Thursday, July 19, 2012

The BMJ's Amazing Shock and Awe Assault on Sport Drink Science


Wow, WOw, WOW!

What words would you use to describe a situation where one of the world's most prominent medical journal publishes, not just one article critical of a specific category of food, but seven such articles, and where those articles come to the conclusion that the food is being marketing on the basis of food industry funded hype and collusion?

I'd use the words, "Thank You"!

You'll definitely hear about it in the news today as the British Medical Journal has 7 incendiary pieces that are highly critical of sport and energy drinks, their Big Food parents and the researchers that are conflicted by them.

The first piece, Research: The evidence underpinning sports performance products: a systematic assessment has researchers analyzing sport drink advertising and identifying an astonishing 431 performance enhancing claims for 104 different products. Those claims were "backed up" by references made on the products' websites to 146 references. Of those 146, the authors could only actually find half of them, and of that half,
"84% were judged to be at high risk of bias",
while only 3 were deemed to be of high quality and of low risk of bias. Ultimately the authors not surprisingly concluded that,
"The current evidence is not of sufficient quality to inform the public about the benefits and harms of sports products"
The next piece, The truth about sports drinks sees BMJ's Investigations Editor Deborah Cohen explore the funding and financial ties between sports drinks' parent Big Food companies and professional sport organizations and expert advisory panels. Her hard hitting piece is absolutely fascinating and covers how sport drink friendly messaging evolved and later became questionably incorporated into official medical and sport recommendations, often by advisory boards with multiple members on sport drink payrolls.

Then the BMJ tackles the EFSA's criteria for sport drink claims in, How valid is the European Food Safety Authority’s assessment of sports drinks?. The authors were highly critical of the two claims approved by the EFSA, that sport drinks, "improved water absorption during exercise" and that they helped with "maintenance of endurance performance" stating that the EFSA asked Big Food to supply the references upon which their decision was based, had no formal criteria to evaluate which studies warranted inclusion in the analysis (Big Food submitted non-peer reviewed book chapters, opinion pieces, etc), and that of those studies supplied to the EFSA many were absent methodologies.

For the "maintenance of endurance" claim the authors combed through the 26 scientific studies presented to the EFSA and concluded 19/26 were of poor quality; that 89% of the subjects were men; that 73% of the subjects were endurance trained men; that 65% of subjects were endurance trained men between the ages of 20 and 30; and that only one measured performance in a race setting.

For the "improved water absorption during exercise" claim, there were only 22 scientific studies of which 17 were deemed to be of poor quality, and where of the predominantly male subjects only 3 studies included people over the age of 30 and not a one had an outcome that included performance in a race or a sporting event.

The next explosion comes from Tim Noakes, the Discovery Health Chair of Exercise and Sport Science from the University of Capetown in his commentary on, Role of hydration in health and exercise where his take can succinctly be summarized as, if you get thirsty you should drink and that over-hydration is much more common and dangerous risk to the athlete than dehydration.

Next up is an analysis of the science behind the GSK sport drink Lucozade's claims that it boosts performance in, Forty years of sports performance research and little insight gained where the authors' conclusion says it all,
"From our analysis of the current evidence, we conclude that over prolonged periods carbohydrate ingestion can improve exercise performance, but consuming large amounts is not a good strategy particularly at low and moderate exercise intensities and in exercise lasting less than 90 minutes. There was no substantial evidence to suggest that liquid is any better than solid carbohydrate intake and there were no studies in children. Given the high sugar content and the propensity to dental erosions children should be discouraged from using sports drinks."
And there's still more!

Next authors explore the marketing of sports drink through social media and user endorsements in, Medicine and the Media: Miracle pills and fireproof trainers: user endorsement in social media. Not surprisingly, Big Food are savvy marketers, and Facebook and Twitter let them get away with making claims that even the EFSA would frown upon. Basically what companies do is try to encourage "user-generated content" which in turn they can then claim they didn't themselves write.

