Supplements in Sport – which ones work?

Unknown-1The use of supplements by athletes is almost universal, and used correctly and appropriately, can help to achieve optimum performance.

However, clever marketing by supplement companies often exaggerates or invents nutrition claims. The use of pseudo science is common, using seemingly impressive words and phrases.

Unfortunately, many professional and recreational athletes rely on information from unreliable websites, or are advised by unqualified and inexperienced nutritionists (there are some fabulous nutritionists out there, however, anyone can call themselves a nutritionist as it is an unregulated title). Without the correct training, it is easy to misinterpret and misquote published scientific evidence and come to the wrong conclusions.

It is common for athletes to be motivated by celebrity endorsements, a big selling point for a product, “If x uses it it then it must work!”. Additionally, there is the fear that colleagues or competitors are taking a supplement, and if they do not, then they will be losing out on having ‘the edge’.

All this results in money being wasted on products that simply do not work, and at worst can cause physical harm. Importantly, supplements are a distraction from the factors that can really enhance health, recovery and performance.

It may not seem exciting or cutting edge, but the sound foundations of good nutrition need to be

Balanced meals with protein, vegetables and whole grains

Real food with protein, vegetables, healthy fats and whole grains

firmly in place (focusing on real food and getting quality nutrients from carbs, protein and healthy fats). These, coupled with optimum timings of nutrient intake is the basis for ultimately achieving the best performance in training and competition.

There are a select few supplements, however, that have a good amount of evidence behind their effectiveness:

  • Recovery shakes – Carbohydrate & Protein powders for use after exercise. Carbs allow glycogen replenishment of the muscles and help to shuttle protein in to the muscle for repair and growth. Although carbs and protein can be sourced from food or milk, sometimes it is more convenient to take as a supplement (20-30g protein, approx 60-90g carbs). For higher protein needs of resistance training, whey protein is quickly absorbed and can be a more convenient and often cheaper way to achieve requirements than from solely high protein food (up to a total of 1.7g/kg/day of protein from food and supplements)
  • Caffeine – Sound evidence exists that caffeine enhances endurance and provides a small but worthwhile enhancement of performance over a range of exercise protocols. Caffeine also improves mental sharpness. Avoid if it gives you the jitters, and for many people it acts as a gut stimulant causing diarrhoea (70-200mg taken before and during exercise. A cup of instant coffee has approx 70mg, one ProPlus tablet 50mg)
  • Creatine – for about 80% of people, creatine can increase muscle mass, strength and high intensity exercise performance. Effective for sports involving short periods of maximal intensity and repeated bouts with intermittent rest periods. The quickest way to “creatine load” is to take large doses (20-30 g per day) for around 5-7 days. Typically, these doses are split over the day e.g. 5g, four to five times each day. Eating a large amount of carbohydrate (about 70-100 g) with each dose increases creatine uptake via the stimulatory effects of insulin.
  • Nitrates –  Dietary nitrate has become increasingly popular as an ergogeimages-3nic aid, with a $T2eC16dHJGoFFvPOJJ3UBR0ZfTsjj!~~60_35number of recent studies finding benefits to sports performance. Nitrates increase blood flow by causing blood vessels to dilate. High nitrate foods include beetroot, beetroot juice, celery, spinach, lettuce, rocket, leeks and parsley (preferably non-organic).
  • Vitamin D – there is a direct relationship between vitamin D levels in the body and muscle power, force and velocity. Vitamin D deficiency increases risk of muscle injury. In a recent study (2014) one third of American college athletes were deficient in vitamin D. There aren’t many good food sources of vitamin D, therefore for those who are deficient, supplementing with 1000IU is advisable. Severely deficiencies may require higher doses.

    A selection of supplements.......

    A selection of supplements…….

  • Omega 3s – anti-inflammatory, also protects against heart attacks and strokes, may also benefit memory and general mental performance. If no oily fish is eaten, then 500-1000mg daily of EPA & DHA is a good amount to take.
  • Probiotics – maintains gut function and health, preventing the immunosuppressive effects of intense exercise, and reducing susceptibility to illness. Also appropriate to take if travelling abroad for competition to avoid traveller’s diarrhoea. The specific strain of probiotic supplement needs to be carefully selected.
  • Multivitamins – when you can’t guarantee that your diet is always a healthy and balanced one.

