Performance enhancement with supplements: incongruence between rationale and practice

Analysis of Sports Supplement Consumption in 1688 Federated Road Cyclists

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.

Trends in dietary supplement use among athletes selected for doping controls

Background

Dietary supplements (DS) may be beneficial for athletes in certain situations, whereas incorrect or excessive use may impair performance, pose a risk to the athlete's health and cause positive doping tests by containing prohibited substances. To provide athletes with relevant and tailored information on safe supplement use, a better knowledge about DS trends over time and between sport disciplines are needed.

Methods

This study examines the use of DS among athletes who have participated in doping controls by extracting information derived from 10,418 doping control forms (DCF) collected by Anti-Doping Norway from 2015 to 2019.

Results

Overall, 51% of the DCFs contained information about at least one DS. National level athletes (NLA) more often reported using DS than recreational athletes (RA) (53 vs. 47%, p < 0.001). Athletes in strength and power (71%), VO2max endurance (56%) and muscular endurance sports (55%) had the highest proportion of DCFs with information about DS. Medical supplements were the most used supplement category for both genders and across all sports. Dietary supplements with a high risk of containing doping substances were most common among male, RA in strength and power sports. There were small and non-significant year-to-year variations in the prevalence of athletes using DS, while the number of products used concomitantly peaked in 2017 before declining in 2019 (2.30 vs. 2.08, p < 0.01). The use of medical supplements and ergogenic substances increased slightly for both NLA and RA from 2015 to 2019, while the use of all other supplement categories declined.

Conclusion

Half of the 10,418 DCFs contained information about DS, with variations within the athlete population. DS with high risk of containing prohibited substances were mostly seen in sport disciplines requiring a high degree of specialization in strength/power, including powerlifting and weightlifting, as well as in some team sports, such as cheerleading and american football.

Dietary Supplements as a Major Cause of Anti-doping Rule Violations

Dietary supplements encompass a large heterogenic group of products with a wide range of ingredients and declared effects used by athletes for a multitude of reasons. The high prevalence of use across all sports and level of competition, combined with the well-documented risks of such products containing prohibited substances have led to several doping cases globally. Despite being a considerable concern and persistent focus of sport organizations and anti-doping agencies, the magnitude of anti-doping rule violations associated with supplement use is not well-known. This study examines 18-years of doping controls of a national anti-doping program to determine the relationship between the presence of prohibited substances in athlete's doping samples and the use of dietary supplements. In 26% (n = 49) of all the analytical anti-doping rule violation cases in the period 2003–2020 (n = 192), the athlete claimed that a dietary supplement was the source of the prohibited substance causing an adverse analytical finding. Evidence supporting this claim was found in about half of these cases (n = 27, i.e., 14% of all analytical ADRV's). Stimulants were the most prevalent substance group linked to supplements (n = 24), of which methylhexanamine was associated with 16 cases. High risk products were predominantly multi-ingredient pre-workout supplements (n = 20) and fat-burning products (n = 4). Anti-doping organizations should develop strategies on how to assist athletes to assess the need, assess the risk and assess the consequences of using various dietary supplements.

Creatine Supplementation in Children and Adolescents

Creatine is a popular ergogenic aid among athletic populations with consistent evidence indicating that creatine supplementation also continues to be commonly used among adolescent populations. In addition, the evidence base supporting the therapeutic benefits of creatine supplementation for a plethora of clinical applications in both adults and children continues to grow. Among pediatric populations, a strong rationale exists for creatine to afford therapeutic benefits pertaining to multiple neuromuscular and metabolic disorders, with preliminary evidence for other subsets of clinical populations as well. Despite the strong evidence supporting the efficacy and safety of creatine supplementation among adult populations, less is known as to whether similar physiological benefits extend to children and adolescent populations, and in particular those adolescent populations who are regularly participating in high-intensity exercise training. While limited in scope, studies involving creatine supplementation and exercise performance in adolescent athletes generally report improvements in several ergogenic outcomes with limited evidence of ergolytic properties and consistent reports indicating no adverse events associated with supplementation. The purpose of this article is to summarize the rationale, prevalence of use, performance benefits, clinical applications, and safety of creatine use in children and adolescents.

Prevalence of use of permitted pharmacological substances for recovery among athletes

Objectives: Food supplements and medicines which are not on the list of prohibited substances of the World Anti-Doping Agency are included in the group of permitted pharmacological agents for athlete’s recovery.

The aim of this study was to describe qualitatively and quantitatively food supplements (FS) and over-the-counter drugs use among athletes in the last six month.

Methods: This was a cross sectional study. Data on food supplements and the over-the-counter drugs, usage were collected during 2018 by self-administered, anonymous questionnaire.

Results: A total of 112 athletes completed the survey. A total of 51.8% (n = 58) athletes reported the use of food supplements. The use of medical supplements was reported by 50.0% (n = 56) of athletes, 26.8% (n = 30) reported using ergogenic supplements, 1.8% (n = 2) using of sports food and 4.5% (n = 5) using other supplements. The use of over-the-counter drugs was reported by 35.7% (n = 40) of athletes. The over-the-counter analgesic drugs were used by 95% (n = 38) of over-the-counter drug users. Concomitant administration two or more over-the-counter drugs was reported by 40% (n = 16) athletes. Doctors and coaches had no advisory role in the use of food supplements or over-the-counter drugs.

The Role of Vitamin C in Two Distinct Physiological States: Physical Activity and Sleep

This paper is a literature overview of the complex relationship between vitamin C and two opposing physiological states, physical activity and sleep. The evidence suggests a clinically important bidirectional association between these two phenomena mediated by different physiological mechanisms. With this in mind, and knowing that both states share a connection with oxidative stress, we discuss the existing body of evidence to answer the question of whether vitamin C supplementation can be beneficial in the context of sleep health and key aspects of physical activity, such as performance, metabolic changes, and antioxidant function. We analyze the effect of ascorbic acid on the main sleep components, sleep duration and quality, focusing on the most common disorders: insomnia, obstructive sleep apnea, and restless legs syndrome. Deeper understanding of those interactions has implications for both public health and clinical practice.

Safe use of chemicals and risk communication among dentists and dental students in Greece

Use of chemicals, most often classified for intrinsic hazards, is rather common among dentists. To date, no data have been recorded in the European Union (EU) on dentists' awareness regarding the safe use of chemicals. In the EU regulatory framework, two Regulations with wide applications, namely Regulations (EC) 1907/2006 (REACH) and 1272/2008 (CLP), have been introduced to protect human health and the environment and clearly communicate hazards posed by chemicals to workers and consumers. The aim of this study was to assess the extent of comprehension of hazard communication of chemicals among Greek dentists. For this, a closed-ended, anonymous and validated questionnaire was initially distributed to a total of 300 Greek dentists, both professionals and university students, over a period of 4 months. The collected data from 240 final responders were subjected to statistical analysis (frequencies, percentages, chi-square (χ²) and significance (p < 0.05)). The vast majority (90%) of the interviewed dentists are not aware of the CLP. Main sources of information regarding chemical hazard and safe use was the supplier through direct communication (90%), while some dentists also consulted the product labels (39%) and the material safety data sheets (54%). Regarding hazard communication, the perceived information from the pictograms is confusing to the vast majority of the dentists (86%), especially for systemic hazards (carcinogenicity and/or reproductive toxicity). In addition, 88% of the professional dentists have not noticed any changes in the labelling of chemical products, which also shows the low input of labels to hazard communication. On the other hand, 90% of the responders always utilize personal protective equipment (PPE), although it is not clear whether this PPE is adequate. In conclusion, rising awareness campaigns are needed, in collaboration with universities and dental care professional associations, to inform dentists about the safe use of chemicals not only to ensure protection of their own health but also to contribute to environmental sustainability.

