Nutritional Supplements and Adolescent Athletes – June 2003

Nutritional Supplements and Adolescent Athletes by Bonnie Spear, PhD, RD – June 2003

ADA's PIPPAH Pearl
June, 2003
Written by Dr. Bonnie Spear

Adolescent athletes are constantly searching for the competitive edge and may try potentially harmful practices. An alarmingly large number of adolescents using ergogenic aids and their use may pose significant health risks.  The principal substances misused by adolescents are anabolic steroids, stimulants, caffeine, and protein and vitamin supplements. Supplements that include stimulants (amphetamines, caffeine and ephedrine) may lead to increase restlessness, tachycardia, and cardiac arrhythmias.

Ergogenic Aid  Potential Adverse Effects
Creatine  Muscle cramping, muscle strains, dehydration
Androstenedione  Decreased testosterone
Stimulants (amphetamines, caffeine, ephedrine, sympathomimetic amines) Restlessness, insomnia, anxiety, tremor, palpitations, tachycardia, cardiac arrhythmia, hypertension, disruptions in thermoregulation.

Amino Acid/Protein Supplements

Moderate (<2g/kg body mass/d) 

Excessive amounts (>2g/kg body weight/d)

 

None


Dehydration, gout, gastrointestinal upset, hepatotoxicity, renal toxicity, hypercalciuria, impaired essential amino acid absorption

Vitamin A

Moderate amounts

Excessive amounts (>300% RDA) 

 

None

Fatigue, irritability, increased intracranial pressure, gastrointestinal upset, hepatocellular toxicity, bone and joint pain, hypercalcemia, skin and nail abnormalities

Niacin

Moderate amounts 

Excessive amounts (>300% RDA)

 

None

Flushing, gastrointestinal upset, glucose intolerance, hyperuricemia

Vitamin B6 

Moderate amounts

Excessive amounts (>300% RDA)

 

None

Headache, nausea, sensory neuropathy, hepatocellular toxicity

Additionally, many of these supplements increase the need for fluids (e.g., creatine, protein) and if extra fluids are not consumed this may lead to increased risk of heat-related illnesses.

Many of these supplements are sold over the counter, in grocery stores, at smoothie stores, as well as in health food stores.  Often they are advertised as an energy drink or an “all natural” product.   It is important for professionals working with adolescents and adolescent athletes to make sure a history of supplements and herbal preparations is obtained.  This screening and assessment can occur during health supervision visits or sports preparations physical examinations.  Educating parents regarding the risk of certain supplements is also important. 

Adapted from Patrick K, Spear BA, Holt K, Sofka D, eds. 2001.  Bright Futures in Practice: Physical Activity. Arlington, VA: National Center for Education in Maternal and Child Health.  (www.brightfutures.org)

References:

Williams MH. 1995. Nutritional Ergogenics in Athletes. J. Sports Sciences. 13(suppl.): S663-S74.

Sowell Jennings, Debbi, MS, RD, and Suzanne Nelson Steen, DSc., RD Play Hard, Eat Right. 1995, The American Dietetic Association.

Nutrition and athletic performance — Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine. J Am Diet Assoc. 2000; 100:1543-1556.