PEPonline Professionalization of Exercise Physiologyonline An international electronic journal for exercise physiologists ISSN 1099-5862 Vol 8 No 11 November 2005   The Negative Impact of Marketers on Children, Athletics, and Exercise Physiology Tommy Boone, PhD, MPH, FASEP, EPC Professor and Chair Director, Exercise Physiology Laboratories Department of Exercise Physiology The College of St. Scholastica Duluth, MN 55811    Sports should feature competition among athletes, not contests among biological preparations.”  -- Andrew Pipe, MD [23]  Since 1998, I have written articles and published them in the PEPonline journal.  It is obvious that some of my articles are controversial.  Frankly, I think that a different view is a good thing. For example, I believe that exercise science is not exercise physiology.  I also believe that exercise physiologists should be members of their own professional organization.  To some extent, my articles and books may have helped with the professional development of exercise physiology.  As you might have imagined, I have strong beliefs about what should be sports nutrition, how it should be taught, and serious reservations regarding sports supplements.   If my comments make certain readers uncomfortable, then so be it.  I am not going to skirt what I believe is the truth and what needs examination.  So, if the reader is not interested in what I have to say, it is best to stay away from the PEPonline journal.  It really is that simple.  And until more exercise physiologists speak up, in particular, about sports supplements and athletics and the impact of marketers on exercise physiology, I will either address it on PEPonline, in more traditional print-copy publication formats, or on a completely new and different website devoted 100% to the problem of performance enhancing substances.  In fact, the issues that result from the use of these substances are simply too important to not bring attention to them.  I am especially concerned that only a few exercise physiologists are speaking out and not near loud enough about the negative impact of sports supplements on children and athletics.  This is a problem.  In my view, there is no acceptable level of sport supplement use (however defined as performance enhancing substances).  It is simply not acceptable for athletes to believe that they must use supplements to perform better.  And, yet there are increasingly more websites that promote sport and dietary supplements.  The Internet display of “supplement commercialism” have become so commonplace that it is a huge distraction to meaningful content.  With the Internet at 12 million new users per year [1], the potential for financial growth for these businesses is huge.  Even now, the 40 to 140 million users per year have changed the way business is done.  The get-rich-quick scams and advertising tricks are full of deceptive statements (e.g., gain bigger muscles and run faster using our product).  The scams do not end there, however.  For instance, it is only logical that exercise physiologists with an interest in sports nutrition, because of the popularity of strength training and participation in athletics, will continue to extend their involvement as consultants in the sports supplements industry.  The rise of their involvement is a function of several factors, including the growth of the industry worldwide and the financial incentives to consultants. Strangely enough, much of today's supplement problems stems from the exercise physiologists' interest in research (i.e., sports physiology).  Perhaps, little did they know that not having a professional code of ethics for decades, there was little chance they would question the direction of their work.  Now, they have become adept at manipulating the research, and are using athletics and sports nutrition, to gain influence at all levels.  Most importantly, the commercialization of sports supplements and the growing emphasis on “winning-at-all-costs” have changed the face of athletics and sports nutrition.  By bringing supplements in the exercise physiology laboratory, industry incursion in classrooms has gone under the radar.  This has unfortunately increased the use of supplements by all athletes, regardless of age, to level the playing field.   While the majority of the exercise physiologists have not addressed sports nutrition advertising, the consequences of the industry’s money in exercise physiology laboratories, the coalition of supplement manufacturers and employees of the same, and the academic consultants to the industry are critical for obvious reasons.  The spread of advertising from fitness magazines and web sites to academia is a form of coercing captive students to listen to sports supplements ads in the form of lectures.  Also, disguised advertising in the form of a research article is part of the commercialization of supplements.  “Place-based” advertising is not new.  Examples include ads before movies, on buses and trains in cities, airports, videos, gas pumps, and in doctors’ offices.  Hardly anything will stop the companies from advertising their products.  Another form of advertising is “product placement.”  The industry pays to have a product included in the professor’s research agenda.  As a result, many publications are little more than sales pitches rather than objective science.  