Interventions like supplements and diets are evaluated based on measurable changes in specific outcomes like LDL and blood pressure. See what the evidence shows.Information on Examine is organized into 26 health categories covering hundreds of conditions. Examine analyzes and summarizes research to determine which supplements and non-pharmaceutical interventions work. The US public is not well protected by existing laws, with the potential for harm from supplement use ranging from financial loss to serious adverse health consequences. They are available in the form of powders, gummies, protein bars, and ready-to-drink shakes and have been shown to have effects on almost every system in the body. We are a team of industry-leading experts specializing in dietary supplement compliance. Navigating the complex world of dietary supplement compliance can be tough. 4. Prevalence of Dietary Supplement Use among Athletes The review authors find it difficult to account for the different effect seen in the study by Cano‐Torres, as both the Casals and the Cano‐Torres studies enrolled hospital inpatients (Cano‐Torres 2017; Casals 2015). Since investigators reported data as mean (SD) admissions, these could not be combined with data from the other studies reporting this outcome. Two studies (230 participants) reported on interventions at 12 months and over (Fernandez‐Barres 2017; Weekes 2009). This can be done via in-person meetings in which individuals can connect with the research team and have their questions answered. Surgeons, pathologists, radiologists, and many other specialists play an integral role in the conduct of quality clinical trials. AE, adverse event; CRF, case report form; IRB, institutional review board. In addition to pursuing basic research training requirements, CRAs and research nurses should be encouraged to pursue specialty certification because instruction about conducting clinical research is generally not taught in health science or nursing education programs. The review authors judged two out of 12 studies to have a low risk of bias from blinding of nutritional outcomes (Pivi 2011; Singh 2008) and two further studies had an unclear risk of bias (Ravasco 2005a; Ravasco 2005b).In terms of performance recovery, there is no clear evidence for the effectiveness of protein-based supplements due to mixed results reported by the reviewed studies.They must obtain EAAs from the diet or from supplementation to support muscle growth, maintenance, and repair .However, dietary surveys have revealed that whole grains (especially rye), legumes, fruits, vegetables, nuts, tea, and coffee can also be considered good sources of lignans.The mean energy intakes of professional male team sport athletes reported in the literature have decreased from those reported by a previous review ; however, in comparison female athletes are consuming diets of relatively similar energy density (i.e., 7.3–9.8 MJ/day) .A recent study supplemented men with β-alanine for 10 weeks and showed that muscle carnosine levels were significantly increased after 4 and 10 weeks of β-alanine supplementation.In the case of combat skills, time to complete a specific wrestling test , the number of attacks but not defensive actions and handgrip strength 45,55 were improved with 3–6 mg/kg of caffeine compared with the placebo group. Although the creation and upkeep of this tool call for a substantial time and resource investment and likely will only include the most applicable data or facets necessary for each supplement, it will greatly improve the accuracy of nutrient intake estimates from surveys and self-reports. This interface allows for the collection, classification, and sharing of supplement information from various databases according to a dozen key “facets” such as product type, ingredients, dietary uses, label claim, and geographical region. The DSOL does not actually test any supplements, but it does provide a clear and easy-to-use resource for checking the labeling of supplement ingredients to ensure self-reporting accuracy on both the consumer and researcher sides of the survey. Subclassifications of malnutrition are crucial for the understanding of the related complexities and to plan treatment. Malnutrition can be defined as “a state resulting from lack of intake or uptake of nutrition that leads to altered body composition (decreased fat‐free mass) and body cell mass leading to diminished physical and mental function and impaired clinical outcome from disease” (de van der Schueren 2019). Downgraded once due to risk of bias within the included trials, particularly across the domains of randomisation or allocation concealment, or both. Although it is not possible to blind for this type of study, we felt that for this outcome the allocation may have an effect on the subjective QoL. Downgraded once due to risk of bias in the included trials for this outcome; there were particular concerns across the domains of randomisation and allocation concealment. In elite soccer, studies assessing the use of dietary supplements among players are still scarce (4, 5, 8) and the available results pointed out health concerns as the main reason for using these products. Not surprisingly, nutritionists have been considered among the most well-informed professionals and preferred source of information about dietary supplements in surveys conducted among athletes (16). Nutritionists working with elite soccer players consider the use of dietary supplements for performance-enhancement purposes and not only to compensate for nutritional deficits, which might contribute to their higher interest, training and perceived knowledge about this topic. Faccio 2021 published data only During the early stages of endurance exercise, caffeine might mobilize free fatty acids as a source of energy and spare muscle glycogen . Unlike other EAAs, the BCAAs can be metabolized by mitochondria in skeletal muscle to provide energy during exercise 74,75. BCAAs make up approximately 25% of the amino acids in foods containing complete proteins (including all EAAs) ; most of these foods are animal products, such as meat, poultry, fish, eggs, and milk (see section on protein). However, the ISSN notes that HMB can enhance recovery by reducing exercise-induced skeletal muscle damage in both trained and untrained individuals . 