DHEA Caught in a Headlock

For some reason, when I think of "performance-enhancing substances," images of professional wrestlers flexing their inordinately large biceps and triceps always spring to my mind. Sadly, in the past few years, certain illegal substances have also made their way into the hands of professional and amateur athletes, some of whom have been indicted in high-profile cases for using banned performance-enhancing substances to cheat and give themselves an edge in competition. And some have pointed their finger at dietary supplements for causing them to test positive for steroids or illegal substances. In most cases, it's simply not true. Dietary supplements are legal, safe, legitimate products-no well-made supplement product on the market should cause an athlete to test positive for illegal anabolic steroids.

It seems recently, however, that dehydroepiandrosterone (or DHEA), which is a safe, legal dietary supplement, has received a smack-down of sorts. DHEA is primarily used by hundreds of thousands of older adults due to their bodies' inability to effectively produce healthy hormone levels on their own as they age. Late last year, the U.S. Senate introduced legislation to amend the Controlled Substances Act to prevent access to DHEA by minors and to create penalties for those who would provide DHEA to minors. The introduction of this legislation was tied to the Mitchell Report on illegal steroid and drug problems in Major League Baseball and suggested that restricting access to a safe, legal dietary supplement, DHEA, would somehow address the problem of illegal anabolic steroid use in minors, who look to professional athletes as role models.

The Council for Responsible Nutrition (CRN; Washington, DC) continues to strongly oppose this legislation. First, there is no evidence to suggest that DHEA works as a performance-enhancing substance in young, healthy adults, nor that minors are abusing DHEA. Second, when Congress enacted the Anabolic Steroid Control Act of 2004, it intentionally did not add DHEA to the Controlled Substances List for good reason. Finally, restricting access to DHEA would set a misguided precedent for other supplements and would create a misimpression that DHEA is dangerous and deserves to be hidden behind the counter, while simultaneously making it difficult for those consumers who need the product to obtain it.

SPORTS NUTRITION FOR OLYMPIANS-AND THE REST OF US

WHETHER THEY ARE OLYMPIANS OR WEEKEND WARRIORS, athletes are seeking out nutritional supplements to gain a competitive edge. Over the past few years, scientists have learned more about the relationship between nutrition and performance, and that knowledge is trickling down to professional and amateur athletes, as well as the average consumer.

DSM Nutritional Products (Parsippany, NJ) recently provided nutritional assistance and materials to athletes competing in the 2008 Summer Olympics in China. In addition to supplying 20,000 servings of its sports nutrition ingredient PeptoPro, the company also dispensed more than 100 cooling vests and baths to help regulate the temperature of the athletes. PeptoPro contains easily digestible di- and tripeptides that accelerate muscle recovery and refueling.

PeptoPro's history goes back to the 2004 Olympic Games in Athens, according to Reto Rieder, senior marketing manager for PeptoPro. In 2008, the company helped support several individual athletes as well as the Dutch Olympic team.

"Our studies with PeptoPro were conducted by some of the leading scientists in sports nutrition in the United States and Europe, and the positive results quickly found their way to professional athletes," Rieder says. "The positive feedback related to faster recovery time, improved endurance and performance, as well as ease of use, because PeptoPro is completely water soluble. Professional athletes can give very exact feedback about whether a sports nutrition product works."

DSM also made some special improvements and modifications to help the athletes this time around. First, the company developed a powdered form that is easy to transport and preserve. Second, DSM employees designed a novel drink device that enables athletes to adjust the concentration of PeptoPro in beverages, according to their individual nutritional needs.

While some Olympic athletes used PeptoPro, regular consumers who don't compete at elite levels can also benefit from the product, says Rieder.

"I think the awareness has grown that the combination of carbs and electrolytes and PeptoPro is an outstanding training tool for both professional athletes and those who simply enjoy exercise," Rieder says. "This has also been demonstrated by the large amount of new products introduced over the past two years in the United States, Europe, and Asia."

One source of these troubles is that the word steroid has recently gotten a bad reputation. It's important to remember that not all steroids are created equal, nor are all steroids bad. While we commonly think of steroids as of the anabolic variety, steroid is a generic term used for any naturally occurring chemical molecule containing certain fat-soluble organic compounds in a particular carbon atom formation-cholesterol, by definition, is a steroid or steroid precursor, as is vitamin D. Though steroids are similar to one another structurally, their functionalities in the body are very different.

So, yes, DHEA is a steroid, but it is not like anabolic steroids or steroid hormone precursors, such as androstenedione ("andro"), that produce the muscles I associate with those professional wrestlers. The primary function of anabolic steroids, such as testosterone, is to increase muscle size and strength beyond what one could normally achieve-thus making these products "performance-enhancing substances." Unlike anabolic steroids, DHEA is naturally produced and is the most common steroid hormone in the body. The body tightly regulates the conversion of DHEA, preventing excess production of testosterone. In other words, under normal conditions, the body simply recognizes when it is already achieving normal hormone levels and "ignores" the additional DHEA.

Furthermore, research from many randomized, controlled trials has consistently shown that DHEA supplementation does not increase testosterone levels, or enhance muscle mass or muscle strength in young, healthy adults, nor does it cause the myriad side effects that accompany anabolic steroid abuse, such as cardiovascular conditions, liver conditions, reduced fertility, or the adverse psychiatric and behavior problems sometimes associated with anabolic steroid abuse. Even clinical studies that regrettably have failed to confirm other potential benefits of DHEA have still demonstrated that there are no significant safety issues associated with DHEA use either.

