RSTC Part I (Reading)

i. Should females lower in testosterone be able to "level the playing field "with therapeutic-use exemptions for testosterone to catch up with gifted counterparts?

1. No. If we were to argue that females lower in testosterone should be able to level the playing field, it would logically follow that we should allow males to level the playing field as well. But nobody would argue that low performance male athletes should all be lifted up to the same levels of gifted athletes. Thus, we cannot extend aid to females, else we normalize extending it to males.

i. Should genetically "gifted" females be banned or required to take testosterone-suppressing SARMs?

1. Not necessarily. It's possible that a woman possesses a disorder in their androgen receptors such that the enhanced levels of testosterone in their body does not result in performance enhancement. Any woman who has high testosterone levels but such a disorder should not be banned. Secondly, what would happen to the sport if no women was allowed to compete without being leveled to the same playing field as other women? For instance, Olympic champion Michael Phelps possesses double jointed knees, allowing him to kick harder than other swimmers. Genetic inequality may not be fair, but it makes the game more exciting.

a. What are the criteria of determining a "true" or valid VO2max test?

i. A true VO2max test needs: 1. A RER (Respiratory Exchange Ratio) of > 1.15 2. A heart rate maximum of +/- 10 bpm of age-predicted MHR, a plateau of VO2 with increasing workload, a post blood lactate (BL) greater than 8 mmol/L, and the newest criterion: the rating of perceived exertion (RPE)>17.

a. What are the potential factors in determining one's VO2max (Figure 1)? The link to Jelkmann & Lundby, 2011 will be of assistance.

i. VO2max can be determined by hemoglobin concentration and blood volume, which determine hemoglobin mass; maximum heart rate and maximum stroke volume, which determine maximum cardiac output; and O2 affinity of the blood and mitochondrial respiratory capacity, which determine maximum O2 extraction.

1. Cooper discusses what is known in sport science as closed versus open sports. Provide another example (not provided by Cooper) of each. Why does he use an example of a closed sport to give evidence of enhancement over time in elite sport? What empirical methodological advantage is there in studying closed sports to assess evolution of human performance? (p. 48)

a. A open sport is one where your competitor directly influences your response on the field of play to their actions. A great example of this is soccer, where the direction and plays of the enemy team force your team to adapt. A closed sport means that the environment and constraints of the game influence your actions on the field of play. An example of this is dart throwing, "where there is no obvious interference from the opponent-every time a player has exactly the same shot to take" (Cooper, 2012, p. 48). An example of a closed sport that Cooper does not give is swimming, where competing swimmers have no effect on the actions of their competitors, except perhaps the psychological effect of competition. b. The reason Cooper uses a closed sport to give evidence of enhancement over time in elite sport is because open sports could show no sign of improvement if competing athletes dope. In baseball, for instance, the rate of home runs might not change if both the pitcher and hitter use PEDs, because "if both pitcher and hitter increased their abilities," their skills would cancel out and result in no observable change (Cooper, 2012, p. 47). Thus, it's hard to say if people improve in a sport like baseball. By contrast, in the closed sport of dart throwing, there was a clear increase of score from 90 in 1999, to 94 in 2009 (Cooper, 2012, p. 48). Since athletes experience no interference in dart throwing, the increase in performance of dart throwers can be easily determined to be due to skill.

1. Air: Why would a person competing in the 100 m prefer competing in Mexico City (1968) while a marathoner would much prefer Paris (2024)? (p. 33)

a. A person competing in the 100 m would prefer Mexico City, while a marathoner would prefer Paris, because Mexico City has lower air pressure than Paris. On the one hand, low air pressure benefits short distance runners because "the lower the pressure, the lower the air resistance" (Cooper, 2012, p. 33). A runner at low air pressures, that is to say, will face less friction with the air and thus move faster. Thus, a short distance runner will prefer a low air pressure city: Mexico City. On the other hand, higher air pressure benefits long distance runners because more air means more oxygen, allowing a marathoner to run off of aerobic respiration for longer. Thus, a long distance runner will prefer a high air pressure city: Paris.

1. We don't have 14 days to acclimatize to conditions in Mexico City for a soccer match!!! Back to the kidneys...using the following diagrams, discuss the mechanisms of acetazolamide (Diamox) action on altitude acclimatization. Explain the diagrams and how renal inhibition of carbonic anhydrase affects respiratory rate. (p. 35-36)

a. Acetazolamide functions as a CAH (carbonic anhydrase) inhibitor. CAH is an enzyme that catalyzes the reaction which turns carbon dioxide and water into carbonic acid, or carbonic acid into carbon dioxide and water. Normally, carbonic anhydrase enzyme, when released in an epithelial cell, it will combine CO2 and H2O into carbonic acid. Then, it will break carbonic acid into H and HCO3. It will then send Hydrogen into the tubular fluid, and the HCO3 into the bloodstream. By doing so, it helps the body reach homeostasis. What Acetazolamide does is it inhibits CAH and prevents bicarbonate from being absorbed back into the blood stream. This means that the blood becomes more acidic, which triggers the body to ventilate more. Thus, acetazolamide triggers an increased level of inhalation to account for a difference in altitude.

1. Link clearly, the terms: anaerobic/aerobic, glycolysis, oxidative phosphorylation, high-power, low-power and identify where in the cell each of these occurs? (p. 59)

a. Aerobic respiration is a low-power method of power generation which converts both fats and carbohydrates into ATP. The aerobic pathway occurs in the mitochondria, which performs oxidative phosphorylation. Oxidative phosphorylation uses FADH2 and NADH to produce 26 of the 30 molecules of ATP formed by the aerobic pathway. The other four molecules of ATP come from the Krebs cycle, and glycolysis. Though aerobic respiration is a low-power pathway, it is also more efficient, because "exercise with oxygen is more efficient" (Cooper, 2012, p. 59). b. The anaerobic pathway is a high-power method of power generation, which converts only carbohydrates into ATP. This energy comes from glycolysis, which occurs in the cytoplasm of the cell. The reason it is considered high-power is because, though it produces less net ATP, it is much faster than the aerobic pathway.

