How Sports Health Professionals Perceive and Prescribe Nutritional Supplements to Olympic and Non-Olympic Athletes
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Questionnaire
2.3. Data Analysis
3. Results
3.1. Characteristics
3.2. Self-Reported Knowledge and Attitudes
3.3. Professions and Sports Nutrition Knowledgeability
3.4. Classification of Ergogenic Effect of Supplements and Supplement Advise
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A. Contains the Full Pre-Defined List of Nutritional Supplements Questioned after the Reference Section
Do You Think This Supplement Has an Ergogenic Effect? | Do You Advise This Supplement to Your Athletes? | |||||||
---|---|---|---|---|---|---|---|---|
Total (n = 305) | Sports Dietitian (n = 58) | Other (n = 247) | p-Value | Total (n = 305) | Sports Dietitian (n = 58) | Other (n = 247) | p-Value | |
Dietary supplements (i.e., vitamins, minerals, and essential fatty acids) | ||||||||
Multi vitamin | 31 (94) | 33 (19) | 30 (75) | 0.363 | 57 (174) | 91 (53) | 49 (121) | <0.001 |
Fish oil | 29 (87) | 33 (19) | 28 (68) | 0.207 | 45 (136) | 79 (45) | 37 (91) | <0.001 |
Magnesium | 27 (81) | 7 (4) | 31 (77) | <0.001 | 37 (113) | 31 (18) | 38 (95) | 0.147 |
Vitamin D | 22 (66) | 36 (21) | 18 (45) | 0.001 | 33 (99) | 71 (41) | 23 (58) | <0.001 |
Iron | 19 (59) | 16 (9) | 20 (50) | 0.207 | 30 (90) | 50 (29) | 25 (61) | <0.001 |
Combination vitamin | 19 (59) | 22 (13) | 19 (46) | 0.256 | 28 (86) | 36 (21) | 23 (65) | 0.066 |
Combination mineral | 20 (60) | 14 (8) | 21 (52) | 0.106 | 26 (80) | 31 (18) | 25 (62) | 0.178 |
Vitamin C | 16 (48) | 14 (8) | 16 (40) | 0.326 | 25 (76) | 36 (21) | 22 (55) | 0.014 |
Vitamin B-complex | 16 (48) | 16 (9) | 16 (39) | 0.480 | 24 (72) | 40 (23) | 20 (49) | <0.001 |
Anti-oxidants | 13 (40) | 12 (7) | 13 (33) | 0.397 | 18 (55) | 24 (14) | 17 (41) | 0.090 |
Vitamin B12 | 14 (43) | 8 (5) | 15 (38) | 0.092 | 18 (55) | 28 (16) | 16 (39) | 0.018 |
Zinc | 12 (35) | 7 (4) | 13 (31) | 0.113 | 16 (48) | 17 (10) | 15 (38) | 0.364 |
Calcium | 9 (26) | 3 (2) | 10 (24) | 0.062 | 15 (47) | 21 (12) | 14 (35) | 0.109 |
Folic acid | 9 (26) | 3 (2) | 10 (24) | 0.062 | 12 (37) | 16 (9) | 11 (28) | 0.191 |
Selenium | 8 (24) | 2 (1) | 9 (23) | 0.027 | 9 (28) | 2 (1) | 11 (27) | 0.014 |
Vitamin B6 | 6 (18) | 3 (2) | 6 (16) | 0.190 | 7 (21) | 3 (2) | 8 (19) | 0.126 |
Chrome | 6 (18) | 2 (1) | 7 (17) | 0.067 | 7 (20) | 3 (2) | 7 (18) | 0.145 |
Vitamin A | 5 (15) | 2 (1) | 6 (14) | 0.106 | 5 (15) | 5 (3) | 5 (12) | 0.461 |
B-carotene | 5 (15) | 0 (0) | 6 (15) | 0.027 | 5 (14) | 2 (1) | 5 (13) | 0.124 |
Vitamin B1 | 6 (19) | 5 (3) | 6 (16) | 0.356 | 5 (16) | 3 (2) | 6 (14) | 0.248 |
Vitamin B2 | 6 (17) | 3 (2) | 6 (15) | 0.217 | 5 (14) | 3 (2) | 5 (12) | 0.323 |
Vitamin E | 4 (12) | 0 (0) | 5 (12) | 0.044 | 5 (14) | 3 (2) | 5 (12) | 0.323 |
Other oils | 4 (13) | 2 (1) | 5 (12) | 0.146 | 6 (17) | 4 (2) | 6 (15) | 0.219 |
