PerformanceEnhancing
Substances
Overview
• Ergogenic Aids Defined
• Types of Ergogenic Aids
• Dietary Supplements
• Anabolic Steroids, Blood
Doping, EPO
• Dangerous Supplements
Ergogenic Aid Defined
• Any substance (performance
enhancing drugs and dietary
supplements) or phenomenon
(i.e. altitude training, weight
training…) taken or used for the
purpose of improving sport
performance
Types of Ergogenic Aids
• Ergogenic aids fall into the following
categories:
–Mechanical Aids (i.e., resistance
training)
–Dietary Supplements (i.e., vitamins)
–Physiological Aids (i.e., massage,
altitude training)
–Psychological Aids (i.e., cheering)
–Drugs (i.e., anabolic steroids)
Types of Mechanical Aids
• Any physical object that affects sports performance
• They are usually safe
– Weights, Weighted Vests, Uphill/Downhill
Running, Heart Rate Monitors, Parachutes,
Treadmills, Solid Disk Wheels for Cycling
– Nasal Strips
– Streamlined Swimsuits
– Computers/video recorders - analyze VO2 max,
technique, test results etc Weights
– Clothing and Footwear
– Timing Equipment
Dietary Supplements
• The sport supplement industry throughout
the world has exploded, with more than 600
sport nutrition companies marketing over
4,000 products that produce annual sales of
more than $4 billion in the United States
alone
Dietary Supplements
•
The distinction between a drug and a dietary
supplement is linked to FDA approval for safety and
effectiveness
• Definition of Products That Can Be Sold as Dietary
Supplements:
– A product (other than tobacco) intended to
supplement the diet that contains one or more
of the following dietary ingredients:
• vitamin, mineral, amino acid, herb or other
botanical
• The product must also be intended for ingestion and
cannot be advertised for use as a conventional food or
as the sole item within a meal or diet.
Dietary Supplements Regulation
• Under the Dietary Supplement Health and
Education Act of 1994 (DSHEA), the dietary
supplement manufacturer is responsible for
ensuring that a dietary supplement is safe
before it is marketed
• FDA is responsible for taking action against any
unsafe dietary supplement product after it
reaches the market
• Generally, manufacturers do not need to
register their products with FDA nor get FDA
approval before producing or selling dietary
supplements.
• www.fda.gov
Buyer Beware
• Be aware of claims that the products being
advertised will produce rapid results
• Beware of claims for products that seem
unreasonably distorted e.g. "25 lbs of muscle in one
month."
• Be aware of recommendations that have been taken
from one study that supports the sale of the product
• Be cautious about recommendations that focus only
on selling the product
• Be aware of recommendations that are taken from
studies that have been published without peer
review
Protein and Amino Acid Supplementation:
Do They Work?
• “Heavy resistance exercise increases the
rates of both protein synthesis and protein
breakdown in muscle for some hours after
a workout, but in the absence of food
intake, the rate of breakdown exceeds the
rate of synthesis. This means that if
weightlifters do not eat after they work out,
they actually begin to lose muscle mass”
• www.gssiweb.com
Protein and Amino Acid Supplementation:
Do They Work?
• “It appears that only a small amount of food is
required to produce an environment within the
muscle that favors protein building, at least for a
few hours. For example, ingesting a drink
containing 6 grams of essential amino acids,
either immediately prior to exercise or during
the first few hours of recovery, seems to
promote an “anabolic” environment within the
muscle. Although not yet proven, this may lead
to enhanced muscle growth during habitual
training.” (www.gssiweb.com)
Protein and Amino Acid Supplementation: Do
They Work?
• American College of Sports Medicine (ACSM),
American Dietetic Association (ADA), and Dietitians of
Canada (DC) have concluded that athletes have only
slightly higher protein requirements than do nonathletes
• The vast majority of athletes consume protein in their
normal diets far in excess of any increased protein
requirement.
• If good nutrition is followed and energy intake is
sufficient to maintain body weight, athletes require
about15% of their total caloric intake from protein and
do not need to fortify their diets with expensive protein
or amino acid supplements (www.gssiweb.com)
Caffeine
• A central nervous stimulant
• Ergogenic aid that may enhance performance in
aerobic and anaerobic athletes
• “Recent, well-controlled studies have established
that moderate doses of caffeine ingested 1 hour
prior to exercise enhances the performance of
certain types of endurance exercise in the
laboratory. The results are specific to well-trained
elite or recreational athletes. There is little
information on the performance and metabolic
effects of caffeine in recreationally active or
untrained individuals” (www.gssiweb.com)
Caffeine
• Adverse Effects
–Anxiety
–Gastrointestinal Disturbances
–Restlessness
–Insomnia
–Tremors
–Heart Arrhythmias
–Increased Risk for Heat Illness
–Is physically addicting
L-Carnitine
• L-Carnitine is a naturally occurring amino acid which
stimulates the breakdown of fat
• It transports fatty acids into the mitochondria
• Studies examining L-carnitine’s role as an ergogenic
aid for increasing fat oxidation have not shown clear
efficacy
• Studies show L-carnitine may enhance recovery from
exercise
Creatine
• Creatine, in the form of creatine
phosphate (CP), has an essential
role in energy metabolism as a
substance for the formation of
adenosine triphosphate (ATP),
especially during short-duration,
high-intensity exercise.
