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CORK Bibliography: Athletes

64 citations. 2007 to present

Prepared: December 2008

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).

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.

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.

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.

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 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.

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.

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.

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.

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.

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.

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.

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.

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.

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.)

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.

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.)

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; 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.

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.

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.