Tuesday, October 01, 2002

By CARA HALSTEAD

Your teenage son and his friends are suddenly shopping health food stores, in search of the perfect supplement to build muscle and bulk up for high-school athletics. The powders and bars tout energy and strength, but you have your doubts. Is the latest craze harmless, helpful, or something a parent should be concerned about?

Dr. Eric Small, Assistant Clinical Professor of Pediatrics and Orthopedics at Mt. Sinai School of Medicine, has many concerns about the use of supplements by young people. He has included an entire chapter about this topic in his new book, KIDS and SPORTS: Everything You and Your Child Need to Know About Sports, Physical Activity, Nutrition, and Good Health - A Doctor‘s Guide for Parents and Coaches (Newmarket Press).

Small does not recommended that teens ever take supplements. Of primary concern, he says, is the fact that supplements can be bought by anyone, at any age, in any health food store. Over-the-counter drugs such as Tylenol and aspirin are under governmental regulation. Bodybuilding supplements are not.

Unregulated

Manufacturers of supplements are not required to report what is in their products. This raises questions about the purity of supplements used for body building. According to Small, some have been found to contain steroids (synthetic substances related to the male hormone) or steroid precursors.

“I and some of my colleagues have witnessed kids in high schools fainting on the field due to use of ephedra [an herbal stimulant],” Small recalls. “Ephedra had been widely used as a weight loss supplement as it increases metabolic rate, however, it causes heart arrhythmias, palpitations, increased heart rate, and dehydration. If ephedra is in a nutritional supplement, there may be toxic effects if larger than recommended doses are taken.”

Small referred to a report in the Journal of the American Academy of Pediatrics about supplements and use by adolescents. The survey revealed that 5.6% of athletes in grades 6 through 12 had taken Creatine, and 30% of athletes surveyed in 11th and 12th grades had taken Creatine. Small thinks that although the survey was anonymous, underreporting is likely.

According to Small, the medical community strongly discourages the use of body building hormonal supplements due to potential impurity and the resulting risks of overdosing. Creatine causes dehydration and muscle cramping. If kids take it and practice in the heat, they are likely to become dehydrated. A French study also found that chronic use of Creatine may cause certain cancers.

Jon Wein, Nutrition Director at Elevations, one-on-one personal fitness clubs in Rockland County, NY, recommends that teens who work out take a multi-vitamin. “Someone who works out regularly cannot get all the nutrients needed from food alone, especially when body fat is a concern,” he says. “A multi-vitamin is always helpful.”

Hormone concerns

However, Wein does not believe that teens should take supplements that lead to elevated levels of hormones. “It is not safe or a good idea for teens to take hormone elevating supplements due to limited research and the fact that teens’ hormones are naturally at a peak,” he explains.

After news that St. Louis Cardinals' first baseman, Mark McGwire, took androstenedione, popular holistic physician Dr. Andrew Weil wrote on his Web site of his mailbox being barraged by people of all ages, asking about its safety and effectiveness.

Androstenedione is a male sex hormone, produced by the body as a precursor to testosterone. Those who take it do so in the hopes of increasing testosterone production for superior athletic performance and building lean muscle mass.

Weil is generally opposed to hormonal supplements and thinks it would be a mistake for young athletes to emulate McGwire in this way. He advises developing healthy habits that include nutrition and exercise.

Weil says there are too many unknowns about androstenedione supplements to warrant their use and that regularly consuming high levels of hormones increases the risks for heart attacks and several cancers. To achieve the desired effect, a person would have to take them indefinitely which may lead to production of the female hormone estrogen instead of testosterone.

Body building supplements remain a hot topic in professional sports and in local gyms. With steroid use not allowed in sports training, supplements seem to be today’s answer to the ever-elusive perfect body.

There are nutritional supplements and hormonal supplements. Some may be safer than others, but the general consensus among health-care professionals consulted for this article is that teens do not need and probably should not take supplements, especially not hormonal supplements. Multi-vitamins and protein shakes (assuming there are no hidden ingredients) seem to be thought of as generally harmless.

When asked whether supplements should be taken by teens, Dr. Richard Bloom, a chiropractor in Chestnut Ridge, NY, said, “It depends on what kind of supplements, but generally speaking, teens don’t need them and many of them don’t work.” He works out regularly himself and doesn’t take hormonal supplements. He doesn’t know of any long-term side effects, but feels that their effectiveness has not been proven.

Healthy habits

Small worries that taking supplements could lead to abuse of illegal and other harmful substances. He cautions that although no studies have been done to prove this, the long term psychological effects of relying on any substances to achieve the perfect body are not yet known. Small and some of his colleagues have spoken in Rockland, Westchester, and Bergen counties to educate students at school health fairs about the potential dangers of relying on supplements.

