Prevalence of 'health supplement' use and androgenic anabolic steroid abuse among athletes in Jammu and Kashmir / Khawar Khan, Rabbanie Tariq Wani, Najeeb Rasool. - (International Journal of Advanced Research 6 (2018) 11 (November); p. 70-74).
- DOI:10.21474/IJAR01/7973

Introduction:
The use of anabolic steroids and the health supplements by athletes has been increasing over last few decades. The health risks associated with the use of them makes it necessary to study the patterns and prevalence of such behavior.

Aim:
To study the prevalence of Health Supplement and androgenic anabolic steroid use among the athletes in Jammu and Kashmir Methods and materials: Gyms were randomly selected over Jammu and Kashmir and the athletes were made to fill in the questionnaires after proper instruction by the investigator, the questionnaires with discrepancies and inadequacy were left out.

Results:
The study enrolled 214 athletes, both men and women all over J&K. The mean age of the participants was 26.98. The prevalence of health supplement use was 38.32% which mainly included protein based supplements, the prevalence of androgenic anabolic steroid use was 7.1%.

Conclusion:
There is high prevalence of health supplement use among the athletes in Jammu and Kashmir, the prevalence of steroid abuse was also considerable. There is an urgent need for education of athletes about the potential risks of indulging in such behaviour.

Prevalence of blood doping in samples collected from elite track and field athletes /
Pierre-Edouard Sottas, Neil Robinson, Giuseppe Fischetto, Gabriel Dollé, Juan Manuel Alonso, and Martial Saugy.
Clinical Chemistry 57:5 p. 762–769 (2011)

BACKGROUND:
No reliable estimate of the prevalence of doping in elite sports has been published. Since 2001, the international governing body for athletics has implemented a blood-testing program to detect altered hematological profiles in the world's top-level athletes.

METHODS:
A total of 7289 blood samples were collected from 2737 athletes out of and during international athletic competitions. Data were collected in parallel on each sample, including the age, sex, nationality, and birth date of the athlete; testing date; sport; venue; and instrument technology. Period prevalence of blood-doping in samples was estimated by comparing empirical cumulative distribution functions of the abnormal blood profile score computed for subpopulations with stratified reference cumulative distribution functions.

RESULTS:
In addition to an expected difference between endurance and non-endurance athletes, we found nationality to be the major factor of heterogeneity. Estimates of the prevalence of blood doping ranged from 1% to 48% for subpopulations of samples and a mean of 14% for the entire study population. Extreme cases of secondary polycythemia highlighted the health risks associated with blood manipulations.

CONCLUSIONS:
When applied at a population level, in this case the population of samples, hematological data can be used to estimate period prevalence of blood doping in elite sports. We found that the world's top-level athletes are not only heterogeneous in physiological and anthropometric factors but also in their doping behavior, with contrasting attitudes toward doping between countries. When applied at the individual level, the same biomarkers, as formalized in the Athlete Biological Passport paradigm, can be used in analysis of the observed different physiological characteristics and behavioral heterogeneities.

Prevalence of Body Dysmorphic Disorder and Muscle Dysmorphia Among Entry-Level Military Personnel / John D. A. Campagna, Barbara Bowsher . – (Military Medicine 181 (2016) 5 (May) : p. 494-501). - PMID: 27136659. - DOI: 10.7205/MILMED-D-15-00118

Abstract:

Objective: To determine the prevalence of body dysmorphic disorder (BDD) and muscle dysmorphia
(MD) in enlisted U.S. military personnel; and secondarily, to determine supplement use and relationship with BDD and MD.
Methods:
A survey of advanced individual training of tri-service personnel at Fort Sam Houston, Texas, was performed combining the dysmorphia concern questionnaire, the MD symptom questionnaire, a supplement questionnaire, and demographic factors. Results: Of the 1,320 service members approached, 1,150 (87.1%) completed the survey. The majority of participants were male, 62.8% (n = 722) and Army soldiers 59.0% (n = 679). The prevalence rate of BDD was 13.0% in males and 21.7% in females. The prevalence of MD was 12.7% in males and 4.2% in females. There was a strong correlation between having BDD and using supplements to get thinner (odds ratio 5.1; 95% confidence
interval 3.4–7.8; p < 0.001) and MD to get more muscular (odds ratio 5.4; 95% confidence interval 3.5–8.3; p < 0.001).
Conclusions:
Our study shows a higher than expected prevalence rate of BDD and MD in service members. This indicates a need for increased awareness of dysmorphias in mental health providers, primary care providers, and commanders and justifies further military specific BDD and MD research.

