Reading Labels

Complying with NCAA bylaw 16.5.2.g, which restricts what supplements schools can distribute to its athletes, is complicated. Understanding the ingredients and the 30-percent protein rule are key.

By Greg Scholand

Greg Scholand is an Assistant Editor at Training & Conditioning. He can be reached at: gs@MomentumMedia.com.

Training & Conditioning, 15.7, October 2005, http://www.momentummedia.com/articles/tc/tc1507/labels.htm

When the NCAA implemented bylaw 16.5.2.g in August of 2000, restricting which nutritional supplements Division I institutions could distribute to their athletes, the University of Texas was confident it had taken all the necessary steps to comply. Athletic department staff members evaluated every supplement they gave out to make sure it fit the requirements. They even submitted breakdowns of the products’ nutritional content to NCAA Membership Services to verify that everything was acceptable. And all the supplements had been cleared through the National Center for Drug Free Sport to ensure that they contained no banned substances.

Then, this spring, the Fort Worth Star-Telegram revealed that Texas had spent $90,000 on impermissible supplements since the rule took effect. “We had no idea we were doing anything wrong,” says Tina Bonci, MS, ATC, Assistant Athletic Director for Sports Medicine at Texas. “We absolutely believed we had done everything the legislation required.”

Indeed, the NCAA acknowledged that Texas had not intentionally broken any rules. But the association also agreed with the Star-Telegram report concluding that the purchases were in violation. Despite all its precautions, the university had been distributing impermissible supplements for several years—and until an outside investigation uncovered the problem, the athletic department was completely unaware of it.

The Longhorns are hardly alone in having struggled with the rule—Texas Tech, Texas A&M, Indiana University, Purdue University, San Diego State University, and the University of Minnesota have all learned this year that they were distributing at least one supplement that ran afoul of 16.5.2.g. The specific products varied from school to school, but many of the incidents shared a common thread: a misunderstanding of exactly what is not permissible, combined with uncertainty about how to properly evaluate the supplements being given out.

None of the schools have been sanctioned, but the NCAA released a clarification of its supplement rules in May and warned that future violations could result in penalties. It also noted that institutions need to do a better job of evaluating the supplements they provide to athletes. In this article, we’ll take a close look at the now five-year-old legislation and talk to athletic trainers about how to keep your program in compliance.

LETTER OF THE LAW
Bylaw 16.5.2.g was put in place for two very specific reasons. “The primary concern that drove this rule was an escalating trend of institutions providing dietary supplements to student-athletes, despite the fact that the supplement industry is not very well regulated,” explains Mary Wilfert, NCAA Assistant Director of Education Outreach and Chief Liaison to the Committee on Competitive Safeguards and Medical Aspects of Sport, which recommended the proposal to the Management Council in 1999. “So, first of all, we wanted to restrict dietary supplement distribution.”

The second concern, Wilfert says, was competitive balance. Before the bylaw was implemented, schools with deeper pockets were able to offer supplements that helped athletes build muscle, gain weight, and increase their energy level. In the NCAA’s view, this gave them a competitive advantage over programs with less money to spend.

The bylaw places strict limitations on what types of products schools can distribute to student-athletes. “It essentially allows institutions to provide things that will replace the calories, electrolytes, and fluids lost during athletic participation,” Wilfert says. “They are not allowed to hand out any supplements that contribute to performance enhancement or promote weight gain.”

According to the NCAA’s guidelines, a supplement must satisfy three separate tests to be permissible. First, it must fall into one of four general categories: carbohydrate/electrolyte drinks, energy bars, carbohydrate boosters, or vitamins and minerals. These were identified as acceptable by the NCAA because they typically don’t contribute to performance enhancement. In addition, they are generally accepted and widely used by the public at large.

