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García-Durán J, González-Jurado JA, Sánchez-Oliver AJ. Analysis of Sports Supplement Consumption in 1688 Federated Road Cyclists. Nutrients 2023; 16:123. [PMID: 38201954 PMCID: PMC10780486 DOI: 10.3390/nu16010123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 12/20/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
The widespread use of sports supplements (SS) to enhance athletic performance extends to cyclists, although little research has been conducted on this subject within this sport. This descriptive and cross-sectional study involved 1688 federated road cyclists, aiming to analyse the pattern of SS consumption concerning the degree of scientific evidence and different categories. This study categorised SS based on the groups and subgroups established by the Australian Sport Institute (AIS, 2023) based on the level of evidence. Our results showed that 62.5% of the sample cyclists used SS, with an average of 12.2 ± 8.6 supplements consumed per participant. Health status (78.2%), pharmacies (62.5%), and medical doctors (45.7%) were the main reasons, purchase sites, and sources of information for SS consumption, respectively. The most prevalent SS consumed were Sports Gels (94%), Sports Bars (89.3%), and Sports Drinks (73.8%). Notably, 80% of the top ten most consumed SS belonged to the group with the highest level of evidence according to the AIS, with an average of 6.9 ± 3.2 supplements per participant. However, 23.3% of the total SS consumers used prohibited substances. In conclusion, while the prevalence of SS consumption among road cyclists is considerable and the primary sources for purchasing SS and obtaining advice are reliable, there is a notable prevalence of prohibited substance use within the sample.
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Affiliation(s)
- Jesús García-Durán
- Facultad de Ciencias del Deporte, Universidad Pablo de Olavide de Sevilla, 41013 Sevilla, Spain
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Mauger AR, Thomas T, Smith SA, Fennell CRJ. Tramadol is a performance-enhancing drug in highly trained cyclists: a randomized controlled trial. J Appl Physiol (1985) 2023; 135:467-474. [PMID: 37410900 PMCID: PMC10538983 DOI: 10.1152/japplphysiol.00338.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/05/2023] [Accepted: 07/05/2023] [Indexed: 07/08/2023] Open
Abstract
Tramadol is a potent narcotic analgesic reportedly used in multiple sports to reduce exertional pain and confer a performance advantage. This study sought to identify whether tramadol enhances performance in time trial cycling. Twenty-seven highly trained cyclists were screened for tramadol sensitivity and then attended the laboratory across three visits. Visit 1 identified maximal oxygen uptake, peak power output, and gas exchange threshold through a ramp incremental test. Participants returned to the laboratory on two further occasions to undertake cycling performance tests following the ingestion of either 100 mg of soluble tramadol or a taste-matched placebo control in a double-blind, randomized, and crossover design. In the performance tests, participants completed a 30 min non-exhaustive fixed intensity cycling task at a heavy exercise intensity (272 ± 42 W), immediately followed by a competitive self-paced 25-mile time trial (TT). Following removal of two outlier data sets, analysis was completed on n = 25. Participants completed the TT significantly faster (d = 0.54, P = 0.012) in the tramadol condition (3758 s ± 232 s) compared with the placebo condition (3808 s ± 248 s) and maintained a significantly higher mean power output (+9 W) throughout the TT (ηp2 = 0.262, P = 0.009). Tramadol reduced perception of effort during the fixed intensity trial (P = 0.026). The 1.3% faster time in the tramadol condition would be sufficient to change the outcomes of a race and is highly meaningful and pervasive in this cohort of highly trained cyclists. The data from this study suggests that tramadol is a performance-enhancing drug.NEW & NOTEWORTHY In the current study, when cycling with tramadol participants completed a time trial on average 50 s faster and at a 9 W higher power output than the placebo control. The study used both a fixed intensity and self-paced time trial exercise tasks to reflect the demands of a stage race. The outcomes from this study were used by the World Anti-Doping Agency to inform their addition of tramadol to the Prohibited List in 2024.
