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CORK Bibliography: Athletes

64 citations. 2007 to present

Prepared: December 2008

Adachi-Mejia AM; Primack BA; Beach ML; Titus-Ernstoff L; Longacre MR; Weiss JE et al. Influence of movie smoking exposure and team sports participation on established smoking. Archives of Pediatrics & Adolescent Medicine 163(7): 638-643, 2009. (35 refs.)

Objective: To examine the joint effects of movie smoking exposure and team sports participation on established smoking. Design: Longitudinal study. Setting: School-and telephone-based surveys in New Hampshire and Vermont between September 1999 through November 1999 and February 2006 through February 2007. Participants: A total of 2048 youths aged 16 to 21 years at follow-up. Main Exposures: Baseline movie smoking exposure categorized in quartiles assessed when respondents were aged 9 to 14 years and team sports participation assessed when respondents were aged 16 to 21 years. Main Outcome Measure: Established smoking (having smoked >= 100 cigarettes in one's lifetime) at follow-up. Results: At follow-up, 353 respondents (17.2%) were established smokers. Exposure to the highest quartile of movie smoking compared with the lowest increased the likelihood of established smoking (odds ratio = 1.63; 95% confidence interval, 1.03-2.57), and team sports nonparticipants compared with participants were twice as likely to be established smokers (odds ratio = 2.01; 95% confidence interval, 1.47-2.74). The joint effects of movie smoking exposure and team sports participation revealed that at each quartile of movie smoking exposure, the odds of established smoking were greater for team sports nonparticipants than for participants. We saw a dose-response relationship of movie smoking exposure for established smoking only among team sports participants. Conclusions: Team sports participation clearly plays a protective role against established smoking, even in the face of exposure to movie smoking. However, movie smoking exposure increases the risk of established smoking among both team sports participants and nonparticipants. Parents, teachers, coaches, and clinicians should be aware that encouraging team sports participation in tandem with minimizing early exposure to movie smoking may offer the greatest likelihood of preventing youth smoking.

Aguilera R; Chapman TE; Pereira H; Oliveira GC; Illanes RP; Fernandes TF et al. Drug testing data from the 2007 Pan American Games: Delta C-13 values of urinary androsterone, etiocholanolone and androstanediols determined by GC/C/IRMS. Journal of Steroid Biochemistry and Molecular Biology 115(3-5): 107-114, 2009. (45 refs.)

The main purpose of this article is to show the application of the CG/C/IRMS in real time during competition in the steroid confirmation analysis. For this reason, this paper summarizes the results obtained from the doping control analysis during the period of the 2007 Pan American Games held in Rio de Janeiro, Brazil. Approximately 5600 athletes from 42 different countries competed in the games. Testing was performed in accordance to World Anti-Doping Agency (WADA) technical note for prohibited substances. This paper reports data where abnormal urinary steroid profiles, have been found with the screening procedures. One 8 mL urine sample was used for the analysis of five steroid metabolites with two separate analyses by gas chromatography/combustion/isotope ratio mass spectrometry (GC/C/IRMS). Urine samples were submitted to GC/C/IRMS for confirmation analysis to determine the C-13/C-12 ratio of selected steroids. Fifty-seven urine samples were analyzed by GC/C/IRMS and the delta C-13 values (parts per thousand) of androsterone, etiocholanclone, 5 beta-androstane-3 alpha, 17 beta-diol (5 beta-diol), 5 alpha-androstane-3 alpha, 1 beta p-diol (5 alpha-diol) and 5 beta-pregnane-3 alpha, 20 alpha-diol (5 beta-pdiol), the endogenous reference compound are presented. One urine sample with a testosterone/epitestosterone (T/E) ratio of 4.7 was confirmed to be positive of doping by GC/C/IRMS analysis. The delta values of 5 beta-diol and 5 alpha-diol were 3.8 and 10.8, respectively, compared to the endogenous reference compound 5 beta-pdiol, which exceeded the WADA limit of 3 parts per thousand. The results obtained by CG/C/IRMS confirmation analyses, in suspicious samples, were conclusive in deciding whether or not a doping steroid violation had occurred.

Agullo-Calatayud V; Gonzalez-Alcaide G; Valderrama-Zurian JC; Aleixandre-Benavent R. Consumption of anabolic steroids in sport, physical activity and as a drug of abuse: An analysis of the scientific literature and areas of research. British Journal of Sports Medicine 42(2): 103-109, 2008. (24 refs.)

Objective: The consumption of anabolic steroids (AS) has been growing continuously in recent years. It has gone beyond the sports world; anabolic steroids are now widely used as drugs of abuse in connection with bodybuilding. This study sets out to assess the state of scientific research in the area. Design: Bibliometrics were employed to evaluate the literature retrieved from the principal relevant bibliographic databases: MEDLINE, SportDiscus, the Science Citation Index Expanded and the Social Sciences Citation Index. The core journals were identified along with the leading authors and research groups and their institutional affiliations. Techniques based on social network analysis were applied in order to build up a concept map of research. Results: 1325 documents were retrieved. They were produced by 3131 different researchers giving a Collaboration Index of 3.32. The institutions with the most productive authors were Ball State University (Muncie, IN, USA), the Ecole Nationale Veterinaire de Nantes (ENVN), the Institut Municipal dInvestigacio Medica (IMIM) (Barcelona, Spain), the Institute of Biochemistry of the German Sport University Cologne (DSHS), Iowa State University, Maastricht University and the University of Iowa. Conclusions: It was concluded that there has been an upward trend in the number of research projects. The sources used complemented one another, as 78.04% of the documents retrieved were unique to one source. The productivity ranking was headed by sports medicine journals, followed by journals of chemistry, physiology, endocrinology and substance abuse. Besides sporting activities, the most important research clusters were those connected with bodybuilding and with youth groups.

Anielski P. Hair analysis of anabolic steroids in connection with doping control - results from horse samples. Journal of Mass Spectrometry 43(7): 1001-1008, 2008. (33 refs.)

Doping control of anabolic substances is normally carried out with urine samples taken from athletes and horses. Investigation of alternative specimens, e.g. hair samples, is restricted to special cases, but can also be worthwhile, in addition to urine analysis. Moreover, hair material is preferred in cases of limited availability or complicated collection of urine samples, e.g. from horses. In this work, possible ways of interpretation of analytical results in hair samples are discussed and illustrated by practical experiences. The results demonstrate the applicability of hair analysis to detect anabolic steroids and also to obtain further information about previous abuse. Moreover, the process of incorporation of steroids into hairs is described and the consequences on interpretation are discussed, e.g. on the retrospective estimation of the application date. The chosen examples deal with the detection of the anabolic agent testosterone propionate. Hair samples of an application study, as well as a control sample taken from a racing horse, were referred to. Hair material was investigated by a screening procedure including testosterone, nandrolone and several esters (testosterone propionate, phenylpropionate, decanoate, undecanoate, cypionate; nandrolone decanoate, dodecanoate and phenylpropionate; limits of detection (LODs) between 0.1 and 5.0 pg/mg). Confirmation of testosterone propionate (LOD 0.1 pg/mg) was carried out by an optimised sample preparation. Trimethylsilyl (TMS) and tert-butyl dimethylsilyl derivatives were detected by gas chromatography-high-resolution mass spectrometry (GC-HRMS) and gas chromatography-tandem mass spectrometry (GC-MS/MS).

Beck TW; Housh TJ; Malek MH; Mielke M; Hendrix R. The acute effects of a caffeine-containing supplement on bench press strength and time to running exhaustion. Journal of Strength and Conditioning Research 22(5): 1654-1658, 2008. (18 refs.)

The purpose of the present study was to examine the acute effects of a caffeine-containing supplement (SUPP) on one-repetition maximum (1-RM) bench press strength and time to running exhaustion (TRE) at a velocity that corresponded to 85% of the peak oxygen uptake ((V) over dotO(2) peak). The study used a double-blinded, placebo-controlled, crossover design. Thirty-one men (mean +/- SD age = 23.0 +/- 2.6 years) were randomly assigned to take either the SUPP or placebo (PLAC) first. The SUPP contained 201 mg of caffeine, and the PLAC was microcrystalline cellulose. All subjects were tested for 1-RM bench press strength and TRE at 45 minutes after taking either the SUPP or PLAC. After 1 week of rest, the subjects returned to the laboratory and ingested the opposite substance (SUPP or PLAC) from what was taken during the previous visit. The 1-RM bench press and TRE tests were then performed in the same manner as before. The results indicated that the SUPP had no effect on 1-RM bench press strength or TRE at 85% (V) over dotO(2) peak. It is possible that the acute effects of caffeine are affected by differences in training status and/or the relative intensity of the exercise task. Future studies should examine these issues, in addition to testing the acute effects of various caffeine doses on performance during maximal strength, power, and aerobic activities. These findings do not, however, support the use of caffeine as an ergogenic aid in untrained to moderately trained individuals.

Beedie CJ; Foad AJ. The placebo effect in sports performance: A brief review. Sports Medicine 39(4): 313-329, 2009. (49 refs.)

The placebo effect, with its central role in clinical trials, is acknowledged as a factor in sports medicine, although until recently little has been known about the likely magnitude and extent of the effect in any specific research setting. Even less is known about the prevalence of the effect in competitive sport. The present paper reviews 12 intervention studies in sports performance. All examine placebo effects associated with the administration of an inert substance believed by subjects to be an ergogenic aid. Placebo effects of varying magnitudes are reported in studies addressing sports from weightlifting to endurance cycling. Findings suggest that psychological variables such as motivation, expectancy and conditioning, and the interaction of these variables with physiological variables, might be significant factors in driving both positive and negative outcomes. Programmatic research involving the triangulation of data, and investigation of contextual and personality factors in the mediation of placebo responses may help to advance knowledge in this area.

Berneman SB. One strike and you're out: Alcohol in the major league baseball clubhouse. Vanderbilt Journal of Entertainment and Technology Law 11(Winter): 399-424, 2009. (187 refs.)

Summary: In the past decade, much has been written about Major League Baseball's (MLB) mistaken policies regarding performance-enhancing substance abuse by players. MLB executives are shortsighted, however, if they believe that steroids are the only substances being abused by players. Along with performance-enhancing drugs, professional baseball has a long-standing history of alcohol abuse. Steroids may provide better headlines-Congress has never held an investigation into alcohol abuse by professional athletes-but professional baseball faces a real danger from the unchecked liability of allowing players to overindulge at the ballpark and drive home shortly thereafter. By serving beer in the clubhouse after games, clubs are subjecting themselves, their players, and the public to undue danger. This Note asks whether an MLB club would be vicariously liable for injuries to third parties resulting from the drunk driving of players who drank club-provided alcohol following a game. To address this question, the Note first will show that baseball and alcohol have a long and often negative history. Subsequently, it discusses the legalframework for third-party liability, describing three formulations of vicarious liability that may create liability for the clubs. Next, this Note argues that MLB clubs could be held liable under both standard theories of third-party liability as well as respondeat superior employer liability. Finally, this Note proposes potential and easy solutions to MLB's problem.

Botre F. New and old challenges of sports drug testing.(editorial). Journal of Mass Spectrometry 43(7): 903-907, 2008. (20 refs.)

This brief note gives a general overview on the activity of the antidoping laboratories accredited by the World Anti-Doping Agency (WADA), outlining the evolution, over the last four decades, of the analytical methods and techniques in the detection of prohibited substances and methods. Special emphasis is given to the future trends of the fight against doping in sports, as seen from the perspective of a laboratory scientist, in the wider context of fair play, health protection, and perception of the activity of the antidoping laboratories by the general public.

Brenner J; Swanik K. High-risk drinking characteristics in collegiate athletes. Journal of American College Health 56(3): 267-272, 2007. (27 refs.)

Objective: The authors aimed to further describe the relationship of alcohol use by college athletes to variables, such as sport participation, time of year, and level of competition. Participants: There were 720 participants from Divisions 1, 11 and III who participated in either a team sport. or an individual sport. Methods: The authors measured characteristics of alcohol use by college athletes at 9 colleges and universities. Results: Participants reported a high rate of consuming 5 or more drinks per occasion in the past 2 weeks. There were greater percentages of team sport athletes reporting this behavior than athletes of individual sports, and there were significant differences according to level of competition. Conclusions: The college athletes in this study reported high-risk alcohol use at percentages much higher than previously reported. The findings and practical application of the results are discussed.

Burke LM; Millet GE; Tarnopolsky MA. Nutrition for distance events. Journal of Sports Sciences 25(Supplement 1): S29-S38, 2007. (76 refs.)

The goal of training is to prepare the distance athlete to perform at his or her best during major competitions. Whatever the event, nutrition plays a major role in the achievement of various factors that will see a runner or walker take the starting line in the best possible form. Everyday eating patterns must supply fuel and nutrients needed to optimize their performance during training sessions and to recover quickly after-wards. Carbohydrate and fluid intake before, during, and after a workout may help to reduce fatigue and enhance performance. Recovery eating should also consider issues for adaptation and the immune system that may involve intakes of protein and some micronutrients. Race preparation strategies should include preparation of adequate fuel stores, including carbohydrate loading for prolonged events such as the marathon or 50-km walk. Fluid and carbohydrate intake during races lasting an hour or more should also be considered. Sports foods and supplements of value to distance athletes include sports drinks and liquid meal supplements to allow nutrition goals to be achieved when normal foods are not practical. While caffeine is an ergogenic aid of possible value to distance athletes, most other supplements are of minimal benefit.

Buzzini SRR. Abuse of growth homone among young athletes. (review). Pediatric Clinics of North America 54(4): 823-843, 2007. (211 refs.)

This article reviews the non-medical use of growth hormone among athletes. It covers the physiology and pharmadynamics of growth hormone, and the relationship to excercise, which is a potent stimulus for GH release and sensitive to mutliple factors including duration, intensity, and type, as well as afected by gender. The short and long-term risks of GH use in athletic training are not well known; the potential side effects are described. (Among children there are adverse effects with medical use, and approximately 10% of adults; these therapeutic doses are much lower than that used by athletes. Prior to the 2004 Olympic games, growth hormone doping was considered undetectable, as a result of its biochemical properties. The amino acid sequence of the recombinant molecule is identical to a major isoform secreted by the pituitary gland. In addition, the intra- and interindividual variability made detection difficult to detect doping. The tests developed to circumvent these problems are described. And too potential ways to circumvent tests are noted.

