Health Advice



Supplements and Kids

Charlyn Fargo on

You may want to check your kids' backpacks. If he or she is a middle-school athlete, you might find some supplements instead of healthy snacks.

In a recent investigation into the prevalence of dietary supplement and sports food use in male and female middle-school-aged runners, researchers found that almost half the study participants used these products on two or more days a week during the prior year. Characteristics associated with supplement use included a prior bone stress injury, following a vegetarian diet and behaviors suggesting dietary restrictions such as losing weight and skipping meals. The study was published in the Journal of the Academy of Nutrition and Dietetics.

"The preadolescent years represent a crucial period of growth. While previous studies have examined the use of dietary supplements in high school and college athletes, intake among preadolescent athletes was unknown," wrote lead author Michelle Barrack, registered dietitian with the Department of Family and Consumer Sciences, California State University, Long Beach, California.

"It is important to evaluate this population due to the recognition of an elevated risk of low bone mineral density, bone stress injury, and inadequate intake of energy," said Barrack. "Additionally, in some cases, dietary supplements have been associated with the development of adverse events in children and adolescents."

Data were gathered from 2,113 middle school-aged cross-country runners who completed a survey on dietary supplement use and related factors. Dietary supplements included vitamin/mineral and non-vitamin/mineral products; sports foods included energy bars, carbohydrate-electrolyte drinks, and protein bars or drinks. The survey covered demographic information, weight, height, sports participation history, weekly exercise training, running performance times, dietary patterns, menstrual function, history of a clinical eating disorder, and injury history. Respondents were asked to indicate the type and frequency of supplements and sports food consumption over the last year.

Among the middle school runners surveyed, 42.7% used either a dietary supplement or sport food on two or more days per week. Overall, 26.1% of runners reported using one or more dietary supplements, and 32.6% reported use of a sports food. Girls reported higher use of multivitamins/minerals, vitamin D, calcium, iron, probiotics and diet pills. Boys reported higher use of creatine and sports food.


A higher proportion of runners with supplement use, compared to preadolescents with no supplement use, followed a vegetarian diet; were underweight; had one or more running-related injuries; met criteria for elevated dietary restraint; had a diagnosed eating disorder; or reported currently attempting to gain weight. Supplement use was reported by 51% of runners who skipped meals and 77% of runners with weight loss in the past year. The findings support associations between higher supplement use and factors consistent with lower food intake or energy deficiency.

Researchers say this is the first study to observe the association in youth runners and that the findings point to the need for teaching middle school runners about the importance of getting enough calories and not skipping meals.

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