Influence of knowledge and beliefs on consumption of performance enhancing agents in north-western Saudi Arabia

Impact of an educational flyer and sensitization on performance-enhancement attitudes of bodybuilders in United Arab Emirates

Background

A high proportion of bodybuilders use supplements to improve performance, with some turning to prohibited substances and methods. The attitudes of bodybuilders towards performance enhancement may be gauged through surveys such as the Performance Enhancement Attitude Scales (PEAS). Educational interventions are recommended as part of anti-doping measures. The objective of this project was to assess the impact of a pharmacy-led intervention using an antidoping educational flyer and the performance enhancement attitude scale to measure the attitude of bodybuilders in the United Arab Emirates (UAE).

Methods

The PEAS eight-item short form questionnaire was administered to male bodybuilders in the UAE. The PEAS was conducted before and after administration of an educational flyer concerning the problems associated with supplement use among bodybuilders. The Wilcoxon Signed-Rank and Kruskal Wallis tests were used for data analysis.

Results

A total of 218 bodybuilders, who reported taking dietary supplements, filled out the survey both pre and post viewing the antidoping educational flyer. A difference was observed between the full-time professional bodybuilders, students, and part-time bodybuilders with other primary occupations (p-value <0.05). In addition, PEAS score decreased among the study population for all eight PEAS items (p-value <0.05).

Conclusions

The pharmacy-led intervention using an antidoping educational flyer and sensitization by PEAS achieved more favorable scores, suggesting a significant shift of opinion toward avoiding use of performance enhancing substances among the bodybuilder study population. More research is required on sustaining the attitude and demonstrating the impact on doping behavior.

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.

Anabolic-androgenic steroids and dietary supplements among resistance trained individuals in western cities of Saudi Arabia

Background

Anabolic–androgenic steroids (AAS) contain testosterone-like androgens and are used as supplements to improve performance, therapeutic measures, appearance, and muscular development.

Purpose

This study aimed to estimate using anabolic–androgenic steroids (AAS) and good and bad practices about dietary supplements among resistance-trained individuals. It further seeked to determine the use of common drugs and supplements containing anabolic steroids among resistance-trained individuals (who work out at the sports centre) and assess users' knowledge about its side effects.

Methods

A cross-sectional survey was conducted at the sports centres of the western cities of Saudi Arabia. A self-administered questionnaire was used to collect data from 120 male resistance-trained individuals.

Results

The majority of the participants (80%) reported that they had not used any hormonal bodybuilding supplement last year, while 20% said they had used such hormonal supplements. Approximately half (52.5%) of participants reported that they always used dietary supplements. A total of 44.2% of participants possessed inadequate knowledge of these products. The main reason behind the use of hormones and supplements was to increase muscle mass.

Conclusions

A minority of resistance-trained individuals in the studied population frequently misused AAS. However, the results cannot be generalised to the whole of Saudi Arabia. AAS consumption can be reduced by enhancing the level of awareness and knowledge of potential adverse health outcomes.

Anabolic-Androgenic Steroid Abuse among Gym Users, Eastern Province, Saudi Arabia

Background and Objectives: The main aim of the present study was to assess the use of androgenic–anabolic steroids (AAS) and to investigate its potentially unfavorable effects among gym members attending gym fitness facilities in Eastern Province, Saudi Arabia. Materials and Methods: A cross-sectional questionnaire-based study was carried out during the summer of 2017. Male gym users in the Eastern Province region of Saudi Arabia were the respondents. Information on socio-demographics, use of AAS, knowledge, and awareness about its side effects were collected using a self-administered questionnaire. Results: The prevalence of AAS consumption among trainees in Eastern Province was 21.3%. The percentage was highest among those 26–30 years of age (31.9%), followed by the 21–25 (27.4%) (p = 0.003) age group. Participants in the study were not aware of the potential adverse effects of AAS use. Adverse effects experienced by 77% of AAS users include psychiatric problems (47%), acne (32.7%), hair loss (14.2%), and sexual dysfunction (10.7%). Moreover, it appears that trainers and friends are major sources (75.20%) for obtaining AAS. Conclusion: AAS abuse is a real problem among gym members, along with a lack of knowledge regarding its adverse effects. Health education and awareness programs are needed not only for trainees, but also for trainers and gym owners as they are reportedly some of the primary sources of AAS.

