Contemporary evidence suggests current standardised
guidelines are optimal for only a sub-set of the athlete 1 Introduction
population. Clearer understanding of the factors under-
pinning inter-individual variation potentially facilitates a 1,3,7-Trimethylxanthine (caffeine) is one of the most
more nuanced, and individually and context-specific cus- widely used performance enhancing drugs. Between 1984
tomisation of caffeine ingestion guidelines, specific to an and 2004, caffeine was banned for in-competition use,
individual’s biology, history, and competitive situation. although only at very high doses (12 lg mL-1). Never-
Finally, we identify current knowledge deficits in this area, theless, this did not deter athletes, with research demon-
along with future associated research questions. strating that 74% of samples tested via the anti-doping
process contained measurable levels of caffeine [1]. Since
the removal of the ban, caffeine use has remained consis-
tent, with measurable levels found in 74% of samples
between 2004 and 2008 [2], illustrating that the use of
& Craig Pickering caffeine is widespread in athletic populations.
craig@dnafit.com The performance enhancing effects of caffeine have
been known for over 100 years [3]. These effects are well
21
1
Institute of Coaching and Performance, School of Sport and
Wellbeing, University of Central Lancashire, Preston replicated in both endurance-based activities [4] and
PR1 2HE, UK repeated high-intensity efforts [5]. Similarly, caffeine
2
Exercise and Nutritional Genomics Research Centre, DNAFit appears to have a positive effect on muscular endurance
Ltd, London, UK
18/3/19
Inter-individual Variation in Caffeine Ergogenicity 13
Metabolizador lento
Downloaded from http://bjsm.bmj.com/ on March 15, 2018 - Published by group.bmj.com

BJSM Online First, published on March 14, 2018 as 10.1136/bjsports-2018-099027
Consensus statement
IOC consensus statement: dietary supplements and