Why Do Athletes Choose Dietary Supplements? Reliability and Validity of the Dietary Supplement Choice Questionnaire (DSCQ) among Japanese College Athletes

To assess the reliability and validity of the Dietary Supplement Choice Questionnaire (DSCQ) to capture dietary supplement choice motives among Japanese college athletes. The cross-sectional study was performed in 2014. This study recruited 1,451 college athletes from sports-oriented clubs at the University of Tsukuba, Japan. The participants completed the DSCQ, health literacy, and subjective economic status; part of the participants completed a test-retest (n=378). A sample of 975 participants (28.0% female) included in the analysis. The DSCQ was developed through factor analysis. Seven factors emerged, and were labelled "popularity," "functionality," "price," "taste," "convenience," "antidoping" and "familiarity." Mostly acceptable reliability was seen across seven DSCQ factors (the internal consistency, Cronbach's α=0.62-0.85; the test-retest reliability coefficients, r=0.62-0.82), whereas convergent validity for price and antidoping factors was provided by significant associations with economic status and literacy (p<0.01). Findings showed reasonable evidence of reliability and validity of the DSCQ and provided the opportunity to comprehensively assess dietary supplement choice motives among Japanese college athletes.

How to foster informed decision making about food supplements: results from an international Delphi study

Food supplement use can have beneficial and detrimental effects, making informed decisions about supplement use important. How these decisions are made and which communication strategies can stimulate informed decision making is unclear. This study identified the important characteristics of (i) informed decision making about food supplement use and (ii) important factors indicating how to communicate about food supplements to foster informed decision making. An online three-round Delphi study was conducted. International experts within the field of (risk) communication about food supplements or related fields were recruited via email. The participants' age ranged from 25 to 69 years, and sample sizes for the three rounds were 38, 89 and 51, respectively. Experts indicated that for making an informed decision about food supplement use one needs to have knowledge of their positive and negative effects, the ability to compare these effects, knowing alternatives besides supplements, feeling informed, and feeling able (self-efficacious) to make the decision and making the decision voluntarily. Important communication strategies mentioned were: provision of information about positive and negative effects and the nature of these effects including scientific evidence, ensuring information is easily accessible, well ordered, tailored and provided by a trustworthy, credible and independent source.

Common Habits, Adverse Events, and Opinions Regarding Pre-Workout Supplement Use Among Regular Consumers

The purpose of the present study was to examine characteristics of multi-ingredient pre-workout supplement (MIPS) users, their common patterns/habits of MIPS ingestion, and their associated feelings about the effectiveness and safety of this class of supplements. An online electronic survey was distributed through social media to assess self-reported supplementation practices and preferences among adult males and females who reported regular MIPS use. A total of 1045 individuals responded, with 872 of these individuals (males: n = 636, 72.9%; females: n = 233, 26.7%; mean ± SD; age = 27.7 ± 7.9 years; training age = 8.2 ± 7.3 years) completing the survey. The majority of respondents reported the length of current or past MIPS consumption as greater than one year (n = 630, 72.2%), with ingestion frequencies primarily of four (n = 210, 24.1%) or five (n = 212, 24.3%) days per week of training. In addition, the three most popular goals for ingesting MIPS were increased energy and focus (n = 776, 89.0%), muscular endurance (n = 325, 37.3%), and blood flow or “pump” (n = 322, 37.0%). Although most users reported ingesting one serving size with each use, 14% reported ingesting two or more, and 18% indicated they ingest MIPS more than once per day. Importantly, over half (54%) of the respondents reported experiencing side-effects following MIPS use, including skin reactions, heart abnormalities, and nausea. Females were more likely than males to experience these side effects, despite being less likely to consume two or more serving sizes per dose. Our findings also indicated that MIPS users should consume no more than the recommended serving size of a given supplement, as the potentially significant variability in the caffeine content of MIPS products is compounded as more doses are consumed. Furthermore, MIPS users should minimize the ingestion of other supplements which contain high levels of niacin and caffeine, as the concurrent consumption of such products may put users above the tolerable upper limits for these substances.

Effects of placebo on bench throw performance of Paralympic weightlifting athletes: a pilot study

BACKGROUND

The aim of the present study was to analyse the effects of placebo on bench throw performance in Paralympic weightlifting athletes.

METHODS

The study involved four Paralympic weightlifting male athletes (age: 40.25 ± 9.91 years, weight: 60.5 ± 8.29 kg, height: 1.60 ± 0.15 m) that visited the laboratory in three occasions, separated by 72 h. In the first session, the athletes were tested for bench press one repetition maximum (1RM). The other two sessions were performed in a randomized counter-balanced order and involved bench throw tests performed either after taking placebo while being informed that the capsule contained caffeine or without taking any substance (control). The bench throw tests were performed with loads corresponding to 50, 60, 70 and 80% of the bench press 1RM.

RESULTS

According to the results, mean velocity (∆: 0.08 m/s, ES 0.36, p < 0.05) and mean propulsive velocity (∆: 0.11 m/s, ES 0.49, p < 0.05) at 50% of 1RM were significantly higher during placebo than control (p < 0.05). However, there were no difference between control and placebo for 60, 70 and 80% of 1RM (p > 0.05).

CONCLUSION

Our results suggest that placebo intake, when the athletes were informed they were taking caffeine, might be an efficient strategy to improve the performance of explosive movements in Paralympic weightlifting athletes when using low-loads. This brings the possibility of using placebo in order to increase performance, which might reduce the risks associated with ergogenic aids, such as side-effects and positive doping testing.

Sport Nutrigenomics: Personalized Nutrition for Athletic Performance

An individual's dietary and supplement strategies can influence markedly their physical performance. Personalized nutrition in athletic populations aims to optimize health, body composition, and exercise performance by targeting dietary recommendations to an individual's genetic profile. Sport dietitians and nutritionists have long been adept at placing additional scrutiny on the one-size-fits-all general population dietary guidelines to accommodate various sporting populations. However, generic "one-size-fits-all" recommendations still remain. Genetic differences are known to impact absorption, metabolism, uptake, utilization and excretion of nutrients and food bioactives, which ultimately affects a number of metabolic pathways. Nutrigenomics and nutrigenetics are experimental approaches that use genomic information and genetic testing technologies to examine the role of individual genetic differences in modifying an athlete's response to nutrients and other food components. Although there have been few randomized, controlled trials examining the effects of genetic variation on performance in response to an ergogenic aid, there is a growing foundation of research linking gene-diet interactions on biomarkers of nutritional status, which impact exercise and sport performance. This foundation forms the basis from which the field of sport nutrigenomics continues to develop. We review the science of genetic modifiers of various dietary factors that impact an athlete's nutritional status, body composition and, ultimately athletic performance.

