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Prevalence of Dietary Supplement Use by Athletes: Systematic Review and Meta-Analysis



Dietary supplements (DSs) are commercially available products consumed as an addition to the usual diet and are frequently ingested by athletes.


Our objective was to examine the prevalence of DS use by athletes.

Data Sources

PubMed, Ovid MEDLINE, OVID Healthstar, and Cumulative Index to Nursing and Allied Health were searched for original research articles published up to August 2014. Search terms included specific sports, specific DSs, and other terms.

Study Selection

Studies were selected if they were written in English, involved athletes, and provided a quantitative assessment of the proportion of athletes using specific DSs.

Summary Measure

Percent of athletes using specific DSs.

Synthesis of Data

Methodological quality of studies was assessed by three reviewers using an 8-point scale that included evaluations for sampling methods, sampling frame, sample size, measurement tools, bias, response rate, statistical presentation, and description of the participant sample. Where there were at least two investigations, meta-analysis was performed to obtain summary (pooled) prevalence estimates (SPEs) on (1) DS use prevalence by sport and sex, (2) DS use prevalence by elite versus non-elite athletic status, and (3) specific DS prevalence for all athletic groups combined. Meta-analyses included evaluations of homogeneity and publication bias.


A total of 159 unique studies met the review criteria. Methodological quality was generally low with an average ± standard deviation of 43 ± 16 % of available rating points. There was low homogeneity for SPEs when compiled by sport, athletic status, and/or specific DSs. Contributing to the lack of homogeneity were differences in studies’ objectives and types of assessments used (e.g., dietary surveys, interviews, questionnaires). Despite these limitations, the data generally indicated that elite athletes used DSs much more than their non-elite counterparts. For most DSs, use prevalence was similar for men and women except that a larger proportion of women used iron while a larger proportion of men used vitamin E, protein, and creatine. No consistent change in use over time was observed because even the earliest investigations showed relatively high use prevalence.


It was difficult to generalize regarding DS use by athletes because of the lack of homogeneity among studies. Nonetheless, the data suggested that elite athletes used dietary supplements far more than their non-elite counterparts; use was similar for men and women with a few exceptions; use appeared to change little over time; and a larger proportion of athletes used DSs compared with the general US population. Improvements in study methodology should be considered in future studies especially (1) defining DSs for participants; (2) querying for very specific DSs; (3) using a variety of reporting timeframes (e.g., daily, 2–6 times/week, 1 time/week and <1 time/week); (4) reporting the sampling frame, number of individuals solicited, and number responding; (5) reporting characteristics of volunteers (and non-volunteers, if available); and (6) using similar methods on several occasions to examine possible temporal trends among athletes.

FormalPara Key Points
When dietary supplement use was compiled by sport, elite versus non-elite athletic status, and supplement type there was high variability in use prevalence among studies.
Elite athletes appeared to use dietary supplements much more than their non-elite counterparts.
For most dietary supplements, use prevalence appeared similar for men and women. Exceptions were that a larger proportion of women used iron and a larger proportion of men used vitamin E, protein, and creatine.


A dietary supplement is a commercially available product that is consumed as an addition to the usual diet and includes vitamins, minerals, herbs (botanicals), amino acids, and a variety of other products [1]. Marketing claims for some dietary substances include improvements in overall health status, enhancement of cognitive or physical performance, increase in energy, loss of excess weight, attenuation of pain, and other favorable effects. The Dietary Supplement Health and Education Act (DSHEA) of 1994 [2] established the regulatory framework for dietary supplements in the US. Since this act became law, US sales of dietary supplements has increased from $US4 billion in 1994 to $US33 billion in 2012 [3, 4], an eightfold increase over 18 years. Global sales of supplements were $US96 billion in 2012 and estimated at $US104 billion in 2013 [5].

Patterns of dietary supplement use may differ in distinctive subpopulations. Athletes in different sports may use different dietary supplements depending on the nature of the physical activities they perform and the desired outcomes from the dietary supplements. Athletes often perform intense and prolonged physical activity and often report that their primary reason for using dietary supplements is to enhance performance or recover from exercise [614], although improving/maintaining health can also be an important rationale [1519]. In contrast, the general population appears to consume dietary supplements primarily for health-related reasons, with only minor interest in performance enhancement [20, 21]. Competitive athletes also need to be concerned with excessive use and possible adverse interactions due to polypharmacy [22, 23], and inadvertent doping due to the inadequate quality control of some dietary supplements [24, 25].

This paper presents a systematic literature review describing the prevalence of dietary supplement use in athletes. Where possible, meta-analyses were performed on dietary supplements by sport and sex, by elite versus non-elite athletic status, and by specific dietary supplements for all athletic groups combined. An older review on the prevalence of vitamin and mineral supplementation by athletes is also available [26].


This investigation generally followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [27].

Information Sources and Search

Literature searches were conducted in PubMed, Ovid MEDLINE (including OLDMEDLINE), OVID Healthstar, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). No limitations were placed on the dates of the searches, and the final search was completed in August 2014. After reviewing PubMed medical subject headings for ‘dietary supplements’ and ‘athletes’, keywords selected for the search included athlete, sport, football, wrestling, soccer, ballet, dancing, running, gymnastics, swimming, basketball, hockey, tennis, softball, baseball, triathlete, triathlon, body building, weight lifting, volleyball, track, and crew. These keywords were combined with nutrition, dietary supplement, supplement, vitamin, mineral, amino acid, protein, herb, herbal, sport drink, sport bar, nutriceutical, neutraceuticals, food supplements, and food supplementation. To find additional studies, the reference lists of the articles obtained were searched, as was the literature database of an investigator with extensive experience with dietary supplement research.

Eligibility Criteria

Articles were selected for the review if they were (1) written in English, (2) involved athletes, and (3) provided a quantitative assessment of the proportion of athletes using dietary supplements of any type, as defined by the DSHEA of 1994 [2]. Titles were first examined and abstracts were reviewed if the article appeared to involve athletes and either nutrition or dietary supplements. The full text of the article was retrieved if there was a possibility that dietary supplements were included within the investigation. Quantitative prevalence data could be contained within the text of the article, in tabular form, or presented in graphs. Data presented in graphic form were estimated. If the authors did not specifically reference dietary supplement prevalence, but data were available in the article to calculate it, then the article and the data were included in the review.

Not included in the review were studies that (1) examined athletic-related occupations (coaches, athletic trainers, physicians) or former athletes; (2) asked athletes about dietary supplements they would like to use (as opposed to actual use); (3) asked athletes about dietary supplement use they had observed; (4) mixed athletes with non-athletes, unless the athlete data were reported separately or could be calculated from the data provided; and (5) examined dietary supplement use during competitive events (because of the short timeframe and special, atypical circumstances). A number of studies that were identified did consider intake of dietary supplements in calculating nutritional intake of various athletic groups but did not specifically report the dietary supplement prevalence and so could not be used in this review. Abstracts, case studies, and case series were also not included. Stand-alone abstracts (without full-text articles) were excluded because they were difficult to locate, were generally not included in reference databases, and in many cases were not peer reviewed. Case studies and case series involved few individuals and were often published because they were atypical.

Summary Measure

The summary statistic was the percent of athletes using a specific dietary supplement. Data extracted from each study were (1) the number of athletes using a particular dietary supplement and (2) the number of athletes in the entire sample. Dividing the former by the latter and multiplying by 100 % produced the use prevalence as a percent. Data from a number of studies required recalculation because authors expressed data as a percent of dietary supplement users rather than as a percent of the total sample.

Considerations in Data Collection and Compilation

A “unique study” was defined as a single data collection period. Multiple publications could be produced from a single unique study. When there were multiple publications from a unique study, all dietary supplement prevalence reported in any of the publications were included in the data extraction process; however, the publication was included only once in the analyses so as not to bias prevalence estimates to studies with more publications.

To be included in the review, the dietary supplement examined in the publication had to be specifically identified. That is, dietary supplements grouped into categories like ‘antioxidant’, ‘pro-performance’, ‘herbal supplement’, ‘ergogenics’, ‘thermogenics’, ‘bodybuilding’, and the like were not included in the data extraction process. Exceptions were the general category of vitamins and minerals, which were included since so many studies reported these. Sport drinks, sports bars, and energy drinks were also included in the review for the same reason, although these substances are classified as ‘nutritional supplements’ since they contain nutritional labeling as specified by the DSHEA. Brand names that contained multiple supplements were not included unless the brand name could be identified as having a single major identifiable dietary supplement.

To summarize the raw data, two major tables were constructed, one describing the methodology used by each study [see Table S1 in the Electronic Supplementary Material (ESM)], the other containing the prevalences of the most frequently reported dietary supplements (see Table S2 in the ESM).

Methodological Quality Ratings

Methodology quality of the investigations was assessed using the technique of Loney et al. [28], which was developed specifically for rating prevalence investigations. Studies were graded on an 8-point scale that included evaluations for sampling methods, sampling frame, sample size, measurement tools, bias, response rate, statistical presentation, and description of the participant sample. The eight items were rated as either ‘yes’ (1 point) or ‘no’ (no point), based on specific criteria. Thus, the maximum possible score was 8. Three authors independently rated each of the selected articles. Following the independent evaluations, the reviewers met to examine the scores and reconcile major differences. The average score of the reviewers served as the methodological quality score. Scores were converted to a percent of the total available points by dividing the average score for each study by 8 and multiplying by 100 %.


