Background
Prevalence of sports dietary supplement use
Reasons for increased use of SDS among gym members
The risk of taking sports nutrition supplements
Loopholes in the regulation
Communicating SDS risk
Methods
The research population
Trainees | |||||
---|---|---|---|---|---|
No. | Trainee | Age | Gender | Background | Weekly frequency of training |
1 | A | 40 | Male | Professor of immunology | Runs outdoors daily and goes to the gym before work. |
2 | H | 27 | Male | A former broker | Works out regularly at high intensity. |
3 | I | 26 | Male | A student and fitness trainer | Works out at the gym regularly |
4 | I | 50 | Male | An accountant | Works out three times/week at the gym +rides a road bike |
5 | M | 29 | Male | Security/protection | Works out regularly at the gym + runs outdoors |
6 | D | 21 | Male | A lifeguard | Works out approximately three times a week + swims |
7 | T | 29 | Male | Student of veterinary medicine | Works out 3–4 times/week |
8 | B | 26 | Male | Student | Works out 3–4 times/ week |
9 | E | 37 | Male | A PhD student (formerly in high tech) | Works out regularly at the gym |
10 | I | 27 | Male | Student | Works out 3–4 times/week at the gym |
11 | M | 20 | Female | Soldier in active duty. | Works out intensively on a daily basis. Practices ju jitsu. |
12 | S | 23 | Female | MA student from Singapore | Works out at the gym on a weekly basis |
13 | M | 29 | Female | A rugby player and trainer | Plays rugby +works out at the gym |
14 | M | 29 | Female | A PhD student | Swims +attends classes at the gym |
15 | M | 34 | Female | Clinical psychologist | Combines studio classes with gym workouts |
16 | B | 21 | Female | Student from the USA | Works out regularly |
17 | H | 40 | Female | Learning to be a fitness trainer | Indoor cycling +gym training +outdoor cycling +running daily |
18 | I | 40 | Female | A judo wrestler | Six training sessions a week and cross fitness training |
19 | T | 32 | Female | High tech | Works out at the gym three times/week |
20 | D | 43 | Female | Works at a bank | Works out at the gym three times/week |
Trainers | |||||
No. | Trainee | Age | Gender | Background | |
1 | V | 30 | Male | Trainer, who practices a professional sport | |
2 | R | 26 | Female | Trainer from the Christian Arab sector | |
3 | A | 27 | Female | Trainer and body builder | |
4 | G | 28 | Male | Trainer | |
5 | A | 30 | Male | Trainer | |
Dietitians | |||||
No. | Dietitians | Age | Gender | Background | |
1 | I | 45 | Female | Clinical dietitian | |
2 | G | 30 | Male | Clinical dietitian and sports dietitian | |
3 | G | 40 | Male | Clinical dietitian with a BA in physical education | |
4 | S | 43 | Male | Clinical dietitian and sports dietitian | |
5 | A | 41 | Male | Clinical dietitian and sports dietitian, and food technologist | |
6 | H | 32 | Male | Clinical dietitian and sports dietitian | |
7 | N | 40 | Male | Clinical dietitian, lecturer and fitness trainer | |
8 | M | 38 | Female | Clinical dietitian, former athlete and fitness trainer | |
9 | R | 35 | Female | Clinical dietitian, former athlete |
Research tools
Theme | Questions |
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Risk perception and risk communication | 1. Some people say that taking dietary supplements in different dosages might be effective, but if they are taken beyond these dosages they might have side effects. What is your opinion on this issue? 2. In your opinion, what is the benefit versus the risk of taking dietary supplements? What do you think are the benefits, and do the benefits exceed the risk? 3. For trainers only - As a trainer, do you warn your clients about possible risks? |
The source of information and its reliability | 1. What sources of information do you use to learn about dietary supplements? 2. Do you think the information is reliable? |
The impact of environmental norms | 1. Are there any dietary supplements in the gym where you work out? Please describe where they are located. 2. What do you think about it? 3. In your opinion, how does the presence of those supplements at the gym affect the gym members? 4. Does someone in your community (friends/gym members/ family members) use sports dietary supplements? 5. Who assists and directs them as to what kind of supplements they should take and what they are for? 6. Do you know about the consumption of supplements among trainers? |
The authority status in the gym members’ point of view | 1. In your opinion, which of the following agents (a physician /trainer /dietitian) influences a gym member, and in what order of importance? 2. If there was a case in which a trainer recommended one thing and a physician recommended another, to whom would you listen? 3. If a dietitian and a trainer recommended two different things, to whom would you listen? Why? |
Sample and data collection
The research procedure
The sampling method
Quality control and data handling
Analysis
Results
Risk perception of dietary supplement use and communication of information
Risk perception among gym members
"I know that protein supplements can cause stomach pains and gas, and I think I've heard that creatine might do something but I can't remember what." (M., a female gym member)
Risk perception among trainers
"If there is a very exaggerated consumption of certain supplements, but not something that I can say… Maybe anything that is taken too much, is bad, I guess, but I've never encountered that personally or heard of such a thing." (G., male trainer)
