Teens face many pressures growing up as part of their passage into adulthood. Besides the usual suspects of alcohol, drugs and smoking, there is another lurking pressure: the supplement industry. In fact, ask any teen who has ever set foot in a health food store about the barrage of supplements being marketed to them promising gains in size, energy, and strength. You may also want to ask them about the salespersons who work in such stores who dispense advice about these products.
Trying to gain a better understanding of the tactics used in this industry, one research team decided to do just that: conduct a study to understand the recommendations of such salespersons who dispense advice to teens who are interested in using these supplements.
In the study, one of the researchers went undercover, posing as a 15-year-old football player with a goal of trying to build muscle and called 244 health food stores, inquiring as to whether he should take creatine, a well known sports performance supplement, and naturally occurring substance in the body that is involved in energy production.
The results of the study were quite surprising: 67% of sales attendants in stores nationwide recommended that he use the supplement .The study is published online today in the journal Pediatrics. “The results of our study are an eye-opener and certainly a wake-up call”, explained Dr. Ruth Milaniak, Director, Neonatal Neurodevelopmental Follow-up Program, Cohen Children’s Medical Center, New Hyde Park, New York, and the lead author of the study.
The study found that almost 40% of store workers recommended creatine without being asked about it first, while 29% additionally recommended it when prompted about the product.
Upon further analysis of data in the study, male salespersons—compared with female salespersons—were also more likely to recommend creatine without being asked about it first.
But even more concerning was the finding that 74 percent of salespersons stated that the 15-year-old could buy creatine without a parent or guardian.
As a response to the findings of this study, Milaniak urges all pediatricians to have a frank discussion with their teenage patients, and especially athletes, to inform them about the unknown long-term risks associated with use of creatine and testosterone boosters. A separate discussion, she adds, should also take place between parents and teens to set the record straight about such risks.
Creatine works by drawing water out of blood vessels and into muscles, leading to engorgement and enlargement of muscles, which is falsely perceived as gains in size and mass by bodybuilders and athletes. This false sense of gain in muscle mass is actually a gain in water weight, and not enlargement or growth of muscles themselves. The shift of water between compartments can place users at risk for kidney and liver failure, electrolyte abnormalities, as well as rhabdomyolysis, which is associated with muscle breakdown.
The American Academy of Pediatrics (AAP) has issued a recommendation against the use of creatine , even though warning labels on creatine powders, bars, and drinks state it is not to be used under the age of 18. The American College of Sports Medicine has also issued the same warning against use of creatine under the age of 18.
“There is no magic pill to make gains in size and strength,” cautioned Milniak . “It’s the old-fashioned recipe of hard work, a balanced diet, sound nutrition and regular exercise.”
“We need to counsel teens about safe and healthy approaches to improve athletic performance that do not involve powders, pills and the use of such supplements,” she added.
The study also highlights the ongoing issue that the FDA does not regulate supplements–which, in fact, are technically considered a “food” and not a drug. In truth, legal loopholes and maneuvers keep supplements under a protected status, allowing them to avoid direct regulation. And in truth, when it comes to supplements, the FDA has often been reactive, rather than proactive in its stance, with the additional concern that such products may also be tainted and contain impurities, further placing consumers at risk for injury, harm or even death.
Milaniak and her co-authors recommend that retailers and state legislatures consider placing bans on the sale of these products to minors.
“We have to continue to put pressure on our legislators to push for bans on supplements,” urged Milaniak.
While alternative measures such as warning labels may potentially alert consumers to dangers, teens often will not read these labels, Milaniak explained, making this measure less effective compared with an all-out ban.
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