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2 Literature review The intersection of supplement use and anti-doping efforts in sport has increasingly examined in its intersection with anti-doping regulation, with particular attention to the risks of inadvertent doping, inconsistencies in regulatory oversight, and the implications of policy design across diverse sporting contexts ( 2.1 Global supplement use and the anti-doping regulatory landscape The prevalence of supplement use among athletes is extensively documented, with usage spanning from recreational participants to elite professionals who utilize products for training support, recovery, and performance enhancement ( The 2026 WADA Prohibited List defines the regulatory boundaries of anti-doping by categorizing banned substances into classes such as anabolic agents (S1), hormone and metabolic modulators (S4), and stimulants (S6)

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108 In addition to peripheral bone destruction, the bone marrow microenvironment may also suffer dysfunction in cancer cachexia

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