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Learning Objectives 2/26/2019 To help ensure the integrity of competition for Dirty Dozen: High Risk athletes, sports organizations and fans Sport Supplement worldwide. Ingredients Lara Gray, MS, RD, CSSD Senior Director of Education, Board Certified Sports Dietitian 1 Welcome! Learning Objectives Things to note: At the end of the presentation, attendees will 1. It is required by the BOC for Certified Athletic Trainers that you are actively be better able to: present in the live event AND complete the post-webinar survey in order to • Identify dietary ingredients that pose a threat to drug tested athletes. receive your CEU certificate. • Explain how high risk dietary ingredients are being used in sports 2. CEU Statements of Credit (if applicable) supplements. will be emailed to attendees no later than Friday, March 1st. • Analyze sports supplements for high risk dietary ingredients. 3. Please use the “Questions” box in GoToWebinar. Questions will be reviewed by the moderator and answered at the Drug Free Sport International (BOC AP# P8729) is approved by the Board of Certification, Inc. to end. provide continuing education to Athletic Trainers. This program is eligible for a maximum of 1 Category A hour/CEU. ATs should claim only those hours actually spent in the educational program. 4. Download today’s handouts from the “Handouts” tab. 1 2/26/2019 Today: An In-Depth Look 40% - 100% ATHLETES USE SUPPLEMENTS • Type of sport • Level of competition • Definition of supplements Garthe, Ina, and Ronald J. Maughan. "Athletes and Supplements: Prevalence and Perspectives." International journal of sport nutrition and exercise metabolism 28.2 (2018): 126‐138. The Dirty Dozen in 2019 1. Phenethylamine (PEA) Largest category of current “designer” drugs Stimulants Beta-phenethylamine ß-phenylethylamine 1. Phenethylamines (PEAs) N-phenethylamine 2. 2-aminoisoheptane 2-phenylethaneamine 3. AMPiberry Beta-methyl phenethylamine (BMPEA), 4. Advantra Z, Citrus aurantium, bitter orange Acacia rigidula 4-Fluoroethamphetamine 5. Nelumbo Nucifera (Lotus leaf), higenamine 6. IGF-1 Contributors: Colostrum, Deer antler velvet Often seen in products 7. Yohimbe, Yohimbine advertised for: 8. Noopept Pre-workout 9. Ostarine Energy 10. Cannabidiol Focus 11. Clomiphene “Lifestyle” products 12. Green tea extract Thermogenic/ Fat-burner Weight loss 2 2/26/2019 Phenethylamine (PEA) Phenethylamine (PEA) Endogenous and exogenous • Increases: – Heart rate Naturally occurring or synthetic Popular alkaloids in supplements - n-phenethyl dimethylamine – Respiration Similar to amphetamine – Blood pressure (Eria jarensis (orchid) extract) – Body temperature Similar side effects Hordenine N-methyl tyramine • Similar structure to dopamine – Effects on the brain • Can cause: – Hallucinations – Confusion CNS stimulants or hallucinogens – Depression – Dizziness Mescaline (peyote) – Nausea/vomiting Designer psychadelics – Diarrhea (Ecstasy/MDMA, 2C-B) – Headaches Dopamine – Body pains 2. 2-aminoisoheptane 2-aminoisoheptane Aconiti kusnezoffii, Aconite extract • Psychoactive CNS stimulant Juglans regia (Walnut bark) • Similar structure to DMAA, DMHA, dimethylhexylamine, AMP Citrate (DMBA), and Octodrine, 2-amino-6-methylheptane Ephedrine (synthetic), 2-metil-5-amino-eptano • Safety not established Studied as a drug in 1950s Reemerged in 2012, peaking in 2018 • Not a legal dietary ingredient Advertised as “legal” or “safe” alternative to other illegal stimulants 3 2/26/2019 • 2016 Trademark owned by LeCheek Nutrition, Inc – 2015: LeCheek receives warning letter from FDA • AMPilean and AMPItropin for listing AMP citrate 2-aminoisoheptane – LeCheek owns Insane Labz 3. AMPiberry Often seen in products • Claims related to “The New DMHA” advertised for: Juniperus communis – Stimulant effects Pre-workout (Juniper berry) – “Smooth energy curve” with caffeine Thermogenic/ Fat-burner • Other Claims Weight loss – Diuretic (most evidence, but rodent models) Seems oddly similar to AMP – Fat loss Reported side effects: citrate (4-amino-2- • Mood swings methylpentane citrate) or 1, • Tremors 3-dimethylbutylamine (DMBA) • Difficulty concentrating • Over-stimulation • Energy crashes Used in: • Anxiety Pre-workouts • High blood pressure • Difficulty breathing Energy • Tachycardia • Heartburn 5. Nelumbo Nucifera (Lotus leaf), Aconite, 4. Advantra Z Higenamine (typically synthetic), Norcoclaurine, Citrus aurantium demethylcoclaurine Bitter orange Beta-2 Agonist activity, Stimulant effects (cardiac) Contains: -tachycardia • Synephrine Found in: • But also: tyramine, n- • Pre-workout methyltyramine, • Energy hordenine and • Weight loss octopamine • Sleep (!) Doses tested in humans: Patented for: 2.5 – 5 mg Stimulating thermogenesis Reducing weight Increasing lean muscle mass Doses found in Improving athletic performance supplements: Suppressing appetite 0 - 60+ mg 4 2/26/2019 6. IGF-1 Contributors: 6. IGF-1 Contributors: Colostrum, Deer antler velvet Colostrum, Deer antler velvet IGF-1 = Insulin-like growth factor IGF-1 = Insulin-like growth factor WADA Prohibited under Peptide WADA Prohibited under Peptide Hormones, Growth Factors and Hormones, Growth Factors and Related Substances Related Substances PED potential: PED potential: Amplifies anabolic effects of Amplifies anabolic effects of human growth hormone human growth hormone Side effects: Side effects: Hypoglycemia, acromegaly, heart Hypoglycemia, acromegaly, heart palpatations, tumor growth palpatations, tumor growth Typically Found in: Typically Found in: Recovery, Joint Health Recovery, Joint Health Male Health Male Health Anabolic, Libido Anabolic, Libido Overall Well-being Overall Well-being 7. Yohimbe 7. Yohimbe Yohimbine (a Rx drug), Pausinystalia Serious side effects (dose Yohimbe (from bark of tree in Africa) dependent): Promoted for: aphrodisiac, erectile dysfunction, athletic performance (stimulant effects), weight loss • Cardiac arrhythmia • Heart attack • Kidney failure • Seizure • Nausea/vomiting, diarrhea • Decreased libido • Muscle aches • Tremors • Dizziness, headache, vertigo • Insomnia • Anxiety Significant stimulant activity – especially in association with other stimulants (i.e. caffeine) Dosage in supplements: Unlisted Found in: EVERYTHING with caffeine! (seemingly) Inaccurate (25-150% of listed amount) Thermogenic/Fat burner Pre-workout Weight loss Not specifically banned in Testosterone-booster sport. 5 2/26/2019 8. Noopept 9. Ostarine N-phenylacetyl-L-prolylglycine ethyl Enobosarm, MK-2866, GTx-024 ester, noopeptide, Ноопепт or GVS- 111 (Russian patent) Selective Androgen Receptor Modulator • A synthetic, more potent (SARM) analogue of Piracetam (a nootropic) • Research drug - NOT approved dietary ingredients • Nootropics: Promoted for neuro- • Similar to anabolic agents, but tissue cognitive enhancement specificity Not controlled substances Not FDA-approved drugs • NOT approved for human use Not approved as a dietary Amounts found in supplements 7-10 times higher than ingredient researched in clinical trials Long term risks unknown Effects: • Use is intentional (online purchase) or Mild cognitive boost (only unintentional (supplement contamination) evidenced in those with cognitive trauma) 410% increase in SARM-positive drug tests (2014-15 to Psychostimulant 2017-18) • Banned by ALL sport organizations Found in: Remain in the body 30+ days after use Brain/Memory enhancers Pre-workouts Solo/bulk products 10. CBD 10. CBD Cannabidiol Cannabidiol • Research drug (i.e. Epidiolex) NOT a Hemp Seed Oil vs dietary ingredient CBD Oil • Schedule I Controlled Substance •Cannabis seeds do not contain CBD or THC • No quality control Hemp seed • Not 100% “THC-free” • May contain other contaminants (pesticides, fungicides) Hemp oil (from seeds) • Clinical evidence for therapeutic uses in humans is ABSENT •Caution: “Hemp Oil” may be used • High risk for all sport organizations synonymously with CBD Oil • Specifically banned in MLB • Not TSA approved Hemp Extract = CBD, other cannabinoids 6 2/26/2019 Clomiphene-positive drug tests for 2018-19 are already 82% of last 11. Clomiphene year’s totals (with 6 months of testing 12. Green Tea Extract left) Selective Estrogen Receptor Camellia sinensis Modulator (SERM) Found in: • EVERYTHING (seemingly) FDA-approved drug for • Weight loss fertility treatment • MVI Products • Pre-workout/Energy • Not FDA-approved for men • Anabolics • Protein Blends Alters testosterone levels in • Brain-boosting men via negative feedback Health risks: • Small dose = anti-estrogen • Dizziness • Large dose = estrogen effect • Ringing in ears “We can send parcels all over the States.” • Decreased iron absorption Used to counter negative side effects • Increased BP and HR of anabolic steroids (i.e. gynomastia) • Liver damage 12. Green Tea Extract Camellia sinensis QUESTIONS? [email protected] Popular for: • Caffeine content • Polyphenol content Primary polyphenols: green tea catechins antioxidant, anti- inflammatory, anti- carcinogenic properties - Epicatechin - Epicatechin gallate - Epigallocatechin - Epigallocatechin gallate (most potent) 7 2/26/2019 Upcoming Webinars, 12-1pm CST Infographics 3/12 Recovery Nutrition Tips Speaker: Katie Knappenberger, MS, RD, CSSD, ATC, Director of Performance Nutrition at Northwestern Athletics 3/27 Addiction and the Young Mind Speaker: Megan Fowler, LMSW, Clinical Team Leader at First Call KC Available Now: https://www.drugfreesport.com/infographic-products/ [email protected] 1. Phenethylamines (PEAs) 2. 2-aminoisoheptane QUESTIONS? 3. AMPiberry 4. Advantra Z 5. Higenamine 6. IGF-1 Contributors 7. Yohimbe 8. Noopept 9. Ostarine 10. Cannabidiol 11. Clomiphene 12. Green tea extract 8.
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