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Aggressive sports supplement marketing campaigns aimed at schoolchildren have been slammed by the South African Sports Medicine Association (SASMA). The organisation has issued a position statement on the use of the products by schoolchildren and says that as a general rule “persons under the age of 18-years-old should not use sports supplements”. It hit out at commercial exploitation of children by sports supplement manufacturers, saying a significant concern was “the increasingly aggressive marketing and false claims [being made] at schools”. SASMA president Dr Phatho Zondi says supplement use at schools had been “escalating over a few years and now we have a situation where children are being indirectly incentivised to use them”. SASMA’s position statement on “the use of dietary and sports supplements in school-going athletes” says marketing campaigns include: *          Supplement manufacturers sponsoring school teams, fields or stadiums; *          And “of great concern, campaigns that see schools competing for points awarded for purchasing specific supplements and hosting certain promotional events”. In one of these campaigns the top scoring school would win a concert by a popular South African musician. The statement questions the ethics of such campaigns, “specifically as there are health and doping-related concerns associated with this type of sponsorship”. Turning to the dangers of supplement use among under 18s, it says a major concern “is the emerging evidence of dietary supplements containing non-dietary ingredients such as steroids, stimulants and other potentially harmful ingredients that are often not specified as such on the product label”. Because of the potential health risks, research on the effects of supplements is not typically done on youths. However, “it is a major concern that cross-sectional studies conducted in high schools (internationally) show an increasing trend of supplement use in under 18 athletes”. One particular South African study indicated that 55% of rugby playing schoolboys in that study sample used some form of supplement. “The use of performance enhancing supplements … starts as early as 10-years-old, increasing in prevalence with age,” the statement adds. Zondi points out that “recently some progress has been made in drafting a roadmap that aims to address the issue of regulating complementary medicines (which includes supplements). Unfortunately there are a number of loopholes with the proposed regulatory model, and the real challenge will be implementation and policing”. As it stands: *          Products are still being sold “without proof regarding the claims they make about their efficacy”; *          Products are sold without adequate research being done on the risks associated with using them; *          Products “could be mislabelled or contaminated” which may result in inadvertent use of a banned substance. “SASMA’s position is that, as a general rule, supplements are not required and should be avoided in adolescent and youth athletes,” says the statement. Instead, they should be “encouraged to optimise their diet, refine training habits, and improve recovery strategies in order to boost health and athletic performance”. SASMA’s statement adds: “Contrary to product claims, only a small percentage of supplement ingredients have been shown to have performance-enhancing potential (in adult athletes), if used correctly. The gains in performance are typically very small and not seen in all individuals”. The position statement also endorses the supplement guidelines issued by the South African Institute for Drug Free Sport’s (SAIDS). These include a recommendation that healthy “children and adolescents engaged in sport should stay clear of supplement use as far as possible”. If a “specific dietary gap” has been identified a suitably qualified health professional may recommend supplementation. SAIDS also urges consumers to “be extremely cautious of supplements advertising ‘muscle building’ and ‘fat burner’ or ‘enhanced energy’ or containing herbal ingredients as these are likely to contain banned substances such as anabolic steroids, pro-hormones or stimulants”. It adds: “Guard against individuals closely involved with youth athletes (such as trainers, coaches and teachers) that become distributors and sell ‘performance-enhancing’ supplements to children and adolescents. This is considered a serious conflict of interest.”