Module 7 - Anti-Doping and RED-S Flashcards

1
Q

What are the 3 Risk Levels of RED-S?

A
  • High Risk: Red Light
  • Moderate Risk: Yellow Light
  • Low Risk: Green Light
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2
Q

What does RED-S mean?

A
  • Relative Energy Deficiency in Sport
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3
Q

Describe the Red Light Risk Level of RED-S

A
  • High Risk
  • No clearance for sport participation
  • Sport participation may pose serious risk to health
  • Sport participation may distract attention from treatment and recovery
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4
Q

Describe the Yellow Light Risk Level of RED-S

A
  • Moderate Risk
  • Cleared for super-vised sport participation
  • 1-3 month duration
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5
Q

Describe the Green Light Risk Level of RED-S

A
  • Low Risk
  • Full Sport Participation
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6
Q

What is the Definition of RED-S?

A
  • Impaired physiological functioning
  • Caused by relative energy deficiency
  • Includes impairments to: metabolic rate; menstrual function; bone health; immunity; protein synthesis; and cardiovascular health
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7
Q

What was RED-S previously called?

A
  • Female Athlete Triad
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8
Q

What is the equation for Energy Availability?

A

Energy Availability = Energy Intake(kcal) - Exercise Energy Expenditure (kcal) / Fat Free Mass (kg)
EA = EI - EEE / FFM

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9
Q

What is exercise energy expenditure (EEE)?

A

EEE = the additional energy expended above that of daily living during the exercise bout

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10
Q

What is the healthy physiological function in women?

A

45 kcal/kg FFM/day

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11
Q

What is low energy availability?

A

<30 kcal/kg FFM/day

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12
Q

What does low energy availability mean?

A
  • Many systems are perturbed
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13
Q

What are some of the health consequences of RED-S?

A
  • Immunological
  • Menstrual Function
  • Bone Health
  • Endocrine
  • Metabolic
  • Hermatological
  • Growth + Development
  • Psychological (goes both ways)
  • Cardiovascular
  • Gastrointestinal
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14
Q

What are some performance consequences of RED-S?

A

Decrease
- Endurance Performance
- Training Response
- Judgement
- Coordination
- Concentration
- Glycogen Stores
- Muscle Strength
Increase
- Injury Risk
- Irritability
- Depression

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15
Q

What are some strategies for prevention of RED-S?

A
  • Awareness, Education
  • Screening at-risk athletes is difficult
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16
Q

Why is it difficult to screen at-risk athletes?

A

A gap in our understanding of RED-S (specific sport)
- energy demands
- Performance criteria
- Ethnicities
- Cultural perspectives

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17
Q

What does RED-S Present?

A
  • Disordered Eating (De)/Eating Disorders (eD)
  • Weight Loss
  • Lack of normal growth and development
  • Endocrine Dysfunction
  • Recurrent Injuries and Illnesses
  • Decreased Performance/Performance Variability
  • Mood Changes
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18
Q

Describe the IOC Assessment Tool of the High-Risk Level of RED-S

A
  • Anorexia Nervosa (other eating disorders)
  • Serious medical conditions: related to low energy
  • Extreme weight loss techniques
  • Severe ECG abnormalities (ie. bradycardia)
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19
Q

Describe the Assessment Tool of the Moderate Risk Level of the RED-S

A
  • prolonged abnormal low % body fat
  • Substantial weight loss
  • Reduced Expected Growth and Development
  • Abnormal Menstrual Cycle
  • No menarche by age 15y in females
  • Reduced bone mineral density
  • History of 1 or more stress fractures
  • Physical/psychological complication related to low EA
  • Diagnostic test abnormalities
  • Prolonged relative energy deficiency
  • Disordered eating behaviour
  • Lack of progress in treatment/compliance
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20
Q

Describe the Risk Assessment Tool for Low Risk of RED-S

A
  • Appropriate Physique without undue stress
  • Healthy eating habits
  • Healthy functioning endocrine system
  • Healthy bone mineral density
  • Healthy musculoskeletal system
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21
Q

What is the protocol for Red and Yellow zone of RED-S risk?

A
  • Immediate medical evaluation and treatment
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22
Q

What multidisciplinary areas of medicine are useful for the treatment and evaluation of RED-S?

A
  • Sports Medicine Physician
  • Sport Dietician
  • Mental Health Practitioner
  • Exercise Physiologist
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23
Q

What are the concomitant treatment areas for RED-S?

A
  • Mood disorders
  • Eating Disorders
  • Substance Use Disorders
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24
Q

What risk factors for RED-S require inpatient treatment?

