Special Issue - Doping and Dietary Supplements in Sport [& Some]

[Michael Scally MD]

Go To: SEU - Annali di Igiene

[OA] Erice 2018 Charter on The Role of The National Health Service in The Prevention of Doping

The Erice 2018 Charter was unanimously approved at the conclusion of the 53rd Residential Course of the International School of Epidemiology and Preventive Medicine “Adapted Physical Activity in Sport, Wellness and Fitness; the role of the Departments of Prevention and of the National Health Service in doping prevention and health promotion”, held on 15-19 May 2018 in Erice, Italy, at the “Ettore Majorana” Foundation and Centre for Scientific Culture, and promoted by the Study Group on “Movement Sciences for Health” of the Italian Society of Hygiene, Preventive Medicine and Public Health.

The event was part of a larger project supported by the Ministry of Health aimed at preventing doping in the general population involved in sport and physical activities. After an intense discussion the participants focused on ten statements involving the following critical issues:

1. responsibility,

2. priority,

3. message,

4. alphabetization,

5. networks and alliances,

6. school promoting health,

7. player and opportunities,

8. competences,

9. know-how,

10. programming and acting.

These statements provide hints to approach doping within a public health frame and summarize the role of the Departments of Prevention and NHS in promoting and coordinating preventive actions with other institutions and stakeholders.

Doping represents a complex phenomenon related to cultural, social, economic and legal issues. In addition to regulatory or repressive actions, education to health and legality is proposed as the fundamental strategy to contrast doping by promoting healthy lifestyles, based on scientific knowledge and respect for legality

Spica VR, Di Rosa E, Savino G, et al. Erice 2018 Charter on the role of the National Health Service in the prevention of doping. Ann Ig. 2019;31:523-32. SEU - Annali di Igiene

 

[Michael Scally MD]

[OA] Education to Legality and Doping

When planning actions to prevent doping in the general population, public health operators may collide against the interests of criminal organizations involved in illicit trafficking of drugs. In addition to technical and professional expertise, or clinical and pharmacological skills, also a deep knowledge of legal and social issues is strongly required to face the problem and assure the effectiveness of the preventive actions.

Sports competitions, athletes training or adapted physical activity may all represent conditions and environments at risk for misusing or abusing drugs and dietary supplements. A correct approach to sport and physical activity implies respect of competition rules, attention to own body limits and knowledge of risk factors. Health education campaigns and preventive actions should also consider education to legality in the different settings.

The comprehension of the complex net that is available to access doping, locally or globally through online Internet sites, is essential as well as the awareness of the huge economic burden of crime interests behind the illicit trafficking of drugs. A modern whole rounded approach needs to consider doping not only as a violation of sport rules but also of the own body health, representing almost a form of addiction involving individuals and communities, and being supported by crime.

Within this frame, doping is considered not just as a sport violation or a risk factor for individual's health, but as a disease of the society, in the society, against the society. A peculiar equilibrium seems to prevail between crime external pressures and resigned internal acceptance, according to the 'mafia hypothesis' model, where hosts accept parasitism to avoid retaliation.

Here, main contributes and topics from the Erice 53rd Course are summarized and reviewed, providing links and references for further studies in the field. Health education and education to legality represent two sides of a same question, concerning both the general population and the health authorities. In conclusion, education to legality is a key component for prevention of doping and a priority for public health operators involved in protecting population health.

Tripi F, Ciotti L, Lusi A, Romano Spica V. Education to legality and doping. Annali di igiene: medicina preventiva e di comunita 2019;31:626-41. SEU - Annali di Igiene

 

[Michael Scally MD]

[OA] Dietary Supplements, Drugs and Doping in The Sport Society

Consumption of supplements and the use/abuse of drugs to support athletic performance is increasingly growing. The aim of this paper is to approach the phenomenon by providing a tool to develop critical awareness of these problems.

By reviewing scientific articles, we collected information on the use of licit and illicit substances among professional and non-professional athletes, showing a widespread scenario also based on false myths.

The use of supplements, drugs and doping substances represents a complex and still debated issue, that deserves greater consideration among both sportsmen and health operators.

A more critical and informed approach to these topics can support empowerment and a conscious use of drugs by respecting eating habits, own health and healthy lifestyles.

Savino G, Valenti L, D'Alisera R, Pinelli M, Persi Y, Trenti T. Dietary supplements, drugs and doping in the sport society. Annali di igiene : medicina preventiva e di comunita 2019;31:548-55. SEU - Annali di Igiene

 

[Michael Scally MD]

[OA] The Prevention of Doping and The Improper Use of Drugs and Food Supplements in Sports and Physical Activities

INTRODUCTION: Doping is an important public health problem widespread not only among elite athletes, but also among amateur and recreational athletes and the general population. In Italy the introduction of doping prevention within the Essential Levels of Care (LEA) with the DPCM 12/1/2017 represents a crucial step towards the implementation of education and health promotion interventions.

