Despite the American Academy of Pediatrics’ recommendations against pediatric use of creatine and testosterone boosters, research suggests that many young teenagers take these dietary supplements. Our objective was to determine to what extent health food stores would recommend and/or sell creatine and testosterone boosters to a 15-year-old boy customer.
Research personnel posing as 15-year-old high school athletes seeking to increase muscle strength contacted 244 health food stores in the United States via telephone. Researchers asked the sales attendant what supplements he/she would recommend. If a sales attendant did not mention creatine or testosterone boosters initially, each of these supplements was then specifically asked about. Supplement recommendations were recorded. Sales attendants were also asked if a 15-year-old could purchase these products on his own in the store.
A total of 67.2% (164/244) of sales attendants recommended creatine: 38.5% (94/244) recommended creatine without prompting, and an additional 28.7% (70/244) recommended creatine after being asked specifically about it. A total of 9.8% (24/244) of sales attendants recommended a testosterone booster. Regarding availability for sale, 74.2% (181/244) of sales attendants stated a 15-year-old was allowed to purchase creatine, whereas 41.4% (101/244) stated one could purchase a testosterone booster.
Health food store employees frequently recommend creatine and testosterone boosters for boy high school athletes. In response to these findings, pediatricians should inform their teenage patients, especially athletes, about safe, healthy methods to improve athletic performance and discourage them from using creatine or testosterone boosters. Retailers and state legislatures should also consider banning the sale of these products to minors.
Comments
RE:
Dr. Herriman and her co-authors are to be commended for developing, implementing and publishing “Dietary Supplements and Young Teens: Misinformation and Access Provided by Retailers.” It is a very helpful look at what really happens when teens actively seek information on the topic of performance enhancing agents from non-medical resources. As Dr. Herriman points out, there are many issues surrounding use of performance enhancing agents in the pediatric population, and the American Academy of Pediatrics (AAP) has a long history of recommending against their use.
Although Dr. Herriman cited AAP’s 2005 policy statement on use of performance enhancing agents, the AAP’s current policy on this issue is actually contained in the clinical report “Use of Performance-Enhancing Substances” published in Pediatrics in July 2016. This updated report reviews data on those substances in most common use, and also gives providers practical information on counseling adolescents and parents on this topic.
As Dr. Herriman reports, health care practitioners are often not considered resources for information on performance enhancing agents, which leads to the misinformation described in their article. The AAP recently collaborated with the Food and Drug Administration on a project designed to enhance the provider’s ability to comfortably and effectively discuss this topic with patients and families. The end result of this collaboration is entitled “Artificial Perfection” and is a free continuing medical education (CME) activity which guides participants through simulated conversations with teens and parents who raise concerns about use of performance enhancing substances.