Intake of nutritional supplements among people exercising in gyms and influencing factors

Investigation of thallium as a contaminant in dietary supplements marketed for weight loss and physical fitness

Dietary supplements are drastically growing as a category of consumer products all over the world. The abuse of supplements marketed for slimming purposes and physical fitness has been observed worldwide in recent years, which raises concerns in terms of public health. In this study, different types of dietary supplements marketed and delivered through the e-commerce were studied for the determination of thallium as a hazardous inorganic contaminant. The total content of thallium was determined by a sensitive voltammetric method after a microwave-assisted oxidative digestion of the sample. In addition, a comparative spectrometric method was applied for validation of the results in the samples. The maximum concentration found for thallium was found to be 2.89 mg kg-1, which well agree with the comparative measurement. Considering the 32 studied formulations, it can be pointed out that ∼24% of the of dietary supplements presented Tl concentrations at concentrations higher than 1 mg kg-1. The results permitted the assessment of the health risk related to thallium from contaminated samples, based on the calculation of the estimated daily intake (EDI) and the risk quotient (HQ). The highest daily intake of thallium was calculated as 82.0 µg day-1 in a protein-based supplement, which is equivalent to an EDI of 1.17 µg kg-1 day-1. This work highlights the need to develop regulations on the limits of toxic elements such as thallium in widely consumed dietary supplements, as well as an in-depth look at the adverse effects caused by this element in the human body.

Effect of Social Media on Diet, Lifestyle, and Performance of Athletes: A Review of Current Evidence

PURPOSE OF REVIEW

Social media (SM) plays an important role in providing diet and health advice to athletes, but it also carries with it a risk of credibility in the information sought for and received. The objective of this review is to assess the knowledge gap on how SM influences dietary and lifestyle practices in athletes.

RECENT FINDINGS

For this, relevant literature was searched in three leading databases with appropriate keywords, which were subjected to proper scrutiny that led to inclusion of 22 articles (original research papers, reviews, viewpoints, and commentaries). The current era of digitalization has seen an over-reliance on internet and SM for nutrition and lifestyle advice for an athlete. SM has become a powerful tool in athlete's choice of food, nutrition information, healthy living, and performance, with merits and demerits. Their role in choosing dietary supplements and particular food types (e.g., ketogenic diet), body image, self-esteem and eating disorders, and in lifestyle and performance are discussed. SM should be used with caution and should not be used alone as a source of information for nutrition related pieces of advise by athletes. Any food type and supplements trending in SM should be discussed with a sports nutritionist before consumption. SM influencers having a big follower base may not always be disseminating the right knowledge on food and nutrition, thus caution should be exercised. For optimal benefit to the athlete, SM information should be in alignment with recommendations provided by sports nutrition and coaches.

Bodybuilders and high-level meat consumers' behavior towards rabbit, beef, chicken, turkey, and lamb meat: A comparative review

In bodybuilders' diets, protein plays a crucial role in supporting muscle growth and repairing damaged muscle tissue. These individuals meet their protein needs by combining dietary sources with supplements. Animal-based proteins are often preferred over plant-based proteins because they are believed to better support muscle protein synthesis. This review explores the meat consumption patterns of bodybuilders and high-level meat consumers, focusing on rabbit, beef, chicken, turkey, and lamb. We describe and compare the types of meat bodybuilders commonly consume and provide an overview of protein supplements, including meat-based options, plant-based alternatives, and whey-based products. Our aim is to gain insight into the dietary preferences of bodybuilders and high-level meat consumers, considering their nutritional requirements and the potential effect on the meat industry. We conducted an extensive search across various databases, including Scopus, Web of Science, PubMed, and Google Scholar. We found that individual choices vary based on factors such as attitudes, trust, taste, texture, nutritional content, ethical considerations, and cultural influences. Nutritional factors, including protein content, amino acid profiles, and fat levels, significantly influence the preferences of bodybuilders and high-level meat consumers. However, it is crucial to maintain a balance by incorporating other essential nutrients such as carbohydrates, healthy fats, vitamins, and minerals to ensure a complete and balanced diet. The findings from this review can inform strategies and product development initiatives tailored to the needs of bodybuilders and discerning meat enthusiasts.

Protein supplement intake by non-athlete gym attendees in Jazan region: misconceptions and gender differences

BACKGROUND

Protein supplements (PSs) have gained widespread popularity among non-athlete gym attendees, who often perceive them as essential tools for muscle growth and recovery. However, misinformation surrounding PSs may lead to inappropriate use and negative health consequences. This study aimed to assess whether non-athlete gym attendees using PSs have greater misconceptions than non-users while also examining the prevalence of PS consumption and gender differences.

METHODS

A cross-sectional study of 387 participants in the Jazan region was conducted. Customers of 10 fitness centers were screened with a questionnaire comprising questions to measure PS misconceptions. Participants were divided into PS users and non-users. Data were analyzed using descriptive statistics and the Chi-square test to assess the associations between variables. An independent t-test was used to compare the PS Misconception Index Score between the two groups.

RESULTS

A total of 82.4% of non-athlete gym attendees consumed at least one PS. Our findings revealed a significant association between gender and PS utilization (P<0.001), with a higher proportion of females (90.8%) consuming PS than males (77.6%). PS users had a significantly lower PS Misconception Index Score than non-users (26.8 vs. 28.3; P=0.006), indicating that PS users had a higher number of misconceptions. The internet (41.37%) and coaches (gym instructors/trainers) (34.48%) were the most common sources of information about PSs, with muscle gain being the primary reason for consumption (82.75%).

CONCLUSIONS

PS consumption is highly prevalent among non-athlete gym attendees in the Jazan region, with many individuals having misconceptions about their benefits and potential risks. Targeted educational interventions are needed to promote evidence-based knowledge about PSs for gym attendees, as well as for coaches, given that they were among the primary sources of information on supplements.

Assessment of dietary nitrate supplementation: prevalence of use, knowledge, attitudes and beliefs among active Australians

Introduction

Use of nitrate as a dietary supplement has gained popularity among athletes and recreationally active individuals to enhance exercise performance. However, the prevalence and patterns of use, and knowledge of nitrate as a dietary supplement are unknown.

Methods

Individuals (≥16y) completed a 42-item online questionnaire to collect (i) sociodemographic information; (ii) participation in activity and sport; (iii) nitrate supplementation use and reasons; (iv) attitudes and beliefs regarding information sources and the safety of nitrate as a dietary supplement; and (v) knowledge of dietary nitrate supplements.

Results

In total, 1,404 active adults (66% female) took part in the study. Only about one in 10 respondents (11.9%) reported they had consumed dietary nitrate ("users") in the past, most commonly as beetroot juice (31.3%). Over two-thirds (69.4%) of users could not correctly identify the correct timing of intake relative to performance time to best improve exercise performance, and most users (82.3%) were unsure of the contraindications to oral consumption of dietary nitrate supplements. Only 3.9% of users experienced adverse effects after ingesting dietary nitrate supplements. Among non-users, the most common reasons respondents selected for not using dietary nitrate supplements were "I do not think I need to" (70.2%) and "I have never thought about it" (69.2%).

Discussion

There is evidence to support the efficacy of dietary nitrate intake in improving exercise performance. However, findings from this study suggest dietary nitrate is under-utilized. Educational messages that target dietary nitrate consumption should be targeted toward nutritionists, coaches, and exercise physiologists to bridge the gap between knowledge-to-practice.