Prevalence of doping use in elite sports: a review of numbers and methods / O. de Hon, H. Kuipers, M. van Bottenburg. - (
Sports Medicine 45 (2014) 1 (29 aug) p. 57-69)

• PMID: 25169441
• DOI: 10.1007/s40279-014-0247-x

The prevalence of doping in elite sports is relevant for all those involved in sports, particularly for evaluating anti-doping policy measures. Remarkably, few scientific articles have addressed this subject so far, and the last review dates back to 1997. As a consequence, the true prevalence of doping in elite sports is unknown. Even though it is virtually impossible to uncover the exact prevalence of a prohibited activity such as doping, various methods are available to uncover parts of this particular problem, which enables the circumvention (to a certain degree) of the issues of truthfulness, definition problems and the limits of pharmacological evidence. This review outlines the various methods that exist and presents the scarce data available in this area. It is concluded that a combination of questionnaires using the Randomised Response Technique and models of biological parameters is able to provide the statistical possibilities to reveal accurate estimates of this often undisclosed practice. Data gathered in this way yield an estimation of 14–39 % of current adult elite athletes who intentionally used doping.
These period prevalences have been found in specific subgroups of elite athletes, and the available data suggest that the prevalence of doping is considerably different between sub-groups with varying types of sport, levels and nationalities. The above-mentioned figure of 14–39 % is likely to be a more accurate reflection of the prevalence of intentional doping in elite sports than that provided by doping control test results (estimate of doping: 1–2 % annually) or questionnaire-based research (estimations between 1 and 70 % depending on sport, level and exact definitions of intent and doping). In the future, analytical science may play a more important role in this topic if it may become feasible to detect very low concentrations of prohibited substances in sewage systems downstream of major sporting events. However, it is clear that current doping control test results show a distinct underestimation of true doping prevalence. It does not seem feasible to distil better estimates of the prevalence of doping based on performance indicators or ego documents because of the various existing effects that influence athletic performance. Such information can only be used as extra information to augment the accuracy of prevalence rates that have been found by using other techniques. True doping prevalence studies have been scarce in elite sports so far. With the correct application of the available scientific methods, preferably using harmonised definitions of the terms ‘doping’ and ‘elite sports’, more information on this topic may be gathered in a relatively short time. This would assist antidoping professionals in the future in order to evaluate the effects of possible anti-doping measures, and better antidoping policies would serve athletes who compete without doping. The existing anti-doping measures seriously impact the lives of elite athletes and their immediate entourage, which imposes a moral burden to evaluate these measures in the best possible way.

Prevalence of Performance-Enhancing Substance Use and Associated Factors Among Portuguese Gym/Fitness Users / Ana Sofia R. Tavares, Sidónio Serpa, Luís Horta, Elisabete Carolino, António Rosado. - (Substance Use & Misue (2020) 18 February; p. 1-9).

• PMID: 32068479.
• DOI: 10.1080/10826084.2020.1726392

Abstract

Background:
Nowadays, doping is not confined to elite sport, it is also spread throughout gymnasia and fitness centers, and it is seen as a public health concern. Studies focusing on performance-enhancing substances (PES) use among gym users are few and mostly concern the practice of bodybuilding and the use of anabolic-androgenic steroids (AAS), without providing information about social indicators to further explore why this specific population use these substances.

Objectives:
To investigate the extent of PES use and examine the way social indicators, exercise profile and gym modalities influence the use of these substances among a sample of gym users.

Methods:
Cross-sectional descriptive study, among a convenience sample of 453 Portuguese gym users, recruited directly by five institutional gyms´ email and Facebook. Data were collected via a structured web-based survey, between October and November 2017. Multiple binary logistic regression, the Chi-Square test or Monte Carlo Simulation or Fisher’s Exact test were used. The odds ratios and their respective 95% confidence intervals were calculated.

