Use of Nutritional Supplements and Factors Associated with it Among Gym Users in Ajman UAE

Transcription

1 Use of Nutritional Supplements and Factors Associated with it Among Gym Users in Ajman UAE Mohamad El-Saleh 1*, Ziad Al-Mousa 1, Oubada Al-Kowatli 1, Sayed Mohamad Khalaf 1, Yousef Al-Yousef 1, Jayakumary Muttappallymyalil rd year MBBS students, 2 Department of Community Medicine, Gulf Medical University Ajman, UAE. *Presenting Author ABSTRACT Objectives: This research assessed the proportion of gym users in Ajman, UAE who consume nutritional supplements and factors associated with it. Materials and Methods: This research adopted a cross-sectional study design which focused on a population of gym users in Ajman, UAE who are 18 years or older. A total of 267 gym users participated in the research. Information required to achieve the objectives was collected using an interviewer-administered questionnaire which covered domains such as socio-demographic characteristics, type of gym activities, and type of exercise performed, reasons for supplement use as well as sources of information about supplements. Data analysis was performed using SPSS version 21. Descriptive and inferential statistics were done. Chi-square test was done to determine the associated factors. Results: This study was conducted among 267 gym users from four gyms in Ajman, UAE. The proportion of gym users that used nutritional supplements was found to be 39.7%. Common nutritional supplements used were protein powder (55 %), and energy supplements (35.8%). Majority of the participants (253(96.6%)) reported that people use supplements for muscle building followed by 230 (87.8%) to boost their energy. Majority of the participants (177(68.1%)) received information from media/health magazines. Statistically significant association was observed between participants level of education and use of nutritional supplement. There was no statistically significant association between age, gender, nationality and level of BMI, and the use of nutritional supplements. Conclusion: Of the 267 participants, around 40% were supplement users. Majority of the participants believe that nutritional supplements are used for muscle building, and the second highest proportion believes that they are energy boosting. Only level of education showed an association with use of nutritional supplement. Keywords: Nutritional supplement, factors, gym users Page 6

2 INTRODUCTION A nutritional supplement is a product containing vitamins, minerals, or proteins intended to enhance or bridge the gap in a person's diet. Nutritional supplements may be found in many forms, such as tablets, capsules, powders, or liquids 1. In the modern world the demand for nutritional supplements is on the increase. Nutritional supplements claim to enhance both mental and physical energy. There are many brands and choices available in the market today. In the past few decades, nutritional supplements have played a vital role in the day to day life of youth and adults 2. Attributed to heighten mental vigor or to provide a swift energy boost, these nutritional supplements have become easily available, accessible and acceptable to the gym users 3,4. Nutritional supplements are basically proteins or pharmacological preparations of carbohydrates or fats and not food substances 5,6. Typically, they are offered in forms such as powders, pills, or capsules. Although they are used by many people from different demographics, it is abundantly clear that they are mostly purchased by those engaged in sports activities 7. It is commonly known that a well-balanced diet is sufficient for a person s protein requirement 8. However the usage of nutritional supplements continues to rise. Nutritional supplements are endorsed by and marketed for their stimulant effects and unsubstantiated claims offering an array of advantages including enhanced physical and mental acuity, performance, endurance, and weight loss. The irrational use of nutritional supplements carries several health risks, some of which require admittance to the intensive care unit, such as sympathetic nervous system stimulation, peripheral neuropathy or myopathy, hypertensive reaction, gastrointestinal disturbance, blood coagulation abnormalities, central nervous system depression. Several reputable organizations in the U.S. and Canada do not recommend the use of nutritional supplements, as they say that a well-balanced diet contains all the nutrients that a person requires 9. But around three million people have been reported to be using sports enhancing supplements in the U.S The Asia-Pacific market is growing rapidly in the sale of supplements. Japan is the largest consumer, followed closely by China. By 2017 the dietary supplement market in India is expected to grow by 70%. Russia is the largest consumer of dietary supplements in Eastern Europe. By 2017, Russia is expected to have a 20% market share 12. In the time period between 2007 and 2011, the dietary supplement market was the fastest growing market in natural pharmaceuticals in the Middle East and North Africa. The proteins and peptides market was the largest segment of that market in the MENA region 12. This study on nutritional supplement consumption among gym users will bring to light a great deal of information about a topic that has not been researched in this part of the country before, and has barely been researched in the Middle East. Moreover, the information will be very important to nutrition educators as they will have more evidence to back up their theories when helping people with their diets. The present study was conducted to assess the proportion of nutritional supplement consumers and reasons for use among gym goers in Ajman, UAE. MATERIALS AND METHODS This cross-sectional study was conducted among 267 adult gym goers in four gyms in Ajman, U.A.E. Gym users in the past one month above 18 years old, of both genders, and of any nationality who give a signed consent were included in the research. Convenience sampling technique was adopted to recruit the participants. An interviewer-administered questionnaire was used as the instrument to collect the data needed to achieve the objectives of the study. The questionnaire covered the following domains: Socio-demographic characteristics like age, gender, nationality, education, marital status and occupation- and kind of supplement used by the participant (protein powder, vitamins/minerals, weight loss supplements, creatine, casein protein, whey protein, energy supplements, weight gainers, or isotonic drinks); Reasons for supplement Page 7

