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{{short description|Dietary supplement used for bodybuilding}}
'''Bodybuilding supplements''' are [[substances]] taken by [[bodybuilders]] - people attempting to add [[muscle]] mass. The industry producing supplements is big business and this has lead to a number of companies promoting false claims about their products. It has also lead to difficulties in consumers obtaining reliable information due to most bodybuilding [[magazine]]s and [[website]]s being owned or heavily sponsored by supplement companies.
{{more medical citations needed|date=November 2016}}
'''Bodybuilding supplements''' are [[dietary supplement]]s commonly used by those involved in [[bodybuilding]], weightlifting, mixed martial arts, and [[Athletics (physical culture)|athletics]] for the purpose of facilitating an increase in [[lean body mass]]. Bodybuilding supplements may contain ingredients that are advertised to increase a person's muscle, body weight, athletic performance, and decrease a person's percent body fat for desired muscle definition. Among the most widely used are [[Protein supplement|high protein drinks]], [[pre-workout]] blends, [[Branched-chain amino acids|branched-chain amino acids (BCAA)]], [[glutamine]], [[arginine]], [[essential fatty acids]], [[creatine]], [[beta-Hydroxy beta-methylbutyric acid|HMB]], [[whey protein]], [[ZMA (supplement)|ZMA]], and [[weight loss]] products.<ref>{{Cite journal|last=Cruz-Jentoft|first=Alfonso J.|date=2018|title=Beta-Hydroxy-Beta-Methyl Butyrate (HMB): From Experimental Data to Clinical Evidence in Sarcopenia|url=https://pubmed.ncbi.nlm.nih.gov/28554316/|journal=Current Protein & Peptide Science|volume=19|issue=7|pages=668–672|doi=10.2174/1389203718666170529105026|issn=1875-5550|pmid=28554316|access-date=2021-07-29|archive-date=2021-07-29|archive-url=https://web.archive.org/web/20210729175918/https://pubmed.ncbi.nlm.nih.gov/28554316/|url-status=live}}</ref><ref name="navarro">{{cite journal | vauthors = Navarro VJ, Khan I, Björnsson E, Seeff LB, Serrano J, Hoofnagle JH | title = Liver injury from herbal and dietary supplements | journal = Hepatology | volume = 65 | issue = 1 | pages = 363–373 | date = January 2017 | pmid = 27677775 | pmc = 5502701 | doi = 10.1002/hep.28813 }}</ref> Supplements are sold either as single ingredient preparations or in the form of "stacks" – proprietary blends of various supplements marketed as offering synergistic advantages.


== Food ==
==History==
[[Athletes in ancient Greece]] were advised to consume large quantities of meat and wine. A number of herbal concoctions and tonics have been used by strong men and athletes since ancient times across cultures to try to increase their strength and stamina.<ref>{{cite book | vauthors = Dalby A |title=Food in the ancient world, from A to Z |date=2008 |publisher=Routledge |location=London |isbn=978-0-415-86279-0 | page = 203 }}</ref>


In the 1910s, [[Eugen Sandow]], widely considered to be the first modern bodybuilder in the West, advocated the use of dietary control to enhance muscle growth. Later, bodybuilder Earle Liederman advocated the use of "beef juice" or "beef extract" (basically, [[consomme]]) as a way to enhance muscle recovery. In the 1950s, with recreational and competitive bodybuilding becoming increasingly popular, Irvin P. Johnson began to popularize and market [[egg]]-based protein powders marketed specifically at bodybuilders and physical athletes. The 1970s and 1980s marked a dramatic increase in the growth of the bodybuilding supplement industry, fueled by the widespread use of modern marketing techniques and a marked increase in recreational bodybuilding.
Due to the large amount of food bodybuilders need to consume, the majority choose to consume some as a supplement (often in liquid form) as this is more convenient.


In October 1994, the [[Dietary Supplement Health and Education Act]] (DSHEA) was signed into law in the USA. Under DSHEA, responsibility for determining the safety of the [[dietary supplement]]s changed from the government to the manufacturer, and supplements no longer required approval from the U.S. [[Food and Drug Administration]] (FDA) before distributing the products. Since that time, manufacturers did not have to provide FDA with the evidence to substantiate safety or effectiveness unless a new dietary ingredient was added. It is widely believed that the 1994 DSHEA further consolidated the position of the supplement industry and lead to additional product sales.<ref>{{cite journal| vauthors = Higgins M |title=Hard to Swallow: While federal law shut the door on regulation of dietary supplements, marketing hype may be leading the popular aids up courthouse steps|journal=ABA Journal|date=June 1999 |volume=85|issue=6|pages=60–63}}{{JSTOR|27840828}}</ref>
=== Protein ===


==Protein==
Bodybuilders often take [[protein]], the essential building blocks for muscles, as a supplement as it is necessary to consume large quantities and protein shakes are convenient. The most commonly consumed type is [[whey protein]] since it is a naturally complete protein and is a rich source of branched chain amino acids (BCAAs), containing the highest known levels of any natural food source. It is also very quickly absorbed by the body and metabolized.
{{further|Protein quality|Protein supplement}}
[[File:Protein shake.jpg|thumb|Protein shakes, made from protein powder (center) and milk (left), are a common bodybuilding supplement.]]


