Not so long ago, shopfronts filled with rows of gaudy coloured plastic barrels boasting the potential of “extreme gains” and “shredded” or “ripped” physiques were a high street rarity. In 2019, they are as common as the corner store, replete with a dizzying array of products promising to dissolve body fat, build muscle and help you work out harder, for longer.
But the industry came under a cloud last month when the Australian swimmer Shayna Jack suggested her recent positive drug test may have been the result of contaminated sports supplements.
So what is in those barrels? Who uses such products? And how dangerous are they?
Sports supplements include an array of substances from run-of-the-mill multivitamins to complex concoctions that purport to build muscle and increase speed. The simplest and most common of these is protein powder – usually whey protein from cow’s milk, but varieties have expanded in recent years to include soy, pea, hemp, rice, and even sweet potato proteins – which assist in muscle repair after a strenuous workout. Other common sports supplements include creatine and amino acids for muscle energy, performance-enhancing “pre-workouts” and fat burners, also known as thermogenics, which supposedly increase the body’s metabolism to burn fat.
Sports supplements are not just taken by Olympic athletes and AFL players. The primary market for sports nutrition products is males aged between 19 and 30. The Australian gym and fitness industry is now worth about $2.5bn, and the market share of vitamin and supplements stores has grown alongside it, with bricks and mortar stores worth about $533.5m and online sales worth $159.2m, according to IbisWorld.Together they represent a corporate juggernaut fuelled by the idolisation of sports stars on one hand and the cultural obsession with fitness and a particular Instagrammable aesthetic on the other.
The giant tubs of protein powder and little sachets of formula have their cultural roots in the world of bodybuilding. With their cartoonishly large muscles, fake tan and oiled up flex-poses, bodybuilders may seem a long way from Olympic swimming, but the small group of (mostly) men who pioneered the modern incarnation of the sport on Muscle Beach, California, in the 1960s and 1970s sparked a massive shift in physical ideals perceived by people across the western world. The aesthetic of a particular kind of physique and body-fat-to-muscle ratio – representing a kind of exaggerated masculine and feminine – have permeated all aspects of contemporary physicalculture, primarily through Hollywood. And fitness practices have followed suit.
In bodybuilding, supplementation is king. Mike Debenham, a personal trainer and retired professional bodybuilder (he was three times crowned Mr New Zealand) told Guardian Australia supplements played a critical role during the 23 years he competed.
“When I was competing I rattled when I walked because there were so many supplements going through me,” he says. “It was just dependent on what time of day it was as to what I would take. The list would be as long as my arm.”
As he rose through the ranks of the sport, he was sponsored by various supplement companies who would provide products free or at very little cost. He eventually opened his own supplement store franchise on the Sunshine Coast in 2012.
He says the average consumer was interested in “the next best, greatest pre-workout”, often ignoring basics like nutrition. He says the practice of trying to find a quick fix made people more likely to take risks.
“Protein powder’s protein powder. It’s been around for 40 years and it will be around for another 40 years,” he says. “But it’s those pre-workouts and fat burners that seem to be the real crux of the industry in the supplements era. People come in and they go, ‘what’s the strongest, best, hottest pre-workout you have?’”
Clint Hill, 40, who has worked for 23 years as a specialist strength and conditioning coach for professional and semi-professional sportspeople as well as the general population, also names pre-workouts as the area in which muscle-hungry gym junkies were most enthusiastic.
“I’ve seen incredibly diligent people get amazing effects by the use of supplements, even caffeine, to get a result in the gym. It can be done very well. The other side of it is that people can take everything that their mate told them to take rather than getting proper advice,” he says.
Much like vitamins, the effectiveness of supplements is often disputed, and depends on many things including the supplement, the individual and the context in which it’s taken. While most people who use them will probably have no major adverse effects, sports supplements have occasionally been deadly.
In Australia, sports supplements generally fall within the purview of the Therapeutic Goods Administration, though classification is complex. It takes into consideration things like each product’s ingredients, the claims being made about it, the way it’s labelled, and the form in which it comes (eg. pills, powder, bars, etc). The products must be either “listed” or “registered” with the TGA depending on their risk level. Manufacturers must comply with particular principles, and those products classified as “low-risk” can only contain active ingredients from a TGA pre-approved list.
Evaluation and oversight of the manufacturers, however, is the job of the product’s “sponsor” – that is, the person legally responsible for it being in Australia. The TGA does randomly audit manufacturers and products for compliance, as well as in response to complaints or reports of adverse events. But there have been multiple incidents of contaminated products or products with unlisted ingredients making their way to market. Many products bought over the internet from overseas-based sites are not TGA regulated, and the TGA has repeatedly issued warnings about quality control and safety of these products.
The New South Wales health authority issued warnings in 2018 about workout supplements that contained the chemical 2,4-dinitrophenol (DNP), saying it had contributed to deaths locally and overseas. Other contaminants that have been found in supplements include methylhexaneamine (DMAA), which the TGA made illegal in 2012 due to concerns that it could be lethal, and the structurally similar compound 1,3-dimethylbutylamine (DMBA). Asada warned athletes in 2014 that DMBA may have been replacing DMAA in off-the-shelf supplements after the TGA ban. DMBA itself was banned in 2017.
Even apparently innocuous substances can be dangerous. West Australian Meegan Hefford, 25, an aspiring bodybuilder, died earlier this year after a rare genetic condition left her body unable to cope with her extremely high-protein diet, which included protein supplements, resulting in a toxic build-up of nitrogen in her system. On New Year’s Day in 2018, Lachlan Foote, 21, died at his home in Blackheath, NSW, from caffeine toxicity after including pure caffeine powder in a protein shake he consumed after a night out. The US Food and Drug Administration last year issued a warning about pure caffeine powder after it had been linked to two deaths, saying a teaspoon could contain the equivalent of 28 cups of coffee.
The particular subset of drug that Shayna Jack tested positive for was a selective androgen receptor modulator (SARM), developed to treat muscle wasting diseases. All SARMs are classified as Schedule 4 controlled substances by the TGA in Australia, which means they require a prescription. Nevertheless, bodybuilders and other athletes have been known to procure them. Asada issued a warning to athletes in November last year about Ligandrol. It has also repeatedly warned athletes over the past decade about the potential for supplements to contain unlisted and banned ingredients.
Hill, who has been involved with Asada and Wada’s clean sport program and drug testing at both a professional and semi-professional level, says the information and communication from the anti-doping bodies has been very clear, particularly for professional sportspeople.
“It’s very difficult to believe anyone would put themselves in a situation where they didn’t ask everything they could about a supplement they were taking,” he says.
Debenham sold his supplements store after only a few years, partly because he believed that most players in the industry did not take consumer safety and product integrity seriously enough.
In comments echoed by Hill, Debenham says there are a few supplement companies using only local ingredients, and some that batch-tested routinely to prevent contamination and to be able to market themselves to professional sporting bodies as a trusted product. But these companies are the exception.
“People are always trying to push the limits and some supplement companies will try and ride that knife’s edge.”