New Guidance on Muscle-Building Supplements for Teens

According to a commentary in the Journal of Adolescent Health, there is widespread use of muscle-building dietary supplements among adolescents and young adults, especially boys and young men, and this use is primarily motivated by the pressure to maintain a muscular and lean body ideal.

The authors, Jason M. Nagata, M.D., M.Sc., of the Department of Pediatrics at the University of California, San Francisco, and Kyle T. Ganson, Ph.D., M.S.W., of the Factor-Inwentash Faculty of Social Work at the University of Toronto, offer advice to medical professionals on identifying and reducing risks related to the use of these supplements.

The commentary, titled “Adolescent and Young Adult Use of Muscle-Building Dietary Supplements: Guidance for Assessment and Harm Reduction Approaches to Mitigate Risks,” underscores the need for healthcare professionals to proactively address muscle-building supplement use among their adolescent and young adult clients.

The authors point out that there are possible negative effects, such as disability and death, despite the general belief that dietary supplements are generally harmless. “Despite the common use of muscle-building supplements, there remains little guidance for health and mental healthcare professionals on how to assess best and support adolescents and young adults using muscle-building supplements, and how to determine whether its use is problematic,” they write.

The authors note that lifetime and 12-month prevalence estimates of protein supplement usage range from 55% to 83% for boys and young men, while creatine use ranges from 19% to 50%. The authors base their conclusions on multiple research and data sets. The need to obtain a particular body image and social pressures are two factors that frequently impact the use of muscle-building supplements. “Indeed, the high use of muscle-building supplements among boys and young men is driven by pressures to adhere to the muscular and lean body ideal,” the authors write.

It is recommended that healthcare providers evaluate and treat clients who use muscle-building supplements utilizing a harm-reduction strategy. The goal of harm reduction is to lessen the negative consequences that come with engaging in dangerous conduct. This approach recognizes that given the prevalence of supplement usage in their social and physical situations, abstinence may not be a realistic aim for many teenagers and young adults. “Harm reduction emphasizes multiple principles and practices that are intended to reduce negative effects associated with risky behaviors, including substance use,” according to the authors.

The commentary offers medical practitioners comprehensive advice. They advise determining which muscle-building supplements are being taken, as well as how often, how much, and how. It’s also critical to comprehend the client’s objectives and reasons for using supplements. Assessing the client’s degree of awareness regarding the supplements they use and their sources of information is also crucial. The writers advise taking into account the client’s family members’ or parents’ assistance. “Without this critical information, there is little foundation for engagement and harm reduction interventions,” they say.

Healthcare providers should also determine whether the client’s food intake satisfies their nutritional demands and whether taking supplements is required. In addition, the authors advise evaluating any activities aimed at altering performance, appearance, weight, shape, or strength because they may be signs of eating disorders or problems with body image. They point out, “Understanding the current dietary intake of the client provides information as to whether they are consuming appropriate calories and macronutrients to grow and develop.”

In order to ascertain whether supplement use is negatively impacting the client’s physical, psychological, and social health, the commentary highlights the significance of conducting a comprehensive biopsychosocial examination. Given that the use of muscle-building supplements can be a predictor of future use of anabolic-androgenic steroids (AAS), healthcare providers should exercise caution when evaluating potential, present, or past AAS use. “Given the connection between muscle-building dietary supplement use and AAS use, healthcare professionals should assess the client for potential and current or past use of AAS,” the researchers suggest.

The authors conclude by recommending a harm-reduction strategy for teens and young adults who take muscle-building supplements. To reduce hazards, they advise medical practitioners to proactively evaluate supplement use, inform patients and their families, and offer continuing assistance and monitoring. In order to inform the creation of clinical practice guidelines regarding the use of muscle-building supplements for this population, the commentary advocates for a formal evidence-based evaluation. “A harm reduction approach is advocated, prioritizing the mitigation of risks when absolute abstinence is not considered a viable option by the client,” the article says.

For more information: Adolescent and Young Adult Use of Muscle-Building Dietary Supplements: Guidance for Assessment and Harm Reduction Approaches to Mitigate Risks, Journal of Adolescent Health, https://doi.org/10.1016/j.jadohealth.2024.05.027