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reaction\ttime,\tpsychomotor\nperformance\nAnabolic\tandrogenic\nsteroids\nGain\tmuscle\tmass\nand\tstrength\nIncrease\tmuscle\nmass\tand\nstrength,\nespecially\twhen\ncombined\twith\nstrength\nMultiple\torgan\tsystems\tincluding\ninfertility,\tgynecomastia,\tfemale\nvirilization,\thypertension,\natherosclerosis,\tphyseal\tclosure,\naggression,\tdepression,\n\tsuicidal\nideation
|
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training\tand\nhigh-protein\ndiets\nAndrostenedione\nIncreases\ntestosterone\tto\ngain\tmuscle\nmass\tand\nstrength\nIncrease\tmuscle\nstrength\tand\nsize\nTendopathy,\trhabdomyolysis;\ttendon\nrupture\nDHEA\nIncreases\ntestosterone\tto\ngain\tmuscle\nmass\tand\nstrength\nNo\tmeasurable\neffect\nIncreases\testrogens\tin\tmen;\timpurities\nin\tpreparation\nHuman\tgrowth\thormone
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] |
in\tpreparation\nHuman\tgrowth\thormone\nIncrease\tmuscle\nmass,\tstrength,\nand\tdefinition\nDecreases\nsubcutaneous\nfat\tand\nincreases\nlipolysis;\nincreases\nmuscle\tmass\nand\tstrength;\nimproves\nwound\thealing;\nstimulates\ntestosterone\nproduction\nAcromegaly,\tglucose\tintolerance,\nphyseal\tclosure,\tincreased\tlipids,\nmyopathy\nStimulants\t(ephedrine\nalkaloids,
|
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] |
myopathy\nStimulants\t(ephedrine\nalkaloids,\namphetamines,\ncocaine)\nIncreases\tweight\nloss;\tfatigue\ndelay\nIncreases\nmetabolism,\tno\nclear\nperformance\nbenefit,\nalthough\tmay\nbenefit\tpower,\nendurance,\nstrength,\n\tor\nspeed;\treduces\ntiredness;\nincreases\nalertness\tand\naggression\nMuscle\tand\tjoint\tpain;\tmisjudgment\tin\ntime\torientation;\ttremors;\tcerebral
|
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] |
time\torientation;\ttremors;\tcerebral\nvascular\taccident,\tarrhythmia,\nmyocardial\tinfarction,\tseizure,\npsychosis,\thypertension,\tdeath\nArimidex,\t(anastrozole);\nselective\testrogen\nreceptor\tmodulators\n(SERMs)\tlike\ntamoxifen\nCancer\tdrug\tused\nto\tdecrease\nestrogen\tlevels\nassociated\twith\ntestosterone\nuse\nNone;\tincrease\ntestosterone,\nluteinizing\nhormone
|
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testosterone\nuse\nNone;\tincrease\ntestosterone,\nluteinizing\nhormone\nsecretion;\nincrease\tmuscle\nstrength\tand\nsize;\tprevent\nbone\tloss\nSide\teffects\tassociated\twith\ttaking\nthese\tagents;\tearly\tfatigue;\nincreased\tbone\tresorption\tand\ndecreased\tBMD\t(hip,\tlumber\tspine)\nGhrelin\tmimetics\n(GHRP6\tand\tGHRP2)\nIncrease\tGH\nsecretion\nIncrease\tmuscle\nmass;\tstimulate
|
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] |
Increase\tGH\nsecretion\nIncrease\tmuscle\nmass;\tstimulate\nglycogenesis;\nanabolic\teffects\non\tmuscle\tmass\nGH-associated\tside\n\teffects\t(see\tabove)\nGlucocorticoids\nAlleviate\tpain;\nreduce\ntiredness\nNo\timprovement\nGrowth\tsuppression,\tosteoporosis,\navascular\tnecrosis\tof\tfemoral\thead;\ntendon\tor\tfacial\trupture\t(by\tlocal\ninjections)\tosteoarthritis\nBMD
|
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] |
tendon\tor\tfacial\trupture\t(by\tlocal\ninjections)\tosteoarthritis\nBMD\n,\tBone\tmineral\tdensity,\t\nBP\n,\tblood\tpressure;\t\nCNS\n,\tcentral\tnervous\tsystem;\t\nDHEA\n,\tdehydroepiandrosterone;\t\nGH\n,\tgrowth\thormone;\t\nHR\n,\theart\nrate.\nRefs:\tPesta,\tD\tet\tal\t2013;\tNikolopoulios,\n\tD\tet\tal\t2011,\tRogol\tA\t2010;\tHoffman\tJ\tet\tal\t2009.