Fig. 1 Genetic and non-genetic factors influencing caffeine ingestion decisions
the high-performance athlete
1. Can the existing research on CYP1A2 and ADORA2A
Ronald J Maughan,1 Louise M Burke,2,3 Jiri Dvorak,4 D Enette Larson-Meyer,5
the performance enhancing effects 6,7 of caffeine in a way that8
be replicated, and can other genes that modify caffeine is matched to their Peterunique
Peeling,
biology.Stuart M Phillips,
In addition, the Eric S Rawson,9 Neil P Walsh,10 Ina Garthe,11
12 13 3,14
ergogenicity be identified? Hans and
awareness from coaches athletesRomain
Geyer, Meeusen,
that sizeable variation Lucas J C van Loon, Susan M Shirreffs,1
15
2. Are there different optimal dosages and timing strate- Lawrence
exists in the response to caffeine ingestionMark
L Spriet, Stuart,16 Alan Vernec,17 Kevin Currell,18 Vidya M Ali,19
may encourage
20 the evolution
gies for different genotypes? Richard GM
them to be more experimental andBudgett,
flexible in Arne Ljungqvist,21 Margo Mountjoy,22,23 Yannis P Pitsiladis,19
3. Does caffeine habituation occur differently across
Torbjørn Soligard,20 Uğur Erdener,19 Lars Engebretsen20
of their caffeine strategies.
genotypes?
4. Does the individual’s sex further alter the modifying Compliance with Ethical Standards
aspect of genotype on caffeine ergogenicity?
For numbered affiliations see ABSTRACT good health by contributing to the required intake
end of article. Nutrition
Conflict of interest Craig usually
Pickering is makes a smallofbut
an employee potentially
DNAFit Ltd, a of specific nutrients, the management of micro-
By answering these questions and creating personalised genetic testing company. He received
valuable no financial
contribution incentives
to successful for the in elite
performance nutrient deficiencies, and the provision of energy
Correspondence to of this manuscript. John Kiely declares that he has no
preparation and macronutrient needs that might be difficult to
Downloaded
caffeine guidelines, athletes will be ablefrom http://bjsm.bmj.com/
to fully maximise onconflict athletes,
March 15, 2018 - Published by and dietary supplements can make a minor
group.bmj.com
BJSM Online First, published on Professor Ronald
March 14, J Maughan,
of interest.
2018 as
School of Medicine, St Andrews
10.1136/bjsports-2018-099027
contribution to this nutrition programme. Nonetheless, achieve through food intake alone. Other specific
University, St Andrews, UK;
Consensus
supplement use is widespread at allstatement
levels of sport. uses of supplements reported by athletes include
ronmaughan@st-andrews.ac.uk Products described as supplements target different direct performance enhancement or the indirect
IOC consensusAccepted
statement:
3 February 2018 dietary supplements and
issues, including (1) the management 123
of micronutrient
deficiencies, (2) supply of convenient forms of energy and
benefits that arise from the provision of support
for hard training, the manipulation of physique, the
the high-performance athleteperformance or (4) indirect benefits such
macronutrients, and (3) provision of direct benefits to
as supporting
alleviation of musculoskeletal pain, rapid recovery
from injury and enhancement of mood.
intense training regimens. The appropriate use of some Some sporting bodies now support the pragmatic
Ronald J Maughan,1 Louise M Burke,2,3 Jiri Dvorak, 4
D Enette
supplements Larson-Meyer,
can benefit
5
the athlete, but11others may use of supplements that have passed a risk-ver-
Peter Peeling,6,7 Stuart M Phillips,8 Eric S Rawson, 9
harm Neil P Walsh,
the athlete’s
10
health,Ina Garthe, and/or livelihood
performance, sus-benefit analysis of being effective, safe and
Hans Geyer,12 Romain Meeusen,13 Lucas J C vanandLoon, 3,14 (if an antidoping rule violation
reputation Susan M Shirreffs,1 results). A permitted for use, while also being appropriate to
the athlete’s age and maturation in their sport. This
Lawrence L Spriet,15 Mark Stuart,16 Alan Vernec,complete
17
Kevinnutritional
Currell,
before decisions22,23
assessment
18
Vidya M should19
Ali, be undertaken
regarding supplement use are19made. review summarises the issues faced by high-per-
20 21
Richard
Downloaded from http://bjsm.bmj.com/ on GM
March 15, 2018 Arne
Budgett, Ljungqvist,
- Published Margo Mountjoy,
Supplements
by group.bmj.com claimingYannis
to directlyP or
Pitsiladis,
indirectly enhance formance athletes and their support team (coach,
Torbjørn Soligard,20 Uğur Erdener,19 Lars Engebretsen 20
performance are typically the largest group of products trainer, nutritionist, physician) when considering
Consensus statement marketed to athletes, but only a few (including caffeine, the use of supplements, with the goal of providing
creatine, specific buffering agents and nitrate) have good information to assist them to make informed
For numbered affiliations see ABSTRACT good health by contributing to the required intake
end of article. Nutrition usually makes a small but potentially of evidence
specific of benefits. However,
nutrients, responsesofaremicro-
the management affected decisions.
18
Table 1 Examples of micronutrients often requiring supplementation in athletes
valuable contribution to (see Larson-Meyer
successful performanceetin al
elite for additional
nutrient information)
by the deficiencies,
scenario of use andthe
and mayprovision
vary widely
of between
energy
Micronutrient Overview
Correspondence to
Diagnosis andathletes,
outcomes and of
dietary supplements can Protocols
insufficiency make a minor and outcomes andindividuals
macronutrient
of
because
supplementation
of factors
needs that include
that might genetics,
be difficult to the WHAT IS A SUPPLEMENT?
Professor Ronald J Maughan, microbiome andfood habitual diet. Supplements intended
School of Medicine, St Andrews contribution to this nutrition programme. Nonetheless, achieve through intake alone. Other specific There is no single definition, either legal or within
Vitamin D It is important in the regulation of No consensus supplement
University, St Andrews, UK;
over the serum use25-hydroxyvitamin
is widespread at allDlevels Supplementation
of sport. of between
usesto of 800
enhance IU and 1000–2000
performance
supplements reported IU/day
should isathletes
bybe thoroughly trialled
include
gene transcription in most tissues, so concentration (the marker of vitamin D status) that recommended to maintain status for the general population. nutritional science, of what constitutes a dietary
ronmaughan@st-andrews.ac.uk Products described as supplements target different in training or simulated competition
direct performance enhancement or the indirect before being used
insufficiency/deficiency affects many body defines deficiency, insufficiency, supplement. The US Congress, for example, in
issues, including (1)sufficiency and a of
the management Supplementation
micronutrient guidelines benefitsare notthatyetarise
in competition. established
Inadvertent
from the in athletes.
ingestion
provisionofof substances
support
systems.42 Accepted 3 February 2018 upper limit.
tolerable Short-term, high-dose framing the 1994 Dietary Supplement Health and
deficiencies, (2) supply of convenient forms of energy and supplementation
forprohibited
hard training, which
under thetheincludes
antidoping
manipulation 50 000 codes that govern
of physique, the
Many athletes are at risk of insufficiency The need to supplement depends on UVB exposure IU/week for 8–16 weeks or 10 000
alleviation IU/day for several weeks may Education Act (DSHEA; https://ods.od.nih.gov/
macronutrients, and (3) provision of direct benefits to elite sportofismusculoskeletal
a known risk of taking pain, rapid
some recovery
supplements.
at various times throughout the year.43 and skin type. performance or (4) indirect benefits such be as
appropriate
supportingfor restoring
from status
injuryinand deficient athletes.
enhancement Careful
of mood. About/DSHEA_Wording.aspx), described a dietary
Protection of the athlete’s health and awareness of
is necessary toSome sporting 44
bodies supplement as:
intense training regimens. The appropriate use of some
monitoring avoid
the toxicity.for
potential harm nowmust support the pragmatic
be paramount; expert
Iron Suboptimal iron status may result from supplements can benefit
Several measures performed simultaneously the athlete, but others may
Athletes who do not maintain use of supplements
professional
adequateopinion that
iron statusandmay have passed
assistance a risk-ver-
need is strongly advised ‘…a product, other than tobacco, which is used in
limited iron intake, poor bioavailability provide the bestharm the athlete’s
assessment and health,
determineperformance,
the and/or livelihood
supplemental sus-benefit
iron at doses before
greater analysis
anthan
athlete of being
theirembarks
RDA effective,
on supplement
(ie, >18 mg/ safe
use. and conjunction with a healthy diet and contains one or
and/or inadequate energy intake, or and reputation
stage of deficiency. Recommended (if an measures:
antidoping rule violation results).and >8
day for women A permitted
mg/day for for men).use, whilewith
Athletes alsoironbeing appropriate to more of the following dietary ingredients: a vitamin,
complete nutritional assessment should be undertaken the athlete’s age and maturation in their sport. This mineral, herb or other botanical, an amino acid, a
excess iron need due to rapid growth, serum ferritin, transferrin saturation, serum deficiency require clinical follow-up, which may include
before decisions regarding supplement use are made. review summarises the issues faced by high-per- dietary substance for use by man to supplement
high-altitude training, menstrual blood iron, transferrin receptor, zinc protoporphyrin, supplementation with larger doses of oral iron supplementation
Supplements claiming to directly or indirectly enhance formance athletes 45 and their support team (coach, the diet by increasing the total daily intake, or a
loss, foot-strike haemolysis, or excess haemoglobin, haematocrit and mean corpuscular along with improved dietary iron intake. Numerous oral iron
INTRODUCTION
performance are typically the largest group of products trainer, nutritionist, physician) when considering concentrate, metabolite, constituent, extract, or
losses in sweat, urine or faeces.45 volume.46 preparations are availableDietary and mostsupplements
are equally effective
are usedas long
by athletes at all levels combinations of these ingredients’.3
marketed to athletes, but only a few (including caffeine, 47 the use of supplements, with the goal of providing
as they are taken. High-dose iron supplements, however, should
creatine, specific buffering agents ►and nitrate)
http:// dx.doi.have
org/10.good of sport, reflecting
1136/ information to assist the them prevalence
to make of their
informeduse in the
notarebe taken unless iron deficiency is present.
evidence of benefits. However, responses bjsports- 2018- 099199
affected wider society. About half of the adult US popula- This definition is unsatisfactory, as it depends on
decisions.
Calcium Avoidance of dairy products and other There is no appropriate indicator
by the scenario of calcium
of use and maystatus. Calcium
vary widely intakes of 1500 mg/day
between tion uses and 1500–2000
some form IU ofvitamin
dietaryD supplements,1 and whether or not a ‘healthy diet’ is consumed. For
calcium-rich foods, restricted energy Bone mineral density scanbecause
individuals may be of indicative
factors that includeare recommended
genetics, the to optimise bone health
although thereinare athletes with low
regional, cultural and economic the purposes of this overview, we define a dietary
intake and/or disordered eating increases of chronic low microbiome andbut
calcium intake, habitual
other diet. Supplements
factors energyintended
WHAT
availability or menstrual
ISdysfunction.
A SUPPLEMENT? 45
differences, a similar
There is no single definition, either legal prevalence is likely
or within in many supplement as the following:
risk of suboptimal calcium status.45 to enhance
including suboptimal performance
vitamin D status and should beTo thoroughly
cite: Maughan RJ,
trialled other countries.
nutritional science, ofAthletes describea adietary
what constitutes range of A food, food component, nutrient, or non-food
in training
disordered eating are alsoorimportant.
simulated competition Burke LM,
beforeDvorak J,
being used et al. 2
Br J Sports Med Epub ahead supplement. different reasons The USforCongress,their supplementfor example, choices,in and compound that is purposefully ingested in addition
Note: Indiscriminate supplementation with any of the above nutrients is notinrecommended.
competition. Inadvertent
Deficiencies ingestion
should of substances
first
of print: be identified
[please through
include Day products
nutritional
framing that Dietary
the assessment,
1994 fit thewhich description
includes Health
Supplement of ‘supplement’
and to the habitually consumed diet with the aim of
17 prohibited under the antidoping codes that govern
Month Year]. doi:10.1136/
dietary intake and the appropriate blood or urinary marker, if available. can target
Education Actvarious
(DSHEA; roles within the od.
https://ods. athlete’s
nih.gov/ perfor- achieving a specific health and/or performance
elite sport is a known risk of taking some supplements.
bjsports-2018-099027 mance
About/ DSHEA_ plan.Wording.
These aspx),include the maintenance
described a dietary of benefit.
Protection of the athlete’s health and awareness of
supplement as:
or prevent further deficiencies can contribute to the the overall In these
potential for harm must be cases, sports
paramount; foods can provide Maughan RJ,
expert a convenient, et al. Br Jalthough
Sports Med 2018;0:1–17. doi:10.1136/bjsports-2018-099027 1
treatment plan. professional opinion and assistance
usually moreCopyright is strongly
expensive, advised alternative ‘…a product,
option other than
foremployer) tobacco,
meeting these which is used in
before an athlete embarks on supplement use.
Article author (or their
conjunction with a healthy diet and contains one or
2018. Produced by BMJ Publishing Group Ltd under licence.
Nutritional assessment of an athlete involves systematic nutrient goals. Table 2 provides anmore overview of products
of the following that fit a vitamin,
dietary ingredients:
protocols that obtain, verify and interpret evidence of nutri- this description and their more common evidence-based
mineral, herb uses.
or other botanical, an amino acid, a
tion-related problems, as well as their causes and significance. dietary substance for use by man to supplement
the diet by increasing the total daily intake, or a
A complete assessment should ideally include a detailed INTRODUCTION medical concentrate, metabolite, constituent, extract, or
and nutritional history, diet evaluation, anthropometry and body
Dietary
Supplements that directly
supplements are used by athletes at all levels
improve sports performance
combinations of these ingredients’. 3
181136/ A few performance-enhancing supplements might, at the present

