Use of Performance-Enhancing Substances

Abstract

Performance-enhancing substances (PESs) are used commonly by children and adolescents in attempts to improve athletic performance. More recent data reveal that these same substances often are used for appearancerelated reasons as well. PESs include both legal over-the-counter dietary supplements and illicit pharmacologic agents. This report reviews the current epidemiology of PES use in the pediatric population, as well as information on those PESs in most common use. Concerns regarding use of legal PESs include high rates of product contamination, correlation with future use of anabolic androgenic steroids, and adverse effects on the focus and experience of youth sports participation. The physical maturation and endogenous hormone production that occur in adolescence are associated with large improvements in strength and athletic performance. For most young athletes, PES use does not produce signifi cant gains over those seen with the onset of puberty and adherence to an appropriate nutrition and training program.

Evaluation and Behavior of Spanish Bodybuilders: Doping and Sports Supplements

“…The use of banned substances by athletes and the non-athletic population is estimated at 1–5% of the population and over 50% in some sports modalities, with a greater use in men than women [24,25]. The use of doping agents, once restricted to professional athletes, has these days become a public health problem, as it also affects young and non-competitive amateurs in different sports [26,27] and entails considerable risks for health that include, among others: cardiovascular illnesses, diabetes, cancer, mental health problems, virilization in women and the suppression of the androgens produced naturally in men [24].…”

Prevalence Estimates for Pharmacological Neuroenhancement in Austrian University Students: Its Relation to Health-Related Risk Attitude and the Framing Effect of Caffeine Tablets

“…Furthermore, PN consumption is, depending on dosage, associated with diverse adverse acute and chronic effects on physical and mental health, has been assumed to lead to addiction and produces a gateway to other drugs ( Kumar, 2008 ; Dietz et al, 2013b ; Wolff and Brand, 2013 ; LaBotz and Griesemer, 2016 ). For example, stimulant use is associated with the risk of cardiovascular events, hypertonia, tachycardia, and even sudden cardiac death ( Kumar, 2008 ).…”

Associations between legal performance-enhancing substance use and future cardiovascular disease risk factors in young adults: A prospective cohort study

“…These potential cardiovascular effects warrant further examination, especially given mixed findings in various short-term health-related outcomes. For example, short-term creatine supplementation is generally safe in adults [20], does not appear to adversely affect blood lipid profiles (e.g., cholesterol, triglycerides) [21], and may even have favorable glycemic effects (when combined with exercise) for individuals with type-2 diabetes [22]. However, creatine use also has been linked to weight gain [23], which could represent a detriment to long-term cardiovascular health, as higher weight and BMI are primary risk factors for CVD [24].…”

“…Caffeine, a stimulant that can be used for performance enhancement and is commonly included in mixtures of legal PES, activates the sympathetic nervous system and catecholamines, leading to elevations in blood pressure [27,28]. Finally, other legal forms of PES, such as androgen prohormones, could have particularly deleterious health-related impacts, especially if associated with adverse cardiovascular effects similar to those resulting from misuse of AAS (which they are designed to chemically emulate) [20].…”