The theory of planned behavior and dietary behaviors in competitive women bodybuilders

BACKGROUND

Women bodybuilders build their ideal physique by manipulating their diet, supplement, and exercise regimens to extreme levels. Excess protein intake and dietary supplement use is ubiquitous in women bodybuilders preparing for a competition, i.e., in-season competitors, however the impetus for these two dietary behaviors are relatively unknown. The Theory of Planned Behavior (TPB) has been used to explain dietary behaviors. The purpose of the study was to examine how the TPB can explain protein intake and dietary supplement use in in-season competitors.

METHODS

Using a cross-sectional design, an online questionnaire was developed, validated, and administered to collect dietary supplement use, TPB variables, and other measures from 112 in-season competitors. Protein intake was assessed using multiple 24-h dietary recalls. Associations between TPB and protein intake and dietary supplement use were determined with multiple regression analysis while adjusting for confounders.

RESULTS

For protein intake: attitude, subjective norm, and perceived behavioral control explained 8% of the variance in intention; subjective norm independently predicted intention. Behavioral beliefs predicted attitude; subjective norm was predicted by trainer/coach, workout partners, and social media influencers. For dietary supplement use: intention explained 5% of the variance in dietary supplement use; attitude, subjective norm, and perceived behavioral control together explained 38% of the variance in intention. Attitudes towards dietary supplements use were predicted by five factors (not a waste of money, help improve physique, sustain energy levels, provide enough calories, help with recovery). Primary determinants of subjective norm were fellow competitors, social media influencers, and trainer/coach. Perceived behavioral control was predicted by three factors (ease of purchase, affordability to purchase, availability to purchase).

CONCLUSIONS

TPB predicted dietary supplement use in women bodybuilders during in-season but there was little evidence for the prediction of protein intake using the TPB. Health professionals should develop effective interventions using strategies that align health education messages with in-season competitors' outcome beliefs and collaborate with their referent others to influence safer and effective dietary supplement use.

Perceived Body Image towards Disordered Eating Behaviors and Supplement Use: A Study of Mauritian Gym-Goers

Purpose: Individuals with body image distortions tend to develop an obsession with calorie intake and weight, leading to compounded coping strategies such as modified eating behaviors, supplement use, and excessive exercise. In the local context, little is known about the equation connecting body image to improper eating behaviors and other potential coping mechanisms. This study primarily aims at critically identifying the nexus between features of disordered eating behavior including supplement use, and body image. Methodology: A probabilistic randomized sample of 305 gym members was assessed based on their level of body satisfaction and its influence on their eating habits and supplement use through a structured survey. Findings: Only 37% of the participants were satisfied with their body image. The results concurred with the notion of a poor body image influencing body esteem (χ2 (10) = 137.21, p < 0.05; Cramer V = 0.474). While exercise motivated the use of supplements, a significant relationship was also observed between disordered eating habits and supplement use (χ2 (4) = 48.63, p < 0.05; Cramer V = 0.399). A predictive model was successfully drawn inclusive of the disordered eating behaviors dimensions as a potent predictor of body image (χ2 (56) = 397.12, p < 0.001. Implications: This study presents an in-depth analysis of the magnitude of disordered eating behaviors with respect to individuals in the local fitness industry, and the need for professional support programs toward the re-alignment of body image in an effort to curtail the development of eating disorders in Mauritian gym-goers.

Intake of Food Supplements, Caffeine, Green Tea and Protein Products among Young Danish Men Training in Commercial Gyms for Increasing Muscle Mass

Sixty-three men (15-35 years of age) regularly training in Danish gyms and supplement users were interviewed about the use of supplemental protein and food supplements, intake of caffeine- and (-)-epigallocathechin-3-gallate (EGCG)-containing supplements and beverages and any experienced adverse effects. Protein powder (60%), fish oil (54%) and multivitamin/mineral supplements (41%) were the most popular products. The daily supplementary protein intake (mean 0.42 g/kg body weight, users only) in adult men contributed substantially to their protein intake and exceeded the recommended allowance (0.83 g/kg body weight) for six adult participants (14%). Thirty-eight percent of the adult men exceeded the daily caffeine intake presumed to be safe (400 mg) with coffee as the main contributor. Thirty percent drank green tea and among this percentage, two participants had an extreme daily intake (1.5 and 2 -L). EGCG intake could not be estimated from the food supplements due to the lack of label information. Eighteen participants (29%) reported having experienced adverse effects but seventeen did not consult a physician or report the adverse effect to the Danish food authority. The most common adverse effects were insomnia, shaking, headache and palpitations, itching of the skin and stinging. Pre-workout products accounted for 53% of the adverse effects. Three adverse effects came after intake of two brands of supplements known to have contained substances such as 1,3-dimethylamine or derivatives of phenylethylamines previously having caused serious adverse effects.

Why Did I Consult My Pharmacist about Herbal and Dietary Supplements? An Online Survey Amid the COVID-19 Pandemic in Malaysia

Herbal and dietary supplements (HDSs) are frequently obtained from community pharmacies, but community pharmacists (CPs) have been underutilized for information regarding them. This study aimed to determine the prevalence of, factors behind, and reasons for consultation with CPs among HDS consumers in Malaysia. A cross-sectional study using an online survey was conducted among conveniently sampled individuals in Malaysia. Reasons for consultation or non-consultation with CPs about HDSs were sought from the respondents. A logistic regression analysis was conducted to determine the predictors of consultation with CPs. Overall, 40.3% (239/593) of participants consulted CPs about the HDSs that they purchased. The participants were predominantly unmarried (362/588, 61.6%) and belonged to the 18-29 age group (332/593, 56%). The multivariate analysis showed that a suburban residential setting was the only significant predictor for consultation with CPs (adjusted odds ratio = 0.390, 95% CI = 0.260-0.583). Respondents who consulted CPs generally agreed that the CPs were the right people to consult on HDSs (mean = 4.37, SD = 0.73). However, their discussion with CPs regarding HDSs mostly revolved around the benefits and directions for use, but little on the potential risks. Meanwhile, most respondents who did not consult CPs agreed that they had never thought of consulting CPs about their HDS use (mean = 3.45, SD = 1.02). The majority of them referred to the Internet (61.3%, 217/354) and social media (59.9%, 212/354) for information about HDSs. The findings from this study show that more efforts are warranted in encouraging consumers to consult CPs about their HDS use and to enhance their awareness of the roles of CPs in ensuring the safe use of HDSs.

Self-Learning about Herbal and Dietary Supplements: Perspectives Using the Theoretical Domains Framework

Background: Self-learning (SL) is a process in which individuals take the initiative to acquire knowledge with or without the help of others. Knowledge about herbal and dietary supplements (HDS) is important for pharmacists. Unfortunately, there is limited coverage of topics relating to HDS in the pharmacy curricula. The present focus group study applies the Theoretical Domains Framework (TDF) to explore pharmacy students' practices and beliefs regarding SL about HDS (SL-HDS). Methods: Focus group interviews (FGIs) were conducted between April and May 2019 among a sample of undergraduate pharmacy students at a public university (n = 20). Four FGI sessions were conducted, each lasting about 60 to 75 min, and all the sessions were audio-recorded. The interviews were transcribed verbatim and analysed using thematic content analysis. Results: Beliefs about SL-HDS were categorised into 12 domains based on the TDF. Students showed positive attitudes towards SL-HDS and agreed that their involvement in SL-HDS was instrumental in improving their knowledge about various aspects of HDS including indications, adverse effects, and HDS-drug interactions. Various facilitators and barriers influencing students' participation in SL-HDS were uncovered (e.g., access to the internet, time, availability of reference resources). The students demanded to be equipped with critical appraisal skills, as they had limited confidence in assessing literature or information about HDS. Conclusion: This study revealed that the students saw the benefits of SL-HDS. They also perceived that engaging in SL-HDS is compatible with the role of pharmacy students. The findings showed students' readiness and willingness to conduct SL-HDS.

