Prevalence of Supplement Consumption in Iranian Athletes: A Systematic Review and Meta‑Analysis

Farzin Halabchi, Sakineh Shab-Bidar, Maryam Selk-Ghaffari

Abstract


Background: Due to widespread use of supplement among athletes, determining the prevalence and pattern of dietary supplement consumption and its moderators will be a road map for developing a strategic planning in the national level to achieve healthy lifestyle and avoid harmful nutritional approaches.

Methods: A systematic search of the electronic resources including Medline, PubMed, Scopus, Google Scholar and National Persian Databases including Magiran, SID, IranDoc and CIVILICA (between 1979 and November 2019 in Persian and English language) was accomplished. Inclusion criteria were (a) studies containing the prevalence rate of dietary supplement consumption, specifically (b) studies were conducted in athletes. Finally, 32 articles were included.

Results: The prevalence rate of supplement use in overall Iranian athletic population was 64.8% (95% CI, 55.8%‑73.8%) with significant heterogeneity (I2 = 99.7%, P < 0.001). The prevalence rate was reported to be higher in male athletes, athletes aged 25 and older and elite athletes (P < 0.05). The most prevalent source of information about supplement use among athletes were trainers, followed by physicians, friends‑teammates and dietitians.

Conclusions: According to the high prevalence of supplement consumption among Iranian athletes, policy making for educational programs is mandated. Trainers are the most popular source to provide information about supplements and educational programs should be conducted for this target population.


Keywords


Athletes,; dietary supplements; prevalence; public health

Full Text:

PDF

References


Zeinalian M, Eshaghi M, Hadian M, Naji H, Asgary S.

Personalized nutrition: An ancient concept in Iranian traditional

medicine. Int J Prev Med 2019;10:94.

Sousa M, Fernandes MJ, Carvalho P, Soares J, Moreira P,

Teixeira VH. Nutritional supplements use in high‑performance

athletes is related with lower nutritional inadequacy from food.

J Sport Health Sci 2016;5:368‑74.

Thomas DT, Erdman KA, Burke LM. Position of the academy of nutrition and dietetics, dietitians of Canada, and the American

college of sports medicine: Nutrition and athletic performance.

J Acad Nutr Diet 2016;116:501‑28.

Knapik JJ, Steelman RA, Hoedebecke SS, Austin KG,

Farina EK, Lieberman HR. Prevalence of dietary supplement use

by athletes: Systematic review and meta‑analysis. Sports Med

;46:103‑23.

De Silva A, Samarasinghe Y, Senanayake D, Lanerolle P. Dietary

supplement intake in national‑level Sri Lankan athletes. Int J

Sport Nutr Exerc Metab 2010;20:15‑20.

Baltazar‑Martins G, de Souza DB, Aguilar‑Navarro M,

Muñoz‑Guerra J, del Mar Plata M, Del Coso J. Prevalence and

patterns of dietary supplement use in elite Spanish athletes. J Int

Soc Sports Nutr 2019;16:30.

Dascombe B, Karunaratna M, Cartoon J, Fergie B, Goodman C.

Nutritional supplementation habits and perceptions of elite

athletes within a state‑based sporting institute. J Sci Med Sport

;13:274‑80.

McDowall JA. Supplement use by young athletes. J Sports Sci

Med 2007;6:337‑42.

Seif‑Barghi T, Halabchi F, Dvorak J, Hosseinnejad H. How the

Iranian football coaches and players know about doping? Asian J

Sports Med 2015;6:e24392.

Halabchi F, Esteghamati A, Razzaghi A, Noori A. How the

Iranian free‑style wrestlers know and think about doping?–A

knowledge and attitude study. World Acad Sci Eng Technol

;59:209‑14.

Jovanov P, Đorđić V, Obradović B, Barak O, Pezo L, Marić A,

et al. Prevalence, knowledge and attitudes towards using sports

supplements among young athletes. J Int Soc Sports Nutr

;16:27.

Froiland K, Koszewski W, Hingst J, Kopecky L. Nutritional

supplement use among college athletes and their sources of

information. Int J Sport Nutr Exerc Metab 2004;14:104‑20.

Angoorani H, Halabchi F. The misuse of anabolic‑androgenic

steroids among Iranian recreational male body‑builders and their

related psycho‑socio‑demographic factors. Iran J Public Health

;44:1662‑9.

Angoorani H, Jalali M, Halabchi F. Anabolic‑androgenic steroids

and prohibited substances misuse among Iranian recreational

female bodybuilders and its associated psycho‑socio‑demographic

factors. Addict Health 2018;10:216‑22.