Castillo EM. Prevalence of use of performance-enhancing substances among United States adolescents. (review). Pediatric Clinics of North America 54(4): 663-675, 2007. (40 refs.)

Adolescents may regard the use of performance-enhancing substances as an easy means to gain self-esteem through improved body appearance and athletic performance. The use of performance-enhancing substances by adolescents is particularly troubling because safety data are largely lacking. This poses a dilemma for the pediatrician who needs correct information, including the potential efficacy and negative health effects of such substances, to identify the patients in need of counseling and to find the best way to help adolescent patients make informed decisions to promote healthy behaviors. This article is intended to assist pediatricians by providing a summary of the current state of knowledge regarding the prevalence of use of performance-enhancing substances by United States adolescents.

Catlin DH; Fitch KD; Ljungqvist A. Medicine and science in the fight against doping in sport. (review). Journal of Internal Medicine 264(2): 99-114, 2008. (48 refs.)

The fight against doping in sports commenced as a result of the death of a Danish cyclist during the Rome Olympic Games in 1960. The International Olympic Committee (IOC) established a Medical Commission (IOC-MC) which had the task of designing a strategy to combat the misuse of drugs in Olympic Sport. Some International Sport Federations (IF) and National Sports Federations followed suit, but progress was modest until the world's best male sprinter was found doped with anabolic steroids at the Olympic Games in Seoul in 1988. Further progress was made following the cessation of the cold war in 1989 and in 1999 public authorities around the world joined the Olympic Movement in a unique partnership by creating WADA - the 'World Anti-Doping Agency'. The troubled history of the anti-doping fight from the 1960s until today is reviewed. In particular, the development of detection methods for an ever increasing number of drugs that can be used to dope is described, as are the measures that have been taken to protect the health of the athletes, including those who may need banned substances for medical reasons.

Chapman RF; Stager JM. Caffeine stimulates ventilation in athletes with exercise-induced hypoxemia. Medicine and Science in Sports and Exercise 40(6): 1080-1086, 2008. (36 refs.)

Introduction/Purpose: Many athletes with exercise-induced hypoxemia (EIH) show an insufficient ventilatory response to exercise and low resting ventilatory responsiveness. The purpose of this project was to determine whether a moderate dosage of caffeine, a common ventilatory stimulant, could augment testing ventilatory responsiveness, exercise ventilation (PE), end-tidal 0, partial pressure (PETO2), and arterial oxyhemoglobin saturation (HbSaO(2)) in athletes with EIH. Methods: Eight highly trained males ((V) over dotO(2max), 69.2 +/- 4.0 mL.[kg.min](-1)) who demonstrated EIH at VO2max (HbSaO(2), 88.0 +/- 1.7%), ingested in a randomized design a placebo or caffeine (CAF, 8 mg.kg(-1) body wt) I h before testing. Ventilatory responsiveness at rest was assessed via the isocapnic hypoxic and hyperoxic hypercapnic ventilatory responses (HVR and HCVR, respectively). Dependent measures of metabolic variables, ventilation, and saturation were determined during progressive treadmill exercise to exhaustion. Results: V-E was higher at 75%, 80%, and 100% of VO2max with CAF (P < 0.05). V-E/VO2, PETO2, and HbSaO(2) were increased at 75%, 80%, and 90% of VO2max With CA-F but were not different at VO2max, despite an increase in VE. No change in VO2max was observed between treatments. HVR and HCVR were not different between the two conditions, indicating that the increased V-E likely came from central stimulation or secondary effects of CAF. Conclusion: The failure of HbSaO(2) to increase at VO2max despite an increase in V-E suggests that mechanisms influencing HbSaO(2) other than an inadequate hyperventilatory response may operate to different degrees across individuals as VO2max is approached.

Chiamulera C; Leone R; Fumagalli G. Smokeless tobacco use in sports: 'legal doping'? (editorial). Addiction 102(12): 1847-1848, 2007. (10 refs.)

Dams-O'Connor K; Martin JL; Martens MP. Social norms and alcohol consumption among intercollegiate athletes: The role of athlete and nonathlete reference groups. Addictive Behaviors 32(11): 2657-2666, 2007. (23 refs.)

The relationship between perceived alcohol use among peers and personal alcohol use was assessed in a sample of collegiate athletes. Data were collected on 109 intercollegiate athletes during the competitive season and 119 athletes during the off-season at a large, state university in the Northeastern United States. Participants were asked to estimate the normative alcohol use of four reference groups (closest athlete friend, closest nonathlete friend, typical athlete, and typical nonathlete). Results of both in-season and off-season analyses indicated that athletes estimated that others consumed more drinks per week than they did, and perceptions of these social norms predicted personal use. Although the typical athlete norm emerged as the strongest predictor of personal alcohol use, the relative strength of the relationships between individual behavior and the athlete and nonathlete norms varied according to seasonal status. Results have implications for the content and timing of prevention and intervention programs aimed at reducing high-risk alcohol use among intercollegiate athletes.

Davis E; Loiacono R; Summers RJ. The rush to adrenaline: Drugs in sport acting on the beta-adrenergic system. (review). British Journal of Pharmacology 154(3): 584-597, 2008. (163 refs.)

Athletes attempt to improve performance with drugs that act on the beta-adrenergic system directly or indirectly. Of three beta-adrenoceptor (AR) subtypes, the beta(2)-AR is the main target in sport; they have bronchodilator and anabolic actions and enhance anti-inflammatory actions of corticosteroids. Although demonstrable in animal experiments and humans, there is little evidence that these properties can significantly improve performance in trained athletes. Their actions may also be compromised by receptor desensitization and by common, naturally occurring receptor mutations (polymorphisms) that can influence receptor signalling and desensitization properties in individuals. Indirectly acting agents affect release and reuptake of noradrenaline and adrenaline, thereby influencing all AR subtypes including the three beta-ARs. These agents can have potent psychostimulant effects that provide an illusion of better performance that does not usually translate into improvement in practice. Amphetamines and cocaine also have considerable potential for cardiac damage. beta-AR antagonists (beta-blockers) are used in sports that require steadiness and accuracy, such as archery and shooting, where their ability to reduce heart rate and muscle tremor may improve performance. They have a deleterious effect in endurance sports because they reduce physical performance and maximum exercise load. Recent studies have identified that many beta-AR antagonists not only block the actions of agonists but also activate other (mitogen-activated PK) signalling pathways influencing cell growth and fate. The concept that many compounds previously regarded as 'blockers' may express their own spectrum of pharmacological properties has potentially far-reaching consequences for the use of drugs both therapeutically and illicitly.

Davis JK; Green JM. Caffeine and anaerobic performance ergogenic value and mechanisms of action. Sports Medicine 39(10): 813-832, 2009. (157 refs.)

The effect caffeine elicits on endurance performance is well founded. However, comparatively less research has been conducted on the ergogenic potential of anaerobic performance. Some studies showing no effect of caffeine on performance used untrained subjects and designs often not conducive to observing an ergogenic effect. Recent studies incorporating trained subjects and paradigms specific to intermittent sports activity support the notion that caffeine is ergogenic to an extent with anaerobic exercise. Caffeine seems highly ergogenic for speed endurance exercise ranging in duration from 60 to 180 seconds. However, other traditional models examining power output (i.e. 30-second Wingate test) have shown minimal effect of caffeine on performance. Conversely, studies employing sport-specific methodologies (i.e. hockey, rugby, soccer) with shorter duration (i.e. 4-6 seconds) show caffeine to be ergogenic during high-intensity intermittent exercise. Recent studies show caffeine affects isometric maximal force and offers introductory evidence for enhanced muscle endurance for lower body musculature. However, isokinetic peak torque, one-repetition maximum and muscular endurance for upper body musculature are less clear. Since relatively few studies exist with resistance training, a definite conclusion cannot be reached on the extent caffeine affects performance. It was previously thought that caffeine mechanisms were associated with adrenaline (epinephrine)-induced enhanced free-fatty acid oxidation and consequent glycogen sparing, which is the leading hypothesis for the ergogenic effect. It would seem unlikely that the proposed theory would result in improved anaerobic performance, since exercise is dominated by oxygen-independent metabolic pathways. Other mechanisms for caffeine have been suggested, such as enhanced calcium mobilization and phosphodiesterase inhibition. However, a normal physiological dose of caffeine in vivo does not indicate this mechanism plays a large role. Additionally, enhanced Na+/K+ pump activity has been proposed to potentially enhance excitation contraction coupling with caffeine. A more favourable hypothesis seems to be that caffeine stimulates the CNS. Caffeine acts antagonistically on adenosine receptors, thereby inhibiting the negative effects adenosine induces on neurotransmission, arousal and pain perception. The hypoalgesic effects of caffeine have resulted in dampened pain perception and blunted perceived exertion during exercise. This could potentially have favourable effects on negating decreased firing rates of motor units and possibly produce a more sustainable and forceful muscle contraction. The exact mechanisms behind caffeine's action remain to be elucidated.

Del Coso J; Estevez E; Mora-Rodriguez R. Caffeine effects on short-term performance during prolonged exercise in the heat. Medicine and Science in Sports and Exercise 40(4): 744-751, 2008. (29 refs.)

Purpose: To determine the effect of water, carbohydrate, and caffeine ingestion on fatigue during prolonged exercise in the heat. Methods: Seven endurance-trained cyclists ((V) overdot O-2max=61 +/- 8 mL.kg(-1).min(-1)) pedaled for 120 min at 63% (V) overdot O-2max in a hot-dry environment (36 degrees C; 29% humidity), ingesting either no fluid (NF), water (WAT) to replace 97% fluid losses, the same volume of a 6% carbohydrate-electrolyte solution (CES), or each of these treatments along with ingestion of 6 mg of caffeine per kilogram of body weight (NF + C-AFF, WAT + C-AFF, and CES + C-AFF). At regular intervals during exercise, maximal cycling power (P-MAX) was measured. Before and after exercise, maximal voluntary contraction (MVC), voluntary activation (VA), and electrically evoked contractile proper-ties of the quadriceps were determined. Results: Without fluid replacement (NF and NF + C-AFF), subjects were dehydrated by 3.8 +/- 0.3%, and rectal temperature reached 39.4 +/- 0.3 degrees C, while it was maintained at 38.7 +/- 0.3 degrees C in trials with rehydration (P < 0.05). Trials with caffeine ingestion increased P-MAX by 3% above trials without caffeine (P < 0.05). MVC reductions after exercise were larger with NF (-11 +/- 5%) than for the rest of the trials (P < 0.05). MVC was reduced in WAT compared with CES + C-AFF (-6 +/- 4 vs 2 +/- 4%; P < 0.05). However, NF + CAFF maintained MVC at the level of the CES trial. VA showed the same treatment response pattern as MVC. There were no differences in electrically evoked contractile properties among trials. Conclusion: During prolonged exercise in the heat, caffeine ingestion (6 mg.kg(-1) body weight) maintains MVC and increases P-MAX despite dehydration and hyperthermia. When combined with water and carbohydrate, caffeine ingestion increases maximal leg force by increasing VA (i.e., reducing central fatigue).

Desbrow B; Leveritt M. Well-trained endurance athletes' knowledge, insight, and experience of caffeine use. International Journal of Sport Nutrition and Exercise Metabolism 17(4): 328-339, 2007. (17 refs.)

This descriptive cross-sectional study assessed the perceptions, knowledge, and experiences of caffeine use by athletes competing at the 2005 lronman Triathlon World Championships. Questionnaires were distributed to 140 athletes (105 men and 35 women, 40.3 +/- 10.7 y old) representing 16 countries during prerace registration. A large proportion (73%) of these endurance athletes believe that caffeine is ergogenic to their endurance performance, and 84% believe it improves their concentration. The most commonly reported positive caffeine experiences related to in-competition use of cola drinks (65%) and caffeinated gels (24%). The athletes' ability to accurately quantify the caffeine content of common food items was limited. The most popular sources of caffeine information were self-experimentation (16%), fellow athletes (15%), magazines (13%), and journal articles (12%). Over half the athletes (53%) could not identify an amount of caffeine required to improve their triathlon performance. Mean (+/- standard deviation) suggested doses were 3.8 (+/- 3) mg/kg body weight. Few side effects associated with taking caffeine during exercise were reported.

Docherty JR. Pharmacology of stimulants prohibited by the World Anti-Doping Agency (WADA). (review). British Journal of Pharmacology 154(3): 606-622, 2008. (184 refs.)

This review examines the pharmacology of stimulants prohibited by the World Anti-Doping Agency (WADA). Stimulants that increase alertness/reduce fatigue or activate the cardiovascular system can include drugs like ephedrine available in many over-the-counter medicines. Others such as amphetamines, cocaine and hallucinogenic drugs, available on prescription or illegally, can modify mood. A total of 62 stimulants ( 61 chemical entities) are listed in the WADA List, prohibited in competition. Athletes may have stimulants in their body for one of three main reasons: inadvertent consumption in a propriety medicine; deliberate consumption for misuse as a recreational drug and deliberate consumption to enhance performance. The majority of stimulants on the list act on the monoaminergic systems: adrenergic ( sympathetic, transmitter noradrenaline), dopaminergic ( transmitter dopamine) and serotonergic ( transmitter serotonin, 5-HT). Sympathomimetic describes agents, which mimic sympathetic responses, and dopaminomimetic and serotoninomimetic can be used to describe actions on the dopamine and serotonin systems. However, many agents act to mimic more than one of these monoamines, so that a collective term of monoaminomimetic may be useful. Monoaminomimietic actions of stimulants can include blockade of re-uptake of neurotransmitter, indirect release of neurotransmitter, direct activation of monoaminergic receptors. Many of the stimulants are amphetamines or amphetamine derivatives, including agents with abuse potential as recreational drugs. A number of agents are metabolized to amphetamine or metamphetamine. In addition to the monoaminomimetic agents, a small number of agents with different modes of action are on the list. A number of commonly used stimulants are not considered as Prohibited Substances.

Doumas DM; Haustveit T. Reducing heavy drinking in intercollegiate athletes: Evaluation of a Web-based personalized feedback program. Sport Psychologist 22(2): 212-228, 2008. (50 refs.)