composition analysis, and biochemical ► http://testing.
dx.doi.org/10. Unlikeofthe
sport,
adreflecting the prevalence of their use in the
bjsports-2018-099199 time, half
wider society. About be of considered
the adult UStopopula-
have anThis adequate
definitionlevel of supportas to
is unsatisfactory, it depends on
hoc use of nutrient supplements taken by athletes as an insurance 1
whether
tion uses some suggest that marginal
form of dietary performance
supplements, and gainsormay not bea ‘healthy
possible. diet’These
is consumed. For
policy, this nutritional assessment should ensure that the although athlete:there are regional, cultural and economic the purposes of this overview, we define a dietary
supplements include caffeine, creatine (in the form of creatine
1. can address the factors that led to the nutrient deficiency, differences, a similar prevalence is likely in many supplement as the following:
monohydrate), nitrate, sodium bicarbonate and possibly also
including ensuring that the To cite: Maughan RJ,
athlete’s
Burke LM, nutrition
Dvorak J, et al. plan countries.
other is Athletes describe a range of A food, food component, nutrient, or non-food
Beta-alanine.
different reasons for their supplement The choices,
mechanisms
2
and ofcompound
action, typical dose, poten-
adequate in energy, macronutrients and
Br J Sports Medmicronutrients
Epub ahead that is purposefully ingested in addition
22
of print: [please include Day tialtheperformance
products that fit description of benefits and known
‘supplement’ side effects
to the habitually consumed of diet
eachwithofthe aim of
2. would benefit from an acute or Month
chronic period of supplemen-
Year]. doi:10.1136/ can target various roles within the athlete’s perfor-
these supplements are summarised in table achieving 3. Performance-en-
a specific health and/or performance
tation to correct and/or preventbjsports-2018-099027
a nutrient deficiency mance and can plan. These include the maintenance
hancing supplements shouldofbe considered
benefit.
only where a strong
understand the appropriate supplementation protocol
evidence
Maughan RJ, base
et al. Br J Sports supports doi:10.1136/bjsports-2018-099027
Med 2018;0:1–17. their use as safe, legal and effective, 1
3. is not at risk for health issues associated with supplement use,
Copyright Article author (or theirand ideally 2018.
employer) after Produced
adequacy by of sports nutrition Group
BMJ Publishing dietaryLtd practices
under licence.
18/3/19
Jugadores de Fútbol profesional
75
Vitamina D
65
55
45
35
26,9 26,5
25
19,5
18,3 16,5
15
Valor deseable > 30 ng/ml

Marzo Junio
Deseable > 30
Jugadores de Fútbol profesional
Ferritina
225
175
125
75
55,4 56,6
47,8 52,8 50,1
25
Valor deseable > 50 ng/ml