A dietitian can carry out an assessment and advise on the most appropriate supplements to take (if any), dose and timings*. Advice is tailored to take in to account factors such as specific sport, training goals and food intake.

*Dietitians do not sell nutritional supplements and do not have a commercial interest in promoting them.



10 top foods for recovery

You may feel that you have worked out to the max during your sessions burning 100s of calories, so does it really matter if you have some crisps, chocolate, a danish pastry or chips? Time and time again, research shows that the answer is “yes”. Replacing calories isn’t the only objective of recovery.

Between each workout, game or race the body needs to adapt to the physiological stress that has just been applied, so that it can recover and become fitter, stronger and faster. Whether you are a triathlete, a gym addict, or your child is playing in a weekend rugby tournament, optimum recovery nutrition can help you to perform better in the short and long term.

There are many ‘recovery drinks’ and powders marketed for refuelling after exercise. While

Real Food

Real Food

these have their place, they are not necessarily the best option. It can be argued that real food is the best fuel for recovery, providing everything that a recovery drink can, as well as all the vitamins, minerals, antioxidants, phytochemicals etc that simply cannot be bottled or made in to a powder.

What’s happening during recovery?

  • refuelling of muscle and carbohydrate stores
  • replacing fluids and electrolytes lost in sweat
  • manufacturing new muscle protein and blood cells
  • allowing immune system to manage damage caused by exercise


What are the recovery ‘rules’?

  • multiple daily exercise sessions – if less than 24 hours until next session e.g. professional athletes, weekend rugby tournament, compulsive gym exercisers: recovery nutrition after your session ASAP, ideally within an hour. If next session starts within an hour, recovery drinks or anything low fibre and low fat to help with faster digestion (lasagne not a good option!)
  • more than 24 hours between exercise sessions – generally no need to eat soon after exercise, try to have your next usual meal. consisting of some protein and carbohydrate. If trying to gain muscle, then you can add a recovery snack to fuel this catabolic process. If trying to lose weight and hungry after training, be careful not to increase overall daily calorie intake. Have something light to eat e.g. yogurt.


Why carbs & protein are important

Immediately post exercise, good recovery nutrition will consist of protein & carbohydrate. Aim for 1g carbohydrate per kg of body weight, and approximately 25g protein (a chicken breast is about 25-30g, a mug full of rice is about 70g carbohydrate). Unfortunately, eating lots of extra protein does not make bigger muscles.

Carbs and protein work together: carbs help to shuttle protein in to the muscles, and protein helps to stimulate faster muscle glycogen replacement. Low fat helps the food to be absorbed more quickly, as does low fibre (so don’t be too concerned about choosing ‘healthy’ whole grain carbs like whole wheat bread). Fruit & veg can be included in the next meal to provide antioxidants.

If you don’t feel like eating food or don’t have the time or facilities, then recovery drinks or shop bought milkshakes can be useful. Here is a more in-depth look at some of the most popular commercial recovery drinks. If you are trying to lose weight, then watch the calories……..don’t increase overall calories through the day.


10 snack foods for fast recovery:

330ml Milkshake – e.g. Yazoo, Frijj, For Goodness Shakes

Homemade recovery smoothie

Post exercise shakes have their place, but watch the extra calories!Large skinny latte & handful of nuts


Bagel with peanut butter

Milk: perfect recovery protein & carbs

Breakfast cereal with milk e.g Cornflakes, Rice Krispies, Cheerios

2 Eggs on 2 white toast

Sandwich/roll/wrap/pitta: filled with chicken, fish or eggs

Jacket potato with cottage cheese/tin of tuna/Baked Beans

Banana or yogurt

Yogurt & Banana

Homemade Seriously Healthy Flapjacks

Mud, Muscles and vitamin D

The days are closing in as autumn and winter approach. For many athletes, this means moving workouts and training sessions indoors. Even when training outside during the colder months, the low sun, cloud cover, and wearing clothes prevent our bodies from converting sunlight to vitamin D.


