Module 7 - Anti-Doping and RED-S Flashcards
What are the 3 Risk Levels of RED-S?
- High Risk: Red Light
- Moderate Risk: Yellow Light
- Low Risk: Green Light
What does RED-S mean?
- Relative Energy Deficiency in Sport
Describe the Red Light Risk Level of RED-S
- High Risk
- No clearance for sport participation
- Sport participation may pose serious risk to health
- Sport participation may distract attention from treatment and recovery
Describe the Yellow Light Risk Level of RED-S
- Moderate Risk
- Cleared for super-vised sport participation
- 1-3 month duration
Describe the Green Light Risk Level of RED-S
- Low Risk
- Full Sport Participation
What is the Definition of RED-S?
- Impaired physiological functioning
- Caused by relative energy deficiency
- Includes impairments to: metabolic rate; menstrual function; bone health; immunity; protein synthesis; and cardiovascular health
What was RED-S previously called?
- Female Athlete Triad
What is the equation for Energy Availability?
Energy Availability = Energy Intake(kcal) - Exercise Energy Expenditure (kcal) / Fat Free Mass (kg)
EA = EI - EEE / FFM
What is exercise energy expenditure (EEE)?
EEE = the additional energy expended above that of daily living during the exercise bout
What is the healthy physiological function in women?
45 kcal/kg FFM/day
What is low energy availability?
<30 kcal/kg FFM/day
What does low energy availability mean?
- Many systems are perturbed
What are some of the health consequences of RED-S?
- Immunological
- Menstrual Function
- Bone Health
- Endocrine
- Metabolic
- Hermatological
- Growth + Development
- Psychological (goes both ways)
- Cardiovascular
- Gastrointestinal
What are some performance consequences of RED-S?
Decrease
- Endurance Performance
- Training Response
- Judgement
- Coordination
- Concentration
- Glycogen Stores
- Muscle Strength
Increase
- Injury Risk
- Irritability
- Depression
What are some strategies for prevention of RED-S?
- Awareness, Education
- Screening at-risk athletes is difficult
Why is it difficult to screen at-risk athletes?
A gap in our understanding of RED-S (specific sport)
- energy demands
- Performance criteria
- Ethnicities
- Cultural perspectives
What does RED-S Present?
- 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
Describe the IOC Assessment Tool of the High-Risk Level of RED-S
- Anorexia Nervosa (other eating disorders)
- Serious medical conditions: related to low energy
- Extreme weight loss techniques
- Severe ECG abnormalities (ie. bradycardia)
Describe the Assessment Tool of the Moderate Risk Level of the RED-S
- 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
Describe the Risk Assessment Tool for Low Risk of RED-S
- Appropriate Physique without undue stress
- Healthy eating habits
- Healthy functioning endocrine system
- Healthy bone mineral density
- Healthy musculoskeletal system
What is the protocol for Red and Yellow zone of RED-S risk?
- Immediate medical evaluation and treatment
What multidisciplinary areas of medicine are useful for the treatment and evaluation of RED-S?
- Sports Medicine Physician
- Sport Dietician
- Mental Health Practitioner
- Exercise Physiologist
What are the concomitant treatment areas for RED-S?
- Mood disorders
- Eating Disorders
- Substance Use Disorders
What risk factors for RED-S require inpatient treatment?
- Severe Bradycardia
- Hypotension
- Electrolyte Imbalance
How does the severity of RED-S relate to the treatment?
- Increase in resistance to treatment
What is the protocol for High Risk RED-S?
- No competition
- No training
- Use of written contract
What is the protocol for Moderate Risk RED-s?
If following treatment plan
- May train
When medically cleared
- May compete under supervision
What is the protocol for Low-Risk RED-S?
- Full Sport Participation
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
Why might athletes dope?
- Belief other competitors are cheating
- Determination to succeed
- Pressure from others
What are the three categories of prohibited substances?
- Anabolic Agents
- Hormones and Related Substances
- Beta Agonists
Describe Anabolic Agents
- Derivative of Androgens
- Anabolic Effect
- Anticatabolic Effect
- Enhancement of Aggressive Behaviour
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
Describe Beta-2 Agonists involved in doping
- Bronchodilators Used to treat asthma
- Purported Benefit for Endurance Athletes
What are the exceptions of Beta-2 Agonists?
- Salbutamol
- Salmeterol
- Ventolin
What are the prohibited methods of enhancement of oxygen transfer?
- Homologous Blood Doping
- Autologous Blood Doping
- Erythropoietin Analogues
What is homologous blood doping?
Transfusion
- Athletes used the blood of someone else with the same blood type
What is Autologous Blood Doping?
Transfusion
- Athlete’s own blood stored for future use
What is Erythropoietin Analogues?
hormone
- Stimulates production of red blood cells
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)
What does Erythropoietin do?
- Thickens blood
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
What is Gene Doping?
Use of Genes, Genetic Elements, or Cells for:
- non-therapeutic purposes of enhancing performance
What are the methods of gene doping?
- Gene therapy
What is gene therapy?
- Introduce new genes into human body
What does gene therapy do?
- Correct absent or abnormal natural genes
- Improve athletic performance
How can Gener Therapy improve Athletic performance?
- Increase Muscle Growth
- Increase O2 Transfer
What are some side effects of gene doping?
- Cancer
- Metabolic Deregulation
- Allergy
What is an athlete’s biological passport?
- measurement of key laboratory variables
What are athletes’ biological passports used for?
Look for changes over time
- Useful for identifying blood doping/EPO missuse
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)
What is an RTP?
- Registered Testing Pool
What do athletes in a RTP have to do?
- provide a 60min period every day where they are available to be tested
What is a filing failure?
Whereabouts Strike
- When you fail to submit whereabouts information quarterly
- Provide incomplete information
What is a missed test?
Whereabouts strike
- Failure of doping control officer to find you at specified location during 60min testing period
What are the two whereabouts strikes?
- Filing Failure
- Missed Test
What happens when you have three whereabouts strikes in a 12-month period?
- Anti-doping rule violation
What are the risks of supplements?
- Substitutions
- Adulterations
- Unlisted Ingredients
- Contamination
What types of adulterations are found in supplements?
- Economic adulteration
- Pharmaceutical adulteration
What is economic adulteration?
- Less expensive ingredient is used in place of a more expensive ingredient listed on the label
What is pharmaceutical Adulteration?
- Active drug is included in a purportedly botanical supplement
What percentage of supplements in the study on 634-non hormonal supplements contained anabolic steroids or androgens?
- 15%
What percentage of herbal supplements included unlisted ingredients?
- 59%
in a study of 44 supplements at University of Guelph, how many had substituted ingredients?
- 30
What were the most common types of supplements that the FDA warned about?
- Weight loss
- Mass Gaining
- Sexual performance
What are some high risk suplements?
- Pre-workout
- Fat burning supplements
- Weight gain supplements
What is the advice for athletes regarding the consumption of foodstuff?
- Certain food and drink products may contain prohibited substances
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
What is the advice for athletes on social drugs of abuse?
- Extreme caution
What are some drugs of abuse prohibited by WADA?
- Cannabinoids
- Narcotics
- Amphetamines
- Cocaine
Are the drugs of abuse that WADA prohibits for in-competition or always?
- In-competition only
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
Are needles allowed during the Olympics?
- Only under certain exceptions and conditions