Creatine
• 50% of creatine in our bodies is ingested
through the foods we eat while the other
50% is made in the liver, kidney, and
pancreas. Roughly one-third is in its free
form as creatine, while the remainder is
bound to phosphate (University of Maryland
Medical Center)
• The primary dietary sources of creatine are:
– Fish: herring, salmon, tuna, cod
– Beef
– Pork
Creatine Supplementation
• Creatine supplementation has been
shown to increase strength and
improve training by reducing fatigue
and enhancing post-workout recovery
• Body Mass Changes
–Prolonged creatine supplementation has
been generally associated with
increases in body weight, especially
increases in fat-free mass
Creatine Side Effects
• Controlled studies have been unable to
document any significant side effects from
creatine supplementation
• Dehydration:
– Much of our body water follows creatine into
skeletal muscle, possibly depriving our
remaining tissues of much needed fluid,
especially when exercising in hot and humid
environments. this may lead to impaired
thermoregulation and subsequent heat
exhaustion
Creatine Side Effects
• Concerns include gastrointestinal disturbances
and strain on the kidneys
• Gastrointestinal Distress:
– Stomach Cramps
– Nausea
– Flatulence
– Diarrhea
• These side effects are primarily due to the
presence of large quantities of undisclosed
creatine particles
• Hydration helps break down those undisclosed
creatine particles
Nitric Oxide
• Nitric Oxide is synthesized by the body to help keep
blood vessels relaxed and flexible
• Nitric Oxide supplementation (NO2) promises muscle
hypertrophy, increases in muscle strength and
recovery, and muscle pump
• There are no scientific studies showing NO2
supplementation directly increases nitric oxide levels
in the blood by a significant level
• Side effects include diarrhea,
nausea, and weakness
• Very expensive-retails for $80.00
Anabolic Steroids
• The synthetic (man-made)
derivatives of the male sex
hormone, testosterone
• Anabolic refers to muscle-building
• Androgenic refers to increased
masculine characteristics
• Steroids refers to the class of
drugs
Anabolic Steroids
• Who Uses Anabolic Steroids?
• Olympic athletes, professional athletes,
collegiate athletes, and high school athletes
have been reported to use steroids
• Many users are not involved in sports; they
use steroids to improve appearance
• Ergogenic Benefits
• Muscle Mass and Strength
–Increases in muscle protein synthesis with
steroid use are likely responsible for
increases in lean body mass
–Changes occur in both recreationally
trained and competitive athletes
Anabolic Steroids
• Dosing
– Athletes typically use anabolic steroids in a
“stacking” regimen, in which they administer several
different drugs simultaneously
– Most users take anabolic steroids in a cyclic
pattern, meaning that they use the drugs for several
weeks or months and alternate these cycles with
periods of discontinued use.
– Often athletes administer the drugs in a pyramid
(step-up) pattern in which dosages are steadily
increased over several weeks. Toward the end of
the cycle, the athlete “steps down” to reduce the
likelihood of negative side effects.
Anabolic Steroids
• Potential Female
Side Effects:
– Masculinization
– Growth of facial hair
– Male-pattern
baldness
– Changes in or
cessation of the
menstrual cycle
– Enlargement of the
clitoris
– Deepened voice
– Severe acne
Anabolic Steroids
• Potential Male Side
Effects:
– Feminization: excessive
levels of testosterone
are converted into
estrogen
– Gynecomastia:
development of breasts
– Decreased testicular
size
– Decreased sperm count
– Impotence
– Baldness
– Increased risk for
prostate and liver cancer
– Acne
Anabolic Steroids
• Adolescents
–Growth halted prematurely through
premature skeletal maturation and
accelerated puberty changes.
–Risk remaining short for the remainder
of their lives if they take anabolic
steroids before the typical adolescent
growth spurt
• People who inject anabolic steroids run
the added risk of contracting or
transmitting HIV/AIDS or hepatitis
Anabolic Steroids
• Anabolic steroids are available legally
only by prescription, to treat
conditions that occur when the body
produces abnormally low amounts of
testosterone, such as delayed puberty
and some types of impotence
• They are also prescribed to treat body
wasting in patients with AIDS and
other diseases that result in loss of
lean muscle mass
Blood Doping
• Blood doping refers to any illegal method of
boosting an athlete's red blood cell supply in
advance of competition
• Since red blood cells carry oxygen through
the bloodstream, increasing their number
allows an athlete's blood to deliver oxygen to
muscles more efficiently, reducing fatigue
and giving the athlete an edge.
