Current Insights into the Steroidal Module of the Athlete Biological Passport.

For decades, the class of anabolic androgenic steroids has represented the most frequently detected doping agents in athletes' urine samples. Roughly 50% of all adverse analytical findings per year can be attributed to anabolic androgenic steroids, of which about 2/3 are synthetic exogenous steroids, where a qualitative analytical approach is sufficient for routine doping controls. For the remaining 1/3 of findings, caused by endogenous steroid-derived analytical test results, a more sophisticated quantitative approach is required, as their sheer presence in urine cannot be directly linked to an illicit administration. Here, the determination of urinary concentrations and concentration ratios proved to be a suitable tool to identify abnormal steroid profiles. Due to the large inter-individual variability of both concentrations and ratios, population-based thresholds demonstrated to be of limited practicability, leading to the introduction of the steroidal module of the Athlete Biological Passport. The passport enabled the generation of athlete-specific individual reference ranges for steroid profile parameters. Besides an increase in sensitivity, several other aspects like sample substitution or numerous confounding factors affecting the steroid profile are addressed by the Athlete Biological Passport-based approach. This narrative review provides a comprehensive overview on current prospects, supporting professionals in sports drug testing and steroid physiology.

Low energy availability in exercising men is associated with reduced leptin and insulin but not with changes in other metabolic hormones.

Low energy availability, defined as low caloric intake relative to exercise energy expenditure, has been linked to endocrine alterations frequently observed in chronically energy-deficient exercising women. Our goal was to determine the endocrine effects of low energy availability in exercising men. Six exercising men (VO2peak: 49.3 ± 2.4 ml · kg(-1) · min(-1)) underwent two conditions of low energy availability (15 kcal · kg(-1) fat-free mass [FFM] · day(-1)) and two energy-balanced conditions (40 kcal · kg(-1) FFM · day(-1)) in randomised order. During one low energy availability and one balanced condition, participants exercised to expend 15 kcal · kg(-1) FFM · day(-1); no exercise was conducted during the other two conditions. Metabolic hormones were assessed before and after each 4-day period. Following both low energy availability conditions, leptin (-53% to -56%) and insulin (-34% to -38%) were reduced (P < 0.05). Reductions in leptin and insulin were independent of whether low energy availability was attained with or without exercise (P > 0.80). Low energy availability did not significantly impact ghrelin, triiodothyronine, testosterone and IGF-1 (all P > 0.05). The observed reductions in leptin and insulin were in the same magnitude as changes previously reported in sedentary women. Further research is needed to understand why other metabolic hormones are more robust against low energy availability in exercising men than those in sedentary and exercising women.

Glycerol administration before endurance exercise: metabolism, urinary glycerol excretion and effects on doping-relevant blood parameters.

Glycerol is prohibited as a masking agent by the World Anti-Doping Agency and a urinary threshold has recently been recommended. However, little is known about urinary glycerol excretion after exercise, when (1) exogenous glycerol is metabolized increasingly and (2) endogenous glycerol levels are elevated. The purpose of the placebo-controlled cross-over study was to determine the effects of pre-exercise glycerol administration on glycerol metabolism, urinary excretion, and selected blood parameters. After administration of glycerol (G; 1.0 g/kg body weight (BW) + 25 ml fluid/kg BW) or placebo (P; 25 ml fluid/kg), 14 cyclists exercised 90 min at 60% VO2max . Samples were taken at 0 h (before administration), 2.5 h (before exercise), 4 h (after exercise) and 6.5 h and additional urine samples were collected until 24 h. Exercise increased endogenous plasma glycerol (0.51 ± 0.21 mmol/l) but peak concentrations were much higher in G (2.5 h: 15.6 ± 7.8 mmol/l). Urinary glycerol increased rapidly (58,428 ± 71,084 µg/ml after 2.5 h) and was significantly higher than in P until 13.6 ± 0.9 h (p < 0.01). In comparison with placebo administration, G caused significantly greater changes in plasma volume and haemoglobin concentrations after 2.5 h. BW and urine production were significantly different between P and G after 2.5 h and post-exercise. Despite exercise-induced increases in endogenous glycerol in the control group, urinary excretion remained well below the previously recommended threshold. In addition, exercise-related glycerol degradation did not appear to negatively affect the detection of exogenously administered glycerol.

Meta-analysis: Effects of glycerol administration on plasma volume, haemoglobin, and haematocrit.

