Will the London Olympics be the cleanest yet? The audience at the Bishop-Lefanu lecture for 2012 were sceptical, 59% disagreeing with the proposition.
The lecture, given every two years, commemorates W J Bishop, librarian at the Wellcome, founder of the Medical Section of the Library Association, the ancestor of HLG, and William LeFanu, Librarian of the Royal College of Surgeons in England (and husband of the composer Elizabeth Maconchy). This year’s lecturer, in Olympic year, was Dr Yannis Pitsiladis, Reader at Glasgow University’s Institute of Cardiovascular and Medical Sciences and member of the World Anti-Doping Agency’s Prohibited List Expert Group.
I looked forward to his lecture as, apart from his work on performance enhancement, he has worked with studied the performance of East African athletes, studying the physiological factors behind their extraordinary performances, and is also the author of this:
We were handed clickers as we entered the hall, as Dr Pitsiladis promised us an interactive lecture. We were to be members of the committee that oversees the prohibited list. There are three criteria and, to be banned, a substance must meet at least two.
First of all it must have the potential to enhance performance to a significant extent, though races can hang on tiny differences in performance. The placebo effect may also come into play. The Wales rugby team famously endured cryotherapy before and athletes in many disciplines use ice baths but there’s no evidence that either are effective (I thought here that ice baths, at least for distance runners, are taken to speed recovery, rather than enhance performance per se). Growth hormone again is ineffective.
Secondly a substance must not harm athletes. So, Dr Pitsiladis asked us, are the risks of anabolic steroids exaggerated? The evidence suggests they are, perhaps to discourage use. Thirdly, it must violate the spirit of sport. Caffeine was banned until 2004. It enhances performance, and has potential side-effects, but it is impossible to tell what the dosage is. Here Dr Pitsiladis referred to us to study on the amount of caffeine served in single espressos in coffee shops around Glasgow: Crozier TW, Stalmach A, Lean ME, Crozier A.
Espresso coffees, caffeine and chlorogenic acid intake: potential health implications.
Food Funct. 2012 Jan;3(1):30-3
My prejudices were confirmed when I saw how feeble a Starbucks espresso is.
As for energy drinks, Dr Pitsiladis trailed the research published the following week in the BMJ and also the subject of a Panorama programme:
Cohen D. The truth about sports drinks.
BMJ. 2012 Jul 18;345:e4737.
Heneghan C, Howick J, O'Neill B, Gill PJ, Lasserson DS, Cohen D, Davis R, Ward A, Smith A, Jones G, Thompson M.
The evidence underpinning sports performance products: a systematic assessment.
BMJ Open. 2012 Jul 18;2(4). pii: e001702.
Should one of the three criteria, specifically the performance enhancement one, be given greater weight than the others, he asked us.
Who cheats? If detection is effective, then it’s a little less than 1%. Weightlifters are the worst, then athletes. Paralympians dope too, at about the same rate. The most common substances detected are anabolic steroids, followed by stimulants and cannabinoids. Perhaps unsurprisingly, there's no evidence that cannabis enhances performance, though it may help overcome anxiety. Less often found are glucocorticoids, whose presence on the list is a matter of controversy, beta-blockers and hormone antagonists
Why dope? To cope with injury, to enhance performance, improve strength, because it’s the social norm (especially in weightlifting) and to cope with anxiety (which is why footballers use cannabis). Athletes can be doped without their knowledge, as has been alleged to be the practice at certain football clubs. To detect newer methods of doping, for example the use of EPO, requires a systems biology approach. The window for detection is short, though the effects long lasting. However the effects of altitude training are very similar to EPO, at least as far as haematocrit is concerned and Dr Pitsiladis is working on a study comparing East African and Glaswegian athletes. Blood passports can pick up EPO doping, and potentially could detect genetic doping, the trend for the future.
There was time for one question, about the effect of altitude on training. Dr Pitsiladis replied that it certainly works. No sea level athlete can win in distance events. The answer is to live at altitude and choose your parents wisely. Live high and train low, though Haile Gebrselassie, the world record holder for the marathon, lives high and trains high.