1. Temperature: Why would a person competing in the triathlon prefer competing in Helsinki (1952) over Sydney (2000)? (p. 33)

a. As Cooper notes, "performance in long distance sporting events is always compromised by extremes of heat, but rarely of cold" (Cooper, 2012, p. 33). The reason long distance athletes suffer from heat is because exercise always generates heat to compensate for a cool environment. Since Helsinki is far cooler than Sydney, a participant in the triathlon would have an easier time in Helsinki than Sydney.

1. Gravity: Why would a person competing in the javelin prefer competing in Rio (1952) over Stockholm (1912)? (p. 33)

a. As Cooper notes, the effective gravitational forces on falling objects "is far more dependent on the distance from the equator" (Cooper, 2012, p. 33). To be specific, gravity can increase by about "0.5 per cent at the poles compared to the equator" (Cooper, 2012, p. 33). Because Rio is closer to the equator to Stockholm, it stands to reason that gravity would be lighter in Rio than in Stockholm. And if gravity is lighter in Rio than in Stockholm, a thrown object in Rio will go further than in Stockholm. Therefore, a person competing in the javelin would have a better chance of breaking world records in Rio than in Stockholm, and would prefer competing in Rio.

1. What are beta-blockers and how would they be beneficial to certain closed sports and detrimental to open sports? (p. 50) a. Which of the factors of VO2max would be most directly affected by beta-blockers?

a. Beta blockers decrease the contractility of the heart. It has "the potential to enhance performance by relaxing the athlete," though has the potential to inhibit "if the sport also has a significant physical component" (Cooper, 2012, p. 50) In other words, beta blockers allow one to focus on technical events like sharpshooting, but don't help in events such as marathons. For this reason, WADA generally bans beta blockers for closed sports such as dart throwing, but not open sports like soccer. b. The factor of VO2max most directly affected by beta-blockers would be Max. Cardiac output.

1. Why was Carl Lewis not punished for his positive test for pseudophedrine, ephedrine, and phenylpropanolamine in 1988? What would happen today and why (according to the WADA Code book page 18)?

a. Carl Lewis was not punished for his positive test for pseudoephedrine, ephedrine, and phenylpropanolamine in 1988 because at the time the US Olympic Committtee (USOC) policy was to only punish athletes who demonstrated "a deliberate attempt to affect performance" with supplements (Cooper, 2012, p. 2). In other words, Carl Lewis was able to excuse his drug use by arguing that he had inadvertently tested positive due to unrelated use of cold remedies. Today, however, Carl Lewis would have been penalized by WADA. This is because WADA's code book specifically states that "Athletes are responsible for any Prohibited Substance or its Metabolites or Markers found to be present in their Samples" (WADA, p. 18). In other words, any banned substance such as ephedrine is grounds for punishment even if take in an innocuous manner.

1. It was cited that the chances of Armstrong's suppressed reticulocyte values were due to natural factors were less than one in a million. How does a scientist make an educated, non-exaggerated claim such as "one in a million"? (xii). Please explain. (Hint: "p")

a. In order for a scientist to make the claim that some possibility has a less than one in a million chance, there must be a very low p-value. A p-value is, in essence, the likelihood that the evidence collected is how it is with the null hypothesis being true. In this case, the null hypothesis would be that Armstrong's reticulocytes were not affected by anything other than natural factors. The data collected by Prof. Gore, however, was so unlikely to have occurred with the null hypothesis being true, that the p-value was less than 0.000001. This p-value serves as a confidence indicator that the changes of Armstrong's suppressed reticulocyte values being due to natural factors alone was less than one in a million.

1. What was the evolutionary argument provided by Cooper suggesting women might benefit from doping to a greater extent than male counterparts? (p. 25-29)? Explain how to interpret the following supportive data:

a. Cooper argues that females possess less strength than males not due to selective pressures on females, because in most mammal species the female do the hunting. Instead, males are stronger than females due to "males fighting other males in competition for mates," otherwise known as "sexual dimorphism" (Cooper, 2012, p. 25). Moreover, when communities are made, labor becomes segregated between males and females, further driving males to adapt greater strength over time. As a result, females generally have lesser strength than males, meaning that evolution has left a "large scope for improvement" to those females that take performance enhancing drugs (Cooper, 2012, p. 26). Females, in other words, benefit more from drugs that raise them to male levels, compared to males who are already generally at a more optimal level of strength. b. This is why Figure 3 shows an abnormally high rate of record setting by females at the Olympics pre-1990: steroid doping in the 1980s boosted female Olympians to a greater degree than it did for male Olympians. There is also evidence that women who have naturally higher testosterone levels in sports could be raised far above their fellow female athletes compared to male athletes. For instance, 8 out of 3387 females in the 1996 Olympics had a Y chromosome, but still had female characteristics due to the presence of Androgen Insensitivity Syndrome (AIS). AIS causes a lack of response to testosterone and "generally results in external genitalia that are mostly female" (Cooper, 2012, p. 27). Though it is difficult to measure whether or not women with Y-chromosomes and AIS perform better, such women appear 100 times more in the Olympic Games compared to their representation in the general population. Thus, the overrepresentation of Y-chromosome AIS women suggests that women with such traits may receive some level of performance from the disorder. c. Similarly, Klinefelter Syndrome could have been disproportionately represented before doping protocols were put in place, and so explains why record setting for female athletes could have gone down.

1. *Of the five domains of physical fitness (e.g. muscular strength, muscular endurance, cardiorespiratory fitness, body composition, flexibility), Cooper argues that the one that drugs and PEDs "are least likely to have an impact [on], it is in the field of the ultramarathon." Why does he make this statement? (p. 24)

a. Cooper argues that the one that drugs and PEDs would have the least effect in the "field of the ultramarathon" because it is the main physical task to which humans have evolved beyond other animals (Cooper, 2012, p. 24). The reason humans have evolved for "slow long running" is in order to track down an animal over the period of a day: a technique called "persistent hunting" (Cooper, 2012, p. 23). Humans do so with long legs, muscular buttocks to replace our tails, an independently twisting neck, a lack of fur to prevent overheating, sweating to cool our bodies (we have 2-4 million sweat glands in our body), and thin skin with blood vessels near the surface to maximize heat transfer out of the body (Cooper, 2012, p. 23). We also have a special running gait, with two phases: aerial, when we are in the air, and stance, when our feet hit the ground. When our feet hit the ground, the kinetic energy from the impact is transferred into energy by our springy tendons which send us into the next aerial phase, making it easier to move forward. Our evolutionary ability to hunt is so great that a human can chase down an animal like a horse over the time period of a day. Thus, any attempts to enhance this innate ability would not be able to add on to what evolution already perfected. That is why drugs and PEDs are unlikely to affect our ability to run at length in ultramarathons.

