Who needs steroids when you have the placebo effect?
- A study suggests that the effectiveness of sports drinks may depend in part on their color.
- Runners who rinsed with a pink liquid ran better than those who consumed the same but colorless drink.
- Improvement in their performance is likely due to a placebo effect.
The "placebo effect" is real. It's the name for a strange phenomenon that most notably occurs during clinical trials. People who are given an inactive substance, like a sugar pill, often experience the same therapeutic benefit as those who are given actual medicine. It's not their imagination — it really happens. (Even better, recent research suggests that therapeutic benefits occur even when the person knows that they were given a placebo.)
Now, a new study from the University of Westminster (UOW) Centre for Nutraceuticals in London and published in Frontiers in Nutrition suggests that the placebo effect may explain yet another phenomenon: Athletic performance.
The research showed that treadmill runners who rinsed their mouths with a pink liquid increased their performance over runners who swished with exactly the same liquid but without the coloring. Why pink? The color is generally linked to sweetness, and the researchers wondered if that association would subconsciously trick the runners into an expectation of more carbohydrates and thus energy.
Author Sanjoy Deb explains:
"The influence of color on athletic performance has received interest previously, from its effect on a sportsperson's kit to its impact on testosterone and muscular power. Similarly, the role of color in gastronomy has received widespread interest, with research published on how visual cues or color can affect subsequent flavor perception when eating and drinking."
Running for science
Credit: Ryan De Hamer / Unsplash
For the study, the researchers recruited ten healthy adults — six men, four women. All were regular exercisers, with an average age of 30. The participants were told that they would be testing the relative benefits of two commercial sports drinks after watching a brief video explaining the value of such beverages. Previous research found that mid-exercise rinsing with such drinks can reduce the perceived intensity of exercise.
The drinks consisted of 0.12 grams of sucralose dissolved in 500 mL of plain water — an artificially sweetened rinse low in calories. The liquids contained no other additives common to sports drinks such as caffeine. The pink version had non-caloric coloring added but was otherwise identical.
After a 12-minute warmup phase of jogging followed by running, the athletes ran at a difficult pace for 30 minutes, rinsing with their drinks as they ran. Following a brief cool-down, they were interviewed to capture their impressions of the exercise session. (Each runner tested both drinks.)
The researchers found that when the volunteers used the pink rinse, they ran an average of 212 meters farther and 4.4 percent faster. They also enjoyed the exercise more.
Deb said, "The findings from our study combine the art of gastronomy with performance nutrition, as adding a pink colorant to an artificially sweetened solution not only enhanced the perception of sweetness, but also enhanced feelings of pleasure, self-selected running speed, and distance covered during a run."
The researchers also plan to dig deeper into the phenomenon by investigating the possibility that the pinkness of the beverage is somehow directly activating the brain's reward areas.
A new study used functional near-infrared spectroscopy (fNIRS) to measure brain activity as inexperienced and experienced soccer players took penalty kicks.
- The new study is the first to use in-the-field imaging technology to measure brain activity as people delivered penalty kicks.
- Participants were asked to kick a total of 15 penalty shots under three different scenarios, each designed to be increasingly stressful.
- Kickers who missed shots showed higher activity in brain areas that were irrelevant to kicking a soccer ball, suggesting they were overthinking.
In a 2019 soccer match, Swansea City was down 1-0 against West Brom late in the first half. A penalty was called against West Brom. Swansea midfielder Bersant Celina was preparing to deliver a penalty kick. He scuttled up to the ball, but his foot only made partial contact, lobbing it weakly to the right.
Was it a simple mistake? Maybe. But there might be deeper explanations for why professional athletes choke under high-pressure situations.
A new study published in Frontiers in Computer Science used functional near-infrared spectroscopy (fNIRS) to analyze the brain activity of inexperienced and experienced soccer players as they missed penalty shots. Although past research has explored why soccer players miss penalty shots, the recent study is the first to do so using in-the-field fNIRS measurement.
The results showed that kickers who choked were activating parts of their brain associated with long-term thinking, self-instruction, and self-reflection. The chokers, in other words, were overthinking it.
