Navigating the Risks Beyond the Label: Unpacking Global Nutritional Supplement Safety
Year: 2025
Type: article
Abstract: Nutritional supplement use is common among athletes aiming to enhance performance, recovery, and health. However, variable regulatory frameworks and limited safety oversight create risks for inadvertent doping violations. This article provides a global overview of supplement use, relevant authorities, legislation, and safety measures, with a focus on third-party testing (TPT) as a risk-mitigation strategy. Data from six global regions-Africa, Asia, Australia/New Zealand, Europe, Latin America, and North America-were synthesized from peer-reviewed studies, governmental sources, and regional expert contributions. Reported supplement use ranged from 7% to 100% among athletes (variability within regions), with protein powders, vitamins/minerals, creatine, caffeine, and sports drinks being most prevalent. High-risk products (potential anti-doping rule violations), including certain herbal blends, preworkouts, and weight-management supplements, were reported across all regions. While some countries have robust regulatory systems, most lack harmonized or enforceable safety frameworks. TPT programs, which independently verify products for prohibited substances, remain concentrated in the global northwest (Europe, North America, and Australia/New Zealand); awareness and use of TPT certification vary widely, and even in regions with established systems, athlete adherence is inconsistent. Barriers to low-risk supplement use are limited TPT availability, cost, differences in labeling (including language), and cultural factors. Firsthand experiences and perceptions highlight widespread misconceptions about supplement safety and certification. The authors recommend expanded athlete and team-around-the-athlete education, improved global access to TPT low-risk supplements, and policy initiatives to harmonize safety standards. This work emphasizes the need for coordinated international efforts to protect athlete health and integrity while allowing access to evidence-based supplementation.
Authors: Floris C. Wardenaar, Stephen F. Burns, Marcus Campos, Yat Chan, Amanda Claassen-Smithers, Christel Dunshea-Mooij, Salah Eddine Haddou, Daan Hoogervorst, Andrew Jagim, Pedro Reinaldo Garcia, Ina Garthe, Anne P. Nugent, Maged Ossama Aly, Bryan Saunders, Kinta D. Schott, Yasuki Sekiguchi, Gary Slater, Naomi Speers, Matthew T. Stratton, Thorben Aussieker
Institutions: Arizona State University, Nanyang Technological University, National Institute of Education, Universidade Estadual Paulista (Unesp), University of Cape Town, Mayo Clinic Health System, Baylor College of Medicine, Children's Nutrition Research Center at Baylor College of Medicine, University College Dublin, Queen's University Belfast, King Faisal University, Universidade de São Paulo, Fundação Faculdade de Medicina, Texas Tech University, University of the Sunshine Coast, Technical University of Munich
Language: English
Topic: Doping in Sports
Subfield: Sociology and Political Science
Field: Social Sciences
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W4417415305