Sports nutrition supplements and adverse events – a meta-epidemiological study of case reports specifically addressing causality assessment

Abstract

Purpose This meta-epidemiological study aimed to systematically review case reports regarding sports nutrition supplements and adverse events (AEs), specifically addressing the issue of causality assessments. Methods Through a systematic literature search we identified all published case reports of AEs associated with sports nutrition supplements between 1 January 2008 and 1 March 2019. Data regarding AEs, suspected supplements, relevant causality assessment factors and the reporting of clinical reasoning and/or systematic causality assessment methods were extracted. Results In all, 72 publications were included, reporting 134 supplements and 37 different AEs in 97 patients (85% males; median age: 30 years [range: 14–60]). Information regarding previous health and regular prescription drugs was not presented in 30% (29/97) and 46% (45/97) of cases, respectively. In 23% (22/97) of the cases, no alternative cause was mentioned. Clinical reasoning was identified in 63% (61/97), and in 13% (8/61) of these, a systematic causality assessment method was applied. In cases with clinical reasoning, a theoretic rationale (92% vs 78%, P = 0.05), a description of previous cases (90% vs 72%, P = 0.021) and body fluid analysis (18% vs 3%, P = 0.027) were reported to a greater extent. Among cases with clinical reasoning, the application of a systematic causality assessment method captured additional important aspects: use of medication (100% vs 55%, P = 0.015), alcohol use (88% vs 43%, P = 0.020) and illicit drug use (88% vs 40%, P = 0.011). Conclusions In published case reports where sports nutrition supplements were suspected to have caused AEs, essential factors for causality assessment were left out in a non-negligible proportion. Clinical reasoning was identified in most cases whereas a systematic causality assessment method was applied in a minority. Factors of importance for causality assessment were reported to a greater extent in cases including clinical reasoning, and the application of a systematic causality assessment method captured additional aspects of importance.

How Sports Health Professionals Perceive and Prescribe Nutritional Supplements to Olympic and Non-Olympic Athletes

“…The tool, will help to guide discussion between sports health professionals about the need of specific supplements. Taking in account that there are many challenges, like problems with time management [34] and/or limited professional support [35], sports health professionals need to reserve time as part of their team work to agree on the topic of meaningful and safe supplement usage to ensure athletes are served with the highest quality of advice [36].…”

Dietary supplements and Side Effects: Persistent Atrial Fibrillation

“…8 Zeijon et al revealed that "Protein,DMAA, Cafeine, Creatine, Methasteron, Testosterone, Anabolic steroid, Synephrine, Methylstenbolone, Nandrolone, Citrus aurantium" were the most reportedsupplements for adverse effects. 3 In Turkey, especially in the Trakya region, "Glucosamine Chondritin, Biotin (vitamin B7), Coenzyme Q-10, Panax Ginseng, St.John's Wort, Vitamin B12, Vitamin C, Vitamin D3, Multivitamins, Iron, Calcium, Magnesium, Zinc Folic Acid (vitamin B9), Fish Oil (Omega 3, 6, 9 Fatty acids)" wasreported as most frequently used supplements. 9 Campbell et al reported that thereason to use supplements were "Key themes that influenced supplement usewere weight loss, body image, nutrition, training, education, challenges, need,and time."…”

“…However, it is important to not undervalue the risk of fatal side effects in young adults, particularly cardiovascular side effects. 3,5 According to a research which was published in 2021; especially 1,3-dimethylamylamine is the most detected supplement in doping samples. So we can say that 1,3-dimethylamylamine has a very common use as doping in the atletics.…”

“…2 Its herbal origin is emphasized while told that has no adverse effect on the promotion. 3 Furthermore, the most frequently reported side effect of supplementary products is ranged from "jaundice and liver failure" to "a seizure with tachycardia and hypertension" and also "transient ischemia attack". 4 One of these products is Jack3D whichconsists of arginine alphaketoglutarate, creatine monohydrate, beta-alanine, caffeine, 1,3-Dimethylamylamine HCl, Schizandrol A, Citric Acid,Natural Flavors, Silicon Dioxide, Acesulfame Potassium, Sucralose, VegetableStearate, Beta Carotene.…”

In Vitro Activation of Human Adrenergic Receptors and Trace Amine-Associated Receptor 1 by Phenethylamine Analogues Present in Food Supplements

“…Despite the large-scale use of these supplements, their adverse health effects are poorly investigated. Over the years, several cases of serious adverse health effects, like palpitations, myocardial infarction, cardiac arrest and brain haemorrhages, have been linked to the use of pre-workout and fat burner supplements [ 3 , 4 , 5 , 6 , 7 , 8 , 9 ]. Most of these adverse health effects are specifically associated with the cardiovascular system [ 10 ].…”