Article Review 500-700 words

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  • Competency 5: Evaluate the objectivity and legitimacy of biology information found in articles and online.
    • Compare article with multiple sources of information about the same concepts.
    • Evaluate sources by answering the questions in the source evaluation forms and provide an analysis within the paper.
  • Competency 6: Apply biological concepts to factors related to human health.
    • Describe the main points presented about supplements, including specific areas of research and the findings.
    • Explain the role of supplements and athletics, including why supplements are currently unregulated, and if supplements should undergo more stringent testing.
  • Competency 7: Communicate effectively in a variety of formats.
    • Write coherently to support a central idea in appropriate format with correct grammar, usage, and mechanics, including correct APA format and citations
  • Review the article "Athletics and Herbal Supplements" from this unit's readings and write and submit a summary. Include the following:
    • Describe the main points presented in the article. What message is the author trying to convey? Discuss specific areas of research and the findings.
    • Explain the role of supplements and athletics. Why are supplements currently unregulated? Do you think supplements should undergo more stringent testing? If so, how would this be monitored and paid for?
    • Cross-check the information. What do other sources of information say about the same concepts presented in the article? Are there discrepancies between the information in the article and from other sources?
    • Include an evaluation of your source by answering the questions in the Source Evaluation Form – Journals given in the resources. Explain in a paragraph or two why you would or would not consider this article to be a credible source of information on this topic.
    Your paper should be between 500 and 700 words unless otherwise specified by your instructor. Read the Article Review – Supplements Scoring Guide prior to submitting to make sure you have met all expectations of the assignment.

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Athletics and Herbal Supplements Do current products enhance athletes' health and performance? David S. Senchina A thletes' use of herbal supplements has skyrocketed in the past two decades. At the top of the list of popular herbs are echinacea and ginseng, whereas garlic, St. John's wort, soybean, ephedra and others are also surging in popularity or have been historically prevalent. According to a publication by the American Botanical Council, herbal supplement sales grossed $5.3 billion in the United States during 2011, a 4.5 percent increase from the preceding year. Despite their increasing popularity, recent events have illuminated possible concerns regarding efficacy and safety of herbal supplements. Remarkable sports performances at the end of the 20th century raised suspicions about supplement use by athletes, prompting the formation of the World AntiDoping Agency, or WADA. Shortly thereafter, the deaths of two professional athletes raised concerns that an herbal supplement, ephedra, may have contributed to their deaths. These events and others have prompted clinicians and scientists to reevaluate the role of herbal supplements in athletics. The meaning of the term herbal supplement is itself nebulous. Some use it to refer to products derived directly from plants, whereas others use it to mean any product containing molecules of botanical origin, such as caffeine pills. Herbal supplements are David S. Senchina is an associate professor of medical microbiology and kinesiology at Drake University in Des Moines, Iowa. He holds two B.A. degrees from the University of Northern Iowa (biology and elementary education) and a Ph.D. in immunobiology from the Kinesiology Department (formerly Health and Human Performance) at Ioiva State University. Address: Biology Department, Drake University, 2507 University Ave., Drake University, Des Moines, IA 50311. Email: dssenchina@drake.edu 134 American Scientist, Volume 101 variously called botanicals, phytomedicines, dietary supplements, nutritional supplements or nutraceuticals. In this article, the term herbal supplement refers to plant-derived products containing multiple bioactive chemicals, with some exceptions for products of fungal or bacterial origin (which are technically not "herbal" but are often treated the same). Although industry has kept pace with athletes' interests and simultaneously spurred them, research has lagged behind and many questions linger. Why do athletes consume these herbs? Do they use the product as directed on the label or by a doctor? What claims are made about these supplements, and does clinical research support them? How can scientists and sports medicine personnel best design experiments to answer these questions, and what obstacles do they encounter? studies, aerobic endurance exercise or anaerobic strength training regimens. But such studies frequently lack information about the chemical contents, botanical origin or agricultural provenance of the supplements. In addidon, medical pilot studies are often characterized by small sample sizes, and a paltry number of studies typically exist for a given