BooneThink

I must confess that I’ve been caught up in numerous other writing projects during the past several months. Like anyone else, what was at the top of my agenda was pushed down. Today, while I was cleaning the garage, I ran upon a stack of papers I printed from the Internet weeks ago. As the day would have it, the first of many in the 6-inch stack is all about sports supplements by Paul Benedetti [1] of the Canoe Network. Like a lot of parents, I am one who is entirely tired of the sports supplement industry. Yes, to a degree, athletes can do whatever they please with their own bodies. But I do not have to like it, and I have an equal right to my opinion. As you might imagine, my thoughts differ on the subject considerably compared to some.

Okay, now that I have your attention, we should clear up one thing. I’m not an expert in sports supplements. I have not spent my academic career researching sports supplements. All I can say, “Thank you God.” Having said that, what is the point of this article? Very simply, I live in America which allows for different views on a topic. This article is all about disagreeing with almost every aspect of the endless search for performance-enhancing substances. Hence, it is about the ethics and honor of athletic competition. It is not about winning at all costs. Athletics and sports programs (and, yes, recreational programs) serve an important function in society. There is not reason to allow them to be disfigured by anyone.

Point in fact, Mark Myhal [1, p. 1] is reported to have said, “Dietitians and other health professionals must…drop the negative bias they have against ergogenic acids that athletes use to help build muscle and burn fat.” Well, he has the right to make such the comment, and I have the right to say this: “Myhal’s thinking is inconsistent with the concerns that underpin the use of sports supplements.” Interestingly, he is also reported to have said, “Pills do not explain performance. Athletic success is based on, among other factors, skills, training, diet, and genetics.” Of course, the latter part of the statement makes sense. Frankly, the first part makes little sense. The given in this thinking is the latter statement. No one disagrees, except that pills do explain performances. This is why drug testing is so popular.

After all, it is foolish to think the use of sports supplements is just about adults and professional athletes. With the continued marketing of supplements, it is reasonable to conclude that every junior high school athlete will be taking something. The attitude that it is okay to do whatever to win has changed the culture of sports. It is okay to cheat! Supplements and drugs are popular among high school athletes. Seldom do their coaches and trainers raise questions about product efficacy, safety, or ethics. The bottom line is this: if the athlete’s nutrition is poor, then correct it. The idea that it is correct to substitute supplements for sound nutrition does not cut it. Also, the idea that every athlete “must be a winner” raises questions.

When I was growing up, it was enough to take part in athletics. The most important thing was not to win. Of course this kind of thinking may be view as very narrow. Indeed, I have little tolerance for athletes and all others (especially college teachers) who profess the right to take performance-enhancing substances. Gaining the edge over the opponent is not always going to happen, regardless of what the coach, trainer, or athlete may do. There are times therefore when it is actually as simple as black and white. Not all athletes are going to be (or even should be) winners!

Athletics is over the edge in many ways. Who is at fault is not necessarily a mystery. Just think about the stories and headlines of diverse athletic behaviors, as reported by the U.S. Anti-Doping Agency [3]:

• Athletes driving drunk
• Corrupt officials fixing competitions
• Players shaving points for gambling purposes
• High-school athletes going to Mexico to purchase steroids and selling them to teammates
• Coaches having inappropriate relationships with players
• Parents brawling at youth sporting events
• Fans crossing the line and assaulting coaches, players, and officials
• Athletes breaking records with the help of performance-enhancing substances

The Agency also states that this list is just a few examples that wrong with sports. What happened to the role of sports in teaching courage, skills, discipline, integrity, and humility? The answer is obvious: All these things have been pushed to the side. Rather than young people and adults learning about self-esteem and athletics for health reasons, they learn to cheat. It is bad enough in academics [4], why must cheating be so popular in athletics. Why isn’t there a code of conduct in athletics from the first moment young people engage in sports? Shouldn’t coaches teach ethics in sports with the same intensity as they teach skills? I think the answer is “yes.”

