Last week’s article was an introduction to performance supplements, reviewing general information and categories. Supplement use in youth is concerning since these were not designed for those under 18. The occurrence of side effects and the presence of other substances not listed on the label is a tremendous safety issue.
This article will review
Amino acids
Caffeine
Creatine
Protein
Nitric oxide
I will explain their use, list side effects, and give natural food alternatives for each.
AMINO ACIDS
Photo depicting a three dimensional representation of a molecular structure made with colored plastic pieces to show how amino acids are made into proteins.
Amino acids are the building blocks of protein. They are the molecules that make protein. There are 20 amino acids. Of the twenty, the body can make 11. The other 9 are essential amino acids; these must come from food since the body cannot make them.
The following foods contain all nine essential amino acids. These are considered complete proteins.
Beef
Poultry
Fish
Eggs
Dairy
Soy
Quinoa
Buckwheat
Many foods are incomplete proteins, meaning they are protein sources but don’t have all 9 essential amino acids. Incomplete protein foods are mostly plant-based and include:
Nuts
Seeds
Beans
Legumes
Whole grains
Rice
Soy products
Some vegetables
Combining two incomplete proteins will give you a complete protein. Thus, we can get all the amino acids we need from our food and what we make.
The amino acids in supplements are typically one or more of the three branched-chain amino acids (BCAAs) - valine, leucine, and isoleucine. These are concentrated in muscle tissue and beneficial for stimulating muscle growth and repair. Other supplemental amino acids include glutathione, cysteine, arginine, glutamine, and citrulline. They usually come in the form of pills and powders.
Because the body makes amino acids, we can get what we need through diet. If we get adequate protein, additional amounts are unnecessary and not recommended for kids. Most studies do not show benefits from these supplements. Taking these can create an imbalance or excess. The following side effects have been noted:
Nausea/vomiting
Diarrhea
Muscle cramps
Increase in ammonia levels
Increase in the protein load to the kidneys
Tremor
Dizziness
Headache
CAFFEINE
Picture of the chemical formula of caffeine made with coffee beans and cups of coffee.
Caffeine is a stimulant found in many supplements, including energy drinks, soda, pills, gum, and other chews. Caffeine can briefly boost mental and physical performance about 30 minutes to an hour after ingestion. Up to 200 mg (about 2 cups of coffee) is considered safe for adults, but that can be compounded by other supplements and dietary sources (such as tea and coffee). Too much caffeine is dangerous for children, especially if exercising in the heat. The amount of caffeine in energy drinks and supplements is not regulated.
Side effects include:
Stomach upset
Headaches
Irritability
Shakiness
Sleep disturbances
Dehydration (caffeine is a diuretic)
Racing heart
Irregular heartbeat (arrhythmia)
Caffeine in large doses can be deadly due to heart arrhythmias, especially when consumed before exercise in hot weather.
The American Academy of Pediatrics has stated that stimulants or energy drinks should not be consumed by children or adolescents (under 18). The amount of caffeine in these drinks is not regulated and can be dangerous.
CREATINE
Creatine is an amino acid derivative and is made by the body. It is also in meat, poultry, and fish. It is marketed for high-intensity activities, such as weight-lifting and sprinting, and for increased muscle mass and energy. Creatine comes as a powder that is mixed in liquid or in gummy form.
The word creatine written in creatine powder with blue dumbbells and a measuring tape. Creatine is commonly used in power sports.
The American Academy of Pediatrics and the American Society of Sports Medicine recommend against creatine use in individuals under 18.
Creatine causes muscles to retain water, which is thought to possibly increase the risk of dehydration. This is concerning for athletes in sports who may purposely lose weight and dehydrate, such as wrestlers.
Creatine may also affect kidney function and should not be taken by those with kidney disease or those at risk.
The following side effects have been noted:
Digestive issues such as cramping, nausea, and diarrhea
Muscle cramping
Water retention
Dehydration
Impact on kidneys in those susceptible
Because the body makes creatine, and we can get it from our diet, creatine supplements under 18 are thought to be unnecessary and are not recommended. Long and short-term effects on children are unknown.
