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Active Voice: Sport Supplements: Emphasize Education Not Just Regulation

Active Voice is an occasional column by ACSM experts. These comments do not necessarily reflect the views or positions of ACSM.

Jay Hoffman, Ph.D., FACSM, is 23-year member of the American College of Sports Medicine. He is an exercise physiologist, with special research interests in musculoskeletal training and performance in sports. Dr. Hoffman is Professor and Chair of the Health & Exercise Science Department, The College of New Jersey, Ewing, NJ. He also is currently President of National Strength and Conditioning Association.

Recently, the United States Anti-Doping Association has begun a campaign aimed at the federal government that hopes to rid the sport supplement industry from unscrupulous companies selling supplements containing illegal performance-enhancing drugs (ACSM is involved in the efforts). The sports medicine community should vehemently support these efforts to rid this industry from the relatively small percentage of unethical companies that circumvent the regulations that are presently in place. However, are banned substances within supplements the major issue that we face regarding supplement use among athletes or amongst our youth? Should we not focus more on ensuring that these populations are educated on making sound judgments in the first place when it comes to supplement use?

Sport supplements are a multi-billion dollar industry. The use of sport supplements are prevalent in both adult and youth populations (Froiland et al., Int J Sport Nutr Exerc Metab. 14:104–20, 2004; Herbold et al., Int J Sport Nutr Exerc Metab. 14:586–93, 2004; Hoffman et al., Med. Sci. Sports Exerc. 40:15-24, 2008). Recent studies have indicated that more than 70 percent of adolescents and between 60 percent and 90 percent of intercollegiate athletes admit to using nutritional supplements. The vast majority of these individuals, though, will use supplements that do not contain any illegal performance-enhancing drugs. Only a handful of individuals have ever tested positive for illegal performance enhancing drugs that originated in a contaminated nutritional supplement. There are strict regulatory mechanisms in place that most ethical supplement companies follow. Furthermore, there are additional mechanisms to ensure that supplements are guaranteed to be free of any banned substances. This is critical for those athletes that are tested as part of their participation in athletic competitions. Both Informed Choice and NSF® International are organizations that provide certifications that a specific supplement is free of any banned substance. Athletes should be advised to ensure the supplements they consume are indeed certified for use in sport.

One caveat to this certification is that it does not determine efficacy. That is, a supplement can be free of any banned substances but have no ergogenic benefit. This is our biggest mistake as sports medicine professionals. We have gotten so bogged down in the use of illegal performance-enhancing drugs that we have failed to focus on educating athletes regarding whether the supplement they think may work actually does what it says it does; or, more importantly, if the individual should be using a supplement at all!

In an article published in ACSM’s official scientific journal, Medicine & Science in Sports and Exercise, in 2008, some of the primary sources of education for sport supplements are the health and fitness professionals who work with these athletes. As athletes mature, they tend to rely on their coaches to be the primary resource for information regarding supplements and performance enhancing drugs. For this reason it becomes imperative that athletic programs and professional sports teams empower their coaches to be the information resource for their athletes regarding use and safety of supplements. By limiting the ability of coaches to communicate with their athletes about which supplements to choose, or by hiring coaches who do not have the educational background to provide such consultation, we run the risk of athletes being in the dark about supplement use, or worse, getting the information from uninformed or “ethically challenged” individuals.

In this area, Major League Baseball has been at the forefront in requiring their strength and conditioning coaches to be certified with the added responsibility of providing education on supplements. This provides athletes with an expert on staff and in the locker room who is responsible for educating and helping the athlete make intelligent decisions about sport supplements. This is where the sports medicine community can have the greatest impact in requiring the teams they work with – and the schools they cover – to hire knowledgeable professionals to be the primary source of information on sport supplementation. The greatest responsibility and accountability should rest with those individuals that have the most interaction with the athlete.


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