The FINA Sports Medicine Web Pages are designed to provide team physicians and allied medical support staff with up to date medical and scientific information to guide their daily care of the aquatic athlete.
Coaches, athletes and parents can also use these pages to answer their questions regarding aquatic health issues.
It is claimed that sport supplements are the new ergogenic means in sport populations including swimmers. Different factors such as the high prevalence of overtraining in swimmers, the high load of swimming training, the heavy annual program, the high load of travel, and the specific nutritional needs of this athletic group results in high rates of supplementation. However, it is imperative to understand different aspects of supplement use in swimmers. In this paper, I am trying to highlight some important medical, legal and nutritional aspects of sport supplements.
What is a sport supplement?
Sport supplements are relatively new nutritional products commonly used by different athletic groups. According to Burke & Read (1993), there are some definition criteria for sport supplements. A sport supplement:
• contains nutrient(s) in amounts generally similar to the levels specified in the recommended dietary intakes or allowances (RDIs/RDAs), and similar to the amounts found in food;
• provides a convenient or practical way of ingesting these nutrients, particularly in the athletic setting;
• help athletes to achieve their known physiological or nutritional requirements;
• contains nutrient(s) in large amounts for use in treating a known nutrient deficiency;
• has been shown to meet a specific physiological or nutritional need that improves sports performance; and
• is generally acknowledged as a valuable product by sports medicine and science experts.
Prevalence of Supplementation in Swimming
Supplement use is widespread among sportsmen and women, but few of these products are supported by a sound scientific research and some may even be harmful to the athlete. Swimmers should consider carefully the effects, the side effects and the risks of supplements before trying to use them.
Table 1 summarizes the prevalence of supplement use reported among a variety of swimmer populations, and shows that more than half of the population are supplement users, although the prevalence rate differs between different levels of swimmers. Of course, it is possible that the variation in the supplement use reported by different athletic groups is due to methodological differences in collecting this information.
Table 1 - Prevalence rate of supplementation among swimmers
|Adams et al. 1982
||Female college swimmers||% 33|
|Barr & Costill 1992
||Male college swimmers
|Berning et al. 1986||Male and female elite swimmers||% 63|
||Male and female Olympic swimmers||% 89|
|Houston 1980||Male elite swimmers||% 75|
|Female elite swimmers
Why do swimmers use sport supplements?
Generally, swimmers look to nutritional supplements for many benefits, often to offset the heavy annual training program. However, the main reasons are:
• to promote adaptation to training;
• to increase energy sources and supplies;
• to allow more consistent and intensive training by promoting recovery between training sessions;
• to maintain good health and reducing interruptions to training due to overtraining, illness or injury;
• to achieve peak performance.
Although there are different nutritional ergogenic aids and a wide range of sport supplements used by swimmers, in the scientific research literature, creatine monohydrate is the most common supplement studied in different swimming populations. The research results are inconsistent for long-term creatine supplementation. Although, there are no reports showing serious side effects for creatine monohydrate supplements, we need more well-designed scientific studies to delineate the performance-enhancing effects of creatine.
Apart from creatine monohydrate, few research studies have been conducted in swimming. Alkaline supplements (sodium bicarbonate) to reverse the ill effects of lactic acid in high intensity swimming have some ergogenic effects but there is significant gastrointestinal (stomach) upset as a side effect. There are highly supportive scientific data on caffeine and its fat-burning effects (and improving aerobic capacity). Other substances such as HMB (resistance training) and L- Carnitine (fat-burning) need more rigorous scientific research scrutiny.
There are two important questions on safety and health aspects of dietary supplements:
1) Is the supplement safe at the recommended dosages?
Many nutritional ergogenic aids and sport supplements are relatively safe at a low dose, but have adverse effects at the recommended dose for improved performances that far outweigh the benefits of the product.
2) Does the product cause long-term health problems?
Some sport supplements require the swimmer to consume pills, powders, or liquids for relatively long periods of time. However, many supplements may not be safe in the long-time. Unfortunately, the majority of supplements are not evaluated more than 8-10 weeks. A large number of supplement products are new and their long-term side effects are unknown. Thus, swimmers using supplements for long-term periods may be at serious health risks.
Doping and Contamination Issues
Swimmers who are liable for drug testing under national or international programs should be especially cautious about supplement use. Some nutritional ergogenic aids are prepared in unhygienic conditions and contain toxins, bacterial and fungal contamination that may cause gastrointestinal problems or induce infections.
