Article

The Use of Dietary Supplements and Medications by Canadian Athletes at the Atlanta and Sydney Olympic Games

Authors:
  • University of Ottawa Heart Institute, Ottawa, Canada
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Abstract

To learn more about the prevalence of dietary supplement and medication use by Canadian athletes in the Olympic Games in Atlanta 1996 and Sydney 2000. Data were collected from personal interviews with Canadian athletes who participated at the 1996 Atlanta and 2000 Sydney Olympic Games. The athletes were interviewed by Canadian physicians regarding the use of vitamins, minerals, nutritional supplements, and prescribed and over-the-counter medications. Of the 271 Canadian athletes who participated at the Atlanta Olympics, 257 athletes were interviewed; at the Sydney Olympics, 300 of 304 Canadian athletes were interviewed. A quantitative and qualitative description of the use of dietary supplements by Canadian athletes at the Atlanta and Sydney Olympics. At the Atlanta Games, 69% of the athletes used some form of dietary supplements, whereas 74% of the athletes used dietary supplements at the Sydney Games. Vitamins were taken by 59% of men and 66% of women in Atlanta, and 65% of men and 58% women in Sydney. Mineral supplements were used by 16% of men and 45% of women in Atlanta, and 30% of men and 21% of women in Sydney. Nutritional supplements were used by 35% of men and 43% of women in Atlanta, and 43% of men and 51% of women in Sydney. The most popular vitamins were multivitamins in both Olympics. The most popular mineral supplements were iron supplements. The most commonly used nutritional supplement in Atlanta was creatine (14%), but amino acids (15%) were the most commonly used nutritional supplement in Sydney. In Atlanta, 61% of the athletes were using some form of medication, 54% of the athletes were using medications in Sydney. Nonsteroidal antiinflammatory drugs (NSAIDS) were the most commonly used medications at both Olympic Games. Among all sports, the highest prevalence of vitamin use occurred in boxing (91%) in Atlanta and swimming (76%) in Sydney. Rowers (56%) and cyclists (73%) demonstrated the highest use of mineral supplements. Nutritional supplement use occurred most often in swimming (56%) and cycling (100%). The use of NSAIDs was highest in softball (60%) in Atlanta and gymnastics (100%) in Sydney. This review demonstrates that dietary supplement use was common among Canadian athletes at both the Atlanta and Sydney Olympic Games. There was a slight increase in total dietary supplement use at the Sydney Games. Widespread use of supplements, combined with an absence of evidence of their efficacy and a concern for the possibility of "inadvertent" doping, underscore the need for appropriately focused educational initiatives in this area.

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... Les ultra-traileurs font partie des catégories de sportifs recourant à la consommation d'AINS, que ce soit en phase de préparation ou pendant la compétition. Bien que notre questionnaire ne nous ait pas permis de trouver de corrélation entre prise d'AINS et intensité de la pratique sportive, notre constat rejoint les quelques données actuelles disponibles sur ce sujet [4,11]. La douleur est la raison principale de cette consommation. ...
... La douleur est la raison principale de cette consommation. Qu'elle soit aiguë ou chronique, la douleur est évoquée par plus de 50 % des consommateurs d'AINS de notre étude, en conformité avec les résultats de l'étude canadienne de Huang et al. [11] pour qui l'utilisation des AINS reflétait en majeure partie la recherche d'antalgie. Or, l'effet analgésique des AINS ne serait pas supérieur à celui d'antalgiques purs, tel le paracétamol [12,13]. ...
... Or, l'effet analgésique des AINS ne serait pas supérieur à celui d'antalgiques purs, tel le paracétamol [12,13]. 11 Les participants alléguant des lésions ont justifié leur prise d'AINS par des lésions essentiellement tendineuses (n=52, 49,5 %), ligamentaires pour 33,6% (n=35) et musculaires pour 24,5 % (n=26). Or ces motifs de recours aux AINS invoqués par les participants à notre étude ne semblent pas avoir de substrat scientifique. ...
Article
Introduction: The Ultra-trail ® has enjoyed unlimited popularity over the past decade. During this type of race, ultra-marathon runners regularly force their bodies to exceed their physical and mental limits, which is why they sometimes use non-steroidal anti-inflammatory drugs (NSAIDs). Objective: The aim of this study was to determine, for the first time, the prevalence, type of use and level of awareness of NSAIDs among the ultra-marathon runners training for the Grand Raid 2016 edition in Reunion Island. (167 km; 9700 m ascending elevation gain). Methods: Self-reporting, prevalence, descriptive epidemiological survey. A self-reported questionnaire concerning the use of NSAIDs and awareness of potential risks and adverse effects was sent anonymously by email to each of the ultra-marathon runners registered for one of the Ultra-trails ® at the Grand Raid 2016. Results: A total of 30.7% (n = 1142) of the 3725 registrants responded to the questionnaire. Four hundred and nine (35.8%) ultra-marathon runners reported using NSAIDs in the year prior to the race (January 1, 2015 to October 20, 2016). Among NSAID users, 31.5% (n = 129) used NSAIDs without a prescription. The main reason stated was the treatment of acute pain. The majority would rarely use NSAIDs and 73% (n = 300) would usually use them for a short period of time (< 3 consecutive days). Apart from the anti-inflammatory and analgesic effect, most ultra-marathon runners were unaware of the properties of NSAIDs and the risks of complications other than digestive and/or renal. Conclusion: The prevalence rate of NSAID use is high among ultra-marathon runners, who have only limited knowledge of their properties and side effects. Self-medication is important. Education of ultra-trailers on the benefits and risks of NSAIDs should be strengthened, involving their general practionner.
... Específicamente, los deportistas de alto rendimiento suelen tomar un mayor número de suplementos deportivos que los deportistas amateur (1,9). Para un mismo nivel deportivo, los hombres usan más suplementos deportivos con el objetivo de incrementar la fuerza y la masa muscular (especialmente creatina) que las mujeres, mientras que las mujeres suelen usar más vitaminas y minerales (especialmente hierro) que los hombres (3,9,12). Finalmente, el uso de suplementación deportiva se incrementa con la edad (9), mientras que el tipo de suplementos deportivos está muy influenciado por las características fisiológicas del deporte (1,8,12). ...
... Para un mismo nivel deportivo, los hombres usan más suplementos deportivos con el objetivo de incrementar la fuerza y la masa muscular (especialmente creatina) que las mujeres, mientras que las mujeres suelen usar más vitaminas y minerales (especialmente hierro) que los hombres (3,9,12). Finalmente, el uso de suplementación deportiva se incrementa con la edad (9), mientras que el tipo de suplementos deportivos está muy influenciado por las características fisiológicas del deporte (1,8,12). En cualquier caso, la congruencia en las conclusiones de estas investigaciones está afectada por las diferencias en la definición de "suplementación", el uso de cuestionarios no validados y la selección inapropiada de muestras de estudio (9,13). ...
... Entre los deportistas que reconocen el uso de suplementos, se ha determinado que los deportistas tienden a usar más de un suplemento deportivo de manera simultánea (3,6), con algunos deportistas que alcanzan hasta una combinación de 20 suplementos diferentes (12,14,15). Entre los suplementos deportivos más utilizados se encuentran los multivitamínicos/multiminerales, la vitamina C, los productos con cafeína, los suplementos de proteínas y las bebidas deportivas (1,8). ...
... When the literature is examined, there is generally strong evidence that the use of nutrition support products increases both in elite athletes and in non-athlete individuals (Maughan, Depiesse, & Geyer, 2007). As a matter of fact, the percentage of Canadian athletes using nutrition support products in Atlanta Olympic Games is 35% in male athletes and 43% in female athletes, while in Sydney Olympic Games, this percentage is 43% in male athletes and 51% in female athletes (Huang, Johnson, & Pipe, 2006). According to the findings of this study, 47.4% of male taekwondo athletes and 41.7% of female taekwondo athletes use nutrition support products. ...
... In this study conducted with male and female taekwondo athletes, creatine use of both groups was 9.4% for males and 8.3% for females. Creatine, which is frequently used by athletes, was one of the most consumed nutritional supplements by Canadian athletes in Atlanta Olympic Games organized in 1994 with the percentage of 14% (Huang, Johnson, & Pipe, 2006). Rafael, et al. reported in their study on 10 male taekwondo athletes using creatine that there is no increase in the anaerobic performance of athletes using this product, and that taekwondo athletes may have an increase in fat mass and serum triglyceride concentration. ...
... Vitamins were used by 59% of Canadian male athletes and 66% of Canadian female athletes in Atlanta Olympic Games, there were used by 65% of Canadian male athletes and 58% of Canadian female athletes in Sydney Olympic Games. While the use of minerals in Atlanta was 16% for males and 45% for females, their use in Sydney was 30% for males and 21% for females (Huang, Johnson, & Pipe, 2006). In another study conducted with 292 male and female athletes from 13 different sports branches, it was reported that each of the athletes used at least 4 nutrition support products and preferred vitamin and mineral supplement products with a maximum percentage of 67% (Sousa et al., 2013). ...
Article
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The purpose of this study was to determine the use of nutrition support products by male and female athletes who are involved in taekwondo and their level of knowledge in this respect. The sample group was formed with male and female (n=300) athletes who are actively involved in taekwondo. 300 of the collected questionnaires, which were determined to have been filled in correctly, were evaluated. Of the questionnaires evaluated, 108 belonged to female taekwondo athletes and 192 belonged to male taekwondo athletes. The arithmetic average, standard deviation and percent frequency (%) distributions of the obtained data were calculated. It was stated that 47.4% of male athletes and 41.7% of female athletes use the nutrition support products and the most preferred products by male athletes are protein powder (38%); amino acid (18.2%); vitamin (13.5%); mineral 8.9%; creatine (9.4%) and other nutrition support products (%12). It was found that female athletes also use the same products and these products are protein powder (30.6%); amino acid (15.7%); vitamin (18.5%); mineral 13%; creatine (8.3%) and other nutrition support products (13.9%). It was determined that the use of nutrition support products in male athletes was provided through doctor (20.8%), pharmacist (10.9%), friends (10.4%) and neighbors (3.6%), and in female athletes, through doctor (23.1%), pharmacist (16.7%), friends (6.5%) and neighbors (2.8%). Reasons for taekwondo athletes to use nutrition support products were to improve their athletic performance for 65.1% of males and 67.6% of females, and to cope with the fatigue for 17.2% of males and 17.6% of females. Our study results show that athletes who are involved in taekwondo use nutrition support products at a high level in order to increase their athletic performances. It is important for athletes using nutrition support products to use these products under the supervision of an expert for their health.
... A similar prevalence of DSU has been reported for American collegiate/student-level athletes, reporting the most frequent DS usage of vitamins/minerals (73.3%), calorie-replacement drinks (47%), protein supplementation (40.3%), and creatine (31,4%) [15,16]. Reports on Canadian Olympic athletes showed a somewhat lower prevalence of DSU of 65% [17]. The DSU in European athletes ranges from 70 to 80% in young German and elite Finish athletes [18,19], 90% in Croatian swimmers [11], > 95% in European tennis players [20] and 55% in rugby players [12]. ...
... Although the practice of DSU is actually ancient (i.e., historical evidence notes usage even in ancient Olympians), the physiological and psychological demands of sport participation have increased exponentially over the last few decades, coinciding with increased DSU in athletes [17,28,30]. Additionally, modern athletes are often in out-of-home situations, travel frequently, consume nonfamiliar foods, train and compete in different climates, etc. ...
Article
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Background: Issues related to knowledge of nutrition and dietary supplementation (DS) are understudied in professional athletes. This study aimed to examine the possible association between knowledge of nutrition and DS (KN&DS) and dietary supplement use (DSU) among professional athletes involved in team sports. Methods: The sample comprised professional team-sport athletes (N = 912, age: 22.11 ± 3.37 years, 356 females) involved in four Olympic sports: basketball (N = 228), soccer (N = 324), volleyball (N = 154), and handball (N = 206). The participants were tested by previously validated questionnaires to examine their self-perceived competence on nutrition and DS (S/KN&DS), their objectively evaluated (tested) KN&DS (O/KN&DS), sociodemographic and sport-specific variables (predictors), and DSU (criterion). Associations between the predictors and the criterion (No-DSU - Irregular-DSU - Regular-DSU) were determined by multinomial regression analysis for the total sample and separately for the studied sports. Results: DSU was found to be less prevalent in older and more successful players. The O/KN&DS and S/KN&DS were positively correlated with DSU, but S/KN&DS was a stronger predictor of DSU than O/KN&DS. Sport-specific associations between predictors and criterion were identified, with stronger correlations in sports with a higher prevalence of DSU. Conclusions: Due to the low correlations between O/KN&DS and S/KN&DS in the studied players, this study highlights the necessity for more frequent monitoring of biomarkers of nutritional status and its usage by coaches and practitioners to provide quantitative instruction.