Fran was unlikely to get his vitamin D dose from the sunshine today

At the London Irish training ground in Sunbury, rain or shine, rugby and fitness training takes place out on the pitches. Muddy, wet, and cold may not be pleasant, but it prepares everyone for real game day conditions. I’m all for a bit of mess, until I get a muddy mountain of washing dumped in the laundry basket at the end of the day. In winter it’s not just shorts, T-shirts and socks, but tracksuit bottoms, tops, Skins and jackets. Would it be unreasonable for me to politely suggest a laundry room at the new training ground at Hazelwood?! So to my point…..when covered with clothes (and mud!) any small amount of vitamin D provided by the sun in winter, won’t reach the skin.

For those training near the equator, sunlight and vitaminD aren't such a problem

For those training near the equator, sunlight and vitamin D aren’t such a problem

The importance of sunlight and sports performance has been known for centuries, but it is only recently that the science behind the physical benefits have been investigated. We are still in the early days of discovering the tiny details of how vitamin D affects muscles. Other benefits of vitamin D have already been established e.g. for the prevention of diabetes, heart disease and some cancers.

Scientific studies are slowly piecing together how vitamin D affects muscle. This is what we know so far about vitamin D and involvement with muscle:

  • muscle contraction – calcium and phosphate are essential for the muscle fibres to move, and vitamin D may help this mechanism to work. Vitamin D may also be important for the actual parts of the muscle that make the contraction work (actin and myosin)
  • muscle repair – after exercise, there will be damage to the tiny muscle fibres. Vitamin D may help to repair this damage
  • muscle building – vitamin D stimulates new muscle, and the blood vessels feeding the muscles

In real life?

Although studied at a cellular level, there aren’t many studies yet on vitamin D and how levels in young, healthy athletes affects performance. However, in elderly people, low vitamin D has been shown to result in poorer muscle function and muscle loss.

Should I supplement?


Vitamin D spray

There are very few good food sources of vitamin D, it comes mostly from the sun. Some foods, like breakfast cereals have vitamin D added, and if you take a multivitamin it may contain some vitamin D.

I advise to take a daily supplement of vitamin D during the winter months (October – May). Unless otherwise advised by your doctor, up to 1000IU per day is safe for adults. It comes in tablet, drops or spray form.

If you aren’t sure how much vitamin D you are getting, I can perform a nutritional analysis of your current diet and the supplements you are taking, and advise you on improving your diet. You can get in touch using the contact form.

Information from Nutri-facts

World Mental Health Day – Omega 3s can make a difference

Today is World Mental Health Day, as Conor and I discovered walking through Kingston town

Conor with his balloon from mental health charity MIND

Conor with his balloon from mental health charity MIND

centre this morning. He was delighted to be handed a balloon by MIND volunteers promoting the day, while I was delighted that the balloon entertained him for over an hour in his pushchair. Happy child, happy mummy.

It is well established that omega 3 fats help in heart disease and brain development. However, new research is emerging that these oils found in fish can also be effective in improving mood disorders, such as depression and schizophrenia.

At any one time, 1 in 10 people in the UK suffer from depression, while post natal depression is  estimated to affect 15% of new mums. Experts think that for those without a family history of depression, taking omega 3s can reduce depression rates.

Omega-3 researcher David Mischoulon, MD, PhD, director of research in the Depression Clinical and Research Program at Boston’s Massachusetts General Hospital and an associate professor of psychiatry at Harvard Medical School, says omega 3s oils (EPA and DHA) “are thought to be active as antidepressants” in the brain.

Salmon - omega 3 oils

Salmon – omega 3 oils

So when can omega 3s be helpful?

  • depression
  • pre and post natal depression
  • menopausal depression
  • people at risk of schizophrenia
  • self harm

Safety: Omega 3 fats may help some people with mood disorders, and are safe for most people to take. However, fish oils, as supplements or in the natural form of fish, shouldn’t be used as a home remedy for mood disorders. Always see your doctor first. Do not stop your current medication without seeking your doctors advice.


