More teens are using muscle enhancing products, according to a study published Monday in Pediatrics, a journal of the American Academy of Pediatrics.

"These behaviors are a little more common among young people than we previously thought," said lead study author Dr. Marla Eisenberg "We want to put it on the radar for pediatricians, parents and other people working with adolescents."

Dr. Jennifer Shu, a pediatrician in Atlanta, says some teens don't always realize that these type behaviors can be harmful.

"First thing to do is try to educate and say, 'You know, I’m glad you are active and playing sports and trying to be happy. Just remember most kids don’t need protein supplements, or even energy drinks because they are getting the electrolytes in their diet,'" Shu says. "It's good for parents to be aware because they might think it’s good and buy teens these protein powders."

Researchers found the number of teens reporting muscle enhancing behavior to be substantially higher than in previous years. Boys were more likely to report these behaviors, which included supplement use and consumption of protein shakes. The concern is that this type of behavior leads to more serious behavior, excessive use and use of illegal substances (something that was reported by some of the teens).



"I think that having an open discussion about the use of any of these products designed to increase body mass and strength are important," says Dr. Nicholas Fletcher, an assistant professor of orthopaedic surgery at Emory University School of Medicine who treats teenagers. "If you don't get at the point early and discuss danger areas such as steroid use then it may get away from you."

Parents need to be aware of what to look for in their kids, says Eisenberg, especially if they notice a big change in exercise patterns. She says parents should treat it the same way they would a body image disorder.

Fletcher says he definitely sees kids working towards increasing their body mass and overall strength. While he says hasn't found muscle enhancing products an issue in his practice, he says he does find kids trying to be like their idols.

"As their idols have increased in size they are continually pushed to get stronger, bigger and faster... there is that trickle down effect."

Researchers looked at a diverse group of about 3,000 teens who were attending urban middle or high schools in the Minneapolis/St. Paul metropolitan area during the 2009-2010 school year. Of the study subjects, 46.8% were male and 53.2% were female. The average age was 14 years old.

Thirty-five percent of boys reported using protein powders; 6% reported using steroids; and two-thirds reported changing their diet to increase muscle tone or size. Twenty-one percent of girls reported using protein powders; 4.6% used steroids; 5.5% used other muscle-enhancing substances. Twelve percent of boys and 6% of girls said they used three or more of these substances and/or behaviors.

Teens were monitored using the EAT (eating and activity in teens) 2010 data analysis - a 235 question survey where teens self report their weight status, dietary intake, physical activity, weight control behaviors and other related factors.

Prevention programs need to alert pediatricians, parents and coaches so they are aware this is happening, Eisenberg said. She does't want this study to make it seem as though exercising isn't important.

"We want kids to be active and eating right to improve overall health and well-being," she said.