... The largest group of included articles (n 5 45) reported frequency of medication use by athletes across a range of sports. Often, these studies described analyses of doping control forms, therapeutic use exemptions, pharmacy services, or other reports collected during major sporting events, such as the Olympic Games, 10,22,[27][28][29]40,77 Paralympic Games, 22,76 Pan-American Games, 30,81 Asian Games, 57 and Fédération Internationale de Football Association (FIFA) tournaments. 11,17,18,26,58,75,80 Other studies surveyed collegiate athletes. ...
... 38 Studies consistently suggested that NSAID use rates are concerning for myriad reasons, including concurrent use of multiple NSAIDs, multiple routes of administration, higher than the manufacturer's recommended dosing, use for prophylaxis of pain, limited evidence-based clinical guidance, adverse effects, and limited evidence regarding effects on injury healing. 5,10,11,17,29,38,40,58 However, some male former athletes may actually be less likely to use NSAIDs when compared with age-matched controls. 43 And, there is some indication that the frequency of NSAID use decreased during the 2014 FIFA Men's Football World Cup compared with previous years' tournaments. ...
Article
Objective: To identify the prevalence, frequency of use, and effects of analgesic pain management strategies used in elite athletes. Design: Systematic literature review. Data sources: Six databases: Ovid/Medline, SPORTDiscus, CINAHL, Embase, Cochrane Library, and Scopus. Eligibility criteria for selecting studies: Empirical studies involving elite athletes and focused on the use or effects of medications used for pain or painful injury. Studies involving recreational sportspeople or those that undertake general exercise were excluded. Main results: Of 70 articles found, the majority examined the frequency with which elite athletes use pain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, anesthetics, and opioids. A smaller set of studies assessed the effect of medications on outcomes such as pain, function, and adverse effects. Oral NSAIDs are reported to be the most common medication, being used in some international sporting events by over 50% of athletes. Studies examining the effects of pain medications on elite athletes typically involved small samples and lacked control groups against which treated athletes were compared. Conclusions: Existing empirical research does not provide a sufficient body of evidence to guide athletes and healthcare professionals in making analgesic medication treatment decisions. Based on the relatively robust evidence regarding the widespread use of NSAIDs, clinicians and policymakers should carefully assess their current recommendations for NSAID use and adhere to a more unified consensus-based strategy for multidisciplinary pain management in elite athletes. In the future, we hope to see more rigorous, prospective studies of various pain management strategies in elite athletes, thus enabling a shift from consensus-based recommendations to evidence-based recommendations.
... The current data suggested little difference between team and individual sport athletes, other than individual sport athletes using more sports gels and team-sport athletes being supplied their supplements more from family and friends. Previous studies have identified that similar types of supplements are used in these categories, however individual athletes tend to have higher usage rates (Giannopoulou et al., 2013;Huang et al., 2006;Lazic et al., 2011). The reasons for this difference are unclear and future research should look to identify any root causes of the difference. ...
... Several studies have assessed temporal changes in supplement use and reported increased (+5%;Huang, Johnson, and Pipe, 2006), steady (-3%;Shaw, Slater, and Burke, 2016) and reduced (-8%; Heikkinen et al., 2011) usage. Shaw et al. (2016) investigated supplement use amongst elite Australian swimmers from 1998-2009 and reported unchanged usage (-3%), and our data suggests that usage rates within Australia may have remained relatively stable from 2009-2016 despite our predictions that usage may have declined over time given the perceived negative impact of recent doping violations. ...
Article
The authors aimed to update knowledge of the use of supplements among Australian athletes at a state-based sports institute. The authors conducted a cross-sectional survey using an online questionnaire to assess the influence of age, sports category, and scholarship category on supplement use. Of 94 completed questionnaires, 82 (87%) indicated supplements in the previous 12 months (mean = 4.9 ± 3.3). No significant difference in supplement usage rate was identified when considering age, scholarship category, or sport category. The most frequently used supplements were sports drinks (70%), caffeine (48%), protein powder (42%), and sports bars (42%). Recovery (63%), health maintenance (59%), and improved energy (50%) were the most frequently reported rationale to use supplements. Allied health professionals and credible online resources were the predominant sources of influence regarding use. However, athletes from lower scholarship categories were more likely to have social media, parents, and siblings influence usage, and age was inversely related to increased influence from parents, social media, physicians not associated with the institute, the Internet, and siblings. Older athletes and those on higher scholarships were more likely to source supplements from training facilities and sports nutrition staff outside of the institute or direct from a supplier, whereas those on lower scholarships tended to rely more on family and friends for their supplements. Findings from this study show a high prevalence of supplement use and are the first to show an influence of social media, particularly in younger athletes. Opportunities exist to optimize how athletes are informed regarding supplement use and organizational and supplement policy.
... 9 The most common type of medication used by athletes is prescription and over-the-counter (OTC) analgesic and/or anti-inflammatory medication (AAIM). 30 Analgesic/antiinflammatory medication use during training, competition, and recovery is common practice in many athletes including Olympic athletes, 31,32 Paralympic athletes, 33 elite track and field athletes, 34 football (soccer) players, [35][36][37][38] athletes participating in multicoded sports events, 39 college athletes, 40 athletes participating in triathlon, 41,42 and endurance cycling. 43,44 Furthermore, the types of AAIM typically used in athlete populations are nonsteroidal anti-inflammatory drugs [(NSAIDs) oral, topical, and injectable forms], analgesics (paracetamol, opioids, and other nonopioids), anesthetics (injectable and transdermal), and other OTC medication. ...
... This finding is consistent with all previously published data on the types of AAIM used by runners immediately before and during races, 29,[45][46][47][48] or by athletes participating in different sports. [31][32][33][34][35][36][37][38][39][40][41][42] The main novel findings in our study are related to factors associated with AAIM use. The unadjusted PR of AAIM use in our population showed that female runners, older runners, 56-km versus 21.1-km runners, runners with a history of musculoskeletal injuries or EAMC, and runners with symptoms of CVD, risk factors for CVD, and those with a variety of underlying chronic diseases have a significantly higher risk of AAIM use. ...
Article
Objective: Analgesic/anti-inflammatory medication (AAIM) increases the risk of medical complications during endurance races. We determined how many runners use AAIM before or during races, AAIM types, and factors associated with AAIM use. Design: Cross-sectional study. Setting: 21.1-km and 56-km races. Participants: Seventy-six thousand six hundred fifty-four race entrants. Methods: Participants completed pre-race medical screening questions on AAIM use, running injury or exercise-associated muscle cramping (EAMC) history, and general medical history. Main outcome measures: Analgesic/anti-inflammatory medication use, types of AAIM (% runners; 95% confidence interval), and factors associated with AAIM use (sex, age, race distance, history of running injury or EAMC, and history of chronic diseases) [prevalence ratio (PR)]. Results: Overall, 12.2% (12.0-12.5) runners used AAIM 1 week before and/or during races (56 km = 18.6%; 18.0-19.1, 21.1 km = 8.3%; 8.1-8.6) (P < 0.0001). During races, nonsteroidal anti-inflammatory drugs (NSAIDs) (5.3%; 5.1-5.5) and paracetamol (2.6%; 2.4-2.7) were used mostly. Independent factors (adjusted PR for sex, age, and race distance; P < 0.0001) associated with AAIM use were running injury (2.7; 2.6-2.9), EAMC (2.0; 1.9-2.1), cardiovascular disease (CVD) symptoms (2.1; 1.8-2.4), known CVD (1.7; 1.5-1.9), CVD risk factors (1.6; 1.5-1.6), allergies (1.6; 1.5-1.7), cancer (1.3; 1.1-1.5), and respiratory (1.7; 1.6-1.8), gastrointestinal (2.0; 1.9-2.2), nervous system (1.9; 1.7-2.1), kidney/bladder (1.8; 1.6-2.0), endocrine (1.5; 1.4-1.7), and hematological/immune (1.5; 1.2-1.8) diseases. Conclusions: 12.2% runners use AAIM before and/or during races, mostly NSAIDs. Factors (independent of sex, age, and race distance) associated with AAIM use were history of injuries, EAMC, and numerous chronic diseases. We suggest a pre-race screening and educational program to reduce AAIM use in endurance athletes to promote safer races.
... A high prevalence of medicine use has been reported during many international sporting events such as FIFA (The Fédération Internationale de Football Association) World Cups in 2002 and 2006 [4] Athens Paralympic Games in 2004 [12] and Atlanta and Sydney Olympics [13]. A high intake of NSAIDs was common in all above, which was a cause for concern. ...
... A high intake of NSAIDs was common in all above, which was a cause for concern. Also, the use of inhaled β2 agonists was higher than expected in Atlanta and Sydney Olympics [13]. Triathletes in Brazil reported a high prevalence of NSAID use, limited awareness of the adverse effects and a high rate of non-prescribed use [6]. ...
... Moreover, this nutritional deficiency may present a prevalence of 27% in finishing the competitive period in rowing [40]. The consumption of vitamin supplements is similar to other investigations in elite rowers (84%) [41], but greater than other studies in elite athletes from different sports modalities (35-50%) [27,35]. This may be due to the possible use of these supplements as antioxidants, since there is a correlation between antioxidant status and performance in competitive rowers [42]. ...
... The rest had a consumption of ≤25%. SS consumption continues to increase among elite athletes [41] due to a perceived need for supplementation [57], especially in elite rowers, as was found in this study. However, it is necessary to educate athletes on the use of SSs by promoting educational programs on having the appropriate combinations and doses of supplements in order to minimize the possible health risks caused by inappropriate use [57]. ...
Article
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The aim of this study was to analyze the anthropometric characteristics and sport supplement (SS) consumption patterns of heavyweight and lightweight international rowers. Methods: The 13 heavyweights (11 males) and seven lightweights (five males) of the Spanish National Rowing Team were recruited for the study. Body composition was measured by bio-impedance analysis, and the questionnaire used in this investigation was previously validated to assess SS consumption. According to anthropometrics parameters, it was reported that male heavyweight rowers were heavier (p < 0.001) and taller (p < 0.001), but no statistical differences were reported for % body fat (p = 0.104) or % lean body mass (p = 0.161). All rowers reported consumption of at least one SS. Based on the Australian Institute of Sport's classification, higher medical supplement consumption was observed when comparing heavyweight rowers to lightweight rowers (2.5 ± 1.1 vs. 1.7 ± 0.5, p = 0.040). There were no differences in the totals of group A (strong scientific evidence for sports scenarios, p = 0.069), group B (emerging scientific support, deserving of further research, p = 0.776), or group C (scientific evidence not supportive of benefit and/or security amongst athletes, p = 0.484). The six most consumed SSs were iron (85%), caffeine (85%), β-alanine (85%), energy bars (85%), vitamin supplements (80%), and isotonic drinks (80%), with no statistical differences between heavyweight and lightweight rowers (p > 0.05). These results suggest that the absence of differences in body composition (expressed as a percentage) do not represent anthropometric disadvantages for heavyweight rowers. In addition, SS consumption was similar between rowers, reporting only higher medical supplement consumption in heavyweight rowers.
... Une atteinte digestive préexistante favorise la survenue des troubles, allant de la colopathie fonctionnelle à la maladie de Crohn. d"AINS autour de 30% en fonction des sports [39][40][41][42][43] . ...
... (3,5%) parmi cette automédication était inférieure à celle attendue (jusqu"à 30% dans certaines études [39][40][41][42][43] ). Cette différence est probablement le fait d"une meilleure information de la population triathlétique par rapport aux athlètes et footballeurs des études citées. ...
Thesis
La pratique sportive, ou du moins l'activité physique est de nos jours, tout autant unphénomène de société qu'un enjeu majeur de santé publique. Néanmoins celle-cis'accompagne d'évènements indésirables allant du plus bénin au plus grave. Les troublesdigestifs à l'effort recouvrent tout ce panel de gravité et se distinguent par leur fréquenceimportante, notamment lors des efforts de longue durée. Le triathlon longue distance en est à la fois le plus célèbre représentant ainsi que le prototype d'effort prolongé à l'origine de nombreuses études sur le sujet. Notre travail s'est attaché, dans une première partie à évoquer les nombreuses étiologies à l'origine de ce type de troubles ainsi que leur physiopathologie complexe, après avoir effectué quelques rappels anatomiques, histologiques et physiologique. Dans une seconde partie, nous nous sommes proposé d'évaluer la prévalence de la pathologie digestive à l'effort, de l'automédication et les relations éventuelles entre elles par l'intermédiaire d'une enquête ponctuelle réalisée lors de l'EmbrunMan du 15 Août 2011Celle-ci a été réalisée au moyen d?un questionnaire incluant l?ensemble des participants(abandons inclus). Nous avons pu étudier un échantillon de 283 triathlètes, parmi lesquels lestroubles digestifs avaient une prévalence de 68,9%. L?automédication était de 21,9%. Lejeune âge et le sexe masculin sont apparus comme étant des facteurs de risque.La conclusion a permis de mettre en lumière l?absence d?évolution patente concernant laprévalence, l?automédication ou les habitudes dans ce contexte
... Nevertheless, the combination with narcotic analgesics may be performed to manage severe pain to obtain synergic effects [76]. To date, several options are currently available in the pharmacological non-invasive approach in acute traumatic injury, including paracetamol [78][79][80][81], non-steroidal anti-inflammatory drugs (NSAIDs) [80,[82][83][84][85], and opioids [79][80][81][86][87][88]. ...