11. Anti-fatigue and improves stamina We excluded studies carried out in pregnant women or people with eating disorders and in conditions of food insufficiency (inadequate availability of food in a whole or part of a country meaning that the population are at risk of famine). The data in this analysis were from only nine out of 38 eligible studies and should be interpreted with caution. However, we do not know which nutrient or combination of nutrients in ONS is responsible for any benefits (protein, energy, vitamins, trace elements) and it may not be possible to modify food intake to produce comparable changes to those achieved with ONS. In conclusion, the lack of homogeneity among studies regarding the definition of dietary supplements, reporting timeframes, and data collection methods complicates the attempt to compare the findings. The integration of nutritional-knowledge programs may be highly valuable to increase the knowledge, beliefs and intentions of athletes who choose to consume dietary supplements . Knowledge about nutrition and dietary supplement use is vital to athletes choosing to consume dietary supplements. Only one study reported information on this and found that while over 90% of participants believed it was vital to know whether the dietary supplement was third party tested, only 57% purchased third-party tested supplements . Furthermore, the authors showed improvements using beta-alanine in specific combat skills, namely a higher number and force of punches, but only as a time × group interaction , and there were no changes in power or the fatigue index . The other two studies, which lasted 4 weeks using 6 g/day or 0.3 g/kg/day of beta-alanine, observed mixed results in blood lactate levels compared with the placebo group 35,37. One study lasted 10 weeks with a dose of 4.9–5.4 g/day and showed improvements in general fitness (as peak power in lower limbs and less power drop in upper limbs, but not in strength or blood lactate levels) . Beta-alanine, which has a role as an intracellular buffer precursor, has been used in three studies examining striking combat sports 35,36,37. Locher 2013 published data only Only one study (25 participants) provided analysable data for the change in protein intake at four to six months (Stow 2015) and reported a significantly higher protein intake in the ONS group compared with the dietary advice group, MD ‐6.00 g (95% CI ‐9.91 to ‐2.09) (Analysis 2.9). Regarding the minimum level of evidence required before feeling confident in utilizing or recommending specific dietary supplements to soccer players, most participants reported systematic reviews (44.6%), randomized controlled trials (36.9%), and meta-analysis (7.7%). Public health research on dietary supplements has heavily focused on efficacy, with large studies and systematic reviews concluding that the evidence to support routine supplementation for primary prevention of chronic diseases is inadequate.10–14 The US Preventive Services Task Force has concluded that there is insufficient evidence to recommend single-nutrient, paired-nutrient, or multivitamin supplementation for the prevention of cardiovascular disease and cancer or vitamin D3 and calcium supplementation, either alone or in combination, for the prevention of fractures.81,82 However, the impact of regulatory challenges may not have been adequately considered in these studies. Protein supplements were initially designed to provide athletes and bodybuilders with an extra source of protein, but they are now being used in the dietary management of patients with various medical conditions, such that researchers have been studying the effects of protein supplementation on health (Figure 1). Natural health products, often referred to as dietary supplements, are naturally occurring substances intended to supplement the diet to restore or maintain good health . Thus, ongoing research in sports nutrition is crucial for providing evidence-based and evidence-oriented recommendations to practitioners and optimizing nutrient intake strategies to support athletic performance, enhance recovery, and promote health and well-being. It is considered acceptable for the athletes with nutritional supervision to include the strategic use of a small number of nutritional supplements under a low-risk “Food First but Not Always Food Only” framework . The review authors judged that none of the 13 studies in this comparison had an overall low risk of detection bias. The review authors judged two out of 22 studies in this comparison to have an overall low risk of detection bias (Gonzalez‐Espinoza 2005; Wilson 2001). One study had a low risk of performance bias as although the study participants and personnel were not blinded to the group allocation, this is unlikely to have affected the assessment of outcomes (Alo 2014). One study, for example, randomly assigned 40 male weightlifters (average age 48 years) to receive DHEA (100 mg/day), androstenedione (100 mg/day), or a placebo for 12 weeks while continuing their training programs.Some minerals have been found to be deficient in athletes or become deficient in response to training and/or prolonged exercise.Hypoxia contributes to chemoresistance, and HBOT as an adjuvant has demonstrated enhanced effects both in vitro and in vivo, although certain chemotherapeutic agents might interact negatively .Overall we rated the certainty of the evidence as low for most results, which means that we cannot be confident about the findings we report.The Delphi technique is well suited as a method for consensus-building by using a series of questionnaires delivered using multiple iterations to collect data from a panel of selected subjects.A 70-kg individual ingesting a recommended dose of 300 mg/kg body weight would consume approximately 5,750 mg sodium.Doing Barry's Bootcamp twice a day is further away from these two workouts, and I suspect this is not the best way to approach exercise. In addition, selected systematic reviews and meta-analysis papers offer for a fuller picture of the state of the science, even though many of these publications did not specifically mention what type of MVM supplement was used (Table 1). These types of studies often require more invasive actions and resources than other types of valuable research, but they also tend to yield direct and evidence-based information on cause-and-effect relations between nutrient supplementation and specific outcomes. An appropriate modification to this methodology was investigated in 2009 through an NIH-sponsored workshop with the goal of creating a standardized set of data that would aid consumers and health care practitioners in becoming more informed about supplement bioavailability. It is also electronically linked to other important health and safety Web sites and databases such as PubMed and MedlinePlus so that consumers can be more properly informed of their supplement usage (19). Therefore, the database allowed for better precision of self-reported intakes by both consumers and individuals estimating nutrient intakes for MVM research surveys. A 2009 study found similar improvements in performance in youth swimmers at distances of 50 to 200 m. In elite male swimmers sodium bicarbonate supplementation significantly improved 200 m freestyle performance . A number