Sauna Use As a Lifestyle Practice

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By: Vanika Chawla, MD

Emerging evidence suggests that beyond its use for pleasure, sauna bathing may be linked to several health benefits including cardiovascular, neurological and metabolic benefits. A recent review by Patrick & Johnson outlines evidence of the benefits of sauna use, potential mechanisms of action, and adverse effects and contraindications.  Sauna bathing is characterized by short-term exposure to high temperatures (ranging from 113F to 212F), and there are various forms including “dry” and “wet” saunas which differ in the amount of humidity. 

 

A large study done by Laukkanen et al., examining data from over 2000 middle-aged men in Finland showed that men who used saunas two to three times a week had a 27% reduction in mortality associated with cardiovascular disease compared to those who used saunas once a week, and men who used saunas four to five times a week had a 50% reduction rate in mortality associated with cardiovascular disease. The risk of mortality from all causes was reduced by 40% in frequent sauna users compared to infrequent users! Duration of sauna use was inversely correlated with the risk of cardiovascular disease and coronary heart disease, meaning those who used saunas for longer than 19 minutes had better outcomes than those who used saunas for less than 11 minutes. Results were adjusted for factors such as socioeconomic status. 

 

Many of the physiological effects of sauna use are similar to those elicited during moderate to vigorous-intensity aerobic exercise. Studies show that aerobic exercise in combination with frequent sauna use has a synergetic effect in reducing cardiovascular and all-cause mortality. Exposure to high temperatures stresses the body and this heat exposure induces protective responses that promote cardiovascular health, such as increased heart rate, decreases in blood pressure, and improved blood flow. Heat stress may lead to improved physical fitness by increasing cardiorespiratory fitness, endurance and preserving muscle mass. During exercise the core body temperature rises and heat acclimation from the sauna optimizes the body for tolerating core body temperature elevations during future exercise, as well as supporting other cardiovascular and thermoregulatory functions that are important in fitness and exercise. pThese mechanisms contribute to muscle mass maintenance and prevent muscle loss that can occur with aging.

 

Further analysis of the data from Finland also showed that men who used saunas four to seven times a week had a 66% lower risk of developing dementia compared to those who used saunas once per week. Proposed mechanisms for improved brain health in response to sauna include heat exposure and the subsequent cardiovascular response increasing the expression of brain-derived neurotrophic factor (BDNF), which is an important factor that supports the development of new neurons in the brain, and increased blood flow to the brain. Heat shock proteins also protect against brain disease. 

 

Findings from the study also show that regular sauna users had a lower risk of developing pneumonia and sauna use may bolster the response of the immune system and promote respiratory health. 

 

Caution should be exercised for sauna use in special populations such as pregnant women and children. There are some reports of reduction in male sperm count following sauna use in a 10-person study, but measures returned to normal within 6 months of sauna use cessation. Some contraindications for sauna use include alcohol use, hypotension, recent heart attack, severe aortic stenosis, and altered or reduced sweat function (such as in certain autoimmune or neurological disorders). Proper hydration is recommended prior to and during sauna use. 

 

You may want to consider using a sauna as you cultivate a positive, healthy lifestyle. It can be pleasant and soothing on a cold winter’s day, and may reduce your risk for some upper respiratory infections. There is no clear evidence indicating whether the benefits of sauna are limited to specific climates or seasons, or whether sauna bathing during hot weather confers health benefits. 

References:

Patrick RP, Johnson TL. Sauna use as a lifestyle practice to extend healthspan. Exp Gerontol. 2021;154:111509. doi:10.1016/j.exger.2021.111509

 

Laukkanen T, Khan H, Zaccardi F, Laukkanen JA. Association between sauna bathing and fatal cardiovascular and all-cause mortality events. JAMA Intern Med. 2015;175(4):542-548. doi:10.1001/jamainternmed.2014.8187

An Interview with Barbara Waxman: The Leading Authority on Middlescence

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Barbara Waxman is the leading authority on Middlescence and a passionate advocate for aging, wisdom, and thriving in midlife. Her mission is to shift cultural norms around aging by establishing Middlescence as a unique life stage. Barbara is the founder of Odyssey Group Coaching, which aims to help middlescents thrive personally and professionally. She is one of the only Gerontologist-coaches in the United States. Here are her thoughts on the field of Lifestyle Medicine:

What made you interested in Lifestyle Medicine?

