A Behaviourally Informed Approach to Reducing the Risk of Inadvertent Anti-doping Rule Violations from Supplement Use

Abstract

For many reasons, athletes’ use of supplements is highly prevalent across sports and competitive levels, despite the risk of these products containing a substance on the World Anti-Doping Agency Prohibited List. Contravening anti-doping rules through supplement use could have serious consequences for competitive athletes (e.g., ineligibility from major competitions, loss of medals and funding) due to the principle of strict liability. Indiscriminate supplement use also poses a risk to athlete health. To reduce the possibility of ingesting a supplement containing prohibited substances, independent quality assurance and certification programs have been established (e.g., Informed Sport). However, these programs do not completely eliminate risk, leading to some anti-doping organisations promoting a ‘just say no’ to supplements stance. Yet, this approach can be problematic as a small number of supplements may be necessary for athletes to consume, in certain situations. Recognising that athletes will continue to use these heavily marketed products, this narrative review describes a theoretically underpinned and systematic approach to preventing inadvertent doping by considering the barriers to and enablers of athlete adherence to risk minimisation supplement use guidelines (RMSUG). By outlining a conceptual shift towards a behaviourally informed approach, this review serves to stimulate the development of multifaceted interventions to prevent inadvertent doping through supplement use. Recognising that risk-minimised supplement use involves a myriad of behaviours, the problem of inadvertent doping through supplement use is framed, and research appraised, through the lens of the Behaviour Change Wheel.

Development of a screener to assess athlete risk behavior of not using third-party tested nutritional supplements

“…To start, the majority of athletes participating in high level competitive sports need to comply with WADA regulations ( 28 ). Not complying may result in a positive doping test ( 4 ). Supplements often contain impurifications, that can be on the WADA (or in this case NCAA) prohibited substances list.…”

“…In the United States, the number of doping violations with sanctions associated with supplements ranges from 0 to 17% of total investigated cases per year and has averaged around 9% of all doping cases annually since 2006 ( 3 ). One of the risk mitigation strategies to ensure athletes use safe nutritional supplements free from doping-related substances is to use products that are third-party tested (TPT) ( 4 , 5 ). Despite the literature consistently mentioning the need for the use of TPT supplements ( 6 , 7 ), research shows that a substantial number of athletes report inconsistently using TPT supplements ( 8 , 9 ).…”