Chapter 10 Nutritional Supplements and Ergongenic Aids

Match the common herbal supplement with its reported indication. A. Gingko biloba B. St. John's wort C. Echinacea D. Flaxseed 1 Cardiovascular health 2 Memory 3 Immune system 4 Cold symptoms 5 Depression

1 D 2 A 3 C 4 C 5 B

Sam, an elite junior Olympic sprinter, was banned from his sport for a year after testing positive for a banned substance, which resulted from taking a supplement that was contaminated. In his appeal, what defense can Sam take? A. False positive B. Inadvertent doping C. Guilt by ignorance D. Violation of manufacturing policy

B

Which of the following is a goal of the Current Good Manufacturing Practices (CGMP) guidelines instituted by the Food and Drug Administration? Select all that apply. A. Ensure that all supplements are safe for consumer intake. B. Prevent inclusion of incorrect ingredients in the product. C. Outline the impact that the supplement will have on health. D. Prevent contaminants in the product. E. Minimize mislabeling.

B, D, E

What practice is characterized by ingesting a substance for the express purpose of enhancing performance? A. Supplementing B. Nutritional enhancement C. Boosting D. Doping

D

T/F Dietary supplements are closely regulated by the Food and Drug Administration (FDA).

False

T/F Performance enhancing effects of caffeine use are stronger in chronic caffeine users.

False

Explain the process by which caffeine physiologically crosses the blood-brain barrier and creates the stimulant effects associated with its consumption.

Due to its lipophilic or "fat-loving" chemical structure, caffeine easily crosses the blood-brain barrier, the brain's security system aimed to prevent water-soluble toxins from damaging the all-important organ. To a nerve cell, caffeine resembles adenosine, a molecule that slows down the nervous system, dilates blood vessels, and allows sleep. The nerve's adenosine receptor cannot tell the difference between the two molecules, so caffeine and adenosine compete for receptor binding. When caffeine wins, an exaggerated stress response takes hold. The cell activity speeds up, the brain's blood vessels constrict, and neuron firing increases. The pituitary gland responds to the increased activity by sending a message to the adrenal glands to produce adrenaline, the "fight or flight" hormone. Pupils and breathing tubes dilate. Heart rate increases. Blood flow shunts to the muscles. Blood pressure rises. Muscles contract. The liver releases extra glucose into the blood stream to fuel the fight or flight, thus sparing muscle glycogen stores.

T/F Most hormones are strictly banned as performance-enhancing supplements.

True

T/F Research supports supplementation of folic acid in pregnant women.

True

Identify the key steps that an allied health provider should take when evaluating a nutritional supplement.

1. Understand the claim. 2. Assess the credibility. 3. Assess the relevance. 4. Evaluate the safety. 5. Evaluate the risks versus benefits. 6. Consider possible drug, supplement, and nutrient interactions. 7. Make an informed decision. 8. Continuously evaluate the need (or lack of need) for supplementation.

A patient with a history of heart disease and depression is looking for natural ways to decrease risk and minimize the impact of these conditions. Which of the following recommendations are appropriate for this patient? A. Increase consumption of cold-water fish such as cod, tuna, and mackerel, or discuss omega-3 supplementation with a physician. B. Increase consumption of soy-containing food products like soy nuts or edamame. C. Add a soy isolate shake to the daily eating plan. D. Purchase a fish oil supplement to take with meals.

A

A wrestler would like to select a whey supplement to provide additional protein for the purpose of gaining muscle mass. Which of the following forms of whey provide the highest percentage of protein? A. Whey protein isolate B. Whey protein powder C. Whey protein concentrate D. Whey protein isoflavone

A

What recommendation should be made to a recreational athlete who is interested in supplementing with branch-chain amino acids? A. Food sources of protein and amino acids may provide basically the same effects at a fraction of the cost. B. Amino acid supplementation is most effective just prior to an endurance workout. C. Research is showing conclusive evidence of the ergogenic effects of amino acid supplementation. D. Little is known about the role that branched-chain amino acids play in muscle building.

