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Nutrition and Performance in Sport

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Christophe Hausswirth

Chapter 2. Nutrition, sport and health

Topic 2. Delivery of nutrition-education systems to elite athletes – The AIS Sports Supplement Programme

Louise M Burke

Résumé

The Australian Institute of Sport (AIS) Supplement Programme:
• was a cutting-edge programme implemented from 2000 to 2013 following a major review of supplement practices by AIS athletes and their related issues;
• was designed to provide world’s best practice in the research, education and provision of sports foods and supplements for AIS athletes and coaches;
• was overseen by the AIS Sports Supplement panel, whose membership included people playing key roles in the AIS and Australian Sports Commission (ASC) environment which intersect with supplement use by AIS athletes. The AIS Sports Supplement panel meets regularly to update the principles and practices of the programme;
• was driven largely by the AIS sports nutrition team, with daily activities including the maintenance of high-level education resources related to supplements and sports foods, a pro active research programme, and a database to track use of supplement products by AIS athletes;
• has evolved, following the change to the governance and funding of high performance sport in Australia in 2014, into a leadership activity in which the AIS Sports Supplement Framework now drives the development and implementation of separate supplement programmes by national sporting organizations and professional sports in Australia;
• continues to communicate its activities and resources via the AIS Sports Nutrition website (www.ausport.gov.au/ais/nutrition/supplements) which provides free and transparent information to Internet users.

Texte intégral

1. Introduction

1The discipline of sports nutrition at the Australian Institute of Sport (AIS) was formally created in 1990 with two major roles,

  1. To provide evidence-based nutrition services, including development of the nutrition environment and food systems, for elite athletes within the AIS scholarship programme

  2. To provide a leadership role nationally and internationally in the dissemination of credible and state-of-the-art information on matters related to sports nutrition.

2While the preparation of elite athletes is the core business of the AIS and its sports science/sports medicine team, we identified a clear overlap and interplay between the roles of delivering a daily training environment for high-level athletes and national leadership in sports nutrition education. Developing a reputation for expertise in sports nutrition, via leadership activities in sports nutrition education, helped to build rapport with our athletes and gain their confidence in our credibility. Meanwhile, developing systems to deliver programmes in sports nutrition with elite athletes helped us to gain new expertise to underpin our reputation.

3As the AIS Sports Nutrition programme grew in size from one full-time sports dietician (1990) to a staff of ten sports dieticians and four consultants (2014), so did its capacity to undertake a proactive and systematic approach to the delivery of sports nutrition services. The early days of the sports nutrition programme focused on the provision of a range of individual and group activities to assist athletes to achieve optimal nutrition. Goals of these activities were:

  • to be based on sound scientific evidence;

  • to be individualized to the specific athlete and their sport;

  • to be proactive in assessing and addressing nutrition problems in early stages;

  • to promote a holistic and inter-disciplinary approach;

  • to be innovative and creative in education styles.

4While a self-assessment of the success of early activities suggested these goals were mostly achieved, we further realized that a large amount of time was being spent on similar issues without complete resolution of underlying issues. Therefore, we decided to tackle some issues with a systematic approach in which a series of protocols could promote standard practices across the AIS underpinned by clear education. The theme of sports foods and supplements was ideal to tackle with such an approach. A main goal of this review is to summarize our experiences in running a Sports Supplement Programme targeting a scholarship-funded athletic population from 2000 to 2013.

5In 2013, a major change in the funding and governance of high performance sport in Australia was implemented, to devolve the role of the AIS in running its own daily training environments and sports programmes to the national sports organizations while focusing the role of the AIS to provide support for these programmes as well as build capacity for the system. Thus, this review will finish with a summary of how the AIS Sports Supplement Programme has further evolved into a National Framework to allow national sporting organizations to develop and implement their own supplement policies and guidelines.

2. Background on sports foods and supplements

6According to surveys, athletes are major consumers of supplements and an important target group for the multibillion dollar supplement industry (for review, see Burke et al. 2010). There is an increasing number of products that claim to prolong endurance, enhance recovery, reduce body fat, increase muscle mass, minimize the risk of illness, or achieve other goals that enhance sports performance. In addition to persuasive marketing of these products, athletes provide each other with testimonials or hearsay about the benefits attributed to supplements and sports foods. Many athletes fear that their opponents might have a secret weapon, and even in the absence of scientific evidence to support the claims for a certain supplement they often feel compelled to use the product to maintain a level playing field.