of studies indicated that sodium phosphate supplementation (e.g., 1 gram taken 4 times daily for 3-6 days) can increase maximal oxygen uptake (i.e., maximal aerobic capacity) and anaerobic threshold by 5-10% . A 2003 study found that ingesting 20 grams of creatine for 5 days improved endurance and anaerobic performance in elite rowers . Sports nutrition research aims to determine the optimal nutrient intake for athletes following their training, performance goals, and body composition.Given the specificity of the information that is required by some athletes and their support staff to assess the effectiveness of a supplement (eg, related to a targeted event and its conditions, the specific individual, the combination with other performance strategies), it is unreasonable to expect that definitive evidence will always be available.The review authors judged that none of the 13 studies in this comparison had an overall low risk of detection bias.Where studies of dietary advice also included escalation of intervention to include enteral and parenteral feeding, studies have only been included if additional feeding was received by 10% or fewer of included participants or if results for participants receiving dietary advice with or without ONS were presented seperately.Additionally, the heterogeneity of metabolic reprogramming, even within a single tumor, is worth considering, as well as the interaction of the tumor with whole body metabolism .Due to their various bioactive properties, dietary intake of lignan-rich foods may prevent certain types of cancers and lower the risk of developing cardiovascular disease.No study reported hospitalisations and there may be little or no effect on days in hospital after three months, MD ‐1.81 (95% CI ‐3.65 to 0.04) or six months.Dietary supplements cannot excuse inadequate diets, and therefore, it is recommended that athletes optimize and prioritize their nutrient intake from whole foods. Published studies may be used as pilot studies for estimating effect size and power, hence determining the minimum sample size required for noteworthy research. The level of measurement needed for specific analytical procedures and the statistical power-effect size-sample size triangle (if known) can also be given a priori consideration. Prospective studies have the advantage of using tailored research design and methods with the specific research question in mind. From those, 69 responses were received (50.0% response rate); however, three belonged to nutritionists who refrained from participating due to their club's policy. The items of the 5-point Likert-type scales were grouped into three categories for the analysis (strongly disagree and disagree; neutral; agree and strongly agree). Overall, questions from the original questionnaire used by Marx et al. (12) were kept, but since it was focused on nutritionists working within a clinical context, some minor adaptations were applied in order to fit the nutritional context of elite soccer. Finally, ingesting carbohydrate and protein immediately following exercise can enhance carbohydrate storage and protein synthesis 1,3. Consequently, frequent ingestion of water and/or sports drinks during exercise is one of the easiest and most effective ergogenic aids. Preventing dehydration during exercise is one of the keys of maintaining exercise performance (particularly in hot/humid environments). Dietary supplement ingredients that were lawfully sold prior to 1994, have been "grandfathered" into the Act, meaning that a manufacturer is not required to submit to FDA the evidence it relies upon to substantiate safety or effectiveness before or after it markets these ingredients. Dietary supplements are typically sold in the form of tablets, capsules, soft gels, liquids, powders, and bars. The law defined a "dietary supplement" as a product taken by mouth that contains a "dietary ingredient" intended to supplement the diet. Baldwin 2011. Due to severe side effects, high doses of cyclosporin A (CsA) cannot be used in the long term treatment of kidney allograft recipients. The mice in the IgAN model fed with 1% F-2 in diet had significant reduction of hematuria and proteinuria together with histopathologic improvement. Further in IgAN animal model where hematuria and proteinuria was induced by R36A (Pneumococcal C-polysaccharide purified from Streptococcus pneumoniae) as antigen and anti-R36A IgA monoclonal antibody. Crude MeOH extract obtained from fruiting bodies of CS, further subjected to fractionation by silica gel column chromatography to have 6 fractions. Hypotheses include microbiome changes from higher intake of vegetables that may improve nutrient absorption or utilization and parental factors that may influence treatment adherence or other relevant lifestyle factors. The finding that higher vegetable intake may increase chance of behavioral improvement with multinutrients is interesting and merits further exploration of potential mechanisms. These findings are clinically important because they suggest that multinutrient supplementation may benefit children with ADHD and irritability independent of overall diet quality. The study objectives were to evaluate the main nutrients used as supplements in sports and to propose a nutritional quality index (NQI) that enables sportspeople to optimize their use of supplements and detect and remedy possible nutritional deficits. Vitamin and mineral supplements are unnecessary if the energy intake is sufficient to maintain body weight and derives from a diet with an adequate variety of foods. People are turning to supplements for many purposes such as supplementing normal nutrition, feeling more energetic, enhancing the immune system by taking vitamins and minerals that they think they do not get enough, and meeting their body's needs when they cannot eat a balanced and healthy diet. Interactions of some dietary supplement ingredients with other ingredients, foods and nutrients, and drugs can also cause adverse reactions (Gurley, Fifer, and Gardner 2012; Tsai et al. 2012). The same study showed that almost half of these supplements were in the early stages of rancidity and that the majority had peroxide levels higher than recommended by the Global Organization for omega-3 fatty acid supplements containing EPA and DHA (docosahexaenoic acid) (Opperman and Benade 2013). An analysis of omega-3 fatty acid supplements found that only 42% contained 90% to 110% of the declared amount of EPA (eicosapentaenoic acid). In the Netherlands, 74% of sexual health supplements seized were found to contain one of these PDE-5 inhibitor analogs (Venhuis and de Kaste 2012). Two studies (137 participants) reported on change in cognitive function (Baldwin 2011; Kapoor 2017). One study (32 participants) reported on change in social function at six months (Kapoor 2017). Three studies (214 participants) reported on change in social function at up to three months (Baldwin 2011; Kapoor 2017; Norman 2008b). Four studies (316 participants) reported on change in mental function at up to three months (Baldwin 2011; Beattie 2000; Kapoor 2017; Norman 2008b). One study (32 participants) reported on change in physical function at six months (Kapoor 2017). Other studies have reported mixed results on altering body composition using various forms of higher fiber diets . A recent study found that a Mediterranean diet that was high in fiber resulted in a more dramatic weight loss that a traditional low-fat diet and had beneficial effects on glycemic control . In addition, high fiber diets/supplements help lower cholesterol and blood pressure, enhance insulin sensitivity, and promote weight loss in obese subjects . Luteolin has also been reported to increase the deacetylation of SIRT6, regulate the expression of other SIRTs and Forkhead box O3a (FOXO3a) in human monocytes, and suppress ROS production under hyperglycemic conditions (Kim et al., 2017; Akter et al., 2021). Although luteolin is a minor component in daily nutrition, accumulating data suggest it has numerous health benefits including potent antioxidant, anti-inflammatory, and antiallergic properties. A study investigated the potential antioxidant and prooxidant effects of quercetin on cultured non-small lung cancer A549 cells. However, low-dose administration of quercetin (10 mg/kg) gave rise to antioxidant and protective effects on nitrergic innervation and interstitial cells of Cajal, nitrergic neurons, macrophages and oxidative/antioxidant status in diabetic rats (Vieira-Frez et al., 2020). However, in the meta-analysis of fasting insulin levels by Mason, et al., five out of the nine included trials were published after the last search date of the most recent systematic review in Ashor’s umbrella review. We were unable to determine the degree of overlap between the umbrella review and the newer meta-analysis for the outcomes of insulin resistance as the included trials in the umbrella review were not cited. Although one of the older systematic reviews included in Ashor’s umbrella review found a significant decrease in fasting insulin , the newer meta-analysis by Mason did not find any differences between vitamin C and placebo for fasting insulin or HOMA-IR. While there are limited clinical data on the benefits of berberine, a randomized, double-blind study demonstrated that berberine in a dose of 300 mg twice daily significantly reduced the risk of recurrent colorectal adenomas following polypectomy . A meta-analysis showed an inverse association between tea catechin intake and various cancers , and another meta-analysis demonstrated that GTCs reduced the risk of gastrointestinal, breast, gynecological, leukemia, lung, and thyroid cancers . Vitamin D deficiency increases the risk of breast, colon, prostate, and other cancers, while supplemental vitamin D intake has an inverse relationship with cancer risk 318,329. Overall, these dietary and lifestyle recommendations aim to support health and potentially impact cancer management positively by optimizing blood glucose levels, promoting a favorable microbiome, and ensuring a balanced intake of fats and oils. Vegetable intake appears to be an important aspect of diet quality in relation to ADHD and should be further explored by investigating the relationship between participants’ dietary patterns, microbiome, genetics, and response to the multinutrient treatment. One study with four intervention groups and a control group reported that overall 23 of 88 (26%) participants died during the four‐month study, but mortality is not reported according to group allocation, so it is not possible to include these results in the analysis (Dixon 1984).Taking more, however, is unlikely to improve performance further and increases the risk of side effects.Several patients said they felt providers should provide feedback about the accuracy of information obtained from outside sources, such as friends, the internet, television, or other healthcare providers.The review authors did not undertake a combined analysis as one study reported length of hospital stay at several time points.One study reported similar baseline characteristics, but was stopped prematurely which led to an overall unclear risk of bias from other sources of bias (Baldwin 2011).In this article, we have reviewed several recently identified natural products with potential antiaging properties and have highlighted their cellular and molecular mechanisms.Based on the studies included in this review, it appears the main reasons for dietary supplement use are improving athletic performance, improving health, and accelerating recovery.The second component to optimizing training and performance through nutrition is to ensure that athletes consume the proper amounts of carbohydrate (CHO), protein (PRO) and fat in their diet.According to the current literature we know that the addition of protein and or BCAA before or after resistance training can increase protein synthesis and gains in lean mass beyond normal adaptation. Both arsenic and lead exposure, even at low levels, impact human health in the form of an increased risk of cancer, blood disorders, gastrointestinal diseases, impaired brain development and functioning, and kidney and liver damage. The presence of arsenic and lead contamination in most of the analyzed protein products in our study is of grave concern. In our study, we identified aflatoxins in 4 products, all of which were plant-based proteins, among which 3 were soy based and 1 was a multiherbal containing hyacinth bean. A recent study supplemented men with β-alanine for 10 weeks and showed that muscle carnosine levels were significantly increased after 4 and 10 weeks of β-alanine supplementation. Additionally, some concern has been expressed that ingestion of caffeine prior to exercise may contribute to dehydration although recent studies have not supported this concern 414,418,419. In addition to the apparent positive effects on endurance performance, caffeine has also been shown to improve repeated sprint performance benefiting the anaerobic athlete 415,416. Caffeine is a naturally derived stimulant found in many nutritional supplements typically as gaurana, bissey nut, or kola. When a powdered formulation is designed, the list of ingredients and raw materials are typically sent to a flavoring house and packaging company to identify the best way to flavor and package the supplement. If the company is working on a new ingredient, they often conduct toxicity studies on the new nutrient once a purified source has been identified. Others wait until research has been presented in patents, research abstracts, or publications