We used the Comprehensive Meta-Analysis Statistical Package, Version 3.2 (Biostat, Englewood, NJ, USA) to perform meta-analyses on (1) dietary supplement prevalence by sport and sex; (2) dietary supplement prevalence by elite versus non-elite athletic status; and (3) prevalence by specific dietary supplements for all athletic groups combined. These analyses required at least two studies and only studies that queried athletes about ‘current’, ‘usual’, or ‘regular’ use of dietary supplements were considered so that the reporting timeframe was similar. Studies asking about the use of dietary supplements at other times (e.g., last 2 months, last 6 months, etc.) were not included in the meta-analyses. For the sport-specific meta-analyses, the sport had to be explicit (e.g., football, basketball, tennis). If sports were grouped into broad categories (e.g., ‘combat sports’, ‘racquet sports’, ‘speed sports’, ‘power sports’, ‘endurance sports’, ‘ball sports’), they were not included. Elite athletes were defined as those competing professionally, at national or international level. Athletes competing at high schools, colleges, or universities were not considered elite. Only studies that involved adults and provided separate prevalence data for men and women were included in the elite versus non-elite meta-analyses. If sample sizes were not provided for a particular group or subgroup, the study could not be included because sample sizes are required for meta-analysis.

For all meta-analyses, we used a random model that considered users and non-users of dietary supplements to produce a summary prevalence estimate (SPE) and a summary 95 % confidence interval (S95 % CI) that represented the pooled data of all the individual investigations. Homogeneity of the pooled prevalence estimates was assessed using the Q- and the I 2-statistics [29]. I 2 indicated the percent of heterogeneity among studies, with smaller values denoting more homogeneity and larger values less homogeneity. In calculating I 2, negative values were set to zero, which indicated very little heterogeneity [30]. Where there were four or more studies, publication bias was assessed by examining the symmetry of study data in funnel plots (1/standard error of prevalences vs. logit of the prevalences) and further appraising the information with the trim and fill evaluation. The trim and fill evaluation imputes the number of ‘missing’ studies in the funnel plot and re-computes an adjusted SPE and S95 % CI with the ‘missing’ studies included [31]. Where there were fewer than four studies, symmetry of studies about the funnel plot could not be interpreted.


Figure 1 shows the number of publications included and excluded at each stage of the literature search. The initial search identified 16,694 citations, 5926 of which were duplicate publications (from different databases) that were removed. Based on a review of titles and abstracts, 311 full articles were obtained for review, and subsequently 136 were removed for not having information on prevalence or meeting the exclusion criteria. A total of 175 studies were further reviewed, but 16 of these did not contain useful data because of the manner in which the dietary supplements were categorized (‘antioxidant’, ‘pro-performance’, ‘herbal supplement’, etc.). In total, 159 unique studies (and 165 published papers) finally met the inclusion criteria. Two unique studies produced two reports each [3235], one resulted in three publications [3638], and one resulted in four articles [12, 3941].

Fig. 1

Publications included and excluded at each stage of literature review

Study Methodologies

Table S1 in the ESM shows the participants and methods in the 159 unique investigations. In terms of specific sports, there were 14 studies of football players [7, 8, 4253]; 12 of swimmers [7, 44, 45, 48, 5461] and soccer players [7, 44, 45, 48, 52, 6268]; ten of body builders [6, 6977] and basketball players [7, 4246, 52, 7880]; nine of volleyball players [7, 4347, 49, 52, 81]; eight of wrestlers [7, 4245, 47, 48, 82] and tennis players [7, 4348, 52]; seven of ballet dancers [8389] and gymnasts [7, 44, 45, 9093]; six with marathoners [36, 63, 9497], baseball players [7, 43, 45, 46, 48, 52], triathletes [63, 98102], and golfers [7, 4447, 52]; five with dancers [47, 89, 103105]; four with ultra-marathoners [106109]; three with runners [110112], figure skaters [15, 113, 114], alpine skiers [44, 48, 115], cheerleaders [7, 45, 48], cross-country runners [7, 44, 52], lacrosse players [44, 45, 48], softball players [7, 43, 52], and ice hockey players [44, 116, 117]; two with field hockey players [45, 48]; and one each with aerobic dancers [118], cyclists [119], divers [45], fencers [45], Nordic skiers [115], rugby players [120], sailors [121], speed skaters [122], synchronized swimmers [89], surfers [123], table tennis players [124], and weight lifters [63]. Eight studies involved athletes in ‘track and field’ sports without defining the specific sport [7, 16, 43, 44, 46, 104, 125, 126]. Other studies looked at groups of sports with elite athletes [9, 13, 14, 18, 19, 34, 35, 127138] (including Olympic athletes [32, 139145]), university or college athletes [11, 146156], high school athletes [157162], fitness/health/wellness club or gym users [10, 17, 95, 163169], and other groups of athletes [12, 23, 79, 170177].

The data in Table S1 in the ESM indicate that 63 of 159 unique studies (40 %) used questionnaires to obtain dietary supplement information from participants, and these were either focused on general or more specific (e.g., creatine or protein) dietary supplement. A total of 63 studies (40 %) centered on topics other than dietary supplements but included some items on general or specific dietary supplement use. Some studies used dietary records, asking athletes to record what they consumed in periods of 1 day (n = 1), 3 days (n = 26), 4 days (n = 2), 7 days (n = 10), or 14 days (n = 1), with some studies collecting data over several periods (n = 6). A few investigations used dietary recall (n = 7) and/or food frequency questionnaires (n = 4). Some studies interviewed athletes (n = 7) or used interviews in combination with other methods (n = 3). In a few cases (n = 3), the methods for collecting the study data were not stated.

The data in Table S1 of the ESM indicate that the athletes’ reporting timeframe differed among studies. There were 108 studies (68 %) that involved current, regular, or usual use of dietary supplements. Some studies focused on dietary supplement use in specific periods of time including the last 3 days (n = 1), last month (n = 5), last 2 months (n = 1), last 3 months (n = 3), last 6 months (n = 6), last 12 months (n = 5), in the bulking phase of body building (n = 1), for >6 months in the previous 3 years (n = 1), or use in athletes’ college sports careers (n = 1). A number of studies asked about dietary supplement use at any time, currently or in the past (n = 14). In some studies, the reporting timeframe was not clear (n = 13).

Table S1 in the ESM shows that the proportion of solicited athletes participating in the investigations ranged from 7 to 100 %, with 36 investigations (23 %) achieving ≥66 % participation and 32 studies (20 %) with participation of <66 %. In 89 studies (56 %), the proportion of the solicited athletes participating in the study was not specified. In two cases (1 %), the nature of the study was such that participation could not be determined (i.e., a case-control study and a study that only reported the proportion of high schools participating).

As shown in Table S1 in the ESM, rating from the methodological quality reviews ranged from 8 to 83 % of available points, with an average ± standard deviation rating of 43 ± 16 %. Only 54 studies (34 %) had scores of ≥50 % and only eight studies (5 %) had scores of ≥70 %. Very few investigations drew true random samples or specified a sampling frame. In some cases, lower methodological quality was associated with the fact that the study was not focused on dietary supplement prevalence. For example, studies on medication use or ‘doping’ [23, 135, 142, 143, 176] and studies on the nutritional intake [54, 62, 81, 133] included information on dietary supplement prevalence, but this was not the main purpose of the investigation. Table 1 shows that the methodological quality scores in the studies published in the 1969–1989 period were slightly lower than those published later, but the overall difference between the two publication periods (1969–1989 vs. 1990–2014) was only 6 %.

Table 1 Methodological quality scores at various publication times

Dietary Supplement Use Reported in Individual Investigations

Table S2 in the ESM shows the prevalence of dietary supplement use documented in each study. Information on the prevalence of any dietary supplement use was included in 95 studies (60 %). The use of any vitamins and/or minerals was reported in 67 investigations (42 %), multivitamin/multimineral use in 67 studies (42 %), and specific vitamins and/or minerals in 70 studies (44 %). Amino acid and/or protein supplementation was reported in 82 investigations (52 %), while creatine use was reported in 50 (31 %). There were 27 studies (17 %) that reported on specific herbal supplements. Sports drink use was reported in 33 studies (21 %), sports bar use in 18 studies (11 %), substances containing omega-3 fatty acids in 11 studies (7 %), caffeine use in eight studies (5 %), and energy drink consumption in seven studies (4 %).

Meta-Analyses on Dietary Supplement Prevalence

Table 2 presents the meta-analyses conducted on studies that provided data by sport, sex, and specific dietary supplements and where there were at least two investigations involving specific dietary supplements. Very few investigations provided the necessary data for conducting meta-analyses by these categories. Some studies that would have been appropriate for these analyses did not provide sample sizes by sport [4345, 47, 48, 52], while other studies that did provide sport and sample size did not separate dietary supplement data by sex [56, 58, 60, 61, 96, 106, 109, 112, 113, 118, 121]. Where appropriate data were available, many of the SPEs had wide S95 % CIs and low homogeneity. Of the 31 analyses in Table 2, only about half (n = 16) had Q statistic p values >0.05, and 29 % (n = 9) had I 2 values ≤50 %. Despite this, the data suggested that the largest prevalence of dietary supplement use was among male soccer players and body builders, with other groups having lower use prevalences.

Table 2 Summary data on prevalence of dietary supplement use of athletes by sport and sex

Table 3 shows the results of the meta-analyses of selected dietary supplements (any dietary supplements, multivitamins/multiminerals, and vitamin C) comparing sex-specific elite and non-elite athletic groups. A wide variety of sports were represented in these comparisons. With few exceptions, the SPEs demonstrated low homogeneity, with only 4 of the 12 analyses (33 %) having Q statistic p values >0.05 and I 2 values ≤50 %. There was generally little indication of publication bias, with the exception of any dietary supplement use in elite athletes. For elite athletes, the trim and fill adjusted SPE for any dietary supplement use was lower than the unadjusted values, but still higher than that of the non-elite athletes. Compared with non-elite athletes, a larger proportion of elite athletes also used multivitamins/multiminerals and vitamin C.

