# Fundamentals of Human Nutrition/Ergogenic Aids
## Ergogenic Aids

Many substances, objects, or treatments are ergogenic, meaning work enhancing. Ergogenic aids are substances, devices, practices, or treatments that improves athletic or physical performance. Ergogenic aids can improve physical functions, as well as mental functions by removing psychological constraints that may impact physical performance. Some ergogenic aids have harmful side-effects and some have even been banned in professional sports. Ergogenic aids can come in many forms, ranging from very simplistic techniques or processes to drug supplementation. Forms of ergogenic aids include physiological, psychological, mechanical, pharmacological, and nutritional aids.
Dietary Supplements that Perform as Claimed
Convenient dietary supplements
These supplements include energy bars, gels, and drinks, and liquid meal replacers. Convenient dietary supplements provide extra energy and can be useful before competition. However they do not provide complete nutrition and should be used as supplements and not as a replacement for food.
Caffeine
Caffeine can enhance endurance and support high intensity exercise for short durations. It also improves alertness and can reduce fatigue. Caffeine also appears to spare glycogen by releasing fatty acids in the blood and triglycerides in muscles. (Graham & Lawrence, 1996) However, caffeine can cause side effects such as headache, nervousness, and stomach discomfort. The NCAA restricts caffeine use for athletes.
Creatine
Creatine improves high intensity, repetitive exercise but does not help with endurance exercise. Creatine can also increase muscle mass and strength, along with its glycogen capacity. Creatine cause weight gain. It is quite widely used among athletes. There do not appear to be negative side effects however long term effects are unclear and those with kidney disease may be at risk. Some have claimed that can cause heat illness however tests do not suppor such claims. (Rawson & Clarkson, 2003)
Sodium Bicarbonate
Sodium bicarbonate neutralizes acid and carbon dioxide produced during high intensity activity when taken before activity. This causes exercise capacity to increase, however it may also cause diarrhea.
Beta-alanine
Beta-alanine raises the concentration of carnosine, a buffer, in muscles. This is helpful for high intensity activity. A potential side effect is a “pins and needles” sensation.
Dietary Supplements that May Perform as Claimed
Beta-hydroxymethylbutyrate
Beta- hydroxymethylbutyrate increases muscle strength and size in untrained athletes. It is unclear if supplements are beneficial in trained individuals.
Ribose
Ribose is claimed to raise ATP levels and improve performance. Ribose plays a role in ATP synthesis in muscle however research does not support these claims.
Dietary Supplements that Do Not Perform as Claimed
Carnitine
Carnitine helps to transfer fatty acids across membranes of the mitochondria. It is claimed to raise fatty acid oxidation however supplements do not increase concentrations in muscle cells.
Chromium picolinate
Chromium plays a role in carbohydrate and lipid metabolism. Some say chromium picolinate is more absorbable than regular chromium. They also claim it increases strength and decreases fat. These claims however are unsupported. Banned Supplements

