Over half of adults use at least one nutritional supplement, and up to 100% of athletes depending on the population. Supplement use is expected to continue to grow, even extending into youth. Due to weak regulation of nutritional supplements on the market athletes are at risk of unknowing exposure to unsafe substances which could pose a risk to safety and threaten eligibility; third-party tested nutrition supplements are seen as a safer alternative. Data suggests athletes acknowledge it is important to know if supplements are tested for banned substances, yet a large percentage of athletes use supplements that are not third-party tested; this brings up the question, why? A validated tool is necessary to help organizations gain insight about this topic to tailor education to athletes' needs. This was a two-part, single cohort survey design validation study using a previously developed nutrition questionnaire composed of 76 questions and 88 items over six themed blocks. In Part 1, reliability was assessed via test-retest method and internal consistency measured using Cronbach's Alpha. In Part 2, face validity was assessed using a focus group.
All participants (N=55) reported the use of at least one nutrition supplement with the most consumed being sports drinks, caffeine, and protein shakes. The questionnaire was found to have a moderate average weighted correlation coefficient of 0.499 and a poor percent match of 37%. Following suggested modifications after initial Round 1 Cronbach's Alpha analysis, the questionnaire would be able to reach an acceptable value of 0.749. Finally, all participants of the focus group reported the questionnaire had too many questions or was too lengthy.
The final suggested version of the questionnaire would include 52 questions reflecting a 32% decrease in length. The questionnaire is customizable in that each block exists on its own and includes an "optional" category. This questionnaire served as an intermediate step towards the development of a shorter questionnaire used to screen athlete behavior as it relates to third-party tested supplements.

Supplement use is common among collegiate athletes, which comes with doping risk. This cross-sectional study aimed to explore differences between male and female use, compliance, knowledge, and/or attitudes toward third-party tested (TPT) supplements. Student-athletes, coming from eight PAC-12 athletic departments (n=725, 49.9% female, 50.1% male, age 20.0+/-1.55), were surveyed addressing demographics, nutrition information sources, supplement knowledge, supplement use, attitudes and barriers toward supplement use, including scales based on the theory of planned behavior (TPB), and third-party tested supplement recognition. Data were reported for the total group and stratified for sex. Sex differences were analyzed using Chi-square tests, with p set for significance at ≤0.05. On average, participants used 8 supplements within the past year. Female athletes reported an average of 7.41 and male athletes reported using an average of 7.34. Overall, 64.6% (n=468) of athletes reported inconsistent TPT. When split for sex, more female athletes (71.0%, n=257) compared to male athletes (58.1%, n=211) self-reported inconsistent use of third-party tested supplements (p=0.001). Results for supplement use were stratified into three categories: low users (0-3 supplements, ≤25th percentile), average users (4-11 supplements, between 25-50th percentile), and high users (11-30 supplements, >75th percentile). Male student athletes reported a higher frequency of supplement use in the low user category (30.3%, n=110) as compared to females. Female student athletes reported higher supplement use in the average user category (53.3%, n=193). The lowest total frequency across both sexes (26.2%, n=190) was the high user category.
Sports drink was the most frequently reported nutritional supplement used within the total sample (60.8%, n=441), but more so in females (65.5%, n=237) than males (56.2%, n=204) (p=0.011). A large amount of the sample recognized at least one TPT logo 74.8% (n=542), but a lower number of females (69.3%, n=251) than males (80.2%, n=291) recognized one logo (p<0.001). In conclusion, this study did not observe a difference in M/F overall supplement use, but when categorizing for low/medium/high number of supplements used males report more extreme on both ends than females. A higher frequency of female athletes reported inconsistent compliance with TPT supplements. More male than female athletes recognized a TPT logo.

This study investigated the effect of environmental heat stress on physiological and performance measures during a ~4 mi time trial (TT) mountain hike in the Phoenix metropolitan area. Participants (n = 12; 7M/5F; age 21.6 ± 2.47 [SD]) climbed ‘A’ mountain (~1 mi) four times on a hot day (HOT; wet bulb globe temperature [WBGT] = 31.6°C) and again on a moderate day (MOD; WBGT = 19.0°C). Physiological and performance measures were made before and throughout the course of each hike. Mean pre-hike hydration status (urine specific gravity [USG]) indicated that participants began both HOT and MOD trials in a euhydrated state (1.016 ± 0.010 and 1.010 ± 0.008, respectively) and means did not differ significantly between trials (p = .085). Time trial performance was impaired by -11% (11.1 minutes) in the HOT trial (105 ± 21.7 min), compared to MOD (93.9 ± 13.1 min) (p = .013). Peak core temperatures were significantly higher in HOT (38.5 ± 0.36°C) versus MOD (38.0 ± 0.30°C) with progressively increasing differences between trials over time (p < .001). Peak ratings of perceived exertion were significantly higher in HOT (14.2 ± 2.38) compared to MOD (11.9 ± 2.02) (p = .007). Relative intensity (percent of age-predicted maximal heart rate [HR]), estimated absolute intensity (metabolic equivalents [METs]), and estimated energy expenditure (MET-h) were all increased in HOT, but not significantly so. The HOT condition reduced predicted maximal aerobic capacity (CRFp) by 6% (p = .026). Sweat rates differed significantly between HOT (1.38 ± 0.53 L/h) and MOD (0.84 ± 0.27 L/h) (p = .01). Percent body mass loss (PBML) did not differ significantly between HOT (1.06 ± 0.95%) and MOD (0.98 ± 0.84%) (p = .869). All repeated measures variables showed significant between-subjects effects (p < .05), indicating individual differences in response to test conditions. Heat stress was shown to negatively affect physiological and performance measures in recreational mountain hikers. However, considerable variation exists between individuals, and the degree of physiological and performance impairment is probably due, in part, to differences in aerobic fitness and acclimatization status rather than pre- or during-performance hydration status.