Sports foods (i.e., sports drinks, protein shakes, energy bars and isolated carbohydrate or protein supplements) | ||||||||
Recovery drink | 61 (185) | 86 (49) | 56 (136) | <0.001 | 65 (195) | 91 (52) | 59 (143) | <0.001 |
Beverage with carbs and electrolytes | 46 (139) | 84 (48) | 38 (91) | <0.001 | 53 (159) | 95 (54) | 43 (105) | <0.001 |
Energy bar | 41 (124) | 67 (38) | 36 (86) | <0.001 | 48 (144) | 79 (45) | 41 (99) | <0.001 |
Protein drink | 44 (130) | 46 (26) | 43 (104) | 0.341 | 44 (101) | 54 (31) | 41 (101) | 0.038 |
Beverage with carbs, electrolytes and protein | 36 (108) | 67 (38) | 29 (70) | <0.001 | 37 (112) | 74 (42) | 29 (70) | <0.001 |
Energy gel | 35 (104) | 72 (41) | 26 (63) | <0.001 | 35 (105) | 74 (42) | 26 (63) | <0.001 |
Lemonade syrup | 27 (82) | 56 (32) | 21 (50) | <0.001 | 31 (93) | 61 (35) | 24 (58) | <0.001 |
Protein bar | 29 (86) | 32 (18) | 28 (68) | 0.289 | 30 (89) | 39 (22) | 28 (67) | 0.049 |
Grape sugar | 26 (79) | 30 (17) | 26 (62) | 0.259 | 30 (90) | 33 (19) | 29 (71) | 0.278 |
Energy drink | 28 (83) | 49 (28) | 23 (55) | <0.001 | 27 (82) | 53 (30) | 22 (52) | <0.001 |
Maltodextrin * N = 84 | 55 (46) | 78 (21) | 44 (25) | 0.002 | 14 (41) | 35 (20) | 9 (21) | <0.001 |
Ribose | 5 (14) | 0 (0) | 6 (14) | 0.032 | 4 (13) | 4 (2) | 5 (11) | 0.365 |
Ergogenic supplements (i.e., supplements other than above, claiming to aid in performance, recovery or health) | ||||||||
Creatine | 39 (115) | 67 (38) | 32 (77) | <0.001 | 32 (95) | 63 (36) | 25 (59) | <0.001 |
Caffeine | 36 (107) | 56 (32) | 32 (75) | <0.001 | 30 (88) | 53 (30) | 24 (58) | <0.001 |
Amino acids | 31 (91) | 32 (18) | 30 (73) | 0.403 | 30 (99) | 30 (17) | 30 (72) | 0.481 |
Probiotics | 13 (37) | 40 (23) | 5 (13) | <0.001 | 26 (75) | 77 (44) | 13 (31) | <0.001 |
Beetroot/dietary nitrate | 29 (85) | 54 (31) | 23 (54) | <0.001 | 25 (74) | 49 (28) | 19 (46) | <0.001 |
Glucosamine-chondrotoïne | 10 (28) | 9 (5) | 10 (23) | 0.415 | 15 (44) | 16 (9) | 15 (35) | 0.423 |
B-alanine | 18 (54) | 44 (25) | 12 (29) | <0.001 | 13 (38) | 32 (18) | 8 (20) | <0.001 |
MCT | 11 (32) | 4 (2) | 13 (31) | 0.023 | 13 (39) | 7 (4) | 14 (35) | 0.069 |
L-carnitine | 12 (36) | 14 (8) | 12 (28) | 0.324 | 11 (32) | 7 (4) | 12 (28) | 0.149 |
Sodium bicarbonate | 15 (44) | 32 (18) | 11 (26) | <0.001 | 10 (30) | 14 (8) | 9 (22) | 0.144 |
CLA | 4 (13) | 4 (2) | 5 (11) | 0.370 | 6 (19) | 9 (5) | 6 (14) | 0.199 |
Herbs | 4 (11) | 0 (0) | 5 (11) | 0.049 | 5 (16) | 2 (1) | 6 (15) | 0.086 |
Other | 5 (14) | 4 (2) | 5 (12) | 0.311 | 3 (10) | 4 (2) | 3 (8) | 0.480 |
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Group Total | Working with Olympic Athletes | Profession | |||||
---|---|---|---|---|---|---|---|
Yes | No | p-Value | Sports Dietitian | Other Profession | p-Value | ||
N | 320 | 144 | 176 | 59 | 261 | ||
Sex M/F | 174/146 | 75/69 | 99/77 | 0.457 | 2/57 | 172/89 | <0.001 |
Highest achieved education level * | <0.001 | 0.082 | |||||