### Pharmacological Aids

Pharmacological ergogenic aids can be described as drugs, both legal and illegal, that are used to enhance physical performance. Pharmacological aids are commonly used by athletes of various sports competitions in order to gain a more competitive edge. They should be used with caution as pharmacological aids can have harmful side-effects and can potentially be dangerous or life-threatening when abused. Before taking a pharmacological aid, it is important to conduct research to find out the effectiveness of the drug, any possible side effects, and if the drug is legal.
Common examples of pharmacological ergogenic aids include:
* Amphetamines – Improves concentration, decreases fatigue and appetite
* Anabolic steroids – Increases training time and intensity of workouts, as well as reduces recovery time.
* Beta-hydroxymethylbutyrate (HMB) – Improves strength and muscle mass
* Creatine – Increases muscle energy, short term endurance, strength, and lean muscle mass
* Caffeine – Stimulates the central nervous system, increases focus and alertness.
* Carnitine – Claimed to increase fat metabolism
* Chromium picolinate – Falsely promoted to build muscle, enhance energy, and burn fat
* Dehydroepiandrosterone (DHEA) – Increases endogenous steroid production
* Human growth hormone (hGH) – Hormone naturally produced in the pituitary gland that regulates growth and development.
Harmful and Illegal Pharmacological Ergogenic Aids
Laws and regulation prohibit a number of ergogenic aids in non-medically prescribed circumstances; a fair amount of ergogenic aids have also been banned by major sporting commissions such as the Olympic commission due to their ability to increase athletic performance or due to the negative effects that they may have on a player (Krans, 2014). Some of these “banned” substances included HGH, anabolic steroids, and Ephedrine. A more descriptive and full list will be found below:
Anabolic and other steroids:
Steroids are a class of drugs that are usually injected or taken orally. They are sometimes prescribed for medical conditions, but, when abused, are usually taken in amounts that exceed normally dosing by 10 to 100 times. Anabolic-Androgenic steroids, as they are formally known, are often used by athletes to increase strength and muscle mass, however, there are numerous side effects that can result in irreversible changes to the body and even prove fatal, such as heart enlargement (Piccoli, 1991.) Another widely used steroid is known as DHEA, or androstenolone, is a widely present steroid hormone in humans. It is often used as an ergogenic aid to increase strength and improve body composition. Like anabolic steroids, side effects include an increased risk of diabetes and cardiovascular disease, which is why they are banned among sport commissions (Medscape, 2010.)
Ephedrine:
Ephedrine is a Central Nervous System stimulating drug that can be used to simulate adrenaline in human body. This often results in a decrease in fatigue, which is why numerous athletes have used it as a performance-enhancing drug. Ephedrine can also be found in a number of prescription class drugs such as antihistamines (Gilles et al., 1996.) Harmful side effects of Ephedrine include stroke, psychosis, and death.
Human Growth Hormone (HGH):
HGH is a man-made growth hormone that was originally synthesized to aid children with growth deficiencies. It is still used today to treat disorders such as HGH Deficiency, premature birth, and Turner's syndrome. However, due to its effects that include regulation of body composition, muscle and bone growth, and sugar and fat metabolism it has become a popular drug among those looking for an athletic “edge.” Not only has it been banned due to its performance-enhancing capabilities, but it also comes along with numerous side effects, such as nerve pain, raised cholesterol, and edema, that can prove dangerous (WebMD, 2014.)
Blood Doping:
Probably one of the better-known ergogenic aids in the media recently is known as blood doping, which is the injection of red blood cells into the blood stream. The effect this has is that there is a higher concentration of blood carrying cells in the body, which can increase a person's aerobic capacity (Also known as VO2 Max.) Blood doping is more of a category than an actual aid as it encompasses blood doping aids such as EPO, Hypoxia-inducible factor stabilizers, and Darbepoetin Alfa (Lunby, 2011.) Some of the adverse effects of blood doping include decreased cardiac output, blood contamination, and decreased liver function.
Anabolic steroids
The anabolic steroids are the most dangerous of these supplements. They are related to testosterone and increase lean body mass and strength. Negative side effects include aggression, hostility, baldness, heart disease and liver damage. Use by adolescents can hinder growth. (Yesalis & Bahrke, 2015)
DHEA and Androstenedione
DHEA (dehydroepiandrosterone) and androstenedione are adrenal gland hormones and precursors for testosterone. They are claimed to build muscle but these claims are unsupported. These substances can cause acne, aggression, testicular shrinkage, and liver damage.
hGH
Human growth hormone is hormone produced by the pituitary gland. Supplements promote lean tissue growth. Supplementation can cause several side effects including diabetes, heart disease, thyroid disorder, and acromegaly. In acromegaly bones and organs grow too much.

### Nutritional Aids

Ergogenic aids are defined as “substances or treatments that purportedly improve athletic performance above and beyond what is possible through training”(Whitney).. Nutritional aids are one of the more common types of the various ergogenic aids. This section of ergogenic aids are used by many athletes, usually professional, primarily to “[enhance] performance at increasing lean body mass or muscle mass by stimulation of protein synthesis and at reducing body fat content” (Maughan 2009). In addition to these helpful aspects, supplements that help to ward off infection and disease can help to aid in performance indirectly. Although not defined as ergogenic aids, these can help by reducing the risk of illness and therefore reduce interruptions from training (Maughan 2009).
Many of the nutritional aids can help enhance performance and work as they claim to. Others may work as they claim to and many others fall under the category of not performing how they claim. (Whitney)
Perform as Claimed Caffeine: Caffeine is readily available and can be an effective ergogenic supplement. Considered a stimulant, caffeine is thought to increase alertness and improve reaction time. (Brolinson). It can help with fast intense training, as well as longer, more endurance based training. Caffeine stimulates the release of fatty acids during endurance activities but does not reduce muscle glycogen use. In fact some use caffeine because it can increase the circulation FFA in the blood in order to "spare" glycogen because it alters the utilization of substrates. (Thein). In addition to sparing glycogen use, because caffeine is a stimulant, it can enhance alertness and reduce fatigue and in turn can increase performance. Too much caffeine can cause adverse affects and intake should be monitored. (Whitney)
Creatine: Studies show that creatine is one of the most popular ergogenic aids used throughout sports right now. Supplementing with creatine can replenish phosphocreatine stored in the muscles when it combines with the phosphate in the muscles this in increases “turnover of adenosine triphosphate during exercise involving short, intermittent bursts of anaerobic activity (Brolinson).” It primarily is used for high intensity activities because in the long, run high intensity training can actually make muscles adapt and in turn, perform better. In fact, there is evidence that shows that emphasis on short-term high-intensity exercise can be improved by supplementation” (Maughan 2009). Although creatine has been found effective in short term intensity workouts, it does not help to improve endurance. Specifically, creatine is a more effective ergogenic supplement in increasing muscle strength and size, and cell hydration. (Maughan 2009)
Sodium Bicarbonate: Sodium bicarbonate is an ergogenic supplement that can be very effective. When ingested it can actually enhance exercise capacity by neutralizing some of the carbon dioxide that builds up in the body during exercise. The recommended dosage is .3 g per kilogram body weight. (Whitney) Although it can be very helpful it is warned that there is a “significant risk of adverse gastrointestinal side effects” (Maughan 2009).
P. Gunnar Brolinson, Nancy Clark, Mark S. Juhn, Matthew D. Vukovich(2004). Nutrition Supplements as Ergogenic aids. Patient Care for the Nurse Practitioner. Jan 15, 2004 pNA.
R. J. Maughan (1999). Nutritional ergogenic aids and exercise performance. Nutrition Research Reviews, 12, pp 255–280. doi:10.1079/095442299108728956.
Whitney, Eleanor Noss, and Sharon Rady Rolfes. "MindTap - Cengage Learning." MindTap - Cengage Learning. N.p., n.d. Web. 10 July 2015.
Thein, Lori A., Jill M. Thein, and Gregory L. Landry. "Ergogenic aids." Physical Therapy May 1995: 426+.Student Resources in Context. Web. 9 Dec. 2015.
Nutritional ergogenic aids generally consists of organic substances used to enhance physical performance and are typically a healthy alternative to pharmacological aids. Nutritional ergogenic aids can vary from alterations of the fluid, carbohydrate, fat, and protein content in a diet, to nutrient and food supplements in various form of tablets, liquids, bars, injections or powders. Common examples of nutritional aids include protein, carbohydrates or fat in the form of powders or bars, sports drinks such as Gatorade, as well as vitamins and minerals.
Nutritional aids can be classified as:
* Products that enhance physical performance, specifically strength, speed, power, or endurance.
* Products that change body composition.
* Products that enhance recovery.