Omega 3 supplement

How much: for the general population without mood disorders, about two servings per week of oily fish is recommended, this equates to about 500mg/day (DHA & EPA).  For people with mood disorders benefits may be seen with up to 1000mg/day.

Iron: are you getting enough?


Recent statistics show that 40% of women under the age of 34 have seriously low intakes of iron and are at risk of anaemia as a result. Up to 15% of children don’t get enough iron, and 1 in 8 children between 1 1/2 and 2 years are anaemic.


Anaemia can cause:

  • tiredness and weakness
  • decreased work and school performance
  • slow cognitive and social development during childhood
  • difficulty maintaining body temperature
  • decreased immune function, which increases susceptibility to infection
  • glossitis (an inflamed tongue)
  • palpatations
  • restless leg syndrome

Symptoms of iron deficiency anaemia could be caused by many different things. A blood test is needed to confirm the presence of iron deficiency anaemia.

People at risk of anaemia:

  • Infants over 6 months
  • Toddlers
  • Adolescents
  • Pregnant women
  • Pre menopausal women


How much iron do I need?

Gender Age Group Recommended intake (mg/day), number of
Children 1-3 years 7
Children 4-6 years 6
Children 7-10 years 9
Teenage boys 11-18 years 11
Teenage girls 11-18 years 15
Men 19-50 years 9
Women 19-50 years 15
Men 50+ years 9
Women 50+ years 9


Food sources of iron

  • Iron from animal sources is much better absorbed by the body than plant sources
  • Vitamin C helps with absorption. High vitamin C foods include: red peppers, broccoli, strawberries, kiwi fruit & oranges.
  • Tea and coffee reduce the absorption of iron, so don’t drink a cup too close to a meal

 Meat sources:

Food Average portion Stars
Liver 40g, thick slice ★★★
Liver pate 1 tbsp
Beef steak 150g, medium size ★★★
Sausage 2
Beef mince 125g, 4 tbsp cooked ★★★
Chicken 100g cooked
Pork chop 120g, 1 average
Sardines/salmon/mackerel 50g
Tuna 100g (1/2 tin)

 Other sources (less well absorbed):

Food Average portion Stars
Ready Brek 20g dry (1 small ptn) ★★★★★★
Branflakes 25g (4 tbsp) ★★★★
Weetabix 2 biscuits ★★★
Rice Krispies 30g (4 tbsp) ★★
Chickpeas 100g (4 tbsp) ★★
Lentils green/brown 75g (1/2 cup cooked) ★★
Lentils red 75g (1/2 cup cooked) ★★
Baked beans 120g (3 tbsp) ★★
Humus 50g (1 tbsp)
Eggs 1
Sunflower seeds 30g (1/4 cup) ★★
Sesame seeds 12g (1 tbsp)
Dried Apricots 8 ★★
Dried figs 4 ★★★
Raisins 35g (1 tbsp)
Spinach 120g (3 tbsp) boiled ★★
Avocado ½
Peas 75g (2.5 tbsp)
Broccoli 4 spears (200g)
Ovaltine 25g serving (4 tsp) ★★★
Milo (chocolate malt) 20g serving (4 tsp) ★★★★★★
Sainsburys: £3.99

Sainsburys: £3.99Tesco: £2.99  Tesco: £2.99

Iron Supplements

If you have iron deficiency anaemia, your doctor may prescribe you iron supplements, as even a diet rich in iron will not be enough to correct the deficiency.

If you experience a stomach upset with iron tablets, try taking a liquid form instead.

For further information on iron or for a dietary assessment to assess the amount of nutrients in your diet, use the contact form to get in touch.

Frightening Calcium Facts


Wow!……..50% of women, and 25% of men over 50 will experience a bone fracture due to osteoporosis!

Until recently, doctors and dietitians have recommended calcium supplements for those not getting enough from their diet. Recent research is emerging to show that calcium from supplements may not be effective at improving bone health, and may even increase risk of heart disease. The research is suggesting that dietary sources trump the supplements.

Rickets (child)

Rickets (child)

Hip fracture

Hip fracture (adult)

Why is calcium important?