Teachers can be viewed in a similar way with their students and those who cheat on test. Obviously, teachers do not condone cheating. Too many people now believe that athletes who use performance-enhancing substances are cheating. So, given this as a beginning point, then, whenever a coach finds out that an athlete is using sports supplements, the athlete should be questioned and the matter corrected just as a teacher is expected to do in the classroom. The fact that cheating is common in sports is not justification for turning a blind eye. However, having said that, the threat of punishment per se is not the answer to supplement use.

Coaches should teach a set of standards that guide the athletes’ conduct, and they need to be prepared to hold athletes accountable for supplement and drug use. The Six Pillars of Ethical Decision-Making is such an excellent document published by the U.S. Anti-Doping Agency that all athletes and their coaches should be a required to read it and learn from it [3]. The Agency believes that it provides an excellent framework from which athletes can make ethical decisions about their sports participation. In addition, the Pillars should help decrease the physical side effects of anabolic steroids. And, in this regard, note the comments of the NIDA Director, Dr. Nora D. Volkow [5]:

John P. Mamana, a medical doctor and CEO of American Health Sciences agrees [6]. He says that “The time has come for health care professionals and fitness professionals to convince our clients that the best route to building muscle is the old fashioned way: eat a healthy diet and make a commitment to training.” After all, he further concludes that “…and the sports supplement industry is not reliable.” The products are available in fitness facilities. They are marketed next to sports drinks and high-performance equipment and clothing. Also, owners of some sports stores are making a lot of money by creating their own miracle pills and powders [7]. The problem is obvious: There is no one to make sure these products are safe. This is why banned doping products can be found mixed into the unregulated supplements.

The problem with supplements being unsafe is well known, and it should not be tolerated by coaches, trainers, and athletes. For example, everyone knows the following: “The dietary supplement industry is completely unregulated in the United States; as a consequence, an abundance of supplement products of dubious value, content, and quality are now available around the world. It is known that many supplement products contain substances that are prohibited in sport-typically stimulants or anabolic steroid precursors.” These remarks were written by Andrew Pipe, a medical doctor, and co-author, Christiane Ayotte, a PhD. They were published in the Clinical Journal of Sports Medicine [8]. They must be asking themselves, “Does anyone care?” The point being: The Internet is full of published accounts of using sports supplements, but the use per se isn’t decreasing. Instead, the problem is only getting worse.

It can reasonably be argued, then, that all 8 and 12 years will at some point in the near future be users of supplements. The thousands of athletes who don’t take supplements or worse (drugs) will be in the minority. Coaches have a major responsibility to do something about this problem. Coaches and athletes literally cocreate, coconstitute athletics. This thinking is not new; as I noted in earlier articles, it is past time for this to change. It is past time for athletes to resist the sports supplement industry and their pushers. Together, coaches and athletes can bring out the best in sports. Obviously, this view has moral implications. Coaches and athletes share responsibility for ethical leadership and participation, respectively.

All of this raises the question, what can be done? Well, however simple this may sound, perhaps, the answer lies in another question. How can exercise physiologists get from bad leadership, or no leadership, to better leadership? This is the issue, isn’t it? When will exercise physiologists start thinking about the importance of developing leaders? When will they get beyond yesterday’s thinking? Ineffective and/or unethical leaders are bad leaders. They lead no where but to negative places and results. In other words, the parallel is this, just as it is no longer acceptable for CEOs to rob the employees of their pensions, it is no longer acceptable for so-called leaders not to stop what most believe is unethical practices in athletics. Whether it is an accounting scam or pushing sports supplements, it is wrong. Why? They know! They know why, especially those who are paid by the supplement industry.

But, as I have witnessed since the founding of the American Society of Exercise Physiologists in 1997, change is a very slow process. New thinking comes at a price, often only after decades of staying the course. Obviously, no amount of work through published articles, such as I’ve done, is going to change the direction of supplements in athletics any time soon. No uplifting thoughts or otherwise is going to change the course of events, at least not in the foreseeable future. Also, it is clear that this is a multi-factorial problem involving not only coaches and athletes, but CEOs, marketers, and society’s overall behavior regarding competition. All of these factors contribute to the sports supplement problem. Finally, much like other addictions in life, the distorted emphasis on winning at all cost is not going away unless the cost of crooked thinking outweighs the benefits of straight thinking.

