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Chapter 23
Special Aids to Exercise Training
and Performance
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Pharmacologic Agents
• IOC-banned substance categories
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Stimulants
Narcotic analgesics
Androgenic-anabolic steroids
-Blockers
Diuretics
Peptide hormones and analogs
Substances that alter urine sample integrity
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Anabolic Steroids
• Structure and action
– Sterol structure similar to testosterone
– Increases muscle growth
• Stacking
– Combining multiple steroid preparations in oral
and injectable form
• Pyramiding
– Progressively increasing the dosage
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Anabolic Steroids
• Drug with a considerable following
– Becoming increasingly popular with more than
just strength athletes
• Effectiveness
– Dosage is an important factor.
– Training volume accompanies use.
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Anabolic Steroids
• Side effects and medical risks
• Cystic acne, “roid rage,” peliosis hepatitis,
increased plasma lipoproteins
• In males: testicular atrophy and
gynecomastia
• In females: clitoral enlargement, squaring of
the jaw, lowering of voice
• ACSM Position Statement on Anabolic
Steroids
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Growth Hormone
• Genetic engineering comes to sports
– Human growth hormone
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Produced in the pituitary gland
Stimulates bone and cartilage growth
Enhances fatty acid oxidation
Reduces glucose and amino acid breakdown
– Excess GH may result in
• Gigantism
• Acromegaly
– No unanimity among researchers
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
DHEA: A Worrisome Trend?
• DHEA
– Steroid hormone produced by the adrenal glands
• Claims for DHEA
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Testosterone booster
Bolsters immune system
Preserves youth
Decreases fatigue and joint pain
Slows aging
Invigorates sex life
– An unregulated compound with uncertain safety
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Androstenedione
• Claims
– Stimulates production of endogenous
testosterone
– Enables one to train harder
– Increases muscle mass
– Rapidly repairs tissue injury
• Research shows no effect of supplementation on
basal serum testosterone or any training response
on muscle size and strength.
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Amino Acid Supplements for an
Anabolic Effect
• Claims
– Boost body’s natural production of
• Testosterone
• Growth hormone
• Insulin-like growth factor I
– Resulting in an increase in muscle mass and a
reduction in fat mass
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Amino Acid Supplements
• Stimulating an anabolic effect
– Consuming carbohydrate and/or protein
immediately after resistance training
augments hormonal response to the training.
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Amphetamines
• Stimulate the CNS = sympathomimetics
• Claims
– Increase alertness
– Decrease sensation of muscle fatigue
• Dangers
– Physiologic or emotional dependence
– Headache, fever, dizziness, tremors
– Suppression of normal responses to pain
• Use and athletic performance
– Do not enhance physical performance.
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Caffeine
• Ergogenic effects
– Proposed mechanism for ergogenic action
• Increases use of fatty acids, sparing glycogen
– Effects on muscle
• May act directly on muscle to enable more
prolonged endurance performance
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Warning About Caffeine
• Possible side effects
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Nervous irritability
Muscle twitching
Psychomotor agitation
Elevated HR and blood pressure
Increased occurrence of PVCs
Insomnia
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Ginseng
• Claims
– Boosts energy
– Diminishes stress
• No compelling scientific evidence of
ergogenic effect
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Ephedrine
• Effects
– Increases heart rate, cardiac output, blood
pressure
– Bronchodilation
– Hypertension, insomnia, irritability
– Increases anaerobic power output, endurance
– Possibly heart attack, stroke, death
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Buffering Solutions
• Claims
– Pre-exercise alkalosis facilitates H+ efflux from
the cell, delaying the fall in pH.
– May be ergogenic for high-intensity endurance
performance
– Effect related to dosage and degree of
anaerobic metabolism
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Glutamine
• Promotes muscle glycogen accumulation
• May blunt immunosuppression from
exhaustive exercise
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Phosphatidylserine
• May modify neuroendocrine response to
stress
• Diminishes ACTH and cortisol release
• Does not affect growth hormone release
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
ß-Hydroxy-ß-Methylbutyrate
(HMB)
• Metabolite from the breakdown of leucine
• Claims
– Inhibits protein catabolism
• Research
– Ergogenic benefits may be transient.
