Can supplements improve sports performance in kids?  Are they legal?  Are they dangerous?  These are the questions I'll try to address.  The best sports performance enhancers for kids are water, sugar (in moderate amounts), and electrolytes.  There is some evidence that caffeine, ephedrine, sodium bicarbonate, and creatine may increase performance however adverse effects can be dangerous.  Anabolic steroids, growth hormone, erythropoietin, and blood transfusions are illegal methods of performance enhancement.  Protein shakes and amino acid supplements are taken with the intention of increasing muscle mass, but there is little evidence that they provide any benefit.  A typical healthy diet usually contains all the protein necessary to build lean body mass.

Amino acids

No proven benefit.  I see this like throwing bricks against a house with a broken wall.  Bricks (amino acids) are necessary for rebuilding the wall (protein) but bricks are plentiful in kids with normal diets.  Exercise (and specifically anaerobic exercise like weight lifting) is necessary to build muscle.  Excess amino acid consumption may lead to kidney stones.

Anabolic steroids

Illegal.  Dangerous. Anabolic steroids build muscle mass but the effects stop when the steroids are stopped.  Most of us have seen sports celebrities who have taken steroids and have seen how steroids can harm sports careers and reputations.

The side effects include:  

• High blood pressure
• High cholesterol
• Abnormal glucose regulation (i.e., diabetes)
• Increased heart disease
• Baldness
• Acne
• Liver damage
• Breast development in males
• Stunted growth in adolescents
• Testicular atrophy
• Heart muscle strain
• Psychiatric effects (i.e., "roid rage") 

Beta-hydroxy-beta-methylbutyrate (HMB)

No proven benefit.

Blood transfusion and erythropoietin

Illegal.  Dangerous.

Caffeine

There is evidence that caffeine increases endurance and improves concentration.  High doses of caffeine (i.e., energy drinks) may be harmful especially in kids not accustomed to consuming caffeine and who are in poor physical condition.  Caffeine has a diuretic effect (increases urine production) that may contribute to dehydration.

Creatine

Limited effect.  Creatine is an organic chemical that helps provide energy to muscle.   Your body creates creatine easily from amino acids and therefore is not essential in the diet.  Additional consumption of creatine may be helpful for some males who are serious weight lifters.  Creatine causes water retention and short-term increases in weight due to this excess water may be confused with gain of muscle mass.  Excess creatine may increase stress on the kidneys.

Ephedrine and pseudoephedrine

Some effect but dangerous!  These over-the-counter medications may increase short-term sports performance but do so at a considerable risk.  These medications stimulate the heart to beat faster and also increase blood pressure. 

Adverse effects:

• Increases heart rate
• Increases blood pressure
• Agitation
• Anxiety
• Tremors
• Sleep disturbance
• Some reports of heart attacks, strokes, and death 

Human growth hormone

Illegal.  No significant benefit.  Dangerous

Iron

No benefit unless you have iron deficiency.  Check with your doctor.  Dangerous in high doses.

Sodium bicarbonate

Minimal (if any) benefit.  Dangerous in high doses.

Vitamins

No benefit unless you have a vitamin deficiency.  Vitamin deficiencies in American children are rare.  Some vitamins are dangerous in very high doses (i.e., vitamin A, niacin)

DrTummy's view

The best sports performance enhancers are adequate water, carbohydrates, and electrolytes.  For kids, adequate water intake is the most important exercise supplement.  For vigorous or long-lasting exercise, sports drinks add sufficient carbohydrates (sugar) and electrolytes.

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