Marzo Junio Normales 25 – 400
Deseable > 50
Bajo < 25
23
18/3/19
Downloaded from http://bjsm.bmj.com/ on March 15, 2018 - Published by group.bmj.com
Consensus statement
Table 3 Supplements with good to strong evidence of achieving benefits to performance when used in specific scenarios
Cafeina
Beta-Alanine
Overview Caffeine is a stimulant that possesses well-established benefits for athletic performance across endurance-based situations, and short-term,
supramaximal and/or repeated sprint tasks.
Mechanism Adenosine receptor antagonism; increased endorphin release; improved neuromuscular function; improved vigilance and alertness; reduced the
perception of exertion during exercise29 48
Protocol of use 3–6 mg/kg of body mass (BM), in the form of anhydrous caffeine (ie, pill or powder form), consumed ~60 min prior to exercise49
Lower caffeine doses (<3 mg/kg BM, ~200 mg), provided both before and during exercise; consumed with a CHO source48
Performance Impact Improved endurance capacity such as exercise time to fatigue50 and endurance-based time-trial (TT) activities of varying duration (5–150 min),
across numerous exercise modalities (ie, cycling, running, rowing and others)49
Low doses of caffeine (100–300 mg) consumed during endurance exercise (after 15–80 min of activity) may enhance cycling TT performance by
3%–7%.51 52 from http://bjsm.bmj.com/ on March 15, 2018 - Published by group.bmj.com
Downloaded
During short-term, supramaximal and repeated sprint tasks, 3–6 mg/kg BM of caffeine taken 50–60 min before exercise results in performance
gains of >3% for task completion time, mean power output and peak power output during anaerobic activities of 1–2 min in duration,53 and of
Consensus statement 1%–8% for total work output and repeat sprint performances during intermittent team game activity.54 55
Larger caffeine doses (≥9 mg/kg BM) do not appear to increase the performance benefit,56 and are more likely to increase the risk of negative
Further considerations and
side effects, including nausea, anxiety, insomnia and restlessness.29
potential side effects
Table 3 Supplements withLower
goodcaffeine
to strongdoses,evidence
variationsof achieving
in the timing ofbenefits to performance
intake before when and
and/or during exercise, usedtheinneed
specific
for (orscenarios
lack thereof) a caffeine withdrawal
period should be trialled in training prior to competition use.
Beta-Alanine Caffeine consumption during activity should be considered concurrent with carbohydrate (CHO) intake for improved efficacy.52
Overview Caffeine
Caffeine is aisstimulant
a diuretic that
promoting increased
possesses urine flow, but
well-established this effect
benefits is smallperformance
for athletic at the dosesacross
that have been shown tosituations,
endurance-based enhance and short-term,
performance.57
supramaximal and/or repeated sprint tasks.
Creatine
Mechanism Adenosine receptor antagonism; increased endorphin release; improved neuromuscular function; improved vigilance and alertness; reduced the
Overview Creatine of
perception loading canduring
exertion enhance29 the
acutelyexercise 48 performance of sports involving repeated high-intensity exercise (eg, team sports), as well as the chronic
outcomes of training programmes based on these characteristics (eg, resistance or interval training), leading to greater gains in lean mass and
49
Protocol of use 3–6muscular
mg/kg ofstrength
body mass
and (BM),
power.in58 the
59 form of anhydrous caffeine (ie, pill or powder form), consumed ~60 min prior to exercise
48
Mechanism Lower caffeine doses (<3 mg/kg BM, ~200 mg), provided both before and during exercise; consumed with a CHO source
Supplementation increases muscle creatine stores, augmenting the rate of PCr resynthesis, thereby enhancing short-term, high-intensity exercise
60 50
Performance Impact Improved
capacityendurance capacity
and the ability to such as exercise
perform repeatedtime
boutstooffatigue and endurance-based
high-intensity effort. time-trial (TT) activities of varying duration (5–150 min),
Protocol of use across numerous
Loading phase:exercise modalities
~20 g/day (ie, cycling,
(divided into four equalrunning, days6149
rowingforand5–7others)
daily doses),
62
Maintenance phase: 3–5 g/day (single dose) for the duration of the supplementation period
Low doses of caffeine (100–300 mg) consumed during endurance exercise (after 15–80 min of activity) may enhance cycling TT performance by
Note: concurrent consumption with a mixed protein/CHO source (~50 g of protein and CHO) may enhance muscle creatine uptake via insulin
3%–7%.51 52 10
stimulation.
During short-term, supramaximal and repeated sprint tasks, 3–6 mg/kg BM of caffeine taken 50–60 min before exercise results in performance
Performance Impact Enhanced maximum isometric strength63 and the acute performance of single and repeated bouts of high-intensity exercise (<150 s duration); 53 most
gains of >3% foreffects
pronounced task evident
completion time,
during tasks <30 s13 61 output and peak power output during anaerobic activities of 1–2 min in duration, and of
mean power
54 5558 59
1%–8% for total work output and repeat sprint performances during intermittent team game
Chronic training adaptations include lean mass gains and improvements to muscular strength and power. activity.
64 65
Further considerations and Lesscaffeine
Larger common:doses
enhanced endurance
(≥9 mg/kg BM) doperformance
not appearresulting fromthe
to increase increased/improved protein
performance benefit, 56 synthesis, glycogen storage and thermoregulation
and are more likely to increase the risk of negative
Potential anti-inflammatory and antioxidant effects are noted.66
potential side effects side effects, including nausea, anxiety, insomnia and restlessness.29
Further considerations and No negative health effects are noted with long-term use (up to 4 years) when appropriate loading protocols are followed.67
Lower caffeine doses, variations in the timing of intake before and/or during exercise, and the66need for (or lack thereof) a caffeine withdrawal
potential side effects A potential 1–2 kg BM increase after creatine loading (primarily as a result of water retention 68) may be detrimental for endurance performance
period
or inshould
events be trialled
where the in
BMtraining
must beprior
movedto competition use.(eg, high jump, pole vault) or where athletes must achieve a specific BM target.
against gravity
Caffeine consumption during activity should be considered concurrent with carbohydrate (CHO) intake for improved efficacy.52
Nitrate
Caffeine is a diuretic promoting increased urine flow, but this effect is small at the doses that have been shown to enhance
Overview 57 (NO −) is a popular supplement that has been commonly investigated to assess any benefits for prolonged submaximal exercise69
Dietary nitrate
performance. 3
Creatina 70 71
and high-intensity, intermittent, short-duration efforts.
Creatine
Mechanism Enhances nitric oxide (NO) bioavailability via the NO3−-nitrite-NO pathway, playing an important role in the modulation of skeletal muscle
function72
Overview Creatine loading can acutely enhance the performance of sports involving repeated high-intensity exercise (eg, team sports), as well as the chronic
Nitrate augments exercise performance via an enhanced function of type II muscle fibres73; a reduced ATP cost of muscle force production; an
outcomes
increasedof efficiency
training programmes basedrespiration;
of mitochondrial on these characteristics (eg, flow
an increased blood resistance
to the or interval
muscle; training),
and a leading
decrease to greater
in blood flow to gains in lean mass and
VO2 heterogeneities.74
58 59
Protocol of use muscular strength and power.
High nitrate-containing foods include leafy green and root vegetables, including spinach, rocket salad, celery and beetroot.
− 75
Mechanism Acute performance
Supplementation benefits
increases are generally
muscle creatine seen
stores,within 2–3 hoursthefollowing
augmenting an NO
rate of PCr bolus ofthereby
resynthesis,
3
5–9 mmol (310–560short-term,
enhancing mg). high-intensity exercise
60 periods of NO − intake (>3 days) also appear beneficial to performance70 76 and may be a positive strategy for highly trained athletes,
Prolonged
capacity and the ability to3 perform repeated
−
bouts of high-intensity effort. 77
where performance gains from NO3 supplementation appear harder to obtain.
Protocol of use
Performance impact
Loading phase: ~20 g/day (divided into four equal daily doses), for 5–7 days61
Supplementation has been associated with improvements of 4%–25% in exercise time to exhaustion and of 1%–3% in sport-specific TT
Maintenance phase: 3–5 g/day
performances lasting <40 min(single dose)73for78 the duration of the supplementation period62
in duration.
Note: concurrent consumption
Supplementation is proposedwith a mixedtype
