Journal of Sports Sciences, 2002, 20, 353± 358

The type, amount, frequency and timing of dietary supplement use by elite players in the First Spanish League

H. SCHR™DER,1* E. NAVARRO,2 J. MORA,3 J. SECO,4 J.M. TORREGROSA5 and A. TRAMULLAS1 1Department of Sports Medicine, Sports Medicine Barcelona, Barcelona, 2Institut de Recerca Oncologica, Hospitalet de Llobregat, Barcelona, 3Departamento de Fisioterapia, Universidad de Valencia, Valencia, 4Servicio Medico Fisioterapia, , Vitoria and 5Servicio Medico, Baloncesto , Fuenlabrada, Spain

Accepted 3 December 2001

The aims of this study were to determine the type, frequency and amount of dietary supplement consumption among a group of professional basketball players. The type, amount and speci® c timing of supplement use were recorded by 55 professional basketball players from seven diþ erent teams of the First Spanish Basketball League. Most participants (58%) consumed dietary supplements. Multivitamins and vitamins were the most frequently used supplements among the athletes (50.9%), followed by sport drinks (21.8%), miscellaneous supplements (21.8%), amino acids (14.5%), proteins (12.7%) and carbohydrates (12.7%). The average daily dietary supple- ment was one capsule of multivitamins, one capsule of antioxidant vitamins, 0.2± 1.0 g vitamin C, 10.3 g protein, 1.9 g amino acids, 16.2 g carbohydrates and 377 ml of a commercial sport drink. Although the proportion of participants who consumed dietary supplements before, during and immediately after exercise was 25.4%, 16.3% and 7.3% respectively, only a few consumed a potentially ergogenic supplement at these times. It would appear unlikely that the type or amount of dietary supplements consumed had a bene® cial eþ ect on the physical performance of these professional basketball players, with the possible exception of antioxidant vitamins and the commercial sport drinks.

Keywords: antioxidants, basketball, nutrition, sport, supplements.

Introduction ments, including carbohydrates, proteins, vitamins and antioxidants, are promising alternatives. However, some The physical demands of professional sports are so supplements contain labelled ingredients or impurities high that even the smallest advantage gained by an that are either banned or will result in a positive drug athlete can provide a bene® t during competition. For test (Burke, 2000). this reason, top sportsmen and women use dietary Professional basketball produces high physical and supplements to improve performance. Several scienti® c psychological stress (McInnes et al., 1995), making studies have examined the eþ ects of supplement use by players vulnerable to the uncontrolled use of dietary athletes (Haymes, 1991; Williams, 1999). In contrast, supplements, including some that have dubious eþ ects little attention has been given to the prevalence and on physical performance. As these players are also role patterns of supplement consumption. In competitive models, the excessive use of dietary supplements could events, where the diþ erence between winning and losing be considered a serious health concern. is small, many athletes seek ergogenic aids that have no Very little is known about the use of supplements in side-eþ ects and which are not banned. Dietary supple- basketball (Short and Short, 1983; Nowak et al., 1988). To the best of our knowledge, no scienti® c study has focused on the consumption behaviour of supplements * Address all correspondence to Helmut Schr”der, Department of Nutrition, Sports Medicine Barcelona, c/ Lázaro Cárdenas 9, by professional basketball players. The aims of this E-08017 Barcelona, Spain. e-mail: [email protected] study were to assess the type, frequency, amount and

Journal of Sports Sciences ISSN 0264-0414 print/ISSN 1466-447X online Ó 2002 Taylor & Francis Ltd http://www.tandf.co.uk/journals 354 Schr”der et al. timing of dietary supplement use by professional bas- Gatorade Thirst Quencher) or glasses (200 ml). To ketball players in the First Spanish Basketball League evaluate timing of supplement use, the participants (ACB). were requested to record their supplement use (as above) as being `immediately before’, `during’ or `after’ a match or training session. Methods

