Performance enhancement and health最新文献

Background and objective

Social science research on people who use androgenic-anabolic steroids (AAS) has sometimes interpreted the events individuals describe as associated with their initiation and maintenance of AAS linearly, often neglecting the personal meanings and broader contextual factors influencing use decisions. To extend knowledge, the current study employs an existential psychological lens to interpret the factors long-term AAS users believe led to, and maintain, their use. A central feature of this perspective is that people have a restricted freedom to choose their existence and lead authentic lives. Hence, employing this perspective may reveal how our participants' actions in the world (i.e., their body projects and AAS use) may serve (or be a response to) fundamental concerns.

Methods

In-depth life-history interviews with co-created timelining and multiple informal conversations were undertaken with four British male bodybuilders (Mean age = 33 SD 9.23 years) who, on average, had been using AAS for 10.25 years (SD = 4.5 years). Data were put to a structural narrative analysis, where we identified central existential themes in participants' stories and crafted a master plot.

Findings and discussion

In childhood and adolescence, participants’ stories centred on a set of boundary situations (e.g., bullying, parents’ critical illness) that disrupted their routine and underscored their everyday uncertainties. Their search for meaning led them to exercise; developing their body became their method to control their situation. Building muscle and becoming absorbed by a bodybuilding routine created self-worth for them and enabled them to transform their identity. In early adulthood, however, further boundary situations (e.g., injury) disrupted the permanency of their muscular self-identify. These situations prompted participants to reflect on the meaning muscle provided in their lives. The threat of losing the core of what they believed defined their identity was inconceivable. Consequently, these men turned to AAS because they believe(d) it to be an authentic way to restore and sustain their identity.

Conclusion

These findings extend the linear descriptions of AAS use by showing how these men interpreted their life experiences and chose to use AAS to navigate their world.

The Enhanced Games (TEG) is a new idea to counteract the Olympic Games as an environment where athletes can emerge as “enhanced”. These athletes can use whatever drugs they want and receive a wage for their participation. Since the announcement, it has received much criticism, with the mainstream media and sporting bodies calling it “unsafe” and “a joke”. However, despite the negative commentary, its interest and popularity continue to grow, with former Olympic athletes expressing their interest in the games and the organisation receiving financial backing from multiple investors. This commentary piece will delve into TEG to provide a deeper understanding of what it is and what it means for the practices surrounding harm reduction, reducing stigma through the use of inclusive language and together the impact this has upon the Image and Performance Enhancing Drug (IPED) communities. Then, the work will discuss the potential risks and limitations of such a concept of a games. Finally, the work will end with recommendations and opportunities for the Enhanced Games to explore additional avenues within the field of human enhancement. Overall, TEG has a mission to ensure the health and safety of their athletes to enhance athletic performance. Nevertheless, more work needs to be done by TEG to reduce risk and harm when all forms of image and performance enhancing drugs are allowed to be used at their future events.

Background

Given the high prevalence of use of muscle-building supplements, such as whey protein and creatine monohydrate, there remains a need for more research to understand use among adolescents and young adults. This study aimed to describe the influences of muscle-building supplement use, the amount of time researching muscle-building supplements, common places of purchase, information sources, symptoms during use, medical attention sought, and perceptions of problematic use.

Methods

Data from the Canadian Study of Adolescent Health Behaviors (N = 912) were analyzed. Descriptive statistics were used to describe the primary variables and chi-square tests and one-way ANOVAs were used to identify gender differences. Regression analyses were conducted to determine the sociodemographic associations with reported symptoms during use, not seeking medical attention for symptoms, and perceived problematic use.

Results

Protein bars (58.9 %) and whey protein powders or protein shakes (52.2 %) were the most reported muscle-building supplements used. Nearly half (43.7 %) of participants reported social media influencers as a primary influence of use, while over two-thirds (69.3 %) reported seeking information from online websites. Participants spent the most time researching the risks and benefits of creatine monohydrate. Nearly two-thirds of participants reported at least one symptom while using muscle-building supplements, despite 87.8 % of those participants not seeking medical attention. Only 9.8 % of participants perceived their use as problematic, with distinct sociodemographic factors linked to symptoms and perceptions of problematic use.

Conclusions

Findings provide important information about the use of muscle-building supplements among adolescents and young adults that can guide harm reduction and intervention efforts among healthcare, public health, and policymaking professionals.

Introduction

Long-term anabolic-androgenic steroid (AAS) use poses several health risks, including secondary hypogonadism. There is a knowledge gap on treatment targeting the hypothalamic-pituitary-gonadal (HPG) axis among men with anabolic steroid-induced hypogonadism (ASIH). This study aims to gain insights into the potential utility of endocrine therapy to restore endogenous testosterone levels and alleviate ASIH symptoms in AAS dependent men.

Methods

In this proof-of-concept, single-site, open longitudinal pilot study, AAS dependent men with continuous AAS use and a desire to permanently discontinue use, were given endocrine therapy. The treatment included 25 mg clomiphene citrate (CC) every second day for 16 weeks, transdermal testosterone daily during the first four weeks, and if indicated, human chorionic gonadotropin (hCG) injections for a maximum of eight weeks. Physical exams including blood collection and online questionnaires were completed every four and two weeks, respectively.