The commercial use of academic classrooms should be forbidden since it undermines the students’ education.  Most of the articles are either 100% in favor of sports supplements or written with the language of weasel words.  It is therefore a rather easy step for athletes to give in to what Lousteau [2] says is an “…industry that is corrupted by companies that market worthless, dangerous and sometimes deadly products.”   It's not that athletes are attracted to quacks and other pseudo-scientists anymore than others. Everyone gullible to finding easy answers to run faster or get bigger.  It is even reasonable for athletes to think that getting stronger automatically equates to a better performance.  Of course success in athletics is more complicated than looking for a miracle in a bottle or can. Yet, there is no doubt that quick fixes are appealing to athletes.  This is why the potential for quackery and fraud is huge. Ransford [3] concludes that the quackery includes, “…half-truths, testimonials and anecdotes, unpublished or uncited studies, buzzwords or pseudomedical jargon, secret formulas, quick results, and missing or questionable credentials.”  In agreement, Williams [4] states that, “Given the fraudulent claims made for most nutritional supplements marketed for trained athletes…let the buyer beware.”  The multivitamin/mineral supplement is such a product.  Yet, it is clear that the supplement does not enhance sport performance [5]. This is the case with most supplements.  There simply is no firm scientific support for most of the claims made by the supplement industry and, if there were such  scientific facts, they would not make it correct to use the supplements. Here again, though, athletes do not normally stop to think about the ethical implications of cheating.  Just think, they have been known to spend as much as $400 per month for supplements [6].  The reason athletes spend such large sums of money on supplements isn't hard to understand?  Everyone wants to be a winner!  There are many other reasons, too. One in particular stands out.  Advertisements are written to get the reader’s attention. Persuasive writing is built into the advertisements.  The bottom line is rather simple: The industry CEOs and consultants hope and expect the advertisements will get the readers to buy their products.  “Bigger Muscles” or “Huge Arms” may be the “hook" or "grabber” to get the athlete’s attention.  Reaching athletes through their emotions is also powerful another way to sell supplements.  It does not take a rocket scientist to figure out that the promoters offer solutions for virtually every athletic problem, from enhancing cellular function to recovery from sore muscles.  For some athletes, supplements offer hope and success.  Supplement promoters understand these points all too well.  That is why they present themselves as the “caring professionals” of the athlete.  Among other popular arguments, they have convinced athletes that eating a nutritious and well balanced diet is not possible in the United States. As a result, protein supplements or creatine becomes the answer the athlete was looking for.  The reality, however, is that this thinking is not true. The misplaced trust is akin to jumping on the bandwagon, regardless of the questionable endorsements, testimonials, and inflated statistics and conclusions.  Many advertisements, if not most, have little to no scientific basis.  But, athletes and many others are seldom aware of this fact.  Often times, they are impressed by the long list of references and/or the apparent scientific content of an advertisement.  Athletes seldom take the time to determine whether the references or content are valid or irrelevant.  It is also fair to say that without special instructions in how to read and evaluate a research paper, students may not have the analytical skills to determine the quality of the paper or its intent.  Of course, the supplement promoters, including the instructors as paid consultants, know this all too well.  They want the athletes (and students) to believe them and their message.  You may even have even heard the following statement by sports nutritionists, “What does the exercise physiologist know about athletics and nutrition?”  In other words, they urge athletes to disregard scientific evidence in favor of their experience and/or agenda.  In the end, it is all about the members of the supplement industry and their business agenda to sell products.  This fact alone is reason enough to keep the promoters away from athletes and outside of the academic classroom.  The idea that athletes cannot survive without supplements is driven by the bottom line (i.e., money pade from marketing more and more products).  Naturally, the industry and their paid academics are not happy with anyone who disagrees with them.  Critics of the sports supplement industry are said to be biased and closed-minded, such as the content in this article.  The industry believes that it has the right to do as it pleases.  After all, it just business! That is why the industry has turned to the academics, particularly if they are engaged in research.  This trend is troubling for many reasons.  To some extent, some companies have, in effect, purchased the right to say:  “Our supplement is the department’s official supplement product for enhancing athletics.”  