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Affiliation(s)
- Alexis R Mauger
- School of Sport and Exercise Sciences, University of Kent, Canterbury, United Kingdom
| | - Trudy Thomas
- Medway School of Pharmacy, Universities of Kent and Greenwich, Chatham, United Kingdom
| | - Samuel A Smith
- School of Sport and Exercise Sciences, University of Kent, Canterbury, United Kingdom
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Hurst P, Schiphof-Godart L, Kavussanu M, Barkoukis V, Petróczi A, Ring C. Are dietary supplement users more likely to dope than non-users?: A systematic review and meta-analysis. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 117:104077. [PMID: 37267738 DOI: 10.1016/j.drugpo.2023.104077] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/11/2023] [Accepted: 05/14/2023] [Indexed: 06/04/2023]
Abstract
In the past decade, a body of evidence has reported that dietary supplement use is related to prohibited performance enhancing substance use (i.e., doping). To help international and national sport organisations understand the degree to which dietary supplement use is related to doping, the objectives of this systematic review and meta-analysis were to 1) compare the prevalence of doping between dietary supplement users and non-users and 2) identify whether supplement use is related to doping social cognitive factors. We searched for studies sampling athletes and that measured both dietary supplement use and doping in EMBASE, MEDLINE, PsychINFO, CINAHL and SPORTDiscus from database creation to May 2022. Risk of bias was assessed using JBI Critical Appraisal Checklist for cross-sectional studies and the STROBE checklist. Twenty-six cross-sectional studies, involving 13,296 athletes were included. Random-effect models revealed that doping was 2.74 (95% CI=2.10 to 3.57) times more prevalent in dietary supplement users (pooled prevalence = 14.7%) than non-users (6.7%), and that users reported stronger doping intentions (r=0.26, 0.18 to 0.34) and attitudes (r=0.21, 0.13 to 0.28) compared to non-users. Preliminary evidence also suggests that dietary supplement users were less likely to dope if they were more task oriented and had a stronger sense of morality. Results of the review are limited by the cross-sectional design used in all studies and lack of consistency in measurement of dietary supplement use and doping. Data indicate that athletes using dietary supplements are more likely to self-report doping Anti-doping policy should, therefore, target dietary supplement use in anti-doping education programmes by providing alternative strategies for performance enhancement or highlighting the safest ways they can be consumed. Similarly, as a large proportion of athletes use dietary supplements without doping, further research is needed to understand the factors that protect a dietary supplement user from doping. No funding was received for the review. A study protocol can be found here: https://osf.io/xvcaq.
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Affiliation(s)
- Philip Hurst
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, United Kingdom.
| | - Lieke Schiphof-Godart
- Department of Medical Informatics, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Maria Kavussanu
- School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Vassilis Barkoukis
- Department of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andrea Petróczi
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, London, United Kingdom; Institute of Health Promotion & Sport Sciences, Eötvös Lóránd Tudományegyetem (ELTE), Budapest, Hungary
| | - Christopher Ring
- School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
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Bourgonjon B, Vermeylen K, Tytgat N, Forget P. Anaesthesia for elite athletes. Eur J Anaesthesiol 2022; 39:825-834. [PMID: 35943185 DOI: 10.1097/eja.0000000000001719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sports participation has been growing rapidly since the 1960s. Anaesthesiologists are increasingly confronted with athletes in a peri-operative setting. The right choice of type of anaesthesia technique, pain management of injuries, specific physiologic adaptations of the athlete and knowledge of prohibited substances are eminent for a correct approach of this subpopulation. PURPOSE This review aims to give an overview of athletes' specific anaesthetic management in peri-operative and postoperative settings and to guide the nonspecialised anaesthetist. METHODS We comprehensively reviewed the literature, gathered all the information available on, and synthesised it in a narrative way, regarding preoperative evaluation, intraoperative implications and postoperative pain management of the elite athlete undergoing a surgical procedure. RESULTS An anaesthesiologist should recognise the most common benign ECG findings in athletes like bradycardia, isolated left ventricle hypertrophy on voltage criteria and early repolarisation as normal features in the athlete's heart. Isotonic physiology typically produces four-chamber dilation. In contrast, isometric stress creates high intravascular pressure leading to left ventricular hypertrophy. Pre-operative evaluation should also identify possible consumers of performance-enhancing drugs. Intraoperative points of interest for the anaesthesiologist is mainly avoiding drugs on the prohibited list of the World Anti-Doping Agency (WADA). Postoperative and chronic pain management are still developing fields in this population. The International Olympic Committee (IOC) proposed treating acute pain with a combination of paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), topical analgesics, injectable NSAIDs and local anaesthetics. It may be suggested that chronic pain management in elite athletes could benefit from treatment in specialised multidisciplinary pain clinics. CONCLUSION This literature review aims to serve as a guide for the anaesthesiologist taking care of the elite athlete.
