Performance enhancement & ergogenic aids

Question 1

What is the definition of an “ergogenic aid”?

Answer 1

An “ergogenic aid” is a substance or technique used to improve athletic performance by enhancing physiological, psychological, or biomechanical functions. The term “ergogenic” itself means work producing

Question 2

What are some examples of categories of ergogenic aids discussed in the sources?

Answer 2

The sources discuss ergogenic aids related to weight/strength gain (growth promoting, protein synthesis) and weight loss/aerobic performance.

Question 3

What are some examples of substances listed under “Weight/strength gain (growth promoting, protein synthesis)” ergogenics?

Answer 3

Examples include anabolic steroids, prohormones (like Androstenedione), DHEA/S, growth hormone (GH), β-hydroxy- β-methylbutyrate (HMB), and β2-adrenergic agonists (bronchodilators such as clenbuterol, salbutamol, albuterol)

Question 4

How do prohormones function as ergogenic aids?

Answer 4

Prohormones circulate in the blood in an inactive form, ready to turn on. Androstenedione (Andro) is mentioned as a precursor to testosterone, and DHEA/S turns into Testosterone

Question 5

How might β-hydroxy- β-methylbutyrate (HMB) act as an ergogenic aid?

Answer 5

β-hydroxy- β-methylbutyrate (HMB) stimulates muscle

Question 6

How do β2-adrenergic agonists like clenbuterol, salbutamol, and albuterol function as ergogenic aids?

Answer 6

These drugs are bronchodilators that can also stimulate muscle mass, particularly in the elderly.

Question 7

What are some examples of pharmaceutical agents used for weight loss/aerobic performance enhancement?

Answer 7

Examples include thermogenic drugs (like ephedrine or ephedrine/caffeine/aspirin cocktails) and anorexiant drugs (like fenfluramine and fluoxetine, which cause loss of appetite)

Question 8

Besides pharmaceutical agents, what other substances are mentioned for weight loss/aerobic performance?

Answer 8

Nicotine is mentioned as an appetite suppressant, and diuretics are used for rapid weight loss

Question 9

How do thermogenic drugs like caffeine and ephedrine work?

Answer 9

Caffeine and ephedrine stimulate the sympathetic nervous system (SNS), which is a major regulator of thermogenesis

Question 10

What are the types of adrenergic receptors stimulated by the SNS, and where are they located?

Answer 10

The SNS stimulates α receptors, including α1 (found in the heart and vascular smooth muscle) and α2 (found in presynaptic terminals and vascular and other smooth muscle cells), and β receptors, including β1, β2, and β3 (found in the heart, lungs, and blood vessels). This system is similar to the fight or flight system.

Question 11

What are some physiological effects of SNS stimulation relevant to performance?

Answer 11

SNS stimulation can lead to vasodilation to working muscles, and it can increase fat burning

Question 12

Name some examples of SNS stimulants.

Answer 12

Examples include adrenaline/epinephrine, noradrenaline/norepinephrine, amphetamine, and ephedrine

Question 13

According to the Prohibited List 2017, what are some potential benefits and risks associated with CNS stimulants like ephedrine/pseudoephedrine?

Answer 13

Potential benefits include weight loss, improved reaction time/acceleration/speed, strength/power/muscular endurance, possibly improved aerobic endurance, higher max HR and peak lactate at exhaustion, and better focus. Risks include death, cardiac arrhythmias, delayed sensation of fatigue, extreme nervousness, aggressive behavior, and insomnia

Question 14

What is the mechanism of action of ephedrine?

Answer 14

Ephedrine is a sympathomimetic substance that stimulates the SNS. It is also a stimulant that can prevent low blood pressure

Question 15

How does pseudoephedrine compare to ephedrine? Where can it be found?

Answer 15

Ephedrine is more effective than pseudoephedrine. Pseudoephedrine is available over the counter in products like Sudafed or Primatene as a decongestant. The herb má huáng (Ephedra sinica) contains both ephedrine and pseudoephedrine and is classified as a herb (dietary supplement)

Question 16

What are the proposed effects of ephedrine and amphetamines?

Answer 16

Ephedrine and amphetamines are sympathomimetic, meaning they stimulate α and β receptors. Ephedrine has both thermogenic and appetite suppressive effects, leading to weight loss

Question 17

What other potential benefits of ephedrine are mentioned regarding body composition during calorie restriction?