Next comes mythbusting in, Mythbusting sports and exercise products. Among the busted myths,
  • The colour of urine accurately reflects hydration (nope)
  • You should drink before you feel thirsty (nope)
  • Energy drinks with caffeine or other compounds improve sports performance (nothing other than equivocal benefit from caffeine)
  • Carbohydrate and protein combinations improve post-workout performance and recovery (nope)
  • Branched chain amino acids improve performance or recovery after exercise (subjectively did help, objectively equivocal)
  • Compression garments improve performance or enhance recovery (performance probably not, recovery yes)
Finally there is another piece on how to stay hydrated in, Commentary: To drink or not to drink recommendations: the evidence. Their 4 conclusions?
  1. There's a wide range of hydration within which our amazing bodies work wonderfully.
  2. Freely chosen rates of fluid intake among elite athletes match sport body recommendations (0.4-0.8 litres per hour).
  3. Intake at rates higher than sport body recommendations confer no advantages.
  4. Athletes who lose the most body mass during marathon, ultra-marathon or Ironman races do the best
These articles are all unbelievably important, both in regard to the recommendations we give ourselves and our children, as well as in regard to just how unwise it is to let Big Food push an agenda.  They are not our friend.

Huge props to the BMJ and to their investigative partner BBC Panorama for this groundbreaking series.


  1. Thanks for the heads up about the series. For a long time sports drinks have been a huge pet peeve of mine. The fact that they are so heavily marketing to athletes and non-athletes, children and adults alike, is appalling. It’s high time they're getting the skepticism they deserve. I'm looking forward to reading the series!

    1. Anonymous9:04 pm

      Then drink soda or co2 water. m8 you need to degenerate acid in muscles and for that you need salt - soda powder is one of the best, but isotonics are not bad also. Do not believe everything media write, I studied farmacy (human and animal), they are wrong about "do not take drinks with salts".

      When you get spasm don't cry in pain. all other thing they wrote are fine.

  2. Absolutely fantastic. Hopefully more people will start to realize that sports drinks are just sugar water wrapped in a halo of athletic glory.

  3. Anonymous11:37 am

    Now can someone bust the 'golden arches at the Games', please? - faster! fatter!

  4. Thanks for sharing this detailed info on Sports Drinks.

  5. Anonymous3:04 pm

    Thank you for this! I'm sending it to all of my friends.

  6. Anything do the hydration job better than water? :)

  7. Anonymous6:43 pm

    Just 7 papers by little known authors at BMJ coreographed for release with a TV program a week before London 2012....smells like schoolyard science and a chase for TV ratings to me. I will happily stick to the recommendation of hundreds of clinical studies and leading nutritionists and choose specialist supplements for my training. You should choose water for your 1km fun runs to and from the fat/quack farm.

    1. Anonymous12:02 pm

      Whoever wrote this comment is clearly from the beverage industry. What normal person would criticize the articles for having "little known authors"? And even if the authors are little-known, that has nothing to do with the validity of the arguments they are making.

      Also note that this comment does nothing to actually address the evidence presented in the above articles, such as how only 3 of the "hundreds of clinical studies" are of high quality and low risk for bias.

  8. Alexie5:57 pm

    I remember very clearly when the sports drinks companies began heavy marketing in the 1990s. I was in my 20s, and I believed that 'energy drinks' were healthy. I began drinking them.

    And I got fat. Really fat. Amazingly quickly.

    It took me years to realise that it was all the 'energy drinks' that I'd consumed that had done the damage, because I hadn't changed my eating habits. Today, people assume that you're stupid if you don't realise that energy drinks = sugary drinks. But, twenty years ago, that links wasn't clear. So I got fat.

    Thanks Gatorade!

  9. Anonymous10:29 am

    I think these criticisms make sense. However, credibility is lost with arguments based on who benefits and/or I got more scientists than you do or your scientists are paid by industry or your scientistists are paid by the media to find an industry conspiracy. All of this is soo silly. Science is science. Why can't we just stick to that.

    1. Anonymous6:19 pm

      We are sticking to that. Science requires critical, recurring discussion of past results and claims. Who pays for the science is equally important, as this can introduce bias.

  10. Does this article have anything to do with Lustig's 7 incendiary slides kept secret in this video?