Sports Nutrition

Boys, Body Image and Supplements

News articles surfaced focusing on some conclusions from a recently published Pediatrics journal study report suggesting adolescent boys have increased their muscle-building behaviors, including supplements and steroids, to satisfy growing body image issues.

When I was in high school in the 80s and early 90s, I actually exercisedcycling, running and tennis, in addition to other sports and general games in the neighborhoodfor fun. On my high school football team, they took us to a renowned Philadelphia-area sports medicine clinic for physical assessments, including body fat measurements. I thought it was cool when some of us had the body fat percentages of world-class athletes. We were also 17 years old and had been active our entire childhood. We may have compared numbers for a few minutes, but it didn't mean too much to us beyond that day. I also don't recall our coaches ever pushing us to use supplements or steroidsthere was a linebacker or two we suspected of steroids, but nothing was confirmed. Having six-pack abs wasn't something we sought, but was a consequence of years of unintentional cross-training. A few people would comment on a particularly fit body in middle or high school, but I don't recall any big movement such as is described in the recent issue of Pediatrics journal.

Researchers from University of Minnesota, Minneapolis, and Columbia University, New York, the use of muscle-enhancing methods, including diet changes, supplements and steroids, amongst teenage boys is much higher than previously reported and is cause for concern. They surveyed nearly 3,000 adolescents (both boys and girls, mean age 14.4 years) at 20 urban middle and high schools for their use of five muscle-enhancing behaviors: dietary changes, exercise, protein powders, steroids or other muscle-enhancing substances. Use of muscle-enhancing methods was common in both boys and girls. The data showed about 35 percent used protein powders or shakes, 11 percent use other substances such as DHEA and creatine, and 6 percent admitted to using steroids. However, most methods of muscle enhancement were more common among the boys surveyed. Adjusting for variables, the data indicated use of muscle-building methods was associated with Asian race, grade level,  BMI (body-mass index) and participation in sports.

Resultant articles by NY Times, CNN and Health Day focused on the study's data concerning teen  boys. The consensus was boys aren't just exercising to perform better, but they want to look better,  including looking like their idols, including the Portuguese soccer star Cristiano Ronaldo. CNN highlighted the authors' concerns about the results, including the potential for increased use of supplements and diet changes to lead to more dangerous muscle-building behaviors such as steroids and other drugs. NY Times noted  the cases involving Lance Armstrong and Barry Bonds may suggest to these boys the use of steroids and other substances can be managed successfully. Health Day noted research into body image among teens only started a decade or so ago, so there is little comparative data to conclude boys are more conscious of their body and muscles now than in past generations.

One of the main concerns cited by pediatric and other relevant experts is the effects heightened use of supplements, steroids and other substances can have on developing adolescent bodies. Add in major dietary changes and lack of physician or even parental supervision of all these drastic methods, and you have a situation that could be dangerous to the kids' health.

As a high school tennis coach, I am not aware of any of my player's use of protein powders or supplements, let alone steroids and other serious substances. And based on the snack foods they eat before, during and after matches, there are no noticeable dietary attempts at muscle-building among my players.

Sports nutrition expert Anthony Almada, founder of EAS and co-founder, president and CEO of Genr8 Inc., questioned how representative the study population is of American adolescents as well as some of the findings. "They found 5.0 percent of teens use steroids? No way; I'd say the real number is double that figure," he assured. To Almada, the authors' interpretation of the datathey said the behaviors were risky and implied supplements are unsafeignores the elephant in the room that is childhood obesity. "I'd rather have teens engaged in these [muscle-building behaviors], minus steroids, being inactive and increasing their body fat," he declared. "As for any implications supplements such as protein powders and creatine are unsafe, there is no evidence to support this allegation."

On the other hand, he noted DHEA is a hormone that could definitely affect teens' health, and he does not advocate any adolescents take this compound, which is widely available as a supplement. As for protein powders and creatine, he advises teens use these under the guidance of someone who knows the research and knows how they are metabolized in the body, especially in the case of creatine which can be a tricky supplement to get right. "The challenge is not a safety issue, but rather getting the maximum benefit out of the supplement," he clarified. Overall, he said supplements such as protein and creatine have been extensively studied in adolescents and at considerable dosesAlmada and a research team investigated creatine in teen swimmers at high doses, to no ill effects. "Creatine has even been shown safe in studies on infants taking considerable doses," he noted.

The Natural Products Association (NPA) also responded to the news on body image and supplement risks in teens, reminding the supplement industry is fully regulated, including strict labeling laws for contents, and emphasized steroids are not dietary supplements. " Echoing the sentiments from Almada, NPA stated, in response to the NY Times piece, that it objects to "the idea that young people focusing on health and wellness translates into obsessive behavior.  Your own story says 'most boys are eager for advice on the healthiest, drug-free ways to get in shape.' That is something to encourage, not condemn."

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