Such deep pockets within the industry have led to intense competition among academic marketers.  And, unfortunately, there has not been an adequate analysis (i.e., philosophically, ethically, or professionally) of what is sports nutrition and why it is important to exercise physiology.  Lacking this information has encouraged the notion that the use of sports supplements is neither wrong nor unethical.  In practice, the view of those who engaged in supplement research is that the use of legal sports supplements should not raise ethical concerns.  In fact, they say that it is legal and, if it is legal, there is no ethical problem.    A similar view is that individual academic freedom gives the professors the right to research any topic.  This sense of independence is so strong among faculty that it is difficult to discuss what is taught and why.  Although differences of opinion and tolerance of views are believed to be an important feature of academic freedom and critical thinking [7], faculty members do not have carte blanche to teach and do as they please.  There are consequences to what is taught and how it is taught.  If conduct or methods are in conflict with ethical behavior and thinking that undergirds a college eduation, then either can have a negative influence on the students’ values and safety.  For example, it is not right to argue that because everyone is believed to be cheaters that it is okay to cheat.  Similarly, just because teachers believe they have the freedom to teach what they want to teach doesn't make it right either.  Pprofessor cannot do as they please without expecting criticism.  Academic freedom carries with it the academic and professional, if not ethical, responsibility to safeguard students, colleagues, and the profession.  The most striking illustration of questionable academic freedom is presently being lived out in the sports nutrition course.  Using dubious justifications of empowering athletes, they flatter college students by making it easier for them to agree that sports supplements are necessary to be a good athlete.  This is an excellent marketing model that has been used for several decades.  And, frankly, it continues to trap young athletes into buying supplements.  Of course, generally speaking, students are not aware of the role of the faculty in promoting supplements through corporate sponsorship of their research.  Students are seldom aware of the role of the faculty in promoting supplements or how they use words with a scientific tone to hide their bias.  As a result, the content in their papers is more like a scientific statement even if, which is in the majority of the cases, the data have been manipulated to look as though the supplements work.  As mentioned earlier, the use of certain words, such as those referred to as “weasel words,” are used for a specific purpose.  Some believe they are “…intended to, or have the effect of, softening the force of a potentially controversial statement…” [8].  In short, weasel words draw attention from something the author does not want to emphasize and, therefore, needs to give the appearance of truth.  Students, parents, and even teachers are completely misguided by the bag of persuasive words used by marketers.  Some are even impressed because advertising in the form of published articles works just like any well-designed advertising campaign.  This is why the study of advertising is important to all exercise physiologists.  Students should be aware of the use of these persuasive techniques, especially in regards to supplements and sports performance articles. The author’s goal is to create the illusion that the supplements work by linking the assumed effects of the supplement to a theoretical underpinning.  As an example, what do you think of the following sentence? Theoretically, the athlete’s supplementation with selenium could prevent RBC peroxidation of the membrane and substructures of the muscle cell involved in the metabolism of oxygen, possibly enhance aerobic exercise performance. It sounds scientific.  The word theoretically suggests, as in theory or, that is, in accordance to the assumed facts.  The adjective means concerned primarily with theories or hypotheses rather than practical considerations, so the use selenium works!  Of course, the problem is the use of weasel words to convince the reader to buy the supplement.  Note that they are strategically placed in the sentence to pull “theory and implication” together, which raises the question:  “What is the purpose of the sentence?”  Again, the answer is to encourage the reader to think that selenium is important to enhancing aerobic exercise performance. Remember, the objective is to create the connection between the supplement and performance.  Everyone wants to enhance aerobic exercise performance, selenium “could possibly enhance” aerobic performance.   Research indicates that chromium supplementation does not increase lean body mass, does not decrease body fat, and does not have any significant ergogenic effect on high-intensity exercise.  Thus, supplementation with chromium does not appear to enhance body composition or performance in well-trained individuals. Notice the first sentence is direct and to the point.  Chromium supplement does not have an ergogenic effect or enhance body composition.  