[[Bodybuilder]]s may supplement their diets with [[protein in nutrition|protein]] for reasons of convenience, lower cost (relative to meat and fish products), ease of preparation, and to avoid the concurrent consumption of carbohydrates and fats. Additionally, some argue that bodybuilders, by virtue of their unique training and goals, require higher-than-average quantities of protein to support maximal muscle growth.<ref name="pmid14971434">{{cite journal | vauthors = Tipton KD, Wolfe RR | title = Protein and amino acids for athletes | journal = Journal of Sports Sciences | volume = 22 | issue = 1 | pages = 65–79 | date = January 2004 | pmid = 14971434 | doi = 10.1080/0264041031000140554 | s2cid = 16708689 | url = http://www.uni.edu/dolgener/Advanced_Sport_Nutrition/protein_intake.pdf | access-date = 2012-01-10 | archive-date = 2016-03-04 | archive-url = https://web.archive.org/web/20160304201037/http://www.uni.edu/dolgener/Advanced_Sport_Nutrition/protein_intake.pdf | url-status = live }}</ref><ref>{{cite journal | vauthors = Lemon PW | title = Beyond the zone: protein needs of active individuals | journal = Journal of the American College of Nutrition | volume = 19 | issue = 5 Suppl | pages = 513S–521S | date = October 2000 | pmid = 11023001 | doi = 10.1080/07315724.2000.10718974 | s2cid = 14586881 }}</ref><ref>{{cite journal | vauthors = Phillips SM | title = Dietary protein for athletes: from requirements to metabolic advantage | journal = Applied Physiology, Nutrition, and Metabolism | volume = 31 | issue = 6 | pages = 647–54 | date = December 2006 | pmid = 17213878 | doi = 10.1139/h06-035 }}</ref><ref>{{cite journal | vauthors = Phillips SM, Moore DR, Tang JE | title = A critical examination of dietary protein requirements, benefits, and excesses in athletes | journal = International Journal of Sport Nutrition and Exercise Metabolism | volume = 17 Suppl | pages = S58-76 | date = August 2007 | pmid = 18577776 | doi = 10.1123/ijsnem.17.s1.s58 }}</ref><ref>{{cite journal | vauthors = Slater G, Phillips SM | title = Nutrition guidelines for strength sports: sprinting, weightlifting, throwing events, and bodybuilding | journal = Journal of Sports Sciences | volume = 29 | pages = S67-77 | year = 2011 | issue = Suppl 1 | pmid = 21660839 | doi = 10.1080/02640414.2011.574722 | s2cid = 8141005 | doi-access = }}</ref><ref>{{cite journal | vauthors = Tipton KD, Wolfe RR | title = Protein and amino acids for athletes | journal = Journal of Sports Sciences | volume = 22 | issue = 1 | pages = 65–79 | date = January 2004 | pmid = 14971434 | doi = 10.1080/0264041031000140554 | s2cid = 16708689 }}</ref><ref>{{cite journal | vauthors = Phillips SM, Van Loon LJ | title = Dietary protein for athletes: from requirements to optimum adaptation | journal = Journal of Sports Sciences | volume = 29 | pages = S29-38 | year = 2011 | issue = Suppl 1 | pmid = 22150425 | doi = 10.1080/02640414.2011.619204 | s2cid = 33218998 }}</ref><ref name="lemon">{{cite journal | vauthors = Lemon PW | title = Do athletes need more dietary protein and amino acids? | journal = International Journal of Sport Nutrition | volume = 5 Suppl | pages = S39-61 | date = June 1995 | pmid = 7550257 | doi = 10.1123/ijsn.5.s1.s39 | s2cid = 27679614 }}</ref> While the recommended dietary allowance is much less,<ref name="fnic.nal.usda.gov"/> Harvard Medical School points out in Health Health Publishing that this RDA (recommended daily allowance) is “the minimum amount you need to keep from getting sick — not the specific amount you are supposed to eat every day.”<ref>https://www.health.harvard.edu/blog/how-much-protein-do-you-need-every-day-201506188096#:~:text=The%20Recommended%20Dietary%20Allowance%20(RDA,meet%20your%20basic%20nutritional%20requirements. Harvard Medical School , Harvard Health Publishing. “How much protein do you need every day?” Reviewed by Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing. June 22, 2023.</ref> Protein supplements are sold in ready-to-drink [[health shake]]s, bars, meal replacement products (see below), bites, oats, gels and powders. Protein powders are the most popular and may have flavoring added for palatability. The powder is usually mixed with water, milk or fruit juice and is generally consumed immediately before and after exercising or in place of a meal. The sources of protein are as follows and differ in [[protein quality]] depending on their amino acid profile and digestibility:
=== Meal Replacement ===


* [[Whey protein]] contains high levels of all the [[essential amino acids]] and [[branched-chain amino acids]]. It also has the highest content of the amino acid [[cysteine]], which aids in the biosynthesis of [[glutathione]]. For bodybuilders, whey protein provides amino acids used to aid in muscle recovery.<ref name=wolfe/> Whey protein is derived from the process of making [[cheese]] from [[milk]]. There are three types of whey protein: whey concentrate, whey isolate, and whey hydrolysate. Whey concentrate is 29–89% protein by weight whereas whey isolate is 90%+ protein by weight. Whey hydrolysate is enzymatically predigested and therefore has the highest rate of digestion of all protein types.<ref name=wolfe>{{cite journal | vauthors = Wolfe RR | title = Protein supplements and exercise | journal = The American Journal of Clinical Nutrition | volume = 72 | issue = 2 Suppl | pages = 551S–7S | date = August 2000 | pmid = 10919959 | doi = 10.1093/ajcn/72.2.551S | doi-access = free }}</ref>
Meal replacement products (in the form of a drink or bar) contain sufficient nutrients (protein and carbs) that a bodybuilder could take them in place of a normal meal. There is controversy over certain products that, in order to increase the calorie count and reduce costs, include a large amount of simple sugars.
* [[Casein protein]] (or milk protein) has [[glutamine]], and [[casomorphin]].<ref name="wolfe"/>


[[File:Osaka protein shaker.jpg|thumb|upright|Shaker Bottle commonly used to mix supplements. Often has mesh or a metal whisk inside to breakdown lumps in the mixture.]]
== Hormones ==


Some nutritionists have suggested that higher calcium excretion may be due to a corresponding increase in protein-induced calcium absorption in the intestines.<ref>{{cite journal | vauthors = Kerstetter JE, O'Brien KO, Insogna KL | title = Dietary protein, calcium metabolism, and skeletal homeostasis revisited | journal = The American Journal of Clinical Nutrition | volume = 78 | issue = 3 Suppl | pages = 584S–592S | date = September 2003 | pmid = 12936953 | doi = 10.1093/ajcn/78.3.584S | doi-access = free }}</ref><ref>{{cite journal | vauthors = Kerstetter JE, O'Brien KO, Insogna KL | title = Low protein intake: the impact on calcium and bone homeostasis in humans | journal = The Journal of Nutrition | volume = 133 | issue = 3 | pages = 855S–861S | date = March 2003 | pmid = 12612169 | doi = 10.1093/jn/133.3.855S | doi-access = free }}</ref><ref>{{cite journal | vauthors = Dawson-Hughes B, Harris SS, Rasmussen H, Song L, Dallal GE | title = Effect of dietary protein supplements on calcium excretion in healthy older men and women | journal = The Journal of Clinical Endocrinology and Metabolism | volume = 89 | issue = 3 | pages = 1169–73 | date = March 2004 | pmid = 15001604 | doi = 10.1210/jc.2003-031466 | doi-access = free }}</ref>
=== Anabolic steroids ===


===Amino acids===
[[Anabolic steroid]]s are [[hormone]]s that promote cell growth and division, in the form of [[muscular]] [[hypertrophy]]. They are illegal for recreational use in most countries, but can be prescribed for various conditions in countries such as [[Canada]].
Some bodybuilders believe that amino acid supplements may benefit muscle development, but consumption of such supplements is unnecessary in a diet that already includes adequate protein intake.<ref name=sizer>{{cite book|vauthors=Sizer FS, Piché LA, Whitney EN|title=Nutrition: Concepts and Controversies|url=https://books.google.com/books?id=Q7VRgwLhGKgC&pg=PA407|year=2012|publisher=Cengage Learning|isbn=978-0-17-650258-4|page=407}}</ref>


=== Prohormones ===
==Prohormones==
{{Main|Androgen prohormone}}
An androgen prohormone, or proandrogen, is a [[prohormone]] (or [[prodrug]]) of an [[anabolic-androgenic steroid]] (AAS). They can be prohormones of [[testosterone]] or of [[synthetic compound|synthetic]] AAS, for example, [[nandrolone]] (19-nortestosterone). [[Dehydroepiandrosterone]] (DHEA), [[DHEA sulfate]] (DHEA-S), and [[androstenedione]] may all be considered proandrogens of testosterone.<ref name="Erkkola2006">{{cite book|author=Risto Erkkola|title=The Menopause|url=https://books.google.com/books?id=1AU_NI__fpUC&pg=PA5|year=2006|publisher=Elsevier|isbn=978-0-444-51830-9|pages=5–}}</ref>


Since 2005, the use of steroid precursors (prohormones) has been illegal in the U.S.<ref>Friedel, Angelika, et al. "17β-hydroxy-5alpha-androst-1-en-3-one (1-testosterone) is a potent androgen with anabolic properties." Toxicology letters 165.2 (2006): 149-155.</ref>
[[Prohormone]]s are precursors to hormones - most typically sold to bodybuilders as a precursor to the natural hormone testosterone. There are currently many kinds of pro-hormones available, 1-AD , DHEA 19-Nordiol, and Androstenedione are examples. Prohormones suppress the body's Hypothalamus-Pituitary-Testicular axis (HPTA), so they ''cannot'' be used on a continuous basis, but rather must be ''cycled'' on and off. They are currently illegal in the United States and many European countries.


