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Navigating the Risks Beyond the Label: Unpacking Global Nutritional Supplement Safety.

Floris C Wardenaar1, Stephen F Burns2, Marcus Campos3

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International Journal of Sport Nutrition and Exercise Metabolism
|December 30, 2025
PubMed
Summary
This summary is machine-generated.

Athletes widely use nutritional supplements, but inconsistent regulations and limited safety oversight risk doping violations. Third-party testing (TPT) helps mitigate risks, though global access and athlete awareness of TPT certification vary significantly.

Keywords:
adulterationcontaminationdopingspikingthird-party testing

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Area of Science:

  • Sports Science
  • Nutritional Biochemistry
  • Regulatory Affairs

Background:

  • Nutritional supplement use is prevalent among athletes seeking performance enhancement and improved health.
  • Inconsistent global regulatory frameworks and safety oversight pose risks for inadvertent doping violations.
  • Third-party testing (TPT) is a key strategy for mitigating these risks.

Purpose of the Study:

  • To provide a global overview of supplement use, regulations, and safety measures.
  • To assess the role and limitations of third-party testing (TPT) in risk mitigation.
  • To identify barriers to low-risk supplement use and propose recommendations.

Main Methods:

  • Synthesis of data from peer-reviewed studies, governmental sources, and regional experts across six global regions.
  • Analysis of reported supplement usage patterns, including common and high-risk products.
  • Evaluation of the availability, awareness, and adherence to third-party testing (TPT) programs.

Main Results:

  • Supplement use varies widely (7%–100%) among athletes globally, with common products including protein powders, vitamins, creatine, caffeine, and sports drinks.
  • High-risk supplements, potentially leading to anti-doping rule violations, are found across all regions.
  • Third-party testing (TPT) programs are concentrated in the global northwest, with inconsistent athlete awareness and adherence.

Conclusions:

  • Significant misconceptions exist regarding supplement safety and certification among athletes.
  • Limited TPT availability, cost, labeling differences, and cultural factors hinder low-risk supplement use.
  • Recommendations include enhanced education, improved global access to TPT-certified supplements, and harmonized safety standards.