The truth is that my interest in Lifestyle Medicine stems from a painful experience back in 1999. My daughter, Jill, was 8 years old and was diagnosed with an autoimmune disease. We spent about a year having her see specialists (in traditional western medicine) while also trying a number of other drug therapies. None were successful. At the point surgery was recommended we decided to suspend our disbelief and research ‘alternative’ options. This was over twenty years ago, before Lifestyle Medicine was on the map.

I learned the importance of integrating ancient wisdom with newfound approaches. I fully immersed myself into into learning everything I could about integrative medicine and the important role it can play in health maintenance. I’m happy to report that it worked! A combination of modalities resolved Jill’s disease and she is now 31 and in full health.

Just a few years later I was diagnosed with Hashimoto’s (an autoimmune disorder of the thyroid). It motivated me to develop tools for myself and my clients to better understand the cornerstone principles of energy and health. I learned that lifestyle is medicine. My involvement with the American College of Lifestyle Medicine; Stanford Lifestyle Medicine and more, was born out of these experiences.

What is your main career focus?

As a gerontologist and professional leadership coach I focus on working with adults, midlife and better. Think of me as a leadership and life stage expert supporting people to have more clarity, joy and impact in their lives. I deliver on that mission through coaching, speaking, advising and workshops.

What are the key findings from Lifestyle Medicine coaching?

Every client I work with takes an initial assessment of their overall wellbeing; this is based on the principles of lifestyle medicine. One of the key findings that I share is an understanding of how energy needs to be understood to maximize one’s feelings of empowerment, clarity and the ability to have impact. Our prevailing culture emphasizes quick fixes to problems that can be resolved in sustainable ways with shifts in daily habits and rituals. For example, understanding the sleep one needs is foundational to having sustainable clarity and resourcefulness throughout the day. I regularly share the idea that one’s most valuable currency is not money or time—it’s the energy one brings to the time available. Lifestyle medicine is not about avoiding death but about living your best life.

What are your top three recommendations for improving lifestyle?

Invest in the relationships that fuel you and divest yourself of those that deplete you (to the extent possible).

In the words of Michael Pollan: “Eat food. Not too much. Mostly plants.”

Do one kind thing for someone or something in service to others daily.

What’s your favorite Lifestyle Medicine practice in your own life?

Breathing in nature, even if it’s sometimes only stepping outside my front door, is cleansing and clarifying. Taking moments of reflection and emptying my mind every single day is one of my top picks.

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Why We Need Exercise: An Evolutionary Perspective

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By Maya Shetty

By now, we have all heard that exercise is good for us. But why is this true? And if it’s so good for us, why is it so hard to get up and do it? The Center for Disease Control (CDC) claims we need 150 minutes of moderate exercise and 2 days of muscle strengthening exercise a week to reduce our risk of chronic disease and other adverse health outcomes. However, nearly 80% of US adults are not meeting these guidelines, and 6 in 10 have one or more preventable chronic diseases. To understand this disconnect, we need to begin by examining the evolutionary perspective of exercise – why did humans evolve to exercise in the first place?  

The first Homo Sapiens emerged around 200,000 years ago and their lives looked very different from our lives in the modern day. While we complain about having to take the escalators instead of the stairs or our food delivery taking too long, our ancient ancestors were running from predators and hunting for prey. Humans subsisted through hunting and gathering for food, and this was the primary way of life for 95% of human history. This means the majority of our evolution was spent living as nomadic hunter-gatherers. Therefore, our body and behavior is primarily adapted for this lifestyle.

Now, you may be wondering how this translates to exercise in today’s society. Well, as hunter-gatherers, our ancestors’ main advantage was endurance. We are not the strongest or fastest animals out there, so survival was dependent on our ability to outrun our predators and prey. Evolutionarily, we are endurance athletes adapted for consistent, long bouts of physical activity. If this is the case, then why does the average American spend most of their time relatively immobile? This is because we are also adapted for inactivity and energy conservation whenever possible. Thinking again about the hunter-gatherer lifestyle, our ancestors were constantly trying to maintain their energy balance – food intake vs. energy expenditure. It made sense to exercise only when necessary for survival, and conserve energy whenever possible. In today’s society, however, this biological tendency no longer serves us, as our environment has been engineered for an extremely positive energy balance: excess food with little energy expenditure. Now we must go against our biological tendencies and make the decision to exercise, even when our body is telling us not to, in order to maintain good health. 