Herbs as an Active Ingredient in Sport: Availability and Information on the Internet

The use of supplements containing herbal active ingredients in sport has increased in recent years. Their consumption is explained by the benefits they may provide and because their natural origin do not involve health complications, from the point of view of the consumers. The aim of this study is to analyze the availability of four supplements (caffeine, turmeric, ginseng, cannabidiol) on the internet and understand the nature of these websites. A descriptive, observational, and cross-sectional study design was used. A detailed search was carried out with specifically developed software. The searches and data evaluation took 10 days. The websites consulted correspond to those that sell supplements, or some sport websites in the case of the Spanish ones, whereas those in English belong to pharmacies, parapharmacies, or herbalists. It is concluded that the websites do not provide adequate information to ensure proper consumption and lack advice on the choices of supplements and their administration guidelines.

Branched-chain amino acid supplementation impairs insulin sensitivity and promotes lipogenesis during exercise in diet-induced obese mice

OBJECTIVE

Branched-chain amino acids (BCAAs) are popular dietary supplements for exercise. However, increased BCAA levels positively correlate with obesity and diabetes. The metabolic impact of BCAA supplementation on insulin sensitivity during exercise is less understood.

METHODS

Male C57BL/6 mice were fed for 12 weeks with a high-fat diet, normal chow diet, or BCAA-restricted high-fat diet. They were subjected to running exercise with or without BCAA treatment for another 12 weeks.

RESULTS

Exercise reduced body weight, improved insulin sensitivity, lowered BCAAs in plasma, and inhibited the upregulation of BCAAs and metabolites caused by BCAA supplementation in the subcutaneous white adipose tissue (sWAT) of obese mice. BCAA supplementation reversed insulin sensitivity ameliorated by exercise. The phosphorylation of protein kinase B (Ser473 and Ser474) was decreased by BCAAs in the sWAT of obese mice. However, BCAA supplementation had no such effects in lean mice. BCAAs also increased the expression of fatty acid synthase and other lipogenesis genes in the sWAT of exercised obese mice. BCAA restriction had no effect on body weight and insulin sensitivity in obese mice.

CONCLUSIONS

BCAA supplementation impaired the beneficial effect of exercise on glycolipid metabolism in obese but not lean mice. Caution should be taken regarding the use of BCAAs for individuals with obesity who exercise.

Prevalence and Attitudes Towards Using Protein Supplements Among Female Gym Users: An Online Survey

Background:

Protein supplements have become a widespread practice amongst athletes and gym users worldwide. However, studies on the use of protein supplements among female gym users in Saudi Arabia are lacking.

Objective:

The aim of this study was to investigate the prevalence of protein supplement usage among female gym users and their attitudes towards protein supplementation in Riyadh city, Saudi Arabia.

Methods:

In this cross-sectional study, 502 female gym users aged ≥18 years completed a structured, self-administered online questionnaire on the usage of protein supplementation. Socio- demographic information, anthropometry, health status, exercise frequency, attitudes and knowledge regarding protein supplements were obtained.

Results:

The overall prevalence rate of protein supplement use among the study respondents was 36.3%. There were significant associations between the use of protein supplements and educational level (p< 0.05), the duration of being a gym member (p< 0.05) and frequency of gym visits per week (p< 0.05). Whey protein was the predominantly used supplement (57.8%), and the reason attributed to the use of protein supplement was muscle building (53.9%). The main sources of information regarding protein supplement use included the internet (30.2%) followed by gym coaches (25.3%).

Conclusion:

Our findings demonstrated that a considerable number of females exercising in gyms use protein supplements, and most rely on unreliable sources for decision-making of protein supplements use. Nutritional education and consultations regarding protein supplement use are warranted.

Sportsmen's Attitude towards Dietary Supplements and Nutrition Knowledge: An Investigation in Selected Roman Area Gyms

The non-professional sport environment is a grey zone not as widely assessed as that of elite athletes. The purpose of this research was to investigate the dietary supplementation habits and the nutrition knowledge on sport (NKS) in a sample of gym users. The level of adequacy of NKS was set at ≥60% of correct answers. Almost half (46.4%) of respondents stated they used food supplements, in particular multivitamins (31.0%), amino acid pills (29.5%), minerals (29.1%), and protein powders (28.7%). Supplements were used to increase muscle mass (36.9%) and to repair muscle (35.1%). Gym trainers were the preferred source of information on the use of supplements, especially in males (84%). The NKS correct response rate was 57.1% and the proportion of respondents with a sufficient level of NKS was 47.3%. The prevalence of correct answers was highest in males (61.5%) and for respondents with the highest educational attainment levels (44.5% and 53%). This study demonstrated that non-professional sportsmen do not have sufficient knowledge of nutrition and that the gym environment does not facilitate the circulation of the correct information on the role of supplementation. Considering the importance of nutrition for sportsmen, it is necessary to put in place actions aimed at increasing the knowledge of nutrition of gym users and their trainers.

Knowledge, Attitudes, and Use of Protein Supplements among Saudi Adults: Gender Differences

Saudi Arabia has witnessed recent reforms and positive socio-political changes that have led to increased opportunities for women to participate in fitness centers. This study investigated protein supplement consumption among Saudi females compared with that among males and examined the knowledge and attitudes of the participants toward protein supplement use. A cross-sectional study was conducted in Riyadh using a previously validated, self-administered online survey. The questionnaire included items related to the prevalence, knowledge, attitudes, and practice of protein supplementation. The participants were 354 adults (58.2% were females). The results showed that over 47% of the participants attended fitness centers with more male (80.3%) than female (41%) attendees. Nearly 50% of the participants consumed protein supplements, with males (68.7%) using significantly (p < 0.001) more protein supplements than females (35.6%). The powdered form was most commonly consumed. The percentage of gym attendees (67.8%) who used protein supplements was higher than that among non-gym attendees (32.2%). Gaining muscles (56.1%) followed by compensating for protein deficiency (28.6%) were the reasons for taking protein supplements, with a significant gender difference (p < 0.001). Coaches provided the most information on protein supplements. The participants appeared to be knowledgeable about protein supplements. Although over 68% of protein supplement users suffered from various symptoms, only 20% of the participants thought that there was no risk in taking protein supplements, with significant gender differences. It was concluded that Saudi male participants are twice more likely to attend the gym and consume protein supplements compared with females. Of both genders, those attending the gym consumed more protein supplements than non-gym attendees.

Bodybuilding, dietary supplements and hormones use: behaviour and determinant analysis in young bodybuilders

BACKGROUND

Among athletes, bodybuilders are more predisposed to the use of dietary supplements (DS) and hormones (H) to increase in adaptations to physical training and performance. The purpose of the study was to identify social, psychological, and organisational factors that are associated with the use of food supplements and hormones in young bodybuilders of the metropolitan area of Naples.

METHODS

107 athletes, practicing bodybuilding, were consecutively recruited in 30 gyms, randomly selected in the metropolitan area of Naples. Athletes were administered an anonymous questionnaire. The questionnaire consists of 5 sections (socio-demographic, frequency and reasons for bodybuilding, knowledge, attitudes and behaviours). Descriptive statistics were performed using T-test and Chi-square statistics. A score was created for knowledge, attitudes, behaviours. Multivariable logistic regression models were employed to assess association between each score and the use of DS and H. Statistical analyses were carried out using STATA 15.