before developing nutritional formulations featuring the nutrient. In our experience, companies who adhere to these ethical standards prosper while those who do not struggle to comply with FDA and FTC guidelines and rapidly lose consumer confidence, signaling an early demise for the product. This trend is due in part to greater scrutiny from the FDA and FTC, but also in response to an increasingly competitive marketplace where established safety and efficacy attracts more consumer loyalty and helps ensure a longer lifespan for the product in commerce. Generally, the findings were consistent in terms of reasons for use and sources of information. Making responsibility, accountability, and doing the right thing the rule, not the exception. I’m discouraged by the acts of selfishness, irresponsibility, complacency, and even violence that we all observe in our… Ultimately, a team that regularly engages in constructive dialogue is better positioned for growth, innovation, and success. Authors of the 2005 Ravasco study published additional data in 2012 which described additional follow‐up to a median of 6.5 (range 4.9 to 8.1) years (Ravasco 2005a; Ravasco 2012). If investigators did not report data or information at a specific time point, then the authors have not included any text. Review authors collected data on a variety of outcome measures encompassing clinical and functional status and QoL. In one study, investigators described the groups as similar in the text, but data are not shown (Persson 2007). Two studies reported some differences between groups at baseline (Hampson 2003; Payette 2002). This protein-mediated effect is primarily attributed to the fact that protein supplementation during recovery increases the rate of muscle protein synthesis (Lunn et al., 2012; Breen et al., 2011) and as such facilitates muscle repair and remodeling (Breen et al., 2011) and accelerates performance recovery (Saunders, 2007). This performance deterioration is accompanied by a rise in delayed onset of muscle soreness (DOMS), immune system activation, inflammatory response and EIMD markers such as creatine kinase activity (CK) and C-reactive protein (CRP), pro-inflammatory cytokines, adhesion molecules and oxidative stress markers (Ispirlidis et al., 2008; Fatouros et al., 2010; Chatzinikolaou et al., 2014a; 2014b; Draganidis et al., 2015; Mohr et al., 2016). Protein-based supplementation attenuated the rise in muscle damage markers and enhanced performance recovery in six (60% of the studies included) and three (30% of the studies included) out of 10 studies, respectively. And in similar studies, mice demonstrated their improved swimming capabilities after 6 weeks of CS supplementation compared with a control group (Xiao et al., 1999). Supplements are prepared in various forms using nutrients such as vitamins, minerals, proteins, amino acids, plants, enzymes, fiber and fatty acids. They are widespread andaccording to popular beliefhealthier and safer than synthetic drugs. Currently, the European Community is concerned about food products, including FS, launched on the market because the citizens require reliable protection of their health. Relevant publications were searched and found in MEDLINE/PubMed, Scopus Database, Web of Knowledge, and in Internet-based search with predefined keywords. Although the responsibility for the safety of these compounds/foods lies with the food business operator placing the product on the market, the European Food Safety Authority (EFSA) carries ou... The SD of weight change was imputed for three studies at up to three months (Arnold 1989; Fuenzalida 1990; Sharma 2002a; Sharma 2002b). There was no difference in energy/fatigue between groups receiving advice compared with groups receiving ONS, SMD ‐8.41 (95% CI ‐18.21 to 1.39) (Analysis 2.17). There was no difference in pain between groups receiving advice compared with groups receiving ONS, SMD ‐5.42 (95% CI ‐11.40 to 0.56) (Analysis 2.16). Removal of each study individually did not reduce the heterogeneity noticeably, however, we expect the heterogeneity reflects the differences in QoL instruments used, and the differences in clinical backgrounds and care settings. Of the 14 blended formulations, 7 contained herbal extracts, and the rest included various types of protein sources, such as pea, soy, egg, milk (whole, whey, or casein), and peanuts. Seals were broken, and the products were opened for analysis under standard operating conditions in the laboratory. The study adhered to all pertinent regulatory standards or guidelines for product testing, particularly relating to food and drug safety regulations. Summary of inclusion, protocols, and industry-based standards of methodical analysis of protein powders. Once the products were received at the analytical laboratory, they were opened under standard operating protocol-based conditions, and the powder samples were transferred to sterile containers and marked with the product code in the context of each analysis. Confirmation of this awaits further trials with adequate control for dietary patterns. Short-chain fatty acids (SCFA) such as butyrate activate G-protein coupled receptor (Gpr) 43 result in suppression of insulin signalling in adipose tissue and prevent fat accumulation, as well as enhancing insulin sensitivity via promotion of glucagon-like peptide-1 (GLP1) secretion in the gut . However, given the majority of studies administered vitamin C for 49,55]. On subgroup analysis, a shorter (54], however the safety of long-term administration of chromium remains unclear as the maximum duration of administration in RCTs was 25 weeks . The effects of chromium did not appear to be dose-dependent (based on a 200 μg cut-off). Although studies reporting statistical trends may be of interest and lead researchers to conduct additional research, studies reporting statistically significant results are obviously more convincing. Well-controlled clinical trials provide stronger evidence as to the potential ergogenic value. For ergogenic aid research, the study should be a placebo controlled, double-blind, and randomized clinical trial if possible. Compared with those taking the placebo, participants taking the creatine improved their performance in both 100-meter sprints and six intermittent 60-m sprints. Participants taking the supplement had significant improvements in peak power output during all five sets of jump squats and in repetitions during all five sets of bench presses on three occasions. In one example, a study randomized 14 healthy, resistance-trained men (age 19–29 years) to receive 25 g creatine monohydrate or a placebo for 6–7 days . Whether athletes in specific sports or activities might benefit from taking supplemental citrulline remains to be determined . They excel at providing practical solutions