Performance Enhancing Substances ERGOGENIC AIDS

KEY KNOWLEDGE
Perceived benefits and harms to the athlete of legal and illegal performance enhancing strategies including: 1. altitude training, 2. creatine supplementation, 3. enhancement of oxygen transfer, 4. gene doping, 5. hormones (including steroids, erythropoietin and growth hormones), 6. diuretics and masking agents, stimulants and beta blockers The reasoning behind anti-doping codes used by the World Anti-Doping Agency (WADA) and the Australian Sports Anti-Doping Authority (ASADA)

KEY SKILLS
Evaluate anti-doping codes used within sports by world and Australian authorities such as the World AntiDoping Agency (WADA) and the Australian Sports AntiDoping Authority (ASADA)

Performance Enhancing Substances ERGOGENIC AIDS

http://www.youtube.com/watch?v=uUSpReeSixk An ergogenic aid is any &feature=related substance or technique that improves or is thought to improve physical performance (legal & illegal). Often called doping however not all aids are illegal. The word doping is probably derived from the Dutch word dop, the name of an alcoholic beverage made of grape skins used by Zulu warriors in order to enhance their prowess in battle. Ergogenic means workproducing.

Anti-Doping Initiatives
Drugs have been used as early as 400BC in the ancient Greek games. The Romans used mixtures of plant extracts and herbs in gladiators and chariot horses. Athlete commonly used drugs until drug testing was introduced in the late 1960s. Modern doping began in 1935 when the Nazis used testosterone injections in their athletes 1936 team. Later used by the Soviets. Those involved has turned a blind eye to the side effects and ethical implications of taking drugs. After drug use was wide spread at the 1952 and 1956 Olympics, countries spoke out against performance aids and their side effects

Anti-Doping Initiatives
Anti-doping development took place in 1960 in Europe. The televised death of drug taker Tommy Simpson in 1967 (below) shook the athletics world. http://www.youtube.com/watch?v=YtAyGvZqiwk The IOC then became actively involved. First drug tests were conducted at the 1968 Olympics A list of banned substances was constructed by the IOC.

 The USA Anti-Doping Initiatives developed a synthetic form of testosterone called anabolic steroids in 1955. Athletes continued to take drugs during the 1960s and 70s. The East Germans had a heavy drop taking protocol and were very successful at international competitions (See Heidi Krieger). Coaches and athletes worked out methods of beating the drug tests The 1980s saw the introduction of human growth hormones (GBH) and synthetic GBH. Both were undetectable In the 1990s, erythropoietin (EPO) became the drug of choice. It is very hard to detect as it is a naturally occurring hormone. Sydney 2000 was the first accurate EPO test.

Anti-Doping Initiatives
Analytical measures such as gas chromatography and mass spectrometry where therefore introduced. Ben Johnson was famously stripped of his 1988 100m gold medal for steroid use. Procedures and standards for laboratories were set up by the IOC In 1999 the World Anti-Doping Agency (WADA) was established after the drug taking in the tour de France scandal. In 2003 all major federations and governments signed a Anti-doping code. In the 2004 Olympic games: 3000 drug tests were conducted with 23 athletes being found positive of banned drugs.

Illegal Performance Enhancers

Illegal Group Substances Used for Side Effects Stimulants Ephedrine, amphetamines, cocaine and caffeine Mask intolerance to lactic acid. Increase alertness, competitiveness and aggression. Anxiety, increased HR, irregular heart beat, dependence, depression, sleep disorders. Dependence, respiratory failure.

Narcotics

Codeine, morphine and opiates

Used to reduced moderate to severe pain so that athletes can continue to play while injured. Increase muscle bulk, power and strength. Training recovery is quicker and training intensity levels can also be higher. Used to reduce blood pressure and pre-competition stress relaxation.

Anabolic Agents

1. Anabolic Androgenic Steroids -Synthetic protein building chemicals. 2. Beta 2 Agonists Heart and blood pressure prescription drugs.

Steroid rage, acne, sudden death, tumours, liver damage, reproductive problems in females. Hypotension, hypoglycemia, cardiac failure, asthma severity. Dehydration, cramps, muscle strains, irregular heart beat. Peptide Diabetes, hypotension, decreased immune function, heart failure. Polypeptide Blood transfusion risks.

BetaBlockers

Diuretics

Kidney and liver prescription drugs.

Weight reduction (water and electrolyte loss). Can be used to dilute illegal substances. Peptide increase muscle and bone development. Believed to offset the effects of steroids. Polypeptide Increases RBC production.

