Supplements and Fitness Professionals. For good or ill these two topics seem to go hand in hand. But what is their relationship?
We have talked about how to make sure that you are not offering medical advice as a fitness professional, and the legal issues with offering nutritional advice as a fitness professional. There are even disclaimers and waivers relating to nutrition available for you to download. The truth is that Fitness Professionals face both philosophical and practical challenges in working out the boundaries of their professional practice. This is called “scope of practice.”
To be clear, fitness professionals should discuss general nutritional principles with their client-athletes. If you are aware of your scope of practice and encourage your clients to see how nutritional and dietetics advice from a professional, you do not need to avoid discussion of nutrition entirely. Discussing nutrition in general terms is not the same, of course, as recommending specific nutritional supplements or providing a custom meal plan which is outside of practice of most fitness professionals.
We need to talk about supplements and the special legal issues that arise when fitness professionals promote, recommend or sell supplements to their clients. You may mean well and genuinely want to find ways to help your client-athletes but “naturalness” does not prevent you from being legally liable if you “prescribe” something that turns out to be dangerous to your client, especially if you are not qualified to be giving nutritional advice. More than the risks of injury or damage, it remains that it is illegal in many US jurisdictions to offer dietetics or nutritional advice without a license. In addition, many of the professional associations also have detailed codes of ethics that clearly detail the scope of practice for a fitness professional and specifically indicate that designing or implementing a specific diet or recommending specifically nutritional supplement for your clients as being outside the scope of practice.
More than 40 US state jurisdictions require nutrition or dietetics professionals to be licensed, and offer detailed guidance for the kinds of activities and advice that require dietetics and nutritionist licensing. The Commission on Dietetics Registration are the people to ask for more information about registration as a dietician.
Under US law, to be sold as “dietary supplements” products must include at least one “vitamin, mineral, amino acid, enzyme, or other substance used by the body.” This is very broad definition. The quality of marketing and the sales of a supplement may or may not relate to the quality and effectiveness of the product.
One risk of taking supplements is that over the last few years quite a few have been found to contain additional substances not listed on the label, including banned substances (from the steroid family), and other dangerous ingredients that have been responsible for illness or injury to those athletes who have taken them. The billion-dollar supplement industry in the US is largely unregulated. The FDA has indicated that it has found dozens of illegal products being openly marketed and sold. Due diligence may not be enough if the supplement turns out to be adulterated.
So there’s a couple of legal issues here. The first is the duty of care you may have to your client – by recommending they take a specific supplement (if outside your scope of practice) and that supplement turns out to cause illness or injury you may be liable if they have relied on that advice. The second is that there are not currently guidelines from the USDA or regulations from the FDA about supplementation, which means your scope of practice as a fitness professional is limited to general information about positives and negatives of supplementation; client-athletes who want further information or recommendations about supplementation should be referred to their doctor or a specialist sports nutritionist. The third is that if you are receiving compensation, including commissions, then you need to be aware of the Federal Trade Commission (FTC) requirements to disclose that financial relationship to your clients.
Some of the questions your clients might ask you about supplementation include:
- Should I use supplements before or after a workout?
- Does creatine or a pre-workout really help do XX (whatever it claims to do)?
- Should I take supplement B or supplement C?
- Is there a supplement that jumpstart my metabolism?
- What should I be taking after a training session?
So what aspects of nutritional and supplementation can speak about with your clients? Focus on sharing published and authoritative information – for example, you could share information on topics from the US Department of Agriculture Guidelines about recommended daily allowances for vitamins and minerals, protein and carbohydrate intake, USDA recommendations for hydration, dietary needs for different populations, timing of meals following a workout and how food impacts recovery. You could suggest that they keep a food diary (in part because research shows that self-awareness positively impacts healthy behavior), but a client who needs specific help with creating a diet or meal plan should be referred to dietician or nutritional professional.
If you still have additional questions about your scope of practice as a fitness professional, you should review the state policies and regulations that apply to diet and nutrition advice, and the guidance provided as part of any certification or continuing education. If in doubt, consult with an attorney before you embark on offering supplementation products and advice. Finally, discuss with your insurance broker about professional indemnity insurance and make sure that you have coverage if you provide incorrect (but not intentionally negligent) advice.
What if a fitness facility – like a gym or health club – require their employees to sell nutritional supplements?
If you are a contractor you should review all contracts to make sure that you are not obligating yourself to undertake unethical or illegal behavior. If you are unsure, ask an attorney for advice.
In any case, if promoting or selling nutritional supplements is a condition of your employment, some organizations including ACE suggestions that fitness professionals review the scientific research addressing the safety and efficacy of the supplement. This research could be provided by a qualified healthcare professional or another credible source, including the Office of Dietary Supplements, the National Center for Complementary and Alternative Medicine, and the Food and Drug Administration. These US government websites are credible resources for examining the risks and benefits associated with a specific supplement. They can also sometimes give you insight into the validity of claims made by the manufacturer or promoter of the supplement. You should be careful of not offering your own guidance or holding yourself out to be an expert if you are not qualified. By providing information directly from government resources you are not relying on your own knowledge.