If a supplement fits into one of the categories, the next step is determining the percentage of its calories that come from protein. By rule, no more than 30 percent of calories can come from protein, a figure the association says represents a calories-from-protein ratio comparable to a typical balanced meal. Wilfert also notes that protein ratios above 30 percent are frequently found in muscle-building and weight-gain supplements. To calculate the percentage of calories from protein in any product, multiply the protein content (in grams) by four, then divide by the total calories. For example, a product with six grams of protein and 100 calories per serving is permissible because according to the formula, 24 percent of its calories come from protein (6 x 4 = 24, 24 / 100 = .24, or 24 percent).

A supplement that fits an accepted category and falls below the protein limit must also meet one more test: It may not contain any ingredient specified by the NCAA as impermissible (see “Not Allowed” below). The impermissible list includes several popular supplements and compounds considered to be performance enhancing, such as ginseng, tribulus, and ginkgo biloba. It also includes protein powders, because any product containing added protein from non-whole-food sources cannot be distributed to athletes. Such sources are often referred to on labels as a “protein blend” or “proprietary protein.” Products that contain added amino acids or amino acid chelates are also impermissible.

Wilfert emphasizes that the impermissible list is not exhaustive, and that schools must understand the spirit of the legislation rather than focus exclusively on the names that appear on the list. “Our list contains examples of things that aren’t allowed. It does not include every impermissible substance and ingredient, because it’s practically impossible to keep up with all the new products on the market,” she says. “Unless something creates such a level of danger that it comes to the attention of the FDA, there’s no real oversight of supplement ingredients. If an institution is unsure about a specific ingredient that’s not on the list, they should contact Membership Services for further clarification.”

It’s also important to remember that a label may call an impermissible ingredient by a different name than that found on the list. For example, L-lysine and L-proline are both specific amino acids that make a product impermissible, though the list only identifies “amino acids” as a general category.

LEARNING FROM MISTAKES
Passing the impermissible ingredients test has proven to be the biggest stumbling block for athletic programs. In Texas’s case, its supplements were in violation of the bylaw’s prohibition on added amino acids (also known as free-form amino acids). As the building blocks of protein molecules, amino acids are naturally present in any product containing protein, but when they’re added artificially—that is, when they show up on a product’s ingredient list—that product cannot be distributed to athletes.

Before the noncompliance was uncovered, Texas believed it was following all the right steps in analyzing its supplements. The sports-medicine staff calculated the protein content of each supplement and sent the information to NCAA Membership Services for verification. But focusing on the 30-percent provision of the rule, and not the ingredient list, turned out to be a critical oversight.

“When we sent our product information to the NCAA, we had already evaluated the products ourselves, and we were looking for an interpretation that considered the entire legislation,” Bonci says. “But the NCAA didn’t see the ingredients, so they were just looking at the breakdowns we provided in which we calculated the protein percentages. They said we had interpreted that part correctly, and we took that to mean the supplements were okay to distribute.”

As soon as the sports-medicine staff learned otherwise, they re-evaluated the supplements that had been found impermissible and immediately stopped distributing them. The compliance office then self-reported the violation. “We also submitted the products to the NCAA a second time,” Bonci says, “just to verify and document that the supplements were in fact impermissible.”

Purdue’s run-in with 16.5.2.g began in much the same way Texas’s had. Just over a month after the first Star-Telegram article, the Indianapolis Star reported that its own investigation had uncovered a combined $47,000 in impermissible supplement purchases by the athletic departments at Purdue and Indiana. Among the culprits at Purdue were a recovery drink that contained “branched chain amino acids” on the ingredient list, and a supplement that had an ingredient identified as a “protein blend.”

Dennis Miller, ATC, PT, Head Athletic Trainer at Purdue, says his department took what it believed were all the necessary steps to ensure that nothing unsafe or illegal was being provided to student-athletes. “We felt then, and we still feel, that we complied with the spirit of the legislation completely,” he explains. “When we originally evaluated our supplements, we looked at several things to make sure they fit within the rules and determined that they were alright.”