This understanding is tragic enough, but the reality is sadder still. How in the world are athletes, parents, and professionals going to come to terms with the presence of sports supplements and drugs in athletics? You don’t have to be a college professor to know that it is wrong to use performance-enhancing substances to gain an advantage over a competitor. It is my hope, of course, that this article is regarded as a contribution to the belief that the use of sports supplements is unethical [9] for obvious reasons. And, unfortunately, much of the problem stems from the fact that [10] “…nutrition as a discipline is still in its infancy, and sports nutrition is embryonic.” Obviously, there are far more unanswered questions than answers. Most importantly, perhaps, is the question of regulation and monitoring of sports supplements (also known as ergogenic aids).

Tipton [11] said, “An intrinsic component of both ancient and modern Olympic Games is to provide fair and equal opportunities for all participants, and since the modern revival it has been the responsibility of the IOC to safeguard this legacy.” Think about it for a moment. Tipton’s statement bears directly on the question of regulation and monitoring of ergogenic aids, which are any substance used to enhance athletic performance. In other words, the IOC should not all for the use of “any supplement” if it enhances athletic performance. Certainly, this thinking is the only way to safeguard fair and equal athletic opportunities. If exercise physiologists (who may also call themselves sports nutritionists) fail to address this basic point, these are indeed dangerous times for athletes. Increasingly, in this “new sports nutrition/sports supplement environment,” it is easy to find inventive ways of sports nutritionists who violate fundamental professional values.

This is most unfortunate for the young athletes who will be held prisoner to the sports supplement education by paid consultants of the industry [12]. This is a problem that is not unique to exercise physiology. Other professions suffer from members of their profession who are hopeless bent on marketing products over ideas. And, the warnings on behalf of others have also gone largely unheeded. The problem here, unexplored by most academic exercise physiologists, is that the failed logic of the sports nutritionists isn’t much different from the information that one reads in journals and hears at meetings. As a result, from within the field, there are no promising developments. Forget any discussion of shared ethical principles for professionals who have anything to do with athletes. They aren’t interested in anything but their agenda just as athletes aren’t interested in anything but winning. The IOC must get involved.

In the midst of all of this is the bad leadership in sports nutrition. The self-appointed experts who are encouraging athletes to use performance-enhancing substances are doing an injustice to athletics and its culture. It is tragic, surely, to note that young junior high and high school athletes are “the” growing participants in supplement usage. Fortunately, some adults are doing something about it. State Senator Jackie Speier, and coauthors, Senators Alquist and Kuehl, engineered the passing of SB37 by the Senate on September 8, 2005 [13]. Among other concerns, the intent of the Legislature is that local school districts must emphasize “…the harmful effects associated with the use of steroids and prohibited performance-enhancing dietary supplements enumerated by the United States Anti-Doping Agency by adolescents.” Clearly, well-trained coaches are vital to success and safety of their athletes.

This bill also prohibits the marketing, sale, and distribution of prohibited dietary substances on a school site or at a school-related event. This is a beginning only. The use of supplements is not a joking matter. It is a huge problem. Aside from the ethical issues, there is the problem of not knowing what is actually in supplements. The industry is not regulated like prescription drugs. It would be pretty hard for the industry not to know that their supplements are contaminated. The bottom line is this says Maxwell Mehlman, law and bioethics professor at Case Western Reserve [14]: “The supplement industry is the wild, wild West of pharmaceuticals.” Just because supplements are not illegal does not mean they are safe. Coaches and university officials must get beyond the idea that athletes need supplements to make them better. They must come to terms with the reasons student-athletes take supplements, as identified by Rachel Olander, resource specialist at the Center for Drug Free Sport [15]:

1. Student-athletes believe the advertisements and marketing.

2. They don’t believe the product is going to hurt them.

3. They don’t care if the product hurts them. They want to make the team, make the starting lineup or perform at a higher level.

4. They take it in pursuit of a better body image. They want more muscle, want to appear more “ripped” or thinner.

5. They believe someone else is using it. If there is a chance it will make them half a second faster, they are going to use it.