1. With a competitive field in the Tour de France replete with illegally, doping colleagues, Cooper identifies three possible interpretations of Armstrong's repeated wins on page xi. Unpack each of these statements for complete clarity by explaining each of these possibilities.

a. Cooper identifies three possible interpretations of Armstrong's repeated wins. b. First of all, that he was a naturally better cyclist and his doping merely leveled the playing field. This possibility entails that Armstrong is legitimately more skilled than the other cyclists, but still would have lost against less skilled cyclists using PEDs. Thus, once Armstrong started taking the same PEDs as other cyclists, his natural skill allowed him to get an edge over other cyclists who were also using PEDs. c. Second of all, that he was not a naturally better cyclist. Instead, he took the same PEDs as other cyclists, but he benefited more from the PEDs due to a natural affinity to the PEDs. In other words, he didn't have better PEDs than other players, but his body used the PEDs more effectively than other players. d. Finally, that he was neither a naturally better cyclist, nor possessed a natural affinity to PEDs, but simply had superior PEDs to other players.

1. What is the 2-3 sentence summary statement of the section entitled "A history lesson?" What is the purpose of the author including this section? (p. 13-17)

a. For a long time, performance enhancing drugs were tolerated in sports, be it herbs in the coliseum, strychnine injections in 1904, or even cocaine and amphetamines in the inter-war years. Later on, however, drugs were banned, and by the 1970s, drugs were considered "America's Public Enemy No. 1" (Cooper, 2012, p. 16). Since then, there has been a narrative of sports as a battle between "drug cheats" and "anti-drug heroes" (Cooper, 2012, p. 17). b. The purpose of the author including this section is to show that attitudes towards doping have changed over time. Once a reader who may have unquestioningly accepted the anti-drug hegemony reads this, it would give them reason to question why they perceive drugs so negatively. This could lead to more critical thinking and a more objective perspective on how to view drugs today.

1. *What is glycogen loading and for which athletic events would it possibly be ergogenic? (p. 62)

a. Glycogen loading is a process by which the glycogen stores in a body are increased to their maximal level, particularly for long athletic events such as marathons. The process works in steps, originally devised by Swedish scientists in 1967 (Cooper, 2012, p. 62). Firstly, one runs a long race a week before the marathon. This helps "deplete all your muscle glycogen stores," wiping your slate clean (Cooper, 2012, p. 62). Secondly, one exercises lightly and on a low carb diet, a process called "tapering" (Cooper, 2012, p. 62). Doing so places the glycogen storage mechanisms into a hunger state where its ability to store glycogen is optimized. Finally, eat as much carbohydrate as possible before the race, causing a "super-compensation," raising the muscle glycogen levels higher than ever before (Cooper, 2012, p. 62). From here, the athlete will have a larger glycogen storage once the marathon starts, and have an ergogenic edge.

1. The terms hypertrophy and hyperplasia are described on page 46 although not used as such. What do these terms describe and which is relevant to improvements seen with training?

a. Hypertrophy is when muscle cells that you have get bigger. This is the theory of why muscles get stronger during training. Hyperplasia is when the number of muscle cells increase, which is a postulated effect of long term training. Thus, though it is possible that hyperplasia is relevant to improvements during training, hypertrophy is by far the primary source of improvements. b. If hyperplasia could happen, it might be because cells grow large and divide, resulting in two cells that look normal, therefore hiding the division. If hyperplasia happens, it could have significant long term effects, but because effects over long periods of time are difficult to study, it'd be difficult to properly research.

1. What is modafinil and how would it be beneficial to certain closed sports and detrimental to open sports? (p. 50) The following article from Garrard & Malcolm, 2007, along with this Wikipedia link will be useful here.

a. Modafinil is an "an anti-narcolepsy drug" which is used by armies to keep their soldiers awake and alert (Cooper, 2012, p. 50). It does so by stimulating the release of Orexin in the hypothalamus, which stimulates the feeling of awakeness. As opposed to a beta blocker, which calms a user, Modafinil excites a user. Thus, while Modafinil would be useful in an open sport such as soccer, its alertness effect could be a detriment in a closed sport such as dart throwing. For this reason, WADA bans the use of Modafinil for open sports, but not for closed sports.

1. Have you been instructed previously with ATP being referred to as a "high energy" molecule? Why does Cooper discourage this? (p. 55)

a. Often times ATP is taught as a molecule whose terminal bond is teeming with latent energy; when the bond is broken, ATP releases its high energy charge. As Cooper notes, however, it is not accurate to state that ATP is a "high energy" molecule. In reality, as phosphate bonds go, "it is in the 'Goldilocks' zone: just right for a universal energy transducer in the body" (Cooper, 2012, p. 55). It is flexibility rather than sheer power, in other words, which makes ATP a great energy source. Rather than using many different energy sources for different reactions, ATP serves as a universal fuel for all reactions in the body.

1. Please elucidate the following quote "the great tragedy of science is 'the slaying of a beautiful hypothesis with an ugly fact." How does this apply to the many sports supplements on the market and their potential effectiveness without the extensive four-stage FDA drug approval process? (p. 72)

a. Sports supplements often have "beautiful hypotheses" as to how they could potentially improve an athlete's performance. Sometimes, the hypothesis is "too good to not be true" (Cooper, 2012, p. 72). And, even when the theory should dictate that a drug should improve an athlete's performance, the final trials may still show no ergogenic effects. This is why supplements, no matter how reasonable their effects may sound, cannot be trusted. For instance, as a common consumer, the theory behind BCAA may have been so convincing that you would have taken it and believed it was working due to the Placebo effect. It is only in a rigorous series of studies that a supplement can truly be shown to be effective.

