Dietary supplements and medications in elite sport- polypharmacy or real need?


Journal Title (Medline/Pubmed accepted abbreviation): Scand. J. Med. Sci. Sports
Year: 2011
Volume: 21
Page numbers: 260-267
doi (if applicable): 10.1111/j.1600-0838.2009.01026.x

Summary of Background and Research Design

Background: Athletes often consume dietary supplements and/or mediations (such as ibuprofen) to enhance health and performance and to accelerate recovery.

Research questions: What types of supplements and medications are common among elite athletes? How much of these substances are they taking? Who (age, gender, sport) takes which substances?

Subjects: Elite athletes who underwent doping controls by the Anti-Doping Agency of Serbia on national and international competitions between 2006-2008 (3 yrs) and some medal winners from international and national competitions. The total number of athletes was 912, age 23.9 ± 6 yrs (range 13-48), 72% male. There were 34 sports represented with the largest number of athletes coming from water polo (141), basketball (128), and football (the name for soccer in Serbia; 118).

Protocol: Supplements and medications were tabulated from questionnaires. Dietary supplements were classified into 4 groups according to scientific merit, as described by the Australian Institute of Sport (AIS).

Summary of research findings
  • Dietary supplements had been taken by 61.2% of the athletes, with an average of 3.17/user. The most common supplements were vitamins (53.2% of athletes), minerals (21.5%), and amino acids (15.5%).
  • Medications had been consumed by 40.6% of the athletes with an average of 1.98/user. The most common medications were non-steroidal anti-inflammatory drugs (NSAIDS, like ibuprofen and aspirin, 24.7% of athletes), and cough and cold preparations (10.5%).
  • An even percentage of male and females represented dietary supplement users. However, 50.6% of females used medications whereas only 36.8% of males used medications (p <0.01). Among those who took dietary supplements or medications, there was no difference in gender for the quantity that was taken.
  • Among athletes who used dietary supplements, the athletes in individual sports consumed an average of 3.64/user compared to 2.63/user in team sports.
  • More than one-third of the supplements that were taken by athletes were not conclusively shown to provide performance benefits, as classified by the AIS.

Interpretation of findings/Key practice applications

The use of dietary supplements and medications is extremely common, despite the lack of proof of efficacy for many of these supplements. Because of their widespread use, it is important for athletes and coaches to become educated on the potential risks and benefits of medications and supplements before taking them. A physician is the best person to talk to regarding personal medication use, though it is often difficult for doctors to keep up with supplement information. It is best to acquire supplement information from nonbiased sources such as primary literature and the government (not from the website of the company selling the drug or supplement).

Limitations

Most of the data was acquired from athletes for 3 days before large competitions. It is therefore possible that their medication and supplement use was different on these days compared to their normal regime. For example, they could have taken more pain medication (to ward off pain in competition that they might not practice with normally), take less supplements (if they are banned by the doping agency or in case they have banned substances that were not on the label), or take more supplements to improve performance for the competition. It would be interesting to conduct a questionnaire of athletes’ normal medication and supplement practices.
      This study also was not designed to look into why the athletes were taking the substances and medications and how they choose which ones to take. What benefits they are they expecting (or seeing)?
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