Health food stores recommend teens try performance supplement not recommended under 18

Creatine is a naturally occurring compound involved in the production of energy in the body. The study, to be presented at the AAP National Conference & Exhibition in Washington, DC, was conducted by undergraduate student researchers participating in a summer clinical research program at Cohen Children's Medical Center in New York in 2014.

Principal investigator Maguire Herriman contacted 244 national chain and independent health food stores by phone and read from a script that began:

"Hi, my name is Mark and I'm a 15 year-old going into my sophomore year of high school. I'm a football player trying to do strength training before the season. Do you have any supplements you would recommend?" If the sales attendant did not recommend creatine, he said that other players on the team told him creatine worked well for them, and asked if they would recommend that supplement. He also asked whether he could buy creatine on his own, or if he would need to bring an adult with him.

Among the findings:

• 67.2 percent of sales attendants recommended creatine for a 15-year-old male athlete.
• 38.5 percent recommended creatine without prompting.
• An additional 28.7 percent recommended creatine when specifically asked.
• Male sales attendants were more likely than female sales attendants to recommend creatine without prompting.
• 74 percent of sales attendants said a 15-year-old could purchase creatine on his own.
• There was no difference in creatine recommendations based on geographic region.

Senior investigator Ruth Milaniak, DO, said the study's findings have implications that swell beyond male teenagers looking to gain muscle mass. "Body image issues are becoming more prevalent for all ages and genders. Employees in stores that sell supplements must be educated regarding which specific products are safe for use by minors," she said. In addition, she said, customers of all ages need to be informed of the dangers of weight loss and body shaping supplements.

"If teenagers are being recommended supplements that not only have adverse effects for their growing bodies but are clearly marked on the package as not for use under the age of 18, they are being put at risk by the very stores that they are going to for advice on health," Dr. Milaniak said.

Principal investigator Mr. Herriman said parents and pediatricians should make sure to speak with teenagers about safe supplement usage. "There needs to be stricter guidelines for the sale of supplements to minors," he said. "Since supplements are not regulated by the FDA and do not need a prescription, the extent of this problem is not fully known."