Discussion at the December 2014 Committee on Competitive Safeguards and Medical Aspects of Sports (CSMAS) meeting included consideration of the dietary protein needs of collegiate student-athletes. The Committee requested a joint response from the Sports, Cardiovascular, and Wellness Nutrition (SCAN) group and the Collegiate and Professional Sports Dietitians Association (CPSDA) regarding the state of the science and the state of practice within collegiate athletics on student-athlete dietary protein needs.
The specific rule under consideration is rule 16.5.2 (g) Nutritional Supplements, and its current designation of muscle-building supplements as impermissible. Part of the interpretation of this rule is that “…Nutritional supplements containing more than 30 percent of calories from protein are classified as muscle-building supplements and may not be provided to student-athletes.” A small working group of SCAN and CPSDA Sports RDs collaborated to answer key questions proposed by CSMAS. Below are the questions/comments and the joint task force response.
1. CSMAS: Updated research on protein needs of student-athletes and best practices for fueling.
The modern view for establishing recommendations for protein intake in athletes extends beyond the Dietary Reference Intakes (DRIs). Focus has clearly shifted to evaluating the benefits of providing enough protein at optimal times to support tissues with rapid turnover and maximize metabolic adaptations initiated by training stimulus.1,2 Dietary protein interacts with exercise, providing both a trigger and a substrate for the synthesis of contractile and metabolic proteins as well as enhancing structural changes in non-muscle tissues such as tendon and bone.1,2
Studies of the response to resistance training show up-regulation of muscle protein synthesis (MPS) for at least 24 hours in response to a single session of exercise, with increased sensitivity to the intake of dietary protein over this period.3 Similar responses occur following aerobic exercise or other exercise types (e.g. intermittent sprint activities and concurrent exercise), albeit with potential differences in the type of proteins that are synthesized.
Current data suggest that dietary protein intake necessary to support metabolic adaptation, repair, remodeling and protein turnover generally range from 1.2 to 2.0 g/kg/d. Higher intakes may be indicated for short periods during intensified training or when reducing energy intake.1,4 For athletes in “making weight” sports, the availability of higher protein food/supplement choices falls in line with recommended strategies for these athletes to achieve a slight energy deficit to achieve a slow rather than rapid rate of loss, while increasing dietary protein intake.
It is well accepted that the two most powerful stimuli of muscle protein synthesis are exercise and nutrition.5 Just one bout of resistance exercise can increase muscle protein synthesis by 40%, and by as much as 150%, but it is also followed by periods of muscle protein breakdown. Muscles need to be “fed” essential amino acids (EAA) in the post-exercise period, to reduce muscle protein breakdown.5 For those athletes who want to build muscle, high quality protein (i.e., one that contains all of the EAAs) consumed after a bout of resistance exercise is the best practice.
For endurance athletes, protein intake after exercise can help to increase mitochondrial proteins which enhances oxygen utilization by working muscles in future exercise bouts.6 The amount of EAA used in studies ranges between 8-10 grams. Phillips et al. examined the amino acid composition of high quality protein foods (milk, meat and eggs) and determined that 10 grams of EAA translates to about 25 grams of each of these proteins.7 Most complete proteins are about 40% EAA; hence the recommendation to consume 20-25 grams of intact, high quality protein after exercise.
Sometimes called the “window of anabolic opportunity,” the post-exercise window can last up to 24 hours, but most researchers agree that early feeding is more advantageous because this is when muscle protein synthesis is greatest.5 In addition, the International Olympic Committee Consensus Statement on Sports Nutrition8 encourages protein consumption in the post-exercise period to aid in long-term maintenance of muscle and bone and to repair tissues damaged by acute exercise. Protein requirements can fluctuate based on “trained” status (experienced athletes requiring less), training (sessions involving higher frequency and intensity, or a new training stimulus at higher end of protein range), carbohydrate availability, and most importantly, energy availability.9
All athletes are individuals. To positively influence the life and health of the student athlete, the mission should be to ensure all athletes have access to the highest quality food sources and ingredients. Providing high quality foods and ingredients is important for the health and performance of the athlete. Institutions should foster an environment that will help athletes implement a nutrition strategy to improve their health and performance. Institutions need the ability to deconstruct nutrition and re-compartmentalize individual macronutrients in a way allows the formulation of the best nutrition support possible for individual athletes.
