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See other sections of this fact sheet for information on the amino acids arginine and glutamine as well as the BCAAs leucine, isoleucine, and valine. The potential of these amino acids to enhance exercise and athletic performance is not related to their incorporation into proteins.

Efficacy : Adequate protein in the diet is required to provide the EAAs necessary for muscle-protein synthesis and to minimize muscle-protein breakdown. Dietary protein consumption increases the concentration of amino acids in the blood, which muscle cells then take up. Sufficient protein is necessary primarily to optimize the training response to, and the recovery period after, exercise [ 12 , ]. Muscle protein synthesis leading to increases in strength and muscle mass appears to be optimal with the consumption of high-quality protein providing about 10 g EAAs within 0—2 hours after exercise, in the early recovery phase [ 12 ].

However, a meta-analysis of randomized clinical trials found that ingesting protein within an hour before or after exercise does not significantly increase muscle strength or size or facilitate muscle repair or remodeling [ 77 ]. The period after exercise when protein intake reduces muscle protein breakdown, builds muscle, and increases mitochondrial proteins to enhance oxygen use by working muscles the so-called "window of anabolic opportunity" can last for up to 24 hours [ 79 ]. Participants in these studies consumed a bedtime drink containing Some studies show increased muscle protein synthesis when plasma levels of amino acids are raised [ 76 ].

Safety : The Food and Nutrition Board has not set a UL for protein, noting that the risk of adverse effects from excess protein from food is "very low" [ ]. However, it advises caution for those obtaining high protein intakes from foods and supplements because of the limited data on their potential adverse effects. High-protein diets e. Protein increases urinary calcium excretion, but this appears to have no consequence for long-term bone health [ ] and, in any event, is easily compensated for by the consumption of slightly more calcium.

Implications for use : Many foods—including meats, poultry, seafood, eggs, dairy products, beans, and nuts—contain protein. Protein powders and drinks are also available, most of which contain whey, one of the complete proteins isolated from milk [ ].

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Digestion of casein, the main complete protein in milk, is slower than that of whey, so the release of amino acids from casein into the blood is slower [ 72 ]. Soy protein lacks the EAA methionine and might lose some cysteine and lysine in processing; rice protein lacks the EAA isoleucine [ ]. Many protein supplements consist of a combination of these protein sources.

All EAAs are necessary to stimulate muscle protein synthesis, so users should select singular or complementary protein sources accordingly. Since the Food and Nutrition Board developed the RDA for protein, more recent data have suggested that athletes require a daily protein intake of 1. Athletes might benefit from even greater amounts for short periods of intense training or when they reduce their energy intake to improve physique or achieve a competition weight [ 12 ].

The — National Health and Nutrition Examination Survey showed that the average daily intake of protein by adult men is g and by women is 69 g [ ]. Athletes who require additional protein can obtain it by consuming more protein-containing foods and, if needed, protein supplements and protein-fortified food and beverage products. Quercetin is a polyphenolic flavonol that is naturally present in a variety of fruits such as apples , vegetables such as onions , and beverages such as wine and, especially, tea.

The mechanisms by which quercetin might enhance exercise and athletic performance when taken in much larger amounts are not known, but many have been hypothesized. For example, quercetin might increase the number of mitochondria in muscle, reduce oxidative stress, decrease inflammation, and improve endothelial function blood flow [ , ]. Efficacy : Numerous small studies have assessed quercetin in supplemental form as a potential ergogenic aid in young adult, mostly male, participants.

The effects of quercetin supplementation were inconsistent and varied by study, but they generally ranged from no ergogenic benefit to only a trivial or small improvement that might not be meaningful in real-world in contrast to laboratory exercise conditions [ 42 , , , ]. The safety of longer-term use of that amount of quercetin or more has not been studied. Implications for use : More research, including larger clinical trials, on quercetin supplementation to improve aerobic capacity in trained athletes during specific sports and competitions is needed before any recommendations can be made [ ].

Ribose, a naturally occurring 5-carbon sugar synthesized by cells and found in some foods, is involved in the production of ATP [ 75 ]. The amount of ATP in muscle is limited, and it must continually be resynthesized. Therefore, theoretically, the more ribose in the body, the more potential ATP production [ ].

Safety : The authors of the short-term studies investigating ribose as a potential ergogenic aid have not reported any safety concerns. No studies have assessed the safety of long-term ribose use as a dietary supplement.

