A study looks at the performance benefits delivered by asthma drugs when they're taken by athletes who don't have asthma.
- One on hand, the most common health condition among Olympic athletes is asthma. On the other, asthmatic athletes regularly outperform their non-asthmatic counterparts.
- A new study assesses the performance-enhancement effects of asthma medication for non-asthmatics.
- The analysis looks at the effects of both allowed and banned asthma medications.
The most common chronic disease among athletes competing in the Olympic Games is asthma. It's not a coincidence — asthma is a risk associated with activities that require increased ventilation, such as high-performance athletics. One treatment for the condition is the inhalation of β-agonists prior to exercise as a means of warding off asthma symptoms. The drugs relax the airways that provide oxygen to the lungs.
But β-agonists pose a problem for World Anti-Doping Agency (WADA) officials — drugs have been tied to performance enhancement. In fact, asthmatic athletes, who have a sound medical reason to use β-agonists, have consistently outperformed non-asthmatic athletes at the Games. There has been unconfirmed speculation that athletes who don't have asthma may also be taking β-agonists in hopes of gaining their own performance boost.
A new study published in British Journal of Sports Medicine seeks to be the most comprehensive look yet at the effect of β-agonists on athletic performance, looking at a broad selection of β-agonist drugs, including medications both allowed and banned by the WADA.
Image source: joel bubble ben/Shutterstock
When inhaled β-agonists first came out just before the 1972 Olympics, they were immediately banned altogether by the WADA as possible doping substances. Over the years, the WADA has reexamined their use and refined the organization's stance, evidence of the thorniness of finding an equitable position regarding their use. As of January 2020, only three β-agonists are allowed — salbutamol, formoterol, and salmeterol —and only in inhaled form. Oral consumption appears to have a greater effect on performance.
Image source: MinDof/Shutterstock
Of primary interest to the authors of the study is confirming and measuring the performance improvement to be gained from β-agonists when they're ingested by athletes who don't have asthma.
The researchers performed a meta-analysis of 34 existing studies documenting 44 randomized trials reporting on 472 participants. The pool of individuals included was broad, encompassing both untrained and elite athletes. In addition, lab tests, as opposed to actual competitions, tracked performance. The authors of the study therefore recommend taking its conclusions with just a grain of salt.
The effects of both WADA-banned and approved β-agonists were assessed.
Approved β-agonists and non-asthmatic athletes
Image source: Andrey Yurlov/Shutterstock
What the meta-analysis showed is that the currently approved β-agonists didn't significantly improve athletic performance among those without asthma — what very slight benefit they may produce is just enough to prompt the study's authors to write that "it is still uncertain whether approved doses improve anaerobic performance." They note that the tiny effect did increase slightly over multiple weeks of β-agonist intake.
Banned β-agonist and non-asthmatic athletes
Image source: Nejron Photo/Shutterstock
The study found that for athletes without asthma, however, the use of currently banned β-agonists did indeed result in enhanced performance. The authors write, "Our meta-analysis shows that β2-agonists improve anaerobic performance by 5%, an improvement that would change the outcome of most athletic competitions."
That 5 percent is an average: 70-meter sprint performance was improved by 3 percent, while strength performance, MVC (maximal voluntary contraction), was improved by 6 percent.
The analysis also revealed that different results were produced by different methods of ingestion. The percentages cited above were seen when a β-agonist was ingested orally. The effect was less pronounced when the banned substances were inhaled.
Given the difference between the results for allowed and banned β-agonists, the study's conclusions suggest that the WADA has it about right, at least in terms of selection of allowable β-agonists, as well as the allowable dosage method.
The study, say its authors, "should be of interest to WADA and anyone who is interested in equal opportunities in competitive sports." Its results clearly support vigilance, with the report concluding: "The use of β2-agonists in athletes should be regulated and limited to those with an asthma diagnosis documented with objective tests."
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A Duke University study that found over 40 percent of our actions aren’t actually decisions, but habits. Here's how to build good ones.
Chocolate—the key to working out, says NY Times journalist Charles Duhigg. While I’m apt to reply, yes, chocolate is the key to most everything, Duhigg is specifically addressing a way to “trick your brain” into getting fitter. For those lacking the motivation to hit the trail or get into the gym, chocolate just might be the answer.
Kale chips, he goes on, are not the way to develop an exercise habit. He says people get it wrong—you shouldn’t punish yourself by following up a workout with something you don’t enjoy but think is good for you. (Let’s pause to remember all kale chips are not created equal. Some are truly terrible, though.)