• Endurance athletes often train at high
altitude for precisely this reason. The lower
air pressure and diminished atmospheric
oxygen at altitude spur the body to generate
extra red blood cells
Types of Blood Doping Transfusions
• Red blood cells from a
compatible donor are
harvested,
concentrated and then
transfused into the
athlete’s circulation
prior to competition
• The athlete harvests
his or her own RBC’s
well in advance of
competition and then
re-introduces them
before competition
Blood Doping
• Side Effects:
–Infection and the potential toxicity of
improperly stored blood
–AIDS
–Hepatitis
–Malaria
–A Transfusion Reaction
–Heart Failure
–Embolism (traveling blood clot)
–Stroke
–Sudden Death
Erythropoietin (EPO)
• A naturally occurring hormone,
produced by the kidneys, which
stimulates the body to produce
more red blood cells
• It is used to treat anemia
• It can be given to people with
cancer who have anemia, either
because of the disease or their
chemotherapy treatment
Erythropoietin (EPO)
• Side Effects:
– Injections of EPO are associated with elevations in
both hematocrit (amount of red blood cells) and
hemoglobin (oxygen carrying pigment in red blood
cells)
– Blood becomes more viscous (heart cannot pump
thick blood)
– Heart Attack, Stroke, Sudden Death
– High blood pressure
– Headaches
– Dehydration
– Fainting or feeling light-headed
– Hematoma (blood accumulating under the skin)
– Infection
– Multiple punctures to locate veins
Dangerous Dietary Supplements
• Ephedrine (Ma Huang ):
–Structurally similar to the amphetamines
–Increases risks of heart attack, stroke,
seizures, psychosis and death
–Increases heart rate and blood pressure
–Dizziness, headaches, tremors,
nervousness, gastrointestinal distress,
heart palpitations, irregular heart beat
Dangerous Dietary Supplements
• Androstenedione:
– A "prohormone" steroid that can be converted
to testosterone and is marketed as a
supplement that can increase muscle mass
and strength.
– Associated with decreases in HDL cholesterol
and increases in serum estrogen levels, which
may have adverse health consequences
during long-term supplementation
– The NCAA, IOC, and NFL all ban
Androstenedione
Dangerous Dietary Supplements
• Yohimbine
–Extracted from yohimbe bark
–It supposedly increases serum
testosterone levels
–Side effects include headaches,
anxiety, psychological tension, high
blood pressure, increased heart
rate, heart palpitations, and
hallucinations
Dangerous Dietary Supplements
• Kava:
– An herb included in supplements
– Allegedly promotes relaxation and relieves
menopausal symptoms.
– Kava-containing products have been
associated with hepatitis, cirrhosis, and liver
failure
– In the U.S., the FDA had received a report of a
previously healthy young female who required
a liver transplant, as well as several reports of
liver-related injuries associated with the use of
kava
Dangerous Dietary Supplements
• Hydroxycut
– Associated with jaundice and liver failure
• Ripped Fuel, Metabolife, Diet Fuel
– Contained Ephedrine
• Alli
– Linked to breast cancer, liver and bowel problems,
and prevents the body from absorbing essential
nutrients
Banned Ergogenic Aids
• Ergogenic aids are banned
from athletic competition when
it provides an unfair competitive
advantage or is a significant
health risk
• Each year the list of banned
substances is subject to
change
Banned Ergogenic Aids
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Blood Doping
Erythropoietin
Amphetamines
Methadone
Beta Blockers
Human Growth
Hormone
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Diuretics
Testosterone
Androstenedione
Cocaine
Codeine
Morphine
Heroin
Save Your Money
• The most important factor for an for
an active individual is to take in
enough calories
• Sufficient calories from carbohydrates
are needed to fuel the body so that
protein is used to build and repair
muscle tissue.
• Otherwise, with low calorie diets,
protein is burned for energy instead
Save Your Money
• Carbohydrates provide fuel for the
muscles, and also bring about a hormonal
response that enhances muscle synthesis
• Studies have shown that when the ratio of
protein to carbohydrate intake is 1:4 (15
percent of calories from protein and 60
percent of calories from carbohydrates),
testosterone levels used in muscle
building have been known to increase the
most for all healthy people
Save Your Money
• Carbohydrates, eaten within one hour of
resistance training (1 gram of
carbohydrate per kilogram of body
weight), will also decrease the breakdown
of muscle protein and help build muscle
tissue
• In addition to what you eat, resistance
training is the best way to increase lean
body mass.
• There are no short cuts or quick fixes