Doping in sports

1. Doping in Sports Dr. Abhijit Salvi MBBS, Masters in Sports Medicine (U.K) BCCI Anti-Doping and Age-Verification Officer

2. Origin “Dope” – from Dutch word ‘Dop’ – an alcoholic beverage from grape skins, used by Zulu warriors to enhance their power in battle.

3. Definition Doping is defined as occurrence of one or more of the following: Presence of Prohibited Substance in an Athlete’s Sample Use or Attempted Use Refusing or failing without compelling justification to submit to Sample Collection after notification Violation of applicable requirements regarding Athlete availability for Out-of-Competition Testing Tampering or Attempted Tampering Possession Trafficking or Attempted Trafficking Administration or Attempted administration to any Athlete of a Prohibited Substance or Prohibited Method

4. World Anti-Doping Agency (WADA) Established in 1999 HQ – Montreal, Canada 192 countries and more than 570 sporting organizations have signed up with WADA WADA’s budget of US$ 25.5 million is shared equally by member governments and the IOC.

5. Infamous Doping Offenders

6. India: High on drugs, low on medals India has the highest number of failed dope tests internationally . In 2010, 103 Indian sportspersons, including juniors, failed dope tests. The 2011, 121 tested positive while more than 130 have failed in 2012. At the National School Games (U-16) at New Delhi in January 2012, 11 out of 81 samples collected tested positive for banned substances which included 3 Wrestlers, 3 Weightlifters and 5 Boxers. The Weight Lifting Federation of India has been suspended twice by the International body.

7. Why to combat Doping in Sport? Doping threatens Athlete’s Health It also threatens Integrity of Sport Athletes are role models to many youngsters

8. Why do athletes take drugs ? Ignorance about drugs Amateurism to professionalism. Drugs, a must for Winning. Fame & fortune. To cope with stress and injuries. Pressure from peers, coach, support staff, family, media & nation.

9. WADA tightening the noose! Most athletes are victims rather than culprits. Often only the athlete is sanctioned, as the weakest link. The athlete in the WADA Code Acceptance Form has to list his coach, manager, trainer & physiotherapist. Any positive doping test will lead to all being watch listed and target tested Re-testing of samples once new methods are available. Urine and blood samples are now being preserved for 8 years to identify new drugs

10. The WADA Prohibited List WADA reviews the Prohibited list annually The revised list is published on 1 st October every year and comes into effect 3 months later i.e. from the following 1 st of January.

11. The 2013 WADA Prohibited List Substances and Methods Prohibited at all times (In- & Out-of Competition) Substances and Methods Prohibited In-Competition Substances Prohibited in Particular Sports Specified Substances

12. A. Substances & Methods Prohibited In- & Out-of-Competition Substances: S0 Non-approved substances S1 Anabolic a gents S2 Peptide Hormones, Growth factors & related substances S3 Beta-2 agonists (except Salbutamol & Salmeterol) S4 Hormone & Metabolic modulators S5 Diuretics & other Masking agents Methods: M1 Manipulation of Blood & b lood components M2 Chemical & Physical manipulation M3 Gene doping

13. B. Substances & Methods Prohibited In- Competition S0 Non-approved substances S1 Anabolic agents S2 Peptide Hormones, Growth factors & related substance s S3 Beta-2 agonists (except Salbutamol & Salmeterol) S4 Hormone & Metabolic modulators S5 Diuretics & other Masking agents M1 Manipulation of Blood & blood components M2 Chemical & Physical manipulation M3 Gene doping In Addition: S6 Stimulants S7 Narcotics S8 Cannabinoids S9 Glucocorticosteroids

14. C. Substances & Methods Prohibited in particular sports P1 Alcohol Prohibited In-Competition only, in following sports. Detection conducted by breath/blood analysis. Violation threshold is 0.10 g/L Aeronautic, Archery, Automobile, Karate, Motorcycling, Powerboating P2 Beta-Blockers In-Competition only, in following sports Shooting, Archery, Automobile, Billiards, Darts, Golf, Skiing/Snowboarding

15. D. Specified Substances The prohibited list may identify specified substances which are particularly susceptible to unintentional Anti-Doping violations because of their availability in medicinal & food products or which are likely to be successfully abused as doping agents Ephedrine Methylhexanamine L-methyl Amphetamine

16. Therapeutic Use Exemption (TUE) TUE may be granted to a player permitting the use of prohibited substance in the prohibited list The player should submit a TUE application when necessary and exemption will be granted if sanctioned in accordance with strict criteria . In a medical emergency, treatment is a priority. Player/Doctor should apply for a TUE retroactively

