Vitamin D improves strength and reduces injuries in dancers, while iron lowers anemia prevalence

IntroductionProfessional and pre-professional dancers experience exceptional physical demands and an increased risk of injuries and health concerns, often leading to the use of medication and dietary supplements.ObjectiveTo examine the prevalence of dietary supplement and medication utilization among professional and pre-professional dancers and their effects on performance, health outcomes, and dance-related pathologies.MethodsThis systematic review followed PRISMA 2020 guidelines and was registered in PROSPERO (CRD420251000872). PubMed, Scopus, Web of Science, and Cochrane Library were searched from inception to April 2025. Eligible studies included professional or pre-professional dancers using dietary supplements or medication with potential therapeutic or ergogenic effects. Data extraction and risk-of-bias assessments were performed independently by two reviewers using RoB 2, ROBINS-I, and JBI tools.ResultsA total of 22 studies were included (12 observational, 6 randomized controlled and 4 non-randomized interventions) involving 654 female and 86 male dancers from various disciplines. Supplement use ranged from 11 to 57%, with multivitamins, vitamin C, caffeine, and isotonic beverages most frequently consumed. Vitamin D improved isometric strength, jump performance, and reduced injury incidence. Iron decreased anemia prevalence, while folic acid enhanced endothelial function. Whey protein and creatine increased lean mass without consistent performance benefits. Analgesics and non-steroidal anti-inflammatory medication were reported by up to 90% of dancers.ConclusionPharmacological and nutritional substances use among dancers is widespread yet heterogeneous, with limited evidence of benefits and potential health risks. High-quality randomized controlled trials are needed to establish evidence-based guidelines for safe and effective use in dance populations.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251000872, CRD420251000872.