The Physiological Mechanisms of Effect of Vitamins and Amino Acids on Tendon and Muscle Healing: A Systematic Review

Aims/Objectives: To evaluate the current literature via systematic review to ascertain whether amino acids/vitamins provide any influence on musculotendinous healing and if so, by which physiological mechanisms. Methods: EBSCO, PubMed, ScienceDirect, Embase Classic/Embase, and MEDLINE were searched using terms including “vitamins,” “amino acids,” “healing,” “muscle,” and “tendon.” The primary search had 479 citations, of which 466 were excluded predominantly due to nonrandomized design. Randomized human and animal studies investigating all supplement types/forms of administration were included. Critical appraisal of internal validity was assessed using the Cochrane risk of Bias Tool or the Systematic Review Centre for Laboratory Animal Experimentation Risk of Bias Tool for human and animal studies, respectively. Two reviewers performed duel data extraction. Results: Twelve studies met criteria for inclusion: eight examined tendon healing and four examined muscle healing. All studies used animal models, except two human trials using a combined integrator. Narrative synthesis was performed via content analysis of demonstrated statistically significant effects and thematic analysis of proposed physiological mechanisms of intervention. Vitamin C/taurine demonstrated indirect effects on tendon healing through antioxidant activity. Vitamin A/glycine showed direct effects on extracellular matrix tissue synthesis. Vitamin E shows an antiproliferative influence on collagen deposition. Leucine directly influences signaling pathways to promote muscle protein synthesis. Discussion: Preliminary evidence exists, demonstrating that vitamins and amino acids may facilitate multilevel changes in musculotendinous healing; however, recommendations on clinical utility should be made with caution. All animal studies and one human study showed high risk of bias with moderate interobserver agreement (k = 0.46). Currently, there is limited evidence to support the use of vitamins and amino acids for musculotendinous injury. Both high-quality animal experimentation of the proposed mechanisms confirming the physiological influence of supplementation and human studies evaluating effects on tissue morphology and biochemistry are required before practical application.

Use of nutritional supplements contaminated with banned doping substances by recreational adolescent athletes in Athens, Greece

Although the use of nutritional supplements by adult athletes has been extensively studied, information on supplements consumption by adolescent athletes is still limited. The present study reports on the use of nutritional supplements contaminated with banned doping substances among 170 recreational adolescent athletes from eleven, randomly selected, gym centres, in Athens, Greece. Nutritional supplements consumption was reported by almost 60% of the study population, with proteins/amino acids and vitamins being the most popular. Nine per cent of the users were found to consume nutritional supplements contaminated with anabolic steroids, prohormones, selective androgen receptor modulators (SARMs) and aromatase inhibitors, all pharmacological substances with endocrine modulating properties not stated on the label. None of these individuals had previously consulted a physician or a nutritionist. A representative sample (ca 15%) of the protein/aminoacids and creatine preparations used by the study population were also tested and found free from doping substances. The majority (63%) of adolescents purchased products from the internet. In conclusion, exercising adolescents can have easy access to contaminated nutritional supplements and "black market" products, which could constitute a risk for public health. Low level of awareness and low involvement of medical care professionals among recreational adolescent athletes is also observed.

Achieving Optimal Post-Exercise Muscle Protein Remodeling in Physically Active Adults through Whole Food Consumption

Dietary protein ingestion is critical to maintaining the quality and quantity of skeletal muscle mass throughout adult life. The performance of acute exercise enhances muscle protein remodeling by stimulating protein synthesis rates for several hours after each bout, which can be optimized by consuming protein during the post-exercise recovery period. To date, the majority of the evidence regarding protein intake to optimize post-exercise muscle protein synthesis rates is limited to isolated protein sources. However, it is more common to ingest whole food sources of protein within a normal eating pattern. Emerging evidence demonstrates a promising role for the ingestion of whole foods as an effective nutritional strategy to support muscle protein remodeling and recovery after exercise. This review aims to evaluate the efficacy of the ingestion of nutrient-rich and protein-dense whole foods to support post-exercise muscle protein remodeling and recovery with pertinence towards physically active people.

Effects of dietary almond- and olive oil-based docosahexaenoic acid- and vitamin E-enriched beverage supplementation on athletic performance and oxidative stress markers

Functional beverages based on almonds and olive oil and enriched with α-tocopherol and docosahexaenoic acid (DHA) could be useful in modulating oxidative stress and enhancing physical performance in sportsmen. The aim of this work was to evaluate the effects of supplementation with functional beverages on physical performance, plasma and erythrocyte fatty acids' and polyphenol handling, oxidative and nitrative damage, and antioxidant and mitochondrial gene expression in young and senior athletes. Athletes performed maximal exercise tests before and after one month of dietary supplementation and blood samples were taken immediately before and one hour after each test. The beverages did not alter performance parameters during maximal exercise. Supplementation increased polyunsaturated and reduced saturated plasma fatty acids while increasing the DHA erythrocyte content; it maintained basal plasma and blood polyphenol levels, but increased the blood cell polyphenol concentration in senior athletes. Supplementation protects against oxidative damage although it enhances nitrative damage in young athletes. The beverages enhance the gene expression of antioxidant enzymes in peripheral blood mononuclear cells after exercise in young athletes.

Safe use of chemicals by professional users and health care specialists

The awareness of Greek professional users and health care specialists regarding the safe use of chemicals was investigated, to be the best of our knowledge, for the first time after the introduction of Regulations (EC) 1907/2006 (REACH) and 1272/2008 (CLP) on chemicals. A total of 200 professional users and 150 health care specialists from various regions of Greece contributed to the use of a closed-ended, anonymous and validated questionnaire. The findings showed that over 85% of the responders were not aware of classification, labelling and packaging (CLP) and 67.8% of the responders were unaware of any changes made in the labeling of the products they were using. The majority (>75%) of individuals were cognizant that they were using hazardous products; however, the perception of hazard varied significantly between the two groups (P=0.012) and statistically were dependent on the educational (P=0.022) and the profession (P=0.014) level. One third of the professional users read the label as the main source of information for the product, while for health care specialists the number increased to 65% and a strong correlation was detected with the educational level (P=0.017). In both groups, 7% of professional users and health care specialists declared that hazard communication through product labeling is not well understood. The use of personal protective equipment (PPE) is almost universal for health care specialists with women being more sensitive (P=0.041), while 25% of the professional users do not use any PPE. Almost 60% of the health care specialists are required to provide instructions regarding the safe use of chemicals or the action to be undertaken in case of accident. In the latter situation, the National Poisoning Centre is the reference point for information. Limited use of the safety data sheets has been observed both for professional users (18%) and health care specialists (23%). In conclusion, rising awareness campaigns are needed, in collaboration with trade unions and health care professional associations, in order to alert professionals regarding the safe use of chemicals and protect human health and the environment.