A

Which of following forms the basis for the government's regulation of dietary supplements? A. Dietary Supplement Health Education Act (DSHEA) B. United States Department of Agriculture Supplement Guide C. Healthy Supplement Implementation Bill D. Food and Drug Administration Best Practices Act

A

Which of the following statements best summarizes the research related to vitamin supplementation? A. No significant health benefits have been shown with vitamin supplementation. B. Supplementation of vitamin E and C has shown decreases in heart disease in men. C. A multivitamin supplement has been shown to decrease risk of cancer and heart disease in women. D. Vitamin E and selenium supplementation can decrease the risk of prostate cancer.

A

Which organization provides voluntary testing and labeling for products that meet their quality guidelines? A. United States Pharmacopeia (USP) B. Food and Drug Administration (FDA) C. United States Department of Agriculture (USDA) D. United States Supplement Regulatory Agency (USSRA)

A

Who is the best person to help a patient evaluate the risks and benefits of taking a specific nutritional supplement? A. Primary care physician B. Allied health care provider C. Strength and conditioning specialist D. Coach

A

Why are the stimulants ephedrine, sibutramine, and methylhexaneamine commonly involved in claims of inadvertent doping? Select all that apply. A. Labeling often contains unrecognizable names. B. Alternate names for the substances are not included on the banned substance list. C. Herbal supplements are not typically banned. D. These substances used to be considered legal. E. Manufacturers are not required to list all ingredients on the label.

A, B

According to the Dietary Supplement Health Education Act (DSHEA), a dietary supplement contains which of the following ingredients? Select all that apply. A. Vitamin B. Mineral C. Amino acid D. Concentrate, metabolite or constituent, extract E. Herb or other botanical

A, B, C, D, E

Which of the following correctly characterizes the recommendations related to consumption of soy products? Select all that apply. A. Early studies indicate soy isolates decreased low-density lipoprotein cholesterol and blood pressure. B. The American Heart Association retracted the claim that soy proteins and isoflavones had significant cardiovascular benefits. C. The 1999 claim by the Food and Drug Administration (FDA) that soy protein is linked to cardiovascular benefits remains in place. D. Whole food soy products are recommended as opposed to soy isolates. E. Food manufacturers and consumers responded to early research by increased offerings and consumption of soy products.

A, B, C, D, E

Which of the following are regulated by Current Good Manufacturing Practices (CGMP) instituted by the Food and Drug Administration? Select all that apply. A. The design and construction of physical plants that facilitate maintenance B. Cleaning C. Proper manufacturing operations D. Guarantee product has no health risks E. Ensure independent research is used to test product safety F. Handling consumer complaints G. Maintaining records

A, B, C, F, G

What are some of the negative effects associated with chronic caffeine use? Select all that apply. A. Hypertension B. Hyperglycemia C. Forgetfulness D. Withdrawal symptoms E. Insomnia

A, B, D, E

Which of the following effects are attributed to caffeine use during exercise? Select all that apply. A. Enhanced speed in endurance events B. Negative impact on water-electrolyte imbalances C. Reduced heat tolerance D. Decreased perceived exertion during exercise E. Less fatigue noted with high intensity exercise

A, D, E

Which options are health benefits associated with the consumption of omega-3 fatty acids? Select all that apply. A. Reduced disability from depression and attention deficit hyperactivity disorder (ADHD) B. Decreased risk of breast cancer C. Decreased risk of colon cancer D. Improved brain development in fetuses and young children E. Decreased risk of heart disease

A, D, E

Marie, a 40-year-old kindergarten teacher who is slightly overweight and borderline hypertensive, would like to take a weight-loss supplement to enhance her goal of losing 10 pounds. What recommendation would you make to Marie? A. She should select a weight loss supplement that is labeled "thermogenic," as these tend to be safer. B. She should consult with her physician before taking any weight-loss supplement because of her hypertension. C. She should select a weight-loss supplement that consists of only natural substances. D. Weight-loss supplements are never recommended, as all are unsafe.