Table 3 Use of selected dietary supplement by elite and non-elite athletic status

An attempt was made to examine dietary supplement use in all athletic groups combined; the results are shown in Table 4. There was very little homogeneity among the studies. Of the 61 analyses, only two had a Q statistic p value >0.05 and only one had an I 2 ≤ 50 %. Despite this, the SPEs seem to indicate that the overall prevalence of dietary supplement use was high, with about 60 % of athletes using dietary supplements of any type and with vitamin/minerals, multivitamins/multiminerals, vitamin C, protein, sport drinks, and sport bars among the most commonly used. Male and female athletes had similar SPEs for most dietary supplements, with a few exceptions: compared with men, a larger proportion of women used iron and a smaller proportion used vitamin E, protein, and creatine. There was some indication of publication bias but these cases had little effect on the trim and fill adjusted SPEs.

Table 4 Prevalence of dietary supplement use in combined athletic groups


This review illustrates the difficulty in obtaining a comprehensive description of the prevalence of dietary supplement use in athletes. Studies on this topic have used different data collection methods (e.g., dietary surveys, interviews, questionnaires), collected data on different dietary supplements, and used different reporting timeframes. The methodological quality of the studies was generally very low, with only 34 % of studies acquiring even half the available points on the Loney et al. [28] checklist. Methodological quality of the studies published after the 1990s improved slightly, but average improvement was only an additional 6 % of available points (37 vs. 43 %). Using meta-analysis, an attempt was made to summarize the data by sex and sport, but few studies reported use of the same dietary supplements, and where this was the case the prevalence values in many individual studies varied widely (low homogeneity), resulting in broad S95 % CIs. Nonetheless, the tables in the present study provide a comprehensive summary of available data on the use of dietary supplements by athletes.

When comparisons were made between elite and non-elite athletes, the SPEs suggested that elite athletes tended to use dietary supplements to a greater extent than the non-elite athletes. However, prevalence ranges among studies were still wide, demonstrating low homogeneity. Further, this comparison was complicated by differences in the types of sports that might be included in the two groups. Athletes involved in different sports might be expected to use different dietary supplements, although the combined data on specific dietary supplements in specific sports was too sparse to test this hypothesis (Table 2). The sex comparisons within the elite/non-elite groups might be more appropriate because the comparisons involve similar (although not identical) sports. However, the prevalence values still varied widely and the SPEs lacked homogeneity. Nonetheless, examining the individual study prevalences and the SPEs within the elite or non-elite groups suggested little difference between men and women in overall prevalence of dietary supplement use.

Like comparisons by sport and elite/non-elite status, the attempt to summarize the sex-specific prevalences of particular dietary supplements for all studies on athletes suffered from a lack of homogeneity. Nonetheless, SPEs appeared to be similar between men and women, with a few exceptions. Compared with men, a larger proportion of women appeared to use iron supplements. A much larger proportion of active women appear to be iron deficient compared with active men [178], and the recommended daily allowances for iron are more than twice as high for premenopausal women (18 mg/day) than for men (8 mg/day) [179]. This may lead more athletic women to supplement with iron to enhance health and/or performance. Consumption of iron supplements was associated with a lower prevalence of iron deficiency among adult women in a US national survey [180]. Protein and creatine were also taken by a larger proportion of men than women, possibly because of differences in rationales for using dietary supplements. When men and women were queried separately on their reasons for using dietary supplements within the same study, men reported the development of strength and/or muscle mass as a higher priority than did women [7, 11, 19]. Protein and creatine supplementation have both been demonstrated to increase strength and lean body mass [181, 182].

Table 5 shows summary data from the National Health Interview Surveys (NHIS) [183185] and the National Health and Nutrition Surveys (NHANES) [186189], both of which are nationally representative samples of the general US population. Both surveys observed a secular (temporal) trend, indicating that dietary supplement use has been increasing over time, although the most recent NHANES data suggested a leveling off in use [188, 189]. The increase in dietary supplement use is in consonance with data showing an eightfold increase in commercial dietary supplement sales from 1994 to 2012 [3, 4]. In the present review, studies were compiled by publication date in an attempt to determine whether a temporal trend was present, but no such trend could be discerned. Even the earliest studies in the literature demonstrated that a very large proportion of athletes were using dietary supplements [54, 56, 83, 95, 139, 147].

Table 5 Summary data on dietary supplement use in US national surveys

Additionally, Table 5 includes summary data on multivitamins/multiminerals and vitamin C, mostly from the NHIS [183185], but including one NHANES survey [188]. There are some limitations in comparing these national survey data with those of the athletes. The NHIS survey asked individuals about daily use of supplements, and the NHANES asked about use in the last month. In the meta-analyses of athletes presented here (Tables 2, 3, 4) the reporting timeframe included ‘current’, ‘usual’, or ‘regular’ use. The athlete data were also collected over a much greater range of years than the NHIS/NHANES data, and the temporal trends differed, as noted above. Despite these limitations, a comparison of the data suggested that prevalence of use of any vitamins/minerals and multivitamins/multiminerals was somewhat higher, and that of vitamin C much higher among athletes than the general US population. Similar to the athlete data, a recent systematic review showed that the prevalence of multivitamin/multimineral and vitamin C use was higher in the military than in civilian samples [190]. Military and athletic groups may be more likely to use dietary supplements because of a greater concern with health and performance [10, 35, 53, 149, 191196]. For example, consider protein supplements. Protein supplementation in combination with resistance training augments gains in fat-free mass [182]. National surveys in the USA indicate that only 1 % of the general population uses amino acid supplements [197]. In contrast, the athlete data suggests a much larger prevalence of use (Table 4), as does the more limited military data [190].

Use of herbal supplements could be high in some athletic subgroups, especially among elite athletes. For example, use of ginseng ranged from 16 to 51 % in a study of Korean Olympic athletes [144, 153] and 27 % in a study of Saudi Arabian professional soccer players [68]. Echinacea was used by 60 % of professional surfers [123], 39 % of elite Australian swimmers [58], and 28 and 44 % of elite male and female, respectively, figure skaters [15]. Nonetheless, in most groups of athletes, 10 % or fewer used herbal supplements [10, 19, 23, 49, 67, 80, 101, 121, 128, 159, 198]. In US national surveys, the most commonly used herbal supplements were Echinacea, garlic, Ginkgo biloba, ginseng, and Saint John’s Wort, with most use prevalences well below 5 % [185, 197, 199]. Since the studies reviewed here were conducted over a long period of time, the popularity of different supplements may have changed over time as they have in the general US population [199, 200].

We suspected there would be differences among studies based on nationality because of cultural and/or socioeconomic conditions. Some differences were noted in the use of ginseng, since Korean and Saudi Arabian athletes had a higher prevalence of use of this herbal supplement [68, 144, 153] than other nationalities [912, 15, 19, 49, 58, 80, 131, 132, 141, 149, 152, 159, 198]. However, no other major differences were noted; there was a wide range of dietary supplement usages regardless of nationality.

Suggestions for Improving Research on Dietary Supplement Use in Athletes

Because of the lack of homogeneity in dietary supplement use prevalences among athletes, the most appropriate way to conclude this review is to offer suggestions for improving the collection of dietary supplement data. Future studies on athletes and other groups should consider five major issues. First, the definition of dietary supplement should be clearly stated. The legal definition provided by the DSHEA of 1994 [2] can serve as a standard. Second, studies should be specific about the types of dietary supplements used by study participants. Reporting in general categories like ‘antioxidant’, ‘energy’, ‘herbal’, ‘bodybuilding’, and the like may be useful for some purposes but does not provide the specificity needed for comparisons across studies or the identification of the specific dietary supplements that are being used by athletes. Third, the reporting timeframe should be specific and include several periods. The most useful reporting timeframes appear to be daily, 2–6 times/week, 1 time/week, and <1 time/week. Fourth, the response rate (those volunteering/those solicited) should be specified and, if possible, characteristics of respondents and non-respondents described so that possible bias can be assessed. Finally, studies are needed that use the same experimental methods to compare dietary supplement use across a wide variety of sports so sport-specific differences and temporal trends can be established. Following these guidelines will assist in providing more accurate and comparable data on dietary supplement use in specific athletic populations.


When dietary supplement use was compiled by sport, elite versus non-elite athletic status, and supplement type, there was high variability in use prevalence among studies. Elite athletes appeared to use dietary supplements much more than their non-elite counterparts. For most dietary supplements, use prevalence appeared similar for men and women, with the exception of iron, creatine, protein, and vitamin E. Suggested improvements in future studies include (1) defining dietary supplements in surveys and dietary evaluations; (2) querying for very specific dietary supplements; (3) using a variety of reporting timeframes (e.g., daily, 2–6 times/week, 1 time/week and <1 time/week); (4) reporting the sampling frame, number of individuals solicited, and number responding; (5) reporting characteristics of volunteers (and non-volunteers, if available); and (6) using similar methods on several occasions to examine possible temporal trends among athletes.


  1. 1.

    National Institute of Health. Strengthening knowledge and understanding of dietary supplements. 2013. Available from: Cited 4 Feb 2013.

  2. 2.