Prohibited Contaminants in Dietary Supplements

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.

The Effectiveness of a New School-Based Media Literacy Intervention on Adolescents' Doping Attitudes and Supplements Use

The aim of the study was to evaluate the effectiveness of a media literacy intervention targeting, for the first time, the specific topic of Performance and Appearance Enhancing Substances (PAESs) use in high-school students. Overall, 389 students (52% male) aged between 13 and 19 years (mean = 16.56 year; SD = 1.26) participated to a media literacy intervention (i.e., “intervention group”) while 103 students aged between 14 and 19 year (mean = 16.10 year; SD = 1.38) were considered as the control group (i.e., “control group”). In two separate occasions over the course of six consecutive months, students in both groups filled out a set of questionnaires which included measures of social-cognitive beliefs (i.e., attitudes, subjective norms, intentions) and a self-reported measure of retrospective use of doping (Yes/No) and supplements (Yes/No). Compared to students in the control group (Mean_(time1) = 1.96; SD_(time1) = 0.85; and Mean_(time2) = 2.09; SD_(time2) = 0.94), intervention students on average expressed relatively stronger attitudes against doping use over time (Mean_(time1) = 2.2; SD_(time1) = 0.85; and Mean_(time2) = 2.05; SD_(time2) = 0.82). Students in the latter group also showed a statistically significant decrease in self-reported supplement use (Use_(time1) = 6.7%; Use_(time2) = 3.8%; p = 0.05, McNemar Test). Interestingly, albeit marginally significant, students in the control group showed a relative increment in the self-reported use of supplements over time (Use_(time1) = 4.9%; Use_(time2) = 8.7%; p = 0.22, McNemar Test). Overall, the media literacy intervention investigated in the present study was effective in decreasing adolescent student’s positive attitudes toward doping use and in reducing the use of legal PAES. These findings supported the generalizability and the usefulness of a media literacy approach in the specific field of PAES.

Effects of Almond- and Olive Oil-Based Docosahexaenoic- and Vitamin E-Enriched Beverage Dietary Supplementation on Inflammation Associated to Exercise and Age

n-3-polyunsaturated fatty acids and polyphenols are potential key factors for the treatment and prevention of chronic inflammation associated to ageing and non-communicable diseases. The aim was to analyse effects of an almond and olive oil beverage enriched with α-tocopherol and docosahexaenoic, exercise and age on inflammatory plasma markers, and immune gene expression in peripheral blood mononuclear cells (PBMCs). Five young and five senior athletes who were supplemented for five weeks with a functional beverage performed a stress test under controlled conditions before and after beverage supplementation. Blood samples were taken immediately before and 1 h after each test. Plasma, erythrocytes and PBMCs were isolated. Beverage supplementation increased plasmatic Tumour Necrosis Factor α (TNFα) levels depending on age and exercise. Exercise increased plasma non esterified fatty acids (NEFAs), soluble Intercellular adhesion molecule 3 (sICAM3) and soluble L-selectin (sL-Selectin), and this increase was attenuated by the supplementation. Exercise increased PGE2 plasma levels in supplemented young and in senior placebo athletes. Exercise increased NFkβ-activated levels in PBMCs, which are primed to a pro-inflammatory response increasing pro-inflammatory genes expression after the exercise mainly in the young group after the supplementation. The functional beverage supplementation to young athletes enhances a pro-inflammatory circulating environment in response to the exercise that was less evident in the senior group.

Nutritional supplements use in high-performance athletes is related with lower nutritional inadequacy from food

BACKGROUND

The use of nutritional supplements (NS) among athletes is widespread. However, little is known about the relationship between nutritional adequacy and NS usage. The aims of this study were to evaluate the NS usage and to compare the nutritional intake from food and prevalence of micronutrient inadequacy (PMI) between NS users and non-users.

METHODS

Portuguese athletes from 13 sports completed an NS usage questionnaire and a semi-quantitative food-frequency questionnaire assessing information over the previous 12 months. The estimated average requirement cut-point method was used to calculate PMI. General linear models were used to compare nutritional intake and NS usage. Chi-squared tests and logistic regression were performed to study, respectively, relationships and associations between PMI and NS usage.

RESULTS

From the 244 athletes (66% males, 13-37 years), 64% reported NS usage. After adjustment, NS users showed a higher intake from food (p < 0.05), for at least 1 gender, for energy, and for 7 of the 17 studied nutrients. The highest PMI were seen for vitamins D and E, calcium, folate, and magnesium. After adjustment, NS users, irrespective of gender, reported lower PMI for calcium (OR = 0.28, 95%CI: 0.12-0.65), and female users for magnesium (OR = 0.06, 95%CI: 0.00-0.98).

CONCLUSION

Athletes using NS reported a higher nutritional intake from food, and a lower PMI for several nutrients. Perhaps, those who were taking NS were probably the ones who would least benefit from it.

Reflection on sports nutrition: Where we come from, where we are, and where we are headed

ABSTRACT From a historical perspective of athletes' eating practices, the advancement of science and the provision of food in the modern Olympic Games, the author seeks to show that many challenges in practicing Sports Nutrition have their roots in how these processes were built. This essay aims to provide arguments for a reflection on the work of dietitians in the sports' scenario considering the growth of interest in this area, as well as the hosting of major sports events in Brazil. The professional training and the skills required to work in this area, as well as the eating practices of athletes, often far from the nutritional recommendations but heavily laden with symbolism and representations, making it important for their identity within their peer group, are among the current challenges that can be emphasized. As the main prospects for the comprehensive care of athletes, the author highlights the importance of adopting an interdisciplinary approach, and of dietitians fully understanding the meaning of nutrition for athletes in order to address the gap between their food practices and the recommendations.

Proteomics in quality control: Whey protein-based supplements

The growing consumption of nutritional supplements might represent a problem, given the concern about the quality of these supplements. One of the most used supplements is whey protein (WP); because of its popularity, it has been a target of adulteration with substitute products, such as cheaper proteins with lower biological value. To investigate this type of adulteration, this study used shotgun proteomics analyses by MS(E) (multiplexed, low- and high-collision energy, data-independent acquisition) of WP-based supplements. Seventeen WP-based supplement samples were evaluated. Chicken, maize, rice, potato, soybean, and wheat proteins were considered as probable sources of bovine whey adulteration. Collectively, 523 proteins were identified across all 16 samples and replicates, with 94% of peptides inside a normal distribution within 10ppm of maximum error. In 10 of the 16 samples analyzed, only proteins from bovine whey could be detected, while in the other samples several other protein sources were detected in high concentrations, especially soybean, wheat, and rice. These results point out a probable adulteration and/or sample contamination during manufacturing that could only be detected using this proteomic approach.

