Running Head: PRE-WORKOUT SUPPLEMENT EFFECTS

Effects of Pre-Workout Supplements on Students at Rowan University

Andrew Ubil

HLT00327: Consumer Health Decisions

Dr. Bullard

October 14, 2015

Rowan University Running Head: PRE-WORKOUT SUPPLEMENT EFFECTS

Introduction

Pre-workout supplements have increased in popularity over the last few years and the use of them continues to grow. According to the National Center for Biotechnology Information, many athletes believe supplementation prior to training will result in greater focus, quicker reaction time, and increased power (National Center for Biotechnology Information, 2013). Pre- workout supplements come in a few different forms such as; powders, pills and drinks. Recent research indicates energy drinks are the most popular supplement next to multi-vitamins in the young adult population (18-35 year) (National Center for Biotechnology Information, 2013).

Some of the most popular pre-workout products are; C4 by Cellucor, N.O Xlpode and Dymatize

Pursuit Rx. These supplements have grown in popularity because they claim to give the consumer the energy they need workout and increase their performance. Some claims of increased performance include more explosiveness when exercising and an increase in strength and muscle mass with continued use. The most common ingredients in pre-workout supplements are; caffeine, arginine and niacin.

Research Questions

Why do consumers choose a pre-workout supplement as opposed to eating a nutritious meal or drinking a cup of coffee before exercise?

Since pre-workout supplements are still new, does the consumer think of any long term effects of pre-workout supplement use?

Significance Statement

According to the National Center for Biotechnology Information, supplementation with various over-the-counter dietary supplements and “nutrient timing” are two popular approaches Running Head: PRE-WORKOUT SUPPLEMENT EFFECTS used by athletes to aid in performance and recovery (National Center for Biotechnology

Information, 2014). Since pre-workout supplements have had such an increase in popularity over the last few years, many people buy into a product they know nothing about. Many consumers purchase pre-workout supplements without knowing some key information such as the ingredients in the supplement and the side effects of the supplement. According to Wellness FX, several pre-workout supplements have been banned because they contained substances known to increase the rate of heart attacks, bleeding of the brain and even death (Wellness FX, 2015).

Review of Literature

Among both recreational and professional athletes, the prevalence of supplementation has grown. It is estimated that 48-53% of Americans use supplements on a regular basis, often citing overall health and wellness as reasons for supplementation (Food & Nutrition Research, 2015).

Pre-workout supplements generally contain multiple ingredients that claim to provide ergogenic benefits. Many athletes believe that supplementation prior to training will result in improved strength, focus and enhanced training adaptations (Food & Nutrition Research, 2015). The pre- workout time period has become an extremely popular window of nutrient administration where athletes ingest various combinations of key ingredients in an attempt to maximize training adaptations and promote recovery (National Center for Biotechnology Information, 2014).

A study investigated the effects of 8 weeks of supplementation with a pre-workout supplement containing caffeine, creatine and branched chain amino acids and found that consuming the supplement had greater increases in lean mass, quadriceps muscle thickness and bench press strength compared with placebo (Food & Nutrition Research, 2015). Moreover, the pre-workout supplement did not produce changes in hematology and the researchers concluded Running Head: PRE-WORKOUT SUPPLEMENT EFFECTS the supplement as safe. Finally, a pre-workout supplement containing caffeine, creatine and beta- alanine observed increases in strength along with no unusual changes in blood chemistry, indicating its safety (Food & Nutrition Research, 2015).

A study was done to examine the effects of the pre-workout supplement Assault™ on a multi-faceted, exercise testing protocol. The results suggest that the pre-workout supplement significantly improved muscular endurance and choice reaction time (National Center for

Biotechnology Information, 2013). Results indicated positive effects on perceived alertness, energy, and focus, which may have contributed to a 4% improvement in CRA and CRM30, and a

5% improvement in CRM15 (National Center for Biotechnology Information, 2013).

Supplement manufacturers often advertise products whose use in sports is neither scientifically founded nor safe, resulting in an irrational use of dietary supplements that are of little benefit, and which may lead to unwanted side effects (National Center for Biotechnology

Information, 2014).

The lifetime prevalence of sports supplement use among U.S military members is 40.1%

(Military Medicine, 2012). According to the Institute of Medicine, misuse of popular dietary and sports supplements may adversely impact military performance and readiness (Military

Medicine, 2012).

A hemorrhagic thalamic stroke occurred in a young, healthy service member, possibly attributable to a commonly used sports supplement, Jack3d (Military Medicine, 2012).

