Teens Don’t Need Performance-Enhancing Substances. Here's Why. - Nemours Blog


Teens Don’t Need Performance-Enhancing Substances. Here’s Why.

Teens Don’t Need Performance-Enhancing Substances. Here's Why, Powered by Nemours Children's Health System

The term performance-enhancing substances brings to mind elite athletes, doping trials and drug tests. But substances like creatine, protein supplements and caffeine are commonly used by teenagers who are driven to perform-and look-their best. It’s a trend that has pediatricians concerned, and one that parents should be aware of.

What Are Performance-Enhancing Substances?

Performance-enhancing substances, also called sports supplements, are products that claim to use natural products to enhance athletic performance. The claims include increasing muscle mass, strength, speed, endurance, fat loss or recovery time. Most are available over the counter. They may include vitamins, minerals, amino acids, herbs, or botanicals (plants)-or any concentration, extract, or combination of these ingredients.


One of the most popular supplements on the market, creatine, is easy to obtain and comes in a variety of forms (like powders, tablets, energy bars). Creatine is a natural substance that we usually get from protein-rich foods in our diet, such as meat and fish. These foods are broken down to creatine phosphate in the body. Creatine phosphate then helps make adenosine triphosphate (ATP), which provides energy for muscles to contract. It’s been suggested that taking the best creatine supplements could improve strength, increase lean body mass and shorten recovery time after exercise. It is perfectly safe for adults to use. However, the research available on the potential benefits of creatine is mixed, and there is very little research on the use of creatine in children. And just because it’s “natural,” does not mean it’s safe.

While most creatine-containing products do include warnings about their use in people younger than 18, a recent study showed that creatine was routinely recommended to teenagers by sales associates at nutrition stores.

Anabolic Steroids

Anabolic steroids and steroidal supplementals are other sports supplements marketed to youth. These products are hormone supplements, mainly testosterone. It’s argued that the use of steroids promotes muscle mass and strength, as well as reduces recovery time from exercise. While often more difficult to obtain because they typically require a prescription, steroids are undoubtedly found, if not talked about, in most locker rooms. The use of steroids poses some negative health risks.

The Risks of Performance-Enhancing Substances

The American Academy of Pediatrics recommends against the use of performance-enhancing substances by teenagers and young adults, for good reason. Not only are creatine and other substances potentially harmful to young people, they’re also completely unnecessary. Good nutrition, proper training, and the hormone changes that occur naturally in growing teenagers are more than enough to propel young bodies to their peak athletic performances.

What’s more, nutritional supplements like creatine and protein aren’t regulated by the FDA, so there’s no real way to know what you’re getting. These substances may be contaminated with dangerous ingredients, or claim benefits that haven’t been studied or proven. Additionally, products that contain caffeine can cause anxiety and racing or irregular heartbeat.

The use of performance-enhancing substances may also be associated with an increased risk for future steroid use. That is, athletes who take over-the-counter substances today may be more likely to try illegal steroids later.

Changing the Game

Performance-enhancing substances are also harmful because they change the way kids and teenagers experience sports, and their reasons for playing them. Teenagers report that they participate in sports for things like fun, camaraderie, being with friends, and improving their skills. When performance-enhancing substances enter the picture, they instantly shift the focus of sports and activities. Instead of playing for fun and health, young athletes begin to play solely to win-or to look good doing it.

With so much confusion and misdirection, it’s important to talk openly to your young athlete about the use of supplements. Point out items you see advertised or for sale in stores. Talk about nutrition and training with your teenager, and emphasize the benefits of healthy foods and exercise over performance-enhancing substances. Be mindful about where your teenager gets his or her advice about nutrition and training. And always involve your pediatrician in the discussion if you have any questions or concerns.

Jaclyn Costantino, RD, LDN

Jaclyn Costantino is a registered dietitian nutritionist at Nemours Children's Hospital in Wilmington, Del.