SIGNIFICANCE

The present work shows how shotgun proteomics can be used to provide reliable answers in quality control matters, especially focusing on Whey Protein nutritional supplements which are a very popular subject in food and nutrition. In order to achieve an appropriate methodology, careful evaluation was performed applying extremely rigorous quality criteria, established for the proteomic analysis. These criteria and the methodological approach used in this work might serve as a guide for other authors seeking to use proteomics in quality control.

Prevalence of Dietary Supplement Use by Athletes: Systematic Review and Meta-Analysis

BACKGROUND

Dietary supplements (DSs) are commercially available products consumed as an addition to the usual diet and are frequently ingested by athletes.

OBJECTIVE

Our objective was to examine the prevalence of DS use by athletes.

DATA SOURCES

PubMed, Ovid MEDLINE, OVID Healthstar, and Cumulative Index to Nursing and Allied Health were searched for original research articles published up to August 2014. Search terms included specific sports, specific DSs, and other terms.

STUDY SELECTION

Studies were selected if they were written in English, involved athletes, and provided a quantitative assessment of the proportion of athletes using specific DSs. Percent of athletes using specific DSs.

SYNTHESIS OF DATA

Methodological quality of studies was assessed by three reviewers using an 8-point scale that included evaluations for sampling methods, sampling frame, sample size, measurement tools, bias, response rate, statistical presentation, and description of the participant sample. Where there were at least two investigations, meta-analysis was performed to obtain summary (pooled) prevalence estimates (SPEs) on (1) DS use prevalence by sport and sex, (2) DS use prevalence by elite versus non-elite athletic status, and (3) specific DS prevalence for all athletic groups combined. Meta-analyses included evaluations of homogeneity and publication bias.

RESULTS

A total of 159 unique studies met the review criteria. Methodological quality was generally low with an average ± standard deviation of 43 ± 16% of available rating points. There was low homogeneity for SPEs when compiled by sport, athletic status, and/or specific DSs. Contributing to the lack of homogeneity were differences in studies' objectives and types of assessments used (e.g., dietary surveys, interviews, questionnaires). Despite these limitations, the data generally indicated that elite athletes used DSs much more than their non-elite counterparts. For most DSs, use prevalence was similar for men and women except that a larger proportion of women used iron while a larger proportion of men used vitamin E, protein, and creatine. No consistent change in use over time was observed because even the earliest investigations showed relatively high use prevalence.

CONCLUSION

It was difficult to generalize regarding DS use by athletes because of the lack of homogeneity among studies. Nonetheless, the data suggested that elite athletes used dietary supplements far more than their non-elite counterparts; use was similar for men and women with a few exceptions; use appeared to change little over time; and a larger proportion of athletes used DSs compared with the general US population. Improvements in study methodology should be considered in future studies especially (1) defining DSs for participants; (2) querying for very specific DSs; (3) using a variety of reporting timeframes (e.g., daily, 2-6 times/week, 1 time/week and <1 time/week); (4) reporting the sampling frame, number of individuals solicited, and number responding; (5) reporting characteristics of volunteers (and non-volunteers, if available); and (6) using similar methods on several occasions to examine possible temporal trends among athletes.

Evaluation of congruence among dietary supplement use and motivation for supplementation in young, Canadian athletes

Background

Dietary supplement use is endemic in young athletes; however, it is unclear if their choices are congruent with their motivation for supplementation and the established benefits of the dietary supplements. The aim of this study was to evaluate the relationships between dietary supplement use and self-reported rationale in young athletes.

Methods

Canadian athletes (n = 567; 11–25 years; 76 % club or provincial level, 24 % national or higher) completed a questionnaire designed to assess supplementation patterns and motivation for supplementation. Chi square tests examined associations between dietary supplements and self-reported rationale for use.

Results

Vitamin and mineral supplements, including vitamin-enriched water, were associated with several health- and performance- related reasons (p < 0.001). Branched chain amino acids (BCAA) and glutamine were linked to improving diet and immune function (p < 0.01), but were more strongly associated with performance reasons, as were performance foods (protein powder, sport bars, sport gels, etc.). Plant extracts and fatty acids were primarily associated with health reasons, particularly immune support (p < 0.001).

Conclusions

Congruencies exist between performance rationales and supplementation for common ergogenic aids, however, less so for vitamin and mineral supplements, vitamin-enriched water, and plant extracts. Incongruences were found between fatty acids, protein supplements, vitamin and mineral supplements, vitamin-enriched water, and plant extracts and health motivators for supplementation. Educational interventions are essential to ensure young athletes are using dietary supplements safely and effectively.

Nutritional supplement and doping use in sport: Possible underlying social cognitive processes

There is growing evidence suggesting that nutritional supplement (NS) use is strongly associated to doping use in elite and amateur sports. However, there is a paucity of research on the psychological processes that underlie this association. The present study investigated the cognitive and behavioral components of the association between NS use and doping among adolescent sub-elite athletes. Six hundred and fifty adolescent athletes completed a questionnaire including measures of doping intentions, attitudes, norms, and beliefs about NS use. The results showed that NS users who did not report doping use had significantly stronger doping intentions and more positive attitudes and favorable beliefs toward doping use, as compared with athletes who did not use NS. In support of the "shared mental representations" hypothesis, the present findings show that NS use is associated with biased reasoning patterns in favor of doping use. This mechanism may explain why some NS users decide to engage in doping.

Doping in gymnasiums in Amman: the other side of prescription and nonprescription drug abuse

This study investigated the abuse of over-the-counter (OTC) products (e.g., proteins, dietary supplements) and prescription drugs (e.g., hormones) in gymnasiums in Amman by random distribution of a structured questionnaire to 375 gym clients (November 2012-February 2013). Data were analyzed using SPSS for Windows (version 17.0). A total of 31 (8.8%) clients admitted to using 21 products (mentioned 71 times) of anabolic steroids and other hormones (e.g., growth hormone and thyroxine) to increase muscular power at the gym or build muscle mass. Abuse of different prescription and OTC drugs among gymnasium clients is present in Jordan, but current methods for controlling the problem are ineffective. Better methods should be developed. The study's limitations are noted.

A systematic review and meta-analysis on the prevalence of dietary supplement use by military personnel

Background

Although a number of studies have been conducted on the prevalence of dietary supplement (DS) use in military personnel, these investigations have not been previously summarized. This article provides a systematic literature review of this topic.

Methods

Literature databases, reference lists, and other sources were searched to find studies that quantitatively examined the prevalence of DS use in uniformed military groups. Prevalence data were summarized by gender and military service. Where there were at least two investigations, meta-analysis was performed using a random model and homogeneity of the prevalence values was assessed.

