- Annie Bothma, IOPN Sports Performance Nutritionist (EQF Level 7. Masters), Running Coach and Elite Marathon Runner
As we venture into the second installment of our Sport Nutrition Supplement Series, our exploration takes a shift from performance-centric supplements to those that can profoundly impact both your athletic prowess and overall health. Building upon the foundation laid in the initial installment, which focused on supplements designed to enhance performance, we now turn our attention to a holistic approach.
This segment of the series delves into supplements that go beyond the realm of speed and strength, delving into the intricate interplay between nutrition, health, and athletic achievement. Whether you're an athlete striving for excellence or an individual committed to a wellness-driven lifestyle, join me on this journey as we uncover the supplements that bridge the gap between optimal performance and comprehensive well-being and health.
Let's unravel the layers of sports nutrition together and explore how these supplements can be instrumental in elevating both your health and athletic prowess.
IRON
BENEFITS
Oxygen Transport: Iron is a key component of hemoglobin, the protein in red blood cells that carries oxygen from the lungs to the rest of the body.
Energy Production: Iron is involved in the production of adenosine triphosphate (ATP), the primary energy currency of cells.
Immune System Support: Iron plays a role in the proper functioning of the immune system.
Cognitive Function: Iron is essential for cognitive development and function, especially in children.
BONUS BENEFITS
Improved Exercise Performance: Adequate iron levels contribute to better oxygen transport and utilization, which can enhance exercise performance.
Healthy Pregnancy: Sufficient iron is crucial during pregnancy to prevent iron-deficiency anemia and support the growing fetus.
RECOMMENDED DOSE
The recommended daily intake of iron varies by age, gender, and life stage.
For adults, the recommended dietary allowance (RDA) is typically around 8-18 milligrams (mg) per day. The recommended amount for males are 8 mg/day and females need 18 mg/ day on an omnivorous diet.
Due to reduced bioavailability the recommended intake for vegan and vegetarians is 80% higher. Vegans and vegetarians need to aim for iron intakes of 14 mg/day for males and 33 mg/day for females.
Pregnant women may require higher doses.
It's important to note that iron needs can vary, and individuals with certain conditions, such as iron-deficiency anemia, may need higher doses under the guidance of a healthcare professional.
MOST EFFECTIVE FORM
Iron supplements come in various forms, including ferrous sulfate, ferrous gluconate, and ferrous fumarate.
Among these, ferrous sulfate is often recommended as it contains a higher percentage of elemental iron and is more readily absorbed by the body. However, the choice of the most effective form may depend on an individual's tolerance and specific health needs.
TIMING
Usually taken on an empty stomach, but can cause stomach upset, so some prefer taking it with food.
Avoid taking it with calcium-rich foods or supplements, as calcium can inhibit iron absorption.
Polyphenols are found in black and herbal tea, coffee, wine, legumes, cereals, fruit, and vegetables and have been demonstrated to inhibit iron absorption.
FOOD-FIRST APPROACH
Iron from animal sources (heme iron) is better absorbed by the body compared to iron from plant sources (non-heme iron).
Heme-iron
Red meat (beef, lamb, pork)
Poultry (chicken, turkey)
Seafood (especially shellfish like clams, oysters, and mussels)
Organ meats (liver, kidneys)
Non-heme iron
Legumes (lentils, beans, chickpeas)
Tofu
Spinach and other dark leafy greens
Quinoa
Fortified cereals and bread
Nuts and seeds (pumpkin seeds, sesame seeds)
Dried fruits (raisins, apricots)
Dark chocolate
TIP: To enhance iron absorption from plant-based sources, consume them with vitamin C-rich foods like citrus fruits, strawberries, or bell peppers.
POTENTIAL SIDE-EFFECTS
Digestive Discomfort: Iron supplements can cause gastrointestinal issues such as constipation, nausea, or stomach cramps.
Staining of Teeth: Some liquid iron supplements may stain the teeth, so it's recommended to take them through a straw or dilute them with water.
Overdose Risk: Excessive iron intake, especially from supplements, can lead to iron toxicity. This is particularly a concern for young children who may accidentally ingest iron supplements. Test for deficiency before just supplementing with iron.
VITAMIN C
BENEFITS
Immune System Support: Vitamin C is essential for the proper functioning of the immune system and helps the body defend against infections and illnesses.
Antioxidant Properties: As an antioxidant, vitamin C helps protect cells from damage caused by free radicals, which may contribute to aging and the development of various diseases.