to enhance protein/CHO source
II muscle fibre (~50 g73ofresulting
function, protein inandtheCHO) may enhance
improvement muscle
(3%–5%) creatine uptakeintermittent,
of high-intensity, via insulin
10 exercise of 12–40 min in duration.70 71
team-sport
stimulation.
Evidence is equivocal for any benefit to exercise tasks lasting <12 min.76 79
Performance Impact Enhanced maximum isometric strength63 and the acute performance of single and repeated bouts of high-intensity exercise (<150 s duration); most
Further considerations and The available evidence suggests there appear13to61be few side effects or limitations to nitrate supplementation.
pronounced effects evident during tasks <30 s
There may exist the potential for GI upset in susceptible athletes, and should therefore be thoroughly trialled in training.
58 59
Chronic
There training
appears adaptations include
to be an upper lean
limit to themass gainsof and
benefits improvements
consumption (ie, notogreater
muscular strength
benefit and mmol
from 16.8 power.(1041 mg) vs 8.4 mmol (521 mg)).80
LessPerformance
common: enhanced endurance
gains appear harder toperformance resulting from
obtain in highly trained increased/improved
athletes.77
protein synthesis, glycogen storage and thermoregulation64 65
Beta-alanine Potential anti-inflammatory and antioxidant effects are noted.66
67
Further considerations and
Overview NoBeta-alanine
negative health effectsintracellular
augments are noted with long-term
buffering use having
capacity, (up to 4potential
years) when appropriate
beneficial loading
effects on protocols
sustained are followed.
high-intensity exercise performance.
66 68
Mechanism A potential 1–2 kg BM increase after creatine loading (primarily as a result of water retention ) may be detrimental for endurance performance
A rate-limiting precursor to the endogenous intracellular (muscle) buffer, carnosine; the immediate defence against proton accumulation in the
or incontracting
events where the BM during
musculature must beexercise
moved81against gravity (eg, high jump, pole vault) or where athletes must achieve a specific BM target.
Chronic, daily supplementation of Beta-alanine increases skeletal muscle carnosine content.82
Nitrate
Continued
Overview Dietary nitrate (NO3−) is a popular supplement that has been commonly investigated to assess any benefits for prolonged submaximal exercise69
6 and high-intensity, intermittent, short-duration efforts.70 71 Maughan RJ, et al. Br J Sports Med 2018;0:1–17. doi:10.1136/bjsports-2018-099027
Mechanism Enhances nitric oxide (NO) bioavailability via the NO3−-nitrite-NO pathway, playing an important role in the modulation of skeletal muscle
function72
Nitrate augments exercise performance via an enhanced function of type II muscle fibres73; a reduced ATP cost of muscle force production; an
increased efficiency of mitochondrial respiration; an increased blood flow to the muscle; and a decrease in blood flow to VO2 heterogeneities.74
Protocol of use High nitrate-containing foods include leafy green and root vegetables, including spinach, rocket salad, celery and beetroot.
Acute performance benefits are generally seen within 2–3 hours following an NO3− bolus of 5–9 mmol (310–560 mg).75
Prolonged periods of NO3− intake (>3 days) also appear beneficial to performance70 76 and may be a positive strategy for highly trained athletes,
where performance gains from NO3− supplementation appear harder to obtain.77
Performance impact Supplementation has been associated with improvements of 4%–25% in exercise time to exhaustion and of 1%–3% in sport-specific TT
performances lasting <40 min in duration.73 78
Supplementation is proposed to enhance type II muscle fibre function,73 resulting in the improvement (3%–5%) of high-intensity, intermittent, 24
team-sport exercise of 12–40 min in duration.70 71
76 79
outcomes of training programmes based on these characteristics (eg, resistance or interval training), leading to greater gains in lean mass and
period strength
muscular should beand
trialled in training
power. 58 59 prior to competition use.
52
Mechanism Caffeine consumption
Supplementation increasesduring activity
muscle shouldstores,
creatine be considered
augmenting concurrent
the ratewith carbohydrate
of PCr (CHO)
resynthesis, intakeenhancing
thereby for improved efficacy.high-intensity exercise
short-term,
Caffeine
capacity 60
is athe
and diuretic
57
abilitypromoting increased
to perform urinebouts
repeated flow,ofbut this effect iseffort.
high-intensity small at the doses that have been shown to enhance 18/3/19
Protocol of use performance.
Loading phase: ~20 g/day (divided into four equal daily doses), for 5–7 days61
Maintenance phase: 3–5 g/day (single dose) for the duration of the supplementation period62
Creatine Note: concurrent consumption with a mixed protein/CHO source (~50 g of protein and CHO) may enhance muscle creatine uptake via insulin
stimulation.10
Overview Creatine loading can acutely enhance the performance of sports involving repeated high-intensity exercise (eg, team sports), as well as the chronic
Performance Impact Enhanced maximum isometric strength63 and the acute performance of single and repeated bouts of high-intensity exercise (<150 s duration); most
outcomeseffects
pronounced of training programmes
evident based on sthese
during tasks <30 13 61 characteristics (eg, resistance or interval training), leading to greater gains in lean mass and
58 59
muscular
Chronic strength
training and power.
adaptations include lean mass gains and improvements to muscular strength and power.58 59
Less common: enhanced endurance performance resulting from increased/improved protein synthesis, glycogen storage and thermoregulation64 65
Mechanism Supplementation increases muscle creatine stores, augmenting66the rate of PCr resynthesis, thereby enhancing short-term, high-intensity exercise
Potential anti-inflammatory
60 and antioxidant effects are noted.
capacity and the ability to perform repeated bouts of high-intensity effort.
Further considerations and No negative health effects are noted with long-term use (up to 4 years) when appropriate loading protocols are followed.67
Protocol
potential of use
side effects Loading phase:
A potential 1–2 kg~20
BMg/day (divided
increase afterinto four equal
creatine loadingdaily(primarily
doses), foras 5–7 daysof61 water retention66 68) may be detrimental for endurance performance
a result
or inMaintenance phase:
events where the 3–5
BM g/day
must be moved 62 athletes must achieve a specific BM target.
(single dose)against
for thegravity
duration(eg,ofhigh jump, pole vault)period
the supplementation or where
Nitrate Note: concurrent consumption with a mixed protein/CHO source (~50 g of protein and CHO) may enhance muscle creatine uptake via insulin
10
Overview stimulation.
Dietary nitrate (NO3−) is a popular supplement that has been commonly investigated to assess any benefits for prolonged submaximal exercise69
and high-intensity, intermittent, short-duration
63 efforts.70 71
Performance Impact Enhanced maximum isometric strength and the acute performance of single and repeated bouts of high-intensity exercise (<150 s duration); most
Mechanism Enhances nitric oxide (NO) bioavailability via the13 61NO3−-nitrite-NO pathway, playing an important role in the modulation of skeletal muscle
pronounced effects evident during tasks <30 s
function72 58 59
Chronic
Nitrate trainingexercise
augments adaptations include lean
performance via mass gains andfunction
an enhanced improvements
of typetoII muscular strength
muscle fibres73 and power.
; a reduced ATP cost of muscle force production; an
64 65
Less common:
increased enhanced
efficiency endurance respiration;
of mitochondrial performanceanresulting fromblood
increased increased/improved proteinand a
flow to the muscle; synthesis, glycogen
decrease storage
in blood flow and thermoregulation
to VO 2
heterogeneities.74
66
Protocol of use HighPotential anti-inflammatory
nitrate-containing foods and antioxidant
include effects
leafy green andareroot
noted.
vegetables, including spinach, rocket salad, celery and beetroot.
Acute performance benefits are generally seen within 2–3 hours following an NO3− bolus of 5–9 mmol (310–560 mg).75 67
Further considerations and Prolonged
No negative health effects
− are noted with long-term use (up to 4 years) when appropriate
periods of NO3 intake (>3 days) also appear beneficial to performance70 76 and may
loadingbeprotocols are followed.
a positive strategy for highly trained athletes,
66 68
potential side effects A potential
where 1–2 kggains
performance BM increase
from NOafter
3
− creatine loading (primarily as a result of water
supplementation appear harder to obtain.77 retention ) may be detrimental for endurance performance
Performance impact or in events where
Supplementation has the
beenBMassociated