Regardless of the uphill climb to convince athletes not to use supplements, parents, coaches, trainers, and all others (e.g., exercise physiologists/sports nutritionists) involved in athletics should do two things: (1) tell athletes the truth, regarding good food and hard work; and (2) tell athletes that the supplement mindset will not be tolerated. Coaches, in particular, must speak out and let the researchers, consultants, and trainers know that the pushing of supplements is no longer acceptable. It paints a picture of professionals that simply isn’t right. There is absolutely no reason to continue down the dark side of exercise physiology. Even though it may not be deliberate, it is nonetheless harmful to young athletes and the culture of athletics. This thinking should not mess us up, but it does. Yet, to deny the bad leadership in sport nutrition/exercise physiology is misguided, tantamount to a preacher that would claim to teach John 3:16 while ignoring Jesus Christ as the Son of God.

Americans are familiar with unethical leaders. But exercise physiologists and all others who are involved with athletics are not aware of the kinds of things pushed by some sports nutritionists. Understandably, this is a strong statement. But, once, again, let me make clear that even they (meaning, those within sports nutrition) are often times unaware of the industry’s influence on the field. Put another way, individuals with good leadership skills can go over the deep end when they begin to believe their own hype. And, now these same experts are promoting the use of performance enhancing supplements such as Andro and Creatine. Bartee [16], in fact, points out that more than 40% of female athletes in grades 9 through 12 report using sports supplements. Perko and colleagues [17, p. 5] asked several important questions:

1. Do we care that parents and coaches are promoting the use of supplements to female athletes as early as 10 years of age?
2. Do we care that none of these supplements have been tested on adolescents or children?
3. Do we care whether or not young women may grow up with a “winning is everything” attitude?
4. Do we want young people to look for unjustified short-cuts and magic bullets to increase sport performance and look better?

These questions have been raised before [18-19]. Trust me, the problem of supplement use by young females is only going to get worse. According to Shaun Assael, a senior writer for ESPN The Magazine, it is already over the edge for young boys [20]. He said, “…I get really scared about where we’re heading.” The culture of sports has gone crazy when parents give body-building supplements to their kids. Here again, it is all about winning at all costs and, if not winning, it is all about the money. This is exactly why contributions in the form of soft money have increased substantially [21]. And, yet there is little controversy within exercise physiology/sports nutrition regarding sports supplementation. As a result, there is essentially no discussion about the ethical and legal issues for those who serve as consultants to the industry while also serving as a resource (and often times, as college teachers) for athletes making decisions regarding supplements [22].

Not just stupidity, but our silence in terms of ethical issues of using performance-enhancing substances that are not banned has not been resolved [23]. Beyond being controversial, there is the very real possibility that the marketing and proliferation of ergogenic aids per se in addition to the use of the aids are unethical. It is critical, therefore, that exercise physiology professionals be skeptical of the sports nutrition research, especially when funded by the supplement industry. Aside from the economic exploitation, the spread of misinformation is huge with far-reaching and potentially harmful consequences. This is why exercise physiologists should pay particular attention to the “Red Flags” of junk science. The following list was adapted from Duyff [24] and Stahl [25]:

1. Recommendations that promise a quick fix.
2. Claims that sound too good to be true.
3. Simplistic conclusions drawn from a complex study.
4. Recommendations based on a single study.
5. Dramatic statements that are refuted by reputable scientific organizations.
6. Recommendations made to help sell a product.
7. Recommendations based on studies published without peer review.

Claims that sound too good to be true should be obvious, but too many athletes don’t see through the quick fix sell. Fortunately, a California judge did see through the fraud. A $12.5 million false-advertising judgment against the company, Cytodyne Technologies, maker of Xenadrine RFA-1, the supplement implicated in the death of a Baltimore Orioles pitcher, had not just exaggerated the findings, the judge said Cytodyne had also cajoled some researchers into fudging results in their scientific papers [26]. What it all comes down to is, that to knowingly misuse the scientific data is fraud, quackery, and unethical [27]. In fact, everyone knows that most of the time, there is no scientific support for the industry’s claims, or else the industry works its magic on the research to promote sales of their supplements. Many questions remain as to the ethical conduct of the members of the industry.