In this context, the Departments of Prevention (DP) of the Local Health Authorities (LHA) have to play a fundamental role, becoming the cultural and operational reference on this issue. As part of the "Doping prevention: development of a permanent educational tool coordinated by the National Health Service Prevention Departments" project, funded by the Italian Ministry of Health, a survey was conducted on the activities carried out by the DP regarding doping prevention and improper use and abuse of drugs and food supplements in sports and physical activities, as a basis for the harmonization of organizational structures and prevention programs and the creation of a collaboration network at a regional and national level.

METHODS: A semi-structured questionnaire consisting of 11 questions, prepared on an electronic platform, was sent to the DP of all the Italian LHA.

RESULTS: A total of 38 DP out of 131 (29%) completed the questionnaire, with representation from all regions. 42.1% of DP carried out or are still running programs for the prevention of doping, a percentage that decreases to 27% considering the programs for the prevention of misuse and abuse of drugs and food supplements in sports and in physical activities; in less than half of the DP, 37.5% and 41.7%, respectively, dedicated funds have been allocated.

The professionals most involved in prevention of doping are the Specialists in Sport Medicine (81.3%) followed by Specialists in Hygiene (43.8%) and Psychologists (37.5%), while Health Care Assistants (50%) are the professionals most involved in the prevention of the improper use of drugs and food supplements, followed by Specialists in Hygiene and Specialists in Sport Medicine (40%). Most of the DP (71.9%) believe that the introduction of programs to prevent and counteract doping in the LEA will have repercussions on their approach against doping.

CONCLUSIONS: The survey, although conducted on a limited sample, has provided an important framework relating to programs for the prevention of doping and the misuse and abuse of drugs and food supplements in sports and in the physical activities carried out by DP. A remarkable heterogeneity has been highlighted, both at national and regional level.

It is urgent to provide DP with homogeneous and effective organizational models and adequate operational tools, paying particular attention to the training of all the professionals involved. It is also essential to implement permanent monitoring tools.

Pasquarella C, Pompili M, Valeriani F, et al. The prevention of doping and the improper use of drugs and food supplements in sports and physical activities: a survey on the activity of the prevention departments of Italian local health authorities. Annali di igiene : medicina preventiva e di comunita 2019;31:533-47. SEU - Annali di Igiene

 

[Michael Scally MD]

[OA] Peer Education Strategies for Promoting Prevention of Doping in Different Populations

BACKGROUND: In the field of doping prevention, alongside the traditional functions of repression and control of the phenomenon, educational aspects are becoming increasingly important. Article 18 of the World Anti doping Code obliges the signatories to invest in anti-doping education with the aim of preserving the spirit of sport.

The educational commitment should involve young people in health promotion interventions for the prevention of risk behaviors. Therefore, our attention has focused on finding the mechanisms that lead people to make certain behavioral choices.

MATERIAL AND METHODS: In the context of preventive programs, to counter the doping phenomenon through health promotion programs, the most recognized method is peer education, particularly with adolescents. It is an educational method according to which some members of a group are empowered and trained to carry out specific activities with their peers. It is constituted as an example of equal relationship and finds its basis in cooperation and solidarity with the aim of increasing empowerment and a healthy development of the identity and collective dimension in young people.

RESULTS: Numerous experts - biologists / nutritionists, hygienists, sports coaches, psychologists, teachers of physical education in secondary schools and other stakeholders have actively participated in the co-construction of a training package aimed at activating cascade training processes on the knowledge and skills of peer education in contexts of youth aggregation, such as schools, gyms, sports associations, social gatherings of all kinds. The path allowed to define a peer education model capable of enabling the participants to activate health promotion interventions for the prevention of doping risk behaviors, each in their own setting.

CONCLUSIONS: In conclusion, we can say that prevention programs are the more effective the more they are addressed to young people and adolescents and provide interactive and action-oriented interventions.


Successful initiatives aim to emphasize the development of life skills and to influence numerous determinants of behavior, including individual attitudes, knowledge, motivations, interpersonal relationships and social norms.

If the aim is to act on the change of behavior, the efforts will be more successful if the content of the intervention will give due consideration to the context in which it applies and the target population, involving it and addressing its specific needs and values.