must be moved against gravityof(eg,4%–25%
with improvements high jump, pole vault)timeor where
in exercise athletes and
to exhaustion mustofachieve
1%–3% a specific BM target.TT
in sport-specific
performances lasting <40 min in duration.73 78
Nitrate Supplementation is proposed to enhance type II muscle fibre function,73 resulting in the improvement (3%–5%) of high-intensity, intermittent,
team-sport exercise of−12–40 min in duration.70 71
Overview Dietary nitrate (NO ) is a popular supplement that has been commonly76investigated to assess any benefits for prolonged submaximal exercise69
Evidence is equivocal3for any benefit to exercise tasks lasting <12
70 71 min. 79
and high-intensity, intermittent, short-duration efforts.
Further considerations and The available evidence suggests there appear to be few side effects or limitations to nitrate supplementation.
Mechanism
potential side effects Enhances
There nitrictheoxide
may exist (NO) bioavailability
potential the NO3−-nitrite-NO
for GI upset inviasusceptible pathway,
athletes, and shouldplaying an important
therefore role intrialled
be thoroughly the modulation of skeletal muscle
in training.
There 72 to be an upper limit to the benefits of consumption (ie, no greater benefit from 16.8 mmol (1041 mg) vs 8.4 mmol (521 mg)).80
appears
function 77
Performance gains appear harder to obtain in highly trained athletes. 73
Nitrate augments exercise performance via an enhanced function of type II muscle fibres ; a reduced ATP cost of muscle force production; an
Beta-alanine increased efficiency of mitochondrial respiration; an increased blood flow to the muscle; and a decrease in blood flow to VO2 heterogeneities.74
Overview Beta-alanine augments intracellular buffering capacity, having potential beneficial effects on sustained high-intensity exercise performance.
Protocol of use High nitrate-containing foods include leafy green and root vegetables, including spinach, rocket salad, celery and beetroot.
Mechanism A rate-limiting precursor to the endogenous intracellular (muscle) buffer, carnosine; − the immediate defence against 75proton accumulation in the
81 seen within 2–3 hours following an NO3 bolus of 5–9 mmol (310–560 mg).
Acute performance benefits are generally
contracting musculature during
− exercise 70 76
Prolonged
Chronic, dailyperiods of NO3 intake
supplementation (>3 days) alsoincreases
of Beta-alanine appear beneficial to performance
skeletal muscle and may82 be a positive strategy for highly trained athletes,
carnosine content.
where performance gains from NO3− supplementation appear harder to obtain.77 Continued
Performance impact Supplementation has been associated with improvements of 4%–25% in exercise time to exhaustion and of 1%–3% in sport-specific TT
6 performances lasting <40 min in duration.73 78 Maughan RJ, et al. Br J Sports Med 2018;0:1–17. doi:10.1136/bjsports-2018-099027
Supplementation is proposed to enhance type II muscle fibre function,73 resulting in the improvement (3%–5%) of high-intensity, intermittent,
team-sport exercise of 12–40 min in duration.70 71
Evidence is equivocal for any benefit to exercise tasks lasting <12 min.76 79
Further considerations and The available evidence suggests there appear to be few side effects or limitations to nitrate supplementation.
potential side effects There may exist the potential for GI upset in susceptible athletes, and should therefore be thoroughly trialled in training.
Downloaded
There appears to befrom http://bjsm.bmj.com/
an upper limit to the benefits ofonconsumption
March 15,(ie,2018 - Published
no greater by16.8
benefit from group.bmj.com
mmol (1041 mg) vs 8.4 mmol (521 mg)).80
Performance gains appear harder to obtain in highly trained athletes.77
Consensus statement
Beta-alanine
Overview Beta-alanine augments intracellular buffering capacity, having potential beneficial effects on sustained high-intensity exercise performance.
Table 3 Continued
Mechanism A rate-limiting precursor to the endogenous intracellular (muscle) buffer, carnosine; the immediate defence against proton accumulation in the
Beta-Alanine contracting musculature during exercise81
Chronic, daily supplementation of Beta-alanine increases skeletal muscle carnosine content.82
Coffeine
Continued
Protocol of use Daily consumption of ~65 mg/kg BM, ingested via a split-dose regimen (ie, 0.8–1.6 g every 3–4 hours) over an extended supplement time frame of
82
10–12 weeks
6 Performance impact Maughan RJ,
Small, but potentially meaningful performance benefits (~0.2%–3%) et al.bothBr Jcontinuous
during Sports Medand2018;0:1–17. doi:10.1136/bjsports-2018-099027
intermittent exercise tasks of 30 s to 10 min in
duration82–84
Further considerations and A positive correlation between the magnitude of muscle carnosine change and performance benefit remains to be established.82
potential side effects Large interindividual variations in muscle carnosine synthesis have been reported.85
The supplement effectiveness appears harder to realise in well-trained athletes.86
There is a need for further investigation to establish the practical use in various sport-specific situations.82 87
Possible negative side effects include skin rashes and/or transient paraesthesia.
Sodium bicarbonate
Overview Sodium bicarbonate augments extracellular buffering capacity, having potential beneficial effects on sustained high-intensity exercise performance.
Mechanism Acts as an extracellular (blood) buffer, aiding intracellular pH regulation by raising the extracellular pH, and HCO3− concentrations81 88
The resultant pH gradient between the intracellular and extracellular environments leads to efflux of H+ and La− from the exercising muscle.88 89
Protocol of use Single acute NaHCO3 dose of 0.2–0.4 g/kg BM, consumed 60–150 min prior to exercise90 91
Alternative strategies include the following:
Split doses (ie, several smaller doses giving the same total intake) taken over a time period of 30–180 min92
Serial loading with 3–4 smaller doses per day for 2–4 consecutive days prior to an event93–95
Performance impact Enhanced performance (~2%) of short-term, high-intensity sprints lasting ~60 s in duration, with a reduced efficacy as the effort duration exceeds
10 min90
Further considerations and Well-established GI distress may be associated with this supplement. 25
potential side effects Strategies to minimise GI upset include the following:
96
Table 3 Continued
18/3/19
Beta-Alanine
Coffeine
Protocol of use Daily consumption of ~65 mg/kg BM, ingested via a split-dose regimen (ie, 0.8–1.6 g every 3–4 hours) over an extended supplement time frame of
10–12 weeks82
Performance impact Small, but potentially meaningful performance benefits (~0.2%–3%) during both continuous and intermittent exercise tasks of 30 s to 10 min in
duration82–84
Further considerations and A positive correlation between the magnitude of muscle carnosine change and performance benefit remains to be established.82
potential side effects Large interindividual variations in muscle carnosine synthesis have been reported.85
The supplement effectiveness appears harder to realise in well-trained athletes.86
There is a need for further investigation to establish the practical use in various sport-specific situations.82 87
Possible negative side effects include skin rashes and/or transient paraesthesia.
Sodium bicarbonate
Overview Sodium bicarbonate augments extracellular buffering capacity, having potential beneficial effects on sustained high-intensity exercise performance.
Mechanism Acts as an extracellular (blood) buffer, aiding intracellular pH regulation by raising the extracellular pH, and HCO3− concentrations81 88
The resultant pH gradient between the intracellular and extracellular environments leads to efflux of H+ and La− from the exercising muscle.88 89
Protocol of use Single acute NaHCO3 dose of 0.2–0.4 g/kg BM, consumed 60–150 min prior to exercise90 91
Alternative strategies include the following:
Split doses (ie, several smaller doses giving the same total intake) taken over a time period of 30–180 min92
Serial loading with 3–4 smaller doses per day for 2–4 consecutive days prior to an event93–95
Performance impact Enhanced performance (~2%) of short-term, high-intensity sprints lasting ~60 s in duration, with a reduced efficacy as the effort duration exceeds
10 min90
Further considerations and Well-established GI distress may be associated with this supplement.
potential side effects Strategies to minimise GI upset include the following:
Coingestion with a small, carbohydrate-rich meal (~1.5 g/kg BM carbohydrates)96
Use of sodium citrate as an alternative97
Split dose or stacking strategies93–95
Given the high potential for GI distress, thorough investigation into the best individualised strategy is recommended prior to use in a competition
setting.
ADVERSE EFFECTS of supplements. According to the 1994 DSHEA (https://ods.od.