Participants Results Fifty-® ve basketball players in the First Spanish Basket- ball League participated in the study. The players Fifty-® ve players completed the questionnaire. The were recruited during the competition season and mean (± s) physical characteristics of the participants were informed of the procedures before providing their (with values for 137 other players in the ACB in paren- voluntary consent to participate. The protocol was theses) were: age 25.1 ± 4.0 (26.2 ± 3.6) years, height approved by the institutional review board. The players 1.97 ± 0.09 (1.98 ± 0.09) m, body mass 93.2 ± 10.5 kg completed 8± 10 training sessions a week, with an and BMI 24.0 ± 1.5. There were no diþ erences in mean average weekly training load of 15.5 ± 2 h, and com- values of continuous variables (age and height) between peted one to two times a week during the 1996± 97 com- the 55 participants and the other 137 ACB basketball petition season. They also participated in international players, with the statistical power to detect diþ erences competitions. of 2 years or 0.04 m between the two groups > 90%. Hence, both groups were homogeneous in age and height and the study group could be considered to be Dietary supplement questionnaire representative of ACB basketball players for these With the permission of the respective physicians of characteristics. seven basketball teams, a supplement questionnaire was Fifty-eight per cent of athletes (n = 32) recorded administered to the players (n = 77). Fifty-® ve players using dietary supplements. Twenty-six (81.2%) con- answered the questionnaire, a compliance rate of sumed supplements daily, whereas 18.8% consumed 71%. The questionnaire was structured in the following them only once a week (Fig. 1). Multivitamins and way: players were asked if they consumed dietary vitamins were taken most frequently (50.9%), followed supplements regularly and, if they did, they were by sport drinks (21.8%), miscellaneous supplements requested to record in detail the type, frequency, (21.8%), amino acids (14.5%), proteins (12.7%) and amount and timing of supplement use on training and carbohydrates (12.7%) (Fig. 2). The average daily competition days. intakes of multivitamins, antioxidants, vitamin C, sport Supplements used by the players were coded by drinks, amino acids (arginine, ornithine and BCAAs), type, frequency, amount and timing of use. Coding for type was broken down into six categories: multi- vitamins or vitamins, proteins, amino acids, carbo- hydrates (de® ned as supplements in powder form containing carbohydrates as the sole macronutrient), sport drinks (de® ned as an isotonic beverage containing 6± 8% carbohydrates) and a miscellaneous category. Frequency of use was coded by daily or weekly con- sumption of supplements. To avoid misclassi® cation of supplements by the players, we provided examples of types of supplements; the participants were requested to record the commercial name of the supplement and the company that sells it. The amounts of multivitamins and antioxidants consumed were recorded by number of capsules (and later converted to grams), whereas pro- tein and carbohydrate supplement use was recorded in grams, in tablespoons or the corresponding units of the commercial product used by the athletes (and later converted to grams). Commercial vitamin C supple- ment use varied considerably; we therefore calculated daily minimum and maximum ingestion. Sport drink Fig. 1. Consumption and frequency of use of dietary supple- consumption was recorded by bottles (i.e one bottle of ments by the basketball players (n = 55). Dietary supplement use by elite basketball players 355 proteins and carbohydrates are shown in Table 1. The after (7.3%) exercise (Table 2). Generally, more par- miscellaneous supplements consumed by the partici- ticipants recorded consuming supplements before, pants included carnitine, co-enzyme Q, inosine, choline, during and after competition than training. Multi- lecithin, iron, ginseng and commercial plant extract vitamins were the most commonly used supplement mixtures (Fig. 3). They tended to consume protein before competition (20%; Table 2). Sport drinks were and multivitamin supplements on a daily rather than a consumed by 14.5% of the participants during com- weekly basis (Fig. 2) and preferred to take more than one petition, whereas only 1.8% did so during training. supplement (77.4%). Supplement use before exercise was more frequent (25.4%) than during (16.3%) or Discussion

