The authors also found that overweight and obese girls had significantly greater odds of using protein powders or shakes than girls of average BMI.
After adjusting for all covariates, the authors found high school boys were 70 percent more likely than other participants to use protein shakes and powders and other muscle-enhancing substances.
Asian males were more likely to use steroids compared with white males, while Asian females had around a greater chance of using steroids or other muscle-enhancing substances.
Both girls and boys who participated on a sports team were significantly more likely to engage in all muscle-enhancing behaviors besides taking steroids and, among girls, other muscle-enhancing substances.
The authors noted that the study sample from a single U.S. state may not be generalizable, and that study measures of muscle-enhancing behavior were self-reported.
Nonetheless, "pediatricians and other healthcare providers should ask their adolescent patients about muscle-enhancing behaviors," they advised. "Healthcare providers should counsel adolescent patients about appropriate exercise, general nutrition, and the lack of efficacy and potential dangers of muscle-enhancement products."
They added that future research could include more detailed assessments of participants' body composition and weight.