  • bone health – 99% of calcium is in the bones , it is needed to prevent osteoporosis (softening of bones), resulting in fractures and to prevent rickets in children.
  • 1% of calcium found outside the bones is essential for: muscle contraction, blood clotting, stabilising blood pressure, normal brain function, communicating essential information among cells.

How much calcium do I need?

Age Calcium/day Stars (1 star = 60mg)
Babies <1 525mg 9
1-3 350mg 6
4-6 450mg 7.5
7-10 550mg 9
11-18 Girls 800mg/Boys 1000mg 13/16
19+ 700mg 11
Breastfeeding mums 1250mg 25
Post menopausal women 1200mg 20
Coeliac disease Adults 1500mgChildren 750mg 2512

Sources of calcium:

Food Amount Calcium stars
Milk 200ml ★★★★
Cheese Matchbox size (30g) ★★★★
Cheese triangle 15g ★★
Yoghurt 1 pot (150g) ★★★★
Rice pudding ½ tin (200g) ★★★
Custard 120ml ★★
Ovaltine original 25g (with milk) ★★★★★★★
Calcium enriched soya/rice/oat/almond milk 200ml ★★★★
Sardines ½ tin ★★★★
Prawns 3 tablespoons ★★
Salmon, tinned ½ tin ★★
Baked beans Small tin (220g) ★★
Hummus 150g
Sesame seeds 1 tablespoon
Brazil nuts 9
Almonds 12
Broccoli 1 cup ★★★
Spring greens 75g
Kale 1 cup
Soya beans (edamame) 1 cup ★★★
Orange 1
Figs, dried 4 ★★★
Apricots 8
Bread 2 slices
Pitta/chapatti 1
ReadyBrek 1 serving ★★★★

Vitamin D – It essential for bone health to have good levels of vitamin D, as it is needed for the gut to absorb calcium, and for bone formation. It is difficult to get enough vitamin D from diet alone, and during winter months from sunlight, which is why I recommend a vitamin D supplement. Here’s more info on vitamin D

Anything else?

Other dietary factors are important for bone health include:

  • protein – meat, fish, eggs, dairy

    Balanced meals with protein, vegetables and whole grains

    Balanced meals with protein, vegetables and whole grains

  • magnesium – dairy, fruit, veg, whole grains
  • phosphorous – excessive intake harmful (fizzy drinks)
  • potassium – fruit and veg
  • vitamin K, vitamin C, vitamin A – fruit and vegetables, fish, meat, eggs
So as you can see, a balanced diet including calcium rich foods, fruit, vegetables, with some meat, fish and eggs are all important for the health of your bones.
If you are not getting enough calcium from your diet, then it is worth consulting with a dietitian who can help you redesign your diet and give easy and practical suggestions for upping your intake.

ADHD – management using Omega 3s

Attention Deficit Hyperactivity Disorder (ADHD) is a relatively common behavioural disorder estimated to affect up to 12% of children worldwide. ADHD can have a profound effect on a child’s life. British Medical Journal on effects of ADHD

Problems associated with ADHD: aggression, clumsiness, short attention span, hyperactivity, mood swings, non-compliance, sleep disturbances and temper tantrums.

  • Omega 3 and omega 6 fats are essential for brain function
  • Studies show that supplementing with these fatty acids can improve attention span and school performance (reading and spelling age)
  • Up to 558mg of EPA taken daily from supplements is most effective

Typically, children with ADHD are offered psycho stimulants, which have a calming effect e.g. Ritalin. Understandably, parents worry about medicating their children and many are open to using a non-drug intervention. Supplementation with right dosage of omega 3 fats could provide this solution. Further research is needed on whether these are most effective alone, or with the conventional medication.

How much should be given?

These provide the dosages found to be of benefit for children with ADHD. To be taken for at least 3-4 months. These can be bought in Boots, Equazen products can also be found in supermarkets and pharmacies.

15ml per day (3 teaspoons)

15ml per day (3 teaspoons) – 200ml £11.99


6 capsules per day – 180 capsules £22.69


10ml per day (2 teaspoons) – 200ml £4.33