==Creatine==
Their use remains quite controversial and side effects are not uncommon. They are the precursors of testosterone, but some can also convert readily to [[DHT]] and [[estrogen]]. To date most prohormone products have not been thoroughly studied, and the health effects of prolonged use are mostly unknown.
{{Main|Creatine supplements}}
[[Creatine]] is an [[organic acid]] naturally occurring in the body (and in red meats)<ref>{{Cite journal |last=Williams |first=Melvin H. |last2=Branch |first2=J. David |date=June 1998 |title=Creatine Supplementation and Exercise Performance: An Update |url=http://www.tandfonline.com/doi/abs/10.1080/07315724.1998.10718751 |journal=Journal of the American College of Nutrition |language=en |volume=17 |issue=3 |pages=216–234 |doi=10.1080/07315724.1998.10718751 |issn=0731-5724}}</ref> that supplies energy to muscle cells for short bursts of energy (as required in lifting weights) via [[creatine phosphate]] replenishment of [[Adenosine triphosphate|ATP]]. Scientific studies have shown that creatine supplementation can increase the consumer's strength,<ref>{{cite journal | vauthors = Becque MD, Lochmann JD, Melrose DR | title = Effects of oral creatine supplementation on muscular strength and body composition | journal = Medicine and Science in Sports and Exercise | volume = 32 | issue = 3 | pages = 654–8 | date = March 2000 | pmid = 10731009 | doi = 10.1097/00005768-200003000-00016 | doi-access = free }}</ref> energy during performance,<ref>{{cite journal | vauthors = Birch R, Noble D, Greenhaff PL | title = The influence of dietary creatine supplementation on performance during repeated bouts of maximal isokinetic cycling in man | journal = European Journal of Applied Physiology and Occupational Physiology | volume = 69 | issue = 3 | pages = 268–76 | year = 1994 | pmid = 8001541 | doi = 10.1007/BF01094800 | s2cid = 8455503 }}</ref> muscle mass, and recovery times after exercise. In addition, recent studies have also shown that creatine improves brain function.<ref>{{cite journal | vauthors = Rae C, Digney AL, McEwan SR, Bates TC | title = Oral creatine monohydrate supplementation improves brain performance: a double-blind, placebo-controlled, cross-over trial | journal = Proceedings. Biological Sciences | volume = 270 | issue = 1529 | pages = 2147–50 | date = October 2003 | pmid = 14561278 | pmc = 1691485 | doi = 10.1098/rspb.2003.2492 }}</ref> and reduces mental fatigue.<ref>{{cite journal | vauthors = Watanabe A, Kato N, Kato T | title = Effects of creatine on mental fatigue and cerebral hemoglobin oxygenation | journal = Neuroscience Research | volume = 42 | issue = 4 | pages = 279–85 | date = April 2002 | pmid = 11985880 | doi = 10.1016/S0168-0102(02)00007-X | s2cid = 6304255 }}</ref>


Some studies have suggested that consumption of creatine with protein and carbohydrates can have a greater effect than creatine combined with either protein or carbohydrates alone.<ref>{{cite journal | vauthors = Green AL, Hultman E, Macdonald IA, Sewell DA, Greenhaff PL | title = Carbohydrate ingestion augments skeletal muscle creatine accumulation during creatine supplementation in humans | journal = The American Journal of Physiology | volume = 271 | issue = 5 Pt 1 | pages = E821-6 | date = November 1996 | pmid = 8944667 | doi = 10.1152/ajpendo.1996.271.5.E821 }}</ref>
=== Human Growth Hormone ===


While generally considered safe, long-term or excessive consumption of creatine may have an adverse effect on the [[kidneys]], liver, or heart and should be avoided if any pre-existing conditions affecting these organs exist.<ref>{{Cite web|title=Creatine|url=https://www.mayoclinic.org/drugs-supplements-creatine/art-20347591|access-date=2020-12-16|website=Mayo Clinic|language=en|archive-date=2020-12-09|archive-url=https://web.archive.org/web/20201209180918/https://www.mayoclinic.org/drugs-supplements-creatine/art-20347591|url-status=live}}</ref>
[[Human Growth Hormone]] (HGH) is a protein [[hormone]] synthesized in the human body that stimulates growth and cell reproduction. It can be produced synthetically and is often taken by large bodybuilders.