    Federal Drug Administration. Dietary Supplement Health and Education Act of 1994. 1994. Available from: Cited 11 Mar 2013.

  3. 3.

    Saldanha LG. The dietary supplement marketplace. Constantly evolving. Nutr Today. 2007;42(2):52–4.

    Article  Google Scholar 

  4. 4.

    Infographics: highlights from the 2013 Supplement Business Report. Nutr Bus J. 2013. Accessed 23 Aug 2014.

  5. 5.

    Nutrition Business Journal Global Supplement and Nutrition Industry Report 2014. Nutr Bus J. 2014. Accessed 23 Aug 2014.

  6. 6.

    Brill JB, Keane MW. Supplementation patterns of competitive male and female bodybuilders. Int J Sport Nutr. 1994;4:398–412.

    PubMed  CAS  Google Scholar 

  7. 7.

    Krumbach CJ, Ellis DR, Driskell JA. A report on vitamin and mineral supplement use among university athletes in a division I institution. Int J Sport Nutr. 1999;9:416–25.

    PubMed  CAS  Google Scholar 

  8. 8.

    Swirzinski L, Latin RW, Berg K, et al. A survey of sports nutrition supplements in high school football players. J Strength Cond Res. 2000;14(4):464–9.

    Google Scholar 

  9. 9.

    Sundgot-Borgen J, Berglund B, Torstveit MK. Nutritional supplements in Norwegian elite athletes-impact of international ranking and advisors. Scand J Med Sci Sports. 2003;13:138–44.

    PubMed  CAS  Article  Google Scholar 

  10. 10.

    Morrison LJ, Gizin F, Shorter B. Prevalent use of dietary supplements among people who exercise at a commercial gym. Int J Sports Nutr Exerc Metabol. 2004;14:481–92.

    CAS  Google Scholar 

  11. 11.

    Froiland K, Koszewski W, Hingst J, et al. Nutrition supplement use among college athletes and their sources of information. Int J Sports Nutr Exerc Metabol. 2004;14:104–20.

    Google Scholar 

  12. 12.

    Petroczi A, Naughton DP, Mazanov J, et al. Performance enhancement with supplements: incongruence between rationale and practice. J Int Soc Sports Nutr. 2007;4:19.

    PubMed  PubMed Central  Article  Google Scholar 

  13. 13.

    Kim J, Chun YS, Kang SK, et al. The use of herbal/traditional products supplementation and doping tests in elite athletes. Int J Appl Sports Sci. 2010;22(2):137–49.

    Google Scholar 

  14. 14.

    Sousa M, Fernandes MJ, Moreira P, et al. Nutritional supplement usage by Portuguese athletes. Int J Vit Nutr Res. 2013;83(1):48–58.

    CAS  Article  Google Scholar 

  15. 15.

    Ziegler PJ, Nelson JA, Jonnalagadda SS. Use of dietary supplements by elite figure skaters. Int J Sports Nutr Exerc Metabol. 2003;13:266–76.

    CAS  Google Scholar 

  16. 16.

    Nieper A. Nutritional supplement practices in UK junior national track and field athletes. Br J Sports Med. 2005;39:645–9.

    PubMed  PubMed Central  CAS  Article  Google Scholar 

  17. 17.

    Goston JL, Correia MITD. Intake of nutritional supplements among people exercising in gyms and influencing factors. Nutrition. 2010;26:604–11.

    PubMed  Article  Google Scholar 

  18. 18.

    Dascombe DJ, Karunaratna M, Cartoon J, et al. Nutritional supplementation habits and perceptions of elite athletes within a state-based sporting institute. J Med Sci Sports. 2010;13:274–80.

    CAS  Article  Google Scholar 

  19. 19.

    Lun V, Erdman KA, Fung TS, et al. Dietary supplementation practices in Canadian high-performance athletes. Int J Sports Nutr Exerc Metabol. 2012;22:31–7.

    CAS  Google Scholar 

  20. 20.

    Bailey RL, Gahche JJ, Miller PE, et al. Why US adults use dietary supplements. JAMA Int Med. 2013;173(3):355–61.

    CAS  Article  Google Scholar 

  21. 21.

    Dickinson A, Bonci L, Boyon N, et al. Dietitians use and recommend dietary supplements: report of a survey. Nutr J. 2012;11:14.

    PubMed  PubMed Central  Article  Google Scholar 

  22. 22.

    Huang HY, Caballero B, Chang S, et al. The efficacy and safety of multivitamin and mineral supplement use to prevent cancer and chronic disease in adults: a systematic review for a National Institute of Health State-of-the-Science Conference. Ann Int Med. 2006;145:372–85.

    PubMed  CAS  Article  Google Scholar 

  23. 23.

    Lazic JS, Dikic N, Radivojevic N, et al. Dietary supplements and medications in elite sport-polypharmacy or real need? Scand J Med Sci Sports. 2011;21:260–7.

    PubMed  Article  Google Scholar 

  24. 24.

    Outram S, Stewart B. Doping through supplement use: a review of available empirical data. Int J Sports Nutr Exerc Metabol. 2015;25(1):54–9.

    Article  Google Scholar 

  25. 25.

    Petroczi A, Taylor G, Naughton DP. Mission impossible? Regulatory and enforcement issures to ensure safety of dietary supplements. Food Chem Toxicol. 2011;49(2):393–402.

    PubMed  CAS  Article  Google Scholar 

  26. 26.

    Sobal J, Marquart LF. Vitamin/mineral supplement use among athletes: a review of the literature. Int J Sports Nutr. 1994;4:320–34.

    CAS  Google Scholar 

  27. 27.

    Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.

    PubMed  PubMed Central  Article  Google Scholar 

  28. 28.

    Loney PL, Chambers LW, Bennett KJ, et al. Critical appraisal of health research literature: prevalence or incidence of a health problem. Chronic Dis Can. 2000;19(4):170–6.

    Google Scholar 

  29. 29.

    Huedo-Medina T, Sanchez-Meca J, Marin-Martinez F, et al. Assessing heterogeneity in meta-analysis: Q-statistic or I 2 index? Psychol Methods. 2006;11(2):193–206.

    PubMed  Article  Google Scholar 

  30. 30.

    Higgins JPT, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analysis. Br Med J. 2003;327:557–60.

    Article  Google Scholar 

  31. 31.

    Duval S, Tweedie R. Trim and Fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56(2):455–63.

    PubMed  CAS  Article  Google Scholar 

  32. 32.

    Heikkinen A, Alaranta A, Helenius I, et al. Use of dietary supplements in Olympic athletes is decreasing: a follow-up study between 2002 and 2009. J Int Soc Sports Nutr. 2011;8:1.

    PubMed  PubMed Central  Article  Google Scholar 

  33. 33.

    Heikkinen A, Alaranta A, Helenius I, et al. Dietary supplement habits and perceptions of dietary supplement use among elite Finnish athletes. Int J Sport Nutr Exerc Metab. 2011;21:271–9.

    PubMed  Google Scholar 

  34. 34.

    Erdman KA, Fung TS, Reimer RA. Influence of performance level on dietary supplementation in elite Canadian athletes. Med Sci Sports Exerc. 2006;38(2):349–56.

    PubMed  Article  Google Scholar 

  35. 35.

    Erdman KA, Fung TS, Doyle-Baker PK, et al. Dietary supplementation of high-performance Canadian athletes by age and gender. Clin J Sport Med. 2007;17(6):458–64.

    PubMed  Article  Google Scholar 

  36. 36.

    Deuster PA, Kyle SB, Moser PB, et al. Nutritional survey of highly trained women runners. Am J Clin Nutr. 1986;44:954–62.

    PubMed  CAS  Google Scholar 

  37. 37.

    Deuster PA, Kyle SB, Moser PB, et al. Nutritional intakes and status of highly trained amenorrheic and eumenorrheic women runners. Fertil Steril. 1986;46(4):636–43.

    PubMed  CAS  Google Scholar 

  38. 38.

    Singh A, Deuster PA, Moser PB. Zinc and copper status of women by physical activity and menstrual status. J Sports Med Phy Fitness. 1990;30(1):29–36.

    CAS  Google Scholar 

  39. 39.

    Petroczi A, Naughton DP. The age-gender-status profile of high performing athletes in the UK taking nutritional supplements: lessons for the future. J Int Soc Sports Nutr. 2008;5:2.

    PubMed  PubMed Central  Article  CAS  Google Scholar 

  40. 40.

    Petroczi A, Naughton D, Mazanov J, et al. Limited agreement exists between rationale and practice in athletes’ supplement use for maintenance of health: a retrospective study. Nutr Res. 2007;6:34.

    Google Scholar 

  41. 41.

    Mazanov J, Petroczi A, Bingham J, et al. Towards an empirical model of performance enhancing supplement use: a pilot study among high performance UK athletes. J Sci Med Sport. 2008;11:185–90.

    PubMed  CAS  Article  Google Scholar 

  42. 42.

    Short SH, Short WR. Four-year study of university athletes’ dietary intake. J Am Diet Assoc. 1983;82(6):632–45.

    PubMed  CAS  Google Scholar 

  43. 43.

    Jacobson BH, Aldana SG. Current nutrition practices and knowledge of varsity athletes. J Appl Sport Sci Res. 1992;6(4):232–8.

    Google Scholar 

  44. 44.

    Sobal J, Marquat LF. Vitamin/mineral supplement use among high school athletes. Adolescence. 1994;29(116):835–45.

    PubMed  CAS  Google Scholar 

  45. 45.

    LaBotz M, Smith BW. Creatine supplement use in an NCAA Division I athletic program. Clin J Sport Med. 1999;9:167–9.

