Why you should still be wary of sports supplements

Whether it's bogus claims about performance benefits, or mislabelling of ingredients, runners should be cautious of the sports supplements they take.
Are sports supplements like protein powder useful?

Before I delve into the myriad issues associated with sports supplements, a quick personal note: I rarely take medication. I’m the guy who will turn down a paracetamol when he’s got a throbbing headache (much to my wife’s frustration). I’ll opt instead to chug a litre of water. 

This aversion had also extended to supplements. When I used to workout in my student days (far more regularly than I do now), I never took protein or muscle-building powder.

It’s not that I was strongly against these products (though I was doubtful of their claimed benefits to help me get shredded). I just wasn’t terribly tempted to indulge in gooey-pink, post-workout protein-shakes. Partly because they were always getting stirred-up inside sweaty, smelly locker room. No thanks! 

But now, as a slightly iron-deficient distance runner in my mid-30s — with higher than healthy cholesterol levels — I’ve had to readjust my stance on supplements, somewhat.

Iron (ferritin) tablets are already in the rotation. Next-up: whey protein. Apparently it’s good for cholesterol. And so, on a recent shopping trip, my wife picked up a relatively small, 400g white tub of whey protein. She obviously values the continued functioning of my heart.

I’ve now stared at this white tub of protein for a week. I sprinkled a tiny bit into some healthy, home-made muesli bars; I dropped a tablespoon into a Milo drink; but I’ve yet to mix-up a full-on, vanilla-flavoured shake.  

Why the hesitation?

My wife asked me this, and proceeded to roll her eyes like marbles when I gave my answer.

What if it’s got a banned substance in it?

Okay, so I don’t exactly have drug-testers knocking on my door (a fact she quickly pointed out). And in all likelihood, I never will. But I care about the spirit of our sport; the integrity of running and competition more broadly, and I don’t want to cheat, knowingly or unknowingly.

So, rather than committing to taking the protein, I’ve been doing some preliminary reading to educate myself. There’s a lot to be sceptical about when it comes to sports supplements. And — spoiler — my reading has not alleviated previously-held concerns.

Below I’ve outlined some interesting takeaways from my research on sports and nutritional supplements.

(FYI: Anyone interested in this topic should visit the Australian Sports Anti-Doping Authority (ASADA) website. It’s also worth checking out the Australian Institute of Sport nutrition page.)  

First things first: let’s cover some hard truths

According to ASADA:

  • Supplements are one of the leading cause of failed anti-doping tests in Australia.
  • Roughly one Australian athlete per month fails a drug test due to supplement use.
  • In the last 5 years, about half of all anti-doping violations (and sport bans) have been due to supplement use.
  • Supplement manufacturers are not required to prove that their product is safe or that it works as advertised.
  • It’s “not uncommon for banned substances to be added deliberately” to supplements during manufacturing, or accidentally through unintentional contamination.
  • Ingredients can be mislabelled and/or omitted altogether on nutritional packaging information.

What’s ASADA’s default position on supplements? 

Effectively, ASADA recommends that athletes steer clear of supplements.

Either that, or else: use at your own risk! 

The following hard-line statements are across the ASADA website

  • “ASADA’s long standing advice is that no supplement is safe to use and athletes should not risk their careers by taking a supplement.”
  • “The avoidance of supplement products is the safest path for athletes to follow.”
  • “Remember: No supplement is 100% safe. The only way to have zero risk, is to take zero supplements.”

Yikes! It gives you pause for thought, or should, the next time you’re browsing the aisles of Chemist Warehouse.

And in circumstances where supplements are taken or recommended by a sports dietitian, ASADA says athletes should:

“Only use supplements which have been screened for prohibited substances by an independent company, such as HASTA or Informed Sport.”  

The onus is on the athlete

What’s one of the biggest issues with sports supplements?

In my opinion, it’s this: the onus falls not on the manufacturer, but on the athlete to check (as best they can) the status of their supplement.

It’s the athlete who has to do the difficult — often complex — leg-work. They have to determine whether ‘Product X’ is safe and legitimate. They need to judge whether it might result in a failed drug test and ban. 

Several resources are available to use (which I outline below), but they’re not always straightforward to navigate.

Now, don’t get me wrong: athletes and individuals need to use some common sense. They should be careful when considering the products they purchase, and plan to ingest. But making consumers the primary arbiter of what’s safe (or what ingredients are allowed) is problematic.

The following excerpt — from the 2018 International Olympic Committee consensus statement on sports supplements, published in the British Journal of Sports Medicine — illustrates this clearly:

“It takes considerable effort and expert knowledge to identify which products are appropriate, how to integrate them into the athlete’s sports nutrition plan, and how to ensure that any benefits outweigh the possible negative side effects, including the potential for an anti-doping rule violation. A strict risk-benefit analysis… requires the input of a well-informed sports nutrition professional.”

Why the bold position from ASADA?

ASADA is in a tricky position. It obviously doesn’t want athletes to cheat, but it’s battling a behemoth industry. And this industry doesn’t seem to care about the integrity of sport. It also wants its products to continue to exist in a murky, regulatory grey area.

The multi-billion-dollar supplement industry operates with poor regulations. It would almost be silly, if it wasn’t so serious for the people it negatively affects (namely, athletes who have copped bans). Ingredients can be blatantly wrong, and sometimes sneakily mislabelled.

Marathon runner Cassie Fien’s cautionary tale is worth a quick watch. Or you could listen to the excellent interview with her over at Inside Running Podcast. In her case, the illegal substance higenamine was labelled under its alternative (fruit extract) name: Nandina domestica. It’s a heart-breaking, gut-wrenching story, and it resonates because it could happen to anyone.    

