A Pharmacist's Guide to OTC Therapy: Sports Nutrition

Ms. Terrie is a clinical pharmacy writer based in Haymarket, Virginia.

According the American Dietetic Association (ADA), Dietitians of Canada, and the American College of Sports Medicine, the physical activity, athletic performance, and recovery from exercise are improved by an optimal nutritional plan.¹ Furthermore, these organizations state that the proper selection of foods, the timing of their intake, as well as supplement choices are essential for optimal health and exercise performance.¹

Many individuals have established a routine exercise regimen and on average may spend 5 to 10 hours per week exercising.² As a result, many of these individuals may seek ways to maintain or supplement their nutritional intake to sustain or increase their level of physical activity.²

The various sports nutrition products marketed to athletes can be divided into 2 general categories²:

• Ergogenic aids that improve power and strength
• Endurance aids that prolong duration of exercise by providing fuel for continued effort and replacing electrolyte loss from perspiration to support normal muscle contractions.

A wide variety of sports nutrition products are currently on the market, including electrolyte replacement beverages, energy drinks, energy bars and gels, nutrient-enhanced water and juices, and recovery drinks, as well as a variety of nutritional supplements, including tablets, powders, and capsules.² Many sports drink products typically contain carbohydrates, sodium, potassium, magnesium, and calcium, whereas some sports nutrition products are formulated with additional vitamins, minerals, and trace elements, as well as protein in various amounts.

In addition to these products, some multivitamin/mineral supplements are specially formulated to meet the nutritional needs of active individuals. Examples of these products include NatureMade Multimax (Pharmavite) and One A Day Maximum and One A Day Active (Bayer Consumer Care).

Pharmacists may encounter patients seeking assistance in the selection of the various sports nutrition products. They should remind patients about the importance of hydration while exercising. Individuals exercising for long periods of time should use a sports beverage with electrolytes to minimize the risks of hyponatremia.² Sports drinks that contain concentrations of carbohydrates that range from 4% to 8% are recommended for intense exercise events that last >60 minutes. These drinks are also appropriate for hydration during exercise events lasting <1 hour, although plain water is appropriate under these conditions as well.^1,3 Patients should be informed to monitor for signs of dehydration (eg, excessive thirst, decreased urine output,headache, and muscle weakness) and advised to seek medical care when warranted.

Patients electing to use protein supplements also should be advised to use these supplements as directed, as well as be counseled about the dangers of ingesting high amounts of protein and the effects on renal function. The ADA recommends a daily intake of 1.2 to 1.4 g/kg/day of protein for active adults who participate in endurance exercises, while athletes should not exceed the ADA recommendation of 1.5 g/kg/day of protein to increase body mass.²

Individuals who wish to enhance their exercise performance always should adhere to a well-balanced nutritional plan, maintain adequate hydration, use supplements and ergogenic aids with caution, minimize severe weight-loss practices, and eat a variety of foods in sufficient amounts.¹

Those individuals currently taking any medications and/or those with preexistingmedical conditions should always seek the advice of their primary health care provider prior to starting any exercise routine or using any of the available sports nutrition products. Patients should be advised only to use products from a reputable company. Many products marketed as ergogenic aids have not been proven to be effective, and studies have classified many of them as unsafe.² Studies have shown that good nutrition can have a positive impact on sports performance, however.^1,2 Finally, patients always should be reminded that no substitute exists for eating a well-balanced diet and adequate hydration, especially when implementing an exercise routine or engaging in any sports activity.

For more information on sports nutrition, please visit the following Web sites:

American Dietetic Association Web site at www.eatright.org

American College of Sports Medicine Web site at www.acsm.org

References

• Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and athletic performance. J Amer Diet Assoc. 2000;100: 1543-1556.
• Newnham M. Sports Nutrition and Performance-Enhancing Nutrients. In: Berardi R, Kroon L, Newton G, et al, eds. Handbook of Nonprescription Drugs. 15th Edition. Washington, DC: American Pharmacists Association; 2006: 503-519.
• American College of Sports Medicine. Exercise and Fluid Replacement. www.acsm-msse.org/pt/~.