Should Sports Supplements Be Banned for Teens?
By Rick Collins, Esq.
Q: Will new laws restrict teens from buying sports supplements?
A: Lawmakers in some states1 have introduced bills to make it illegal to sell supplement products that are marketed to build muscle or manage weight to anyone under 18 years of age without a prescription. In addition to over-the-counter diet pills, the bills would ban supplements like creatine, BCAAs and assorted herbal products like ashwagandha from being sold to minors either in stores or online.2 One group advocating such legislation presents safety videos highlighting the dangers of sports nutrition products and recommending pharmaceutical-level regulations over supplements.3 They also argue that diet pills and muscle-building supplements promote teen eating disorders. The legislatures of both California and New York have already passed these bills, but their governors vetoed them, likely because of ambiguity as to how state health authorities would determine which specific products would be subject to enforcement. That doesn’t mean the issue is resolved. We can expect the advocates and lawmakers pushing them to make revisions and try again.
Supplement industry representatives say the claims are baseless. “It’s disingenuous and flat-out wrong to suggest the use of dietary supplements causes eating disorders,” said Daniel Fabricant, Ph.D. president and CEO of the Natural Products Association. “There is not a single data point that reflects these absurd claims.” A Freedom of Information Act request to the FDA produced no data connecting dietary supplements to eating disorders. While everyone agrees that disordered eating among teens is a problem that should be taken seriously, directing the blame at supplements is the point in contention.
Proponents of teen restrictions claim that supplements intended to achieve weight loss or to build muscle encourage unhealthy body ideals and entice young people to look too thin or too buff. But body composition is just one tiny piece of the much larger problem of cultural imagery and social media influence pressuring teens toward vanity modifications and surgical procedures to their lips, cheeks, chin, breasts and butts.
Just how prevalent is the use of diet pills and muscle-building products among teens? Is it a rising epidemic? The “go to” resource for answers is the Monitoring the Future survey, an annual study of adolescent behaviors, attitudes and values conducted by the University of Michigan since 1975. The 2022 data have just been published and include the reported annual use prevalence of drugs such as anabolic steroids (including androstenedione) but also of over-the-counter weight-loss pills and sports supplements like creatine.4
For over-the-counter diet pill use, annual prevalence among 12th graders is 1.6%. But annual use has gradually decreased since it peaked 20 years ago at 15.1%. By comparison, look at adolescent obesity. While two opposing problems can coexist, obesity – which leads to future risks of debilitating and deadly diseases including diabetes, heart disease and some cancers – is the vastly more prevalent and worrisome problem at a staggering 22.2% among 12- to 19-year-olds.5
For creatine use among 12th graders, the 2022 annual prevalence of 11.8% is just a tiny bit higher than the 11.7% of 2001. Prevalence over the intervening years was generally 8% to 10% (the prevalence among 8th and 10th graders is relatively lower but has risen). But while the legacy media keep sounding the alarms about creatine6, the comprehensive International Society of Sports Nutrition position stand states: “[A] number of short- and long-term studies using relatively high doses of creatine have been conducted in infants, toddlers and adolescents … These studies provide no evidence that use of creatine at recommended doses pose a health risk to individuals less than 18 years of age.”7 While some researchers argue that more studies of creatine use in adolescent populations are needed, they concede that there is currently “insufficient data to justify age restrictions on creatine.”8
The 2022 usage data for androstenedione (explicitly a drug, not a supplement) are more puzzling. While 1.9% for 12th graders is less than the 3.0% high in 2001 before it was classified as a controlled substance, androstenedione can now only be available from illicit steroid sources. Have you heard of a black market for andro? Of course not, when far more effective gear can be purchased from the same dealers. This odd data may be a case of teens confusing andro with dietary supplements or with peptides or SARMs.9
As for the annual use prevalence of anabolic steroids, there’s no big news. The 2022 numbers (e.g., 1.3% for 12th graders) are in line with pre-pandemic levels over the past 15 years, with reports from all grades way down from the highs back in the early 2000s.
In sum, there’s no credible support for the proposed restrictions based on eating disorder concerns. Even if there was merit to STRIPED’s theory that the marketing or availability of certain products cause unhealthy eating, then shouldn’t lawmakers begin by banning all the high-calorie, sugar-overloaded, low-nutrient garbage lining supermarket shelves nationwide? How can you blame fit-focused supplement products while ignoring health-destroying food products – many of them specifically targeted at kids – when childhood obesity rates are at all-time highs?!
Rick Collins, Esq., CSCS [https://rickcollins.com/] is the lawyer who members of the bodybuilding community and dietary supplement industry turn to when they need legal help or representation. [© Rick Collins, 2023. All rights reserved. For informational purposes only, not to be construed as legal or medical advice.]
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References:
1. States include California, Massachusetts, New Jersey, New York and Rhode Island.
2. Although generally exempting protein powders, drinks and foods, the bills provide no guidance as to how state health departments are to determine precisely which products would be illegal (e.g., would “muscle building” include recovery drinks?).
4. https://monitoringthefuture.org/wp-content/uploads/2022/12/mtf2022.pdf
5. www.cdc.gov/obesity/data/childhood.html
6. However, the “biggest concern for teens is the potential impurity” of dietary supplements generally, not creatine itself. www.npr.org/sections/health-shots/2017/01/02/507478762/is-the-warning-that-creatines-not-for-teens-getting-through
7. https://jissn.biomedcentral.com/articles/10.1186/s12970-017-0173-z#Sec18
8. www.ncbi.nlm.nih.gov/pmc/articles/PMC6279854/
9. If confused kids are erroneously reporting “andro” usage, are they also erroneously reporting “steroid” usage? Are all the numbers partially inflated?
