Research published in the December issue of the journal Pediatrics Monday morning sheds light on teens’ efforts to attain more-muscular bodies.

A survey of more than 2,700 middle and high school students (the average age was 14.4 years) at 20 schools in Minnesota reveals that many have taken steps — some more healthful than others — to build muscle size or tone. Those steps included changing their eating behaviors and getting more exercise to less-healthful, or even dangerous, actions such as consuming protein powders or shakes or using steroids or other muscle-enhancing substances. Nearly all the adolescents surveyed had engaged in at least one of these behaviors.

Researchers at the University of Minnesota and Columbia University found that about 68 percent of boys said they’d changed their eating habits to enhance their muscle-building, and 90 percent said they’d exercised more to pursue that goal. Nearly 35 percent had used protein powders or shakes, about 6 percent had used steroids, and 10.5 percent said they’d used another muscle-enhancing substance (such as creatine, amino acids, hydroxyl methylbutyrate, DHEA or growth hormone).

Among the girls surveyed, just over 62 percent had changed the way they ate and nearly 82 percent said they’d exercised more to build better muscles; 21.2 percent of girls had used protein powders, 4.6 percent had used steroids and 5.5 percent had used another muscle enhancer.

Muscle-enhancement efforts were more common among teens who participated in team sports than among those who did not, the study found. But interestingly, those efforts did not appear to “cluster” at any particular schools, which suggests that coaches or fellow team members were most likely not steering these teens toward use of muscle enhancers.

The authors acknowledge that changing eating behaviors and exercising more can of course be good for teens, but in the context of muscle-enhancement efforts, those seemingly positive activities can turn ugly if they’re overdone. “Although these may be beneficial,” the authors write, “compulsive or excessive use is cause for concern, because they may be a precursor to the development of more severe and unhealthy behaviors over time. Health-care providers should counsel adolescent patients about appropriate exercise, general nutrition and the lack of efficacy and potential dangers of muscle-enhancement products.”

The authors suggest that, given the association between athletic-team participation and muscle-enhancement efforts, sports physicals might provide the perfect opportunity for pediatricians to discuss these matters with their young patients. They also suggest that muscle-enhancement awareness messages be folded into existing body-image programs.