Collagen Formation: Vitamin C is necessary for the synthesis of collagen, a protein that plays a crucial role in skin, blood vessels, bones, and other connective tissues.
Wound Healing: Vitamin C promotes the healing of wounds and assists in the repair and maintenance of tissues.
Iron Absorption: Vitamin C enhances the absorption of non-heme iron from plant-based foods, aiding individuals with iron-deficiency anemia.
BONUS BENEFITS
Cardiovascular Health: Some studies suggest that vitamin C may have a positive impact on heart health by reducing the risk of cardiovascular diseases.
Eye Health: Vitamin C may contribute to the prevention of age-related macular degeneration (AMD) and cataracts.
RECOMMENDED DOSE
The recommended daily intake of vitamin C varies by age, gender, and life stage.
For adults, the recommended dietary allowance (RDA) is typically around 75-90 milligrams (mg) per day for women and men, with slightly higher amounts recommended during pregnancy and lactation.
Higher doses may be recommended for individuals with specific health conditions or increased stress.
MOST EFFECTIVE FORM
Ascorbic acid is the most common and effective form of vitamin C. It is readily absorbed by the body, and many vitamin C supplements use ascorbic acid as their primary ingredient.
Other forms, such as sodium ascorbate or calcium ascorbate, may also be used in supplements and can be suitable for those who experience stomach irritation with ascorbic acid.
TIMING
Can be taken at any time, with or without food. It's water-soluble and generally well-tolerated.
FOOD-FIRST APPROACH
Citrus fruits
Kiwifruit
Guava
Papaya
Red and green bell peppers
Pineapple
Mango
Berries
Broccoli
Tomatoes and tomato products like tomato juice
POTENTIAL SIDE-EFFECTS
Gastrointestinal Distress: High doses of vitamin C, particularly from supplements, can cause stomach cramps, diarrhea, and nausea in some individuals. It is generally recommended to start with lower doses and gradually increase to tolerance levels.
Interference with Certain Medications: Vitamin C supplements may interact with certain medications, such as blood thinners and chemotherapy drugs. Consultation with a healthcare professional is advised for individuals on medication.
VITAMIN B12
BENEFITS
Energy Production: Vitamin B12 plays a crucial role in the synthesis of DNA and the metabolism of fatty acids, contributing to the production of energy.
Red Blood Cell Formation: B12 is essential for the formation of red blood cells, which transport oxygen throughout the body.
Neurological Function: B12 is involved in the maintenance of the nervous system and the synthesis of myelin, a protective covering for nerves.
Mood Regulation: Adequate levels of B12 are linked to improved mood and may help prevent symptoms of depression.
BONUS BENEFITS
Cognitive Health: Some studies suggest that B12 may play a role in cognitive health and may help reduce the risk of neurodegenerative diseases.
Heart Health: Adequate B12 levels are important for cardiovascular health, as they help regulate homocysteine levels.
RECOMMENDED DOSE
The recommended daily intake of vitamin B12 is typically around 2.4 micrograms (mcg) for adults.
However, individual requirements can vary, and certain groups, such as older adults and individuals with absorption issues, may require higher doses.
Vitamin B12 is water-soluble, and excess amounts are usually excreted in the urine.
MOST EFFECTIVE FORM
Methylcobalamin and hydroxocobalamin are often considered the most effective forms of vitamin B12. Methylcobalamin is the active form and does not require conversion in the body, making it readily available for use.
Hydroxocobalamin is another form that is converted into active B12 in the body and is often used in medical treatments.
TIMING
Can be taken at any time, with or without food. Some people prefer taking it in the morning to avoid potential interference with sleep.
FOOD-FIRST APPROACH
Vitamin B12 is primarily found in animal-based foods, and it can be challenging to obtain from plant-based sources.
Good sources of vitamin B12 include:
Meat: Beef, pork, and lamb
Poultry: Chicken and turkey
Fish: Salmon, trout, and tuna
Seafood: Clams, oysters, and mussels
Dairy products: Milk, cheese, and yogurt
Eggs
For individuals who follow a vegan or vegetarian diet, getting enough vitamin B12 can be hard for athletes. In such cases, fortified foods and supplements are often recommended to meet the daily B12 requirements. Look for fortified cereals, plant-based milk, and nutritional yeast products that contain vitamin B12.
POTENTIAL SIDE-EFFECTS
Allergic Reactions: While rare, some individuals may be allergic to vitamin B12 supplements and may experience symptoms such as rash or itching.
