National Federation of State High School Associations (NFHS)
Sports Medicine Advisory Committee (SMAC)
The NFHS Sports Medicine Advisory Committee (SMAC) strongly opposes the use of dietary supplements for the purpose of obtaining a competitive advantage. Research shows that there continues to be widespread use of dietary supplements by adolescent and high school athletes, despite considerable safety concerns. Dietary supplements are marketed as an easy way to enhance athletic performance, increase energy levels, lose weight, and feel better. Adolescents are more susceptible to peer pressure and these advertising messages, which may increase the incidence of dietary supplement usage and reinforce a culture more concerned about short-term performance rather than overall long-term athletic development and good health.
The Dietary Supplement Health and Education Act (DSHEA) of 1994 removes dietary supplements from pre-market regulation by the Food and Drug Administration (FDA). Under DSHEA, a manufacturing firm is responsible for determining that the dietary supplements it manufactures or distributes are safe and that any representations or claims made about them are substantiated by adequate evidence to show that they are not false or misleading. This essentially classifies dietary supplements as a food and not a drug, and as such, they are not subject to the same strict tests and regulations as prescription and “over-the-counter” medications by the FDA. Only the companies that produce dietary supplements are responsible for ensuring that their products are pure, safe and effective for their intended use. As the FDA has limited resources to analyze the composition of dietary supplements, there is often no guarantee concerning the true amount, concentration or purity of the ingredients as listed on the label. In fact, the FDA cannot remove a dietary supplement from the marketplace unless the supplement has been shown to be “unsafe.”
The NFHS SMAC strongly opposes the use of supplements by high school athletes for performance enhancement, due to the lack of published, reproducible scientific research documenting the benefits of their use and confirming no potential long-term adverse health effects with their use, particularly in the adolescent age group. Dietary supplements should be used only upon the advice of one’s health care provider for health-related reasons – not for the purpose of gaining a possible competitive advantage. School personnel and coaches should never recommend, endorse or encourage the use of any dietary supplement, drug, or medication for performance enhancement.
We recommend that coaches, athletic directors, and other school personnel develop strategies that address the prevalence and growing concerns of using dietary supplements. Such strategies may include conversations with athletes and their parents about the potential dangers of dietary supplement use. Athletes should be encouraged to pursue their athletic goals through hard work, appropriate rest and good nutrition, not unsubstantiated dietary shortcuts.
In order to discourage dietary supplement use for athletic performance:
- School personnel, coaches, and parents should allow for open discussion about dietary supplement use, and strongly encourage obtaining optimal nutrition through a well-balanced diet.
- Remind athletes that no supplement is harmless or free from consequences and that there are no short cuts to improve athletic performance.
- Because they are not strictly regulated, dietary supplements may contain impurities and banned substances not listed on the label.
American College of Sports Medicine (ACSM). Nutrition and Athletic Performance Position Statement. March 2009.
Dietary Supplement Health and Education Act of 1994 (DSHEA). http://www.fda.gov/opacom/laws/DSHEA.html
Dodge TL, Jacard JJ. The effect of high school sports participation on the use of performance-enhancing substances in young adulthood. Journal of Adolescent Health 39: 367-373, 2006.
Koch JJ. Performance-enhancing substances and their use among adolescent athletes. Pediatrics in Review 23: 310-317, 2002.
Mellion MB, Walsh, WM, et al. The Team Physician’s Handbook. 3rd ed. Philadelphia: Hanley & Belfus, 2001.
McKeag DB, Moeller JL. ACSM’s Primary Care Sports Medicine. 2nd ed. Philadelphia: Lippincott Williams & Wilkins, 2007.
National Federation of State High School Associations. http://www.nfhs.org.
Overview of Dietary Supplements. http://www.fda.gov/Food/DietarySupplements/ConsumerInformation/ucm110417.htm
The National Center for Drug Free Sport, Inc. http://www.drugfreesport.com.
United States Anti-Doping Agency. http://www.usantidoping.org/.
Revised and Approved April 2012
DISCLAIMER – NFHS Position Statements and Guidelines
The NFHS regularly distributes position statements and guidelines to promote public awareness of certain health and safety-related issues. Such information is neither exhaustive nor necessarily applicable to all circumstances or individuals, and is no substitute for consultation with appropriate health-care professionals. Statutes, codes or environmental conditions may be relevant. NFHS position statements or guidelines should be considered in conjunction with other pertinent materials when taking action or planning care. The NFHS reserves the right to rescind or modify any such document at any time.