Performance-enhancing aids in sport: health consequences and nutritional alternatives

Adolescent anabolic steroid use, gender, physical activity, and other problem behaviors*

To test the comparative value of strain theory and problem behavior theory as explanations of adolescent anabolic steroid use, this study examined gender-specific relationships among steroid use, physical activity, and other problem behaviors. Based on the United States Centers for Disease Control and Prevention's 1997 Youth Risk Behavior Survey, a nationally representative sample of over 16,000 U.S. public and private high school students, binge drinking, cocaine use, fighting, and sexual risk-taking were associated with higher odds of lifetime steroid use. In gender-specific analyses, steroid use was strongly associated with female fighting and smokeless tobacco use as well as male sexual risk. Neither athletic participation nor strength conditioning predicted odds of steroid use after controlling for problem behaviors, nor did steroid-using athletes report more frequent use than steroid-using nonathletes. The study's limitations and policy implications were noted. These data suggest that other problem behaviors such as substance use, fighting, and sexual risk are better predictors of adolescent steroid use than physical activity. Interventions to prevent steroid use should not be limited to male participants in organized sports programs, but should also target adolescents identified as at risk for other problem behaviors.

Nutrition and sports supplements: fact or fiction

BACKGROUND

In an age of highly competitive sports, whether it be the high school student, the weekend warrior, or the professional athlete, more individuals are using "performance-enhancing" nutritional supplements. Many feel they are gaining a "competitive edge," without thinking of the potential consequences. Consumers are inundated with claims of strength, weight loss, and improved body definition, but they are rarely given information on the potentially harmful side effects. There are few large, multicenter, randomized trials of these various nutritional supplements that look at the purported claims and potential side effects.

STUDY

We reviewed the available studies, including case reports, and researched data on five of the most popular performance-enhancing supplements, including androstenedione, creatine, chromium, ephedra, and protein and amino acid supplements.

CONCLUSIONS

Of the reviewed supplements, only creatine may be marginally beneficial. The potential benefit would probably only be useful to the professional athlete and not the average person. All of the supplements reviewed have potentially harmful side effects; however, certain supplements clearly show harmful effects, and use should strongly be cautioned. In addition, ephedra should be withdrawn from the marketplace. At this time, without better-designed studies, these agents cannot be recommended.

Anabolic steroids

Anabolic steroids are synthetic derivatives of testosterone modified to enhance the anabolic rather than the androgenic actions of the hormone. The anabolic effects are considered to be those promoting protein synthesis, muscle growth and crythopoiesis. There are numerous side-effects to anabolic steroids, including hypertension and atherosclerosis, blood clotting, jaundice, hepatic carcinoma, tendon damage, psychiatric and behavioural effects and, in males, reduced fertility and gynaccomastia. Anabolic steroids were added to the International Olympic Committee's list of banned substances in 1975. The majority of 'evidence' concerning the efficacy of anabolic steroids as performance enhancing agents is anecdotal. In the main, experimental investigations have been poorly designed scientifically, clinically and statistically. The percentage of positive test results from IOC accredited laboratories has remained consistently low. However, athletes take their steroids during training and out-of-competition testing is not conducted in all countries, although international co-operation is now under consideration. Despite the lack of conclusive evidence, steroids users will continue to hold the view that their effects are efficacious and they are therefore unlikely to be persuaded to curtail their use.

Potential for the effects of anabolic steroid abuse in the immune and neuroendocrine axis

Some of the effects that high-dose anabolic steroid abuse have and could have on the interactions between the immune and neuroendocrine systems are reviewed. Considering the past demonstrations on the actions of normal steroids on endocrine and immune responses, it is apparent that pharmacologically high doses of both normal and derivatized androgens (anabolic steroids) could have a significant effect. Indeed, some of the pathologies attributed to anabolic steroid abuse point to disturbances in the intimate connection between neuroendocrine and immune function and interaction. We attempt to review both the direct and indirect effects of this abuse, not only on this interaction but also on certain immune functions in particular.

The use of nutritional ergogenic aids in sports: is it an ethical issue?

As nutritional technology advanced, scientists have been able to synthesize and manufacture all known nutrients, and many of their metabolic by-products, essential to human physiology. Many of these substances are theorized to possess ergogenic potential when taken in quantities or forms normally not found in typical foods or diets. Research, although limited in most cases, supports the ergogenicity of some nutrients (e.g., creatine) when consumed in substantial amounts, suggesting such nutrients may function as drugs or nutraceuticals. The International Olympic Committee (IOC) doping legislation stipulates that any physiologic substance taken in abnormal quantity with the intention of artificially and unfairly increasing performance should be construed as doping, violating the ethics of sport performance. Given this stipulation, the IOC and other athletic-governing organizations should consider the legality and ethics underlying the use of ergogenic nutraceuticals in sport.

Anabolic steroids: a review of their effects on the muscles, of their possible mechanisms of action and of their use in athletics

Anabolic steroids are synthetic molecules developed in the hope of obtaining a complete separation of the androgenic and myotrophic (anabolic) actions of testosterone. Such a goal has never been fully achieved. However, some synthetic steroids present a partial dissociation between these two activities. Since a single hormonal receptor apparently mediates the androgenic as well as the anabolic actions of testosterone, differences in patterns of androgen metabolization in the muscles and the sex accessory organs have been proposed as a possible cause of this phenomenon. Undoubtedly, androgens are able to exert a trophic effect on skeletal and cardiac muscle fibres in subjects with low circulating levels of testosterone such as prepubertal or hypogonadal males and females; however, the widespread use of anabolic steroids in male athletes to increase their physical performances poses the question of whether these compounds are active in the presence of normal circulating levels of testosterone. Most experimental animal studies indicate that anabolic steroids are ineffective in this situation. Since the results of the experiments performed in humans are largely contradictory, it is still not clear whether anabolic steroids are able to improve athletic performances. These and other relevant issues are reviewed.