Results:
11,1% of gym users reported the use of prohibited PES, which varies significantly according to gender, education, exercise profile and type of practice. Gender was associated with the class of PES used. Polypharmacy was a common practice among users, increasing the risk of side-effects. Peer effect and media appear to be strikingly important in the misuse of PES.

Conclusion:
Results provide precise insight into the specific factors associated with PES use, which could support prevention strategies in gym/fitness context.

Prevalence of therapeutic use exemptions at the Olympic Games and association with medals : an analysis of data from 2010 to 2018 / Alan Vernec, David Healy. - (British Journal of Sports Medicine (2020) 102028 (6 May); p. 1-6).
- PMID: 32376674.
- DOI: 10.1136/bjsports-2020-102028

Abstract

Objectives: The percentage of athletes with Therapeutic Use Exemptions (TUEs) competing in elite sport and the association with winning medals has been a matter of speculation in the absence of validated competitor numbers. We used International Olympic Committee (IOC) and World Anti-Doping Agency (WADA) data to identify athletes competing with TUEs at five Olympic Games (Games) and a possible association between having a TUE and winning an Olympic medal.

Methods: We used the IOC's competition results and WADA's TUE database to identify the number of TUEs for athlete competitions (ACs, defined as one athlete competing in one event) and any associations with medals among athletes competing in individual competitions. We calculated risk ratios (RR) for the probability of winning a medal among athletes with a TUE compared with that of athletes without a TUE. We also reported adjusted RR (RRadj) controlling for country resources, which is a potential confounder.

Results: During the Games from 2010 to 2018, there were 20 139 ACs and 2062 medals awarded. Athletes competed with a TUE in 0.9% (181/20 139) of ACs. There were 21/2062 medals won by athletes with a TUE. The RR for winning a medal with a TUE was 1.13 (95% CI: 0.73 to 1.65; p=0.54), and the RRadj was 1.07 (95% CI: 0.69 to 1.56; p=0.73).

Conclusion: The number of athletes competing with valid TUEs at Games is <1%. Our results suggested that there is no meaningful association between being granted a TUE and the likelihood of winning a medal.

Prevalence of tramadol findings in urine samples obtained in competition / Joao Gabriel Baltazar‐Martins, Maria del Mar Plata, Jesús Muñoz‐Guerra, Gloria Muñoz, Daniel Carreras, Juan Del Coso. - (Drug Testing and Analysis (2019) 8 February).
- PMID: 30735314.
- DOI: 10.1002/dta.2575

Tramadol drew the attention of anti-doping authorities because this analgesic, used to treat moderate to severe pain,might alsoproduce several drawbacks such as dizziness, loss of alertness, and drowsiness that could affect the athletes’ safety. The current letter presents an analysis of samples measured in the Madrid Doping Control Laboratory and the results of the 2017 Monitoring Program report. Both analyses reveal that tramadol is being abused in some sports, particularly cycling.

Prevalence of use of performance enhancing drugs by fitness centre members / Janine H. Stubbe, Astrid M.J. Chorus, Laurence E. Frank, Olivier de Hon, Peter G.M. van der Heijden. - (Drug Testing and Analysis 6 (2013) 5 (May) p. 434-438). - doi: 10.1002/dta.1525. Epub 2013 Sep 9.

Abstract:

Studies on the use of performance enhancing drugs (PED) in fitness centres rely predominately on conventional survey methods using direct questioning. However, research indicates that direct questioning of sensitive information is characterized by underreporting. The aim of the present study was to contrast direct questioning of different types of PED use by Dutch fitness centre members with results obtained with the Randomized Response Technique (RRn. Questionnaires were conducted among members of fitness centres. PED were classified into the following categories: anabolic steroids, prohormones, substances to counteract side-effects, growth hormone and/or insulin, stimulants (to reduce weight), and miscellaneous substances. A total of 718 athletes from 92 fitness centres completed the questionnaire. The conventional method resulted in prevalences varying between 0% and 0.4% for the different types of PED with an overall prevalence of 0.4%. RRT resulted in prevalences varying between 0.8% and 4.8% for the different types of PED with an overall prevalence of 8.2%. The overall prevalence of the two survey methods differed significantly. The current study showed that the conventional survey method using direct questioning led to an underestimation of the prevalence. Based on the RRT results, the percentage of users of PED among members of fitness centres is approximately 8.2%. Stimulants to lose weight had the highest prevalence, even higher than anabolic steroids. The key task for future preventive health work is to not only focus on anabolic steroid use, but also include interventions focusing on the use of stimulants to lose weight.