Trade school | 20 (63) | 16 (23) | 23 (40) | 2 (1) | 24 (62) | ||
Bachelor (BS) | 44 (140) | 42 (60) | 46 (80) | 76 (45) | 36 (95) | ||
Master/Doctorate (MS/PhD) | 30 (97) | 41 (59) | 23 (38) | 20 (12) | 33 (85) | ||
Profession | <0.001 | <0.001 | |||||
Different | 64 | 10 | 54 | 0 | 64 | ||
Sports dietitian | 59 | 39 | 20 | 59 | 0 | ||
Coach | 43 | 18 | 25 | 0 | 43 | ||
Sports physician | 39 | 27 | 12 | 0 | 39 | ||
Masseur | 33 | 13 | 20 | 0 | 33 | ||
Physiotherapist | 26 | 15 | 11 | 0 | 26 | ||
Sport scientist | 17 | 4 | 13 | 0 | 17 | ||
Caregiver | 17 | 8 | 9 | 0 | 17 | ||
Sport manager | 12 | 5 | 7 | 0 | 12 | ||
Mental coach | 8 | 5 | 3 | 0 | 8 | ||
Strength coach | 2 | 0 | 2 | 0 | 2 |
Working with Olympic Athletes | Profession | |||||||
---|---|---|---|---|---|---|---|---|
Questions | Total | Yes | No | p-Value | Sports Dietitian | Other Profession | p-Value | |
No. (type of scale) | % (N) | % (N) | % (N) | % (N) | % (N) | |||
Knowledge | ||||||||
1 (L) | Contaminated NSs have no small effect or positive effect at all. | 35 (111) | 41 (59) | 39 (52) | 0.033 | 36 (26) | 25 (85) | 0.005 |
2 (L) | Use of contaminated NSs can lead to a positive doping test. | 68 (216) | 81 (116) | 57 (100) | <0.001 | 88 (52) | 63 (164) | 0.003 |
3 (Y/N) | Are you familiar with NSs of which ingredients are listed on the WADA doping list? | 44 (141) | 55 (79) | 35 (62) | <0.001 | 66 (39) | 39 (102) | <0.001 |
4 (Y/N) | Are you familiar with the NZVT system? | 47 (151) | 69 (99) | 30 (52) | <0.001 | 88 (52) | 38 (99) | <0.001 |
5 (Y/N) | Products listed on the NZVT list are not tested on efficacy. * | 61 (89) | 67 (66) | 47 (23) | 0.017 | 78 (40) | 51 (49) | 0.007 |
6 (Y/N) | Only products with the NZVT logo on the label are always tested. * | 53 (78) | 44 (43) | 47 (23) | 0.295 | 61 (31) | 49 (47) | 0.106 |
7 (Y/N) | The absence of the NZVT logo on the label indicates that only certain batches of the NSs are tested. * | 43 (63) | 46 (45) | 37 (18) | 0.290 | 59 (30) | 34 (33) | 0.155 |
8 (Y/N) | The NZVT system does provide a 99% guarantee that tested NSs are free from doping substances. * | 72 (106) | 74 (72) | 69 (34) | 0.604 | 88 (45) | 64 (61) | 0.111 |
Working with Olympic Athletes | Profession | |||||||
---|---|---|---|---|---|---|---|---|
Questions | Total | Yes | No | p-Value | Sports Dietitian | Other Profession | p-Value | |
No. (type of scale) | % (N) | % (N) | % (N) | % (N) | % (N) | |||
Attitude | ||||||||
1 (L) | I would like to know what the risk of incorrect use of NSs is. | 86 (274) | 89 (128) | 83 (146) | 0.133 | 83 (49) | 86 (225) | 0.127 |
2 (L) | I find the idea of using a contaminated NS without knowing this unacceptable. | 89 (285) | 90 (129) | 89 (156) | 0.787 | 90 (53) | 89 (232) | 0.478 |
3 (L) | I would like to know what the risk is of taking a contaminated NS. | 87 (278) | 89 (128) | 85 (150) | 0.335 | 83 (49) | 88 (229) | 0.101 |
