How Safe are Sports Supplements for Teens?

Fueling the glory days
By Adam Swenson

“Each year in the US over 25 percent of high school athletes will use some type of performance-enhancing drug, and well over 50 percent will use some type of energy-enhancing substance,” says Mike Gimbel. Gimbel is a substance abuse trainer for the NCAA and runs a program called “Powered by Me!”

“Many of these supplements and products are legal and some are not. While not as many young athletes are using hardcore anabolic steroids (maybe five percent), the majority of these kids are going to a health food store or on the internet to purchase some type of dietary/muscle-boosting supplement without knowing or understanding the ingredients.”

If you have a child in high school athletics, you know the pressures that can be brought to bear by coaches and teammates—it’s enough to drive many kids to seek any advantage they can. “There is not a young athlete I have worked with that doesn’t want to get bigger, stronger, and faster—usually as quickly as possible,” Gimble says.

“Weight training, cardiovascular exercise, and practice used to be the only tools available to the adolescent athlete,” says Jeff Hendricks, MD, creator of the Rize drink and physician and co-owner at Biogenesis Medical and Wellness Center. “However, with the explosion of nutritional biochemistry research, exercise physiology research, and performance-based nutrition research, nutritional supplements have become ubiquitous among professional, college, and now high school athletes.”

Supplements: three questions to ask

The temptation for teens to seek performance in a bottle is understandable. Parents need good information so they can talk kids through this issue just like any of the other potential pitfalls of adolescence. There are three main questions to ask when considering any individual supplement for a teen athlete: Is it necessary? Is it safe? Is it banned in your particular sport’s governing body? (A fourth question—Is it ethical?—is also worthy of consideration. But I’ll leave that one to you.)

We’ll look at three of the popular performance-enhancing (or perceived to be performance-enhancing) supplements as examples.

Whey protein

Whey protein is probably the most commonly used supplement among teen athletes. Whey protein powder is safe for teens provided they don’t have an allergy to it, aren’t overdoing it, and provided the whey doesn’t contain any banned substances that aren’t on the label.

The banned substance concern sparked the formulation of TwinLab’s Clean Series and Douglas Labs’ Klean Athlete lines. Both undergo rigorous testing to ensure that the label claims are accurate and that they are free of banned substances. TwinLab’s Clean Series whey protein, for example, undergoes banned substance testing from HFL Sports Science, NSF’s “tested and certified” program to verify that what’s on the label is what’s in the bottle, a gluten-free certification, and a third-party non-GMO certification. “If it sounds like we are overwhelming people with certifications, it’s because we’re trying to,” says Marc Stover, director of marketing at TwinLab. “We’re trying to provide this oasis of trust out there in a sea of scary sports nutrition supplements.”

So, looking at our questions, whey protein is safe and legal: Is it necessary? Probably not for most kids. Joel Harper—Dr. Oz’s personal trainer and a spokesperson for TwinLab’s Clean Series—says that an athlete’s diet should be 35 percent protein. If a kid is getting a good amount of clean protein in their diet—from eggs, meats, beans, fish, and so on—and their overall protein needs are not that great, then they probably don’t need it.

But, as Dr. Hendricks points out, “Have you seen your teenager’s diet lately? Have you seen the school cafeteria menu? Our children are eating extremely calorie-dense diets with far too much fat and far too much simple sugar. When I was a medical student, the only type 2 diabetics were overweight adults—type 2 diabetes in children was almost unheard of. It is now common and approaching epidemic levels. This is one of the biggest travesties for our youth today and the next generation will pay an unbelievable price for it. So, while I agree with the statement that ‘kids should get what they need through diet, period,’ what should be happening and what is happening are miles apart.”

If a kid needs a very large amount of protein (a 200 pound football player doing a lot of weightlifting might need 160 grams of protein a day) it may be very difficult to meet those requirements through diet alone. If that’s the case, it’s appropriate for the parents to discuss with the athlete and coach a whey protein that is certified free of banned substances.

Creatine

Creatine has been popular among the weightlifting set for quite some time now. Bodybuilding.com says, “Creatine works very well for increasing muscle mass. It is naturally occurring in the body. It’s safe and very effective for anybody, especially if you’ve never used it before … The basics behind it are this: it increases ATP (the main energy source muscles use for explosive power) availability so that you can perform more reps and sets and lift more weight, consequently growing more muscle tissue.”

What red-blooded 17-year-old man-child can resist that? Who doesn’t want to build more muscle? And it’s natural! Well yes, but … Let’s run it through the three questions.

Dr. Hendricks says, “Creatine is not necessary: It can interfere with kidney function in high doses, can increase risk of injury to muscle during exercise, and can worsen performance and quickness due to fluid retention. Overall I think it is of limited use except in aggressively training bodybuilding which is a completely different sport with many, many risks that are inappropriate for adolescent athletes.”

The University of Maryland also noted a survey conducted with college students finding that teen athletes frequently went over the recommended dosages of creatine. On top of that, it hasn’t been tested for safety or effectiveness in those under 19. Creatine is not a banned substance, so it passes in that regard, but there’s really no reason for teens to take it. Your body produces it, and it occurs in fairly high levels in meats anyway: better by far to get it from your diet.

DHEA

DHEA is sneaky. It’s so innocuous looking, sitting there on the shelf at Walmart, 60 capsules for six bucks—and if anyone asks you can always say you’re buying it for grandma.