Adverse effects from the use of supplements may arise from a nih.gov/About/DSHEA_Wording.aspx) passed by US Congress,
number of factors, including the safety and composition of the nutritional supplements sold in the USA that do not claim to
product per se and inappropriate patterns of use by athletes. diagnose, prevent or cure disease are not subject to regulation
Poor practices by athletes include the indiscriminate mixing and by the Food and Drugs Administration (FDA). Similar regu-
matching of many products without regard to total doses of some lations apply in most other countries, where supplements are
ingredients or problematic interactions between ingredients. regulated in the same way as food ingredients and are therefore
Even commonly used products may have negative side effects, not subject to the stringent regulations that are applied to the
especially when used outside the optimal protocol. For example, pharmaceutical industry. This means that there is no require-
iron supplementation in those with already
Downloaded adequate iron stores
from http://bjsm.bmj.com/ on March ment to prove
15, 2018 claimedbybenefits,
- Published group.bmj.com no requirement to show safety
can result in symptoms
Consensus statement that may begin with vomiting, diarrhoea with acute or chronic administration, no quality assurance of
and abdominal pain, and develop to haemochromatosis and content, and liberal labelling requirements. It is well-recognised
liver failure.26 Bicarbonate may cause gastrointestinal distress that there are problems with some of the dietary supplements on
Table 4 Nutritional supplements for immune health in athletes: proposed mechanism of action and evidence for efficacy
when ingested in amounts sufficient to enhance performance; sale, but the options open to those responsible for food safety
Supplement Proposed mechanism of action
this can impair rather than improve performance and may coun- Evidence are for efficacyby the legislation that applies. The FDA regularly
limited
teract
VitamintheD benefits ofThis
other
is an supplements taken
essential fat-soluble at the
vitamin knownsame time.27 Moderate
to influence usessupport
its powers to recall products in breach of the regulations,
several aspects of immunity, particularly innate immunity Evidence for deficiency in some athletes and soldiers, particularly in the winter (decreased
The ‘more is better’(eg,philosophy, when applied to caffeine, may although they fully admit that their resources are insufficient
expression of antimicrobial proteins). Skin exposure to skin sunlight exposure)
result in side effects, sunlightincluding
accounts fornausea,
90% of theanxiety, accelerated
source of vitamin D. for comprehensive
Deficiency has been associated monitoring,
with increased URS. and recalls generally occur only
heart rate and insomnia, that outweigh the performance bene- Recommend after many people
1000 IU/day
98
are harmedto maintain
D3 autumn-spring (https://ww w.fda.gov/food/recall-
sufficiency
fits.28 Unwanted outcomes become more common with caffeine Furthersoutbreaksemergencie support required
s/recalls/default. htm): they have recently
Probiotics Probiotics are live micro-organisms that when administered Moderate support in athletes with daily dose of ~1010 live bacteria
doses ≥9 mg/kg body mass, but maximal
orally for several weeks 29
benefits are
can increase the numbers of
usually recalled supplement products containing excessive doses of vita-
Cochrane review of 12 studies (n=3720) shows ~50% decrease in URS incidence and ~2 day
achieved with intakes of 3–6
beneficial mg/kg.
bacteria The
in the gut. possibility
These have minsofA,URS;D,minor
of more shortening
been associated B6 and selenium because of potentially toxic levels
side effects.
serious outcomes iswith illustrated
a range of by adverse,
potential benefitsand potentially
to gut as Moreof
fatal,
health, as well theseis required
evidence components.
supportingExamples of gastrointestinal
efficacy to reduce product complaints
distress and have
23 99
modulation of immune function.
responses in two separate incidents in which very large doses infection, for example,
included in a travellingofathlete.
the presence impurities, including lead, broken glass
Vitamin C This is an essential water-soluble antioxidant vitamin
(up to 30 g) of caffeine were administered to healthy volunteers Moderate and support
metalforfragments,
‘preventing URS’
because of the failure of the producers to
that quenches ROS and augments immunity. It reduces Cochrane review of 5 studies in heavy exercisers (n=598) shows ~50% decrease in URS
participating in laboratory
interleukin-6studies (http://www.
and cortisol responses to telegraph. co.uk/ takingobserve
exercise in humans. vitamin C good
(0.25–1.0manufacturing
g/day). practice. The risk of gastrointes-
news/2017/01/25/university-fined-400k-students-taking-part- Furthertinal upset
support because of poor hygiene during the production and
required
caffeine-experiment/). These incidents were due to errors in Unclear if antioxidants
storage blunt adaptation
of products is alsoinofwell-trained
concern. Although this may seem
Relatively small effects on cortisol compared with carbohydrate; immune measures no
the dose calculation: if this can happen in a university research different a minor inconvenience,
from placebo
and of similarity to food safety issues,
environment with supposed oversight by experienced staff, the No support the coincidence
for ‘treating URS’ of problems around a crucial training period or
potential clearly exists for similar errors by athletes and coaches. Cochrane competitive
reviews showevent mayof significantly
no benefit initiating vitamininterfere with the
C supplementation (>200athlete’s
mg/day)
onset of URS.100 101
Athletes and members of their support team should be aware after performance goals. It should be noted, though, that all of these
Carbohydrate (drinks, It maintains blood glucose during exercise, lowers stress Low-moderate support
ofgels)the regulations that govern the manufacture and marketing Ingestion
hormones, and thus counters immune dysfunction.
problems are also regularly reported in normal foods.
of carbohydrate (30–60 g/hour) attenuates stress hormone and some, but not all,
immune perturbations during exercise.
Maughan RJ, et al. Br J Sports Med 2018;0:1–17. doi:10.1136/bjsports-2018-099027Very limited evidence that this modifies infection risk in athletes19 102 7
Bovine colostrum First milk of the cow that contains antibodies, growth Low-moderate support that bovine colostrum blunts the decrease in saliva antimicrobial
factors and cytokines proteins after heavy exercise
Claimed to improve mucosal immunity and increase Some evidence in small numbers of participants that bovine colostrum decreases URS
resistance to infection Further support required103 104
Polyphenols, for These are plant flavonoids. In vitro studies show strong Low-moderate support
example, Quercetin anti-inflammatory, antioxidant and antipathogenic Human studies show some reduction in URS during short periods of intensified training and
effects. Animal data indicate an increase in mitochondrial mild stimulation of mitochondrial biogenesis and endurance performance, although in small
biogenesis and endurance performance. numbers of untrained subjects. 26
Limited influence on markers of immunity
Putative antiviral effect for Quercetin