But, if the article is written to promote supplementation, the writer leaves doubt in the reader’s mind.  For example, chromium does not appear to enhance body composition or performance.  The reader concludes that it is best to be on the safe side and supplement with chromium just in case. Although this kind of misinformation is wrong, it is so common that no one takes issue with it. In an era when advice about supplements is dispensed freely within solid, non-biased published articles, there is the increased possibility of the content having a destabilizing influence on athletics.  This is a principal tenet of sports nutrition gone wrong.  No one seems to get that the supplement illusion can have important consequences (e.g., health, legal, and ethical).  The illusion has led to a substantial body of literature with implications for supplement use based on  “may,” “could possibly,” “suggest,” “appears,” and on and on.  The literature is so convincing to the uncritical reader that it is easy to think that supplements work.  To make matters worse, some of the supplements do work. The catch to this dilemma is the issue of “what is fair play” and “ethical thinking.”  Of course, if there is such a thing as athletes who are not taking supplements, then those who are taking supplements are doing the wrong thing for the wrong reasons?  Perhaps not until after exercise physiologists and other “professionals” start writing and talking about these issues will athletes and others get suspicious of the influence of the supplement industry.  And, yet it is obvious that none of this is going to happen anytime soon.  It should be recognized that members of the industry know what works and what does not. They know what researchers want, and they have the resources to provide them with money, equipment, and free trips.  This is the first step to getting into the mind of the consultants within the academy.  Then, after they gain the attention of the researchers, they create a lot of reasons to buy into the supplement business.  The secret is obvious, and it is brilliant.  People in the advertising business understand it all too well.  It is all about money and getting a foothold everywhere opportunity exists to promote supplements.  This is at the very least a morally ambiguous state of affairs within the industry and its relationship to exercise physiology, especially since there is the impression that exercise physiologists now think of their work as a “product” that they need to pitch to department chairs and deans.  Education has, therefore, become a commodity with a business pitch.  And, unfortunately, research has become institutionalized within diverse business opportunities with far-reaching academic implications.  This leaves exercise physiologists with a whole range of pressing ethical and professional questions.  The concern now is that the dogma taught at the college level will become the common everyday language of children.  So insidious is the supplement culture that surrounds athletics that it has caused some exercise physiologists to be concerned.  They know that the commercialization of childhood sports is happening now, and they know that it is going to get worse.  The supporters of the industry understand that if they can get the children hooked on supplements, they will do whatever is necessary to do an end-run around the parents to get the supplements.  Most parents do not have any idea of the serious cultural contradictions that underpins athletics.  They do not get that if their children are left to those who have a financial interest in their children’s decisions, then, forget talking about the ethics of sports.  After all, it is increasingly common knowledge that advertisers portray parents as having little more than a basic understanding of sports and what it takes to be an athlete.  This commercial culture is exactly what is feeding the dogma that promotes the conformity in the growing commercialization of young athletes.   Hymowitz [9] puts it this way.  Between the ages of 4 and 12, children spend billions in purchases.  Older kids spend even more.  The corporate CEOs and marketers loyal to the supplement industry understand these points very well.  Such potentially deep pockets will lead to intense competition among marketers.  And, since there are very few, if any, obstacles to stop the CEOs and marketers from luring kids, teenagers, and college-age students to use supplements, it is just a matter of time that every 8 year-old through college will be on some kind of supplement.  That is also why the marketers are going to do their best to put their supplement logos in the face of every child and student possible.  They know that children and students are the target audience.  Children are naïve and easily influenced.  Student athletes can be manipulated and transformed into supplement users, too.  Without question, the CEOs and marketers will be unbelievably successful if something is not done to stop them.  The irony is that few parents, professionals, including college teachers, seem to fully grasp the larger social and ethical dynamics of the powerful influence of the marketers.  Exercise physiologists should be among the first to clarify how marketers use the system to their advantage.  They, in particular, should appeal to other healthcare professionals to stand up against the marketers advertising to children and athletes.  