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What supplements should you really take for exercise performance?
There are many performance-enhancing supplements used by athletes. In this article, we give you our top recommendations for the recreational athlete and discuss the key supplements to enhance exercise performance. Read on for the details!
** Please note: If you want the short summary version of this article with a video, then please click here **
Our Top Three Recommendations to Enhance your Exercise Performance:
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Our Top Three Recommendations to Enhance your Exercise Performance:
- Protein: Be sure to eat enough protein. We talked about the importance of protein in our blog here. That can take care of the branched chain amino acids (BCAAs) unless activity level is very high. Use whey protein and add leucine if you are very active and want to build muscle. We recommend grass-fed whey and ideally a whey protein isolate (that does not contain casein, which may cause an issue for people who react to dairy). Whey protein is much more bioavailable than other plant-based protein powders.
- Caffeine: You can try experimenting with a little caffeine, as long as you tolerate it. Some people may not tolerate caffeine well, or have HPA axis issues, in which case it is better to avoid caffeine.
- BHB or Ketones: Experiment with ketones if your activity level really is high and fast recovery is important.
In addition, beetroot juice is easily added to the diet so try it to see if it works well for you. It is best taken away from caffeine. Magnesium (Mg) is important to add for the electrolytes, to avoid cramping, for good sleep, not to mention the 300 enzymatic reactions it supports!
Read on for more details on these and other additional supplements for performance.
The Supplements to consider for Exercise Performance are
- Whey protein
- Beta hydroxy butyrate (BHB)
- Branched chain amino acids (BCAAs)
- Beta-hydroxy-beta-methyl butyrate (HMB)
- Beetroot juice
Whey protein is a high-quality source of protein with all of the essential amino acids (Davies RW, 2018). It has the highest BCAA content of natural protein sources (Kårlund A, 2019). It boosts MPS after exercise (Davies RW, 2018), which is important to avoid muscle protein breakdown (Kårlund A, 2019). See our article here for more on the importance of protein.
Adding extra protein increases changes in muscle strength and size during prolonged resistance training in healthy adults (Morton RW, 2017). The effect of the extra protein is stronger in trained athletes than in sedentary people (Morton RW, 2017). However, it is never too late to start exercising and building up this effect. Older age decreases the effect of protein on muscle strength and size, so it is important with age, to continue (or even just start) exercising and getting sufficient protein either through the diet or through supplements like whey protein.
More is not necessarily better. More than 1.6 g /kg body weight /day of protein does not add further to gains in muscle mass (Morton RW, 2017). A 20 g dose of whey protein is sufficient to stimulate MPS in muscle of 80 kg resistance-trained male athletes (Witard OC, 2014). Higher protein doses of 40 g do not further increase MPS (Kårlund A, 2019).
Other benefits of whey protein are:
- Weight loss (Paddon-Jones D, 2008)
- Appetite suppression (Paddon-Jones D, 2008)
- Increased metabolism (Veldhorst MAB, 2009)
- Insulin release, which reduces blood glucose levels and improves insulin resistance (Frid AH, 2005)
Timing is everything:
Before exercise: Protein before exercise has less influence on muscle protein synthesis (MPS) but may still help muscle conditioning, depending on the type of exercise (Kårlund A, 2019).
During exercise: Consuming both protein and carbohydrate during prolonged resistance or endurance-type exercise for several hours stimulates MPS during the exercise time period (Kårlund A, 2019). It also increases net protein balance, (the difference between MPS and muscle breakdown (MPB)). A gain in net protein balance means an increase in muscle mass (Kårlund A, 2019).
After exercise: A combination of carbs and protein after exercise works best for recovery. Eating only carbohydrates post-exercise can cause a negative net protein balance (Kårlund A, 2019).
A large protein intake after exercise is better for protein synthesis than smaller doses (West D, 2011). In one study, a single 25 g dose was more effective for MPS than 10 ‘pulsed’ 2.5 g drinks every 20 min after exercise (West D, 2011).
Before bed: Protein before sleep enhances MPS and post-exercise recovery (Kårlund A, 2019). 30–40 g of casein (the type of protein in whey protein) after evening exercise can stimulate net muscle gains throughout the night and improve the net protein balance (Kårlund A, 2019).
Protein supplements are not necessarily better than real food. We do favor a 'food first' approach to nutrition. However, sometimes it is just easier to get higher amounts of protein in through supplements like whey protein or essential amino acids, versus diet, for athletes needing a high protein intake.
Caffeine improves performance and stamina (Graham, 2001). It increases strength and muscular endurance, so that an athlete can train harder and longer (Grgic J, 2019). It also improves resistance to fatigue (Graham, 2001). It is thought to lead to a decrease in perceived exertion which might contribute to the performance-enhancing effects (Grgic J, 2019).