... Nevertheless, the combination with narcotic analgesics may be performed to manage severe pain to obtain synergic effects [76]. To date, several options are currently available in the pharmacological non-invasive approach in acute traumatic injury, including paracetamol [78][79][80][81], non-steroidal anti-inflammatory drugs (NSAIDs) [80,[82][83][84][85], and opioids [79][80][81][86][87][88]. ...
Article
Full-text available
Pain management is a crucial issue for athletes who train and compete at the highest performance levels. There are still evidence gaps for the use of analgesics for sports injuries despite the growing interest in training and competition settings. However, high-quality research is needed to determine the most appropriate and optimal timing and formulations in non-steroidal anti-inflammatory drug and opioid management, particularly given the strictness of anti-doping regulations. Indeed, the role of pharmacological therapy in reducing acute traumatic pain in athletes should still be addressed to minimize the timing of return to sport. Therefore, the aim of this comprehensive review was to summarize the current evidence about pain management in the setting of acute injury in elite athletes, providing the most informed strategy for pain relief and performance recovery.
... In a recent report entitled "Protein Ingredients Market by Source (Animal and Plant), Application (Food & Beverage, Animal Feed, Cosmetics & Personal Care and Pharmaceuticals), and Region-Forecast to 2022", the market for protein ingredients was projected to reach 58.49 billion dollars by 2022 (i.e., compound annual growth rate of 6.0% from 2017). Indeed, Olympic as well as college athletes and many people exercising in gyms regularly use supplements with amino acids representing 10-20% of these nutritional strategies [1][2][3][4]. Branched chain amino acids (BCAAs)-i.e., leucine, isoleucine and valine-account for almost 50% of the essential amino acids in food and 35% of the total content of essential amino acids in muscle proteins [5,6]. ...
... Criteria for study inclusion were chosen using the Population-Intervention-Comparator-Outcomes-Study design (PICOS) format [29]. Articles and studies were included if they met all the following criteria: (1) experiments performed in humans; (2) healthy subjects received at least one oral BCAAs supplementation as a nutritional strategy in the context of skeletal muscle damage (i.e., decrease in muscle performance and/or increase in plasma/serum intracellular component concentration); ...
Article
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Amino acids and more precisely, branched-chain amino acids (BCAAs), are usually consumed as nutritional supplements by many athletes and people involved in regular and moderate physical activities regardless of their practice level. BCAAs have been initially shown to increase muscle mass and have also been implicated in the limitation of structural and metabolic alterations associated with exercise damage. This systematic review provides a comprehensive analysis of the literature regarding the beneficial effects of BCAAs supplementation within the context of exercise-induced muscle damage or muscle injury. The potential benefit of a BCAAs supplementation was also analyzed according to the supplementation strategy—amount of BCAAs, frequency and duration of the supplementation—and the extent of muscle damage. The review protocol was registered prospectively with Prospective Register for Systematic Reviews (registration number CRD42017073006) and followed Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Literature search was performed from the date of commencement until August 2017 using four online databases (Medline, Cochrane library, Web of science and ScienceDirect). Original research articles: (i) written in English; (ii) describing experiments performed in Humans who received at least one oral BCAAs supplementation composed of leucine, isoleucine and valine mixture only as a nutritional strategy and (iii) reporting a follow-up of at least one day after exercise-induced muscle damage, were included in the systematic review analysis. Quality assessment was undertaken independently using the Quality Criteria Checklist for Primary Research. Changes in indirect markers of muscle damage were considered as primary outcome measures. Secondary outcome measures were the extent of change in indirect markers of muscle damage. In total, 11 studies were included in the analysis. A high heterogeneity was found regarding the different outcomes of these studies. The risk of bias was moderate considering the quality ratings were positive for six and neutral for three. Although a small number of studies were included, BCAAs supplementation can be efficacious on outcomes of exercise-induced muscle damage, as long as the extent of muscle damage was low-to-moderate, the supplementation strategy combined a high daily BCAAs intake (>200 mg kg−1 day−1) for a long period of time (>10 days); it was especially effective if taken prior to the damaging exercise.
... This could be explained by the intensive marketing, which may only result in a temporary placebo effect caused by TT supplementation [14]. Despite the beneficial effect of TT supplementation on muscle performance, this plant could lead to a positive doping control test (Australian Institute of Sport [80]; the National Centre for Sports Medicine in Poland and the Medical Commission of the Polish Olympic Committee [81]; Canadian Cycling Association [82]). Although it is thought to be relatively safe, higher dose of TT (≥1000 mg per day) could lead to sleeping disorder, burnout and fatigue, hypertension, and high heart rate [83,84]. ...
Article
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The use of herbal medicinal products and supplements has increased during last decades. At present, some herbs are used to enhance muscle strength and body mass. Emergent evidence suggests that the health benefits from plants are attributed to their bioactive compounds such as Polyphenols, Terpenoids, and Alkaloids which have several physiological effects on the human body. At times, manufacturers launch numerous products with banned ingredient inside with inappropriate amounts or fake supplement inducing harmful side effect. Unfortunately up to date, there is no guarantee that herbal supplements are safe for anyone to use and it has not helped to clear the confusion surrounding the herbal use in sport field especially. Hence, the purpose of this review is to provide guidance on the efficacy and side effect of most used plants in sport. We have identified plants according to the following categories: Ginseng, alkaloids, and other purported herbal ergogenics such asTribulus Terrestris, Cordyceps Sinensis. We found that most herbal supplement effects are likely due to activation of the central nervous system via stimulation of catecholamines. Ginseng was used as an endurance performance enhancer, while alkaloids supplementation resulted in improvements in sprint and cycling intense exercises. Despite it is prohibited, small amount of ephedrine was usually used in combination with caffeine to enhance muscle strength in trained individuals. Some other alkaloids such as green tea extracts have been used to improve body mass and composition in athletes. Other herb (i.e. Rhodiola, Astragalus) help relieve muscle and joint pain, but results about their effects on exercise performance are missing.
... In addition, men used dietary supplements more frequently than women in both 2002 and 2009. Interestingly, despite the trend towards a decrease in dietary supplement use during these years, the percentage of athletes that were using dietary supplements were still greater than that reported by Canadian athletes in both the 1996 (69% of the athletes reported using a dietary supplement) and 2000 (74% of the athletes reported using a dietary supplement) Olympic games ( 27 ). Consistent among all investigations examining Olympic athletes, the most popular dietary supplements used are multivitamins (ranging from 44% to 57%) and protein (ranging from 38% to 47%). ...
... This could be explained by the intensive marketing, which may only result in a temporary placebo effect caused by TT supplementation [14]. Despite the beneficial effect of TT supplementation on muscle performance, this plant could lead to a positive doping control test (Australian Institute of Sport [80]; the National Centre for Sports Medicine in Poland and the Medical Commission of the Polish Olympic Committee [81]; Canadian Cycling Association [82]). Although it is thought to be relatively safe, higher dose of TT (≥1000 mg per day) could lead to sleeping disorder, burnout and fa- tigue, hypertension, and high heart rate [83,84]. ...
Article
ABSTRACT Background: Nutritional practices targeting improved exercise performance and training adaptations are considered to be ergogenic aids. Currently, the majority of attention is given to the macronutrients carbohydrate and protein, while micronutrients are considered to a lesser scale. Though literature does exist, very little attention is given to fruit and respective fruit extracts. Scope and Approach: Fruit as a whole, contains macro- and micronutrients, fiber, minerals, vitamins, a number of bioactive phytochemicals, including phenolic compounds such as anthocyanins and ellagitannins and intuitively should be considered a regular part of an athletes diet. The primary aim of this review is to review the extant literature and provide a narrative overview of studies involving fruit, respective fruit extracts, and their effects on exercise performance and recovery. Included in this review are blackcurrant, grapes, pomegranate, cherry, banana, watermelon and blueberry. Key Findings and Conclusions: There appears to be a consistent pattern in the literature for fruits extracts to improve antioxidant capacity. Data supporting performance improvements are less compelling. While the health affects of whole fruits is intuitive, there is a paucity of studies examining whole fruits as part of an athletic diet. Key Words: Fruit; Fruit Extracts; Anti-oxidant; Exercise; Sport; Performance
... Therapies impacting mal-alignment appear to have the greatest impact on patients with non-mechanical knee pain when other options do not seem to be effective 85 . Non steroidal anti-inflammatory drugs (NSAIDs) are widely used to treat musculoskeletal conditions, almost indiscriminately 86 . In addition to negative systemic effects with long-term use, the body of evidence is growing demonstrating that NSAIDs prolong healing, and inhibit healing in some cases 87 . ...
Article
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The author reports that in a specialized center for musculoskeletal disorders, the presentation of patients with failure after arthroscopic knee procedures for degenerative conditions is very common and increasing in frequency. The commonly accepted notion that arthroscopic knee surgery is reserved for those with mechanical symptoms is accurate and leads to good outcomes. However, as suggested by many, arthroscopy for pain, the results are quite unpredictable. Thus, the aim of this article is to present the concept of thinking about the degenerative painful knee not as a summation of discrete focal lesions requiring immediate surgical treatment, but as an overall diseased system that should be individually assessed, characterized, and optimized prior to ultimate intervention. Presented is an outline of alternative strategy in managing the patient with a degenerative, predominantly painful knee, utilizing many 21 st century treatment modalities.
... Athletes are highly disposed to purchase and consume nutritional supplements; a large majority of Canadian athletes at the 1996 and 2000 Olympic Games were using a supplement of some kind (69% and 74% respectively). (69) Since 1994 the US Supplement industry has, until recently, been largely unregulated. The result has been that athletes (and would-be athletes) have been exposed to a variety of "supplements" whose nature, manufacture and marketing are unregulated. ...
Article
The use of performance-enhancing drugs is an unfortunatereality of contemporary sport. It would be a mistake tobelieve that this is a phenomenon found only in elite sport.Athletes at all levels and young adults may be tempted toaccentuate performance or physique with prohibited drugsor products marketed as supplements. No defined populationsof users ingesting known quantities of known substances are generally available for study. Many of these products have been associated with adverse health effects; cardiac structure and function are known to be affected by many of the products commonly abused. Changes to the lipoprotein profile, propensity for coagulation, coronary circulation, and ventricular function may accompany the use of many performance-enhancing compounds and methods. Anabolic steroids, other peptide hormones, stimulants, erythropoietin and blood doping, have all been associated with significant cardiovascular consequences. So-called nutritional supplements aggressively marketed to the athletically inclined, are available over the Internet and typically totally unregulated in the country of their origin. Clinicians should be aware of the problems that such drug use can engender, and be sensitive to the possibilities of such abuse in caring for athletes and young patients, particularly in those presenting with unusual or unanticipated cardiovascular signs and symptoms.
... 2018; 9(4):e14325. proaching and even exceeding the results of prevalence among elite athletes, for whom physical requirements and degree of performance are higher as compared to paddle players (9,25). ...
Article
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Background: Medications for pain and inflammation have increased lately, and dietary supplements and stimulants have increasingly been used to maximize sports performance. They can be harmful to health if they are unnecessary or misused. Objectives: The aim of this study was to estimate the prevalence and associated factors of the use of dietary supplements, stimulants, and medications among paddle tennis players in a southern Brazilian city. Methods: A cross-sectional study was conducted on 162 paddle players in Tubarão, state of Santa Catarina, Brazil. Estimates of prevalence ratio, Chi-square test, Fisher’s exact and modified Poisson regression for data analysis were performed, at a 95% significance level. Results: The prevalence of use of dietary supplements, stimulants and medications was 69.1%, 21% and 63.6%, respectively. Statistically significant associations were found between dietary supplements and age (P = 0.029), and dietary supplements and alcohol abuse (P≤0.001), between medication use and alcohol abuse (P≤0.001), and medication use and smoker (P = 0.030). Conclusions: The study concluded that paddle players showed a high prevalence of use of dietary supplements and medications. Educational programs with information about the efficacy of supplements and medications should be implemented in sites where sports are practiced.
... However, previous studies have shown that intake of athletes from different sports and continents does not reach the recommended values according to these documents [3,4], confirming the need for nutritional interventions by experts [5,6]. The intake of dietary supplements has increasingly become more widespread among athletes [7], generating billions of dollars annually [8]. However, the use of supplements is not always based on nutritional deficiencies, efficacy, safety or legality, leading to unnecessary costs for athletes, clubs and/or sponsors, in addition to the risk of positive doping [9]. ...
