When coach Frank Noppenberger notices his teenage athletes at East Brunswick High School in New Jersey bulking up suddenly, he always takes them aside for a confidential chat.
What he says is simple and to the point: "I hope you're not doing it the wrong way. I hope you're doing it the right way."
The right way is through a proper diet and a tough weight-training regime. The wrong way, according to the athletic director, is with performance-enhancing nutritional supplements.
Mr. Noppenberger's stern talk is one going on at hundreds of high schools across the United States as a growing number of student athletes turn to the supplements to build up their bodies.
While the substances are legal, many coaches are concerned about the ethics and health effects of their use by American youths. Sales of the over-the-counter substances have risen dramatically in recent years - particularly in the wake of the publicity surrounding home-run doyens Sammy Sosa and Mark McGwire.
"When the newspapers reported the home run king was using this stuff ... suddenly the kids were running to get it," says Sandra Scott, executive director of the New York State Public High School Athletic Association.
Both Mr. McGwire and Mr. Sosa say they use creatine, a supplement made up of three amino acids that occur naturally in the body. It helps athletes gain weight and recover more quickly from workouts. McGwire also takes androstenedione - a more controversial supplement that is a precursor to steroids. The players' popularity is forcing thousands of high school coaches like Noppenberger to face a difficult question: Can and should they be banned for young athletes?
Several things are fueling the coaches' concern. While many studies have found creatine to be safe for use in the short term, no long-term studies on the health effects have been done, particularly on young athletes.
Androstenedione is another story. Known as andro, it's believed to carry all of the well-documented risks incurred when hormone balances are thrown out of whack. But again, no long-term studies have been done.
Then there are ethical concerns raised by the use of pharmacology to increase an individual's competitiveness, and the overall impact on sportsmanship. "I ... think of the use of steroids as cheating," says Pat Mediate, physical education teacher at Greenwich High School in Connecticut.
Finally, many coaches are concerned the use of performance-enhancing supplements sends kids the wrong message. "It feeds the attitude that there's an easy way to success, that it can be obtained without doing the hard work," says Jerry Diehl, assistant director of the National Federation of State High School Associations (NFHS).
DESPITE all the concern, high school sports experts say there's no easy way to deal with nutritional supplements because they are legal and sold over the counter.
This summer, the NFHS issued a sweeping recommendation that no school personnel or coaches should dispense any drug, medication, or food supplements, "except with extreme caution." But it was, at best, a recommendation.
The national organization has no authority to ban such legal substances. And even it if did, it wouldn't have the capability to enforce such a rule, according to Don Herrmann, chairman of NFHS's sports-medicine advisory group. Enforcement would require drug testing, a complicated and expensive endeavor that now is used by only a few high schools nationally.
But even if every school did have drug-testing capability, it would do no good. Both creatine and androstenedione occur naturally in the body. A student could easily explain a high level of creatine by saying he ate several steaks the night before. So the NFHS has chosen instead to focus on education and persuasion.
"What our statement suggests is that high schools should adopt a rule that would prohibit their coaches from distributing, selling, dispensing in any way, shape, or form," says Mr. Herrmann.
While no one knows how many student athletes take supplements in general, use of creatine is believed to be widespread.
A recent survey of high school and college coaches and private trainers by the National Strength and Conditioning Association in Colorado Springs, Colo., found that 86 percent of the people they deal with "to the best of their knowledge" used creatine. Sixty-nine percent said they believed it was a safe way to enhance their training.
Steve Plisk, the director of sports conditioning at Yale University, believes that creatine, at least, has been studied thoroughly enough for adult athletes to use safely. But he is concerned about the quality of some of the creatine that's available now because of booming demand. "The problem is the market has been flooded with low quality product and/or contaminated product that's been cut with fillers," says Mr. Plisk. "It's important to be sure you're getting it from a reputable vender."
Despite the acceptance of creatine among many older and professional athletes, some high school sports leaders would still like to see supplements banned for youths. East Brunswick is investigating the possibility. But coach Noppenberger says it's a complex issue. "We can ban alcohol because there's a drinking age. But for these over-the-counter ones, there is none that I know of."
Yet others contend that student involvement in sports is a privilege. Thus, they believe students can be required to adhere to a set of higher set of standards.