The psychology of penalty kicks
Penalty shots offer an interesting case study of how mental pressure affects physical performance. After all, there's a lot at stake, not only because the kick can sometimes render a win or loss, but also because there are sometimes millions of people anxiously watching, some of whom might have a financial interest in the outcome.
That pressure is no joke. For example, research on Men's World Cup penalty shoot-outs has shown that when the score is tied and a goal means an immediate win, players score 92 percent of kicks. But when teams are facing elimination in a shootout, and the kick determines an immediate tie or loss, players only score 60 percent of the time.
"How can it be that football players with a near perfect control over the ball (they can very precisely kick a ball over more than 50 meters) fail to score a penalty kick from only 11 meters?" study co-author Max Slutter, of the University of Twente in the Netherlands, said in a press release.
"Obviously, huge psychological pressure plays a role, but why does this pressure cause a missed penalty? We tried to answer this by measuring the brain activity of football players during the physical execution of a penalty kick."
In the new study, the researchers aimed to answer two key questions about choking under pressure among both experienced and inexperienced players: (1) What is the difference in brain activity between success (scoring) and failure (missing) when taking a penalty kick? (2) What brain activity is associated with performing under pressure during a penalty kick situation?
To find out, the researchers asked ten experienced soccer players and twelve inexperienced players to participate in a penalty-kicking task. The task was divided into three rounds, each of which was designed to be increasingly stressful:
- Round 1 had no goalkeeper and was labeled as a practice round.
- Round 2 had a friendly goalkeeper who wasn't allowed to distract the kicker.
- Round 3 had a competitive goalkeeper who was allowed to distract the kicker, and kickers were also competing for a prize.
Participants kicked five shots in each round. They wore a fNIRS-equipped headset during the task that measured activity in various parts of the brain.
All participants performed worse in the second and third rounds and reported experiencing the most pressure in the third round. Inexperienced players performed worse than experienced players, which might suggest that they were less able to deal with the mental stress.
The locations in which experienced and inexperienced players kicked the ball in each round. Red dots represent missed penalties and green dots represent scored penalties.Slutter et al., Frontiers in Computer Science, 2021.
The neuroscience of choke artists
So, what types of brain activity were associated with missed shots?
The most noticeable result was that kickers missed more shots when they showed higher activity in their prefrontal cortex (PFC), an area of the brain associated with long-term planning. This was especially true among participants who reported higher levels of anxiety. More specifically, experienced soccer players who missed shots showed high activity in the left temporal cortex, which is related to self-instruction and self-reflection.
"By activating the left temporal cortex more, experienced players neglect their automated skills and start to overthink the situation," the researchers wrote. "This increase can be seen as a distracting factor."
Also, when players of all experience levels felt anxious and missed shots, they showed less activity in the motor cortex, which is the brain area most directly associated with kicking a penalty shot.
Don't overthink it
The results suggest that mental pressure can activate parts of the brain that are irrelevant to the task at hand. In general, expert athletes show more efficient brain activity — that is, more activity in relevant areas, and less activity in irrelevant areas — and therefore experience fewer distractions. This is likely one reason why they were more successful at penalties than inexperienced players in high-stress situations.
This principle is described by neural efficiency theory, and it applies not only to athletes but experts in any field. As you gain mastery over something, you can rely more on automatic brain processes rather than deliberate thinking, which can lead to distractions. The authors of the study concluded that their results provide supporting evidence for neural efficiency theory.
Still, as long our experts are human, it seems that high-pressure situations can turn anyone into a choke artist.
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Light-emitting tattoos could indicate dehydration in athletes or health conditions in hospital patients.
- Researchers at UCL and IIT have created a temporary tattoo that contains the same OLED technology that is used in TVs and smartphones.
- This technology has already been successfully applied to various materials including glass, food items, plastic, and paper packaging.
- This advance in technology isn't just about aesthetics. "In healthcare, they could emit light when there is a change in a patient's condition - or, if the tattoo was turned the other way into the skin, they could potentially be combined with light-sensitive therapies to target cancer cells, for instance," explains senior author Franco Cacialli of UCL.
Scientists at University College London (UCL) and the IIT (Istituto Italiano di Tecnologia) have created a temporary tattoo that contains the same light-emitting technology used in TVs and smartphone screens.