Article
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Objective To assess how much food supplements contribute to the nutritional adequacy of energy and macronutrients in relation those recommended for athletes. Methods This was a cross sectional study was composed of 182 athletes from 19 sports (150 men and 32 women) with a mean age, weight, height and body mass index of 23.8±7.5 years, 73.7±15.6kg, 1.7±0.1m, 24.2±4.0kg/m², respectively. The 24 hours dietary recall was applied to assess intake and the Multiple Source Method to evaluate usual intake. We used the t-test, Mann-Whitney test, Analysis of Variance and Kruskal-Wallis for comparative analysis among the diets, gender and types of groups, and the comparison of two-proportion test to assess the diets Food and Food and Supplementation. Results Of the athletes studied, less than half used dietary supplements (39.0%). Energy intake was below the recommended (52.7%) in Food diet, and 45.6% in Food and Supplementation diet. The mean total of carbohydrate inadequacy (g.kg⁻¹.day⁻¹) was high for athletes of both genders and between Food and Food and Supplementation diets. The protein intake was above the recommended levels in Food diet (23.1%) and in Food and Supplementation diet (33.5%). The lipid intake was also above the recommended dietary levels in Food (47.3%) and in Food and Supplementation diets (50.0%). Conclusion The use of supplements did not significantly reduce inadequacies of diet and the athletes’ intake of calories and carbohydrates was below the recommended for these groups. However, the protein intake was above the recommended levels for athletes.
... athletes may take NSAIDs with medical instruction [92]. Though permitted by WADA, elite athletes should not take non-doping classified medicines without medical supervision [93] because of the risk of the side effects [94][95][96]. ...
Article
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Professional athletes involved in high-performance sport are at a high injury risk, which may lead to long-term health consequences. Professional athletes often expose themselves to risky behaviours, resulting in a higher acceptance level of occupational risk compared to other occupations. To date, many studies have focused on elite athletes’ specific injury prevention techniques. The objective of this narrative review is to (1) summarise elite athletes’ attitudes towards important occupational safety and health (OSH) practices, including injury reporting, medicine usage and personal protective equipment (PPE) usage, and (2) explore factors that may influence elite athletes’ injury awareness. If injury awareness were given a similar weighting in elite sports as in any other highly physical occupation, the potential benefits to elite athletes and their long-term health could be highly significant. This review identifies that most elite athletes are not aware that sporting injuries are occupational injuries requiring behaviours determined by OSH rules. All the 39 studies identified met the moderate methodological quality criteria according to the Mixed Methods Appraisal Tool (MMAT). The factors impeding athletes’ injury awareness from achieving occupational health standards are discussed from three safety management perspectives: organisational, societal and individual. This review contributes to a better understanding of how to build a positive safety culture, one that could reduce elite athletes’ injury rate and improve their long-term wellbeing. Further research is required to develop a quantitative measurement instrument to evaluate occupational health awareness in the sport context. Based on the papers reviewed, the study population was categorised as elite, professional, high-performance amateur and student-athletes.
... Supplements are recommended for people who need and in certain situations/conditions. The American Dietetic Association, the Dietitians of Canada, and the American College of Sports Medicine stated that only those persons who restrict their energy intake, use severe weight-loss practices, eliminate one or more food groups from their diets or consume high-carbohydrate diets with low micronutrient density may require dietary supplementation (Huang SH, Johnson K, Pipe AL, 2006). However, little is known about ergogenic supplement consumption among people exercising in fitness centers. ...
Article
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This research was motivated by the curiosity of the researchers about supplements those were often consumed by sportsmen, especially on members of the fitness center so that this study discussed the consumption of ergogenic supplements in physical fitness training (survey of members of the fitness center in Sleman district). The purpose was to obtain an empirical picture of the phenomenon of consumption of ergogenic supplements, understanding of ergogenic supplements, the reality of consuming ergogenic supplements, and the impact of consumption of ergogenic supplements on members of the fitness center in Sleman Regency. The research subjects used in this study were members of the fitness center in Sleman Regency which numbered 258 people. The method of data collection was through surveys conducted at 12 fitness centers located in Sleman district and research instruments using questionnaires. The data analysis technique used is descriptive statistics and chi-square test with p
... The Italian data are also in accordance with those reported in other countries, collected on the occasion of major international sporting events. [3][4][5] Even if the administration of non-banned drugs and nutritional supplements cannot be considered a doping practice, some of these compounds and/or their metabolites can interfere, especially in the cases of the concurrent intake of doping substances, with the correct identification and/or accurate quantification of prohibited substances and/or their metabolite(s)/marker(s). This is particularly relevant to the quantitation of threshold substances and of "pseudo-endogenous" steroids (synthetic anabolic androgenic steroids that are also produced endogenously, such as testosterone and its precursors). ...
Article
Rationale Isoflavones are a group of flavonoids that may be of interest in sport doping because they can be used by athletes in the recovering periods after the administration of anabolic steroids, with the aim of increasing the natural production of luteinizing hormone (LH) and, consequently, the biosynthesis of endogenous androgens. Methods The in vivo metabolism of methoxyisoflavone (5‐methyl‐7‐methoxy‐isoflavone) and ipriflavone (7‐isopropoxy‐isoflavone), respectively present in a dietary supplement and in a pharmaceutical preparation, was investigated. The study was carried out by the analysis of urinary samples collected from male caucasian subjects before, during and after the oral administration of methoxyisoflavone or ipriflavone. After enzymatic hydrolysis and liquid‐liquid extraction, all urinary samples were analyzed by GC/qTOF electron ionization MS. Results Eight metabolites of methoxyisoflavone and six metabolites of ipriflavone were isolated. The corresponding accurate mass spectra are specific of isoflavone structures and revealed also a retro Diels‐Alder fragmentation. Conclusion When excreted in large amounts, the urinary metabolites of methoxyisoflavone and ipriflavone can be traced to potential confounding factors in doping analysis. As methoxyisoflavone and ipriflavone have been shown to inhibit the enzyme aromatase, thus interfering with the normal metabolic pathways of testosterone, the detection of their intake, by screening for the presence of their main metabolites in urine, might be helpful in routine doping control analysis.
... Elite athletes commonly use prescription and overthe-counter analgesics to prevent or relieve pain. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] These have typically included: oral non-steroidal anti-inflammatory drugs (NSAIDs), 2 4 6 16 17 injectable NSAIDs, 5 other non-opioid analgesics, 1 4 8 9 opioid analgesics, 1 3 4 7 8 10 18 injectable and transdermal anaesthetics 11 and other medications and over-the-counter supplements. 1 3 12-15 Despite the perception that the use of medications and non-pharmacological strategies to relieve and prevent pain is widespread in sport, 8 9 12 we could identify no comprehensive assessment of the frequency and effects of such use among elite athletes. ...
Article
Pain is a common problem among elite athletes and is frequently associated with sport injury. Both pain and injury interfere with the performance of elite athletes. There are currently no evidence-based or consensus-based guidelines for the management of pain in elite athletes. Typically, pain management consists of the provision of analgesics, rest and physical therapy. More appropriately, a treatment strategy should address all contributors to pain including underlying pathophysiology, biomechanical abnormalities and psychosocial issues, and should employ therapies providing optimal benefit and minimal harm. To advance the development of a more standardised, evidence-informed approach to pain management in elite athletes, an IOC Consensus Group critically evaluated the current state of the science and practice of pain management in sport and prepared recommendations for a more unified approach to this important topic.
... Prevalence of whey protein in this study deviates from the one of 21.7% reported by Froiland et al. [10]. However, the consumption of whey protein increased over the last two decades [23], first to 30% in 2006 [19] than 53.5% in 2014 [12] and finally 54.5% in this study. In reaching new world records, current intensive training regimes demand higher protein intake for greater metabolic adaptation, better remodelling and faster tissue repair. ...
Article
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Background: The aim of this international study was to investigate the prevalence of the use of sports supplements among young athletes, as well as their knowledge and attitudes towards sports supplementation. Methods: Organized survey study testing the level of knowledge, attitudes, beliefs and practices concerning the use of sports supplements was administered to 348 athletes, 15-18 year olds from 4 countries competing in 18 sports at the international level. Results: The prevalence rate of the intake of sports supplements was 82.2%, with the protein supplements being predominant (54.5%). Coaches were identified as the primary source of information regarding supplementation (41.4%). The enhancement of athletic performance (35.4%) was the major motivation for the supplements intake. The majority of athletes (72.1%) were aware of associated health risks. The young athletes possess varying levels of knowledge regarding their own supplementation. The obtained data about the level of knowledge were statistically analyzed using the correspondence analysis. Less than 40% of athletes had the knowledge about the proper and intended use of protein, creatine, amino acids, beta alanine and glutamine, while they had greater understanding about vitamins and minerals, sports drinks and caffeine. The athletes in developed countries had greater access and utilization of professional resources such as dieticians. Young athletes are still unfamiliar with WADA regulations (55.5%), and the misuse of sports supplements represents an ethical dilemma for some. Conclusion: These findings indicate the necessity of a comprehensive education of all team members about sports supplements and careful supervision of the athletic development of young athletes.
... In this study, the reasons were: pain relief from injury (35%), recovery (26.7%), cramping (22.2%), general soreness (17.2%), muscle tightness (9.4%), preventing injury or pain (8.9%), and increase energy (2.2%). These findings are consistent with the previous literature, in which treatment for injury and pain relief were the main reasons for NSAIDs use [2,28]. ...
Article
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Many athletes suffering from musculoskeletal pain and dysfunction will use some types of complementary and alternative medicine (CAM) or Non-steroidal anti-inflammatory drugs (NSAIDs). Therefore, this study aimed to determine the prevalence, awareness, and behaviors related to NSAIDs and CAM use in Palestinian student-athletes. This was a cross-sectional study that involved 227 students from the Faculty of Sports at An-Najah National University. A self-administered questionnaire was designed in Arabic; it had six sections and a number of open-ended and closed-ended questions. SPSS version 21 was used to analyze the results. Descriptive statistics (i.e., frequencies, percentages) were used to describe the results including demographic characteristics. Overall, 79.3% of the student-athletes had used NSAIDs in the past and 89.0% had used CAM. The CAM methods used by participants were: herbals (57.3%), supplements (32.2%), cupping (11.9%), acupuncture (2.2%), massage (51.5%), yoga (4.0%), praying (18.1%) and ice packs (20.7%). The herbs commonly used by participants were: sage (20.7%), Menthol (21.1%), Aniseed (10.6%), Chamomile (4.0%), Cinnamon (1.3%), Turmeric (4.0%), Ginger (35.7%), and a mixture of herbs (18.5%); Regarding the perceived advantages of CAM use, 82.2% thought that CAM is beneficial for their health, 79.7% thought CAM is safe, 71.3% used it because of the successful experience of others, and 60.9% used it because it’s more available than medical therapy. Among NSAIDs users, 17.2% reported recent use of over-the-counter (OTC) NSAIDs, and 33.9% of users used prescribed NSAIDs within the last three months for sport-related reasons. When asked to report any side-effect of NSAIDs they knew, only 22.6% were able to list at least one side-effect. This study shows a high prevalence of NSAIDs and CAM use among student-athletes in Palestine with a low level of knowledge and awareness of their side-effects. Therefore, education strategies that focus on enhancing and improving student-athletes’ knowledge of the proper use and the possible side-effects of NSAIDs and CAM are needed.
... For example, dietary supplement and medication use have been shown to be very different among sporting disciplines. 47 Finally, evidence from the external comparison groups provide grounds for assessing the overall effect of sport participation, including all pros and cons, and it is expected to be associated with better health due to a selection effect, and also partially to the physical activity, and general healthy habits that athletes display in comparison with any non-athlete group (healthy cohort effect), as previously found. 43 44 Nonetheless, this selection effect might be heterogeneous across sports, 45 and it might be mitigated by the emergence of some lifestyle choices after retirement, as demonstrated for increased body mass index. ...
Article
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Introduction Understanding whether concussion in sport is associated with worsening cognitive function in later life will likely have immediate repercussion on sports concussion prevention and management policy and sporting rules and regulations. This systematic review aims to summarise the evidence on the association between concussion sustained by professional/elite athletes and long-term cognitive impairment. Methods Embase, PubMed and Web of Science were used to search for eligible studies. Studies including professional/elite athletes from any sport were considered. Three comparison groups were considered: internal comparison (concussed vs non-concussed athletes within the same sample); between-sport comparison (contact sport athletes vs non-contact sports ones); external comparison (athletes vs samples of the general population or population norms). Results 14 studies were included (rugby, American football, ice hockey players, boxers and marital art fighters). The general quality of the evidence was poor. The overall evidence, weighted for type of comparison and study quality, points towards an association between sustaining a sport-related concussion and poorer cognitive function later in life in rugby, American football and boxing, although it is unclear to what extent this is clinically relevant. Data on ice hockey and martial arts were too sparse to allow conclusions to be drawn. Conclusion High-quality, appropriately designed and powered epidemiological studies are urgently needed to assess the association between sustaining a sport-related concussion and cognitive impairment later in life. Particular emphasis should be put on the clinical translational value of findings.
... It is estimated that up to 90% of all athletes worldwide consume dietary supplements at some level mainly because they are easily accessible (Huang et al. 2006;Denham 2011;Giannopoulou et al. 2013). In particular, amateur athletes often use WP based on their own prescription, usually obtained directly from sellers or through websites, ignoring the possible risks associated with chronic and excessive intake of a particular nutrient, such as proteins (Walter 2001;Allen and Haskell 2002;Laure and Binsinger 2005). ...
