Dietary Supplement Use by Children and Adolescents in the United States to Enhance Sport Performance: Results of the National Health Interview Survey

Evans MW Jr, Ndetan H, Perko M, Williams R, Walker C. J Prim Prev. 2012 Feb 2. [Epub ahead of print]

Dietary supplements may improve sports performance in adults but there is little research exploring dietary supplements in children. In 2005, the American Academy of Pediatrics released a position statement on the use of performance-enhancing substances and stated the academy “strongly condemns the use of performance-enhancing substances and vigorously endorses efforts to eliminate their use among children and adolescents.” To gain a better understanding of what children and adolescents are consuming Evans et al assessed self-or parental-reported use of dietary supplements to enhance athletic and sport performance among children and adolescents as well as determine the national population estimates of those using herbal as well as vitamin/mineral supplements for this purpose. The authors conducted a secondary analysis of the National Health Interview Survey (NHIS) 2007 dataset; particularly alternative medicine data related to children (<10 years) and adolescents (<18 years). In 2007, children/adolescents or their parents were asked whether the child/adolescent had “’improved their sports performance’ within past 30 days by taking either a vitamin or mineral supplement or herb for the purpose of ‘enhancing sport performance.’” The survey also questioned about the specific use of several herbs, vitamins, and minerals for sports performance. In total, 9,417 responses were analyzed. Based on national population estimates, approximately 1.2 million (1.7%) children or adolescents reported improvement in sports performance within the 30 days prior to being surveyed (to place this in context: it’s estimated that there are 44 million youth athletes in organized sports in the US). The average age of individuals reporting supplement use for sports performance was 11 years of age (58% were > 10 years of age). Almost all of those who reported using performance-enhancing supplements (94.5%) used a multivitamin and/or mineral combination. The next most common supplements were fish oil, omega-3, or DHA fatty acids (43.5%), creatine (34.1%), and fiber or psyllium (25.9% of those using supplements). Males were twice as likely as females to report using supplements for sports performance compared to females. Adolescents were also twice as likely as children (<10 years) to use supplements for sports performance. Whites reported a greater use of supplements than other races. Usage of supplements for sports performance could not be predicted well by parent-based demographics (e.g., education of parents, parents in household).

This study is interesting because it suggests that “the vast majority of youth sport participants do not report taking dietary supplements for sports performance…” within 30 days prior to answering the survey. It is not clear how many children or adolescents experiment with supplements for sports performance at some point in their athletic career. A 2006, online survey suggested that 46% of teenagers reported using dietary supplements in their lifetime (but this wasn’t necessarily for sports performance; Wilson et al. 2006). The authors raise a concern regarding “the potential for future use of more dangerous substances as well, if use of any supplement is occurring at 11 years of age.” The authors acknowledge that they were not able to determine how many participants in the study population were competing in sports and if the participants were consuming supplements that may contain other performance enhancement substances. It would also be interesting to learn about the diet of kids that use and don’t use supplements. This study is just the first step to gaining a better understanding of the supplements are younger athletes may be consuming. Do you find that a lot of your high school or middle school athletes are trying supplements to enhance their playing performance?

Written by: Jeffrey Driban
Reviewed by: Stephen Thomas

Evans MW Jr, Ndetan H, Perko M, Williams R, & Walker C (2012). Dietary Supplement Use by Children and Adolescents in the United States to Enhance Sport Performance: Results of the National Health Interview Survey. The Journal of Primary Prevention PMID: 22297456