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Ganson KT, Nagata JM. Adolescent and Young Adult Use of Muscle-Building Dietary Supplements: Guidance for Assessment and Harm Reduction Approaches to Mitigate Risks. J Adolesc Health 2024; 75:379-382. [PMID: 38970604 DOI: 10.1016/j.jadohealth.2024.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 07/08/2024]
Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, California
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2
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McNaughton M, Hunt DL, O'Brien M, Sugimoto D, Meehan WP, Miller P, Stracciolini A. Sport specialisation and performance-enhancing substance use by young athletes. BMJ Open Sport Exerc Med 2023; 9:e001702. [PMID: 38022758 PMCID: PMC10660423 DOI: 10.1136/bmjsem-2023-001702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives To investigate the association of reported legal performance enhancing substance (PES) use and consideration of banned PES use among sport-specialised and non-sport-specialised young athletes. Methods and design Cross-sectional study of 1049 young athletes enrolled in an injury prevention programme from 2013 to 2020. We used logistic regression modelling to determine the independent association between sports specialisation. We reported (1) legal PES use and (2) consideration of banned PES use after adjusting for the effects of gender, age, having a relative as a coach, unrestricted internet access, use of a weight training regimen, and weeknight hours of sleep. Results The final cohort consisted of 946 athletes with a mean age of 14. 56% were female, and 80% were sport-specialised athletes. 14% reported legal PES use, and 3% reported consideration of banned PES use. No difference was found between sport-specialised athletes who reported legal PES use (OR=1.4; 95% CI 0.81 to 2.43; p=0.23) or consideration of banned PES use (OR=3.2; 95% CI 0.78 to 14.92; p=0.1) compared with non-sport-specialised athletes. Reported legal PES use was more common among athletes who were male, older, used weight training, and slept less. Reported consideration of banned PES use was more common among male and older athletes. Conclusions PES use is not independently associated with sport specialisation in young athletes. Athlete sex, age, training, and sleep patterns are important factors for young athletes to consider in PES use.
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Affiliation(s)
- Michael McNaughton
- Department of Pediatrics, Brown University Hasbro Children’s Hospital, Providence, MA, USA
| | - Danielle L Hunt
- Division of Sports Medicine, Boston Children’s Hospital, Boston, MA, USA
- The Micheli Center for Sports Injury Prevention, Walham, MA, USA
| | - Michael O'Brien
- Division of Sports Medicine, Boston Children’s Hospital, Boston, MA, USA
- The Micheli Center for Sports Injury Prevention, Walham, MA, USA
- Department of Orthopaedics, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Dai Sugimoto
- The Micheli Center for Sports Injury Prevention, Walham, MA, USA
- Faculty of Sport Sciences, Waseda University, Tokyo, Japan
| | - William P Meehan
- Division of Sports Medicine, Boston Children’s Hospital, Boston, MA, USA
- The Micheli Center for Sports Injury Prevention, Walham, MA, USA
- Department of Orthopaedics, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Patricia Miller
- Department of Orthopaedics, Boston Children's Hospital, Boston, MA, USA
| | - Andrea Stracciolini
- Division of Sports Medicine, Boston Children’s Hospital, Boston, MA, USA
- The Micheli Center for Sports Injury Prevention, Walham, MA, USA
- Department of Orthopaedics, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA
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3
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Ergun-Longmire B, Greydanus DE, Patel DR. Ergogenic Aids and Testing in Pediatric Athletes. Pediatr Ann 2023; 52:e207-e212. [PMID: 37280002 DOI: 10.3928/19382359-20230411-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In the quest for winning the game, some athletes take various chemicals (ie, drugs, herbs, or supplements) in attempts to develop greater strength, endurance, or other elements that bring a competitive advantage. There are more than 30,000 chemicals sold throughout the world with unrestrained and unproven claims; however, some athletes consume them with hopes of increasing their athletic abilities, often without knowledge of the potential adverse effects and with limited evidence of efficacy. Complicating this picture is that research on ergogenic chemicals is typically conducted with elite adult male athletes and not with athletes who are in high school. A few of these ergogenic aids include creatine, anabolic androgenic steroids, selective androgen receptor modulators, clenbuterol, androstenedione, dehydroepiandrosterone, human growth hormone, ephedrine, gamma hydroxybutyrate, caffeine, stimulants (amphetamines or methylphenidate), and blood doping. In this article, we describe the purpose of ergogenic aids as well as the potential side effects. [Pediatr Ann. 2023;52(6):e207-e212.].
