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Ganson KT, Sinicropi E, Nagata JM. Analyzing Social Media Policies on Muscle-Building Drugs and Dietary Supplements. Subst Use Misuse 2024; 59:380-387. [PMID: 37919881 DOI: 10.1080/10826084.2023.2275557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
BACKGROUND Use of legal and illegal muscle-building drugs and dietary supplements has been linked to many adverse health and social outcomes. Research has shown that social media use is associated with the use of these drugs and dietary supplements; however, it remains unknown whether social media companies have specific policies related to the content and advertising of muscle-building drugs and dietary supplements on their platforms. Therefore, this study aimed to assess the content and advertising policies of eight popular social media companies related to muscle-building drugs and dietary supplements. METHODS Content and advertising policies for YouTube, TikTok, Instagram, Snapchat, Facebook, Twitter, Twitch, and Reddit were analyzed in November 2022 to determine whether there were any provisions related to legal (e.g., whey protein) and illegal (e.g., anabolic-androgenic steroids) muscle-building drugs and dietary supplements. Policies were classified as either none, restricted, or prohibited. RESULTS All eight social media platforms had explicit policies prohibiting user-generated content and advertising of illicit drugs and substances (e.g., anabolic-androgenic steroids). User-generated content and advertising policies related to legal muscle-building dietary supplements across the platforms varied; however, none of the eight social media companies had a specific policy regarding user content. CONCLUSIONS Findings underscore the need for stronger social media content and advertising policies related to legal muscle-building dietary supplements.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Eliana Sinicropi
- Munk School of Global Affairs and Public Policy, University of Toronto, Toronto, ON, Canada
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
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Ganson KT, Nagata JM. Surveys on androgen abuse: a review of recent research. Curr Opin Endocrinol Diabetes Obes 2023; 30:291-299. [PMID: 37603040 DOI: 10.1097/med.0000000000000833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
PURPOSE OF REVIEW To summarize recent survey research on androgen abuse [i.e., anabolic-androgenic steroids (AAS)], including prevalence among international samples, risk factors for use, associated impairments of use, and treatment and interventions for abusers. RECENT FINDINGS Recent research has documented the prevalence of androgens abuse remains most common among boys and men compared to girls and women, which was stable across nations. However, fewer studies have focused on population-based samples and instead focused on convenience or high-risk samples (i.e., gym goers). Androgen abusers commonly report a history of violent victimization, including adverse childhood experiences. Research continues to document many adverse biological, psychological, and social effects related to androgen abuse, including more than 50% of abusers reporting at least one side effect. Mental health problems and polysubstance use continues to be highly prevalent among androgen abusers. Despite these adverse effects from use, there remains little survey research on treatment and interventions for androgen abusers, representing an important area of future investigation. SUMMARY Androgen abuse remains relatively common, particularly among boys and men, with adverse health effects regularly occurring. Healthcare professionals and systems can adapt their treatment approaches to focus on reducing harms associated with androgen abuse.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
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Tschampl CA, Lee MR, Raffoul A, Santoso M, Austin SB. Economic Value of Initial Implementation Activities for Proposed Ban on Sales of Over-The-Counter Diet Pills and Muscle-Building Supplements to Minors. AJPM FOCUS 2023; 2:100103. [PMID: 37790657 PMCID: PMC10546557 DOI: 10.1016/j.focus.2023.100103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction Over-the-counter diet pills, weight-loss supplements, and muscle-building supplements often contain harmful ingredients and are associated with eating disorder diagnoses and other negative health outcomes. This study estimated the value of state initial implementation activities, for example, regulation development, to implement a ban on the sale of dangerous over-the-counter diet pills and muscle-building supplements to minors. Methods We enumerated minimum, best, and maximum values for 22 inputs among 11 activities state employees may undertake if the legislation were signed into law. For employment costs, we estimated staff hours on the basis of data from 10 key informants and obtained salary ranges from a state government website. Data were collected and analyzed between September 2021 and January 2022. We calculated 95% CIs using 10,000 Monte Carlo simulations that varied inputs simultaneously and probabilistically. We conducted two sensitivity analyses using all minimum and all maximum salaries. Results The estimated value of state start-up activities was $47,536 (95% CI=$36,831-$57,381). Inputs with the largest impact on this estimate corresponded to combinations of the highest salary and greatest hours per task. Conclusions The state's one-time opportunity cost to initiate this age-restriction policy would be minimal considering potential health gains. Sensitivity analyses did not change the conclusion, especially if the state produces subregulations linked to existing law rather than new regulations.