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18/3/19

Dr. Jorge Cancino L. PhD.

Toda condición que mejore

Toda condición que empeore

El suplemento ideal tiene que ser:

Suplementos Nutricionales para la

Los Quackery nutricionales

Rev Andal Med Deporte. 2016;9(3):99–104

Consumo, características y perfil del consumidor de suplementos

información del artículo r e s u m e n

Consumption, characteristics, and profile: Consumers of nutritional

∗ Autor para correspondencia.

CONSUMO DE SUPLEMENTOS NUTRICIONALES EN GIMNASIOS, PERFIL DEL CONSUMIDOR Y CARACTERÍSTICAS DE SU USO

Consumo de suplementos nutricionales según tipo de educación del usuario

CONSUMO DE SUPLEMENTOS NUTRICIONALES EN GIMNASIOS,

NUTRITIONAL SUPPLEMENT INTAKE IN GYMNASIUM,

Fernando Rodríguez R. (1), Mirta Crovetto M. (2) Andrea González A. (2),

(1) Escuela de Educación Física, Facultad de Filosofía y Educación,

INTRODUCCIÓN El crecimiento de la industria de gimnasios en Chile,

Rev Chil Nutr Vol. 38, Nº2, Junio 2011

Fernando Rodríguez R. (1), Mirta Crovetto M. (2) Andrea González A. (2),

(1) Escuela de Educación Física, Facultad de Filosofía y Educación,

Análisis del uso de suplementos nutricionales

292 Arch Med Deporte 2018;35(6):

THE AIS SPORTS

Overview of Sub-categories Examples

Evidence level: Sports foods Sports drink

Overview of Sub-categories Examples

Evidence Level: Food polyphenols Cherries, berries and

Overview of category Subcategories Examples

Evidence Level: Category A and B products See list for Category A

May be permitted for use by

Overview of category Subcategories Examples

Beta-2 agonists Higenamine

Other Colostrum – not

Qué suplemento podría ayudar en la economía de carrera?

Received: 21 October 2016; Accepted: 30 December 2016; Published: 6 January 2017

Keywords: nutrition; sport; exercise; nitric oxide; physical activity

Keywords: nutrition; sport; exercise; nitric oxide; physical activity

stomach. NO3 3 and

endogenously produced by synthesizing nitric oxide from L-arginine oxidation.

Nutrients 2017, 9, 43; doi:10.3390/nu9010043 www.mdpi.com/journal/nutrien

The performance benefits are particularly seen

(a) 1.6 therefore the creation of a nitrate-depleted beetroot ju

Sports Med (2014) 44 (Suppl 1):S35–S45

longer following nitrate supplementation (8.2 ±

The lack of effect

100 g = 4 mMol o 250 mg

Peak es obtenido 2-3 horas luego

• Acute supplementation with beetroot juice may have an ergogenic effect on

Sports Medicine (2019) 49 (Suppl 1):S25–S37

From Paper to Podium: Quantifying the Translational Potential

Published online: 22 January 2019

The field of sport nutrition has evolved substantially dur-

whether the study is intended as ‘purely’ mechanistic (e.g.

Sports Med (2018) 48:7–16

Are the Current Guidelines on Caffeine Use in Sport Optimal

Fue doping en altas dosis > 12 ug/ml entre 1984 – 2004