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Ganson KT, Hallward L, Cunningham ML, Murray SB, Nagata JM. Use of Legal Appearance- and Performance-Enhancing Drugs and Substances: Findings from the Canadian Study of Adolescent Health Behaviors. Subst Use Misuse 2023; 58:289-297. [PMID: 36576273 DOI: 10.1080/10826084.2022.2161318] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Use of appearance- and performance-enhancing drugs and substances (APEDS) is common among adolescent and young adults. Many APEDS are legally sold "over-the-counter," however research has documented contamination of legal APEDS and many adverse effects of use. Despite this, little research has been conducted on legal APEDS use in Canada, particularly regarding the prevalence and sociodemographic predictors of use, which was the aim of this study. METHODS Data from the Canadian Study of Adolescent Health Behaviors (N = 2,731) were analyzed. Prevalence and frequency of use of 10 common APEDS in the past 12 months were estimated overall and across genders. Multiple modified Poisson regression analyses were conducted to determine the sociodemographic predictors of APEDS use. RESULTS Overall, use of caffeine was most common among the sample (71.3%), along with protein bars (63.4%), and whey protein powders or protein shakes (63.1%). Boys and men reported greater prevalence of use of eight of the 10 APEDS, with the exception of diuretics or water pills and probiotics, compared to girls and women and transgender/gender non-confirming participants. Over three quarters (82.5%) of boys and men reported use of whey protein powders or protein shakes and 50.3% reported use of creatine monohydrate. Use of APEDS varied based on several key sociodemographic identifiers. CONCLUSIONS This study is the first to document legal APEDS use among a sample of Canadian adolescents and young adults, providing important implications for health care and policymaking professionals. Further research is needed to gain greater insight into APEDS use among Canadian young people.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Laura Hallward
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada.,School of Kinesiology, Western University, London, Canada
| | | | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
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5
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Thirumalai A, Anawalt BD. Androgenic Steroids Use and Abuse. Urol Clin North Am 2022; 49:645-663. [DOI: 10.1016/j.ucl.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Psychosocial aspects of sports medicine in pediatric athletes: Current concepts in the 21 st century. Dis Mon 2022:101482. [PMID: 36100481 DOI: 10.1016/j.disamonth.2022.101482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Behavioral aspects of organized sports activity for pediatric athletes are considered in a world consumed with winning at all costs. In the first part of this treatise, we deal with a number of themes faced by our children in their sports play. These concepts include the lure of sports, sports attrition, the mental health of pediatric athletes (i.e., effects of stress, anxiety, depression, suicide in athletes, ADHD and stimulants, coping with injuries, drug use, and eating disorders), violence in sports (i.e., concepts of the abused athlete including sexual abuse), dealing with supervisors (i.e., coaches, parents), peers, the talented athlete, early sports specialization and sports clubs. In the second part of this discussion, we cover ergolytic agents consumed by young athletes in attempts to win at all costs. Sports doping agents covered include anabolic steroids (anabolic-androgenic steroids or AAS), androstenedione, dehydroepiandrostenedione (DHEA), human growth hormone (hGH; also its human recombinant homologue: rhGH), clenbuterol, creatine, gamma hydroxybutyrate (GHB), amphetamines, caffeine and ephedrine. Also considered are blood doping that includes erythropoietin (EPO) and concepts of gene doping. In the last section of this discussion, we look at disabled pediatric athletes that include such concepts as athletes with spinal cord injuries (SCIs), myelomeningocele, cerebral palsy, wheelchair athletes, and amputee athletes; also covered are pediatric athletes with visual impairment, deafness, and those with intellectual disability including Down syndrome. In addition, concepts of autonomic dysreflexia, boosting and atlantoaxial instability are emphasized. We conclude that clinicians and society should protect our precious pediatric athletes who face many challenges in their involvement with organized sports in a world obsessed with winning. There is much we can do to help our young athletes find benefit from sports play while avoiding or blunting negative consequences of organized sport activities.
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Siegmund LA. Appearance and Performance Enhancing Drugs and Substances: The Role of the School Nurse. NASN Sch Nurse 2022; 37:263-269. [PMID: 35466806 DOI: 10.1177/1942602x221093938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this article is to provide the school nurse with the ability to recognize performance and appearance enhancing substance use and understand treatment and prevention strategies to reduce associated health risks. The use of appearance and performance enhancing drugs and substances, also known as "doping," has been an ethical and health issue in sports for many years. It is vital that school nurses learn to recognize performance and appearance enhancing substance use to ensure student athletes and exercisers receive the care and education they need. Commonly used performance and appearance enhancing substances include anabolic-androgenic steroids, stimulants, diuretics, growth hormone, and supplements. Signs and symptoms that may look similar to other health concerns include palpitations, stunted growth, acne, severe headaches, muscle cramps, dizziness, and dehydration, but some long-term severe complications occur as well. Doping can lead to severe and sometimes permanent organ damage, including liver, kidney, and heart disease. The school nurse can play a key role by working with parents, coaches, school counselors, and educators to foster an anti-doping culture.
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Cabral MD, Patel DR, Greydanus DE, Deleon J, Hudson E, Darweesh S. Medical perspectives on pediatric sports medicine–Selective topics. Dis Mon 2022; 68:101327. [DOI: 10.1016/j.disamonth.2022.101327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Ganson KT, Testa A, Jackson DB, Nagata JM. Associations between Concurrent Substance Use and Anabolic-Androgenic Steroid Use among Adolescents. Subst Use Misuse 2022; 57:1160-1163. [PMID: 35459422 DOI: 10.1080/10826084.2022.2064510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Concurrent use of e-cigarettes, cigarettes, and cannabis is common among adolescents, while illicit anabolic-androgenic steroid (AAS) use has recently been on the rise. Today, no known research has investigated the patterns of concurrent substance use and AAS use among adolescents in the United States. OBJECTIVE To determine the association between concurrent lifetime use of e-cigarettes, cigarettes, and cannabis and illicit AAS use among adolescents. METHODS Cross-sectional data from the 2019 Youth Risk Behavior Survey (N = 13,677) were analyzed in 2021. Four mutually exclusive categories of concurrent substance use (no use, any single use, any dual use, and triple use) were constructed, along with any lifetime AAS use. One logistic regression model was estimated to determine the association between concurrent substance use and lifetime AAS use. RESULTS Compared to no use, lifetime triple use (adjusted odds ratio 3.95, 95% confidence interval 1.73-8.95) was associated with lifetime AAS use while adjusting for potential confounders. CONCLUSIONS Findings underscore an overlapping pattern of problematic substance use that may be harmful for adolescents. Health care professionals should be aware of these patterns to improve substance use assessment protocols.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Alexander Testa
- Department of Criminology & Criminal Justice, University of Texas at San Antonio, San Antonio, TX, USA
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, CA, USA
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Effects of Caffeine and Caffeinated Beverages in Children, Adolescents and Young Adults: Short Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312389. [PMID: 34886115 PMCID: PMC8656548 DOI: 10.3390/ijerph182312389] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/20/2021] [Accepted: 11/22/2021] [Indexed: 12/03/2022]
Abstract
The prevalence of ED consumption has increased over the past 10–15 years. Studies describing the effects of caffeine and caffeinated beverages show confusing results, so it seems important to regularly summarize the available facts, and in more detail. By a thorough analysis of more than 156 scientific papers, the authors describe the molecular background of absorption, as well as the positive and negative effects of different dosages of caffeine, just like its effects in physical activity and performance. ED and EDwA consumption is a regular habit of not only adults, but nowadays even of children and adolescents. There are no safe dosages described of caffeine or ED consumption for children. There are no positive short- or long-term effects of these compounds/products concerning developing brain functions, psycho-motor functions, or social development. Instead, there are many unpleasant side effects, and symptoms of regular or higher-dose ED consumption, especially at younger ages. This mini review describes many details of these unpleasant side effects, their severity, and motivations for consuming these compounds/products. In a quantitative research in Hungary (10–26 years, mean age: 15.6 ± 3.8 y, 1459 subjects, randomly chosen population), a survey based on a questionnaire asking people about their ED consumption habits was conducted. According to the data, 81.8% of the participants consumed EDs at least once, and 63.3% tried several products of the kind. A positive correlation was found between age and consumption (p < 0.001). The results show that a high proportion of this group often consumed EDwA, in many cases leading to harmful side-effects of caffeine overdose. In a sample of Hungarian high school and college students (17–26 years), ED consumption matched the international data, and only 19.7% of respondents did not use EDs at all (had never tasted an ED in their life).
