Context: Nutritional supplement use in athletes is common, accompanied by potential doping risk.
Objective: Determine athletes' nutritional supplement and third-party tested (TPT) supplement use, supplement knowledge as well as factors influencing their behavior.
Design: Cross-Sectional Study.
Setting: NCAA DI athletic departments.
Participants: Student-athletes (n=410, 53% female, age 21.4±1.6 years).
Main outcome measures: Survey questions addressed topics including nutritional supplement knowledge and use, TPT supplement knowledge, use and logo recognition and data were 11 stratified for sex differences.
Results: Athletes (91%) report the use of supplements, but the total number of supplements used (median and interquartile range, IQR) is lower in females (7, 4-11), than males (9, 4-12), with U=17960, p=0.01. A total of 48% (n=191, out of 402 responses) reported purchasing supplements outside of their athletic department, with significantly fewer females (40%, n=84) than males (56%, n=107) reporting this behavior (χ2=11.20, p<0.001). No association between TPT logo recognition and TPT use was seen (χ2=0.238, p=0.63). Of all athletes using supplements, 38% (n=140) reported "consistent TPT use", while females (36%, n=70) reported this less often than males (41%, n=70, χ2=0.952, p<0.32). No sex differences were seen for receiving nutritional counseling (89%, p=0.37), or the low nutritional supplement knowledge (<50%, p=0.38), however, males had 2.5 times greater odds at recognizing a TPT organization logo than females (OR=2.45, with 95% CI=1.58-3.79).
Conclusions: Most athletes use nutritional supplements. Females report slightly fewer supplements than males, while also less frequently purchasing them outside their athletic department, potentially explaining the lower TPT logo recognition in female athletes.
Keywords: Dietary supplements; anti-doping; banned substances; ergogenic aids; sport foods.