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Teens Want to Bulk Up

Study finds a third think about becoming more toned, having bigger muscles

MONDAY, Aug. 1, 2005 (HealthDay News) -- Nearly a third of adolescent and pre-adolescent boys and girls frequently think about becoming more toned and more muscular, a new study suggests.

The research reveals that while boys may not be as prone as girls to becoming obsessed with weight loss, they are nonetheless similarly vulnerable to developing a different -- and just as serious -- form of body dissatisfaction.

The authors found that, for a small percentage of both boys and girls, this particular body-image issue centers around muscle mass -- leading to the use of poorly understood over-the-counter products such as creatine, growth hormone and protein supplements to enhance performance, strength and muscle definition.

"We tend to think of weight concerns as a female issue, and we tell parents to intervene early if their daughters are overly concerned about their weight," said study author Alison E. Field, an assistant professor at Harvard Medical School who also works in the division of adolescent medicine at Children's Hospital in Boston. "But boys -- and surprisingly girls as well -- can sometimes have a different weight concern that is not about being thinner or about being fat, but are about a desire to have a more toned body and more defined muscles."

In the August issue of Pediatrics, Field and her colleagues report on their work analyzing data that had been collected between 1996 and 1999 concerning physical activity habits, weight concerns and media exposure among more than 10,000 boys and girls drawn from across the United States.

At the start of the study, all the children were between the ages of 9 and 14, most were white, and all were the sons and daughters of working nurses.

Over the course of the three-year study period, all the kids were repeatedly asked about their activity routines, body dissatisfaction, and their use of six specific products they may have used to improve their physical appearance, including protein powders and shakes, creatine, amino acid supplements such as hydroxy methylbutyrate (HMB), the steroid hormone DHEA, growth hormone, and anabolic and injectable steroids.

The boys and girls also indicated how much and what kind of TV they watched each week, and which types of magazines they most often read.

Exploring the potential for media to engender body dissatisfaction, Field and her team found that boys were more likely than girls to watch TV, and to watch sports.

The vast majority of both sexes read magazines -- although the girls tended to read women's, teen, fashion and health/fitness publications, while the boys were much more likely to read sports-related glossies.

The authors found that those girls who did read sports magazines were more likely to use body-enhancing products, as were boys who read men's magazines. The researchers did not, however, find a similar association between TV-viewing habits and the use of such products. Nevertheless, 4 percent of the boys said they went to great strides to look like men and boys they saw in the media, whether on TV or in the movies or magazines.

In terms of actual physical condition, the researchers found that while 23 percent of the boys were either already overweight or at risk for being overweight, only 15 percent of the girls had a similar problem.

Perceptions about body image did not follow the reality, however -- with body dissatisfaction numbers reversed. About 47 percent of the girls revealed body image concerns, compared to 36 percent of the boys. As for wanting more toned or defined muscles, 33 percent of girls and 30 percent of boys were found to be thinking often about the issue.

To this end, girls were more likely than boys to try to shed pounds -- while boys, by contrast, were engaged in efforts to pack them on.

Protein powder or shakes were the most commonly consumed products used to improve appearance, muscle mass, or strength among both boys and girls.

All told, 8 percent of girls and 10 percent of boys said they had used a protein powder/shake in the prior year -- although less than 4 percent of either group had consumed the product frequently. Creatine was used by 4 percent of boys and less than 1 percent of girls, while weekly use of any product was nearly three times more common among boys than girls (5 percent compared with 2 percent).

Field and her team emphasized that it remains unclear whether media-exposure habits are the trigger for, or the reflection of, adolescent body image issues.

But they concluded that the issues themselves -- whether losing weight or increasing muscle mass -- are real and potentially harmful to a significant number of both girls and boys. The frequent use of body-enhancement products, however, remains relatively rare, they noted -- more commonly involving boys than girls.

"Whatever the story, there's really no disadvantage to making young people more aware of what they're seeing," said Field. "It's wonderful if they want to be more physically active, but we don't want them aspiring to looks that are not achievable because it's a downward spiral from trying healthy methods to get there to using less and less healthy means to achieve the goal."

Cynthia Sass, a spokeswoman for the American Dietetic Association, said the kind of body-enhancing supplementation reviewed in the study is exactly the kind of unhealthy tool for achieving muscle growth that needs to be discouraged among adolescents.

"My concern would be that the use of products like those is very widespread, and I'm surprised the numbers in the study aren't even higher," said Sass. "Supplements are easier to get now. You can buy them at grocery stores and corner stores, and some you can get at gas stations, and I have concerns about the use of these products among kids who aren't fully developed yet."

Sass said that if her own work with boys, in particular, is any indication, dangerous supplement use will continue to rise so long as body-image issues proliferate.

"I work with children, teens and college students, and I do see body image disturbances in very young boys who are very concerned about bulging muscles and being big," she said. "Halloween costumes for boys now have ripped abs and huge pecs, and biceps that are actually sewn into the pads of the costumes. This has an effect over time, and I think the manufacturers of products like those in the study are probably aware of this. So these products are going to be more and more in demand."

More information

For more on body image and eating disorders, check out the National Eating Disorders Association.

SOURCES: Alison E. Field, assistant professor, Harvard Medical School, and division of adolescent medicine, department of medicine, Children's Hospital, Boston; Cynthia Sass, R.D., Tampa, Fla., and spokeswoman, American Dietetic Association; August 2005, Pediatrics
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