Food and Nutrition
Protein Supplements and Anabolic Steroids
 

​​Overview:

  • Anabolic steroids have been proven to be effective in muscle-bulking, but should only be used under medical supervision.
  • Using steroids has been prohibited in sports competitions, given their negative effects on health.
  • Athletes need to take protein supplements, since vigorous physical activity requires a greater daily protein intake than normal.
  • Taking protein supplements will be of no use in cases where the individual gets an adequate protein intake from food, and does resistance training exercises.
  • Dietary supplements are complementary for food, and not a substitute of it.
Introduction:
Millions of people worldwide consume dietary supplements and anabolic steroids to reap more and more health benefits, such as weight-loss and muscle-bulking. But is it safe to take dietary supplements and steroids? In fact, some supplements are harmful. As for steroids, they must not be used unless prescribed by a doctor. 

Anabolic Steroids:
Hormones:
Chemical substances secreted by the endocrine glands to organize and control the physiological functions.
Steroids:
Natural or manufactured hormones that stimulate growth, and help enlarge the muscle tissue. Their functions vary according to their type.
Anabolic hormones:
  • They are “anabolic” because they stimulate anabolism, and hence accelerate building bones and muscles. Including the growth hormone (GH), testosterone and IGF-1, anabolic hormones are known to be effective in muscle-bulking, and should only be used under medical intervention.
  • Sometimes, athletes consume steroids without prescription for improving performance and bulking, which is against the rules and laws of fair play. Since they can be devastating to health, steroids have been banned in sports competitions.
  • Steroids can be administered as: tablets, creams, patches, injections or tongue drops.
  • Some steroid users consume animal steroids, which are often the same as human steroids, but not as pure.
Side effects of anabolic steroids:
There are several physical and mental side effects associated with anabolic steroids. In men, steroid use affects fertility, and causes the testicles to shrink, in addition to gynecomastia and hair loss. As for women, steroids change the woman's voice, cause the genitals to grow abnormally larger, stimulate body-hair growth, and cause the breasts to shrink. Besides, men and women using steroids are susceptible to hypertension, acne, heart diseases. They also affect the liver and kidneys, lead to aggressiveness, moodiness and depression. Steroid injections can lead to transmission of infections, such as HIV and hepatitis. Moreover, buying steroids over-the-counter increases the risk of getting counterfeit and substandard products.

Side effects:
Physical side effects:
  • Acne 
  • Hair loss and balding
  • Liver problems and tumors
  • Blood clotting
  • Heart diseases
  • High blood pressure (hypertension)
Psychological side effects: 
  • Aggressiveness
  • Depression
  • Paranoia
  • Hallucination
In women:
  • Growth of facial hair
  • Masculine voice
  • Increased growth of body hair
  • Menstrual disorders
  • Increased appetite
  • Clitoromegaly
In men:
  • Gynecomastia 
  • Testicle shrinkage
  • Impaired fertility
Protein Supplements:
Proteins are quintessential for several physiological functions, most importantly building and restoration of cells and tissue, including those of the muscles. Additionally, they are the essential for the production of hormones, enzymes and antibodies. An adequate intake of protein is especially important for athletes, more especially bodybuilders.

How protein works:
Proteins accelerate the growth of muscles, by securing the basic protein components (amino acids). Amino acids are naturally produced by the body to help build muscles quickly and effectively. They are especially needed by athletes, since vigorous physical activities require greater intake of protein than usual. As the protein intake is increased, the muscles grow larger, and the tissue damaged due to physical activity are restored.

Athlete’s protein intake:
The daily intake of protein for normal (non-athlete) individuals, as recommended by most international health organizations, is 0.8-1g per kilogram of their body weight. Persons with health problems in the liver or kidneys should seek the doctor's advice. As for athletes, the recommended protein intake varies depending on the intensity of exercise. But it commonly ranges between 1.2 - 1.8g per kilogram of the body weight. According to some studies, though, if the protein intake is greater than 1.6 g per kilogram of weight, this will not affect muscle bulking. 

A moderate increase of protein intake (around 1.2-1.3g/kg of body weight) by the individuals following a weight-loss diet can help reduce the risk of muscle loss.  

Protein supplement defined:
A dietary supplement (other than normal food) taken as tablets or powder that is mixed with milk, water or fruit juice to improve its taste. It is usually a byproduct of dairy processing (e.g. whey protein). It can also be plant-based (as in the case of the protein supplements extracted from peas, soybeans or rice, etc.)

Types of protein supplements: 

Animal-based protein (including the protein extracted as a byproduct of dairy processing);

Plant-bases protein (extracted from plants).
​Type
​Protein %
​Lactose
​Fat
​​​Notes
​Whey Concentrate
​30-85%​

​Contains a low level of lactose.
​Contains small amounts of fat and carbohydrates relative to other nutrients.
​The low lactose level makes it tolerable by most individuals who have lactose intolerance.
Whey significantly improves the sugar control in the blood, by stimulating the secretion of insulin, and reducing the levels of glucose levels in the plasma. This effect is especially pronounced when the whey is taken before meals, as it reduces dependence on blood sugar (in healthy adults and Type-2 diabetics) to produce insulin.
​Whey Isolate
>90%
​​Contains a low amount (or none at all) of fat and carbohydrates.
It is suitable for the individuals willing to reduce the intake of fat, as well as the individuals having severe lactose intolerance.
Whey hydrolysate
80-90%
​ -
​-
Produced by heating it with an acid or enzyme, whey hydrolysate breaks the bonds among amino compounds, which enables the body to absorb them easily and quickly; given that the protein absorption rate varies according to the level of decomposition.
Casein/ Milk Protein
Casein is another milk product. Actually, most of the milk protein (80%) is casein.​​​​

The key difference between whey and casein is that the former is absorbed in the digestive system quickly, whereas casein is absorbed slowly and steadily.
Casein may not be marketed under this name; it is usually referred to as “calcium caseins”.
​​Egg White Protein
Egg white protein is another protein product naturally containing extremely low levels of fat and carbohydrates. It is cholesterol-free, and is recommended for those willing to avoid dairy products.
​ -
​-

Plant-based Protein
The sources of plant-based protein include: peas, soybeans or rice.