Peptide and Polypeptide hormones

Peptide HGH and corticosteroids. Polypeptide Erythroprotein (EPO)

Performance enhancement
Reasons why athletes might take illegal performance enhancers Ongoing dissatisfaction with performance Psychological dependence Self-pressure and doubt, lack of confidence, nervousness, stress, anxiety or depression Relaxation/socialisation The belief that such practices may not cause any long-term harm Wanting to keep up with other athletes Believing they can get away with it Being easily influenced by peers A win-at-all-costs mentality Personal pride and the need to retain a hero or role-model status Environment-related reasons for athletes taking illegal performance enhancers Friends or peers using illegal practices (drug culture) with improved results Pressure to win from others Unreasonable scheduling of events (allowing insufficient recovery time) The financial rewards offered as prize money by sponsors, product endorsements etc The prestige and fame associated with being the best The influence of role-models The demanding qualifying standards required to make national selection National honour and pride

ILLEGAL SUBSTANCES & METHODS

ERGOGENIC AIDS
PROHIBITED SUBSTANCES IN DETAIL

ANABOLIC AGENTS
Anabolic steroids are related in structure and function to testosterone Most commonly used illegal sporting drug Anabolic steroids (synthetically produced chemical) attempts to maximise the PROTEIN BUILDING (muscle growth)/anabolic effect Anabolic steroid use increases muscle bulk, power and srength by: 1.Increasing protein synthesis (Improves recovery period) 2.Blocking hormones responsible for the break down of muscle tissue following intensive exercise (Improves recovery period) 3.Increases aggressive behaviour promotes greater quantity and quality of training

ERGOGENIC AIDS
PROHIBITED SUBSTANCES IN DETAIL

HORMONES AND RELATED SUBSTANCES

HUMAN GROWTH HORMONES (HGH) & CORTICOSTEROIDS Used to: 1. increase muscle and bone development (train with greater intensity for longer durations-improved athletic performance) 2.Induce a state of euphoria (less fatigue) 3.An anti-inflammatory preparation (Improves recovery 4.Normalise testosterone-epitestosterone ratio used in dope testing (Used to conceal other illegal ergogenic aids)

SIDE EFFECTS
1. 2. 3. Diabetes Hypotension (Chronic High Blood Pressure) Decreased immune function 1. 2. 3. 4. Sodium and water retention Skin changes Impotence Heart Failure

ERGOGENIC AIDS
PROHIBITED SUBSTANCES IN DETAIL

INSULIN-LIKE GROWTH FACTORS (IGF)

IGF-1 is a naturally occurring hormone that stimulates many processes in the body including protein synthesis Athletes use the drug to: 1. enhance muscle bulk 2.Reduce muscle cell breakdown 3.Reduce body fat

SIDE EFFECTS FROM LARGE DOSES

1. 2. 3. 4. 5. HYPOGLAECEMIA SWELLING OF THE BRAIN ENLARGEMENT OF THE HEART DIABETIC COMA ALL CAN BE FATAL

ERGOGENIC AIDS
PROHIBITED SUBSTANCES IN DETAIL

BETA-2-AGONISTS
Beta 2 agonists are commonly inhaled to treat asthma If taken intravenously (blood) can have anabolic effects Prohibited except for inhaled bronchodilator medications Athletes take beta-2 agonists to improve their uptake of 02 to enhance their performance.

BETA-BLOCKERS
Beta-blockers prevent the effect of beta receptors (nerve impulse receptors found in the heart and blood vessels They control: SIDE EFFECTS 1. blood pressure Hypotension, 2.Slow the heart rate Hypoglycemia 3.Lower anxiety levels (pre competition) Increased severity of asthma Cardiac failure 4.Reduce tremors Used in fine motor skill sports to increase accuracy

ERGOGENIC AIDS
PROHIBITED SUBSTANCES IN DETAIL

MASKING AGENTS
Drugs taken to mask/hide the presence of specific illegal drugs and have the ability to impair or conceal banned substances in urine samples Examples of Masking Agents: 1.Diuretics 2.Plasma volume expanders. Taken to mask use of artificially produced EPO (Erythropoietin (EPO): A hormone produced by the kidney that promotes the formation of red blood cells in the bone marrow). When plasma volume expanders are taken with EPO, they can elevated blood volume while maintaining the % of RBC in the blood and % haemoglobin levels within the legal range. http://www.youtube.com/watch?v=iQZnBpoC2jc&feature=relate d