Interaction with Medications: B12 supplements may interact with certain medications, including proton pump inhibitors and certain antibiotics. Consultation with a healthcare professional is advised.
FOLATE
BENEFITS
Cell Division and DNA Synthesis: Folate is crucial for cell division and DNA synthesis, making it essential for normal growth and development.
Neurological Function: Folate plays a key role in the synthesis of neurotransmitters, such as serotonin and dopamine, contributing to proper neurological function.
Red Blood Cell Formation: Folate is involved in the production of red blood cells, helping to prevent anemia.
Pregnancy Support: Adequate folate intake is critical during pregnancy to prevent neural tube defects in the developing fetus.
Cardiovascular Health: Folate may contribute to cardiovascular health by helping to regulate homocysteine levels, which, when elevated, may be a risk factor for heart disease.
BONUS BENEFITS
Mood Regulation: Folate is linked to mental and emotional well-being, and its deficiency has been linked to symptoms of depression.
Cancer Prevention: Some studies suggest that adequate folate intake may help reduce the risk of certain cancers.
RECOMMENDED DOSE
The recommended daily intake of folate varies by age and gender.
For adults, the recommended dietary allowance (RDA) is typically around 400 micrograms (mcg) per day.
Pregnant women may need a higher dose, and it's advisable to consult with a healthcare professional for personalized recommendations.
MOST EFFECTIVE FORM
The most effective form of folate is often considered to be L-methylfolate (or 5-MTHF). This is the active, bioavailable form of folate that can be directly utilized by the body.
Some individuals may have difficulty converting folic acid (the synthetic form of folate found in supplements and fortified foods) into its active form, so using L-methylfolate can bypass this step and ensure optimal absorption.
TIMING
Can be taken at any time, with or without food.
FOOD-FIRST APPROACH
Dark leafy greens: Spinach, kale, collard greens, and Swiss chard.
Legumes: Lentils, chickpeas, black beans, and pinto beans.
Citrus fruits: Oranges, grapefruits, and their juice.
Fortified foods: Some cereals, bread, and other products are fortified with folate.
Avocado
Asparagus
Brussels sprouts
Broccoli
Papaya
Sunflower seeds
POTENTIAL SIDE-EFFECTS
Masks B12 Deficiency: High folate intake can mask a deficiency in vitamin B12, another essential nutrient. It's important to monitor B12 levels, especially in older adults.
Interaction with Medications: Folate supplements can interact with certain medications. Individuals taking anticonvulsant drugs, methotrexate, or certain other medications should consult their healthcare provider.
Allergic Reactions: While rare, some individuals may be allergic to folate supplements, experiencing symptoms such as rash or itching.
CALCIUM
BENEFITS
Bone Health: Calcium is a vital mineral for the development and maintenance of strong and healthy bones and teeth.
Muscle Function: Calcium is involved in muscle contraction and relaxation, contributing to proper muscle function.
Blood Clotting: Calcium plays a role in blood clotting, helping to prevent excessive bleeding when injuries occur.
Nerve Transmission: Calcium is essential for nerve impulse transmission, facilitating communication between nerve cells.
Cell Signaling: Calcium is a key signaling molecule in various cellular processes, including cell division and enzyme activity.
BONUS BENEFITS
Weight Management: Some studies suggest that an adequate intake of calcium may aid in weight management and fat loss.
Blood Pressure Regulation: Calcium may contribute to the regulation of blood pressure, although the evidence is not conclusive.
RECOMMENDED DOSE
The recommended daily intake of calcium varies by age and gender.
For adults, the recommended dietary allowance (RDA) is typically around 1000-1300 milligrams (mg) per day.
Older adults, especially postmenopausal women, may require higher doses.
Consultation with a healthcare professional is advised for individuals on medication.
MOST EFFECTIVE FORM
Calcium carbonate and calcium citrate are two common forms of calcium supplements.
Calcium carbonate is often taken with food, as stomach acid enhances its absorption, while calcium citrate can be taken with or without food and is generally better absorbed, especially for individuals with low stomach acid.
The "most effective" form can vary based on individual needs and tolerances.
TIMING
Typically taken with meals, as it's better absorbed in the presence of food. Calcium supplements may interfere with the absorption of iron and certain antibiotics.