|
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D\tet\tal\t2011,\tRogol\tA\t2010;\tHoffman\tJ\tet\tal\t2009.\nThe\tbiggest\tconcern\tfor\tathletes\tis\tthe\tuse\tof\tdrugs\tprohibited\tin\tsport\tand\tthe\tpossibility\tthat\ta\nsupplement\tmay\tcontain\tsomething\tthat\twill\tresult\tin\ta\tpositive\tdrug\ttest,\twhich\tmay\talso\tapply\tto\nsupplemental\tsport\tfood\tproducts\tsuch\tas\tdrinks,\tshakes,\tand\tbars.\tIn\tfact\ta\twide\trange\tof
|
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stimulants,\tsteroids,\tand\tother\tagents\tthat\tare\tincluded\n\tin\tthe\tWorld\tAnti-Doping\tAgency’s\t(WADA)\nprohibited\tlist\thave\tbeen\tidentified\tin\tsupplements.\tThis\tmay\toccur\teither\tintentionally\tor\nunintentionally\tby\tthe\tmanufacturers\tin\tthe\tpreparation\tof\tthe\traw\tingredients\tor\tin\tthe\tformulation
|
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0.07936468720436096,
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0.11133000999689102,
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0.06908519566059113,
0.016224637627601624,
0.011131965555250645,
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0.07060220092535019,
0.05288783833384514,
0.11023968458175659,
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] |
of\tthe\tfinished\tproduct.\tIn\tsome\tcases,\tthe\tamount\tof\tproduct\tmay\tbe\texceptionally\thigher\tor\tlower\nthan\tthe\ttherapeutic\tdose\t(\nTable\t22.6\n).\tThe\tFDA\thas\tidentified\n\tsports\tsupplements\tand\tergogenic\naids\tamong\tthe\thighest\trisk\tfor\tadulteration\twith\tdrugs\tand\tbaned\tsubstances\t(see\t\nChapter\t11\n).
|
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0.03441547229886055
] |
TABLE\t22.6\nFoods\tHigh\tin\tBranched-Chain\tAmino\tAcids\nBranched-Chain\tAmino\tAcid\nFood\tSources\nLeucine\nMeat,\tdairy,\tnuts,\tbeans,\tbrown\trice,\tsoy,\tand\twhole\twheat\nIsoleucine\nMeat,\tchicken,\teggs,\tfish,\talmonds,\tchickpeas,\tsoy\tprotein,\tand\tmost\tseeds\nValine\nMeat,\n\tdairy,\tsoy\tprotein,\tgrains,\tpeanuts,\tand\tmushrooms
|
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Valine\nMeat,\n\tdairy,\tsoy\tprotein,\tgrains,\tpeanuts,\tand\tmushrooms\nResearch\tsuggests\tthat\tall\ttoo\toften,\tphysically\tactive\tindividuals,\tincluding\thigh-level\tathletes,\nobtain\tnutrition\tinformation\tfrom\tcoaches,\tfellow\tathletes,\ttrainers,\tadvertisements,\tand\tthe\tInternet
|
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rather\tthan\twell-informed\tand\teducated\tsports\tdietitians,\tphysicians,\tand\taccredited\texercise\nprofessionals\t(\nMorente-Sánchez\tand\tZabala,\t2013\n).\nInformation\ton\tthe\tefficacy\tand\tsafety\tof\tmany\tof\tthese\tproducts\tused\tby\tathletes\tis\tlimited\tor\ncompletely\tlacking.\tSports\tnutritionists\tneed\tto\tbe\ton\tthe\tforefront\tof\tinformation;\tknow\thow\tto
|
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] |
evaluate\tthe\tscientific\tmerit\tof\tarticles\tand\tadvertisements\tabout\texercise\tand\tnutrition\tproducts\tso\nthat\tthey\tcan\tseparate\tmarketing\thype\tfrom\tscientifically\tbased\ttraining\tand\tnutrition\tpractices\t(see\nChapter\t11\n).\tCertification\tprograms\tsuch\tas\tNational\tSanitation\tFoundation\t(NSF)\tfor\tSport\tand