This study evaluated the efficacy of a Web-based personalized feedback program aimed at reducing drinking in freshman intercollegiate athletes. The program was offered through the Athletic Department freshman seminar at a NCAA Division I university. Seminar sections were randomly assigned to one of two conditions: Web-based personalized feedback (WPF) or Web-based education (WE). Assessment measures were completed at baseline, 6 weeks, and 3 months. Athletes were classified as high-risk or low-risk drinkers based on baseline reports of binge drinking. Results indicated for high-risk athletes, students in the WPF condition reported significantly greater reductions in drinking and changes in beliefs about peer drinking than those in the WE condition. In addition, reductions in drinking were related to reductions in peer drinking estimates for athletes in the WPF group. Findings provide initial support for the efficacy of Web-based personalized feedback for reducing the quantity and frequency of heavy drinking in freshman intercollegiate athletes.

Duff C; Munro G. Preventing alcohol-related problems in community sports clubs: The Good Sports program. Substance Use & Misuse 42(12-13): 1991-2001, 2007. (19 refs.)

Community-based sporting clubs in Australia are often sites of unregulated, problematic and unsafe drinking. The Good Sports program, initiated in Victoria in 2001, offers such clubs a model of incremental change designed to eliminate harmful drinking practices and establish safer norms of alcohol use. The Good Sports model was developed in situ over a period of 5 years and is currently operating in 1600 sporting clubs across Australia. It has strong face validity and is supported by sporting organizations and key stakeholders including public health, law enforcement, road safety, and local government. The article outlines the model, explains early evaluation results, and identifies challenges for the future.

Dufka F; Galloway G; Baggott M; Mendelson J. The effects of inhaled L-methamphetamine on athletic performance while riding a stationary bike: A randomised placebo-controlled trial. British Journal of Sports Medicine 43(11): 832-835, 2009. (15 refs.)

Objective: L-methamphetamine (the non-abused isomer of methamphetamine) is banned in athletic competition because it may improve athletic performance, but there are no studies assessing its effects on performance. In the United States L-methamphetamine is formulated in the non-prescription Vick's Vapor Inhaler (VVI) nasal decongestant. VVIs sold elsewhere (we used ones from the UK) contain similar inactive ingredients (menthol, camphor and Siberian pine oil) but no L-methamphetamine. This study tested the effects of inhaled L-methamphetamine delivered from a widely available nonprescription product on athletic performance. Design: In a 2-session double-blind placebo-controlled study 12 participants (ages 14-17) were dosed with 4 (session 1) and 12 (session 2) inhalations from VVIs with (USA) or without (UK) L-methamphetamine and then performed two 20 minute rides on a stationary bike with rides separated by a 30 minute rest. Outcome measure: The main outcome measure was miles travelled during each 20 minute ride. Secondary outcome measures included postride urine toxicology; heart rate and blood pressure before, 1, 5 and 10 minutes postride; energy, performance, endurance, and ability to breathe; and VVI preference. Data were analysed using Excel statistical macros. Results: After similar to 16 mu g L-methamphetamine distance travelled was 5.26 (SD 0.53) miles vs 5.30 (0.55) with placebo; p=0.81. After similar to 48 mu g L-methamphetamine distance travelled was 5.30 (0.51) vs 5.35 (0.43) with placebo; p=0.85. The similar to 16 mu g dose increased systolic blood pressure from 72.6 (4.3) to 79.6 (6.6) mm Hg (p=0.03) at 5 minutes postride but there were no other differences in outcomes. Conclusions: Modest doses of inhaled L-methamphetamine probably do not improve athletic performance but do minimally raise diastolic blood pressure.

Ellenbogen S; Jacobs D; Derevensky J; Gupta R; Paskus T. Gambling behavior among college student-athletes. Journal of Applied Sport Psychology 20(3): 349-362, 2008. (33 refs.)

Analyzing data from a representative sample of 20,739 U.S. college student-athletes, this study sought to determine whether certain student-athletes were more prone to frequent or problem gambling behavior. Relative to other studies of college students, a lower percentage of National Collegiate Athletic Association (NCAA) student-athletes reported gambling (males 62.4%, females 43%) and having gambling problems (males 4.3%, females 0.4%), but a high prevalence of weekly gambling was reported (males 13.0%, females 3.3%). Male student-athletes in high profile sports (e.g., baseball, football) were more likely to report a gambling-related problem compared to their counterparts in other sports (e.g., track field, volleyball). Sports wagering remains a cause for concern. Only a very small number of student athletes reported major infractions such as attempting to alter the outcome of a game or sharing inside information. Future research should investigate why certain student-athletes are more prone to develop gambling problems.

Elliot DL; Cheong J; Moe EL; Goldberg L. Cross-sectional study of female students reporting anabolic steroid use. Archives of Pediatrics & Adolescent Medicine 161(6): 572-577, 2007. (52 refs.)

Objective: To determine the characteristics of female US high school students reporting anabolic steroid use. Design: Cross-sectional assessment using the 2003 Centers for Disease Control and Prevention national school-based Youth Risk Behavior Survey database. Setting: Nationally representative sample of US high schools. Participants: Female students in grades 9 through 12 (n = 7544). Main Outcome Measures: Participants' self-reported anabolic steroid use was compared with other health-related behaviors and with sports participation. Results: Prior or ongoing anabolic steroid use was reported by 5.3% of female high school students. Those adolescent girls had a marked increase in other health-compromising behaviors, including past 30-day use of alcohol (odds ratio [OR], 8.83; 95% confidence interval [CI], 5.49-14.20]), cigarettes (OR, 5.14; 95% CI, 3.14-8.42), marijuana (OR, 7.91; 95% CI, 5.20-12.04), cocaine (OR, 10.78; 95% CI, 6.18-18.81), and diet pills (OR, 4.86; 95% CI, 2.98-7.93). They were more likely to carry a weapon (OR, 7.54; 95% CI, 4.83-11.76), have had sexual intercourse before age 13 years (OR, 2.90; 95% CI, 1.58-5.33), and have had feelings of sadness or hopelessness almost every day for at least 2 consecutive weeks (OR, 4.13; 95% CI, 2.57-7.22). They were less likely to play school-sponsored team sports (OR, 0.52; 95% CI 034-0.80). Steroid users participating in sports shared the same problem behaviors as steroid users not participating in team athletics. Conclusion: Self-reported anabolic steroid use is not confined to adolescent girls in competitive athletics and is an indicator of adolescent girls with a marked increase in a cluster of other health-harming behaviors.

Foad AJ; Beedie CJ; Coleman DA. Pharmacological and psychological effects of caffeine ingestion in 40-km cycling performance. Medicine and Science in Sports and Exercise 40(1): 158-165, 2008. (27 refs.)

Aim: To explore the psychological and pharmacological effects of caffeine in laboratory cycling performance. Method: Fourteen male competitive cyclists performed 14 40-km time trials (eight experimental interspersed with six baseline). The experimental phase consisted of two trials for each of four experimental conditions: informed caffeine/received caffeine, informed no treatment/received caffeine, informed caffeine/received placebo, and informed no treatment/received no treatment. Conditions were nonrandomized. ANOVA was used to estimate main effects and interactions for mean values of power, heart rate, blood lactate, and maximal oxygen uptake. Probabilistic inferences for mean power were based on a smallest worthwhile change of 1.5%. Results: Relative to baseline, a very likely beneficial main effect of receiving caffeine (3.5%; 95% confidence interval 1.5 to 5.5%), and a possibly beneficial main effect of being informed of caffeine (0.7%; -0.7 to 2.1%) were observed. A substantial interaction between belief and pharmacology indicated that caffeine exerted effect on performance in conditions when subjects were informed that they had not ingested it, whereas belief exerted a greater influence on performance in the absence of caffeine (2.6%; -0.7 to 5.9%). A possibly harmful negative placebo (nocebo) effect was observed when subjects were correctly informed that they had ingested no caffeine (- 1.9%; -4.1 to 0.3%). No clinically significant changes relative to baseline were observed in mean heart rate. Clear and substantial increases in blood lactate were evident after receipt of caffeine. Data for mean oxygen uptake were unclear. Conclusion: Our data support the ergogenic efficacy of caffeine but suggest that both positive and negative expectations impact performance.

Ford JA. Alcohol use among college students: A comparison of athletes and nonathletes. Substance Use & Misuse 42(9): 1367-1377, 2007. (39 refs.)

This study examines alcohol use among college students, focusing on variation in binge drinking based on involvement in athletics. Prior research indicates that college students who participate in athletics are more likely to report binge drinking than are students who are not involved in athletics. However, existing research has not offered an explanation why college athletes are at a greater risk for binge drinking. Using data from the 1999 Harvard School of Public Health College Alcohol Study, a national study examining substance use and other health risk behaviors of college students in the United States, the current research examines social norms as a possible source of the elevated levels of binge drinking among college athletes. Findings indicate that athletes are more likely to report binge drinking, in part, because they view alcohol use as being more normative.

Ford JA. Substance use among college athletes: A comparison based on sport/team affiliation. Journal of American College Health 55(6): 367-373, 2007. (36 refs.)

Objective: Prior research shows that college athletes have higher rates of substance use, especially alcohol, than do college students who are not involved in athletics. To augment the literature, the author sought to determine which sports/teams are at the greatest risk for substance use. Participants: The author used data from the 1999 Harvard School of Public Health College Alcohol Study, a national survey of college and university students in the United States. Methods: A series of chi-square and logistic regression models examined variation in substance use among college athletes on the basis of sport/team affiliation. Results: Findings indicated that male hockey and female soccer athletes were the most likely to report substance use and that male basketball and cross-country/track athletes reported lower levels of substance use. Conclusion: There is variation in substance use on the basis of sport/team affiliation, and future researchers should examine why certain groups of athletes have higher rates of substance use.

Furlanello F; Serdoz LV; Cappato R; De Ambroggi L. Illicit drugs and cardiac arrhythmias in athletes. (review). European Journal of Cardiovascular Prevention & Rehabilitation 14(4): 487-494, 2007. (99 refs.)

The current management of athletes with cardiac arrhythmias has become complicated by the widespread use of illicit drugs, which can be arrhythmogenic. The World Anti-Doping Agency annually updates a list of prohibited substances and methods banned by the International Olympic Committee that includes different classes of substances namely, anabolic androgenic steroids, hormones and related substances, beta 2-agonists, diuretics, stimulants, narcotics, cannabinoids, glucocorticosteroids, alcohol, beta-blockers and others. Almost all illicit drugs may cause, through a direct or indirect arrhythmogenic effect, a wide range of cardiac arrhythmias (focal or reentry type, supraventricular and/or ventricular) that can even be lethal and which are frequently sport activity related. A large use of illicit drugs has been documented in competitive athletes, but the arrhythmogenic effect of specific substances is not precisely known. Precipitation of cardiac arrhythmias, particularly in the presence of a latent electrophysiologic substrate including some inherited cardiomyopathies, at risk of sudden death or due to long-term consumption of the substances, should raise the suspicion that illicit drugs may be a possible cause and lead cardiologists to investigate carefully this relationship and appropriately prevent the clinical consequences.

Gaffney GR. Gene doping: A review of performance-enhancing genetics. (review). Pediatric Clinics of North America 54(4): 807-822, 2007. (37 refs.)

Unethical athletes and their mentors have long arrogated scientific and medical advances to enhance athletic performance, thus gaining a dishonest competitive advantage. Building on advances in genetics, a new threat arises from athletes using gene therapy techniques in the same manner that some abused performance-enhancing drugs were used. Gene doping, as this is known, may produce spectacular physiologic alterations to dramatically enhance athletic abilities or physical appearance. Furthermore, gene doping may present pernicious problems for the regulatory agencies and investigatory laboratories that are entrusted to keep sporting events fair and ethical. Performance-enhanced genetics will likewise present unique challenges to physicians in many spheres of their practice.

Ganio MS; Klau JF; Casa DJ; Armstrong LE; Maresh CM. Effect of caffeine on sport-specific endurance performance: A systematic review. (review). Journal of Strength and Conditioning Research 23(1): 315-324, 2009. (65 refs.)

Endurance athletes often ingest caffeine because of its reported ergogenic properties. Although there are a vast number of studies quantifying caffeine's effects, many research studies measure endurance performance using a time-to-exhaustion test (subjects exercise at a fixed intensity to volitional exhaustion). Time-to-exhaustion as a performance measure is not ideal because of the high degree of measurement variability between and within subjects. Also, we are unaware of any endurance sports in which individuals win by going a longer distance or for a longer amount of time than their competitors. Measuring performance with a time-trial test (set distance or time with best effort) has high reproducibility and is more applicable to sport. Therefore, the purpose of this review was to critically and objectively evaluate studies that have examined the effect of caffeine on time-trial endurance (>5 minutes) performance. A literature search revealed 21 studies with a total of 33 identifiable caffeine treatments that measured endurance performance with a time-trial component. Each study was objectively analyzed with the Physiotherapy Evidence Database (PEDro) scale. The mean PEDro rating was 9.3 out of 10, indicating a high quality of research in this topic area. The mean improvement in performance with caffeine ingestion was 3.2 +/- 4.3%; however, this improvement was highly variable between studies (20.3 to 17.3%). The high degree of variability may be dependent on a number of factors including ingestion timing, ingestion mode/vehicle, and subject habituation. Further research should seek to identify individual factors that mediate the large range of improvements observed with caffeine ingestion. In conclusion, caffeine ingestion can be an effective ergogenic aid for endurance athletes when taken before and/or during exercise in moderate quantities (3-6 mg.kg(-1) body mass). Abstaining from caffeine at least 7 days before use will give the greatest chance of optimizing the ergogenic effect.

Glassman T; Werch CE; Jobli E; Bian H. Alcohol-related fan behavior on college football game day. Journal of American College Health 56(3): 255-260, 2007. (24 refs.)

High-risk drinking on game day represents a unique public health challenge. Objective: The authors examined the drinking behavior of college football fans and assessed the support for related interventions. Participants: The authors randomly selected 762 football fans, including college students, alumni, and other college football fans, to complete an anonymous online game-day survey. Methods: The authors collected data on participants' drinking behaviors and support for specific game-day interventions. Results: Analysis revealed that, overall, fans drank significantly more on game day than they did the last time they partied or socialized. Nondrinkers were the most supportive of game-day interventions, followed by moderate drinkers, whereas heavy drinkers offered the least support. Conclusions: With the exception of limiting tailgating hours on game day, fans support game-day interventions, including alcohol-free alternatives, designating tailgating areas where open containers are permitted, and increasing law enforcement efforts.

Gregory AJM; Fitch RW. Sports medicine: Performance-enhancing drugs. Pediatric Clinics of North America 54(4): 797-806, 2007. (20 refs.)