Sundgot‑Borgen J, Berglund B, Torstveit MK. Nutritional

supplements in Norwegian elite athletes—impact of international

ranking and advisors. Scand J Med Sci Sports 2003;13:138‑44.

Halabchi F. Doping in athletes. Hakim Res J 2007;10:1‑12.

Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C.

Methodological guidance for systematic reviews of observational

epidemiological studies reporting prevalence and incidence data.

Int J Evid Based Healthc 2015;13:147‑53.

Alidoust Ghahfarrokhi E, Mokhlesi S, Shariati J. An investigation

of consumption and awareness of side effects of doping and

weight loss drugs in non‑professional athletes in Tehran fitness

clubs. Sport Physiol Manag Investig 2017;9:113‑26. [Persian].

Aghili M, Gholami M. Prevalence of ergogenic substance misuse

and awareness toward the side effects of doping agents in male

bodybuilders of Tehran 2011: 6th scientific-students congress on

physical education and sport sciences; Sport Sciences Research

Institute of Iran. 2011. [Persian]. https://www.civilica.com/PaperSSTU06-SSTU06_174.html.

Fakhari‑Rad F, Gholami M. The prevalence of the use of

ergogenic aids and awareness of their side effects among Iranian

body builders. Int J Sport Stud 2014;4:830‑5.

Kordi R, Ziaee V, Rostami M, Wallace WA. Patterns of weight

loss and supplement consumption of male wrestlers in Tehran.

Sports Med Arthrosc Rehabil Ther Technol 2011;3:4.

Minasian V, Sarlak M. Prevalence, attitude and knowledge of

side effects of ergogenic substances in elite athletes of national

teams and professional clubs of Tehran province. Sport Manag

Stud 2010, 4:119‑30. [Persian].

Saeedi P, Mohd Nasir MT, Hazizi AS, Vafa MR,

Rahimi Foroushani A. Nutritional supplement use among fitness

club participants in Tehran, Iran. Appetite 2013;60:20‑6.

Shojaee Mahallati A. Frequency of Nutrition Supplements and

energy enhancing drugs in bodybuilding athletes in Tehran.

[M.D. Thesis], Islamic Azad University of Tehran; 1999. [Persian].

Hozoori M, Safaei‑Motlagh A, Marzban A. The epidemiology of

dietary supplements consumption in the athletes of Karaj Iran.

Int J Epidemiol Res 2016;3:222‑31.

Mahdavi M, Shooshtarizadeh ASF, Sadri B, Bigdeli O,

Miraftabi S, Ehsanifar S. Study of prevalence of consumption

and consumer awareness of doping substances and supplements

side effects among male bodybuilders in Karaj. Res Pharm Sci

;7:65‑72.

Shoshtarizadeh F, Bahramian F, Safari A, Pourghaderi M,

Barati H. Investigation of prevalence of energizer drugs

and supplements consumption and effective factors among

bodybuilder men in Karaj (2011). Alborz Univ Med J

;2:175‑82.

Hozoori M, Ehteshami M, Haghravan S, Azarpira A. Prevalance,

reasons of consumption and information sources about dietary

and sports supplements in different disciplines athletes in Tabriz.

Sports Biosciences 2012;12:77-91. [Persian]

Khabiri A. Evaluation of Knowledge and Prevalence of Using

Supplements and Stimulating Drugs in Elite Athletes in the

Province of East Azarbaijan. Tabriz University of Medical

Sciences, Faculty of Pharmacy; 2019.

Darvishi L, Askari G, Hariri M, Bahreynian M, Ghiasvand R,

Ehsani S, et al. The use of nutritional supplements among male

collegiate athletes. Int J Prev Med 2013;4(Suppl 1):S68‑72.

Karimian J, Esfahani PS. Supplement consumption in body

builder athletes. J Res Med Sci 2011;16:1347‑53.

Allahverdipour H, Jalilian F, Shaghaghi A. Vulnerability and the

intention to anabolic steroids use among Iranian gym users: An

application of the theory of planned behavior. Subst Use Misuse

;47:309‑17.

Khorramabady Y. The Effect of Muscle Dysmorphia and Social

Physique Anxiety on the Use of Supplements and Drugs.

Zahedan Journal of Research in Medical Sciences 2017;19:1-6.

Golshanraz A, Hakemi L, Pourkazemi L. Prevalance of dietary

supplement use among elite Iranian athleetes (male & female

national level athletes). Br J Sports Med 2014;48:599‑600.