RESULTS

81.31% of the subjects reported to use DS while 35.51% H. Females are less likely to practise bodybuilding frequently than males (OR 0.18 (95% CI 0.05-0.69), p = 0.01). Subjects who have attended high school or university have a lower probability of taking DS (OR 0.17 (95% CI 0.04-0.65), p = 0.01). H users also use supplements more frequently (OR 61.21 (95% CI 3.99-939.31), p < 0.001). Those who scored higher on knowledge scores are more likely to take DS (OR 1.53 (95% CI 1.11-2.12), p < 0.001). Attitudes are correlated with the use of DS; those who scored higher were less likely to use DS (OR 0.77 (95% CI 0.30-0.98), p = 0.03). People who use DS are 30 times more likely to use H at the same time (OR 30.25 (95% CI 2.51-365.24), p < 0.001). Subjects who have a higher score for knowledge and attitudes are less likely to use H (OR 0.68 (95% CI 0.54-0.87), p < 0.001, OR 0.75 (95% CI 0.62-0.90), p < 0.001).

CONCLUSIONS

Prevalence of H and DS' use, although lower than reported in the literature, is a worrying public health problem. Better knowledge can lead to an informed use. Gym instructors should be trained to provide accurate and scientifically sound information. Health professionals should combine their expertise to provide more comprehensive guidance to the exercisers.

Usage of nutritional supplements and its side effects among gym goers in Pune

Nutritional supplements have always been a point of attractionfor physically active people. These have improved exercise performance,increased muscular strength, weight gain or weight loss,etc. The irrational use of supplements has led to various side effectsassociated with them. There is a shortage of evidence suggestingthe usage and knowledge regarding the consumption ofdietary supplements. A cross-sectional study was conducted witha 121 sample size randomly chosen from 5 different zones of thecity. A structured questionnaire was designed to collect informationwherein participants reported their demographics, physical activity,supplement usage patterns, source of information, and side effects.Descriptive statistics, chi-square test, was used with p<0.05 as significant.Samples used different dosages, forms, brands, and accessto supplements. The participants coming to the gym for moreextended periods were likely to consume supplements in higherdosages (p = 0.020). Protein powder was consumed by 97.5% ofthe samples. There was a significant association between differenttypes of supplements across gender, age group, and period of exercisingin the gym. Side effects such as cramps (p = 0.015) andnausea were significantly associated with high dosages of supplementconsumption. The majority of them (51.2%) took advice fromtrainers. Only 9.9% consulted dieticians. Individuals consumed supplementswithout the guidance of any health professionals, whichwas predisposing them to various side effects. This reflects a lackof knowledge and awareness of supplement usage and highlightseducating various stakeholders and gym-goers.

Social Media, Body Image and Resistance Training: Creating the Perfect 'Me' with Dietary Supplements, Anabolic Steroids and SARM's

BACKGROUND

Few studies have assessed the use of dietary supplements, anabolic androgenic steroids (AAS) and selective androgen receptor modulators (SARM) in male gym users. The comparison of physical appearance with others on social media and the exposure to fitness-related content on social media (i.e., image-centric social media use) may have a profound role in using these compounds due to its role in creating negative body images in male gym users.

OBJECTIVE

Provide contemporary data on the use of dietary supplements, AAS and SARM among young male gym users, and test the hypothesis that social media is associated with the use of dietary supplements, AAS and SARM, as a result of a negative body image.

METHODS

In this cross-sectional study, conducted in the Netherlands, male gym users (N = 2269; 24 ± 6 years) completed an online questionnaire including self-reported measures regarding resistance training participation, image-centric social media use, dietary supplement intake, and body image. The prevalence of AAS and SARM use was assessed with randomized response, a technique to ask sensitive questions indirectly.

RESULTS

Of all participants, 83% used ergogenic dietary supplements (mainly protein and creatine), and an estimated 9 versus 2.7% had ever used AAS versus SARM. Image-centric social media use was positively associated with the use of dietary supplements (r = .26; p < 0.01) and AAS (p < 0.05), but not SARM. Image-centric social media use was associated with a more dissatisfied body image (r = .34; p < 0.01). Body image did not mediate the relationship between image-centric social media use and the use of doping compounds.

CONCLUSIONS

The use of dietary supplements in young male gym users is exorbitant, with the use of AAS and SARM being substantial. Image-centric social media use is positively associated with the use of dietary supplements and AAS.

Knowledge and Prevalence of Supplements Used by Brazilian Resistance Training Practitioners Before Coronavirus Outbreak

Introduction

The use of dietary supplements and ergogenic aids (DSEA) is popular among physical activity enthusiasts. Particularly, resistance training (RT) practitioners represent important DSEA consumers due to its easy access and the appeal of claims related to muscle hypertrophy, aesthetics, and physical performance improvements.

Methods

Our aim was to study knowledge, prevalence, and profile of DSEA used by Brazilian recreational RT practitioners. For this, RT practitioners of both sexes (n=129, female=58 and male=71) answered a paper-based questionnaire. The questionnaire was specifically created for the studied population to assess different aspects of the DSEA used and sociodemographic variables.

Results

Seventy-seven percent of the participants (n=99) declared that they had already used DSEA. The majority (53%) searched the internet to obtain information about DSEA. Whey protein (66%) was the most used followed by branched chain amino acids (48%).

Conclusion

The use of DSEA, before coronavirus outbreak, was popular among RT practitioners; protein and amino acids were the most used DSEA. Most users used internet to obtain information about DSEA. The results suggest the need for appropriate attitude and guidance by health professionals who deal with this population, especially dietitians, nutritionists, and physical training professionals in order to promote best and security practices.

Liver and kidney function markers among gym users: the role of dietary supplement usage

Dietary supplements have been increasingly used by gym users and are often consumed without the guidance of a health professional. Moreover, the indiscriminate supplements use can have adverse health effects, such as changes in liver and kidney function. The aim of this study was to verify the association between dietary supplements intake with alterations in the liver and kidney function among gym users. A cross-sectional study was conducted with 594 gym users (mean age 37 (sd 14) years, 55·2 % women) from a city in southern Brazil. A questionnaire was used to evaluate the use of dietary supplements. The markers of the liver (alanine aminotransferase, aspartate aminotransferase (AST), alkaline phosphatase, γ-glutamyltransferase) and renal (creatinine and urea) function were also evaluated on a subsample of the study population. Data were analysed by binary logistic regression, adjusted for sex, age and education. The prevalence of dietary supplement intake was 36·0 %. Individuals who intake dietary supplements showed a higher prevalence to present slight alterations in the AST enzyme and in the urea after adjustments for potential confounders. In conclusion, the use of dietary supplement was associated with slight alterations in AST enzyme and in the urea among gym users. These findings show the importance of using supplements correctly, especially with guidance from professionals trained to avoid possible risks to health.

Qualifications and Competence to Prescribe Dietary Supplements: Perception of Fitness Instructors

This research aims to understand fitness instructors and personal trainers' perception of their qualifications and competence to prescribe dietary supplements. To this end, a questionnaire was applied to 154 fitness instructors and personal trainers with professional functions in health clubs/gyms. The results obtained show that the sale of these products in gyms is seen as stimulating their consumption and that most fitness professionals consider professionals in this area do not have competence to prescribe this type of service. The lack of confidence about knowledge of dietary supplements; degree courses with a weak curriculum in this domain; and the shortage of curricular units related to dietary supplements are possible reasons for these professionals not feeling sure about giving advice on this matter. Regarding ways of updating knowledge, although these professionals consider academic journals, conferences, congresses and nutrition courses as the most reliable sources of information, they resort more frequently to the Internet, despite considering this source as the least reliable. These results can have direct implications for various stakeholders, particularly for consumers to be more informed about the risks involved in consuming dietary supplements without due orientation; for fitness professionals who have little knowledge about this type of substance; for gym managers who need to understand the implications of selling this type of product in their establishments; for teaching institutions, who should reflect on, and organize their academic curricula in order to provide sufficient grounding for fitness professionals to feel safe and confident about their knowledge in this area; and for the producers of these products, in order to improve information about, and the safety of the substances they put on the market.