The following are five common scenarios that demonstrate individual variation in protein requirements of athletes and when it may be prudent to provide a higher percentage of calories from protein:
A. Vegetarian Athletes
Vegetarian and vegan diets can be healthful dietary patterns for some athletes. However, making sure these athletes meet the requirements of nutrients such as calcium, iron, zinc, iodine, vitamin B12, vitamin D, and protein is especially important. Vegetarian collegiate athletes encounter additional challenges in finding high-quality protein sources beyond those of their peers who consume animal protein sources. Many vegetarian collegiate athletes may have limited access to high-quality plant protein. Especially if they are on a campus meal plan, where they may find limited healthy vegetarian options. Social, religious and family beliefs all play a role in a person’s decision to maintain a vegetarian lifestyle and it is the responsibility of each institution to respect and support the needs of this type of lifestyle. Being able to provide a plant-based protein supplement can help these athletes meet their protein needs, while avoiding them from feeling left out or unaccepted by other individuals.10-13
B. Inadequate Nutrient Intake
It is widely known and accepted that athletes require greater macronutrient intake than their inactive peers. Protein needs, for example, must be increased to support gains in lean body mass. According to research, the diets of both male and female athletes were low in both carbohydrates and protein. Male athletes obtained over 30% of total calories from fat, most of those sources being from saturated fat. It has been shown that football players consumed significantly less energy, carbohydrate, protein and fat per kilogram of body weight than male athletes in baseball, track and field and swimming and diving. The study suggests that it may be difficult for athletes with large energy expenditures to consume adequate energy. The reality is that is sometimes easier for an athlete to drink calories instead of eating them. Another challenge is to find solutions for those athletes who skip breakfast. Inadequate protein consumption in the early hours of the day can lead to inadequate energy and protein intake by the end of the day. One study reported only 27% of female student athletes consume breakfast and of those, the main sources of breakfast were cereal and biscuits with sausage.14 For those athletes who do not tolerate breakfast well, a high-quality protein smoothie, individualized for their needs, could provide a viable option.
C. Eating Disorders/Female Athlete Triad
The female athlete triad is defined by three components: 1. low energy availability with or without disordered eating; 2. menstrual dysfunction; and 3. low bone mineral density. An athlete that presents with some or all of these characteristics is at great risk for injury. Low energy availability can lead to protein deficiency which can further lead to deficiencies in iron and zinc. In cases of energy restriction, elevated protein intakes as high as 1.8-2.0 g/kg/day or higher may be advantageous in preventing lean mass loss.1,4 Exercise performance is negatively affected by energy deficits and maximal oxygen consumption has been shown to decrease significantly in elite female athletes during starvation and malnutrition. Many athletes who struggle with eating disorders or disordered eating may avoid carb-rich food and beverages, such as permissible meal replacement shakes, for fear of gaining weight or getting fat. Compliance may be enhanced if we are able to provide a protein supplement that is lower in calories and carbohydrate for athletes at risk.15-18
D. Metabolic Syndrome
Metabolic syndrome is defined by criteria that includes levels of triglycerides, HDL-C, abdominal obesity, glucose and blood pressure. An abnormality in three of these five criteria meets the definition of metabolic syndrome. Sports dietitians must currently choose products with a blend of protein, fat, and carbohydrate, which are often primarily simple sugars. Football lineman are at greatest risk for developing metabolic syndrome and providing a recovery cocktail that is high in simple sugars only increases the risk of developing insulin resistance and abdominal weight gain.19 In a study with 90 division I football players, 8 players met the criteria for metabolic syndrome and 100% of those were lineman.20 In another study, twelve of 62 division I football players presented with metabolic syndrome.21 High-carbohydrate supplements puts an already at-risk population at a greater risk of developing metabolic syndrome. Providing these at-risk athletes with a high protein post-workout supplement, plus complex carbohydrate foods would help decrease the amount of simple sugars consumed in their diets. As health professionals, we are tasked with not only improving the performance of our athletes, but assuring long-term health and quality of life.