Article
Whey protein comprises soluble whey proteins and its benefits are well described in the literature. However, there are not many studies investigating the potential adverse effect of a diet with indiscriminate use of this supplement. The aim of this study was to perform a systematic review of papers that addressed this theme. A search was conducted in Medline, LILACS, TOXNET, Web of science, and Scopus electronic databases. In the end, 11 documents comprised this review. The majority of the papers associated the damaging effect with the chronic and abusive use of whey protein, with the kidneys and liver being the main organs affected. The other studies related whey protein to aggravation of aggression, presence of acne, and modification of the microbiota. Therefore, excessive consumption over a long period of protein supplementation may have some adverse effects on the body, which is aggravated when associated with sedentary lifestyle. PROSPERO registration no.: CRD42020140466. Novelty: A systematic review of experimental and randomized studies about the use of whey proteins supplements and its impact on physical health. Analysis revealed that chronic and without professional guidance use of whey protein supplementation may cause some adverse effects specially on kidney and liver function. Presented data support a need for future studies co-relating the use of different types of whey protein with and without exercise to better see the impact on human physical health.
... The use of DS is also a risk factor for illicit substance use and may cause so-called inadvertent doping due to the contamination of their ingredients with, for example, oxilofrine, β-methylphenethylamine (BMPEA) and N,β-dimethylphenethylamine (NBDM-PEA), the stimulant 4-methylhexan-2-amine (methylhexaneamine, 1,3-dimethylamylamine, DMAA), the anabolic steroids boldione (1,4-androstadiene-3,17-dione) and 5-androstene-3β,17α-diol (17α-AED), the beta-2 agonist higenamine and the beta-blocker bisoprolol [7,8]. However, the exact health benefits DS are still not well established [9,10]. Moreover, various possible hazards were described when used inappropriately or without medical consultation [11]. ...
Article
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Background: Among athletes, bodybuilders are more predisposed to the use of dietary supplements (DS) and hormones (H) to increase in adaptations to physical training and performance. The purpose of the study was to identify social, psychological, and organisational factors that are associated with the use of food supplements and hormones in young bodybuilders of the metropolitan area of Naples. Methods: 107 athletes, practicing bodybuilding, were consecutively recruited in 30 gyms, randomly selected in the metropolitan area of Naples. Athletes were administered an anonymous questionnaire. The questionnaire consists of 5 sections (socio-demographic, frequency and reasons for bodybuilding, knowledge, attitudes and behaviours). Descriptive statistics were performed using T-test and Chi-square statistics. A score was created for knowledge, attitudes, behaviours. Multivariable logistic regression models were employed to assess association between each score and the use of DS and H. Statistical analyses were carried out using STATA 15. Results: 81.31% of the subjects reported to use DS while 35.51% H. Females are less likely to practise bodybuilding frequently than males (OR 0.18 (95% CI 0.05-0.69), p = 0.01). Subjects who have attended high school or university have a lower probability of taking DS (OR 0.17 (95% CI 0.04-0.65), p = 0.01). H users also use supplements more frequently (OR 61.21 (95% CI 3.99-939.31), p < 0.001). Those who scored higher on knowledge scores are more likely to take DS (OR 1.53 (95% CI 1.11-2.12), p < 0.001). Attitudes are correlated with the use of DS; those who scored higher were less likely to use DS (OR 0.77 (95% CI 0.30-0.98), p = 0.03). People who use DS are 30 times more likely to use H at the same time (OR 30.25 (95% CI 2.51-365.24), p < 0.001). Subjects who have a higher score for knowledge and attitudes are less likely to use H (OR 0.68 (95% CI 0.54-0.87), p < 0.001, OR 0.75 (95% CI 0.62-0.90), p < 0.001). Conclusions: Prevalence of H and DS' use, although lower than reported in the literature, is a worrying public health problem. Better knowledge can lead to an informed use. Gym instructors should be trained to provide accurate and scientifically sound information. Health professionals should combine their expertise to provide more comprehensive guidance to the exercisers.
... 5 Furthermore, the recommendations for usage of NS are clear and suggest usage only among those individuals with restricted diets, those with severe weight loss and those that consume high quantities of one food group. 6 However, as an increasing number of people purchase NS, more of those products continue to flock the market due to the increasing interest among users. 2 Among recreational athletes in Greece, low levels of awareness and lack of information have been previously highlighted as a challenge. ...
Preprint
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Background: This study focused on investigating the prevalence of nutritional supplement (NS) usage, establishing their source and the motivating factors for the usage of NS among Gym users in Kampala city, Uganda. Methods: The study employed a cross-sectional research design. Multistage random sampling techniques were used to select 45 gym users among the 5 divisions that constitute Kampala city. Data were collected using questionnaires and analyzed using SPSS Version 26, where means, SD, frequencies and percentages were obtained. Chi-square tests were used for categorical comparisons between variables. Results: The results showed that there were more male participants (62.2%) than female participants (37.8%). The majority (76.9%) of gym users obtained NS from retail stores such as pharmacies, (10.2%) from their sports coaches, (7.7%) nutritionists/dieticians, and (5.1%) from team mates. Non-professional gym users (62.3%) reported higher levels of energy drink consumption than professional gym users (26.7%). The consumption of vitamins, herbal products and proteins was also considerably high. We also identified coaches/trainers (30.8%) as the main source of information, followed by nutritionists/dieticians (23.1%) and online websites (20.5%). Most gym users strongly agreed that supplements increase endurance training, increase strength, and make one healthier. Conclusions: The prevalence of nutritional supplement usage among gym users was high, with energy drinks and herbal products being the most preferred supplements.
... The U.S. Food and Drug Administration do not review dietary supplements for safety or effectiveness before they are sold. The DSs have been suggested to be used to improve health status, preventing nutritional deficiencies, boosting immunity and reducing stress [12][13][14], but exact benefits still not proven [15][16][17]. ...
Research
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Dietary supplements (DSs) use has been on rise in the recent years and their use for various reasons with or without medical advice. It is very important to know that DS have not been regulated and many untested are sold in market. This study was conducted to know the DS use in university students and their knowledge about them.
... Furthermore, UGTs are not only involved in the metabolism of AS, but they also contribute to the metabolism of various compounds including non-steroidal anti-inflammatory drugs (NSAIDs) [1]. The NSAIDs ibuprofen and diclofenac are commonly used by athletes for the treatment of pain and inflammation [7][8][9][10][11][12], and it has been reported that both drugs competitively inhibit the testosterone glucuronidation activity of UGT2B17 and other UGTs, in vitro [13]. Common dietary substances such as white tea and green tea [14] and red wine [15], have also exhibited similar inhibitory effects in in vitro studies. ...
Preprint
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In vitro studies show that diclofenac inhibits enzymatic steroid glucuronidation. This study was designed to investigate the influence of diclofenac on the excretion of stanozolol and 3'-hydroxystanozolol via analyses in hair, blood and urine in vivo in a rat study. Brown Norway rats were administered with stanozolol (weeks 1-3) and diclofenac (weeks 1-6). Weekly assessment of steroid levels in hair was complemented with spot urine and serum tests. Levels of both stanozolol and 3'-hydroxystanozolol steadily increased in hair during stanozolol treatment and decreased post-treatment, but remained readily detectable for 6 weeks. In contrast, compared to control rats, diclofenac significantly reduced urinary excretion of 3’-hydroxystanozolol which was undetectable in most samples. This is the first report of diclofenac altering steroid metabolism in vivo, detrimentally affecting detection in urine, but not in hair which holds considerable advantages over urinalysis for anti-doping tests.
... Performance in high-level competitive sports is so balanced that small differences have been shown to determine an athlete's chances of winning. Thus, many athletes consume dietary supplements aiming to optimize their performance, especially among elite athletes (Huang et al., 2006). It has been established that elite athletes consume dietary supplements with the objective to: i) increase power; ii) prevent nutritional deficits; iii) maintain health condition; iv) prevent from injuries; and v) improve sport performance (Maughan et al., 2018). ...
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The potential ergogenic effect of nutritional supplements depends on their dosage and the type of exercise executed. Aiming at reviewing the research literature regarding sport supplements utilized in judo in order to improve performance, a literature search was performed at the following databases: Dialnet, PubMed, Scielo, Scopus and SportDiscus. A total of 11 articles met the inclusion criteria and were selected. Evidence revised indicates that supplementation with caffeine, β-alanine, sodium bicarbonate, creatine, and β-hydroxy-β-methylbutyrate has a positive effect on judo-related performance. Moreover, there is evidence suggesting that combining some of these nutritional supplements may produce an additive effect.
... Dietary supplements and ergogenic aids (DSEA) are easily available and widely used to improve physical performance. [1][2][3] Previous studies showed that more than three million people in the US use or have used DSEA. 4,5 DSEA is usually consumed for obtaining aesthetic and physical results and is heavily influenced by media advertising. ...
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Introduction: The use of dietary supplements and ergogenic aids (DSEA) is popular among physical activity enthusiasts. Particularly, resistance training (RT) practitioners represent important DSEA consumers due to its easy access and the appeal of claims related to muscle hypertrophy, aesthetics, and physical performance improvements. Methods: Our aim was to study knowledge, prevalence, and profile of DSEA used by Brazilian recreational RT practitioners. For this, RT practitioners of both sexes (n=129, female=58 and male=71) answered a paper-based questionnaire. The questionnaire was specifically created for the studied population to assess different aspects of the DSEA used and sociodemographic variables. Results: Seventy-seven percent of the participants (n=99) declared that they had already used DSEA. The majority (53%) searched the internet to obtain information about DSEA. Whey protein (66%) was the most used followed by branched chain amino acids (48%). Conclusion: The use of DSEA, before coronavirus outbreak, was popular among RT practitioners; protein and amino acids were the most used DSEA. Most users used internet to obtain information about DSEA. The results suggest the need for appropriate attitude and guidance by health professionals who deal with this population, especially dietitians, nutri�tionists, and physical training professionals in order to promote best and security practices.
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Objectives The production and sale of performance-enhancing drugs (PEDs) with annual increase in number and diversity have now become a beneficial industry. At present, there is a kind of creatine supplement, called as creatine hydrochloride (CHCL), which is claimed to have a much higher absorption compared to creatine monohydrate (CRM) supplementation and does not require a loading period. However, this claim has not been fully examined yet. Therefore, the present study aimed to compare the effects of two types of creatine (CHCL and CRM) on physical activity, plasma levels of testosterone (T), and cortisol (Cor) in trained young men. Equipment and methods The statistical population of this study included 36 healthy subjects selected by purposive sampling method and with at least six months of resistance training. The subjects were randomly divided into four groups (Group 1: 20 g of CRM, Group 2: 3 g of CRM, Group 3: 3 g of CHCl per day for a week, and Group 4: placebo). The supplements were given to subjects by double-blind manner. Physical performance variables were evaluated on the morning of the first day and before the supplementation, and blood samples (5 cc) were taken in fasting conditions (8–10 hours) to measure the plasma levels of T and Cor. The blood samples were taken again after seven days for physical performance measurements. Results The results showed that there were no significant differences between the effects of 3 and 20 g of CRM and 3 g of CHCL on the vigor, power, plasma levels of T and Cor, and T/C ratio. In other words, 3 g of CHCL did not result in improved performance and hormonal changes compared to 20 g of CRM. Conclusion According to the results, the multi-day period of supplementation with CHCL in comparison to CRM cannot have much effect on performance and improve the hormonal status of individuals in the short term.
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Nutritional supplements have always been a point of attractionfor physically active people. These have improved exercise performance,increased muscular strength, weight gain or weight loss,etc. The irrational use of supplements has led to various side effectsassociated with them. There is a shortage of evidence suggestingthe usage and knowledge regarding the consumption ofdietary supplements. A cross-sectional study was conducted witha 121 sample size randomly chosen from 5 different zones of thecity. A structured questionnaire was designed to collect informationwherein participants reported their demographics, physical activity,supplement usage patterns, source of information, and side effects.Descriptive statistics, chi-square test, was used with p<0.05 as significant.Samples used different dosages, forms, brands, and accessto supplements. The participants coming to the gym for moreextended periods were likely to consume supplements in higherdosages (p = 0.020). Protein powder was consumed by 97.5% ofthe samples. There was a significant association between differenttypes of supplements across gender, age group, and period of exercisingin the gym. Side effects such as cramps (p = 0.015) andnausea were significantly associated with high dosages of supplementconsumption. The majority of them (51.2%) took advice fromtrainers. Only 9.9% consulted dieticians. Individuals consumed supplementswithout the guidance of any health professionals, whichwas predisposing them to various side effects. This reflects a lackof knowledge and awareness of supplement usage and highlightseducating various stakeholders and gym-goers.