herb. This complex interplay of factors makes results hard to replicate or interpret and makes it difficult to identify confounding variables among studies. Even when every study for an herb is stalwartly reviewed, one is typically forced to conclude that the data are equivocal—for every study that supports efficacy, another refutes it, even after controlling for demographics, dosing and so forth. The predictable outcome is confusion and miscommunicafion within the sports science community. Dovetailing botany, chemistry and A Multidisciplinary Framework medical disciplines from cell biology Herbal supplement sales, the number to physiology is absolutely crifical to of available herbs and the number of the advancement of research on herbal preparation types have all grown in re- supplements in athletic contexts. In adcent years, and many of these are popu- dition to many others' work on this lar among American athletes (see Figure subject, collaborators fiom Drake and 2). Despite this burgeoning industry, Iowa State Universities Nisarg Shah, research on supplements' effects on Danielle Doty, Cole Sanderson, Justus human biology remains inconclusive Hallam and I have developed novel overall, and athletes are often left to experimental data on previously netrust manufacturers' claims or team- glected preclinical factors. The species of mates' advice when it comes to makirig plant chosen, the location from which choices about what supplements to take the plant was gathered, the specific orand whether to take them. gan extracted or the extracfion method Early studies of any herbal supple- may in large part explain the heterogement are almost exclusively of the neous clinical outcomes. clinical variety. They strive to address One of the biggest challenges such quesfions of efficacy by testing supple- a multidisciplinary approach presents ments available for over-the-counter is conceptualizing the myriad prepurchase. Studies often include de- clinical and clinical factors that can tailed information on subjects' char- potentially influence a trial. In a 2009 acterisfics, dosing regimens, methods article in Exercise Immunology Review, for assessing efficacy and, in athletic we proposed a conceptual model for this multidisciplinary approach. We originally categorized factors in our model by botanical, chemical and clinical disciplines. Our revised seedto-stomach model incorporates these as well as commercial factors to better reflect the societal context of herbal supplement research (see Figure 3). The model discourages the mistaken conclusion that equivocal is synonymous with ineffectual, moving the field from simplistic questions of "Does a given supplement 'work'?" to "Under what conditions does a given supplement produce a given outcome?" Why Athletes Use Herbs Exercise is a physical stress. If the athlete's body can manage the stress, it adapts by increasing muscle mass, optimizing metabolism or improving motor performance. If the athlete's body cannot manage the stress, then muscle soreness, malnutrition or declines in performance may manifest. Thus exercise can serve as either a positive or negative Stressor. For example, the J-curve model proposed by David Nieman of Appalachian State University shows that individuals who exercise regularly at moderate intensities have lower incidence of upper respiratory infection events than their sedentary or rigorously training counterparts (see Figure 4). Individ^uals who train moderately—for example, people who run three times a week for 30 minutes— demonstrate decreased incidence of such infections compared to sedentary coimterparts. On the other hand, elite athletes often demonstrate increased incidence of such infections due to the stress of their demanding training schedules. The category "very high" in Figure 4 includes individuals such as professional or Olympic athletes, but from a medical standpoint it could encompass any athletes who train at levels beyond what their bodies can accommodate. These athletes may include college and high school athletes and even so-called (often erroneously) amateur recreational athletes. Herbal supplements appeal to the sports community because of their potential for improving performance capacity either through conferring ergogenic benefits or through offsetting the deleterious effects of rigorous training regimens. Most herbal supplements, such as ginseng and echinacea, are available over the counter, making them both www.americanscientist.org Figure 1. Teammates may be the primary and most frequent source of information about herbal supplements for "recreational" athletes, such as these city league baseball players, who do not have access to support systems like professional athletes do. (Photographs courtesy of the author, unless otherwise noted.) legal and readily available; others, such as ephedra or ma huang, are now illegal. Whether a given supplement is illegal varies by country and sports regulatory agency; within the context of sports, illegality is often declared if a supplement engenders an unfair ergogenic benefit ("doping") or constitutes a health threat. Ephedra, for example, is banned because it has no confirmed ergogenic benefits yet contains toxic alkaloids. Importantly but not surprisingly, athletes' rationales for choosing and using any given supplement are often discordant with contemporary