==β-Hydroxy β-methylbutyrate==
== Amino Acids ==
{{Main|Beta-Hydroxy beta-methylbutyric acid}}
When combined with an appropriate exercise program, dietary supplementation with [[β-hydroxy β-methylbutyrate]] (HMB) has been shown to [[dose-dependent]]ly augment gains in [[muscle hypertrophy]] (i.e., the size of a muscle),<ref name="PEDs in sports 2015 review" /><ref name="Meta-analytic systematic review September 2015">{{cite journal | vauthors = Wu H, Xia Y, Jiang J, Du H, Guo X, Liu X, Li C, Huang G, Niu K | display-authors = 6 | title = Effect of beta-hydroxy-beta-methylbutyrate supplementation on muscle loss in older adults: a systematic review and meta-analysis | journal = Archives of Gerontology and Geriatrics | volume = 61 | issue = 2 | pages = 168–75 | date = September 2015 | pmid = 26169182 | doi = 10.1016/j.archger.2015.06.020 }}</ref> [[Physical strength|muscle strength]],<ref name="PEDs in sports 2015 review" /><ref name="Molecular Aspects of Medicine 2016 review" /><ref name="Effects of amino acid derivatives 2015 review" /> and [[lean body mass]],<ref name="PEDs in sports 2015 review" /><ref name="Molecular Aspects of Medicine 2016 review" /><ref name="Effects of amino acid derivatives 2015 review" /> reduce exercise-induced skeletal muscle damage,{{#tag:ref|The effect of HMB on skeletal muscle damage has been assessed in studies using four different [[Biomarker (medicine)|biomarkers]] of muscle damage or protein breakdown: [[blood serum|serum]] [[creatine kinase]], serum [[lactate dehydrogenase]], urinary [[urea nitrogen]], and urinary [[3-methylhistidine]].<ref name="PEDs in sports 2015 review" /><ref name="Effects of amino acid derivatives 2015 review" /><ref name="ISSN position stand 2013" /> When exercise intensity and volume are sufficient to cause skeletal muscle damage, such as during [[long-distance running]] or [[progressive overload]], HMB supplementation has been demonstrated to attenuate the rise in these biomarkers by 20–60%.<ref name="PEDs in sports 2015 review" /><ref name="ISSN position stand 2013" />|group="note"}}<ref name="PEDs in sports 2015 review" /><ref name="Meta-analytic systematic review September 2015" /><ref name="Effects of amino acid derivatives 2015 review">{{cite journal | vauthors = Luckose F, Pandey MC, Radhakrishna K | title = Effects of amino acid derivatives on physical, mental, and physiological activities | journal = Critical Reviews in Food Science and Nutrition | volume = 55 | issue = 13 | pages = 1793–807 | date = 2015 | pmid = 24279396 | doi = 10.1080/10408398.2012.708368 | quote = HMB, a derivative of leucine, prevents muscle damage and increases muscle strength by reducing exercise-induced proteolysis in muscles and also helps in increasing lean body mass.&nbsp;... The meta analysis studies and the individual studies conducted support the use of HMB as an effective aid to increase body strength, body composition, and to prevent muscle damage during resistance training. | s2cid = 22657268 }}</ref> and expedite recovery from high-intensity exercise.<ref name="PEDs in sports 2015 review">{{cite journal | vauthors = Momaya A, Fawal M, Estes R | title = Performance-enhancing substances in sports: a review of the literature | journal = Sports Medicine | volume = 45 | issue = 4 | pages = 517–31 | date = April 2015 | pmid = 25663250 | doi = 10.1007/s40279-015-0308-9 | quote = Wilson et al. [91] demonstrated that when non-resistance trained males received HMB pre-exercise, the rise of lactate dehydrogenase (LDH) levels reduced, and HMB tended to decrease soreness. Knitter et al. [92] showed a decrease in LDH and creatine phosphokinase (CPK), a byproduct of muscle breakdown, by HMB after a prolonged run.&nbsp;... The utility of HMB does seem to be affected by timing of intake prior to workouts and dosage [97]. | s2cid = 45124293 }}</ref><ref name="ISSN position stand 2013">{{cite journal | vauthors = Wilson JM, Fitschen PJ, Campbell B, Wilson GJ, Zanchi N, Taylor L, Wilborn C, Kalman DS, Stout JR, Hoffman JR, Ziegenfuss TN, Lopez HL, Kreider RB, Smith-Ryan AE, Antonio J | display-authors = 6 | title = International Society of Sports Nutrition Position Stand: beta-hydroxy-beta-methylbutyrate (HMB) | journal = Journal of the International Society of Sports Nutrition | volume = 10 | issue = 1 | pages = 6 | date = February 2013 | pmid = 23374455 | pmc = 3568064 | doi = 10.1186/1550-2783-10-6 | doi-access = free }}</ref> HMB is believed to produce these effects by increasing muscle protein synthesis and decreasing muscle protein breakdown by various mechanisms, including activation of the [[mechanistic target of rapamycin]] (mTOR) and inhibition of the [[proteasome]] in skeletal muscles.<ref name="Molecular Aspects of Medicine 2016 review">{{cite journal | vauthors = Brioche T, Pagano AF, Py G, Chopard A | title = Muscle wasting and aging: Experimental models, fatty infiltrations, and prevention | journal = Molecular Aspects of Medicine | volume = 50 | pages = 56–87 | date = August 2016 | pmid = 27106402 | doi = 10.1016/j.mam.2016.04.006 | s2cid = 29717535 | url = https://hal.archives-ouvertes.fr/hal-01837630/file/2016_Brioche_MAM_1.pdf | quote = In conclusion, HMB treatment clearly appears to be a safe potent strategy against sarcopenia, and more generally against muscle wasting, because HMB improves muscle mass, muscle strength, and physical performance. It seems that HMB is able to act on three of the four major mechanisms involved in muscle deconditioning (protein turnover, apoptosis, and the regenerative process), whereas it is hypothesized to strongly affect the fourth (mitochondrial dynamics and functions). Moreover, HMB is cheap (~30– 50 US dollars per month at 3 g per day) and may prevent osteopenia (Bruckbauer and Zemel, 2013; Tatara, 2009; Tatara et al., 2007, 2008, 2012) and decrease cardiovascular risks (Nissen et al., 2000). For all these reasons, HMB should be routinely used in muscle-wasting conditions especially in aged people.&nbsp;... 3&nbsp;g of CaHMB taken three times a day (1 g each time) is the optimal posology, which allows for continual bioavailability of HMB in the body (Wilson et al., 2013). | access-date = 2020-09-01 | archive-date = 2021-11-24 | archive-url = https://web.archive.org/web/20211124021646/https://hal.archives-ouvertes.fr/hal-01837630/file/2016_Brioche_MAM_1.pdf | url-status = live }}</ref><ref name="Skeletal muscle homeostasis 2016 review">{{cite journal | vauthors = Brook MS, Wilkinson DJ, Phillips BE, Perez-Schindler J, Philp A, Smith K, Atherton PJ | title = Skeletal muscle homeostasis and plasticity in youth and ageing: impact of nutrition and exercise | journal = Acta Physiologica | volume = 216 | issue = 1 | pages = 15–41 | date = January 2016 | pmid = 26010896 | pmc = 4843955 | doi = 10.1111/apha.12532 }}</ref>


The inhibition of exercise-induced skeletal muscle damage by HMB is affected by the time that it is used relative to exercise.<ref name="PEDs in sports 2015 review" /><ref name="ISSN position stand 2013" /> The greatest reduction in skeletal muscle damage from a single bout of exercise appears to occur when calcium HMB is ingested 1–2&nbsp;hours prior to exercise.<ref name="ISSN position stand 2013" />
=== Glutamine ===


==Controversy==
[[Glutamine]] is an [[amino acid]] used in the immune system and muscle cells. A deficiency can lead to a weakened immune system and wasting of muscle tissue. Many bodybuilders supplement with glutamine. It plays a vital role in [[protein synthesis]].Sold as a micronized, intsantly [[soluble]] powder. Glutamine helps rebuild muscle tissue and increases their ability to '''recover''' and '''rebuild'''. Research has shown glutamine helps the body increase [[HGH]] production, and has benefits for the [[Gastrointestinal Tract]]. Others argue that gluatamine also causes a larger insulin response (see [[#Insulin|insulin]] section for effects).
{{cleanup press release|date=February 2020}}