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Aim We report on the results of the ‘IOC Needle Policy’ applied during the course of the Games of the XXXI Summer Olympiad in Rio de Janeiro, Brazil. The policy was intended to empower physicians to ensure appropriate clinical use of needles within team medical environments, enhance the safety of those responsible for housekeeping services and others in the Olympic environment, and permit documentation of such procedures as an adjunct to the doping control programme. Any needle use required the submission of an ‘Injection Declaration Form’ to IOC medical officials. Method All ‘ Injection Declaration Forms’ were reviewed and archived. The declarations provided basic information regarding the nature of the needle use and the product(s) involved, the physician, athlete and respective National Olympic Committee (NOC). The details of the declarations were subsequently categorised. Results A total of 367 declarations were received from physicians representing 49 NOCs. Needle-use declarations were more common in athletics, gymnastics, football and aquatics. A single product was administered in 60% of the cases, and more than one product was administered in 40%. The majority of declarations indicated the use of local anaesthetics, glucocorticoids, non-steroidal anti-inflammatory drugs and analgesics. Conclusion The introduction of a ‘Needle Policy’ in the Olympic Games setting was intended to minimise the use of needles by non-physicians, promote evidence-based practice and to deter needle-based doping practices. Declarations were received from 49 of 209 NOCs suggesting either that needle use is minimal among certain teams or opportunities remain to enhance compliance with such policies at future games.
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Introducción: el uso de suplementos deportivos es una estrategia generalizada entre los deportistas de alto rendimiento. Sin embargo, no existe ningún cuestionario validado en castellano para determinar la prevalencia en el uso de suplementos deportivos en deportistas. Objetivo: el objetivo de esta investigación fue validar un cuestionario en castellano para estudiar la prevalencia del uso de suplementos deportivos. Material y métodos: en una primera fase, el cuestionario fue diseñado para recabar información sobre la frecuencia en el uso de cinco categorías de suplementos (estimulantes, potenciadores del rendimiento, suplementos para control de peso, "recuperadores" y medicamentos). Posteriormente, el contenido del cuestionario fue validado por un grupo de seis expertos que valoraron la pertinencia y claridad de cada pregunta del cuestionario en escalas de 1-10 puntos. La versión final del cuestionario fue completada en dos ocasiones separadas por un mes (test-retest) por un grupo de 39 atletas de élite, con el objetivo de verificar la reproducibilidad en las respuestas a este cuestionario. Resultados: la versión final del cuestionario, obtenida tras la validación de contenido, tiene 81 preguntas que recaban información sociodemográfica y sobre motivos, frecuencia y condiciones de compra de suplementos deportivos. En el test-retest se comprobó una alta congruencia en todas las preguntas del cuestionario, sin diferencia estadística en ninguna de las respuestas en el test-retest. Conclusión: el cuestionario derivado de este estudio cumple con los parámetros de validez y fiabilidad necesarios para la obtención de información vinculada al tipo y frecuencia en el uso de suplementos deportivos.
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Doping is a global problem that threatens the credibility of sport. The concept of doping as an unnatural trap and a feeling of shame for being penalized, discourages athletes from this illegal and unsporting practice. The reasons why an athlete can resort to doping are varied and heterogeneous. Different authors have studied the motivations that determine that an athlete consumes a prohibited substance or resorts to an illegal method. According to the results of doping control tests, it has been revealed that the percentage of samples containing prohibited substances has remained relatively stable both before and after the creation of WADA (World Anti-Doping Agency). To date, most strategies implemented to fight doping have not taken into account the particularities of each sports discipline in terms of doping misconduct. The objective of this Doctoral Thesis was to evaluate and analyse the prevalence of doping in Olympic sports in the last decade, with the final purpose of identifying sports with greater vulnerability to doping. In addition, to investigate and determine the prevalence of the use of sports supplements mostly used by elite athletes. In order to achieve these objectives, eight investigations were proposed. Study 1 analysed the evolution of doping / anti-doping figures from 2003 to 2015 on the samples analysed and categories of substances that are most found in the athletes’ samples. In these investigations, it was observed that the increase in anti- doping pressure from 2003 to 2015 did not produce a higher percentage of adverse / atypical findings. However, the fight against doping has been effective in increasing the absolute number of samples classified as doping (from 2247 in 2003 to 5912 in 2015). Anabolic agents remain the most detected doping substances, while the rest of the substances are found much less frequently in doping control samples. In study 2, the differences in the incidence of doping between sports were assessed by analysing the frequency of adverse / atypical findings reported by the anti-doping laboratories from 2003 to 2015. In this investigation, it was determined that the incidence of adverse / atypical findings was not uniform in all sports disciplines from 2003 to 2015. Study 3 analysed the number and distribution of adverse analytical findings per drug class in individual and team sports. Analysis of the WADA anti-doping testing figures reports specify that prohibited substances used as doping agents may be different depending on the type of sport. Study 4 described the prevalence of adverse analytical findings that lead to a violation of anti-doping rules. The analysis of Anti-Doping Rule Violations reports suggests that the adverse analytical results that ultimately ended up as ADRV were not uniform across all sports disciplines. Study 5 aimed to describe changes in urine caffeine concentrations in Olympic sports using samples obtained in 2004, 2008 and 2015. In this investigation, it was observed how the concentration of caffeine obtained in competitive doping controls in Olympic sports increased from 2004 to 2015. Individual sports athletes or sports athletes of aerobic nature are more likely to use caffeine in competition. In Study 6, a questionnaire was created and validated to determine the nature of the use of dietary supplements in the population of Spanish elite athletes. The process of content validation obtained after the evaluation of a group of experts, along with the evaluation of reproducibility through a test-retest, suggests that the questionnaire meets the criteria necessary to make assessments on the use and consumption of dietary supplements in sports. Finally, Study 7 and 8 aimed to determine the prevalence on the use of supplements in a population of elite athletes and to know the gender-specific differences in patterns of consumption. A considerable proportion of athletes consume supplements with a low level of scientific evidence. In addition, athletes seem to rely on inadequate sources of information and may largely ignore the sources to detect contamination of the supplement. Men had a higher prevalence in the use of sports supplements than women, specifically in the use of proteins, and are more prone to self-prescription of these products. Key words: doping, anti-doping, banned drugs, type of sport, sport supplement, elite athlete.
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RESUMO O presente estudo visa analisar o perfil do praticante de atividade física que faz uso de suplementos alimentares ergogênicos, baseando-se no seu gênero, idade, índice de massa corporal(IMC), escolaridade e os suplementos nutricionais utilizados. Foram entrevistados 229 praticantes através de questionário em 7 cidades do Nordeste e Noroeste paulista: Ribeirão Preto, Jaboticabal, Cajuru, Taquaritinga, Catanduva, São José do Rio Preto e Pindorama. Destes 229, 100 (43,6%) utilizavam ergogênicos nutricionais, sendo 69 (69%) homens e 31 (31%) mulheres. A faixa etária média foi de 26,8 anos tendo como valores mínimo e máximo respectivamente 15 e 60 anos; o IMC médio foi de 24,95; e a escolaridade prevalente foi o Terceiro Grau completo ou incompleto, sendo o incompleto composto por estudantes. Os suplementos mais utilizados em geral foram: ricos em proteína (73%), aminoácidos de cadeia ramificada (36%), ricos em carboidratos (35%) e creatina (29%); lembrando que os usuários poderiam consumir mais de um ergogênico nutricional. No público masculino, os suplementos mais utilizados foram: ricos em proteína (80%), aminoácidos de cadeia ramificada(39%), ricos em carboidratos (39%) e creatina (36%); já o feminino foram: ricos em proteína (58%), queimadores de gordura (32%), aminoácidos de cadeia ramificada (29%) e ricos em carboidratos (26%). O perfil geral do usuário aponta para um indivíduo jovemadulto na faixa etária entre 20 a 30 anos, com ensino superior e IMC de 24,9 kg/m, mostrando sua preocupação tanto física quanto nutricional.
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A high-performance liquid chromatography method employing a diode-array detector and mass spectrometry detector was developed, validated and implemented for determining Synephrine, Caffeine, Clenbuterol, Nandrolone, Testosterone and Methylhexaneamine in Nutritional supplements. The use of Nutritional supplements is widespread. Hazards relating to concentration, composition, individual contaminants, supplements interactions as well as positive doping results among athletes present increasing concerns regarding nutritional supplement consuming. The proposed method was validated according to the International Conference on the Harmonization of the Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) standards. The proposed method observed to be accurate, linear, precise, sensitive, required minimal sample preparation and uncomplicated mobile phase. The implementation of the proposed method on nine commercial supplements shows that inaccurate labeling for some supplements regarding the concentration of the ingredients.
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We measured serum concentrations of thiamin, riboflavin, nicotinic acid, pyridoxine, folate, cyanocobalamin, ascorbic acid, retinol, tocopherol, zinc, magnesium, copper, iron, and ferritin as well as hemoglobin, hematocrit, percentage transferrin saturation, and total iron-binding capacity in athletes who ingested a multivitamin and mineral supplement for 3 mo. All blood variables were normal and except for pyridoxine and riboflavin there were no significant changes in the blood concentrations of any other vitamins or minerals measured. This may have been due to variable interactions between the vitamins and minerals in the supplement that prevented their being adequately absorbed. There were no signs or symptoms of serious toxic side effects. We conclude that multivitamin and mineral supplementation was without any measurable ergogenic effect and that such supplementation is unnecessary in athletes ingesting a normal diet.
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The popularity of fast pitch softball in the US and throughout the world is well documented. Along with this popularity, there has been a concomitant increasein the number of injuries. Nearly 52% of cases qualify as major disabling injuries requiring 3 weeks or more of treatment and 2% require surgery. Interestingly, 75% of injuries occur during away games and ~31 % of traumas occur during nonpositional and conditioning drills. Injuries range from contusions and tendinitis to ligamentous disorders and fractures. Although head and neck traumas account for 4 to 12% of cases, upper extremity traumas account for 23 to 47% of all injuries and up to 19% of cases involve the knee. Approximately 34 to 42% of injuries occur when the athlete collides with another individual or object. Other factors involved include the quality of playing surface, athlete's age and experience level, and the excessive physical demands associated with the sport. Nearly 24% of injuries involve base running and are due to poor judgement, sliding technique, current stationary base design, un-orthodox joint and extremity position during ground impact and catching of cleats. The increasing prevalence of overtraining syndrome among athletes has been attributed to an unclear definition of an optimal training zone, poor communication between player and coach, and the limited ability of bone and connective tissue to quickly respond to match the demands of the sport. This has led routinely to arm, shoulder and lumbar instability, chronic nonsteroidal anti-inflammatory drug (NSAID) use and time loss injuries in 45% of pitching staff during a single season. Specific attention to a safer playing environment, coaching and player education, and sport-specific training and conditioning would reduce the risk, rate and severity of fast pitch traumas. Padding of walls, backstops, rails and dugout areas, as well as minimising use of indoor facilities, is suggested to decrease the number of collision injuries. Coaches should be cognisant of overtraining, vary day-to-day training routines to decrease repetitive musculoskeletal stress, focus on motor skills with equal emphasis on speed and efficiency of movement, and use drills that reinforce sport-specific, decision making processes to minimise mental mistakes. Conditioning programs that emphasise a combination of power, acceleration, flexibility, technical skill, functional capacity and injury prevention are recommended. Due to the limited body of knowledge presently available on this sport, a greater focus on injury surveillance would provide a clearer picture of injury causation and effective management procedures, leading toward safer participation and successful player development.
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A survey was conducted to examine the source of information and usage of nutritional supplements in 115 male and 88 female varsity athletes at a Division I university. The survey asked each athlete to define supplement, and report supplement use and type, source of information, and reasons for use. Supplement use frequencies were determined, and comparisons were made between gender and sport. Eighty-nine percent of the subjects had or were currently using nutritional supplements. Many athletes did not consider sports drinks and calorie replacement products as supplements. Females were more likely to take calcium and multivitamins, and males had significant intake for ginseng, amino acids, glutamine, hydroxy-methyl-buterate (HMB), weight gainers, whey protein, and Juven. The most frequently used supplements overall were energy drinks (73%), calorie replacement products of all types (61.4%), multivitamin (47.3%), creatine (37.2%), and vitamin C (32.4%). There was also significant supplement use noted per sport. Females were more likely to obtain information from family members regarding supplementation, and males from a store nutritionist, fellow athletes, friends, or a coach. Female athletes were more likely to take supplements for their health or because of an inadequate diet, while men reported taking supplements to improve speed and agility, strength and power, or for weight/muscle gain.
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For the athlete training hard, nutritional supplements are often seen as promoting adaptations to training, allowing more consistent and intensive training by promoting recovery between training sessions, reducing interruptions to training because of illness or injury, and enhancing competitive performance. Surveys show that the prevalence of supplement use is widespread among sportsmen and women, but the use of few of these products is supported by a sound research base and some may even be harmful to the athlete. Special sports foods, including energy bars and sports drinks, have a real role to play, and some protein supplements and meal replacements may also be useful in some circumstances. Where there is a demonstrated deficiency of an essential nutrient, an increased intake from food or from supplementation may help, but many athletes ignore the need for caution in supplement use and take supplements in doses that are not necessary or may even be harmful. Some supplements do offer the prospect of improved performance; these include creatine, caffeine, bicarbonate and, perhaps, a very few others. There is no evidence that prohormones such as androstenedione are effective in enhancing muscle mass or strength, and these prohormones may result in negative health consequences, as well as positive drug tests. Contamination of supplements that may cause an athlete to fail a doping test is widespread.