The idea of attracting “cradle-to-grave” supplement loyalty is a foothold that simply does not make sense and, therefore, should not be allowed to continue.  Imagine the battle before those who decide to take it on.  There are marketers who are already marketing thong underwear and lip gloss to eight-year-old girls [9].  People in the advertising business simply do not get it or don't care. Remember, it all about the bottom line.  They don't believe the problem exists with them.  They make the point that parents are the problem.  Parents are buying their children “…belly shirts, R-rated video games, and the like…” [9].  This view is too easy.  It is true that parents are responsible for much of what their children wear, play with, and ingest.  But, clearly, the marketers are using the Internet, scientific looking articles, paid professionals, and conferences to make the young athletes believe they need supplements to be good athletes.  The upside of it all is that the growing commercialization of sports supplements has led to a serious increase in the notion that supplements are safe and necessary.  This commercial imperative is a problematic part of athletics, as is the lack of any ethical discussion about supplements.  It has polluted and transformed the idea of athletics building moral character.  It is no longer the opportunity for children to learn about themselves and to grow as a person and as an athlete who understands the importance of winning as well as losing.  Just as children now have DVD players, computers, iPods, cell phones, PlayStations, $150 sneakers, designer clothes, and on and on, it is just a matter of time that they will become the epicenter of the supplement marketing.  None of this is new or exaggerated.  Children between the ages of 4 and 12 spend an estimated $30 billion a year in direct purchases [10].  It is just a matter of time that children will be the prime advertising target.   The pages of fitness magazines are smothered in supplement advertisements.  Many fitness facilities could double as paid advertisements for the supplement industry.  And, athletes who use supplements are walking, talking, and wearing industry logos.  The industry has made huge inroads into the American fitness culture in general and the sports nutrition course in particular.  Paid consultants within the university environment are researching supplements via theses and dissertations that are then marketed to their students.  They have sidestepped the gatekeeping professionals and gone directly to athletes.  The unfortuante result is that many young athletes have been transformed into supplement users, who then pass on the industry message that winning is the only thing that is important to their peers.  Trends in thinking that supplements are needed to win in sports, rather than mere participation is a well-established belief.  In the meantime, the result is a growing dependence on supplements and an attitude that winning is the only thing important.  The problem is even more magnified when the attitude is integrated into everyday matters.  To be sure, others suspect more than a simple connection between supplement use, leveling the playing field, and the cheating behavior in academic coursework.  Indeed, this scenario makes good sense of an otherwise obvious observation with business dealings by CEOs and their executives when ethical thinking is pushed to the side.  In other words, society’s beliefs about athletics, competition, character, and business dealings are being reshaped by the bottom line thinking of the supplement industry.  Perhaps most alarming has been the failure to think ethically about the excessive commercialism.  Athletes are inundated with advertising for better abs and more muscle. Most students and their teachers are blind to this reality, however.  And, yet if they were to get involved, they would risk complaints from colleagues.  This is not a minor point.  Look at the recent postings on the ASEP Public Forum [11].  Is the teaching of sports supplements diminishing our sense of what is right from wrong?  For certain, the unchallenged teaching of supplements has contributed to a narrowing of the scientific discourse of sports nutrition. Where is the professional support to restrict the growing commercialism?  This will be the biggest battle faced by exercise physiologists in the 21st century.  The CEOs of the supplement industry have entwined themselves into the academic structure so deeply that it may be impossible to get rid of them.  They have, for now, managed to convince a certain significant number of exercise physiologists to promote their products.  Where are the conflict of interests documents that usually oversee academic pursuits outside of the classroom? What can individuals do who disagree with the use of supplements expect?  The biggest threat is that the academic consultants for the supplement companies are likely to increase targeting anyone who disagrees with their position.  One wonders just how much they are paid in free products, discounts, and sponsorships.  And, since they frequently have the ear of athletes, they can use word-of-mouth “buzz” to hook unsuspecting peers on products.  The problem is that the unsuspecting person is not likely to know who is paid to share consumer opinion.  In other words, is it right for students and professors to market to others if they do not know that there is a payoff for their recommendations?  People need to know when a conversation about athletic performance and nutrition is an advertisement.  If they do not know, it is deception, wrong, and unethical.  No one has the right to gain access to others (students in particular) when they do so by getting around the person’s defenses against persuasion.  But, strangely, somewhere along the way some exercise physiologists decided to stop teaching sound nutrition.  Why this happened is an interesting question.  Part of the answer is that no one expected the transition from research into commercialization that has occurred. No one suspected exercise physiologists would fail to avoid at all costs the appearance of doing the wrong thing.   And, everyone knows that athletes are looking for a competitive edge. Right!  They are taking supplements, and they are doing extreme nutritional routines [12].  But, note what the American Academy of Orthopaedic Surgeons said about sports supplements: Supplements that claim to increase athletic performance can have adverse effects on growing bodies.  Several are derived from hormones that are already being produced by the body.  They can have permanent negative effects on your health, both physical and mental. They can increase your body’s production of cholesterol, cause the body to produce sex characteristics found more commonly in people of the other gender (i.e., breast growth in males and baldness and increased facial hair in females), and damage your liver, kidneys, and heart.  If you are eating a nutritionally balanced diet, you are getting the necessary amount of carbohydrates, proteins and fats along with the important vitamins and minerals your body needs for optimum functioning. [12] Why some exercise physiologists are not interested in the remarks of the Academy remains a mystery.  It is common knowledge that not just athletes harbor game-day superstitions. Exercise physiologists are known for being stubbornly interested in the financial return of business deals.  One does not have to explore the idea much at all to get the big picture.  Supplements, research projects, manuscripts, conferences, presentations, grants, and personal consulting fees; they are all powerful incentives to support the industry.  The money from grants is huge since it pays for the equipment to do research.  The costs to attend meetings, the financial needs to develop and post websites and last, but certainly not least, the consulting fees pay for the investment in time, name, and contacts (particularly, athletes and colleagues in academia).  The "money is good" is an understatement.  How else can a person add on a room or purchase a big house or a fancy car, especially if that person is a teacher.   Life, it seems, is about money, if not more of it, which is exactly the reason why commercialization of supplements is a huge business.  From a professor’s perspective, such as myself, who disagrees with the use of supplements, this is not life as it should be.  I know that others agree, although they are often very reluctant to say so.  They are squarely in the corner that disagrees strongly with advertising aimed at young athletes.  And, since there are many academics who disagree with the consumerism of subliminal supplement products, it is just a matter of time that commercializing supplements will be recognized as a bad thing.  Until then, the never-ending come-on of the advertising aimed at young athletes is worrisome.  In fact, it should be recognized that advertising is very troubling to many adults as well.  They fear that young athletes will not grow up with the same values about sports and athletics as they did.  They are also uncomfortable with the role of friends, coaches, trainers, parents, and even medical professionals who entice adolescent athletes to consider using supplements and/or drugs to improve their performance [13].   What is also very troubling is that none of the practices marketers use today is regulated. They can do just about anything that captures the attention of potential users.  No one within exercise physiology is even near to suggesting an industry-wide review process to oversee sports nutrition gurus and others.  No one seems the least bit concerned with the potential for increased risk to young athletes on supplements.  Most students and even athletes are unaware of the commercial activities in which they participate, much less the risks associated with supplements and drugs.  In fact, Laure and Binsinger [13] point out that, “…the consumption of certain substances in order to improve performance, fight against pain or help recuperation, is judged as problematic as it can lead to major areas of concern fraught with physical danger for the athletes, and ethical dilemmas for the Sporting Community.  For example, there may be damage to the athlete’s health linked to the nature of the substances taken, doses, the methods of administration or even the combination of products.  After years of ads in a multitude of magazines and journals, the exposure to supplements is over the edge.  The nutritious and muscle growth products have reached a level of connection that undermines athletics (and exercise physiology via sports nutrition).  Presently, “Surveys indicate that 75 percent of college athletes and almost 100 percent of body builders use at least one product that allegedly boosts performance.” [14]  Yet, athletes regularly consume diets that are sufficient to support the metabolism of athletics.  The idea that creatine, as an example of one of many supplements, is necessary to enhance athletic performance is consistent with the spirit of sports and, frankly, is entirely incorrect.  Similarly, selective prohibition of performance enhancing substances is a step in the wrong direction.  It is a fairytale solution to the cheating in sports (i.e., one can't be partly ethical). Professionals should examine the athlete’s understanding and awareness of the role of marketing.  There should be rules specific to different ages to help ensure protections from all forms of marketing.  Exercise physiologists, in particular, must become frontrunners in shielding athletes from commercializing pressures that undermine their integrity, health, and character development.  Students and their parents should be able to rely on exercise physiology professionals to investigate all forms of commercial activities that impact athletics. At a minimum, students have the right to expect that: Professional exercise physiologists should eliminate commercializing activities on behalf of the supplement industry. The exercise physiology professional organization should enact policies providing for the financial disclosure and reporting of industry related activities, donations of equipment and sponsorships of conferences; and Academic institutions should undertake a review of the research activities of the faculty supported by supplement companies. For the good of young athletes and athletics, exercise physiology professionals cannot afford to allow the marketers go unchallenged.  They are destroying the next generation of athletes.  The two purposes of sports are to build character and physical fitness.  Students have the right to expect that college teachers will talk about fraudulent promoters who use claims like "scientific breakthrough"  and "best ever and safe, too."  Baker [15], a professor of pediatrics at the Medical University of South Carolina, said that:  "It's a crapshoot.  You have no idea what these products contain."   This includes steroids as well, and just think, in 2003, the authors of a survey of high school students found that over 300,000 teens between 8th and 12th grade used steroids.  Among a list of recommendations for parents, the Mayo Clinic concludes that parents should "Discuss the ethics of fair play and explain that the use of performance enhancers is similar to cheating [16]. Sports do not exists for the marketers to make money and, for certain, they are not role models.  Richmond of The Hoya, a newspaper of Georgetown University [17], is a role model.  In 2003, he said:  “It’s absolutely despicable when these two simple functions of sports are perverted in the name of getting an edge.”  And, just think, it is a matter of time before the marketers, in all forms and titles, will be promoting performance enhancement through gene doping.  It is all about the money, and supplements are a multi-billion-dollar industry in the United States.  Supplement use is widespread.  Almost one-third of a sample of 21,225 college student-athletes was currently using supplements in 2001 [18].  While exercise physiologists by title (e.g., retail stores, 58.7%; nutritionist/dietician, 9.1%; friend or family member, 9%; strength coach, 5.2%, coach, 4.8%, and athletic trainer, 4.5%) were not implicated as a main source of where student-athletes get their supplements and why they take them, it is nonetheless inexcusable when exercise physiologists overlook the use of supplements and even worse when they encourage the use.  Marketers are not concerned with the integrity of sports and the health of athletes.  Both could be irreparably changed if exercise physiologists (among others) do not stand up and stop the invasion of commercial interests.  Rushall [19], Professor Emeritus of San Diego State University, believes that this is already a problem in swimming.  Bodysuits alter performance, thus “…increases the efficiency of a swimmer’s muscular function above that of a natural state.”  Rushall also said that, “Swimming races must be fair and decided on athlete’s merits.  It should never be said that one athlete was better because of the costume that was worn.”  In other words, like it or not, the outcomes of competitions should not be decided by the suits/fabrics (or in the case of supplement marketers, the supplements/enchancers) used by athletes.  It is bad for athletics, and it is a bad image for adults who embrace marketing and sales strategies to improve the bottom line of their business at the exclusion of ethical practices.  Hoffman [20] agrees, “Making money and corrupting the morals of a minor at the same time is not my idea of ethical advertising.”  This is another reason why exercise physiologists have got to stand up in front of athletes and talk about what is wrong with deceit as part of the competitive spirit of athletics.  Of course there is nothing wrong with wanting to be fast or strong or even to win.  Winning takes place everyday by someone who is competing. Cheating also happens everyday, and it is getting so common that it is hardly noticed.  