We can see just how much our physical activity differs from our hunter-gatherer ancestors by studying the few modern day hunter-gatherer communities. These populations are often used as models in public health due to their remarkably low rates of chronic disease and disability with age, a stark difference from modern day America. Researchers analyze the behaviors of these populations to have a better understanding of the evolutionary causes of chronic diseases – Why are they so common now vs. then? The most commonly studied population is the Hadza, a hunter-gatherer population in Tanzania. Decades of research has quantified their daily physical activity and how it changes throughout the lifetime. Most notably, the Hadza people average 15,800 steps, about 6 to 9 miles, per day. Meanwhile, Americans average less than 4,800 steps, about 2 miles, per day – about ⅓ the steps of modern hunter-gatherers. On top of this, the average American reduces the amount of steps they take per day by about half between the ages of 40 to 70. The Hadza people, on the other hand, barely change their physical activity levels with age. These behaviors have measurable effects on our physiology. By the age of 60, most Americans walk 33% slower, have less muscle mass, and their VO2max – an indicator of cardiovascular health – decreases by 25%. These functional losses are seen at a significantly lesser rate, if at all, in hunter-gatherer populations. These findings align with the theory of disuse and aging brought forth by Walter Bortz II, a Professor of Medicine at the Stanford University School of Medicine, and one of America’s most distinguished scientific experts on aging and longevity. Dr. Bortz claims the changes commonly associated with aging, such as loss of muscle mass and decreased maximum oxygen consumption (VO2max), are due to disuse with age, rather than aging itself. The differences in physical capabilities with age seen between the modern American and the Hadza people suggest our sedentary lifestyle may contribute to accelerated aging. By being sedentary, we oppose the evolutionary history encoded in our genes for periodic activity, leading to accelerated physiologic loss with age due to disuse. 

 Regular physical activity stimulates our body to allocate energy toward repair and maintenance, slowing cellular senescence and aging. It has also been seen to have dose dependent effects on the risk of several chronic conditions. 

These include:

-Cardiovascular disease and hypertension

-Type 2 diabetes

-Arthritis 

-Osteoporosis

-Stroke

-Lung disease

-Many cancers

-Alzheimer’s disease and dementia of any type

Many theories have been suggested about how exercise is able to elicit such powerful health effects. It is widely accepted that many benefits stem from the prevention of excessive weight gain, maintenance of normal blood pressure, decreased levels of unhealthy triglycerides, increased levels of healthy lipoproteins, decreased blood sugar levels, reduced systemic inflammation, and decreased stress levels. However, how these effects come about is still debated. 

Studies have also found that regular physical activity stimulates brain growth and improves cognitive function, counteracting the loss of memory and cognition seen with age. Specifically, running has been shown to stimulate the production of neurotrophic factors, or biomolecules that support the growth and survival of neurons. Brain-derived neurotrophic factor (BDNF), for instance, strengthens neuron synapses, increases the production of new nerve cells, and promotes the growth of dendrites. BDNF expression directly increases in response to exercise and is an exciting example of how exercise attenuates cognitive loss.

The World Health Organization suggests that about 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise reduces the risk of all-cause of mortality by ~50% in otherwise sedentary individuals (1). Aside from reducing risk of mortality, regular physical activity has been shown to improve functionality, cognition, mood, and healthspan – the amount of time spent in good health- without the functional losses of aging. Despite the extensive benefits of exercise, most of us do not routinely exercise and spend the majority of the day sedentary. Our drive to not exercise, however, is as encoded into our genes as our necessity to exercise.  As difficult as it is to find the time and energy to exercise, we as humans are genetically selected for lifelong physical activity and, because of this, regular exercise is synonymous with good health. Our world has been engineered for our convenience, not our health, and for this reason we need to make the personal decision each day to walk more, sit less, and make physical activity a regular habit. Something is better than nothing, so find something that brings you joy! Identify activities that you like and can see yourself consistently doing throughout your life. When you are short on time, taking the stairs instead of the elevator or a short walk after a stressful day can still have tremendous benefits.  Whether it be running, dancing, boxing, walking, pilates, biking, etc., just remember to find joy in it and be proud of yourself for putting in the effort. Your health will thank you later.

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Computer Science x Human Performance

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By Brigid Reidy

Artificial intelligence and machine learning have taken the world around us to new heights. We find these systems operating in the background of some of our most loved and appreciated products such as at home smart-speakers, ride-booking apps, social media, and even google translate. In the past year these branches of computer science have begun to enter our world in another way as well, namely in the area of at home fitness. 

Last year, Peloton launched the Peloton Guide, a machine learning and computer vision-backed camera that helps to guide the user through the strength based portions of the Peloton platform. The camera is equipped with: a movement tracker that locates and records you wherever you are in the room, ‘Self Mode’ which helps you view your form in comparison to the instructors so you can ensure you are safely executing the exercises, ‘Body Activity’ which recommends workouts based on the muscles groups you worked in previous classes and what you should focus on next, and voice activation so you can control the class without having to reach for the remote mid-bicep curl. 

Peloton is not the only company utilizing computer sciences in the fitness space. Tempo, another at-home fitness company, utilizes Microsoft’s Azure Kinect DK, a 3D motion sensor and artificial intelligence software, to provide constant feedback on form during classes. Think, personalized trainer but without the person. This software is akin to the now discontinued Microsoft Kinect for Xbox One that aimed to provide users with a fully immersive at-home gaming experience by allowing the games to be remote control free and instead used computer vision to track the players movements as game controls. The newest program, utilized by Tempo, has functionality that allows for the system to provide weight recommendations for specific exercises, count your repetitions, and even provide detailed stats on your progress in form, pace, strength gains and more. 

Although both systems are in their early phases, they offer a promising solution for those that want to get started with strength training at home by clearly offering cues for proper form and organizing a user’s strength plan that helps to evenly target all areas – I for one could definitely use the reminders to do my upper body exercises. The beauty of machine learning being behind these products too means that with continued use, they’re only going to get better at providing recommendations and insights into our training regiments. 

What’s more exciting is that these are only two examples of a plethora of systems that are using computer science to improve health and performance. While we can’t get into all the ways artificial intelligence is helping us to advance, there are several research projects underway at companies such as Sparta Science, and Stanford research groups like Stanford Medicine’s Clinical Excellence Research Center, and Stanford Medicine’s Partnership in AI-Assisted Care that are using machine learning and computer vision to enhance lives.

Sparta Science, is a software company that utilizes artificial intelligence, machine learning, and data science to evaluate movement and provide preventative diagnostics in healthcare and sport. The company visualizes its users through a different mechanism from Peloton and Tempo. Instead, Sparta has created a force plate that measures a whole host of movement and stability areas once the user steps on. Both means of data collection, force plate or the previously discussed cameras, are aimed at recognizing inefficiencies and improving performance outcomes. Most notably, Sparta Science has been able to use computer systems to track athletic performance and decrease risk of sports-related injuries. With this data, the athlete is then able tailor training to improve risk areas and track improvements over time. In the realm of preventative healthcare, their systems are able to detect deficiencies in movement and movement disorders, create custom treatment plans, and similar to the work with athletes, track improvements over time. This may have specific applications for aging populations as evaluating stability and movement can be a useful tool in assessing risk areas, such as fall risk, and allowing the individual and their healthcare providers to determine a plan for improving performance and maintaining independence. 

Another group utilizing AI to help the aging population is Stanford Medicine’s Partnership in AI-Assisted Care. This group is currently conducting research in Senior Care, with the goal of using machine learning and computer vision to help the aging population maintain independence and continue living at home as opposed to a senior care facility. Through installation of a few sensors in the home, researchers are using computer vision to analyze 17 key activities such as slowed movement, eating periods, sleep, unstable transfer while walking, chair and bed immobility, detecting falls, and notifying expert assistance when needed or when risks are detected. These sensors utilize similar machine learning and activity detection as we have discussed in the fitness space for improving training and performance. This design is being put into practice too. Through human centered design, Stanford’s AI for Eldery Care and the Stanford Thailand Consortium, are implementing these sensors to improve the performance and safety of the aging population in Thailand – and depending on the outcomes of this study, possibly the aging populations around the world. 

