Food First. Not Food Only.
It is fair to say the topic of supplements can be a controversial one in sports nutrition!
What is almost universally agreed these days is that we should aim to operate a FOOD FIRST approach to diet.
Which was recently defined by Close et al (2022) in their recent review as:
“where practically possible, nutrient provision should come from whole foods and drinks rather than from isolated food components or dietary supplements.”
But as they outline, food first does not mean food only.
Why? Because there are some things that may support performance that we cannot get from our habitual diet. And there may be some things that it is challenging or inconvenient to consume in whole food form. In both cases supplements may help in getting what we will need. Now, to see the most effective marginal gains from these you are typically going to want to add them to a nutrient rich diet. Otherwise it is a bit like fitting a rear spoiler and narrow tyres on a Fiat 500 … not going to make you noticeably faster or more powerful … But assuming your basic diet is on point, supplements may have a place when used appropriately and informed on what they can do and what their limitations are!
So let’s look at some of these circumstances and examples, as highlighted by Close et al (2022):
Nutrients that cannot be obtained in sufficient quantities in the diet or would require excess consumption of energy or other nutrients to obtain
Great examples of this are creatine, vitamin D (in the absence of sufficient daily sunlight) and beta alanine. All are present in small doses in certain meat, fish and dairy products … but not enough to obtain the amounts needed to support health or performance. So supplementation is needed when these molecules are needed!
Nutrients abundant only in foods athletes do not like
A very common example of this are the key omega 3s, EPA & DHA. Oily fish are the food sources of these and include salmon, sea bass, tuna steak (but not tinned tuna, as the tinning process strips the omega 3 oils!), sardines, mackerel and kippers. Plant based omega 3s (ALA) are converted to EPA and DHA in the body, but very inefficiently. So, if you are not a fan of oily fish, then the UK government recommends a daily supplement of omega 3s containing 250-500mg EPA+DHA (from oily fish of plant based microalgae sources). Side note: store in the dark in the fridge to avoid degradation of the supplement into something that is not useful in the body.
Nutrient content may be highly variable making it difficult to ensure an effective dose
Great examples of this are caffeine content of coffee, or the nitrate content of dark leafy greens and beets! Which may mean a specified caffeine supplement (e.g. energy drink) or nitrate salts may be most effective.
Nutrients required in concentrated doses to reverse a deficiency or support the immune system
If you have a vitamin or mineral deficiency, or if your body has a sudden increase in the need for a nutrient because of injury or illness, then you may not be able to obtain enough of this fast enough from food. So a short course of supplementation may be recommended. This might include zinc lozenges in the case of upper respiratory tract infections, or iron tablets in the case of anaemia.
Wholefoods may be challenging to consume during or after exercise
The easiest example of this is carbs in endurance exercise! You are not going to shovel a bowl of pasta or a sandwich in your face whilst running a marathon! But you need carbohydrates to maintain pace and avoid ‘hitting the wall’. This is where carbohydrate powders and gels can come in handy!
Tested supplements may help alleviate contamination or hygiene concerns
When travelling you may not know where your food has been sourced from or the conditions it has been prepared in. If you are a drug tested athlete, meat contamination with clenbuterol may be a concern in some countries, for example. Or, before a competition you may be concerned with risks of food poisoning. In these situations to keep getting the protein your body needs, you may rely on protein supplements, for example.
So you can see, whilst “where practically possible, nutrient provision should come from whole foods and drinks rather than from isolated food components or dietary supplements”, there are some situations where supplements may help support an athelte’s short and / or long term performance.
Close et al. (2022). “Food First but Not Always Food Only”: Recommendations
for Using Dietary Supplements in Sport. International Journal of Sport Nutrition and Exercise Metabolism, https://doi.org/10.1123/ijsnem.2021-0335