Last Thursday, one of my patients stopped me on my way out of a treatment room to ask me a seemingly simple question. “I have a daughter that is a collegiate, 400 m hurdler. She has been looking for a post run/workout recovery supplement, and I was wondering if you had any thoughts or recommendations?” I immediately started thinking about well known supplements such as Creatine, Syntha-6, or MuscleMilk, and the importance of fish oil, as well as other supplements such as Magnesium, L-Glutamine, and Vitamin D. But rather than offering up a hasty answer, I decided to reach out to Joan Rubinger, The Director of Clinical Sports Medicine and Nutrition for Tim Grover’s Attack Athletics, an expert that routinely answers similar questions from professional, and world class athletes.
Below is a recap of my conversation with her:
JOAN:
I re
cently read several journal articles addressing similar questions. Interestingly enough, the most “pushed” supplements out there (e.g., creatine, Beta-alanine) have been shown to not have significant benefit in muscle recovery, especially for sprinters, AS WELL AS protein-enriched post-exertion meals/drinks. No difference in results. (citations below)
I have found that keeping true to more organically found products such as milk rather than the engineered supplements seem to have better results. Chocolate milk has been the subject of many recent studies (within past 3 years), and shown to significantly increase muscle recovery and reduce blood lactate levels. AN
ANDY
Wow, that is really good news for the pocket book of families with multiple growing athletes! Why is it that chocolate milk is getting so much press these days?
JOAN
I feel that regular milk (as opposed to chocolate) seems better for the athlete, due to less glucose, HOWEVER, chocolate milk appears to be more palatable, post-exertion. Chocolate milk is easy to suggest, and easy to access and afford, and usually, there is good adherence as opposed to protein shakes at 4 dollars each. Chocolate has more sugar but usually better compliance due to taste preference over reg milk.
ANDY
Is there a preferred prescription of skim vs 1%, or 2%?
JOAN
No- depending on athlete’s fat needs and body comp, you can do skim, 1%, or 2% or whole. That’s the best part about milk. So many preparations to fit different needs.The proportion of protein and carb stays the same, only fat changes. Keep in min that milk does not have as much protein per serving as some of the post workout shakes, but this can be addressed easily through dietary intake. The best part about milk is that it has all its components in perfect proportion to what the body needs. Like ratio of protein to carb to fat is all perfect.
ANDY
I have traditionally told patients that healthy eating decisions can cover most nutritional needs, and that deficiencies do not happen over night. Therefore, improving eating habits, is a good starting point. When I do recommend supplements, I usually recommend Fish Oil, Magnesium, Vitamin D, and L-Glutamine. Any thoughts?
JOAN
There is no substitute for healthy eating decisions, but Magnesium (plain) was recently proven to increase serum testosterone levels in athletes, at an appropriate level in women. Vitamin D3 is important to bone health as well as connective tissue elasticity and resilience. There has been a significant increase in population found to have clinical vitamin D deficiency, most specifically caucasians in northern and scandinavian areas.
Here’s a few recommendations, not in any specific order or priority.
1) Magnesium, 10 mg/kg/day.
Cinar, V., Polat, Y., Baltaci, A. K., & Mogulkoc, R. (2011). Effects of magnesium supplementation on testosterone levels of athletes and sedentary subjects at rest and after exhaustion. Biological trace element research, 140(1), 18-23.
2) L-carnitine L-titrate (LCLT), 2 grams/day
Kraemer, W. J., Volek, J. S., French, D. N., Rubin, M. R., Sharman, M. J., Gomez, A. L., … & Hakkinen, K. (2003). The effects of L-carnitine L-tartrate supplementation on hormonal responses to resistance exercise and recovery.Journal of Strength and Conditioning Research, 17(3), 455-462.
3) Milk, 8 oz following workout (ideally 24 oz/day in three 8 oz servings)
Cockburn, E., Stevenson, E., Hayes, P. R., Robson-Ansley, P., & Howatson, G. (2010). Effect of milk-based carbohydrate-protein supplement timing on the attenuation of exercise-induced muscle damage. Applied Physiology, Nutrition, and Metabolism, 35(3), 270-277.
Gilson, S. F., Saunders, M. J., Moran, C. W., Moore, R. W., Womack, C. J., & Todd, M. K. (2010). Research article Effects of chocolate milk consumption on markers of muscle recovery following soccer training: a randomized cross-over study.
4) Vitamin D3, 2000 IU/day
Cannell, J. J., Hollis, B. W., Sorenson, M. B., Taft, T. N., & Anderson, J. J. (2009). Athletic performance and vitamin D. Med Sci Sports Exerc, 41(5), 1102-10.
**THIS POST DOES NOT IN ANY WAY INSINUATE THAT IT IS OK FOR ANYONE THAT IS LACTOSE INTOLERANT TO CONSUME MILK AS A POST WORKOUT SUPPLEMENT. NOR IS IT APPROPRIATE FOR DIABETICS TO CONSUME CHOCOLATE MILK. I WILL PROVIDE AN UPDATE REGARDING ALTERNATIVES TO MILK IN THE NEAR FUTURE**
p.s. The following articles showed no benefit to sprinters with intake of their respective substances:
Izquierdo, M. I. K. E. L., Ibanez, J. A. V. I. E. R., Gonzalez-Badillo, J. J., & Gorostiaga, E. M. (2002). Effects of creatine supplementation on muscle power, endurance, and sprint performance. Medicine and science in sports and exercise, 34(2), 332-343.
Kinugasa, R., Akima, H., Ota, A., Ohta, A., Sugiura, K., & Kuno, S. Y. (2004). Short-term creatine supplementation does not improve muscle activation or sprint performance in humans. European journal of applied physiology, 91(2-3), 230-237.
Kreider, R. B., Ferreira, M., Wilson, M., Grindstaff, P., Plisk, S., Reinardy, J., … & Almada, A. L. (1998). Effects of creatine supplementation on body composition, strength, and sprint performance. Medicine and science in sports and exercise, 30, 73-82.
Rowlands, D. S., Thorp, R. M., Rossler, K., Graham, D. F., & Rockell, M. J. (2007). Effect of protein-rich feeding on recovery after intense exercise.International Journal of Sport Nutrition & Exercise Metabolism, 17(6).
Rowlands, D. S., Rössler, K., Thorp, R. M., Graham, D. F., Timmons, B. W., Stannard, S. R., & Tarnopolsky, M. A. (2007). Effect of dietary protein content during recovery from high-intensity cycling on subsequent performance and markers of stress, inflammation, and muscle damage in well-trained men.Applied Physiology, Nutrition, and Metabolism, 33(1), 39-51.
Sweeney, K. M., Wright, G. A., Brice, A. G., & Doberstein, S. T. (2010). The Effect of [beta]-Alanine Supplementation on Power Performance During Repeated Sprint Activity. The Journal of Strength & Conditioning Research,24(1), 79-87.
PT of Costa Rican National Soccer Team for 2007 World Cup in Victoria, CAN. Clinical Instructor for University of Minnesota Doctor of Physical Therapy Affiliations
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