A preliminary investigation of nutritional intake and supplement use in Australians with myalgic encephalomyelitis/chronic fatigue syndrome and the implications on health-related quality of life.

BACKGROUND:Worldwide, studies have shown a high prevalence of hormones and nutritional supplement use by athletes and gym members. Many athletes consume unproven, potentially harmful or even banned supplements.OBJECTIVES:To assess the prevalence of the use of hormones and nutritional supplements by people who exercise in gyms in Riyadh, Saudi Arabia, and the types of supplements they most commonly use and to obtain a general view of the main reasons for using these enhancements.MATERIALS AND METHODS:A cross-sectional study using a self-administered questionnaire was conducted at gyms in Riyadh that were selected randomly from different sectors of the city. The sample size was estimated at 289, but the actual number of randomly selected participants in the study was 457.RESULTS:The number of gym members who participated in this study was 457. Approximately 47.9% of the sample reported an intake of nutritional supplements and 7.9% reported that they took hormones. Protein powder was consumed by 83.1% of the participants. Approximately 16.8% of supplement users had noticed some side effects, and 25.7% of those who took hormones had stopped taking them because of adverse effects. Only half of the hormone users (54.2%) reported that they had had medical checkups. The major source of information on supplement and hormone use was non-health professionals; friends being major source (40%) of information on the use of hormones. The use of nutritional supplements was significantly associated with BMI (OR = 1.89, CI = 1.06–3.39), duration of daily exercise (OR = 4.23, CI = 2.06–8.68), and following a special diet (OR = 8.42, CI = 5.37–13.2). There was a very strong association between nutritional supplement consumption and hormone use (P < 0.001).CONCLUSION:Approximately half of the participants who regularly exercised in gyms took nutritional supplements, and most had received their information from nonhealth professionals. There was an association between the duration of exercise and the use of hormones and supplements. Fewer than half of hormone users had obtained a health-care provider's advice before taking it. The atmosphere in the gym can play an important role in members' decisions. Educating gym employees and members may have a positive influence on the use of supplements and hormones.

Although dietary nutrient intake is often adequate, nutritional supplement use is common among elite athletes. However, high-dose supplements or the use of multiple supplements may exceed the recommended daily allowance (RDA) of particular nutrients or even result in a daily intake above tolerable upper limits (UL). The present case report presents nutritional intake data and supplement use of a highly trained male swimmer competing at international level. Habitual energy and micronutrient intake were analysed by 3d dietary reports. Supplement use and dosage were assessed, and total amount of nutrient supply was calculated. Micronutrient intake was evaluated based on RDA and UL as presented by the European Scientific Committee on Food, and maximum permitted levels in supplements (MPL) are given. The athlete's diet provided adequate micronutrient content well above RDA except for vitamin D. Simultaneous use of ten different supplements was reported, resulting in excess intake above tolerable UL for folate, vitamin E and Zn. Additionally, daily supplement dosage was considerably above MPL for nine micronutrients consumed as artificial products. Risks and possible side effects of exceeding UL by the athlete are discussed. Athletes with high energy intake may be at risk of exceeding UL of particular nutrients if multiple supplements are added. Therefore, dietary counselling of athletes should include assessment of habitual diet and nutritional supplement intake. Educating athletes to balance their diets instead of taking supplements might be prudent to prevent health risks that may occur with long-term excess nutrient intake.