Fallace P, Aiese P, Bianco E, et al. Peer Education strategies for promoting prevention of doping in different populations. Annali di igiene : medicina preventiva e di comunita 2019;31:556-75. SEU - Annali di Igiene

 

[Michael Scally MD]

[OA] Preface for the Dedicated Issue: Doping and Dietary Supplements in Sport as An Emerging Hazard for Public Health

To conclude, we want to stress that all NHS actions aimed to promote healthy lifestyles cannot ignore the role that a safe sport and a safe physical activity can represent for that purpose.

Therefore, we feel that the moment has come that the graduates in sport and movement sciences (16), well prepared by many of our universities, be considered by the NHS as invaluable collaborators, within the DPs, to plan, organize and perform a series of qualified initiatives in favor of the population, such as offering occasions of practicing “doping free” sport and a regular physical activity for all those interested, but mostly fighting sedentarity of children, adults and, overall, the elderly (17, 18).

We believe that the national legislator should include their degree, with its unique expertise, in the list of the NHS professionals.

Romano Spica V, Fara GM. Preface for the Dedicated Issue: Doping and dietary supplements in sport as an emerging hazard for public health. Annali di igiene : medicina preventiva e di comunita 2019;31:519-22. SEU - Annali di Igiene

 

[Michael Scally MD]

[OA] Take Home Messages from The Dedicated Issue: Doping and Dietary Supplements in Sport as An Emerging Hazard for Public Health

Nowadays, doping represents a wrong habit and a social disease more than just a violation of sport rules during a specific competition (1-3). The misuse of drugs and dietary supplements overcomes the impact on the restricted élite of top athletes and appears as a wider phenomenon, spreading through the general population of different ages, in European countries and worldwide (4-7).

In this broader meaning, doping represents not only an individual risk for health, but also an illness within the globalized modern societies and an emerging issue for public health. The WHO objectives toward promoting physical activity as a priority for population health, further emphasize the need for safe environments for sport, from gym to urban areas (8-11).

…

The final take-home message from this 6/2019 issue is that doping prevention is an emerging question of public health and a valuable opportunity of health promotion for the NHS. …

Romano Spica V. Take home messages from the Dedicated Issue: Doping and dietary supplements in sport as an emerging hazard for public health. Annali di igiene : medicina preventiva e di comunita 2019;31:649-51. SEU - Annali di Igiene

 

[Michael Scally MD]

[OA] Anabolic Steroids Among Resistance Training Practitioners

OBJECTIVE: To compare the use of anabolic steroids (AS), the motivation to use them, their side effects, the source of information and the form in which AS were obtained, the medical follow-up, and the periodic examinations in resistance training practitioners who are either current or former users of AS.

METHODS: A prevalence survey was performed in the gyms of the city of Curitiba, including 719 current and former AS users who self-administered a questionnaire. The chi-square and z of proportions (p <0.05) statistical tests were conducted.

RESULTS: Esthetics was the main motivation associated with AS intake, leading to satisfactory results. The information about the form in which to use AS was provided by doctors and AS were either purchased at the pharmacy with a prescription or illegally. Current users reported a higher number of cycles and doses, a longer duration of use, as well as larger economical investments into AS. This shows a higher consumption of such drugs, regardless of the medical follow-up and post-cycle therapy.

CONCLUSION: Given that a change in the usage pattern was observed when increasing the AS consumption, this should be considered in the elaboration of public policies to inhibit such a trend.

Pereira E, Moyses SJ, Ignacio SA, et al. Anabolic steroids among resistance training practitioners. PLoS One 2019;14:e0223384. Anabolic steroids among resistance training practitioners

 

[Michael Scally MD]

[OA] [RUFKM] [BMH] Use of Hormones in Doping and Cancer Risk

Hormones with anabolic properties such as growth hormone (GH) and insulin-like growth factor-1 (IGF-1) are commonly abused among professional and recreational athletes to enhance physical ability. Despite their adverse effects are well-documented, the use of GH and IGF-1 has recently grown.

This article highlights the anabolic activity related to mechanisms of cancer development and progression. GH/IGF-1 axis is able to activate cellular mechanisms that modulate every key stage of cancer formation and progression, such as inhibition of apoptosis, resistance to treatments, and induction of angiogenesis, metastatic process and cell proliferation.

Results from pre-clinical studies and epidemiological observations in patients with an excess of GH and IGF-1 production or treated with these hormones showed a positive association with the risk to develop several types of cancer.

In conclusion, athletes should be made aware that long-term treatment with doping agents might increase the risk of developing cancer, especially if associated with other licit or illicit drugs and/or high-protein diet.

De Santi M, Baldelli G, Brandi G. Use of hormones in doping and cancer risk. Annali di igiene : medicina preventiva e di comunita 2019;31:590-4. SEU - Annali di Igiene