Tom Roper's Weblog

Doping in sport: the evidence for performance enhancement at the Olympics

Will the London Olympics be the cleanest yet? The audience at the Bishop-Lefanu lecture for 2012 were sceptical, 59% disagreeing with the proposition.

The lecture, given every two years, commemorates W J Bishop, librarian at the Wellcome, founder of the Medical Section of the Library Association, the ancestor of HLG, and William LeFanu, Librarian of the Royal College of Surgeons in England (and husband of the composer Elizabeth Maconchy). This year’s lecturer, in Olympic year, was Dr Yannis Pitsiladis, Reader at Glasgow University’s Institute of Cardiovascular and Medical Sciences and member of the World Anti-Doping Agency’s Prohibited List Expert Group.

I looked forward to his lecture as, apart from his work on performance enhancement, he has worked with studied the performance of East African athletes, studying the physiological factors behind their extraordinary performances, and is also the author of this:

Pitsiladis Y, Beis L.
To drink or not to drink to drink recommendations: the evidence
BMJ. 2012 Jul 18;345:e4868.

 We were handed clickers as we entered the hall, as Dr Pitsiladis promised us an interactive lecture. We were to be members of the committee that oversees the prohibited list. There are three criteria and, to be banned, a substance must meet at least two.

First of all it must have the potential to enhance performance to a significant extent, though races can hang on tiny differences in performance. The placebo effect may also come into play. The Wales rugby team famously endured cryotherapy before and athletes in many disciplines use ice baths but there’s no evidence that either are effective (I thought here that ice baths, at least for distance runners, are taken to speed recovery, rather than enhance performance per se). Growth hormone again is ineffective.

Secondly a substance must not harm athletes. So, Dr Pitsiladis asked us, are the risks of anabolic steroids exaggerated? The evidence suggests they are, perhaps to discourage use. Thirdly, it must violate the spirit of sport. Caffeine was banned until 2004. It enhances performance, and has potential side-effects, but it is impossible to tell what the dosage is. Here Dr Pitsiladis referred to us to study on the amount of caffeine served in single espressos in coffee shops around Glasgow: Crozier TW, Stalmach A, Lean ME, Crozier A.
Espresso coffees, caffeine and chlorogenic acid intake: potential health implications.
Food Funct. 2012 Jan;3(1):30-3

My prejudices were confirmed when I saw how feeble a Starbucks espresso is.

As for energy drinks, Dr Pitsiladis trailed the research published the following week in the BMJ and also the subject of a Panorama programme:

Cohen D. The truth about sports drinks.
 BMJ. 2012 Jul 18;345:e4737.
and

Heneghan C, Howick J, O'Neill B, Gill PJ, Lasserson DS, Cohen D, Davis R, Ward A, Smith A, Jones G, Thompson M.
The evidence underpinning sports performance products: a systematic assessment.
BMJ Open. 2012 Jul 18;2(4). pii: e001702.

Should one of the three criteria, specifically the performance enhancement one, be given greater weight than the others, he asked us.

Who cheats? If detection is effective, then it’s a little less than 1%. Weightlifters are the worst, then athletes. Paralympians dope too, at about the same rate. The most common substances detected are anabolic steroids, followed by stimulants and cannabinoids. Perhaps unsurprisingly, there's no evidence that cannabis enhances performance, though it may help overcome anxiety. Less often found are glucocorticoids, whose presence on the list is a matter of controversy, beta-blockers and hormone antagonists

Why dope? To cope with injury, to enhance performance, improve strength, because it’s the social norm (especially in weightlifting) and to cope with anxiety (which is why footballers use cannabis). Athletes can be doped without their knowledge, as has been alleged to be the practice at certain football clubs. To detect newer methods of doping, for example the use of EPO, requires a systems biology approach. The window for detection is short, though the effects long lasting. However the effects of altitude training are very similar to EPO, at least as far as haematocrit is concerned and Dr Pitsiladis is working on a study comparing East African and Glaswegian athletes. Blood passports can pick up EPO doping, and potentially could detect genetic doping, the trend for the future.

There was time for one question, about the effect of altitude on training. Dr Pitsiladis replied that it certainly works. No sea level athlete can win in distance events. The answer is to live at altitude and choose your parents wisely. Live high and train low, though Haile Gebrselassie, the world record holder for the marathon, lives high and trains high.