"Of consumption? So the risk comes only in high dosages. What is a high dosage? Twice the recommended dosage… If you take more than that, if they take it frequently, maybe twice the consumption, in that case it may happen, it may happen but it has to be examined on a case-by-case basis, I don't think that side effects come so fast because a person needs a little bit more than this supplement." (G., a male trainer)
"Side effects… I know about steroids, but I don't know much about dietary supplements." (A., a female trainer and body builder)
"There is a 100% benefit and it is better than taking medications…" (V., a male trainer)
Risk communication by trainers
"No, we usually don't talk about it that much, I haven't heard or learned about such a supplement either but I always warn them and say: Look, I'm not the right professional to give you dosages and diets so you should read about it and learn about it by yourselves as well, if you decide about some supplement that you want to take – read about it, learn about it more deeply." (A., a female trainer and body builder)
Risk perception according to dietitians
"I have a very harsh opinion about them, I think they are excellent for those who manufacture them but for us they are less good. I use supplements where it has clearly been proved that there's a certain deficit and only then do I give the body what it specifically requires, I prefer to have a doctor or pharmacist looking at the dosages, I don't make light of the supplements." (Y., a clinical dietitian and sports dietitian)
"There are side effects; as for creatine, for example, there's a phenomenon of water accumulation while taking it and it hurts your flexibility and you have to watch out for injuries, or, iron supplements have side effects to your digestion system… There are always side effects that we should pay attention to." (M., a clinical dietitian and fitness trainer)
Risk communication by dietitians
"Always, and I also ask them to take blood tests. I want to have an indication. I will ask. For example, omega 3 supplements cause clotting disorders, just like curcumin in sports dietary supplements. There might also be kidney problems and liver problems as a result of protein supplements. In general, I'm cautious, particularly about kidney and liver functions." (H., a dietitian)
Sources of information and reliability
"…If the supplement is highly rated then it is more moderated, I probably take what the majority of people take." (S., a female trainee, an MA student from Singapore)
"…I simply read the list of ingredients, and then I try to get an idea of each one. I have common sense; I take product A and compare it to a product of manufacturer B, which is supposed to do the same thing and apparently comes from the same kind of protein…" (Y., a male trainee, a student)
Uncertainty about information reliability
"Good question. I assume that a large part of it is marketing." (A., male gym member)
"The product is sold according to basic marketing principles, and in my opinion that's how it works as well. But that doesn't mean that it doesn't help at all, though the description of the product is not real in my opinion, their promises…" (H., a male trainee, a broker)
"…People come to a gym so they see certain instructors and notice that someone takes supplements, and then they're like, 'Maybe I should take them too', many times people ask me, "Do I also have to take this?" So where do they get this idea from? Because you hear from your friends, that guy takes this, so you say, maybe I'm wrong that I'm not taking this too." (M, a female trainee, a rugby player)
Impact of social norms on supplement consumption
"…In my family everybody's old already so… I’m just kidding, but I remember two uncles of mine who were weightlifters. When they came to visit, the first thing they took out of their suitcase were dietary supplements. In my family, everybody works out or used to work out. That's just one more family affair, like jobs, money…" (R., a female gym member)
Impact of physical environment on sports dietary supplement consumption
"I think it's good, because if you forget to bring them with you or you want to buy them here… They also have shakes…" (M., an American female gym member)
"I think it's good that it's here. If you haven't eaten adequately and you want to train, so you still can do that…" (S., a Singaporean female gym member)
"I think it's perfectly fine but it has to be accompanied by someone who explains what… If it’s necessary, how much and in what way and for whom it is right and in what dosages. It has to be a part of a process." (M., a female gym member)
"As for trainers, if they have the ability to make money out of it, then they'll try, and it happens in many chain sports clubs. The members think they need it, because he sees it and thinks this might help him a little bit. And we're in such a society of here and now and want to get our thing." (G., a male trainer)
"In my opinion this is something that should be criticized. I know it's a part of the 2016 business in sports clubs. Large chain sports clubs earn their living off it, but I think that's the wrong step to take… I wouldn't have left the decision to provide dietary supplements in the trainers' hands but rather in more qualified hands… This is not what's actually happening…" (G. a clinical dietitian and education professional)
Influence of authority
"Of the three, the most authoritative person is the one who is in the same place as the gym member. He will have the strongest connection to him. The gym member will trust him because he is most available. 'Here I'm working out now - come and give me some advice.' But if he goes to a doctor and wants to ask him this is also fine. But you usually ask whoever is accessible … " (M. a female gym member)