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Barrack MT, Sassone J, Dizon F, Wu AC, DeLuca S, Ackerman KE, Tenforde AS. Dietary Supplement Intake and Factors Associated with Increased Use in Preadolescent Endurance Runners. J Acad Nutr Diet 2021; 122:573-582. [DOI: 10.1016/j.jand.2021.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 01/09/2023]
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Bhasin S, Hatfield DL, Hoffman JR, Kraemer WJ, Labotz M, Phillips SM, Ratamess NA. Anabolic-Androgenic Steroid Use in Sports, Health, and Society. Med Sci Sports Exerc 2021; 53:1778-1794. [PMID: 34261998 DOI: 10.1249/mss.0000000000002670] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This consensus statement is an update of the 1987 American College of Sports Medicine (ACSM) position stand on the use of anabolic-androgenic steroids (AAS). Substantial data have been collected since the previous position stand, and AAS use patterns have changed significantly. The ACSM acknowledges that lawful and ethical therapeutic use of AAS is now an accepted mainstream treatment for several clinical disorders; however, there is increased recognition that AAS are commonly used illicitly to enhance performance and appearance in several segments of the population, including competitive athletes. The illicit use of AAS by competitive athletes is contrary to the rules and ethics of many sport governing bodies. Thus, the ACSM deplores the illicit use of AAS for athletic and recreational purposes. This consensus statement provides a brief history of AAS use, an update on the science of how we now understand AAS to be working metabolically/biochemically, potential side effects, the prevalence of use among athletes, and the use of AAS in clinical scenarios.
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Affiliation(s)
- Shalender Bhasin
- Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Disa L Hatfield
- Department of Kinesiology, University of Rhode Island, Kingston, RI
| | - Jay R Hoffman
- Department of Physical Therapy, Ariel University, Ariel, Israel
| | - William J Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, OH
| | | | | | - Nicholas A Ratamess
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ
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Ganson KT, Murray SB, Mitchison D, Hawkins MAW, Layman H, Tabler J, Nagata JM. Associations between Adverse Childhood Experiences and Performance-Enhancing Substance Use among Young Adults. Subst Use Misuse 2021; 56:854-860. [PMID: 33726612 PMCID: PMC11385237 DOI: 10.1080/10826084.2021.1899230] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND OBJECTIVE Adverse childhood experiences (ACEs) are associated with negative health outcomes, yet their associations with performance-enhancing substance (PES) use are unclear. This study aimed to determine whether ACEs predict greater use of legal and illegal PES in young adults. METHODS We analyzed data from the National Longitudinal Study of Adolescent to Adult Health (n = 14,322), Waves I (1994-1995) and III (2001-2002). ACEs included childhood sexual abuse, physical abuse, two neglect indicators, and cumulative ACEs. Legal (e.g. creatine monohydrate) and illegal (e.g. non-prescription anabolic-androgenic steroids; AAS) PES use was assessed. RESULTS Sexual abuse had the greatest effect and predicted higher odds of legal PES use (men: adjusted odds ratio [AOR] 1.66, 95% confidence interval [CI] 1.06-2.59; women: AOR 3.74, 95% CI 1.63-8.59) and AAS use (men: AOR 8.89, 95% CI 5.37-14.72; women: AOR 5.73, 95% CI 2.31-14.18). Among men, a history of physical abuse (AOR 3.04, 95% CI 2.05-4.52), being left alone by a parent/guardian (AOR 2.33, 95% CI 1.50-3.60), and basic needs not being met (AOR 3.47, 95% CI 2.30-5.23) predicted higher odds of AAS use. Among women, basic needs not being met (AOR 2.94, 95% CI 1.43-6.04) predicted higher odds of AAS use. Among both men and women, greater number of cumulative ACEs predicted higher odds of both legal and illegal PES use. CONCLUSIONS ACEs predict greater PES use among young adults. Clinicians should monitor for PES use among those who have experienced ACEs and provide psychoeducation on the adverse effects associated with PES use.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Misty A W Hawkins
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Harley Layman
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Jennifer Tabler
- Department of Criminal Justice and Sociology, College of Arts and Sciences, University of Wyoming, Laramie, Wyoming, USA
| | - Jason M Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
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14
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Liu A. Pediatric Complementary Medicine. Pediatr Ann 2021; 50:e91-e95. [PMID: 34038648 DOI: 10.3928/19382359-20210217-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Complementary medicine is being used more broadly by many patients and physicians; however, little formal education has been provided on the topic. Given the prevalence of its use, pediatricians should have awareness of the options available as well as a certain level of comfort in counseling patients and families. This article aims to broaden knowledge on this topic as well as the evidence to support its use. [Pediatr Ann. 2021;50(3):e91-e95.].