indications, as evidenced by surveys of U.K. athletes performed by Andrea Petróczki at Kingston University, in collaboration with colleagues at the University of Birmingham and Swansea Urüversity. Their work has shown that professional athletes may use supplements 2013 March-April 135 for reasons other than their purported purpose; ignore advice from medical professionals despite the fact that athletes consult those professionals for advice more frequently than coaches or trainers; misunderstand side effects or assume a supplement is safe because it is "natural"; and sacrifice health benefits for perceived performance benefits. Circumstances may be different for nonprofessional, noncollegiate athletes. Many people assume that the Food and Drug Administradon regulates herbal supplements, but in the United States the Dietary Supplement Health and Education Act of 1994 allows most herbal supplements to be sold without FDA approval. Vendors position herbal supplements on store shelves alongside regulated items such as vitamins, which may perpetuate this percepdon. John s wort ginseng elderberry 10 15 20 25 30 sales of supplements (millions of dollars) Figure 2. Sales of selected supplements popular among athletes, including soy (#2 in overall sales), garlic (#4), echinacea (#7), St. John's wort (#9), ginseng (#10), elderberry (#18) and Siberian ginseng (#36), are compared to cranberry (#1). (Data from M. Blumenthal et al., HerbalGram 95:60.) Popular Herbs The extent of athletes' herbal supplement use is unclear. Part of the problem 5.. consumer factors 4 . postproduction factors a. storage 3. production factors a. harvest 1. planning factors Figure 3. The seed-to-stomach model identifies preclinical factors that may impact clinical trial outcomes. Each factor in an herbal supplement's production introduces mounting variation. Generally, these preclinical factors are not accounted for. Planning factors (1) occur prior to planting (selection of species and seed supplier). Field factors (2) are introduced as the crop grows, such as ecological factors (hydration, soil, sunlight exposure, pathogen infections and time grown). Production factors (3) include harvest factors (a), or how the plants were removed and transported to the processing site, and manufacturing facility factors (b), or how the herb was processed and packaged, such as the plant organs, solvents, procedures or bottling used. Postproduction factors (4) cover warehouse factors (a), market factors (b) and household factors (c), because storage conditions such as temperature, oxidation and expiration often vary across these sites. Consumer factors (5) include demographics, supplement dosing, preexisting health status and psychological or societal contexts of those individuals enrolled in the study. 136 American Scientist, Volume 101 is that few studies address this topic. Surveys of athletes' supplement use exist, but herbal supplements are often relegated to a category called "other." And when supplements are idenñfied as a separate category, the specific supplements used are often unreported. In the United States alone, 17 to 61 percent of athletes reported usüig herbal g. supplements, although the categorization of herbal supplement varied across surveys, and this likely explains the huge discrepancy. Although these numbers should be interpreted cautiously, it appears safe to conclude that athletes' use of herbal supplements is higher than in the general public. very high moderate sedentary Purportedly performance-enhancing herbs include those that benefit total exercise workload both endurance and strength athletes, such as ginseng (Panax species or Eleii- Figure 4. Individuals who exercise regularly at moderate intensities have lower incidence therococcus senticosus), ephedra (Ephedraof upper respiratory infections than sedentary or rigorously training counterparts. (Figure sinica) and arctic root (Rhodiola rosea). adapted from D. C. Nieman, Journal of Athletic Training, 32:344.) They also include herbs such as caltrop (Tribulus terrestris) that may primarily as having more specialized functions, chemical compounds produced by benefit strength athletes (see Figure 5). such as the supposed metabolism-en- living organisms but not required for Ephedra and ginseng are also consid- hancing fungus, Cordyceps sinensis. Still their primary functions. Many herbs ered central nervous system sümulaiits others are treated as multipurpose food used in sports supplements or energy along with guaraná (Paullinia ciipana). ingredients, for example, the cyanobac- drinks contain alkaloids—small, nitrogen-based compoxinds that encompass Herbs taken primarily to boost im- terium Spirulina (Spirulina species). many notorious naturally derived molThe organisms mentioned above mune function include echinacea (Echinacea speciesj, elderberry (Sambucus demonstrate that these supplements ecules, from morphine to cocaine—that nigra) and milk vetch (Astragalus spe- are taxonomically diverse and include act as stimulants. Examples include cies). Other herbs, such as caltrop, soy ñowering, seedless vascular and non- caffeine from the kola plant (Cola spe(Glycine max) and sarsaparilla (Smilax vascular plants, fungi and algae with cies), ephedrine and pseudoephedrine species), are believed to contain plant- distinct evolutionary liistories. The bio- from ephedra, guaranine