This is the ® rst detailed study of the pattern of supplementation of elite basketball players (29% of all professional basketball players in the First Spanish Basketball League, ACB). It has previously been shown that the amount and frequency of dietary supple- mentation is higher among elite than non-elite athletes (Sobal and Marquart, 1994). In the present study, supplement use (58.2%) was similar to the pooled mean (59%) found by Sobal and colleagues among elite athletes. However, the prevalence of supplementation was almost twice that in our study group than in college basketball players (Short and Short, 1983; Nowak et al., 1988). The intensive training loads and travel experienced by elite athletes may have social and lifestyle implications. The frequency and timing of training sessions, or Fig. 2. Frequency of use of multivatimins or vitamins (MV), even travel, may increase the risk of poor food choices, protein (PR), amino acids (AA), sport drinks (SD), carbo- leading to temporary nutritional imbalances. We hydrate (CHO) and miscellaneous supplements by the basket- found that multivitamins are the most frequent type of ball players (n = 55). j , total users; h , daily users; , weekly dietary supplement used by the players in the present users. study, which is in line with previous results (Short and

Fig. 3. Type and frequency of use of miscellaneous supplements by the basketball players (n = 55). 356 Schr”der et al.

Table 1. Dietary supplement use by 55 basketball players

Dietary supplement Percentage of total Amount per day a

Multivitamins or vitamins multivitaminsb 48.8 Vitamin C: 60± 98 mg Vitamin B1: 1.4± 2.0 mg Vitamin B2: 1.6± 2.0 mg Vitamin B6: 1.0± 1.8 mg Vitamin B12: 1.0± 4.4 mg Vitamin E: 10.0± 13.5 mg Vitamin A: 2480± 4000 IU Vitamin D: 200± 400 IU Folate: 200± 400 mg Niacin: 15± 18 mg Pantothenic acid: 8± 10 mg vitamin C 14.5 200± 1000 mg antioxidants c 3.6 Vitamin C: 250 mg Vitamin E: 75 mg b-carotene: 4.75 mg Niacin: 10 mg Vitamin B2: 2.5 mg Vitamin B6: 5 mg Glutathion: 12.5 mg Selenium: 75 mg Flavonoides: 50 mg

Protein (g) 12.7 10.3 ± 8.8 Amino acids (g) 14.5 1.9 ± 1.4 Sport drink (ml) 21.8 377 ± 363 Carbohydrate (g) 12.7 16.2 ± 3.3

a Intake of supplements by athletes reporting the use of the corresponding supplement. b Amount of multivitamin supplements containing vitamins. c Composition of antioxidant supplement. Note: Amino acids: arginine, ornithine and branched-chain amino acids.

