How common is protein powder, creatine in Canada?

A new study shows that the use of legal performance-enhancing drugs and substances has negative effects on the mental and sometimes physical health of young people in Canada.

Somewhat worrying Side effects in young people include mental health problems such as eating disorders and physical side effects such as hospitalizationsays a study published in the December 2022 issue of the National Library of Medicine.

In some cases, legal performance-enhancing drugs (APED) are contaminated with stimulants or are mislabeled, the study says, which can cause further adverse effects.

The study is one of the first of its kind in Canada to document how widespread the use of muscle-building or weight-loss supplements and substances is among youth. Using previous research from the United States, this study was able to establish links between the increased use of legal supplements and the effects on young Canadians.

Knowing the risks and lack of awareness associated with APEDs, one expert is advocating for Health Canada to push for stricter regulations.

APEDs are defined as any drug or substance used to “improve not only athletic appearance and performance but also cognitive and sexual performance.”

Over a 12-month period, the majority of young Canadians reported using substances such as caffeine, protein bars, whey protein powder and creatine monohydrate.

While legally sold “over-the-counter” products are inspected by Health Canada, the effects these substances can have on the health of young people, especially men and boys, are of greater concern, the study says.

WHAT ARE APPEDS?

In interviews conducted in November and December 2021, researchers asked participants if they had used any of the following APEDs in the past 12 months:

• amino acids or branched chain amino acids (BCAA);
• caffeine;
• creatine monohydrate;
• Diuretic or water tablets (eg furosemide [Lasix] hydrochlorothiazide, spironolactone);
• energy drinks (for example, Monster, NOS);
• pre-workout drinks or powders (eg Bang!, Jack3D, Cellucor C4, JYM);
• probiotics;
• protein bars;
• “weight gainers”; and:
• whey protein powders or protein shakes.

These substances are used to change or maintain a person’s body weight and shape, as well as to improve overall athletic performance, the study said.

A number of APEDs are considered legal in Canada, but should not be confused with illegal anabolic-androgenic steroids that use the male hormone testosterone to increase muscle power.

Health Canada considers APEDs as a “natural health product”.

“Whey protein actually promotes adequate protein intake for muscle growth,” study lead researcher Kyle Ganson said in a March 6 presentation. “You use powders and different protein drinks to increase the amount. grams of protein can be consumed per day, which clearly increases muscle growth aid.”

Because of the concentrated nature of the product, people can consume more protein than if they ate protein-rich foods like chicken, Ganson says.

“Creatine is a natural substance that is actually present in our bodies,” Ganson said. “It improves exercise performance and muscle growth.”

Amino acids come in pill or powder form and are used to repair muscles and reduce fatigue, Ganson explained.

Other APEDs include weight loss agents such as diet pills and diuretics.

“Diet pills are reported to sort of help reduce appetite or increase fat-burning abilities,” Ganson said. “With diuretics or water pills, it helps the body get rid of salt and water to reduce the appearance of weight it may have.”

Products such as pre-workouts and BCAAs, which usually come in powder form, have a combination of amino acids that help the body recover after physical activity. Pre-workouts contain caffeine, and BCAA products are typically taken post-workout.

CONTINUED OUTCOMES OF YOUNG CANADIANS

10 different APEDs were common among study participants.

Using the data Canadian Study of Adolescent Health Behavior2,731 youth were analyzed for prevalence and frequency of use of certain APEDs. The survey was completed by people aged 16 to 30 from all 13 provinces and territories.

Some of the effects of muscle building and weight loss supplements include “problem alcohol behaviors such as binge drinking, future use of anabolic-androgenic steroids, criminal offending, intimate partner violence, sexual risk behaviors, muscle dysmorphia and eating disorder symptoms, disability.” and death,” the study said.

The most common APED used was caffeine, with 71.3 percent of respondents saying they had used it in the past 12 months, followed by protein bars (63.4 percent) and whey protein powders or shakes (63.1 percent).