4 (L) | The topic of contaminated NSs is relevant to me, and therefore, it is of interest to me. | 53 (171) | 73 (105) | 38 (66) | <0.001 | 78 (46) | 48 (125) | <0.001 |
5 (L) | I have a clear idea what the effect is of misusing NSs. | 49 (157) | 60 (87) | 40 (70) | <0.001 | 73 (43) | 44 (114) | <0.001 |
6 (L) | I have a clear idea how a contaminated NS can result in a positive doping test. | 50 (159) | 67 (96) | 36 (63) | <0.001 | 71 (42) | 45 (117) | <0.001 |
7 (Y/N) | Do you use the NZVT list while purchasing products? * | 80 (118) | 89 (87) | 63 (31) | <0.001 | 92 (47) | 74 (71) | 0.004 |
8 (Y/N) | Are you satisfied with the NZVT system? * | 71 (105) | 66 (65) | 82 (40) | 0.054 | 59 (30) | 78 (75) | 0.007 |
Dietitian | Coach | Sports Physician | Masseur | Physio-Therapist | Sports Scientist | Caregiver | Sports Manager | Mental Coach | Strength Coach | |
---|---|---|---|---|---|---|---|---|---|---|
General sports nutrition (n = 249) | 80% (n = 199) | 6% (n = 15) | 5% (n = 12) | 2% (n = 5) | 2% (n = 6) | 2% (n = 6) | 1% (n = 3) | 1% (n = 2) | 0% (n = 0) | 1% (n = 1) |
Nutritional supplements (n = 223) | 74% (n = 165) | 9% (n = 20) | 10% (n = 23) | 1% (n = 1) | 2% (n = 5) | 2% (n = 4) | 2% (n = 4) | 1% (n = 1) | 0% (n = 0) | 0% (n = 0) |
Dietitian (n = 59) | Coach (n = 43) | Sports Physician (n = 39) | Masseur (n = 33) | Physio-Therapist (n = 26) | Sports Scientist (n = 17) | Caregiver (n = 17) | Sports Manager (n = 12) | Mental Coach (n = 8) | Strength Coach (n = 2) | Other (n = 64) | |
---|---|---|---|---|---|---|---|---|---|---|---|
General nutrition | 94% | 72% | 67% | 50% | 50% | 83% | 68% | 58% | 64% | 100% | 64% |
Sports nutrition | 82% | 53% | 56% | 45% | 43% | 50% | 69% | 50% | 55% | 100% | 35% |
Nutritional supplements | 62% | 42% | 46% | 40% | 23% | 50% | 42% | 25% | 27% | 75% | 47% |
Do You Think This Supplement Has an Ergogenic Effect? | Do You Advise This Supplement to Your Athletes? | |||||||
---|---|---|---|---|---|---|---|---|
Total (n = 305) | Dietitian (n = 58) | Other (n = 247) | p-Value | Total (n = 305) | Dietitian (n = 58) | Other (n = 247) | p-Value | |
Dietary supplements (i.e., vitamins, minerals, and essential fatty acids) | ||||||||
Multivitamin | 31 (94) | 33 (19) | 30 (75) | 0.363 | 57 (174) | 91 (53) | 49 (121) | <0.001 |
Fish oil | 29 (87) | 33 (19) | 28 (68) | 0.207 | 45 (136) | 79 (45) | 37 (91) | <0.001 |
Magnesium | 27 (81) | 7 (4) | 31 (77) | <0.001 | 37 (113) | 31 (18) | 38 (95) | 0.147 |
Vitamin D | 22 (66) | 36 (21) | 18 (45) | 0.001 | 33 (99) | 71 (41) | 23 (58) | <0.001 |
Iron | 19 (59) | 16 (9) | 20 (50) | 0.207 | 30 (90) | 50 (29) | 25 (61) | <0.001 |
Vitamin C | 16 (48) | 14 (8) | 16 (40) | 0.326 | 25 (76) | 36 (21) | 22 (55) | 0.014 |
Vitamin B-complex | 16 (48) | 16 (9) | 16 (39) | 0.480 | 24 (72) | 40 (23) | 20 (49) | <0.001 |
Anti-oxidants | 13 (40) | 12 (7) | 13 (33) | 0.397 | 18 (55) | 24 (14) | 17 (41) | 0.090 |
Vitamin B12 | 14 (43) | 8 (5) | 15 (38) | 0.092 | 18 (55) | 28 (16) | 16 (39) | 0.018 |