from guaraproduced compotmds capable of mod- active moleciües attributed to each tax- ná, and theobromine and theophylline ulating anabolic steroidal pathways. on are equally diverse, although most from the chocolate plant (Theobroma And some supplements are promoted are classified as secondary metabolites. cacao). Figure 5. Herbs popular with athletes include supplements from the above plants, clockwise from top left, arctic root (Rhodiola rosea), echinacea (Echinacea purpurea), caltrop (Tribulus terrestris), ginseng (Panax ginseng) and elderberry (Sambucus nigra). (Photographs courtesy of Wikimedia Conunons. Top right photograph by Forest & Kim Starr [http://www.hear.0rg/starr/I.) www.americanscientist.org 2013 March-April 137 or after a scheduled bout of exercise. The reduced incidence of infections was corroborated by molecular immunological data from blood, saliva Immunoglobulins are and urine samples, demonstrating inmolecules produced by white creases in circulating concentrations of blood cells. In mucus and certain antibodies and changes in cirsaliva, they serve as the first Cytokines are important culating concentrations of several sigline of immune defense. One signaling molecules in type, immunoglobulin A, naling molecules important in regulatthe immune system and increased In saliva. ing infiammafion (see Figure 6). White are produced by white blood cells are the cells associated with blood cells. Some types the immune system, but no changes of cytokine increase; others decrease. in white blood cell subsets or counts Aerobic performance, Because these molecules were identified. Taken together, the as measured by have complex functions, findings suggest that echinacea may V02max and running it Is difficult to conclude economy, increased. reduce incidence and severity of upper whether such changes are good or bad for respiratory infections by changing the athletic performance. quantities of immune molecules produced by white blood cells, rather than Two hormones changing other aspects of white blood Red blood cell increased: cortisol, function, as measured related to stress and cells, such as their rate of multiplicaby cell counts, metabolism, and tion or specific functions. In further hematocrit and erythropoetin, which support of the link between echinacea, hemoblobin, did not controls red blood exercise and upper respiratory infecchange. cell production. tions, Roland Schoop and colleagues Figure 6. Immunological and physiological effects of Echinacea purpurea supplementation in aero- at Bioforce AG in Switzerland reportbic athletes, summarized from five studies, and based on illness rates and blood, saliva and urine ed reduced incidence and duration of analyses. Athletes supplemented with echinacea reported reduced incidence or duraHon of upper self-reported upper-respiratory-infecrespiratory infections, perhaps because of changes in circulating concentrations of immune system tion symptoms in athletes dosed in a signaling molecules (cytokines) and antibodies. However, more studies are needed to understand similar manner to those in the previthe full gamut of possible outcomes. Pictured: Erin Poss, Drake University cross-country. ous two studies, when compared to a control group generalized from control Current research on the dozens of It is important to differentiate these data in previous studies. botanical dietary supplements used by molecules because the body processes Looking at physiological paramathletes all suffer from the problems them differently and they have differ- eters important in athletic perforoutlined above. Two of the most well ent effects. Alkamides move from gut mance, Malcolm Whitehead, now at known of these supplements, echina- to bloodstream apparently unmodified Stephen F. Austin State University in cea and ginseng, will serve as repre- within an hour. Complex carbohydrates Texas, published two reports with colsentative examples. have largely been discounted by mul- leagues from Troy University, College tiple studies due to their inability to of Charleston and the University of Echinacea move fiom gut to bloodstiream without Southern Mississippi on a recreational Echinacea is purported to boost de- modification. Roots contain the highest group of athletes, dosed with £. purfense against upper respiratory ir\fec- levels of these compounds, but often- purea for four weeks and compared to tions, so athletes use it primarily to times manufacturers will instead har- placebo-treated controls. They found offset the deleterious effects of intense vest aboveground parts, such as leaves that common measures of aerobic pertraining on immunity. Although the and stems, to allow the plants to regrow formance—maximal oxygen consumpgeneral public uses the genus name and thus provide multiple harvests per tion (VO2max), running economy (oxas the common name, genus Echinacea planting. In North America, echinacea ygen use efficiency) and erythropoietin is comprised of nine species (some di- is most widely consumed as capsules (a hormone that controls red blood vided into subspecies). The three spe- or tablets. cell genesis)—were higher among the cies most often used commercially are Only five studies have been pub- echinacea-treated group than among Echinacea angustifolia, E. pallida and E. lished concerning in vivo dosing of athcontrols. However, the authors