The use of glycerol in combination with excess fluid can be used to increase total body water. Because glycerol hyperhydration may also be misused to mask the effects of blood doping on doping-relevant parameters, namely haemoglobin and haematocrit, glycerol has been prohibited by the World Anti-Doping Agency since 2010. In order to test this rationale, the purpose of this meta-analysis was to quantify the effects of glycerol hyperhydration on plasma volume, haemoglobin, and haematocrit in comparison to administration of fluid only. Following a literature search, a total of seven studies was included and meta-analyses were performed separately for the effects on plasma volume (5 studies, total n = 54) and on haemoglobin (6 studies, n = 52) and haematocrit (6 studies, n = 52). The meta-analysis revealed that the increase in plasma volume was 3.3% larger (95%-CI: 1.1-5.5%) after glycerol administration when compared to fluid only. Reductions in haemoglobin were 0.2 g/dl (95%-CI: -0.3, 0.0) larger and there was no difference in the changes in haematocrit between glycerol and fluid administration (95%-CI: -0.7-0.8%). In comparison with other plasma-volume expanding agents, glycerol hyperhydration has a very limited potential in increasing plasma volume and altering doping-relevant blood parameters.

Comparison of self-reported energy availability and metabolic hormones to assess adequacy of dietary energy intake in young elite athletes.

Previous intervention studies suggest that leptin, insulin, insulin-like growth factor 1 (IGF-1), and triiodthyronine (T3) are sensitive markers of inadequate energy intake in relation to exercise expenditures. Because of limitations in metabolic hormone measurements, self-reported energy availability (EA) based on food and activity records may present an alternative for characterizing energy status in young athletes. The purpose of the current study was to assess whether self-reported EA is related to leptin, insulin, IGF-1, and T3 in 352 young athletes. Sex, body composition, sport participation, and acute weight changes were considered as confounding variables. Multiple linear regression revealed that EA was negatively associated with leptin (p < 0.05) but not with insulin, IGF-1, or T3. Female athletes with low EA (<30 kcal·kg(-1) fat-free mass (FFM)) had higher leptin concentrations (5.0 ± 4.7 ng·mL(-1)) and more body fat (18.3% ± 5.1%) than did females with normal EA (leptin, 3.1 ± 2.4 ng·mL(-1); body fat, 15.8% ± 4.2%; both, p < 0.001). Athletes reporting acute weight loss (>1 kg·week(-1)) had a lower EA (18.9 ± 7.4 kcal·kg(-1) FFM) than did weight-stable athletes (30.0 ± 11.2 kcal·kg(-1) FFM) or athletes reporting weight gain (>1 kg; 49.7 ± 13.1 kcal·kg(-1) FFM). IGF-1 and T3 were also reduced in athletes who lost weight (p < 0.01). This cross-sectional study reveals a lack of association between self-reported EA and metabolic hormones indicative of energy status in young athletes. Further studies are needed to investigate whether self-reported EA and metabolic hormones are in better agreement when measured repeatedly.

Case study: simulated and real-life energy expenditure during a 3-week expedition.

During prolonged periods of high energy expenditure (EE), restricted food intake can lead to a loss of body mass. This case study describes the preexpedition support for an unsupported 3-wk crossing of the Atacama Desert in Chile. The goals were to simulate the energy requirements of walking under varying conditions and to predict energy intake and EE to evaluate whether the expected weight loss was in acceptable limits. The expeditionist (male, 35 yr, 197 cm, basal weight 80 ± 0.5 kg) was a well-trained endurance athlete with experience of multiple expeditions. During the simulation, he walked on a treadmill at speeds of 2-7 km/hr under varying conditions of inclination (0%, 7.5%), backpack weight (0 kg, 30 kg), and altitude (sea level, simulated altitude of 3,500 m). Under all conditions, the lowest EE was observed at 5 km/ hr. Based on the simulation data, we predicted an average EE of 4,944 kcal/day for the expedition. Because energy intake was restricted to 2,249 kcal/day, we expected the expeditionist to lose considerable weight and consequently advised him to gain 5 kg of body-fat reserves. During the actual desert crossing, he covered a distance of 26 ± 7 km/day at an average speed of 3.8 ± 0.4 km/hr. Daily EE (4,817 ± 794 kcal/day) exceeded energy intake (1,771 ± 685 kcal/day), and the negative energy balance was in agreement with the actual weight loss of 10.5 kg, which was most notable in the lower trunk.

Urinary excretion of exogenous glycerol administration at rest.

Since 2010, glycerol has been ruled a masking agent by the World Anti-Doping Agency and consequently its administration is prohibited in sports. A detection method is available but little is known about the urinary excretion following administration. Fourteen well-trained cyclists (27.0 ± 5.4 years; VO(2max): 63.9 ± 8.5 ml/kg/min) were administered glycerol (1 g/kg body mass + 25 ml water/kg body mass) and placebo (25 ml water/kg) in a cross-over study. Blood and urine samples were collected before administration and after 2.5, 4, and 6.5 h. Urine samples were further collected up to 24 h post-administration. Following glycerol administration, urinary glycerol increased from 10.9 ± 15.5 to 50581 ± 23821 µg/ml within 2.5 h. In the placebo group, urinary glycerol did not exceed 26.8 ± 31.3 µg/ml. Urinary concentrations in the glycerol group were significantly higher than in the placebo group for 16.9 ± 1.0 h. In comparison to placebo, glycerol caused a larger increase in body weight (0.69 ± 0.42 vs. 0.27 ± 0.44 kg; p < 0.05) and a reduced urine output (972 ± 379 vs. 1271 ± 387 ml; p < 0.05). Reductions in haemoglobin and haematocrit were significantly greater after glycerol (-0.60 ± 0.28 g/dl; -1.7 ± 0.7%) than after placebo administration (-0.29 ± 0.39 g/dl; -0.9 ± 1.1%). The study shows that glycerol administration was detectable in urine for several hours. Even though there were significant reductions in haemoglobin and haematocrit after 2.5 h, the plasma expansion by glycerol appeared rather marginal in comparison to placebo.

