Adolescents frequently use substances such as dietary supplements and steroids to improve their appearance, rather than boost athletic functioning, according to a clinical report by the American Academy of Pediatrics.
The report, "Use of Performance-Enhancing Substances," will be published in the July 2016 Pediatrics (online June 27).
The article updates and consolidates prior statements concerning both illicit pharmaceutical drugs and legal over-the-counter supplements, which remain unregulated. Reviews of multiple studies show that, while overall use of many substances has gone down, use remains prevalent in children and adolescents. Males are at higher risk than females for most performance-enhancing substances, such as protein powders, creatine and anabolic steroids. Girls report much higher rates of nonprescription diet pill use. The article raises concern about contamination in over-the counter products. Several studies that tested protein supplements found that 8 percent to 20 percent of the products were contaminated with significant amounts of heavy metals. Multiple studies also have shown a correlation between the use of performance-enhancing substances and use of alcohol and drugs, as well as other risk-taking behaviors. For most young athletes, the use of such substances prove to be no better than gains made during the onset of puberty, with proper nutrition and appropriate athletic training.
AAP recommends that pediatricians be aware of the evolving trends of substance use, as aggressive marketing efforts and lack of regulatory oversight can make it difficult to assess reliability of information sources.