reportpurpurea. letes with echinacea supplements (Fig- ed no differences in total red blood Bioactive molecules produced by ure 6). Studies by Aloys Berg of Albert cell count, hemoglobin (the molecule these species include alkamides, or- Ludwigs University and collaborators within red blood cells that carries oxyganic molecules made of fatty acids and Heather Hall of Elmhurst College gen) or hematocrit (packed red blood often found in plants, and phenols, an- and collaborators reported reduced cell volume) between the two groups. other class of organic molecules also incidence or duration of upper respi- The fact that there were no changes in dubbed carbolic acids that are known ratory infection events after intense red blood cell-associated parameters for their acidity. Phenols encompass exercise (such as competitive sprint but there were changes in performance caffeic acid derivatives, echinacoside triathlons or laboratory sprint cycling) parameters is difficult to interpret but and ketones; distributions and quanti- in athletes dosed with E. purpurea sup- may suggest that echinacea suppleties of these molecules vary by species. plements for four weeks either before mentation influences performance by White blood cells are involved in fighting disease; counts of these immune system cells did not change across studies. 138 American Scientist, Volume 101 changes observed in aerobic athletes supplemented with echinacea 1. plants are grown in common gardens where field conditions are controlled 6. white blood cells are isolated and stimulated in vitro 2 . extracts are produced and stored \ under controlled conditions, with a portion being subjected to phytochemical analysis 5. a postexercise blood sample is obtained 3. a pre-exercise • blood sample is obtained 4 . the athlete _-{II|l.performs an acute exercise bout Figure 7. Putting the seed-to-stomach model into action reduces variation introduced by preclinical factors. (1) Plants are grown in common gai^ dens, where field conditions are controlled. (2) Extracts are produced and stored under controlled conditions and analyzed for bioactive chemicals. These first two steps account for many preclinical factors that are ignored in many studies. (3) A pre-exercise blood sample is obtained. (4) The athlete performs an acute exercise bout. Using metabolic monitoring, intensity is standardized. (5) A postexercise blood sample is obtained. (6) White blood cells are isolated and treated in vitro with the plant extracts from steps 1 and 2. Measurements such as cell proliferation rates or signaling molecule production are used as markers of immune function. modulating oxygen dynamics or metabolism at body sites distinct from the red blood cells themselves. Other scientific teams report relatively good tolerability and low side effects from echinacea supplements, although interactions with certain prescription medications have been documented. In contrast to studies in athletes, studies of echinacea supplementation in the general population have yielded conflicting findings, likely due to the confounding factors discussed previously. Our team has endeavored to reduce the problem of preclinical factor variation by translating the concepts from our seed-to-stomach model into an experimental design adapted for athletic applications (Figure 7). We opted for an ex vivo approach, where white blood cells were taken from study participants before and after an acute exercise bout and then treated with echinacea extracts in the laboratory. This method, although less representative of the organismal context, allows us to more tightly control some variables. www.americansciendst.org 60-1- E. simulata E. pallida Figure 8. Different species of echinacea may result in different immime system effects. White blood cells isolated from the blood of male soccer athletes, both before (rest) and after (post) a two-hour aerobic exercise bout, were cultured in vitro with Echinacea pallida tincture, £. simulata tincture or a solvent vehicle control. After 72 hours, cell cultures were assayed for a cytokine important during infection, called iitterleukin-10 (IL-10). E. simulata extract, but not E. pallida extract, improved IL-10 production. (Figure adapted from D. S. Senchina et al.. Exercise Immunology Review 15:66.). Inset, Drake University soccer player Logan North. 2013 March-April 139 changes observed in anaerobic athletes supplemented with ginseng White blood celi counts did not show a consistent change across studies. Cytokines did not consistent trends in changes in concentration. Some studies demonstrated no difference in cytokine concentrations from controls. An immunoglobulin that serves as the immune system's first line of defense, called salivary immunogiobuiin A, increased. An enzyme controlling muscle energy dynamics, called creatine kinase, decreased in the two studies that measured it. This enzyme is important to ballistic movement, so such a decrease could reduce performance in athletes needing spurts of high energy. 