Answer 17

Ephedrine prevents loss of fat-free mass (FFM) during restriction, may be protein sparing, and may influence protein synthesis. It may also prevent a drop in resting metabolic rate (RMR) with restriction.

Question 18

What did the study by Shekelle et al. (JAMA 2003) suggest about ephedrine for weight loss?

Answer 18

The study suggested that ephedrine can lead to high-quality weight loss while maintaining muscle mass

Question 19

What is the synergistic effect of ephedrine and caffeine on weight loss?

Answer 19

There is a synergistic effect of ephedrine and caffeine. Studies by Shekelle et al. (JAMA 2003) showed a tendency for a dose effect for ephedrine, with higher doses showing more weight loss (though not always statistically significant). Combining more ephedra with caffeine leads to more weight loss, and vice versa. Overall, the effect is more effective for weight loss when both ephedrine and caffeine are combined, resulting in higher monthly weight loss

Question 20

What are some common and serious side effects of ephedrine (Ephedra)?

Answer 20

Common side effects include tremors, nervousness, increased BP and HR. More serious side effects include MI (myocardial infarction/heart attack), stroke, and seizures. Ephedra-containing products accounted for a high percentage of adverse reactions to herbs in the US and have been linked to deaths and permanent disabilities. It has been banned in diet drugs since 2004

Question 21

What are the WADA prohibited urine concentrations for ephedrine and pseudoephedrine as of 2010?

Answer 21

WADA 2010 prohibited urine concentrations are >10 μg/mL for ephedrine and >150 μg/mL for pseudoephedrine.

Question 22

Where is caffeine commonly found?

Answer 22

Caffeine is found mostly in coffee beans, tea leaves, cocoa beans, and cola nuts.

Question 23

What is the typical pharmacokinetic profile of caffeine after consumption?

Answer 23

Caffeine typically reaches its peak in the blood about 60 minutes after consumption, and its half-life ranges from 2 to 10 hours.

Question 24

What are the proposed effects of caffeine on mental and physical performance?

Answer 24

Caffeine is proposed to increase mental awareness, reduce the perception of fatigue, increase central drive, and increase fiber recruitment.

Question 25

How does caffeine affect adenosine receptors?

Answer 25

Caffeine acts as an adenosine receptor antagonist. Adenosine binding to its receptors slows neural activity and makes one feel sleepy, so caffeine inhibits this effect and stimulates metabolism

Question 26

How does caffeine influence noradrenaline levels?

Answer 26

Caffeine reduces the negative feedback that inhibits the secretion of noradrenaline, meaning the body keeps secreting this neurotransmitter

Question 27

What are some other physiological effects attributed to caffeine?

Answer 27

Caffeine relaxes smooth muscles (leading to increased blood flow), increases intestinal CHO absorption, and may help stimulate the adrenal medulla to release adrenaline (hormone). It also increases lipolysis (from adipocytes), leading to increased free fatty acids (FFA) and fat

Question 28

How is caffeine metabolized in the liver? What are its primary metabolites and their effects?

Answer 28

Caffeine is metabolized in the liver by the cytochrome P450 oxidase enzyme into three main metabolites: * Paraxanthine (84%): Has the effect of increasing lipolysis, leading to elevated glycerol and free fatty acid levels in the blood plasma. * Theobromine (12%): Dilates blood vessels and increases urine volume. It is also the principal alkaloid in cocoa and chocolate. * Theophylline (4%): Relaxes smooth muscles of the bronchi and is used to treat asthma

Question 29

What have short-term studies shown regarding caffeine and weight loss?

Answer 29

Short-term studies have shown that 100mg of caffeine increased resting oxygen consumption by 3–4% in both lean and postobese subjects.

Question 30

What have long-term studies indicated about caffeine's effect on weight loss?

Answer 30

Long-term studies suggest that caffeine alone does not seem to result in much more weight loss than placebo

Question 31

How does chronic caffeine use affect its ergogenic benefits?

Answer 31

In long-term users, the body is already used to the effects, so there may be no additional benefits

Question 32

What are the general findings regarding caffeine's impact on VO2max, maximal strength, and endurance?

Answer 32

Caffeine generally shows no benefits on VO2max and maximal strength. However, it shows benefits on submaximal aerobic and anaerobic endurance, often increasing the time to fatigue at a certain intensity

Question 33

Who is likely to experience a greater impact from caffeine use?

Answer 33

Individuals who are not regular caffeine users are likely to experience a greater impact than those who are

Question 34

What are some potential side effects of caffeine?

