Evidence-Based Supplementation For the Recreational Powerlifter / by Muhammad Amir Ayub

A lot of the discussions among Malaysian keyboard warriors include the topic of supplementation, i.e. how one does not need to take any of them for general health. This is especially so for fish oil, where numerous studies have shown that taking them does lead to a positive trend of improved outcomes in those of high risk of CVD, just that the results are not statistically significant and especially so with proper implementation of guideline-directed medical therapy. This doesn't mean that fish oil isn't effective (hence cardiologists are still prescribing them); just that in those who are given all of the proper drugs and interventions (giving in correctly or incorrectly to the pharma industrial complex), fish oil doesn't make a big difference. I'd be interested in seeing how omega-3 fish oil compares on a head-to-head basis with standard medical therapy as regards to costs, NNT's (numbers needed to treat) and NNH's (numbers needed to harm) as many modern drugs and stents and surgical costs are much more expensive than fish oil (with the costs hidden somewhat by subsidies and insurance schemes), but on the other hand the standard capsule dose of fish oil could be too small (as even 1 g/day of supplementation is considered an insufficient dose).

Resistance to antiplatelet agents is associated with increased risk of CHD events, and although this resistance may be reduced by: (I) triple therapy with ASA + clopidogrel + cilostazol, (II) high-dose ASA use, or (III) OM3 supplementation, the use of OM3 may be the safer option. OM3 does not seem to increase risk of bleeding.

The best evidence for the use of OM3 and CV health is for CHD mortality, SCD, post-MI and HFrEF. The AHA now recommends treatment for patients with HFrEF with OM3 to reduce mortality and hospitalizations. Some of these studies have shown favorable results with higher OM3 dosage (4 grams/day) and treatment early following MI or heart transplant, despite being used in patients receiving optimal medical therapy. OM3 use is reasonable for patients with CHD, such as recent MI, according to the AHA.


According to the AHA, the evidence does not support the use of OM3 supplementation in the general population who are not at high CVD risk, and there was a lack of consensus about the treatment of those at high risk. Treatment is also considered reasonable for secondary prevention of CHD death, and does not appear to have any role in treatment or prevention of AF. The AHA has no class I recommendations for the use of OM3, and our findings indicate that there is currently insufficient
evidence for OM3 use in the primary prevention of CVD in general, which is in agreement with recommendations from the AHA and National Institute of Health.

A recurring argument for proponents of OM3 use is that even modest reduced risk of CVD or CV events should encourage the use of a largely innocuous therapy. Although the majority of authors from the AHA concluded that treatment with OM3 is not indicated for patients at high CVD risk, the AHA concluded that a potential reduction of CHD death by 10% would justify the use of OM3. The AHA acknowledges that the lack of evidence of benefit differs from evidence of a lack of effect, however, the magnitude of benefit from OM3 for CV health remains largely undetermined. However, in patients with even moderately elevated LDL-C and /or TGs, this therapy could be strongly considered based on potential benefits and low cost and toxicity.

Anyways, I take 3 supplements now that I hope will improve my overall health and physical performance. They are not the same goals. Taking things for health only mean that you don't fall sick/die young. Taking things for performance mean that you take stuff to get you over the edge, whether it's better stamina, more reps/plates on the bar, faster recovery, etc. People don't care if you're only 1% stronger, that may not be significant statistically; that can be the difference between 1st and 2nd place. I decided the other day to look at some studies done on vitamin C, fish oil and magnesium on athletes.

On vitamin C:

Vitamin C decreases oxidative stress taken in doses of 0.2 to 1 g/d. Vitamin C in larger doses appears to reduce training-induced adaptations by reducing mitochondrial biogenesis or by possibly altering vascular function. A small dose of vitamin C (0.2 g/d), provided by five servings of fruit and vegetables daily, may be sufficient to reduce oxidative stress but not past a threshold that will impair optimal training adaptations. Short-term intakes (1 to 2 wk) of 90.2 g daily may benefit athletes during times of increased stress. Further research is required to clarify a dose-response and nutrient timing protocols on vitamin C.

I take 500 mg/day of vitamin C. It looks like I'll continue this practice.