In the final analysis, the thinking that surrounds supplements and athletics is believed by many as appropriate. They can’t understand my concerns. My athletic paradigm (i.e., a shared set of assumptions) is entirely different from theirs. In other words, my perception of athletics is based on my assumptions. I believe athletes have no business using sports supplements. Obviously, not everyone agrees with my model of athletics. Paradigms do not change very easily [28], but they do change.

Many parents share the assumptions of the paradigm I’ve presented in this article. Although the old paradigm that supports supplement usage is popular, and although the new paradigm (i.e., sports supplements and Crack are both bad) makes them feel uncomfortable, and may even sound bizarre, athletics will cease to have value if it becomes a gladiator sport. It should be noted, too, that even if professional sports continue to display the gladiator-driven mentality, it is entirely incorrect for non-professional sports programs. Perhaps, one important reason for disagreeing with the use of supplements is the big push by athletes to do whatever is believed necessary to win even if the supplements should kill them. This cloud of mis-managed assumptions is very similar, if not exactly the same as the historical point of view of gladiators. Remember, they were condemned criminals, prisoners of war, or slaves bought for the purpose of gladiatorial combat.

“Athletes as gladiators” is not a new idea. Gladiators compete just as athletes do. Both will do anything to last longer and to win. No doubt this is why they feel enormous pressure to exceed the limits of human performance standards. And, therefore, it isn’t surprising (or is it) that athletes turn to sports supplements to get an edge in training and competition. By now, there shouldn’t be any doubt that this thinking threatens the integrity of athletes. Also, this thinking has paved the way for revenue sales of sports supplements projected to reach in excess of $4.5 billion by 2007 [30].

The sports supplement problem is only going to get worse! This is why I wrote the following in the PEPonline journal in 2005 [31]:

References

1. Benedetti, P. (2001). Sport Supplement Use is Widespread. Canoe Internet, C-Health. [Online]. http://www.canoe.ca/Health0106/11_supp-can.html
2. Applegate, E. A. and Grivetti, L. E. (1997). Search for the Competitive Edge: A History of Dietary Fads and Supplements. Journal of Nutrition. 127:869S-873S.
3. U.S. Anti-Doping Agency. (2006). Why Care About Ethics. [Online]. http://www.usantidoping.org
4. McCabe, D. L., Trevino, L. K., and Butterfield, K. D. (2001). Cheating in Academic Institutions: A Decade of Research. Ethics & Behavior. 11:219-232. [Online]. http://www.swarthmore.edu/NatSci/cpurrin1/plagiarism/docs/McCabe_et_al.pdf
5. Volkow, N. D. (2005). Message from the Director: Consequences of the Abuse of Anabolic Steroids. National Institute on Drug Abuse. [Online]. http://www.drugabuse.gov/about/welcome/messagesteroids305.html
6. Mamana, J. P. (2006). Performance Enhancing Supplements: A Physician’s View. Clinician’s Choice. [Online]. http://www.clinicians-choice.com/art9.php
7. Sawf News Connect. (2006). Questionable ‘Supplements’ Stoke US Sports. [Online]. http://news.sawf.org/Lifestyle/17772.aspx
8. Pipe, A. and Ayotte, C. (2002). Thematic Issue: Drugs and Performance-Enhancing Agents in Sport. Clinical Journal of Sports Medicine. 12:245-249.
   