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Miskulin I, Grbic DS, Miskulin M. Doping Attitudes, Beliefs, and Practices among Young, Amateur Croatian Athletes. Sports (Basel) 2021; 9:25. [PMID: 33572386 PMCID: PMC7916256 DOI: 10.3390/sports9020025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/25/2021] [Accepted: 02/05/2021] [Indexed: 12/11/2022] Open
Abstract
Recent studies revealed that amateur athletes, especially young ones, have an increasing tendency of performance-enhancing drugs (PEDs) usage. The aim of this study was to explore PEDs attitudes, beliefs, and practices among young, amateur Croatian athletes. This cross-sectional study using a specially designed questionnaire as a research tool was done during the August 2019 to January 2020 period among a convenient sample of 400 amateur athletes of median age 18 (interquartile range 15 to 21) years. The prevalence of current PEDs usage was 1.3%, while past PEDs usage prevalence was 3.3%. Current PEDs usage was more frequent among young adults (p = 0.048) and athletes playing individual sports (p = 0.001). Athletes who were engaged in sports from one to five years had more permissive attitudes toward PEDs (p < 0.001) as measured by the Performance Enhancement Attitude Scale. Female athletes had more positive beliefs about PEDs usage (p = 0.008). The study did not establish any correlation between current or past PEDs usage and attitudes toward PEDs as well as beliefs about PEDs usage. However, there was a weak positive correlation between attitudes toward PEDs and athletes' beliefs about PEDs usage (rs = 0.465, p < 0.001). PEDs usage is present among young Croatian amateur athletes. There is a need for interventions directed toward the prevention of PEDs usage in an observed subgroup of athletes.
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Affiliation(s)
- Ivan Miskulin
- Department of Public Health, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
| | - Danijela Stimac Grbic
- Department of Social Medicine and Organization of Health Care, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Maja Miskulin
- Department of Public Health, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
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Nagata JM, Ganson KT, Cunningham ML, Mitchison D, Lavender JM, Blashill AJ, Gooding HC, Murray SB. Associations between legal performance-enhancing substance use and future cardiovascular disease risk factors in young adults: A prospective cohort study. PLoS One 2020; 15:e0244018. [PMID: 33320903 PMCID: PMC7737961 DOI: 10.1371/journal.pone.0244018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 12/01/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Legal performance-enhancing substances (PES), such as creatine, are commonly used by adolescents and young adults. As PES are mostly unregulated by the US Food and Drug Administration, there has been limited empirical attention devoted to examining their long-term safety and health outcomes. Preliminary studies have demonstrated associations between PES use and severe medical events, including hospitalizations and death. PES could be linked to cardiovascular disease (CVD), the most common cause of mortality in the US, by altering the myocardium, vasculature, or metabolism. The objective of this study was to examine prospective associations between the use of legal PES in young adulthood and CVD risk factors at seven-year follow-up. MATERIALS AND METHODS Nationally representative longitudinal cohort data from the National Longitudinal Study of Adolescent to Adult Health, Waves III (2001-2002) and IV (2008), were analyzed. Regression models determined the prospective association between the use of legal PES (e.g. creatine monohydrate) and CVD risk factors (e.g. body mass index, diabetes, hypertension, hyperlipidemia), adjusting for relevant covariates. RESULTS Among the diverse sample of 11,996 male and female participants, no significant differences by PES use in body mass index, diabetes, hypertension, or hyperlipidemia were noted at Wave III. In unadjusted comparisons, legal PES users (versus non-users) were more likely to be White, be male, be college educated, drink alcohol, and engage in weightlifting, exercise, individual sports, team sports, and other strength training. There were no significant prospective associations between legal PES use at Wave III and body mass index, hemoglobin A1c, systolic and diastolic blood pressure, and cholesterol (total, HDL, LDL, triglycerides) deciles at seven-year follow-up (Wave IV), adjusting for demographics, health behaviors, and Wave III CVD risk factors. Similarly, there were no significant prospective associations between legal PES use and diabetes, hypertension, or hyperlipidemia based on objective measures or self-reported medications and diagnoses, adjusting for demographics, health behaviors, and Wave III CVD risk. CONCLUSIONS We do not find evidence for a prospective association between legal PES use and CVD risk factors in young adults over seven years of follow-up, including BMI, diabetes, hypertension, or hyperlipidemia. It should be noted that legal PES use was operationalized dichotomously and as one broad category, which did not account for frequency, amount, or duration of use. Given the lack of regulation and clinical trials data, observational studies can provide much needed data to inform the safety and long-term health associations of legal PES use and, in turn, inform clinical guidance and policy.
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Affiliation(s)
- Jason M. Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, United States of America
| | - Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | | | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Jason M. Lavender
- Military Cardiovascular Outcomes Research Program (MiCOR), Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- The Metis Foundation, San Antonio, Texas, United States of America
| | - Aaron J. Blashill
- Department of Psychology, San Diego State University, San Diego, California, United States of America
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University, San Diego, California, United States of America
- San Diego Joint Doctoral Program in Clinical Psychology, University of California, San Diego, California, United States of America
| | - Holly C. Gooding
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Stuart B. Murray
- Department of Psychiatry & Behavioral Sciences, University of Southern California, Los Angeles, California, United States of America
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17
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Nagata JM, Ganson KT, Gorrell S, Mitchison D, Murray SB. Association Between Legal Performance-Enhancing Substances and Use of Anabolic-Androgenic Steroids in Young Adults. JAMA Pediatr 2020; 174:992-993. [PMID: 32421175 PMCID: PMC7235901 DOI: 10.1001/jamapediatrics.2020.0883] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This cohort study uses data from the National Longitudinal Study of Adolescent to Adult Health database to describe the association between anabolic-androgenic steroid use and legal performance-enhancing substances in young adults.
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Affiliation(s)
- Jason M. Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco
| | - Kyle T. Ganson
- School of Social Work, Simmons University, Boston, Massachusetts
| | - Sasha Gorrell
- Department of Psychiatry, University of California, San Francisco
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia,Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Stuart B. Murray
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles
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18
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Yergaliyev KA, Aveling EL, Lee RM, Austin SB. Lessons for Local Policy Initiatives to Address Dietary Supplement Use Among Adolescents: A Qualitative Study of Stakeholders' Perceptions. J Adolesc Health 2020; 67:550-556. [PMID: 32387096 DOI: 10.1016/j.jadohealth.2020.03.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 02/10/2020] [Accepted: 03/07/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Weight-loss and muscle-building dietary supplements can have adverse health consequences for youth. At a time, when the Food and Drug Administration is considering increasing oversight of dietary supplements, this study aimed to explore community stakeholders' perceptions about the use of and access to such supplements among adolescents and to identify challenges and opportunities to engage stakeholders with policy initiatives to curtail youth access to supplements at the local level. METHOD We conducted 32 key informant semistructured interviews in four municipalities in Massachusetts with purposefully selected participants representing three categories of community stakeholders who could contribute to policy agenda setting at the local level: policy professionals, youth service providers, and young adults aged 18-25 years who used weight-loss or muscle-building supplements as minors. Interviews were audio-recorded, transcribed, deidentified, and analyzed using thematic analysis approach, facilitated by Dedoose software. RESULTS Community stakeholders reported wide availability and easy access to dietary supplements. Most participants were unaware of health risks. Many stakeholders did not perceive the use of these products as an issue impacting youth in their communities. The challenges identified in engaging stakeholders were competing concerns on the policy agenda, limited capacity of stakeholders, and uncertainty about who is accountable for the problem. CONCLUSION This study indicates the need for complementary, multipronged approaches at the municipal level to address the problem of weak regulation and easy access to potentially dangerous weight-loss and muscle-building supplements for youth.