3 use: reason for starting use (to lose weight, build muscles, boost his/her energy, to cover for a nutritional deficiency, prevent a disease, improve performance, replace a meal, to decrease stress); Information about the supplements: source of information, level of knowledge about it and source of supplements. Face and content validity of the draft questionnaire was determined by 2-3 experts in the field of public health. After modification a pilot study was conducted among 5-10 gym users to finalize the questionnaire. After receiving the approval from the ethics and research committees to perform the study, permission was taken from the gym owners and administrators of several gyms in Ajman to recruit participants. The interviewers ensured that all participants recruited for the research received adequate verbal information about the purpose, and relevance of the study. The participants who did not wish to participate in the research had the opportunity to refuse participation. Informed consent was taken from all participants who fulfilled the inclusion criteria. Then interviewer-administered questionnaire was used to collect the data needed to cover the study objectives. Anonymity was maintained by not collecting any information that might reveal the subject s identity. On achieving the sample size and collecting enough data, the data were entered on an Excel sheet. The data collected were analyzed using the SPSS version 21 software. Descriptive and analytical statistics were used to express the results. Chisquare test and Fisher exact test were used to ascertain the association between initiation of nutritional supplements and independent variables. RESULTS The present study was conducted among 267 gym goers in Ajman, UAE to assess the utilization of nutritional supplements and factors associated with its use among them. Table 1: Distribution of Socio-demographic characteristics of Participants (N= 267) Socio-demographic Characteristics Groups No. % Age in years <=20 years Gender Nationality (As per WHO categorization) Education BMI years years years Male Female South East Asian region Eastern Mediterranean region African region Others Higher Secondary Undergraduate Postgraduate < Table 1 shows the distribution of participants by their socio-demographic characteristics. Most of the participants were aged 20 to 30 years, 48.3% (129), then those aged 30 to 40 years, 21.3% (57) which almost equals to the proportion less than 20 years old which is 20.6% (55), the lowest number of participants is aged above 40 years, 9.7% (26). Most of the participants are males 88.4% (236) and 11.6% (31) females. Most of the participants 63.3% (169) are from the Eastern Mediterranean region, 27.3% Page 8

