DRUGS

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DRUGS SUPPLEMENTS

• Can They Enhance Performance?
• By Kimberly Davis, MS, RD

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DRUGS TRAINING

• Purpose of training?
• Do drugs / supplements benefit or hinder normal
  training effects?
• Do performance-enhancing drugs work forever?

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MUSCLE BUILDERS

• Anabolic Steroids
• Natural hormones produced by the body that help
  build muscle
• Increase size of muscle fibers
• Non-addictive
• Stacking
• Gradually increasing then decreasing doses

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MUSCLE BUILDERS (cont.)

• Anabolic Steroids
• Androstenedione (Andro)
• Very small role in the production of testosterone
• Marginally increases testosterone levels
  doesnt measurably increase strength
• Converted into estrogen at a higher rate than it
  is turned into testosterone

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MUSCLE BUILDERS (cont.)

• Anabolic Steroids
• Dangerous Side Effects
• Heart circulatory system effects
• Cancer
• Liver disease
• Psychological effects
• Increase in strains and tears of tendons
  ligaments

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MUSCLE BUILDERS (cont.)

• Growth Hormone
• Rapid skeletal growth height increases during
  puberty
• Slight effect on muscle deposition cartilage
  growth in adults
• Can improve lean body mass in those who dont
  have enough hormone
• Effects on normal, healthy people are small

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MUSCLE BUILDERS (cont.)

• GHB (gamma hydroxybutyrate)
• Can release a tiny amount of growth hormone from
  pituitary gland probably not enough to increase
  muscle deposition
• Overdoses can be lethal
• Also marketed as sleep aid

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MUSCLE BUILDERS (cont.)

• Clenbuterol
• Makes muscles look bigger, but doesnt make them
  stronger or increase endurance
• Improves blood flow to muscle, causes breakdown
  of fat
• Side Effects
• Increases heart rate
• Causes jitteriness

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MUSCLE BUILDERS (cont.)

• Creatine Phosphate
• Provides phosphate for ATP resupply
• Increases body weight (mainly water)
• Sprint-like activities improved (1-5)
• Does not improve endurance during aerobic exercise

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MUSCLE BUILDERS (cont.)

• Insulin
• Stimulates uptake of amino acids (precursors of
  protein) into muscle
• Probably ineffective very dangerous
• Dangerously low blood glucose levels
• Racing heartbeat, clammy skin, nausea
• Slows down breakdown of fat so taking extra can
  lead to more fat deposition

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MUSCLE BUILDERS (cont.)

• Chromium Piccolinate
• Improves insulin sensitivity in diabetics
• No effect has been shown on measures of lean body
  mass or athletic performance
• Amino Acid/Protein Supplements
• Simply eating protein does not stimulate muscle
  formation

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MUSCLE BUILDERS (cont.)

• Amino Acid/Protein Supplements
• There is no proven benefit to taking individual
  amino acid supplements
• Need all 22 amino acids to make protein
• Stomach intestines break down dietary protein
  into their constituent amino acids, then absorbed
  used throughout the body in production of new
  proteins

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MUSCLE BUILDERS (cont.)

• Protein Requirements
• Normal healthy adult .8-1g/kg body weight
• Athletes 1-2g/kg body weight
• Weight lifters 1.2-1.5g/kg body weight
• Endurance athletes may need more
• Athletes in early stages of training may require
  up to 2g/kg body weight
• Example 154 pound (70kg) athlete needs 140gm
  for early stages of training. Average American
  consumes approx 100 gm/day

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APPETITE SUPPRESSANTS

• Inhibit hunger center and/or stimulate satiety
  center
• Phentermine (Adipex, Fastin)
• Methamphetamine (Desoxyn)
• Sibutramine (Meridia)
• Phenylpropanolamine (Dexatrim)

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APPETITE SUPPRESSANTS

• Side Effects
• Some are addictive
• Increase heart rate
• Increase blood pressure
• Produce irregular heart beats during maximal
  exercise

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FAT BURNERS

• Thyroid Hormone (Triiodothyronine)
• Regulates rate of basal metabolism
• Can cause dangerous increases in heart rate and
  blood pressure
• Forces body to use protein for fuel
• DNP (Dinitrophenol)
• Increases metabolism body temperature

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FAT BURNERS (cont.)