Background: worldwide, studies have shown a high prevalence of hormones and nutritional supplements use by athletes and gym members. Many athletes consume unproven, potentially harmful or even banned supplements. Objectives: to assess the prevalence of the use of hormones and nutritional supplements by people who exercise in gyms in Saudi Arabia, and the types of supplements they most commonly use and to obtain a general view of the main reasons for using these enhancements. Materials and Methods: a cross-sectional study using a self-administered questionnaire was conducted at gyms in Saudi Arabia that were selected randomly from different sectors. The sample size was estimated at 289, but the actual number of randomly selected participants in the study was 457. RESULTS: the number of gym members who participated in this study was 457. Approximately 47.9% of the sample reported an intake of nutritional supplements and 7.9% reported that they took hormones. Protein powder was consumed by 83.1% of the participants. Approximately 16.8% of supplement users had noticed some side effects, and 25.7% of those who took hormones had stopped taking them because of adverse effects. Only half of the hormone users (54.2%) reported that they had had medical checkups. The major source of information on supplement and hormone use was non-health professionals, friends being major source (40%) of information on the use of hormones. The use of nutritional supplements was significantly associated with BMI (OR = 1.89, CI = 1.06-3.39), duration of daily exercise (OR = 4.23, CI = 2.06-8.68), and following a special diet (OR = 8.42, CI = 5.37-13.2). There was a very strong association between nutritional supplements consumption and hormone use (P < 0.001). CONCLUSION:approximately half of the participants who regularly exercised in gyms took nutritional supplements, and most had received their information from non-health professionals. There was an association between the duration of exercise and the use of hormones and supplements. Fewer than half of hormone users had obtained a health-care provider’s advice before taking it. The atmosphere in the gym can play an important role in members’ decisions. Educating gym employees and members may have a positive influence on the use of supplements and hormones.

Background: worldwide, studies have shown a high prevalence of hormones and nutritional supplements use by athletes and gym members. Many athletes consume unproven, potentially harmful or even banned supplements. Objectives: to assess the prevalence of the use of hormones and nutritional supplements by people who exercise in gyms in Saudi Arabia, and the types of supplements they most commonly use and to obtain a general view of the main reasons for using these enhancements. Materials and Methods: a cross-sectional study using a self-administered questionnaire was conducted at gyms in Saudi Arabia that were selected randomly from different sectors. The sample size was estimated at 289, but the actual number of randomly selected participants in the study was 457. RESULTS: the number of gym members who participated in this study was 457. Approximately 47.9% of the sample reported an intake of nutritional supplements and 7.9% reported that they took hormones. Protein powder was consumed by 83.1% of the participants. Approximately 16.8% of supplement users had noticed some side effects, and 25.7% of those who took hormones had stopped taking them because of adverse effects. Only half of the hormone users (54.2%) reported that they had had medical checkups. The major source of information on supplement and hormone use was non-health professionals, friends being major source (40%) of information on the use of hormones. The use of nutritional supplements was significantly associated with BMI (OR = 1.89, CI = 1.06-3.39), duration of daily exercise (OR = 4.23, CI = 2.06-8.68), and following a special diet (OR = 8.42, CI = 5.37-13.2). There was a very strong association between nutritional supplements consumption and hormone use (P < 0.001). CONCLUSION:approximately half of the participants who regularly exercised in gyms took nutritional supplements, and most had received their information from non-health professionals. There was an association between the duration of exercise and the use of hormones and supplements. Fewer than half of hormone users had obtained a health-care provider’s advice before taking it. The atmosphere in the gym can play an important role in members’ decisions. Educating gym employees and members may have a positive influence on the use of supplements and hormones.