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Implications for use : Supplemental ribose does not appear to improve aerobic or anaerobic performance [ 1 , 75 ]. Sodium bicarbonate is commonly known as baking soda. The consumption of several teaspoons of sodium bicarbonate over a short time temporarily increases blood pH by acting as a buffering agent. The precise mechanism by which this induced alkalosis leads to an ergogenic response to exercise is unclear. It is thought that "bicarbonate loading" enhances disposal of hydrogen ions that accumulate and efflux from working muscles as they generate energy in the form of ATP via anaerobic glycolysis from high-intensity exercise, thereby reducing the metabolic acidosis that contributes to fatigue [ , ].

As a result, supplementation with sodium bicarbonate might improve performance in short-term, intense exercises e. Efficacy : Many studies have assessed sodium bicarbonate as an ergogenic aid in swimmers, cyclists, rowers, boxers, tennis and rugby players, judo practitioners, and others [ ].

These studies usually included a small number of participants who underwent one or more trials in a laboratory over several days. Because the research results are conflicting, the activities and individuals most likely to benefit from sodium bicarbonate supplementation in real-world conditions is not clear. However, individuals have varied responses to bicarbonate loading; the practice does not benefit some users, and it can worsen rather than enhance performance in others.

Recreationally active individuals, in particular, might find the supplements to be ergogenic for one exercise session but not another. Many study findings suggest that supplementation with sodium bicarbonate is most likely to improve the performance of trained athletes [ , ]. Safety : The main side effect of sodium bicarbonate supplementation in gram quantities is gastrointestinal distress, including nausea, stomach pain, diarrhea, and vomiting. Supplement users can reduce or minimize this distress by consuming the total dose in smaller amounts multiple times over an hour with fluid and a snack of carbohydrate-rich food [ , ].

Sodium bicarbonate is Such a large intake of sodium with fluid can lead to temporary hyperhydration, which could be useful in activities where large sweat losses might otherwise lead to significant fluid deficits. However, the slight increase in body weight from fluid retention might hinder performance in other sports [ ].

Studies have not evaluated the safety and effectiveness of long-term use of sodium bicarbonate as an ergogenic aid over months or longer. Many athletes find this amount of sodium bicarbonate powder dissolved in fluid to be unpalatably salty [ ].

The Australian Institute of Sport supports the use of bicarbonate for improving sports performance in suitable athletic competitions under the direction of an expert in sports medicine, but it notes that more research might be required to understand how the supplement should be used for best results [ 29 ].

The Montmorency variety of tart or sour cherry Prunus cerasus contains anthocyanins and other polyphenolic phytochemicals, such as quercetin. Researchers hypothesize that these compounds have antiinflammatory and antioxidant effects that might facilitate exercise recovery by reducing pain and inflammation, strength loss and muscle damage from intense activity, and hyperventilation trauma from endurance activities [ ].

The labels on tart-cherry juice and concentrate products do not usually indicate that they are dietary supplements, although the labels on products containing encapsulated tart-cherry powder do. Efficacy : Much of the limited research on use of tart cherry to enhance exercise and athletic performance involves short-term use of a tart-cherry product or placebo by young resistance- trained men for about a week before a test of strength such as single-leg extensions or back squats ; participants continue taking the supplements for about 2 days after the test.

None of the participants who drank the juice experienced airway inflammation causing upper respiratory tract symptoms after the marathon a common complaint in many marathon runners , but half of those drinking the placebo did. Participants took the supplements once a day for 10 days, including the day they ran a half-marathon, then for 2 days after the run.

Further research is needed to determine the value of tart-cherry products for enhancing performance and recovery from intense exercise or participation in sports—especially when used on a regular basis—and the amounts of supplement, juice, or concentrate needed to provide any benefits. Safety : Studies have not identified any side effects of the fresh tart-cherry juice or concentrate or of supplements of dried tart-cherry-skin powder. However, they have not adequately assessed the safety of tart-cherry dietary supplements. Implications for use : There is no expert consensus on the value of taking tart-cherry products to enhance exercise and athletic performance.

Tribulus terrestris common names include bindii, goat's-head, bullhead, and tackweed , is a fruit-bearing plant that is most common in Africa, Asia, Australia, and Europe. It has been used since ancient times in Greece, China, and Asia to treat low libido and infertility [ ]. Tribulus terrestris extracts contain many compounds, including steroidal saponins [ ].