“Most people start with whey protein and then move to creatine,” Ganson said. “Whey protein is considered the first step for many young people trying to build muscle mass, while creatine is often the next step.”

More than a third (34.6 percent) used energy drinks, 25.5 percent used creatine, and just under a quarter (24.5 percent) used pre-sports drinks or BCAAs (21.3 percent).

The least common were “weight gainers” (4.5 percent), which are high-calorie products, and water pills (2.3 percent).

About half of respondents said they wanted to gain weight or gain muscle mass (52.8 percent), indicating increased use of muscle-building APEDs. The majority of the sample (62.2 percent) also said they had exercised in the past 12 months.

“There were gender differences in the prevalence of APED use,” the study said.

More than three-quarters (80 percent) of young Canadian men who responded use whey protein powder or protein shakes. About 75 percent of men and boys reported using caffeine, and about 50.3 percent reported using creatine monohydrate.

Use of all APEDs was “significantly higher” for men and boys compared to women or transgender/gender nonconforming participants, except for water pills and probiotics, which women and girls used more.

Despite the increase in APEDs in men and boys, the study also notes that a “significant proportion” (50 percent) of girls and women consume whey protein. Almost 10 percent reported using creatine and 15 percent using BCAAs.

“Together, these findings likely highlight new pressures for girls and women to adhere to a fit and toned body ideal,” the study explains.

The study blames different genders’ body ideals for why they use APEDs differently.

“Regarding sociodemographic predictors of APED use, compared to girls and women overall, boys and men were more likely to use APEDs marketed to increase performance, weight, and muscle mass,” the study said.

HOW TO PROTECT YOUNG PEOPLE?

Due to the common use of APEDs and the lesser-known effects of continued use, Ganson said Health Canada could implement a number of pre-market and post-market regulations.

Before the products are made available to the public, Ganson suggests putting age limits on APEDs to reduce the number of young Canadians using the substances.

Like cigarettes and alcohol, Ganson suggests these products should also be taxed to discourage young Canadians from using them.

“If we raise the funds through taxation, we can actually fund research prevention intervention efforts to understand what happens in the long term and educate young people,” he said.

Along with curbing use, Ganson believes these products should not be readily available and could be behind the pharmacist’s counter, allowing consumers to interact with someone who understands the implications.

Ganson hopes Health Canada will get involved with more pre-market trials, better regulation of advertisements that encourage the use of APEDs and better notices of side effects on products.

“Creating more transparency (and) being clearer about some of these products and their concerns around them is very important,” Ganson said.

Once the product is released for public consumption, Ganson wants Health Canada to conduct more testing to ensure product contamination, further education and improved monitoring of adverse side effects.

CTVNews.ca reached out to Health Canada to find out its position on Ganson’s recommendations.

A spokesperson for CTVNews.ca said via email. “There is some risk associated with the use of any health product. To minimize risks, Health Canada regulates natural health products to be sold to Canadian consumers through a rigorous licensing process that includes: extensive pre-market review and ongoing post-market evaluation of health product safety, efficacy and quality”.

The federal health agency went on to say that it evaluates the benefits and risks of all products it approves and monitors adverse reactions.

“Through the Health Products and Food Inspection Branch, Health Canada is responsible for health product compliance, monitoring and enforcement activities such as industry inspection and product investigations,” the spokesperson said.

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The following is a list of resources and hotlines dedicated to helping people:

The National Eating Disorders Clearinghouse provides resources and referrals to support people who are directly or indirectly affected by an eating disorder.

Toll Free: 1-866-633-4220

Kids Help Phone offers free, anonymous and confidential professional telephone counseling and online counseling available 24/7 for children and young people aged 20 and under.

1-800-668-6868

Get Support

Canada’s Suicide Prevention Helpline is available to anyone who is or knows someone who is in immediate crisis or has concerns about suicide.

1-833-456-4566 (24/7)

1-866-277-3553 in Quebec (24/7)

Text 45645 (4 p.m. – midnight ET). Text message rates apply. French text support is currently unavailable.