Like Texas, Purdue had focused on the 30-percent provision and did not recognize that the words “protein blend” on an ingredient list meant that a supplement was impermissible. The supplement in question had a total protein content, including the protein blend, under 30 percent of its calories, and the athletic department even found out from the manufacturer that the source of the protein was natural—it came from beef, whey, and eggs. Nonetheless, since the label did not specify the nature of the protein additive, the NCAA ruled the supplement to be impermissible.

Purdue’s case also raised a separate question: Can the name of a product render it impermissible? One of the supplements purchased by the athletic department had the words “Heavyweight Gainer” in its name, even though its protein content and ingredients did not appear to make it a weight gainer based on the NCAA’s criteria. According to Wilfert, that posed a bit of a riddle.

“We placed ‘weight gainers’ on the impermissible list because products that are marketed that way are usually high in protein and contain a lot of amino acids,” she says. “But in continuing to review this rule, we realized that some products called ‘weight gainers’ really aren’t weight gainers. Technically, if it meets all of our criteria, even something that’s sold as a weight gainer could be considered permissible.”

The bottom line, says Miller, is that correctly interpreting the rules on supplement distribution can be tricky, and the key is closely scrutinizing anything that your department gives out. “We understand that as a member institution it’s our job to evaluate all the products we use, and that’s certainly what we try to do,” he says. “We really look hard at the labels on all the products that we consider, and we won’t order anything without giving it a close look to make sure it won’t create a problem.”

TEAM APPROACH
Giving everything that “close look” means athletic trainers or strength coaches should not be trying to comply with this rule by themselves. Because it can take a trained eye to recognize an individual amino acid or a specific impermissible compound among a long list of ingredients, Texas has assembled a team of trained eyes to review supplements before they make it onto the athletic department’s shelves.

All the school’s supplement purchases are supervised by a panel that includes members of the sports-medicine and strength and conditioning staffs, the head team physician, a consulting nutritionist, the director of compliance, and the chair of the pharmacology department. After a product has been checked for banned substances using the National Center for Drug Free Sport’s Resource Exchange Center, its ingredients and nutritional content are reviewed by the panel to ensure that it is permissible under 16.5.2.g. If it fails, it is not purchased. If it passes, the panel documents its findings and the supplement is approved for distribution. If questions arise, the director of compliance seeks a specific interpretation from the NCAA.

It’s also important that everyone in the athletic department—not just the athletic trainers and strength and conditioning staff—understands the limits on what can be distributed. “Many times the marketers of a supplement will contact one of the sport coaches, and give them a pitch about a new product that they claim can have amazing results,” says Carolyn Peters, MA, ATC, CSCS, Assistant Athletic Trainer at San Diego State University. “They’ll sometimes offer a free or reduced-price trial, and if that coach isn’t fully aware of all the details of the NCAA rules, they may accept it because at first glance it doesn’t throw up any red flags.

“Also, just because a marketer says a product doesn’t contain anything that is banned by the NCAA, that doesn’t mean it’s okay for the institution to distribute,” Peters continues. “Obviously the institution has to follow stricter rules when it comes to distributing the supplement, so there needs to be good communication between the compliance director, every sport’s coaching staff, directors of operations, strength and conditioning coaches, and athletic trainers about any supplements that may come in. All those people need to be kept updated about what is not allowed.”

THE SAFE ROUTE
If the potential for confusion and the time-consuming evaluation of product labels sounds unappealing, there is one simple way to steer clear of supplement distribution problems: Don’t distribute supplements. At Butler University, this strategy has kept the athletic department from having to worry about breaking rules, not to mention any concern about the safety of supplements being handed out.

The only substance that student-athletes at Butler can ever expect to receive from someone on staff is a sports drink, according to Bruce Willard, ATC, Director of Sports Medicine. “So many supplements are really unproven, not only in terms of their effectiveness but also in terms of unanticipated effects they may have,” he explains. “Our policy was established primarily for the welfare of our athletes. It’s difficult to know exactly what some of these supplements do—both in the short term and the long term—and we didn’t want to be a part of distributing something that was potentially harmful.”