This article summarizes current scientific information regarding the use of performance-enhancing drugs in young athletes. It begins with a review of the federal laws that pertain to different classes of drugs used to enhance athletic performance. A 1994 law that designated some drugs as health or dietary supplements and thus removed them from FDA oversight. With an increase in research, there have been several revisions, such as the banning of epheda, and the inclusion of anabolic steroid precursors were similarly restricted. While limited, prevalence of anabolic steroids and legal supplements use among young athletes is provided. it is pointed out that along with coaches and parents, physicians are seen as having considerable influence. The role of the phsycian is providing accurate information is noted, and the effects and potential side effects of major types of supplements used are outlined with particular attention to creatine, stimulants, steroids, The importance of screening for supplement use is stressed, along with the need to provide education, not only to the possible negative side effects, but to counter the oft times inaccurate claims of those marketing and provide accurate information. Two prevention programs developed by Oregoan Health and Science University specifically designed for high school athletes are described -- ATLAS and ATHENA.

Grossbard J; Geisner IM; Neighbors C; Kilmer JR; Larimer ME. Are drinking games sports? College athlete participation in drinking games and alcohol-related problems. Journal of Studies on Alcohol and Drugs 68(1): 97-105, 2007. (31 refs.)

Objective: Studies indicate greater heavy episodic drinking and related consequences for college student-athletes compared with nonathletes. Surprisingly, little research has examined college athletes' participation in drinking games, a context associated with excessive alcohol consumption and negative alcohol-related consequences in college students. Method: We examined how drinking game participation contributes to alcohol consumption and alcohol-related consequences among college-level intramural and intercollegiate athletes compared with nonathletes in two independent samples. Study 1 consisted of 1,395 randomly selected students (61% women) at a West Coast college campus, including 335 students who reported intramural athletic participation. Study 2 consisted of 6,055 randomly selected college students (63% women) from three college campuses, including 1,439 intramural athletes and 317 intercollegiate athletes. Results: Results of Study 1 indicated that intramural athletes consumed significantly more drinks per week, had significantly higher typical and peak blood alcohol concentration levels, and reported more negative consequences than nonathletes. Drinking game participation mediated the relationship between intramural athlete status and measures of consumption and consequences. Results of Study 2, including both intramural and intercollegiate athletes, were consistent with those of Study 1, revealing drinking game participation as a mediator of the relationships between athlete status and alcohol consumption and consequences. Conclusions: Drinking games represent contexts for college athletes to engage in heavy episodic drinking, and participation in drinking games mediates the relationship between alcohol consumption and negative consequences in athletes. Interventions targeted at college athletes should consider the impact of drinking game participation.

Grossbard J; Hummer J; LaBrie J; Pederson E; Neighbors C. Is substance use a team sport? Attraction to team, perceived norms, and alcohol and marijuana use among male and female intercollegiate athletes. Journal of Applied Sport Psychology 21(3): 247-261, 2009. (50 refs.)

This research examined the role of attraction to one's team in predicting alcohol and marijuana use among intercollegiate athletes. Attraction to team and alcohol-related information were collected via an online survey and marijuana use-related information was gathered in a live setting. We investigated the influence of attraction to one's team above and beyond the influence of gender and perceived norms, and attraction to team as a moderator of these relationships. Attraction to one's team accounted for significant variance in marijuana use, and alcohol-related consequences after controlling for alcohol consumption. Regression analyses revealed significant interactions between gender, attraction to team, and norms in predicting alcohol and marijuana use. Stronger attraction to one's team may increase alcohol use but decrease marijuana use among male athletes, suggesting the importance of attraction to team when developing interventions for athletes.

Grossbard JR; Geisner IM; Mastroleo NR; Kilmer JR; Turrisi R; Larimer ME. Athletic identity, descriptive norms, and drinking among athletes transitioning to college. Addictive Behaviors 34(4): 352-359, 2009. (54 refs.)

College student-athletes are at risk for heavy alcohol consumption and related consequences. The present study evaluated the influence of college student and college athlete descriptive norms and levels of athletic identity on drinking and related consequences among incoming college students attending two universities (N=1119). Prior to the beginning of their first year of college. students indicating high school athletic participation completed assessments of athletic identity, alcohol consumption, drinking-related consequences, and normative perceptions of alcohol use. Estimations of drinking by college students and student-athletes were significantly greater than self-reported drinking. Athletic identity moderated associations among gender, perceived norms, drinking, and related consequences. Athlete-specific norms had a stronger effect on drinking among those reporting higher levels of athletic identity, and higher levels of athletic identity exclusively protected males from experiencing drinking-related consequences. Implications of the role of athletic identity in the development of social norms interventions targeted at high school athletes transitioning to college are discussed.

Grossbard JR; Lee CM; Neighbors C; Hendershot CS; Larimer ME. Alcohol and risky sex in athletes and nonathletes: What roles do sex motives play? Journal of Studies on Alcohol and Drugs 68(4): 566-574, 2007. (45 refs.)

Objective: Studies indicate greater sexual risk-taking behaviors and alcohol use in student-athletes compared with nonathletes, particularly in college samples. Although research has documented an association between drinking and risky sex, studies have not examined the role of sex motives in predicting risky sex in athletes. The purpose of the current study was to extend previous research on athletes' risk-taking behaviors by examining incoming college student-athletes and nonathletes' alcohol consumption, risky sexual behavior, and sex motives. Method: Participants included 2,123 (58.9% female) incoming college students attending a northwest university, 221 of whom reported intercollegiate athletic participation during their upcoming year. Hierarchical multiple regression analyses were conducted to examine associations between sex motives and risky sexual behaviors using a cross-sectional design. Results: Results indicated greater weekly alcohol consumption, frequency of drinking before or during sex, and number of sexual partners in athletes compared with nonathletes. Athletes also reported greater levels of enhancement motives for sex and lower levels of intimacy motives than nonathletes, although no differences were found for coping motives. Significant interactions indicated that, for athletes, greater levels of enhancement sex motives predicted a greater number of sexual partners and more frequent drinking before or during sex, and greater levels of intimacy motives predicted less frequent drinking before or during sex. Conclusions: Student-athletes are at risk for problematic outcomes associated with risky sex, including drinking before or during sex and having sex with multiple partners. Prevention efforts targeted at incoming college student-athletes should consider the role of sex motives.

Haller CA; Duan MJ; Jacob P; Benowitz N. Human pharmacology of a performance-enhancing dietary supplement under resting and exercise conditions. British Journal of Clinical Pharmacology 65(6): 833-840, 2008. (29 refs.)

AIMS: Dietary supplements (DS) promoted to enhance athletic performance often contain herbal sympathomimetics such as Citrus aurantium (synephrine) and caffeine. We aimed to characterize the pharmacology of a performance-enhancing DS in the setting of exercise. METHODS: Ten healthy adults (three women) aged 20-31 years participated in a three-arm, double-blind, placebo-controlled, crossover study. Subjects ingested one dose of DS (Ripped Fuel Extreme Cut((R)) with 21 mg synephrine and 304 mg caffeine by analysis) under resting conditions and 1 h prior to moderately intense exercise (30 min on cycle ergometer at 75-80% HRmax), with a placebo (PLC)/exercise control. Plasma synephrine and caffeine concentrations were measured over 12 h, and vital signs, serum electrolytes, oxygen consumption and perceived exercise exertion were monitored. RESULTS: No significant adverse events occurred. Synephrine and caffeine pharmacokinetics were unaffected by exercise. Post-exercise diastolic blood pressure was higher after DS (peak mean 71.7 +/- 8.7 mmHg) than PLC (63.0 +/- 4.9 mmHg) (p = 0.007). There were no substantial treatment-related differences in post-exercise HR, systolic blood pressure, or temperature. Postprandial plasma glucose increased to 121.0 +/- 31.6 mg dl(-1) with DS and exercise vs. 103.7 +/- 25.5 mg dl-1 with PLC and exercise (P = 0.004). No treatment differences in exercise-related oxygen consumption, serum lactate, or insulin were observed. Exercise was rated less difficult with DS than PLC (P = 0.001). CONCLUSIONS: Blood pressure and plasma glucose increased post-exercise with DS use, which could be detrimental in some people. Exercise was perceived as less strenuous after DS, presumably due to the stimulant effects of caffeine.

Hatton CK. Beyond sports-doping headlines: The science of laboratory tests for performance-enhancing drugs. (review). Pediatric Clinics of North America 54(4): 713-733, 2007. (27 refs.)

This primer on urine analysis in sports-doping control is an overview with an emphasis on the main analytical chemistry technologies in use: gas chromatography-mass spectrometry (GC-MS), liquid chromatography-tandem mass spectrometry (LC-MS-MS), isotope ratio mass spectrometry detection of exogenous testosterone use, and isoelectric focusing detection of recombinant erythropoietin (EPO) use. Included are graphic examples of GC-MS selected ion monitoring and full scan, LC-MS-MS, and EPO test electropherogram data; a list of common acronyms; and answers to questions frequently asked about tampering and test accuracy.

Hilderbrand RL. The world anti-doping program and the primary care physician. (review). Pediatric Clinics of North America 54(4): 701-711, 2007. (15 refs.)

The presence of a prohibited substance in an athlete's urine (or blood, when applicable) or the use of a prohibited method constitutes a doping offense, even if the substance is a pharmaceutical and is properly prescribed. To avoid a doping offense for the therapeutic use of a prohibited substance or method the International Standard for Therapeutic Use Exemptions (TUE) must be followed. When the TUE is required, the appropriate process must be completed before testing under conditions where the substance or method is prohibited. This article describes the World Anti-Doping Code and the International Standards, which are part of the Code. In addition, the procedures for the proper preparation and submission of TUE requests are presented along with the manner in which the requests are considered by the Therapeutic Use Exemption Committees.

Hoffman JR; Ratamess NA; Ross R; Shanklin M; Kang J; Faigenbaum AD. Effect of a pre-exercise energy supplement on the acute hormonal response to resistance exercise. Journal of Strength and Conditioning Research 22(3): 874-882, 2008. (35 refs.)

The effect of a pre-exercise energy sport drink on the acute hormonal response to resistance exercise was examined in eight experienced resistance trained men. Subjects were randomly provided either a placebo ( P: maltodextrin) or the supplement ( S: combination of branched chain amino acids, creatine, taurine, caffeine, and glucuronolactone). Subjects performed 6 sets of no more than 10 repetitions of the squat exercise at 75% of their 1 repetition maximum (1RM) with 2 minutes of rest between sets. Blood draws occurred at baseline pre-exercise, immediately post- (IP), 15 minutes post- (15P), and 30-minutes post (30P) exercise for measurement of serum growth hormone, total and free testosterone, cortisol, and insulin concentrations. Although significant differences were seen only at set 5, the total number of repetitions and training volume tended ( p = 0.08) to be higher with S compared to P. Serum growth hormone and insulin concentrations were significantly higher at 15P and IP, respectively, in S compared to P. Results suggest that a pre-exercise energy S consumed 10 minutes before resistance exercise can enhance acute exercise performance by increasing the number of repetitions performed and the total volume of exercise. The enhanced exercise performance resulted in a significantly greater increase in both growth hormone and insulin concentrations, indicating an augmented anabolic hormone response to this pre-exercise S.

Holland-Hall C. Performance-enhancing substances: Is your adolescent patient using? Pediatric Clinics of North America 54(4): 651-662, 2007

Small, but significant, numbers of adolescents use anabolic-androgenic steroids to improve their appearance or sports performance. Many more use creatine and other performance-enhancing substances with the hope of achieving these goals. This article assists primary care physicians in the office assessment of adolescents who may be using these substances, focusing on identifying adolescents at risk, asking the right questions, and helping adolescents feel comfortable discussing this sensitive topic. Providers must present themselves as credible sources of information on the topic to communicate effectively with adolescent athletes.

Huang JH; Jacobs DF; Derevensky JL; Gupta R; Paskus TS. Gambling and health risk behaviors among US college student-athletes: Findings from a national study. Journal of Adolescent Health 40(5): 390-397, 2007. (26 refs.)

Purpose: To examine prevalence and associations of gambling problems and health risk behaviors among college athletes from the first national survey of gambling among U.S. college student-athletes. Methods: Conducted by the National Collegiate Athletic Association (NCAA), this self-administered and anonymous survey collected information from a nationally representative sample of 20,739 student-athletes. Results: Males consistently had higher past-year prevalence of gambling than females (e.g., 62.4% of males reported some type of gambling vs. 42.8% of females). Based on DSM-IV Gambling Screen, this study identified 4.3% of males and 0.4% of females as problem/pathological gamblers. A general upward trend existed that as the level of gambling problems increased, so did the prevalence of substance use, gorging/vomiting, and unprotected sex. Cross-group comparisons by gambler type were all significant. Problem and pathological gamblers also experienced significantly more drug/alcohol-related problems than non-gamblers and social gamblers. Conclusions: Direct associations found between gambling and multiple risk behaviors in college student-athletes support the persistence of the youth problem-behavior syndrome and suggest the need for multi-faceted initiatives to tackle these risk behaviors simultaneously.

Hudson GM; Green JM; Bishop PA; Richardson MT. Effects of caffeine and aspirin on light resistance training performance, perceived exertion, and pain perception. Journal of Strength and Conditioning Research 22(6): 1950-1957, 2008. (35 refs.)

This study compared independent effects of caffeine and aspirin on muscular endurance (repetitions), heart rate (HR), perceived exertion (RPE), and perceived pain index (PPI) during light resistance training bouts performed to volitional failure. It was hypothesized that the hypoalgesic properties of these ergogenic aids would decrease pain perception and potentially result in enhanced performance. College-aged men (n = 15) participated in a within-subjects, double-blind study with three independent, counterbalanced sessions wherein aspirin (10 mg.kg(-1)), caffeine (6 mg.kg(-1)), or matched placebo were ingested 1 hour before exercise, and RPE, HR, PPI, and repetitions (per set and total per exercise) were recorded at 100% of individual, predetermined, 12-repetition maximum for leg extensions (LE) and seated arm curls (AC). Repeated-measures analyses of variance were used for betweentrial comparisons. Caffeine resulted in significantly greater (p < 0.05) HR (LE and AC), total repetitions (LE), and repetitions in set 1 (LE and AC) compared with aspirin and placebo. Aspirin resulted in significantly higher PPI in set 1 (LE). In LE, 47% of participants' performance exceeded the predetermined effect size (> 5 repetitions) for total repetitions, with 53% exceeding the effect size (>= 2 repetitions) for repetitions in set 1 with caffeine (vs. placebo). In AC, 53% (total repetitions) and 47% (set 1 repetitions) of participants exceeded effect sizes with caffeine (vs. placebo), with only 13% experiencing decrements in performance (total repetitions). Aspirin also produced a higher PPI and RPE overall and in set 1 (vs. placebo). This study demonstrates that caffeine significantly enhanced resistance training performance in LE and AC, whereas aspirin did not. Athletes may improve their resistance training performance by acute ingestion of caffeine. As with most ergogenic aids, our analyses indicate that individual responses vary greatly.

