Promoting functional foods as acceptable alternatives to doping: potential for information-based social marketing approach
Journal Title (Medline/Pubmed accepted abbreviation): J Int Soc Spor Nutr
Year: 2010
Volume: 7
Number: 37
Page numbers: 1-11
doi: 10.1186/1550-2783-7-37

Summary of Background and Research Design

Background: Performance enhancing agents include functional foods (FF), dietary supplements, and prohibited performance enhancing drugs (PED). Anti-doping campaigns have typically focused on the negative consequences associated with PEDs, rather than offering comparable or alternative options for improved performance. Use of social marketing strategies for anti-doping education can complement existing approaches by promoting acceptable alternatives to PEDs.

Hypothesis/purpose of study: This study was conducted to determine whether a single exposure to a social media-based anti-doping education initiative could modify awareness, beliefs, and automatic associations regarding performance enhancements.

Subjects:Subjects (N = 115, age 18 to 45 yr) included male body builders, athletes, and recreational gym users (n = 108) with some experience or knowledge of nutritional supplementation.

Experimental design:Repeated-measure, blinded psychological evaluation

Treatments and protocol:This paper describes the second phase of an ongoing trial. In the first phase, volunteers were asked to give 5 examples in each category of healthy foods, muscle building, and endurance supplementation. The most common answers were used to populate a questionnaire and computerized test (Brief Implicit Assessment Test) that was completed before reviewing a brief informational pamphlet on nitrite/nitrate and erythropoietin (social media intervention). These 2 topics were chosen because they are representative of FF and PED approaches, respectively, to achieve similar sports performance benefits (basically associated with improved oxygen delivery and utilization). The questionnaire assessed:
  • Knowledge, beliefs, and automatic associations to the utility of FFs and chemical-based supplements
  • Questions pertaining to nitrate supplementation
  • Which information sources the volunteer used for supplement knowledge
  • Rating comparison test of FFs and chemical-based supplements
    • Gym users answered an additional Likert-style questionnaire regarding the degree of stimulation, endurance, strength, overall competitiveness and overall performance enhanced by each FF or supplement
  • Rating of fruits and FFs by either functionality or health
The questionnaire was completed again after reviewing the informational pamphlet (at least 24 hours later). Next, computerized assessment was performed that measured automatic associations between FFs and PEDs/supplements to strength of association with the agents relating to functionality or health.

Summary of research findings:
  • Before the intervention, 73 of 115 subjects felt that FFs were not comparable healthy alternatives to PEDs. However, after the intervention, 78 of 114 did believe that FFs were a comparable healthy alternative toPEDs.
  • Before the intervention, most responders believed that substances on the World Anti-Doping Association (WADA) List of Prohibited Substances were effective for performance enhancement (extremely effective: 17.4%, fairly effective: 21.7%, effective: 26.1%, somewhat effective: 29.6%, not at all effective: 5.2%). These numbers were unchanged after the intervention.
    • 2 belief measures increased after intervention: beetroot juice as an endurance performance aid significantly increased (Z = -6.312, P < .001) and belief in FFs as overall performance enhancers (Z = -7.601, P < .001).
  • Knowledge was significantly increased by the information-based intervention (pamphlet) in 3 key areas (P < .001 for each):
    • Knowledge of nitrate supplementation (77%).
    • Recognizing foodstuffs as FFs (93%).
      • However, this occurred at the expense of foodstuffs being concurrently recognized as “health-oriented.”
    • Knowledge of erythropoeitin (74%).
      • The question on erythropoetin was included for comparison purposes. The authors had to provide some information on erythropoetin, although the educational material was largely geared to nitrates/nitrites and nitric oxide. Despite the more intense focus on nitric oxide in the pamphlet, it appears that the information on erythropoetin transferred better, as just 2.6% of subjects had an increased knowledge of nitric oxide.
  • The primary information sources for nutritional supplements were the internet (47%), training partners (41%), and friends (38%). Coaches, family, fitness and/or specific sport magazines, television, and information pamphlets were less significant information sources (< 3%).

Interpretation of findings/Key practice applications:

The results provided evidence that knowledge (achieved via a meaningful message) is, in fact, linked to beliefs and implicit attitude formation. However, a single exposure to a positive social educational tool about the healthful and performance-enhancing effects of FFs can change beliefs and alter preconceived associations on the utility of these foods in recreational gym users. Following intervention, FFs were viewed more as potential performance enhancers, rather than just a healthy food option, suggesting that beliefs and associations toward FFs can be modified in the short term by persuasive positive literature. Increased knowledge of the physiologic and performance-enhancing effects of FFs, especially nitrate-rich foods, can change attitudes and opinions. Adopting social marketing and communications techniques such as observing market segmentation and targeted messaging may have a positive effect on the perception of FFs as acceptable alternatives to PEDs.
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