7Although some athletes and coaches believe that sports scientists have a closed mind and dismiss the use of supplements as unnecessary, in fact most sports scientists are interested in supplements and sports foods as part of their search for new strategies to enhance training, recovery, and competition performance. Many scientists undertake the applied sports nutrition research that has helped to develop new products and investigate the specific ways in which these products can be used to optimize performance. Unfortunately, the many challenges to undertaking such research mean that it is impossible to keep pace with the number of new products that appear on the market. Thus, the majority of products used by athletes are either untested or have failed to live up to expectations in the preliminary studies that have been conducted. Scientists believe that well-controlled research should underpin the promotion of any sports nutrition practice and are understandably frustrated that producers of supplements often make impressive claims about their products without adequate or, in some cases, any proof. In most countries, legislation regarding supplements or sports foods is either minimal or unenforced, allowing unsupported claims to flourish and products to be manufactured with poor compliance to labelling and composition standards. Athletes and coaches are usually unaware of these lapses.

8In 2000, the AIS Sports Nutrition Discipline undertook a major review of the practices and issues related to supplement use by AIS athletes. At that time, the accepted protocol of use was that AIS sports programmes should only purchase sports foods or supplements with the written approval of an AIS sports physician. However, this policy did not appear to be universally implemented, and was further weakened by the sourcing of supplements and sports food by individual athletes. Education messages by professional bodies such as the International Olympic Committee generally stated that athletes did not need to consume supplements to optimize their performance and should rely instead on a balanced diet. Against this background, we identified a number of significant new issues regarding supplement use by athletes in general, as well as specific problems related to supplement use by AIS athletes. These issues are summarized in Table 1, and include comments about more recently recognized dangers.

Table 1: Assessments made by a 2000 review of supplements and sports foods by AIS Sports Nutrition.

Changes in issues related to supplements and sports foods which have changed the landscape in which these products are used

■ Although the position stand of many major sporting organizations is that athletes do not need to use supplements, this is out of touch with the practices of most athletes and ignores scientific evidence that some products are safe, legal and effective in enhancing sports performance. These education messages do not resonate with athletes

■ The line between “supplement” and “sports food” is becoming blurred. Traditionally, sports foods (sports drinks, bars, gels) have been recognized as providing a valuable and practical source of nutritional support for use by athletes. However, many now also contain ingredients considered to be supplements (i. e. nutritional ergogenic aids). A practical scheme to work with supplements in sports needs to be inclusive of all these products

■ Major changes in the regulation of supplements in many countries have created opportunities for new substances to be included in products and to shift the burden of proof regarding the safety and efficacy of products away from the manufacturer (e. g. the 1994 DSHEA act in the United States of America altered law so that it is now the responsibility of the authorities–Food and Drug Administration–to prove that a supplement is unsafe or that claims made regarding its efficacy are untrue)

■ There has been an explosion in the total numbers of supplements available to athletes making it difficult for sports scientists to keep pace with new products and ideas/claims
■ The rewards for good performances are higher and athletes/coaches are aware that margins of success are often determined by hundredths of seconds or millimeters, providing incentives for athletes to consider any strategy or product that might claim to enhance sports performance by even small increments

■ Internet provides a significant increase in access to information about sports supplements (e.g. googling “sports supplements” produces 35.8 million hits), these sources being available 24/7 and also via social media (Facebook, YouTube, Twitter)

■ Supplements are commonly distributed via network marketing sales techniques (“pyramid selling” schemes involving the recruitment of independent distributors to sell products to their own client base via personal testimonials)

■ Athletes have access to supplements outside their own country’s market and regulation via mail order, Internet sales and increased international travel

■ In many countries, criminal elements have become involved in the manufacturing and distribution of supplements

■ There is a significant problem with inadvertent doping by elite athletes due to their consumption of banned substances (prohormones and stimulants) that are found in supplements, often as contaminants

Particular concerns related to the use of supplements by AIS athletes

■ AIS athletes and coaches do not consider AIS sports dieticians/scientists/physicians to have expertise regarding supplements and sports foods

■ Issues that have been demonstrated to make a major contribution to performance (e. g. everyday diet, training, equipment, recovery strategies) are overlooked in favour of supplements

■ Athletes are particularly interested in supplements and products with limitedproof/no proof of benefits