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Affiliation(s)
- Bram Bourgonjon
- From the Department of Anaesthesiology, GZA Antwerpen (BB), Department of Anaesthesiology, AZ Turnhout, Turnhout (KV), Department of Anaesthesiology, ASZ Aalst, Aalst, Belgium (NT) and Institute of Applied Health Sciences, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen; Department of Anaesthesia, NHS Grampian, Aberdeen, UK (PF)
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Effect of Tadalafil Administration on Redox Homeostasis and Polyamine Levels in Healthy Men with High Level of Physical Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18199962. [PMID: 34639267 PMCID: PMC8508218 DOI: 10.3390/ijerph18199962] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/14/2021] [Accepted: 09/20/2021] [Indexed: 01/07/2023]
Abstract
Background: The phosphodiesterase type 5 inhibitor (PDE5I) tadalafil, in addition to its therapeutic role, has shown antioxidant effects in different in vivo models. Supplementation with antioxidants has received interest as a suitable tool for preventing or reducing exercise-related oxidative stress, possibly leading to the improvement of sport performance in athletes. However, the use/abuse of these substances must be evaluated not only within the context of amateur sport, but especially in competitions where elite athletes are more exposed to stressful physical practice. To date, very few human studies have addressed the influence of the administration of PDE5Is on redox balance in subjects with a fitness level comparable to elite athletes; therefore, the aim of this study was to investigate for the first time whether acute ingestion of tadalafil could affect plasma markers related to cellular damage, redox homeostasis, and blood polyamines levels in healthy subjects with an elevated cardiorespiratory fitness level. Methods: Healthy male volunteers (n = 12), with a VO2max range of 40.1–56.0 mL/(kg × min), were administered with a single dose of tadalafil (20 mg). Plasma molecules related to muscle damage and redox-homeostasis, such as creatine kinase (CK), lactate dehydrogenase (LDH), total antioxidant capacity (TAC), reduced/oxidized glutathione ratio (GSH/GSSG), free thiols (FTH), antioxidant enzyme activities (superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx)), as well as thiobarbituric acid reactive substances (TBARs), protein carbonyls (PrCAR), and polyamine levels (spermine (Spm) and spermidine (Spd)) were evaluated immediately before and 2, 6 and 24 hours after the acute tadalafil administration. Results: A single tadalafil administration induced an increase in CK and LDH plasma levels 24 after consumption. No effects were observed on redox homeostasis or antioxidant enzyme activities, and neither were they observed on the oxidation target molecules or polyamines levels. Conclusion: Our results show that in subjects with an elevated fitness level, a single administration of tadalafil induced a significant increase in muscle damage target without affecting plasma antioxidant status.