On magnesium:

Supplementation of Mg (in the form of MgO) at a dose rate of 350 mg · d–1 over a 4 week period improved alactic anaerobic metabolism in volleyball players as demonstrated by the increase (of up to 3 cm) in the plyometric parameters countermove- ment jump and countermovement jump with arm swing at after supplementation period. However, aerobic and lactic anaerobic metabolisms of the athletes were apparently not affected by Mg supplementation. Since the players were not Mg-deficient at before supplementation period, the enhancement in vertical jump performance following Mg supplementation was most likely related to the role of Mg as a cofactor for creatine kinase, the key enzyme of the alactic anaerobic energy system.
The effects of exercise and magnesium supplementation on free and total testosterone levels in tae kwon do athletes and sedentary subjects are reported in this study. The results show that strenuous exercise increases testosterone levels in sedentary and practicing tae kwon do athletes. The plasma testosterone levels are higher in exercising and magnesium supplemented subjects than in sedentary controls, suggesting that magnesium supplementation increases performance by increasing plasma testosterone.
Mean magnesium intake was significantly lower than the recommended daily allowance. Regression analysis indicated that magnesium was directly associated with maximal isometric trunk flexion, rotation, and handgrip, with jumping performance tests, and with all isokinetic strength variables, independent of total energy intake. The observed associations between magnesium intake and muscle strength performance may result from the important role of magnesium in energetic metabolism, transmembrane transport and muscle contraction and relaxation.
On the contrary, Zimmermann (2003) reviewed that Mg supplementation does not affect performance when serum Mg is within the normal range of values and the review also suggested that the effect of Mg supplementation might be equivocal. In addition, Manore et al.(1995) investigated that Mg supplementation (250mg per day) of men during 12-week placebo-control trial increased VO2max; however, they did not find improved performance under the program of aerobic or a combination of aerobic and anaerobic activities. Newhouse et al. (2000) also concluded that Mg supplementation effect on performance was equivocal under strength, aerobic, and anaerobic situation.


To date, there is limited evidence that Mg supplementation will improve human performance. Furthermore, it is currently unclear whether regular exercise increases the need for dietary intake of Mg supplements. Longitudinal studies would be necessary for verifying Mg supplementation effect in athletes.

I guess 250 mg/day (is that elemetal or the compound weight?) of magnesium is too low; remember, magnesium is a major intracellular ion, and thus plasma values may not properly display the true total magnesium levels. Currently, I take 30 mmol/day (from 1 g of the aspartate dihydrate formulation) of magnesium, and will continue to do so.

Now on fish oil:

In conclusion, these preliminary findings suggest that 1 week of 3000 mg·d of DHA/EPA omega-3 supplementation decreases the severe localized soreness, as a sign of inflammation, that results from eccentric strength exercise. Based on these findings, omega-3 supplementation could provide benefits by minimizing post-exercise soreness and thereby facilitate exercise training in individuals ranging from athletes undergoing heavy conditioning to sedentary subjects or patients who are starting exercise programs or medical treatments such as physical therapy or cardiac rehabilitation.

That’s a lot of fish oil. And:

Subjects in the experimental group were asked to consume omega-3 (1000 mg/day for 12 weeks), while those in placebo were refused any doses of omega-3. The pulmonary variables were measured at baseline and at the end of 12 weeks of training program. Results indicated that consuming omega-3 during 12 weeks training had a significantly positive effect on pulmonary variables such as FEV1, FVC, VC, MVV, FEF25–75, FIV1 (p = 0.001), but no significant changes were observed in FEV1% (p = 0.141) and FIV1% (p = 0.117). The results of the present study suggest that consuming omega-3 during intensive wrestling training can improve pulmonary function of athletes during and in post-exercise.


However, in subjects with EIB, the n-3 PUFA diet improved postexercise pulmonary function compared with the normal and placebo diets. FEV1 decreased by 3 ± 2% on n-3 PUFA diet, 14.5 ± 5% on placebo diet, and 17.3 ± 6% on normal diet at 15 minutes postexercise. Leukotriene (LT)E4, 9α, 11β-prostaglandin F2, LTB4, tumor necrosis factor–α, and interleukin-1β, all significantly decreased on the n-3 PUFA diet compared with normal and placebo diets and after the exercise challenge. These data suggest that dietary fish oil supplementation has a markedly protective effect in suppressing EIB in elite athletes, and this may be attributed to their antiinflammatory properties.

That’s one excuse to continue encouraging my 3rd child with postinfectious bronchiolitis obliterans to continue taking my fish oil, as long as he actually takes them. But in general, there’s not much that I see is studied regarding fish oil for athletes. And my current intake of just 2 capsules per day is probably an underdose, but taking more means a much higher expenditure.

All in all, I see no evidence that I shouldn’t be taking the above 3 supplements. My estimated time before developing a heart attack or stroke may not be different much from someone who doesn’t take the above supplements (the bane of statistical significance), but at least I can lift heavier than most before I die while being completely stimulant-dependent for daily living; you don’t lift 3 times a week being a dogtor without taking stuff to at least keep the eyes half-open. I guess that can already be considered a good life, and damned statistics won’t be able to negate the numbers on that bar. Unless if I start taking roidz.