Athletes and Supplements: Prevalence and Perspectives
Open accessAbstract
In elite sport, where opponents are evenly matched, small factors can determine the outcome of sporting contests. Not all athletes know the value of making wise nutrition choices, but anything that might give a competitive edge, including dietary supplements, can seem attractive. Between 40% and 100% of athletes typically use supplements, depending on the type of sport, level of competition, and the definition of supplements. However, unless the athlete has a nutrient deficiency, supplementation may not improve performance and may have a detrimental effect on both performance and health. Dietary supplements are classified as a subcategory of food, so manufacturers are not required to provide evidence of product safety and efficacy, nor obtain approval from regulatory bodies before marketing supplements. This creates the potential for health risks, and serious adverse effects have been reported from the use of some dietary supplements. Athletes who compete in sports under an anti-doping code must also realize that supplement use exposes them to a risk of ingesting banned substances or precursors of prohibited substances. Government systems of regulations do not include specific laboratory testing for banned substances according to the WADA list, so a separate regulatory framework to evaluate supplements for their risk of provoking a failed doping test is needed. In the high-performance culture typical of elite sport, athletes may use supplements regardless of possible risks. A discussion around medical, physiological, cultural, and ethical questions may be warranted to ensure that the athlete has the information needed to make an informed choice.
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Estrogen-based hormone replacement therapy results in an increased basal plasma osmolality, plasma volume expansion, and an earlier osmotic threshold for arginine vasopressin release (e.g. 280 vs. 285 mOsmol/kg H2O), but a reduction in urine output, resulting in greater overall fluid retention.
“Estrogen-based hormone replacement therapy results in an increased basal plasma osmolality, plasma volume expansion, and an earlier osmotic threshold for arginine vasopressin release (e.g. 280 vs. 285 mOsmol/kg H2O), but a reduction in urine output, resulting in greater overall fluid retention.”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [281]
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Experimental — accuracy not yet measuredThe higher overall fluid retention from estrogen-based hormone replacement therapy is not due to increased free-water retention, but rather increased sodium retention- the synthetic estrogens inducing a reduction in sodium excretion, eliciting a slight reduction in the hyponatremic risk.
“However, the higher overall fluid retention is not due to increased free-water retention, but rather increased sodium retention- the synthetic estrogens inducing a reduction in sodium excretion [278,281], eliciting a slight reduction in the hyponatremic risk.”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [281]
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- Authors
- Garthe, I., & Maughan, R. J.
- Affiliations
- The Norwegian Olympic and Paralympic Committee and Confederation of Sport
- University of St Andrews (GB)
- ORCID
- Maughan, Ronald J.
- Venue
- International Journal of Sport Nutrition and Exercise Metabolism
- Publisher
- Human Kinetics
- Published
- 2018-03-01
- Volume
- 28
- Issue
- 2
- Pages
- 126-138
- ISSN
- 1526-484X (ISSN-L)
- 1543-2742
- OpenAlex
- W2794494875
- Cited by
- 383
- References
- 61
- Citations by year
- 2026: 45 · 2025: 47 · 2024: 65 · 2023: 54 · 2022: 54 · 2021: 51 · 2020: 35 · 2019: 16 · 2018: 16
- FWCI
- 10.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Sport Nutrition and Exercise Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- World Anti-Doping Agency
- Topics
- Social Sciences › Sociology and Political Science › Doping in Sports
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
- Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
- Keywords
- dietary supplements, athletes, elite sport, anti-doping, banned substances, supplement regulation, supplement safety, ergogenic aids, dietary supplementation, informed choice
- MeSH terms
- Doping in Sports, Humans, Nutritional Requirements, Dietary Supplements, Athletes, Performance-Enhancing Substances, Sports Nutritional Physiological Phenomena
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