1. Why was Tatyana Tomashova stated to be "she was too good at being tested for drugs?" (p. 7)

a. Tatyana Tomashova was stated to be "too good" at being tested for drugs because, unlike other athletes who need to be hunted down to be tested, Tomashova was always "ready and waiting exactly when requested" (Cooper, 2012, p. 7). She even had a positive, excited demeanor to give her samples. Her exceptional punctuality, in a twist of irony, drew suspicion from anti-doping officials, and led them to investigate her past tests further, causing them to find that the DNA in many of her past urine samples did not match her actual urine DNA sample. In other words, she was participating in urine swapping.

1. What is the stated trade-off between different ATP producing systems of the body? (why can't you run 100-meter pace longer than...10 seconds?). (p. 59)

a. The anaerobic pathway allows one to run more quickly, but only for a short period of time, "partly because you run out of energy and partly because you build up toxic intermediates" (Cooper, 2012, p. 59). In other words, anaerobic pathways use carbohydrates, which run out much quicker than fats. They also create toxic lactic acid, which eventually forces anaerobic glycolysis to stop in order to flush it out of the muscles. b. The aerobic pathway is much slower than the anaerobic pathway, but is much more efficient. This is because oxygen is a more efficient way of releasing energy; squeeze a ball repeatedly with a tourniquet wrapped around your arm, and "realize how much more quickly you tire" (Cooper, 2012, p. 59).

1. Cooper provided many examples of technological implications of sport. Which of these has become the best example over time of acceptable technology that improved the sport? (p. 37-39)

a. The best example of an acceptable technology that improved a sport was the replacement of sand pits with deep foam matting in the high jump, which allowed high jumps to land on their back "with no concern for the fine safety details of the impact" (Cooper, 2012, p. 38). This technological improvement is great for two reasons. Firstly, the introduction of deep foam mats for the high jump did not alter the rules sport itself, only the end of it. Because it did not alter the fundamental rules of the sport, it made the sport safer without changing its mechanics. Secondly, it led to a natural evolution of the sport. The new mats allowed for "head-first backward flopping styles," which are exciting for spectators and more freeing for athletes (Cooper, 2012, p. 38).

1. What are the different processes the body uses to re-synthesize ATP? (p. 58)

a. The best way the body makes ATP is by "completely burning fat or carbohydrate to carbon dioxide and water" (Cooper, 2012, p. 58). This can create as many as thirty molecules of ATP from each molecule burned, when aerobic respiration is used to do so. When oxygen is not used, each molecule creates two molecules of ATP. Moreover, in the absence of oxygen, the body can only turn carbohydrate into ATP.

1. What distinction between PEDs and ergogenic aids is Cooper discussing and what is the larger point he makes about the decision to use the term "drug" in organizations like WADA? (p. 12)

a. The distinction between PEDs and ergogenic aids is between the "accepted" (ergogenic aids) and the "unacceptable performance enhancing drugs" (Cooper, 2012, p. 12). The problem with labelling banned substances as "drugs," however, is that it makes the PED usage more difficult to discuss. On the one hand, when PEDs are labeled as drugs, it assigns an "unacceptable" level of immorality to the use of PEDs. On the other hand, it drives up PED use by making the drugs seem "magic" or "powerful" (Cooper, 2012, p. 13). WADA, in order to avoid such cultural and moral baggage, opts to use the terminology of "doping offense" as opposed to "drug," (Cooper, 2012, p. 13). This terminology, as Cooper points out, helps discuss doping more objectively, but cannot change the use of the word "drug" outside of official releases.

1. Many athletes implicated in doping support their defense by saying they have never failed any drug test. Assuming this is true, what does this in fact confirm about one's doping status? (xiv)

a. The fact of the matter is that whether or not an athlete fails a test does not absolve them of scrutiny. If anything, performing beyond expectations without getting caught can lead to accusations of doping "with no evidence other than that they can run fast, swim quick, or throw long" (Cooper, 2012, p. xiv). The simple reality is that Lance Armstrong's case has forever tainted the credibility of clean drug tests; whether or not athletes cheat is established more based on testimony or base suspicion than science.

1. What specific challenges do Usain Bolt and other tall sprinters have to overcome in obtaining a high cycling rate during his strides? Additionally, the following is data involving animals of extremely varying sizes and the result of this body size on maximal shortening velocity of the muscle fiber types. The same thing has been shown to occur in humans according to height. How does this finding support the notion that Bolt is unique among sprinters? (p. 44)

a. The factors that determine one's velocity is stride length multiplied by frequency, meaning that between two athletes of the same frequency, the athletes with the greater stride length will be much faster. This suggests, intuitively, that a tall person will always be faster than a short person when running. However, data shows that as the mass of an animal increase, their maximal shortening velocity of all muscles decreases. What this means is that larger animals have slower muscles than small animals, and so should theoretically have a lower stride frequency. Therefore, the tall Usain Bolt should theoretically have a slower stride frequency than his shorter competitors, meaning his higher stride length should be offset by his slower muscles. b. Strangely, Usain Bolt's longer stride length does not appear to affect his stride frequency, due to a genetic abnormality. Thus, due to having an equal stride frequency to his peers but a longer stride length, Usain Bolt has a higher overall velocity than any other sprinter.