|
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Informed\tChoice\tcan\thelp\tguide\tdietitians\tand\tathletes\tto\tselecting\tcertified\tsafe\tsport\tsupplements.\nNSF\tfor\tSport\tis\ta\tprogram\tthat\tfocuses\tprimarily\ton\tthe\tsports\tsupplement\tmanufacturing\tand\nsourcing\tprocess,\tprovides\tpreventive\tmeasures\tto\tprotect\tagainst\tadulteration\tof\tproducts,\tverifies\nlabel
|
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] |
label\n\tclaims\tagainst\tproduct\tcontents,\tand\tidentifies\tathletic\tbanned\tsubstances\tin\tthe\tfinished\nproduct\tor\tingredients.\tThe\tprogram,\tdesigned\tfor\tmanufacturers\tand\ttheir\tproducts,\tincludes\nproduct\ttesting\tfor\tmore\tthan\t180\tbanned\tsubstances,\tlabel\tcontent\tconfirmation,\tformulation\tand
|
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] |
label\treview,\tand\tproduction\tfacility\tand\tsupplier\tinspections,\tas\twell\tas\tongoing\tmonitoring\tin\tline\nwith\tsubstance\n\tprohibitive\tlists.\tThe\tprogram\tis\trecognized\tby\tthe\tNFL,\tNational\tFootball\tLeague\nPlayers\tAssociation\t(NFLPA),\tMajor\tLeague\tBaseball\t(MLB),\tMajor\tLeague\tBaseball\tPlayers
|
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] |
Association\t(MLBPA),\tProfessional\tGolfers\tAssociation\t(PGA),\tLadies\tProfessional\tGolf\tAssociation\n(LPGA),\tand\tCanadian\tCentre\tfor\tEthics\tin\tSports\t(CCES).\nInformed\tChoice\tis\talso\ta\tquality\tassurance\tprogram\tfor\tsports\tnutrition\n\tproducts,\tsuppliers\tto\tthe
|
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products,\tsuppliers\tto\tthe\nsports\tnutrition\tindustry,\tand\tsupplement\tmanufacturing\tfacilities.\tIts\ttesting\tcapability\tfor\nsupplements/ingredients\tincludes\tthe\tanalysis\tof\tover\t146\tsubstances\tthat\tare\tconsidered\tprohibited\nin\tsport\tand\tsubstances\tthat\tpose\ta\tthreat\twith\trespect\tto\tproduct\tcontamination.\tThese\tsubstances
|
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include\tdrugs\tof\tabuse,\tanabolic\tagents,\tstimulants,\tbeta-2-agonists,\tmasking\n\tagents,\tand\tso\ton.\nTesting\tmethods\tused\tfor\ta\trange\tof\tsubstances\tfrom\tthese\tcategories\thave\tbeen\tvalidated\tand\naccredited\tto\tthe\tISO\t17025\tstandard\tin\tsupplements/ingredients\tin\teach\tof\tthe\trelevant\tmatrices:
|
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] |
powders,\tbars,\tliquids,\tcapsules,\ttablets,\tand\tso\ton,\twith\tdefined\tmethod\tcapabilities/reporting\nlimits.\nPopular\tergogenic\tAIDS\nCreatine\nAs\tan\tamino\tacid,\tcreatine\tis\tproduced\tnormally\n\tin\tthe\tbody\tfrom\targinine,\tglycine,\tand\tmethionine.\nMost\tdietary\tcreatine\tcomes\tfrom\tmeat,\tbut\thalf\tis\tmanufactured\tin\tthe\tliver\tand\tkidneys.\tFor\tmeat
|
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] |
eaters,\tdietary\tintake\tof\tcreatine\tis\tapproximately\t1\tg\tdaily\t(\nKreider\tet\tal,\t2017\n).\tThe\tbody\talso\nsynthesizes\tapproximately\t1\tg\tof\tcreatine\tper\tday,\tfor\ta\ttotal\tproduction\tof\tapproximately\t2\tg\tdaily\n(\nKreider\tet\tal,\t2017\n).\nIn\tnormal,\thealthy\tpersons\n\tapproximately\t40%\tof\tmuscle\tcreatine\texists\tas\tfree\tcreatine;\tthe