=== BCAAs ===
=== Mislabeling and adulteration===
While many of the claims are based on scientifically-based physiological or biochemical processes, their use in bodybuilding parlance is often heavily colored by bodybuilding lore and industry marketing and, as such, may deviate considerably from traditional scientific usages of the terms. In addition, ingredients listed have been found at times to be different from the contents. In 2015, [[Consumer Reports]] reported unsafe levels of [[arsenic]], [[cadmium]], [[lead]], and [[Mercury (element)|mercury]] in several of the protein powders that were tested.<ref name="MyUser_Theglobeandmail.com_December_11_2015c">{{cite web |vauthors=McGinn D |date=7 November 2010 |url=https://www.theglobeandmail.com/life/health-and-fitness/health/conditions/are-protein-shakes-the-weight-loss-magic-bullet/article596648/ |title=Are protein shakes the weight-loss magic bullet? - The Globe and Mail |newspaper=Theglobeandmail.com |access-date=December 11, 2015 |archive-date=2 June 2016 |archive-url=https://web.archive.org/web/20160602013106/http://www.theglobeandmail.com/life/health-and-fitness/health/conditions/are-protein-shakes-the-weight-loss-magic-bullet/article596648/ |url-status=live }}</ref>


In the United States, the manufacturers of dietary supplements do not need to provide the Food and Drug Administration with evidence of product safety prior to marketing.<ref name=FDAtestimony>{{cite web | url = https://www.fda.gov/NewsEvents/Testimony/ucm184497.htm | publisher = Food and Drug Administration | title = Body-building Products and Hidden Steroids: Enforcement Barriers|archive-url=https://web.archive.org/web/20150314235825/https://www.fda.gov/NewsEvents/Testimony/ucm184497.htm|archive-date=2015-03-14}}</ref> As a result, the incidence of products adulterated with illegal ingredients has continued to rise.<ref name=FDAtestimony/> In 2013, one-third of the supplements tested were adulterated with unlisted steroids.<ref name="spike">{{cite web | vauthors = O'Connor A | date = 21 December 2013 | url = https://www.nytimes.com/2013/12/22/us/spike-in-harm-to-liver-is-tied-to-dietary-aids.html?_r=0 | title = Spike in Harm to Liver Is Tied to Dietary Aids | work = [[The New York Times]] | access-date = 26 February 2017 | archive-date = 10 April 2019 | archive-url = https://web.archive.org/web/20190410210623/https://www.nytimes.com/2013/12/22/us/spike-in-harm-to-liver-is-tied-to-dietary-aids.html?_r=0 | url-status = live }}</ref> More recently, the prevalence of [[designer steroid]]s with unknown safety and pharmacological effects has increased.<ref>{{cite journal | vauthors = Joseph JF, Parr MK | title = Synthetic androgens as designer supplements | journal = Current Neuropharmacology | volume = 13 | issue = 1 | pages = 89–100 | date = January 2015 | pmid = 26074745 | pmc = 4462045 | doi = 10.2174/1570159X13666141210224756 }}</ref><ref>{{cite journal | vauthors = Rocha T, Amaral JS, Oliveira MB | title = Adulteration of Dietary Supplements by the Illegal Addition of Synthetic Drugs: A Review | journal = Comprehensive Reviews in Food Science and Food Safety | volume = 15 | issue = 1 | pages = 43–62 | date = January 2016 | pmid = 33371574 | doi = 10.1111/1541-4337.12173 | doi-access = free | hdl = 10198/15401 | hdl-access = free }}</ref>
[[Amino acid]]s are the building blocks for protein - the body breaks consumed protein into these in the [[stomach]] and [[intestine]]s. Branch chain amino acids (BCAAs) are the specific aminos [[leucine]], [[isoleucine]], and [[valine]] which are metabolized in the muscles (rather than the [[liver]]).


In 2015, a [[Canadian Broadcasting Corporation|CBC]] investigative report found that protein spiking (i.e., the addition of amino-acid filler to manipulate analysis) was not uncommon;<ref name="Griffith-Greene_2015">{{cite web | vauthors = Griffith-Greene M | work = Marketplace | publisher = CBC News | date = 13 November 2015 | url = http://www.cbc.ca/news/health/marketplace-protein-powders-1.3313084 | title = M Some protein powders fail fitness test | access-date = 11 December 2015 | archive-date = 8 September 2017 | archive-url = https://web.archive.org/web/20170908232102/http://www.cbc.ca/news/health/marketplace-protein-powders-1.3313084 | url-status = live }}</ref> however, many of the companies involved challenged these claims.<ref name="Griffith-Greene_2015" />
== Other ==


=== Creatine ===
=== Health problems ===
{{tone|section|date=September 2020}}
The US FDA reports 50,000 health problems a year due to dietary supplements<ref name=skip>{{Cite web | url = https://www.nytimes.com/2013/12/15/opinion/sunday/skip-the-supplements.html?_r=0 | title = Skip the Supplements | vauthors = Offit PA, Erush S | work = [[The New York Times]] | date = 14 December 2013 | access-date = 26 February 2017 | archive-date = 17 July 2019 | archive-url = https://web.archive.org/web/20190717115958/https://www.nytimes.com/2013/12/15/opinion/sunday/skip-the-supplements.html?_r=0 | url-status = live }}</ref> and these often involve bodybuilding supplements.<ref>{{cite web | url = https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/MedicationHealthFraud/ucm234523.htm | title = Tainted Body Building Products | work = U.S. Food and Drug Administration | date = 17 December 2010 | access-date = 16 December 2019 | archive-date = 23 April 2019 | archive-url = https://web.archive.org/web/20190423022416/https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/MedicationHealthFraud/ucm234523.htm | url-status = live }}</ref> For example, the "natural" best-seller Craze, 2012's "New Supplement of the Year" by bodybuilding.com, widely sold in stores such as [[Walmart]] and [[Amazon (company)|Amazon]], was found to contain [[N,alpha-Diethylphenylethylamine]], a [[methamphetamine]] analog.<ref>{{Cite news | vauthors = Young A | url = https://www.usatoday.com/story/news/nation/2013/10/14/tests-of-supplements-craze-and-detonate-find-methamphetamine-like-compound/2968041/ | publisher = USA Today | date = 25 October 2013 | title = Popular sports supplements contain meth-like compound | quote = Cohen said researchers informed the FDA in May about finding the new chemical compound in Craze. The team found the compound — N,alpha-diethylphenylethylamine — has a structure similar to methamphetamine, a powerful, highly addictive, illegal stimulant drug. They believe the new compound is likely less potent than methamphetamine but greater than ephedrine. | access-date = 24 August 2017 | archive-date = 12 November 2019 | archive-url = https://web.archive.org/web/20191112103646/https://www.usatoday.com/story/news/nation/2013/10/14/tests-of-supplements-craze-and-detonate-find-methamphetamine-like-compound/2968041/ | url-status = live }}</ref>