1. What are some of the challenges to our ability to generate definitive information on the effectiveness of PEDs as presented by Cooper? (p. 18-22)

a. The first challenge to our ability to measure the effectiveness of PEDs is that the test subjects are "not healthy enough" to properly model the effect of a PED on an elite athlete (Cooper, 2012, p. 19). Most PED trials, to elaborate, are performed on normal healthy athletes, who are not as healthy or trained as elite athletes. Just because a PED has an effect on a normal healthy athlete, however, does not mean that the same PED will have an effect on an elite athlete. This is because, "by a combination of genetic predisposition and extensive training," the elite athlete may have already achieved the effects the PED aims to provide (Cooper, 2012, p. 20). Thus, no test on a PED except performed on an elite group of athletes could ever predict a PED's effect on elite athletes. b. The second challenge to our ability to measure the effectiveness of PEDs is the likelihood of PEDs and nutritional aids interfering with a new PED. The only way to properly isolate the effects of PED in a cocktail of drugs would be to "dope a population of fit athletes, remove one compound at a time from the list and explore the resulting performance effect" (Cooper 2012, p. 21). Having to forego their normal PED routine, moreover, would result in the athlete forgoing athletic success so that the researcher may study a single variable, which disincentives athletes from participating in such studies. To do so, unfortunately, would be prohibitively time consuming. c. The third challenge to our ability to measure the effectiveness of PEDs is the ethical issue. The scrutiny against studies which perform research on humans is much greater than research on animals, which incentivizes animal research instead of human research. d. We can still use the tried and true "randomized double-blind placebo-controlled trial," since it is the most effective way of measuring the effect of drugs (Cooper, 2012, p. 22). The randomized double-blind placebo, however, will never be able to represent an increase in performance that maps directly onto effects on elite athletes.

*In discussing Lance Armstrong and the potential relative contributions of "natural" and "doping" in his accomplishments, the author states "one thing I do state is that he [Armstrong] was able to use oxygen efficiently without producing lactic acid." Look up the concept of lactate threshold then address how the comment of the author (Cooper) is relevant to Armstrong's success. (xi)1. *In discussing Lance Armstrong and the potential relative contributions of "natural" and "doping" in his accomplishments, the author states "one thing I do state is that he [Armstrong] was able to use oxygen efficiently without producing lactic acid." Look up the concept of lactate threshold then address how the comment of the author (Cooper) is relevant to Armstrong's success. (xi)

a. The lactate threshold is the maximum running speed (km/h) before the body begins increasing amount of Lactate in the bloodstream in nmol/L. The reason the lactate threshold exists is because, before that threshold, the body produces energy using entirely aerobic glycolysis, meaning it produces no lactic acid. Above the level of exertion—the lactate threshold—the body switches to anaerobic respiration, which produces lactic acid. Once anaerobic glycolysis builds up enough lactic acid, the athlete must stop to recover from their exercise. Therefore, so long as an athlete stays below their lactate threshold, they can sustain high level performance for a long time. Having a high lactate threshold is critical to success, because if an athlete's lactate threshold is very high, then they can sustain a higher level of performance longer than any other athlete.

1. Cooper offers a major difference between technological doping and chemical doping. What does he say is the difference here between technical and chemical? (p. 39)

a. The major difference between technical and chemical is that "the former does not have the potential to harm the health of the athlete" (Cooper, 2012, p. 39). In other words, chemical doping such as THG pose health risks, while technological advancements in sports like Formula 1 reduce health risks.

1. The use of metaphors is useful to explain complex things. The key is that the metaphor must be 1) simpler than what it is being compared to and 2) must be familiar to the intended audience. What it the point of the metaphor used by Cooper on p. 22? (hint: it is not about the benefits of sunscreen)

a. The point of the metaphor used by Cooper on p. 22 is to explain that ergogenic aids will only benefit our ability to perform tasks that we did not evolve to perform optimally. This is because, if our ability to perform a certain task were highly selected in evolution, then there would be little doctors or trainers could do to enhance our ability to perform that task.

1. *Same as previous, but for sodium bicarbonate. (p. 66)

a. The policy for the use of Sodium Bicarbonate as a dietary supplement will be as follows: athletes should take about 0.3g/kg of Sodium Bicarbonate thirty minutes before exercise, so that they don't urinate it out of their system before then. However, the athletes should be warned that Sodium Bicarbonate can lead to belching or gas in the digestive system. This happens because sodium bicarbonate's hydrogen, carbon, and oxygen can break down into carbon dioxide gas.

1. *You are the strength coach for LMU's entire athletic department. Create a policy for the use of creatine as a dietary supplement. Which teams and athletes will be encouraged to supplement with creatine and what recommendation and warnings might you provide to these athletes and coaches? (p. 65-66)

a. The policy for the use of creatine as a dietary supplement will be as follows: athletes should load 0.3g/kg of Creatine Monohydrate a day for 5-7 days, followed by 3-5 g/day. This will increase and maintain elevated creatine levels for up to 3-4 weeks. Moreover, when the athletes take Creatine, they should take it while eating carbs (CHO), in order to increase the absorption of Creatine.

1. What is the principle of initial values and how does this relate to the effectiveness of nutritional methods discussed by Cooper? (p. 62-63)

a. The principle of initial values goes hand in hand with the principle of diminishing returns. If you have an untrained individual and a trained individual, the trained individual may possess higher initial values in endurance compared to the untrained individual. Hypothetically, if both were to undergo the same nutritional regimen, the "nutritional effects [would be] most dramatic on the untrained person" (Cooper, 2012, p. 62). This is because, in the cause of a trained person, they have already have optimized bodies that benefit little from further training. In the case of the untrained person, a nutritional program could "more than double glycogen stores and increase competitiveness" (Cooper, 2012, p. 62).

1. *What is the principle of reversibility and what is the example given by Cooper on page 46? Create an additional original example of this principle.

a. The principle of reversibility is that, in general, even Olympic level training does not permanently alter one's physiology, and thus an athlete's organs will return to normal size after no longer training. This is because "most, if not all, of the new muscle mass [from training] is due to increased muscle protein in individual cells, not the formation of new cells" (Cooper, 2012, p. 46). A great example that Cooper gives is the heart. Long distance runners generally attain an "athlete's heart," which has "increase weight, volume, and size" (Cooper, 2012, p. 46). However, this heart returns to normal once exercise ends. Another example not given by Cooper are the ability for lifter to deadlift weights; a weightlifter may be able to lift 300 pounds, but once they stop training their muscles will revert to normal.

