Muscle-building behaviors from adolescence to emerging adulthood: A prospective cohort study

Jason M. Nagata, Vivienne M. Hazzard, Kyle T. Ganson, S. Bryn Austin, Dianne Neumark-Sztainer, Marla E. Eisenberg

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


This study aimed to identify patterns of change in muscle-building behaviors from adolescence to emerging adulthood and determine what adolescent factors predict new-onset muscle-building behavior in emerging adulthood. Prospective cohort data from a diverse sample of 1,535 participants followed from adolescence (baseline, Mage = 14.4 ± 2.0 years) to emerging adulthood (follow-up, Mage = 22.1 ± 2.0 years) from the population-based EAT 2010–2018 (Eating and Activity over Time) study were analyzed. Changes in muscle-building behavior were identified (starting, stopping, persistent use, or never use). Log-binomial regression models examined adolescent predictors of starting (i.e., new-onset) muscle-building behaviors in emerging adulthood. Prevalence of any use in adolescence (EAT 2010) and/or emerging adulthood (EAT 2018) was 55.1% (males) and 33.0% (females) for protein powder/shakes, 6.7% (males) and 5.4% (females) for steroids, and 19.4% (males) and 6.5% (females) for other muscle-building substances (e.g., creatine, amino acids). In particular, 22.6% (males) and 13.7% (females) started protein powder/shakes, 2.2% (males) and 1.0% (females) started steroid use, and 9.0% (males) and 2.0% (females) started other muscle-building substances during emerging adulthood. Adolescent protein powder/shake consumption was associated with starting steroids/other muscle-building substances use in emerging adulthood in males (adjusted risk ratio [ARR] 2.09, 95% confidence interval [CI] 1.29–3.39) and females (ARR 4.81, 95% CI 2.01–11.48). Adolescent use of protein powders/shakes may lead to a two- to five-fold higher risk of new use of steroids and other muscle-building products in emerging adulthood. Clinicians, parents, and coaches should assess for use of muscle-building behaviors in adolescents and emerging adults and discourage use of harmful products.

Original languageEnglish (US)
Article number101778
JournalPreventive Medicine Reports
StatePublished - Jun 2022

Bibliographical note

Funding Information:
This research was supported by the National Heart, Lung, and Blood Institute (Grant numbers R01HL084064 and R35HL139853, PI: Dianne Neumark-Sztainer; Grant number K08HL159350, PI: Jason Nagata), the National Institute of Mental Health (Grant number T32MH082761, PI: Scott Crow), and the American Heart Association (Grant number CDA34760281, PI: Jason Nagata). S. B. Austin is supported by the Maternal and Child Health Bureau, Health Resources and Services Administration, and US Department of Health and Human Services training grant T76-MC-00001. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute, the National Institute of Mental Health, or the National Institutes of Health.

Publisher Copyright:
© 2022 The Author(s)


  • Anabolic–androgenic steroids
  • Body image
  • Muscle-enhancing behavior
  • Performance-enhancing substances
  • Protein

PubMed: MeSH publication types

  • Journal Article


Dive into the research topics of 'Muscle-building behaviors from adolescence to emerging adulthood: A prospective cohort study'. Together they form a unique fingerprint.

Cite this