9. Summarized from eight different studies on the effects of ginseng on immime function in strength athletes, research remains inconclusive and contradictory. Preclinical factors could account for some of the wide variation in results. For example, four different ginseng prepaiiations were used across these eight studies. Pictured: Travis Merritt, Drake University football. We inifially worked with white blood cells from resting donors to establish the effects of key preclinical factors. Several interesting findings accrued; for example, our lab and others have repeatedly demonstrated that different echinacea species vary in the way they modulate the immune system, probably because of differences in plant chemistry. We showed how deliberate choices in species, plant organ, solvent and extracfion method influenced cell growth rates and production rates of immune system signaling molecules. After the work in resting subjects we incorporated an acute exercise component, still controlling for the preclinical factors as we had in our previous studies. Early work conducted on teams of wrestlers and soccer players showed that the different species of echinacea plant, given in tincture form to the players' white blood cells cultured under laboratory conditions, resulted in different effects on signaling molecules important during infecfion (Figure 8). We also showed that acute exercise changed how echinacea supplements interacted with the white blood cells. However, we have since switched to testing athletes individually on treadmills and stationary bicycles so we can better ensure that the amount of exercise is more consistent across subjects. 140 American Scientist, Volume 101 Collectively, data from studies of echinacea in athletes suggest that different species of echinacea have different effects on the human body, that exercise changes these effects and that effects are cell- and body site-specific. The work also suggests that preclinical factors have not been adequately accounted for across studies; further, preclinical factors are expected to vary greatly between manufacturers and even between batches from the same manufacturer. Given that awareness, and the understanding that so few studies have been conducted and often with smaO sample sizes, one cannot conclusively argue for or against the use of echinacea by athletes. Ginseng Like echinacea, ginseng is taken to augment immunity, but its primary indication is to improve performance. The name ginseng refers to any of approximately a dozen species within the genus Panax, three of which are used most often commercially (P. ginseng is used most frequently, but also P. pseudoginseng and P. quinquefolius). Ginsensosides, from the plant steroids' saponin subgroup (plant-derived chemicals that in solution produce soaplike foaming when shaken), are the classically recognized bioactive molecules in ginseng. Roots are used most often, typically in dried or powdered form. So-called Siberian ginseng, Eleutherococcus senticosus, is sometimes confused with ginseng and is also frequently used by athletes, although it has different bioactive molecules and may be less effecfive in the context of performance enhancement. Unlike echinacea, studies of ginseng or Siberian ginseng in athletic contexts have yielded conflicting results owing to differences in experimental design or outcomes measured. Systemafic reviews by Johannah Shergis and colleagues at Royal Melbourne Institute of Technology University, and Michael Bahrke of Human Kinefics along with collaborators at University of Wisconsin-Madison, have concluded that human studies have not convincingly demonstrated any ergogenic benefits of ginseng supplementation in athletes, although supplementafion may transiently alter cardiological or pulmonary funcdon. Side effects and prescription drug interactions appear to be more severe and extensive than those associated with echinacea and may include insomnia, gastrointestinal upset and heart palpitations. Less contentious but more complicated are findings regarding the effects of ginseng supplements on immune function in athletes (Figure 9). From eight different studies that used no fewer than four different ginseng preparations along with a spectrum of exercise modalifies, no clear overall patterns emerge. This lack of clarity is probably due to interexperimental variability. Indicators of immune sys- . tem activity including wliite blood cell counts, subsets and acfivifies, as well as interactions with signaling molecules associated with the immune system, were variously upregulated, downregulated or unaffected. Conservatively, these facts together indicate ginseng is likely a modulator of immune system acfivity, but the specific effects that different preclinical factors have on clinical outcomes are poorly understood. Thus, although ginseng is a much more popular herbal supplement than echinacea in the United States and globally, experimental data supporting its use in athlefic contexts are currently weak. Contrasting echinacea studies with ginseng studies reveals that immunological findings from the echinacea studies were more consistent, whereas those from the ginseng studies were more variable (see Figures 6 and 9). There are fewer studies of echinacea's effects on athletes than ginseng's effects on athletes, so variation in the effects of ginseng may be better documented than the variation in echinacea's effects. Echinacea studies mostly focus on aerobic performance, whereas ginseng studies mostly focus on anaerobic, strength athletes' performance. Although the names echinacea and ginseng encom- • pass multiple species each, studies of them in the context of athletic performance focus on one