Quality Control of Protein Supplements: A Review

The growing consumer awareness regarding health and fitness has been leading to a huge rise in the consumption of nutritional supplements and, consequently, to an increase in concerns about their quality. In this sense, one of the most consumed products is protein supplements and, despite being safer than other types of supplements, there are several studies showing incompatibilities between what is present on the labels and their actual content. Therefore, this review is focused on gathering information about the problems arising from poor manufacturing practices and inadequate quality control of sport protein supplements. These issues are mainly related to three aspects: reduction of the supplements’ nutritional value, the presence of pharmacological substances, and contamination with microorganisms or toxic metals. Regarding the first aspect, reports about the “classic” addition of nitrogen-rich compounds to mask the protein content measured by the Kjeldahl method were discussed, as well as recent topics such as the addition of cheaper proteins to produce an “undetectable” adulteration in whey protein supplements. With respect to the presence of pharmacological compounds, it is a finding that is not very common in protein supplements; however, even trace amounts of foreign substances in this type of product may cause adverse effects to consumers, and, in the case of an elite athlete, may result in doping. Finally, we discuss about the contamination with microorganisms and toxic metals, this latter being a subject that should be further explored due to few studies in the literature.

Photobiomodulation Therapy at 808 nm Does Not Improve Biceps Brachii Performance to Exhaustion and Delayed-Onset Muscle Soreness in Young Adult Women: A Randomized, Controlled, Crossover Trial

Objective

This study aims to investigate the effects of laser photobiomodulation (PBM) at 808 nm on biceps brachii performance to exhaustion, rating of perceived exertion (RPE), and delayed onset muscle soreness (DOMS) in untrained young women.

Methods

Thirteen young women (20.1 ± 2.9 years) participated in a crossover study in which they received, in a counterbalanced manner, active and placebo laser PBM on two occasions (T1 and T2), separated by a 7-day washout period. During T1 and T2, participants received active (100 mW output power, irradiance of 35.7 W cm^–2, and total energy of 28 J/arm) or placebo laser irradiation on the biceps brachii muscle at 20 min before the repetitions-to-failure test [six sets at 60% of one-repetition maximum (1RM) until failure] for elbow flexion exercise. The number of repetitions performed and RPE over the six sets, as well as DOMS from basal up to 72 h after the repetitions-to-failure test, were recorded.

Results

There was a significant (time, p < 0.05) reduction in the number of repetitions performed and an increase in RPE over six sets, with no statistical differences between placebo and active laser conditions (treatment × time, p > 0.05). DOMS increased at 24 h postexercise and progressively returned to baseline after 72 h in both conditions (time, p < 0.05; treatment × time, p > 0.05).

Conclusion

Our results indicate that acute laser PBM at 808 nm does not improve biceps brachii performance to exhaustion, RPE, and DOMS in untrained women.

Ergogenic potential of foods for performance and recovery: a new alternative in sports supplementation? A systematic review

In recent years, there have been studies in the literature reporting the ergogenic effect of some different foods on sports performance. Given the reasonable number of studies in which some food has shown improvement in some physiological variables related to physical performance, a review is pertinent in order to produce a compilation of these studies, providing new elements for athletes and coaches which aim to optimize their performance. Thus, the objective of this work was to present a systematic review of the findings regarding the potential ergogenic effect of food for athletes. Researchers performed a double-blind research in Medline/PubMed considering articles published until January 2019 which resulted in 71 articles. Increased time until exhaustion, improved aerobic capacity and strength recovery were the most commonly reported physical effects. In general, food showed equal or superior ergogenic activity over supplements. Although the number of foods investigated is reasonable, there is still no body of evidence for each studied food, except beets. The current data support the possibility of certain foods being able to enhance athletic performance, as well as serving as an energy source. However, a larger volume of studies is needed to form a body of evidence on each of these foods.

High Prevalence of Supplement Intake with a Concomitant Low Information Quality among Swiss Fitness Center Users

BACKGROUND

The aim of this study was to screen the prevalence of supplement use in Swiss fitness center users and what information sources they consulted.

METHODS

Customers of 10 fitness centers were screened with a quantitative questionnaire.

RESULTS

Eighty two percent of the 417 fitness center users consumed at least one supplement per week. Supplement intake correlated with training frequency (rs = 0.253, p < 0.001). The most prevalent products were protein supplements (used by 49% of the study population), magnesium (34%), and multi-micronutrient supplements (31%). The average number of supplement servings per week among consumers was 17.1 (SD: 16.1, median: 11.0) and the average number of different products used was 6.9 (SD: 4.4, median: 6.0). The most frequently used information sources were the coach/trainer (28%), the website of the supplement seller (26%), and training peers (24%). Thirty seven percent were informed or informed themselves about potential risks associated with the supplement used. The leading reasons for selecting the information source were the desire for scientific-based information followed by the education level of the informing person.

CONCLUSIONS

A high prevalence of supplement intake among Swiss fitness center users was associated with a low level of information quality and a low prevalence of risk information. A discrepancy between a desire for high quality evidence-based information and a contrasting behavior was detected.

Gym Members Show Lower Nutrition Knowledge than Youth Engaged in Competitive Sports

OBJECTIVE

Adolescents may be vulnerable to misleading nutritional information and adopt unhealthy food habits. In addition, specific features related to physical training, either aimed to improve fitness or to comply with sport demands, may influence food habits of the youth. This cross-sectional study was aimed to compare nutrition knowledge, food habits and adherence to Mediterranean diet in youth engaged in fitness training, competitive sports or inactive.

METHODS

Three questionnaires, the General and Sport Nutrition Knowledge (GeSNK) questionnaire, a food habit questionnaire and the KIDMED were administered to gym members, athletes engaged in volleyball, long-distance swimming, and gymnastics, and inactive adolescents.

RESULTS

The total sample included 211 youth (age 16.8 ± 1.7 years). Gym members, like the inactive youth, had lower general and sport-related nutrition knowledge compared to athletes (p = 0.001). In the whole sample, general nutrition knowledge was positively associated with healthy food habits (p < 0.01) and adherence to the Mediterranean diet pattern (p < 0.02).

CONCLUSIONS

Gym members had a level of nutrition knowledge lower than young athletes and similar to inactive youth. Healthy food habits were related with nutrition knowledge among adolescents. Specific nutritional education programs are needed to address food habits in fitness settings.

Prevalence of dietary supplement use by gym members in Portugal and associated factors

Background

Although there seems to be an increasing interest in the use of dietary supplements in those who exercise recreationally and want to improve body composition, there is little published data regarding gym users and dietary supplement use.

Methods

This cross-sectional study describes the prevalence and type of supplements used by gyms members, the reasons for using them and the information source using a self-administered online questionnaire.