The incidence of [[hepatotoxicity|liver damage]] from herbal and dietary supplements is about 16&ndash;20% of all supplement products causing injury, with the occurrence growing globally over the early 21st century.<ref name=navarro/> The most common liver injuries from weight loss and bodybuilding supplements involve [[Hepatocyte|hepatocellular]] damage and [[jaundice]]. The most common supplement ingredients attributed to these injuries are [[catechin]]s from [[green tea]], [[anabolic steroid]]s, and the herbal [[extract]], [[Aegle marmelos|aegeline]].<ref name=navarro/> Other products by supplement designer and CEO of Driven Sports, Matt Cahill, have contained dangerous substances causing blindness or liver damage, and his pre-workout supplement ''Craze'' was found to contain illegal stimulants<ref>{{Cite web|date=2019-12-20|title=Driven Sports Inc. - 04/04/2014|url=https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/driven-sports-inc-04042014|access-date=2020-12-16|website=U.S. Food and Drug Administration|language=en|archive-date=2021-01-22|archive-url=https://web.archive.org/web/20210122105247/https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/driven-sports-inc-04042014|url-status=live}}</ref> that resulted in several athletes failing drug tests.<ref>{{cite web | vauthors = Young A | url = https://www.usatoday.com/story/news/nation/2013/07/25/bodybuilding-supplement-designer-matt-cahill-usa-today-investigation/2568815/ | title = Sports supplement designer has history of risky products | work = [[USA Today]] | date = 27 September 2013 | access-date = 24 August 2017 | archive-date = 25 June 2019 | archive-url = https://web.archive.org/web/20190625203255/https://www.usatoday.com/story/news/nation/2013/07/25/bodybuilding-supplement-designer-matt-cahill-usa-today-investigation/2568815/ | url-status = live }}</ref>
[[Creatine]] is an [[organic acid]] naturally occurring in the body that supplies energy to muscle cells for short burst of energy (such as lifting weights). A number of studies have been conducted into its usage and most conclude an increase in body mass. However, a number of people argue this is purely due to water retention. See [[creatine]] article for more information.


=== Insulin ===
===Protein effectiveness===
Some have argued that there is little evidence to indicate any benefit to using bodybuilding protein or [[amino acid]] supplements. A 2005 overview concluded that "[i]n view of the lack of compelling evidence to the contrary, no additional dietary protein is suggested for healthy adults undertaking resistance or endurance exercise".<ref name="fnic.nal.usda.gov">{{cite book |title=Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids |chapter=Macronutrients |chapter-url=https://www.nap.edu/read/10490/chapter/12#661 |date=2005 |publisher=National Academies Press |location=Washington, D.C. |isbn=978-0-309-08525-0 |doi=10.17226/10490 |access-date=2017-01-01 |archive-date=2019-08-14 |archive-url=https://web.archive.org/web/20190814213856/https://www.nap.edu/read/10490/chapter/12#661 |url-status=live }}</ref>


In contrast, a 2018 systematic review, meta-analysis and meta-regression concluded that, “Dietary protein supplementation significantly enhanced changes in muscle strength and size during prolonged RET in healthy adults.“ (RET is an abbreviation for resistance exercise training.)<ref>Morton, Robert W., et al. "A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults." British journal of sports medicine 52.6 (2018): 376-384.</ref>
The effects of [[insulin]] on the body are well known and include increases in cellular intake of glucose, protein synthesis, amino acid uptake, and blood flow. These effects are seen as beneficial to bodybuilders, especially right after a work out. This can be achieved by consuming a drink containing simple sugars (e.g. [[glucose]]) which causes the body to increase insulin levels to deal with the sugar.


== See also ==
Some bodybuilders [[inject]] insulin directly into the blood stream. However this is extremely dangerous and possibly [[fatal]] if an incorrect dosage is taken.
* [[Instant breakfast]]
* [[Protein bar]]


==Notes==
=== Natural Testosterone Boosters ===
{{Reflist|group="note"}}


== References ==
Naturally occurring [[plant]]s and [[vitamin]]s that studies have shown can produce an increase in testosterone levels. However, the usefulness for those with healthy levels is debated but they may help older bodybuilders or those with naturally low testosterone levels. The most commonly taken supplements are [[ZMA (supplement)|ZMA]] and [[tribulus terrestris]].
{{Reflist}}


=== Nitric Oxide ===
== External links ==
{{commons category}}
* {{cite web | url = https://www.fda.gov/food/dietarysupplements/default.htm | title = Dietary Supplement Health and Education Act of 1994 | work = U.S. Food and Drug Administration | date = 4 February 2020 }}


{{Pharmacological body modification}}
[[Nitric oxide]] (NO) relaxes [[smooth muscle]] in the body - like those in the [[arteries]]. This decreases blood pressure, increases blood flow to the muscles. Promoters argue this allows more nutrients to be delivered - aiding muscle growth. However supplements do not actually contain nitric oxide but the amino acid [[arginine]] - which the body uses to synthesize NO. It is not known whether increased arginine actually increases NO levels in the body.
{{Dietary supplement}}
{{Diets}}


[[Category:Bodybuilding]]
{{DEFAULTSORT:Bodybuilding Supplement}}
[[Category:Bodybuilding supplements| ]]
[[Category:Instant foods and drinks]]

Latest revision as of 11:58, 16 April 2024

Bodybuilding supplements are dietary supplements commonly used by those involved in bodybuilding, weightlifting, mixed martial arts, and athletics for the purpose of facilitating an increase in lean body mass. Bodybuilding supplements may contain ingredients that are advertised to increase a person's muscle, body weight, athletic performance, and decrease a person's percent body fat for desired muscle definition. Among the most widely used are high protein drinks, pre-workout blends, branched-chain amino acids (BCAA), glutamine, arginine, essential fatty acids, creatine, HMB, whey protein, ZMA, and weight loss products.[1][2] Supplements are sold either as single ingredient preparations or in the form of "stacks" – proprietary blends of various supplements marketed as offering synergistic advantages.

History[edit]

Athletes in ancient Greece were advised to consume large quantities of meat and wine. A number of herbal concoctions and tonics have been used by strong men and athletes since ancient times across cultures to try to increase their strength and stamina.[3]

In the 1910s, Eugen Sandow, widely considered to be the first modern bodybuilder in the West, advocated the use of dietary control to enhance muscle growth. Later, bodybuilder Earle Liederman advocated the use of "beef juice" or "beef extract" (basically, consomme) as a way to enhance muscle recovery. In the 1950s, with recreational and competitive bodybuilding becoming increasingly popular, Irvin P. Johnson began to popularize and market egg-based protein powders marketed specifically at bodybuilders and physical athletes. The 1970s and 1980s marked a dramatic increase in the growth of the bodybuilding supplement industry, fueled by the widespread use of modern marketing techniques and a marked increase in recreational bodybuilding.

In October 1994, the Dietary Supplement Health and Education Act (DSHEA) was signed into law in the USA. Under DSHEA, responsibility for determining the safety of the dietary supplements changed from the government to the manufacturer, and supplements no longer required approval from the U.S. Food and Drug Administration (FDA) before distributing the products. Since that time, manufacturers did not have to provide FDA with the evidence to substantiate safety or effectiveness unless a new dietary ingredient was added. It is widely believed that the 1994 DSHEA further consolidated the position of the supplement industry and lead to additional product sales.[4]

Protein[edit]

Protein shakes, made from protein powder (center) and milk (left), are a common bodybuilding supplement.