If the manufacturers (and marketers) of supplements have no legal requirement (or incentive) to determine the true composition of their products (or, for that matter, to ensure they are safe, free of toxins and illegal substances, or to prove the advertised benefits are real with clinical evidence), how could we trust them to accurately label ingredients? 

What does all this mean? 

For starters, you don’t always (or ever) know what you’re taking, and you certainly can’t trust the nutritional information.

Beyond banned substances, you could be ingesting a whole plethora of nasty toxins. A 2018 study, conducted by a non-profit organisation in the U.S. called the Clean Label Project, screened 134 protein powder products available for purchase on American shelves. It found that greater than 70 percent of the products contained lead and cadmium (metals). In addition, more than half contained bisphenol-A (BPA), a toxic compound used to make plastic.

This infographic gives a concise, visual summary of what that study found. And while not all screened supplements were contaminated, the results are still alarming.

Why are regulations so lax?

There are some insightful articles in The Atlantic and Business Insider about why (and how) this industry has traditionally been regulated.

And how this problematic situation is continuing.

To some extent, it’s dependent on the country and market. But it essentially boils down to this: most sports and nutrition supplements fall under food product regulations rather than pharmaceutical ones (medicines or therapeutic goods). Therefore, they are not subject to the same scrutiny or mandatory testing as drugs. In other words, the barriers to market entry and supermarket shelves (and the investment in quality control) are far, far lower. 

According to The Atlantic, the supplements industry (in the U.S.) enjoyed massive growth because “these products can go to market without any safety, purity, or quality testing by the FDA [Food and Drug Administration]”.  

The Australian context examined

The FDA’s (rough) equivalent in Australia is the Therapeutic Goods Administration (TGA). The TGA says supplements can be “either a food or a medicine in Australia”.

But it notes that it “can sometimes be complex” to make that determination.

It depends on several factors: what is the form of the supplement (e.g. powder, tablet, liquid)? What are its known ingredients? How is it marketed? What perceived benefits do consumers see, based on those marketing claims?

“With many supplements not falling under therapeutic goods regulation” at present, the TGA cautions that consumers should “take extra care when selecting a product”. Again, we see clearly that the onus falls on the consumer.

In its literature on the subject, ASADA often cites a 2016 study, which showed that 1 in 5 supplement products sold in Australia contained a banned substance. Of the 67 products tested by the study authors (Life Sciences company, LCG), 13 came back tainted. 

Russian Roulette, anyone?

What is a banned substance? 

You can read more about currently banned substances here.

You can also check the World Anti-Doping Agency (WADA) list yourself, if you’re so inclined.

Each year WADA publishes an amended list. These amendments are necessary because of the proliferation of new and modified substances.

And of course, because of the ever-more inventive ways that people will drum-up to cheat! 

ASADA reckons that each year there are “hundreds, if not thousands, of new or modified substances developed in laboratories, or new products released onto the market or black-market”.

It also notes that there are “people willing to push the boundaries with experimental substances and methods which have not been clinically tested or approved for human use”.  

As if that wasn’t enough, the supplements industry is also rife with counterfeit products. If you’re buying online, you need to be especially careful. ASADA has a whole list of red-flags to avoid:

ASADA's red-flags for sports supplements.

Back to my original protein powder dilemma… 

The manufacturer is BodyScience. On their website, they have a Drug Testing page where athletes/consumers can search for the specific product and batch, which are all tested by HASTA. You can even download the certificate. Good stuff!

Except, I was unable to locate my specific product. When I wrote to the company, this was the response I got:

“The 400g proteins we don’t batch test… Even though that product isn’t made with any banned substance, the only way to guarantee safety is by taking a batch tested product.”

Hmmmm. I suppose I have the company’s word there are no banned substances in my small white 400g tub of vanilla-flavoured protein. I just don’t have their guarantee. To get that I have to spend more money, and load-up with more product. (In the response, I was sent links to three other, more expensive tubs of batch-tested protein products.)

However, I want to ignore this point.

Suppose, my protein was clean, and I have the certificate in hand. It’s a start for gaining some degree of confidence. ASADA highly recommends limiting your sports supplements to ones produced by companies that undergo this type of independent testing.

The tedious task of ingredient checking

But I still wouldn’t be home-free. ASADA also recommends: “at a minimum, an athlete should check every ingredient on Global Drug Reference Online (DRO) database.” There’s no easy way to check a brand, or product-type with this tool. I have to go down the list of ingredients, one-by-one. That’s a lot of cross-referencing for a fraught process, given the known labelling issues and ingredient omissions.

So, I’m basically back to square one: skeptically staring at a plastic tub of protein powder, wondering if there might be something sinister (banned or toxic) inside.

The reality, for the time being, is that athletes have to make the call, and bear the consequences. Elite athletes usually have support personnel around them, and trained dieticians who can help them make the right call. But not always. And if you’re someone on the fringes (a sub-elite runner, targeting a 2:20 marathon, say) you probably don’t have that luxury. 

So, if you are turning to sports supplements, be cautious.  

One final note

To it’s credit, the TGA in October 2019 released a consultation paper proposing to regulate more sport supplements like therapeutic products. The government is seeking feedback on this plan, which is still in the pipeline. If it proceeds, it could resolve some major issues. Manufacturers would need to be far more honest about how they represent and market their products. If they are, in fact, deemed to be therapeutic goods, labelling and ingredient listings would need to be accurate, and quality control and purity testing greatly enhanced. And, perhaps most importantly, it would no longer fall to consumers to determine the safety of a product. An update was made in March, but a final decision is pending. This would be a win for elite athletes and consumers, but you there has already been industry resistance. We’ll have to see what happens.

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