Influence of knowledge and beliefs on consumption of performance enhancing agents in north-western Saudi Arabia

BACKGROUND: Consumption of performance enhancing agents (PEAs) has a wide range of negative health consequences, but knowledge of these consequences among gym users of PEAs in Saudi Arabia is not well understood. OBJECTIVES: Identify the knowledge, awareness, beliefs and attitudes of gym users about negative health consequences of using PEAs, and the relationship between these factors and use of these agents. DESIGN: Cross-sectional study. SETTING: Five gyms in Madinah city, Saudi Arabia. SUBJECTS AND METHODS: Convenience sampling was used to recruit gym users. An electronic self-administered questionnaire was used to collect data. MAIN OUTCOME MEASURE(S): Level of knowledge about the negative health consequences of PEAs among gym users. RESULTS: About 70% of 316 participants had used one or more of PEAs over the last six months. Of those, about 68.4% used protein powder supplements and 48.1% used energy drinks. Participants who believed that protein powder supplements (c(2)=52.3, P<.01) and energy drinks (c(2)=35.2, P<.01) had health hazards used these agents less often than others during the six months preceding data collection. Participants who had less knowledge about the negative health consequences were more likely to use protein powder supplement (t=2.38, P=.018). On the other hand, those who were more knowledgeable about the negative health consequences of insulin, were more likely to use insulin (t=2.45, P=.015). CONCLUSION: Misuse of PEAs is widespread among gym users in Saudi Arabia. Improving the level of knowledge and awareness of possible serious health consequences would hopefully lead to reduced PEA consumption. LIMITATIONS: The temporal sequence of cause and effect could not be determined in a cross sectional study. Convenience sampling in a single city limited the generalizability of the findings to all regions of Saudi Arabia.