• Ephedrine Other Stimulants
• Stimulate burning of brown fat
• Make fat available as fuel, but exercise is
  needed to burn calories
• Caffeine
• Theories triggers release of free fatty acids
  blocks actions of adenosine (a hormone that
  prevents fat breakdown)

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FAT BLOCKERS (cont.)

• Prevent fat absorption by intestine
• Side Effects
• Diarrhea
• Flatulence
• Fat-soluble vitamins are not absorbed

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STIMULANTS

• Mimic the actions of the sympathetic nervous
  system (SNS)
• Dilate pupils widen bronchioles increase heart
  rate divert blood to muscles break down glucose
  fat
• Exercise activates the SNS naturally

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STIMULANTS (cont.)

• Probably DO NOT benefit athletes training under
  maximally stressful conditions, but may benefit
  other athletes
• Downside
• Prevents appropriate adaptations that normally
  occur during training

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STIMULANTS (cont.)

• Amphetamines
• Affect athletic performance by increasing
  alertness
• Many risks
• Highly addictive
• Can lead to dangerous increase in body
  temperature during intense exercise
• Increase energy sense of euphoria
• Mask natural warnings (fatigue pain)

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STIMULANTS (cont.)

• Amphetamines
• Many risks (cont.)
• Overstimulation of cardiovascular system, leading
  to fatal disturbance of heart rhythm
• Stroke
• Long-term damage to heart
• Dramatic loss of body weight
• Anxiety, delusions, restlessness

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STIMULANTS (cont.)

• Ephedrine (Ma Huang, Herbal Ecstasy)
• Most widely marketed
• Not addictive
• Clinical studies have not shown to be very
  effective for weight loss
• Increases in heart rate alertness can lead to
  destruction of heart tissue
• 800 reports of adverse events-FDA

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STIMULANTS (cont.)

• Bronchodilators
• Can stimulate heart rate, release fatty acids
• Studies have not shown benefits
• May lead to heart damage
• Can overstimulate muscle receptors, leading to
  tremors
• Inhalers are safe

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STIMULANTS (cont.)

• Decongestants
• Pseudophedrine
• No evidence of improved endurance or strength
• Not addictive
• Constricts blood vessels, raises blood pressure
• Daily use can lead to irreversible damage to
  heart muscle

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STIMULANTS (cont.)

• Caffeine
• Mild stimulant
• Increases arousal mildly activates SNS
• Slightly increases blood pressure
• Helpful during aerobic exercise

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EVALUATING CLAIMS

• Dont believe satisfied consumer testimonials
• Be skeptical of claims on bottle
• Should reference their scientific studies
  (author and/or journal should be mentioned)

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Evaluating Claims (cont.)

• Kinds of evidence
• Poor
• Consumer testimonials
• Advertising brochures
• Manufacturers information
• Potentially Flawed
• Individual case reports
• Studies with small numbers of subjects
• Studies using people who never exercise

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Evaluating Claims (cont.)

• Credible Studies
• Use trained athletes or suitable population
• Involve 15-20 subjects
• Provide comparison subjects who do not receive
  drug or supplement
• Conduct statistical analysis of data
• Use doses that seem reasonable

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THE BOTTOM LINE

• Are the doses used the same as those used by
  athletes?
• Does use during training prevent natural
  adaptations to training?
• Does use in a competitive setting offer
  particular hazards?
• Are there effects on other bodily functions?

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Safe performance-enhancing supplements

• Are legal
• Improve performance without preventing normal
  training-related adaptations
• Are backed by multiple, high-quality scientific
  studies
• Pose no long-term health risks to the athlete at
  the customary doses