Results

Of the 459 participants (301 females) who answered the survey, 43.8% reported using dietary supplements. Users were more likely men (62.7% vs. 33.9%, p < 0.05), younger (32 ± 9 vs. 34 ± 11 years, p < 0.05) and trained more hours per week (6 ± 3 vs 4 ± 3 h, p < 0.05) than non-users. The most consumed supplements were proteins (80.1%), multivitamins and/or minerals (38.3%), sport bars (37.3%), branched-chain amino acids (BCAA’s) (36.8%) and n-3 fatty acids (35.5%). Men consumed more arginine, BCAA’s, creatine, glutamine, β-hydroxy-β-methylbutyrate (HMB), proteins, β-alanine, taurine, multivitamin/minerals, and carbohydrate supplements (p < 0.05). The most commonly cited reasons for the use of supplements were gaining muscle (55.7%), accelerating recovery (52.7%) and improving performance (47.3%). Men have more often referred increase strength, increase resistance, gain muscle mass, accelerate recovery and improve performance as reasons to use supplements than women (p < 0.05). Those who mentioned muscle gain as a reason were younger than those who did not (30.4 years vs. 33.7 years, p < 0.05). The sources of information most mentioned were registered dietitians (23.1%), internet (22.2%) and him/herself (16.6%). The majority (> 70%) of participants declared being well or very well informed about supplements, while only a minority (4%) felt very poorly or poorly informed. Most individuals purchased dietary supplements from the internet (56.2%) and supplement/health food stores (43.4%).

Conclusion

This study concluded that gyms users are large consumers of dietary supplements, and are more likely to be men, young, use protein powders, aiming to increase muscle mass, obtain information from registered dietitians, consider themselves well informed and buy supplements online.

Understanding the Use of Dietary Supplements among Athlete and Non-Athlete University Students: Development and Validation of a Questionnaire

BACKGROUND

The purpose of this study is to develop and test the validity and reliability of a questionnaire to evaluate dietary supplement use based on the Theory of Planned Behaviour (TPB).

METHODS

The questionnaire has sections on demographics, physical activity, dietary supplements, and cognitive constructs based on the TPB. Three stages are followed. In Stage 1, elicitation interviews are conducted on five varsity athletes, five physically active non-athletes, and five physically inactive University of Guelph (UofG) students. In Stage 2, comments and ratings of the TPB-based statements are gathered from 10 subject matter experts to check for content validity. In Stage 3, Cronbach's α is calculated to determine the internal consistency of the cognitive constructs by a pilot test on 84 Applied Human Nutrition UofG students.

RESULTS

Interviews assisted in the formulation of the cognitive constructs' statements, including intentions, attitudes, injunctive norms, descriptive norms, and perceived behavioural control. Content validity ensured that these constructs did not overlap. Few statements from the cognitive constructs were omitted based on findings from the reliability test, achieving acceptable Cronbach's α values across all constructs (≥0.70).

CONCLUSIONS

This supplement use questionnaire will be used in a future study to investigate the use and determinants of dietary supplements among Canadian athlete and non-athlete UofG students.

Protein supplement use and prevalence of microalbuminuria in gym members

BACKGROUND

Protein supplement use is common in bodybuilders because protein supplements are thought to increase muscle mass by preventing protein catabolism during exercise routines. Information on the consequences of protein supplement use is scarce and contradictory. Therefore, the identification of a kidney damage marker, such as microalbuminuria, could be transcendent in preventing probable organ compromise in healthy persons. The aim of this study is to determine the presence of microalbuminuria in gym members and whether there is an associated risk with protein supplement use.

METHODS

An analytic, descriptive, cross-sectional study was conducted. It included gym members whose clinical and nutritional histories were taken, identifying protein supplement use. Microalbuminuria was then determined through a random urine sample. Descriptive and inferential statistics were used for the data analysis. The objective was to determine the presence of microalbuminuria in gym members and whether there is an associated risk with protein supplement use.

RESULTS

A total of 107 gym members, 71 men and 36 women, that met the inclusion criteria of the study were analyzed. Their mean age was 35±13 years, and the prevalence of microalbuminuria was 9.34%. There was active protein supplement use in 58% of the study participants, with a mean consumption duration of 16±22 months. No association with the presence of microalbuminuria was found (P=0.35).

CONCLUSIONS

The prevalence of microalbuminuria in gym members was higher than that of the general healthy population and was not associated with protein supplement use.

Common Habits, Adverse Events, and Opinions Regarding Pre-Workout Supplement Use Among Regular Consumers

The purpose of the present study was to examine characteristics of multi-ingredient pre-workout supplement (MIPS) users, their common patterns/habits of MIPS ingestion, and their associated feelings about the effectiveness and safety of this class of supplements. An online electronic survey was distributed through social media to assess self-reported supplementation practices and preferences among adult males and females who reported regular MIPS use. A total of 1045 individuals responded, with 872 of these individuals (males: n = 636, 72.9%; females: n = 233, 26.7%; mean ± SD; age = 27.7 ± 7.9 years; training age = 8.2 ± 7.3 years) completing the survey. The majority of respondents reported the length of current or past MIPS consumption as greater than one year (n = 630, 72.2%), with ingestion frequencies primarily of four (n = 210, 24.1%) or five (n = 212, 24.3%) days per week of training. In addition, the three most popular goals for ingesting MIPS were increased energy and focus (n = 776, 89.0%), muscular endurance (n = 325, 37.3%), and blood flow or “pump” (n = 322, 37.0%). Although most users reported ingesting one serving size with each use, 14% reported ingesting two or more, and 18% indicated they ingest MIPS more than once per day. Importantly, over half (54%) of the respondents reported experiencing side-effects following MIPS use, including skin reactions, heart abnormalities, and nausea. Females were more likely than males to experience these side effects, despite being less likely to consume two or more serving sizes per dose. Our findings also indicated that MIPS users should consume no more than the recommended serving size of a given supplement, as the potentially significant variability in the caffeine content of MIPS products is compounded as more doses are consumed. Furthermore, MIPS users should minimize the ingestion of other supplements which contain high levels of niacin and caffeine, as the concurrent consumption of such products may put users above the tolerable upper limits for these substances.

Protein supplement consumption is linked to time spent exercising and high-protein content foods: A multicentric observational study

The main aim of this study is to analyze if protein supplement consumption and food patterns vary across three geographical regions and secondly to identify possible factors that increase the likelihood of ingesting protein supplements. A total of 916 responses from gym users of 3 countries (Italy, Turkey and UK) were entered for analysis. Questions were related to supplement consumption (protein and other supplements), food intake and training habits. A descriptive analysis, analysis of variance (ANOVA), and logistic regression were performed. No differences were found across groups regarding: prevalence of protein supplement consumption, typology of other ingested supplement and food intake. No relation was found between level of education (r = .12) or geographical region (r = .16) and protein consumption. The analysis showed that the coach is the main source of suggestion for the intake of protein supplements (52.3%). The logistic regression model highlighted that gym users who exercised more (OR 1.51, p < 0.001) and consumed higher quantities of chicken (OR 1.39, p < 0.001) eggs (OR 1.18, p < 0.001) and canned tuna (OR 1.15, p < 0.05) were more likely to use protein supplements. Geographical area does not seem to influence the supplementation pattern. Time spent exercising and high protein foods are factors associated with protein supplement consumption.

