Ergogenic Aids

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Ergogenic aids are substances or devices that enhance energy production, for use for recovery and provide athletes with a competitive advantage. Numerous ergogenic aids claim to enhance sports performance and are used by amateur and professional athletes. Approximately 50 percent of the general population has reported taking some form of dietary supplements, while 76 to 100 percent of athletes in some sports are reported to use them. Physicians can evaluate these products by examining four factors (method of action, available research, adverse effects, and legality) that will help them counsel patients. Common ergogenic aids include anabolic steroids, which increase muscle mass. These illegal supplements are associated with a number of serious adverse effects, some irreversible. Creatine modestly improves athletic performance and appears to be relatively safe. Dehydroepiandrosterone and androstenedione do not improve athletic performance but apparently have similar adverse effects as testosterone and are also banned by some sports organizations. Caffeine has mild benefits and side effects and is banned above certain levels. Products that combine caffeine with other stimulants (ephedrine) have been linked to fatal events. Protein and carbohydrate supplementation provides modest benefits with no major adverse effects. A hot and humid environment can be detrimental to race performance. Caffeine, on the other hand, has been shown to be an ergogenic aid for improving endurance performance. To examine the influence of caffeine ingestion on race performance during high heat stress, seven endurance trained competitive road racers aged between 23 and 51 years (five men, two women) performed three maximal effort 21-km road races outdoors in hot and humid conditions. The caffeine dose, randomly assigned in a double-blind fashion, consisted of either 0, 5, or 9 mg · kg−1 body mass. During each run, the subjects were allowed to drink waterad libitum at each 5-km point. Blood samples were obtained immediately before and after each run and analysed for changes in concentrations of Na+, K+, glucose, lactate, and hematocrit. Pre and postrun data were also collected for body mass and tympanic membrane temperature. Race times were not significantly different among the races or caffeine doses, with the average times within 1.1% of each other. In addition, none of the other variables measured varied significantly among the races or caffeine doses. In summary, caffeine intake did not affect race performance. Therefore it was concluded from our study that caffeine is not of ergogenic benefit in endurance races during high heat stress.

Supplement Costs*

Product| Cost*|
Creatine powder| $ 26|
Creatine mixture†| 60|
DHEA| 14|
Androstenediol| 30|
Androstenedione| 30|
HMB| 100|
Protein powder (50 g daily)| 85|
Antioxidant formulations| 30|
Energizing/diet capsules| 35|
Multivitamins| 5 to 20|

New products with ergogenic claims appear on the market almost daily. Most are classified as supplements, which means the contents of the product and the claims on the label have not been evaluated by the U.S. Food and Drug Administration and may not have any scientific basis. Anabolic Steroids

Anabolic steroids are testosterone derivatives with three mechanisms of action. First, anticatabolic effects reverse the actions of glucocorticoids and help metabolize ingested proteins, converting a negative nitrogen balance into a positive one. Second, anabolic effects directly induce skeletal muscle synthesis. Third, there is a “steroid rush”—a state of euphoria and decreased fatigue that allows the athlete to train harder and longer.5 Research

Many early studies used physiologic doses, or doses only two to three times these amounts, and provided mixed results. More recent reviews,5 controlling for various measurement methods, have concluded that anabolic steroids do indeed cause increased...
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