Results

The prevalence of any DS use for Army, Navy, Air Force, and Marine Corps men was 55%, 60%, 60%, and 61%, respectively; for women corresponding values were 65%, 71%, 76%, and 71%, respectively. Prevalence of multivitamin and/or multimineral (MVM) use for Army, Navy, Air Force, and Marine Corps men was 32%, 46%, 47%, and 41%, respectively; for women corresponding values were 40%, 55%, 63%, and 53%, respectively. Use prevalence of any individual vitamin or mineral supplement for Army, Navy, Air Force, and Marine Corps men was 18%, 27%, 25%, and 24%, respectively; for women corresponding values were 29%, 36%, 40%, and 33%, respectively. Men in elite military groups (Navy Special Operations, Army Rangers, and Army Special Forces) had a use prevalence of 76% for any DS and 37% for MVM, although individual studies were not homogenous. Among Army men, Army women, and elite military men, use prevalence of Vitamin C was 15% for all three groups; for Vitamin E, use prevalence was 8%, 7%, and 9%, respectively; for sport drinks, use prevalence was 22%, 25% and 39%, respectively. Use prevalence of herbal supplements was generally low compared to vitamins, minerals, and sport drinks, ≤5% in most investigations.

Conclusions

Compared to men, military women had a higher use prevalence of any DS and MVM. Army men and women tended to use DSs and MVM less than other service members. Elite military men appeared to use DSs and sport drinks more than other service members.

Vitamin C and E supplementation hampers cellular adaptation to endurance training in humans: a double-blind, randomised, controlled trial

In this double-blind, randomised, controlled trial, we investigated the effects of vitamin C and E supplementation on endurance training adaptations in humans. Fifty-four young men and women were randomly allocated to receive either 1000 mg of vitamin C and 235 mg of vitamin E or a placebo daily for 11 weeks. During supplementation, the participants completed an endurance training programme consisting of three to four sessions per week (primarily of running), divided into high-intensity interval sessions [4-6 × 4-6 min; >90% of maximal heart rate (HRmax)] and steady state continuous sessions (30-60 min; 70-90% of HRmax). Maximal oxygen uptake (VO2 max ), submaximal running and a 20 m shuttle run test were assessed and blood samples and muscle biopsies were collected, before and after the intervention. Participants in the vitamin C and E group increased their VO2 max (mean ± s.d.: 8 ± 5%) and performance in the 20 m shuttle test (10 ± 11%) to the same degree as those in the placebo group (mean ± s.d.: 8 ± 5% and 14 ± 17%, respectively). However, the mitochondrial marker cytochrome c oxidase subunit IV (COX4) and cytosolic peroxisome proliferator-activated receptor-γ coactivator 1 α (PGC-1α) increased in the m. vastus lateralis in the placebo group by 59 ± 97% and 19 ± 51%, respectively, but not in the vitamin C and E group (COX4: -13 ± 54%; PGC-1α: -13 ± 29%; P ≤ 0.03, between groups). Furthermore, mRNA levels of CDC42 and mitogen-activated protein kinase 1 (MAPK1) in the trained muscle were lower in the vitamin C and E group than in the placebo group (P ≤ 0.05). Daily vitamin C and E supplementation attenuated increases in markers of mitochondrial biogenesis following endurance training. However, no clear interactions were detected for improvements in VO2 max and running performance. Consequently, vitamin C and E supplementation hampered cellular adaptations in the exercised muscles, and although this did not translate to the performance tests applied in this study, we advocate caution when considering antioxidant supplementation combined with endurance exercise.

Sport nutrition and doping in tennis: an analysis of athletes' attitudes and knowledge

Nutrition and doping issues are rarely studied in the sport of tennis. The aims of this investigation were to determine knowledge on doping (KD) and knowledge on sport nutrition (KSN), and corresponding socio-demographic-, sport-, and sport-nutrition- and doping-factors among an international sample of high-level tennis players of both sexes (43 females; 22 years old on average). In the first phase of the investigation, the KSN and KD questionnaires were studied for their reliability and validity. The consumption of NS is found to be very high, with almost of all the females and 80% of the males using NS at least occasionally. The athletes showed a low tendency regarding future doping usage, although most of them are convinced that doping does exist in tennis. Since athletes declared that their coaches are their main source of information about NS and doping, future studies should investigate what coaches actually know about such problems. KSN has been found to be protective against potential doping behavior in the future. Males are found to be more prone to doping than females. Therefore, in order to prevent doping behavior in tennis we strongly suggest intensive educational programs on sports nutrition and doping-related problems. Key PointsThe incidence of nutritional supplementation use among the tennis players is found to be very high, especially among the females.Although most of the subjects are of the opinion that the doping behavior is present in tennis circuit, we have found a low tendency regarding future doping usage, and high levels of athletes' trust in their coaches with regard to nutritional supplementation and doping.There are indices that the knowledge about nutrition is protective factor against potential doping behavior. It clearly reinforces the need to include a wide educational program on sports nutrition in tennis, but also in other sports.

Knowledge, Attitude and Practice of Vitamin Supplementation among Patients visiting Out-Patient Physicians in a Teaching Hospital in Karachi

OBJECTIVE

To determine the knowledge, attitude and practices regarding the use of vitamin supplements among patients visiting Out-Patient clinics of a teaching hospital.

METHODS

Four hundred patients were interviewed during the period of July to September 2008, at the Out-patient clinics, Aga Khan University hospital, Karachi. A pre-tested and structured questionnaire was used to collect information. It consisted of questions regarding demographics, awareness of vitamin supplements and its consumption, reasons for usage and its effects. The purpose of the study was explained and assurance of confidentiality was given. After obtaining written consent, eligible individuals were interviewed. Statistical Package for the Social Sciences version 19.0 was used to analyze the data.

RESULTS

The results revealed that 98% of the respondents were aware of vitamin supplements. The most known vitamin was found to be Vitamin C (16.9%) with Vitamin K being the least well-known (0.4%); while 51.8% of the respondents were unaware of the harmful effects of vitamin supplements. The results also showed that 84.8% of the study population had taken vitamin supplements, and 79% of the participants considered that vitamin supplements to be helpful. Taking vitamin supplements as a compensation for the deficiencies in the body was the most frequently chosen answer (17.7%) as the reason for use of vitamin supplements. On the other hand, a majority of the population was unaware of the indications for use of vitamin supplements.

CONCLUSION

This study highlights a very significant yet ignored issue of vitamin supplementation in Pakistan. A need exists to inform the general population about the use of vitamin supplementation. The media and the medical community are required to play their role in this regard. Short/ refresher training courses are needed for doctors to update and disseminate adequate knowledge of vitamin supplementation to their patients.

Vitamin C status and perception of effort during exercise in obese adults adhering to a calorie-reduced diet

OBJECTIVE

Moderate energy restriction and exercise are recommended for effective weight loss. Obese individuals oxidize less fat and report a higher perceived exertion during exercise, characteristics that may negatively influence exercise behavior. Because vitamin C status has been linked to fatigability, we compared the effects of vitamin C supplementation on self-reported fatigue and on the respiratory exchange ratio and the Ratings of Perceived Exertion scale during moderate exercise in healthy obese adults adhering to a hypocaloric diet.