Boost Me: Prevalence and Reasons for the Use of Stimulant Containing Pre Workout Supplements Among Fitness Studio Visitors in Mainz (Germany)

The rapidly increasing interest in fitness related sports over the past few years has been accompanied by a booming industry of nutritional supplements. Many of these substances have unproven benefits and are even potentially harmful to the user. The aim of this study was to determine the prevalence and reasons for nutritional supplement (NS) use among fitness studio visitors in Mainz (Germany), emphasizing new multi-ingredient based supplements such as pre workout boosters (PWBs). Some of the PWBs contain stimulants such as DMAA, N,α-DEPEA, DMAE and DMBA with so far unknown risks, harms and benefits. Four-Hundred and Ninety Two participants in 13 fitness studios completed a questionnaire on the use of nutritional supplements. Descriptive statistics and chi-square tests were used to examine differences in supplement use regarding training- and intake-reasons. About 57.0% of the participants reported the use of NS during the last 4 weeks. The all-time prevalence of creatine use was 28.7%, whereas 12.2% of the participants stated creatine use during the past 4 weeks. The all-time prevalence of PWB intake was 25.8%, whereas the last month prevalence was 11.8%. Among the group of PWB users, 20.5% stated to search specifically for substances such as DMAA, N,α-DEPEA, DMAE or DMBA. Logistic regression analysis showed positive relations between creatine use and the predictor variables gender, strength training and bodybuilding, as well as the stated exercisers' training reasons to increase physical- and sports-performance, and quality of life. PWB consumption was related to the variables gender, training frequency, and the reason for sports performance enhancement. Specific ingredient focus was related to the predictor variables competition participation and increase of mental performance. The results of the study show a high prevalence of PWB consumption among fitness studios visitors, which is comparable with creatine use. The predicting variables for consumption seem to be slightly different between the supplements, especially if the users are searching for stimulating agents. The current findings help to create preliminary consumption patterns and can help to identify potential endangered fitness studio visitors for prevention and risk communication, especially for PWBs.

Use of nutritional supplements contaminated with banned doping substances by recreational adolescent athletes in Athens, Greece

Although the use of nutritional supplements by adult athletes has been extensively studied, information on supplements consumption by adolescent athletes is still limited. The present study reports on the use of nutritional supplements contaminated with banned doping substances among 170 recreational adolescent athletes from eleven, randomly selected, gym centres, in Athens, Greece. Nutritional supplements consumption was reported by almost 60% of the study population, with proteins/amino acids and vitamins being the most popular. Nine per cent of the users were found to consume nutritional supplements contaminated with anabolic steroids, prohormones, selective androgen receptor modulators (SARMs) and aromatase inhibitors, all pharmacological substances with endocrine modulating properties not stated on the label. None of these individuals had previously consulted a physician or a nutritionist. A representative sample (ca 15%) of the protein/aminoacids and creatine preparations used by the study population were also tested and found free from doping substances. The majority (63%) of adolescents purchased products from the internet. In conclusion, exercising adolescents can have easy access to contaminated nutritional supplements and "black market" products, which could constitute a risk for public health. Low level of awareness and low involvement of medical care professionals among recreational adolescent athletes is also observed.

The Effect of Whey Protein Supplementation on the Temporal Recovery of Muscle Function Following Resistance Training: A Systematic Review and Meta-Analysis

Whey protein (WP) is a widely consumed nutritional supplement, known to enhance strength and muscle mass during resistance training (RT) regimens. Muscle protein anabolism is acutely elevated following RT, which is further enhanced by WP. As a result, there is reason to suggest that WP supplementation may be an effective nutritional strategy for restoring the acute loss of contractile function that occurs following strenuous RT. This systematic review and meta-analysis provides a synthesis of the literature to date, investigating the effect of WP supplementation on the recovery of contractile function in young, healthy adults. Eight studies, containing 13 randomised control trials (RCTs) were included in this review and meta-analysis, from which individual standardised effect sizes (ESs) were calculated, and a temporal overall ES was determined using a random-effects model. Whilst only half of the individual studies reported beneficial effects for WP, the high-quality evidence taken from the 13 RCTs was meta-analysed, yielding overall positive small to medium effects for WP from < 24 to 96 h (ES range = 0.4 to 0.7), for the temporal restoration of contractile function compared to the control treatment. Whilst the effects for WP were shown to be consistent over time, these results are limited to 13 RCTs, principally supporting the requirement for further comprehensive research in this area.

Nutritional strategies of high level natural bodybuilders during competition preparation

BACKGROUND

Competitive bodybuilders employ a combination of resistance training, cardiovascular exercise, calorie reduction, supplementation regimes and peaking strategies in order to lose fat mass and maintain fat free mass. Although recommendations exist for contest preparation, applied research is limited and data on the contest preparation regimes of bodybuilders are restricted to case studies or small cohorts. Moreover, the influence of different nutritional strategies on competitive outcome is unknown.

METHODS

Fifty-one competitors (35 male and 16 female) volunteered to take part in this project. The British Natural Bodybuilding Federation (BNBF) runs an annual national competition for high level bodybuilders; competitors must qualify by winning at a qualifying events or may be invited at the judge's discretion. Competitors are subject to stringent drug testing and have to undergo a polygraph test. Study of this cohort provides an opportunity to examine the dietary practices of high level natural bodybuilders. We report the results of a cross-sectional study of bodybuilders competing at the BNBF finals. Volunteers completed a 34-item questionnaire assessing diet at three time points. At each time point participants recorded food intake over a 24-h period in grams and/or portions. Competitors were categorised according to contest placing. A "placed" competitor finished in the top 5, and a "Non-placed" (DNP) competitor finished outside the top 5. Nutrient analysis was performed using Nutritics software. Repeated measures ANOVA and effect sizes (Cohen's d) were used to test if nutrient intake changed over time and if placing was associated with intake.

RESULTS

Mean preparation time for a competitor was 22 ± 9 weeks. Nutrient intake of bodybuilders reflected a high-protein, high-carbohydrate, low-fat diet. Total carbohydrate, protein and fat intakes decreased over time in both male and female cohorts (P < 0.05). Placed male competitors had a greater carbohydrate intake at the start of contest preparation (5.1 vs 3.7 g/kg BW) than DNP competitors (d = 1.02, 95% CI [0.22, 1.80]).

CONCLUSIONS

Greater carbohydrate intake in the placed competitors could theoretically have contributed towards greater maintenance of muscle mass during competition preparation compared to DNP competitors. These findings require corroboration, but will likely be of interest to bodybuilders and coaches.

Protein Supplement Usage Among Male University Students: Comparisons Between Current and Previous Users

OBJECTIVE

Interest in specialized dietary supplements is leading market growth, and protein supplements are popular for increasing muscle mass among young males. Therefore, this study investigated the attitudes toward and satisfaction with protein supplements to identify detailed consumer behaviors related to the consumption of protein supplements.

METHOD

The study sample includes male university students in their 20s in South Korea. In total, 223 responses were entered for analysis. Questions related to attitudes, satisfaction, and future behavioral intentions were asked using 5-point Likert scales. The responses were divided into two groups, current and previous users, to identify significant differences in terms of attitudes, satisfaction, and future behavioral intentions. A descriptive analysis, analysis of variance (ANOVA), and multiple regression were run.

RESULTS

The majority of respondents prefer the powdered form of supplements in bulk with a price range between 30,000 won and 60,000 won. Online shopping was preferred, while word of mouth and friends/family were considered credible information sources. The most common side effects experienced were problems with digestion and hives, although more than 78% did not experience side effects. In comparison between current and previous users in terms of attitudes and satisfaction, the following areas showed significances. Regarding attitudes, the importance of brand, preference for products from overseas, the search for nutritional facts, and reading carefully all product information were significant, while regarding satisfaction, price, effectiveness, and ease of consumption were significant. All significances showed that current users had more positive attitudes and greater satisfaction. Overall, consumers' satisfaction regarding ease of consumption influenced future behavioral intentions.

CONCLUSIONS

The market for protein supplements has been growing, so measuring consumers' attitudes and satisfaction would help attract potential consumers. In addition, analyzing previous users' opinions on products could guide product development and encourage customers to return for repurchase.