■ Supplements and sports foods that can offer substantial benefits to sports performance are overlooked or poorly used (inappropriate protocols of use, inappropriate sporting situations, inappropriate athletes)

■ Many athletes have a scattergun approach to supplement use–products are used intermittently or a range of products/ingredients is used concurrently, removing any opportunity to document the benefits of individual products/ingredients

■ Finite resources (time, money, interest) are being wasted

■ Supplement use relies on placebo effect but not to maximum benefit (i. e. the opportunity to add a belief effect to a true physiological effect)

■ Products used by AIS athletes provide an “endorsement” which often allows the product to flourish without any need for scientific study

■ Supplements carry the risk of side effects

■ A side effect of importance to elite athletes is an inadvertent doping outcome

■ Dealing with enquiries from the independent distributors of network marketed supplements is time consuming

9In acting on these findings, the Australian Institute of Sport (AIS) Sports Supplement Programme was established in 2000, with the day-to-day management by AIS Sports Nutrition and membership by other key personnel whose professional roles intersect with supplement use by AIS athletes. This includes practitioners from AIS Sports Science/Sports Medicine (e. g. members of the AIS programmes of Physiology, Sports medicine, Strength and conditioning), as well as key administrators (who control budgets and policy) and network coordinators (managers interacting with AIS Sports or outside agencies such as the Australian Sports Anti-doping Authority). The Panel developed and initiated in 2000 a supplement programme for AIS athletes within its funding programme with the following goals:

  • To provide AIS athletes with information on which to make sound decisions about their use of sports foods and supplements;

  • To allow conditional evolution of the programme to match the growing research banks and commercial availability of supplements and sports foods;

  • To provide access to a supply of safe and high-quality sports foods and supplements within the AIS environment;

  • To allow athletes to identify evidence-based use of supplements and special sports foods as a small but important component of their overall nutrition plans;

  • To ensure that supplements and sports foods are used correctly and appropriately to deliver maximum benefits to performance and recovery, and to train consistently and effectively;

  • To give AIS athletes the confidence that they receive cutting-edge advice and achieve state-of-the-art nutrition practices;

  • To establish the AIS and its sports medicine/science professionals as international leaders with expertise in sports foods and supplements;

  • To underpin the AIS Sports Supplement Programme with effective education resources and a proactive applied research programme;

  • As an organization based on government funding, to provide transparency regarding supplement use within its environment as well as sharing education regarding sound uses of supplements and sports foods with the sporting community;

  • To minimize the risk that supplement use by AIS athletes leads to an inadvertent doping offence.

3. Key parts of this programme are described below

3.1 AIS hierarchy of supplements and sports foods

10A key theme in AIS Supplement Programme activities is a ranking system for supplements and sports foods, based on a risk-benefit analysis of each product by the panel of experts in sports nutrition, medicine, and science. This ranking system has four tiers or groups which ranks sports foods, supplements or supplement ingredients according to the likelihood that the product can be used to achieve a detectable benefit to sports performance. These rankings are revisited, at least annually, with a thorough reassessment of supplements and sports foods to ensure that they are placed in the category that best fits the available scientific evidence. However, the system can also be changed quickly, should there be major developments regarding new product or new evidence regarding a product that is already ranked. To prevent a “black” and “white” view that supplements either “work” or “don’t work”; the ranking system divides products into categories based on both a scientific and pragmatic assessment of where resources are best focused.

11 Group A: supported for use in specific situations in sport. Should be used according to specific protocols

12 Group B: deserving of further research to identify specific situations and protocols for use

13 Group C: no meaningful proof of worthwhile benefits

14 Group D: banned or at high risk of containing banned ingredients as contaminants

15A summary of the rankings at the time of publication of this paper are provided in Table 2. The AIS Sports Supplement Panel recognizes the limitations in the quantity and quality of the current supplement research on which the decisions to categorize products or ingredients are made. For example, evidence from a small number of studies which show that a product enhances the exercise capacity of healthy or active people may not translate into benefits to the sport-specific performance of elite athletes. Alternatively, a few studies that have reported a lack of benefits from the use of a compound may not adequately address the potential for a small but worthwhile enhancement of performance when the compound is used to its best effect. Nevertheless, decisions are made both on the best information available, with other pragmatic considerations such as cost, and on the likelihood that any benefits or disadvantages could be large.