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approximately\t40%\tof\tmuscle\tcreatine\texists\tas\tfree\tcreatine;\tthe\nremainder\tcombines\twith\tphosphate\tto\tform\tcreatine\tphosphate\t(CP).\tApproximately\t2%\tof\tthe\nbody’s\tcreatine\tis\tbroken\tdown\tdaily\tto\tcreatinine\tbefore\texcretion\tby\tthe\tkidneys.\tThe\tnormal\tdaily\nexcretion\tof\tcreatinine\tis\tapproximately\t2\tg\tfor\tmost\tpersons.\tThose\twith\tlower\tlevels\tof
|
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] |
intramuscular\tcreatine,\tsuch\tas\tvegetarians,\tmay\n\tbenefit\tfrom\tcreatine\tsupplementation\t(\nMcArdle\tet\nal,\t2014\n).\nCreatine\tmonohydrate\tis\tone\tof\tthe\tmost\tpopular\tsupplements\tused\tby\tstrength\tand\tpower\nathletes.\tSupplementation\televates\tmuscle\tcreatine\tlevels\tand\tfacilitates\tthe\tregeneration\tof\tCP,
|
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] |
which\thelps\tto\tregenerate\tATP.\tA\tvariety\tof\tsynthetic\tcreatine\tsupplements\thave\tbeen\tdeveloped,\nincluding\tcreatine\tmalate,\tpyruvate,\tcitrate,\tand\tmany\n\tmore\twith\tmarketing\tclaims\tof\tgreater\nperformance\tenhancement\tand\tabsorption.\tCreatine\tmonohydrate\tis\tnot\tonly\tthe\tmost\textensively
|
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studied\tbut\tthe\tmost\tclinically\teffective\tform\tof\tcreatine\tfor\tuse\tin\tnutritional\tsupplements\tin\tterms\nof\tmuscle\tuptake\tand\tability\tto\tincrease\thigh-intensity\texercise\tcapacity\t(\nKreider\tet\tal,\t2017\n).\nNumerous\treviews\tidentify\tperformance\tbenefits\twith\trepeated\tbouts\n\tof\thigh-intensity\texercise
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of\thigh-intensity\texercise\nless\tthan\t150\ts\tin\tduration\twith\tthe\tgreatest\timpact\tin\tless\tthan\t30\ts\t(\nLanhers\tet\tal,\t2017\n).\tClassical\nloading\tconsists\tof\tan\tinitial\tloading\tphase\tof\t15\tto\t20\tg\tper\tday\tfor\t4\tto\t7\tdays,\tfollowed\tby\ta\nmaintenance\tdose\tof\t2\tto\t5\tg\tper\tday.\tHowever,\talternative\tdosing\tmethods\talso\thave\tbeen\tshown\tto
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effectively\tincrease\tcreatine\tstores\tand\tresult\tin\tstrength\tgains.\tRegimens\n\twithout\tthe\tloading\ninclude\ta\tdose\tof\t0.3\tg/kg\tbody\tweight\tfor\t5\tto\t7\tdays,\tfollowed\tby\tmaintenance\tdose\tof\t0.03\tg/kg\nbody\tweight\tfor\t4\tto\t6\tweeks.\tHowever,\twith\tthis\tregimen\tcreatine\tstores\tincrease\tmore\tslowly,\tand
|
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it\tmay\ttake\tlonger\tto\tsee\tthe\tstrength\ttraining\teffects\t(\nHall\tand\tTrojian,\t2013\n).\nAs\tcreatine\tis\tone\tof\tthe\tmost\tresearched\tsupplements,\tnumerous\tstudies\tsupport\tthe\tuse\tand\neffectiveness\n\tof\tcreatine\tfor\tshort-term,\tmaximum\toutput\texercise\tsuch\tas\tweight\tlifting,\trunning\ta
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] |
100-m\tsprint,\tswinging\ta\tbat,\tor\tpunting\ta\tfootball.\tWhen\tcreatine\tstores\tin\tthe\tmuscles\tare\ndepleted,\tATP\tsynthesis\tis\tprevented\tand\tenergy\tcan\tno\tlonger\tbe\tsupplied\tat\tthe\trate\trequired\tby\nthe\tworking\tmuscle.\tImproved\tathletic\tperformance\thas\tbeen\tattributed\tto\tthis\tATP\tresynthesis.