### References

Bell, D., Jacobs, I., & Zamecnik, J. (1998). Effects of caffeine, ephedrine and their combination on time to exhaustion during high-intensity exercise. European Journal of Applied Physiology, 427–433.
HGH (Human Growth Hormone): Uses and Side Effects. (n.d.). Retrieved December 2, 2015, from http://www.webmd.com/fitness-exercise/human-growth-hormone-hgh
Jelkmann, W., & Lundby, C. (2011). Blood doping and its detection. Blood, 2395–2404.
DHEA: Dehydroepiandrosterone (2000). Retrieved December 2, 2015, from http://www.medscape.com/viewarticle/406925
Piccoli, B., Giada*, F., Benettin, A., Sartori*, F., & Piccolo, E. (n.d.). Anabolic Steroid Use in Body Builders: An Echocardiographic Study of Left Ventricle Morphology and Function. International Journal of Sports Medicine Int J Sports Med, 408–412.
Charles E. Yesalis & Michael S. Bahrke (2015). Anabolic Steroids. American College of Sports Medicine. Retrieved from https://www.acsm.org/docs/current-comments/anabolicsteroids.pdf
Terry E. Graham & Lawrence L Spriet (1996). Caffeine and Exercise Performance. Gatorade Sports Science Institute, 9 (1). Retrieved from http://www.gssiweb.org/Article/sse-60-caffeine-and-exercise-performance
Eric S. Rawson & Priscilla M. Clarkson (2003). Scientifically Debatable: Is Creatine Worth Its Weight. Gatorade Sports Science Institute, 16 (4). Retrieved from http://www.gssiweb.org/Article/sse-91-scientifically-debatable-is-creatine-worth-its-weight
Bell, D., Jacobs, I., & Zamecnik, J. (1998). Effects of caffeine, ephedrine and their combination on time to exhaustion during high-intensity exercise. European Journal of Applied Physiology, 427–433.
HGH (Human Growth Hormone): Uses and Side Effects. (n.d.). Retrieved December 2, 2015, from http://www.webmd.com/fitness-exercise/human-growth-hormone-hgh
Jelkmann, W., & Lundby, C. (2011). Blood doping and its detection. Blood, 2395–2404.
Piccoli, B., Giada*, F., Benettin, A., Sartori*, F., & Piccolo, E. (n.d.). Anabolic Steroid Use in Body Builders: An Echocardiographic Study of Left Ventricle Morphology and Function. International Journal of Sports Medicine Int J Sports Med, 408–412.
Ergogenic Aids: Nutritional Supplements for Athletes (2007, August 8). Retrieved November 30, 2015,from http://www.mckinley.illinois.edu/handouts/ergogenic_aids.html
Ergogenic Aids (n.d.) Retrieved November 30, 2015, from http://www.getfit.net/body/physiology/ergogenic/index.htm
Pharmacological Ergogenic Aids (n.d.) Retrieved November 30, 2015, from http://www.getfit.net/body/physiology/ergogenic/pharmacological.htm
Nutritional Aids (n.d.) Retrieved November 30, 2015, from http://www.thefitmap.com/body/physiology/aids/nutritional/index.htm
Pharmacological Aids (n.d.) Retrieved November 30, 2015, from http://www.thefitmap.com/body/physiology/aids/pharmalogical/index.htm
Whiteney, E., & Rolfes, S. (2013). Supplements as Ergogenic Aids. Understanding Nutrition (14th ed.). Belmont, CA: Thomson/Wadsworth.