"High school athletes who want to perform at the top of their game have a choice: Sweat and practice. Or down some reputed muscle-builders and energy boosters, like Teen Advantage, which Muscle Marketing USA says was "developed specially for aspiring athletes 11-19 years of age. Increasingly, they're doing the latter." For Young Athletes, Limited Gains -- at a High Risk (Post, April 9).

Join Conrad Earnest, Ph.D., director of exercise physiology at the Cooper Institute in Dallas, Tex., to discuss the effects of health supplements on young athletes. Do you know the truth about these products?

Send your questions now or during the discussion.

Editor's Note: Washingtonpost.com moderators retain editorial control over Live Online discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions.

washingtonpost.com: Good afternoon, we would like to welcome our guest Conrad Earnest, Ph.D., director of exercise physiology at the Cooper Institute in Dallas, Tex. and our discussion on supplements and young athletes. Dr. Earnest, do you think there is more pressure on high school athletes to take performance enhancing substances and are these substances banned on this level?

Conrad Earnest, Ph.D.: Thanks for having me here!
In brief, I think that there is more pressure to win in sports in general and the temptation to take both supplements, and even drugs - especially amongst the marquee sports (ie, basketball, football and baseball is great

Arlington, Va.: Is there such a thing as a "good supplement?" I have been reading about things such as Stacker-2 the fat burner and other things. What do these type of supplements do to your body? How do they "work?"

Conrad Earnest, Ph.D.: Yes, there are good supplements; however, I am a bit hesitant about the "fat- burners" given that they contain so many stimulants that may lead to adverse events.

In small doses, these supplements can have some short term benefits (ie, less than 4 wks of use, perhaps)

However, the American publics seems to suffer from a bit of the "self-indulgence, self-medicating" syndrome by reasoning that if a little is good, more is better and they end up taking 10-fold research substantiated doses - ending up sometimes fatal events.

The supplement companies - many at least - also tend to fight for dosing their products to much

Washington, DC: Are there any concerns with adults taking these supplements?

Conrad Earnest, Ph.D.: Which supplements in particular - the arena is pretty broad

Centreville, VA: How can we expect kids to stay off these supplements when the coaches are encouraging their use?

Conrad Earnest, Ph.D.: Tough question and one that requires a fair amount of philosophic and ethical consideration

One can argue that much of the responsibility should fall on the parent and parenting techniques, as it were.

However, there is also a lot if peer and coaching pressure which probably out weighs parental opinion to the child

So, I don't have any magical answers except to say that an open line of communication between coaches, parents, the school and the athletes should be encouraged

Dallas, TX: Obviously there have been many case studies that outline the harmful side-effects of using andro and creatine at the puberic ages that highschoolers represent. But could these harmful side-effects be minimized or lessened if the amount of time on the drug or cycling of the supplement were introduced? If athletes took creatine and stayed well-hydrated, had proper nutrition, does that make it OK for coaches to have them on it?

Follow-up question:
Is it the athletes or coaches that should be the informed ones on what to take, how to take it, and what the risks are for taking performance enhancing drugs, if they need to take it at all?

Conrad Earnest, Ph.D.: This is a tough question
First, andro products are complete waste of time as [a] they do not work (via substantiated research reports) and [b] can be harmful

Creatine is one of the most totally misunderstood products on the market - So much so , that organizations have come out with anit-creatine position statements that are so unscientifically biased, that they are almost laughable

Thus, it becomes a glorified opinion statement of the medical director of that type of program, who is likely just seeking media attention

To your answer, yes, creatine should be "cycled," per se. There is also an abundance of evidence to show that once tissue are saturated that small (< 3g per day) doses are sufficient

Even further, since the body "hold" creatine so well, there is probably no reason to take it more than every other day

Personally, I think having a coach "make" athletes take anything is unprofessional - This should be a joint decision between athletes, coaches and parents

washingtonpost.com: To read more about high school athletes and supplements read the article For Young Athletes, Limited Gains -- at a High Risk .

Springfield, Va.: I agree with you that there is added pressure to "Be Like Mike." I was wondering, in your best estimation, how many kids at the high school level are using supplements to enhance sports performance?

Conrad Earnest, Ph.D.: "research" would suggest that it is about 50-60%
However, kids don't always tell truth and my interaction with area coaches would suggest >80%

One must also define "supplement" - There is a big difference between the extreme of ANDRO versus a multi-vitamin

bethesda,md: A friend of mine has been taking the slacker 2...is there any harmful effects?

Conrad Earnest, Ph.D.: I am not totally sure what is in stacker 2, would you happen to know the ingredients?

Rockville, MD: My son is 14 and is in a year-round high-level swimming program. What role, if any, these products play in addition to a normally balanced diet or a diet appropriate for a teen athlete?

Conrad Earnest, Ph.D.: Some products such as creatine, may produce "minimal benefits" but still may be advantageous to swimming performance.

Washington D.C.: Is there any legislation that you know of on the high school level to ban these substances? Is there any plan to regulate these by the FDA and if they are being regulated how loose are those restrictions?

Conrad Earnest, Ph.D.: That is not a question for the FDA, that is a question for the high school athletic associaton. To find out these answers, one should check with the state high school athletic association in your state. I know there are restrictions in place for the NCAA.

Lexington Park, MD: Dr. Earnest, is there anything we can do to have supplements defined as drugs by the FDA? Would it take an act of congress?

Conrad Earnest, Ph.D.: Yes it would take an act of congress, however, I do not believe that supplements should have to meet the same scrutiny as drugs. With that said, I do feel that legislation similar to that already in place in other countries takes place to insure product quality assurances and that at least some research be present to suggest so that these supplements meet the expectations that they place.

VA: What's the point of the supplements warning? What do you suggest? 15 more minutes in the gym?

Conrad Earnest, Ph.D.: Supplements typicaly have several different exanages to just training more. First if the supplement is carbohydrate or protein theyre designed to replace different storage areas that are depleted with exercise. Second, some supplements are marketed and fill the role of improving one's rate of recovering following strenuous exercise. Third, only a small percentage of supplements are designed to enhance strength and performance.

Washington, D.C.: What can parents do to ensure their children aren't taking supplements or muscle-building products without their supervision?

Conrad Earnest, Ph.D.: This falls under the difficult task of parenting in general. You as a parent must be willing to either A. accept your child's answers to direct questions regarding supplement use or B. be willing to inspect their gym bag or locker. I would favor A., however the ultimate decision up to you. It certainly falls under the guise of tough love.

Washington, D.C.: Do any of these performance enhancers cause acne or make acne worse? That's one of the few side effects that will turn teenagers off!

Conrad Earnest, Ph.D.: Yes. Anything that has androgen related. These include Andro. Any product with the prefix 19-nor and classically many of the androgens with the last three letters one.

washingtonpost.com: Unfortunately, that is all the time we have for today we would like to thank Conrad Earnest, Ph.D. for joining us.

Conrad Earnest, Ph.D.: Thank you very much for having me, it was my pleasure. And as a concluding statement I would strongly advocate that no child below the sexual development phase of what is known as Tanner Stage 3 take any supplement other than what replaces the macronutrients, carbo, protein or fat or vitamin and mineral. Tanner Stage 3 is something you can have assessed by your family physician.

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