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Affiliation(s)
- Kuanysh A Yergaliyev
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; SDU Business School, Suleyman Demirel University, Almaty, Kazakhstan.
| | - Emma-Louise Aveling
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Rebekka M Lee
- Department of Social and Behavior Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - S Bryn Austin
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Social and Behavior Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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19
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Ganson KT, Mitchison D, Murray SB, Nagata JM. Legal Performance-Enhancing Substances and Substance Use Problems Among Young Adults. Pediatrics 2020; 146:peds.2020-0409. [PMID: 32868471 PMCID: PMC7461208 DOI: 10.1542/peds.2020-0409] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/28/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Legal performance-enhancing substance(s) (PES) (eg, creatine) are widely used among adolescent boys and young men; however, little is known about their temporal associations with substance use behaviors. METHODS We analyzed prospective cohort data from the National Longitudinal Study of Adolescent to Adult Health, Waves I to IV (1994-2008). Logistic regressions were used to first assess adolescent substance use (Wave I) and use of legal PES (Wave III) and second to assess use of legal PES (Wave III) and subsequent substance use-associated risk behaviors (Wave IV), adjusting for potential confounders. RESULTS Among the sample of 12 133 young adults aged 18 to 26 years, 16.1% of young men and 1.2% of young women reported using legal PES in the past year. Adolescent alcohol use was prospectively associated with legal PES use in young men (odds ratio 1.39; 95% confidence interval [CI] 1.13-1.70). Among young men, legal PES use was prospectively associated with higher odds of problematic alcohol use and drinking-related risk behaviors, including binge drinking (adjusted odds ratio [aOR] 1.35; 95% CI 1.07-1.71), injurious and risky behaviors (aOR 1.78; 95% CI 1.43-2.21), legal problems (aOR 1.52; 95% CI 1.08-2.13), cutting down on activities and socialization (aOR 1.91; 95% CI 1.36-2.78), and emotional or physical health problems (aOR 1.44; 95% CI 1.04-1.99). Among young women, legal PES use was prospectively associated with higher odds of emotional or physical health problems (aOR 3.00; 95% CI 1.20-7.44). CONCLUSIONS Use of legal PES should be considered a gateway to future problematic alcohol use and drinking-related risk behaviors, particularly among young men.
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Affiliation(s)
- Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University
of Toronto, Toronto, Ontario, Canada
| | - Deborah Mitchison
- Translational Health Research Institute, School of
Medicine, Western Sydney University, Sydney, New South Wales, Australia;,Department of Psychology, Macquarie University,
Sydney, New South Wales, Australia
| | - Stuart B. Murray
- Department of Psychiatry and the Behavioral Sciences,
University of Southern California, Los Angeles, California; and
| | - Jason M. Nagata
- Division of Adolescent and Young Adult Medicine,
Department of Pediatrics, University of California, San Francisco, San
Francisco, California
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20
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Cuff S, LaBotz M. Legal Performance-Enhancing Substances in Children and Adolescents: Why Should We Care? Pediatrics 2020; 146:peds.2020-012278. [PMID: 32868467 DOI: 10.1542/peds.2020-012278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/22/2020] [Indexed: 12/13/2022] Open
Affiliation(s)
- Steven Cuff
- Divison of Sports Medicine, Nationwide Children's Hospital, Columbus, Ohio; .,Department of Pediatrics, College of Medicine, The Ohio State University, Columbus
| | - Michele LaBotz
- InterMed P.A., Portland, Maine; and.,Department of Pediatrics, School of Medicine, Tufts University, Boston, Massachusetts
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Katsiki N, Mikhailidis DP, Bajraktari G, Miserez AR, Cicero AFG, Bruckert E, Serban MC, Mirrakhimov E, Alnouri F, Reiner Ž, Paragh G, Sahebkar A, Banach M. Statin therapy in athletes and patients performing regular intense exercise - Position paper from the International Lipid Expert Panel (ILEP). Pharmacol Res 2020; 155:104719. [PMID: 32087236 DOI: 10.1016/j.phrs.2020.104719] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 02/18/2020] [Indexed: 02/08/2023]
Abstract
Acute and chronic physical exercises may enhance the development of statin-related myopathy. In this context, the recent (2019) guidelines of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS) for the management of dyslipidemias recommend that, although individuals with dyslipidemia should be advised to engage in regular moderate physical exercise (for at least 30 min daily), physicians should be alerted with regard to myopathy and creatine kinase (CK) elevation in statin-treated sport athletes. However it is worth emphasizing that abovementioned guidelines, previous and recent ESC/EAS consensus papers on adverse effects of statin therapy as well as other previous attempts on this issue, including the ones from the International Lipid Expert Panel (ILEP), give only general recommendations on how to manage patients requiring statin therapy on regular exercises. Therefore, these guidelines in the form of the Position Paper are the first such an attempt to summary existing, often scarce knowledge, and to present this important issue in the form of step-by-step practical recommendations. It is critically important as we might observe more and more individuals on regular exercises/athletes requiring statin therapy due to their cardiovascular risk.
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Affiliation(s)
- Niki Katsiki
- First Department of Internal Medicine, Division of Endocrinology and Metabolism, Diabetes Center, Medical School, AHEPA University Hospital, Thessaloniki, Greece.
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK
| | - Gani Bajraktari
- Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo, Serbia; Medical Faculty, University of Prishtina, Prishtina, Kosovo, Serbia; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Andre R Miserez
- Diagene Research Institute, Reinach, Switzerland; University of Basel, Basel, Switzerland
| | - Arrigo F G Cicero
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy
| | - Eric Bruckert
- Pitié-Salpêtrière Hospital and Sorbonne University, Cardio Metabolic Institute, Paris, France
| | - Maria-Corina Serban
- Department of Functional Sciences, Discipline of Pathophysiology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Erkin Mirrakhimov
- Kyrgyz State Medical Academy, Named after Akhunbaev I.K., Bishkek, Kyrgyzstan
| | - Fahad Alnouri
- Cardiovascular Prevention Unit, Adult Cardiology Department, Prince Sultan Cardiac Centre Riyadh, Saudi Arabia
| | - Željko Reiner
- Department of Internal Diseases University Hospital Center Zagreb School of Medicine, Zagreb University, Zagreb, Croatia
| | - György Paragh
- Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland; Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland.
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Girelli L, Cavicchiolo E, Alivernini F, Manganelli S, Chirico A, Galli F, Cozzolino M, Lucidi F. Doping Use in High-School Students: Measuring Attitudes, Self-Efficacy, and Moral Disengagement Across Genders and Countries. Front Psychol 2020; 11:663. [PMID: 32411040 PMCID: PMC7198734 DOI: 10.3389/fpsyg.2020.00663] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 03/19/2020] [Indexed: 12/11/2022] Open
Abstract
The main aim of this research was to test the factorial validity and measurement invariance across genders and countries of a set of instruments designed to assess high-school students' attitudes, self-regulatory efficacy, and moral disengagement with regard to doping. A second aim was to examine the criterion and predictive validity of these scales. In total, 402 high-school students from Italy, Romania, and Turkey (40.0, 25.1, and 34.9%, respectively; M age 14.78 years old; SD = 1.04; 52.8% females) completed questionnaires measuring attitudes toward doping, self-regulatory efficacy in refraining from doping, doping-specific moral disengagement, and intention to use doping substances. A confirmatory factor analysis (CFA) supported our expectations with regard to the factor structure of the scales. Multigroup CFAs provided evidence for the full equivalence of the measures across males and females and partial equivalence of the measures across the three countries. The results of the latent mean comparison showed that male students had lower levels of self-regulatory efficacy than females and that Romanian and Turkish students had higher levels of moral disengagement and lower level of self-regulatory efficacy than Italian students. Finally, the results of a structural equation modeling supported the hypothesis that the proposed model predicted students' intentions to use doping, thus generally confirming the criterion and the predictive validity of the measures. These findings suggested the validity of a set of instruments measuring attitudes toward doping, self-regulatory efficacy to refrain from doping, and doping-specific moral disengagement in high-school students from a cross-gender and a cross-cultural perspective and provided meaningful estimates of the differences in the three factors between males and females as well as between Italian, Romanian, and Turkish high-school students.
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Affiliation(s)
- Laura Girelli
- Department of Human, Philosophical, and Educational Sciences, University of Salerno, Salerno, Italy
| | - Elisa Cavicchiolo
- National Institute for the Evaluation of the Education System (INVALSI), Rome, Italy
| | - Fabio Alivernini
- National Institute for the Evaluation of the Education System (INVALSI), Rome, Italy
| | - Sara Manganelli
- National Institute for the Evaluation of the Education System (INVALSI), Rome, Italy
| | - Andrea Chirico
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
| | - Federica Galli
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
| | - Mauro Cozzolino
- Department of Human, Philosophical, and Educational Sciences, University of Salerno, Salerno, Italy
| | - Fabio Lucidi
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
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23
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The association of disordered eating with health-related quality of life in U.S. young adults and effect modification by gender. Qual Life Res 2020; 29:1203-1215. [DOI: 10.1007/s11136-019-02396-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2019] [Indexed: 12/12/2022]
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24
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Gheddar L, Ameline A, Raul JS, Kintz P. Designer anabolic steroids: A challenge for toxicologists. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2019. [DOI: 10.1016/j.toxac.2019.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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25
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Or F, Kim Y, Simms J, Austin SB. Taking Stock of Dietary Supplements' Harmful Effects on Children, Adolescents, and Young Adults. J Adolesc Health 2019; 65:455-461. [PMID: 31176525 DOI: 10.1016/j.jadohealth.2019.03.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/06/2019] [Accepted: 03/07/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE The aim of the study was to evaluate the relationship between supplement categories and adverse events in children, adolescents, and young adults. METHODS This is a retrospective observational study using adverse event reports between January 2004 and April 2015 in the U.S. Food and Drug Administration Adverse Event Reporting System on food and dietary supplements database. We quantified the relative risks for severe medical events of dietary supplements sold for various functions relative to vitamins among individuals aged between 0 and 25 years. Severe medical events include death, disability, life-threatening events, hospitalization, emergency room visit, and/or required intervention to prevent permanent disability. RESULTS There were 977 single-supplement-related adverse event reports affecting individuals aged between 0 and 25 years over 11 years (50.6% female; age: mean = 16.5 years, standard deviation = 7.5 years). Supplements sold for muscle building (risk ratio [RR] = 2.7; 95% confidence interval [CI] = 1.9-4.0), energy (RR = 2.6; 95% CI = 1.9-3.6), and weight loss (RR = 2.6; 95% CI = 1.9-3.4) were associated with almost three times the risk for severe medical events compared with vitamins. CONCLUSIONS Consumption of dietary supplements sold for weight loss, muscle building, and energy involved increased risks for severe medical events compared with vitamins. Proactive enforcement of regulations is needed to reduce access and consumption among children, adolescents, and young adults.
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Affiliation(s)
- Flora Or
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Yongjoo Kim
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Juliana Simms
- Harvard University Information Technology, Cambridge, Massachusetts
| | - S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
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26
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Machek SB, Willoughby DS. Non-nutritive Sweeteners: Implications for Consumption in Athletic Populations. Strength Cond J 2019. [DOI: 10.1519/ssc.0000000000000469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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27
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Carl R. Healthy Weight Practices for Child and Adolescent Athletes. Pediatr Ann 2019; 48:e286-e289. [PMID: 31305947 DOI: 10.3928/19382359-20190617-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Sports and other physical activities are an important part of a healthy lifestyle for young people. Activity promotion is a critical part of health supervision visits in the primary care setting. However, participation in athletics during childhood may increase the risk of some types of unhealthy behaviors. Young athletes may be more likely to pursue weight loss or gain to improve performance in their sports. Some methods of weight loss and gain can put a young athlete's health at risk. Primary care providers can incorporate discussion of how athletes can maintain healthy weight into health supervision visits. [Pediatr Ann. 2019;48(7):e286-e289.].