E. Injury Recovery-Maintain Muscle Mass
Injuries are, unfortunately, a part of every athlete’s life. Athlete’s often ask if consuming more protein while injured will help speed recovery and prevent the loss of muscle mass that comes from inactivity and/or immobilization. There is very little information on optimal nutrition strategies for athletes recovering from injury. However, it is known that when a limb is immobilized and/or there is little anabolic stimulus to muscle, a net negative muscle protein balance occurs.22 In fact, the initial two weeks of disuse induces the largest relative loss of muscle mass and it is known that healthy, inactive muscle tissue generally atrophies at approximately 0.5% per day.23 Athletes tend to drastically cut calories when injured because they know they are not training and competing as they were before the injury. Cutting calories too drastically can be counterproductive because the healing process requires energy and the energy cost of movement (for example, using crutches) is higher than many athletes believe.22 There is a delicate balance between providing enough energy for healthy while at the same time minimizing body fat accumulation. So, while consumption of high quality protein is important, sufficient energy and micronutrient consumption is even more important to an injured athlete. Wall et al suggest protein intakes of 1.6-2.5 gm/kg during injury and recovery with 4-6 meals per day with protein evenly spaced throughout the day.23 An athlete recovering from an injury while still balancing classes, treatment, and team commitments may be at risk for not consuming these amounts of protein on a frequent basis. Moreover, many athletes lose their appetite or due to the magnitude of the injury (in a sling, on crutches), and preparing food and making the best food choices is often a second thought. As sports dietitians, we must be able to provide a supplement with the appropriate macronutrient breakdown to assist these athletes during this time of stress and recovery.3,23,24
2. CSMAS: A sense of protein intake among student-athletes, are they meeting protein recommendations through diet alone?
Although data on nutrient intake among collegiate athletes is extremely limited and equivocal, it is believed that many athletes fail to eat optimal levels of energy and nutrients to support health and performance.14,25-27 There is even less data about the factors that contribute to suboptimal nutritional intake, although knowledge and beliefs of collegiate athletes may contribute to suboptimal eating.
Jacobson et al.28 found that among collegiate varsity male and female athletes, only 29%, 12%, and 3% correctly identified the carbohydrate, protein and fat requirements of athletes, respectively. The incorrect beliefs that consuming sugar prior to competition will adversely affect performance, that protein supplements are necessary to build muscle, and that protein is a primary energy source for muscle are common.
Studies assessing energy and protein intake of collegiate athletes have been mixed. Fox et al.29 found that although the perception of protein needs of collegiate male athletes exceeded the recommended amount, their intake did not exceed 2.0 g/kg body weight, and in fact, only 19% of male and 32% of female consumed a minimum of 1.5 g/kg body weight of protein. Hinton et al.14 found that only 26 percent of 345 NCAA Division I athletes consumed adequate protein; however the male athletes exceeded the recommended intake of fat, saturated fat, cholesterol and sodium.
The results of a food frequency and dietary behavior questionnaire found the female athletes were consuming the recommended energy intake, while the male athletes were consuming approximately 400 kcals less than the recommended energy intake.14 Likewise, Cole et al.30 surveyed collegiate football players and found they had significantly inadequate energy intake based on estimated needs of 4,000 to 5,000 kcals.
Conversely, Burke et al.31 found female Olympic athletes had lower intakes relative to body mass than male athletes based on the results of 7-day food records. Eating disorders and restrictive eating among female athletes often result in inadequate energy intake.32,33 Female athletes were found to have inadequate energy intakes based on the results of 3-day food records of synchronized skaters.34 Ousley-Pahnke et al.35 analyzed results of a 5-day food recall and found the energy intake of collegiate female swimmers to be below optimal levels while tapering down their training volume for an event.
The bottom line is that we cannot at this time provide an accurate assessment of energy and/or protein intake of collegiate athletes. Documentation of collegiate athletes’ nutritional intake in the future must become a high priority. Achieving adequate total protein intake for the day is not the only consideration for proper recovery and protein synthesis. Even for those athletes who are consuming adequate protein, the timing of protein intake can improve recovery, and subsequent performance.
Burke et al. (2003) assessed 7-day food diaries of Olympic athletes and found athletes participating in weight conscious sports have suboptimal energy intakes during and immediately after exercise. Perhaps the NCAA could develop/fund a monitoring program that would strongly encourage programs to begin tracking the nutritional intake of their student athletes as part of best practices.
3. CSMAS: Is protein supplementation necessary?
Why now, with food deregulation, is there renewed push for higher protein supplementation? Providing optimal, customized nutrition options is part of successful recovery, optimal body composition and weight. Consistently meeting the needs of a diverse student athlete population requires an “arsenal” that includes a mixture of foods, both fresh and shelf-stable, that can be combined into nutritional options to satisfy the nutritional requirements and palate of all athletes; from a 140 lb woman gymnast to a 330 lb football lineman.
The spectrum of nutrient needs presented in this population is quite broad, with daily energy needs ranging from 2200 to 7000+ calories, daily protein needs ranging from 85 to 250 grams, and recovery protein needs ranging from 20 to 70 grams. The addition of whole foods including fruit, milk and yogurt increases flexibility and offers superior options, but the addition of a whey protein or low carbohydrate, low fat protein powder improves options for the large body mass power athletes, like football lineman and throwers, who are vulnerable to metabolic syndrome.