Nutritional supplement use in athletes is common, accompanied by potential doping risk. To determine athletes' nutritional supplement and third-party-tested (TPT) supplement use, supplement knowledge, and factors influencing their behavior. Cross-sectional study. National Collegiate Athletic Association Division I athletic departments. Student-athletes (n = 410, 53% female, age = 21.4 ± 1.6 years). Survey questions addressed topics including nutritional supplement knowledge and use, TPT supplement knowledge and use, and logo recognition, and data were stratified for sex differences. Athletes (91%) reported the use of supplements, but the total number of supplements used was lower in female (median = 7; interquartile range, 4-11) than in male (median = 9; interquartile range, 4-12) athletes, with U = 17 960 and P = .01. A total of 48% (n = 191, out of 402 responses) reported purchasing supplements outside of their athletic department, with significantly fewer female (40%, n = 84) than male (56%, n = 107) athletes reporting this behavior (χ2 = 11.20, P < .001). No association between TPT logo recognition and TPT use was seen (χ2 = 0.238, P = .63). Of all athletes using supplements, 38% (n = 140) reported "consistent TPT use," whereas female athletes (36%, n = 70) reported this less often than male athletes (41%, n = 70, χ2 = 0.952, P < .32). No sex differences were seen for receiving nutritional counseling (89%, P = .37) or low nutritional supplement knowledge (<50%, P = .38); however, males had 2.5 times greater odds at recognizing a TPT organization logo than females (odds ratio = 2.45; 95% CI, 1.58-3.79). Most athletes use nutritional supplements. Female athletes report slightly fewer supplements than male athletes, while also less frequently purchasing them outside their athletic department, potentially explaining the lower TPT logo recognition in female athletes.

Background: Well-trained elite athletes differ from the general population in being considerably more physically active and by other lifestyle characteristics including intensive training routines and periodisation of their training programs. Hence, adequate intake of energy and nutrients is of great importance to this population to ensure optimal performance and recovery during training or competition and also to minimize health risks. A consistent dietary intake pattern, in line with the sport-specific recommendations can be difficult to achieve for this group. The specific recommendations are formulated for nutritional intake during and after training or within competition. However, a large variation is seen in dietary intake by athletes. Therefore, the question arises as to what extent athletes meet recommendations and use nutritional supplements in an optimal manner. Aims: First, to investigate dietary intake and nutritional supplement use by well-trained Dutch athletes and compare these intakes with recommendations both for the general population and sport nutrition recommendations, which are based on expert consensus. Second, to provide an up-to-date overview of nutrient intake levels in a diverse and relatively large group of Dutch elite and sub-elite athletes practicing sports at the highest competitive level. Methods: As part of this thesis 24-hour recalls and questionnaires were used to gain insight into dietary intake and nutritional supplement use (n=553). To validate our methods, 24-hour nitrogen urine excretions were obtained in a subsample of our athletic population (n=47). A questionnaire was used to 1) investigate the prevalence of nutritional supplement use in a large sample of the athletic population (n=778) and 2) investigate the prevalence of nutritional supplement use in a large sample of the Dutch general population (n=1544). Finally, food intake during an ultramarathon was monitored (n=4) and questioned using a food frequency questionnaire (n=41). Results: Our validation study showed that 24-hour recalls and accompanying questionnaires underestimated protein intake in young elite athletes to the same extent as reported for non- athlete populations. Notwithstanding this, the method was considered suitable for ranking athletes according to their protein intake as needed in epidemiological studies. It was found that most athletes were able to meet the estimated average requirement (EAR) for carbohydrate and protein. Regarding sport nutrition recommendations, most of the athletes met protein (1.2 g/kg) but not carbohydrate recommendations (5 g/kg). No major differences in carbohydrate and protein intake were seen between sports categories (i.e. endurance, team and strength athletes). Athletes were at risk of too low intake levels of several micronutrients, especially when they did not use dietary supplements (i.e. vitamin D, vitamin A, vitamin B1 and B2 in men and women, and iron in women), whereas users of supplements showed a slightly elevated risk of intake levels exceeding the upper intake level (UL). This was in particular the case for vitamin B3. Our investigations in ultramarathon runners showed that these athletes did not reach sports nutrition recommendations from their habitual diet. In men and women, habitual mean carbohydrate (CHO) intake was lower than recommended, as was mean protein intake by women. CHO intake during the race was Conclusion: On a population level and with respect to the existing sport nutrition recommendations, nutritional intake in well-trained Dutch competitive athletes was low to moderate for carbohydrate intake and sufficient for protein intake. Suboptimal consumption of micronutrients was reported based on comparison with the estimated average requirement (EAR) for several micronutrients, especially for vitamin D. The use of dietary supplements adds to dietary intake. However, not all athletes consume these types of products, and day to day compliance in supplement users is low. Athletes are advised to focus on the selection of whole food carbohydrate-rich products with a high nutrient density and to consume a large variety of products containing both fat-soluble and water-soluble vitamins. When athletes experience difficulties in following these recommendations, the advice could be to use a low dose multivitamin (50-100% RDA).