Hummer JF; LaBrie JW; Lac A. The prognostic power of normative influences among NCAA student-athletes. Addictive Behaviors 34(6-7): 573-580, 2009. (47 refs.)

This study evaluated the predictive power of perceived descriptive and injunctive norms on intercollegiate student-athlete alcohol consumption and attitudes toward drinking-related behaviors. The sample consisted of 594 NCAA student-athletes from two geographically opposite sites. Norms variables utilized a school and gender-specific athletic peer reference group. Results indicate that respondents reported greater perceived injunctive norms than actual attitudes, and greater perceived descriptive norms than actual alcohol use. Further, after accounting for demographics and alcohol motivations, perceived injunctive norms were the strongest predictors of athletes' attitudes with the final model explaining 54% of the variance. Similarly. perceived descriptive norms were among the strongest predictors of alcohol use with the final model explaining 69% of the variance. Future research may want to use both of these perceived norms constructs to create a more salient and targeted social norms intervention aimed at reducing risky behavior and permissive alcohol-related attitudes among this population. Utilizing this strong peer reference group as well as targeting both injunctive and descriptive norms may increase the power and saturation of prevention and intervention strategies.

Jenkinson DM; Harbert AJ. Supplements and sports. American Family Physician 78(9): 1039-1046, 2008. (62 refs.)

Use of performance-enhancing supplements occurs at all levels of sports, from professional athletes to junior high school students. Although some supplements do enhance athletic performance, many have no proven benefits and have serious adverse effects. Anabolic steroids and ephedrine have life-threatening adverse effects and are prohibited by the International Olympic Committee and the National Collegiate Athletic Association for use in competition. Blood transfusions, androstenedione, and dehydroepiandrosterone are also prohibited in competition. Caffeine, creatine, and sodium bicarbonate have been shown to enhance performance in certain contexts and have few adverse effects. No performance benefit has been shown with amino acids, beta-hydroxy-beta-methylbutyrate, chromium, human growth hormone, and iron. Carbohydrate-electrolyte beverages have no serious adverse effects and can aid performance when used for fluid replacement. Given the widespread use of performance-enhancing supplements, physicians should be prepared to counsel athletes of all ages about their effectiveness, safety, and legality.

Kahn JP. Baseball, alcohol and public health. American Journal of Bioethics 7(7): 3+, 2007. (2 refs.)

There is a long history of drinking in baseball. According to Roger Abrams in his forthcoming book, "The Dark Side of the Diamond," alcohol and baseball go back to the 19th century. The author points out that this continues, noting the common practice of serving alcohol in the club house after games. Other links inlcude the naming of stadiums after brewers, or the serving of beer in stadiums, and the beer commercials. The question is raised about the impact this has on the general public.

LaBrie JW; Grossbard JR; Hummer JF. Normative misperceptions and marijuana use among male and female college athletes. Journal of Applied Sport Psychology 21(Supplement, 1): s77-s85, 2009. (32 refs.)

This research assessed the frequency of marijuana use and perceptions of gender-specific marijuana use among intercollegiate athletes from two National Collegiate Athletic Association (NCAA) Division 1 universities. Normative data were gathered in a live setting. Male athletes reported significantly greater marijuana use than female athletes and the overall sample reported higher prevalence of use than national averages for college athletes and non-athletes. Gender-specific perceptions among male and female athletes exceeded actual self-reported use, and perceived marijuana use among male athletes was strongly associated with personal use. The findings demonstrate the salience of group-specific marijuana norms and present implications for normative feedback interventions among college athletes.

Labrie JW; Hummer JF; Huchting KK; Neighbors C. A brief live interactive normative group intervention using wireless keypads to reduce drinking and alcohol consequences in college student athletes. Drug and Alcohol Review 28(1): 40-47, 2009. (36 refs.)

Introduction and Aims. Misperceptions of how members of one's social group think and act influence behaviour. The current study was designed to extend the research of group-specific normative feedback interventions among salient campus groups with heightened risk. Although not a randomised controlled trial, this research used normative feedback that was obtained using wireless keypad technology during a live session, within sex-specific student athlete groups to extend the proof of concept of using this brief interactive intervention. Design and Methods. Participants included 660 intercollegiate athletes from all varsity athletic teams at two private, mid-size universities. Intervention data were gathered in vivo using computerised handheld keypads into which group members entered in personal responses to a series of alcohol-related questions. These questions assessed perceptions of normative group behaviour and attitudes as well as actual individual behaviour and attitudes. These data were then immediately presented back in graphical form to illustrate discrepancies between perceived and actual group norms. Results. Results revealed that at 1 month post-intervention, perceived group norms, behaviour, attitudes and consequences reduced compared with baseline. These reductions were maintained at 2 month follow up. Latent growth modelling suggested that the reductions in perceived norms and attitudes were associated with reductions in individual drinking behaviour and negative consequences. Discussion and Conclusions. These results are among the first to suggest the effectiveness of a novel, group-based normative alcohol intervention among student athletes. Limitations of the design preclude strong inferences about efficacy; however, the findings support further trialling of such information technology in alcohol treatment research.

Lattavo A. Creatine and other supplements. (review). Pediatric Clinics of North America 54(4): 735-760, 2007. (112 refs.)

Ergogenic dietary supplement use is highly prevalent among adolescent and collegiate athletes, and use is increasing. To make appropriate recommendations for or against use by individual athletes, physicians who work with adolescent athletes should be knowledgeable about the most commonly used supplements and be able to access high-quality information about others. This article first discusses the legal and regulatory environment of dietary supplements. Several of the most commonly used supplements are then discussed in detail, including creatine, beta-hydroxy-beta-methylbutyrate, protein, amino acids, stimulants, alkalotic agents, glycerol, vitamins, and minerals. Finally, the "Gateway Theory" as it may relate to adolescent supplement and other drug use is discussed.

Leaver-Dunn D; Turner L; Newman BM. Influence of sports' programs and club activities on alcohol use intentions and behaviors among adolescent males. Journal of Alcohol and Drug Education 51(3): 57-72, 2007. (39 refs.)

In the United States, more than 70 percent of all deaths among youth and young adults each year are related to four causes: motor vehicle crashes, other unintentional injuries, homicide, and suicide. Alcohol misuse and abuse contribute to each of these behaviors. Alcohol is the most frequently consumed mind-altering substance among adolescents. In addition to its independent negative health effects and contributions to unintentional injury, alcohol abuse is identified as a correlate of chronic disease. There is a need to understand factors that may influence adolescents' decisions to engage in, or adopt, risky behaviors and to assess differences in these influencing factors. The purpose of this study was to assess the influence of organized activity participation on adolescent males' use of alcohol and intentions to use alcohol. This study revealed protective effects of involvement in recreational activities on alcohol abuse and intentions but no effect of engagement in sports activities. Studies that can successfully address these relationships can enhance the development of multi-dimensional interventions for reducing and preventing risk behaviors in youth.

Lecoultre V; Schutz Y. Effect of a small dose of alcohol on the endurance performance of trained cyclists. Alcohol and Alcoholism 44(3): 278-283, 2009. (36 refs.)

Aim: The aim of this study was to investigate the effect of an acute small ethanol (EtOH) dose (0.5 ml EtOH/kg fat-free mass, combined with carbohydrate) in a drink on endurance performance of trained cyclists. Methods: Thirteen well-trained male cyclists took part in this study. A 60-min cycling endurance performance test (time trial) was performed in a calorimetric chamber after drinking an EtOH (30 +/- 1.8 ml) or a non-EtOH control (C) drink. Results: Overall, EtOH induced a significant decrease in the average cycling power output (PO) (EtOH: 233 +/- 23 W versus C: 243 +/- 24 W, P < 0.01). The time course of mechanical PO showed an early decrease during the EtOH trial as compared to C (P < 0.01). Due to the lower PO, oxygen consumption, carbon dioxide production and glucose oxidation were significantly lower (P < 0.05) as compared to C. Relative to PO, heart rate response and ratings of perceived exertion (RPE) were increased by EtOH as compared to C (P < 0.05). In contrast, EtOH did not influence gross work efficiency, glycaemia and blood lactate concentration. Conclusions: These results show that the acute low dose of EtOH decreased endurance performance. An increase of cardio-vascular strain and psychobiological mechanisms may explain this decrease of endurance performance.

Lenk KM; Toomey TL; Erickson DJ. Alcohol-related problems and enforcement at professional sports stadiums. Drugs: Education, Prevention and Policy 16(5): 451-462, 2009. (8 refs.)

Aims: To assess types and levels of alcohol enforcement and alcohol-related problems at professional sports stadiums. Methods: We conducted a telephone survey in 2005-2006 of state alcohol beverage control and local police agencies in each of the cities and states in the USA that have a professional sports stadium (n = 98). Questions pertained to enforcement actions conducted at stadiums and complaints received about incidents at stadiums that are likely or certainly alcohol-related (e.g. fights, intoxicated patrons, property damage). Findings: We found that underage alcohol compliance checks were the most common type of enforcement but just over 50% of agencies conducted these. The most common types of complaints received by local law enforcement agencies were fights occurring either inside or outside the stadium, with 74-80% of agencies receiving these types of complaints. Among state agencies, 65% received complaints about intoxicated patrons. Conclusions: Given the high profile of alcohol-related violent incidents at professional sports stadiums in recent years along with recent scientific evidence that enforcement of alcohol-related policies is both needed and effective, our results showing high rates of alcohol-related problems and fairly low levels of enforcement at stadiums are particularly timely and point to need for further interventions and research.

Lippi G; Franchini M; Guidi GC. Doping in competition or doping in sport? British Medical Bulletin 86(1): 95-107, 2008. (29 refs.)

Introduction: Since ancient times, competitive athletes have been familiar with the use of ergogenic aids and they will probably continue to use unfair and harmful substances in future, because their inclination to victory, along with the mirage of glory and money, will probably overcome health and legal risks. Sources of data: We searched PubMed using the term doping over the period 1990 to the present day. We also included non-English journals. Areas of agreement: By literature searching, it emerges that the phenomenon of doping is complex and multifaceted. It involves a number of causes and factors that do not originate solely in the athletic field, making universality its main feature. It is in fact observed in all ages and levels of competition, and it concerns all sports, even the most unpredictable. Areas of controversy: The high number of athletes testing positive for anti-doping controls attests that the current strategy might be analytically adequate to unmask most (but not all) doping practices, but it is probably ineffective to prevent athletes to dope and modify this upsetting trend. Growing points: As doping parallels the use of medications, food supplements, alcohol and social drugs, a reinforced preventive policy is advisable. Emerging areas for developing research: The current anti-doping policy should be replaced with a more efficient and practical strategy to identify and monitor abnormal and harmful deviations of the biochemical and haematological profiles.

Machado M; Breder AC; Ximenes MC; Simoes JR; Vigo JFF. Caffeine supplementation and muscle damage in soccer players. Brazilian Journal of Pharmaceutical Sciences 46(2): 257-261, 2009. (12 refs.)

The aim of this work was to evaluate the effect of caffeine supplementation and intermittent exercise on the muscle injury markers in soccer players. 15 male professional soccer players completed a placebo controlled double blind test protocol. 45 minutes before exercise, participants ingested 5.5 mg.kg(-1) body mass of caffeine (EXP, n=8) or placebo (CONT, n=7). The exercise was 12 sets of 10 sprints (20 m each) with 10 see recovery time between sprints and 2 min between sets. Blood samples were collected before (PRE) and 48h after exercise (POST). Serum activity of CK, LDH, AST, and ALT were quantified. Serum enzyme activity was enhanced by exercise in both groups, Without a synergistic effect of caffeine. The findings suggest muscle injury markers concentration increases after physical activities, but caffeine supplementation (as used in this study) has no influence upon muscle cellular integrity.

Martens MP; Labrie JW; Hummer JF; Pedersen ER. Understanding sport-related drinking motives in college athletes: Psychometric analyses of the Athlete Drinking Scale. Addictive Behaviors 33(7): 974-977, 2008. (7 refs.)

Researchers have identified college student-athletes as a high-risk group for heavy alcohol consumption (e.g., Nelson, T. F., & Wechsler, H. (2001). Alcohol and college athletes. Medicine and Science in Sports and Exercise, 33, 43-47). Recently, Martens and colleagues (Martens, M. P., Watson, J. CN., Royland, E. M., & Beck, N. C. (2005). Development of the Athlete Drinking Scale. Psychology of Addictive Behaviors, 19, 158-164) developed a measure of sport-related motivations for drinking: the Athlete Drinking Scale (ADS). Initial research on the reliability and validity of the measure was promising, and the purpose of this study was to conduct additional psychometric analyses on the scale. Data were analyzed from 483 NCAA Division I athletes who volunteered to participate in the study. Results of a confirmatory factor analysis provided satisfactory support for the hypothesized factor structure of the ADS. Correlation and regression analyses indicated that scores on the ADS were associated with relevant alcohol-related outcome variables, even after controlling for the effects of demographic factors and general drinking motives. Thus, the ADS may be a useful tool for both clinicians and researchers working in alcohol prevention among collegiate athletes.

Martha C; Grelot L; Peretti-Watel P. Participants' sports characteristics related to heavy episodic drinking among French students. International Journal of Drug Policy 20(2): 152-160, 2009. (32 refs.)

