such as protein or creatine, according to a new commentary in the Journal of Adolescent Health.
Muscle-building supplements are not tested before going to market, as are pharmaceutical drugs, and they are associated with greater rates of death and disability in adolescents than are vitamin supplements such as A, C, and folate. Even if protein shakes or creatine gummies do not seem to negatively affect a teen, in many cases the needed nutrients are obtained from food intake, and supplements are not necessary.
“For many young people, particularly boys, use of these supplements is pretty ubiquitous,” said Kyle T. Ganson, PhD, MSW, assistant professor of social work at the University of Toronto, and author of the commentary.
Other research has shown that males are more likely to have eating disorders linked to muscle-building, in addition to being the largest number of consumers of muscle-building supplements.
Dr. Ganson’s research has shown that more than 80% of adolescent boys and young men take a protein supplement, and 50% or less take a creatine boost. But health clinicians may not know about use because they do not ask, Dr. Ganson added.
After clinicians ask about use and learn that a teenager or young adult is taking a dietary supplement, they should use a harm reduction approach that encourages curtailing or modifying supplement use rather than insisting on total abstinence, Dr. Ganson and coauthors wrote.
For example, a clinician can assess the patient’s dietary intake of carbohydrates, proteins, fats, calories, vitamins, and minerals, and, if appropriate, advise the teen that he or she can get all the necessary nutrients at mealtime. Michele LaBotz, MD, medical director of the Master of Science in Athletic Training program at the University of New England in Biddeford, Maine, said most teen boys and young adults will not listen to a clinician telling them about the potential harms from supplements.
However, counseling these patients that the supplements are probably a waste of money — muscles will develop just fine with a healthy diet and regular exercise — is more effective at reducing use, according to Dr. LaBotz, who was a sports medicine physician for nearly 20 years.
Keeping open lines of communication about supplements may open the door for teens to share that they are also using muscle-building steroids. Dr. Ganson said the step to a more dangerous product sometimes occurs after teens no longer perceive they are benefiting from supplements.
“It’s not one conversation and you’re done: It’s about providing support and medical monitoring,” Dr. Ganson said.
Dr. Ganson said his colleagues hope professional societies develop formal clinical practice guidelines about muscle-building supplements in teens and young adults.
Contaminated and Dangerous Supplements
Although any teenage boy may want to build muscles, athletes are of particular concern. Dr. LaBotz authored an American Academy of Pediatrics recommendation that young athletes adhere to appropriate nutrition and training programs rather than turning to supplements.