You need an intrinsic reward, a treat that is meaningful and pleasurable. As Duhigg states,
Studies say that the best way to start an exercise habit is to give yourself a reward that you genuinely enjoy.
In his book, The Power of Habit, Duhigg writes that habits are a three-step process: a cue, routine, and reward. He cites a 2006 study at Duke University that found over 40 percent of our actions aren’t actually decisions, but habits. We think we’re putting a novel idea into action when really we’re on autopilot.
Unless you deliberately fight a habit, the habit will automatically unfold. You reach for a cigarette, you pull the phone from your pocket while in line, you don’t go to the gym in the morning. You need to introduce a new cue in order to change the routine. But if the reward isn’t there, or isn’t actually pleasurable, you’ll fall back on old patterns.
Having worked at Equinox since 2004 (and having been going to gyms since the late eighties, when my father ran his company’s exercise facilities on the side), I’ve heard innumerable excuses about why don’t people work out.
Not enough time is first uttered. Strangely, though, many of my students are extremely busy at their jobs. It’s not a matter of having time, but of budgeting it properly to ensure they’re functioning optimally in body and brain. Carving that time into your day has beneficial effects on the other parts when you are swamped with duties.
The second is not enough money to join a gym. While some are not cheap, plenty of gyms run between $10 and $40 a month. But forget the gym for a moment. All you really need is about ten feet of space. Given the number of free workouts on Youtube and Instagram, there is no dearth in available content.
Time and money aren’t the real problem. Habits are. As Duhigg says, the brain of the uninspired has not developed the proper neurological connections between routine and reward. It could be a missing cue: leaving your sneakers next to your bed so you see them first thing in the morning is well-circulated advice, in the same way that removing the office candy dish from the table curbs compulsive snacking. Cues are necessary catalysts for routines.
Whatever cues you choose—post-it notes, sneakers at the door, earlier settings on the alarm clock—the following three pieces of advice are the most effective catalysts I’ve witnessed:
Schedule your workouts. Putting your sessions into your calendar makes fitness part of your day. Treating your workout like everything else in life, from your job to taking care of your children, instills a mindset that this is not a hobby. We recognize that we live in a sedentary culture, yet there has never been so many opportunities to explore such a wide range of exercise options. Devoting that hour a day a few days a week will make a big impact in the rest of your hours. Scheduling it in makes it real in your mind.
Commit to daily exercise. This past weekend two different men stopped me after class to tell me they needed to commit to practicing more yoga. Both get in a class a week. But a little every day is better than one weekly session. Even ten minutes on busy days can be enough. Diversifying your workouts, between cardio, weight and bodyweight training, yoga, and meditation is a solid approach, but to begin, just get moving, daily. That said, don’t overload during your first month. Too many people hit it hard only to get injured and lose focus. This is a long game strategy we’re discussing, not a quick hit of dopamine.
Find movements you enjoy. One of the biggest reasons people stop working out is because they don’t enjoy it. Such a routine will never stick. Just as the reward needs to provide pleasure, so does the routine. If you’re not deriving pleasure during exercise—if you think it’s because you should be doing it instead of want to be doing it—there’s no chance it will last. Fortunately there are thousands of ways to move your body. Taking a running class when you have weak knees or lifting heavy weights when you have a shoulder injury makes no sense. What about ping-pong? Swimming? Hiking? Most every form movement is beneficial, provided you’re being safe and focusing on form.
In The Power of Habit, Duhigg writes,
Only when your brain starts expecting a reward—craving the endorphins or sense of accomplishment—will it become automatic to lace up your jogging shoes each morning. The cue, in addition to triggering a routine, must also trigger a craving for the reward to come.
Hence, chocolate. Yet Duhigg is not repeated that tired trope exercising allows you to be gluttonous. The need for the chocolate wears off in a week and a half (or so) as your brain links the reward to the routine itself. Your brain—you, forgive the metaphysical verbiage—trick yourself into action by giving it a little boost. Then, he says,
After a week and a half your brain will learn that it enjoys the intrinsic reward of exercise.
Not to say a little chocolate is a bad thing. Let’s be real. Life without exercise or chocolate is not an optimal life. Fortunately we can have it both ways.
Derek is the author of Whole Motion: Training Your Brain and Body For Optimal Health. Based in Los Angeles he is working on a new book about spiritual consumerism. Stay in touch on Facebook and Twitter.