Doses in the range of 3-9 mg per kg of body weight is recommended 60 minutes before exercise (Grgic J, 2019). One cup of coffee, 8 fluid oz, has 95 mg of caffeine. The dose for a 120 lb. woman would be 165 – 495 mg of caffeine (1.75 – 5.2 cups) and, for a 200 lb. man, 270 – 810 mg (2.8 – 8.5 cups). It would be more efficient and better controlled to use caffeine supplements rather than coffee, to better monitor the caffeine content.
However, the degree of performance enhancement from caffeine can differ significantly between individuals (Pickering C, 2018). People can react differently to caffeine based on genetics, environmental factors, prior experience or tolerance to caffeine and competitive situation (Pickering C, 2018).
In general, caffeine seems to be safe when taken in the recommended doses. However, doses as high as 9 mg per kg can trigger insomnia (Grgic J, 2019). It is not clear that women would have the same benefits as most of the research has been done on male athletes (Grgic J, 2019).
Evidence suggests that adding caffeine at the same time as mitochondrial supplementation may increase the performance benefits. We talked about supplements to support mitochondria in a recent blog here. Caffeine increases growth of new mitochondria and increases mitochondrial content in the muscles (Vaughan RA, 2012). It also increases metabolism. A caffeine concentration equivalent to 4 cups of coffee improves the function of mitochondria and can protect cardiovascular cells from damage (Ale-Agha N, 2018).
Beta-hydroxybutyrate (BHB) or Ketones:
BHB is a ketone body. This is the alternative (to glucose) energy source that the body uses when in ketosis, or fat-burning mode. A ketone body is a by-product of fat burning, used as fuel. We typically get into ketosis, or fat burning mode, through a high-fat, low-carb ketogenic diet.
Ketosis has many benefits for the body including autophagy or cellular detoxification. This enhances cell renewal and detox. Ketosis also increases protein synthesis, muscle growth, cellular resilience, adaptability to biological cues and mitochondrial biogenesis (Murray AJ, 2016). Higher beta-hydroxybutyrate levels are associated with higher ATP levels in rats on a ketogenic diet (Murray AJ, 2016). More ATP = more energy (see our article here for further explanation).
There is no consistent evidence that the ketogenic diet improves endurance performance. See our discussion on this topic here. Studies on animals in ketosis demonstrate increased physical performance and increased accuracy in performance (Murray AJ, 2016). A ketogenic diet in humans was shown to impair exercise efficiency and cognitive function (Murray AJ, 2016). In some cases, cognitive function may improve but this is not consistently observed (Evans M, 2019).
There is, however, a role for ketones in the prevention of overtraining (Poffé C, 2019). BHB can help with exercise recovery and reduce the effect of overtraining from endurance exercise (Holeček, 2017). In one study, the training load and power output in fit men in endurance sessions were 15% higher with ketones than without, after 3 weeks on the ketones (Poffé C, 2019). This effect can be monitored via a marker called GDF15 (serum growth‐differentiation factor 15) which indicates signs of overtraining (Poffé C, 2019).
Getting into ketosis via the ketogenic diet has some drawbacks, such as increasing cholesterol and LDL, which are risk factors for heart disease (Murray AJ, 2016). The low‐carbohydrate high‐fat keto diet can also be detrimental to endurance exercise performance. This is because the body needs carbs to recover from endurance exercise and to replenish glycogen (Poffé C, 2019).
The challenge is to increase ketone levels with a diet that doesn’t raise cholesterol nor impair glycogen recovery (Murray AJ, 2016). Eating carbs after exercise, as required to replenish glycogen, prevents getting into a state of ketosis. One way to avoid this is to take ketones, or BHB, to induce ketosis in endurance athletes (Poffé C, 2019). The exogenous ketones mean the athlete can be in post‐exercise ketosis and eat carbohydrate and protein, which can synergistically stimulate recovery and adaptation (Holmer BJ, 2019). Another option is to take MCT oil that has been shown to raise ketone levels even when consuming carbohydrates.
Ketone supplements are generally well-tolerated, but some GI effects (nausea, diarrhea, stomach ache) have been reported (Clarke K, 2012). In one study, gastrointestinal symptoms were reported in 68% of athletes taking ketone salts before cycling (Evans M, 2018). Side effects are more common with ketone salts than with ketone supplements. The taste of ketone supplements is unappealing to most people.
Timing is everything:
It is best to take ketones after exercise for the recovery and MPS benefits. Taking them before exercise does not have any benefit. One study found a 1% decrease in time trialed cycling performance when ketones were taken BEFORE exercise (Leckey JJ, 2017). In another study, ketones before exercise did not improve perceived exertion or muscular efficiency (Evans, 2018). We suggest taking ketones right after exercise to enhance recovery and MPS.
The suggested dose is 25 g of ketones following each exercise session (Poffé C, 2019).
