Athletes are such a group of people who you would think would pay more attention to their body. In 1996 spending on supplements in US was $6.5 billion and in 2002 was $18 billion with sports nutritional products making up one third of sales, so sports supplements are a huge market.

It was interesting to read a recent study in the Singapore Medical Journal, which examined the use of nutritional supplements by university athletes in Singapore. As most studies have focused on Caucasian populations, this study looked at university students in Asia, who would be highly educated with access to scientific literature, yet also exposed to traditional herbal products since birth. Over 75% of the 82 athletes questioned used supplements, consuming on average up to 3 products a day. The most popular products included sports drinks (90%), vitamin C (49%) multivitamins (30%) and glucosamine (20%). Over 90% of the athletes were Chinese which could explain why other popular products were traditional/herbal preparations such as essence of chicken (11%), edible birds nest (11%), and ginseng. Interestingly only one athlete took creatine. Similar to studies of their peers in the West, the most popular products were sports drinks and vitamin/mineral supplements. However, whilst the majority of Western university females reportedly consume supplements for general health benefits and male athletes aim to enhance sporting performance, all but one of the Singapore students consumed supplements for health benefits. This could be because elite sports aren’t as prestigious as in the West. You could speculate that some of those taking supplements for sports may be ignorant or blasé to the risks if they are intent on enhancing sporting performance. But surprisingly in this study, it is the university educated people taking supplements to improve their health, who don’t investigate the health risks of what they are consuming.

The study found that:

• 93% didn’t know where to obtain reliable information
• 86.4% unaware supplementation can have adverse health effects.
• More than 1/3 had no or minimal knowledge about the product they consumed
• Males were more likely than females (81% vs 52%) to research a product and those with more knowledge were more likely to use supplements.
• Before using 65.9% sought info from the media, internet, coaches and fellow athletes.
• The most frequent explaination (38.5%) for not seeking further information was that ‘the product must be safe since it is commonly available’

Whilst this study may have limitations, it is concerning that people are unaware of the health effects of their supplements, nor do they know where to get reliable information from. I agree with the conclusions of the authors, which should be taken on board by those taking supplements for either health benefits or sporting performance.

• Supplements with scientific evidence may only benefit specific athletes.
• Athletes must be aware of the additive or synergistic effects of the supplements.
• Endorsements by well known personalities fail to mention the long hours of training and sound nutrition which were responsible for their success.
• Whilst some products have sound scientific backing, many traditional/herbal preparations have not been validated by rigorous scientific investigation.
• Use supplements with caution and examine the product for safety, efficacy, potency and legality with a healthcare professional prior to use.

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