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In brief: A total of 348 coaches, 179 athletic trainers, and 2,977 athletes in high school and college settings answered questionnaires about their nutrition knowledge and practices. Certified athletic trainers had the best nutrition backgrounds, and they believed they should take primary responsibility for athletes' nutrition. Coaches and athletic trainers are most concerned about fluid intake, but athletes are most concerned about weight. Most athletes are familiar with and use the basic four food groups, but 44% take vitamin supplements, 13% take mineral supplements, and 9% take protein supplements.
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The use of food supplements by the general public is poorly quantified, and little information on this subject is available in the medical literature. We surveyed 12 recent issues of popular health and bodybuilding magazines (1) to quantify the number of advertisements for food supplements, the number of products advertised, and the number and type of ingredients in these products; (2) to identify the purported health benefits of these products; and (3) as a preliminary effort to identify areas for future research. We counted 89 brands, 311 products, and 235 unique ingredients, the most frequent of which were unspecified amino acids; the most frequently promoted health benefit was muscle growth. We also found many unusual or unidentifiable ingredients, and 22.2% of the products had no ingredients listed in their advertisements. Health professionals may not be aware of how popular food supplements are or of a particular supplement's potential effects or side effects. In addition, patients may be reluctant to discuss their use of these products with traditional medical practitioners. We recommend that routine history taking include specific questions about patients' use of food supplements and that any possible adverse effects or side effects be reported to public health authorities. (JAMA. 1992;268:1008-1011)
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The effect of vitamin and mineral supplementation was studied over 7 to 8 months of training and competition in 82 athletes from four sports: basketball, gymnastics, rowing, and swimming. Matched subgroups were formed and a double-blind design used, with subgroups being given either the supplementation or a placebo. All athletes were monitored to ensure that the recommended daily intakes (RDI) of vitamins and minerals were provided by diet alone. Sport-specific and some common tests of strength as well as aerobic and anaerobic fitness were performed. Coaches' assessment of improvement was also obtained. The only significant effect of supplementation was observed in the female basketball players, in which the supplementation was associated with increased body weight, skinfold sum, and jumping ability. A significant increase in skinfold sum was also demonstrated over the whole group as a result of supplementation. In general, however, this study provided little evidence of any effect of supplementation to athletic performance for athletes consuming the dietary RDIs.
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The use of food supplements by the general public is poorly quantified, and little information on this subject is available in the medical literature. We surveyed 12 recent issues of popular health and bodybuilding magazines (1) to quantify the number of advertisements for food supplements, the number of products advertised, and the number and type of ingredients in these products; (2) to identify the purported health benefits of these products; and (3) as a preliminary effort to identify areas for future research. We counted 89 brands, 311 products, and 235 unique ingredients, the most frequent of which were unspecified amino acids; the most frequently promoted health benefit was muscle growth. We also found many unusual or unidentifiable ingredients, and 22.2% of the products had no ingredients listed in their advertisements. Health professionals may not be aware of how popular food supplements are or of a particular supplement's potential effects or side effects. In addition, patients may be reluctant to discuss their use of these products with traditional medical practitioners. We recommend that routine history taking include specific questions about patients' use of food supplements and that any possible adverse effects or side effects be reported to public health authorities.
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Information about habitual food intake was systematically obtained from elite endurance, strength, and team sport athletes. The athletes (n = 419) trained at least 1-2 h daily and competed on an international level. A 4- or 7-day food diary was kept. For analysis of the data, a computerized food table was used. Mean energy intake varied from 12.1-24.7 MJ per day for male and 6.8-12.9 MJ per day for female athletes. Protein intake was in agreement with or higher than the Dutch recommendations. Contribution of carbohydrate intake to total energy intake varied from 40%-63%. Fat intake tended to meet the criteria for a prudent diet (less than 35%). Snacks contributed about 35% to the total energy intake and the bread/cereals and dairy food groups were the most important energy sources. It is concluded that in general there are two major concerns. In those sports in which body composition plays an important role, energy and thus nutrient intake is often marginal. In all groups of athletes intake of carbohydrate is insufficient.
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The nutritional habits of elite athletes competing at a national and international top level were determined. Groups of endurance strength, and team sport athletes participated. All athletes trained at least 1-2 h daily. The purpose of the study was to quantify the mineral and vitamin intake and to identify the magnitude of the nutrient supplementation use. Information on food intake was obtained by a 4- or 7-day food diary. It was found that calcium and iron intake was positively related to energy intake. In low energy intakes (< 10 MJ) iron intake might be insufficient. In general, vitamin intake with food was in agreement with the Dutch recommendations. However, if energy intake is high (> 20 MJ) the amount of refined carbohydrate is increased. Consequently, the nutrient density for vitamin B1 drops. Therefore, under these conditions, supplementation for vitamin B1 must be considered. The low vitamin intake found in lower energy intakes can be improved by proper nutritional advice. In body building and in professional cycling, high dosages of vitamins are used. The other groups of athletes used only moderate quantities of vitamin supplements. It is concluded that vitamin and mineral intake is sufficient, when energy intake ranges between 10 and 20 MJ/day.
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The purpose of the present investigation was to study the use of supplements in a large group of endurance runners (no. = 347) who had participated in the 1987 Los Angeles Marathon. Three-day dietary records were analyzed for nutrient content and supplement usage. The runners' supplementation patterns with respect to demographics, dietary quality, training habits, and race performance were investigated. In general, no significant associations were found between supplement use and the aforementioned variables. Use of supplements, especially vitamins C and E, calcium, and zinc, increased with age (p less than .05). Daily use of at least one type of supplement was reported by 29% of the runners; 48% reported use of at least one type of supplement within the 3-day period.
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Twenty male runners were recruited to test whether a commercial ergogenic supplement was of any physiological benefit to endurance performance. Either a placebo or the supplement (a vitamin, mineral, amino acid, and unsaturated fatty acid complex) was administered to the subjects in a dose of three capsules daily over a 4-wk period in a double-blind design. A 60-min submaximal treadmill run (65 to 70% VO2 max) and a max VO2 test were completed by each subject before and after supplementation. The results demonstrated that even though exercise caused a significant decrease in muscle glycogen (36 to 48%) and blood glucose (24 to 34%) levels and an increase in blood free fatty acid (350%) and lactate concentration (200 to 230%), these changes were similar for both placebo and supplement groups. Similarly, the supplement had no effect on maximum oxygen consumption. We conclude that the supplement had no beneficial effect on performance as indicated by its inability to alter significantly any of the metabolic or physiological parameters, and that supplements of this nature are of no physiological value to the athlete who consumes a normal nutritionally balanced diet.
Article
A three day survey of food intake, training and sleep patterns was completed by 8 male and 12 female elite Canadian swimmers. Both groups were swimming similar training distances (ca. 9000m per day) and performed similar flexibility and strength training exercises. Males averaged 5 and females 4 meals per day (p < 0.05). In addition, the male swimmers are significantly more food from the meat, milk and grain food groups, taking in nearly twice as many calories as the female swimmers. The female swimmers were generally deficient in foods from the meat and milk group compared to recommended amounts. Twelve of the 20 athletes took additional food supplements. Both groups slept for similar periods of time each day (ca. 8h).
Article
Vitamin/mineral supplements are often used by athletes as ergogenic aids to improve performance. This paper reviews studies of the prevalence, patterns, and explanations for vitamin/mineral supplement use among athletes. Fifty-one studies provided quantitative prevalence data on 10,274 male and female athletes at several levels of athletic participation in over 15 sports. The overall mean prevalence of athletes' supplement use was 46%. Most studies reported that over half of the athletes used supplements (range 6% to 100%), and the larger investigations found lower prevalence levels. Elite athletes used supplements more than college or high school athletes. Women used supplements more often than men. Varying patterns existed by sport. Athletes appear to use supplements more than the general population, and some take high doses that may lead to nutritional problems. Sport nutritionists should include a vitamin/mineral supplement history as part of their dietary assessment so they can educate athletes about vitamin/mineral supplements and athletic performance.
Article
The nutritional intake of elite athletes is a critical determinant of their athletic performance and ability to compete both physically and mentally. However, their demanding training and travel schedules in addition to a possible lack of nutritional knowledge may prohibit them from maintaining an optimal dietary intake. Sound scientific data about the nutritional habits of elite athletes are limited and, therefore, it is not clear as to whether elite athletes are following nutritional recommendations and maintaining nutritionally sound diets. This review takes a comprehensive look at 22 recent dietary intake studies, including 50 groups of elite athletes. The time period for food record collection ranged from 3 to 7 days except for 2 studies which collected records for 21 and 22 days. Energy intakes of Ingested carbohydrate stored as glycogen serves as the primary fuel for muscle performance. Athletes in training should consume 70% of total calories as carbohydrate. Athletes on low energy diets (> 2200 kcal/day) should have a diet of > 25% fat, and athletes with large energy needs should consume 30% fat in their diet. In general, fat intakes should be reduced and carbohydrate intakes increased. Athletes should also restrict alcohol intake during training and competition periods. Athletes with low calorie intakes should consume foods with high contents of iron, calcium, magnesium, zinc and vitamin B12. Athletes with high calorie intakes should consume foods that are naturally high in or fortified with B-group vitamins. Fluid, electrolyte and energy supplementation is desirable to support circulatory, metabolic and thermoregulatory functions. There is no special food that will help elite athletes perform better; the most important aspect of the diet of elite athletes is that it follows the basic guidelines for healthy eating.
Article
Studies of the dietary practices of athletes report that nutritional supplements are commonly used. Supplementation practices vary between sports and individual athletes; however, there is evidence that at least some athletes use a large number of supplements concurrently, often in doses that are very high in comparison with normal dietary intakes. In exploring supplementation practices we propose a classification system separating the supplements into dietary supplements and nutritional erogogenic aids. The dietary supplement is characterised as a product which can be used to address physiological or nutritional issues arising in sport. It may provide a convenient or practical means of consuming special nutrient requirements for exercise, or it may be used to prevent/reverse nutritional deficiencies that commonly occur among athletes. The basis of the dietary supplement is an understanding of nutritional requirements and physiological effects of exercise. When the supplement is used to successfully meet a physiological/nutritional goal arising in sport it may be demonstrated to improve sports performance. While there is some interest in refining the composition or formulation of some dietary supplements, the real interest belongs to the use or application of the supplement; i.e. educating athletes to understand and achieve their nutritional needs in a specific sports situation. The sports drink (carbohydrate-electrolyte replacement drink) is a well known example of a dietary supplement. Scientific attitudes towards the sports drink have changed over the past 20 years. Initial caution that carbohydrate-electrolyte fluids compromise gastric emptying during exercise has now been shown to be unjustified. Numerous studies have shown that 5 to 10% solutions of glucose, glucose polymers (maltodextrins) and other simple sugars all have suitable gastric emptying characteristics for the delivery of fluid and moderate amounts of carbohydrate substrate. The optimal concentration of electrolytes, particularly sodium, remains unknown. Most currently available sports drinks provide a low level of sodium (10 to 25 mmol/L) in recognition that sodium intake may promote intestinal absorption of fluid as well as assist in rehydration. The sodium level of commercial oral rehydration fluids (used in the clinical treatment of diarrhoea and dehydration) is higher than that of the present range of sports drinks. However, even if research indicates that intestinal glucose transport is optimally stimulated at higher sodium concentrations, concern for the palatability of sports drinks may impose a lower ceiling for sodium levels. Commercial viability of a sports drink requires that it provide a refreshing and palatable fluid replacement across a wide variety of sports and exercise situations. However, in specific situations, the appropriate use of a drink may offer special advantages in meeting physiological requirements. For example, during endurance and ultraendurance exercise, suitable intake of a sports drink to preserve hydration and to supply additional carbohydrate substrate for glycogen-depleted muscles has been shown to enhance performance. Additionally, the sports drink may provide a special advantage in recovery and rehydration after prolonged exercise, particularly where more rapid restoration of body fluid and fuel levels will enhance performance in future exercise bouts. High carbohydrate liquids at higher concentrations (20 to 25% carbohydrate solutions, typically from maltodextrin sources) represent another type of dietary supplement. These high carbohydrate supplements, often known as ‘carbo-loader’ supplements, have been manufactured to assist athletes in achieving a high carbohydrate intake by overcoming problems of dietary bulk or lack of nutritional knowledge. They may be useful in situations where a short term need for carbohydrate supersedes other nutritional goals, e.g. carbohydrate loading and prolonged competition over successive days. Where long term nutritional goals and requirements for a combination of nutrients need to be addressed, liquid meal supplements provide a low-bulk, nutritionally complete choice. Liquid meal supplements may be useful as a compact nutrient-dense high energy supplement for athletes with high energy requirements, particularly when it is not practical or comfortable to consume solid foods. They may be useful in preparation for exercise, both as a pre-event meal and as a low residue preparation. Athletes who consume low energy intakes and/or restricted food variety may consume sub-optimal intakes of micronutrients, particularly minerals such as iron or calcium. Adequate vitamin and mineral status is a requirement for optimal sports performance, since many of the micronutrients play a key role in exercise metabolism, recovery and adaptation. A heavy exercise programme may increase requirements for some nutrients, including the B-group vitamins and iron. Athletes at high risk of inadequate micronutrient intake or nutritional deficiencies such as iron deficiency should benefit from nutritional counselling. Supplementation may be required in cases of ongoing suboptimal dietary intake, or to rapidly restore a diagnosed nutrient deficiency state. While many athletes regard iron supplements as a low cost ‘safety net’ against iron deficiency, there are many disadvantages to unsupervised long term intake of high doses of iron. The debate surrounding biochemical and haematological markers of optimal iron status remains unresolved. In general, screening and individual treatment of athletes in high-risk groups is preferred to a mass treatment programme. There is a need for nutrition education of athletes to explain the appropriate use of these dietary supplements. In many cases, the information is specific to the individual athlete or sports situation and may require one-to-one counselling. In most situations, the use of the supplement will simply be a part of a larger plan of optimal sports nutrition or the clinical management of a nutritional disorder. Effective education will not only ensure that dietary supplements are used correctly, but will highlight the importance of optimal sports nutrition.