    PubMed  CAS  Article  Google Scholar 

  46. 46.

    Greenwood M, Ferris J, Kreider R, et al. Creatine supplementation patterns and perceived effects in select Division I collegiate athletes. Clin J Sport Med. 2000;10:191–4.

    PubMed  CAS  Article  Google Scholar 

  47. 47.

    Smith J, Dahm DL. Creatine use among a selected population of high school athletes. Mayo Clin Proc. 2000;75:1257–63.

    PubMed  CAS  Article  Google Scholar 

  48. 48.

    Metzl JD, Small E, Levine SR, et al. Creatine use among young athletes. Pediatrics. 2001;108(2):421–5.

    PubMed  CAS  Article  Google Scholar 

  49. 49.

    Mason MA, Giza M, Clayton L, et al. Use of nutritional supplements by high school football and volleyball players. Iowa Orthop J. 2001;21:43–8.

    PubMed  PubMed Central  CAS  Google Scholar 

  50. 50.

    Jonnalagadda SS, Rosenbloom CA, Skinner R. Dietary practices, attitudes, and physiological status of collegiate freshman football players. J Strength Cond Res. 2001;15(4):507–13.

    PubMed  CAS  Google Scholar 

  51. 51.

    Cole CR, Salvaterra GF, Davis JE, et al. Evaluation of dietary practices of National Collegiate Athletic Association Division I football players. J Strength Cond Res. 2005;19(3):490–4.

    PubMed  Google Scholar 

  52. 52.

    Scofield DE, Unruh S. Dietary supplement use among adolescent athletes in Central Nebraska and their sources of information. J Strength Cond Res. 2006;20(2):452–5.

    PubMed  Google Scholar 

  53. 53.

    Duellman MC, Lukaszuk JM, Prawitz AD, et al. Protein supplement users among high school athletes have misconceptions about effectiveness. J Strength Cond Res. 2008;22:1124–9.

    PubMed  Article  Google Scholar 

  54. 54.

    Houston ME. Diet, training and sleep: a survey study of elite Canadian swimmers. Can J Appl Sport Sci. 1980;5:161–3.

    PubMed  CAS  Google Scholar 

  55. 55.

    Adams MM, Porcello LP, Vivian VM. Effect of a supplement on dietary intakes of female collegiate swimmers. Physician Sports Med. 1982;10(7):122–34.

    Google Scholar 

  56. 56.

    Campbell ML, MacFadyen KL. Nutrition knowledge. Beliefs and dietary practices of competitive swimmers. Can Home Econ J. 1984;34(1):47–51.

    Google Scholar 

  57. 57.

    Hawley JA, Williams MM. Dietary intake of age-group swimmers. Br J Sports Med. 1991;25(3):154–8.

    PubMed  PubMed Central  CAS  Article  Google Scholar 

  58. 58.

    Baylis A, Cameron-Smith D, Burke LM. Inadvertent doping through supplement use by athletes: assessment and management of the risk in Australia. Int J Sport Nutr Exerc Metab. 2001;11:365–83.

    PubMed  CAS  Google Scholar 

  59. 59.

    Paschoal VCP, Amancio OMS. Nutritional status of Brazilian elite swimmers. Int J Sport Nutr Exerc Metab. 2004;14:81–94.

    PubMed  Google Scholar 

  60. 60.

    Slattery KM, Coutts AJ, Wallace LK. Nutritional practices of elite swimmers during an intensified training camp: with particular reference to antioxidants. J Sports Med Phy Fitness. 2012;52:501–5.

    CAS  Google Scholar 

  61. 61.

    Sajber D, Rodek J, Escalante Y, et al. Sports nutrition and doping factors in swimming: parallel analysis among athletes and coaches. Coll Anthropol. 2013;37(2):179–86.

    Google Scholar 

  62. 62.

    Burke LM, Read RSD. A study of dietary patterns of elite Australian football players. Can J Sports Sci. 1988;13:15–9.

    CAS  Google Scholar 

  63. 63.

    Burke LM, Gollan RA, Read RSD. Dietary intake and food use of groups of elite Australian male athletes. Int J Sports Nutr. 1991;1:378–94.

    CAS  Google Scholar 

  64. 64.

    Ama PFM, Betnga B, Moor VJA, et al. Football and doping: a study of African amateur footballers. Br J Sports Med. 2003;37:307–10.

    PubMed  PubMed Central  CAS  Article  Google Scholar 

  65. 65.

    Waddington I, Malcolm D, Roderick M, et al. Drug use in English professional football. Br J Sports Med. 2005;39:e18.

    PubMed  PubMed Central  CAS  Article  Google Scholar 

  66. 66.

    Tscholl P, Junge A, Dvorak J. The use of medication and nutritional supplements during FIFA World Cups 2002 and 2006. Br J Sports Med. 2008;42:725–30.

    PubMed  PubMed Central  CAS  Article  Google Scholar 

  67. 67.

    Russell M, Pennock A. Dietary analysis of young professional soccer players for 1 week during the competitive season. J Strength Cond Res. 2011;25(7):1816–23.

    PubMed  Article  Google Scholar 

  68. 68.

    Aljaloud SO, Ibrahim SA. Use of dietary supplements among professional athletes in Saudi Arabia. J Nutr Metab. 2013;2013:1–7.

    Article  CAS  Google Scholar 

  69. 69.

    Faber M, Benade AJS. Nutrient intake and dietary supplementation in body-builders. S Afr Med J. 1987;72:831–4.

    PubMed  CAS  Google Scholar 

  70. 70.

    Sandoval WM, Heyward VH, Lyons TM. Comparison of body composition, exercise and nutritional profiles of female and male body builders at competition. J Sports Med Phys Fitness. 1989;29(1):63–70.

    PubMed  CAS  Google Scholar 

  71. 71.

    Heyward VH, Sandoval WM, Colville BC. Anthropometric, body composition and nutritional profiles of bodybuilders during training. J Appl Sports Sci Res. 1989;3(2):22–9.

    Google Scholar 

  72. 72.

    Lamar-Hildebrand N, Saldanha L, Enders J. Dietary and exercise practices of college-aged female body builders. J Am Diet Assoc. 1989;89(9):1308–10.

    PubMed  CAS  Google Scholar 

  73. 73.

    Kleiner SM, Bazzarre TL, Litchford MD. Metabolic profiles, diet, and health practices of championship male and female bodybuilders. J Am Diet Assoc. 1990;90(7):962–7.

    PubMed  CAS  Google Scholar 

  74. 74.

    Linseisen J, Metges CC, Wolfram G. Dietary habits and serum lipids of a group of German amateur bodybuilders. Eur J Nutr. 1993;32(4):289–300.

    CAS  Google Scholar 

  75. 75.

    Walberg-Rankin J, Edmonds CE, Gwazdauskas FC. Diet and weight changes in female bodybuilders before and after competition. Int J Sports Nutr. 1993;3:87–102.

    CAS  Google Scholar 

  76. 76.

    Andersen RE, Barlett SJ, Morgan GD, et al. Weight loss, psychological, and nutritional patterns in competitive male body builders. Int J Eat Disord. 1995;18(1):49–57.

    PubMed  CAS  Article  Google Scholar 

  77. 77.

    Karimian J, Esfahani PS. Supplement consumption in body builder athletes. J Res Med Sci. 2011;16(10):1347–53.

    PubMed  PubMed Central  Google Scholar 

  78. 78.

    Nowak RK, Knudsen KS, Schulz LO. Body composition and nutrient intakes of college men and women basketball players. J Am Diet Assoc. 1988;88:575–8.

    PubMed  CAS  Google Scholar 

  79. 79.

    Schulz LO. Factors influencing the use of nutritional supplements by college students with varying levels of physical activity. Nutr Res. 1988;8:459–66.

    Article  Google Scholar 

  80. 80.

    Schroder H, Navarro E, Mora J, et al. The type, amount, frequency and timing of dietary supplement use by elite players in the first Spanish Basketball League. J Sports Sci. 2002;20:353–8.

    PubMed  CAS  Article  Google Scholar 

  81. 81.

    Beals KA. Eating behaviors, nutritional status, and menstrual function in elite female adolescent volleyball players. J Am Diet Assoc. 2002;102(9):1293–6.

    PubMed  Article  Google Scholar 

  82. 82.

    Oppliger RA, Landry GL, Foster SW, et al. Bulimic knowledge among interscholastic wrestlers: a statewide survey. Pediatrics. 1993;91(4):826–31.

    PubMed  CAS  Google Scholar 

  83. 83.

    Bright-See E, Croy J, Brayshaw J, et al. Nutrition briefs and practices of ballet students. J Can Diet Assoc. 1978;39(4):324–31.

    Google Scholar 

  84. 84.

    Calabrese LH, Kirkendall DT, Floyd M, et al. Menstrual abnormalities, nutritional patterns and body composition in female classic ballet dancers. Physician Sports Med. 1983;11(2):86–98.

    Google Scholar 

  85. 85.

    Cohen JL, Potosnak L, Frank O, et al. A nutritional and hematological assessment of elite ballet dancers. Physician Sports Med. 1985;13(5):43–54.

    Google Scholar 

  86. 86.

    Braisted JR, Mellin L, Gong EJ, et al. The adolescent ballet dancer. Nutritional practices and characteristics associated with anorexia nervosa. J Adolesc Health Care. 1985;6:365–71.

    PubMed  CAS  Article  Google Scholar 

  87. 87.