Anabolic-Androgenic Steroid Use in the Eastern Mediterranean Region: a Scoping Review of Extant Empirical Literature

The use of image- and performance-enhancing drugs particularly anabolic-androgenic steroids (AAS) is not a new phenomenon. AAS use is not limited to athletes, with mainstream populations using these drugs for aesthetic purposes. Prevalence has been predominantly in Western countries, with some recent studies indicating a rise in popularity in the Eastern Mediterranean region. A scoping review of extant empirical literature from the Eastern Mediterranean region described and mapped what is known about the extent of AAS in the region. Four themes emerged from the review: (1) profile of AAS users; (2) AAS within gymnasium practice; (3) AAS regimes of use; and (4) knowledge and understanding of the AAS concept and related adverse effects. The review highlights a relatively new phenomenon of AAS use in the Eastern Mediterranean. The review underscores the need to carry out further research, particularly qualitative and quantitative studies with both genders, and cognisant of the complexities of culture and religiosity.

Knowledge, attitudes and use of anabolic-androgenic steroids among male gym users: A community based survey in Riyadh, Saudi Arabia

Recreational use of anabolic-androgenic steroids (AAS) is a growing worldwide public health concern. However, studies assessing the level of awareness and knowledge of its effects on health are fairly limited, especially in developing countries, including Saudi Arabia. This community-based cross-sectional study was conducted to assess knowledge, attitudes and practices among male gym members toward AAS in Riyadh (Saudi Arabia) from March to October 2016. Twenty gyms were randomly selected from four different geographical regions (clusters) within Riyadh. In total, 482 participants responded to the self-administered anonymous questionnaire, which covered socio-demographic data, data assessing knowledge, attitude and behavior related to AAS use. The mean (±standard deviation) age of study participants was 27.2 (±6.9) years. Among these, 29.3% of participants reported having used AAS, while the majority (53.5%) reported hearing of AAS use, mostly through friends. Most study participants reported awareness of the effects of AAS on muscle mass, body weight and muscles strength (53.2%, 51.1% and 45.5%, respectively). In contrast, a higher proportion of study participants were unaware of the side-effects of AAS use. A high proportion of study participants (43.2%) reported that they had been offered AAS and 68.7% believed that AAS are easily accessible. Most of the gym users (90.1%) reported never having used any narcotics or psychoactive drugs. Regression analysis revealed that use of anabolic-androgenic steroids is significantly associated with “weight lifting practice” OR [95%CI] = 1.9[1.02 − 3.61], P = 0.044; “using supplementary vitamins, OR [95%CI] = 7.8[4.05 − 15.03], P < 0.0001, knowing anyone using anabolic-androgenic steroids’ OR [95%CI] = 7.5[3.78 − 14.10], P < 0.0001, and someone advised Gym users to take anabolic-androgenic steroids” OR [95%CI] = 2.26[1.23 − 4.14], P < 0.008. Our findings suggest that the level of awareness regarding the possible side-effects of AAS is fairly limited. Thus, efforts directed toward educating the public and limiting access to AAS as well as health policy reforms are crucial to reduce future negative implications of AAS use.

Androgen abuse epidemiology

PURPOSE OF REVIEW

To systematically review current epidemiological literature on androgen abuse. Estimates from 32 empirical epidemiological articles were reviewed.

RECENT FINDINGS

Generally, androgen abuse epidemiology and prevalence is higher in Europe, the Middle East, North America (the USA), Oceania (Australia and New Zealand), and South America (Brazil) and lower in Africa and Asia. In contrast to the general population, androgen abuse epidemiology and prevalence is higher among athletes, injection drug users, recreational sportspeople, and sexual and gender minorities.

SUMMARY

From the 1970s, androgen abuse spread from athletes into the general population. Consistent with previous evidence, reviewed studies suggest that androgen abuse epidemiology and prevalence is higher in Western cultural contexts, the Middle East, and South America (Brazil) and lower in Africa and Asia. Evidence also corroborates indications that androgen abuse is less prevalent among women (vs. men), and in the general population in contrast to particular subpopulations consisting of athletes, injection drug users, recreational sportspeople, and sexual and gender minorities. Adolescents' androgen abuse should be of special concern. Androgen abuse in some nonsports occupations (e.g. security workers) requires further exploration. Polypharmacy and the Internet proliferation of androgens and other PIEDs require surveillance for prevention and harm reduction.