The use of currently permissible protein powders, which have higher sugar and fat content in order to meet the 30% rule, could potentially over-feed this population. Overconsumption of sugar and/or fat builds a palate that must be retrained when collegiate sport participation is over. Inclusion of a lower fat, lower carbohydrate protein powder allows inclusion of whole fruits and grains to supply the carbohydrate, in superior nutritional form, with a better ratio of carbohydrate to protein.
With greater frequency, student athletes are reporting to campus with their own recovery products due to dietary limitations, allergies, intolerances, personal beliefs and environmental concerns. Targeting their needs within their specifications requires use of alternative proteins like soy, almond, cashew and rice-based protein options, and powders are often the simplest means of working within their limitations to cultivate consistent recovery practices. Their needs are best served by nutrition professionals working within their limitations to create optimal recovery nutrition options that are acceptable to the student athlete.
Two extremely important considerations about using protein supplements instead of whole-food protein sources are nutrient density and convenience. The following examples demonstrate the effective use of protein powder to maximize convenience and protein intake with fewer calories.
Examples of 20 grams of protein post workout in 300-500 calorie snack:
- 1 cup smoothie (~8g protein) + 1 protein bar (>10g protein, ~20g carbs)
- 1 Chocolate milk carton + 1 protein bar (>10g protein, ~30g carbs)
- 1 6 inch turkey and cheese sandwich
- 1 English muffin with 2 tbsp. peanut butter and + 1 c. milk/chocolate milk
- 1 10 inch bean, rice, and cheese burrito
- 1/2 baked potato with2 tbsp. low-‐fat sour cream and shredded cheese + 4 oz. grilled chicken breast
- 1 c. cooked pasta with marinara sauce + 1-‐2 meat balls + steamed broccoli/zucchini/bell pepper
- 1 applesauce + 8 fl. oz. low-‐fat chocolate milk + 1 stick low-‐fat string cheese
- 2 Gogurts + 1 cup cereal + 1 cup of milk
- 1 bagel with 2 tbsp peanut butter+ 1 yogurt Examples of 20-25 gram foods + 100 calorie whey protein isolate in 150-275 calorie snack:
- 12 oz fruit smoothie (8 oz 100% fruit juice + 1 cup frozen fruit) with 1 scoop whey protein powder
- 1 cup skim milk mixed with ½ scoop protein powder
- 1 cup oatmeal (1/2 cup cooked) mixed with ½ banana and ¾ cup protein powder
The powder could also be premixed into pancakes/waffles as guided by the sports RD to make grab-‐and-‐go snacks higher in protein.
One last consideration is that athletes may better tolerate a liquid protein meal prior to bed, rather than a whole-food protein that must undergo digestion. Res et al36 looked at protein intake before bed as another way to increase muscle protein synthesis. Some athletes have been ingesting the protein casein (a “slow” protein meaning that it is more slowly digested and absorbed compared to “fast” proteins like whey protein) with the theory that the slow rise in amino acid concentrations during sleep would further augment daytime feeding of protein.
Res and colleagues fed 16 recreation athletes who participated in resistance type strength training. Half the subjects got a water placebo and half got water with 40 grams of casein (both were flavored with non-nutritive sweetener). The results showed that the protein consumed before sleep was well digested and absorbed and that it stimulated the rate of muscle protein synthesis and improved overnight net protein balance.36
4. CSMAS: How feasible is it for athletics administrators to provide protein needs through food alone?
The deregulation of feeding has been incredibly popular among student athletes, sparked dialogue among staff members and administrators, and has enhanced the value of nutrition as a factor of athletic development, performance and well-being. On a practical level, deregulation made the tasks of fueling and recovering student athletes much easier for our athletic departments, but there is a spectrum of budget and applied nutrition expertise that drives how resources are utilized.
All collegiate programs need shelf stable protein options in order to consistently offer recovery via food options. For travel and postcompetition recovery, protein supplements—including powders and protein enhanced nutrition bars—are essential tools for consistently meeting the athletes’ needs as well as optimizing nutrient timing and recovery. Shelf stable products travel well and help limit waste that comes with the addition of food products.