B

Which of the following resources would provide the most valid and unbiased information for assessing the credibility of a nutritional supplement? A. The World Anti-Doping Agency B. Governmental agencies such as the Food and Drug Administration or the Office of Dietary Supplements C. International Olympic Committee D. Research I institution

B

Which type of protein supplement provides extended release of the protein over several hours after ingestion? A. Amino acid B. Casein C. Whey isolate D. Whey concentrate

B

Why should consumers exercise caution when purchasing any product that claims to boost muscle mass? A. Muscle building cannot occur without supplementation of additional protein. B. Muscle-building products may be contaminated with anabolic steroids. C. Muscle-building products tend to contain stimulants. D. Muscle-building products are commonly water based and therefore the majority of the product ingested is excreted in urine and sweat.

B

Which of the following serious adverse effects are associated with anabolic steroid use? Select all that apply. A. Increase in muscle mass and strength not proportional to body frame B. Rage C. Increase in cardiovascular endurance not proportional to heart or lung size D. Hypertension E. Gynecomastia

B, D, E

A rookie in the National Basketball Association (NBA) would like to increase his size and strength to be more competitive at training camp. He asks about using androstenedione. What information should be shared with this athlete? Select all that apply. A. Research shows that androstenedione is effective in increasing muscle size and strength. B. Androstenedione is not currently banned by the NBA. C. Androstenedione has no proven negative side effects. D. Androstenedione is more effective than a sound nutrition and resistance training program. E. Taking androstenedione can result in a reduction in high-density lipoprotein (HDL) cholesterol and baldness.

B, E

How should an allied health provider best manage a client who is using a nutritional supplement? A. The allied health professional should leave that conversation to the client and his or her physician. B. The allied health professional should request regular blood work to monitor for any possible side effects. C. The allied health professional should check in with the client regularly regarding efficacy and any noted side effects. D. The allied health professional should make regular recommendations on increasing or decreasing dosage.

C

What is an isoflavone? A. An antioxidant that is found in plants and often added to supplements. B. The isolated form of a specific protein that makes it more easily digestible. C. A phytoestrogen that mimics estrogen and is often combined with protein to make soy isolate. D. A filler added to a multivitamin to promote digestibility.

C

Which of the following correctly characterizes an adulterated substance? A. A substance that has been enhanced to promote its beneficial effects. B. A substance that is synthetically produced. C. A substance that has been deemed unsafe due to significant or unreasonable risk of illness or injury. D. A substance that, when combined with another product, may pose risk to consumers.

C

Which organization is responsible for monitoring and producing the list of currently banned substances utilized by all major organizations? A. International Olympic Committee B. Center for Drug Free Sport C. World Anti-Doping Agency D. Unites States Olympic Committee

C

Which supplement has been shown to increase the body's ability to build muscle mass when combined with intense resistance training workouts without significant risk of side effects? A. Dehydroepiandsterone B. Androstenedione C. Creatine D. Casein

C

What are major drawbacks of herbal (botanical) supplements in lieu of medicine? Select all that apply. A. Herbal supplements are more costly than many generic medicines. B. Herbal supplements are difficult to find. C. Health effects of herbal supplements are not as clearly identified. D. Herbal supplements are not as closely regulated and therefore risk adulteration and contamination. E. Herbal supplements have more associated side effects.

C, D

Which of the following effects are noted in athletes who use stimulants to enhance performance? Select all that apply. A. Increased appetite B. Increased muscle mass C. Increased heart rate D. Increased cardiac output E. Increased glucose availability

C, D, E

Which of the following athletes should exercise caution and consult a physician prior to utilizing a creatine supplement? A. Football player with no significant family history B. Soccer player with lactose intolerance C. Sprinter with history of stress fractures D. Wrestler with one kidney

D

Which of the following claims meets appropriate guidelines to be placed on the packaging of a supplement? A. Vitamin E prevents Alzheimer's disease. B. Fish oil reduces risk of heart disease. C. Vitamin A prevents night blindness. D. Vitamin C enhances immune system function.

D

Which type of supplement is commonly abused by athletes in sports with weight requirements? A. Hormones B. Anabolic steroids C. Botanicals D. Diuretics

D