Bodybuilders may supplement their diets with protein for reasons of convenience, lower cost (relative to meat and fish products), ease of preparation, and to avoid the concurrent consumption of carbohydrates and fats. Additionally, some argue that bodybuilders, by virtue of their unique training and goals, require higher-than-average quantities of protein to support maximal muscle growth.[5][6][7][8][9][10][11][12] While the recommended dietary allowance is much less,[13] Harvard Medical School points out in Health Health Publishing that this RDA (recommended daily allowance) is “the minimum amount you need to keep from getting sick — not the specific amount you are supposed to eat every day.”[14] Protein supplements are sold in ready-to-drink health shakes, bars, meal replacement products (see below), bites, oats, gels and powders. Protein powders are the most popular and may have flavoring added for palatability. The powder is usually mixed with water, milk or fruit juice and is generally consumed immediately before and after exercising or in place of a meal. The sources of protein are as follows and differ in protein quality depending on their amino acid profile and digestibility:

  • Whey protein contains high levels of all the essential amino acids and branched-chain amino acids. It also has the highest content of the amino acid cysteine, which aids in the biosynthesis of glutathione. For bodybuilders, whey protein provides amino acids used to aid in muscle recovery.[15] Whey protein is derived from the process of making cheese from milk. There are three types of whey protein: whey concentrate, whey isolate, and whey hydrolysate. Whey concentrate is 29–89% protein by weight whereas whey isolate is 90%+ protein by weight. Whey hydrolysate is enzymatically predigested and therefore has the highest rate of digestion of all protein types.[15]
  • Casein protein (or milk protein) has glutamine, and casomorphin.[15]
Shaker Bottle commonly used to mix supplements. Often has mesh or a metal whisk inside to breakdown lumps in the mixture.

Some nutritionists have suggested that higher calcium excretion may be due to a corresponding increase in protein-induced calcium absorption in the intestines.[16][17][18]

Amino acids[edit]

Some bodybuilders believe that amino acid supplements may benefit muscle development, but consumption of such supplements is unnecessary in a diet that already includes adequate protein intake.[19]

Prohormones[edit]

An androgen prohormone, or proandrogen, is a prohormone (or prodrug) of an anabolic-androgenic steroid (AAS). They can be prohormones of testosterone or of synthetic AAS, for example, nandrolone (19-nortestosterone). Dehydroepiandrosterone (DHEA), DHEA sulfate (DHEA-S), and androstenedione may all be considered proandrogens of testosterone.[20]

Since 2005, the use of steroid precursors (prohormones) has been illegal in the U.S.[21]

Creatine[edit]

Creatine is an organic acid naturally occurring in the body (and in red meats)[22] that supplies energy to muscle cells for short bursts of energy (as required in lifting weights) via creatine phosphate replenishment of ATP. Scientific studies have shown that creatine supplementation can increase the consumer's strength,[23] energy during performance,[24] muscle mass, and recovery times after exercise. In addition, recent studies have also shown that creatine improves brain function.[25] and reduces mental fatigue.[26]

Some studies have suggested that consumption of creatine with protein and carbohydrates can have a greater effect than creatine combined with either protein or carbohydrates alone.[27]

While generally considered safe, long-term or excessive consumption of creatine may have an adverse effect on the kidneys, liver, or heart and should be avoided if any pre-existing conditions affecting these organs exist.[28]

β-Hydroxy β-methylbutyrate[edit]

When combined with an appropriate exercise program, dietary supplementation with β-hydroxy β-methylbutyrate (HMB) has been shown to dose-dependently augment gains in muscle hypertrophy (i.e., the size of a muscle),[29][30] muscle strength,[29][31][32] and lean body mass,[29][31][32] reduce exercise-induced skeletal muscle damage,[note 1][29][30][32] and expedite recovery from high-intensity exercise.[29][33] HMB is believed to produce these effects by increasing muscle protein synthesis and decreasing muscle protein breakdown by various mechanisms, including activation of the mechanistic target of rapamycin (mTOR) and inhibition of the proteasome in skeletal muscles.[31][34]

The inhibition of exercise-induced skeletal muscle damage by HMB is affected by the time that it is used relative to exercise.[29][33] The greatest reduction in skeletal muscle damage from a single bout of exercise appears to occur when calcium HMB is ingested 1–2 hours prior to exercise.[33]

Controversy[edit]

Mislabeling and adulteration[edit]

While many of the claims are based on scientifically-based physiological or biochemical processes, their use in bodybuilding parlance is often heavily colored by bodybuilding lore and industry marketing and, as such, may deviate considerably from traditional scientific usages of the terms. In addition, ingredients listed have been found at times to be different from the contents. In 2015, Consumer Reports reported unsafe levels of arsenic, cadmium, lead, and mercury in several of the protein powders that were tested.[35]

In the United States, the manufacturers of dietary supplements do not need to provide the Food and Drug Administration with evidence of product safety prior to marketing.[36] As a result, the incidence of products adulterated with illegal ingredients has continued to rise.[36] In 2013, one-third of the supplements tested were adulterated with unlisted steroids.[37] More recently, the prevalence of designer steroids with unknown safety and pharmacological effects has increased.[38][39]

In 2015, a CBC investigative report found that protein spiking (i.e., the addition of amino-acid filler to manipulate analysis) was not uncommon;[40] however, many of the companies involved challenged these claims.[40]

Health problems[edit]

The US FDA reports 50,000 health problems a year due to dietary supplements[41] and these often involve bodybuilding supplements.[42] For example, the "natural" best-seller Craze, 2012's "New Supplement of the Year" by bodybuilding.com, widely sold in stores such as Walmart and Amazon, was found to contain N,alpha-Diethylphenylethylamine, a methamphetamine analog.[43]

The incidence of liver damage from herbal and dietary supplements is about 16–20% of all supplement products causing injury, with the occurrence growing globally over the early 21st century.[2] The most common liver injuries from weight loss and bodybuilding supplements involve hepatocellular damage and jaundice. The most common supplement ingredients attributed to these injuries are catechins from green tea, anabolic steroids, and the herbal extract, aegeline.[2] Other products by supplement designer and CEO of Driven Sports, Matt Cahill, have contained dangerous substances causing blindness or liver damage, and his pre-workout supplement Craze was found to contain illegal stimulants[44] that resulted in several athletes failing drug tests.[45]

Protein effectiveness[edit]

Some have argued that there is little evidence to indicate any benefit to using bodybuilding protein or amino acid supplements. A 2005 overview concluded that "[i]n view of the lack of compelling evidence to the contrary, no additional dietary protein is suggested for healthy adults undertaking resistance or endurance exercise".[13]

In contrast, a 2018 systematic review, meta-analysis and meta-regression concluded that, “Dietary protein supplementation significantly enhanced changes in muscle strength and size during prolonged RET in healthy adults.“ (RET is an abbreviation for resistance exercise training.)[46]

See also[edit]

Notes[edit]

  1. ^ The effect of HMB on skeletal muscle damage has been assessed in studies using four different biomarkers of muscle damage or protein breakdown: serum creatine kinase, serum lactate dehydrogenase, urinary urea nitrogen, and urinary 3-methylhistidine.[29][32][33] When exercise intensity and volume are sufficient to cause skeletal muscle damage, such as during long-distance running or progressive overload, HMB supplementation has been demonstrated to attenuate the rise in these biomarkers by 20–60%.[29][33]

References[edit]