1. The process of FDA approval for prescription drugs involves four clinical phases. List each of these phases and describe the importance of each phase. How does this process differ from the approval process of supplements under DSHEA? (p. 20)

a. The process of FDA approval for prescription jobs involves: i. The preclinical phase: The drug creator must identify a legitimate concept for a drug grounded in medical knowledge. Then, they must do one to two years of testing in animals, and see if the drug confers any benefits or negative effects. If they pass this phase, they file with the FDA for an investigative new drug (IND) filing to show that there could be some legitimate biochemistry that applies to humans. ii. Phase 1: A group of 20-100 healthy human volunteers test the IND for a year to see the possible side effects on humans at what dosage, which 70% of INDs pass. iii. Phase 2: In a hospital setting, 100-300 humans with the relevant disease test the IND to see if it is effective on the disease that the IND is meant to treat, and safety is further monitored. Results are compared against a placebo group. 33% of INDs pass this process. iv. Phase 3: Larger scale tests are carried out with 1,000 to 3,000 human patients, which gather more information about safety and effectiveness by trying different demographics, using the drug with other drugs, and different dosages. b. All in all, only about 1 in 5,000 to 10,000 drugs complete the FDA Approval process, which is far stricter than the method that the DSHEA uses to "approve" supplements. The DSHEA does not even require any premarket testing. i. The FDA cannot generally remove a supplement from the market or prevent it from being sold unless it can prove that it causes "a significant or unreasonable risk of illness or injury;" no premarket testing is required unless the supplement has an ingredient in it that was in the food supply prior to 1994. ii. If there is a new ingredient (since 1994) in the supplement, then the FDA requires a literature citation showing it exists 75 days prior to being released to the market.

1. What is the purported hypothesis behind BCAA administration prior to and during endurance exercise? (p. 72)

a. The purported hypothesis behind BCAA administration was as a tryptophan suppressant. Tryptophan is an amino acid which is "the precursor to serotonin formation in the brain" (Cooper, 2012, p. 72). Because "increasing your serotonin levels induces fatigue," and tryptophan is its precursor, it logically follows that the suppression of tryptophan to the brain would reduce fatigue (Cooper, 2012, p. 72). And, since BCAA has the potential to bind to the same sites as tryptophan and block it from activating serotonin, it's possible that BCAA could prevent fatigue. Moreover, preliminary studies showed promising results on BCAA's ability to lower tryptophan. Unfortunately, in the end, there simply was no real evidence that BCAA raised performance.

1. What is the purported mechanism of benefit from small amounts of pre-workout carbohydrate ingestion on performance? (p. 61)

a. The reason eating small amounts of pre-workout carbohydrate works is because it raises insulin levels. When insulin levels are raised, it indicates that the body is stocked with carbohydrate, and "suggests that there is no need to open carbohydrate reserves" (Cooper, 2012, p. 61). Since the athlete therefore will use less carbohydrate when exercising, their fat fuel tank will be depleted rather than their carbohydrate fuel tank. This helps athletes "manage the balance of fuels efficiently" and not tire out during a run (Cooper, 2012, p. 60).

1. Explain the elaborately proposed evolutionary advantage to nitrate ingestion and subsequent conversion to nitric oxide. (p. 74)

a. The reason that we convert nitrate to nitric oxide in our mouth is as a health measure. In our bodies, there are two types of bacteria: the "bad bacteria in the stomach" such as E. coli and Salmonella, and the "good bacteria in the mouth" (Cooper, 2012, p. 74). Because nitric oxide is toxic to the bad bacteria in the stomach, it has been hypothesized that it became an evolutionary advantage to use the good bacteria in the mouth to produce gas to kill the bad bacteria in the stomach. In other words, nitric oxide serves as a cleanser for potential bacterial threats in the stomach. That's why "the salad course traditionally preceded the potentially bacterially infested meat course;" so that the nitric oxide produced from the salad would kill the dangerous bacteria in the meat (Cooper, 2012, p. 74).

1. What is the potential disadvantage for organic production of vegetables with reference to ergogenic benefit? (p. 75)

a. The reason to eat vegetables such as lettuce, spinach, or beetroot is due to their high nitrate content. However, if the vegetables come from an organic farm, one should not eat them because they "don't use nitrate fertilizer" (p. 75). This means that they will not prove the mouth nitrate for its bacteria to break into nitric oxide, and thus confer no ergogenic benefits.

1. Sports performance is not about the quantity of ATP present in a muscle at any one time, but rather the rate by which ATP can be re-synthesized. What does this mean, and what evidence is provided by Cooper? (p. 57)

a. The reason why sports performance is not about the quantity of ATP present at any one time is evidenced by the fact that, while the body only contains 0.25 kg of ATP at any instant, it burns about 45 kg of ATP a day (Cooper, 2012, p. 57). In other words, the amount of ATP stored in a body at an instant would only power a runner for a second before running out. This is why the body must constantly re-synthesize ATP in order to maintain sports performance: "you need to make ATP fast to run fast" (Cooper, 2012, p. 57).

1. *What are the properties of human muscle fiber types? Why do we not test fiber type percentage and ban anyone competing in the marathon who exceeds 95% type I fiber in the soleus? (p. 59)

a. There are three types of muscle fibers. The first is Type 1, which is small, contracts slowly, and has high resistance to fatigue. The second is Type 2a, which is medium sized, contracts quickly, and has intermediate resistance to fatigue. The third is Type 2b, which is large, contracts very quickly, and has low resistance to fatigue. While the slow twitch muscle Type 1 uses triglycerides to fuel its movements, Type 2b and Type 2a use phosphocreatine, phosphate, and glycogen. b. The reason we don't test fiber type percentage and ban anyone with 95% Type I fiber is because training always increases the percentage of Type I fiber in the body. If somebody possesses a very high percentage of Type I, it's most likely due to training and not innate genetics.

1. What is the mechanism by which beetroot juice of all things might be beneficial to aerobic activities? (p. 75) This link from Jones 2014: will be of assistance.

a. There is evidence that, by consuming nitrate via beetroot juice, one can stave off fatigue longer during aerobic activities. Nitric oxide allows an athlete to exercise at 10% less the relative VO2max level, because it "reduces the oxygen cost of submaximal exercise" (Jones, 2014, p. 1). In other words, by making aerobic exercise less oxygen intensive, athletes need exert themselves less when on nitrate supplementation.

