Tendency to Consume Anabolic Steroids and Body-Building Supplements in the General Population: An Ecological Study
Keywords:
Supplements, Anabolic Steroids, Protein Supplement, Testosterone, COVID-19, Google TrendsAbstract
Background: Anabolic steroids and bodybuilding supplements are products that are readily available in the market and are increasingly being used by young people and athletes. This trend has become a social issue worldwide. Objectives: The purpose of this study is to examine and determine the changes in the prevalence and trends of anabolic steroid usage in Iran. Methods: This ecological study utilized the Google Trends database as its primary source. Initially, we searched for specific keywords related to "anabolic steroids (AS)", "Body-building supplements (BBS)", and "COVID-19" among all searches conducted using GTs from January 2017 to December 2022. Subsequently, Spearman's correlation coefficient was employed to assess the association between the keywords "AS" and "BBS" with the term "COVID-19" during various years. Results: The preference for consuming protein (58.19 ± 15.24) was highest among BBS, while recovery (12.14 ± 17.09) was the lowest. In the case of AS, the highest search frequency was related to Testosterone (56.64 ± 9.57), while the lowest was related to Primobolan (13.72 ± 8.21). In early 2020, we observed a significant impact of the COVID-19 pandemic on the inclination to use BBS and AS, leading to a substantial decrease in willingness to use. However, we did not observe a statistically significant correlation between keyword searches for COVID-19 and AS & BBS. Conclusions: The trend of AS and BBS usage in Iran is on the rise. The indiscriminate use of supplements is a cause for concern and calls for educational interventions.
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References
1. Barkoukis V, Lazuras L, Ourda D, Tsorbatzoudis H. Are nutritional
supplements a gateway to doping use in competitive team sports?
The roles of achievement goals and motivational regulations. J Sci
Med Sport. 2020;23(6):625-32. [PubMed ID: 31928883].
https://doi.org/10.1016/j.jsams.2019.12.021.
2. Burke LM. Supplements for optimal sports performance. Curr Opin
Physiol. 2019;10:156-65. https://doi.org/10.1016/j.cophys.2019.05.009.
3. Martinez-Sanz JM, Sospedra I, Ortiz CM, Baladia E, Gil-Izquierdo A,
Ortiz-Moncada R. Intended or unintended doping? A review of the
presence of doping substances in dietary supplements used in
sports. Nutrients. 2017;9(10). [PubMed ID: 28976928]. [PubMed
Central ID: PMC5691710]. https://doi.org/10.3390/nu9101093.
4. Villavicencio Kim J, Wu GY. Body building and aminotransferase
elevations: A review. J Clin Transl Hepatol. 2020;8(2):161-7. [PubMed
ID: 32832396]. [PubMed Central ID: PMC7438350].
https://doi.org/10.14218/JCTH.2020.00005.
5. Austin KG, McLellan TM, Farina EK, McGraw SM, Lieberman HR.
Soldier use of dietary supplements, including protein and body
building supplements, in a combat zone is different than use in
garrison. Appl Physiol Nutr Metab. 2016;41(1):88-95. [PubMed ID:
26702674]. https://doi.org/10.1139/apnm-2015-0387.
6. McVeigh J, Begley E. Anabolic steroids in the UK: An increasing issue
for public health. Drugs: Educ Prev Policy. 2016;24(3):278-85.
https://doi.org/10.1080/09687637.2016.1245713.
7. El Osta R, Almont T, Diligent C, Hubert N, Eschwege P, Hubert J.
Anabolic steroids abuse and male infertility. Basic Clin Androl.
2016;26:2. [PubMed ID: 26855782]. [PubMed Central ID: PMC4744441].
https://doi.org/10.1186/s12610-016-0029-4.
8. Thornborrow T, Onwuegbusi T, Mohamed S, Boothroyd LG, Tovee MJ.
Muscles and the media: A natural experiment across cultures in
men's body image. Front Psychol. 2020;11:495. [PubMed ID:
32308635]. [PubMed Central ID: PMC7145896].
https://doi.org/10.3389/fpsyg.2020.00495.
