Asking the Right Questions

By G. Douglas Andersen, DC, DACBSP, CCN

Sports nutrition interest, application, research, marketing and hype continue to explode in the 1990s and are showing no signs of abating. From peer review journals to health and fitness magazines to supermarket tabloids, nutritional supplements are making news. As the amount of knowledge continues to snowball, it becomes increasingly difficult for those of us in the trenches, working the 8 to 6 shift Monday through Friday, to keep up. What used to be simple -- Gatorade or protein powder -- is now quite complex.

There are seemingly hundreds of products for every type of athletic activity or phase of training. The market is expanding so quickly that many doctors feel they don't have the time to keep up with the latest developments. Asking the right questions can reduce a seemingly infinite amount of purported miracle nutrients to a finite amount of research-backed sports aids. Shortcuts to remaining current will be discussed today. These ideas can be applied both when writing for product information or when product representatives call on you at your office.

The last few years have ushered in many new sports nutrition companies. Although some are reputable, many just want to make a buck. Their target market is the young athlete looking for a magic bullet. Competition for market share is fierce. This results in many products entering the market with inadequate testing or research. There are product labeling problems as well. Many times the amounts listed on the label are incorrect, and the labels do not contain a full disclosure of their ingredients. Where their labels and research may be lacking, their packaging and marketing excel in promoting the next (usually monthly) "miracle, all natural" product that will enhance performance.

Advertisements will typically show a bar graph from a "study" that shows their product against the competitors and pharmacological preparations. Needless to say, "the research shows" how wonderful their product is. The bright side to this sometimes out-of-control situation is that it provokes independent researchers to analyze the substances that various companies are constantly rushing to the marketplace. This does result in an occasional validation of a substance researchers would not have otherwise thought to investigate.

There are two types of representatives who will call on you in your office. The first type are those who work for small, quality conscious companies whose target market is the health care professional. They are generally well-informed about both their product and their competitor's product. This type of person would not work for a company if he or she did not feel they were selling fresh bioactive and bioavailable products. The second type of representative is the classic salesman who last week was selling stereos and is now into nutrition. Although they do not have the background of the aforementioned "reps," their presentation is generally very smooth and they are strong in marketing and selling techniques. You must realize, however, that both types of representatives do have the same goal: to sell you their product. They will overwhelm you with literature on why their formulas work better than others.

When I was a student just learning about nutrition, every time I heard a representative give a presentation at school I would usually buy their products. I would be ready to throw out all the supplements I had just purchased before (and often did) and buy half of the new line. Then I would see an impressive advertisement in a lifting, cycling, or running magazine and buy even more supplements. It took me awhile to realize that I was spending a lot of money based on faith and marketing instead of logic and chemistry.

To save doctors time and to maximize the quality of information received, here are some suggestions to cut the fat out of the literature the representative will give you, and questions to ask that will reduce the time you spend in meetings.

1. Save the testimonials. Whether I'm calling or writing for product information, or talking to sales representatives in person, I tell them to skip the testimonials. We all have testimonials. I have never met a chiropractor who doesn't have a great story or two about a patient who returned to their office after the first treatment and was totally asymptomatic, even though the doctor's impression after the initial examination was a prognosis of weeks or even months of care to stabilize the patient. Every vitamin company, too, has these types of incredible stories. Our goal, however, is to buy a product based on fact, and not a testimonial.

    

2. If a representative continues to quote one man or woman repeatedly, find out if the "great scientist" who has authored volumes of "factual" unreferenced literature on why this substance or formula is the best, coincidentally works for that company. If the "scientist" is an employee or paid consultant, you must realize that the information provided is not from a neutral source and, therefore, you should ask the representative to provide you similar information offered by parties who are not involved financially.

    

3. When you are reading product literature and you come upon remarkable claims that are referenced, ask the representative to provide you with the reference. If he or she just gives you the reference sheet and suggests that you go to the library, I recommend that you inform them which references you would like, and have the sales representative do the legwork. Obviously, if they refuse to provide you with the references you request, you will know not to buy their product.

    

4. "Studies have shown..." When you see or hear these three little words, it is time to immediately take control of the situation. You can do so with the following questions:

A. Was the study human or animal?
B. Was the study with oral or injectable preparation?
C. If human, what was the age, sex, and activity level of the group studied?
D. Who did the study (that is, was it independent or was it done by the company selling the product)?
E. Was it double blind and placebo controlled?

Whether you are talking to a representative or writing for product information, these simple questions will give you a good idea of how likely it is that the product will work. I prefer double-blind, placebo-controlled, crossover studies performed by independent institutions that use oral preparations on human subjects in the same age, gender, and activity group to whom I will be supplementing. What I object to and what the above questions will hopefully prevent, are those times when a representative, an advertisement, or a literature packet will result in sales to doctors who are under the erroneous impression that the products they've ordered are based on target group studies.

As an example, the trace mineral boron has been advertised in various publications which target young athletic males to "raise testosterone naturally." These ads state that the testosterone elevation claims are based on human studies. What no advertisement stated was that the "studies" were based on postmenopausal females over 60 years of age. This raises four issues:

1. The study neither proves nor disproves that boron would have a hormonal effect on the 25-year-old males the companies are targeting.

    

2. I am not opposed to doctors who recommend a product based in clinical instinct or theoretical extrapolation and are aware that the specific substance they are using has not yet been proven effective in controlled studies.

    

3. My question is: How many doctors who recommend boron to their athletes and patients, based on what they assumed was proof that boron did work on the group that was targeted in advertisements, would do so if they were fully informed of the specifics of the study that the claims were based?

    

4. This is simply one illustration that can be repeated with many other athletic-enhancing substances on the market. As for boron, I urge those selling it to young, athletic males to provide us with peer reviewed target group studies to support your claims.

Asking the right questions will reduce an overwhelming array of miracle sports nutrients to a reasonable amount of research-backed ergogenic substances. The number of products backed only by untested theories, questionable research, and creative extrapolations will be easily apparent and placed in your "send me the real proof" file. With the right techniques, keeping up on what really works is neither hard nor time consuming.

For references pertaining to this article please contact:

Douglas Andersen, D.C.
916 E. Imperial Hwy.
Brea, California 92621

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