The use of herbal and nutrition supplements is widespread. It has been reported that about 80% of the world's population use herbal medicines [1, 2, 3, 4]. Very few supplement use studies have been conducted in the Gulf Cooperation Council (GCC) and neighboring nations (5,6). Supplement use data among young adults is scarce. In one study aimed at determining the use of supplements among athletes in Qatar (5), over 60% of the study participants reported using vitamin supplements. Data regarding attitudes on the use of supplements among young adults is almost non-existent. The data on their perceptions about alternative medicine practitioners is also inadequate. We thus conducted a survey in which we examined the a) prevalence of supplement use among college students in Qatar, and b) their perceptions about the use of supplements and alternative medicine practitioners. We have previously presented our study findings regarding the use of supplements (7). At this meeting we will present our study findings concerning the perceptions of college students about the a) effectiveness and safety of supplements and b) alternative medicine practitioners.

Although the use of nutritional supplements by professional athletes and the benefits thereof have been extensively studied, information on recreational athletes' use of supplements is limited. This study investigated the consumption of nutritional supplements, source of information and supply of supplements, and level of awareness with regard to the relevant legislation among individuals who undertake regular exercise in Athens, Greece. A closed-ended, anonymous questionnaire was answered by 329 subjects (180 men, 149 women), age 30.6 ± 12.1 yr, from 11 randomly selected gym centers. Preparations declared as anabolic agents by the users were submitted to a gas chromatographic analyzer coupled to a mass spectrometric detector. Consumption of nutritional supplements was reported by 41% of the study population, with proteins/amino acids and vitamins being the most popular. Age (r = .456, p = .035), sex (χ2 = 14.1, df = 1, p < .001), level of education (χ2 = 14.1, df = 3, p < .001), and profession (χ2 = 11.4, df = 4, p = .022) were associated with the subjects' decision to consume nutritional supplements. Most (67.1%) purchased products from health food stores. Only 17.1% had consulted a physician or nutritionist, and one third were aware of the relevant legislation. Two preparations were detected containing synthetic anabolic steroids not stated on the label. In conclusion, use of nutritional supplements was common among recreational athletes in Athens, Greece. A low level of awareness and low involvement of health care professionals as sources of information and supply were observed.

This study aimed to characterise the nutritional intake according the use of nutritional supplements (NS) by elite adult Portuguese athletes. Two hundred and two adult (23±4 years) athletes (78% males), representatives of Portugal in 13 sports, voluntarily filled a semiquantitative food-frequency questionnaire and a questionnaire about the use of NS. The total nutritional daily intake did not consider the nutrients provided by NS. Statistical analyses were performed using SPSS V.16.0. The majority of athletes (74%) reported having used at least one NS in the previous year, with a mean consumption of 5.9±3.7 NS per athlete. The most frequently consumed nutritional supplements were sport drinks (63%), proteins (58%), magnesium (56%), iron (30%), vitamin C (29%), sport gels (23%), antioxidants (21%), vitamin B12 (15%) and vitamin E (9%). The mean energy intake was 2875±1313 kcal/days, for males, and 2612±1152 kcal/days, for females. For proteins, the males' intake was 1.7±0.8 g/kg/days and females' intake was 2.1±1.2 g/kg/days. Males consumed 4.8±2.5 g/kg/days of carbohydrates, while females consumed 5.6±2.6 g/kg/days. Intake of less than recommended was observed in 33% for vitamin E in females, and 17% for vitamin E, 5% for folate and 5% for magnesium, in male athletes. For all other micronutrients intakes were above recommended amounts for both genders. There were no differences in the vitamin and mineral intake between supplement users and nonusers, for both genders. The use of NS is very prevalent in elite adult Portuguese athletes and not associated with nutritional total intake.

