Key study points:
1. Both adolescent boys and girls report unhealthy muscle-enhancing behavior including steroid and other supplement usage, though these behaviors were more common among boys.
2. Asian race, increased BMI, and participation in team sports were associated with an increased rate of muscle-enhancing behaviors.
Primer: Media images of thin females have long been associated with unhealthy diet and exercise habits among adolescent girls. In recent years, there has been a shift in media and cultural norms towards an athletic/muscular body type for both boys and girls. This cultural shift raises an important question: have adolescent boys and/or girls adjusted their behaviors with the goal of achieving a muscular body-type? If so, to what extent do adolescents employ healthy versus unhealthy muscle-enhancing strategies?
This [survey]: was administered to 2793 adolescents. The survey addressed the use and frequency of five muscle-enhancing behaviors:
1) Change in eating
2) Increase in exercise
3) Consumption of protein powder or shakes
4) Use of steroids
5) Use of other muscle-enhancing substances (such as creatine, amino acids, hydroxyl methylbutyrate [HMB], DHEA, or growth hormone
Muscle-enhancing behavior was prevalent among both boys and girls, with more than ⅔ of boys reporting changes in eating and >90% exercising to increase muscle mass. Unhealthy muscle-enhancing strategies were also employed. Specifically, 5.9% of males and 4.6% of females reported steroid usage and 10.5% of males and 5.5% of females reported usage of other muscle-enhancing substances.
Asian boys were 3.5x more likely to use steroids compared with their white peers. Obese or overweight male and female adolescents reported higher rates of muscle-enhancing behaviors. Similarly, participation in a sports team was associated with higher rates of changes in eating, increase in exercise, and consumption of protein powder or shakes.
In sum: Overall, the study suggests that muscle-enhancing behaviors are prevalent in adolescent boys and girls, and that they are not always healthy. Health care providers must be aware of these trends and counsel their adolescent patients on topics such as appropriate amounts of exercise, eating a balanced diet, and avoidance of steroids or other unhealthy supplements.
One limitation of this study is the restriction to one metropolitan area in the United States. The extent to which the data from this study is applicable to adolescents in other urban and/or rural populations is less clear. The data were also self-reported, and are therefore vulnerable to bias.
By [SS] and [DB]
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