The technology uses organic light-emitting diodes (OLEDs) and is applied in the same way as simple water-transfer tattoos. The OLEDs are fabricated onto a temporary tattoo paper and then transferred to a new surface by being pressed onto it and dabbed with water.
According to the research, these OLED devices being developed are 2.3 micrometers thick in total (less than one 400th of a millimeter) and about one-third of the length of a single red blood cell. The device consists of an electroluminescent polymer (a polymer that emits light when an electric field is applied) that is placed in between electrodes. An insulating layer is then placed in between the electrodes and the commercial tattoo paper.
This process has already been successfully applied to various materials.
Once the research team had perfected the technology, they applied the tattoo-able OLEDs (which emit green light) onto various surfaces including a pane of glass, a plastic bottle, an orange, and paper packaging. The first OLEDs were used in a flatscreen television more than 20 years ago, and now, through this proof-of-concept study, "smart tattoos" may be a thing of the (very near) future.
Why “smart tattoos” could be beneficial
OLEDs are used to create digital displays in devices (such as television screens computer monitors, smartphones, etc).
Credit: Hanna on Adobe Stock
While this is perhaps the most obvious way you could use light-emitting tattoo technology, the world of tattoo art and design could see a huge surge in new exciting trends based on light-emitting tattoo technology.
It's not just about looks—this approach provides a quick and easy method of transferring OLEDs onto practically any surface.
OLEDs are used to create digital displays in devices (such as television screens computer monitors, smartphones, etc). While some may get OLED and LED confused, they are quite different, with OLED displays emitting visible light and therefore being able to be used without a backlight. The breakthrough process of being able to transfer OLEDs onto virtually any surface can be useful in many different applications and settings.
Light-emitting tattoos could be used to indicate (and potentially even treat) various health conditions in the future.
The eventual implementation or use of OLED tattoos could be combined with other tattoo electronics to, for instance, emit light when an athlete is dehydrated, or when a person is being exposed to too much sun and is prone to sunburn.
"In healthcare, they could emit light when there is a change in a patient's condition - or, if the tattoo was turned the other way into the skin, they could potentially be combined with light-sensitive therapies to target cancer cells, for instance." - Professor Franco Cacialli (UCL)
OLED tattoo devices
Credit: Barsotti - Italian Institute of Technology
Similarly, this technology could be used on the packaging of various items to give us more information about them.
For example, OLEDs could be tattooed onto the packaging of a fruit to signal when the product is passed its expiration date or will soon become inedible.
In reality, creating light-emitting tattoo technology doesn't have to be expensive.
Professor Franco Cacialli explains to Eurekalert: "The tattooable OLEDs that we have demonstrated for the first time can be made at scale and very cheaply. They can be combined with other forms of tattoo electronics for a very wide range of possible uses. These could be for fashion - for instance, providing glowing tattoos and light-emitting fingernails. In sports, they could be combined with a sweat sensor to signal dehydration."
"Our proof-of-concept study is the first step. Future challenges will include encapsulating the OLEDs as much as possible to stop them from degrading quickly through contact with air, as well as integrating the device with a battery or supercapacitor."
Contrary to what some might think, the brain is a very plastic organ.
As with many other physicians, recommending physical activity to patients was just a doctor chore for me – until a few years ago. That was because I myself was not very active.
Over the years, as I picked up boxing and became more active, I got firsthand experience of positive impacts on my mind. I also started researching the effects of dance and movement therapies on trauma and anxiety in refugee children, and I learned a lot more about the neurobiology of exercise.
I am a psychiatrist and neuroscientist researching the neurobiology of anxiety and how our interventions change the brain. I have begun to think of prescribing exercise as telling patients to take their “exercise pills." Now knowing the importance of exercising, almost all my patients commit to some level of exercise, and I have seen how it benefits several areas of their life and livelihood.
We all have heard details on how exercise improves musculoskeletal, cardiovascular, metabolic and other aspects of health. What you may not know is how this happens within the brain.
How exercise improves the brain.
Brain biology and growth
Working out regularly really does change the brain biology, and it is not just "go walk and you will just feel better." Regular exercise, especially cardio, does change the brain. Contrary to what some may think, the brain is a very plastic organ. Not only are new neuronal connections formed every day, but also new cells are generated in important areas of the brain. One key area is the hippocampus, which is involved in learning and memory and regulating negative emotions.
