FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Hans Braun - Dipl. Sportlehrer - Dipl. Oecotrophologe
- German Sport University Cologne – Institute of Biochemistry
- momentum – German Research Center of Elite Sports
- Olympic Training Center Rhineland
FIH Medical Seminar - June 4, 2014
Nutrition and Health in Elite Hockey Players
Dietary Supplements
Risks and Benefits
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Top Athlete – Standardized Athlete?
Quelle: www.howardschatz.com
One Size does not fit all!
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
43 kg , 153 cm
~ 1800 kcal pro Tag
146 kg , 183 cm
~ 8000 kcal pro Tag
Top Athlete – Standardized Athlete?
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
http://www.london2012.com
Olympic Games London 2012
www.london2012.com London 2012 Men‘s High Jump
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Dietary Supplements – Statements
Leading sport organizations (IOC, FIFA, IAAF, ACSM) recommend that :
athletes should ensure they have a
good diet before contemplating
supplement use
DS should not be used by
underage athletes
Maughan et al. (2007)
Supplement use requires individual assessment and advice by a qualified
sports nutrition professional and medical practitioner. Maughan et al. (2007)
individual nutrition consulting
young athletes ~18%
olympic athletes ~54%
dietary supplement use
young athletes ~80%
olympic athletes ~95% Braun et al. (2009)
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Dietary Supplements - Risks and Benefits
• Introduction
• Prevalence of Dietary supplements
• Groups of Dietary supplements
– Sports Drinks
– Sport Gels & Sport Bars
– Protein & Protein Components
– Micronutrients
– Ergogenic Aids
– Contamination & Doping
• Summary
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
AIS Supplement Classification System www.ausport.gov.au
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Reference Intake – Risk of Supplementation
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Reference Intake – Risk of Supplementation
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Pilot Study – DS use and micronutrient intake
• April/May 2011 – 27 athletes (15,6 ± 2,1 years)
• No athlete reported nutrition consulting before
• 12 athletes (44%) used DS
• 16 different products (14 x vitamins/minerals, 1x amino acids, 1x protein powder + VitMin)
Athlet Nr. DS product Amount per week
1 Orthomol Sport 7
1 Am Sport Aminosäuren 70 g
1 Ferro Sanol 100mg 7
2 Biolectra Magnesium (365 mg) 6
3 Orthomol Sport 6
3 Cevitt Immun direct (C+Zink) 1
4 All Vital Zellschutz 17
4 All Vital Vitamin B Komplex 14
5 Ferro Sanol 100 mg 7
6 Champ Muscle 90 Protein Shake 15 g
7 Juice Plus Obst 3
7 Juice Plus Gemüse 4
8 Taxofit Eisen Plus Vitamin C (50mg + 50mg) 4
9 Magnesium 400 mg Kneipp 2
10 Magnesium Abtei 400 mg + C 80mg + E 12 mg 2
11 Magnesium, Kneipp Calcium 400mg + Mg 245mg + C 37 mg 7
11 Das gesunde plus Vitamin Sticks (Multivitamin) 7
12 Hämatopan 75 mg Eisen 7
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
0% 50% 100% 150% 200% 250% 300% 350%
Vit. A
Vit. D
Vit. E
Vit. B1
Vit. B2
Niacin
Pantothenic Acid
Vit. B6
Biotin
Folic Acid
Vit. B12
Vit. C
Potassium
Calcium
Magnesium
Iron
Zinc
Copper
Mangan
Fluoride
Iodine
Without DS
< 100% RDA
Vit. A 6
Vit. D 11
Vit. E 6
Vit. B1 3
Vit. B2 2
Niacin 1
Pantothenic Acid 6
Vit. B6 2
Biotin 3
Folic Acid 11
Vit. B12 6
Vit. C 2
Potassium 3
Calcium 4
Magnesium 2
Iron 6
Zinc 1
Copper 0
Mangan 3
Fluoride 12
Iodine 12
Pilot Study – DS use and micronutrient intake
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
0% 100% 200% 300% 400% 500% 600% 700% 800% 900% 1000% 1100% 1200%
Vit. A
Vit. D
Vit. E
Vit. B1
Vit. B2
Niacin
Pantothenic Acid
Vit. B6
Biotin
Folic Acid
Vit. B12
Vit. C
Potassium
Calcium
Magnesium
Iron
Zinc
Copper
Mangan
Fluoride
Iodine
1542%
2896%
Pilot Study – DS use and micronutrient intake
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
DS use leads to exceed nutrient intakes higher than suggested Upper Intake Levels
EFSA USA
(11-14y; 15-17y) (14-18y)
Iron NA 45 mg
Magnesium 250 mg Supplement 350 mg Supplement
Zinc 18-22 mg 34 mg
Vitamine B6 15-20 mg 80 mg
3 athletes (99 mg, 111 mg, 121 mg)
3 athletes high dosage Mg products
2 athletes (19 mg, 38 mg)
1 athlete (163 mg)
EFSA, 2006
Pilot Study – DS use and micronutrient intake
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
I. „Athletes eat more, therefore they have a higher micronutrient intake“