Soy and cannabis protein is a unique plant-based protein; since it contains all the basic amino acids.

Plant-based proteins are usually preferred by vegetarians, as well as the individuals suffering lactose intolerance.
Most protein powders contain a mixture of plant-based protein, aiming for a full nutritional value that covers all the basic amino acids.
Among the other benefits of soy-protein is that it is an antioxidant, in addition to many other benefits for the heart. It is often prescribed by the women experiencing menopause. However, it may not be suitable for men, as it increases the level of estrogen
Beef Protein
Skimmed and cholesterol-free, beef protein tastes differently from beef. Various flavors can be added to it.
It may be preferred by the individuals looking for alternatives for dairy protein and plant-based protein. It is among the best natural sources of kreatinKreatin may be good for the athletes willing to increase their capacity for physical activity, and hence boost their speed or muscle-bulking. It is not recommended for the individuals experiencing (or at risk of) kidney problems. And because misuse of kreatin may lead to renal failure, a doctor’s advice must be sought before taking it.

Determinants of the required protein intake:
  1. Tissue building: Individuals at the growth stage, and pregnant women, need a higher protein intake.
  2. Protein type: Vegetarians (who do not get protein from an animal source) should diversify the protein sources to ensure getting all the basic amino acids.
  3. Health condition: Some diseases and medical conditions that affect tissue increases the need for a higher protein intake (such conditions include: surgeries and severe burns).
  4. Physical activity: The more the physical activity, the higher the burn rate, and the greater the need for proteins, which are converted to tissue, and hence assist in muscle-bulking.
  5. Required energy: Protein is a backup for energy, in cases where carbohydrates and fat are non-available.

Remember
  • Carbohydrates are necessary for supplying muscles with energy. The recommended intake of carbohydrates varies depending on the duration and intensity of physical activity.
  • Proteins help build as well as repair muscles.
  • Nutritionists recommend that snacks contain carbohydrates and proteins at a ratio of 1:4.
  • It is recommended to have a meal 1-3 hours before exercise, and 20 minutes afterwards.
Do athletes need to take protein supplements?
Most research indicate that most athletes who get an adequate protein intake from food don’t need to take protein supplements. As for athletes who don’t manage to meet their needs for protein through food, they can take protein supplements (especially whey); provided that the aggregate protein intake (from food and supplements) does not exceed the protein needs. \

When to take protein supplements?
There are several factors that affect the digestion and absorption of protein, including: age, hormones, physical activity level, and the muscle mass. Protein is recommended:
  • 30-60 minutes before exercise
  • 45-60 minutes after exercise
  • Beginning of the day: Taking protein supplements immediately after waking up prevents muscle loss, which occurs naturally after a non-eat interval of over 8 hours (during sleep). This is not specific to protein supplements, though. Any natural source or protein can do the same function (that source might be: salmon, chicken, beef, dairy products and oats). 
  • End of the day: As mentioned above, stopping eating during sleep for over 8 hours can lead to muscle loss. Taking protein before sleep can help prevent or make up for such loss. Casein is preferable before sleep, since it is slowly absorbed.
Contraindications to the use of protein supplements:
You must talk to your doctor before using protein supplements if you suffer problems in the kidneys or liver, or have lactose intolerance (especially in the case of whey or casein), or if you suffer from gout. Whey may also conflict with the effect of some medications (e.g. antibiotics and some osteoporosis medicines). 

Guidelines for the use of protein supplements:
  1. Most people get an adequate protein intake, and do not need protein supplements.
  2. Protein supplements must not replace food proteins; since food proteins include the other natural nutrients (e.g. vitamins and minerals).
  3. Some individuals who follow a strict diet plan (e.g. vegetarians) may not be able to take an adequate protein intake from food. Protein supplements may be useful for them.
  4. There are concerns associated with protein supplements; they may burden the liver, and hence cause enduring harms.
  5. When using protein supplements, the nutritionist’s guidelines should be followed, to make sure the used quantity is appropriate, and not excessive.
  6. When it comes to muscle-bulking, there is no a one-size-fits-all technique: the appropriate technique varies according to the individual’s response to protein supplements.
  7. Children must not use protein supplements.
  8. On the onset of any side effects associated with protein supplements, medical attention should be sought.
  9. Protein supplements are not adequate for boosting the mass, strength and endurance of muscles. Using protein supplements must be accompanied by adequate physical activity and a sufficient intake of carbohydrates.
  10. There is no magic formula for maintaining an ideal body. To have a good body, you need to commit yourself to intense exercise and healthy food for years, and not days or months.
  11. Dietary supplements are complementary for food, and not a substitute of it.

FAQ:
  • Q: Do protein supplements affect men's fertility?
    • A: No, absolutely not.
  • Q: Are protein supplements recommended for women?
    • A: Men and women are the same in this regard.


Clinical Education General Department
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