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

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.