Wendi A. Johnson, a MD at the CentraCare Women's and Children's Clinic in St. Cloud Minnesota argues in her article on the Contemporary Pediatrics Archive that teenagers should not use supplements on the market to enhance their athletic performance and give them an advantage over competition. Johnson states "the supplement market has experienced major growth over the last several years. Since enactment of the Dietary Supplement Health Education Act of 1994, it has been largely unregulated as well, leading to increased availability of nutritional ergogenic aids. Any substance classified as a nutritional or dietary supplement is not subject to regulation by the Food and Drug Administration. There are no standards for purity, quality, or quantity of active compounds, and a substance cannot be removed from the market until it is proven to be unsafe. Manufacturers of supplements do not need to publish benefits or precautions. Supplements may be recommended to a young person by a coach or teammate to treat a suspected deficiency (for example, iron for tiredness), to meet an increased requirement of a certain substance related to athletics (more protein to build muscle), or solely to enhance performance.Supplement use by athletes of all ages has been reported to be anywhere from 30% to 100%. Vitamin supplementation in British children 4 to 12 years of age is known to increase with socioeconomic status (that is, those with the least need are the most likely to receive supplements). It is unknown whether this finding pertains to performance-enhancing supplements or applies to children in the United States. None of the performance-enhancing supplements discussed in this article have been studied in youths under 18 years of age. Because the risks of supplements are unknown, prepubertal and pubertal children should be strongly discouraged from using them.