ERGOGENIC AIDS
PROHIBITED SUBSTANCES IN DETAIL

STIMULANTS
Stimulants are substances that act on the brain, effecting the body both mentally and physically. Similar affect to adrenaline and noradrenaline (produced by the body). Stimulants increase: 1.Alertness 2.Competitiveness 3.Aggression and also help combat fatigue. 4.They make the athletes feel stronger, more energetic and decisive TYPES: 1.Psuedoephedrine (counter cold medication Sudafed) SIDE EFFECTS 2.Ephedrine Increase blood pressure Convulsions 3.Cocaine Increase body temperature Heart Attack 4.Amphetamines and Insomnia Stroke 5.Caffeine Irregular heart beats Can be addictive

ERGOGENIC AIDS
PROHIBITED SUBSTANCES IN DETAIL

NARCOTICS
Used to reduce moderate to severe pain (painkillers) thus enhancing performance Enables athletes to continue competing while injured. Highly addictive The high associated with taking Narcotics can impair judgement, balance and concentration. EXAMPLES: 1.Codeine 2.Morphine 3.Derivatives from opium poppies 4.buprenorphine, dextromoramide, heroin, pethidine SIDE EFFECTS 1.Addiction 2.Respiratory depression (decreased rate of breathing) 3.Death

ERGOGENIC AIDS
PROHIBITED SUBSTANCES IN DETAIL

GLUCOCORTICOSTEROIDS
Powerful anti-inflammatory drugs. Used to help treat arthritis, asthma, and allergic reactions. Athletes use them to reduce pain and the sensation of fatigue ACUTE SIDE EFFECTS (Immediate) 1.Fluid retention 2.Hyperglycemia (high blood sugar levels) 3.Mood alterations
CHRONIC SIDE EFFECTS (changes over time) 1.Increased chance of infections 2.Musculoskeletal problems (Osteoporosis, softening of connective tissue 3.Weakening of muscles, bones and ligaments

ERGOGENIC AIDS
PROHIBITED METHODS & PRACTICES IN DETAIL

BLOOD DOPING

PROHIBITED METHODS/PRA CTICES

GENETIC MANIPULATION

CHEMICAL/PHYSICA L MANIPULATION

ERGOGENIC AIDS
PROHIBITED METHODS & PRACTICES IN DETAIL

BLOOD DOPING
An ergogenic procedure in which an increased red blood cell count is achieved by using transfusion of the athletes own blood or transfusion from someone else with same blood type. PROCEDURE: 1.Approximately 500ml of blood extracted from athlete well in advance of the competition and stored 2.In sufficient time, the athletes blood levels return to normal levels. 3.Just prior to competition the harvested blood is intravenously replaced into the athletes CV system, thus increasing blood levels and 02 carrying capacity thus increasing aerobic capacity and improved endurance performance. 4.Detected by blood test which detects higher than normal RBC levels

ERGOGENIC AIDS
PROHIBITED METHODS & PRACTICES IN DETAIL

CHEMICAL AND PHYSICAL MANIPULATION

Prohibited to tamper with or attempt to alter the integrity and validity of urine/blood samples E.G. swapping samples, intravenous infusions to avoid detection.

GENETIC MANIPULATION (GENE DOPING)

In 2005, WADA stated that the non-therapeutic use of cells, genes, genetic elements or the modification of gene expression, having the capacity to enhance athletic performance, is prohibited.

Legal performance-enhancing practices

Many legal strategies also provide athletes with performance advantages. These include the following dietary manipulation practices / strategies: Mechanical aids Nutritional aids Creatine supplementation Fluid replacement Caffeine supplementation Protein supplementation Other legal practices, such as altitude training target endurance performance improvements. As with training, performance-enhancing practices must be tailored, and must be specific to training and competition demands.

Legal performance-enhancing practices

MECHANICAL AIDS
Selection

of correct training programs Heart Rate Monitors Resistance Devices (weights, weighted vests, tyre towing etc Computers/Software Video Recording Compression Garments Altitude training/rooms/tents Specifically designed clothing/footwear Specifically designed equipment

Legal performance-enhancing practices

MECHANICAL AIDS: High-altitude training High altitude is defined as any altitude where the oxygen available to the body is less than that available at sea level (usually altitudes in excess of 2000 m) At these altitudes the body finds itself in serious oxygen deficit and is forced to produce a greater number of red blood cells to transport oxygen. acute responses to higher altitudes include: 1. increased breathing rate, 2.increased heart rate, 3.reduced blood flow to the brain, 4.headache, 5.nausea, 6.sleeplessness and 7.decrease in the volume of oxygen we can take up, or VO2 max. Collectively, these responses reduced the athletes work capacity. It can take an athlete up to three weeks to acclimatize and familiarise themselves with these new environmental conditions.