Results

Ten participants, with median age 32 years (interquartile range 30–45), with mean ± standard deviation AAS use of 11 ± 4 years, completed the CC intervention. Seven participants received hCG as part of their treatment protocol. Mild adverse events included headaches, dizziness, and mood swings, and no serious adverse events occurred. During the intervention, there was a decrease in levels of hematocrit, hemoglobin and ALT (alanine aminotransferase), as well as an increase in serum FSH (follicle stimulating hormone), LH (luteinizing hormone) and SHBG (sex hormone binding globulin). Five of ten participants reached a total testosterone level within normal range (9–30 nmol/l). The HPG axis response varied greatly among participants, and was not aligned with the severity of ASIH related withdrawal symptoms.

Conclusions

The findings from this proof-of-concept study may guide future randomized controlled trials aiming to investigate potential endocrine therapeutic approaches to ASIH.

The continuing success of esports as a mass phenomenon is accompanied by an increase in challenges regarding governance and regulation as well as integrity. Besides match-fixing and software/hardware cheating, the consumption of performance-enhancing substances by esports players continues to cause negative publicity for the industry. While the number of scholarly contributions on this topic increases, there still is a clear lack of empirical studies that take the perspectives of players into account. In an online survey, we reached 226 esports (Defense of the Ancients 2, DotA 2) players, inquiring about the (perceived) prevalence and legitimacy of alleged performance-enhancing substances as well as aspects relating to governance, integrity, and regulation. Our results disclose a widespread self-reported use of caffeinated drinks and nicotine, with a notable proportion of participants reporting occasional or rare use of prescription drugs. Besides substance use, participants identified match-fixing and cheating as significant challenges to the integrity of esports. The results further indicate a lack of awareness of global governing/regulatory bodies by esports players and underscore the need for enforced regulation and concerted governance initiatives.

Background

Use of image and performance enhancing drugs (IPEDs), such as anabolic-androgenic steroids, has in the last decades spread from elite athletes to recreational exercisers seeking a shortcut to a lean and muscular physique. The drugs are associated with multiple potential negative health consequences, some of which may be particularly harmful for adolescents. To better develop adequate and targeted preventive measures, identifying individuals and groups at risk for using IPEDs are important.

Methods

By analyzing quantitative data extracted from Ungdata, a national data collection survey on adolescent health and well-being, this study describe self-reported physical activity and exercise habits, IPED prevalence, and attitudes and intentions towards IPEDs among 88 412 Norwegian adolescents aged 13–19 years.

Results

72 % participated in weekly sport or physical exercise. Young adolescents mostly exercised in sport clubs while older adolescents preferred training in gyms. Average lifetime IPED prevalence was 2.2 % (0.7 %–4.0 % depending on exercise activity). Respondents reported more favorable attitudes and higher intentions to use IPEDs when it was related to increasing muscle size (18 % and 5.8 %, respectively) and reducing weight (19 %, 8.1 %), compared to improving sport performance (5.6 %, 3.0 %). Large variations in attitudes and intentions were found between exercise groups, with individuals exercising in gyms having more favorable attitudes toward IPEDs than other groups.

Conclusion

The study finds a low relative prevalence, but high acceptance for IPED use in certain exercise groups. Education and preventive measures should specifically target groups at risk for future use of these drugs.

Objective

Symptoms of muscle dysmorphia (MD) are prevalent among males who engage in weight training. If symptoms remain undetected and untreated, it can impair their health and wellbeing. Research indicates that men are reluctant to seek professional help on their own, and there is a lack of intervention options for people with MD symptoms. Health and exercise professionals’ competence and perspectives may offer important knowledge around the development of future interventions. However, research has yet to do so. This study therefore aimed to explore health and exercise professionals’ views and perspectives on MD in the Norwegian population.

Method

Semi-structured interviews were conducted with seven health and exercise professionals to discuss their knowledge and experiences with MD, and their views on prevention measures and interventions.

Results

Thematic analysis identified three overarching themes: (1) MD symptomatology, including experiences with symptoms and consequences of MD, (2) challenges related to identifying MD symptoms, and (3) managing MD.

Conclusion

Symptoms of MD were described by participants to be severe and complex yet challenging to identify among their clients/patients. There is a need to develop interventions aimed at reducing symptom development, as well as resources to assist health and exercise professionals in approaching individuals with MD symptoms.

Background

The use of both licit and illicit appearance and performance-enhancing drugs (APED) has been recognized as a key public health concern. While it is estimated that rates of APED usage in non-athlete populations is increasing, true prevalence studies are limited by a lack of psychometrically reliable and valid measures. This paper describes the development and psychometric evaluation of a survey tool for assessing APED usage.

Method

Initial items for the Appearance and Performance Enhancing Supplement/Substance Use Scale (APES) were seven licit and 13 illicit APED. Following a preliminary exploration, we evaluated the concurrent validity, internal consistency, and test-retest reliability of the APES in a community sample of 265 participants.

Results

The APES demonstrated strong internal consistency, medium to strong concurrent validity, and good to excellent test-retest reliability.

Conclusions

These results provide preliminary support for the reliability and the validity of APES scores in assessing both licit and illicit APED usage. Future studies are recommended to replicate and extend the psychometric investigations reported here to encompass additional validation studies and populations.