The use of multiple medications, herbs or nutritional supplements can lead to adverse consequences, particularly in the elderly. A significant consequence resulting from polypharmacy, polyherbacy and nutritional supplement use is the potential for interactions to occur among the various products. The primary objective of this study was to estimate the prevalence of polypharmacy, polyherbacy, nutritional supplement use and potential product interactions among older adults living on the US-Mexico border. This was a descriptive study that involved the administration of a bilingual (English/Spanish) questionnaire to a convenience sample of adults aged >or=60 years recruited from senior centres located within the most populated US-Mexico border region from June 2005 to March 2006. Participant demographics were collected in addition to information about current use of prescription medications, over-the-counter (OTC) medications, herbal products and nutritional supplements (i.e. nutraceuticals and vitamins or minerals). The outcomes measured were the number of prescription medications, OTC medications, herbal products, vitamins/minerals and nutraceuticals per participant. Furthermore, the number of potential interactions and major interactions between drugs, herbal products and nutritional supplements were identified for each participant. Additionally, product use patterns between men and women and among locations within the border region were compared. One-hundred-and-thirty participants (mean age 71.4 years) were recruited to complete the questionnaire. The prevalence of polypharmacy among all participants was 72.3% (n = 94), with 38.5% (n = 50) taking five or more concomitant medications (major polypharmacy). Twenty-one participants (16.2%) in the study sample reported taking two or more herbal products (polyherbacy). Thirty-four participants (26.2%) reported taking two or more vitamin/mineral supplements and nine (6.9%) reported using two or more nutraceuticals. Participants living on the US side of the border had higher rates of major polypharmacy, polyherbacy and use of nutritional supplements than those living on the Mexican side of the border. Overall, there were no significant differences in medication, herbal product and nutritional supplement use patterns between men and women. Evaluation of potential interactions revealed that 46.2% (n = 60) of participants were at risk of having at least one potential drug-drug interaction. Regarding drug and herbal product-supplement interactions, 31.5% (n = 41) of participants were at risk of having at least one possible interaction. The prevalence of polypharmacy among older adults living on the US side of the border was similar to national trends (estimates suggest that one-quarter to one-half of US adults aged >or=65 years take five or more medications). However, polypharmacy was less common in older adults living on the Mexican side of the border. Additionally, herb use was higher in older adults living on the US-Mexico border than has been reported in national surveys of US adults, which indicate that less than one-quarter of adults have used a herbal product within the previous 12 months. Furthermore, this study demonstrated that older adults living on the US side of the border consumed more herbs and nutritional supplements than their Mexican counterparts. In addition to describing product use patterns on the border, these findings suggest that almost half of the older adult participants were at risk for a potential drug-drug interaction, with approximately one-third having a potential interaction between their medications, herbs or nutritional supplements.

The use of nutritional supplements is highly prevalent among athletes. In this cross-sectional study, we assessed the prevalence of nutritional supplement use by a large group of Dutch competitive athletes in relation to dietary counseling. A total of 778 athletes (407 males and 371 females) completed a web-based questionnaire about the use of nutritional supplements. Log-binomial regression models were applied to estimate crude and adjusted prevalence ratios (PR) for the use of individual nutritional supplements in athletes receiving dietary counseling as compared with athletes not receiving dietary counseling. Of the athletes, 97.2% had used nutritional supplements at some time during their sports career, whereas 84.7% indicated having used supplements during the last 4 weeks. The top ranked supplements used over the last 4 weeks from dietary supplements, sport nutrition products and ergogenic supplements were multivitamin and mineral preparations (42.9%), isotonic sports drinks (44.1%) and caffeine (13.0%). After adjustment for elite status, age, and weekly exercise duration, dietary counseling was associated with a higher prevalence of the use of vitamin D, recovery drinks, energy bars, isotonic drinks with protein, dextrose, beta-alanine, and sodium bicarbonate. In contrast, dietary counseling was inversely associated with the use of combivitamins, calcium, vitamin E, vitamin B2, retinol, energy drinks and BCAA and other amino acids. In conclusion, almost all athletes had used nutritional supplements at some time during their athletic career. Receiving dietary counseling seemed to result in better-informed choices with respect to the use of nutritional supplements related to performance, recovery, and health.