9. Mathews NM. Prohibited contaminants in dietary supplements.
Sports Health. 2018;10(1):19-30. [PubMed ID: 28850291]. [PubMed
Central ID: PMC5753965]. https://doi.org/10.1177/1941738117727736.
10. Perry JC, Schuetz TM, Memon MD, Faiz S, Cancarevic I. Anabolic
steroids and cardiovascular outcomes: The controversy. Cureus.
2020. https://doi.org/10.7759/cureus.9333.
11. Reyes-Vallejo L. Current use and abuse of anabolic steroids. Actas
Urol Esp (Engl Ed). 2020;44(5):309-13. [PubMed ID: 32113828].
https://doi.org/10.1016/j.acuro.2019.10.011.
12. Corona G, Maggi M. Testosterone therapy is associated with
depression, suicidality, and intentional self-harm: Analysis of a
national federated database testosterone therapy with a man with
equivocal testosterone levels. J Sex Med. 2022;19(7):1201-3. [PubMed
ID: 35450802]. https://doi.org/10.1016/j.jsxm.2022.03.613.
13. Windfeld-Mathiasen J, Christoffersen T, Strand NAW, Dalhoff K,
Andersen JT, Horwitz H. Psychiatric morbidity among men using
anabolic steroids. Depress Anxiety. 2022;39(12):805-12. [PubMed ID:
36281632]. [PubMed Central ID: PMC10092709].
https://doi.org/10.1002/da.23287.
14. Yu J, Hildebrandt T, Lanzieri N. Healthcare professionals'
stigmatization of men with anabolic androgenic steroid use and
eating disorders. Body Image. 2015;15:49-53. [PubMed ID: 26125091].
https://doi.org/10.1016/j.bodyim.2015.06.001.
15. Bond P, Smit DL, de Ronde W. Anabolic-androgenic steroids: How do
they work and what are the risks? Front Endocrinol (Lausanne).
2022;13:1059473. [PubMed ID: 36644692]. [PubMed Central ID:
PMC9837614]. https://doi.org/10.3389/fendo.2022.1059473.
16. Lippi G, Cervellin G. Is digital epidemiology reliable?-insight from
updated cancer statistics. Ann Transl Med. 2019;7(1):15. [PubMed ID:
30788362]. [PubMed Central ID: PMC6351361].
https://doi.org/10.21037/atm.2018.11.55.
17. Cervellin G, Comelli I, Lippi G. Is Google Trends a reliable tool for
digital epidemiology? Insights from different clinical settings. J
Epidemiol Glob Health. 2017;7(3):185-9. [PubMed ID: 28756828].
[PubMed Central ID: PMC7320449].
https://doi.org/10.1016/j.jegh.2017.06.001.
18. Nozari S, Dehghani L, Chabok R, Moloudpour B, Moradi Vastegani Z,
Moalemi S, et al. Google trend as an early warning system for corona
outbreak investigation in Iran. Health Manag Inf Sci. 2022;9(1):16-21.
19. Nuti SV, Wayda B, Ranasinghe I, Wang S, Dreyer RP, Chen SI, et al. The
use of google trends in health care research: a systematic review.
PLoS One. 2014;9(10). e109583. [PubMed ID: 25337815]. [PubMed
Central ID: PMC4215636].
https://doi.org/10.1371/journal.pone.0109583.
20. Hange N, Somagutta MR, Wadagale A, Hamdan AHY, Jain MS, Bobba
SH, et al. Impact of the coronavirus disease on micronutrient search
trends and interest in global population: A worldwide google trend
analysis. Electron J Gen Med. 2022;19(3).
https://doi.org/10.29333/ejgm/11877.
21. Kaminski M, Skonieczna-Zydecka K, Nowak JK, Stachowska E. Global
and local diet popularity rankings, their secular trends, and seasonal
variation in Google Trends data. Nutrition. 2020;79-80:110759.
[PubMed ID: 32563767]. https://doi.org/10.1016/j.nut.2020.110759.
22. Daher J, Mallick M, El Khoury D. Prevalence of dietary supplement
use among athletes worldwide: A scoping review. Nutrients.