FOOD-FIRST APPROACH
Dairy products (milk, cheese, yogurt)
Canned fish like salmon or sardines with bones
Leafy green vegetables (kale, collard greens, broccoli)
Tofu (if prepared with calcium sulfate)
Edamame (young soybeans)
Beans and lentils
Fortified foods like plant-based milk (almond milk, soy milk, etc.), orange juice and cereals
Almonds
Chia seeds and Sesame seeds
Figs
POTENTIAL SIDE-EFFECTS
Constipation or Digestive Issues: Calcium supplements, particularly calcium carbonate, can sometimes cause constipation or other digestive issues.
Kidney Stones: Excessive intake of calcium supplements, especially in the absence of adequate hydration, may increase the risk of kidney stones in susceptible individuals.
Interaction with Medications: Calcium supplements can interfere with the absorption of certain medications, such as those for thyroid conditions or antibiotics. It's important to take calcium supplements at a different time from these medications.
VITAMIN D
BENEFITS
Inflammatory properties: The active form of Vitamin D (1,25 (OH)D) binds to receptors in your muscle cells, the production of pro-inflammatory hormones called cytokines is suppressed while their counterparts (protectins, resolvins and maresins) are put to work.
Bone Health: Adequate vitamin D levels are crucial for bone health and overall wellness. Some athletes may benefit from supplementation, especially if they have limited sun exposure.
BONUS BENEFITS
Improved mood: Find that when your mood instantly lifts when the sun comes out? No surprise: Vitamin D is involved in the body's production of serotonin - often called the body's happy hormone - so it is important for your overall health to reap this benefit.
RECOMMENDED DOSE
The Endocrine Society states, for example, that to maintain serum 25(OH)D levels above 75 nmol/L (30 ng/mL), adults might need at least 37.5 to 50 mcg (1,500–2,000 IU)/day of supplemental vitamin D, and children and adolescents might need at least 25 mcg (1,000 IU)/day.
MOST EFFECTIVE FORM
Vitamin D3 is the best according to research it can be absorbed up to 500 times faster and is 87% more effective at raising vitamin D levels compared to vitamin D2.
TIMING
Best taken with a meal containing healthy fats to enhance absorption. Morning or early afternoon is often recommended.
FOOD-FIRST APPROACH
Most of the vitamin D we get is produced by our skin when it's exposed to sunlight.
Foods naturally rich in vitamin D are somewhat limited, but some sources include:
Fatty fish (salmon, mackerel, sardines)
Cod liver oil
Egg yolks
Cheese
However, some foods are fortified with vitamin D, which is a common way to increase intake. These fortified foods include:
Fortified dairy products (milk, yogurt, and some cheeses)
Fortified plant-based milk (soy milk, almond milk)
Fortified orange juice
Fortified cereals
Fortified tofu
POTENTIAL SIDE-EFFECTS
Consuming to much can cause nausea and vomiting. Although it is extremely rare, vitamin D is a fat-soluble vitamin that stores in your body, therefore, it is best to get your levels tested before you consider supplementing to make sure you actually need it.
MAGENSIUM
BENEFITS
Energy Production: Magnesium is an indirect energy booster; adenosine triphosphate (ATP) - the body's main energy carrier - only becomes biologically active once it binds to itself to a magnesium ion. ATP molecules store and transfer energy to your cells, including those of your muscles, so when you are exercising for longer periods, you require ATP to be produced more quickly and work more efficiently to support your muscles.
Combat Fatigue: A deficiency in magnesium will limit energy production and lead to fatigue, especially during longer sessions. It is also important to note that you lose magnesium in your sweat, so if you are not consuming enough through your diet you are more likely to be deficient as a runner.
BONUS BENEFITS
Better sleep: Magnesium may help improve sleep by activating your parasympathetic nervous system, which slows down your heart rate, lowers your blood pressure and can help send your body into a state of relaxation. Sleep, of course, is key to recovery, so you will be more primed to perform at your next session or race.
RECOMMENDED DOSE
200-300 mg per day.
MOST EFFECTIVE FORM
Magnesium citrate: Magnesium citrate is known for its relatively high bioavailability, which means it is easily absorbed by the body. It's often used when a more rapid increase in magnesium levels is desired. Due to its efficient absorption, magnesium citrate can have a laxative effect in some individuals, especially when taken in larger doses.
Magnesium glycinate: Magnesium glycinate is a form of magnesium that is bound to the amino acid glycine. It is also well-absorbed and is known for its gentle and non-laxative nature, making it a good option for those with sensitive digestive systems.
TIMING
Often taken with meals or at night-time before bed, but can be taken at any time.
