Pervasive muscle-building supplement use among adolescents and young adults, warns new research

05 Jun 2024 --- A new study reveals a high use of muscle-building supplements, such as protein bars and powder, among Canadian adolescents and young adults (aged 16 to 30). Close to 60% of the 912 respondents reported using protein bars, and 52% use whey protein powders or protein shakes. Use was most common among boys and men.

Other commonly used muscle-building supplements included plant-based protein (30.4% of all participants), creatine monohydrate (25.7%), pre-workout supplements (22.3%) and amino acids or BCAAs (16.3%). Almost 80% of participants reported buying supplements in grocery stores. 

“The boys and men in our study reported using an average of three muscle-building supplements in the past 12 months,” says Dr. Kyle T. Ganson, assistant professor at the University of Toronto, Canada, and the study’s lead author. “This figure exemplifies the pervasiveness of boys and men attempting to adhere to the muscular body ideal.”

At the same time, nearly two-thirds of participants reported at least one symptom while using these supplements, such as fatigue, digestive issues and cardiovascular problems. However, 87.8% of people with symptoms did not seek medical attention. 

The researchers note that their findings underscore the need for healthcare providers to be knowledgeable about muscle-building supplements and to assess their use among adolescents and young adults. 

Social media influence  
The research, published in Performance Enhancement & Health, analyzes data from the Canadian Study of Adolescent Health Behaviors. The 912 participants from across Canada were recruited over social media. The researchers divided the group into boys and men, girls and women and transgender/gender-expansive participants. 

Social media was also reported as a “primary influence of use” for 43.7%, while 69.3% of participants said they used information from online websites. The researchers noted that participants spent the most time researching the risks and benefits of creatine monohydrate (12 h on average), followed by whey protein powders or shakes (11 h). 

The sources of information differed among gender groups. Girls and women reported more influences from healthcare professionals, a parent or older relative, a partner or significant other, or the fitness community. 

Last year, the same research team urged social media companies to implement stricter and more explicit policies on advertising and user-generated content on muscle-building supplements. 

Social media was an important influence on information for muscle-supplements use.Ganson adds: “We know that, in Canada, regulations of muscle-building supplements are weak and social media companies do not restrict content on muscle-building supplements, which may negatively impact young people’s perceptions of the safety and efficacy of muscle-building supplements.”

Meanwhile, a UK study suggests that following healthy social media accounts may inspire better dietary habits, such as improving fruit and vegetable consumption. 

Problematic use 
According to the research, only 9.8% of all participants perceived their use of muscle-building supplements as problematic. Transgender and gender-expansive participants reported a higher perception of problematic use at 15.7%. Also, black participants reported a higher rate of self-perceived problematic use than white participants. 

“While we did not specifically assess whether the use of muscle-building supplements caused the symptoms experienced by users, it is clear that their physical health symptoms may be relevant for young people to be aware of before using muscle-building supplements, and healthcare professionals should be alerted to these concerning findings,” underscores Ganson.

Over a third of participants reported systemic symptoms, while around 30% reported cardiovascular and digestive symptoms. Moreover, transgender and gender-expansive participants, gay/lesbian and bisexual participants reported a more significant number of symptoms than heterosexual participants. 

The researchers call on healthcare professionals to expand their knowledge of the influences and information sources for muscle-building supplement use. They should also assess symptoms and provide appropriate care. 

“This is particularly important for transgender and gender-expansive and sexual minority individuals, who reported higher symptom rates,” says Ganson. “Public health programs should focus on harm reduction education, emphasizing the potential risks of muscle-building supplements and promoting the use of reputable information sources.”

The researchers call on healthcare providers to be knowledgeable about muscle-building supplements and assess their use.Supplement access 
The study suggests that policymakers consider implementing stronger regulations on social media companies to ensure that content and advertising are not harmful to adolescents and young adults. 

“It is critical for healthcare, public health and policymaking professionals to understand where young people are accessing information on muscle-building supplements to inform harm reduction approaches,” comments Ganson. 

Typical places of purchase included grocery stores (79.8% of all participants), supplement stores (44.4%) and online stores (40.4%). 

Meanwhile, last year, legislators in New York, US, signed a bill into law to restrict sales of weight loss or muscle-building supplements to people under eighteen.

The US trade association for supplement and functional foods, the Council for Responsible Nutrition (CRN), filed a lawsuit challenging the law’s constitutionality earlier this year. The association fears that the law’s “broad and ambiguous definitions” of weight loss or muscle-building supplements could lead retailers to over-restrict a broader range of supplement sales.

A federal court has since denied the State of New York’s motion to dismiss CRN’s claims, allowing the association to continue its arguments. 

By Jolanda van Hal