1. Create a method to use someone else's urine as a tampered sample of your own with the assumption that the WADA collections official will watch the urine exit your body into their test tubes. What would you need to do successfully beat this method of testing? (p. 7)

a. To beat this method of testing, one might use a Whizzinator. First, one must start by storing a container of clean urine. They could then freeze this urine, until they knew the WADA collections official would come. At that point, the athlete would take out the urine, defrost it, and place it in the Whizzinator: a fake penis. They would then place the Whizzinator between their thighs and squeeze it into the collections container. b. Another method is to reverse inject your clean urine back into your own bladder. Theoretically this method would be undetectable. However, before the test, you need a clean bladder.

1. Why do we have multiple names for the same molecules? What is the difference between brand names and constituent names (e.g. Viagra/sildenafil, Super Monster Milk/whey protein)? (p. 13)

a. We have multiple names for the same molecules because, as Cooper notes, it affects "efficacy as well as marketability" (Cooper, 2012, p. 13). Scientific names, in other words, mean nothing to the average consumer. A name like whey protein may be the scientific way to identify a molecule, but a name like Super Monster Milk is superior when communicating with a lay audience. The name Super Monster Milk, unlike the name whey protein, communicates to the customer the intended ergogenic benefits of whey protein: it makes you super, and a monster. The first-impression impact of brand names can be so strong, marketers may use multiple brand names to market to different audiences. For instance, to market to audiences with arterial hypotension, pharmaceutical companies may sell sildenafil as "Revatio," which has rejuvenating connotations (Cooper, 2012, p. 13). The same marketers, however, may sell it as "Viagra" to people with erectile dysfunction (Cooper, 2012, p. 13). b. Nevertheless, as a future health or medical practitioner, the scientific name is more relevant to my awareness. It's important to know the scientific nomenclature when discussing the effects of specific drugs, because lay terminology can confuse. For instance, an article on the effects of cold medicine is more general than an article on the effects specifically of ephedrine.

1. What benefit can be gain from the fuel tank analogy for fat and carbohydrates? What is the theoretical (oversimplification here, but go with it) distance a person could run while exclusively using fat stores? Then repeat for glycogen stores. Consider the following:

a. What the fuel analogy helps us understand is that there is no such thing as a single reserve of fuel for our body. Instead, we have a high speed but low capacity fuel tank (carbs) versus a low speed but high capacity fuel tank (fats). Immediately exhausting your smaller carbohydrate fuel tank can result in you "hitting the wall [when] there is a dramatic need to switch to fats as an energy source" (Cooper, 2012, p. 60). Thus, using the fuel analogy can help athletes avoid hitting the wall by better managing their fuel sources. b. The theoretical distance a person could run while exclusively using fat stores given the data is 1802.5 miles. i. 73 kg * 0.32% body fat = 23.36 kg fat ii. 23.36 kg fat = 51.5 lb fat iii. 51.5 lb fat * 3500 kcals/lb = 180250 kcals iv. 180250 kcals * 1/100 miles/kcals = 1802.5 miles c. The theoretical distance a person could run while using exclusively glycogen stores is 29.8 miles. i. 73 kg * 0.68% non-fat body weight = 49.64 kg non-fat ii. 15 g glycogen/kg * 49.64 kg = 744.6 g glycogen iii. 744.6 g glycogen * 4 kcals/g = 2978.4 glycogen iv. 2978.4 kcals * 1/100 miles/kcals = 29.8 miles

1. Why are the carbohydrate related reasons that CES are effective at delaying fatigue during endurance events? (p. 63)

a. When blood glucose (a carbohydrate) levels dip during a race, it causes two problems. Firstly, a drop in blood glucose means a drop in the fuel to the brain, which will send a signal that "what you are doing is bad" (Cooper, 2012, p. 59). Secondly, a drop in blood glucose signals carbohydrate depletion to the body, which will result in the opening of the low power fat stores. Both of these result in fatigue, and CES prevents them by supplementing carbohydrate to the blood sixty minutes into the race, preventing the drop in blood sugar.

1. Describe how the "side effects" of excessive growth hormone use create two different diseases in name and physical outcomes (gigantism and acromegaly). (p. 45)

a. here are two side effects of excessive HGH use. The first is gigantism, which is "the underlying cause of all the world's very tallest people" (Cooper, 2012, p. 45). Gigantism, in other worlds, increases height to abnormal levels. The second is acromegaly, which results in the "enlargement of the hands and feet, an expansion of the skull and protrusions of the brow and lower jaw" (Cooper, 2012, p. 45). Acromegaly, in essence, alters the proportions of one's extremities and head. Despite gigantism's benefits of increased height, neither it nor acromegaly are associated with improved athletic performance. b. Excessive use of HGH can also trigger the growth of abdominal tissues, which can result in the enlargement to the point where it creates a "bubble gut."

a. Why is height never questioned as a violation of the level playing field whereas genetic happenstance such as that encountered by Eero Mantyranta and Castor Sememya are considered controversial?

i. Eero Mantyranta was born with a higher sensitivity to EPO, which made him especially gifted in the Winter Olympics, winning gold medals in cross-country skiing. Castor Sememya was a female athlete who possessed an abnormally high level of testosterone, to a level of one in a million. Because of this, Sememya was banned from WADA and has been demanded to take testosterone lowering drugs to level the playing field with other athletes, which could lower her performance by over 5%. Though such mutations sound strange and almost like cheating, they are no rarer than extremely tall individuals who may also have a one in a million chance of occurring in the population. The reason why unusually high height is not considered as controversial as Mantyranta or Sememya's conditions is likely less because of any rational logic, and more to do with the fact that EPO and testosterone are closely associated with drugs. Since drugs have such a strong stigma, Mantyranta and Sememya's conditions are as well.

