CSSD Supplements and Ergogenic Aids 5 — Questions and Answers
Question 1: A sports dietitian is reviewing a client's supplement stack that includes a pre-workout product containing both caffeine and synephrine. What is the primary safety concern with this combination?
- Reduced caffeine bioavailability when taken together
- Additive or synergistic stimulant effects increasing cardiovascular risk (Correct answer)
- Synephrine blocks caffeine's ergogenic effects
- Gastrointestinal distress exclusively, with no cardiovascular implications
Correct answer: Additive or synergistic stimulant effects increasing cardiovascular risk
Caffeine and synephrine are both stimulants; when combined, they may produce additive or synergistic effects on heart rate and blood pressure, raising cardiovascular safety concerns.
Question 2: Which form of creatine has the most robust scientific evidence supporting its safety and efficacy compared to other commercially available forms?
- Creatine ethyl ester
- Buffered creatine (Kre-Alkalyn)
- Creatine monohydrate (Correct answer)
- Creatine nitrate
Correct answer: Creatine monohydrate
Creatine monohydrate has the largest body of safety and efficacy evidence spanning decades of research, and no alternative form has been shown to be superior in well-controlled trials.
Question 3: An athlete wants to use medium-chain triglycerides (MCT) as a fat fuel source during competition to spare glycogen. What does current research indicate about MCT supplementation during exercise?
- MCTs reliably spare muscle glycogen and improve endurance performance when used before competition
- MCTs are oxidized more rapidly than LCTs but do not provide meaningful glycogen-sparing or performance benefits at practical doses (Correct answer)
- MCTs must be combined with carbohydrates to have any effect on exercise metabolism
- MCTs are only beneficial during ultra-endurance events lasting more than 6 hours
Correct answer: MCTs are oxidized more rapidly than LCTs but do not provide meaningful glycogen-sparing or performance benefits at practical doses
Despite theoretical appeal, controlled studies show that MCTs at tolerable doses do not spare glycogen meaningfully or improve endurance performance, and higher doses cause gastrointestinal distress.
Question 4: A sports dietitian learns that an athlete is using a supplement purchased online that claims to contain SARMs (Selective Androgen Receptor Modulators). Which statement is most accurate?
- SARMs are legal dietary supplements with an established safety record
- SARMs are unapproved investigational drugs banned by WADA, and products may be mislabeled or contaminated (Correct answer)
- SARMs are only banned in Olympic sports and are legal in professional leagues
- SARMs have been approved by the FDA for improving athletic performance
Correct answer: SARMs are unapproved investigational drugs banned by WADA, and products may be mislabeled or contaminated
SARMs are investigational drugs not approved by the FDA for human use, are prohibited by WADA, and are often found in mislabeled or contaminated supplement products.
Question 5: A sports dietitian is asked about ribose supplementation for recovery in a team sport athlete. What does evidence indicate?
- Ribose consistently and significantly accelerates ATP resynthesis and improves performance in healthy athletes
- Evidence does not support ribose supplementation for improving performance or recovery in healthy, well-nourished athletes (Correct answer)
- Ribose supplementation is only effective at doses above 20 g/day
- Ribose is primarily beneficial for endurance athletes but not team sport athletes
Correct answer: Evidence does not support ribose supplementation for improving performance or recovery in healthy, well-nourished athletes
Well-controlled studies in healthy athletes have not demonstrated meaningful performance or recovery benefits from ribose supplementation, as the body can synthesize adequate ribose through the pentose phosphate pathway.
Question 6: When counseling an athlete about vitamin D supplementation, which factor is MOST important to assess before recommending a specific dose?
- The athlete's sport type (indoor vs. outdoor)
- Serum 25-hydroxyvitamin D [25(OH)D] levels through blood testing (Correct answer)
- The athlete's body weight and composition
- The athlete's training volume in hours per week
Correct answer: Serum 25-hydroxyvitamin D [25(OH)D] levels through blood testing
Serum 25(OH)D is the accepted biomarker for vitamin D status; dosing should be individualized based on current levels to avoid both deficiency and toxicity.
Question 7: A sports dietitian is advising a distance runner about omega-3 fatty acid supplementation. Which specific outcome has the strongest evidence for omega-3s in athletes?
- Significant improvements in VO2max with supplementation over 8 weeks
- Attenuation of exercise-induced inflammation and support for muscle protein synthesis when combined with resistance training (Correct answer)
- Reliable reduction of body fat percentage independent of diet changes
- Prevention of stress fractures in female athletes with low bone density
Correct answer: Attenuation of exercise-induced inflammation and support for muscle protein synthesis when combined with resistance training
Omega-3 fatty acids, particularly EPA and DHA, have the best evidence for reducing exercise-induced inflammatory markers and for augmenting the muscle protein synthetic response to resistance training.
CSSD Supplements and Ergogenic Aids 5
A sports dietitian is reviewing a client's supplement stack that includes a pre-workout product containing both caffeine and synephrine.
What is the primary safety concern with this combination?