17. Ill Effects of Doping Androgenic Anabolic Steroids (MALES) -Breast Development in Males -Male Pattern Baldness (Gynecomastia) -Infertility -Liver & Kidney damage - Aggression -High Blood Pressure

18. Ill Effects of Doping Androgenic Anabolic Steroids (FEMALES) -Hair Growth -Menstrual Disturbances -Infertility - Fetal Defects -Liver & Kidney damage -Hoarseness -High Blood Pressure

19. Ill Effects of Doping Stimulants : loss of appetite, insomnia, restlessness, high blood pressure (HBP), palpitations and addiction Narcotics: aggravates injuries, loss of balance/coordination , depression & addiction Peptide Hormones: masculinity, abnormal growth, HBP, diabetes mellitus, myocardial/cerebral infarction, embolism, convulsions

20. Nutritional Supplements & Doping

21. Nutritional Supplements Billion $ Industry Widespread among sports persons Recommended by fitness trainers Not recommended by the IOC Not regulated by the FDA WADA does not accept testing certificates 1 in 4 Nutritional Supplements are contaminated

22. Athletes look to Nutritional Supplements for many benefits Promoting adaptations to training Increasing energy supply Allows more intense training by promoting recovery Maintains good health & reduces interruptions to training due to chronic fatigue, illness or injury Enhancing competitive performance

23. Energy Systems of body Carbohydrates are the main source of energy. Carbs are stored in the liver & muscles. Fats are the secondary & a long term source of energy. Fats stored in fat depots in the body Proteins are essential for muscle growth & repair. Not a major source of energy & they cannot be stored in the body

24. Protein important in the response to exercise Amino acids from protein form building blocks for manufacture of new tissue including muscle and repair of damaged tissue Proteins are building blocks for hormones and enzymes that regulate metabolism Proteins also support the immune system Provides a small source of fuel for the exercising muscle

25. Protein Supplements Protein Supplements, High Protein bars and amino acid preparations - biggest selling sports nutrition products An adequate intake of protein essential for muscle growth and repair RDA can be easily achieved with everyday foods. Hence extra protein seldom required Whole proteins have advantages over individual amino acids

26. Daily recommended intake of Protein Sedentary 0.8 gm/kg BW Elite Athlete 1.2-1.6 gm/kg BW Most athletes consume more than 1.2-1.6 gm /kg BW protein in their normal diet and hence do not need to be encouraged or educated to increase their protein intake Some resistance trained athletes and body builders take up to 2-3 gm /kg BW proteins which is not required

27. Protein-rich foods: 10 gm. of protein is provided by 2 small eggs 300 ml of cow’s milk 20 gm. of skim milk powder 30 gm. of cheese 200 gm. yoghurt 35-50 gm. of meat, fish or chicken 4 slices bread 90 gm. breakfast cereal 2 cups cooked pasta or 3 cups rice 400 ml soy milk 60 gm nuts or seeds 120 gm tofu or soy meat 150 gm legumes or lentils 200 gm baked beans 150 ml fruit smoothie or liquid meal supplement

28. Recent studies suggest, rather than high protein intakes per se, focus on : total balance of the diet timing of protein-carbohydrate meals and snacks in relation to training & competition

29. Whole Milk vs . Whey Protein Whole milk is 82% casein (slow absorption) + 18% whey (fast absorption) Whey is a by-product of whole milk after cheese production Whey protein powder is 10 times more expensive than milk Whey stimulates early protein synthesis but due to faster oxidation this effect is short-acting and complete within an hour Casein stimulates late protein synthesis which lasts for 4 to 7 hours. Besides casein reduces muscle protein breakdown.

30. Milk: Sports Recovery Drink Recent studies show that milk is as effective or more effective as a sports recovery drink than commercially available sports drinks (in lactose tolerant people ) In lactose intolerant people soya milk could be substituted. Besides water, milk also provides high quality protein, carbohydrates, vitamins, electrolytes and minerals such as calcium

31. Nutritional Supplements & Doping Athletes must be aware of the strict liability principle that makes them responsible for everything they eat and drink Surveys have suggested that 1 in 4 may result in a positive test Prohibited compounds are never declared on the label At present, there can be no guarantee of the purity of any commercial supplement If there is any doubt at all, DON’T TAKE IT

32. The choice is yours… OR

33. Ayurveda & Homeopathy Ayurveda & Homeopathy have stood the test of time. People’s perception is that they are effective and safe. The fact is that the ingredients are unknown, no effective product labeling and not recognized by FDA’s.

34. Ayurveda & Homeopathy Upul Tharanga, Sri Lankan opening batsman, tested positive for Prednisolone during the Cricket World Cup 2011. It is presumed that this banned substance came from his homeopathy prescription by a popular Sri Lankan homeopath for treatment of Bronchial Asthma.