In fact, a small study published in October 2000 in the journal Human Reproduction showed that women taking a combination of fertility drugs and supplemental DHEA showed a slightly improved response in ovarian stimulation-release of eggs during fertility treatment-after two months. As a result, some fertility specialists, particularly at the Center for Human Reproduction, one of the leading fertility centers with locations in both Chicago and New York City, have started recommending that patients undergoing fertility treatments also take DHEA supplements to help boost the production of eggs and/or to reduce miscarriage rates, particularly in older women. While I don't recommend that women who are trying to become pregnant rush out and start taking DHEA without their physician's advice, it demonstrates that DHEA supplements are safe, legitimate products and may play an important role in other areas of health.

When Congress enacted the Anabolic Steroid Control Act in 2004, it deliberately omitted DHEA from the Controlled Substances List, due to the fact that it functions differently within the body, a fact that some in Congress seem to have forgotten. Senator Orrin Hatch (R–UT), a long-standing supporter of the dietary supplement industry, even agreed during one of those Senate debates that if it were shown that DHEA caused harm, he would work to place DHEA on the Controlled Substances List. There is no evidence to support a contention that supplemental DHEA causes harm, nor that minors are abusing it. In fact, according to surveys of weightlifters and other athletes conducted by researchers at Harvard University (Boston), while andro and other hormone precursors are or have been used by athletes for performance enhancement, DHEA is rarely used for such purposes. But in their zeal to "do something," some members of Congress want to act in the absence of any evidence. DHEA does not belong on the Controlled Substances List.

Unfortunately, it's easy to conduct a Google search for DHEA and find Web sites that market the ingredient as if it did produce those enormous muscles-for easy sales to gullible teens. So whether DHEA really does produce pro-wrestler-sized muscles or not, the industry's critics get easy ammunition for their efforts to restrict it. As much as I hate to admit it, there are a small number of outliers in the dietary supplement industry, who have the misimpression that DHEA works like an anabolic steroid in the body. But punishing consumers who use it appropriately, as well as the majority of responsible manufacturers that appropriately market DHEA, by restricting access to this safe, legal product, is not the appropriate solution to the problem.

Instead, it makes much more sense for members of the dietary supplement industry to stand together and adhere to a voluntary program for the responsible marketing of DHEA-simply refuse to mismarket DHEA for anabolic effects or to healthy teenagers for whom it will have no effect. Though research suggests that DHEA, when used as directed, has a strong safety profile, manufacturers should still not be marketing this product to those under 18 years of age, because it does not appear to have benefits for that age group. So earlier this year, CRN's members agreed 

• To refrain from marketing DHEA products that they manufacture or market under their brands as providing a general anabolic steroid–like response (muscle enlargement, increased strength, etc.).

• To refrain from targeting those under 18 years old in their marketing or advertising of their DHEA-containing products, as this ingredient is unlikely to provide performance-enhancing benefits in this population.

STUDY EXAMINES ZERO-CALORIE SPORTS DRINK

AQUA-LYTE, SCIENTIFIC FOOD SOLUTIONS' (FAIRFIELD, CA) zero-calorie water beverage, is comparable to leading sports and electrolyte drinks, according to a study by Miami Research Associates (Miami, FL) that was presented in May at the American College of Sports Medicine's (Indianapolis) annual meeting in Indianapolis.

"The findings from this study are real and relevant to any individual concerned about their hydration as well as their waistline," says Douglas Kalman, PhD, RD, one of the study's lead reseachers. "Beverages such as Aqua-Lyte appear to offer many advantages over the typical and popular sports beverage."

In the study, 10 healthy females (aged 18–45) with at least six months' exercise experience walked on a treadmill for one hour at a speed of 3.5 mph. The subjects then drank 2.5 cups of Aqua-Lyte or a comparison sports beverage for each pound of body weight lost during the treadmill exercise.

Measures of hydration were conducted after beverage consumption at each half-hour interval over a span of two hours. During these breaks, the subjects documented their thirst and taste assessment using a 10-point scale.

There were no statistically significant differences in any measure of hydration. "Subjective comments regarding taste and comfort favored Aqua-Lyte over the other sports drink," the researchers concluded.

 Many CRN member companies were already voluntarily recommending on their labels that DHEA products not be used by those under 18, but CRN's program does not call for that labeling because our critics might misconstrue that abundance of caution as an admission of safety concerns. The formalization of this voluntary marketing program is a way for responsible members of the dietary supplement industry to stand together and support self-regulation that's in the best interest of the consumer.

Although this is a voluntary program, and therefore can't be enforced by federal agencies, it serves as a way for the responsible members of the industry to demonstrate accountability to their customers. Along with CRN's other self-regulatory initiatives, such as the program with the National Advertising Division (NAD) of the Better Business Bureaus (BBB), which encourages supplement companies to submit challenges if they see outrageous advertising claims for dietary supplements, it demonstrates that supplement manufacturers put their consumers first. We encourage all companies in the industry to adopt these guidelines as well, to help increase consumer confidence in the industry as a whole.

I recently read that 99% of the 11,000 athletes in attendance at this summer's Olympic Games used dietary supplements of some kind, according to the European Specialist Sports Nutrition Alliance (London)-and there was not a single supplement contamination case. This goes to show that dietary supplements play an important role in an athlete's training regimen for proper nutrition, recovery, and support. Illegal performance-enhancing substances have no place in sports, but safe, legal dietary supplements that have health benefits to consumers certainly do have a place on store shelves and in locker rooms. When lawmakers and regulators recognize that distinction-and the industry can go a long way to help make that happen-athletes who cheat will truly be "down for the count."

Steve Mister is the president and CEO of the Council for Responsible Nutrition (CRN; Washington, DC), a trade association representing dietary supplement industry ingredient suppliers and manufacturers. For more information about CRN, visit www.crnusa.org.