Overall note: the classification system focuses on sports foods and individual ingredients rather than supplement products and brands. The list in each group is identified as “examples” to note the list may not be complete. In addition, the Framework identifies concerns regarding two separate types of supplement products that may be involved in all categories: Supplements sold via network marketing: network marketing involves the promotion/distribution of supplements and sports foods via activities that ignore the need for an appropriate scientific evidence base. Multi-ingredient products: these products contain a large list of individual ingredients. In some cases the doses of these ingredients are not stated on the label, with the excuse that it is a “proprietary blend” over which the manufacturer has special ownership. Concerns about these products include the lack of an effective dose of some of active ingredients, the potential for harmful interactions between ingredients and the increased risk of inadvertent contamination due to the sourcing of ingredients from various locations.

Table 2: AIS Sports Supplement Framework Classification System (2015).

Table 2: AIS Sports Supplement Framework Classification System (2015).

4. Education resources underpinning the AIS Sports Supplement Programme

16The AIS Sports Supplement Programme was supported by a large body of information to explain the pros and cons of supplement use and to make accessible the evidence that was used to classify products into the various groups of the programme. A general education theme recognized the small but often valuable contribution that supplements make to the athlete’s overall nutrition plan (see Fig 1). Education resources on more specific topics include:

Figure 1: The role of sports foods and supplements in the athlete’s overall nutrition plan.

Figure 1: The role of sports foods and supplements in the athlete’s overall nutrition plan.
  • general fact sheets on issues related to supplement use

  • summaries of research on the effect of specific ergogenic supplements on sports performance, with focus on studies involving trained individuals and exercise protocols of relevant to competition sport

  • fact sheets providing state of the art summaries on key supplements (all Group A and Group B products, and some products from Group C and D) following a specific format:

  • background to a product,

  • typical form and composition,

  • role to play in sports nutrition,

  • evidence-based protocols of use in sport, and,

  • concerns related to its use.

17There was a two-fold aim to the development and continual updating of this education material: to provide AIS athletes, coaches and sports scientists with state-of-the-art information on supplements and sports foods, and to gain an international reputation as a source of credible and objective information on this topic. The initial material was developed in hard copy and collected in folders that were provided and replaced annually within the AIS environment. The material was supported and supplemented by the publication of chapters in peer-reviewed textbooks to allow circulation outside this space (Burke et al. 2010). From 2007, however, all materials related to the AIS Sports Supplement programme have been produced in electronic format and hosted on a special section of the AIS Sports Nutrition website (www.ausport.gov.au/ais/nutrition/supplements.)

18The use of a website for education provides a number of advantages. First, it is a modern medium successfully used by supplement manufacturers and others who market or educate about supplements; the AIS programme needs to directly compete in this space. It is also a medium that is easily accessed by our key target group – adolescent and young adult athletes – including during periods when they are travelling. Although the management of a website requires a commitment of resources, it is a cost-effective way to achieve an output with a highly “professional” look. Furthermore, since we can add or update material in a keystroke, it is particularly suited to the presentation of information that is designed to evolve. Finally, its national and international reach allows us to quickly achieve the goals of being transparent and gaining recognition for leadership in the area of sports supplements. Indeed, from 2008 to 2013 we allowed the national sporting organizations and the various state academies/institutes of sport in Australia to adopt the resources and principles of the AIS Sports Supplement Programme via the establishment of a non-exclusive, royalty-free licence.

19The only major disadvantage of our use of a website to achieve the dual uses as of education forum and a resource to manage our internal use of supplements and sports foods is that our information is accessible to other high-level athletes and sporting organizations. Feedback from AIS and other Australian athletes has identified that there is sometimes a level of discomfort that we make specific and valuable information available to the athletes against whom Australian athletes compete! Therefore, an enhancement of the AIS Sports Supplement Programme, introduced into the 2012 update, is the creation of two separate levels of education resources. The website continues to provide freely available material as previously outlined: background material to the Programme and its hierarchical ranking system, fact sheets on supplements within the Group A and B classifications, and summary tables of the relevant research on supplements and sports performance. However, a separate version of these resources is now housed on a secure website (The Clearinghouse for Sport, hosted by the Australian Institute of Sport), which can only be accessed via password by individuals who are approved within the AIS Sports system. Such permissions were made available to a key group of sports scientists/medicine professionals within the national networks of Australian sports, including the AIS staff, and personnel from within national sporting organisations, state institutes/academies of sport and the Australian Olympic Committee. The additional information provided on these protected education resources includes:

  • ■ information on the provision of supplements and sports foods within the AIS environment, including specific information on the range of products used within our programme, the criteria under which they are used, and special protocols of use that we may have developed to meet the specific needs of targeted events;

  • ■ information on new and unpublished research related to the use of supplements and sports foods that we want to keep within our sports system until after key events (e. g. 2012 London Olympics) to maintain a competitive advantage;

  • ■ discussion boards to promote dialogue between Australian sports scientists on key topics related to supplements and sports foods.