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Some marketers claim that Tribulus terrestris enhances exercise and athletic performance by increasing serum concentrations of testosterone and luteinizing hormone, but studies have not adequately determined its potential mechanisms of action [ ]. Efficacy : Only a few small, short-term clinical trials have investigated Tribulus terrestris as an ergogenic aid [ ], and none since A study in 15 resistance-trained men found no differences among those taking 3.

In 22 elite male rugby players aged Safety : The only toxicity studies of Tribulus terrestris were conducted in animals, where unspecified high intakes led to severe heart, liver, and kidney damage [ ]. The clinical studies described above found no side effects of Tribulus terrestris.

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Subsequent tests indicated hepatotoxicity, nephrotoxicity, and neurotoxicity. The man's condition improved after he discontinued the water, but the water was not tested to determine the presence or amount of Tribulus terrestris or any other potential toxin or contaminant. Implications for use : The Australian Institute of Sport advises against the use of Tribulus terrestris by athletes, noting that this supplement and other claimed testosterone boosters are banned from athletic competitions or have a high risk of being contaminated with substances that, if ingested, could lead to positive drug-screening results [ ].

The published biomedical literature provides no support for the efficacy and insufficient support for the safety of Tribulus terrestris for enhancing exercise performance [ ]. This section provides examples of ingredients that the FDA currently prohibits in dietary supplements and that some consumers have used in the past as ergogenic aids, despite the lack of evidence supporting their use. Androstenedione is an anabolic steroid precursor, or prohormone, that the body converts to testosterone which induces muscle growth and estrogen [ ].

Major League Baseball slugger Mark McGwire popularized androstenedione as an ergogenic aid in [ ]. However, two randomized clinical trials found no performance benefits from androstenedione supplements. In one study, 10 healthy young men ages 19—29 years took a single mg dose of androstenedione. The short-term or longer-term use of the supplement did not affect serum testosterone concentrations, nor did it produce any significantly greater gains in resistance-training performance, muscle strength, or lean body mass.

However, participants who took androstenedione for the 6 weeks experienced significant declines in their high-density lipoprotein HDL cholesterol levels and significant increases in serum estrogens. The supplements did not improve participants' muscular strength or lean body mass compared with placebo, but they significantly decreased HDL cholesterol levels and raised levels of serum estrogens. In March , FDA warned companies to cease distributing androstenedione-containing dietary supplements. The rationale was the lack of sufficient information to establish that such products could reasonably be expected to be safe and that FDA had never approved androstenedione as a new dietary ingredient permitted in supplements [ ].

Department of Justice classified androstenedione as a Schedule III controlled substance defined as a drug with a moderate to low potential for physical and psychological dependence in [ ]. Dimethylamylamine DMAA is a stimulant formerly included in some pre-workout and other dietary supplements claimed to enhance exercise performance and build muscle.

Studies have not evaluated DMAA in humans as a potential ergogenic aid. In , FDA declared products containing this ingredient to be illegal after it received 86 reports of deaths and illnesses associated with dietary supplements containing DMAA. These reports described heart problems as well as nervous system and psychiatric disorders [ ]. The agency contended that there is no history of use or data offering sufficient assurance that this compound is not associated with "a significant or unreasonable risk of illness or injury" [ , ].

Ephedra also known as ma huang , a plant native to China, contains ephedrine alkaloids, which are stimulant compounds; the primary alkaloid is ephedrine [ ].

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In the s, ephedra—frequently combined with caffeine—was a popular ingredient in dietary supplements sold to enhance exercise and athletic performance and to promote weight loss. No studies have evaluated the use of ephedra dietary supplements, with or without caffeine, as ergogenic aids.

Instead, available studies have used the related synthetic compound ephedrine together with caffeine and typically measured the effects 1—2 hours after a single dose [ , ]. No data show any sustained improvement in athletic performance over time with continued dosing of ephedrine with caffeine [ ]. Ephedra use has been associated with death and serious adverse effects, including nausea, vomiting, psychiatric symptoms such as anxiety and mood change , hypertension, palpitations, stroke, seizures, and heart attack [ , ].

In , FDA banned the sale of dietary supplements containing ephedrine alkaloids in the United States because they are associated with "an unreasonable risk of illness or injury" [ ]. The FDA regulates dietary supplements for exercise and athletic performance in accordance with the Dietary Supplement Health and Education Act of [ ].