9. Boone, T. (2003). Dietary “Sports” Supplements: The University Teacher’s Role in Teaching Values? Professionalization of Exercise Physiologyonline. 6:7 [Online]. http://faculty.css.edu/tboone2/asep/TeachingVALUES.html
10. Grandjean, A. C. (1997). Diets of Elite Athletes: Has the Discipline of Sports Nutrition Made an Impact? Journal of Nutrition. 127:874S-877S.
11. Tipton, C. M. (1997). Sports Medicine: A Century of Progress. Journal of Nutrition. 127:878S-885S.
12. Boone, T. (2005). The Anatomy of Complicit Behaviors: An Essay for Exercise Physiologists. Journal of Professional Exercise Physiology. 3:6 [Online]. http://www.exercisephysiologists.com/JPEPJune2005ComplicitBehaviors/index.html
13. Getbig.com. (2005). Arnold Schwarzenegger Signed a Bill Banning some Supplements in High Schools. [Online]. http://www.getbig.com/news/2005-04/100705ban.htm
14. Bishop, G. (2005). Boom and Bust: Supplements Tough for Pro Leagues. The Seattle Times Company. [Online]. http://seattletimes.nwsource.com/html/sports/2002553089_boost11.html
15. Hawes, K. (2003). The Culture of Supplements: Pills, Powders, and Potions Have Become Ingrained in Athletes’ Way of Life. The NCAA News. [Online]. http://www.ncaa.org/news/2003/20030609/active/4012n42.html
16. Bartee, R. T. (2000). Predicting the Use of Dietary Supplements Marketed as Nutritional Ergogenic Aids Among High School Athletes. Unpublished Doctoral Dissertation. The University of Alabama, Tuscaloosa.
17. Perko, M., Bartee, T., and Dunn, M. (2004). Sport Supplements, Round III. Girls Gone Wild: Girls as the Next Target Market for Sports Dietary Supplements. Sports MEDIA. [Online]. http://www.sports-media.org/sportapolisnewsletter27newlook.htm
18. Boone, T. (2005). The Negative Impact of Marketers on Children, Athletics, and Exercise Physiology. Professionalization of Exercise Physiologyonline. 8:6 [Online]. http://faculty.css.edu/tboone2/asep/NegativeImpactOfMarketers.html
19. Boone, T. (2006). The Culture of Athletics is Over the Edge. boonethink.com. [Online]. http://www.boonethink.com/
20. Assael, S. (2005). A Business That Won’t Die. ESPN: Page 2. [Online]. http://espn.go.com/page2/s/assael/030307.html
21. O’Keeffee, M. (2001). Supplements, Part I: Companies Flex Political Muscle. The Dallas Morning News: Sports Day, Associated Press Sports Edition. [Online]. http://apse.dallasnews.com/contest/2001/writing/over250.enterprise.third2.html
22. Boone, T. (2003). Open Inquiry and Shared Thoughts about Ethics, Exercise Physiology, and Sports Supplements. Professionalization of Exercise Physiologyonline. 6:10 [Online]. http://faculty.css.edu/tboone2/asep/openINQUIRYexercisePHYSIOLOGYsportsSUPPLEMENTS.html
23. Williams, M. H. (1994). The Use of Nutritional Ergogenic Aids in Sports: Is It an Ethical Issue? International Journal of Sport Nutrition. 4:120-131.
24. Duyff, R. (2002). American Dietetic Association Complete Food and Nutrition Guide. 2^nd ed. New York, NY: John Wiley.
25. Stahl, P. (2000). Status Report on Nutrition in the News. Journal of American Dietetic Association. 1000:1298-1299.
26. DB’s Medical Rants. (2003). Supplements – Lack of Scientific Rigor. Medrants.com. [Online]. http://medrants.com/index.php/archives/1270
27. Boone, T. (2002). Exercise Physiology, Quackery, and Consumer Fraud. Professionalization of Exercise Physiologyonline. 5:5 [Online]. http://faculty.css.edu/tboone2/asep/ExercisePhysiologyQuackery.html
28. Smith, A. (1975). Powers of Mind. New York, NY: Random House.
29. American Society of Exercise Physiologists. (2006). Home Page. [Online]. http://www.asep.org/
30. Tallon, M. (2003). New Rules of Sports Nutrition. Functional Foods and Nutraceuticals. [Online]. http://www.ffnmag.com/NH/ASP/strArticleID/236/strSite/FFNSite/articleDisplay.asp
31. Boone, T. (2005). Cheating, Performance-Enhancing Supplements, and Accountability: A Call for Action. Professionalization of Exercise Physiologyonline. 8:6 [Online]. http://faculty.css.edu/tboone2/asep/CheatingPESandAccountability.html

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Originally published in the Professionalization of Exercise Physiologyonline, 9:9:2006

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