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28
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Nelson A, Patterson K, Groff A, King TS, Brady J, Olympia RP. Themes Depicted in Running-Related Films: An Opportunity for Co-Viewing and Active Mediation. Clin Pediatr (Phila) 2019; 58:778-788. [PMID: 30880444 DOI: 10.1177/0009922819837369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sport participation is an important part of the development of children and adolescents. The objective of this study was to identify and quantify themes depicted in a select number of running-related films. Thirty-one running-related films were independently viewed and analyzed by 4 reviewers. The number of positive and negative themes was 29.5 (95% confidence interval = 26.1-33.4) and 9.0 (95% confidence interval = 7.9-10.2) mean events per hour for all included films, respectively. The most common positive themes were "overcoming physical limitations," "overcoming mental obstacles," and "encouragement from family/friends/fans" (2.6, 2.4, and 2.3 mean events per hour, respectively). The most common negative themes were "giving up/losing confidence," "ignoring injuries," and "discouragement/ridicule from coach/athletic trainer" (1.2, 1.1, and 0.66 mean events per hour, respectively). In conclusion, the co-viewing of running-related films with pediatric athletes in order to focus on "teachable moments" may encourage the acquisition and development of positive themes and the avoidance and de-emphasis of negative themes.
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Affiliation(s)
- Abigail Nelson
- 1 Penn State Hershey Children's Hospital, Hershey, PA, USA
| | | | | | | | - Jodi Brady
- 1 Penn State Hershey Children's Hospital, Hershey, PA, USA
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29
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Abstract
Interest and participation in organized sports for children, preadolescents, and adolescents continue to grow. Because of increased participation, and younger entry age, in organized sports, appropriate practice, game schedules, and content become more important, taking into account athlete developmental stage and skills. Parental support for organized sports in general, with focus on development and fun instead of winning, has emerged as a key factor in the athlete's enjoyment of sports. Schools and community sports organizations who support multiple levels of sport (eg, recreational, competitive, elite) can include more youth who want to play sports and combat sport dropout. This report reviews the benefits and risks of organized sports as well as the roles of schools, community organizations, parents, and coaches in organized sports. It is designed to complement the American Academy of Pediatrics clinical reports "Physical Activity Assessment and Counseling in Pediatric Clinical Settings" and "Sports Specialization and Intensive Training in Young Athletes" by reviewing relevant literature on healthy organized sports for youth and providing guidance on organized sport readiness and entry. The report also provides guidance for pediatricians on counseling parents and advocating for healthy organized sports participation.
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Sánchez-Oliver AJ, Grimaldi-Puyana M, Domínguez R. Evaluation and Behavior of Spanish Bodybuilders: Doping and Sports Supplements. Biomolecules 2019; 9:biom9040122. [PMID: 30925786 PMCID: PMC6523090 DOI: 10.3390/biom9040122] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 03/26/2019] [Accepted: 03/27/2019] [Indexed: 01/04/2023] Open
Abstract
The use of doping agents has these days become a public health problem, as it also affects young and non-competitive amateurs in different sports. To prepare for competition, bodybuilders perform aggressive dietary protocols, so, bodybuilders frequently consume nutritional supplements (NS) and banned substances in large dosages. Thus, the aim of this study is to analyze the prevalence of banned substances consumption and NS intake in competitive level bodybuilders. A total of 48 bodybuilders (44 males and 4 females) completed a validated online questionnaire on NS consumption. The quantitative data was presented as a mean (M) ± standard deviation (SD), as well as having minimum and maximum values. The categorical variables were expressed using frequencies and percentages. 83.3% of the participants declared that they had consumed or would consume banned substances, the most consumed being anabolic steroids (72.9%). One hundred percent of those sampled use NS. Whey protein (96%), branched-chain amino acids (BCAA) (94%), creatine (85%) and vitamin complexes (83%) were the most consumed, however, there is a low consumption of certain NS which could also increase athletic performance.
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Affiliation(s)
| | - Moisés Grimaldi-Puyana
- Department of Physical Education and Sports, Faculty of Educational Sciences, University of Seville, 41013 Seville, Spain.
| | - Raúl Domínguez
- Faculty of Health Sciences of Universidad Isabel I, Universidad Isabel I, 09004 Burgos, Spain.
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La Vignera S, Condorelli RA, Cannarella R, Duca Y, Calogero AE. Sport, doping and female fertility. Reprod Biol Endocrinol 2018; 16:108. [PMID: 30449281 PMCID: PMC6241032 DOI: 10.1186/s12958-018-0437-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 10/24/2018] [Indexed: 01/02/2023] Open
Abstract
This article is a review that addresses the following topics, divided by paragraphs. The first paragraph investigates the effects of physical activity on ovarian function, analyzing in particular the changes concerning the serum concentrations of follicle-stimulating hormone, luteinizing hormone, prolactin, growth hormone, thyroid hormones, leptin, ghrelin, neuropeptide Y. The second paragraph analyzes the effects of doping on the hypothalamic-pituitary-ovarian axis. Finally, the last paragraph analyzes the PCOS category, evaluating the effects of hyperandrogenism in relation to athletic performance.
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Affiliation(s)
- Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy.