Legal performance-enhancing practices

HIGH ALTITUDE TRAINING Cont It generally takes an athlete three months to achieve a greater oxygen capacity at altitude than could be attained at sea level. High-altitude training adaptations will be retained for one to three months even after moving back to sea level (reversibility). The most significant adaptations are: 1.increased erythrocyte volume, (The number of red cells per volume of blood) 2.increased haemoglobin volume and concentration, 3.increased blood viscosity, 4.increased capillarisation. 5.Increased mitochondria 6.Increased myoglobin 7.Increased activity of oxidative enzymes The most common high altitude training is LIVE HIGH-TRAIN LOW (adaptations while living high, but athletes training intensity not compromised while training low) 3 weeks for 12 hours/day minimum time for adaptations to occur. Altitude rooms/tents replicate high altitude locations

Legal performance-enhancing practices NUTRITIONAL AIDS

SPORTS DRINKS (See Ppt slide on Dietary Performance Enhancement) ELECTROLYTE REPLACEMENT SUPPLEMENTS Used to replace a combination of large fluid and electrolyte loss as a result of sweat. If substantial SODIUM has been lost it must firstly be replaced to ensure fluid balance is achievable through fluid replacement Without electrolyte/Sodium replacement, urine output increases and the thirst mechanism decreases thus increasing dehydration.

Legal performance-enhancing practices NUTRITIONAL AIDS

CARBOHYDRATE GELS & BARS Concentrated source CHO Best consumed with a drink (water) Most effective when consumed: 1.As a supplement during prolonged training sessions 2.As a supplement for athletes with a high energy demand 3.Effective post exercise recovery supplement 4.As an effective recovery supplement used during multi-event competitions 5.As a replacement snack or meal when making weighins for specific events

Legal performance-enhancing practices NUTRITIONAL AIDS

LIQUID-MEAL SUPPLEMENTS
good

source of vitamins, minerals, and essential amino acids Good for athletes who are aiming to increase lean body mass (muscle) Good for coping with demanding training programs or growth spurts Good for post recovery snack for high intensity powerful activities.

Legal performance-enhancing practices NUTRITIONAL AIDS

VITAMIN & MINERAL SUPPLEMENTS:
VITAMINS: assist chemical reactions in the body (aid in

energy release from food) MINERALS: assist in: 1.Muscle contractions, 2.Nerve transmission, 3.Fluid balance and 4.Enzyme activity A balanced diet should provide an athlete with sufficient vitamins and minerals. Obviously if diet is not balanced supplements may be required. Supplements can be taken in multi vitamin/mineral (Centrum) or a single nutrient supplement (calcium or iron)

Legal performance-enhancing practices NUTRITIONAL AIDS

VITAMIN & MINERAL SUPPLEMENTS:
IRON:

1.Low iron levels leads to anaemia 2.This reduces 02 carrying ability 3.Balanced diet usually provides sufficient iron 4.Supplementation may be required for: a) Female athletes b) Adolescent athletes growing quickly c) Pregnant athlete d) Athletes adapting to altitude or heat training 5.Best taken with vitamin C for 2-3 months or until deficiency is rectified.

Legal performance-enhancing practices NUTRITIONAL AIDS

VITAMIN & MINERAL SUPPLEMENTS:
CALCIUM

1.Important for: a) muscle contraction b) Nerve transmission c) Enzyme activity d) Blood clotting e) Bone and teeth strength 2.Important for athletes who: a) Have insufficient calcium in diet b) Females with impaired menstrual functions (1500mgms / day) 3.600 milligrams suggested daily intake

NUTRITIONAL ERGOGENIC AIDS Creatine Supplementation

Creatine Used to increase power, strength and anaerobic performances. Creatine can naturally be restored from either food (fish, poultry and red meat) or through amino acids. However, diet alone is not able to fully supersaturate the muscle in phosphocreatine. Supplements are available in capsules, powders or chewable forms (Creatine monohydrate) Manufacturers recommend 10-20g per day to fill up our muscles.

