Dietary supplement (e.g., caffeine, dietary nitrate, creatine) use is widespread across all sports. However, research in the last two decades has shown that dietary supplement users may be at a greater risk of intentionally and unintentionally doping. Two perspectives can be used to explain this. First, dietary supplement users are suggested to be more likely to intentionally dope in the future than non-users due to the normalisation of using substances to improve performance. Second, several athletes have doped unintentionally after the dietary supplement they used was cross-contaminated with a prohibited substance. Given this, international and national sport organisations identify dietary supplements as a significant risk factor for athletes intentionally and unintentionally doping. In this symposium, we will summarise the extant literature and explain why a dietary supplement user may be more likely to intentionally and unintentionally dope than a non-user. The first speaker will offer insight into what may protect a dietary supplement user from unintentionally doping. The second will review and synthesise data from the past 20 years to determine whether dietary supplement users are more likely to dope than non-users. The third will critically analyse the frequency and types of dietary supplements that may predispose an athlete to be more at risk of doping intentionally and unintentionally.
ECSS Paris 2023: IS-SH02
Dietary supplement users are at an increased risk of unintentionally doping than non-users. A body of evidence has shown that due to issues with manufacturing, dietary supplements can become cross-contaminated with substances that are prohibited for use in sport. In fact, reports from the Court of Arbitration for Sport indicate that 45% of athletes who failed a drug test, were attributed to the use of a dietary supplement that had become contaminated with a prohibited substance. Despite athletes being aware of the risks associated with cross-contamination and having received education to ensure the supplements they take have been batch tested (i.e., contain no prohibited substances), athletes continue to use supplements to facilitate their performance. While evidence for the occurrence of cross-contamination is well-established, a paucity of research exists for why athletes choose to use a dietary supplement when a significant unintentional doping risk is present. To help anti-doping organisations develop more effective education interventions and target factors that prevent unintentional doping, a need exists in understanding the psychological reasons for that best protect an athlete from using a dietary supplement. In the anti-doping psychosocial science literature, a number of factors have been identified to be related to doping. Athlete’s beliefs that dietary supplements are effective has consistently been shown to be related to both dietary supplement use and doping. That is, athletes that use dietary supplements are more likely to believe that they are effective and in turn, use prohibited substances. However, no research has considered whether athletes are aware that dietary supplements can be contaminated and if this in turn, influences their beliefs and use of dietary supplements. The aims of the presentation are to explain the role of dietary supplement beliefs in the decision to use performance enhancing substances, and how awareness of the risk of cross-contamination may influence the relationship between dietary supplement beliefs and use. A theoretical model will be posited before highlighting empirical cross-sectional research on the relationship between awareness of cross-contamination, dietary supplement beliefs and use. Finally, the speaker will highlight how anti-doping organisations can use results of this data to develop more effective education interventions that foster better understanding of the risks associated with dietary supplements and unintentional doping.
Read CV Yuka MurofushiECSS Paris 2023: IS-SH02
For over 20 years, researchers have recognised that those who use dietary supplements are more likely to use prohibited performance enhancing substances. Reasons for this are suggested to relate to athletes normalising the use of performance enhancing methods and over time, progressing to doping for equal or better performance improvements. That is, an athlete who uses a dietary supplement is suggested to become comfortable with using these substances to improve performance, normalise the practice of using performance enhancing substances, and over -time seeks out stronger and more potent substances to achieve similar or better results. However while a number of individual studies have examined the phenomena, a need exists in summarising and synthesising the extant literature to help identify the relative risk dietary supplement use has on intentional doping. To help improve precision and understanding of the risk dietary supplement use has on doping, in this presentation, the speaker will report the results of a systematic review and meta-analysis of studies examining the relationship between dietary supplement use and doping. Briefly, the speaker will highlight that from 23 studies including 8,822 athletes, dietary supplement users are over 2.5 (Odds ratio = 2.77, 95% CI = 2.10 to 3.57) times more likely to dope and have a greater intention (pooled r = 0.26, 95% CI = 0.18 to 0.34) and more favourable attitude (pooled r = 0.20, 95% CI = 0.13 to 0.28) to dope than non-users. Reasons for why dietary supplement users progress to prohibited substance use will be described and the psychosocial factors that anti-doping educators can use in their interventions to best protect dietary supplement users from doping will be explained. The speaker will also highlight the practical implications for athlete practitioners (e.g., coaches, nutritionists, physiotherapists) aiming to prevent their athletes from intentionally doping after using a dietary supplement.
Read CV Philip HurstECSS Paris 2023: IS-SH02
In the previous two presentations, dietary supplement use has shown to be a risk for both intentional and unintentional doping. While the research underpinning both presentations highlight the significant risk athletes may be exposing themselves to when using a dietary supplement, evidence is limited in that it does not consider the frequency and types of dietary supplements used. That is, researchers assessing the relationship between dietary supplement use and intentional doping often group all types of dietary supplement users together and do not quantify how often an athlete uses the supplements. Arguably, an athlete using an electrolyte sports drink once to remain hydrated during a competition is less likely to dope than another using a pre-workout supplement daily to gain a competitive advantage. Understanding whether certain supplements pose a greater risk to unintentional and intentional doping is important given that prevelance of dietary supplement use is estimated at over 60% and many athletes will look to seek out ways in which they can facilitate their performance. To help athletes and practitioners identify which supplements are more likely to increase the risk of intentional and unintentional doping, a need exists in examining the relationship between frequency of use and likelihood to dope and identifying the supplements that are more likely to be cross-contaminated and cause unintentional doping. The aim of this presentation is to provide data on the frequency and types of dietary supplement used in relation to the likelihood to intentionally dope and critically review evidence of the substances that athletes may use that could lead to unintentional doping. The speaker will highlight that athletes who use ergogenic and medical supplements daily, are at an increased risk of doping intentionally than those who use sport foods and drinks sparingly. Afterwards, a comprehensive review of studies examining cross-contamination in supplements will be given, which reports multi-ingredient, pre-workout, and muscle-building supplements (e.g., protein shakes) as the greatest risk for cross-contamination, and reasons for why this occurs will be discussed. To help best protect athletes from both unintentional and intentional doping, the speaker will provide recommendations on how athletes and practitioners can recognise the risks of certain types of supplements and offer alternative methods in which they can achieve their goals.
Read CV Elena García-GrimauECSS Paris 2023: IS-SH02