Refined Analysis of a Cross-Sectional Doping Survey Among Recreational Triathletes: Support for the Nutritional Supplement Gateway Hypothesis.

The current literature provides no consensus that nutritional supplements (NS) may provide a gateway to doping. In particular, studies in recreational athletes are lacking. Within a previous cross-sectional empirical study, our group provided first evidence that the use of NS may provide a gateway for the use of doping substances in recreational triathletes. For the present paper, we refine the analysis of the triathletes' survey in order to provide evidence for a NS gateway hypothesis in recreational athletes. A self-report, paper-and-pencil questionnaire was distributed to a sample of 2,997 competitive ironman and half-ironman ( = 1,076; 36.1%) triathletes. The randomized response technique (RRT) was used to assess the 12-month prevalence estimate for the use of doping substances. The prevalence for the use of NS was assessed by using direct questioning. Two-tailed ( = 0.05) large-sample -tests were performed to assess whether the estimated prevalence for the use of doping substances differs significantly between users and nonusers of NS. The 12-month prevalence estimate for the use of doping substances is significantly higher in athletes who report using NS (20.6%) compared to those who do not (11.4%; = 2.595, = 0.0097). The present results are consistent with the hypothesis that the use of NS provides a gateway to the use of doping substances. Therefore, doping prevention concepts should not primarily focus on preventing the use of doping substances , but should start one step earlier, namely by the use of NS.