Seif‑Barghi T, Yosaee S, Halabchi F, Mazaheri R, Djafarian K.

Type and frequency of dietary supplement use by Iranian soccer

players. J Nutr Sci Diet 2015;1:93‑7.

Golshanraz A, Hakemi L, Pourkazemi L, Dadgostar E,

Moradzandi F, Tabatabaee R, et al. Patterns of sports supplement

use among Iranian female athletes. International Journal of Sport

and Health Sciences 2012;6:2480-3.

Hoseini Kakhak AR. The amount and frequency of use of

performance-enhancing adjuvants (drugs and supplements,

protein and vitamins) in elite fitness clubs in the cities of Tehran

and Mashhad. [Thesis], Tarbiat Moallem university; 2001.

[Persian].

Malek M, Ghanaei M, Ghorbani R. Survey of the frequency

percentage of doping drugs among the male body building athletes and rate of knowledge to side effects. KOOMESH

;6:123‑30. [Persian].

Rashid Lamir A, Dehbashi M, Taghizadeh V. Study the

prevalence of legal and illegal supplements between athlete’s

men in Bodybuilders and powerlifting field. Shomal J Manag

Physiol Sport 2014;2:1‑11. [Persian].

Aminpour M. The prevalence of ergogenic substance use,

attitude and tendency toward their use among Bojnord’s body

builders [M.S. Thesis]. Sabzevar Tarbiat Moallem University,

Faculty of physical education and sport science, Iran,

[Persian].

Ekramzadeh M, Taherinasab S. The prevalence of sport dietary

supplements consumption among male athlete students in

Shiraz University of Medical Sciences, Shiraz, Iran. J Nutr Sci

;2:218‑23.

Aliabadi S, Hesami S. The Relation between Awareness, Attitude

and the Amount of Doping Substances and Illegal Supplements

in Body Builders of Sanandaj, Iran. Arabian Journal of Business

and Management Review (Oman Chapter) 2014;4:73-76.

Nakhaee M, Pakravan M. Prevalence and reasons for nutritional

supplement use among athletes in body building gyms, Kerman

J Rafsanjan Univ Med Sci 2014;12:873‑80.

Bahari‑Rad N, Komasi S, Khatooni A, Moradi F, Soroush A.

Frequency and causes of consuming sports supplements and

understanding their side effects among bodybuilders in fitness

gyms of Kermanshah City. Curr Nutr Food Sci 2019;15:735‑44.

Kargarfard M, Kashi A, Sarlak Z. Prevalance of ergogenic

substances use and athletes’knowledge of effects and side effects

of them in Lorestan province, western part of Iran. J Fundam

Ment Health 2009;11:123‑34.

Nakhostin‑Roohi B, Asadi M. The prevalence, level of

knowledge and methods of providing nutritional supplements

among females participating in private sports clubs in the City of

Ardabil, Iran. Int J Nutr Sci 2018;3:18‑24.

Amirsasan R. Study the amount and kind of dietary supplements

consumption in Iranian athletes participating in the London 2012

Olympic Games based on a theory of planned behavior. Sport

Physiol 2014;6:43‑60.

Arazi H, Saeedi T, Sadeghi MM, Nastaran M, Mohammadi

M. Prevalence of supplements use and knowledge regard

to doping and its side effects in Iranian athlete university

students participated in sports Olympiad at summer 2012. Acta

Kinesiologica 2014;8:76-82.

Azizi M, Mali AD, Tabari E. Study of prevalence of supplement

use and knowledge of men national team rowers about doping

and side effects. World Appl Sci J 2012;17:724‑8.

Aljaloud SO, Ibrahim SA. Use of dietary supplements

among professional athletes in Saudi Arabia. J Nutr Metab

;2013:245349. doi: 10.1155/2013/245349.

Nabuco HCG, Rodrigues VB, BARROS WMd, Ravagnani FCDP,

Espinosa MM, Ravagnani CDFC. Use of dietary supplements

among Brazilian athletes. Rev Nutr 2017;30:163-173.

Denham BE. Athlete information sources about dietary

supplements: A review of extant research. Int J Sport Nutr Exerc

Metab 2017;27:325‑34.

Garthe I, Maughan RJ. Athletes and supplements: Prevalence

and perspectives. Int J Sport Nutr Exerc Metab 2018;28:126‑38.

Khanna P, Chattu VK, Aeri BT. Nutritional aspects of depression

in adolescents‑A systematic review. Int J Prev Med 2019;10:42.