The marketers are engaged in behavior that is not representative of fair play.  Athletes get under-the-table payments, players use cork bats, and others lie about steroids.  Some are just being clever, and others are over the edge.  None of it is right, however.  Athletes need to be told the truth about the ethical side of athletics and why it is wrong to cheat.  It is not a question of athletes having used these substances since ancient times [21] or the science of athletic performance through new biotechnology research, or even whether athletes will stop using them.  Rather, it is about helping athletes and society create a culture that does not worship winning at all costs.  Whatever happened to a balanced lifestyle?  Life is already hectic enough.  Must it be centered 100% on winning?  There must be more to life than dribbling a ball, swinging a bat, or running faster.  Maybe, this is exactly where exercise physiologists can help.  By not giving in to the pressure to conform to the performance enhancing mentality, by teaching athletes about sound training principles, why sacrifices are part of the game (win or lose), by discussing ethics and, according to the Mayo Foundation for Medical Education and Research [22], by “…reminding your son or daughter that using a performance enhancing drug not only is similar to cheating, but also could lead to health problems or death.”  Pipe [23] wrote that the “…reports of gratuitous violence, bizarre and hazardous training practices, drug use and doping scandals, the emotional, physical, and sexual abuse of young athletes, the charades that can surround college sports, and the mindless behavior of some professional athletes have left people disenchanted.”  Because of the exercise physiologists’ standards of professional practice [24], they have the ethical responsibility to athletes and to the ideals of sportsmanship and fair competition.  A fundamental step to promote professional and ethical conduct in exercise physiology is already in place with the exercise physiologist’s code of ethics [25].  Such a code illuminates the exercise physiologists’ obligation to act responsibly as a professional, thus encouraging fair competition and promoting the well being of athletes.  Inevitably this means that marketers cannot be allowed to continue to get first-hand contact with young children and athletes.  The signs of quackery include [26]:  “…half-truths, testimonials and anecdotes, unpublished or uncited studies, buzzwords or pseudomedical jargon, secret formulas, quick results, and missing or questionable credentials.”  Marketers are good at standing science on its head. They demand that those who disagree with them prove that they are wrong.  Or, they argue that it works because everyone tells says that it does.  It is all about promoting slogans and buzzwords to sale products.  Exercise physiologists must have the courage and perseverance to be the kind of professionals who will make a difference.  It is not always easy.  But if exercise physiologists have an interest in doing the right thing for the right reason (i.e., promote safe and fair sports), then they will make a difference in the lives of children, high school and college-age sports, which remains me of a piece published in the PEPonline journal [27]:    Cheating is not relative.  Cheating is personal and professional misconduct. Illegally distributing or using steroids and other performance-enhancing drugs by athletes is illegal and morally questionable.  Sports ought to be about mental and physical hard work and the development of athletic skills.  It is in the best interest of everyone to preserve the integrity of athletics.  Exercise physiologists ought to argue for clean sports, not the use of drugs or questionable practices linked to performance enhancing substances.  Not allowing for alternative thinking to that of the marketers compromises our professional goals and objectives.  Avoiding conflicts between personal self-interest and professional judgment is smart and proper. This will make it easier for exercise physiologists to champion their initiatives for professional development.  There is no quick fix to professionalism.  It takes work and dedication to become part of the healthcare industry.  The sound of silence from within exercise physiology with an interest in sports nutrition is not professional or new.  In one sense, it is too easy and only agrees with our past thinking.  And yet, perhaps, this is what defines professionals from nonprofessionals (i.e., avoiding a preoccupation with personal goals for professional standards). References Kim, A.M., Pinter, E.M., and Witmeyer, J.J. (1998). The Same Old Story, Different Medium. [Online]. http://www.fmew.com/archive/fraud/ Lousteau, L. (1999). Dietary Supplements: The Seven Billion Dollar Business Scam.  The Hoya: Georgetown University’s Newspaper of Record. [Online]. http://www.thehoya.com/viewpoint/030599/view3.htm Ransford, M. (2002). 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Cheating in Sports:  What Should Exercise Physiologists Think?  Professionalization of Exercise Physiologistsonline. 7:7 [Online]. http://www.asep.org/asep/asep/CheatingWhatExercisePhysiologistsThink.html   Copyright ©1997-2006 American Society of Exercise Physiologists   All Rights Reserved.