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Affiliation(s)
- Cynthia A. Tschampl
- The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Mary R. Lee
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Amanda Raffoul
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Monique Santoso
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - S. Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Hewlings SJ. Eating Disorders and Dietary Supplements: A Review of the Science. Nutrients 2023; 15:2076. [PMID: 37432190 DOI: 10.3390/nu15092076] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/15/2023] [Accepted: 04/24/2023] [Indexed: 07/12/2023] Open
Abstract
Disordered eating is a serious health concern globally. The etiology is complex and multidimensional and differs somewhat for each specific eating disorder. Several risk factors have been identified which include psychological, genetic, biochemical, environmental, and sociocultural factors. Poor body image, low self-esteem, teasing, family dynamics, and exposure to media images have also been identified as risk factors. While it is enticing to consider a single behavioral risk factor, doing so fails to consider the documented environmental, social, psychological, biological, and cultural factors that contribute to the development of an eating disorder in a multidimensional and complex integration that is undoubtedly unique to everyone. Focusing only on any one factor without taking the complex etiology into account is remiss. For example, it has been suggested that the use of dietary supplements may lead to eating disorders, despite a lack of evidence to support this conjecture. Therefore, the purpose of this review is to examine the evidence-based risk factors for eating disorders and discuss why connecting dietary supplements to eating disorder etiology is not supported by the scientific literature and may interfere with treatment. Established, effective prevention and treatment approaches for eating disorders should be the focus of public health initiatives in this domain.
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Affiliation(s)
- Susan J Hewlings
- Nutrasource Pharmaceutical and Nutraceutical Services, Inc., Guelph, ON N1G 0B4, Canada
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Ganson KT, Testa A, Rodgers RF, Jackson DB, Nagata JM. Muscle-Building Exercise and Weapon Carrying and Physical Fighting Among U.S. Adolescent Boys. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:2566-2584. [PMID: 35546543 PMCID: PMC9850380 DOI: 10.1177/08862605221101192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study aimed to determine the association between engagement in muscle-building exercise and weapon carrying and physical fighting among adolescent boys. Cross-sectional data from the 2019 Youth Risk Behavior Survey (U.S.) were analyzed (N = 4120). Muscle-building exercise was assessed based on the number of days reported in the past 7 days, recategorized into four levels of engagement (no engagement [0 days], low engagement [1-2 days], moderate engagement [3-5 days], and high engagement [6-7 days]). Three forms of weapon carrying (general, on school grounds, gun carrying) and two forms of physical fighting (general, on school grounds) were assessed. Five logistic regression analyses with adjusted odds ratios (AOR) and 95% confidence intervals (CI) were used to determine the association between engagement in muscle-building exercise and weapon carrying and physical fighting, while adjusting for relevant demographic and control variables. Over 75% of participants reported engaging in muscle-building exercise. One in five (19.8%) participants reported any general weapon carrying in the past 30 days, 3.3% reported any weapon carrying at school in the past 30 days, 6.5% reported any gun carrying in the past 12 months, 28.0% reported any general physical fighting in the past 12 months, and 10.7% reported any physical fighting at school in the past 12 months. Logistic regressions showed that, compared to no engagement, participants who reported high engagement of muscle-building exercise had higher odds of general weapon carrying (AOR 2.18, 95% CI 1.54-3.07), gun carrying (AOR 2.12, 95% CI 1.23-3.64), and general physical fighting (AOR 2.07, 95% CI 1.53-2.79). These are novel findings that add to a growing literature related to engagement in muscularity-oriented behaviors among males. Prevention and intervention efforts are needed to ensure that adolescent boys engage in muscle-building exercise in ways that are not harmful and to reduce weapon carrying and physical fighting.
