'Inadequate info sources' add to elite athletes' sparse supplement awareness, researchers say

The Spanish team come to these conclusions whilst discussing elite athletes’ dietary supplement use also highlighting a tendency to self-prescribe and buy without consulting an accredited professional.

“Receiving dietary counselling by a qualified professional - instead of relying on self-prescription - results in better-informed choices with respect to the use of nutritional supplements related to performance, recovery, and health,​ the study said.

“This result highlights the importance of elite athletes placing more reliance on sport nutritionists and scientists to design their supplementation plans.​

“A more informed athlete population will likely reduce the strong effect of purchasing multiple types of supplements that have been driven by dietary supplement manufacturers.​

Previous studies have found the prevalence of supplement consumption ranges from approximately 48 to 81% while proteins and multivitamins are the most popular supplements.

The reasons reported by athletes for using dietary supplements are mainly related to health-related issues, physical and mental performance improvement, and increased rate of recovery.

However, the patterns of use and purchase of supplements have not been well investigated.

IOC and UKAD help ​

Conscious of the need for clarification, The International Olympic Committee (IOC) made available a reference infographic​​ for athletes and dietary supplement users to help decide whether to take or avoid a supplement in 2018.

The infographic, developed by the IOC’s Medical and Scientific Commission, guided users through a flow diagram that asks questions to further ascertain whether or not to take a certain supplement.

In the same year, the UK Anti-Doping Agency (UKAD) expressed concern over new findings​​, which revealed individuals who took supplements lacked the knowledge as to what they contained.

At the time Dr Adam Carey, chairman of the European Specialist Sports Nutrition Alliance (ESSNA), highlighted the part unscrupulous supplement firms played vowing to “shut down these charlatans”.​ ​

“​​It’s true that there is unfortunately a small minority of irresponsible companies out there that illegally sell unlicensed medicines containing banned substances such as DMAA masquerading as sports nutrition products,”​ said Dr Carey.

“But it’s crucial to note that substances like these have no place in the legitimate sports nutrition world.​ ​

“These companies prey on the public’s perceived lack of knowledge about the actual uses of sports nutrition which is why the industry is working hard to better educate the consumer as to how they should take sports nutrition products.”​

As part of its efforts, UKAD revealed it was working with supplement certification service Informed Sport, to minimise the risk of contamination through their supplement batch testing programme.

In the past, The Medicines and Healthcare products Regulatory Agency (MHRA), which oversees medicines, medical devices and blood components for transfusion in the UK, has placed an emphasis on sports supplements, which contain unlicensed medicines such as DMAA.

Led by the team from Camilo José Cela University in Madrid, Spain, the researchers enrolled five hundred and twenty-seven high-performance athletes (346 males and 181 females).

These athletes, which participate in individual and team sports, were asked to complete a questionnaire about use and purchase patterns of dietary supplements.

Room for improvement ​

The team found that 64% or 337 athletes used dietary supplements with age, sex, type of sport, level of competition, and professionalism influencing the prevalence of dietary supplement use.

The most prevalent dietary supplement consumed was proteins (41% or 137 athletes), followed by amino acids/BCAA-based supplements (37%; 124).

Additionally, as per group of supplements according to IOC consensus, 18% of the supplements were rated as having a low level of scientific evidence (e.g., glutamine, HMB, L-carnitine, etc).

Most athletes (45%; 152) purchased dietary supplements in a store and 24%; 81) obtained them from a sponsor.

Most athletes also (42%; 141) reported a self-organisation of supplementation and did not consult with any professional.

Lastly, 81%; 273 of athletes consuming supplements did not know any platform to check supplement safety/quality.

For those who do not use dietary supplements (36% of the total sample; 190), most reported that they do not consider supplements necessary (72%; 137).

‘Education is a critical need’​

“Despite ample evidence that confirms contamination in commercially available products, athletes still purchased supplements with the assumption of safety,”​ the team highlighted.

“Furthermore, only a relatively small percentage of the athletes not taking dietary supplements reported fearing contamination of the supplement. ​

“Together, all these results may indicate that athletes are disturbingly unaware of the contamination risks inherent in dietary supplements,”​ they added.

“Athlete supplement education is a critical need. This is important to not only reduce the cases of unintended doping, but to also avoid unintentional intakes of substances that could potentially have acute and long-term side-effects.”​

Source: Journal of the International Society of Sports Nutrition​

Published online: doi.org/10.1186/s12970-019-0296-5​​

“Prevalence and patterns of dietary supplement use in elite Spanish athletes.”​

Authors: Gabriel Baltazar-Martins et al.