|
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Creatine\tsupplementation\n\tincreases\tbody\tmass\tor\tmuscle\tmass\tduring\ttraining.\tIt\tmay\timprove\nsubmaximal\texercise\tperformance\tfor\thigh-intensity\tinterval\ttraining\t(HIIT),\twhich\tpromotes\tfitness\nsimilar\tto\tendurance\ttraining.\tA\t2013\tstudy\ton\tswimmers\tshowed\tcreatine\tsupplementation
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improved\tswimming\tperformance\tand\treduced\tblood\tlactate\tlevels\tafter\tintermittent\tsprint\nswimming\tbouts\t(\nDabidi\tRoshan\tet\tal,\t2013\n).\nStudies\n\tare\tconflicting\ton\tcreatinine’s\teffect\ton\taerobic\tperformance.\tIn\ta\tdouble-blind,\tplacebo-\ncontrolled\tstudy\t16\tmale\tamateur\tsoccer\tplayers,\tconsuming\t20\tg\tof\tcreatine\tper\tday,\tor\ta\tplacebo,
|
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] |
for\t7\tdays,\texperienced\tno\tbeneficial\teffect\ton\tphysical\tmeasures\tobtained\tduring\ta\t90-minute\tsoccer\ntest\t(\nWilliams\tet\tal,\t2014\n).\nCreatine\tabsorption\tappears\tto\tbe\tstimulated\tby\tinsulin.\tTherefore\tingesting\n\tcreatine\tsupplements\nin\tcombination\twith\tcarbohydrate,\tamino\tacids,\tor\tprotein\tcan\tincrease\tmuscle\tcreatine
|
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] |
concentrations.\tOnce\tcreatine\tis\ttaken\tup\tby\tthe\tmuscles,\tit\tis\ttrapped\twithin\tthe\tmuscle\ttissue.\tIt\tis\nestimated\tthat\tonce\tcreatine\tstores\tin\tthe\tmuscle\tare\televated,\tit\tgenerally\ttakes\t4\tto\t6\tweeks\tfor\ncreatine\tstores\tto\treturn\tto\tbaseline\t(\nKreider\tet\tal,\t2017\n).\nFew\tdata\texist\ton\tthe
|
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] |
Kreider\tet\tal,\t2017\n).\nFew\tdata\texist\ton\tthe\n\tlong-term\tbenefits\tand\trisks\tof\tcreatine\tsupplementation.\tBecause\tof\tthe\nlong-term\trisks,\tthe\tAmerican\tOrthopedic\tSociety\tfor\tSports\tMedicine,\tthe\tACSM,\tand\tthe\tAmerican\nAcademy\tof\tPediatrics\t(AAP)\tadvise\tchildren\tand\tadolescents\tyounger\tthan\t18\tyears\tand\tpregnant\tor
|
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supplementation\tnegatively\taffects\trenal\tfunction\tin\thealthy\tor\tclinical\tpopulations\t(\nKreider\tet\tal,\n2017\n;\t\nWilliamson\tand\tNew,\t2014\n).\nBeta-alanine\nIntermittent\tbouts\tof\t\nhigh-intensity\tinterval\ttraining\t(HIIT)\n\tdeplete\tenergy\tsubstrates\tand\tallow\nfor\n\tmetabolite\taccumulation.\tStudies\tsuggest\tthat\tsupplementation\twith\tbeta-alanine\tmay\timprove
|
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] |
endurance\tperformance\tas\twell\tas\tlean\tbody\tmass\t(\nKern\tand\tRobinson,\t2011\n).\tBecause\tof\tits\nrelationship\twith\tcarnosine,\tbeta-alanine\tappears\tto\thave\tergogenic\tpotential.\tCarnosine\tis\tbelieved\nto\tbe\tone\tof\tthe\tprimary\tacid\tbuffering\tsubstances\tin\tmuscle.\tAlthough\tcarnosine\tis\tsynthesized\tfrom\ntwo\tamino\tacids,
|
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two\tamino\tacids,\n\tbeta-alanine\tand\thistidine,\tits\tsynthesis\tappears\tto\tbe\tlimited\tby\tthe\tavailability\tof\nbeta-alanine,\tthus\ttaking\tsupplemental\tbeta-alanine\tcan\tincrease\tcarnosine\tlevels\tand\treduce\tlactic\nacid\tbuild\tup\tin\tthe\tmuscles\t(\nTrexler\tet\tal,\t2015\n;\t\nPeeling\tet\tal,\t2018\n).
|
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] |
Trexler\tet\tal,\t2015\n;\t\nPeeling\tet\tal,\t2018\n).\nThis\tproposed\tbenefit\twould\thelp\tincrease\tan\tathlete’s\tcapacity\tfor\ttraining\tand\tincrease\ttime\tto\nfatigue.\tSupplementing\twith\tbeta-alanine\n\thas\tbeen\tassociated\twith\timproved\tstrength,\tanaerobic\nendurance,\tbody\tcomposition,\tand\tperformance\ton\tvarious\tmeasures\tof\tanaerobic\tpower\toutput.