to regulatory challenges concerning global food standards, such as the Codex Alimentarius.Two studies (20%) employed a more prolonged protein supplementation protocol.However, in recent interviews (done in 2022) David Sinclair didn’t specifically mention taking this supplement.Immune health products represent approximately 10% of all US dietary supplement sales.Only one study carried out in Germany (101 participants) reported on cost‐effectiveness (Norman 2008b).The incremental area under the insulin curve was significantly higher in the WP group (24.66 nmol/L × min, 1.65–47.66 nmol/L × min) than in the placebo group.57 Thus, adding protein supplements can improve cardiovascular health by positively impacting blood pressure, lipid levels, and glycemic control.Incidents such as this led to calls for stricter regulation and scientific research of dietary supplements (Jiang 2009); but have not addressed the root cause and as a result safety issues remain today.As with hypothesis testing in statistical analysis, the null hypothesis should be that the deviation from the original protocol has had no impact on the results of the study. This review summarises the issues faced by high-performance athletes and their support team (coach, trainer, nutritionist, physician) when considering the use of supplements, with the goal of providing information to assist them to make informed decisions. Nutrition usually makes a small but potentially valuable contribution to successful performance in elite athletes, and dietary supplements can make a minor contribution to this nutrition programme. Additionally, researchers began to attempt to physically identify and record the specific dietary supplements reported by participants. It also includes several recent studies that may be of interest to future committees indicating the potential benefits of these supplements on improving the cognitive performance and mental well-being of healthy populations. Although not a safety concern, beetroot consumption can color the urine pink or red due to the excretion of red pigments in the beets . The amount of nitrate that this amount of juice provides is less than half the total nitrate consumption from a diet rich in vegetables and fruits . Studies have not identified any safety concerns with the consumption of beetroot juice in moderate amounts (about 2 cups/day) for several weeks. No research has assessed longer term supplementation with beetroot-derived nitrate beyond several weeks as an ergogenic aid. Performance benefits are more likely in recreationally active nonathletes than elite athletes 42,46. Milk protein concentrate was used only in one study (Poulios et al., 2018). Inter-individual variability in daily nutrient intake throughout recovery is critical when comparisons across different nutritional interventions are made. In addition, many studies in which recovery periods lasted 24 to 168 h, reported that diet was not controlled during recovery, though it was recorded before intervention (Betts et al., 2009; Gentle et al., 2014; Highton et al., 2013; Naclerio et al., 2014; 2015). Therefore, caution is required when interpreting the results of these studies and incorporating the conclusions drawn to team sports daily practice. Group 5 — Dietary advice with ONS compared with no advice and no ONS Research has clearly shown that not ingesting a sufficient amount of calories and/or enough of the right type of macronutrients may impede an athlete's training adaptations while athletes who consume a balanced diet that meets energy needs can augment physiological training adaptations.With a focus on transparency, they categorize supplements as either Trusted or Untrustworthy, guiding consumers in making informed decisions about their purchases.Personal satisfaction as well as the athletes' livelihoods and their organisations' prosperity depend on success.In response to concerns regarding the bioavailability of vitamins and minerals, USP has developed dissolution standards (Srinivasan 2001).They also consult with marketing and legal teams with the responsibility to ensure structure and function claims do not misrepresent results of research findings.They are typically fortified with vitamins and minerals and differ on the amount of carbohydrate, protein, and/or fat they contain.It can also be used to regulate mitochondrial endoplasmic reticulum coupling and has potential therapeutic effects on various aging-related diseases (Naia et al., 2021).Of the Directive, which permits the continued use of vitamins and minerals not on the 'positive lists', the UK supplement market will remain semi-regulated at least until 2009 . The review authors did not undertake any combined analysis as several studies report data at more than one time point (Analysis 1.8). The review authors did not undertake any combined analysis as several studies report data at more than one time point (Analysis 1.6). The review authors did not undertake any combined analysis as several studies report data at more than one time point (Analysis 1.5). To the best of our knowledge, this is the first time that the practices and perceptions of nutritionists working in the context of elite soccer teams regarding dietary supplements have been explored.The research to date does not support taking glutamine alone to improve exercise and athletic performance 139,140.Data on length of hospital stay were available from four studies (Cano‐Torres 2017; Casals 2015; Gu 2015; Weekes 2009).This organization consistently demonstrates how effective feedback can elevate team performance and customer satisfaction.Phagocytic function of peripheral blood leucocytes, mitogenic response of spleen lymphocytes to Con A, and mixed lymphocyte culture and LPS-induced IL-1 release of macrophages (Zhu & Yu, 1990).Clinical studies have consistently shown that lipophilic statins, such as simvastatin, reduce the incidence and mortality of various cancers, including prostate, breast, colorectal, hepatocellular, and lung 111,116.According to international consensus, the daily reference intake of protein for the healthy adult population is 0.8 g/kg body weight.9,10 However, individuals who engage in physical activity may require more protein, ranging from 1.2 to 2 grams per kilogram of body weight.11 To fulfill these requirements, many athletes and active individuals opt for whey protein (WP) supplements to increase their protein intake. The process does not involve any toxic organic solvents for extraction and is carried out at milder conditions making it the best solvent for extraction of bio-active compounds (particularly non-polar) in its purest form. In recent years, extraction using supercritical CO2 has emerged as an alternate technology having wide applications in chemical and food industries. Though the yield in this method