    Benson J, Gillien DM, Bourdet K, et al. Inadequate nutrition and chronic caloric restriction in adolescent ballerinas. Physician Sports Med. 1985;13(10):79–90.

    Google Scholar 

  88. 88.

    Frusztajer NT, Dhuper S, Warren MP, et al. Nutrition and the incidence of stress fractures in ballet dancers. Am J Clin Nutr. 1990;51:779–83.

    PubMed  CAS  Google Scholar 

  89. 89.

    Zenic N, Peric M, Zubcevic NG, et al. Comparative analysis of substance use in ballet, dance sport, and synchronized swimming. Med Probl Perform Art. 2010;25:75–81.

    PubMed  Google Scholar 

  90. 90.

    Moffatt RJ. Dietary status of elite female high school gymnasts: inadequacy of vitamin and mineral intake. J Am Diet Assoc. 1984;84:1361–4.

    PubMed  CAS  Google Scholar 

  91. 91.

    Loosli AR, Benson J, Gillien DM, et al. Nutrition habits and knowledge in competitive adolescent female gymnasts. Physician Sports Med. 1986;14(6):118–30.

    Google Scholar 

  92. 92.

    Ersoy G. Dietary status and anthropometric assessment of child gymnasts. J Sports Med Phy Fitness. 1991;31(4):577–80.

    CAS  Google Scholar 

  93. 93.

    Jonnalagadda SS, Benardot D, Nelson M. Energy and nutrient intakes of the United States National Woman’s Artistic Gymnastic Team. Int J Sport Nutr. 1998;8:331–44.

    PubMed  CAS  Google Scholar 

  94. 94.

    Lampe JW, Salvin JL, Apple FS. Poor iron status of women runners training for a marathon. Int J Sports Med. 1986;7:111–4.

    PubMed  CAS  Article  Google Scholar 

  95. 95.

    Barr SI. Nutrition knowledge and selected nutritional practices of female recreational athletes. J Nutr Educ. 1986;18:167–74.

    Article  Google Scholar 

  96. 96.

    Thibault G, Lambert J, Rivard M, et al. Utilization of ergogenic aids and the attitudes toward safety in marathon runners. In: Katch FI, editor. The 1984 Olympic Scientific Congress proceedings, volume 2 Sports, Health and Nutrition. Champaign: Human Kinetics Publishers Inc; 1986.

    Google Scholar 

  97. 97.

    Nieman DC, Gates JR, Butler JV, et al. Supplementation patterns in marathon runners. J Am Diet Assoc. 1989;89:1615–9.

    PubMed  CAS  Google Scholar 

  98. 98.

    Khoo CS, Rawson NE, Robinson ML, et al. Nutrient intake and eating habits of triathletes. Ann Sports Med. 1987;3:144–50.

    Google Scholar 

  99. 99.

    Worme JD, Doubt TJ, Singh A, et al. Dietary patterns, gastrointestinal complaints, and nutrition knowledge of recreational athletes. Am J Clin Nutr. 1990;51:690–7.

    PubMed  CAS  Google Scholar 

  100. 100.

    Nogueira JAD, DeCosta THM. Nutrient intake and eating habits of triathletes on a Brazilian diet. Int J Sport Nutr Exerc Metab. 2004;14:684–97.

    PubMed  Google Scholar 

  101. 101.

    Knez WL, Peake JM. The prevalence of vitamin supplementation in ultraendurance triathletes. Int J Sport Nutr Exerc Metab. 2010;20:507–14.

    PubMed  CAS  Google Scholar 

  102. 102.

    Dolan SH, Houston M, Martin SB. Survey results of the training, nutrition, and mental preparation of triathletes: practical implications of findings. J Sports Sci. 2011;29(10):1019–28.

    PubMed  Article  Google Scholar 

  103. 103.

    Evers CL. Dietary intake and symptoms of anorexia nervosa in female university dancers. J Am Diet Assoc. 1987;87(1):66–8.

    PubMed  CAS  Google Scholar 

  104. 104.

    Frederick L, Hawkins ST. A comparison of nutrition knowledge and attitudes, dietary practices, and bone densities of postmenopausal women, female college athletes, and nonathletic college women. J Am Diet Assoc. 1992;92:299–305.

    PubMed  CAS  Google Scholar 

  105. 105.

    Sekulic D, Kostic R, Miletic D. Substance use in dance sports. Med Probl Perform Art. 2008;23(2):66–71.

    Google Scholar 

  106. 106.

    Singh A, Evans P, Gallagher KL, et al. Dietary intake and biochemical profiles of nutritional status of untramarathoners. Med Sci Sports Exerc. 1993;25(3):328–34.

    PubMed  CAS  Article  Google Scholar 

  107. 107.

    Peters EM, Goetzsche JM. Dietary practices of South African ultradistance runners. Int J Sports Nutr. 1997;7:80–103.

    CAS  Google Scholar 

  108. 108.

    Knechtle B, Knechtle P, Schulze I, et al. Vitamin, mineral and race performance in ultra-endurance runners—Deutschlandlauf 2006. Asia Pac J Clin Nutr. 2008;17(2):194–8.

    PubMed  Google Scholar 

  109. 109.

    Hoffman MD, Fogard K. Demographic characteristics of 161-km ultramarathon runners. Res Sports Med. 2012;20:59–69.

    PubMed  Google Scholar 

  110. 110.

    Clark N, Nelson M, Evans W. Nutrition education for elite female runners. Physician Sports Med. 1988;16(2):124–36.

    Google Scholar 

  111. 111.

    Pate RR, Sargent RG, Baldwin C, et al. Dietary intake of women runners. Int J Sports Med. 1990;11:461–6.

    PubMed  CAS  Article  Google Scholar 

  112. 112.

    Beis LY, Willkomm L, Ross R, et al. Food and micronutrient intake of elite Ethiopian distance runners. J Int Soc Sports Nutr. 2011;8:7.

    PubMed  PubMed Central  CAS  Article  Google Scholar 

  113. 113.

    Ziegler PJ, Khoo CS, Kris-Etherton PM, et al. Nutritional status of nationally ranked junior US figure skaters. J Am Diet Assoc. 1998;98(7):809–11.

    PubMed  CAS  Article  Google Scholar 

  114. 114.

    Ziegler P, Sharp R, Hughes V, et al. Nutritional status of teenage female competitive figure skaters. J Am Diet Assoc. 2002;101:374–9.

    Article  Google Scholar 

  115. 115.

    Rosen O, Sundgot-Borgen J, Maehlum S. Supplement use and nutritional habits in Norwegian elite athletes. Scand J Med Sci Sports. 1999;9:28–35.

    Article  Google Scholar 

  116. 116.

    Bobb A, Pringle D, Ryan AJ. A brief study of the diet of athletes. J Sports Med. 1969;9:255–62.

    CAS  Google Scholar 

  117. 117.

    Bents RT, Marsh E. Patterns of ephedra and other stimulant use in collegiate hockey athletes. Int J Sport Nutr Exerc Metab. 2006;16:636–43.

    PubMed  Google Scholar 

  118. 118.

    Soper J, Carpenter RA, Shannon BM. Nutrition knowledge of aerobic dance instructors. J Nutr Educ. 1992;24:59–66.

    Article  Google Scholar 

  119. 119.

    Slavin JL, McNamara EA, Lutter JM. Nutritional practices of women cyclists, including recreational riders and elite riders. In: Katch FI, editor. Sports, health and nutrition. The 1984 Olympic Scientific Congress proceedings, volume 2. Champaign: Human Kinetics Publishers, Inc; 1986. p. 107–11.

    Google Scholar 

  120. 120.

    Walsh M, Cartwright L, Corish C, et al. The body composition, nutritional knowledge, attitudes, behaviors and future educational needs of senior schoolboy rugby players in Ireland. Int J Sports Nutr Exerc Metabol. 2011;21:365–76.

    Google Scholar 

  121. 121.

    Rodek J, Sekulic D, Kondric M. Dietary supplementation and doping-related factors in high-level sailing. J Int Soc Sports Nutr. 2012;9:51.

    PubMed  PubMed Central  Article  Google Scholar 

  122. 122.

    Snyder AC, Schulz LO, Foster C. Voluntary consumption of a carbohydrate supplement by elite speed skaters. J Am Diet Assoc. 1989;89(8):1125–7.

    PubMed  CAS  Google Scholar 

  123. 123.

    Felder JM, Burke LM, Lowden BJ, et al. Nutritional practices of elite female surfers during training and competition. Int J Sport Nutr. 1998;8:36–8.

    PubMed  CAS  Google Scholar 

  124. 124.

    Kondric M, Sekulic D, Mandic GF. Substance use and misuse among Slovenian table tennis players. Subst Use Misuse. 2010;45:543–53.

    PubMed  Article  Google Scholar 

  125. 125.

    Faber M, Benade AJS. Mineral and vitamin intake in field athletes (discus-, hammer-, javelin-throwers and shotputters). Int J Sports Med. 1991;12:324–7.

    PubMed  CAS  Article  Google Scholar 

  126. 126.

    Mullins VA, Houtkooper LB, Howell WH, et al. Nutritional status of US elite female heptathletes during training. Int J Sport Nutr Exerc Metab. 2001;11:299–314.

    PubMed  CAS  Google Scholar 

  127. 127.

    Grandjean AC. Vitamin, diet, and the athlete. Clin Sports Med. 1983;2(1):105–14.

    PubMed  CAS  Google Scholar 

  128. 128.

    Grandjean AC, editor. Profile on nutrition beliefs and practices of the elite athlete. Human Kinetics: Champaign; 1985.