Prevalence of, and risk factors for, HIV, hepatitis B and C infections among men who inject image and performance enhancing drugs: a cross-sectional study / Vivian D. Hope, Jim McVeigh, Andrea Marongiu, Michael Evans-Brown, Josie Smith, Andreas Kimergård, Sara Croxford, Caryl M. Beynon, John V. Parry, Mark A. Bellis, Fortune Ncube. - (BMJ Open 3 (2013) 9 (12 September); p. 1-11)

• PMID: 24030866
• PMCID: PMC3773656
• DOI: 10.1136/bmjopen-2013-003207

Abstract

Objective: To describe drug use, sexual risks and the prevalence of blood-borne viral infections among men who inject image and performance enhancing drugs (IPEDs).

Design: A voluntary unlinked-anonymous cross-sectional biobehavioural survey.

Setting: 19 needle and syringe programmes across England and Wales.

Participants: 395 men who had injected IPEDs.

Results: Of the participants (median age 28 years), 36% had used IPEDs for <5 years. Anabolic steroids (86%), growth hormone (32%) and human chorionic gonadotropin (16%) were most frequently injected, with 88% injecting intramuscularly and 39% subcutaneously. Two-thirds also used IPEDs orally. Recent psychoactive drug use was common (46% cocaine, 12% amphetamine), 5% had ever injected a psychoactive drug and 9% had shared injecting equipment. 'Viagra/Cialis' was used by 7%, with 89% reporting anal/vaginal sex in the preceding year (20% had 5+ female-partners, 3% male-partners) and 13% always using condoms. Overall, 1.5% had HIV, 9% had antibodies to the hepatitis B core antigen (anti-HBc) and 5% to hepatitis C (anti-HCV). In multivariate analysis, having HIV was associated with: seeking advice from a sexual health clinic; having had an injection site abscess/wound; and having male partners. After excluding those reporting male partners or injecting psychoactive drugs, 0.8% had HIV, 8% anti-HBc and 5% anti-HCV. Only 23% reported uptake of the hepatitis B vaccine, and diagnostic testing uptake was poor (31% for HIV, 22% for hepatitis C).

Conclusions: Previous prevalence studies had not found HIV among IPED injectors. HIV prevalence in this, the largest study of blood-borne viruses among IPED injectors, was similar to that among injectors of psychoactive drugs. Findings indicate a need for targeted interventions.

Warner DC, Schnepf G, Barrett MS, Dian D, Swigonski NL.
J Adolesc Health. 2002 Mar;30(3):150-3.
Department of Pediatrics, Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.

PURPOSE: To describe NSAID use among football players and examine differences in attitudes and behaviors associated with reports of daily use.

Data are from 681 selfadministered questionnaires. Independent variables were race (white), insurance status (private), attitudes (whether NSAIDs helped performance), and behaviors (decided independently vs. asked an adult when to take an NSAID, what type, or dose; use of NSAIDs to treat pain vs. block pain). Among NSAID users, independent variables were entered into a logistic regression to determine their effects on the probability of daily use.

Athletes were male, 90% white, mean age 15.8 years, and 88% had private insurance. Four-hundred-fiftytwo (75%) used NSAIDs in the past 3 months, and 90 (15%) were daily users with no significant difference in age, race, or insurance between users and nonusers. Those who perceived better performance owing to NSAIDs (adjusted odds ratio [AOR] = 2.4), who decided on their own when to take NSAIDs (AOR = 2.2), and who used NSAIDs prophylactically were more likely to use daily NSAIDs (AOR = 2.5) after controlling for other variables in the model.

NSAID use in high school football players is highly prevalent. Although package inserts caution against chronic use, nearly one of seven players uses NSAIDs daily. Daily users were more likely to decide independently and to use NSAID prophylactically, raising issues about the need for adult supervision and education of athletes regarding side effects and appropriate use.

PMID:
11869920
[PubMed - indexed for MEDLINE]