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Supplements often put athletes at risk

By Sally Huggins
For NCAA.org

Convincing student-athletes not to take supplements to improve performance is one of the great challenges facing athletics personnel and sports dieticians. So is convincing them that they can achieve the same effects more safely with food, hydration and exercise.

But because these are still “kids,” simply telling them not to participate in the latest fad often falls on deaf ears.

However, the degree of damage to a student-athlete who takes supplements can be measured in eligibility and health. A student-athlete takes a huge gamble when he or she decides to take a supplement for muscle building or for reasons that go beyond athletics performance enhancement. The athlete doesn’t intend to ingest a banned substance, but the supplement industry is essentially unregulated, and supplements often contain ingredients that are banned for athletes.

“The big stick we can use with athletes is that you lose your eligibility if you test positive,” said William Roberts, professor in the department of family medicine and community health at the University of Minnesota and past president of the American College of Sports Medicine. “That’s the bottom line. It’s a zero-tolerance policy. Is the risk worth losing your eligibility?”

Most student-athletes have heard the message, Roberts said, but it can be a losing battle against word of mouth at the gym, the frat house or a good sales pitch.

The students often don’t know why they are taking the supplement, but somebody in a store or someone at the gym who doesn’t have a good understanding of sports tells them about it and how it can improve performance, said Diane King, sports dietician and certified athletic trainer. Even if these people are trying to help, they are not helping, she said.

Education and awareness

To combat the use of supplements, athletic training staffs need to be aware of what their athletes are hearing.

“What I tell ATCs (certified athletics trainers) is that they need to be current with what athletes want to take. Buy the muscle magazines, take a tour of the supplement store, find out who is selling the items,” King said. 

Just as the dietitian is trying to educate the athlete, the athletic trainer needs to educate. Athletic trainers need to discuss with athletes the risks and benefits of supplements and how it might be problematic for drug testing to use any, she said.

“If you have a supplement that really works well, it’s probably tainted,” Roberts said. Studies have shown that about 25 percent of muscle-building supplements contain some amount of steroids, either inadvertently through the manufacturing process or intentionally.

While a number of supplement manufacturers are legitimate, the areas of body building and weight loss seem to be more at risk of unethical behavior, he said. Roberts said that in some cases, manufacturers add a steroid to a product to get an initial positive marketing response and then remove that ingredient. Word of mouth continues to sell the product, but if U.S. Food and Drug Administration testing occurs, the element has been removed.

“The manufacturer gets an initial wave of conversation about how well this works. Then they remove the tainted element and continue to sell based on word of mouth. Taking supplements is probably not worth the risk,” he said.

The quality concerns about supplements are serious, said Michele Macedonio, a registered dietitian and nutrition consultant and a director of sports dietetics with SCAN (Sports, Cardiovascular and Wellness Nutrition). Members of SCAN are experts in nutrition for athletics performance, fitness and weight management.

“Supplements have very little regulation. When it comes to the ingredients, some companies are very careful and some are not. How does an athlete know?” she said.

The supplement industry is unregulated before market. Unlike drugs, supplements are not required to go through FDA testing before they are sold. The FDA enters the picture only when it receives reports of adverse results from a supplement.

“The FDA does after-market review of supplements,” said Macedonio. “If there are reports of adverse events, then they will look into it.”

Student-athletes should consider the source of the information they receive about how effective and how pure a supplement is, she said. The first question should be, “Does this person have any financial gain if you use this?”

Food and hydration alternatives

An important message for athletes, though, is that they can get the performance enhancement they need from proper diet and training without supplements and thus can avoid the chance of failing a drug test.

“The first question athletes often ask is what they can take,” said King. “I always ask, though, what they are eating. Food is fuel. If you don’t have gas in your tank, you can’t make the body go.”

King often has spoken publicly about fuel for athletes. Athletic trainers need to be able to provide information about how to improve performance through proper diet and the training regimen, she said.

“You’ve got to work with them a little at a time. It’s not changing your diet and the next day everything is changed. It’s food and rest and general conditioning at the bottom of the pyramid. Next is training and sport-specific training,” she said.

The message to convey to athletes is that most supplements don’t do what they say, especially if the body is not in the best shape, King said. They want to take the weight-gainer products to add body mass. From a development standpoint, high school and college athletes are still developing, she said. They may not gain weight for a few years because the bodies are still maturing.

“They say they want a quick fix so they don’t have to worry about it. But they need to be eating and hydrating first,” she said. “The problem is when you tell an athlete what they can’t do and not what they can do as an alternative, they just look at you. If we don’t educate them appropriately, where are they getting their information? If we educate about the risks and benefits, they can make a more informed decision.”

Macedonio said athletes want to be the best at what they do. They think if they have that competitive edge, they can come in first, or get into that professional team. They are prey to claims about supplements, she said.

“We wouldn’t think of putting something into our car that wasn’t the right oil or gasoline. But we don’t think twice about it for our bodies,” she said.

Resources are available

Most colleges have resources for their student-athletes to get answers about supplements. Between the athletics training staff and sports dieticians and nutritionists, all the information they need is readily available if they ask.

Macedonio tells the athletes she works with to send her the name of the supplement they are thinking of taking. She then looks at the databases she subscribes to and researches the information.

“I won’t tell them not to take it but I will give them the information. I cull the information and put it into something short and sweet and say here’s what I have found. Information is power,” she said. “You really want an objective source that has no financial gain from what you use.”

Athletes aren’t likely to take the time to look through the information even if they had access to the databases. But athletic trainers have access to several databases that are constantly reviewing the latest information on supplements.

Smaller schools where the athletic trainer has fewer resources often have a more difficult time finding adequate resources to provide the athletes or to educate the coaching staff about supplement use, King said. But online resources are available to all training staff. For example, all NCAA member schools have access to the Resource Exchange Center at the National Center for Drug Free Sport.

Larger schools with full training rooms and registered dieticians who work full time in a sports medicine or athletics department may have their athletes fill out a disclosure form as to what they might be taking. That can be a deterrent and it opens up the opportunity for conversation.

The NCAA and high school associations need to keep talking about the danger of supplements to health and to athletics eligibility, Roberts said. But with human nature being what it is and the emphasis put on athletics performance, it can be a hard sell.

“The bottom line is if you don’t know what’s in a supplement and it’s working really well, there’s something illegal in it, or it’s a placebo effect, or the kid has hit a growth spurt that coincides with taking it,” Roberts said. “If it seems too good to be true, it probably is.”

Sally Huggins is a freelance writer based in Kansas City.