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Aguilar-Navarro M, Muñoz-Guerra J, Del Mar Plara M, Del Coso J. Analysis of doping control test results in individual and team sports from 2003 to 2015. JOURNAL OF SPORT AND HEALTH SCIENCE 2020; 9:160-169. [PMID: 32099724 PMCID: PMC7031807 DOI: 10.1016/j.jshs.2019.07.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 02/27/2019] [Accepted: 04/02/2019] [Indexed: 05/04/2023]
Abstract
BACKGROUND Determining the prevalence of doping in sport might be useful for anti-doping authorities to gauge the effectiveness of anti-doping policies implemented to prevent positive attitudes toward doping. Using questionnaires and personal interviews, previous investigations have found that the prevalence of doping might be different among different sports disciplines; however, there is no sport-specific information about the proportion of adverse and atypical findings (AAF) in samples used for doping control. The aim of the present investigation was to assess the differences in the frequency of adverse analytical and atypical findings among sports using the data made available by the World Anti-Doping Agency. METHODS The data included in this investigation were gathered from the Testing Figures Reports made available annually from 2003 to 2015 by the World Anti-Doping Agency. These Testing Figures Reports include information about the number of samples analyzed, the number of AAFs reported, and the most commonly found drugs in the urine and blood samples analyzed. A total of 1,347,213 samples were analyzed from the individual sports selected for this investigation, and 698,371 samples were analyzed for disciplines catalogued as team sports. RESULTS In individual sports, the highest proportions of AAF were 3.3% ± 1.0% in cycling, 3.0% ± 0.6% in weightlifting, and 2.9% ± 0.6% in boxing. In team sports, the highest proportions of AAF were 2.2% ± 0.5% in ice hockey, 2.0% ± 0.5% in rugby, and 2.0% ± 0.5% in basketball. Gymnastics and skating had the lowest proportions at (≤1.0%) for individual sports, and field hockey, volleyball and football had the lowest proportions for team sports (≤1.4%). CONCLUSION As suggested by the analysis, the incidence of AAF was not uniform across all sports disciplines, with the different proportions pointing to an uneven use of banned substances depending on the sport. This information might be useful for increasing the strength and efficacy of anti-doping policies in those sports with the highest prevalence in the use of banned substances.
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Affiliation(s)
- Millán Aguilar-Navarro
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, 28692, Spain; Faculty of Education, Francisco de Vitoria University, Madrid, 28223, Spain
| | - Jesús Muñoz-Guerra
- Department for Doping Control, Spanish Agency for Health Protection in Sport, Madrid, 28016, Spain
| | - María Del Mar Plara
- Department of Education, Spanish Agency for Health Protection in Sport, Madrid, 28016, Spain
| | - Juan Del Coso
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, 28692, Spain.
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Abstract
OBJECTIVE To identify the prevalence, frequency of use, and effects of analgesic pain management strategies used in elite athletes. DESIGN Systematic literature review. DATA SOURCES Six databases: Ovid/Medline, SPORTDiscus, CINAHL, Embase, Cochrane Library, and Scopus. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Empirical studies involving elite athletes and focused on the use or effects of medications used for pain or painful injury. Studies involving recreational sportspeople or those that undertake general exercise were excluded. MAIN RESULTS Of 70 articles found, the majority examined the frequency with which elite athletes use pain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, anesthetics, and opioids. A smaller set of studies assessed the effect of medications on outcomes such as pain, function, and adverse effects. Oral NSAIDs are reported to be the most common medication, being used in some international sporting events by over 50% of athletes. Studies examining the effects of pain medications on elite athletes typically involved small samples and lacked control groups against which treated athletes were compared. CONCLUSIONS Existing empirical research does not provide a sufficient body of evidence to guide athletes and healthcare professionals in making analgesic medication treatment decisions. Based on the relatively robust evidence regarding the widespread use of NSAIDs, clinicians and policymakers should carefully assess their current recommendations for NSAID use and adhere to a more unified consensus-based strategy for multidisciplinary pain management in elite athletes. In the future, we hope to see more rigorous, prospective studies of various pain management strategies in elite athletes, thus enabling a shift from consensus-based recommendations to evidence-based recommendations.