a. Make arguments both in favor and opposed to WADA-approved therapeutic-use exemptions (TEUs) allowing testosterone prescriptions with older athletic men and women (like Tom Brady, Oksana Chusovitina, Serena Williams for instance) experiencing age-related, non-pathological declines in testosterone? (xii)

i. One might support therapeutic-use exemptions for two primary reasons. 1. First of all, TEUs would benefit the athletes. One of the greatest weakness of sports as a career is that all athletes are ticking time bombs; within little more than a decade, even the greatest athlete is unlikely to be able to compete with younger athletes with high testosterone levels. Thus, giving older athletes TEUs would extend a star athlete's career. The consequences of longer athletic careers would be increased job security, which may end up drawing more athletes to the sport who otherwise would not have due to economic concerns. 2. Second of all, TEUs would benefit the audience. With old athletes being able to stay in the game longer, sports fans would be able to see their favorite athletes play for more games. Since preserving more old athletes would increase the amount of high level athletes overall, additionally, sports fans would enjoy a more diverse and large roster of high level players than if the older athletes had to retire. ii. One might oppose therapeutic use exemptions for two primary reasons. 1. First of all, TEUs could potentially be cheated. An athlete who wanted to cheat could, for instance, claim TEU of testosterone due to old age and declining natural testosterone levels. Then, they could use a PED that affects testosterone levels. When testers notice that their testosterone levels are abnormal, they could excuse it by arguing that it's statistical noise caused by the TEU testosterone injection. 2. Second of all, TEUs could make it harder for new athletes to come into the game. Younger athletes would have to enter games where older athletes dominate due to TEU testosterone; as a result, it's likely that the top roster of games would stay static for extended periods of time, and newcomers would find it hard to make it into the spotlight.

a. What is the relationship between reticulocytes, EPO, and consistent exposure to hypoxic conditions (e.g. aerobic exercise)?

i. Reticulocytes are the remnant cell of an enucleated orthochromatic erythroblast, which descend from stem cells in the bone marrow. In other words, reticulocytes are one of the last steps between bone marrow and mature RBCs. What it has in common with mature RBCs is that it has no nucleus. However, unlike mature RBCs, reticulocytes are not yet packed with hemoglobin. Thus, the amount of reticulocytes in a body signify the level to which a body is producing new blood cells, because they are the stage before mature RBCs. Because an EPO signal increases the amount of red blood cells by stimulating the bone marrows, the amount of reticulocytes can signify the extent to which a body is undergoing an EPO signal. Finally, Hypoxic conditions such as blood loss or altitude changes which decrease the amount of O2 trigger EPO conditions which increase the amount of red blood cells to equalize O2 levels. In conclusion, high levels of reticulocytes in the blood signify exposure to hypoxic conditions. ii. It's important to note that just because reticulocyte levels go up does not mean that hemoglobin levels immediately go up, because reticulocytes are not ye matured. Thus, using EPO to increase the amount of reticulocytes will always have a delayed ergogenic effect.

1. From xiii and according to Bhasin & Jasuja 2010, what are SARMs and why are the chemicals being developed/researched? In addition to androgen deficiency, what is the major impetus or rationale as stated for their development?

i. SARMs are Selective Androgen Receptor Modulators was an attempt to create an anabolic drug without androgenic effects—in other words, a drug that improved performance without masculinization. According to Bhasin & Jasuja, the major impetus for SARM development is "the potential anabolic effects of these compounds on the skeletal muscle and bone" (Bhasin & Jasuga, 2010). The aim, specifically, is to use the anabolic effects on muscle and bone to help prevent chronic illnesses in "older individuals with functional limitations and disabilities" (Bhasin & Jasuga, 2010).

a. Create a second metaphor that captures the same points as the sunscreen example of Cooper. (p. 22)

i. Suppose kangaroos evolved to jump high, but humans did not. A chemical enhancer that aids jump height would fail to work for a kangaroo, whose jump height is already optimized. Such an enhancer would aid the jump height of a human, however, since their body is not optimized for jump height.

a. identify two approaches used to achieve "tissue selectivity of androgen action" for SARMS.

i. The first approach is "to develop SARMs with the desired activity profile and tissue selectivity" (Bhasin & Jasuga, 2010). In other words, one approach is to develop PEDs that are capable of directly stimulating the desired tissues. The second approach is to "activate pathways involved in skeletal muscle hypotrophy, but not the prostate" (Bhasin & Jasuga, 2010). In other words, another approach is to attempt and stimulate molecules that already activate the desired skeletal tissues in the body.

a. As seen in Baillargeon et al. 2018, male testosterone prescriptions peaked in 2013. What was the percentage of all males above the age of 30 that were receiving testosterone prescriptions in the US? Why did these rates start to decline in 2014?

i. The percentage of all males above 30 that were receiving testosterone prescriptions in 2013 was 3.18% to 3.22%. i. The reasons the rates began to decline was due to "a publication linking testosterone to cardiovascular adverse events," other similar reports which led to a decrease in new testosterone users, and a resulting safety bulletin from the US Food and Drug Admnistration (Baillargeon et al., 2018).

a. DNA is produced and found intracellularly. It can appear in the bloodstream following cellular damage (apoptosis) but in most cases is too large to pass from the blood stream to the kidneys through the filtration slits of the glomerulus. Why does endogenous (or exogenous) urine contain DNA?

i. Urine contains DNA, according to Smuts and Pogue from the University of North Texas, because of skin cells shed into the urine from the Kidney tubules. In other words, presence of DNA in urine has less to do with the urine itself and rather accidental loss of cells to the urine. This is why evidence of DNA in urine tends to be very small. In particular, epithelial cells from places like the urethra, bladder, and elsewhere in the urinary track typically serve as the source of DNA in urine, which is why female urine samples tend to hold more DNA than male urine samples.

a. Describe how VO2max is assessed

i. VO2max test is a test of maximum oxygen capacity, or maximum aerobic capacity. What VO2max does is it tests to what degree its cells have mitochondria, and to what degree the mitochondria is consuming oxygen. 1. It starts with a light jog at a self-selected pace for 5 minutes. 2. Once the light jog ends, a mask is fixed on the subject. 3. Stage 1 begins with a 3 minute jog; when the first stage ends, the subject must pick between 5-8 MPH for the speed of the treadmill. The incline then increases by 2.5% every 2 minutes (each time a new stage). ii. At the end of the test, the HR (heart rate) and VO2 (oxygen used) are compared to one another on a graph. The VO2max is the point at which the HR and VO2 stop rising with increasing strain. It also signifies the total mitochondrial activity, or the maximum limit of mitochondrial ATP production.