Others do not contain ingredients – especially the expensive ones – that are listed on the supplement label. Contamination of dietary supplements with substances that may cause a swimmer to fail a doping test is widespread – some surveys have suggested that as many as one in four supplements may result in a positive test. These prohibited compounds have not been declared on the label, so there is no way for the athlete to know that they are present.
At present, there can be no guarantee of the purity of any commercial supplement. The only way to be sure is to avoid supplements altogether, but many athletes are unwilling to accept this advice. The sensible athlete will want to see very good reasons for using a supplement and a very low risk of an adverse test before deciding to use it.
Swimmers are cautioned against the use of these supplements. Athletes must be aware of the strict liability principle that makes them responsible for everything they eat and drink. Ignorance is not an acceptable excuse for a positive doping result. Check all supplements with a medical officer. If there is any doubt at all, don’t take it.
Nutritional ergogenic aids are very appealing to the swimmer who seeks ergogenic aids to assist their performance. However, before using any nutritional ergogenic aid swimmers should need to talk with your sports dietitian or sport physician. However, any sport supplement, even those few ones with proven benefits and safety are not going to enhance athletic performance unless the athlete is practicing well, and have appropriate nutritional strategies. Safe and approved nutritional ergogenic aids are only the “supplement” for good training and nutrition practices, they are not alternatives for them.
Important Key Messages
• Swimmers should consider carefully the effects, the side effects and the risks of supplements before trying to use them.
• Many nutritional ergogenic aids and sport supplements are relatively safe at a low dose, but have adverse effects at the recommended dose for improved performances that far outweigh the benefits of the product.
• A large number of supplement products are new and their long-term side effects are unknown. Thus, swimmers using supplements for long-term periods may be at serious health risks.
• Swimmers are cautioned against the use of these supplements. Athletes must be aware of the strict liability principle that makes them responsible for everything they eat and drink. Ignorance is not an acceptable excuse for a positive doping result.
• Safe and approved nutritional ergogenic aids are only the “supplement” for good training and nutrition practices, they are not alternatives for them.
Ask the Doc
Question: Is there any research evaluating the use of supplements in swimmers at FINA or Olympic events?
Yes, in fact there are two research papers written on this topic. Corrigan & Kauslaskas published a paper on supplement use in swimmers during the Olympic Games in Sydney 2000. The results show that 89% of swimmers declared a substance on their doping control forms. Swimming was the second highest of all of the Olympic disciplines for vitamin ingestion. The group of athletes that had higher vitamin ingestion was the Athletics athletes.
The second study is from the FINA World Championships in Barcelona in 2003 by Pipe, Corrigan and Mountjoy. The following table shows the use of supplements in aquatics:
|Substance Type||Number of athletes||Percentage of total|
The next table shows the comparison from Sydney 2000 to Barcelona 2003 which illustrates a general decrease in overall use:
|SUBSTANCE||SYDNEY 2000||BARCELONA 2003|
|No = 345||No = 308|
|Oral Contraceptive Pill||89||20|
• Leenders N, Sherman WM, Lamb DR, and TE Nelson. (1999). Creatine supplementation and swimming performance. International Journal of Sport Nutrition pp. 251-261.
• Mujika I, Chatard J, Lacoste L, Barale F, and A Geyssant. (1996). Creatine supplementation does not improve sprint performance in competitive swimmers. Medicine and Science in Sports and Exercise 28(11):1435-1441.
• Burke L. et al (2006). Supplements and sport foods. In: Burke L, Deakin V (eds) Clinical Sports Nutrition, 3rd ed. Sydney, Australia: McGraw-Hill, pp 355-384
• Maughan R (2004). Sport supplements. In: Maughan et al (eds) Foods, Nutrition and Sports Performance II. London: Routledge, pp 204-228
• Adams MM, Porcello LP, Vivian VM. Effect of a supplement on dietary intake of female collegiate swimmers. Phys Sportsmed 1982;10:122–34.
• Barr SI, Costill DL. Effect of increased training volume on nutrient intake of male college swimmers. Int J Sports Med 1992;13:47–51.
• Berning J. Swimmers nutrition knowledge and practice. Sports Nutrition News. 4, 1986.
• Cross N. Nutrition and the elite athlete: implications for the management of coaching practices. Swimming Times 1997:25–6.
*Dr. Shahram F. Mevaloo is a medical doctor and anthropometrist. He is currently head of Anthropometry Department of National Olympic Academy of Iran, head of Talent identification Committee of National Swimming Federation. Dr. Mevaloo is a student of IOC Diploma Course in Sport nutrition.