Background: The relationships between involvement in sports and alcohol consumption appear to be complex in the alcohol literature. In this study we aimed to examine this link among French students, taking into account their sports characteristics. We also examined variations in alcohol use among sport sciences students between 2002 and 2006, and the difference in alcohol use and heavy episodic drinking among sport sciences, law and pharmacy students. Method: Design: repeated survey; cross-sectional study; Setting: self-questionnaire survey; Participants: French (south-east France) sport sciences (n = 693), law (n = 325) and pharmacy (n = 338) students (females = 58%). Results: In 2002, 38% of the mate sport sciences students reported repeated heavy episodic drinking, and this proportion has risen to 48% in 2006 (p < 0.05). When compared to law and pharmacy students, female and male sport sciences students were less likely to report repeated heavy episodic drinking (p < 0.05). Engaging in physical activity (whether or not it takes place within an institution) and practising martial art were negatively related to heavy episodic drinking (p < 0.05). Other factors related to heavy episodic drinking were gender-specific: among males, practising sport in a formal context, team sports, and competitive participation at a departmental or regional level represented risk factors (p < 0.05), while practising an individual sport was a protective factor among females (p < 0.05). Conclusion: This study corroborated the importance to take into account the context of practice and the type of sport practised to examine the link between sport participation and alcohol consumption. The normative context of peer socialization among competitive and team sports participants seemed to play a role in alcohol use. Further studies are needed to confirm the role of this putative factor.

Maughan RJ; Depiesse F; Geyer H. The use of dietary supplements by athletes. Journal of Sports Sciences 25(Supplement 1): S103-S113, 2007. (61 refs.)

Many athletes use dietary supplements as part of their regular training or competition routine, including about 85% of elite track and field athletes. Supplements commonly used include vitamins, minerals, protein, creatine, and various "ergogenic" compounds. These supplements are often used without a full understanding or evaluation of the potential benefits and risks associated with their use, and without consultation with a sports nutrition professional. A few supplements may be helpful to athletes in specific circumstances, especially where food intake or food choice is restricted. Vitamin and mineral supplements should be used only when a food-based solution is not available. Sports drinks, energy bars, and protein-carbohydrate shakes may all be useful and convenient at specific times. There are well-documented roles for creatine, caffeine, and alkalinizing agents in enhancing performance in high-intensity exercise, although much of the evidence does not relate to specific athletic events. There are potential costs associated with all dietary supplements, including the risk of a positive doping result as a consequence of the presence of prohibited substances that are not declared on the label.

McCabe SE; Brower KJ; West BT; Nelson TF; Wechsler H. Trends in non-medical use of anabolic steroids by US college students: Results from four national surveys. Drug and Alcohol Dependence 90(2/3): 243-251, 2007. (77 refs.)

This study assessed the prevalence, trends, and student- and college-level characteristics associated with the non-medical use of anabolic steroids (NMAS) among U.S. college students. Data were collected through self-administered mail surveys, from 15,282, 14,428, 13,953, and 10,904 randomly selected college students at the same 119 nationally representative colleges in 1993, 1997, 1999 and 200 1, respectively. The prevalence of lifetime, past-year and past-month NMAS was 1% or less and generally did not change significantly between 1993 and 200 1, with one exception: past-year WAS increased significantly among men from 1993 (0.36%) to 2001 (0.90%). Multiple logistic regression analyses revealed that lifetime and past-year NMAS were associated with student-level characteristics such as being male and participation in intercollegiate athletics. Lifetime and past-year NMAS were also positively associated with several risky behaviors, including cigarette smoking, illicit drug use, drinking and driving, and DSM-IV alcohol use disorders. Nearly 7 out of every 10 lifetime non-medical users of anabolic steroids met past-year criteria for a DSM-IV alcohol use disorder. Although the overall prevalence of NMAS remained low between 1993 and 2001, findings suggest that continued monitoring is necessary because male student-athletes are at heightened risk for NMAS and this behavior is associated with a wide range of risky health behaviors. The characteristics associated with NMAS have important implications for future practice and research.

McGrath JC; Cowan DA. Drugs in sport. (editorial). British Journal of Pharmacology 154(3): 493-495, 2008. (12 refs.)

This themed issue of the British Journal of Pharmacology has been compiled and edited by Ian McGrath, Regius Professor of Physiology at University of Glasgow and David Cowan, Director of the Drug Control Centre at King's College London. It contains 11 articles covering the mechanisms of action of the major groups of drugs used illicitly in sport. The articles, written by experts in how drugs work, set out where drugs can or cannot affect sporting performance, how this relates to their legitimate medicinal use, their other detrimental effects and how they can be detected. Publication coincides with Olympic year, when sport is highlighted in the public mind and much speculation is made concerning the use of drugs. The articles provide a framework of expert, accurate knowledge to inform and facilitate these debates and to help to overcome the ill-informed and dangerous anecdotal information by which sports men and women are persuaded to misuse drugs in the mistaken belief that this will improve their performance without present or future ill effects. A unique article is included by the Spedding brothers, Mike with a long career in drug discovery and Charlie, the 1984 Los Angeles Olympic Marathon Bronze Medallist and still the English National Marathon record holder. From their unique experience, they describe the insidious and unfair way that drug-assisted performance undermines the ethos of sport and endangers the vital place of sport in maintaining the health of the population.

Miller KE. Wired: Energy drinks, jock identity, masculine norms, and risk taking. Journal of American College Health 56(5): 481-489, 2008. (39 refs.)

Objective: The author examined gendered links among, sport-related identity, endorsement of conventional masculine norms, risk taking, and energy-drink consumption. Participants: The author surveyed 795 undergraduate students enrolled in introductory-level courses at a public university. Methods: The author conducted linear regression analyses of energy-drink consumption frequencies on sociodemographic characteristics, jock identity masculine norms, and risk-taking behavior. Results: Of participants. 39% consumed an energy drink in the past month, with more frequent use by men (2.49 d/month) than by women (1.22 d/month). Strength of jock identity was positively associated with frequency of energy-drink consumption; this relationship was mediated by both masculine norms and risk-taking behavior Conclusions: Sport-related identity, masculinity, and risk taking are components of the emerging portrait of a toxic jock identity, which may signal an elevated risk for health-compromising behaviors. College undergraduatess frequent consumption of Red Bull and comparable energy drinks should be recognized its a potential predictor of toxic jock identity.

Moore RF. The interaction between the Americans with Disabilities Act and drug and alcohol addiction in sports. Sports Lawyers Journal 16(Spring): 231-254, 2009. (193 refs.)

Summary: ... Unlike Thurman's case, Cox's was more like the Rickey Higgins' case than it was the Roy Tarpley case because both Higgins and Cox were not disputing the fact that they recently used the substance that they were suspended for using. ... Case law further establishes that a physical impairment alone is not sufficient to establish discrimination; the impairment must substantially limit one or more of a person's major life activities. ... NFL Policy The National Football League (NFL) policy and program for substances of abuse states that the use of illegal drugs and the abuse of prescription drugs, over-the-counter drugs, and alcohol are prohibited for players in the NFL. ... The only argument against these policies appears to be that after a long-term suspension in most leagues, the commissioner is the sole decision maker responsible for deciding whether or not to reinstate a player. ... Professional sports leagues may need to consider adding a provision that specifically allows for arbitration on the issue of reinstatement for athletes with addiction-related issues. ... Based on these facts, Tarpley claims that he has been discriminated against on the basis of his disability as a recovering drug and alcohol abuser.

Mosley PE. Bigorexia: Bodybuilding and muscle dysmorphia. European Eating Disorders Review 17(3): 191-198, 2009. (21 refs.)

Muscle dysmorphia is an emerging condition that primarily affects male bodybuilders. Such individuals obsess about being inadequately muscular. Compulsions include spending hours in the gym, squandering excessive amounts of money on ineffectual sports supplements, abnormal eating patterns or even substance abuse. In this essay, I illustrate the features of muscle dysmorphia by employing the first-person account of a male bodybuilder afflicted by this condition. I briefly outline the history of bodybuilding and examine whether the growth of this sport is linked to a growing concern with body image amongst males. I suggest that muscle dysmorphia may be a new expression of a common pathology shared with the eating disorders.

Mottram D; Chester N; Atkinson G; Goode D. Athletes' knowledge and views on OTC medication. International Journal of Sports Medicine 29(10): 851-855, 2008. (13 refs.)

A questionnaire was administered to elite athletes from Australia, Canada, the UK, and the USA representing 10 Olympic sports in order to explore knowledge and understanding of over-the-counter (OTC) medication since the removal of many of these substances from the World Anti-Doping Agency (WADA) Prohibited List, in 2004. Athletes demonstrated limited knowledge and understanding. Around half (50.5%) knew the penalty incurred following a doping violation involving a banned OTC stimulant. The terms Monitoring Program and Specified Substance List were understood by 43.3% and 67.5% of respondents, respectively. Overall, the status of substances in relation to the Prohibited List was correctly identified in just 35.1% of cases. As a whole, athletes were of the opinion that OTC stimulants posed a risk to health, were performance enhancing and that their use was against the spirit of sport. They were undecided as to whether these drugs should be returned to the Prohibited List. Elite athletes require targeted education programmes that will enable them to make informed decisions on the potential of OTC medications for therapeutic or performance enhancing purposes.

Mroczkowska H. Moral attitudes towards doping: What do athletes on the verge of maturity value? Biology of Sport 26(3): 235-243, 2009. (13 refs.)

The aim of the present study was twofold: a) to verify the previously detected regularities in a group of subjects larger than the one employed in a pilot study, and b) to define the internal structure of the hierarchy of values that can be squandered as a result of doping. For the study, eighty-nine 16-18-year-old students from the fencing, athletics, martial arts, and football classes of the School of Championship in Sports were recruited. Experimental technique developed by Mroczkowska called "Perception of the risk of doping" was employed to individually rank the highly regarded values (e.g., health, medals won, physical appeal, mental balance, financial bonuses, and social respect) that can be lost as a consequence of the use of illegal stimulants. It appears that young athletes would declaratively resign themselves from the loss of a financial bonus rather than from the loss of the social respect and attributes of self-integrity, such as physical and mental health. The detected correlations suggest that the rewarding value of a medal has an internal dimension: it externalizes a sense of self-confidence and confirms high self-esteem. The results indicate that, as perceived by the young, winning a medal with the help of doping is an illusion that does not allow to verify one's own skills and limitations.

Neal DJ; Fromme K. Hook 'em horns and heavy drinking: Alcohol use and collegiate sports. Addictive Behaviors 32(11): 2681-2693, 2007. (18 refs.)

Heavy alcohol consumption has been associated with collegiate sporting events, but little is known about specific levels of consumption over the course of an entire sports season. Ongoing web-based daily monitoring at the University of Texas at Austin allowed assessment of drinking levels of students (n=541) over two full football seasons. High-profile football game days were among the heaviest days for alcohol consumption, comparable to consumption on other well-known drinking days such as New Years Eve and Halloween weekend. Men increased their drinking for all games, and women with greater social involvement were more likely to drink heavily during away games. Among lighter drinkers, away games were associated with a greater likelihood of behavioral risks as intoxication increased.

O'Brien KS; Ali A; Cotter JD; O'Shea RP; Stannard S. Hazardous drinking in New Zealand sportspeople: Level of sporting participation and drinking motives. Alcohol and Alcoholism 42(4): 376-382, 2007. (34 refs.)

Aims: To examine the relationship between athlete drinking motives and hazardous drinking across differing levels of sporting participation (club vs elite-provincial vs elite-international). Methods: Data from 1214 New Zealand sportspeople was collected. We assessed hazardous drinking with the WHO's AUDIT questionnaire and sportspeople's psychosocial reasons for drinking with the ADS. Level of sporting participation (club/social, provincial/state, or international/olympic level) was also assessed. Results: Hazardous drinking behaviours differed across levels of sporting participation, with elite-provincial sportspeople showing the highest level of hazardous drinking, club/social sportspeople the next highest and elite-international sportspeople the lowest. Sportspeople who placed a greater emphasis on drinking as a reward for participating in their sports tended to display more hazardous drinking behaviours, but other ADS motives differed over level of sporting participation. Elite-provincial sportspeople and elite-intemational sportspeople placed more emphasis on drinking as a way to cope with the stresses of participating in their sports. A relationship between team/group motives and AUDIT scores was fully mediated by positive reinforcement motives, and partially mediated by stress-related coping motives. Conclusions: These findings have implications for alcohol education programs targeted at sportspeople and sport administration, and may help improve the efficacy and focus of intervention programs.

O'Brien KS; Kypri K. Alcohol industry sponsorship and hazardous drinking among sportspeople. Addiction 103(12): 1961-1966, 2008. (20 refs.)

To examine the nature and extent of alcohol industry sponsorship of sportspeople, and its association with drinking. A purposive sample of participants (n = 1279) from various sporting codes were asked whether they personally, their team, or club received free and/or discounted alcohol or funding from an alcohol industry body (e.g. pub, brewery, wholesaler); how much they received; and whether they felt they should drink their sponsor's product and/or at the sponsor's premises. Drinking behaviour was assessed with the Alcohol Use Disorders Identification Test (AUDIT) questionnaire. Alcohol industry sponsorship was reported by 47.8% of the sample. Of those sponsored, 47% reported receiving free and/or discounted alcohol products. In multivariate models, those receiving sponsorship at the individual, team and club level had AUDIT scores that were, on average, 2.4 points higher [95% confidence interval (CI): 0.70-4.09] than those who received no sponsorship. Receiving free and/or discounted alcohol (beta(adj) = 0.95, 95% CI: 0.01-1.88) and feeling that they should go to the sponsor's pub/club to drink (beta(adj) = 1.91, 95% CI: 0.85-2.98) were also associated with higher AUDIT scores. Provision of free or discounted alcoholic beverages was associated more strongly with AUDIT scores (beta(adj) = 1.56; 95% CI: 0.62-2.51) than other forms of sponsorship from the alcohol industry (e.g. provision of uniforms). Alcohol industry sponsorship of sportspeople, and in particular the provision of free or discounted alcoholic beverages, is associated with hazardous drinking after adjustment for a range of potential confounders. Sports administration bodies should consider the health and ethical risks of accepting alcohol industry sponsorship.

O'Rourke MP; O'Brien BJ; Knez W; Paton CD. Caffeine has a small effect on 5-km running performance of well-trained and recreational runners. Journal of Science and Medicine in Sport 11(2): 231-233, 2008. (10 refs.)

The purpose of this study was to investigate if caffeine ingestion improves 5-km time-trial performance in well-trained and recreational runners. Using a double-blind placebo-controlled design, 15 well-trained and 15 recreational runners completed two randomized 5-km time-trials, after ingestion of either 5 mg kg(-1) of caffeine or a placebo. Caffeine ingestion significantly improved 5-km running performance in both the well-trained and recreational runners. In comparison to the placebo trial, the caffeine trial resulted in 1.1% (90% CI 0.4-1.6) and 1.0% (0.2-2%) faster times for the well-trained and recreational runners. Reliability testing of the recreational runners indicated a test-retest error of measurement of 1.4%. We conclude that caffeine ingestion is likely to produce small but significant gains in 5-km running performance for both well-trained and recreational runners.