Specific situations – micronutrient requirement
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
0 1000 2000 3000 4000 5000 6000 7000
Zin
c In
tak
e (
mg
/da
y)
Energy Intake (kcal/day)
Männer Frauen
male r= 0,90
female r= 0,85
10 mg/day
7 mg/day
< 100% RDA
(DACH)
m; 7%
w; 7%
male female
Zinc intake of athletes (n=375)
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Niacine r = 0,90
Vitamin B2 r = 0,86
Pantothenic Acid r = 0,86
Biotin r = 0,84
Vitamin B1 r = 0,83
Vitamin B6 r = 0,83
Vitamin E r = 0,80
Folic Acid r = 0,76
Vitamin B12 r = 0,63
Vitamin C r = 0,52
Vitamin A r = 0,45
Vitamin D r = 0,17
Zinc r = 0,90
Iron r = 0,90
Copper r = 0,89
Potassium r = 0,87
Magnesium r = 0,74
Calcium r = 0,66
Fluoride r = 0,62
Iodine r = 0,61
Energy Intake (kcal/day) and dietary micronutrient intake (amount/day)
Dietary Micronutrient Intake in Athletes (n=303)
„Vitamin and mineral supplements are not needed, if adequate energy to
maintain body weight is consumed from a variety of foods. ACSM, Position Stand 2009
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
I. „Athletes eat more, therefore they have a higher micronutrient intake“
Athletes might be in risk:
- during weight reduction periods
- in periods with low energy intake (weight class sport, ski jumper…)
II. „gender specific differences“
Specific situations – micronutrient requirement
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
50.0
0 1000 2000 3000 4000 5000 6000 7000
Iro
n In
tak
e (
mg
/da
y)
Energy Intake (kcal/day) Männer Frauen
male; r= 0,91
female; r= 0,85
< 100% RDA
m; 15%
w; 67%
12 mg/day
15 mg/day
male female
Iron intake of athletes (n=375)
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
I. „Athletes eat more, therefore they have a higher micronutrient intake“
Athletes might be in risk:
- during weight reduction periods
- in periods with low energy intake (weight class sport, ski jumper…)
II. „gender specific differences“
Iron needs are higher for females than males
- Iron supplementation could be of benefit for some females with respect to iron
status
- Supplementation without medical diagnosis should be avoided
III. „Seasonal needs“
Specific situations – micronutrient requirement
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Vitamin D Status in young athletes (n=308)
Braun & de Marées,
2013 (unpublished)
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Vitamin D Status in young athletes (n=308)
Braun & de Marées,
2013 (unpublished)
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
17 ng/ml 19 20 20 20 27 26 35 40 31 21 16
0
10
20
30
40
50
60
70
Jan(n=17)
Feb(n=18)
Mar(n=27)
Apr(n=52)
May(n=29)
Jun(n=18)
Jul(n=11)
Aug(n=28)
Sep(n=28)
Oct(n=26)
Nov(n=33)
Dec(n=12)
Seru
m 2
5(O
H)D
(n
g/m
l)
- Aug & Sep; 25(OH)D < 20ng/ml (11%) and <32 ng/ml (47%) of athletes
- Nov bis Mai; 25(OH)D < 20ng/ml (58%) and <32 ng/ml (96%) of athletes
Braun & de Marées 2013 (unpublished)
Vitamin D Status in young athletes (n=308)
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
I. „Athletes eat more, therefore they have a higher micronutrient intake“
Athletes might be in risk:
- during weight reduction periods
- in periods with low energy intake (weight class sport, ski jumper…)
II. „gender specific differences“
Iron needs are higher for females than males
- Iron supplementation could be of benefit for some females with respect to iron
status
- Supplementation without medical diagnosis should be avoided
III. „Seasonal needs“
- Vitamin D Status might be reduced due to season (endogenous synthesis
reduced in winter month)
- Dietary vitamin D intake does not compensate reduced synthesis
Specific situations – micronutrient requirement
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Dietary Supplements - Risks and Benefits
• Introduction
• Prevalence of Dietary supplements
• Groups of Dietary supplements
– Sports Drinks
– Sport Gels & Sport Bars
– Protein & Protein Components
– Micronutrients
– Ergogenic Aids
– Contamination & Doping
• Summary
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Contamination & Doping
Geyer et al 2004
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Contamination & Doping
Geyer et al 2004
Follow up 2011/2012
597 products
17 countries + Internet
analysis of 43
anabolic steroids
4 products positive
Reduced risk of
contamination with anabolic
steroids
New risk with other
substances (e.g. Stimulants)
or faked products
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Problem:
Methylhexanamine declared
under different names
• Geranamin,
• Forthan
• Floradrene
• Dimethylamylamine,
• Dimethylpentylamine,
• Pentylamin,
• 2-amino-4-methylhexane
1 31
123
283 320
0
50
100
150
200
250
300
350
2008 2009 2010 2011 2012
WADA Statistik für Methylhexanamin (Adverse Analytical Findings)
Contamination & Doping
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Contamination & Doping
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Doping Cases Sotschi 2014
Methylhexanamin Biathlon
Trimetazidine Skilanglauf
Methylhexanamin Eishockey
Methylhexanamin Bob
Pseudoephedrin Eishockey
N-ethyl-1-phenylbutan-2-amine Bob
Erythropoietin Skilanglauf
Dehydrochlormethyltestosteron Eishockey
Contamination & Doping
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Weight loss product and training booster with Stimulants
Nox Pump
Declared Ingredient:
Geranium Root Extract
Not declared:
Methylhexanamin
(15 mg/Kapsel)
Contamination & Doping
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
LIDA Product: Meizitang
slimming product
Herbal diet capsules with sibutramine
(15 mg/capsule) not declared on the
label
50 h following a single administration
of the tea, sibutramine metabolites
were clearly detectable in a volunteer’s
urine and would have caused a failed
doping test.
Contamination & Doping
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
14.07.2013
3 Sprinters positive for Oxilofrin www.spiegel.de
Contamination & Doping
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Contamination & Doping
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Supplement faked with the stimulant
Oxilofrin
(bought in July 2013)
Contamination & Doping
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Dietary supplement
Faked with Oxilofrin
(April 2014)
Contamination & Doping
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Neuroenhancer, adulterated with stimulant Oxilofrine
and other stimulants http://epiphanyd1.com/ online 09.09.2013
Contamination & Doping
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
The Food and Drug Administration (FDA) has found
o nearly 300 fraudulent products
o promoted mainly for weight loss, sexual enhancement, and bodybuilding
o containing hidden or deceptively labeled ingredients
• such as active ingredients in FDA-approved drugs
or their analogs (closely-related drugs)
• other compounds, such as novel synthetic steroids, that do not
qualify as dietary ingredients
www.fda.gov
Contamination & Doping
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Contamination & Health risk
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Contamination & Health risk
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
http://www.fda.gov/Safety/Recalls/ucm375740.htm
Contamination & Health risk
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Contamination & Doping
What can athletes do?
Athletes are advised to take supplements only from “low-risk”
sources.
Germany (www.colognelist.com)
Netherlands (http://www.dopingautoriteit.nl/)
These Databases list supplements from companies, which perform
quality control for anabolic steroids and stimulants.
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Summary
• Before contemplating supplement use, athletes should ensure to have a
healthy, balanced and sport specific diet.
• For implementation, individual nutritional assessment by a qualified sports
nutrition professional is advised.
• Evaluate DS use of your athletes. Why do they use them? What is really
necessary?
• The non-critical intake of micronutrient supplements should not be
underestimated and can lead to an intake higher than the upper intake level.
• Some athletes might benefit from micronutrient supplementation in some
situations.
• Supplements can be contaminated or faked with illegal substances and can
lead to a positive doping case.
• Supplements aggressively advertised for weight loss, reduction of fat mass,
increasing lean body mass, are of high risk.
• If supplements are necessary take them from low risk sources.
FIH Medical Seminar
June 4, 2014 Speaker:
Hans Braun
Olympic Training Center Rhineland
German Sport University Cologne
Hans Braun - Dipl. Sportlehrer - Dipl. Oecotrophologe
- German Sport University Cologne – Institute of Biochemistry
- momentum – German Research Center of Elite Sports
- Olympic Training Center Rhineland
FIH Medical Seminar - June 4, 2014
Nutrition and Health in Elite Hockey Players
Dietary Supplements
Risks and Benefits