METHODS

Twenty adults (4 men and 16 women) were stratified and randomly assigned to receive 500 mg of vitamin C (VC) or placebo (CON) daily for 4 wk while adhering to a vitamin C-controlled, calorie-restricted diet. Feelings of general fatigue as assessed by the Profile of Mood States questionnaire were recorded on a separate day from the exercise session at weeks 0 and 4. Participants walked on a treadmill at an intensity of 50% predicted maximal oxygen consumption for 60 min at weeks 0 and 4, and heart rate, respiratory exchange ratio, and Ratings of Perceived Exertion were recorded.

RESULTS

After 4 wk, the two groups lost similar amounts of weight (≈ 4 kg), and the respiratory exchange ratio was not altered by group. Heart rate and the Ratings of Perceived Exertion during exercise were significantly decreased in the VC versus the CON group (-11 versus -3 beats/min, P = 0.022, and -1.3 versus +0.1 U, P = 0.001, respectively), and the general fatigue score was decreased 5.9 U for the VC group versus a 1.9 U increase for the CON group (P = 0.001).

CONCLUSION

These data provide preliminary evidence that vitamin C status may influence fatigue, heart rate, and perceptions of exertion during moderate exercise in obese individuals.

Iron Deficiency in Athletes

Adequate body stores of iron are necessary for optimal endurance exercise performance. Severe iron depletion resulting in overt iron-deficiency anemia clearly depresses endurance fitness, but it is not clear if milder degrees of iron deficiency (low serum ferritin with normal hemoglobin levels) impair physical capacity. The question is an important one for athletes, particularly females, who are particularly prone to iron deficiency without anemia. This review examines research data, in both animals and humans, which have addressed this issue. Constructing guidelines based on this often-conflicting body of information is difficult. Routine screening is advocated for at-risk athletes, particularly elite-level female competitors in distance sports, and, although controversial, many authorities recommend iron treatment for athletes with hypoferritemia (ferritin <12-20 ng/mL), even without overt anemia. However, “blind” supplementation with oral iron by athletes is not recommended.

Gateway to doping? Supplement use in the context of preferred competitive situations, doping attitude, beliefs, and norms

Nutritional supplement (NS) use is widespread in sport. This study applied an integrated social cognitive approach to examine doping attitudes, beliefs, and self-reported doping use behavior across NS users (n = 96) and nonusers (n = 116). Following ethical approval, 212 competitive athletes (age mean = 21.4, s = 4.5; 137 males) completed self-reported measures of doping-related social cognitions and behaviors, presented in an online format where completion implied consent. Significantly more NS users (22.9%) reported doping compared with nonusers (6.0%; U = 4628.0, P < 0.05). NS users presented significantly more positive attitudes toward doping (U = 3152.0, P < 0.05) and expressed a significantly greater belief that doping is effective (U = 3152.0, P < 0.05). When presented with the scenario that performance-enhancing substances are effective and increase the possibility of winning, NS users were significantly more in favor of competing in situations that allow doping (U = 3504.5, P < 0.05). In sum, doping use is three-and-a-half times more prevalent in NS users compared with nonusers. This finding is accompanied by significant differences in doping attitudes, norms, and beliefs. Thus, this article offers support for the gateway hypothesis; athletes who engage in legal performance enhancement practices appear to embody an "at-risk" group for transition toward doping. Education should be appropriately targeted.

Inside athletes' minds: preliminary results from a pilot study on mental representation of doping and potential implications for anti-doping

BACKGROUND

Despite the growing body of literature and putative links between the use of ergogenic nutritional supplements, doping and illicit drugs, it remains unclear whether, in athletes' minds, doping aligns with illicit behaviour or with functional use of chemical or natural preparations. To date, no attempt has been made to quantitatively explore athletes' mental representation of doping in relation to illegality and functionality.

METHODS

A convenience sample of student athletes from a large South-Eastern Australian university responded to an on-line survey. Competitive athletes (n = 46) were grouped based on self-reported use as follows: i) none used (30%), ii) supplement only (22%), iii) illicit only (26%) and iv) both supplements and illicit drug use (22%). Whereas no athlete reported doping, data provided on projected supplement-, doping- and drug use by the four user groups allowed evaluation of doping-related cognition in the context of self-reported supplement- and illicit drug taking behaviour; and comparison between these substances.

RESULTS

A significantly higher prevalence estimation was found for illicit drug use and a trend towards a biased social projection emerged for supplement use. Doping estimates by user groups showed mixed results, suggesting that doping had more in common with the ergogenic nutritional supplement domain than the illicit drug domain.

CONCLUSIONS

Assessing the behavioural domain to which doping belongs to in athletes' mind would greatly advance doping behaviour research toward prevention and intervention. Further investigation refining the peculiarity of the mental representation of doping with a larger study sample, controlling for knowledge of doping and other factors, is warranted.

Composition of the athletes diet

Sports nutrition is a constantly evolving field with many of research papers published annually. However, designing the most suitable sports diet is very difficult. It must be given to the type of training, its duration and intensity, the age and sex of the athlete and also for overall health. The aim of this article is to summarize knowledges about sports nutrition, especially intake of carbohydrates, proteins, fats and dietary supplements and their influence on the performance and recovery of the athlete.

Use of dietary supplements in Olympic athletes is decreasing: a follow-up study between 2002 and 2009

Background

The aim of this study was to assess the frequency of use of dietary supplements (DS) among large sample of elite Finnish athletes and to describe possible changes in dietary supplement use between the years 2002 and 2009.

Methods

A prospective follow-up study was conducted on Olympic athletes. The first survey was conducted on Olympic athletes in 2002 (N = 446) and the follow-up study was conducted between May 2008 and June 2009 (N = 372).

Results

In 2002, a total of 81% of the athletes used dietary supplements (a mean of 3.37 ± 3.06 DS per user) and in 2009, a total of 73% of the athletes (a mean of 2.60 ± 2.69 per DS user) used them. After adjusting for age-, sex- and sport type, the OR (95% confidence interval, CI) for use of any dietary supplement was significantly less in 2009 as compared with 2002 results (OR, 0.62; 95% CI, 0.43-0.90). Decrease in DS use was observed in all supplement subgroups (vitamins, minerals, nutritional supplements). Athletes in speed and power events and endurance events reported use of any dietary supplement significantly more often than team sport athletes both in 2002 and 2009. In year 2009, the frequency of all dietary supplement use increased when athlete's age increased and the increase was significant in older age groups: of the athletes under 21 years 63%, 21-24 years 83% and over 24 years 90% consumed nutritional supplements.

Conclusions

Based in our study, there seems to be a lowering trend of dietary supplement use among elite Finnish athletes although differences between sport subgroups and age groups are considerable.

