Knowledge, attitudes, and practices regarding dietary supplements among athletes in Morocco: a national cross-sectional exploratory study

Résumé

Abstract Dietary supplement (DS) use is widespread in sports but raises important health and ethical concerns, particularly the risk of unintentional doping. In Morocco, data on this topic remain scarce. This study aimed to assess the knowledge, attitudes, and practices (KAP) of athletes recruited through a convenience sample of 14 Moroccan national sports federations regarding DSs. A descriptive and analytical cross-sectional survey was conducted between December 2023 and October 2024 among 1,094 athletes from 14 national sport federations. Data were collected using an online and face-to-face KAP questionnaire. Descriptive analyses, bivariate tests (χ 2 ), and multivariate analyses (binary logistic regression) were performed using JAMOVI ( p < 0.05). The prevalence of dietary supplement use was 38.1%. No significant difference in supplement use was observed between male and female athletes. Performance enhancement was the main motivation for use (52% of DS users). Nearly half of the athletes were unaware of the potential risks associated with dietary supplements, while 27.3% of DS users reported using supplements under medical or nutritional supervision. An exploratory multivariable logistic regression based on complete-case analysis (N = 366) suggested several factors associated with dietary supplement use. Athletes aged 28–32 years (OR = 2.75; 95% CI 1.34–5.67) and those who had consulted a healthcare professional (OR = 3.38; 95% CI 1.92–5.94) were more likely to report dietary supplement use, whereas athletes training fewer than five hours per week (OR = 0.48; 95% CI 0.25–0.93) and those who did not consider dietary supplements essential for improving performance (OR = 0.43; 95% CI 0.25–0.76) were less likely to use them. The model demonstrated acceptable discrimination (AUC = 0.77) and no evidence of multicollinearity (all VIFs < 2). Among athletes recruited through a convenience sample of 14 Moroccan national sports federations, DS use was common and remained largely unsupervised. These exploratory findings highlight limited knowledge, low engagement with healthcare professionals, and a substantial risk of unintentional doping, providing preliminary evidence supporting the development of educational and regulatory strategies, which should be confirmed by nationally representative studies.

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