– FFM tends to revert to baseline.
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Nonpharmacologic Approaches
• Red blood cell reinfusion—blood doping
– How it works
• Withdrawal of 1 – 4 units of blood
• RBC are frozen.
• Reinfusion 1 – 7 days prior to competition
– Effects
• Increases RBC number, oxygen-carrying
capacity, and ability to perform endurance
exercise
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Hormonal Blood Boosting
• Erythropoietin (EPO)
– Synthetic version of a hormone produced by
the kidneys
– May increase RBC number by 12%
– Unconventional or nonmedical
administration may create < 60% increase.
• Increases risk of stroke, heart attack, heart
failure, pulmonary edema
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Other Means to Enhance Oxygen
Transport
• New substance classes
– Perfluorocarbon emulsions
– Bovine and human hemoglobin solutions
• Potentially lethal side effect
– Increased systemic and pulmonary blood
pressure
– Renal toxicity
– Impaired immune function
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Warm-Up (Preliminary Exercise)
• General warm-up
– Unrelated movements
• Specific warm-up
– Sport-specific movements
• Psychologic considerations
– Athletes feel better prepared
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Warm-Up (Preliminary Exercise)
• Physiologic considerations
– Faster muscle contraction and relaxation
– Greater movement economy from lowered viscous
resistance
– Facilitated oxygen delivery—Bohr effect
– Facilitated nerve transmission and muscle metabolism
– Increased blood flow to active tissues
• Effects on performance
– More research needed
• Sudden strenuous exercise
– Risk of MI in sedentary or those with CHD
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Oxygen Inhalation (Hyperoxia)
• Preexercise oxygen breathing
– Not beneficial if ambient air is breathed before
performing
• Oxygen breathing during exercise
– Improves performance
– Not practical for most sports
• Oxygen breathing during recovery
– Research does not support use.
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Modification of Carbohydrate
Intake
• Carbohydrate loading
– Helps prevent/postpone “hitting the wall”
– Glycogen depletion stage
– Glycogen loading stage
• Creatine supplementation
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Modification of Carbohydrate
Intake
• Negative aspects
– Increased water retention
– Added weight increases the energy cost of
weight-bearing exercise.
– Depletion phase may inhibit ability to train.
– Low carbohydrate intake may create ketosis.
– Vitamin, mineral deficiencies
– Lean tissue loss
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
L-Carnitine
• Facilitates influx of fatty acids into
mitochondria
• Rate of fatty acid oxidation affects aerobic
exercise intensity.
• Research does not support ergogenic benefits.
• Potential benefits
– Vasodilation
– Less postexercise pain, tissue damage
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Chromium
• Potentiates insulin function
• Promotes carbohydrate uptake into cells
• Numerous alleged benefits
– Fat burner
– Muscle builder
• Research does support claims
• Potential downside
– Competes with iron for binding to transferrin
– Possible chromosomal damage
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Coenzyme Q10 (Ubiquinone)
• Used therapeutically for cardiovascular
disease
• Claims: improve stamina and enhance
cardiovascular function
• Research does not support ergogenic
benefits.
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Creatine
• Important component of high-energy
phosphates
• Documented benefits in humans
– Improves muscular strength and power
– Augments short bursts of muscular endurance
– Enables greater muscular overload
• Limited research on potential risks
• Creatine loading
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Inosine
• Claims
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Improves training quality, performance
Facilitates oxygen release, insulin release
Augments cardiac contractility
Vasodilator
• Research does not support ergogenic
effect.
• Risks contraindicate use.
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Choline
• Claims
– Fat burning, metabolism “optimizing”
• Research does not support claims.
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Medium-Chain Triglycerides
• Claims
– Fat burning, glycogen sparing, muscle
building
• Research is inconclusive.
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Hydroxycitrate (HCA)
• Claims
– Fat burning, endurance enhancing
• Research is inconclusive.
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Pyruvate
• Claims
– Fat burning, endurance enhancing
• Additional research is needed.
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Copyright © 2007 Lippincott Williams & Wilkins.
McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition