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FOR DECADES, ATHLETES HAVE BEEN A TARGET for companies selling everything from banned substances to several worthless nutritional products with the hope they will make the diﬀerence between winning and losing. At the expense of being misled, athletes have suﬀered irreparable damage from steroids and hormones as well as the side eﬀects experienced from stimulants and tainted dietary supplements. In addition, the tremendous stress of strenuous exercise and its contribution to oxidative stress, inﬂammation, fatigue,...
FOR DECADES, ATHLETES HAVE BEEN A TARGET for companies selling everything from banned substances to several worthless nutritional products with the hope they will make the diﬀerence between winning and losing. At the expense of being misled, athletes have suﬀered irreparable damage from steroids and hormones as well as the side eﬀects experienced from stimulants and tainted dietary supplements. In addition, the tremendous stress of strenuous exercise and its contribution to oxidative stress, inﬂammation, fatigue, muscle damage and transient immune suppression sets the stage for viewing the athlete in a very diﬀerent way.
In THE MISLED ATHLETE, renowned nutritionist Carl Germano, RD, CNS, CDN and his team present a new look at the athlete as a patient and provide a comprehensive plan for addressing the multiple nutritional needs of the athlete beyond excess protein, stimulants and steroids. Germano discusses the link between the stressor of exercise and the importance of proper recovery through diet manipulation, eﬀective training techniques, and the use of legitimate nutritional supplements.
THE MISLED ATHLETE gives insight into how the foods athletes eat, which training techniques they use, and how the consumption of certain safe nutritional supplements can successfully address the ravages of intense activity, assist the athlete to recuperate better and help prepare for the next battle.
When my son asked my opinion about a sports supplement recommended to him on a popular internet forum, it was a question I had dreaded for some time and the impetus for writing this book. Knowing that he and all young athletes are the target of unscrupulous marketing about the next "hot" product to make them stronger, faster and bigger, I knew it was going to be difficult undoing the brainwashing and misinformation that goes with certain sports nutrition supplement companies. And I'm not alone in my concerns. The Food and Drug Administration and the United States Anti-Doping Association regularly monitor and find products being sold as a sports supplement to contain banned substances. A recent study tested 600 supplement products from around the world for substances that were not listed on the label and are banned by the National Collegiate Athletic Association and U.S. Olympic Committee. Twenty-eight percent of the supplements tested in the United States and fourteen percent of supplements tested outside the United States had banned substances in them with no disclosure on the label. This is quite unfortunate since the legitimate dietary supplement companies are overshadowed by the unscrupulous and deceptive ones.
Marketing hype, coupled with the intense pressure to excel by parents and coaches, has led to increased use of unproven or banned substances by novice and professional athletes alike. An informal survey by a former U.S. Olympic Committee physician showed that more than 50% of elite athletes would be willing to take an illegal substance if it would guarantee them a gold medal, even if they knew that taking the substance would be fatal in a year! While legitimate organizations and websites presenting accurate information about sports nutrition exist, they are also overshadowed by the marketing hype of unsubstantiated claims. The allure of gaining the competitive edge has led professional athletes, varsity teams, and even the weekend warrior, to experiment with everything from unproven nutritional strategies, such as excess protein consumption to the more deleterious anabolic steroids.
There is a clear distinction between what is represented in muscle magazines and the reality of what the body can achieve naturally. That distinction is what this book attempts to convey. If you think that eating large amounts of protein, swallowing hormone analogs or, worse yet, experimenting with steroids is a sustainable approach to physical strength and performance then read this book very carefully as you have been grossly misled. It is my hope and intention that this book will help you view the athlete very differently than how you have done so in the past. My mantra is simple - if you recover better from the stress of exercise, you will perform better! An obvious, yet frequently overlooked concept. Optimal performance is only achievable if athletes are able to recover from the stress that exercise imposes on the body.
An in-depth review of the scientific concepts presented here may be found in texts and research studies for more detailed exploration. I have collected and tied it all together to outline a new view of the athlete. Numerous clinical studies have been published on the various hormonal, immune, and cardiovascular effects of strenuous activity on the human body. In many regards, those effects are similar to the same processes that occur during certain diseases such as in immuno-compromised conditions. Therefore, to address the multiple nutritional needs of the athlete, the athlete must be viewed as a patient. My clinical experience with oncology patients has taught me the apparent similarities between these two different "patient" populations. That is, muscle wasting, fatigue, oxidative stress, inflammation and immune suppression are common symptoms found in cancer patients as well as in athletes during prolonged strenuous activity (extended periods at 80% – 90% of your maximal heart rate) or in overtraining states. This book will cover the effects of exercise and how best to address them with diet, proper supplementation, and effective training techniques. In addition, the subject of banned substances and the dangers of steroids and precursor hormones will be addressed.
The Stress of Exercise
Intense exercise is one of the greatest sources of physical stress that athletes deliberately subject themselves to on a regular basis. Increased metabolism, heart rate, blood pressure, oxygen consumption, hormonal and even free-radical production are normal and transient responses of the body to physical stress. Remove the stress (i.e. exercise) and the body quickly shifts into recovery mode. Thus, the body adapts and becomes stronger. It is only during recovery that the body becomes stronger and capable of facing the next physical challenge. It is a thin line between proper training and overtraining that every competitive athlete walks and the consequences of hampered performance and injury that can result. Overtraining, a condition when the volume and intensity of an individual's exercise exceeds their capacity to recover quickly enough, and restrictive eating can exacerbate the physiological stress placed upon the athlete's body. Symptoms are physical (inflammation, reduced immune function, persistent fatigue, elevated heart rate, decreased muscular strength, tissue breakdown and weight loss), and psychological (irritability, loss of motivation and enthusiasm). Inflammatory markers and free radicals contribute further to muscle breakdown and impede recovery. Female athletes must take additional care to also avoid the "female athlete triad" (characterized by low bone density, amenorrhea and low caloric intake). Chapters two through five examine the physiological effects of exercise and the similarities between overtraining and disease states.
A focus on recovery is as important, if not more important, than the exercise itself and all too often athletes focus on the latter rather than the former. In addition to proper training, emphasizing good nutrition (with the right supplements) and adequate rest is the secret for the body to survive and thrive in spite of the rigors of exercise. Athletes generally recognize the important role nutrition plays in helping them recover and achieve their fitness goals. Depending on their sport, different levels of caloric intake and varying macro- and micronutrient levels need special consideration. The macronutrients (protein, fat, and carbohydrate) play a profound role in sports nutrition and the need for adequate levels of high-biological value protein to support muscular development and repair is necessary. The focus here is adequate high biological value sources not necessarily excess amounts of protein! Unfortunately, the marketplace has overemphasized protein and played "the numbers game," leading to the belief that excessive levels of protein intake are the answers to an athlete's nutritional needs. We need to go beyond excessive protein intake when discussing muscle maintenance and recovery. We must consider sufficient calories from carbohydrates and "good" fats as well. Finally, we need to examine certain nutritional supplements that can play an important and necessary part of an athlete's overall nutritional program.
Sports drinks, gels, caffeine-laden "energy" supplements and bars of varying caloric and nutrient content line the shelves of popular sports nutrition supplement stores in an effort to capitalize on the increased physical demands of athletes. The fact is that many of these products, especially energy drinks fortified with caffeine, only provide a false sense of energy and can actually impede recovery. They are not substitutes for proper nutrition and eating habits and should be viewed strictly as supplements to the diet. This book will review the pertinent diet modifications and sports oriented nutritional supplements that have legitimate application for performance and recovery. Chapters six and seven will specifically detail the proper dietary regimens that support the strength or endurance athlete.
In summary, the marketplace is littered with sports nutrition products claiming to be the panacea for increased muscle and performance. Additionally, the need to excel by professional and novice athletes alike has led to increased use and abuse of steroids with the hopes of achieving "greatness" at the expense of the body. There is no magic bullet and by focusing on the short-term gain that stimulants and steroids promise, popular sports nutrition products fail to address the multiple nutritional needs of the athlete. For reasons that will be outlined in this book, the biochemistry of exercise is very much like the biochemistry of chronic disease. Thus, the concept of the athlete as a patient acknowledges the need to address the critical issues facing the athlete (e.g., oxidative stress, inflammation, energy production, immune health, maintenance of lean muscle, etc.) through application of well-designed diet modification plans, effective nutritional supplements, and proper training techniques. The Misled Athlete focuses on these important issues and how to address them safely and effectively.
Frustrated by periods of listlessness and fatigue or suffering yet another bout of a cold or flu even though you are exercising? Isn't exercise supposed to be good for you and keep you healthy? Even though exercise is beneficial in so many ways, overtraining, not getting enough rest, or eating poorly can tip the scales and impact health for the worse. The immune system is susceptible to the stress of exercise, leading to an overtaxed or poor immune response. As we hinted to in chapter one, the stress of exercise is not too different than the immunological response to certain diseases. Yes, exercise! Every time the body undergoes strenuous activity, it reacts similarly as it would during certain illnesses. This chapter will show that every time an athlete leaves the field, court or gym, the response of the immune system is transiently suppressed and therefore requires support.
The immune system is one of the most biologically complex systems of the body. At its most basic level, its primary function is to guard against injury, infections or to facilitate healing. To do its job the immune system recruits an army of specialized cells with menacing names like natural killer cells and macrophages and lymphocytes like T cells and B cells. Together, they roam the body with total devotion to protect. The immune system also communicates with almost every other cell in the body, including nerve and muscle cells. This total integration allows the body to monitor our health and react quickly when trouble arises. Various chemical messengers called cytokines orchestrate this enormous task appointed to the immune system. Cytokines are to the immune system as neurotransmitters are to the brain. Just as the brain relies on neurotransmitters to exchange information to the rest of the body, cytokines relay information to and from the immune system. They transmit information from cell to cell, either stimulating or calming immune activity and inflammation (an important part of the immune response). This is an important point to stress: cytokines function to balance immune activity – telling immune cells when to fight and when not to fight.
Cytokines can be grouped into two broad categories: those that can cause inflammation and those that reduce inflammation. They control how long, how fast, and in what part of the body the immune system conducts its business. The myriad of cytokines produced during and after an immune response exemplifies the need for the body to react quickly to infection or injury and shut down efficiently when the threat has passed. It was originally thought that cytokine production was produced solely by immune cells. Recent evidence shows that cytokines are also produce by muscle cells and significantly increased during intense exercise. This makes sense considering how exercise affects the body. Strenuous exercise traumatizes muscle tissue that triggers cytokines to mobilize the immune system. Unfortunately, some of those cytokines trigger an inflammatory response. During intense or extended training (i.e. overtraining) prolonged exposure to inflammatory cytokines can have negative effects including muscle damage. In addition to an increased inflammatory response, various studies have demonstrated immune suppression after high-intensity training. Specifically, studies have shown that after strenuous activity there is a decrease in the concentration of protective proteins called immunoglobulins in the nasal cavity indicating that exercise impedes the ability of the upper respiratory tract to clear viruses and bacteria. There are many case studies and reviews by coaches and practitioners who report significantly reduced athletic performance during recent bouts of sickness known in some circles as "post-viral fatigue syndrome."
So, intense exercise paradoxically increases the inflammatory response while suppressing immune function, which leads to poor recovery and increased risk of infection (i.e. upper respiratory tract infections best demonstrated by the popular "J" curve below). This is apparent in even well trained athletes. Poor diet, inadequate rest, overtraining or poor training techniques exacerbate this effect while a balanced regimen of exercise, healthy diet and adequate rest leads to better performance, improved muscle mass and enhanced immune function.
How Much of a Concern for the Athlete? First, the Good News!
We know that regular, moderate exercise is very beneficial and can improve immune response and health. Moderate exercise reduces the risk of colds, flu, upper respiratory and other viral infections compared to those who do not exercise. Moderate exercise protects against inflammation, which is important for athletes to prevent injury and reduce the breakdown of muscle after activity. The key words here are "moderate exercise." It is an unfortunate fact that young athletes as well as professional sports players are pushed to the edge to compete and moderate exercise has no place in their training. Even for bodybuilders, the enormous amount of pre-workout stimulant products that push the body to do more work has made the term moderate exercise obsolete.
Now, the Bad News!
Research points to strenuous activity mimicking the pattern of hormonal and immunological responses we see in post surgical and immune-compromised patients such as those suffering from cancer. Several studies indicate that strenuous exercise produces an immediate immune response similar to the response seen during infections and trauma. We now understand and have identified several immune cytokines that are increased in response to exercise the same way we see them elevated in response to infections, tissue injury, or certain degenerative or immune-compromised diseases. Certain cytokines are destructive inflammatory ones and include interleukin-1 (IL-1), C-reactive protein, tumor necrosis factor, and interleukin-6 (IL-6). Interestingly, IL-6 is considered both inflammatory and sometimes anti-inflammatory, depending on the nutritional state of an athlete and their ability to quickly recover after strenuous activity.
In addition, elevated IL-6 incites another inflammatory marker called C-reactive protein or CRP, which is present in many diseases including certain cardiovascular disorders and cancer. Research has now confirmed that high intensity exercise significantly increases circulating levels of CRP. So, if you think you can perform well when you're sick, think again. While elevation of cytokines and inflammatory markers are normal and an adaptive immune response, it is essential to reduce their levels as quickly as possible since they can contribute to muscle breakdown, fatigue, and increased risk of infection.
In Come the Hormones!
Along with affecting the immune response, rigorous exercise elicits the help of the adrenal glands to deal with this stress. They release hormones, including epinephrine, cortisol, progesterone, estrogen, testosterone, and dehydroepi-androsterone (DHEA) to assist in balancing blood sugar for an even flow of energy throughout the day and managing energy output when under physical or mental pressure. Again, this is a normal response that quickly normalizes when the stress subsides. Under prolonged bouts of stress, the adrenal glands may be over-stimulated and unable to meet the demands of the body, contributing to chronic fatigue, body aches, nervousness, sleep disturbances and digestive problems. Along with its effect on immune function, intense exercise taxes the adrenal glands, leading to increased cortisol production. The result is inhibited uptake of glucose into cells for energy production, suppressed collagen synthesis (an important protein for healthy joints), inhibited bone growth (via inhibition of osteoblast activity – the bone-building cells of the body), and protein synthesis (needed for muscle repair and growth). It's fair to say that you do not want elevated cortisol levels for long periods of time!!
Immune-Inflammation Connection – Burn Baby Burn!
The effect of increased inflammatory response resulting from overtraining is more than just the overt redness, pain, heat, and swelling seen in injury. Those menacing inflammatory molecules can reduce the function of joints as well as contribute to muscle breakdown. When chronically elevated, inflammatory cytokines dilate blood vessels in muscles and joints and increase swelling and cause pain. To combat inflammation associated with overtraining (as well as inflammation from other sources), nonsteroidal anti-inflammatory drugs (NSAIDs) are typically the first line of attack. Unfortunately, long-term use increases the risk of adverse effects such as gastrointestinal problems, ulcers, and kidney and liver damage. The other option is the use of anti-inflammatory steroids (different from anabolic steroids) to halt inflammation. While commonly prescribed steroids such as cortisone and prednisone do the job, chronic use actually has an opposite effect – they eventually impede the healing process by negatively affecting the production of collagen (important for your joints and tissue repair). Neither NSAIDs nor anti-inflammatory steroids are viable options for long-term use. For these reasons, a growing number of practitioners and laypersons alike are now seeking alternatives to reduce the symptoms of inflammation.
Excerpted from The MISLED ATHLETE by CARL GERMANO Copyright © 2011 by Carl Germano. Excerpted by permission of iUniverse, Inc.. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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