Oster-Aaland LK; Neighbors C. The impact of a tailgating policy on students' drinking behavior and perceptions. Journal of American College Health 56(3): 281-284, 2007. (15 refs.)

In the fall of 2004, a midwestern public university changed its tailgating policy from one that did not allow alcohol consumption to one that did. Objective, Participants, and Methods: The authors surveyed students before and after the policy change to measure consumption, problems, perceptions of peer consumption, and reported game attendance. Results: Results showed no change in drinking quantities or prevalence of problems after the policy change; however, there was an increase in students' misperceptions, with students overestimating drinking quantities and the number of students who drank while tailgating. Last, students' predictions about their game attendance if alcohol was allowed were higher than their reported attendance after the policy change. Conclusions: Conclusions suggest that although drinking quantities may not be influenced by policies at tailgating events, misperceptions may be influenced. Administrators should note that the policy did not affect students' self-reported game attendance.

Peck SC; Vida M; Eccles JS. Adolescent pathways to adulthood drinking: Sport activity involvement is not necessarily risky or protective. Addiction 103(Supplement 1): 69-83, 2008. (54 refs.)

Aims: Use pattern-centered methods to examine how adolescents' alcohol use and sports activities are related both to childhood sport and problem behavior and to heavy drinking in early adulthood. Design: The data used in this study come from four waves of the Michigan Study of Adolescent Life Transitions (MSALT) that began in 1983, when participants were approximately age 12, and continued into early adulthood, when participants were approximately age 28. Participants Sixty per cent of the approximately 1000 MSALT youth living in south-eastern Michigan were females and 97% were European American. Approximately 28% of one or both parents held at least a college degree, and 45% held a high school diploma or lower. Findings Pattern-centered analyses revealed that the relation between adolescent sport activity and age 28 heavy alcohol use obtained primarily for sport participants who were also using more than the average amount of alcohol and other drugs at age 18. Similarly, children who were characterized by relatively high levels of sport participation, aggression and other problem behavior at age 12 were more likely than expected by chance to become sport participants who used more than the average amount of alcohol and other drugs at age 18. Conclusions: The results indicate that childhood problem behavior and adolescent sport participation can, but do not necessarily, presage heavy drinking in adulthood and that pattern-centered analytical techniques are useful for revealing such theoretically generated predictions.

Peretti-Watel P. Sports and drugs: Further interpretative hypotheses are necessary. (commentary). Addiction 104(1): 150-151, 2009

Petroczi A. Attitudes and doping: A structural equation analysis of the relationship between athletes' attitudes, sport orientation and doping behaviour. Substance Abuse Treatment, Prevention, and Policy 2: article 34, 2007. (75 refs.)

Background: For effective deterrence methods, individual, systemic and situational factors that make an athlete or athlete group more susceptible to doping than others should be fully investigated. Traditional behavioural models assume that the behaviour in question is the ultimate end. However, growing evidence suggests that in doping situations, the doping behaviour is not the end but a means to an end, which is gaining competitive advantage. Therefore, models of doping should include and anti-doping policies should consider attitudes or orientations toward the specific target end, in addition to the attitude toward the 'tool' itself. Objectives: The aim of this study was to empirically test doping related dispositions and attitudes of competitive athletes with the view of informing anti-doping policy developments and deterrence methods. To this end, the paper focused on the individual element of the drug availability - athlete's personality - situation triangle. Methods: Data were collected by questionnaires containing a battery of psychological tests among competitive US male college athletes (n = 199). Outcome measures included sport orientation (win and goal orientation and competitiveness), doping attitude, beliefs and selfreported past or current use of doping. A structural equation model was developed based on the strength of relationships between these outcome measures. Results: Whilst the doping model showed satisfactory fit, the results suggested that athletes' win and goal orientation and competitiveness do not play a statistically significant role in doping behaviour, but win orientation has an effect on doping attitude. The SEM analysis provided empirical evidence that sport orientation and doping behaviour is not directly related. Conclusions: The considerable proportion of doping behaviour unexplained by the model suggests that other factors play an influential role in athletes' decisions regarding prohibited methods. Future research, followed by policy development, should incorporate these factors to capture the complexity of the doping phenomenon and to identify points for effective anti-doping interventions. Sport governing bodies and anti-doping organisations need to recognise that using performance enhancements may be more of a rational, outcome optimizing behaviour than deviance and consider offering acceptable alternative performance-enhancing methods to doping.

Petroczi A; Naughton DP. The age-gender-status profile of high performing athletes in the UK taking nutritional supplements: Lessons for the future. Journal of the International Society of Sports Nutrition 5(article 2), 2008. (22 refs.)

Background: Owing to the mechanics of anti-doping regulation via the World Anti-Doping Agency's Prohibited List, nutritional supplement use received little attention in comparison to the prevalence of doping. The aims of this study were to investigate supplement use, identify groups of athletes with high levels of supplement use and the prevalence of concomitant use of supplements. Methods: Survey data from 847 high-performing athletes in the UK were analysed using descriptive statistics. The survey, conducted by UK Sport, consisted of questions regarding knowledge of the prohibited substances, testing procedure, nutritional supplement use and perceptions of the doping problem. The proportion of supplement users and the relative use of each supplement were compared by age, gender and professional status. Results: Among 874 high-performing athletes in the UK sample, 58.8% of them reported the use of at least one nutritional supplement. Among supplement users, 82.6% used more than one and 11.5% reported use of more than five nutritional supplements. Of the 9 supplements listed, multivitamins (72.6%) and vitamin C (70.7%) were used most, followed by creatine (36.1%), whey protein (31.7%), echinacea (30.9%), iron (29.9%) and caffeine (23.7%). Less than 11% reported the use of magnesium or ginseng. Creatine use was typically associated with males regardless of status and across all ages, whereas iron was characteristically used by females. A 'typical' supplement user is male, between 24 and 29 years of age, involved in professional sport and using a combination of supplements. Male professional players between age 30 and 34 years, and female non-professional athletes between 24 and 29 years of age also represented a considerable proportion of supplement users. Athletes older than 40 years of age were practically non-users. Concomitant use of supplements is characteristic of male users more than females. Conclusion: As supplement use has been previously shown to increase the probability of prohibited substance use, groups exhibiting high use of nutritional supplements should be monitored. Future research should incorporate a wide range of supplements and enquire about the daily amount ingested. In addition to tutoring, preventive measures should incorporate offering acceptable and healthy alternatives for assisted performance enhancement.

Pokrywka A; Obminski Z; Kwiatkowska D; Grucza R. Cannabinoids: Cases in Polish athletes. Biology of Sport 26(2): 119-135, 2009. (40 refs.)

The aim of this study was to investigate the number of cases and the profiles of Polish athletes who had occasionally been using marijuana or hashish throughout the period of 1998-2004, with respect to: sex, age, and discipline of sport as well as the period of testing (in- and out-of-competition). Results of the study were compared with some data reported by other WADA accredited anti-doping laboratories. Totally, 13 631 urine samples taken from Polish athletes of both sexes, aged 10-67 years, performing 46 disciplines of sport were tested. Cannabinoids were detected in 267 samples. Among Polish athletes the relative number of positive THC (tetrahydrocannabinol) samples was one of the highest in Europe. The group of young Polish athletes (aged 16-24 years) was the most THC-positive. THC-positive cases were noted more frequently in male athletes tested during out of competitions. The so-called contact sports (rugby, ice hockey), skating, boxing, badminton, body building and acrobatic sports were those sports, where the higher risk of cannabis use was observed. The legal interpretation of some positive cannabinoids results would be difficult because of some accidental and unintentional use of the narcotics by sportsmen. It was concluded that national anti-doping organizations (NADO's), which are competent to judge whether the anti-doping rules were violated, should take into account the possibility of non-intentional doping use of cannabinoids via passive smoking of marijuana.

Pokrywka A; Tszyrsznic W; Kwiatkowska DJ. Problems of the use of pseudoephedrine by athletes. International Journal of Sports Medicine 30(8): 569-572, 2009. (28 refs.)

Pseudoephedrine (PSE) as a sympathomimetic is an ingredient of many proprietary medicines which are available on the medical market over the counter (OTC drugs). It can be converted to cathine (CATH, norpseudoephedrine) inside the body. Until the end of 2003, PSE had been a banned substance in sport in case its urinary concentration was greater than 25 mu g/ml. Then the World Anti-Doping Agency (WADA) removed PSE from the prohibited list. Prior to 2004 CATH was a forbidden substance and it is still one. CATH is included on the WADA prohibited list in the group of stimulants. The results of a doping control concerning PSE conducted in the Department of Anti-Doping Research of Institute of Sport in Warsaw in the years 2001-2003 and 2004-2007 have been compared. Moreover, several dozen of urine samples collected from the patients taking OTC drugs with PSE have been analysed. In these samples the concentration of PSE and CATH has been estimated. The results of this study have shown that athletes were using PSE frequently and in high doses between 2004 and 2007 when this substance was permitted by WADA. It is possible that athletes can obtain a positive result of doping control with CATH after the use of PSE.

Pommering TL. Erythropoietin and other blood-boosting methods. (review). Pediatric Clinics of North America 54(4): 691-699, 2007. (48 refs.)

Dating back to the earliest Olympics, athletes have been searching for a performance edge. Recombinant human erythropoietin was made commercially available in 1987 to treat various diseases associated with anemia. Within a few years, elite endurance athletes capitalized on its potential as an undetectable performance-enhancing agent. Although antidoping agencies have developed a test to detect its use, there are pitfalls. More importantly, athletes continue to add more sophisticated doping practices to their armamentarium, challenging regulatory agencies, putting their health at great risk, and tainting the spirit of fair competition.

Rehm J; Kanteres F. Alcohol and sponsorship in sport: Some much-needed evidence in an ideological discussion. (commentary). Addiction 103(12): 1967-1968, 2008. (6 refs.)

Rodek J; Sekulic D; Pasalic E. Can we consider religiousness as a protective factor against doping behavior in sport? Journal of Religion and Health 48(4): 445-453, 2009. (26 refs.)

Religiousness is rarely studied in relation to doping behaviors in sport. In this study, we sampled 27 weightlifting/powerlifting athletes from Bosnia and Herzegovina. Using the originally developed questionnaire and by means of Spearman's correlation, we interpreted data and discussed relationships between (a) social, religious, sport, and educational factors, and (b) substance use criteria, including cigarettes, alcohol, analgesics, nutritional supplementation, and doping behaviors. In conclusion, we found (1) that religiousness can be considered as a potential protective factor against doping, but also (2) that religious subjects tend to deny and underestimate the doping behaviors in their sport. Both of these findings should be extensively studied in future investigations.

Schirlin O; Rey G; Jouvent R; Dubal S; Komano O; Perez-Diaz F et al. Attentional bias for doping words and its relation with physical self-esteem in young adolescents. Psychology of Sport and Exercise 10(6): 615-620, 2009. (46 refs.)

Objectives: Previous studies revealed that adolescence is a period of risk for doping and drug addiction and that young athletes who used doping agents reported low self-esteem. We conducted a preventive study with the aims to investigate whether young adolescents displayed an attentional bias to doping-related words and whether this attentional bias was related to physical self-esteem. Method: Ninety seven adolescents (44 girls and 53 boys) from 11 to 15 years-old participated to a study designed to measure reaction times (RT) in a Stroop emotional task related to doping, cheating and control words. They also completed the Physical Self-Perception Profile subscales assessing perceived general self-esteem, physical self-worth, physical condition, sport competence, body attractiveness, and physical strength. Results: Participants exhibited longer RT after doping words than after control words. RT was also longer after doping than after cheating words. Participants belonging to the low physical self-esteem group exhibited larger carry-over effects than those who were in the high physical self-esteem group. Conclusions: These findings suggest that attentional resources allocated to doping words are already present at the onset of adolescence, and that they may be linked to a psychological feature (physical self-esteem) considered as a risk factor of substance abuse in young adults involved in competitive sports.

Sekulic D; Kostic R; Miletic D. Substance use in dance sport. Medical Problems of Performing Artists 23(2): 66-71, 2008. (25 refs.)

Very few studies have been conducted on substance use (SU) in performing sports. In the current study, we analyzed SU and factors related to SU in dance sport. The sample subjects consisted of 21 female and 22 male dancers, all > 19 years of age, who were given an anonymous questionnaire developed for this study. The questionnaire consisted of questions about 1) social, cultural, educational, and sport-related factors, and 2) SU, including alcohol, opiates, cigarettes, and doping consumption, and personal opinions. The chi-square test was used to define the differences between male and female dancers. To identify the relationships between the studied factors and SU, the Pearson's correlation coefficient was calculated separately in males and females. We found a relatively low incidence of cigarette smoking (<10%) and significant differences between males and females in opinions regarding doping issues. The level of the sport achievement in females and religiousness in male dancers was significantly related to SU. Although not frequent, the consumption of alcohol was more common in more successful and experienced dancers. The use of pain killers was related to age in female dancers (all at P < 0.05). Based on these results, we recommend educational programs regarding SU, especially about doping problems, in sport dance.

Share B; Sanders N; Kemp J. Caffeine and performance in clay target shooting. Journal of Sports Sciences 27(6): 661-666, 2009. (22 refs.)

Controversy surrounds the influence that caffeine has on accuracy and cognitive performance in precision activities such as shooting and archery. The aim of this study was to assess the effects of two doses of caffeine on shooting performance, reaction time, and target tracking times in the sport of clay target shooting. A randomized, double-blind, placebo-controlled design was undertaken by seven elite male shooters from the double-trap discipline. Three intervention trials (2mg caffeinekg-1 body mass (BM); 4mg caffeinekg-1 BM; placebo) were undertaken, in which shooters completed four rounds per trial of 50 targets per round. Performance accuracy (score) and digital video footage (for determination of reaction time and target tracking times) were gathered during competition. Data were analysed using repeated-measures analysis of variance. No differences in shooting accuracy, reaction time or target tracking times among the three intervention trials or across the four rounds within each intervention were observed (P0.05). The results indicate that ingestion of 4mg caffeinekg-1 BM does not provide performance benefits to elite performers of clay target shooting in the double-trap discipline.

Smurawa TM; Congeni JA. Testosterone precursors: Use and abuse in pediatric athletes. (review). Pediatric Clinics of North America 54(4): 787-796, 2007. (38 refs.)