A
  • Severe Bradycardia
  • Hypotension
  • Electrolyte Imbalance
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25
How does the severity of RED-S relate to the treatment?
- Increase in resistance to treatment
26
What is the protocol for High Risk RED-S?
- No competition - No training - Use of written contract
27
What is the protocol for Moderate Risk RED-s?
If following treatment plan - May train When medically cleared - May compete under supervision
28
What is the protocol for Low-Risk RED-S?
- Full Sport Participation
29
What is Doping?
- Prohibited substance in Athlete sample - Refusing to compel with sample collection request - tampering - trafficking of prohibited substances - administration of prohib substance to athlete
30
Why might athletes dope?
- Belief other competitors are cheating - Determination to succeed - Pressure from others
31
What are the three categories of prohibited substances?
- Anabolic Agents - Hormones and Related Substances - Beta Agonists
32
Describe Anabolic Agents
- Derivative of Androgens - Anabolic Effect - Anticatabolic Effect - Enhancement of Aggressive Behaviour
33
Describe Hormones and Related Substances used for doping
- Erythropoietin - Human Growth Hormone: Anabolic - Insulin: Anabolic - Corticotropins (ACTH): causes release of cortisol, DHEA; no ergogenic benefit
34
Describe Beta-2 Agonists involved in doping
- Bronchodilators Used to treat asthma - Purported Benefit for Endurance Athletes
35
What are the exceptions of Beta-2 Agonists?
- Salbutamol - Salmeterol - Ventolin
36
What are the prohibited methods of enhancement of oxygen transfer?
- Homologous Blood Doping - Autologous Blood Doping - Erythropoietin Analogues
37
What is homologous blood doping?
Transfusion - Athletes used the blood of someone else with the same blood type
38
What is Autologous Blood Doping?
Transfusion - Athlete's own blood stored for future use
39
What is Erythropoietin Analogues?
hormone - Stimulates production of red blood cells
40
What are some blood doping symptoms?
- Jaundice - Circulatory Overload - Increase risk of infections diseases - Septicaemia (blood poisoning) - Blood Clots, Stroke or health failure - Metabolic Shock - Allergic reactions (wrong blood used)
41
What does Erythropoietin do?
- Thickens blood
42
What are some risks of using Erythropoietin?
Increased Risk of: - Blood Clot - Stroke - Heart Attacks - Contracting Infectious Diseases - developing EPO antibodies that destroys EPO naturally produced by body
43
What is Gene Doping?
Use of Genes, Genetic Elements, or Cells for: - non-therapeutic purposes of enhancing performance
44
What are the methods of gene doping?
- Gene therapy
45
What is gene therapy?
- Introduce new genes into human body
46
What does gene therapy do?
- Correct absent or abnormal natural genes - Improve athletic performance
47
How can Gener Therapy improve Athletic performance?
- Increase Muscle Growth - Increase O2 Transfer
48
What are some side effects of gene doping?
- Cancer - Metabolic Deregulation - Allergy
49
What is an athlete's biological passport?
- measurement of key laboratory variables
50
What are athletes' biological passports used for?
Look for changes over time - Useful for identifying blood doping/EPO missuse
51
What information can be asked of an athlete in the athlete's whereabouts system?
- Home Address - Training Information and Location - Competition Schedules - Regular Personal Activities (work and school)
52
What is an RTP?
- Registered Testing Pool
53
What do athletes in a RTP have to do?
- provide a 60min period every day where they are available to be tested
54
What is a filing failure?
Whereabouts Strike - When you fail to submit whereabouts information quarterly - Provide incomplete information
55
What is a missed test?
Whereabouts strike - Failure of doping control officer to find you at specified location during 60min testing period
56
What are the two whereabouts strikes?
- Filing Failure - Missed Test
57
What happens when you have three whereabouts strikes in a 12-month period?
- Anti-doping rule violation
58
What are the risks of supplements?
- Substitutions - Adulterations - Unlisted Ingredients - Contamination
59
What types of adulterations are found in supplements?
- Economic adulteration - Pharmaceutical adulteration
60
What is economic adulteration?
- Less expensive ingredient is used in place of a more expensive ingredient listed on the label
61
What is pharmaceutical Adulteration?
- Active drug is included in a purportedly botanical supplement
62
What percentage of supplements in the study on 634-non hormonal supplements contained anabolic steroids or androgens?
- 15%
63
What percentage of herbal supplements included unlisted ingredients?
- 59%
64
in a study of 44 supplements at University of Guelph, how many had substituted ingredients?
- 30
65
What were the most common types of supplements that the FDA warned about?
- Weight loss - Mass Gaining - Sexual performance
66
What are some high risk suplements?
- Pre-workout - Fat burning supplements - Weight gain supplements
67
What is the advice for athletes regarding the consumption of foodstuff?
- Certain food and drink products may contain prohibited substances
68
What are some examples of foodstuffs that contain prohibited substances?
- Clenbuterol: within some meats from countries where it is used as a growth promoter in animals - Narcotics (morphine): Poppy seeds - Cannabinoids: edibles / hemp-containing foodstuffs
69
What is the advice for athletes on social drugs of abuse?
- Extreme caution
70
What are some drugs of abuse prohibited by WADA?
- Cannabinoids - Narcotics - Amphetamines - Cocaine
71
Are the drugs of abuse that WADA prohibits for in-competition or always?
- In-competition only
72
Why might it be risky for an athlete to use drugs of abuse outside of competition?
- could lead to adverse findings in competition due to delayed excretion
73
Are needles allowed during the Olympics?
- Only under certain exceptions and conditions