A molecule called brain-derived neurotrophic factor helps the brain produce neurons, or brain cells. A variety of aerobic and high-intensity interval training exercises significantly increase BDNF levels. There is evidence from animal research that these changes are at epigenetic level, which means these behaviors affect how genes are expressed, leading to changes in the neuronal connections and function.
Moderate exercise also seems to have anti-inflammatory effects, regulating the immune system and excessive inflammation. This is important, given the new insight neuroscience is gaining into the potential role of inflammation in anxiety and depression.
Finally, there is evidence for the positive effects of exercise on the neurotransmitters – brain chemicals that send signals between neurons – dopamine and endorphins. Both of these are involved in positive mood and motivation.
Exercise improves clinical symptoms of anxiety and depression
Researchers also have examined the effects of exercise on measurable brain function and symptoms of depression and anxiety. Exercise improves memory function, cognitive performance and academic achievement. Studies also suggest regular exercise has a moderate effect on depressive symptoms even comparable to psychotherapy. For anxiety disorders, this effect is mild to moderate in reducing anxiety symptoms. In a study that I conducted with others among refugee children, we found a reduction in symptoms of anxiety and PTSD among children who attended eight to 12 weeks of dance and movement therapies.
Exercise could even potentially desensitize people to physical symptoms of anxiety. That is because of the similarity between bodily effects of exercise, specifically high-intensity exercise, and those of anxiety, including shortness of breath, heart palpitation and chest tightness. Also, by reducing baseline heart rate, exercise might lead to signaling of a calmer internal physical environment to the brain.
It is important to note that the majority of studies examined the effects of exercise in isolation and not in combination with other effective treatments of clinical anxiety and depression, such as psychotherapy and medication. For the same reason, I am not suggesting exercise as a replacement for necessary mental health care of depression or anxiety, but as part of it, and for prevention.
There are other perks besides the neurobiological impacts of exercise. When going out for a walk, one gets more exposure to sunlight, fresh air and nature. One of my patients befriended a neighbor during her regular walks, leading to regular taco Tuesdays with that new friend. I have made some great friends at my boxing gym, who are not only my motivators, but also a great supporting social network. One might pick a dog as their running mate, and another might meet a new date, or enjoy the high energy at the gym. Exercise can also function as a mindfulness practice and a respite from common daily stressors, and from our electronic devices and TV.
By increasing energy and fitness level, exercise can also improve self-image and self-esteem .
Practical ways for a busy life
So how can you find time to exercise, especially with all the additional time demands of the pandemic, and the limitations imposed by the pandemic such as limited access to the gyms?
- Pick something you can love. Not all of us have to run on a treadmill (I actually hate it). What works for one person might not work for another. Try a diverse group of activities and see which one you will like more: running, walking, dancing, biking, kayaking, boxing, weights, swimming. You can even rotate between some or make seasonal changes to avoid boredom. It does not even have to be called an exercise. Whatever ups your heartbeat, even dancing with the TV ads or playing with the kids.
- Use positive peer pressure to your advantage. I have created a group messaging for the boxing gym because at 5:30 p.m., after a busy day at the clinic, I might have trouble finding the motivation to go to the gym or do an online workout. It is easier when friends send a message they are going and motivate you. And even if you do not feel comfortable going to a gym during the pandemic, you can join an online workout together.
- Do not see it as all or none. It does not have to be a one-hour drive to and from the gym or biking trail for a one-hour workout vs. staying on the couch. I always say to my patients: "One more step is better than none, and three squats are better than no squats." When less motivated, or in the beginning, just be nice to yourself. Do as much as possible. Three minutes of dancing with your favorite music still counts.
- Merge it with other activities: 15 minutes of walking while on the phone with a friend, even around the house, is still being active.
- When hesitant or low on motivation, ask yourself: "When was the last time I regretted doing it?"
- Although it can help, exercise is not the ultimate weight loss strategy; diet is. One large brownie might be more calories than one hour of running. Don't give up on exercise if you are not losing weight. It is still providing all the benefits we discussed.
Even if you do not feel anxious or depressed, still take the exercise pills. Use them for protecting your brain.