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Australian athletes' knowledge of the WADA Prohibited Substances List and performance enhancing substances. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 56:40-45. [PMID: 29550541 DOI: 10.1016/j.drugpo.2018.02.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 01/23/2018] [Accepted: 02/27/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND This study investigated athlete knowledge of the World Anti-doping Agency (WADA) Prohibited Substances List and the effects of four well-known performance enhancing substances (PES). METHODS A sample of 1925 elite and sub-elite athletes (mean age 20.6 years) completed a questionnaire about the banned status of 30 substances/methods and their knowledge of the effects of amphetamines, anabolic steroids, growth hormone and erythropoietin. RESULTS Athletes showed limited understanding of the WADA Prohibited Substances List, scoring 32.2% correct, 36.3% incorrect, and 31.4% indicated they did not know the status of 30 substances. Responses of >50% correct were given for only eight substances/method: anabolic steroids, amphetamines, blood doping, erythropoietin, caffeine, vitamins/minerals, protein powders and iron. Athletes demonstrated moderate knowledge of the desired effects of the four PES (49% correct), but poor knowledge of their adverse effects (29% correct). Age, sex, ethnicity, professional/amateur status, and current competition level were significant predictors of the number of correct responses (r2 = 0.16, p < 0.05). Athletes most likely to provide correct responses were male, 19-22 year-olds, Caucasian, professional and international representatives. CONCLUSION This comprehensive study of anti-doping demonstrated that Australian athletes had limited knowledge of a wide range of substances and PES. Better targeted drug education towards younger and non-professional athletes and evaluation of current anti-doping programs are warranted.
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Abstract
CONTEXT With the increasing use of unregulated dietary supplements, athletes are at continued risk from adverse medical events and inadvertent doping. EVIDENCE ACQUISITION A review of Clinical Key, MEDLINE, and PubMed databases from 2012 to 2017 was performed using search terms, including dietary supplement, contamination, doping in athletes, inadvertent doping, and prohibited substances. The references of pertinent articles were reviewed for other relevant sources. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 3. RESULTS Poor manufacturing processes and intentional contamination with many banned substances continue to occur in dietary supplements sold in the United States. Certain sectors, such as weight loss and muscle-building supplements, pose a greater threat because they are more likely to be contaminated. CONCLUSION Athletes will continue to be at risk for adverse events and failed doping tests due to contaminated dietary supplements until legislation changes how they are regulated. In the interim, there are several steps that can be taken to mitigate this risk, including improved education of medical staff and athletes and use of third party-certified products.
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Di Luigi L, Sansone M, Sansone A, Ceci R, Duranti G, Borrione P, Crescioli C, Sgrò P, Sabatini S. Phosphodiesterase Type 5 Inhibitors, Sport and Doping. Curr Sports Med Rep 2017; 16:443-447. [DOI: 10.1249/jsr.0000000000000422] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Nabuco HCG, Rodrigues VB, Ravagnani CDFC. FATORES ASSOCIADOS AO USO DE SUPLEMENTOS ALIMENTARES ENTRE ATLETAS: REVISÃO SISTEMÁTICA. REV BRAS MED ESPORTE 2016. [DOI: 10.1590/1517-869220162205154808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO A prevalência de consumo de suplementos alimentares entre atletas tem sido estudada exaustivamente. Contudo, não foi encontrado estudo que reúna e discuta, de forma sistematizada, os fatores que podem desencadear o consumo de suplementos entre atletas. O objetivo foi descrever a prevalência e as características do consumo e compreender quais fatores estão associados ao uso dos suplementos alimentares nessa população específica. Realizou-se uma pesquisa bibliográfica nas seguintes bases de dados: PubMed, Lilacs e Scielo. O Google Scholar foi consultado para identificação de material adicional. Foram incluídos estudos que investigaram a prevalência do uso de suplementos alimentares entre atletas, seus fatores associados, sem limite de idade e em ambos os sexos. De 374 estudos identificados, dezessete foram incluídos nesta revisão. Todos os estudos utilizaram delineamento transversal e o instrumento de coleta mais utilizado foi o questionário autoadministrado. A prevalência do uso de suplementos variou de 37,5% a 98%. Os atletas têm consumido mais vitaminas buscando informações com seus técnicos, visando melhorar o estado geral de saúde. "Prática de esporte individual" e "alto volume de treinamento" foram identificados como fatores associados ao uso de suplementos alimentares. A partir dos dados revisados, verificou-se um amplo intervalo de variação na utilização de suplementos pelos atletas. Os atletas têm consumido mais vitaminas e procuraram informações sobre o consumo com seus treinadores, com o objetivo de melhorar a sua saúde. Esta revisão também destaca a necessidade de uma investigação de alta qualidade sobre os correlatos de consumo de suplemento em atletas, uma vez que os dados foram discrepantes para muitos fatores relatados pelos estudos.
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