We must also consider budgetary implications. Greek yogurt would be a wise whole-food choice for post-workout recovery needs because it is a concentrated protein food, contains a high amount of leucine, is low-lactose, and easy to combine with carbohydrate into smoothies, etc. Similarly, whey protein is a high-biological value protein that is high in branch-chain amino acids (including leucine), that is nonperishable, typically lactose free, and can be easily mixed with carbohydrate into smoothies, etc. Administering enough Greek yogurt to provide each athlete in a program with 20g of protein would require a significant amount of yogurt.
For example, providing this recovery option to a football team would require 900 ounces of Greek yogurt to recover a standard 105-man roster from one workout (providing each athlete with 8.57 ounces to achieve 20g of protein). Given that most football teams train 5 days/week, each institution would require 4,500 ounces of Greek yogurt each week (or 750 standard 6- oz containers) for football alone.
It is noted in the literature, however, that linemen and heavier athletes may need more than 20g of protein post-workout to achieve adequate g/kg recommendations, which would increase the total need. In addition, a moderately-sized institution rosters around 550 student athletes, requiring 3,927 six-ounce containers of Greek yogurt per week to provide recovery for each athlete (assuming training 5 days per week). Refrigeration for this volume alone would pose a large challenge for most institutions, while the budget necessary for this volume would cripple most programs as well (detailed below).
It should be recognized that a meat source could be used as well, but prep and cooking resources must also then be considered, which complicate the matter. Bulk Greek yogurt ~$0.83/6 ounce container x 3,927 servings to recover 550 athletes = $3,259/week Bulk whey protein ~$0.73 per recovery x 2750 servings to recover 550 athletes = $2,008/week ·∙ This leads to a cost savings of more than $50,000 per year when considering an institution with 550 student-‐athletes who train 5 days/week, assuming 40 training weeks per year.
5. CSMAS: Value of protein in recovery and can this be accomplished through food only?
Research on protein intake in the immediate post-exercise period, or the so called “window of anabolic opportunity” has been confirmed by several researchers. To optimize muscle protein synthesis (MPS) in response to exercise, athletes are guided to consume high biological value protein that provides approximately 10 grams of essential amino acids in the early post exercise recovery phase (immediately to 2h after exercise).2,37
When energy availability is high, MPS is maximized with protein intakes equivalent to 0.25-0.3g/kg bodyweight38, which equates to approximately 15-25 g protein across the typical range of athlete body sizes. The acute peak in MPS is critically dependent on the timing and pattern of protein intake, responds to further intake of protein within the 24-hour period after exercise9, and translates into chronic accretion of muscle protein and functional change.
Longitudinal training studies verify that increases in strength and muscle mass are greatest with immediate post exercise provision of protein.39 The practical recommendation to ingest approximately 15-25g high quality protein (0.3 g/kg body weight), after key exercise sessions and every 3-5 hours over approximately 5 or 6 meals, is prudent to support maximal MPS rates for maximal adaptation and accretion of muscle mass, while being compatible with total daily protein guidelines (g/kg) and other dietary goals.
Areta and colleagues9 hypothesized that consuming protein throughout the recovery period, not just limiting protein consumption to the hour or two after exercise, would be the optimal intervention for muscle protein synthesis. The researchers compared three patterns of protein intake during a 12-hour recovery period after a resistance exercise training session. Twenty-four healthy young men were recruited and all had extensive resistance training for at least 2 years (23 participants were included in the final analysis as one subject was excluded due to a lab error).
The subjects all received 80 grams of protein (whey protein) during the 12 hours after resistance exercise but were randomly assigned to one of three groups: 10 grams of protein every 1.5 hours, 20 grams of protein every 3 hours, or 40 grams of protein every 6 hours. Measures of muscle protein synthesis included muscle biopsy to calculate myofibrillar synthetic rate, muscle signaling responses, and mRNA. Results showed that rates of muscle protein synthesis were highest when protein was consumed with regular intake of 20 grams of protein every 3 hours during the recovery phase.9
The researchers conclude that not only the source of protein (whey protein was used in this study) but the distribution of protein throughout the recovery period maximizes muscle protein synthesis. The authors point out that their results are limited to healthy young men of average body weight and other groups should be studied to confirm the findings. They also note that whey protein was used in this study, a “fast” protein that is rapidly digested, and it is unknown if mixed protein sources from food would elicit the same response.9 Nevertheless, consuming protein regularly consumed appears to be superior to a typical pattern of heavy protein intake at the evening meal (>30 grams) with less protein (<30 grams) consumed at breakfast and lunch.40 High-quality dietary proteins such as whey, casein, and soy are effective for the maintenance, repair, and synthesis of skeletal muscle proteins.41
To date, dairy proteins seem to be superior to other tested proteins, largely due to leucine content and the digestion and absorptive kinetics of fluid-based dairy foods42, but further studies are warranted to assess other intact high-quality protein sources and mixed meals following various modes of exercise. Additionally, it is well established that post-exercise protein can support glycogen restoration, especially when carbohydrate availability is limited.37,43,44 This may support exercise performance and benefit athletes frequently involved in multiple training or competitive sessions over same or successive days.