Answer 34

Side effects can include increased HR, being a diuretic (though not commonly a problem with exercise), different reactions in regular vs. non-users, potential interference with the absorption of vitamin C and iron, possible links to bone mineral density and osteoporosis, and insulin resistance and type 2 diabetes

Question 35

What is a rare but serious potential consequence of very high caffeine doses?

Answer 35

In very high doses, caffeine has been associated with death due to caffeine-induced arrhythmia.

Question 36

When was caffeine removed from the WADA prohibited list?

Answer 36

Caffeine was removed from the WADA prohibited list in 2004.

Question 37

What is creatine, and what are its main effects?

Answer 37

The source mentions "Creatine good data behind it". The take-home message is that creatine + resistance training (RT) increases muscle mass and strength in older (57+) adults

Question 38

What are anabolic steroids, and what are their clinical uses?

Answer 38

Anabolic steroids are synthetic substances similar to testosterone. Clinically, they are used to treat delayed puberty, osteoporosis (to increase bone strength), and anemia (to increase RBC count and %Hb).

Question 39

What are the performance-enhancing effects of anabolic steroids?

Answer 39

Anabolic steroids increase muscle size/strength and can reduce recovery time between periods of strenuous activity. However, they have no effect on endurance or stamina and can stimulate the brain to stimulate feelings of euphoria.

Question 40

What are some side effects associated with anabolic steroid use?

Answer 40

Side effects include increased aggressive behaviour, acne, body hair, interference with the natural production of testosterone with prolonged use, hypertension, atherosclerosis, blood clotting, and reduced fertility

Question 41

When did the IOC ban anabolic steroids? What is the effect size of anabolic steroids on strength and lean mass?

Answer 41

The IOC placed anabolic steroids on their list of banned substances in 1975. They have a small effect size on strength but a medium effect size on lean mass, with a big effect on muscle mass overall.

Question 42

Define "doping in sport."

Answer 42

Doping in sport refers to "the presence of prohibited substances or methods to unfairly improve their sporting performances and gain an advantage over their competitors"

Question 43

What are some reasons why athletes might engage in doping?

Answer 43

Reasons include the belief that competitors take drugs, the feeling of needing them to be competitive, dissatisfaction with size/weight, peer/team pressure, community attitudes and expectations, and financial rewards and media influence

Question 44

What are some historical examples of doping leading to death in sports?

Answer 44

The source mentions cyclist Arthur Linton in 1896 who suffered a heart attack following a stimulant overdose. It also notes that during the early 1900s, athletes (especially cyclists) consumed “bomb” during races

Question 45

What are the main categories of prohibited substances and methods according to the Prohibited List 2017?

Answer 45

Prohibited substances include non-approved substances, anabolic agents, peptide hormones, growth factors & related substances, beta-2 antagonists, hormone antagonists & metabolic modulators, and diuretics & masking agents. Prohibited methods include manipulation of blood & blood components (enhancement of oxygen transfer) and chemical or physical manipulation

Question 46

What are some examples of substances prohibited in competition only, and what sports have specific prohibitions?

Answer 46

Alcohol is prohibited in some sports as it can lead to impaired performance (reduced reaction time, hand-eye coordination, accuracy, balance, complex coordination, and regulation of body temperature, and may also reduce strength, power, speed, cardiovascular endurance, and healing of injuries). It is specifically banned in sports like snowboarding and ski jumping if it reduces performance. Beta-blockers are prohibited in specific sports like archery, automobile, billiards, darts, golf, shooting, skiing/snowboarding, and underwater sports due to their calming effect by blocking the release of noradrenaline and reducing heart rate, which can stabilize motor performance and reduce anxiety.

Question 47

What are some examples of mainstream media that have covered the topic of doping in sport?

Answer 47

Examples include the documentary Icarus (during the Russian athlete doping scandal), Pumping Iron (before steroid use went out of favor), and The Program (about Lance Armstrong).

Question 48

What are some critical evaluation questions to consider when assessing nutrition supplement studies?

Answer 48

Key questions include: Does the study have a clear hypothesis? Was the study on cells, tissues, animals or humans? Was the population for which the claims are made comparable to the population in the study? Were external variables controlled? Was the study placebo controlled? Were adequate techniques used? Were the trials randomized? Was a crossover design used? Do other studies confirm the findings? Was the study peer-reviewed? By whom was it funded?. The source also emphasizes that similar structures don't automatically mean benefits for humans and asks can it be replicated?.