species each (E. purpurea and P. ginseng, respectively). Why a clearer pattern emerges from the literature on echinacea's effects on athletes is not known, but the difference in variability may be because the echinacea studies used herbal preparations that were more consistent in species, plant part used and other preclinical factors. Both the echkiacea and the ginseng studies drew their participants from diverse populations in terms of age, gender and physical activity levels. Future studies of ginseng and Siberian ginseng preparations may elicit stronger and more consistent findings if both preclinical and clinical factors are controlled better. and nonathletes alike, and most of those substances have not been clinically tested. Those herbs need to be explored further. For instance, elderberry is an herbal supplement that is increasingly popular in sports contexts, and it appears to have immune-modulating attributes similar to those of ecliinacea and may provide similar benefits. Compounds associated with anüoxidant activities, called lectins and anthocyanins, are found in elderberry and may interfere with influenza binding to human cells. One report by Sepp Porta from the University of Graz and colleagues suggested elderberry extracts may lower exercise-induced lactate levels. Many herbal supplements have the potential to improve both human health and athletic performance, but as the examples show, the potential benefits are greatly influenced by preclinical factors, necessitafing an interdisciplinary approach to studies of herbal supplements. Scientists and sports medicine professionals are taking steps toward such an approach, which we hope will improve our understanding of how supplements work, or don't work, to aid human performance. Bibliography Full Speed Ahead Promising strides have been made in our understanding of herbal supplements in exercise and sport contexts. However, several irksome and perhaps insoluble problems remain. It would be quixotic to expect a single investigative team or lone experiment to address each individual factor— aiid some factors may not be possible to accurately measure or may be beyond manufacturers' control. Preparations containing several herbs and other ingredients, such as those used in traditional Chinese medicine, may compound the difficulty of identifying preclinical factors. And analytical chemists have shown repeatedly that the contents of retail herbal supplements are often inconsistent with their own product labels in terms of ingredients or quantities, even when manufacturers make claims of standardization. Given these realities, even the most diligent clinical or bench scientists cannot accurately report their findings and may imwittingly report false data. Directions for future research are innumerable. Hundreds of herbal supplements are currently used by athletes www.americanscientist.org Bahrke, M. S., W. P. Morgan and A. Stegner. 2009. Is ginseng an ergogenic aid? International Journal of Sport Nutrition & Exercise Metabolism 19:298-322. Berg, A., et al. 1998. Influence of Echinacin (EC31) treatment on the exercise-induced immune response in athletes, journal of Clinical Research 1:367-380. Blumenthal, M., A. Lindstrom, C. Ooyen and M. E. Lynch. 2012. Herb supplement sales increase 4.5% in 2011 despite still-weak economy, herb sales continue multi-year growth. HerbalGram 95:60-64. Castell L. M., L. M. Burke, and S. J. Stear, eds. 2010-2013. A-Z of nutritional supplements (series). British Journal of Sports Medicine, 44-47. Goulet, E. D. B. and 1. J. Dionne. 2005. Assessment of the effects of Eleutherococcus senticosus on endurance performance. International Journal of Sport Nutrition & Exercise Metabolism 14:75-83. Hall, H., M. M. Fahlman and H. J. Engels. 2007. Echinacea purpurea and mucosal immunity. Internationnl Journal of Sports Medicine 28:792-797. Schoop, R., S. BUechi and A. Suter. 2006. Open, multicenter study to evaluate the tolerability and efficacy of Echinaforce Forte tablets in athletes. Advances in Therapy 23:823-833. Senchina, D. S., J. E. Hallam and D. J. Cheney. 2013. Multidisciplinary perspectives on mechanisms of activity of popular in^nuneenhancing herbal supplements used by athletes. Frontiers in Biology. 8:78-100. Sencliina, D. S., J. E. Hallam, A. S. Dias and M. A. Perera. 2009. Human blood mononuclear cell in vitro cytokine response before and after two different strenuous exercise bouts in the presence of bloodroot and Echinacea extracts. Blood Cells, Molecules, & Diseases 43:298-303. Senchina, D. S., et al. 2012. Alkaloids and endurance athletes: A research review and some demonstrations using bloodroot extracts and white blood cells from cyclists and runners. Track & Cross Country Journal 2:2-18. Sencl-iina, D. S., N. B. Shah, D. M. Doty, C. R. Sanderson and J. E. Hallam. 2009. Herbal supplements and athlete immune function—what's proven, disproven, and unproven? Exercise Immunology Review 15:66106. Shergis, J. L., A. L. Zhang, W. Zhou and C. C. Xue. 2012. Panax ginseng in randomized controlled trials: A systematic review. Phytotherapy Research, doi: 10.1002/ptr.4832. Whitehead, M. T., T. D. Martin, T. P Scheet and M. J. Webster. 2008. The effect of 4 wk of oral echinacea supplementation on serum erythropoietin and indices of erythropoietic status. International Journal of Sport Nutrition and Exercise Metabolism 17:378-390. Whitehead, M. T., T. D. Martin, T. P Scheet and M. J. Webster. 