Jack3d is a product produced by USP labs in Dallas, Texas. One scoop (5.55g) of Jack3d contains a proprietary blend of 4.145g of 1,3-dimethylamylamine (better known as DMAA now banned by the FDA), schizandrol A, caffeine, b-Alanine, creatinemonohydrate (CM) and L-

Arginine a-Ketoglutarate (LAAK) (Military Medicine, 2012). Stimulants like DMAA and Running Head: PRE-WORKOUT SUPPLEMENT EFFECTS amphetamine derivatives work by activating receptors in the brain, which then causes the athlete to feel more energetic and to lift more or run farther, Miesfeld said (Arizona Daily Wildcat,

2013). These substances can sometimes be hidden under a healthier-sounding alias, he added.

Some of the companies that were selling products containing DMAA listed it as “pelargonium graveolens extract” or “geranium extract,” according to the FDA report. (Arizona Daily Wildcat,

2013.)

The patient was a 26-year-old active duty male, he reported taking the manufacturer’s recommended daily maximum dose of 3 scoops of Jack3d before his usual exercise regimen

(Military Medicine, 2012). The patient had a headache prior to the use of supplementation and exercise and reported that his headache became worse after supplementation and exercise

(Military Medicine, 2012). The patient had a medical history that included a congenital cataract of the left eye, insomnia which he was taking zolpidem and he was a smoker but stopped 1 week before the event. The patient was also taking a hormone supplement “T-Bond” for five weeks before stopping that (Military Medicine, 2012).

A literature search was conducted using PubMed, Medline and Google Scholar to identify previously reported cases of stroke, intracerebral hemorrhage or hemorrhage associated with Jack3d use (Military Medicine, 2012). No reports were found but, a limited number of case reports described an association of the components of Jack3d with intracerebral hemorrhage and stroke. Of the active ingredients in Jack3d, DMAA and caffeine have been previously reported in association with hemorrhagic strokes (Military Medicine, 2012). CM has been previously reported in association with ischemic stroke, and LAAK has been associated with subconjunctival hemorrhage. Overall, it was hard to conclude that the supplement alone caused Running Head: PRE-WORKOUT SUPPLEMENT EFFECTS

the stroke or the combination of the supplement and other predisposing factors such as the

patient’s tobacco use and use of medication for insomnia. (Military Medicine, 2012)

Methods

The subjects included peers at Rowan University. To gather information from the subjects a

survey was conducted. The timeline for this research was two weeks and began on November 1st.

Below is a sample of the survey:

Gender: Age: How many times a week do you exercise? 1-3 or 4-7 What type of exercise do you do? (Circle all that apply) Weight lifting, Running, Crossfit, Other (list below)

What pre-workout supplement are you using? Do you follow the recommended dosage? Yes or No

Why do you choose a pre-workout supplement over a cup of coffee before exercise or a nutritious meal? (Circle all that apply) I don’t like coffee, not enough time to cook a meal, I like the effect a pre-workout supplement gives me, pre-workout supplements are more convenient, Other (list below)

Do you experience any of the following when using pre-workout supplements? (Circle all that apply) Itchy skin feeling, increased heart rate, sharper mental focus, increased energy, increased performance when exercising, increase in strength and muscle mass (prolonged use), headache after exercise

(If you experience anything else not listed please list in the space provided) Do you think with long term use of pre-workout supplements you might experience any health problems? Yes/No Running Head: PRE-WORKOUT SUPPLEMENT EFFECTS

Results

A survey was conducted amongst Rowan University students that currently use pre-workout supplements. Twelve students (9 male, 3 females) took the survey, the students ranged in age from 21 years old to 25 years old. While administering the survey, several students stated they used to take pre-workout supplements but stopped because they did not like the way it made them feel prior to exercise and after exercise. However, those students did state that they did like the improvement in performance as a result of using the supplement.

Amount of Exercise per week

Of the 12 students surveyed, 8 students (67%) reported to exercise 4-7 times per week while 4 students (33%) reported to exercise 1-3 times per week.

Type of Exercise

All 12 students (100%) reported to doing some type of weight lifting, 9 students (75%) reported to also incorporate running into their exercise, 3 students (25%) reported to do Crossfit and 1 student (8.3%) reported to incorporate parkour into their exercise program.

