Switzerland’s famous Olympic Medical Center is located in the village of Abtwil, in the canton of St. Gallen. This place sees top athletes and future champions walk through its doors every day. Doctor Patrik Noack successfully combines his medical practice and his executive position in the Medical Center. He supervises cross country skiers and triathlon athletes. As a permanent member of the Swiss Olympic team’s medical staff, he attended the Olympic games in Vancouver, London and Sochi, and knows exactly what an athlete needs to make their body work like a Swiss watch – care must be paid to precision, accuracy, maximum efficiency, and results. Sport nutrition is only one of Doctor Noack’s areas of expertise; however, this is the area we decided to discuss with him.
Doctor Noack, mineral nutrients and vitamin complexes are considered to be a crucial part of a sporting diet. Why do athletes need them so much?
– The point is that a normal person can maintain an optimal balance of nutrients merely by following healthy diet principles: the so called “food pyramid” created by nutritionists. The exception to this is when there is a deficiency, such as in iron or vitamin В. Sometimes this may be caused by a lack of the necessary substance due to the nature of the persons diet (vegetarian, lactose-free, citrus-free, etc.). In such cases, nutritional correction by the use of mineral nutrients may actually be necessary.
The nutritional needs of a professional athlete differ from those of a normal person. That is why the Swiss Sports Nutrition Society has developed a special “food pyramid” that matches their needs. All athletes periodically undergo medical examinations and have blood samples taken, so that any nutrient deficiency can be rapidly detected, thus positive changes may be made by selecting and prescribing the correct nutritional supplements. When it is necessary to increase the intensity of training, but the diet is not balanced enough and does not replenish lost energy, then we prescribe microelement complexes.
– Do they really affect the efficiency of training?
– Very much so, especially when a mineral nutrient is promptly prescribed or its prescription is cancelled. It is well known that physical activity speeds up oxygen metabolism, resulting in the production of oxidizing elements or free radicals. They attack the molecules of the human body, partially destroying them and encouraging so called oxidative stress. Therefore, in order to protect an athlete’s body we prescribe antioxidants: vitamins C and D. However, there is a flipside to such a prescription: if overdosing occurs, these vitamins impair the efficiency of training. That is why in some cases we stop antioxidant treatment and maximize oxidative stress.
– Does this mean that prescribing nutritional supplements requires an individualized approach?
– Yes, certainly. I cannot just tell an athlete under my care, “Take these pills and you’ll be fine!” Each human body is unique. One patient may complain about their joints, another may have digestive problems… For example, if a person is prone to infections, I recommend taking zinc and selenium-enriched complexes, and vitamin C, of course, and for those who have troubles with their gastrointestinal tract, it is good to take turmeric or green tea extract.
– And which nutrients and micronutrients are suitable when preparing intensively for competitions and during competition periods?
–Regarding nutrients, I recommend carbohydrate-based sport drinks. The more carbohydrates are contained in such a drink, the more of them are absorbed by an athlete’s gastrointestinal tract, hence the athlete receives more energy. Also, I help them to regain a glycogenic balance by using supplements that should be taken a day before a competition. As well as this, I may prescribe caffeine to be taken before and during competitions in order to boost an athlete’s endurance. Caffeine is permitted and is not recognized as a ‘doping’ drug.
Regarding micronutrients: of course, the requirements of athletes during intensive training and also during competition periods differ from their needs during “normal” training periods. Specialized doctors can compose a targeted supplement in the form of an individual mixture for these special situations. Such kinds of mixtures are to be used for defined periods and can focus on issues such as optimal regeneration, the support of the immune system or stress adaptation.
– What tests do you usually make before prescribing certain mineral nutrients?
– The most important things to be checked are the levels of iron, B vitamins, vitamin D, magnesium, and zinc. Then I check the athletes liver and kidneys, and analyze the urea and uric acid content in the blood; however, it all depends on the situation. Some people may come to me with the results of blood tests or other tests, and then I study the data, question the patient and I may ask for some additional tests to be undertaken. Usually we make such tests in the Swiss Olympic Committee’s sports laboratory.
– May a person take micronutrients without consulting a medical specialist?
– The consumption of any medications, including nutritional supplements, should always be discussed with a doctor. Ideally, an athlete should be supervised not only by their trainer, but also by a medical specialist, whom they may consult whenever necessary.
– Let us suppose that a doctor prescribed a supplement to me. Can I buy it on the Internet? How can I make sure that it is of a high quality?
– I work only with Swiss companies. The nutritional supplements industry in our country is as high-level as in England, France or the Netherlands. Swiss manufacturers (such as the Company Burgerstein, for example) are notable for their accuracy and thoroughness; they set product pureness as their primary goal. I would not recommend buying supplements on the Internet from unknown manufacturers. If the manufacturing process was not properly controlled, the product may be contaminated by viral or bacterial agents (because it contains biomaterials). Unfortunately, this is a problem with many supplements on today’s market.
– Are there any limitations as to the duration of the administration of such complexes? How long can a person take them for?
We give clear recommendations for each product. If some test results of an athlete were abnormal, we would also monitor the influence of a particular substance on the abnormal values.
– And when does such a person need to undergo a follow-up examination or control tests?
– Sometimes this must be done in a week, sometimes in four weeks. It depends on the supplement complex prescribed.
– Which supplements are recommended for those who are going to face an excessive training schedule that they are unaccustomed to?
– I cannot tell you about that without referring to a particular situation. If we talk about athletes who train at high altitudes, they usually need more iron. Even if the level of iron is normal, I always prescribe an iron-based product to such athletes, as this element facilitates blood cell production.
There may be another result: some athletes suffer from muscle cramps during intense training. When their body reacts in such a way, I recommend sports drinks that are high in salts and magnesium. Also, if an athlete is prone to infections, I give him or her vitamin C and Zinc, elderflower extract, and Echinacea.
– If we were talking about normal people, rather than athletes, those who are not physically active, like office workers, what would you recommend for them?
– There are special complexes for raising office employees’ stress tolerance, and they are mostly plant extracts enriched with B vitamins and magnesium. ’They are commonly used for the treatment of burnout syndrome.
Dr. med. Patrik Noack is a specialist in the field of general medicine, sports medicine, and manual therapy. He graduated from the Medical Department of the University of Zurich in 2001. He has been working in the Swiss Olympic Medical Center since 2005. From 2010 to 2012 he worked as a physician for EHC Biel hockey club. In 2010 and 2012 he worked as a physician for the Switzerland national team at the Vancouver and London Olympics. In 2014 he was the deputy chief physician of the national team at the Sochi Olympics. He has been appointed the chief physician of the Switzerland national team at the 2018 Olympics in Pyeongchang. He is the head of the Medical Service of the Swiss Triathlon, Cycling, and Alpine Skiing federations. He also works with the Swiss Athletics and Luge federations. He is a member of the Swiss Society of General Internal Medicine (SGIM), the Swiss Society of Sports Medicine (SGSM), the Swiss Society of Manual Therapy (SAMM), the Swiss Society of Ultrasound Investigation (SGUM), and the Society for Orthopaedic Traumatologic Sports Medicine (GOTS).