A study by Saudi Arabia's King Saud University and King Khalid University made the above discovery after conducting a cross-sectional study to investigate the health beliefs and patterns of dietary supplement usage among fitness centre members.
Researchers enrolled 445 men aged 18 and above, from four large indoor fitness centres in Riyadh for the study and conducted in-person interviews with them, using a newly developed questionnaire.
Through this, they obtained information on the subjects' socio-demographic, smoking, and overall health status, as well as their exercise frequency, average time spent exercising, types of supplements used, supplement sources, and health beliefs surrounding dietary supplements.
Safety before supplementation
Of the 445 participants, 44% reported taking supplements, 66% were between 18 and 25 years old, 74% had a college degree, 77% were non-smokers, 84% were healthy, and 52% exercised at least three times a week, with 63% of them exercising for at least one hour each time.
As for the types of supplements used, multivitamins, amino acids, and omega-3 supplements were the most commonly consumed in this study. Nearly 30% of the supplement users said they bought their supplements overseas, 28% online, 25% from a supplement store or pharmacy, 19% from a clinic, and 17% from peddlers.
The comparably lower percentages of supplement users who purchased their supplements from licensed stores, pharmacies and medical clinics led the researchers to say public health campaigns were necessary to educate the public on the potentially harmful effects of dietary supplements bought from unofficial or unlicensed sellers, or taken without first consulting a medical professional.
Indeed, sports supplements have been the subject of much regulatory scrutiny throughout APAC and the Middle East, with cases of athletic doping arising from uninformed athletes consuming supplements containing prohibited substances.
In March this year, Indian authorities implemented stricter regulations as part of a crackdown on athletic doping. This came after the All India Council of Sports called for better education on sports supplements in August last year.
Not long after, in September, six sports supplements sold in Australia and New Zealand were seized after they were discovered to contain undeclared anabolic steroids.
Despite the study's substantial sample size, it was conducted in only one city, making its results non-applicable to the general Saudi population.
Another issue was recall bias, as some of the participants could not recall the name or active ingredients of some of the supplements they said they had been taking regularly.
There were also important variables that could be linked to the use of dietary supplements, such as health literacy and individual income, that were not recorded.
In conclusion, the researchers wrote: "The results of this study should encourage public health researchers and health advocates to design and implement behavioural interventions through media campaigns and other means to educate the public on the benefits and risks of dietary supplements, especially of those used by athletes to enhance their performance.
"Those campaigns should also raise public's awareness on the unexpected ingredients that have been found in dietary supplements purchased from unauthorised sellers.
"Further, the SFDA (Saudi Food and Drug Authority) should work closely with the Ministry of Health to improve their oversight on the entry of unlicensed dietary supplements into the country, and their inspection of pharmacies, medical clinics, and fitness centres that sell dietary supplements without having a licence to sell such products."
Source: PLOS ONE
https://doi.org/10.1371/journal.pone.0199289
"Use of dietary and performance-enhancing supplements among male fitness center members in Riyadh: A cross-sectional study"
Authors: Yazed AlRuthia, et al.