20This innovation was designed to allow the AIS Sports Supplement Programme to achieve its goals of promoting evidence-based information on sports foods and supplements while maintaining ownership of some material which is either not needed in the public domain or provides a small competitive edge to Australian athletes.

5. Protocols for providing supplements and sports foods to the AIS athletes

21A key focus of the programme was to prioritize the resources of the AIS for supplying supplements and sports foods to its athletes so that the main focus is given to the products that are likely to provide the greatest outcomes. A centralized budget for providing sports foods and supplements to AIS athletes was managed by AIS Sports Nutrition, and included products provided as part of sponsorship arrangements with several sports nutrition companies. General considerations for use of sports foods and supplements were given to each category of the AIS Sports Supplement Programme (see Table 2); within each category there are further subclassifications based on priority for research (Group B) or methods of provision and use (Group A).

22In general, the distribution and monitoring of Group A products fell under the management of AIS Sports Nutrition, although there were many instances where this involves collaboration with other sports scientists (particularly AIS physiologists) or approval from an AIS physician. Typically, Group A products fall into three categories, each requiring a different method of use/distribution. Sports foods were generally distributed via group/team activities tailor-made to address nutritional goals for a specific sport or occasion, such as the implementation of “recovery bar” areas within training and competition arenas to enable access to appropriate sports foods and practical everyday foods around workouts or competition sessions. They were also provided to individual athletes via consultations with an AIS sports dietician to assist the athlete to achieve a specific nutrition plan. The Group A supplements designated, used to address issues of clinical nutrition (e. g. iron, calcium, vitamin D, multivitamins), were distributed only to individual athletes in the form of a prescription, and usually by sports physicians, with a protocol targeted to address a specific nutritional/medical concern. Other Group A products designated as “performance supplements” were also provided on a prescription basis, with an evidence-based protocol of use that has been individualized to the situation and the athlete. In each case, the distribution of products was tracked by a database managed by AIS Sports Nutrition.

23The AIS Sports Supplement Programme is aware of the small but significant risk that contamination of some sports supplements can lead to an inadvertent doping outcome (Geyer et al. 2008). The commercial products used within the AIS environment came only from reputable companies which have good manufacturing practice in place and are considered to be extremely unlikely to be contaminated. Even so, we educated AIS athletes that the use of any supplements carries a small risk of inadvertent doping and that WADA’s strict liability laws require the athlete to carry the burden of any outcome. In particular, AIS athletes were reminded that they should not purchase their own supplements outside the system without discussing this with their sports physician and without considering the level of risk associated with the specific product. More recently, as third-party auditing programmes became available in Australia, the AIS used its influence to encourage supplement manufacturers to invest in these programmes, both to reduce the risk of contamination of products as well as to increase the education to athletes about this area of risk.

5.1 Proactive research programme

24The AIS Sports Supplement Programme makes its decisions regarding the ranking of supplements and sports foods based on the available research, and also commits its own time and resources to contributing to this literature. Group B products were targeted for research opportunities both with AIS athletes and with groups outside our immediate environment. Although Group A supplements are considered to be supported by sound evidence that they can be used to achieve benefits to sports performance, there are still many ways in which the current research literature is inadequate. We particularly recognize the lack of studies that address the specificity of sports events with high-level athletes and conditions which reflect the real life practices seen in sport. For example, creatine supplementation is the topic of at least 200 studies, which show clear evidence of its ability to enhance capacity to undertake repeated bouts of high-intensity exercise interspersed by short recovery intervals. Nevertheless, evidence that it specifically enhances the performance of volleyball, waterpolo or Australian Rules Football – sporting activities that fit this exercise description – is generally rare, and has not been undertaken in elite athletes or specialized populations such as female athletes. Therefore, the AIS was interested to use its research opportunities to undertake projects that investigate such specific uses of supplements.

