Chapter 7: Supplements

As a nutrition coach, you will absolutely be asked about dietary supplements. Unfortunately, the media in our society, along with companies looking to make a “quick buck,” have promoted supplements in a manner that make them seem to be the quickest fix. Obviously we know this not to be true, but this doesn’t change the fact that you WILL be asked about them, and therefore you need to be able to intelligently speak about them. Make sure you only speak to your comfort level – this chapter is brief by design as we feel that your focus as a coach should revolve far more about food and lifestyle changes.

In the book “Macros Explained,” a classification of: essential, recommended, or optional was used to describe the advice for a specific supplement. We will use the same structure for the purposes of this text:

Essential – great for all clients, geared toward health and longevity and may have a performance enhancing benefit

Recommended – proven to be effective for health and longevity, but can also likely be obtained through high quality foods

Optional – scientifically proven to have a positive effect, but the cost/benefit ratio must be determined by the client

1. Fish Oil – essential – perhaps the most widely used supplement, fish oil is a great addition to the diet to help reduce inflammation. Recall from the chapter on fats that the modern North American diet has begun seeing an increase in the ratio of omega-6 fats to omega-3 fats creating a pro-inflammatory environment. By supplementing with fish oil, we are actively reducing this ratio, thereby reducing inflammation.

   Dosing: Fish oil dosing is more about the quantity of EPA/DHA than it is the total dose of fish oil. For that reason, regardless of the product you are using, aim for a dose of .25g EPA/DHA per 10lbs of bodyweight.

2. Vitamin D – essential – Vitamin D deficiency is extremely common in most human beings. While levels may not be clinically low, most individuals will find themselves sub-clinical, or on the low end of the reference range. This can compromise performance, recovery, and even hormonal output.

   While vitamin D is fat soluble, meaning we will not simply excrete excess, we do want to maximize our levels safely. For this reason, supplementing with vitamin D is recommended for all individuals.

   Dosing: Medically you will see doses prescribed as high as 50,000 international units. As a nutrition coach that is not performing blood work, you need to err on the side of caution when prescribing fat soluble vitamins. We have found 2000-5000 units daily to be a safe, effective dose.

3. Probiotics – recommended – Probiotics have multiple benefits stemming from their ability to keep the gut healthy. When you keep your digestive system healthy, you are able to reduce levels of inflammation, keep your immune system functioning, and regulate energy levels throughout the day.

   Dosing: A high quality probiotic supplement will contain 5 billion CFU or more, and will be multi-strain. Take 1 serving twice daily (am and pm).

4. Magnesium – essential – magnesium is under consumed in the typical western diet, and with underconsumption comes an increase in markers for inflammation. It is also important to understand that magnesium is required for energy production and glycolysis – making this nutrient essential to any mixed modal activity.

   Dosing: Magnesium comes in several chelates, but research has shown that magnesium aspartate, citrate, lactate, and chloride are absorbed more completely and are more bioavailable than magnesium oxide or sulfate. Females should take 300mg and males should take 400mg with dinner or the last meal.

5. Vitamin C – essential – There are millions of health benefits when it comes to vitamin C supplementation that will range from immune system function to cardiovascular health. We also have seen evidence in vitamin C contributing to cortisol regulation. Unfortunately, all of these benefits have come in doses that are actually above what the RDA would be through food consumption alone, leaving supplementation to be necessary.

   Dosing: 500mg-2000mg taken each night has proven to be a safe effective dose. If stomach irritation is noticed, ensure you are taking a non-acidic, buffered form of Vitamin C.

6. Glutamine – recommended – Glutamine is the most abundant amino acid found in the body. While we think of it mostly as a “sports supplement,” glutamine is actually used medically to treat the negative effects of cancer treatments. While its physical recovery properties from a training perspective might be overstated by supplement companies, we have seen a tremendous benefit from a GI health perspective.

   Dosing: 5g taken 4 times daily seems to have the best effect to improve GI health.

7. Creatine – recommended – There is scientific evidence that supports an increase in power output production by 5-15% when supplementing with creatine. It is believed that creatine supplementation increases the amount of PCR in the muscle which allows for more ATP to be rapidly produced during exercise.

   While there are a small number of “non responders,” studies have repeatedly shown creatine to be effective when looking at the effects of supplementation on overall strength levels (1RM and number of reps at a given weight).

   Dosing: Creatine works on saturation in the muscle, and should be taken daily. While there may be some dose dependent effects, best results will be seen with longer term consumption. 3-5g taken pre or post workout is advised.

8. BCAA (branched chain amino acid) – recommended – Branched chain amino acids have several very positive benefits. First, they increase the rate of protein synthesis and decrease the rate of protein breakdown. This is very favorable for anyone doing resistance training, as it will ensure, at minimum, the retention of lean tissue (in a calorie deficit it will help with lean tissue acquisition.)

   BCAA supplementation can also reduce the rate of perceived exertion (RPE) and increase the time to exhaustion (TTE). This happens because BCAA compete with another amino acid, tryptophan, for entry into the brain. Tryptophan can be converted to serotonin, and during intense exercise when serotonin levels rise it will increase the perception of fatigue, thereby reducing your output. By supplementing with BCAA, the amount of tryptophan entering the brain is reduced, allowing you to push harder, longer.

   Finally, in a caloric deficit, it is important to understand that valine and isoleucine are considered glucogenic – meaning that if needed they can convert to glucose for immediate energy during training.

   Dosing: 7-15g taken about 20 minutes prior to training and sipped on during training seems to have the best response. In times of severe caloric restriction, an additional serving away from training is advised.

9. HMB – optional – When discussing HMB, it is important to understand that it is a metabolite of leucine. As discussed above, leucine (and BCAA), are extremely beneficial when it comes to increasing protein synthesis and decreasing muscle breakdown synthesis. Unfortunately, once broken down, the amount of HMB absorbed from leucine is minimal, leaving optimal levels of HMB to be achieved via supplementation.

   HMB is also a substrate for cholesterol synthesis, which allows for the maintenance of cell integrity.

   Dosing: Unfortunately, we have seen the dose required for efficacy to be much higher than what is often prescribed by supplement companies. Most products will advise 1-3g daily, with an effective dose being 6-8g daily. If a client has the disposable income, HMB seems to be very promising.

10. Nootropics – optional – As of the printing of this text, “nootropics” are still a relatively new category of supplements. Sometimes referred to as “smart drugs,” nootropics are believed to enhance cognitive abilities leading to improved mental performance.

    We are beginning to see ingredients from nootropic supplements appear in other sports products like pre-workouts, but the combination has no peer reviewed evidence to accurately speak to any efficacy.

    Dosing: Will vary by product.