NATA Position Statement Review Part 9: Evaluation of Dietary Supplements for Performance Nutrition

Athletic trainers play a vital role in supporting athlete health, performance, and safety, and our work is guided by a strong foundation of evidence-based practice. One of the most valuable tools in that foundation is the National Athletic Trainers’ Association (NATA) Position Statements. These documents translate current research into clear, actionable recommendations, helping athletic trainers make informed decisions in fast-moving and often complex situations.

For athletic training students preparing for the Board of Certification (BOC) exam, these statements are more than suggested reading but rather essential study material. Each one aligns closely with the BOC Practice Analysis and reinforces key competencies in clinical evaluation, risk reduction, patient education, and professional responsibility. Understanding them not only strengthens exam readiness but also builds the clinical judgment needed for real-world practice.

This week, we’re giving an overview of the NATA Position Statement on evaluating dietary supplements for performance nutrition. With supplement use widespread in sport, and risks ranging from contamination to adverse health effects, this statement equips future and current athletic trainers to assess products critically, guide safe athlete choices, and uphold best practices in performance care.

1. Food First Philosophy

Before considering supplements, athletic trainers should encourage:

• A well-designed, balanced diet
• Evidence-based sports nutrition strategies
• Collaboration with qualified nutrition professionals (e.g., registered dietitians, CSSDs)

For the BOC: Expect questions about prioritizing whole foods, optimizing macronutrients, and recognizing when diet—not supplementation—is the first-line approach.

2. Athletes Must Understand Supplement Regulation

Supplements are poorly regulated. Here are key points to know:

• The Dietary Supplement Health and Education Act (DSHEA) defines supplements and places responsibility for safety on manufacturers—not the FDA.
• Supplements do not require pre-market testing for purity, safety, or efficacy.
• Label accuracy is not guaranteed unless verified by an outside party.
• ATs must educate athletes that “over the counter” does not mean “safe” or “legal.”

BOC angle: Questions often focus on patient education, risk reduction, and compliance with governing bodies.

3. Safe, Legal, and Effective: All Must Be Considered

Athletes (and ATs) must evaluate supplements based on:

• Purity
• Products may contain undeclared or banned substances.
• Contamination and adulteration are well-documented risks.
• Third-party validation (e.g., NSF Certified for Sport) increases transparency but does not guarantee safety.
• Safety
• Adverse events must be monitored.
• FDA’s MedWatch and similar tools help identify concerns.
• New or untested ingredients pose unknown risks.
• Efficacy
• Evidence is often weak, inconsistent, or misapplied.
• Many products rely on anecdotal claims rather than high-quality trials.

BOC angle: You may see questions asking which resources the AT should use or what steps to take when evaluating a supplement or advising an athlete.

4. Know the Governing Bodies

Different organizations have different rules, and athletes are responsible for what is in their bodies. Key regulatory groups to recognize:

• WADA → Global anti-doping framework
• USADA → U.S. antidoping education/testing
• NCAA → Permissible vs. nonpermissible supplements; banned substances
• Professional leagues → Often rely on NSF programs

BOC angle: Expect scenario questions about an athlete who unknowingly uses a contaminated supplement or needs guidance on permissible products.

5. Strict Liability for Doping

If an athlete tests positive—even unintentionally—they are responsible. This reinforces why ATs must educate athletes on banned substances and supplement risks.

This concept is unforgettable on the exam: Athlete = 100% responsible for what they ingest.

6. Use of Third-Party Verification

Common verification bodies include:

• NSF Certified for Sport
• USP Dietary Supplement Verification Program
• Banned Substances Control Group

Verification improves confidence in label accuracy, but:

• Does not guarantee safety
• Does not guarantee legality for every governing body
• Does not evaluate performance benefit

7. Use Evidence When Evaluating Efficacy

The statement encourages an algorithmic, evidence-based process, using sources like:

• NIH Office of Dietary Supplements
• Natural Medicines Database
• Peer-reviewed research
• Fact sheets from recognized sports nutrition organizations

BOC angle: Be ready to identify high-quality vs. low-quality evidence and appropriate resources for decision-making.

Final Tips for Using Position Statements in Your BOC Prep

• Create your own summary sheets of each position statement.
• Review them alongside the BOC Role Delineation/Practice Analysis.
• Practice explaining major points as if teaching an athlete—this builds clarity.
• Use the recommendations to create mock clinical decisions.

Position statements aren’t just reading material—they’re professional standards. Understanding them strengthens your exam performance and clinical judgment.