    Google Scholar 

  129. 129.

    Fogelholm CM, Himberg JJ, Alopaeus K, et al. Dietary and biochemical indices of nutritional status in male athletes and controls. J Am Coll Nutr. 1992;11(2):181–91.

    PubMed  CAS  Google Scholar 

  130. 130.

    Musaiger AO. Dietary habits of athletes in Bahrain. Nutr Health. 1994;10:17–25.

    PubMed  CAS  Article  Google Scholar 

  131. 131.

    Slater G, Tan B, Teh KC. Dietary supplement practices of Singaporean athletes. Int J Sport Nutr Exerc Metab. 2003;13:320–32.

    PubMed  Google Scholar 

  132. 132.

    Petroczi A, Naughton DP, Pearce G, et al. Nutritional supplement use by elite young UK athletes: fallacies of advice regarding efficacy. J Int Soc Sports Nutr. 2008;5:22.

    PubMed  PubMed Central  Article  Google Scholar 

  133. 133.

    Lun V, Erdman KA, Reimer RA. Evaluation of nutritional intake in Canadian high-performance athletes. Clin J Sport Med. 2009;19:405–11.

    PubMed  Article  Google Scholar 

  134. 134.

    Braun H, Koehler K, Geyer H, et al. Dietary supplement use among elite young German athletes. Int J Sport Nutr Exerc Metab. 2009;19:97–109.

    PubMed  Google Scholar 

  135. 135.

    Tscholl P, Alonso JM, Dolle G, et al. The use of drugs and nutritional supplements in top-level track and field athletes. Am J Sports Med. 2010;38(1):133–40.

    PubMed  Article  Google Scholar 

  136. 136.

    deSilva A, Samarasinghe Y, Senanayake D, et al. Dietary supplement intake in national level Sri Lankan athletes. Int J Sports Nutr Exerc Metabol. 2010;20:15–20.

    Google Scholar 

  137. 137.

    Nazni P, Vimala S. Nutrition knowledge, attitude and practice of college sportsman. Asian J Sports Med. 2010;1(2):93–100.

    PubMed  PubMed Central  Article  Google Scholar 

  138. 138.

    Sato A, Kamei A, Kamihigashi E, et al. Use of supplements by young elite Japanese athletes participating in the 2010 Youth Olympic games in Singapore. Clin Sports Med. 2012;22(5):418–23.

    Article  Google Scholar 

  139. 139.

    Steel JE. A nutritional study of Australian Olympic athletes. Med J Aust. 1970;2:119–23.

    PubMed  CAS  Google Scholar 

  140. 140.

    Barry A, Cantwell T, Doherty F, et al. A nutritional survey of Irish athletes. Br J Sports Med. 1981;15:99–109.

    PubMed  PubMed Central  CAS  Article  Google Scholar 

  141. 141.

    Berglund B. Sports medicine update. Scand J Med Sci Sports. 2001;11:369–71.

    PubMed  CAS  Article  Google Scholar 

  142. 142.

    Corrigan B, Kazlauskas R. Medication use in athletes selected for doping control at the Sydney Olympics (2000). Clin J Sport Med. 2003;13:33–40.

    PubMed  Article  Google Scholar 

  143. 143.

    Tsitsimpikou C, Tsiokanos A, Tsarouhas K, et al. Medication use by athletes at the Athens 2004 summer Olympic Games. Clin J Sport Med. 2009;19(1):33–8.

    PubMed  Article  Google Scholar 

  144. 144.

    Kim J, Kang SK, Jung HS, et al. Dietary supplementation patterns of Korean Olympic athletes participating in the Beijing 2008 summer Olympic Games. Int J Sports Nutr Exerc Metabol. 2011;8:166–74.

    Google Scholar 

  145. 145.

    Diehl K, Thiel A, Zipfel S, et al. Elite adolescent athlete’s use of dietary supplements: characteristics, opinions, and sources of information. Int J Sports Nutr Exerc Metabol. 2012;22:165–74.

    CAS  Google Scholar 

  146. 146.

    Werblow JA, Fox HM, Henneman A. Nutritional knowledge, attitudes, and food patterns of women athletes. J Am Diet Assoc. 1978;73:212–5.

    Google Scholar 

  147. 147.

    Barr SI. Nutritional knowledge of female varsity athletes and university students. J Am Diet Assoc. 1987;87(12):1660–4.

    PubMed  CAS  Google Scholar 

  148. 148.

    Jacobson BH, Sobonya C, Ransone J. Nutrition practices and knowledge of college varsity athletes. J Strength Cond Res. 2001;15(1):63–8.

    PubMed  CAS  Google Scholar 

  149. 149.

    Herbold NH, Visconti BK, Frates S, et al. Traditional and nontraditional supplement use by collegiate female varsity athletes. Int J Sports Nutr Exerc Metabol. 2004;14:586–93.

    CAS  Google Scholar 

  150. 150.

    Burns RD, Schiller R, Merrick MA, et al. Intercollegiate student athlete use of nutritional supplements and the role of athletic trainers and dietitians in nutritional counseling. J Am Diet Assoc. 2004;104:246–9.

    PubMed  Article  Google Scholar 

  151. 151.

    Kristiansen M, Levy-Milne R, Barr S, et al. Dietary supplement use by varsity athletes at a Canadian university. Int J Sports Nutr Exerc Metabol. 2005;15:195–210.

    CAS  Google Scholar 

  152. 152.

    Tian HH, Ong WS, Tan CL. Nutrition supplement use among university athletes in Singapore. Singap Med J. 2009;50(2):165–72.

    CAS  Google Scholar 

  153. 153.

    Kim J, Lee N, Kim EJ, et al. Anti-doping education and dietary supplementation practice in Korean elite university athletes. Nutr Res Pract. 2011;5(4):349–56.

    PubMed  PubMed Central  Article  Google Scholar 

  154. 154.

    Buxton C, Hagan JE. A survey of energy drink consumption practices among student-athletes in Ghana: lessons for developing health education intervention progrmmes. J Int Soc Sports Nutr. 2012;9:9.

    PubMed  PubMed Central  Article  Google Scholar 

  155. 155.

    Hoyte CO, Albert D, Heard KJ. The use of energy drinks, dietary supplements, and prescription medication by United States college students to enhance athletic performance. J Community Health. 2013;38(3):575–80.

    PubMed  Article  Google Scholar 

  156. 156.

    Darvishi L, Askari G, Hariri M, et al. The use of nutritional supplements among male collegiate athletes. Int J Prev Med. 2013;9(Suppl 1):S68–72.

    Google Scholar 

  157. 157.

    Douglas PD, Douglas JG. Nutrition knowledge and food practices of high school athletes. J Am Diet Assoc. 1984;84(10):1198–202.

    PubMed  CAS  Google Scholar 

  158. 158.

    Krowchuk DP, Anglin TM, Goodfellow DB, et al. High school athletes and the use of ergogenic aids. Am J Dis Child. 1989;143:486–9.

    PubMed  CAS  Google Scholar 

  159. 159.

    Massad SJ, Shier NW, Koceja DM, et al. High school athletes and nutritional supplements: a study of knowledge and use. Int J Sports Nutr. 1995;5(3):232–45.

    CAS  Google Scholar 

  160. 160.

    Kim SH, Keen CL. Patterns of vitamin/mineral supplement usage by adolescents attending athletic high school in Korea. Int J Sport Nutr. 1999;9:391–405.

    PubMed  CAS  Google Scholar 

  161. 161.

    Ray TR, Eck JC, Covington LA, et al. Use of oral creatine as an ergogenic aid for increased sports performance: perception of adolescent athletes. South Med J. 2001;94(6):608–62.

    PubMed  CAS  Article  Google Scholar 

  162. 162.

    Bartee RT, Grandjean B, Dunn MS, et al. Predictors of dietary supplement use among adolescent athletes. Pediatr Exerc Sci. 2004;16:250–64.

    Google Scholar 

  163. 163.

    Sheppard HL, Raichada SM, Kouri KM, et al. Use of creatine and other supplements by members of civilian and military health clubs: a cross-sectional survey. Int J Sport Nutr Exerc Metab. 2000;10:245–59.

    PubMed  CAS  Google Scholar 

  164. 164.

    Kanayama G, Gruber AJ, Pope HG, et al. Over-the-counter drug use in gymnasiums: an underrecognized substance abuse problem? Psychother Psychosom. 2001;70:137–40.

    PubMed  CAS  Article  Google Scholar 

  165. 165.

    Chlopicka J, Wandas P, Zachwieja Z. Dietary supplements selected by young people exercising in fitness rooms in Krakow and environs. Roczn PZH. 2007;58(1):185–9.

    Google Scholar 

  166. 166.

    Sanchez-Oliver A, Miranda-Leon MT, Guerra-Hernandez E. Prevalence of protein supplement use at gyms. Nutr Hosp. 2011;26(5):1168–74.

    PubMed  CAS  Google Scholar 

  167. 167.

    Tsitsimpikou C, Chrisostomou N, Papalexis P, et al. The use of nutritional supplements among recreational athletes in Athens, Greece. Int J Sport Nutr Exerc Metab. 2011;21:377–84.

    PubMed  Google Scholar 

  168. 168.

    Bianco A, Mammina C, Paoli A, et al. Protein supplementation in strength and conditioning adepts: knowledge, dietary behavior and practices in Palermo, Italy. J Int Soc Sports Nutr. 2011;8:25.

    PubMed  PubMed Central  CAS  Article  Google Scholar 

  169. 169.

