One of my colleagues (Andy Kilding) has called my attention to the letter you see below, which has just appeared in Eur J Appl Physiol.  This list has been quiet lately, and although many of us are preparing for ACSM or are otherwise as frantically busy as ever, I thought this topic would be worth airing.

Here are what I think are the separate issues, with my personal opinion:

1.  Is research on a black box publishable? 
By “black box” I mean something that achieves its effects by unclear means, in this case because it has several potentially active components. Well, in my opinion it is publishable, because people want to know whether the black box is useful, and publishing is the usual way to help others by communicating your findings.   If the black box is useful, and you can open the box, you can do more research to find out why it is useful.  You could describe this approach is top down, as opposed to the bottom up, where you look at each component separately.  Besides, it’s always possible that the components act synergistically, and you will find out only by looking at them in combination.  You could address that question in a manner that satisfies conservative scientists by doing a study with four or more treatments: Component A, Component B, Components A+B, and placebo.  But the sample size for such studies is almost invariably prohibitive, and people want an answer, so you study only the black box vs control, at least to start with.

Here’s an example from my own recent experience. Carl Paton and I did a study on a particular kind of resistance training that Carl devised by reviewing the lit and combining what seemed to be the best elements.  We wanted a clean answer with the available sample size, so we used only two groups: training as usual vs the new resistance training.  It had spectacular effects on performance in highly trained cyclists in their competitive season.  Incredibly, MSSE bounced the paper, because the training consisted of two kinds of bout and we didn’t include groups doing only one or other kind of bout. We weren’t even given the opportunity to rebut the reviewers. In my opinion there was a failing of the scientific process, not a failing of our design.

2.  Does research on multi-nutrient supplements generate a doping mentality?
That seems a long stretch to me.  Isn’t the doping mentality already at max in many elite sports?  Maybe the only way to stop doping is to increase the penalties so that cheating is no longer cost-effective.  See Michael Shermer’s article in last month’s Scientific American on application of principles of the Prisoner’s Dilemma to doping in sport.

3.  Is long-term use of a multi-nutrient supplement dangerous? 
Possibly, but does that mean we can’t research its effects on performance and publish our findings?  Of course not.

In summary, I see no problem with research on multi-nutrient supplements.

Will 

Is it helpful to study a commercial multi-nutrient supplement on exercise performance?

Jürgen Scharhag • Wilfried Kindermann

Eur J Appl Physiol (2008) 103:487 DOI 10.1007/s00421-008-0732-8

Dear Editor:

With interest we read the article of Kraemer and colleagues, “Effects of a multi-nutrient supplement on exercise performance and hormonal responses to resistance training” (Kraemer et al. 2007) which aimed to determine the effects of the comprehensive nutritional supplement, Muscle Fuel™ on performance, hormonal, and recovery responses to an acute bout of exercise. Although we appreciate the effort and design of the study, some concerns should be mentioned. As discussed by the authors, Muscle Fuel™ contains numerous ingredients and it is, therefore, “impossible to determine which ingredient(s) provided the primary ergogenic response” (Kraemer et al. 2007). Nevertheless, we think that the ingestion of creatine and caffeine may have been of major relevance for the improvements in performance in this study, as this has been shown in previous studies (Racette 2003; Rawson and Volek 2003; Volek 2003; Spriet and Gibala 2004). But in our opinion it is of much greater relevance that studies using a polypragmatic approach in nutritional supplementation, which do not allow to analyse the effects of single substances, are not very helpful for sports medicine and athletes, as physicians, coaches and athletes may be motivated or even forced to supplement many substances simultaneously, and thereby a doping-mentality is generated in athletes. Care should also be taken to recommend caffeine-supplementation for athletes because it is listed in the monitoring program of the World Anti-Doping Agency (WADA) as an in-competition stimulant (World Anti-Doping Agency 2008). In addition, possible negative side effects of chronic multi-nutrient supplementation have to be considered as long as long-term safety has not been established. At the end, the industry may be the winner of such commercial studies whereas sports medicine and athletes may be the losers.

References

Kraemer WJ, HatWeld DL, Spiering BA, Vingren JL, Fragala MS, Ho JY, Volek JS, Anderson JM, Maresh CM (2007) Effects of a multi-nutrient supplement on exercise performance and hormonal responses to resistance exercise. Eur J Appl Physiol 101:637–646

Racette SB (2003) Creatine supplementation and athletic performance. J Orthop Sports Phys Ther 33:615–621

Rawson ES, Volek JS (2003) Effects of creatine supplementation and resistance training on muscle strength and weightlifting performance. J Strength Cond Res 17:822–831

Spriet LL, Gibala MJ (2004) Nutritional strategies to influence adaptations to training. J Sports Sci 22:127–141 Volek JS (2003) Strength nutrition. Curr Sports Med Rep 2:189–193

World Anti-Doping Agency (WADA) The 2008 monitoring program.

http://www.wada-ama.org/rtecontent/document/Monitoring_ Program_2008_En.pdf

Jürgen Scharhag, MD

Wilfried Kindermann, MD, PhD

Institute of Sports and Preventive Medicine

University of Saarland

Campus, Building B 8.2

66123 Saarbrücken, Germany

E-mail: j.scharhag@...