Science-fiction movies have made advancements in artificial intelligence look far too similar to a modern day Frankenstien. But, as we’ve discussed, AI is much less terrifying and in fact, proving to be potentially game changing in the world of athletic training and improved aging. Though these user interfaces and research studies are still in early stages, machine learning gives them the capability to rapidly develop and offer great benefit to so many age groups and all kinds of performance goals. 

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Whole Food Plant-Based Diet

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By Julia Pangalangan

The Standard American diet contributes significantly to risk of disease, mortality, and morbidity in the United States. In contrast, dietary patterns emphasizing a whole food, plant-based approach to eating promotes health and longevity. A whole food, plant-based (WFPB) dietary pattern involves consuming a variety of vegetables, legumes, nuts, seeds, fruits, mushrooms, herbs, and grains. A plant-based approach can be difficult to implement, but even small, incremental changes can be extremely impactful. Increasing intake of minimally processed foods can help to prevent and manage chronic diseases. A plant-forward approach to eating is not a diet, but a lifestyle to move towards. 

Dr. Marily Oppezzo, RD, PhD is an educational psychologist at Stanford University and her research focuses on behavioral approaches to improve health and well-being. I was able to sit down with Dr. Oppezzo to discuss why this type of eating is so challenging for most of us. She used her expertise as a behavioral and learning scientist and her experience as a registered dietician to share helpful insights. 

Firstly, Dr. Oppezzo emphasizes that following a plant-forward approach does not require you to become a vegan or a vegetarian. After all, some vegan foods require a lot of processing and highly processed foods are typically higher in sodium, saturated fat, and sugar. Instead, think about food with minimal processing like homemade maple-glazed carrots or a veggie stir-fry. Dr. Oppezzo would suggest a plate rich in diverse vegetables and whole grains even if that plate also includes chicken. As Americans, we are used to the western diet which is high in meat and prepackaged food, but substituting these for plants and whole grains can have tremendous benefits for our health.

Many people want to change their eating patterns, but change can be hard when the typical western diet has been made so easy. However, making a sustained effort to increase whole foods in one’s diet may help individuals with a variety of health concerns. For instance, an individual may feel their energy is plateauing throughout the day. Another may notice their blood pressure creeping higher at every doctor’s appointment. For some, they already have a chronic disease diagnosis, and they want to manage it well. Despite the large amount of scientific evidence highlighting the potential health benefits of a WFPB diet, making these changes can come with a variety of roadblocks. Dr. Oppezzo believes one major reason for this is because of the continuous flood of marketing campaigns and fad diets. “Dump butter in your coffee, bacon is back, and lose 2 pant sizes by summer,” Dr. Oppezzo listed as she considered all of the dietary claims she has heard. In comparison to these marketing claims, choosing less processed and more green things and making moderate changes rather than drastic ones is quite boring. These phrases and advertisements are made to be alluring but they lack the research backing of a plant-predominant dietary pattern and may lead to unsustainable eating habits. Aesthetic-based fad-diets, supplements, and detoxes are prevalent in marketing, and media often emphasizes visual changes as markers for health instead of how your body and mind feel. A plant-forward diet instead helps you meet your energy needs, tastes delicious, and has been scientifically proven to increase your overall health, longevity, and to help you feel your best.

Moreover, many fad diets tend to leave individuals feeling depleted. These diets often rely on an all or nothing approach — where one must cut out entire food groups and restrict calories. In contrast, a plant-predominant eating pattern is not a diet change but a lifestyle change. To get started, instead of banning all carbs and eliminating all of your favorite foods, Dr. Oppezzo recommends setting up a gradual plan and making one change to your diet per week. Challenge yourself to swap a sugary beverage for herbal tea, remodel your fridge to have the fruits and vegetables front and center, or add one new nutritious food to your grocery list. 

Furthermore, Dr. Oppezzo recommends eating regular meals and snacks to ensure we are meeting our energy needs. If you’re feeling hungry make sure to listen to your body and satisfy that hunger. But, Dr. Oppezzo also recommends being mindful when you are wandering into the snack cabinet if you are bored or upset. This may be a sign that something else is going on such as stress or sleep deprivation. If we can recognize these moments, we can make the choice to call a friend, go for a walk, or engage in something restful instead. 

For more thoughts and tips from a dietician, check out Stanford’s BeWell’s Ask the Dietician.  

 

How to transition to a plant-predominant diet:

  • Set SMART goals: specific, measurable, attainable, relevant, and time-bound.