25There is a practical limit on the amount and scope of the research that can be undertaken on sports supplements at the AIS. To enhance the effectiveness of our proactive sports supplement research programme, we try to include the following elements:

  • identification of priority areas and hot topics for research;

  • fast tracking of ethics approval to enable projects to be undertaken in a timely fashion;

  • prioritization of its own funds and application for funding from other agencies;

  • collaboration with universities and sports scientists within state academies/institutes of sports to either undertake multicentre trials with larger sample sizes or to divide research questions into smaller projects;

  • communication and collaborations with world experts in various aspects of sports supplements;

  • hosting of PhD programmes in sports supplements.

5.2 2014 update: from programme to framework

26The closure of AIS sports programmes on 31 December 2013 terminated the model under which the AIS controlled and delivered daily training and competition preparation programmes to Australian athletes and teams. The operation of the AIS Sports Supplement Programme also ceased, with the responsibility for the use of sports foods and supplements within Australia’s high-performance sports environment now falling under the oversight of national sporting organizations and other sporting organizations/agencies.

27During the transition period of 2013, the AIS identified areas and activities in which it could provide leadership to assist Australian sporting organizations and agencies in achieving the governance requirements of the Australian Sports Commission and its Winning Edge performance targets. The spotlight on poor supplement practices among several professional Australian sporting codes or teams highlighted the risks involved with this area of sports nutrition/medicine/science and the value of the expertise gathered by the AIS during the implementation of its Sports Supplement Programme from 2000 to 2013.

28Interaction with key stakeholders in the Australian sports community produced the following model to commence implementation in February 2014.

29■ The expertise and resources developed during the implementation of the Programme have been remodelled into the AIS Sports Supplement Framework. Its aims are to:

  • provide information and tools to assist Australian sporting organizations/agencies develop and implement their own sports supplement programmes and guidelines to direct the sports food and supplement use by high-performance athletes under their governance;

  • facilitate the implementation of other activities related to the safe, effective and legal use of supplements and sports foods in the Australian high performance sports environment;

30■ Experts on sports foods and supplements within the AIS have formed two groups to assist with the present and ongoing role of the Framework: the AIS Sports Supplement panel to provide oversight and the Framework management team to drive its daily activities and further development. External experts will be invited to join these groups to provide transparency and ensure the Framework is developed with a national perspective to support Winning Edge;

31■ “Tiger teams” (small working groups), involving members of the AIS, national sporting organisations and other experts, have been set up to work on various elements of the AIS Sports Supplement Framework and continue its evolution;

32■ Previous elements of the AIS Sports Supplement Programme, including education resources and research activities, will be continued within the new Framework.

6. Conclusion

33The implementation of the AIS Sports Supplement Programme from 2000 to 2013 allowed it to develop a public reputation for expertise in the complex issue of the use of supplements and sports foods by athletes. Although the Programme requires continual resources and commitment, particularly by the AIS Sports Nutrition team, it has been successful in its goal of achieving world’s best practice in the research, education and provision of sports foods and supplements for AIS athletes and coaches. Changes in the funding and governance of the Australian High Performance Sports System have changed the role of the AIS, but it will continue to develop best practice in the area of supplement use in conjunction with key stakeholders in Australian Sport.

Bibliographie

7. Bibliographic references

Burke LM, Broad L, Cox G, Desbrow B, Dziedzik C, Gurr S, Lalor B, Shaw G, Shaw N and Slater G. 2010. “Dietary supplements and nutritional ergogenic aids.” In Clinical Sports Nutrition. Burke LM and Deakin V (eds). 4th edition. Sydney: McGraw-Hill. pp 419-500.

Geyer H, Parr MK, Koehler K, Mareck U, Schänzer W, Thevis M. 2008. “Nutritional supplements cross-contaminated and faked with doping substances.” In J Mass Spectrom. 43 (7): 892-902.

Table des illustrations

Titre Table 2: AIS Sports Supplement Framework Classification System (2015).
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Titre Figure 1: The role of sports foods and supplements in the athlete’s overall nutrition plan.
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Auteur

PhD. Department of Sports Nutrition
Australian Institute of Sport (AIS) Canberra
ACT Australia 2617
And School of Exercise Science Australian Catholic University
Fitzroy – Victoria, Australia
Phone: 61 422635869
E-mail: louise.burke@ausport.gov.au

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