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy
| | - Ylenia Duca
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy
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32
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Howard MS, DiDonato KL, Janovick DL, Schroeder MN, Powers MF, Azzi AG, Lengel AJ. Perspectives of athletes and pharmacists on pharmacist-provided sports supplement counseling: An exploratory study. J Am Pharm Assoc (2003) 2018; 58:S30-S36.e2. [DOI: 10.1016/j.japh.2018.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 04/30/2018] [Accepted: 05/07/2018] [Indexed: 10/28/2022]
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Dietz P, Iberl B, Schuett E, van Poppel M, Ulrich R, Sattler MC. Prevalence Estimates for Pharmacological Neuroenhancement in Austrian University Students: Its Relation to Health-Related Risk Attitude and the Framing Effect of Caffeine Tablets. Front Pharmacol 2018; 9:494. [PMID: 29946254 PMCID: PMC6006370 DOI: 10.3389/fphar.2018.00494] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/25/2018] [Indexed: 01/22/2023] Open
Abstract
Background: Pharmacological neuroenhancement (PN) is defined as the use of illicit or prescription drugs by healthy individuals for cognitive-enhancing purposes. The present study aimed (i) to investigate whether including caffeine tablets in the definition of PN within a questionnaire increases the PN prevalence estimate (framing effect), (ii) to investigate whether the health-related risk attitude is increased in students who use PN. Materials and methods: Two versions of a paper-and-pencil questionnaire (first version included caffeine tablets in the definition of PN, the second excluded caffeine tablets) were distributed among university students at the University of Graz, Austria. The unrelated question model (UQM) was used to estimate the 12-month PN prevalence and the German version of the 30-item Domain-Specific Risk-Taking (DOSPERT) scale to assess the health-related risk attitude. Moreover, large-sample z-tests (α = 0.05) were performed for comparing the PN prevalence estimates of two groups. Results: Two thousand four hundred and eighty-nine questionnaires were distributed and 2,284 (91.8%) questionnaires were included in analysis. The overall PN prevalence estimate for all students was 11.9%. One-tailed large-sample z-tests revealed that the PN estimate for students with higher health-related risk attitude was significantly higher compared to students with lower health-related risk attitude (15.6 vs. 8.5%; z = 2.65, p = 0.004). Furthermore, when caffeine tablets were included into the example of PN, the prevalence estimate of PN was significantly higher compared to the version without caffeine tablets (14.9 vs. 9.0%; z = 2.20, p = 0.014). Discussion: This study revealed that the PN prevalence estimate increases when caffeine tablets are included in the definition of PN. Therefore, future studies investigating the prevalence of, and predictors for, PN should be performed and interpreted with respect to potential framing effects. This study further revealed that the PN prevalence estimate is increased in students with a higher health-related risk attitude compared to students with a lower one. Therefore, future education and prevention programs addressing PN in the collective of students should not only inform about potential side effects of its use but also address the limited effects on cognition and potential alternatives of PN.
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Affiliation(s)
- Pavel Dietz
- Research Group of Physical Activity and Public Health, Institute of Sports Science, University of Graz, Graz, Austria
- Working Group Social and Health Sciences of Sport, Institute for Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Benedikt Iberl
- Research Group of Cognition and Perception, Institute of Psychology, University of Tübingen, Tübingen, Germany
| | - Emanuel Schuett
- Research Group of Cognition and Perception, Institute of Psychology, University of Tübingen, Tübingen, Germany
| | - Mireille van Poppel
- Research Group of Physical Activity and Public Health, Institute of Sports Science, University of Graz, Graz, Austria
- Working Group Social and Health Sciences of Sport, Institute for Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Rolf Ulrich
- Research Group of Cognition and Perception, Institute of Psychology, University of Tübingen, Tübingen, Germany
| | - Matteo Christian Sattler
- Research Group of Physical Activity and Public Health, Institute of Sports Science, University of Graz, Graz, Austria
- Working Group Social and Health Sciences of Sport, Institute for Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Carl RL, Johnson MD, Martin TJ, LaBella CR, Brooks MA, Diamond A, Hennrikus W, LaBotz M, Logan K, Loud KJ, Moffatt KA, Nemeth B, Pengel B, Peterson A. Promotion of Healthy Weight-Control Practices in Young Athletes. Pediatrics 2017; 140:peds.2017-1871. [PMID: 28827381 DOI: 10.1542/peds.2017-1871] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Children and adolescents may participate in sports that favor a particular body type. Some sports, such as gymnastics, dance, and distance running, emphasize a slim or lean physique for aesthetic or performance reasons. Participants in weight-class sports, such as wrestling and martial arts, may attempt weight loss so they can compete at a lower weight class. Other sports, such as football and bodybuilding, highlight a muscular physique; young athletes engaged in these sports may desire to gain weight and muscle mass. This clinical report describes unhealthy methods of weight loss and gain as well as policies and approaches used to curb these practices. The report also reviews healthy strategies for weight loss and weight gain and provides recommendations for pediatricians on how to promote healthy weight control in young athletes.
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Affiliation(s)
- Rebecca L. Carl
- Institute for Sports Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Miriam D. Johnson
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - Thomas J. Martin
- Department of Pediatrics, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania
- Department of Pediatrics, Milton S. Hershey College of Medicine, Pennsylvania State University, Hershey, Pennsylvania; and
- Central Pennsylvania Clinic for Special Children and Adults, Belleville, Pennsylvania
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Abstract
Despite inconclusive efficacy data and concerning safety data, the use of performance-enhancing drugs (PEDs) in the adolescent population is on the rise. Anabolic-androgenic steroids, growth hormones, stimulants, and erythropoiesis-stimulating agents are among the most widely known and studied prescription PEDs in the adolescent population. The purpose of this article is to describe the proposed mechanism of action, efficacy and adverse effects of these agents as well as discuss prevention measures and treatment considerations for those patients at risk for, considering, or currently using PEDs.
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Affiliation(s)
- Nicole D White
- School of Pharmacy and Health Professions, Creighton University, Omaha, Nebraska
| | - James Noeun
- School of Pharmacy and Health Professions, Creighton University, Omaha, Nebraska
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Abstract
Sports specialization is becoming the norm in youth sports for a variety of reasons. When sports specialization occurs too early, detrimental effects may occur, both physically and psychologically. If the timing is correct and sports specialization is performed under the correct conditions, the athlete may be successful in reaching specific goals. Young athletes who train intensively, whether specialized or not, can also be at risk of adverse effects on the mind and body. The purpose of this clinical report is to assist pediatricians in counseling their young athlete patients and their parents regarding sports specialization and intensive training. This report supports the American Academy of Pediatrics clinical report "Overuse Injuries, Overtraining, and Burnout in Child and Adolescent Athletes."
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