is low, it contains the carbohydrates, adenosine, ergosterol and trace amount of cordycepin, of which ergosterol and related compounds were identified as a major class of active constituents contributing to the in vitro cytotoxicity. Camere 2016 published data only There is elsewhere evidence that academics and students have differing perceptions of what happens in university classrooms, particularly in regard to higher order thinking. Using a qualitative method of research, another study was conducted to see whether the university instructors in the education department who had the responsibility of teaching different courses to the same students were aware of the principles of CT. This study highlights the need for targeted interventions to address discipline-specific challenges and enhance the development of critical thinking across various academic fields. Critical thinking helps students weigh evidence in determining its use in research; use logical and systematic thinking in developing a question at issue and answering it; explore connections between assumptions, points of view, and concepts; and develop criteria for assessing results. Online education necessitates greater reliance on high-quality curriculum materials, which directly impacts student engagement and success in learning critical thinking, as demonstrated by studies indicating equivalent achievement levels in distance and traditional learning environments. Seven studies (610 participants) reported on the change in protein intake up to three months (Beck 2012; Beck 2015; Isenring 2004; Moloney 1983; Ovesen 1993; Schilp 2013; Uster 2013). The review authors did not undertake a combined analysis as three studies report data at more than one time point. The review authors did not undertake a combined analysis as two studies report data at more than one time point. In addition to the discrepancies in defining an MVM, many challenges and methodological issues impede the accuracy of self-reported MVM use (9–11). Because of the lack of a standardized MVM definition, a product could be considered a MVM even if it includes a vast majority of nonvitamin or nonmineral ingredients as long as it contains a few vitamins and minerals. Additionally, they may also promote them for an array of health issues such as eye health, energy production, and healthy immune function (6). FDA also issued formal guidance on current Good Manufacturing Practice to ensure that processes for preparation, packaging, labeling, and storage of supplements and ingredients are documented and meet specifications to ensure purity, composition, and strength. Obtaining adequate vitamins, including use of supplements, may also be prudent behavior for some athletes. In general, health professionals indicate that vitamin supplements are not necessary for the individual on a well-balanced diet, but they may be recommended for certain individuals, such as the elderly, vegans, and women of childbearing age. Athletes who consume vitamin supplements should purchase them only from reputable companies, such as those whose products that carry the USP (United States Pharmacopeia) certification on the label. If no side effects have been reported in the scientific/medical literature, we generally will view the supplement as safe for the length of time and dosages evaluated. When evaluating the safety of a supplement, we suggest looking to see if any side effects have been reported in the scientific or medical literature. Some athletic associations have banned the use of various nutritional supplements (e.g., prohormones, Ephedra that contains ephedrine, "muscle building" supplements, etc). Studies reporting improved performance in rats or persons with type 2 diabetes may be insightful but research conducted on non-diabetic athletes is much more practical and relevant. • Are the studies basic research done in animals/clinical populations or have the studies been conducted on athletes/trained subjects? The mean energy intakes of professional male team sport athletes reported in the literature have decreased from those reported by a previous review ; however, in comparison female athletes are consuming diets of relatively similar energy density (i.e., 7.3–9.8 MJ/day) . Studies included in this review reported dietary intakes that were high in protein, however low in carbohydrates and/or total energy (hypocaloric) 2,3,10,26,28,35,36,38,43. Conversely, the majority of studies found that dietary intake of protein 2,10,24,25,26,28,30,31,33,35,36,37,43,56 and fat 24,27,28,32,35,36,37 exceeded recommendations. Overall, a macronutrient imbalance was found in the majority of studies with most athletes reported consuming diets high in protein and fat, at the expense of carbohydrate. Of the 21 studies included, five studies reported that energy intake was adequate according to the respective dietary recommendations used 23,32,33,37,39. Thirty-nine randomized controlled studies involving populations including children, adults and seniors exposed to stressors, such as air travel, intense exercise, academic stress, and/or exposure to winter weather, met eligibility criteria. Immune health products represent approximately 10% of all US dietary supplement sales. The nutritional quality of their diet and need for supplementation were evaluated by scoring their dietary intake with and without supplementation, yielding two NQI scores (scales of 0-21 points) for each participant. All participants in the intervention group received dietary instruction but the nature and intensity varied.Although protein ingestion resulted in reduced systemic CK and Mb responses in some studies, these changes were not accompanied by performance enhancement and therefore are of limited importance.A further two studies did not provide any information regarding sequence generation and were judged to have an unclear risk of bias (Akpele 2004; Pivi 2011).Still, the study also suggests that a 12-month resveratrol intake may induce renal toxicity (Wong et al., 2009).Key-terms were grouped and searched within the article title, abstract, and keywords using the conjunctions ‘OR’ and ‘AND’.Moderator analysis specifies for whom and under what conditions the treatment works or works best .The FDA was charged with enforcing these laws with a critical function of assessing the safety of new dietary ingredients under the 1958 Food Additive Amendments to the FFDCA (Swann 2016; 85th US Congress 2018).In all but one study the intervention was tailored to individuals' habitual intake or preferences, or both (Chandra 1985). Eight studies declared some funding from a company making commercial nutritional products (Holyday 2012; Isenring 2004; Jensen 1997; Rogers 1992; Starke 2011; Suominen 2015; Uster 2013). All 31 RCTs had a parallel design and most were single‐centre studies; two studies were multicentre (Bonilla‐Palomas 2016; Bourdel‐Marchasson 2014). In four studies, the intervention was given by nurses (Dixon 1984) or research assistants (Burden 2011; Burden 2017) or doctors (Diouf 2016). Zhao 1995 published data only Initially, it was recommended that athletes do not need to ingest more than the RDA for protein (i.e., 0.8 to 1.0 g/kg/d for children, adolescents and adults). For this reason, we recommend that care should be taken to consider the type of carbohydrate to ingest prior to, during, and following intense exercise in order to optimize carbohydrate availability. Ingesting combinations of glucose and sucrose or maltodextrin and fructose have been reported to promote greater exogenous carbohydrate oxidation than other forms of carbohydrate 18-26. While consuming this amount of carbohydrate is not necessary for the fitness minded individual who only trains 3-4 times per week for minutes, it is essential for competitive athletes engaged in intense moderate to high volume training. However, athletes involved in moderate and high volume training need greater amounts of carbohydrate and protein in their diet to meet macronutrient needs. The search was performed as “sports nutrition AND supplementation” using the API of the open access repository Europe PubMed Central. Bibliometric analysis of keyword co-occurrences in sports nutrition in recent years. There has been a consistent increase in the number of scientific publications on the topic of sports nutrition in recent years . No studies have evaluated the use of ephedra dietary supplements, with or without caffeine, as ergogenic aids. The effects of quercetin supplementation were inconsistent and varied by study, but they generally ranged from no ergogenic benefit to only a trivial or small improvement that might not be meaningful in real-world (in contrast to laboratory) exercise conditions 42,170,171,176. Since the Food and Nutrition Board developed the RDA for protein, more recent data have suggested that athletes require a daily protein intake of 1.2 to 2.0 g/kg to support metabolic adaptations, muscle repair and remodeling, and protein turnover 12,167. Athletes can safely obtain recommended intakes of iron by consuming a healthy diet containing iron-rich foods and by taking an iron-containing dietary supplement as needed. Based on the limited data and heterogenicity of results, the study authors suggested that preventing and treating iron deficiency could improve the performance of female athletes in sports that require endurance, maximal power output, and strength. Two studies (91 participants) reported data on change in MAC from baseline to up to three months (Singh 2008; Stow 2015). One study (50 participants) reported data on change in FFM at up to three months (Schwenk 1999). Review authors did not undertake a combined analysis as one study reports data at more than one time point (Analysis 2.4). Other reviews have indicated that although animal studies have shown some promising effects of antioxidant supplementation to lessen exercise-induced oxidative stress damage, studies with humans are less convincing. Overall, a recent review concluded that there is limited evidence that dietary supplementation with antioxidants improves human performance. Only limited data are available, but these studies have shown that CoQ10 supplementation to healthy young or older subjects did not influence lipid peroxidation, heart rate, maximal oxygen uptake, anaerobic threshold, or cycling endurance performance 20-23. In one of the most comprehensive studies, Telford and others evaluated the effect of long term (7–8 months) vitamin/mineral supplementation (100 to 5,000 times the RDA) on exercise performance of nationally ranked athletes in training at the Australian Institute of Sport. Recently my iron was too high, so now I know I need to reduce my intake of iron or add calcium or curcumin to my diet (that reduce iron absorption). A better critique of Blueprint would be to criticise the way he is measuring his health, but I haven't found many critiques of this sort. Johnson might be doing some weird looking light therapy that he mentions in some of the videos as trying, but he's not committed to that; if his skin doesn't get bette I'd guess I'd drop it. Read summaries of the latest studies across 25 categories, or pick the categories that matter most to you. Search by condition to find supplement efficacy, safety, and dosage information. Creatine supports ATP production, which helps with short bursts of muscular power and enhances muscle recovery and size.It’s also showing promise for brain health and neurological function. Vitamin D is essential for immune function, bone health, and mood regulation—but it also plays a key role in reducing inflammation and joint pain. Think of this as your functional wellness toolbox—choose what you need most right now, and layer or cycle additional support over time based on your body’s signals and lab data. The authors of the short-term studies investigating ribose as a potential ergogenic aid have not reported any safety concerns. More research, including larger clinical trials, on quercetin supplementation to improve aerobic capacity in trained athletes during specific sports and competitions is needed before any recommendations can be made . These studies typically examined the endurance performance and VO2max of participants engaged in aerobic activities, such as running or cycling trials, who received either quercetin (most often 1,000 mg/day) or placebo for 1 to 8 weeks 170, . Removal of one study reduced heterogeneity to zero (Uster 2013) and protein intake was significantly greater in groups receiving advice plus ONS if required, MD 8.31 g/day (95% CI 1.33 to 15.30). No combined analysis was undertaken as several studies reported data at more than one time point. Two studies (195 participants) reported final energy intake at up to three months (Carey 2013; Feldblum 2011). We independently buy supplements from retail stores and test them in chemistry labs. Only an acute protocol with 150 mg/kg of l-arginine 60 min before exercise enhanced TTE in wrestlers , according to meta-analyses results , but the study obtained a fair score on the PEDro scale. More studies are necessary using beetroot-based products and well-established nitrate-containing beetroot juices in specific combat tests before providing adequate advice for combat sports. In this case, the NO3− concentration was 12.2 mmol, near the upper end of the range established for other studies with improvements in performance 110,111. Regarding combat sports, neither 2 g/kg of beetroot juice nor 400 and 800 mg of NO3− contained in the juice produced performance advantages; indeed, there were negative effects on power compared with the placebo group .