4 (73) South East Asians, 4.9% (13) Africans and 4.5% (12) are from other regions. With regard to education, it shows that highest proportion of participants, 38.6% (102) are under graduates, 37.9% (100) with higher secondary education and the rest 23.5% (62) are post graduates. BMI of the participants show that 44.5% (119) have a BMI that ranges from 25.0 to 29.9, 42.6% (114) in the range15.5 to 24.9, and the group with BMI more than or equals to 30 is 8.7% (32) and only two (0.007%) have BMI less than or equal to Among the total participants 106 (40%) use nutritional supplement (Figure 1). 161, 60% 106, 40% Yes No Figure 1: Distribution of participants by nutritional supplement consumption (N=267) % % 32.1% 21.7% 19.8% 17% 13.2% 8.5% 6.6% 3.8% 0 Figure 2: Distribution of participants according to type of nutritional supplement consumption (N=106) The number one listed supplement was protein powder with (55%) participants consuming it, followed by energy supplements (35.8%), whey protein (32.1%), creatine (21.7%) and casein protein by (19.8%). Page 9

5 Table 2: Reasons and source of information on nutritional supplements (N=267) Reasons and Recommendation Reasons for use of nutritional supplements Sources of information of nutritional supplements Groups No. % Weight loss Muscle Building Energy Boosting Cover for Nutritional Deficiency Prevent Disease Improve Performance Replace a Meal Decrease Stress Gym trainers Doctors/Medical Professional Media/Health Magazines Friends/Co-gym users Family/Relatives Participants were inquired about the reasons for use of nutritional supplements. Majority 253(96.6%) of the participants reported that people use for muscle building followed by 230 (87.8%) to boost their energy, 228(87%) to improve performance, and 165 (63%) reported that it may tackle nutritional deficiency. Majority 177(68.1%) of the participants received information from media/health magazines followed by family and relatives 170(63.7%), and gym trainers 150 (57.3%). Table 3: Association between participants Socio-demographic characteristics and Nutritional Supplement use (N=267) Sociodemographic Characteristics Groups Use of Nutritional Supplements Yes No No. % No. % p value Age <=20 years NS years years >40 years Male NS Gender Female Nationality South East Asian region Eastern Mediterranean region NS African region Others Higher Secondary Education Undergraduate Postgraduate < BMI NS Page 10

6 Table 3 shows the association between the participants Socio-demographic characteristics and the use of nutritional supplements. It was observed that the largest percentage of supplement users were 20 years old or younger, 49.1%. The next largest number of supplement users was in the age range of years old with a frequency of 53, and a percentage of 41.1%. The least percentage of nutritional supplement users was reported to be in the greater than 40 year old group, 6 participants 23.1%. There was no statistically significant association between age and the use of nutritional supplements. Majority of the participants in the study were males and among males, 93 (39.4%) reported using nutritional supplements. Among females 13(41.9%) reported using nutritional supplements. No statistically significant association was observed between gender and use of nutritional supplements. The largest percentage of nutritional supplement users in the present study was from the South East Asia region which accounts for 46.6%. The second highest percentage observed was from African region, 46.2%. There was no statistically significant association between nationality and the use of nutritional supplements. The largest proportion of supplement users was found to be people with undergraduate level of education, 44.1% or with secondary school education 44%. The lowest percentage of participants reporting supplement use was those in the postgraduate category with only 25.8%. The association observed was statistically significant. The majority of participants who consumed nutritional supplements fell into the BMI range and , 43% and 41.2% respectively. Of the participants with BM1>30, 25% reported using nutritional supplements. There was no statistically significant association between BMI and nutritional supplement usage. DISCUSSION This research explores the proportion of nutritional supplement use among gym users in Ajman, UAE. In the current study, most participants were in the years group of age which is consistent with the results of El Khouryet al. 11 and Gostonet al. 14 who reported that most of the participants were 30 years of age or younger, this shows the similarity in the gym going population. More than half of the participants in our study have higher secondary and under graduate education while in the study in Beirut city 11 most of them were with undergraduate degree. While in the study in Brazil 14 more participants were with undergraduate education. This can be explained by the difference in work and education opportunities in different countries. This shows that majority of the youth use gym as compared to the adults. In the present study the largest percentage of nutrition supplement users falls within the age group less than 30 years. This is in line with the findings from Khoury et al. 11 and the findings of Gostonet al. 14, reported that 39.2% use nutritional supplements among the gym users as compared to our 49% in the same age range. A possible explanation may be the smaller sample size of our study, and that the gyms in our study are situated close to two major universities, where the surrounding area would be inhabited by university students. Unlike Khoury et al, our study shows no significant relation between gender and supplement use. Furthermore, our results show a smaller percentage of men using nutritional supplements than what has been reported in their study 11. This may be explained by the smaller sample size of our study showing us an incomplete picture of the reality. However, our results are in accordance with Goston et al. 14 The discrepancies in the use of nutritional supplement in studies could be explained by the different types of gyms included in the research, the varying socio-demographic characteristics of participants, and over or under-reporting of the nutritional supplement use. Comparing the results for the females will not yield any significant results due to the very small number of female participants and the large rejection rate of females for participation in our study. It is clear from our data that the large majority of our participants who reported supplement usage were holders of secondary school degrees or undergraduate degrees. This falls in line with the results of Khoury et al, who reported Page 11