2012. Running economy and maximal oxygen consumption after 4 weeks of oral Echinacea supplementation. Journal of Strength & Conditioning Research 26:1928-1933. For relevant Web links, consult this issue of American Scientist Or^line: http://www.americanscientist.ora/ issues/id. 101 /past.aspx Nieman, D. C. 1997. Risk of upper respiratory tract infection in athletes: An epideniiologic and immunologie perspective. Journal of Athletic Training 32:344-349. Petróckzi, A., et al. 2008. Nutritional supplement use by elite young U.K. athletes: Fallacies of advice regarding efficacy. Journal of the biternational Society of Sports Nutrition 5:22. 2013 March-April 141 Copyright of American Scientist is the property of Sigma XI Science Research Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. Criteria NonBasic performance Proficient Describe the main points presented about supplements, including specific areas of research and the findings. 20% Identifies but does not describe the main points Does not presented identify the about main points supplements, presented or does not about include supplements. specific areas of research and the findings. Describes and analyses the Describes main points the main presented points about presented supplements, about including supplements, specific areas including of research specific areas and the of research findings, and and the provides findings. personal interpretation. Explain the role of supplements and athletics, including why supplements are currently unregulated, and if supplements should undergo more stringent testing. 20% Identifies but does not explain the role of supplements and athletics, or does not include Does not information identify the on why role of supplements supplements are currently and athletics. unregulated, or if supplements should undergo more stringent testing. Explains the role of supplements and athletics, including why supplements are currently unregulated, and if supplements should undergo more stringent testing, and analyzes the cost of monitoring supplements. Compare article with multiple sources of information about the same Does not compare Explains the role of supplements and athletics, including why supplements are currently unregulated, and if supplements should undergo more stringent testing. Compares Compares article with a article with Distinguished Compares article with Criteria concepts. 20% Evaluate sources by answering the questions in the source evaluation forms and provide an analysis within the paper. 20% Write coherently to support a central idea in appropriate format with correct grammar, usage, and mechanics, including correct APA format and citations. 20% NonBasic performance Proficient Distinguished multiple sources of information about the same concepts. multiple sources of information about the same concepts, and provides an analysis of the similarities and differences. Does not describe sources by answering the questions in the source evaluation forms. Describes but does not evaluate sources by answering the questions in the source evaluation forms or does not provide an analysis within the paper. Evaluates sources by answering the questions in the source evaluation forms and provides an analysis within the paper. Evaluates sources by answering the questions in the source evaluation forms and provides a clear, concise, and deep analysis within the paper. Does not write to support a central idea. Writes to support a central idea but the format is inconsistent and there are errors in grammar, Writes coherently to support a central idea in appropriate format with correct grammar, usage, and Writes coherently to support a central idea in appropriate format with correct grammar, usage, and mechanics, article with other sources of information. single source of information or does not focus on the same concepts. Criteria NonBasic performance usage, and mechanics. Proficient Distinguished mechanics, including correct APA format and citations. including correct APA format and citations, and in addition, uses concise, clear, and thorough language.
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Running head: ATHLETICS AND HERBAL SUPPLEMENTS-ARTICLE REVIEW

Athletics and Herbal Supplements-Article Review
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ATHLETICS AND HERBAL SUPPLEMENTS-ARTICLE REVIEW

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Summary
The article, Athletics and Herbal Supplements discusses the role of herbal supplements in
athletics and clarifies if the current products enhance athletes’ health and performance. It defines
herbal supplements as products derived from plants and containing multiple bioactive chemicals
(Senchina, 2013). This definition does not include products of fungal or bacterial origin but is often
classified under the same class. The use of herbal supplements among athletes has increased
rapidly in the last two decades with the popular herbs being Echinacea and ginseng. In 2011, the
gross sales of herbal supplements were $5.3 billion, a 4.5 % increase from the previous year
(Senchina, 2013). In spite of the increased usage, recent activities have illuminated possible
concerns regarding the efficacy and safety of these products.
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