Table 2. Athletes (n = 55) reporting the use of supplements Short, 1983; Burke et al., 1991). The intake of multi- before, during and after training and competition vitamins might help in preventing temporary vitamin imbalances caused by a sport lifestyle (Telford et al., Event Before (%) During (%) After (%) 1992). In the present study, 18.1% of the participants Training reported regularly consuming vitamin± antioxidant Sport drinks 0 1.8 0 Multivitamins 0 0 0 mixtures or vitamin C. It has previously been suggested Carbohydrates 0 0 0 that supplementation with nutritional antioxidants Ginseng 0 0 0 reduces exercise-induced production of free radicals Inosine 0 0 0 (Jakeman and Maxwell, 1993; Kanter et al., 1993; Carnitine 0 0 0 Alessio et al., 1997). Similarly, Schr”der et al. (2000) demonstrated the ability of a three-compound dietary Competition antioxidant supplement (ascorbic acid, a-tocopherol Sport drinks 0 14.5 0 and b-carotene) to reduce oxidative stress in pro- Multivitamins 20.0 0 3.6 fessional basketball players. These authors found that Carbohydrates 0 0 1.8 lipoperoxide plasma decreased signi® cantly during 32 Ginseng 5.5 0 0 Inosine 3.6 0 0 days of supplementation with the above-mentioned Carnitine 1.8 0 1.8 antioxidant mixture. Consequently, athletes who take antioxidant supplements will receive greater protection Note: Some players consumed more than one supplement at particular against exercise-induced free radical damage. times. Several authors have reported that professional Dietary supplement use by elite basketball players 357 basketball players have high dietary protein intakes as advice from other players, from the coach or from (Nowak et al., 1988, Schr”der et al., 2000). An other non-experts in sport nutrition ± might explain additional intake of 0.11 g ´kg-1 ´day-1 protein as the pattern of supplement use before, during and after supplements (as reported by 12% of the participants in competition and training by the players. this study) should not aþ ect protein balance. Scienti® c evidence suggests that the consumption Several studies have indicated that carbohydrate of multivitamins, ginseng, carnitine, co-enzyme Q and supplements do not only improve exercise performance lecithin does not have an ergogenic eþ ect (Singh et al., in endurance athletes (Coyle et al., 1983; Yaspelkis et al., 1992; Snider et al., 1992; McNaughton et al., 1999; 1993), but also bene® ts short-term, high-intensity, Vogler et al., 1999; Brass, 2000; Buchman et al., intermittent exercise (Anantaraman et al., 1995; 2000). Furthermore, it is unclear whether the amount Akermark et al., 1996; Nicholas et al., 1997; Davis et al., or timing of ingestion of sport drinks, carbohydrate 1999), which could have important implications for and protein supplements by athletes improves physical performance enhancement in team sports (Akermark performance. et al., 1996; Shi and Gisol® , 1998). As professional Safety is at the heart of whether a dietary supplement players in the First Spanish Basketball League train should be recommended and consumed. Vitamins twice a day 5± 6 days a week and compete at least once taken in excess of the recommended daily allowances a week, carbohydrate supplements or carbohydrate- (RDA) or the individual’s needs could be a potential containing sport drinks that are easy to consume might health hazard. The reported use of one capsule of be helpful in maintaining glycogen stores (Coombes vitamin complexes by the athletes did not present a and Hamilton, 2000). Although basketball players risk for hypervitaminosis, as these supplements did not have free access to sport drinks during training and include excessive doses of vitamins. Furthermore, it competition, only 21.8% of the participants in this is unlikely that the consumption of 1 g vitamin C by study consumed these drinks regularly (an average of some players would have adverse side-eþ ects in healthy 377 ml´day-1). To the best of our knowledge, data on people (Hathcock, 1997). sport drink and carbohydrate supplement use by elite We conclude that about 58% of professional Spanish athletes are not available, so it cannot be determined basketball players consume dietary supplements. The whether the consumption of these two dietary supple- prevalence of use of these supplements by these pro- ments is similar among professional basketball players fessional athletes is twice that previously reported and other elite athletes. for college basketball players, but comparable with the The timing of carbohydrate and protein solution average intakes of other elite sportsmen. Given the consumption is important for ensuring the maximum amount and timing of supplement consumption by bene® ts for performance and recovery. Drinking solu- professional Spanish basketball players in the present tions containing carbohydrates before or during short- study, it would appear unlikely that the supplements term, high-intensity or prolonged intermittent exercise consumed had a bene® cial eþ ect on performance or an improves physical performance (Murray et al., 1989; adverse eþ ect on health. Whright et al., 1991; Ventura et al., 1994; El-Sayed et al., 1997; Jeukendrup et al., 1997). Furthermore, protein and glucose consumption immediately after exercise Acknowledgements appears to be more anabolic and to decrease myo- ® brillar protein breakdown, respectively, than when We gratefully acknowledge the cooperation of the ACB ingested some time later (Biolo et al., 1997; Roy et al., directorate and the basketball players and team physicians 1997). Despite these bene® ts, none of the partici- who participated in the study. The study was supported by TM pants recorded using these supplements immediately a grant from the Rehnborg for Nutrition and Well- after training and only one participant regularly ness, Nutrilite Division of Amway Corporation (USA). consumed supplements containing carbohydrate after competition. The consumption of commercial sport drinks con- References taining carbohydrate during training and competition was reported by 2% and 16% of the players in our study, Akermark, C., Jacobs, I., Rasmusson, M. and Karlsson, J. (1996). Diet and muscle glycogen concentration in relation respectively. This might re¯ ect the greater importance to physical performance in Swedish elite players. attached to competition by the players: 20%, 5.5%, International Journal of Sport Nutrition, 6, 272± 284. 3.6% and 1.8% reported regularly using multivitamins, Alessio, H.M., Goldfarb, A.H. and Cao, G. (1997). Exercise- ginseng, carnitine and inosine, respectively, before a induced oxidative stress before and after vitamin C competitive match. In addition to their own decision to supplementation. International Journal of Sport Nutrition, 7, use a particular supplement, external in¯ uences ± such 1± 9. 358 Schr”der et al.

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