This article was first published in The Montreal Gazette
Supplements are not benign. We think they are, but they aren’t. Some promise to boost muscle mass or improve sports performance and are popular with young men. But multiple studies have shown that these products often have inaccurate labels, contain ingredients they shouldn’t, are missing the ingredients they should, and pose a potential safety risk. They might also be the first step along the path toward the use of anabolic steroids.
We should be unambiguously clear that exercise is good for you. We are too sedentary as a society and our kids are no exception. They should move more and spend less time in front of screens. It’s good for kids to play sports, especially team sports, because it provides both cardiovascular benefits and teaches important social skills.
But the goal of working out shouldn’t be to achieve a perfectly chiselled physique. These unrealistic ideals are dangerous. The drive for muscularity that is so prevalent during adolescence and early adulthood in males is not just misplaced, it is associated with increased odds of binge drinking, depression, dieting and the use of muscle-building products.
The problem is these products are not always what they appear to be. A series of studies tested a variety of supplements to determine how closely what was in the bottle matched what was on the label. A 2020 analysis of dietary supplements marketed as natural plant-based alternatives to steroids illustrated the point. Of the 16 listed ingredients tested, six were not detected in the supplements and only four were present in the correct dose. Two products had an ingredient not contained on the label. A subsequent 2021 analysis by the same group found nine prohibited stimulants in the 17 sports supplements they tested. In a further 2023 analysis, 40 per cent of the 57 products tested did not contain any of the labelled ingredients. Many others contained incorrect doses and 12 per cent contained at least one FDA-prohibited ingredient. Only 11 per cent had ingredient doses that matched what was on the label.
These issues prompted the Food and Drug Administration to issue warnings to the public about many bodybuilding products. But a recent study published in JAMA Network Open has suggested another problem. They might be a risk factor for future anabolic steroid use. The study used data from a subset of the Growing Up Today Study (GUTS) and analyzed more than 4,000 males between the ages of 10 and 27. Over the years, they filled out questionnaires about the use of muscle-building supplements like protein shakes, creatine, amino acids and hydroxymethylbutyrate. They also collected data on anabolic steroid use.
Fewer than one per cent of the boys reported using anabolic steroids. But one factor predicted which boys were more likely to have tried anabolic steroids. The odds of trying steroids were eight-fold higher in boys who had taken muscle supplements in the past. And muscle supplements were very common. Nearly in one in three boys admitted to trying them.
There should be little doubt about the dangers of anabolic steroids. A study from Denmark found a three-fold increase in mortality in steroid users. Even if they didn’t kill you, the damage steroids would do to your body would ruin your health.
Not every supplement is dangerous or contaminated with unlabelled ingredients, and most people will not go on to abuse anabolic steroids. But the issue is pervasive enough that it puts young athletes and aspiring athletes at risk. They believe these supplements will improve their sports performance when they probably won’t. They believe they are safe when they may not be. They believe they are necessary to achieve some masculine ideal, when such ideals are a fantasy. They are fundamentally unnecessary.
