A Cross-Sectional Exploratory Study of (Safer) Nutritional Supplement Use and Knowledge in High School Athletes

Nutritional supplements (the combination of dietary supplements, sports foods, and performance-enhancing supplements) are used by many athletes for health and/or performance-related reasons. Nutritional supplements may be contaminated with illegal substances, putting the athlete at risk of adverse health outcomes or a positive doping test. Third-party testing programs help mitigate risk by regulating the purity and safety of supplements. However, it is unknown what percentage of high school athletes are familiar with third-party testing programs and how many athletes use such programs. This study was designed to explore high school athletes’ use of nutritional supplements, whether they were third-party tested, and their attitudes and influences toward safe(r) nutritional supplement use. An online questionnaire was developed to distribute among student-athletes from a private high school in the western US, resulting in a representative sample (n=225). Ninety-four percent (n = 211) of the student-athlete population reported using at least one nutritional supplement within the past year, reporting six different supplements on average. Sports foods were used the most (87%), followed by dietary supplements (76%), and then supplements claiming to enhance performance (58%). The most frequently reported nutritional supplements were sports drinks (72%), vitamins (65%), sports bars (60%), protein powder (58%), recovery drinks (46%), and multivitamin/mineral supplements (40%). One-fourth of student-athletes reported consistent use of third-party tested supplements. Reasons for supplement use include gaining muscle (48%), improving health (46%), improving performance (44%), and losing or gaining weight (29%). Parents (45%) had the most influence on the athlete’s purchasing of supplements, followed by friends, teammates, or other family members (40%), the physician (30%), head sports coach (26%), strength and conditioning coach (25%), and athletic trainer (24%). The sports dietitian was checked by 8% of students as influential. The biggest gap in knowledge was where to find third-party tested supplements (22% knowledgeable) and where to order third-party tested supplements (25% knowledgeable). Based on the results, high school athletes would likely benefit from increased education regarding third-party testing programs and should increase their knowledge of where to find and purchase third-party tested supplements.