Dietary supplement use by athletes is increasing. Marketing and anecdotal evidence promote the use of these supplements as performance enhancers without supporting research. Testosterone precursors, also called prohormones, are similarly marketed. They are precursors in the endogenous production of testosterone and include androstenedione (Andro), dehydroepiandrosterone (DHEA), and androstenediol. Their short- and long-term side effects are not well known, but theoretically they may cause the same adverse side eoects as AASs. In 1994, the Dietary Supplement Health and Education Act allowed for the marketing and sale of ''natural'' dietary supplements without the US Food and Drug Administration (FDA) regulation for guaranteeing the purity and safety. These precursors were included under this law and also can be to be sold as ''natural'' dietary supplements without regulation. In 1996, androstenedione and DHEA became available in the United States market as over-the-counter nutritional supplements. Dosages as high as 787-796 androstenedione,100 to 300 mg per day, and DHEA,150 mg per day, are being recommended by those marketing them. The extent of use is unknown. This article describes how these precursors are handled by the body, questions of safety and the longer term effects which are significant. Of note is the fact that these precursors are banned by most major sports, including the IOC, National Football League, NCAA, FIFA, National Basketball Association, and Major League Baseball. (As a result of the Anabolic Steroid Control Act of 2004, androstenedione is listed as a schedule III controlled substance and is regulated by the FDA.)

Sokmen B; Armstrong LE; Kraemer WJ; Casa DJ; Dias JC; Judelson DA et al. Caffeine use in sports: Considerations for the athlete. (review). Journal of Strength and Conditioning Research 22(3): 978-986, 2008. (67 refs.)

The ergogenic effects of caffeine on athletic performance have been shown in many studies, and its broad range of metabolic, hormonal, and physiologic effects has been recorded, as this review of the literature shows. However, few caffeine studies have been published to include cognitive and physiologic considerations for the athlete. The following practical recommendations consider the global effects of caffeine on the body: Lower doses can be as effective as higher doses during exercise performance without any negative coincidence; after a period of cessation, restarting caffeine intake at a low amount before performance can provide the same ergogenic effects as acute intake; caffeine can be taken gradually at low doses to avoid tolerance during the course of 3 or 4 days, just before intense training to sustain exercise intensity; and caffeine can improve cognitive aspects of performance, such as concentration, when an athlete has not slept well. Athletes and coaches also must consider how a person's body size, age, gender, previous use, level of tolerance, and the dose itself all influence the ergogenic effects of caffeine on sports performance.

Tewksbury R; Higgins GE; Mustaine EE. Binge drinking among college athletes and non-athletes. Deviant Behavior 29(3): 275-293, 2008. (39 refs.)

Concerns about incidence, forms, and consequences of alcohol use among college students lack examinations of the lifestyles and predictors of college student athletes. This article, using a sample of student-athletes and non-athletes from four Southern universities, identifies the lifestyle predictors for each population, identifying patterns and sets of predictors of binge drinking behavior. Findings indicate that for both samples, binge drinking behavior is explained by sex, drinking in bars, number of male friends who drink, and cigarette smoking. Student-athletes' binge drinking is explained further by residing on campus. Non-athlete binge drinking is related to race and amount of study time per week. Implications for these findings are also discussed.

Thevis M; Schanzer W. Mass spectrometry in sports drug testing: Structure characterization and analytical assays. (review). Mass Spectrometry Reviews 26(1): 79-107, 2007. (142 refs.)

Owing to the sensitive, selective, and unambiguous nature of mass spectrometric analyses, chromatographic techniques interfaced to various kinds of mass spectrometers have become the most frequently employed strategy in the fight against doping. To obtain utmost confidence in analytical assays, mass spectrometric characterization of target analytes and typical dissociation pathways have been utilized as basis for the development of reliable and robust screening as well as confirmation procedures. Methods for qualitative and/or quantitative determinations of prohibited low and high molecular weight drugs have been established in doping control laboratories preferably employing gas or liquid chromatography combined with electron, chemical, or atmospheric pressure ionization followed by analyses using quadrupole, ion trap, linear ion trap, or hyphenated techniques. The versatility of modem mass spectrometers enable specific as well as comprehensive measurements allowing sports drug testing laboratories to determine the misuse of therapeutics such as anabolic-androgenic steroids, stimulants, masking agents or so-called designer drugs in athletes' blood or urine specimens, and a selection of recent developments is summarized in this review.

Turrisi R; Larimer ME; Mallett KA; Kilmer JR; Ray AE; Mastroleo NR et al. A randomized clinical trial evaluating a combined alcohol intervention for high-risk college students. Journal of Studies on Alcohol and Drugs 70(4): 555-567, 2009. (88 refs.)

Objective: The current study is a multisite randomized alcohol prevention trial to evaluate the efficacy of both a parenting handbook intervention and the Brief Alcohol Screening and Intervention for College Students (BASICS) intervention, alone and in combination, in reducing alcohol use and consequences among a high-risk population of matriculating college students (i.e., former high school athletes). Method: Students (n = 1,275) completed a series of Web-administered measures at baseline (in the summer before starting college) and follow-up (after 10 months). Students were randomized to one of four conditions: parent intervention only, BASICS only, combined (parent and BASICS), and assessment-only control. Intervention efficacy was tested on a number of outcome measures, including peak blood alcohol concentration, weekly and weekend, drinking, and negative consequences. Hypothesized mediators and moderators of intervention effect were tested. Results: The overall results revealed that the combined-intervention group had significantly lower alcohol consumption, high-risk drinking, and consequences at 10-month follow-up, compared with the control group, with changes in descriptive and injunctive peer norms mediating intervention effects. Conclusions: The findings of the present study suggest that the parent intervention delivered to students before they begin college serves to enhance the efficacy of the BASICS intervention, potentially priming students to respond to the subsequent BASICS session.

Turrisi R; Mastroleo NR; Mallett KA; Larimer ME; Kilmer JR. Examination of the mediational influences of peer norms, environmental influences, and parent communications on heavy drinking in athletes and nonathletes. Psychology of Addictive Behaviors 21(4): 453-461, 2007. (64 refs.)

The present study used perspectives from the general literature on college alcohol consumption to examine mediational influences of peer, environmental, and parental variables on heavy drinking for student athlete and nonathlete samples. Eight hundred thirty-five freshmen who differed in organized sports involvement were compared on heavy drinking outcomes, peer norms, environmental influences, and parental communication. College athletes reported significantly more heavy drinking experiences than nonathletes. Peer norms, environmental influences, and parental communication were all significant mediators of the athlete-heavy drinking relationship. Athletes reported a higher perception of peer drinking, peer approval of drinking, higher alcohol availability, and direct drink offers, which, in turn, were related to higher rates of heavy drinking. Parental communication mediated the athlete-heavy drinking relationship differently, depending on the specific topic of conversation. Discussion surrounding the importance of incorporating a variety of interventions aimed at reducing collegiate athlete drinking on the basis of the peer, environmental, and parental influences observed in the present analyses are presented. Limitations and directions for future research are also noted.

Utter AC; Nieman DC; Kang J; Dumke CL; Quindry JC; McAnulty SR et al. Quercetin does not affect rating of perceived exertion in athletes during the Western States Endurance Run. Research in Sports Medicine 17(2): 71-83, 2009. (28 refs.)

The purpose of this study was to measure the influence of quercetin supplementation on ratings of perceived exertion in ultramarathon runners competing in the 160-km Western States Endurance Run (WSER). Sixty-three runners were randomized to quercetin (Q) and placebo (P) groups, and under double blinded methods ingested four supplements per day with or without 250 mg quercetin for 3 weeks before the WSER. Thirty-nine of the 63 subjects (quercetin N = 18, placebo N = 21) finished the race. At the completion of exercise ratings of perceived exertion (RPE) were assessed at aid stations located at 40, 90, 125, 150, and 160 km (finish line). The pattern of change in RPE over time was not significantly different between the Q and P groups. Ratings of perceived exertion (RPE) did not significantly increase throughout the race (15.2 +/- 2.9 at 40 km -14.2 +/- 4.0 at 160 km) for both groups combined. Race times were not different between the groups (Q = 26.4 +/- 0.7 h and P = 27.5 +/- 0.6 h). Significant time main effects (p < 0.001) were found for both serum glucose and cortisol throughout the race. Quercetin supplementation for 3 weeks prior to the WSER had no effect on RPE during competitive self-paced ultramarathon running. Ratings of perceived exertion (RPE) did not increase in a linear fashion but instead fluctuated nonmonotonically throughout the self-paced endurance running event.

Ward BW; Gryczynski J. Alcohol use and participation in organized recreational sports among university undergraduates. Journal of American College Health 56(3): 273-280, 2007. (29 refs.)

Objective: The authors examined alcohol use among students involved in recreational sports. To the authors' knowledge, this is the first study of alcohol use in which researchers separate recreational sports participants from intercollegiate athletes and examine them as a separate group of interest. Participants: The authors generated a random sample of 494 students from the undergraduate population at a 4-year university. Methods: They used a Web-based survey to collect data and stratified and weighted the sample by residence status to more accurately reflect the population. Results: Students who participated in recreational sports used alcohol at a greater frequency and intensity than did those who were not involved in recreational sports across a variety of measures, even alongside other variables, including race, sex, and Greek membership. Conclusions: On the basis of these findings, alcohol consumption among those participating in recreational sports appears to be an area worthy of consideration in future research.

Wetherill RR; Fromme K. Alcohol use, sexual activity, and perceived risk in high school athletes and non-athletes. Journal of Adolescent Health 41(3): 294-301, 2007. (37 refs.)

Purpose: The current study examined one's sense of personal invincibility as a contributing factor to high school athletes' more frequent behavioral risks compared to those of non-athletes. Perceived risk was assessed as a mediator of sports participation and alcohol use, and sports participation and sexual activity among high school athletes. Methods: Prior to leaving home, college-bound high school graduates (n = 2,247) completed web-based surveys assessing alcohol use, sexual activity, sports participation, and perceived risk. The mediational models were analyzed using generalized linear modeling and the procedures of Baron and Kenny (1986). Results: Relative to non-athletes, athletes reported greater alcohol use, more sexual partners, and lower perceived risk. Perceived risk mediated the association between sports participation and alcohol use for both young men and women. Perceived risk also mediated the association between sports participation and number of sexual partners for women and partially mediated this association for men. Perceived risk partially mediated the association between sports participation and episodes of unsafe sexual activity in both men and women. Conclusions: These findings suggest a potential cognitive mechanism which may account for differences in alcohol use and sexual activity between athletes and non-athletes during late adolescence.

Williams AD; Cribb PJ; Cooke MB; Hayes A. The effect of ephedra and caffeine on maximal strength and power in resistance-trained athletes. Journal of Strength and Conditioning Research 22(2): 464-470, 2008. (36 refs.)

Caffeine and ephedrine-related alkaloids recently have been removed from International Olympic Committee banned substances lists, whereas ephedrine itself is now permissible at urinary concentrations less than 10 mu g.mL(-1). The changes to the list may contribute to an increased use of caffeine and ephedra as ergogenic aids by athletes. Consequently, we sought to investigate the effects of ingesting caffeine (C) or a combination of ephedra and caffeine (C + E) on muscular strength and anaerobic power using a double-blind, crossover design. Forty-five minutes after ingesting a glucose placebo (P: 300 mg), C (300 mg) or C + E (300 mg + 60 mg), 9 resistance-trained male participants were tested for maximal strength by bench press [BP; 1 repetition maximum (1RM)] and latissimus dorsi pull down (LP; 1RM). Subjects also performed repeated repetitions at 80% of 1RM on both BP and LP until exhaustion. After this test, subjects underwent a 30-second Wingate test to determine peak anaerobic cycling power, mean power, and fatigue index. Although subjects reported increased alertness and enhanced mood after supplementation with caffeine and ephedra, there were no significant differences between any of the treatments in muscle strength, muscle endurance, or peak anaerobic power. Our results do not support the contention that supplementation with ephedra or caffeine will enhance either muscle strength or anaerobic exercise performance.

Yan L. Olympic Games in China: A catalyst for smoke-free environments. (editorial). Tobacco Control 17(4): 218-221, 2008. (0 refs.)

Yusko DA; Buckman JF; White HR; Pandina RJ. Alcohol, tobacco, Iilicit drugs, and performance enhancers: A comparison of use by college student athletes and nonathletes. Journal of American College Health 56(3): 281-289, 2008. (31 refs.)

Objective: The authors compared the prevalence and pattern of substance use in undergraduate student athletes and nonathletes from 2005-2006. Participants: Authors collected data from male (n = 418) and female (n = 475) student athletes and nonathletes from 2005-2006. Methods: The authors administered self-report questionnaires to assess prevalence, quantity, and frequency of alcohol and drug use, and to determine patterns of student athletes' alcohol and drug use during their athletic season versus out of season. Results: Male student athletes were at high risk for heavy drinking and performance-enhancing drug use. Considerable in-season versus out-of-season substance use fluctuations were identified in male and female student athletes. Conclusions: Additional, and possibly alternative, factors are involved in a student athlete's decision-making process regarding drug and alcohol use, which suggests that the development of prevention programs that are specifically designed to meet the unique needs of the college student athlete may be beneficial.

Yusko DA; Buckman JF; White HR; Pandina RJ. Risk for excessive alcohol use and drinking-related problems in college student athletes. Addictive Behaviors 33(12): 1546-1556, 2008. (65 refs.)

There is compelling evidence that college student athletes engage in frequent episodes of heavy drinking and are prone to negative consequences resulting from such use. This study sought to identify risk and protective factors associated with student-athlete drinking and determine if student-athlete risk factors differed from those of non-athletes. Athletes compared to non-athletes reported more exaggerated perceptions of peer heavy drinking and lower sensation seeking and coping and enhancement motives for drinking, suggesting a risk profile distinct from non-athletes. In the overall sample, higher sensation seeking, overestimation of peer heavy drinking, non-use of protective behaviors while drinking, and higher enhancement and coping drinking motives were associated with greater frequency of heavy episodic drinking and more negative drinking consequences. In athletes compared to non-athletes, sensation seeking was more strongly associated with heavy episodic drinking and drinking to cope was more strongly associated with negative alcohol-related consequences. Overall, the results suggest that already proven brief intervention strategies, with minor adaptations related to the roles of sensation seeking and drinking to cope, may be helpful for student athletes.