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Affiliation(s)
| | - Alexander Testa
- University of Texas Health Science Center at
Houston, Houston, TX, USA
| | - Rachel F. Rodgers
- Northeastern
University, Boston, MA, USA
- Lapeyronie
Hospital, CHRU Montpellier, France
| | - Dylan B. Jackson
- Johns Hopkins Bloomberg School of Public
Health, Baltimore, MD, USA
| | - Jason M. Nagata
- University of
California, San Francisco, San Francisco,
CA, USA
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Ganson KT, Hallward L, Cunningham ML, Murray SB, Nagata JM. Use of Legal Appearance- and Performance-Enhancing Drugs and Substances: Findings from the Canadian Study of Adolescent Health Behaviors. Subst Use Misuse 2023; 58:289-297. [PMID: 36576273 DOI: 10.1080/10826084.2022.2161318] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Use of appearance- and performance-enhancing drugs and substances (APEDS) is common among adolescent and young adults. Many APEDS are legally sold "over-the-counter," however research has documented contamination of legal APEDS and many adverse effects of use. Despite this, little research has been conducted on legal APEDS use in Canada, particularly regarding the prevalence and sociodemographic predictors of use, which was the aim of this study. METHODS Data from the Canadian Study of Adolescent Health Behaviors (N = 2,731) were analyzed. Prevalence and frequency of use of 10 common APEDS in the past 12 months were estimated overall and across genders. Multiple modified Poisson regression analyses were conducted to determine the sociodemographic predictors of APEDS use. RESULTS Overall, use of caffeine was most common among the sample (71.3%), along with protein bars (63.4%), and whey protein powders or protein shakes (63.1%). Boys and men reported greater prevalence of use of eight of the 10 APEDS, with the exception of diuretics or water pills and probiotics, compared to girls and women and transgender/gender non-confirming participants. Over three quarters (82.5%) of boys and men reported use of whey protein powders or protein shakes and 50.3% reported use of creatine monohydrate. Use of APEDS varied based on several key sociodemographic identifiers. CONCLUSIONS This study is the first to document legal APEDS use among a sample of Canadian adolescents and young adults, providing important implications for health care and policymaking professionals. Further research is needed to gain greater insight into APEDS use among Canadian young people.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Laura Hallward
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada.,School of Kinesiology, Western University, London, Canada
| | | | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
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Nagata JM, Grandis A, Bojorquez-Ramirez P, Nguyen A, Downey AE, Ganson KT, Patel KP, Machen VI, Buckelew SM, Garber AK. Assessment of vitamin D among male adolescents and young adults hospitalized with eating disorders. J Eat Disord 2022; 10:104. [PMID: 35851069 PMCID: PMC9295348 DOI: 10.1186/s40337-022-00627-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 06/29/2022] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Medical complications of eating disorders in males are understudied compared to females, as is the case of vitamin D deficiency. The aim of this study was to assess vitamin D levels among male and female adolescents and young adults hospitalized for medical complications of eating disorders. METHODS We retrospectively reviewed electronic medical records of patients aged 9-25 years (N = 565) admitted to the University of California, San Francisco Eating Disorders Program for medical instability, between May 2012 and August 2020. Serum vitamin D (25-hydroxy) level was assessed at admission as was history of prior calcium, vitamin D, or multivitamin supplementation. Linear regression was used to assess factors associated with vitamin D levels. RESULTS A total of 93 males and 472 females met eligibility criteria (age 15.5 ± 2.8, 58.8% anorexia nervosa; admission body mass index 17.6 ± 2.91). Among male participants, 44.1% had 25-hydroxyvitamin D levels < 30 ng/mL, 18.3% had 25-hydroxyvitamin D levels < 20 ng/mL, and 8.6% had 25-hydroxyvitamin D levels < 12 ng/mL. There were no significant differences in 25-hydroxyvitamin D levels in males compared to females, except that a lower proportion (1.9%) of female participants had 25-hydroxyvitamin D levels < 12 ng/mL (p = 0.001). Only 3.2% of males reported calcium or vitamin D-specific supplementation prior to hospital admission, while 8.6% reported taking multivitamins. White race, prior calcium/vitamin D supplementation, and higher calcium levels were associated with higher vitamin D levels on admission. CONCLUSIONS Nearly half of patients admitted to the hospital for malnutrition secondary to eating disorders presented with low 25-hydroxyvitamin D levels; males were more likely than females to have severe vitamin D deficiency. These findings support vitamin D assessment as part of the routine medical/nutritional evaluation for hospitalized eating disorder patients, with particular attention on male populations.
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Affiliation(s)
- Jason M Nagata
- Department of Pediatrics, University of California, 550 16th Street, 4th Floor, Box 0110, San Francisco, CA, 94143, USA.
| | - Anna Grandis
- Department of Pediatrics, University of California, 550 16th Street, 4th Floor, Box 0110, San Francisco, CA, 94143, USA
| | | | - Anthony Nguyen
- Department of Pediatrics, University of California, 550 16th Street, 4th Floor, Box 0110, San Francisco, CA, 94143, USA
| | - Amanda E Downey
- Department of Pediatrics, University of California, 550 16th Street, 4th Floor, Box 0110, San Francisco, CA, 94143, USA.,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, 94143, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Khushi P Patel
- Department of Pediatrics, University of California, 550 16th Street, 4th Floor, Box 0110, San Francisco, CA, 94143, USA
| | - Vanessa I Machen
- Department of Pediatrics, University of California, 550 16th Street, 4th Floor, Box 0110, San Francisco, CA, 94143, USA
| | - Sara M Buckelew
- Department of Pediatrics, University of California, 550 16th Street, 4th Floor, Box 0110, San Francisco, CA, 94143, USA
| | - Andrea K Garber
- Department of Pediatrics, University of California, 550 16th Street, 4th Floor, Box 0110, San Francisco, CA, 94143, USA
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