Article
Many Americans are using alternative medical therapies as well as nutritional or dietary supplements that include vitamins, minerals, herbal products, tissue extracts, protein solutions, and other chemicals. Potential for both good and harm exists in taking many of these preparations. We surveyed 200 consecutive patients older than 18 years attending a family practice clinic. In addition to demographic data, we asked them about their intake of dietary supplements during the past year, perceived benefits from supplements, source of information, estimated cost of products, and whether their physician knew that they were taking the product. Fifty-two percent of the patients had taken 1 or more supplements during the past year, 18 percent used 2 to 5 supplements, and 3 percent took 6 to 13 different dietary supplements. Twenty-nine percent took them for diet and energy enhancement, and 24 percent for cancer prevention and immune system enhancement. The media was the principal source of patient information. Thirty-three percent of patients had not told their physician of their supplement use. The average estimated expenditure was $ 6.60 per month with a maximum of $ 68.90 per month. Eighty-two percent of the supplements taken were vitamins and minerals at recommended daily allowances (RDAs), whereas 18 percent were other supplements such as herbal products, megadose vitamins, and protein and amino acid preparations. Demographically, only educational level correlated significantly with supplement consumption. Patients with a high school education took significantly fewer supplements than those with more advanced education. Physicians should have a dialogue with their patients about dietary supplements because their use is widespread. Whereas many supplements are taken in safe doses, for others neither safety nor effectiveness has been proven, and for a few there are known toxicities. Additional research is needed to investigate both the safety and effectiveness of these products.
Article
The influences of gender, ethnicity, and sport of varsity athletes on their vitamin/mineral supplementation habits were examined. Subjects included 145 females and 266 males from 22 varsity teams; 80% were Caucasian; 12% African American; and 8% Combined-Other. Over half of the subjects took supplements. Males were more likely than females to give "too expensive" as a reason for not taking supplements, and "improve athletic performance" and "build muscle" as reasons for taking supplements. The most common supplement was multivitamins plus minerals. Females were more likely to take calcium and iron, and males vitamins B12 and A. African Americans were the most likely to take vitamin A. Males were more likely to get supplement information from nutritionists/dietitians and self, and females from family members or friends and physicians or pharmacists. Football players were more likely to get supplement information from nutritionists/dietitians, and males in other sports from coaches/trainers. There were some differences in vitamin/mineral supplement habits of the athletes by gender, ethnicity, and sport.
Article
The problems of doping in sport and the increasing use of nutritional supplements by athletes are issues that intersect to the degree that a large number of supplements may contain substances that are banned in sport. Many supplements contain substances that are associated with significant health hazards. Athletes consuming such supplement products may jeopardize their sporting status, and their health. To clarify and summarize the current status of dietary supplements in general, and to describe specific problems that can be associated with supplement use so that sport physicians might be better prepared to address these issues with their athlete-patients. An analysis of recent and relevant literature accessed through MEDLINE, and interactions with clinicians, laboratory scientists, colleagues, and athletes. The dietary supplement industry is completely unregulated in the United States; as a consequence, an abundance of supplement products of dubious value, content, and quality are now available around the world. It is known that many supplement products contain substances that are prohibited in sport-typically stimulants or anabolic steroid precursors. Many supplements contain substances (e.g., ephedrine) that have been associated with significant morbidity and mortality. Sport practitioners have particular responsibilities in addressing this issue. Athletes need to be aware of the problems that can follow supplement use, and sport authorities need to ensure that nutritional education and guidance for athletes is of the highest standard. The need for the appropriate regulation of dietary supplements is emphasized.
Article
During the Olympic Games held in Sydney in September, 2000 Doping Control was undertaken as specified in the International Olympic Code. During this process information about the medications taken by athletes was collected as a routine and formed part of the paperwork associated with a urine test. In their Post Games Report the World Anti-Doping Agency (WADA) recommended that the information about medications be collated with a view to assessing their use by athletes. Mandatory doping control for winners of events as well as random selection of athletes both during competition and out of competition allowed data to be collected about medications and supplements used by athletes. At the Doping Control Stations all competitors selected for a test, after providing a urine sample for analysis, were asked the same question: "what medications have you taken in the past three days?" The answer was to include all prescription drugs, over-the-counter medications, any other substances taken by mouth, injection, inhalation, ointment or by suppository, as well as vitamins, minerals, and all other supplements. This paper reviews the data from the 2758 Declaration Forms obtained at doping control. The prevalence of use of medications, the number used by an individual, and the pattern of use by these elite sports people were examined. The trends seen in this survey point to a dangerous overuse of nonsteroidal anti-inflammatory agents and an unnecessary overuse of vitamins in this population, while pointing out the increased prevalence of asthma and the dangers of drug interactions. The main objective here is to review some of the medications used by athletes in the Olympic Games in Sydney 2000. During these Games Doping Control was undertaken as specified by the International Olympic Committee. As well as a urine test, information about medications routinely taken was collected. Mandatory doping control for winners of events as well as random selection of athletes both during competition and out of competition required data to be collected about medications and supplements used by athletes as part of the sample collection protocol. At the Doping Control Stations all competitors selected for a test, after providing a urine sample for analysis, were asked the same question: "what medications have you taken in the past three days?" The answer was to include all prescription drugs, over-the-counter medications, any other substances taken by mouth, injection, inhalation, ointment or by suppository, as well as vitamins, minerals, and all other supplements. In this article we review the data from the laboratory copy of the 2758 Declaration Forms obtained at doping control. The cut down version of the Declaration Form submitted to the laboratory had all information identifying the athlete removed. Thus all information used in this article is completely anonymous. The prevalence of use of medications, the number used by an individual, and the pattern of use by these elite sports people were examined at the request of the IOC. In their Post-Games Report, the World Anti-Doping Agency (WADA) acting as independent observers of the anti-doping process recommended to the IOC that the information obtained in the Athlete Declaration Forms concerning medications be collated with a view to assessing their use by athletes. The trends in their use seen in this survey point to an overuse of supplements as well as a dangerous overuse of drugs such as nonsteroidal anti-inflammatory agents together with multiple drug use emphasising the dangers of drug interactions and points out the increased prevalence of asthma in this population.
Article
Unlabelled: The aims of this study were to investigate (a) the use of nutritional supplements (NS) (vitamins, minerals, Omega 3, antioxidants, ginseng, amino acids, Creatine and energy supplements) in elite athletes of different international ranking (b) why athletes are using NS, and (c) who recommends the elite athletes to use NS. The total population of elite athletes in Norwegian National Teams (n = 1620, 960 males and 660 females aged 15-39 years) and randomly selected (n = 1681) (916 males and 765 females) controls from the general population, were given a questionnaire including questions about use of nutritional supplements (NS), and from whom athletes had received information about nutrition and recommendations to use NS. The response rate was 76% for male and 92% for female athletes and 75% and 81% for male and female controls, respectively. A similar percentage of female athletes (54%) and controls (52%) reported use of one or more NS, but more male athletes (51%) than male controls (32%) used NS (P < 0.001). However, independent of gender, more athletes as compared to controls used minerals (males 26% vs. 8%; females 42% vs. 20%), amino acids (males 12% vs. 4%; females 3% vs. 0), and Creatine (males 12% vs. 2%; females 3% vs. 0). A lower percentage of NS users were observed in the best female athletes (52%) as compared to female athletes with less experience of international competition (73%) (P < 0.01). In male athletes, NS use was independent of international ranking (49%-53%). The coach was the main advisor for use of NS for both male (58%) and female athletes (52%). For male and female athletes, the main reason for using NS was that they felt it was needed in addition to their daily intake (56% and 67%, respectively). Forty one percent of the male and 37% of the female athletes using NS felt they were well informed about nutrition in general and NS. However, 8% of the NS users did not know whether the NS they used was doping classified or not. In conclusion: we found that a similar percentage of female elite athletes and controls, but a higher percentage of male elite athletes than controls, reported the use of NS. There was a lower percentage of NS use among the top female athletes, but not the top male athletes as compared to the less successful elite athletes. The coach was the main advisor for NS use both for male and female elite athletes.
Article
The use of performance-enhancing substances by athletes is nearly as old as sport itself. There are two primary categories of substances available to modern athletes: anabolic androgenic steroids (AAS) and nutritional supplements. All AAS and many of the nutritional supplements are used to increase testosterone levels in the body, thereby enhancing the athlete's ability to build lean muscle mass. Other nutritional supplements are used to increase the amount of energy available for workouts or competition. Although steroids are available in the US via physician prescription, nutritional supplements are widely available to all consumers with relatively scant regulation. Steroids are associated with a variety of side effects that can lead to physical changes, psychological disturbances, morbidity, and even mortality. The side effects of nutritional supplements are not as well studied but are presumed to be similarly dangerous. However, for many athletes at all levels facing pressure to excel, the potential benefits of taking these substances appear to be outweighing the associated risks. Increased testing at all levels is recommended.
Article
A survey of university student athletes was conducted to determine supplement use, perceived efficacy of supplements, availability and use of nutrition services, and perceived nutrition knowledge of athletic trainers. Results from 236 athletes showed that 88% used one or more nutritional supplements, yet perceived efficacy was moderate (2.9 or less; 5-point scale). Classes (69.4%), brochures (75%), and individual counseling (47%) were available and were used by 29.9%, 33.2%, and 17.9% of athletes, respectively. Primary sources of nutrition information were athletic trainers (39.8%), strength and conditioning coaches (23.7%), and dietitians (14.4%). Athletes perceived athletic trainers to have strong nutrition knowledge (mean=3.8+/-0.9; 5-point scale). Many (23.5%) did not know whether a dietitian was available. Dietitians must accelerate their marketing efforts to student athletes, work closely with athletic trainers to provide sound nutrition information, and provide services that meet the needs of a diverse population of student athletes.
Article
Strenuous exercise induces a marked reduction in renal hemodynamics. Prostaglandins (PG) play an important role in maintaining renal integrity in the face of hemodynamic changes. Inhibition of cyclooxygenase (COX) and thus PG formation can further compromise renal perfusion. The role of selective COX-2 inhibition on renal hemodynamics during exercise has not been investigated. Twelve healthy males (22-47 yr) took part in a randomized placebo controlled study investigating the effects of nonselective COX inhibition (indomethacin) and COX-2 selective inhibition (celecoxib) on renal hemodynamics during exercise. Renal blood flow (RBF), glomerular filtration rate (GFR), and free water clearance were measured using standard clearance techniques. Each experimental session was performed at least a week apart. The medications were taken for 36 h before study with the last dose at 0700 h on the day of study. Following baseline studies, each participant exercised for 30 min at 80% of their maximal aerobic power. Renal function was monitored for 2 h post-recovery. RBF and GFR fell by 40% after exercise with no significant difference between placebo, indomethacin, or celecoxib. Indomethacin (-2.43 +/- 0.95 mL x min(-1), P < 0.007) and celecoxib (-3.88 +/- 0.94 mL x min(-1), P < 0.0001) significantly reduced free water clearance compared with placebo during recovery. This study has confirmed that selective and nonselective COX inhibition can induce significant inhibition of free water clearance, indicating that these acute changes are regulated predominantly via COX-2. Acute cerebral edema with hyponatremia has been reported after major endurance sporting events. Identifiable risk factors include excessive hydration and use of NSAID. Impaired free water clearance during exercise potentiated by COX inhibition provides a pathophysiological explanation for these observations.
A volleyball players guide to nutritional supplements.
  • Day
Dietary supplement use in the general population.
  • Eliason
Separating fact from fiction in nutrition supplement claims.
  • Coleman
Legal ergogenic aids myths and fallacies.
  • Griffin