Branched-chain amino acids (BCAAs):
The branched-chain amino acids (BCAAs) are leucine, isoleucine and valine, three essential amino acids. They are named branched-chain due to their chemical structure.
BCAAs can be used by mitochondria in muscle to provide energy during exercise (National Institutes of Health, 2019). They, particularly leucine, may stimulate protein synthesis in muscle after exercise although research does show inconsistent results on MPS (National Institutes of Health, 2019). There is not much data showing that BCAAs improve performance in endurance sports (National Institutes of Health, 2019). Short-term studies lasting from 3 to 6 weeks report that BCAAs might lead to gains in muscle mass and strength during training (National Institutes of Health, 2019).
It is not clear that BCAAS add anything more than getting enough good-quality protein in the diet (National Institutes of Health, 2019). BCAAs are found in animal products (meat, poultry, fish, eggs and milk).
Leucine helps to stimulate MPS both at rest and during exercise (Churchward-Venne TA, 2014). Leucine is more effective at triggering MPS than other essential amino acids (Churchward-Venne TA, 2014). Adding leucine to whey protein (discussed below) is more effective than adding BCAAs to whey or consuming whey on its own (Churchward-Venne TA, 2014).
However, leucine alone is not sufficient. An 8‐week trial of leucine alone did not increase muscle (Lim CH, 2018). When combined with exercise training, continuous leucine intake can improve muscles and muscle quality more so than leucine alone (Lim CH, 2018).
HMB (or Beta-hydroxy-beta-methylbutyrate):
Beta-hydroxy-beta-methylbutyrate (HMB) is a metabolite of the BCAA leucine. About 5% of the body’s leucine is converted into HMB (National Institutes of Health, 2019). The conversion of leucine to HMB activates MPS and reduces protein breakdown (National Institutes of Health, 2019).
HMB plays multiple roles in the body. It is related to protein metabolism, insulin activity and increased muscle as a result of exercise (Kaczka P, 2019). In endurance and martial arts athletes, HMB had positive effects on aerobic capacity. In resistance trained athletes, improvements in strength, body fat, muscle mass and power output were seen (Kaczka P, 2019).
HMB can be metabolized by mitochondria in muscle to provide energy during exercise (National Institutes of Health, 2019). According to The International Society of Sports Nutrition (ISSN), HMB helps speed up recovery from exercise-induced muscle damage in both trained and untrained individuals (National Institutes of Health, 2019). HMB can improve strength, power, muscle growth, muscle mass and aerobic performance (National Institutes of Health, 2019). The optimal effects of HMB on muscle growth and strength happen when combined with exercise (Holeček, 2017).
HMB can also reduce sarcopenia, or loss of muscle due to aging, in older people (Holeček, 2017).
For competitive athletes, the most effective dose of HMB supplementation is 3 g/daily for 3 to 4 weeks (Kaczka P, 2019).
We mentioned beetroot juice in our recent article here. Beetroot juice increases nitric oxide, which is related to increased blood flow, mitochondrial biogenesis and efficiency, and stronger muscle contractions (Domínguez R, 2017). It can enhance cardiorespiratory endurance in athletes (Domínguez R, 2017). It can also improve muscle power output and performance at intermittent, high-intensity efforts with short rest periods (Domínguez R, 2018). The effects of beetroot juice may be undermined by interaction with caffeine so check this with your FM practitioner (Domínguez R, 2017).
Magnesium is a mineral which is involved in over 300 enzymatic reactions in the body. It helps muscle and nerve function, regulates blood pressure and supports a strong immune system. It is an electrolyte that can help to prevent muscle cramping. Healthy Mg status is associated with muscle performance, lower-leg power, knee extension torque, ankle extension strength and jumping performance (Zhang Y, 2017).
Exercise can cause a redistribution of magnesium in the body (Nielsen FH, 2006). Even marginal magnesium deficiency can worsen exercise performance and increase oxidative stress from strenuous exercise (Nielsen FH, 2006). Strenuous exercise increases urinary and sweat losses that can increase magnesium requirements by 10-20% (Nielsen FH, 2006). Magnesium supplements, or more high-magnesium foods, help exercise performance in people low in magnesium.
Magnesium supplements in physically active people with adequate magnesium status does not show enhanced physical performance, so more is not better (Nielsen FH, 2006).
Mg is generally found in greens especially spinach, nuts such as almonds and cashews, seeds especially pumpkin seed, beans and whole grains. The RDA for men is 400-420 mg per day and 310-320 mg for women.
** Please stay tuned for next week’s article on Sports Nutrition **
As always, please get in touch with us. If you or someone you know is struggling with sports performance, or general health issues, contact our clinic today. Book a free 15-min discovery call to see how we can help you with your concerns. We can answer your questions and help you book an initial consult with one of the functional medicine doctors in our clinic.
Dr. Miles Nichols and Dr. Diane Mueller have spoken for the following organizations: