Prohibited substances in sport supplements International Conference on Doping and Public Health, Oslo, Norway Olivier de Hon Introduction Supplements & Sport; a topic for several millennia Ancient Olympic (and other) Games: human breast milk, mushrooms, 1800s & birth of modern sport : arsenic, strychnine, 1928 & first anti-doping regulations: any stimulant not normally employed 1980s: the problem of contaminations surface (ginseng tea, nandrolone, ) Supplement Doping 2 1
The risk Dietary supplements can contain doping Declared e.g. higenamine, octopamine, DHEA Hidden declared e.g. geranamine, proprietary blend Spiked (not labeled) Contaminated (not labeled) Would you take the risk? WADA labs use very sensitive test methods They can detect 1 sugar cube dissolved in 10 Olympic Swimming Pools (pictograms per milliliter) 3 and athletes are strictly liable! Each athlete is strictly liable for the substances found in his or her bodily specimen Taking a poorly labeled dietary supplement is not an adequate defense in a doping hearing (WADA) Unstoppable - Dedicated 4 2
Percentages Landmark studies Geyer et al. (2004) 634 products; 15 countries 15% AAS Judkins et al. (2007) 54 products; US market 26% AAS + stim. Actual situation It can happen with many prohibited substances It can happen in any product Pharmaceutical GMP is not sufficient What to do 5 View of Dutch NADO Conservatives: supplements not necessary Large debates on scientific value of claims about performance enhancement But: elite sports is all about details There is added value in certain situations Some supplements may enhance performance If you love sport, you are obliged to do something 6 3
The industry raw material raw material raw material raw material supplier premix raw material supplier formulation manufacturer box/jar/etc packer fitness centre distributor internet distributor 7 (drug) store Source: TNO-voeding The NZVT 8 4
Athlete education Only use what is necessary Avoid declared Avoid hidden declared Avoid too good to be true products (risk of spiking) Deal with risk of contamination 9 NZVT experiences First in the world (est. 2003) Together with the industry (NPN) Paid by the industry ( 500/test) Tested per batch 250 200 150 100 50 # certificates granted Independent testing (LGC) 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 6 # samples positive 5 4 3 10 13 year average: 1,5% (lower limit for athletes) 2 1 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 5
Continuing debates Are you promoting supplement use? Why is there a limited availability of tested products? What is your own liability? Why is 0% contaminations not achievable? Is this still necessary? My advice: continuous data collection is necessary (and a dialogue) 11 New study 12 Research area What percentage of sports supplements contain prohibited substances when these products: are available from Dutch web shops focus on: hormone regulation strengthening muscle weight loss/burning fat raising energy levels have no prohibited substances declared on the label 38% 6
Own study Results 66 products from 17 online retailers Lab: LGC Write Off Positive + health risk 25 (38%) tested positive 30 (45%) tested negative 8 (12%) tested with trace concentrations below the adopted threshold value 3 (5%) were writeoffs 13 Negative 4 Positive 33 % Trace concentration 12 % Own study Results 66 products from 17 online retailers Lab: LGC Health risk 25 (38%) tested positive 30 (45%) tested negative 8 (12%) tested with trace concentrations below the adopted threshold value 3 (5%) were write offs 14 Trace 12% Positive 33 % Risk positive doping control 7
Own study Botanicals and doping natural occurrence sterol conversion Write Off Positive + health risk Positive 33 % 15 More research required! Negative 4 Trace concentration 12 % Own study 3 samples (5%) High concentrations of prohibited stimulants 16 Up to 20x maximum dose Potential serious health issues Removed from Dutch shops Negative 4 Write Off Positive + health risk Positive 33 % Trace concentration 12 % 8
Conclusion Dietary supplements are still a big risk for elite athletes Lower limit: 1,5% Independent testing is needed Study Upper limit: 38% Mainly caused by inadvertent contamination Mainly a specific elite 17 sports problem NZVT In one sentence Yes, it is still a problem! 18 9
The least we should do Continuous education: be careful Continuous cooperation: talk to the industry Continuous helping hand: what can be regarded as lowest risk? 19 We should be careful Is supplement use a stepping stone for doping use? Or is supplement use keeping athletes from stronger substances? 20 10
Biochemical solution More thresholds, perhaps higher thresholds? 21 Excretion of prohibited substances 100000 Injection 100 mg norandrostenedione 10000 Urinary concentration 19-NA (ng/ml) 1000 100 10 1 Doping Control 2 ng/ml cut-off limit 0 30 60 90 120 150 180 210 240 270 time [h] 22 Source: Presentation Hans Geyer at Jornada Científica de la Comissió Antidopatge de Catalunya, 8 July 2004 11
Excretion of prohibited substances 100000 Injection 100 mg norandrostenedione 10000 Urinary concentration 19-NA (ng/ml) 1000 100 10 1 Intake contaminated supplement Doping Control 2 ng/ml cut-off limit 0 30 60 90 120 150 180 210 240 270 time [h] 0 8 23 Source: Presentation Hans Geyer at Jornada Científica de la Comissió Antidopatge de Catalunya, 8 July 2004 Final words Anti-doping regulations have unearthed a contamination problem; solutions will help both the athletic world and society as a whole This problem is not solved yet and it will not solve itself! 24 12
25 Thanks for your attention Questions? Remarks? 13