Dietary supplements reputed to build muscle, such as creatine and testosterone boosters, are used by some teenage boy athletes despite packaging recommending adult use only and warnings by the American Academy of Pediatrics and the American College of Sports Medicine of adverse health effects. A recent study found that sales associates at health food stores were willing to recommend these products to boys.

In the study, a male researcher called 244 health food stores nationally, identified himself as a 15-year-old football player, and asked for product recommendations to improve strength. If the sales associate didn't initially mention the amino acid creatine or testosterone boosters, the researcher asked about them specifically. The researcher also asked if he could purchase them without an adult.

A total of 67.2% of the sales associates recommended creatine either voluntarily or with prompting. Only 30.3% advised against creatine and 2.5% declined to make a recommendation over the phone. Regarding testosterone boosters, 9.8% of sales associates recommended them, but fewer than 1% recommended them without prompting; 88.5% advised against them; and 1.2% declined to make a recommendation.

About three-quarters of sales associates told the caller he could purchase creatine, and about 40% said he could purchase testosterone boosters, on his own. The others said no, owing to store policy or package labeling cautioning against use by minors.

Teenagers generally are unaware of the health risks of dietary supplements and are likely to accept staff recommendations as reliable and informed, the researchers concluded. There are currently no legal restrictions on sales of these products to minors. Health care professionals should proactively discuss the dangers of these products with their teen patients.-Joan Zolot, PA

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