IOC provides point of reference for supplement use amongst athletes

The infographic​​, developed by the IOC’s Medical and Scientific Commission, guides users through a flow diagram that asks questions to further ascertain whether or not to take a certain supplement.

Example questions quiz the user on scientific evidence for the supplement as well as incidences of adverse reactions, medication interactions, and dose requirements of the supplement.

Labelling and manufacture credentials are also examined as the infographic asks the user if there are any prohibited substances mentioned on the supplement label as well as details of a manufacturer’s quality assurance program.

Referring to outcomes from Commission meeting in May 2017, lead author Dr Ron Maughan, explained that evidence for the efficacy of many of the supplements used by athletes was limited.

“Even where some evidence does exist, little is derived from studies of elite athletes and few studies have used experimental models that resemble sporting contests,”​ said Dr Maughan, an honorary professor of St. Andrews University’s school of medicine and IOC member.

“That decision tree has now been converted into an infographic that can help to guide athletes and support staff through the decision-making process.” ​

IOC meeting outcomes  ​

Further outcomes to the three-day meeting, which took place in Lausanne Switzerland, also emphasised supplement use was not without some risks, especially for athletes liable for testing under the code of the World Anti-Doping Agency or the regulations of other Governing Bodies.

“Serious adverse effects of supplements are fortunately rare, but include impairments of health and performance as well as the potential for unwitting ingestion of substances that are prohibited under the antidoping codes that govern elite sport,”​ Dr Maughan said.

Despite the army of support staff professional athletes surround themselves with, the risk of ingesting a banned substance contained within a dietary supplement remains relatively high.

The supplement market, which can include herbals and botanicals, also count the more familiar products such as protein shakes, sports drinks and fortified foods often fortified with essential nutrients in isolated or concentrated form.

However, the market can be vulnerable to products and pills, often introduced from overseas that have not undergone the rigorous quality control standards and regulations expected from consumers.

News​ ​of The Food Safety Authority of Ireland’s (FSAI) intentions to recall a range of branded food supplements was reported in March after the authority suspected certain products were tainted with illegal steroids and stimulants.

Tests by the regulatory body found the stimulant methylhexaneamine (MHA), in Falcon Labs’ Oxyburnpro and Superclen products that was not declared as an ingredient on any of the products.

Under current Irish legislation, neither substance is permitted in food.

Active substances unlisted​

In April, The Norwegian Food Safety Authority and Customs Service (Mattilsynet) claimed to have found drugs, anabolic steroids, high caffeine content and prescription drugs in 27 of 70 supplements​​ purchased via foreign online stores. 

“The import of products containing drugs and anabolic steroids is illegal and will be reported to the police by the Customs Service,”​ said Merethe Steen, head of section in Mattilsynet.

“We also found several examples that active substances found in the analyses are not listed in the ingredient list of the products. This is extra dangerous because people do not know what danger they are exposed to."​

In a research paper on which the infographic is based, Dr Maughan, along with fellow IOC members, commented on efforts being made to address the issues.

These include the use of third-party auditing, such as the certification global quality assurance program Informed-Sport provides, to identify products that athletes may consider to be at “low risk” of containing prohibited substances.

“There can be no absolute guarantee that any product is entirely safe, but these schemes do help the athlete to manage the risk,”​ the paper said.

“Athletes contemplating the use of dietary supplements should consider very carefully whether the possible benefits outweigh the risks of a doping offence that might end their career.”​

Source: British Journal of Sports Medicine​

Published online ahead of print: doi.org/10.1136/bjsports-2018-099510​​

“Infographic: helping athletes make decisions on dietary supplement use.”​

Authors: Ronald John Maughan