Supplementation in Running

What is a supplement? 

The IOC (International Olympic Committee) defines a supplement as a food, food component, nutrient or non-food compound that is purposefully ingested in addition to the habitually consumed diet with the aim of achieving a specific health and/ or performance benefit. 

If working with a dietitian, a food-first approach will be taken. Here the diet is assessed, corrected for any missing nutrients and when appropriate a supplement is added that will potentially have an added benefit. 

One of the big challenges for an elite athlete is ensuring that all supplements are considered WADA-approved (World Anti-Doping Agency). Elite athletes are regularly tested for the presence of illegal or banned substances. Even supplementing with something as generic as a vitamin can put them at risk of testing positive for illegal substances. Therefore, the decision to take a supplement needs to be carefully considered. 

Some questions to consider before purchasing a supplement: 

• Is there proof that this supplement will work for me? i.e., does it have an ergogenic effect or health benefit? 

• Is it worth spending the money on it? Does it have to be consumed multiple times, or be taken in large dosages adding to the cost? 

• Is it safe? Are there any negative side effects? 

• Is it permitted/legal for use? 

If you decide the supplement will be beneficial, trial use away from competition time. If no benefit is seen, then discontinue use. Make sure that you are getting your supplement information from a reputable source. It is crucial that references, websites, and scientific studies are scrutinized before supplements are considered. Discussed below are some well-studied supplements with proven effects that are safe to use in the correct setting.  

Supplements that may prove useful for runners: 

Sports foods: Sports bars, drinks, gels, protein supplements, and electrolyte solutions 

Sports bars, sports drinks, sports gels, protein supplements, and electrolyte solutions are all classified as supplements. Sports foods are designed to provide the necessary nutrients needed to enhance performance in a convenient form without unnecessary extras that may hinder absorption (such as fat and fibre).  

Sports foods provide: 

• Carbohydrates (fueling) 

• Hydration (fluid) 

• Electrolytes (replenish loss in sweat) 

• Recovery (stimulate muscle protein synthesis) 

They should be used as a supplement around training sessions and events to improve training, performance, and recovery. In some instances, certain functions can be combined in one product (such as hydration, electrolytes, and carbohydrates in a sports drink), minimizing how many products you need to use. 

Sports foods are safe to use but avoid those that contain unnecessary or proprietary ingredients. Choose those that have ingredients with known efficacy such as carbohydrates, caffeine, and protein. As with every benefit, there may also be negative side effects, for example, different types and blends of carbohydrates can have varying effects on an individual’s gastrointestinal system therefore labels should be read carefully. 

Performance supplements 

There are several evidence-based performance supplements that may produce a marginal improvement in performance when used in combination with a well-planned diet. Each will be discussed in more detail below.  

Table1: Evidence-based performance supplements that could be considered by runners 

Creatine 

Creatine use is most beneficial for sprinters due to its effect on improving high-intensity exercise performance but may be useful in endurance runners who need to sprint at the end of a race. This needs to be carefully considered because of the 1-2kg weight gain with creatine ingestion. Creatine supplementation can be useful in maintaining muscle mass when injured and can help with brain function after a traumatic brain injury. 

There are numerous protocols of use, either using a loading protocol followed by a maintenance dose or moving straight onto the maintenance dose, both equally effective. The most common protocol includes 5 g creatine monohydrate 4 times per day for 5 days, followed by 3-5g per day (single dose). The recommendation suggests it should be taken at the same time as your recovery meal after training, preferably with a protein- and carbohydrate-rich meal.  

Creatine can cause mild gastrointestinal discomfort, which can be avoided with smaller doses (split dose) and avoiding high-fibre foods along with this supplement. 

Creatine is found naturally in meat, fish, and poultry, but to reach the recommended levels, a supplement would be needed. 

Caffeine 

Caffeine use has been shown to have ergogenic benefits across short-duration events (1-60 minutes), as well as for long-distance runners. Its main mechanism of action is to decrease your perception of pain and fatigue therefore helping you to go further and faster. 

The recommended dosage is 3-6mg caffeine per kg body weight. For example, a 75kg athlete would need 225mg-450mg caffeine to experience an ergogenic effect. The supplement should be taken at least 60 minutes prior to an event, and/ or it can be used during an event to aid in combating fatigue. 

Caution needs to be taken as individuals have different abilities to tolerate caffeine. Some athletes may be more sensitive than others and experience negative side effects including nervousness, anxiety, and interference with fine motor control. 

Sources of caffeine include coffee, tea (black and green), energy drinks, caffeine tablets or shots, energy gels or chews, and pre-workouts. Pre-workouts should be used cautiously because they usually contain other stimulants that can have negative health effects or increase the risk of testing positive for banned substances. 

B-alanine 

B-alanine helps to remove acid from the muscles by reducing fatigue and improving performance. It is useful for middle-distance runners. Supplements should be taken from 4 weeks before an event to build up stores in the body. As this product needs to be taken over an extended period to have an effect, it can be costly.  

The recommended dosage is 6,4g b-alanine per day split into small doses across the day (i.e., 1600mg x 4 per day) for 4 weeks. Side effects include tingling in the hands and feet therefore it needs to be tested and trialed well in advance of events/competitions. Slow-release tablets can help to reduce side effects. 

Although a dietitian would always consider a food-first approach, these doses are difficult to attain with food alone. 

Sodium bicarbonate 

During exercise, there is an increase in acid build-up in our muscles. Sodium bicarbonate helps to buffer/counteract acidity caused by exercise thus reducing fatigue and improving performance. This benefit is more effective for middle-distance runners.  

Negative side effects may include gastrointestinal discomfort like nausea, vomiting, and diarrhea, so it is important to trial well before competitions or events.  

This supplement is easily obtainable as it is extensively used in baking (found in bicarbonate of soda). It is also available in pill form for convenient use. The recommended dosage is 200-400mg sodium bicarbonate per kilogram body weight, 120 minutes before exercise. It should be taken along with 10ml per kg fluid to reduce side effects and eaten with a high carbohydrate meal. Speak to a registered dietitian to guide you if you would like to trial this supplement. 

Nitrates 

Nitrates reduce blood pressure and aid in optimal oxygen use when performing at sub-maximal intensities therefore being more beneficial for longer-distance runners. 

The recommended dose is 350-600mg nitrate 2-3 hours before an event. It can be obtained through food sources (nitrate-rich vegetables such as beetroot and spinach), but quantities are difficult to estimate. Most protocols in research have used pure beetroot juice (800mg nitrates per litre) or Beetroot shots (400mg concentrated nitrates per shot) consumed each day for 2-3 days leading up to an event. 

Studies have shown some promising results, but more research is needed. Evidence suggests that it may produce better results in recreational athletes. Side effects include mild gastrointestinal discomfort in some athletes. 

Areas of caution to consider when taking supplements: 

• It is important to note that certain supplements can interact with each other therefore it is not always possible to use them all together and expect better performance results. Discuss your supplement use with a registered dietitian with an interest in sport. 

• No performance supplements are recommended for those under 18. 

• Supplement companies are not regulated. There is no guarantee that what is written on the label is in the bottle. It is important to scrutinize the product and company manufacturing the product carefully before deciding to use it. 

Useful websites to obtain supplement information: 

Australian Institute for Sports (www.ais.gov.au/nutrition/supplements) 

World Anti-Doping Agency (WADA) (www.WADA-AMA.org) 

South African Institute for Drug-free Sport (SAIDS) (www.drugfreesport.co.za) 

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