7 that 59.1% of supplement users had bachelor degree 11. This can again be explained by the fact that the gyms chosen for the study were close to two major universities, which would skew the results in favor of participants who held secondary school degrees or undergraduate degrees. Young participants may use nutritional supplement to maintain body shape and health. In the present study majority of the participants reported that their sources of information about nutritional supplement were family and relatives whereas in studies conducted in Lebanon, East Carolina and Germany reported that majority obtained information from either a physician or from a dietician 10,15, 16. A study conducted in Italy reported that 10% of the participants received information on nutritional supplements from physicians. In another study conducted in Lebanon reported that they relied on the media as sources of information 11. Bianco et al. reported that majority of the participants obtained information from internet and print media 17. Study in Germany also found that over half of its participants obtained information from pharmacies and physicians 16. A study in Italy found that only 13% obtained information from physicians 17. A study conducted in Nebraska reported that majority obtained their information on supplements from family members 18.This discrepancy in the observation related to the sources of information could be attributed to limited access to the varied sources of information. But it shows that many use supplements without proper evaluation and recommendation by experts. Limitations of the study include, information on use of nutritional supplement is self-reported and assumes that the participants answered accurately and honestly, and the results may not be generalizable to the entire gym goers because of the small sample size and the non-representative sampling. CONCLUSION The proportion of gym users that consumed nutritional supplements was found to be 39.7%. Participants who were less than 30 years had a higher percentage of nutritional supplement use (49.1%) than any other age group. The most significant factor related to use of nutritional supplements appears to be education level, with least use among postgraduate degree holders. Association between age, gender, nationality, and level of BMI were not found to be statistically significant. A nation-wide research may be conducted to achieve a generalizable result and to obtain more information (Gender difference, availability, accessibility) about nutritional supplement use and factors associated with it. REFERENCES 1. FDA.gov,. What is a dietary supplement? [online] Available from:url:: [Accessed 2 Jun. 2014]. 2. Fuhrman E. State of the industry. Beverage Industry. 2006;97: Carvajal-Sancho A, Moncada-Jimenez J. The acute effect of an energy drink on the physical and cognitive performance of male atheletes. KinesiolSlovenica. 2005;11: Food Safety Promotion Board. A review of the health effects of stimulant drinks Available from: URL: www. safefoodonline.com/ safefood/ Uploads/ health_effects. pdf.. [Accessed 5th October 2014] 5. The World Bank. Population Data. Available from: URL: (Accessed 2 June, 2014) 6. U.A.E. Interact. Available from: URL: 0_and_Emiratis_account_for_16/46426.htm (accessed 2 June 2014) 7. Schroder U. Health effects of nutritional supplements, in Health and Doping Risks of Nutritional Supplements and Social Drugs, Schanzer W, Delbeke FT, Deligiannis A, Gmeiner G, Maughan R, and Mester J, Eds., Sport and BuchStrauB: Cologne, Germany; pp Maughan RJ, King DS, T. Lea T. Dietary supplements Journal of Sports Sciences 2004;22(1) The American heart Association. The American Heart Association Diet and Lifestyle Recommendations. Available from: URL: Page 12

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