Effects of beta-hydroxy-beta-methylbutyrate supplementation on strength and body composition in trained and competitive athletes: A meta-analysis of randomized controlled trials

OBJECTIVES

The aim of this meta-analysis was to examine the evidence for the effectiveness of beta-hydroxy-beta-methylbutyrate supplementation interventions on modification in strength and body composition in trained and competitive athletes.

DESIGN

Systematic review and meta-analysis.

METHODS

A systematic search was performed using three databases: MEDLINE, EBSCO and Web of Science. The analysis was restricted to randomized controlled trials that examined the effect of HMB supplementation interventions on modification in bench and leg press strength, body mass, fat-free mass and fat mass. Effect sizes (ES) and 95% confidence intervals (CIs) were calculated using a fixed effect meta-analysis due to low value of the heterogeneity. The Egger test was used to determine the presence of publication bias, and the Q and I² statistics were used to assess heterogeneity among studies. Significance was set at p<0.05.

RESULTS

Six studies were selected for meta-analysis, as they fulfilled the inclusion criteria (n=193 participants). HMB supplementation interventions present a trivial non-significant ES in all variables studied (bench press ES=0.00, leg press ES=0.09, body mass ES=-0.01, fat-free mass ES=0.16, and fat mass ES=-0.20; all cases p>0.05, and null heterogeneity I²=0.0% p>0.05). These results remained constant even analyzing by subgroups (HMB doses, duration of intervention, training level and diet co-intervention).

CONCLUSIONS

This meta-analysis found no effect of HMB supplementation on strength and body composition in trained and competitive athletes.

Knowledge, Attitude and Practice of Iranian Pharmacists, Body Builders, and Their Coaches Regarding Sports Supplements

Objective:

This study is conducted on Iranian pharmacists, coaches, and athletes regarding sports supplements to assess their knowledge, attitude, and practice (KAP) regarding sports supplements.

Methods:

This was a cross-sectional study conducted in 2015. The study population consisted of all community pharmacists, bodybuilders, and bodybuilding coaches. The questionnaire was applied consisting some demographic questions and 25 questions for assessing KAP (6, 9, and 10, respectively). The collected data were analyzed with independent t-test, ANOVA, and Pearson correlation.

Findings:

In all three studied groups, the mean of KAP was upper than intermediate level 3 (P < 0.05) except the pharmacists' knowledge. A statistically significant difference appears between knowledge and age of pharmacists (P = 0.007). In addition, there was a significant relationship between coaches' practice and age (P = 0.04).

Conclusion:

According to the results although the studied groups have the intermediate level of KAP, organized and regular education courses are highly recommended along with paying more attention to the curriculum taught in the pharmacy schools according to the community current needs.

Is Branched-Chain Amino Acids Supplementation an Efficient Nutritional Strategy to Alleviate Skeletal Muscle Damage? A Systematic Review

Amino acids and more precisely, branched-chain amino acids (BCAAs), are usually consumed as nutritional supplements by many athletes and people involved in regular and moderate physical activities regardless of their practice level. BCAAs have been initially shown to increase muscle mass and have also been implicated in the limitation of structural and metabolic alterations associated with exercise damage. This systematic review provides a comprehensive analysis of the literature regarding the beneficial effects of BCAAs supplementation within the context of exercise-induced muscle damage or muscle injury. The potential benefit of a BCAAs supplementation was also analyzed according to the supplementation strategy-amount of BCAAs, frequency and duration of the supplementation-and the extent of muscle damage. The review protocol was registered prospectively with Prospective Register for Systematic Reviews (registration number CRD42017073006) and followed Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Literature search was performed from the date of commencement until August 2017 using four online databases (Medline, Cochrane library, Web of science and ScienceDirect). Original research articles: (i) written in English; (ii) describing experiments performed in Humans who received at least one oral BCAAs supplementation composed of leucine, isoleucine and valine mixture only as a nutritional strategy and (iii) reporting a follow-up of at least one day after exercise-induced muscle damage, were included in the systematic review analysis. Quality assessment was undertaken independently using the Quality Criteria Checklist for Primary Research. Changes in indirect markers of muscle damage were considered as primary outcome measures. Secondary outcome measures were the extent of change in indirect markers of muscle damage. In total, 11 studies were included in the analysis. A high heterogeneity was found regarding the different outcomes of these studies. The risk of bias was moderate considering the quality ratings were positive for six and neutral for three. Although a small number of studies were included, BCAAs supplementation can be efficacious on outcomes of exercise-induced muscle damage, as long as the extent of muscle damage was low-to-moderate, the supplementation strategy combined a high daily BCAAs intake (>200 mg kg^-1 day^-1) for a long period of time (>10 days); it was especially effective if taken prior to the damaging exercise.

Identifying and assessing views among physically-active adult gym members in Israel on dietary supplements

BACKGROUND

Sports dietary supplements are available for sale in public places including sports clubs. Although there is uncertainty regarding their safety, many gym members who regularly work out consume them. The present study aimed to identify the approaches and perspectives of the public who work out in gyms and take dietary supplements. It examined how professionals view sports dietary supplement consumption, and how they communicate this issue to gym members. The literature discusses the prevalence of SDS use among athletes, but rarely discusses or compares between the risk perceptions of gym members, trainers, and dietitians, who represent the physically-active general public, regarding SDS.

METHODS

We conducted constructivist qualitative research in semi-structured one-on-one interviews (n = 34). We held in-depth interviews (n = 20) with a heterogeneous population of adult gym members who take dietary supplements, and (n = 14) with dietitians and fitness trainers.

RESULTS

The main finding was a gap in risk perception of dietary supplement use between dietitians, gym members and fitness trainers. There was low risk perception among dietary supplements consumers. Trainers believed that benefits of supplement consumption exceeded risk, and therefore they did not convey a message to their clients about risk. In contrast, dietitians interviewed for this study renounced general use of sports dietary supplements and doubted whether trainers had proper nutritional knowledge to support it.

CONCLUSION

Lack of awareness of risks suggests that there is a need for communication on this issue. We recommend that professionals (physicians and dietitians) be present in sports clubs that sell such products in an uncontrolled way.

Dietary Supplement Intake and Associated Factors Among Gym Users in a University Community

Dietary supplement intake and associated factors among gym users in a university community in Sharjah, United Arab Emirates (UAE), were assessed using a structured, self-administered questionnaire in this cross-sectional study. Adults (N = 320) from five gyms in the University City of Sharjah participated in this cross-sectional study. The prevalence of dietary supplement intake was 43.8%. Statistically significant associations were found between the use of dietary supplements and sex (47.7% males, 28.1% females; p = .006), as well as weight lifting (88.6% taking supplements vs. 11.4% not taking supplements; p < .001), favoring male gym users. The reasons attributed to the use of dietary supplements varied between the sexes. Male exercisers used supplements to increase or maintain muscles mass, strength, and power and to boost exercise recovery. Females mainly used dietary supplements to increase energy, maintain their health, and prevent nutrition deficiency. Overall, protein supplements (whey proteins [48.6%] and protein powder [45.7%]) were among the most-consumed dietary supplements, followed by multivitamins (38.6%), branched-chain amino acids (36.4%), caffeine (35.0%), and creatine (29.3%). A widespread use of Internet-driven, self-prescribed dietary supplement intake was reported among gym users (60.7%). Only 12.8% of dietary supplement users sought information from dietitians. Practical implications suggest that gym instructors and coaches should be sufficiently trained to be able to provide accurate and scientifically sound information on dietary supplements to the exercisers in gyms in the university environment.