Zinc | 12 (35) | 7 (4) | 13 (31) | 0.113 | 16 (48) | 17 (10) | 15 (38) | 0.364 |
Sports foods (i.e., sports drinks, protein shakes, energy bars and isolated carbohydrate or protein supplements) | ||||||||
Recovery drink | 61 (185) | 86 (49) | 56 (136) | <0.001 | 65 (195) | 91 (52) | 59 (143) | <0.001 |
CHO-electrolyte beverage | 46 (139) | 84 (48) | 38 (91) | <0.001 | 53 (159) | 95 (54) | 43 (105) | <0.001 |
Protein drink | 44 (130) | 46 (26) | 43 (104) | 0.341 | 44 (101) | 54 (31) | 41 (101) | 0.038 |
Energy bar | 41 (124) | 67 (38) | 36 (86) | <0.001 | 48 (144) | 79 (45) | 41 (99) | <0.001 |
CHO-PRO electrolyte beverage | 36 (108) | 67 (38) | 29 (70) | <0.001 | 37 (112) | 74 (42) | 29 (70) | <0.001 |
Energy gel | 35 (104) | 72 (41) | 26 (63) | <0.001 | 35 (105) | 74 (42) | 26 (63) | <0.001 |
Protein bar | 29 (86) | 32 (18) | 28 (68) | 0.289 | 30 (89) | 39 (22) | 28 (67) | 0.049 |
Ergogenic supplements (i.e., supplements other than above, claiming to aid in performance, recovery or health) | ||||||||
Creatine | 39 (115) | 67 (38) | 32 (77) | <0.001 | 32 (95) | 63 (36) | 25 (59) | <0.001 |
Caffeine | 36 (107) | 56 (32) | 32 (75) | <0.001 | 30 (88) | 53 (30) | 24 (58) | <0.001 |
Amino acids | 31 (91) | 32 (18) | 30 (73) | 0.403 | 30 (99) | 30 (17) | 30 (72) | 0.481 |
Probiotics | 13 (37) | 40 (23) | 5 (13) | <0.001 | 26 (75) | 77 (44) | 13 (31) | <0.001 |
Beetroot/dietary nitrate | 29 (85) | 54 (31) | 23 (54) | <0.001 | 25 (74) | 49 (28) | 19 (46) | <0.001 |
B-alanine | 18 (54) | 44 (25) | 12 (29) | <0.001 | 13 (38) | 32 (18) | 8 (20) | <0.001 |
Sodium bicarbonate | 15 (44) | 32 (18) | 11 (26) | <0.001 | 10 (30) | 14 (8) | 9 (22) | 0.144 |
MCT | 11 (32) | 4 (2) | 13 (31) | 0.023 | 13 (39) | 7 (4) | 14 (35) | 0.069 |
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Wardenaar, F.C.; Hoogervorst, D. How Sports Health Professionals Perceive and Prescribe Nutritional Supplements to Olympic and Non-Olympic Athletes. Int. J. Environ. Res. Public Health 2022, 19, 12477. https://doi.org/10.3390/ijerph191912477
Wardenaar FC, Hoogervorst D. How Sports Health Professionals Perceive and Prescribe Nutritional Supplements to Olympic and Non-Olympic Athletes. International Journal of Environmental Research and Public Health. 2022; 19(19):12477. https://doi.org/10.3390/ijerph191912477
Chicago/Turabian StyleWardenaar, Floris C., and Daan Hoogervorst. 2022. "How Sports Health Professionals Perceive and Prescribe Nutritional Supplements to Olympic and Non-Olympic Athletes" International Journal of Environmental Research and Public Health 19, no. 19: 12477. https://doi.org/10.3390/ijerph191912477
APA StyleWardenaar, F. C., & Hoogervorst, D. (2022). How Sports Health Professionals Perceive and Prescribe Nutritional Supplements to Olympic and Non-Olympic Athletes. International Journal of Environmental Research and Public Health, 19(19), 12477. https://doi.org/10.3390/ijerph191912477