It's worth noting that magnesium can interact with certain medications, so it's advisable to consult a healthcare professional.
FOOD-FIRST APPROACH
Nuts
Seeds
Legumes
Dark chocolate
Beans
Tofu
Bananas
Quinoa
Green leafy veggies
POTENTIAL SIDE-EFFECTS
An upset stomach (cramping, diarrhea).
If this happens stop taking the supplement until symptoms subside and consider lowering your dose to only 100 mg.
OMEGA-3 FATTY ACIDS
BENEFITS
Inflammation and Recovery: With omega-3 it is the eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) that you are after. These can help reduce inflammation and aid recovery. They also have Immune-modulatory properties that is important for keeping your immune system strong and healthy.
Omega-3 has been reported to help: reduce muscle soreness, improve oxygen & nutrient delivery, increase muscle synthesis and help reduce inflammation.
BONUS BENEFITS
Cognitive Benefits: DHA has been shown to help improve concentration, since it is the main fatty acid found in your brain and is responsible for blood flow and improving the efficacy of all the cells in the brain. Cognitive tasks are much harder without it.
RECOMMENDED DOSE
1000-2000 mg per day.
MOST EFFECTIVE FORM
Look for a supplement with a higher ratio of EPA to DHA, as EPA is far more effective in delivering physical benefits, like reducing pain, aches and swelling.
Algal oil is derived from microalgae and is a vegan source of both EPA and DHA, the long-chain omega-3 fatty acids. It's often available in supplement form and can be a reliable way to ensure you're getting EPA and DHA in your diet.
TIMING
Can be taken with meals to minimize the risk of fishy aftertaste. However, some people prefer taking it separately to manage their intake better.
FOOD-FIRST APPROACH
Animal-based:
Mackerel
Tuna
Salmon
Trout
Plant-based:
Walnuts
Flaxseeds
Chia seeds
Hemp seeds
Brussle sprouts
Avocado
Seaweed.
POTENTIAL SIDE-EFFECTS
An unpleasant aftertaste in your mouth or slightly fishy-smelling breath - but these both should be very mild.
SUMMARY
Iron: Essential for oxygen transport in red blood cells, iron supports energy production and immune function.
Vitamin C: An antioxidant crucial for immune health, collagen synthesis, and overall cellular protection.
Vitamin B12: Essential for energy production, red blood cell formation, and neurological function, with potential benefits for mood and cognitive health.
Folate: Supports cell division, DNA synthesis, and red blood cell formation, with additional benefits for mood and potential cancer prevention.
Calcium: Vital for bone health, muscle function, blood clotting, and nerve transmission.
Vitamin D: Crucial for bone health, immune function, and calcium absorption, with potential benefits for mood and overall health.
Omega-3: Fatty acids with anti-inflammatory properties, essential for cardiovascular health, brain function, and overall well-being.
CONCLUSION
Remember, it's essential to have your deficiencies diagnosed through blood tests and to follow your healthcare provider's advice on the appropriate supplementation and dosages. Overuse of certain supplements can lead to adverse effects, so it's crucial to seek professional guidance. TEST, DON'T GUESS.
Additionally, it's essential to research the quality and safety of the supplements you choose, as the market can be filled with products of varying quality. Check out a previous blog post for tips and considerations when buying supplements: SPORT NUTRITION SUPPLEMENT SERIES: INTRODUCTION
Stay tuned for the the next post in the sports nutrition supplement series:
Supplements that can help speed up the recovery after an injury.
Read the previous post in the series:
If you would like to work with me one on one to nail down your nutrition as an endurance athlete or you need a running coach to help you prepare for your upcoming race, please click on the link below to learn more about the services I offer.
Contact me at anniesathletes@gmail.com to set up a consultation today.
RESOURCES
Asker Jeukendrup, Micheal Gleeson, Sport Nutrition, Third Edition, 2019
Craig Sale, Kirsty Jayne Elliott-Sale, "Nutrition and Athlete Bone Health," Journal of Sports Medicine, 2017
Neil P. Walsh, Nutrition and Athlete Immune Health: New Perspectives on an Old Paradigm, Sports Medicine, 2019
Ronald J Maughan, Louise M Burke, Jiri Dvorak, IOC consensus statement: dietary supplements and the high-performance athlete, Consensus statement, 2018
Vegan diets: practical advice for athletes and exercisers, (2017), By David Rogerson
Nutrition and Athlete Immune Health: New Perspectives on an Old Paradigm (Neil P. Walsh, 2019)