Butler’s staff also promotes the philosophy that eating a balanced diet and working hard in the weightroom are the best ways to achieve optimum performance, and the athletic department supplying any kind of supplements would contradict that ideal. “In college athletics we don’t spend enough time telling kids to work harder and eat better and do the simple things to be more successful,” Willard says. “At Butler, we say that if you work hard and take care of your body, good things will happen. Do some athletes enjoy positive gains from certain things they take? Of course. But at what cost? That’s the big question, and it’s one we can’t answer.”

The downside of not distributing any supplements is that some athletes may choose to seek out products on their own, which can pose even greater risks. Willard recognizes this, so all Butler student-athletes are strongly encouraged to consult an athletic trainer whenever they are considering a supplement—to determine whether it’s safe, to check for banned substances, and to discuss potential effects and side-effects.

Butler’s athletic trainers also discuss with athletes whether the goals they’re looking to achieve with a supplement could be reached instead through dietary changes. That argument can be a tough sell sometimes, particularly with athletes who want to gain weight or strength, but it’s a message Willard strongly believes in.

“One thing we’ll do is have them keep a journal for a couple of weeks, and then talk to them about foods they can substitute to accomplish a goal that they might otherwise turn to a supplement for,” he explains. “For instance, if someone wants to gain weight and we find out that they’re ingesting a lot of empty calories, we’ll suggest some specific alternatives that can put them on the right track. We would always rather talk to athletes about nutrition and eating the right things than talk to them about supplements.”

THE RIGHT FOCUS
For schools that do choose to distribute supplements, Wilfert suggests focusing on the intent behind the NCAA rule, and remembering that basic nutrition should always be the top priority. “The first thing to do when evaluating any supplement for distribution is to see if it meets the intent of calorie, fluid, and electrolyte replacement,” she says. “Those are the types of products that this legislation has no problem with. For anything besides replenishment, we want to emphasize that student-athletes should get their nutrition through whole foods, and that’s what this bylaw is really about.”

Bonci, for one, has taken that advice to heart. “We want to make sure that we understand the rules and that we are following them completely,” she says. “But above all, we never want to do anything that could endanger the health and safety of our athletes in any way. That alone is enough reason to be very, very careful.”



SIDEBAR:
II and III Rules
NCAA bylaw 16.5.2.g applies only to Division I institutions, but the other divisions have their own restrictions. In Division II, bylaw 16.5.1.h contains nearly identical language, and the intent and application are the same as in Division I. A recent update to the Division II version, which took effect on Aug. 1, was for clarification only and did not make any substantive change to the rule. In Division III, no supplements of any kind may be provided to student-athletes.



SIDEBAR:
Not Allowed
The following ingredients are impermissible in any supplement that an NCAA Division I institution distributes to its student-athletes. The list is not exhaustive and contains substances that may be found on product labels under different names. The NCAA advises schools that are unsure about the permissibility of any supplement or specific ingredient to contact Membership Services for additional guidance.

Amino acids (including amino acid chelates)
Chondroitin*
Chrysin
CLA (conjugated linoleic acid)
Creatine and compounds containing creatine
Garcinia cambogia (hydroxycitric acid)
Gingko biloba
Ginseng
Glucosamine*
Glutathione
Glycerol**
Green tea
HMB (hydroxy-methybutyrate)
Melatonin
MSM (methylsulfonyl methane)
Protein powders
St. John’s wort
Tribulus
Weight gainers
Yohimbe

* Chondroitin and Glucosamine may be provided by an institution to a student-athlete for medical purposes if prescribed by a medical doctor to treat a specific, diagnosed medical condition.

** Glycerol or glycerine is permissible as a binding ingredient in a supplement product.