Journal of Sports Science and Medicine
Journal of Sports Science and Medicine
ISSN: 1303 - 2968   
Ios-APP Journal of Sports Science and Medicine
Androit-APP Journal of Sports Science and Medicine
from September 2014
©Journal of Sports Science and Medicine (2012) 11, 201 - 220

Review article
How Healthy is the Behavior of Young Athletes? A Systematic Literature Review and Meta-Analyses
Katharina Diehl1, , Ansgar Thiel2, Stephan Zipfel3, Jochen Mayer2, David G. Litaker1,4, Sven Schneider1
Author Information
1 Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
2 Institute of Sport Science, Tübingen University, Tübingen, Germany
3 Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
4 Departments of Medicine, Epidemiology and Biostatistics, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, USA

Katharina Diehl
✉ Heidelberg University, Medical Faculty Mannheim, Mannheim Institute of Public Health, Ludolf-Krehl-Straβe 7-11, 68167 Mannheim, Germany
Publish Date
Received: 26-09-2011
Accepted: 08-04-2012
Published (online): 01-06-2012
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Participation in sports during adolescence is considered a healthy behavior. The extent to which adolescent athletes engage in other healthful (or risky) behaviors is less clear, however. We conducted a systematic literature review following the PRISMA Statement to assess the frequency of risky behaviors among athletes in this age group. We searched the PubMed, PsycINFO and SCA Sociological Abstracts databases for observational studies published in English over the last twenty years on the frequency of selected risk behaviors (alcohol consumption, smoking behavior, use of illicit drugs, unhealthy nutrition, and doping) in adolescent athletes. Two independent reviewers selected articles following the PRISMA Statement. Behavior frequency was assessed as was comparability of study design and methods. When possible, meta- analyses were performed using data from subgroups of studies in which operational indicators were comparable. Seventy-eight articles met eligibility criteria. Although report of risky behaviors varied across studies, we observed overall, that studies tend to report higher alcohol use, less smoking, less recreational drug use, and more smokeless tobacco use in (high-involved) athletes. Considerable heterogeneity was noted in study design, definition of target groups and use of operational indicators (I2 ranged from 93.2% to 100%). Especially the higher prevalence of using alcohol and smokeless tobacco needs more attention in interventions targeted to this group. Overall, greater consensus on methods used to assess risky behaviors in adolescent athletes.

Key words: Adolescent, health behavior, alcohol, smoking, sport

           Key Points
  • This is the first systematic review focusing on different health related risk behaviors of adolescent athletes aged ≤ 18 years from different countries.
  • Health related risk behaviors such as alcohol consumption are common among recreational and elite adolescent athletes.
  • Athletes were more likely to consume alcohol, smokeless tobacco, and steroids and less likely to smoke and to use marihuana than non-athletes.
  • Studies show high heterogeneity in the operational indicators, statistical methods, and target groups. Therefore, greater consensus around key definitions and study methods is needed to advance knowledge.
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