2022;14(19). [PubMed ID: 36235761]. [PubMed Central ID:
PMC9570738]. https://doi.org/10.3390/nu14194109.
23. Barrack M, Fredericson M, Dizon F, Tenforde A, Kim B, Kraus E, et al.
Dietary supplement use according to sex and triad risk factors in
collegiate endurance runners. J Strength Cond Res. 2021;35(2):404-10.
[PubMed ID: 33278271].
https://doi.org/10.1519/JSC.0000000000003848.
24. Barrack MT, Muster M, Nguyen J, Rafferty A, Lisagor T. An
investigation of habitual dietary supplement use among 557 NCAA
division i athletes. J Am Coll Nutr. 2020;39(7):619-27. [PubMed ID:
31935156]. [PubMed Central ID: PMC7737658].
https://doi.org/10.1080/07315724.2020.1713247.
25. Tabata S, Yamasawa F, Torii S, Manabe T, Kamada H, Namba A, et al.
Use of nutritional supplements by elite Japanese track and field
athletes. J Int Soc Sports Nutr. 2020;17(1):38. [PubMed ID: 32698870].
[PubMed Central ID: PMC7374838]. https://doi.org/10.1186/s12970-020-
00370-9.
26. Baltazar-Martins G, Brito de Souza D, Aguilar-Navarro M, MunozGuerra J, Plata MDM, Del Coso J. Prevalence and patterns of dietary
supplement use in elite Spanish athletes. J Int Soc Sports Nutr.
2019;16(1):30. [PubMed ID: 31319850]. [PubMed Central ID:
PMC6639916]. https://doi.org/10.1186/s12970-019-0296-5.
27. Wardenaar FC, Ceelen IJ, Van Dijk JW, Hangelbroek RW, Van Roy L, Van
der Pouw B, et al. Nutritional supplement use by dutch elite and subelite athletes: Does receiving dietary counseling make a difference?
Int J Sport Nutr Exerc Metab. 2017;27(1):32-42. [PubMed ID: 27615123].
https://doi.org/10.1123/ijsnem.2016-0157.
28. de Ronde W, Smit DL. Anabolic androgenic steroid abuse in young
males. Endocr Connect. 2020;9(4):R102-11. [PubMed ID: 32229704].
[PubMed Central ID: PMC7219134]. https://doi.org/10.1530/EC-19-0557.
29. McVeigh J, Bates G, Chandler M. Steroids and image enhancing drugs,
2014 survey results. Liverpool, UK: Centre for Public Health, Liverpool
John Moores University; 2015.
https://doi.org/10.13140/RG.2.1.1227.1608.
30. Eskandarion M, Kheirvari Khezerloo J, Hemmatian S, Tabasi M,
Ghorbani R. Prevalence of anabolic steroids among the male
bodybuilding athletes and rate of awareness to side effects in
shahrud. Iran J Forensic Med. 2019;24(4):1-7. Persian.
31. Zoob Carter BN, Boardley ID, van de Ven K. The Impact of the COVID19 Pandemic on Male Strength Athletes Who Use Non-prescribed
Anabolic-Androgenic Steroids. Front Psychiatry. 2021;12:636706.
[PubMed ID: 33828494]. [PubMed Central ID: PMC8019803].
https://doi.org/10.3389/fpsyt.2021.636706.
32. Al-Hajjaj M, Alam OA, Alqralleh M, Zakkor MD, Almarawi H. An
otherwise healthy male developed COVID-19 disease after the use of
anabolic steroid: The second case report. Ann Med Surg (Lond).
2022;82:104605. [PubMed ID: 36097506]. [PubMed Central ID:
PMC9451928]. https://doi.org/10.1016/j.amsu.2022.104605.
33. Althobaiti YS, Alzahrani MS, Alhumayani SM, Assiry SA, Aljuaid HF,
Algarni MA. Potential Association between the Use of Anabolic
Steroids and COVID-19 Infection. Healthcare (Basel). 2022;10(2).
[PubMed ID: 35206811]. [PubMed Central ID: PMC8872191].
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