  1. ^ Cruz-Jentoft, Alfonso J. (2018). "Beta-Hydroxy-Beta-Methyl Butyrate (HMB): From Experimental Data to Clinical Evidence in Sarcopenia". Current Protein & Peptide Science. 19 (7): 668–672. doi:10.2174/1389203718666170529105026. ISSN 1875-5550. PMID 28554316. Archived from the original on 2021-07-29. Retrieved 2021-07-29.
  2. ^ a b c Navarro VJ, Khan I, Björnsson E, Seeff LB, Serrano J, Hoofnagle JH (January 2017). "Liver injury from herbal and dietary supplements". Hepatology. 65 (1): 363–373. doi:10.1002/hep.28813. PMC 5502701. PMID 27677775.
  3. ^ Dalby A (2008). Food in the ancient world, from A to Z. London: Routledge. p. 203. ISBN 978-0-415-86279-0.
  4. ^ Higgins M (June 1999). "Hard to Swallow: While federal law shut the door on regulation of dietary supplements, marketing hype may be leading the popular aids up courthouse steps". ABA Journal. 85 (6): 60–63.JSTOR 27840828
  5. ^ Tipton KD, Wolfe RR (January 2004). "Protein and amino acids for athletes" (PDF). Journal of Sports Sciences. 22 (1): 65–79. doi:10.1080/0264041031000140554. PMID 14971434. S2CID 16708689. Archived (PDF) from the original on 2016-03-04. Retrieved 2012-01-10.
  6. ^ Lemon PW (October 2000). "Beyond the zone: protein needs of active individuals". Journal of the American College of Nutrition. 19 (5 Suppl): 513S–521S. doi:10.1080/07315724.2000.10718974. PMID 11023001. S2CID 14586881.
  7. ^ Phillips SM (December 2006). "Dietary protein for athletes: from requirements to metabolic advantage". Applied Physiology, Nutrition, and Metabolism. 31 (6): 647–54. doi:10.1139/h06-035. PMID 17213878.
  8. ^ Phillips SM, Moore DR, Tang JE (August 2007). "A critical examination of dietary protein requirements, benefits, and excesses in athletes". International Journal of Sport Nutrition and Exercise Metabolism. 17 Suppl: S58-76. doi:10.1123/ijsnem.17.s1.s58. PMID 18577776.
  9. ^ Slater G, Phillips SM (2011). "Nutrition guidelines for strength sports: sprinting, weightlifting, throwing events, and bodybuilding". Journal of Sports Sciences. 29 (Suppl 1): S67-77. doi:10.1080/02640414.2011.574722. PMID 21660839. S2CID 8141005.
  10. ^ Tipton KD, Wolfe RR (January 2004). "Protein and amino acids for athletes". Journal of Sports Sciences. 22 (1): 65–79. doi:10.1080/0264041031000140554. PMID 14971434. S2CID 16708689.
  11. ^ Phillips SM, Van Loon LJ (2011). "Dietary protein for athletes: from requirements to optimum adaptation". Journal of Sports Sciences. 29 (Suppl 1): S29-38. doi:10.1080/02640414.2011.619204. PMID 22150425. S2CID 33218998.
  12. ^ Lemon PW (June 1995). "Do athletes need more dietary protein and amino acids?". International Journal of Sport Nutrition. 5 Suppl: S39-61. doi:10.1123/ijsn.5.s1.s39. PMID 7550257. S2CID 27679614.
  13. ^ a b "Macronutrients". Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, D.C.: National Academies Press. 2005. doi:10.17226/10490. ISBN 978-0-309-08525-0. Archived from the original on 2019-08-14. Retrieved 2017-01-01.
  14. ^ https://www.health.harvard.edu/blog/how-much-protein-do-you-need-every-day-201506188096#:~:text=The%20Recommended%20Dietary%20Allowance%20(RDA,meet%20your%20basic%20nutritional%20requirements. Harvard Medical School , Harvard Health Publishing. “How much protein do you need every day?” Reviewed by Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing. June 22, 2023.
  15. ^ a b c Wolfe RR (August 2000). "Protein supplements and exercise". The American Journal of Clinical Nutrition. 72 (2 Suppl): 551S–7S. doi:10.1093/ajcn/72.2.551S. PMID 10919959.
  16. ^ Kerstetter JE, O'Brien KO, Insogna KL (September 2003). "Dietary protein, calcium metabolism, and skeletal homeostasis revisited". The American Journal of Clinical Nutrition. 78 (3 Suppl): 584S–592S. doi:10.1093/ajcn/78.3.584S. PMID 12936953.
  17. ^ Kerstetter JE, O'Brien KO, Insogna KL (March 2003). "Low protein intake: the impact on calcium and bone homeostasis in humans". The Journal of Nutrition. 133 (3): 855S–861S. doi:10.1093/jn/133.3.855S. PMID 12612169.
  18. ^ Dawson-Hughes B, Harris SS, Rasmussen H, Song L, Dallal GE (March 2004). "Effect of dietary protein supplements on calcium excretion in healthy older men and women". The Journal of Clinical Endocrinology and Metabolism. 89 (3): 1169–73. doi:10.1210/jc.2003-031466. PMID 15001604.
  19. ^ Sizer FS, Piché LA, Whitney EN (2012). Nutrition: Concepts and Controversies. Cengage Learning. p. 407. ISBN 978-0-17-650258-4.
  20. ^ Risto Erkkola (2006). The Menopause. Elsevier. pp. 5–. ISBN 978-0-444-51830-9.
  21. ^ Friedel, Angelika, et al. "17β-hydroxy-5alpha-androst-1-en-3-one (1-testosterone) is a potent androgen with anabolic properties." Toxicology letters 165.2 (2006): 149-155.
  22. ^ Williams, Melvin H.; Branch, J. David (June 1998). "Creatine Supplementation and Exercise Performance: An Update". Journal of the American College of Nutrition. 17 (3): 216–234. doi:10.1080/07315724.1998.10718751. ISSN 0731-5724.
  23. ^ Becque MD, Lochmann JD, Melrose DR (March 2000). "Effects of oral creatine supplementation on muscular strength and body composition". Medicine and Science in Sports and Exercise. 32 (3): 654–8. doi:10.1097/00005768-200003000-00016. PMID 10731009.
  24. ^ Birch R, Noble D, Greenhaff PL (1994). "The influence of dietary creatine supplementation on performance during repeated bouts of maximal isokinetic cycling in man". European Journal of Applied Physiology and Occupational Physiology. 69 (3): 268–76. doi:10.1007/BF01094800. PMID 8001541. S2CID 8455503.
  25. ^ Rae C, Digney AL, McEwan SR, Bates TC (October 2003). "Oral creatine monohydrate supplementation improves brain performance: a double-blind, placebo-controlled, cross-over trial". Proceedings. Biological Sciences. 270 (1529): 2147–50. doi:10.1098/rspb.2003.2492. PMC 1691485. PMID 14561278.
  26. ^ Watanabe A, Kato N, Kato T (April 2002). "Effects of creatine on mental fatigue and cerebral hemoglobin oxygenation". Neuroscience Research. 42 (4): 279–85. doi:10.1016/S0168-0102(02)00007-X. PMID 11985880. S2CID 6304255.
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