A plant-based diet can have substantial short-term and long-term benefits. However, it also has its challenges. It is important to identify why it is important to you to eat a plant-based diet. Try to write a few health goals that are personally meaningful to you. How important is it that you accomplish these goals? How will consuming a plant-based diet help you achieve these goals?

Setting SMART Goals — 

Instead of:

“I am going to eat only whole foods from now on. No exceptions!”

 Try:

“I am going to include one vegetable at lunch and one at dinner on the weekdays.”

 

This goal is specific, easy to measure, achievable given a busy lifestyle, and has a time associated.

 

  • Address the built environment

Our environment influences our decisions and behaviors. It is essential to set up your environment for success. This is particularly important when we are tired and stressed. When you come home from a long day and open the fridge, do you see ready-to-eat veggies and dip? Do you find an empty fridge and immediately open DoorDash? Do you rummage through the pantry to grab a bag of chips or crackers?

If we have set up our environment for success, we can make the healthy choice the easy choice. Here are some ideas for how to set up your environment for success:

  1. Stock up on the good stuff: Make sure to have lots of your favorite fruits and veggies available for the week. Frozen or canned produce are great to have on hand because they are inexpensive, and they last a long time. Lentils, beans, and chickpeas are a wonderful source of plant-based protein that can be added to make any meal more satisfying. 
  2. Enjoy your favorite meals: You don’t need to buy the latest vegan cookbook. You may be surprised how easy it is to make your favorite meals plant-based! Try using Dr. Oppezzo’s one change strategy. Consider a meal you regularly make and then add a vegetable or swap a refined grain for a whole grain.
  3. Make a plan: A plant-based diet can feel overwhelming when we are hungry or short on time. Write a list of easy, quick meals that you feel confident you can make at any time. You can save time by planning to make extra of your meals so you can use them for lunches throughout the week. It can also be helpful to have a list of healthy take-out options

 

  • It’s a group effort (rely on support, talk to loved ones, seek a community of like-minded individuals)

It can feel hard to eat well if those around you do not. Who in your life is supportive of your desire to eat healthy? If you haven’t already, have a conversation with your loved ones to let them know about your health goals. If you feel that you need more support, try joining groups on Facebook . You can also look for groups at gyms and community centers. 

If you are involved at Stanford, check out the BeWell  program resources. If you are not affiliated with Stanford, check to see if your employer offers any wellness programs.  

 

  • Focus on what you get to eat

Many people are hesitant to begin a whole food, plant-based approach because of all of the foods they will have to give up. Instead of dwelling on what you are trying to eat less of, consider all that you get to eat in a day. Try using Dr. Gregor’s “Daily Dozen” as a self checklist. He includes foods like beans, berries, cruciferous vegetables, nuts, and spices. Challenge yourself to add in one new food each week. When you’re trying to eat more items from the Daily Dozen, you won’t be so consumed with the foods you are eating less of. It is less about restricting “bad” foods — It is more about trying to increase your intake of healthful and nourishing foods. 

 

  • Keep it simple (easy and quick staple recipes that you can have on rotation)

Eating a plant-based diet does not mean making fancy new recipes every night or buying expensive green juice and Impossible burgers. It is critical to find what works well for you. Again, what meals do you and your family enjoy? Can you add a new vegetable to that meal? What would it look like to swap a refined grain for a whole grain source?

If you are looking to try some new recipes, there are plenty of wonderful resources. Stanford’s BeWell program has several great suggestions. I also love Forks Over Knives and Ornish Lifestyle Medicine.  

 

It is not important that we have the perfect diet, but that we have a diet that fuels us and makes us feel our best. Through introducing more whole and plant -based foods into your diet you can make sustainable changes towards a healthier you. Each meal we eat is a new chance to make a healthy decision for our long-term health. A whole food, plant-based eating pattern is not a diet. It is a lifestyle change to promote quality of life and longevity.

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Navigating the Difficult World of Supplements

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By Matthew Kaufman

When you think about nutritional supplements for athletic performance, you may imagine an advertised “get fit quick!” and a promise to change your whole life. I remember when friends, teammates or a coach would tell me about a supplement, I would often tune it out for a couple of different reasons. First, we must be aware that if it sounds too good to be true it probably is. Second, the supplement industry does not follow the same FDA standards that other drugs or medications have. This means that some of the supplements people buy may not contain adequate levels of different ingredients or may even contain things that might be harmful to your health like mercury or arsenic.