Current knowledge about sports nutrition

The scientific literature contains an abundance of information on the nutritional demands of athletes. However, designing the most suitable sports diet is very difficult.The principal aim of this article is to summarize knowledge about sports nutrition, especially the intake of macronutrients and dietary supplements.

Promoting functional foods as acceptable alternatives to doping: potential for information-based social marketing approach

Background

Substances with performance enhancing properties appear on a continuum, ranging from prohibited performance enhancing drugs (PED) through dietary supplements to functional foods (FF). Anti-doping messages designed to dissuade athletes from using PEDs have been typically based on moralising sport competition and/or employing scare campaigns with focus on the negative consequences. Campaigns offering comparable and acceptable alternatives are nonexistent, nor are athletes helped in finding these for themselves. It is timely that social marketing strategies for anti-doping prevention and intervention incorporate media messages that complement the existing approaches by promoting comparable and acceptable alternatives to doping. To facilitate this process, the aim of this study was to ascertain whether a single exposure knowledge-based information intervention led to increased knowledge and subsequently result in changes in beliefs and automatic associations regarding performance enhancements.

Methods

In a repeated measure design, 115 male recreational gym users were recruited and provided with a brief information pamphlet on nitrite/nitrate and erythropoietin as a comparison. Measures of knowledge, beliefs and automatic associations were taken before and after the intervention with at least 24 hours between the two assessments. The psychological tests included explicit measures of beliefs and cognitive attitudes toward FF and PED using a self-reported questionnaire and computerised assessments of automatic associations using the modified and shortened version of the Implicit Association Test.

Results

The information based intervention significantly increased knowledge (p < 0.001), changed explicit beliefs in specific FF (p < 0.001) and shifted the automatic association of FF with health to performance (p < 0.001). Explicitly expressed beliefs and automatic associations appear to be independent.

Conclusion

Evidence was found that even a single exposure to a persuasive positive message can lead to belief change and can create new or alter existing associations - but only in the specific domain. Interventions to change outcome expectations in a positive way could be a rewarding avenue for anti-doping. Effective social marketing campaigns for drug free sport should follow appropriate market segmentation and use targeted messages via promoting the natural form as opposed to the purified form of the main active ingredient.

Potentially fatal new trend in performance enhancement: a cautionary note on nitrite

BACKGROUND

Considerable interest has been shown by athletes and scientists in the potential for nitric oxide and associated vasodilators to enhance performance. This study aims to explore potential misuse of vasodilators by the athletes, and to highlight the growing concern over these agents.

METHODS

Retrospective analyses of anonymous inquiries recorded in the Drug Information Database (DID) between January 2006 and June 2008 (inclusive). In this 30-month period, the DID recorded 198,023 inquiries, of which 118,724 were UK Licensed Pharmaceutical products with a further 79,299 inquiries made for substance not found in the database.

RESULTS

Phosphodiesterase type 5 (PDE-5) inhibitors, dominated by Viagra(R), ranked 16th among the substance groups. The proportion of the inquiries made regarding PDE-5 inhibitors, especially in comparison to antibiotics, painkillers or alcohol, appears to be above the level that would normally be expected from medical need. No significant change in the months leading up to the Beijing Olympics was observed. On the contrary, the Nitric/Nitrate group showed a notable increase between 2006-2007 and 2008, suggesting a potential increase in interest in using nitric oxide among athletes.

CONCLUSIONS

With patents recently filed for the use of agents containing sodium nitrite/nitrate to enhance blood flow for performance enhancement in sport, coupled with anecdotal evidence from internet athlete forums and media, there is a concern that athletes may endanger their health by using vasodilators to enhance athletic performance. PDE-5 inhibitors or chemicals in the nitrate/nitrate group are currently not prohibited or tested for by the doping control agencies but some are highly dangerous to health and can lead to cardiovascular collapse, coma and death. Its promotion among athletes as a performance enhancing supplement is ethically and medically questionable.

Sports doping in the adolescent: the Faustian conundrum of Hors de Combat

The drive toward success in sports and the need for a cosmetically acceptable appearance have driven many adolescents to take a wide variety of so-called doping substances. The consumption of these chemicals in the hope and hype of improved sports performance, fueled by the easing of government restrictions on their proof of safety and efficacy, has resulted in an explosion of so-called ergogenic products available to our youth. Agents that have been used include anabolic steroids, anabolic-like agents, designer steroids, creatine, protein and amino acid supplements, minerals, antioxidants, stimulants, blood doping, erythropoietin, beta-blockers, and others. The use of these agents has considerable potential to cause physical and psychological damage. Use and misuse of drugs in this sports doping process should be discouraged. This discussion reviews some of the agents that are currently being used. Clinicians providing sports medicine care to youth, whether through anticipatory guidance or direct sports medicine management, should educate their young patients about the hype and hyperbole of these products that may keep them out instead of in the game at considerable financial cost to the unwary consumer.

Effects of commercial energy drink consumption on athletic performance and body composition

Energy drinks are frequently marketed to individuals interested in athletics and an active lifestyle. From 2001 to 2008, estimates of energy drink use in adolescent to middle-aged populations ranged from 24% to 56%. Most energy drinks feature caffeine and a combination of other components, including taurine, sucrose, guarana, ginseng, niacin, pyridoxine, and cyanocobalamin. This article examines the evidence for 2 commonly purported uses of energy drinks: athletic performance enhancement and weight loss. Observed ergogenic benefits of energy drinks are likely attributable to caffeine and glucose content. There is conflicting evidence regarding the impact of energy drinks on weight loss, although some data suggest that combining energy drink use with exercise may enhance body fat reduction. As with any pharmacologically active substance, energy drinks are associated with adverse effects. Combining energy drinks with alcohol exacerbates safety concerns and is an increasingly common practice contributing to toxic jock identity among college-aged male athletes. Practitioners should monitor identified populations likely to consume these loosely regulated beverages.

Whey protein ingestion activates mTOR-dependent signalling after resistance exercise in young men: a double-blinded randomized controlled trial

The effect of resistance exercise with the ingestion of supplementary protein on the activation of the mTOR cascade, in human skeletal muscle has not been fully elucidated. In this study, the impact of a single bout of resistance exercise, immediately followed by a single dose of whey protein isolate (WPI) or placebo supplement, on the activation of mTOR signalling was analyzed. Young untrained men completed a maximal single-legged knee extension exercise bout and were randomized to ingest either WPI supplement (n = 7) or the placebo (n = 7). Muscle biopsies were taken from the vastus lateralis before, and 2, 4 and 24 h post-exercise. WPI or placebo ingestion consumed immediately post-exercise had no impact on the phosphorylation of Akt (Ser⁴⁷³). However, WPI significantly enhanced phosphorylation of mTOR (Ser²⁴⁴⁸), 4E-BP1 (Thr^37/46) and p70^S6K (Thr³⁸⁹) at 2 h post-exercise. This study demonstrates that a single dose of WPI, when consumed in modest quantities, taken immediately after resistance exercise elicits an acute and transient activation of translation initiation within the exercised skeletal muscle.