    Bianco A, Mammina C, Thomas E, et al. Protein supplementation and dietary behaviors or resistance trained men and women attending commercial gyms: a comparison study between the city center and suburbs of Palermo, Italy. J Int Soc Sports Nutr. 2014;11:30.

    PubMed  PubMed Central  Article  CAS  Google Scholar 

  170. 170.

    Parr RB, Porter MA, Hodgson SC. Nutrition knowledge and practice of coaches, trainers and athletes. Physician Sports Med. 1984;12(3):127–36.

    Google Scholar 

  171. 171.

    Bazzarre TL, Scarpino A, Sigmon R, et al. Vitamin-mineral supplement use and nutritional status of athletes. J Am Coll Nutr. 1993;12(2):162–9.

    PubMed  CAS  Article  Google Scholar 

  172. 172.

    Beals KA, Manore MM. Nutritional status of female athletes with subclinical eating disorders. J Am Diet Assoc. 1998;98:419–25.

    PubMed  CAS  Article  Google Scholar 

  173. 173.

    Beitz R, Mensink GBM, Henschel Y, et al. Dietary behavior of German adults differing in levels of sport activity. Public Health Nutrition. 2004;7(1):45–52.

    PubMed  Article  Google Scholar 

  174. 174.

    Striegel H, Simon P, Wurster C, et al. The use of nutritional supplements among master athletes. Int J Sports Med. 2006;27:236–41.

    PubMed  CAS  Article  Google Scholar 

  175. 175.

    Giannopoulou I, Noutsos K, Apostolidis N, et al. Performance level affects the dietary supplement intake of both individual and team sport athletes. J Sports Sci Med. 2013;12:190–6.

    PubMed  PubMed Central  Google Scholar 

  176. 176.

    Blackhouse SH, Whitaker L, Petroczi A. Gateway to doping? Supplement use in the context of preferred competitive situations, doping attitudes, beliefs, and norms. Scand J Med Sci Sports. 2013;23:244–52.

    Article  Google Scholar 

  177. 177.

    Wiens K, Erdman KA, Stadnyk M, et al. Dietary supplement usage, motivation, and education in young Canadian athletes. Int J Sports Nutr Exerc Metabol. 2014;24(6):613–22.

    Article  Google Scholar 

  178. 178.

    Sinclair LM, Hinton PS. Prevalence of iron deficiency with and without anemia in recreationally active men and women. J Am Diet Assoc. 2005;105:975–8.

    PubMed  CAS  Article  Google Scholar 

  179. 179.

    Institute of Medicine. Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nikel, silicon, vanadium, and zinc. Washington DC: National Academies Press; 2000.

    Google Scholar 

  180. 180.

    Cogswell ME, Kettel-Khan L, Ranakrishnan U. Dietary supplement use among women in the United States: science, policy and practice. J Nutr. 2003;133:1974S–7S.

    PubMed  Google Scholar 

  181. 181.

    Vandenberghe K, Goris M, VanHecke P, et al. Long-term creatine intake is beneficial to muscle performance during resistance exercise. J Appl Physiol. 1997;83(6):2055–63.

    PubMed  CAS  Google Scholar 

  182. 182.

    Cermak NM, Res PT, de Groot LC, et al. Protein supplementation augments the adaptive response of skeletal muscle to resistance-type exercise training: a meta-analysis. Am J Clin Nutr. 2012;96:1454–64.

    PubMed  CAS  Article  Google Scholar 

  183. 183.

    Subar AF, Block G. Use of vitamin and mineral supplements: demographics and amount of nutrients consumed. Am J Epidemiol. 1990;132(6):1091–101.

    PubMed  CAS  Google Scholar 

  184. 184.

    Slesinski MJ, Subar AF, Kahle LL. Trends in the use of vitamin and mineral supplements in the United States: the 1987 and 1992 National Health Interview Surveys. J Am Diet Assoc. 1995;95(8):921–3.

    PubMed  CAS  Article  Google Scholar 

  185. 185.

    Millen AE, Dodd KW, Subar AF. Use of vitamin, mineral nonvitamin and nonmineral supplements in the United States: the 1987, 1992 and 2000 National Health Interview Survey results. J Am Diet Assoc. 2004;104:942–50.

    PubMed  Article  Google Scholar 

  186. 186.

    Koplan JP, Annest JL, Layde PM, et al. Nutrient intake and supplementation in the United States (NHANES II). Am J Public Health. 1986;76(3):287–9.

    PubMed  PubMed Central  CAS  Article  Google Scholar 

  187. 187.

    Balluz LS, Kieszak SM, Philen RM, et al. Vitamin and mineral supplement use in the United States. Arch Fam Med. 2000;9:258–62.

    PubMed  CAS  Article  Google Scholar 

  188. 188.

    Radimer K, Bindewald B, Hughes J, et al. Dietary supplement use by US adults: data from the National Health and Nutrition Examination Survey, 1999–2000. Am J Epidemiol. 2004;160(4):339–49.

    PubMed  Article  Google Scholar 

  189. 189.

    Kennedy ET, Luo H, Houser RF. Dietary supplement use pattern of US adult population in the 2007–2008 National Health and Nutrition Survey (NHANES). Ecol Food Nutr. 2013;52:76–84.

    PubMed  Article  Google Scholar 

  190. 190.

    Knapik JJ, Steelman R, Hodedbecke S, et al. A systematic review and meta-analysis on the prevalence of dietary supplement use by military personnel. BMC Complement Altern Med. 2014;14:143.

    PubMed  PubMed Central  Article  CAS  Google Scholar 

  191. 191.

    Kennedy J, Arsenault J. Dietary supplement use in US Army Special Forces Operations Candidates. Mil Med. 1999;164(7):495–501.

    PubMed  Google Scholar 

  192. 192.

    Brasfield K. Dietary supplement intake in the active duty enlisted population. US Army Med Dep J. 2004, pp 44–56.

  193. 193.

    Boos CJ, Wheble GAC, Campbell MJ, et al. Self-administration of exercise and dietary supplements in deployed British military personnel during operation TELIC 13. J R Army Med Corps. 2010;156(1):32–6.

    PubMed  CAS  Article  Google Scholar 

  194. 194.

    Lieberman HR, Stavinoha TB, McGraw SM, et al. Use of dietary supplements among active-duty US Army soldiers. Am J Clin Nutr. 2010;92(4):985–95.

    PubMed  CAS  Article  Google Scholar 

  195. 195.

    Schutz HG, Read M, Bendel R, et al. Food supplement usage in seven Western states. Am J Clin Nutr. 1982;36:897–901.

    PubMed  CAS  Google Scholar 

  196. 196.

    Perkins JE, Wilson WJ, Schuster K, et al. Prevalence of nonvitamin, nonmineral usage among university students. J Am Diet Assoc. 2002;102(3):412–4.

    Article  Google Scholar 

  197. 197.

    Timbo BB, Ross MP, McCarthy PV, et al. Dietary supplements in a national survey: prevalence of use and reports of adverse events. J Am Diet Assoc. 2006;106:1966–74.

    PubMed  CAS  Article  Google Scholar 

  198. 198.

    Huang SH, Johnson K, Pipe AL. The use of dietary supplements and medications by Canadian athletes at the Atlanta and Sydney Olympic Games. Clin J Sport Med. 2006;16(1):27–33.

    PubMed  Article  Google Scholar 

  199. 199.

    Wu CH, Wang CC, Kennedy J. Changes in herb and dietary supplement use in the US adult population: a comparison of the 2002 and 2007 National Health Surveys. Clin Ther. 2011;33(11):1749–58.

    PubMed  Article  Google Scholar 

  200. 200.

    Kelly JP, Kaufmann DW, Kelley K, et al. Recent trends in use of herbal and other natural products. Arch Intern Med. 2005;165:281–6.

    PubMed  Article  Google Scholar 

  201. 201.

    Stensland SH, Sobal J. Dietary practices of ballet, jazz and modern dancers. J Am Diet Assoc. 1992;92:319–24.

    PubMed  CAS  Google Scholar 

  202. 202.

    Soric M, Misigoj-Durakovic M, Pedisic Z. Dietary intake and body composition of prepubescent female aesthetic athletes. Int J Sport Nutr Exerc Metab. 2008;18:343–54.

    PubMed  CAS  Google Scholar 

  203. 203.

    Kim J, Lee N, Jung SS, et al. Dietary supplementation of high-performance Korean and Japanese judoists. Int J Sport Nutr Exerc Metab. 2013;23:119–27.

    PubMed  CAS  Google Scholar 

  204. 204.

    Sekulic D, Bjelanovic L, Pehar M, et al. Substance use and misuse and potential doping behavior in rugby union players. Res Sports Med. 2014;22:226–39.

    PubMed  Article  Google Scholar 

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Correspondence to Joseph J. Knapik.

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This research was supported in part by an appointment to the Knowledge Preservation Program at the US Army Research Institute of Environmental Medicine (USARIEM) and the US Army Public Health Center (APHC) administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the US Department of Energy and USARIEM. Funding was also provided by the Center Alliance for Nutrition and Dietary Supplement Research. Joseph Knapik, Ryan Steelman, Sally Hoedebecke, Krista Austin, Emily Farina and Harris Lieberman declare that they have no conflict of interest with the content of this review.

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Knapik, J.J., Steelman, R.A., Hoedebecke, S.S. et al. Prevalence of Dietary Supplement Use by Athletes: Systematic Review and Meta-Analysis. Sports Med 46, 103–123 (2016).

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  • Dietary Supplement
  • National Health Interview Survey
  • Elite Athlete
  • Energy Drink
  • Unique Study