Not so fast there, buck. DHEA is produced in large amounts in teen bodies and is a precursor to sex hormones like estrogen and testosterone. DHEA production falls off in our bodies as we age, which is why people supplement: It helps restore energy and maintain bone mass (among other things) in the aging population. All well and good.

But does an 18-year-old have any business adding more testosterone to their system? Absolutely not—their hormones are already redlining without such intervention. On top of that, it’s a banned substance, filed under anabolic agents/anabolic steroids—just keep walking.

So what do teen athletes need?

Good diet. Water. Sleep. Exercise. If you have those in place, you’re well ahead of the game.

“The diet is the best place to address the nutrients coming into your body,” says Andrew Halpner, PhD, vice president of product development and technical services at Douglas Labs. “The core of a good diet and hydration is the place where everybody starts, but especially teens.”

Harper stresses the importance of breakfast: “A lot of teens don’t eat breakfast. However busy you are, you have got to eat breakfast within 30 minutes of getting up.”

Around game time Harper says “a pre-competition meal of quality carbs, lean proteins, and plenty of fluids is smart. Carbs from sources like fruit, grains, pasta, and vegetables will provide the fuel for the young athlete. After competition, make sure to replenish fluids and eat foods rich in carbohydrates within 30 minutes of exercise, and protein within two hours. Yogurt or a fruit smoothie with a bit of lowfat milk is a healthy and easy option. I always put a little protein powder in here as well as my oatmeal in the morning.”

As Harper says, eating within 30 to 60 minutes after exercise is very important to prevent further muscle breakdown and to start recovery, especially if you’ve got another workout coming up in eight hours or less. This is the window when the muscles are most ready to take in nutrients and start rebuilding. Chocolate milk has become a new go-to recovery beverage because studies have shown that a 4:1 ratio of carbs to protein is ideal for recovery, and chocolate milk fits this ratio very nicely. Plus it’s convenient and delicious!

And, for recovery, not all carbs are created equal. Shoot for “short-chain” carbs like glucose and sucrose as opposed to fructose. Pamela Nisevish Bede, MS, RD, writes, “In other words, plan your recovery meal around starchy foods rather than fruits and soft drinks—you don’t have to totally avoid these items; just don’t make them your main source of carbs.”

It’s also appropriate to hedge against potential nutritional shortcomings with a multivitamin, to protect digestive health with a probiotic, and to guard against the free radicals produced by intense exercise with a good omega-3. There’s significant potential upside with these and essentially no risk involved, though parents still ought to look for a sport certification on the multi just for that extra peace of mind that the supplement is free of banned substances.

Regarding hydration, Karen Todd, RD, of Kyowa Hakko, says, “With any athlete at one to two percent dehydration of your body, you’ll get some performance decreases—especially at two percent.” (To clarify, she is talking about losing two percent of your body weight in water.) “You’ll feel kind of lethargic or not as aware of things happening, so it’s important to not get to that point. That [hydration] is probably the single most important part [in preventing] performance decreases.”

Good choices

In the end, there’s no substitute for sleep, water, a healthy diet, and hard work. “I try to educate kids that there is no quick fix,” Harper says. “You’ve got to do the work, and you’ve got to put the time in—that’s when you feel better about yourself.”

 

Energy Drinks: The Good, the Bad, and the Caffeinated

We’d be remiss if we didn’t talk about energy drinks in a feature on sports supplements for teens. Energy drinks are a megamarket and teens guzzle them. (For that reason, the American Medical Association is calling for a ban on marketing energy drinks to teens.) When I asked Dr. Hendricks to comment on how big energy drinks are among teens, he said, “Does this question really need an answer?”

Mike Gimbel noted that, “Energy drinks and other diet supplements will increase their heart rates and increase their blood pressure while giving them a quick (but short-lived) boost of energy and alertness. I always tell kids the familiar saying: ‘What goes up must come down.’ Using energy drinks and caffeine products will eventually take your energy and stamina away. Caffeine is also a diuretic and will dehydrate a person, which is the number-one concern for athletes playing in the summer months.”

On top of that, the caffeine and stimulant combinations are not regulated, and it is not uncommon for energy drinks to contain banned substances, which can go by many names. In 2012, 10 Menomonie High School students in Wisconsin found out that their energy drinks (C4 Extreme) contained a banned substance, synephrine HCL, which is structurally similar to ephedra. The indiscretion cost them the first three games of the season.

For most situations, water is all that is required for athletes. If you want to look into alternatives, check out Dr. Hendricks’ Rize drink and drinks containing Sustamine from Kyowa Hakko—you can get the latter at GNC. Rize will actually provide a sustained energy boost (note that it does contain caffeine), and Sustamine is an excellent ingredient to help with—not hinder—hydration.

 

NCAA Banned Substances

The lists of banned substances varies to some degree between sports governing bodies (and sometimes it’s difficult to even find a list), but if you want a good starting point for banned substances, check out the following list from the NCAA:

>>Stimulants

>>Anabolic Agents

>>Alcohol and Beta Blockers (banned for rifle only)

>> Diuretics and Other Masking Agents

Street Drugs

>>Peptide Hormones and Analogues

>>Anti-estrogens

>>Beta-2 Agonists

Note: Any substance chemically related to these classes is also banned.