Although much focus has been on post-workout recovery, recent research has started to assess the ingestion of protein prior to sleep.36,45 Res et al36 looked at protein intake before bed as another way to increase muscle protein synthesis. Some athletes have been ingesting the protein casein (a “slow” protein meaning that it is more slowly digested and absorbed compared to “fast” proteins like whey protein) with the theory that the slow rise in amino acid concentrations during sleep would further augment daytime feeding of protein. Res and colleagues fed 16 recreation athletes who participated in resistance type strength training. Half the subjects got a water placebo and half got water with 40 grams of casein (both were flavored with non-nutritive sweetener).
The results showed that the protein consumed before sleep was well digested and absorbed and that it stimulated the rate of muscle protein synthesis and improved overnight net protein balance.36 Athletes may better tolerate a liquid protein meal prior to bed, rather than a whole-food protein that must undergo digestion. 6. CSMAS: How do we answer the questions about contamination/adulteration/spiking that continue to plague this industry (JAMA article)? We would argue the contamination and lack of regulation of the sports supplement industry would not be impacted whether or not the protein rule is changed.
This is a perseverating problem that began when the federal government minimized the power of the FDA to regulate the industry in 1994 (DSHEA). The topic of quality assurance for sports supplements goes beyond the concern about banned substance. A 2010 review by Consumer Lab found that 31% of the products failed their quality control testing (ConsumerLab.com).
They reported inaccuracies in protein and sugar content, as well as contamination with heavy metals. Sport supplement doping is not uncommon. A recent review by Outram and Stewart46 estimated that between 10-15% of supplements may contain prohibited substances. An international survey of 215 suppliers in 13 different countries found that 14.8% of the products contained prohormones.47 Analysis of 58 supplements from US retail outlets found that 25% contained low levels of steroid contaminants and 11% were contaminated with stimulants.48 Although contamination could have unintentionally occurred due to poor quality control, it is likely that some doping of sports supplements is intentionally executed by unscrupulous manufacturers.
Even more disturbing is that many of these recalled products remain on the shelves. One study found that 66.7% of recalled supplements were still available for purchase more than 6 months after FDA recalled the product adulterated with banned ingredients.49 Two last serious concerns are the tainting of sports supplements with pharmaceutical drugs and traces of anabolic hormones and growth enhancers in the meat supply that are at high enough levels to lead to a failed drug test.50-52 The bottom line is that contamination, adulteration and spiking are concerns with all nutritional products consumed by student athletes, whether provided by the institution or purchased by the student athlete and permissible supplements are not excluded from these concerns.
In fact, as the line between supplements and food products continues to blur, this issue will continue to expand. Education about dietary supplements will need to continue whether or not the institution provides the products. About 90% of 72 surveyed Olympic-level athletes reported using nutritional supplements, with no difference between female and male athletes.53 The majority of supplementing athletes (n = 63) did not know the active ingredient, side effects, or mechanism of action of the supplements they were taking. Only half of the athletes knew the recommended dosage.
This demonstrates that it is better to have a sports RD who has a solid understanding of dietary supplements make decisions about which supplements to provide than the athletes.53 Lastly, although the only way to guarantee that athletes will not test positive for banned substances is for them to completely abstain from taking any dietary supplement, there exists third-party lab testing programs.
Nutrition products distributed by athletic departments are increasingly third-party lab tested, as athletic department professionals seek additional safety in the procurement process. The responsibility to evaluate, procure and distribute clean products falls upon the institution, and is better left in a professional’s hands than relegated to the individual student athlete.
A large body of research supports the vital role of high-quality protein in supporting the health and performance of athletes. If sports dietitians were permitted to provide protein supplements to their athletes, they would more effectively control the amount and type of protein the athletes receive, and precisely match the individual athlete’s nutritional need. Sports dietitians always take a “food first” approach, but protein supplements are a cost-effective, convenient, and well-tolerated option. By having protein supplements as a “tool in the nutritional toolbox”, sports RDs can provide more effective care to the student-athletes.
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