PROTEIN SUPPLEMENTS
The recommended daily protein intake is 25-30% of our total calorie intake. Many people get more than that. For children, it should be 0.8 - 1.5 grams per kilogram body weight (one pound = 2.2 kilograms (kg). Athletes can be on the higher end of 1 - 1.7 grams per kg body weight. Excess intake is 2 grams/kg body weight or higher.
Protein supplements are usually in the form of bars or powders that are mixed in a liquid to make a shake. If the liquid used is milk, that adds more protein to the mix. The protein source can be from plants - soy, pea, hemp, rice, or from eggs or milk.
You can easily obtain all the protein you need from food. Once the body meets its protein requirements, extra protein cannot be stored, so the excess is burned as energy or converted to fat. Excess protein is also hard on the kidneys and can lead to calcium loss and kidney damage.
Pictured are examples of animal protein sources (above) - meat, poultry, seafood, eggs, cheese - and plant-based protein sources (below) - beans, legumes, nuts, whole grains, tofu.
Protein intake should be spread throughout the day. General recommendations are to consume 15-25 grams per meal. Excessive amounts at one time are not beneficial.
There are many dietary protein sources, both from plants and animals. Focus on healthy proteins derived from seafood, poultry, lean meats, eggs, Greek yogurt, cottage cheese, soy products, beans, legumes, nuts, seeds, whole grains such as wild rice and quinoa, and vegetables such as peas, brussels sprouts, broccoli, and corn.
With all these food sources, getting adequate protein is easily done without supplements.
Side effects of excessive protein:
Excess protein that cannot be used by the body can be turned into fat and raise triglyceride levels.
Excess protein can lead to calcium excretion by the kidneys decreasing bone mass.
Too much protein delivered to the kidney can lead to kidney stones and eventual kidney damage.
High protein levels are burdensome on the liver, creating more nitrogen and making it harder for the liver to process wastes.
Protein supplements often have undesirable additives such as sugar, saturated fats, preservatives, artificial flavorings and sweeteners, and extra vitamins. Many protein powders have been found to contain heavy metals, BPA, pesticides, and other toxins. You can look for these on the Clean Label Project’s website: www.cleanlabelproject.org
Frequent use of calcium-containing protein powders mixed with milk can lead to high calcium in the blood and blood in the urine.
Protein bars and shakes can add significant calories, causing undesired weight gain.
Those with dairy or egg allergies may react to supplements made with these ingredients.
NITRIC OXIDE
Nitric oxide (NO) is made by the body and is a vasodilator - it relaxes the blood vessels, causing them to dilate or widen and increase blood flow. In doing so, supplements are thought to increase the blood flow, oxygen, and nutrients to muscles to improve performance and decrease muscle soreness. Nitric oxide can also lower blood pressure.
Interestingly, these supplements don’t contain nitric oxide but other chemicals (such as nitrate, arginine, and citrulline) our bodies use to make nitric oxide. Many of these supplements also contain amino acids and creatine.
Container of nitric oxide supplement which contains arginine and citrulline, not nitric oxide.
Some individuals, such as those with liver disease or low blood pressure, should not take these supplements.
Once again, nitric oxide can be obtained from natural food sources. These include:
Dark leafy greens - kale, Swiss chard, spinach, arugula, & mustard greens
Vegetables - broccoli, cauliflower, carrots, beets, and beet juice
Nuts and seeds - a source of arginine used to make NO
Watermelon - a source of citrulline used in making NO
Nitric oxide supplementation may have the following side effects
Nausea
Bloating
Diarrhea
Abdominal pain
Headache
Palpitations
The takeaway message is that all of the above supplements are nothing new. Either the body makes them, or they are easily obtained through diet. Consuming these more naturally is unlikely to cause excessive amounts or side effects. Teach your child how to improve their diet, improve their sports performance, and stay healthy naturally.
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