NUTRITIONAL ERGOGENIC AIDS Creatine Supplementation

Creatine supplements increases the rate of PC resynthesis during recovery thus assisting the ATPPC system. Possible side effects; Causes weight gain Causes water retention Can cause seizures, vomiting, diarrhoea, anxiety, muscle weakness, irregular heart beat, deep vein thrombosis (DVT), death. Creatine is a medico-legal drug which should only used under the guidance of a sports dietician or

Additional creatine is stored at the muscles when creatine supplementation and high carbohydrate diets occur together

Increase in muscle concentration (mM.kg dm-1)

Creatin e

NUTRITIONAL ERGOGENIC AIDS Caffeine

Increase in energy drinks by athletes with caffeine (100-200mg) or guarana. Caffeine in coffee and soft drinks is usually 30-80mg per serve Caffeine is a CNS stimulant, diuretic, circulatory and respiratory stimulant. Caffeine can intensify muscular contractions, mask fatigue, can speed up fuel usage, releases adrenaline which causes an increase in fat oxidation and the conservation of muscle glycogen.

 Peak levels in the blood 1-2 hours after consumption 3-9mg prior to exercise has been recorded to enhance performance in running and cycling (3mg =Approx 2 cups of coffee) Doping controls has set a limit of 12 ug/mL Side Effects Restlessness and insomnia Elevated blood pressure and heart rate CNS disruptions High fluid loss (diuretic) Upsets thermal regulation in the body

NUTRITIONAL ERGOGENIC AIDS Caffeine

NUTRITIONAL ERGOGENIC AIDS Bicarbonate Bicarbonate

Increases the bodys ability to dispose of excess hydrogen ions that are produced during anaerobic glycolysis. Hydrogen ions are the main cause of fatigue when working anaerobically Bicarbonate buffering reduces the level of fatigue in the working muscle Relevant in high intensity activities lasting between 3-7 minutes. Not to be combined with caffeine and creatine

Drug Testing
Conducted by Australian Sports Drug Agency ASDA. Urine tests are conducted either at competitions or training. No notice is given to athletes prior to the testing who are selected at random. Two samples are taken to verify the initial testing procedure. No reliable blood tests are used to detect banned drugs.

Intravenous Fluid Use

IV drips used to reverse the effects of dehydration. Famous cases include Justine Henin-Hardenne (2003 US open) and the Brisbane Lions in 2001. It is commonly used in the NFL. Pat Rafter also used the technique. It is considered controversial and unethical. The AFL banned the use of IV drips due to health and hygiene issues. It was concerned with the negative press and its impact on the game.

Intravenous Fluid Use

Standard IV drips contain a saline solution with low levels of glucose. This corrects the bodies hydration levels of fluids, electrolytes and carbohydrates. Athletes use IV drips to decrease recovery time However, athletes are required to lie still for up to 2 hours while receiving the drip Findings have found little difference between IV drips and oral hydration

Intravenous Fluid Use

The Australian Medical Association (AMA) where concerned with the Brisbane Lions using the drips at half time outside of a sterile environment. IV drips are an invasive procedure which runs the risk of disease and infection. Strict medication supervision is required.

Local Anaesthetic Injections

Painkillers are substances that mask the effects of pain. Painkillers are a widespread practice worldwide. They are used to enable the athlete the keep playing They can be creams, tablets, ointments or injections. The use of painkillers is governed by the WADA. Eg. Brisbane Lions in 2003 grand final Up to 18 of the players where injected with pain killers prior to the game.

Local Anaesthetic Injections

Special conditions must be adhered to as set by WADA. Clubs only gave the players injections if they gave their consent, were told of side effects and that there is no risk of further harm. AFL use; Finger joints, AC joint, scar tissue regions, joint inflammation. Risks; Further agreviation of the injury, Athletes training and competiting while injured without knowing the severity of the injury,

Local Anaesthetic Injections

Ethical issues; Dr Peter Larkins Injections should be used to allow player to perform at his normal ability without causing permanent harm or injury. Local anaesthetics are not performance enhancers However, the underlining question is how can the sports doctor make such an important decision for an athlete which could possibly ruin their sporting career. Eg. Craig Whitehead sued Carlton for having him play under pain killers while injured.

Injection of Vitamin Supplements to aid Performance Practice is not illegal or banned its use is widespread. Eg. Australian cycling team, including Jobie Daika, mislead an investigation into allegated drug use. Jobie originally denied using vitamin injections because they werent authorised by the AIS. Lance Armstrong openly admits the use of vitamin injections. Ethical issues; Its unnecessary, its potentially dangerous and damages the image of the sport eg. Cycling.

Genetic Manipulation
Gene therapy Nontherapeutic use of genes, genetic elements and/or cells that have the capacity to enhance athletic performance (WADA). Eg. Use of synthetic genes to enhance performance. Practice is banned under the WADA anti-doping policy. Its side effects are unknown However, it will be undetectable in athletes. In the future, athletes will be modified at a young age, undergoing genetic modification to be the next big star.