Running in the harem

Continuing my art-orgy, started with a visit to the Hammershoi at the Royal Academy, I went to Tate Britain, to see both Martin Creed's Work no 850 and the Orientalism exhibition.

I've referred to Creed before, on my running blog, but seeing it is another matter. Runners, I counted four different ones, three men, one woman, with different physiques and running styles, run the length of the empty Duveen galleries down the centre of the Tate.

Later, on my way to the cloakroom, I met a couple of them as they used the basement passages to return to the start. I am sure if I were allowed to run down the centre of the galleries I should be much louder; their footsteps are quieter than expected. An outdoor activity like running changes the indoor space of an art gallery, in some way I find hard to define. It is partly that the spectators are watching contemporary human movement somewhere where we are used to looking at work produced in the past which stays still for our examination.

In Orientalism, the first room is the fancy dress room, showing the English urge for dressing up in the costumes of the Near and Middle East from the sixteenth century onward, whether as fancy dress, as disguise or as some form of trying to identify with Turk or Arab. In the upper library of my old school, a picture used to hang of a Victorian man in Arab dress; I cannot remember who it was, and have written to the school archivist to see if it is still there, and if so if he can shed any light on it. After a room of genre painting, the room, the Holy City shows Jerusalem through the eyes of British painters. The insatiable needs of Victorian Sunday schools for depictions of the 'Holy Land' to hang on their walls must have created a market for any number of reproductions.

In the harem room, cleverly decorated with a screen, I found myself the only man, apart from the attendants, among a number of women visitors, and was struck by a whimsically Orientalist thought, that I might be the sultan, the other visitors my concubine, and the gallery attendants my eunuchs.

In a room of photographs, and an enlightening visual display the extent of the Ottoman Empire and of journeys by various travellers, Lady Montagu and Byron among them to the Levant and the Orient, I found a display of photographs taken in Jerusalem, Cairo and Constantinople. This last made me remember a song my father used to sing, whose first line was:

'Constantinople. With a C-O-N-S-T-A-N-T-I-N-O-P-L-E'

Seven for the seven stars in the sky

Or seven for the Seventh World Congress, in Unity Theatre's parody of Green Grow the Rushes O, that we used to sing when I was a young thing. The line refers to the Seventh Congress of the Comintern, at which the popular front strategy was launched. There is also a variant line, 'seven for the stars on Connolly's plough', a reference to the starry plough flag of the Irish Citizen Army.

I keep running out of the main blog, but will briefly record here that yesterday I completed the Beachy Head marathon for the fourth time. This was my seventh marathon overall, and the last few miles are over the Seven sisters and Beachy Head. More details here: http://tomroper.typepad.com/marathon2005/

The link to the Unity Theatre above is to their Wikipedia entry. The Unity Theatre Trust's website at http://www.unitytheatre.org.uk/ seems unavailable.

Technorati Tags: beachyheadmarathon, marathon

Neolithic marathon

Most of the time I keep my running safely away from this, my main blog, but I must record here that yesterday I ran the Neolithic Marathon, my sixth, in a time of 4:17:32.

Technorati Tags: avebury, stonehenge, wiltshire

Isle of Wight marathon

I only let running spill over into the mainstream blog when I run a race. So let it be known that today I finished the Isle of Wight Marathon in 4 hours, 10 minutes and 40 seconds, a personal best for the distance.

Beachy Head Marathon

Normally running posts are kept strictly segregated but in this case...yesterday I finished the Beachy Head Marathon in an unofficial time of 4 hours 51 minutes and 54 seconds. More here

Seaford half marathon

It was the Seaford half marathon today. For details see the training blog and for photos see the running photo album

London Marathon

I don't let running spill over into this blog very often, but for once I must.
I ran the London Marathon in 4 hours 32 minutes and 11 seconds, coming 17861st, 14151st among the men and 1562nd in my age group.
My BSMS colleague Claire Brooks did it in 4:16:14
For more see the running blog

Hastings Half Marathon

Full details over on the Marathon Training blog, but I ran the Hastings Half Marathon today which I completed in 1:43:44, by my watch.

Sussex Beacon Half Marathon

It's not my practice to overload this blog with references to my running which would be a tedious waste of bandwidth, but I do record races I have taken part in. So see the marathon training blog for an account of today's Sussex Beacon Half Marathon.