Type of Pre-workout supplement used

Of the 12 students, 7 students (58.3%) use “Cellucor C4”, 3 students (25%) use “BSN NO-

Xplode” and 2 students (16.7%) use a homemade pre-workout supplement including beta-alanine and arginine

Recommended Dosage

Of the 12 students, 10 students (83.3%) reported to follow the manufacturer’s recommended dosage of the supplement while 2 students (16.7%) reported they do not follow the manufacturer’s recommended dosage. Running Head: PRE-WORKOUT SUPPLEMENT EFFECTS

Why the consumers use pre-workout supplements?

Of the 12 students surveyed, 6 students (50%) stated that they like the effect the supplement has on them and that the supplements are more convenient, 4 students (33.3%) stated that they do not like coffee and 2 students (16.7%) stated that the supplement was convenient to use.

Effects of pre-workout supplements on the consumer

Of the 12 students surveyed, all 12 students (100%) experienced increased energy and increased performance during exercise, 4 students (33.3%) experienced an increase in strength and muscle mass with prolonged use of the supplement, 6 students (50%) experienced an itchy skin feeling and 2 students (16.7%) experienced an increase in their heart rate when using the supplement.

Possibility of health problems with long term use

Of the 12 students, 6 students (50%) stated that they think they will experience health problems with the long term usage of pre-workout supplements, the other 6 students (50%) do not think they will experience health problems with the long term usage of pre-workout supplements.

One consumer commented “With long term supplement use, your tolerance for the supplement goes up. When the tolerance goes up, the consumer will want to use more of the supplement and take more than the manufacturer’s recommended dosage, increasing the risk of a health problem occurring” (23 year old Male).

Discussion

Overall, given the population that was surveyed the results were expected, with the exception of why students choose pre-workout supplements as opposed to a nutritious meal or a cup of coffee Running Head: PRE-WORKOUT SUPPLEMENT EFFECTS before exercise. All 12 students surveyed were Health and Exercise Science majors at Rowan

University. Based off of the answers to the research questions all of these students have knowledge of nutrition and supplements. As far as to why students choose pre-workout supplements most students choose them because they do not like coffee and they like the effects of the supplement. The researcher was expecting more students to answer that they like the convenience of the supplement and that they do not have enough time to for a nutritious meal.

When it comes to the research question of the consumer of thinking of long term effects with long term use of pre-workout supplements, the students surveyed do think of what potential health problems could arise with long term use of pre-workout supplements. Of the students who did not take the survey, a lot of them also noted that they stopped taking pre-workout supplements because they did not know of the effects it could have on them long term.

If the research were to be conducted again, the surveys would have been conducted at the recreational center on campus at Rowan University where there are more students that have different majors and a different level knowledge of nutrition and supplements. If the students surveyed were not Health and Exercise Science majors, the results could have been much different. Running Head: PRE-WORKOUT SUPPLEMENT EFFECTS

References

Joy, J. M., Lowery, R. P., Falcone, P. H., Vogel, R. M., Mosman, M. M., Tai, C.. . Moon, J. R.

(2015). A multi-ingredient, pre-workout supplement is apparently safe in healthy males and females. Food & Nutrition Research, 59, 1-7.

Kedia, A.W., Hofheins, J.E., Habowski, S.M., Ferrando, A.A., Gothard, M.D., & Lopez, H.L.

(2014, January 2). National Center for Biotechnology Information. Effects of a Pre-workout

Supplement on Lean Mass, Muscular Performance, Subjective Workout Experience and

Biomarkers of Safety. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3894395/

McEvoy, A. (2013, October 31). Arizona Daily Wildcat . Arizona Daily Wildcat :: Pre-workout powder can harm as much as help. Retrieved from http://www.wildcat.arizona.edu/article/2013/10/pre-workout-powder-can-harm

Spradley, B.D., Crowley, K.R., Tai, C., Kendall, K.L., Fukuda, D.H., Esposito, E.N., Moon,

S.E., & Moon, J.R. (2012, March 30). National Center for Biotechnology Information. Ingesting a pre-workout supplement containing caffeine, B-vitamins, amino acids, creatine, and beta- alanine before exercise delays fatigue while improving reaction time and muscular endurance.

Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3361498/

Young, C.,M.C.U.S.N., Oladipo, O.,M.C.U.S.N., Frasier, S.,M.C.U.S.N., Putko, R.,M.C.U.S.N.,

Chronister, S.,M.C.U.S.N., & Marovich, Mary, MD,D.T.M.H., F.A.C.P. (2012). Hemorrhagic stroke in young healthy male following use of sports supplement Jack3d. Military Medicine,

177(12), 1450-4

Your Pre-workout Supplements: Hype or Health?, Wellness FX (2015, June 3).