Assessing energy expenditure in male endurance athletes: validity of the SenseWear Armband.

PURPOSE: The correct assessment of energy expenditure (EE) in athletes is important to ensure that dietary energy intake is sufficient. In general, athletes are individuals with especially high levels of total EE (TEE) and exercise-related EE (ExEE). The SenseWear Pro3 Armband (SWA) is a multisensor device for the individual assessment of EE, but data on the validity for higher exercise intensities are missing. The aim of the study was to validate the SWA for the assessment of TEE and ExEE in endurance athletes. METHODS: The SWA was worn by 14 male endurance athletes for 7 d during a regular training period, and TEE was measured in parallel with the doubly labeled water method. Two controlled exercise trials (treadmill running=2.4-4.8 m·s, stationary bicycling=140-380 W) were performed, during which indirect calorimetry was used to assess ExEE. RESULTS: TEE assessed with the SWA and TEE measured with the doubly labeled water method were significantly correlated (r=0.73, P<0.01), but there were a proportional bias and considerably wide limits of agreement (-1368 to 1238 kcal·d). The error of TEE assessed with the SWA was related to the athletes' individual lactate thresholds (P<0.05). During running and bicycling, ExEE was significantly underestimated for most exercise intensities, and the underestimation increased with exercise intensity (P<0.001). CONCLUSIONS: According to our results, the SWA does not provide valid results of TEE and ExEE in endurance athletes because of the underestimation of EE at higher exercise intensities. It seems necessary to develop exercise-specific prediction equations to improve EE measurements in athletes.

Parallel assessment of nutrition and activity in athletes: validation against doubly labelled water, 24-h urea excretion, and indirect calorimetry.

The assessment of nutrition and activity in athletes requires accurate and precise methods. The aim of this study was to validate a protocol for parallel assessment of diet and exercise against doubly labelled water, 24-h urea excretion, and respiratory gas exchange. The participants were 14 male triathletes under normal training conditions. Energy intake and doubly labelled water were weakly associated with each other (r = 0.69, standard error of estimate [SEE] = 304 kcal x day(-1)). Protein intake was strongly correlated with 24-h urea (r = 0.89) but showed considerable individual variation (SEE = 0.34 g kg(-1) x day(-1)). Total energy expenditure based on recorded activities was highly correlated with doubly labelled water (r = 0.95, SEE = 195 kcal x day(-1)) but was proportionally biased. During running and cycling, estimated exercise energy expenditure was highly correlated with gas exchange (running: r = 0.89, SEE = 1.6 kcal x min(-1); cycling: r = 0.95, SEE = 1.4 kcal x min(-1)). High exercise energy expenditure was slightly underestimated during running. For nutrition data, variations appear too large for precise measurements in individual athletes, which is a common problem of dietary assessment methods. Despite the high correlations of total energy expenditure and exercise energy expenditure with reference methods, a correction for systematic errors is necessary for the valid estimation of energetic requirements in individual athletes.

Effect of a controlled dietary change on carbon and nitrogen stable isotope ratios of human hair.

The carbon ((13)C/(12)C) and nitrogen ((15)N/(14)N) stable isotope ratios of human hair can be used for the interpretation of dietary habits and nutritional status in contemporary or past populations. Although the results of bulk or segmental isotope ratio analysis of human hair have been used for the reconstruction of an individual's diet for years, only limited data of controlled dietary changes on the carbon and nitrogen isotopic composition of human hair are available. Hair of four individuals, two males and two females, who participated in a dietary change experiment for 28 days was segmentally analysed for delta(13)C and delta(15)N. The dietary change included a change from C3 to C4 plant enriched diets and a simultaneous replacement of terrestrial animal products by marine products. This resulted in an increase in delta(13)C(diet) of +8.5 to +9.9 per thousand and in delta(15)N(diet) of +1.5 to +2.2 per thousand. All subjects showed significant increases in delta(13)C(hair) and delta(15)N(hair) during the dietary change period, although no subject reached a new steady state for either carbon or nitrogen. The change in delta(15)N(hair) was faster than the change in delta(13)C(hair) for all individuals. The magnitude of change of the isotopic composition during the dietary change period could be attributed to the degree of physical activity of the individuals, with a higher physical activity resulting in a faster change.