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Parenting a healthy generation

Sports and kids—Performance-enhancing supplements on the rise

Sep 23 2016

There are a lot of products on the market promising to build muscle or lose weight, and many adolescents may be keen to take these items seeking a gain in performance. A recent study conducted by the American Academy of Pediatrics (AAP) found that performance-enhancing substances did not help an athlete’s performance any more than gains from puberty, training and a well-rounded diet.

Protein powder, creatine and other products were found to not increase athletic performance among adolescents


Edmund Pezalla, M.D., M.P.H., vice president and national medical director of Pharmaceutical Policy and Strategy at Aetna, agrees.

“Proper nutrition and proper exercise and training is much better for performance and appearance,” Pezalla said. “Having some sort of coaching and knowledgeable adult giving them advice is also valuable.”

What are performance-enhancing substances

Performance-enhancing substances are products a person uses in hopes of increasing their abilities. The AAP study found adolescents may also use performance-enhancing substances for appearance reasons.

Performance-enhancing substances can include prescription drugs such as anabolic androgenic steroids (synthetic forms of testosterone which increase muscle building), growth hormones and methylphenidate (such as Ritalin).

Performance-enhancing substances also includes over-the-counter products, such as protein powders, other dietary supplements and energy drinks.

Prevalence among adolescents

Researchers from the AAP used results from various surveys to determine how common performance-enhancing substance use was among students.

Every two years, the U.S. Centers for Disease Control and Prevention administers the Youth Risk Behavior Surveillance System. Of 13,500 students, 3.2 percent of students reporting using steroids, according to the 2013 survey.

A separate study set in urban areas in Minnesota found 38.8 percent of boys and 18.2 percent of girls in high school reported using a protein supplement. The same study found 29.7 percent of boys and 24.7 percent of girls in middle school had a history of protein supplement use.

The dangers and concerns

Methylphenidate, which is an ingredient present in medication used to treat attention deficit disorder, has been used as a performance-enhancing substance because it tricks the person into thinking they’re energized when the body is saying stop, Pezalla said. Using methylphenidate, as well as anabolic steroids, for performance reasons, is dangerous, he said.

“There are lot of side effects,” he said, “and it can be illegal most of the time to obtain them.”

The use of hormone supplements, such as testosterone, can also adversely affect a person’s health, according to John Moore, DO, FAAFP, Aetna’s medical director for the U.S. Northeast Region.

Protein powders can contain heavy metals, such as arsenic and cadmium

“Excessive use of testosterone is not good for you,” Moore said. “It can promote cardiovascular disease, prostate cancer and other tumors.”

Both Pezalla and Moore also cautioned against using dietary supplements and products that may promise weight loss. Those products, Pezalla said, are not regulated by the Federal Drug Administration, so there may not be scientific evidence to back up the claims. “With nutritional supplements, you never know what’s in them. Is this stuff dangerous or not dangerous?”

Testing of various protein powders also found varying amounts of heavy metals, such as arsenic and cadmium.

“If there are heavy metals present, it’s a concern. Arsenic is a poison,” Moore said.

Even using energy drinks to seek a competitive edge may have negative effects on the body, Pezalla said. “They’re high in sugar and caffeine. All that sugar is not good for you; it’s just calories. Large amounts of caffeine can probably overdo it for the nervous and cardiovascular system.”

The natural way

The AAP study found adolescents will see gains with puberty or proper training and diet. And Moore and Pezalla agree.

“A well-rounded diet, proper aggressive physical activity and allowing your body to go through the natural maturing process typically leads to improved performance over time that involves no significant risks,” Moore said. “You don’t really need supplements.”

For anyone concerned about their weight, Pezalla recommends talking with a health professional, such as a primary care physician, to come up with a diet and physical program.