Small advises simply eating healthier. “Nothing replaces good strength training and good nutrition,” he says. “There are no side effects with that. It may take a little more effort, but it is the healthier option in the long run.”

Cara Halstead of Suffern is a writer and mother.

The A to Z’s of vitamins
The roles each play in our health

By ROBIN HOOGSHAGEN

In a perfect world, we would get all the vitamins and nutrients we need from the food we eat, but reality is far from perfect. Recent statistics show that Americans obtain almost 30 percent of their meals outside the home – at restaurants, drive-thrus, and vending machines. And because these meals aren’t always nutritionally balanced, diet-related medical conditions, such as heart disease, diabetes, and obesity, are at epidemic levels.

Even those of us with good health can sometimes benefit from a boost. Many doctors recommend that their patients take a multivitamin or dietary supplement. Let’s take a closer look at some of the different vitamins and the roles they play in our health, but please remember: No one should take vitamins or nutritional supplements without first consulting a physician. It’s possible to do more harm than good if you have certain underlying health conditions, such as diabetes, or you can cause irreparable harm by consuming too much of any one vitamin.

According to the National Institutes of Health:

Vitamin A – plays an important role in night vision, bone growth and reproduction, and maintains the surface linings of your eyes and your respiratory, urinary, and intestinal tracts. Vitamin A also helps your body regulate its immune system, and may help prevent bacteria and viruses from entering your body by maintaining the integrity of your skin and mucous membranes. You can get vitamin A naturally by eating whole eggs, whole milk, and liver.

Vitamin B-6 – performs a wide variety of functions in your body and is essential to good health. The nervous and immune systems need vitamin B-6 to function efficiently, and it helps to maintain normal blood sugar levels. Alcoholics and older adults are more likely to have inadequate vitamin B-6 intake because of limited diet and alcohol’s ability to promote the destruction and loss of B-6. Vitamin B-6 is found in fortified breakfast cereals, salmon and tuna, pork and chicken, bananas, beans, and peanut butter.

Vitamin B-12 – helps maintain healthy nerve cells and red blood cells, and is also needed to make DNA. It is found naturally in fish, milk, eggs, meat, and poultry.

Vitamin D – is found in food, but also can be made in your body by exposure to ultraviolet rays from the sun. Its main role is to maintain normal levels of calcium and phosphorus, and promote strong bones. People with a vitamin D deficiency might suffer from rickets. Milk is now fortified with vitamin D, and it is found naturally in fatty fish and fish oils.

Vitamin E – is a fat-soluble vitamin that exists in eight different forms, and each form has its own functional use in the body – one of which is a powerful antioxidant. Antioxidants act to protect your cells against the effects of free radicals, which can cause cell damage that may contribute to the development of cardiovascular disease and cancer. Vitamin E is found naturally in vegetable oils, nuts, and green leafy vegetables.

Folate – gets its name from the Latin word “folium” for leaf. It is necessary for the production and maintenance of new cells, which makes it especially important during infancy and pregnancy. Folic acid is the synthetic form of folate found in supplements and fortified foods. Not surprisingly, it is found in leafy greens such as spinach and turnip greens, dry beans, and peas.

Iron – is an essential mineral and an important component of proteins involved in oxygen transport and metabolism. Adult men and post-menopausal women lose very little iron, but women with heavy monthly periods can lose a significant amount. Good sources of iron include chicken liver, oysters (breaded and fried), soybeans, and lentils.

Magnesium – is a mineral needed by every cell in your body, and is needed for more than 300 biochemical reactions. It helps maintain normal muscle and nerve function, keeps heart rhythm steady, and bones strong. Foods that are a good source of magnesium include green vegetables, nuts, seeds, and some whole grains.

Selenium – is an essential trace mineral in the body, and plays a major role for normal functioning of the immune system and thyroid gland. Plant foods are the major dietary source of selenium in most countries throughout the world. The amount of selenium in soil, which varies by region, determines the amount of selenium in the foods grown in that soil. Animals that eat grains or plants that were grown in selenium-rich soil have higher levels of selenium in their muscle.

Zinc – stimulates the activity of approximately 100 enzymes, which are substances that promote biochemical reactions in your body. Zinc is needed to help wounds heal, help maintain your sense of taste and smell, and is needed for DNA. Oysters contain more zinc than any other food, but red meat and poultry provide the majority of zinc in the American diet. Other good sources are beans, nuts, whole grains, and dairy products.

Robin Hoogshagen, RPH, is a Wal-Mart pharmacist in Bentonville, Ark.


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