Muscle-building behaviors from adolescence to emerging adulthood: A prospective cohort study

https://doi.org/10.1016/j.pmedr.2022.101778Get rights and content
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Highlights

  • Muscle-building behaviors in adolescence to emerging adulthood were studied.

  • Starting muscle-building behaviors is common from adolescence to emerging adulthood.

  • Prevalence of any protein powder/shakes use was 55.1% in males and 33.0% in females.

  • Prevalence of any steroids use was 6.7% in males and 5.4% in females.

  • Protein powder consumption was associated with future use of steroids.

Abstract

This study aimed to identify patterns of change in muscle-building behaviors from adolescence to emerging adulthood and determine what adolescent factors predict new-onset muscle-building behavior in emerging adulthood. Prospective cohort data from a diverse sample of 1,535 participants followed from adolescence (baseline, Mage = 14.4 ± 2.0 years) to emerging adulthood (follow-up, Mage = 22.1 ± 2.0 years) from the population-based EAT 2010–2018 (Eating and Activity over Time) study were analyzed. Changes in muscle-building behavior were identified (starting, stopping, persistent use, or never use). Log-binomial regression models examined adolescent predictors of starting (i.e., new-onset) muscle-building behaviors in emerging adulthood. Prevalence of any use in adolescence (EAT 2010) and/or emerging adulthood (EAT 2018) was 55.1% (males) and 33.0% (females) for protein powder/shakes, 6.7% (males) and 5.4% (females) for steroids, and 19.4% (males) and 6.5% (females) for other muscle-building substances (e.g., creatine, amino acids). In particular, 22.6% (males) and 13.7% (females) started protein powder/shakes, 2.2% (males) and 1.0% (females) started steroid use, and 9.0% (males) and 2.0% (females) started other muscle-building substances during emerging adulthood. Adolescent protein powder/shake consumption was associated with starting steroids/other muscle-building substances use in emerging adulthood in males (adjusted risk ratio [ARR] 2.09, 95% confidence interval [CI] 1.29–3.39) and females (ARR 4.81, 95% CI 2.01–11.48). Adolescent use of protein powders/shakes may lead to a two- to five-fold higher risk of new use of steroids and other muscle-building products in emerging adulthood. Clinicians, parents, and coaches should assess for use of muscle-building behaviors in adolescents and emerging adults and discourage use of harmful products.

Abbreviations

ARR
adjusted risk ratio
BMI
body mass index
CI
confidence interval
EAT
Eating and Activity over Time
HMB
hydroxyl methylbutyrate

Keywords

Muscle-enhancing behavior
Anabolic–androgenic steroids
Protein
Performance-enhancing substances
Body image

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