ObjectiveThis study identified the prevalence of nutritional supplement (NS) use among older Chinese adults and explored the factors associated with NS use in this population.MethodsWe used data from 11,089 Chinese men and women aged ≥ 65 years from the 2018 Chinese Longitudinal Healthy Longevity Survey. The chi-square test was used to examine the differences in demographics, health status and lifestyles at different levels. Multivariate logistic regression was used to assess the association between NS use and demographic and lifestyle characteristics.ResultsTwelve percent of Chinese adults aged 65 years and above used NS. In terms of the type of supplement used, the most commonly used was calcium (8.49%), followed by protein (2.73%) and multivitamins (2.40%). In terms of demographic characteristics, women, older people, urban residents with other marital status, higher educational level, better living conditions and better lifestyle habits showed a greater use of some kinds of NS to varying degrees. Factors associated with the use of any NS included female gender [OR = 1.71, 95% confidence intervals (95% CI): 1.09–1.44], age 85–94 (OR = 1.30, 95% CI: 1.08–1.58), urban household registration (hukou) (OR = 1.25, 95% CI:1.46–2.00), higher education (primary school and middle school: OR = 1.32, 95% CI:1.14–1.52; high school and above: OR = 1.56, 95% CI:1.25–1.94), average and poor living standard (average: OR = 0.64, 95% CI:0.56–0.73; poor: OR = 0.42, 95% CI:0.32–0.55), poor health status (OR = 1.36, 95% CI:1.13–1.63), former smoking (OR = 1.33, 95% CI:1.11–1.60), and having exercise habits (former exercise: OR = 2.24, 95% CI:1.83–2.74; current exercise: OR = 2.28, 95% CI:2.00–2.61). Women reported taking 2–3 kinds of NSs, and more than 50% of NS users reported taking supplements often.ConclusionThis study provides information on the current prevalence of NS use among older Chinese adults, and it clarifies the association of NS use with demographic, lifestyle and other factors. Providing scientifically based health guidance on NS use for older people is crucial to promoting their health.

Nutritional supplement use among fitness club participants in Tehran, Iran

To examine nutritional supplementation and anabolic steroid (AS) use in adolescent males and females in a multistate, cross-regional study. A secondary purpose of the study was to investigate the knowledge, beliefs, and sources of education on nutritional supplementation and AS in these students. A confidential self-report survey was administered to 3248 students representing grades 8-12 in 12 states in the continental United States by their teachers during homeroom or physical education class. Use of at least one supplement was reported by 71.2% of the adolescents surveyed. The most popular supplements used were multivitamins and high-energy drinks. The use of supplements to increase body mass and strength, and to reduce body fat or mass, increased across grade and was more prevalent in males than females. The number of students that self-reported AS use was 1.6% (2.4% males and 0.8% females). The number of supplements used was related to AS use among adolescents, and this effect was greater among males. Adolescents also seemed willing to take more risks with supplements to achieve their fitness or athletic goals, even if these risks reduced health or caused premature death. This study demonstrates that reliance on nutritional supplements increases as adolescents mature. The apparent willingness of adolescents to use a supplement that may harm their health or shorten their life highlights the need for greater involvement of teachers, coaches, and physicians to provide continued education on the risks and benefits associated with nutritional supplementation and AS use.

Evidence for the Use of Nutritional Supplements and Herbal Medicines in Common Eye Diseases