 

So instead, I decided to investigate these supplements myself and found some interesting research. From my findings, I gathered three big takeaways: (1) Some supplements are safe and rooted in research, while others have mixed evidence for their efficacy, (2) what are considered the most effective supplements surprised me- and may surprise you, and (3) in shopping for supplements, it is difficult to determine how to find the best value.

 

Most common supplements are safe when used and sourced appropriately. For instance, Creatine, a protein our body naturally uses for quick sources of energy and can be used to improve power in high intensity exercise performance, does not lead to kidney dysfunction when taken as recommended (ie. 5g four times daily, or 0.3g/kg of body weight for 5-7 days as a loading dose and then 3-10g/day for maintenance dose) and does not need to be cycled on and off as previously thought. In fact, vegans and vegetarians may benefit even more from daily creatine supplementation because they do not get as much from their diet. With more and more athletes exploring vegetarian, vegan, and plant-based diets to promote longevity, Creatine supplementation may become more important down the line. With common supplements such as Creatine, Caffeine, B-Alanine, BCAA’s, Citrulline, Arginine and Beet Root Juice, minimal safety concerns have been reported from the thousands of research studies conducted. This means the risk of taking these supplements is overall low, so if you feel inclined to try one for yourself, you can feel safe in doing so after discussing with your healthcare provider. Overall, it is important to understand that the common supplements that people take are well regarded for their safety, and after proper consultation with a medical practitioner, will likely not lead to long term consequences.

 

There was also a surprising amount of evidence supporting the efficacy of different supplements for sports performance. Caffeine, for example, has robust evidence for improving performance for athletes. Caffeine has been shown to increase power and velocity in strength training and performance in boxers, shot put, rowers and cyclists. On the other hand, while Branched Chain Amino Acids, or BCAAs, are one of the most popular supplements, the actual evidence did not robustly support their use in sports performance. BCAAs are a specific group of amino acids consisting of isoleucine, leucine and valine that are thought to be linked to recovery and prevention of muscle breakdown. International societies have even weighed in with the Australian Institute of Sport giving BCAAs a grade “C”, meaning that the current evidence is not supportive of benefit amongst athletes OR no research has been performed to guide an informed opinion. Dietary Nitrates, like Beet Root Juice, and Caffeine have an “A”, meaning that there is strong evidence for certain situations in sport with evidence-based protocols. For instance, there is strong evidence, that Beet Root Juice supplementation can lead to prolonged high-end effort as well as improved average and max power especially in the endurance athlete. It is important to realize that every supplement may not help sports performance in all domains. Understanding how each supplement can impact your strength, endurance, recovery, and other aspects of exercise and sport is crucial to knowing the appropriate situations where each supplement is warranted.

 

Finally, my research showed how difficult it can be to purchase the right supplement. When visiting a popular internet marketplace, I had no idea where to start. There were numerous blends of different supplements, with different concentrations and all at different price points. With this immense variation, it is incredibly difficult for any buyer to determine the right product for them.

 

Here are 5 easy steps I recommend for finding quality supplements that will help you meet your athletic goals:

  • Meet with your healthcare provider to decide if and what supplement is appropriate for you and your goals. Make sure to discuss things like the proper dosage and time course!
  • Check for safety information for your supplement on MedWatch (the FDA reporting site for adverse events and reactions).
  • Check for quality and accuracy of reported ingredients in your supplement at ConsumerLab, US Pharmopecia, and NSF International.
  • Check the price of your supplement across multiple stores and vitamin shops to ensure you find the most cost-effective option.
  • After deciding the proper supplement with your physician, report your experience with them!

 

 

From this investigation of sports supplements, it’s clear how important it is that people understand exactly what they are taking, but this is no easy task. Because supplements are not regulated in the same ways as medications, we as consumers must complete the necessary research ourselves. We need to ask ourselves, “What really is in these supplements?” and “What is the impact of the supplement’s ingredients?” The best thing to do would be to talk about your goals with a physician or medical professional who understand these supplements and can recommend a trusted brand or source. Don’t miss the full systematic review, Supplements for Athletic Performance, that will be published in the coming months.