|
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Daily\tsupplementation\twith\t3.2\tto\t6.4\tg\t(approx.\t65mg/kg\tbody\tmass)\tfor\ta\tminimum\tof\t2\tto\t4\nweeks\tcan\tincrease\tmuscle\tcarnosine\tcontent\tabout\t65%\tabove\tresting\tlevels;\textended\tto\t10\tto\t12\nweeks,\t80%\tabove\tresting\tlevels\tand\timproving\ttolerance\tfor\n\texercise\tbouts\tlasting\t30\tseconds\tto\t10
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exercise\tbouts\tlasting\t30\tseconds\tto\t10\nminutes.\tHowever,\tthe\tcorrelation\tbetween\tmuscle\tchanges\tand\tmagnitude\tof\tperformance\tbenefits\nare\tyet\tto\tbe\tdetermined.\tThe\tonly\treported\tside\teffect\tis\tparesthesia\t(tingling),\tbut\tstudies\tindicate\nthis\tcan\tbe\tattenuated\tby\tusing\tdivided\tlower\tdoses\t(1.6\tg)\tor\tusing\ta\tsustained-release\tformula\n(
|
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] |
(\nTrexler\tet\tal,\t2015\n).\nCaffeine\nResearch\ton\tthe\tphysiologic\n\tbenefits\tof\tcaffeine\ton\tperformance\tis\textensive\tin\tareas\tof\tstrength,\nendurance,\trates\tof\tperceived\teffort,\thydration,\tand\trecovery.\tThe\tergogenic\tbenefits\tinclude:\n(1)\t\naffecting\tthe\tcentral\tnervous\tsystem\t(CNS)\tand\tcognitive\tperformance\n(2)
|
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(2)\t\nmobilizing\tfat\tand\tsparing\tglycogen\tduring\texercise\n(3)\t\nincreasing\tintestinal\tabsorption\tand\toxidation\tof\tcarbohydrates\n(4)\t\nspeeding\tup\tresynthesis\n\tof\tmuscle\tglycogen\tin\trecovery\n(5)\t\nreducing\tperceived\texertion\tand\tpain\tof\ttraining.\nCaffeine\tcontributes\tto\tendurance\tperformance,\tapparently\tbecause\tof\tits\tability\tto\tenhance
|
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mobilization\tof\tfatty\tacids\tand\tthus\tconserve\tglycogen\tstores.\tCaffeine\talso\tmay\tdirectly\taffect\nmuscle\tcontractility,\tpossibly\tby\tfacilitating\tcalcium\ttransport.\tIt\tcould\treduce\tfatigue\tas\twell\tby\nreducing\tplasma\tpotassium\n\taccumulation,\twhich\tcontributes\tto\tfatigue.\tAn\tenergy-enhancing\teffect
|
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] |
is\tseen\twith\tup\tto\t3\tmg/kg\tbody\tmass\tor\tabout\t200\tmg\tcaffeine\tfor\tthe\t150-lb\tathlete\t(\nSpriet,\t2014\n).\nUnwanted\tside\teffects\tof\toverconsuming\tcaffeine\tthat\tmay\tlimit\tperformance\tare\theadaches,\ninsomnia,\tGI\tirritation,\treflux,\tshakiness,\theart\tpalpitations,\tand\tincreased\turination.\tPrevious\nreports\tshowed\tthat\tcaffeine\tcombined
|
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reports\tshowed\tthat\tcaffeine\tcombined\n\twith\tephedra\tresulted\tin\tserious\tillness\tand\tdeath,\tand\tthe\ncombination\twas\tbanned\tfrom\tuse\tin\tdietary\tsupplements\tby\tthe\tFDA\tin\t2004.\tSafety\tdata\tfrom\t50\ntrials\tdetermined\tthat\tthe\tuse\tof\tephedra\tor\tephedrine\tcombined\twith\tcaffeine\thas\tbeen\tassociated
|
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with\ta\t2.2-\tto\t3.6-fold\tincreases\tin\todds\tof\tpsychiatric,\tautonomic,\tor\tGI\tsymptoms,\tand\theart\npalpitations\t(\nShekelle\tet\tal,\t2003\n).\nConsumer\tdemand\n\tfor\tcaffeine\thas\tresulted\tin\tgreater\taccessibility\tand\tacceptance\tof\ta\tvariety\tof\nbeverages\tbeyond\tcoffee\tand\ttea.\tAn\temerging\ttrend\tin\tsports\tnutrition\tis\tthe\tintake\tof\tcaffeine-
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containing\tenergy\tdrinks\tand\tdrink\tshots\tfor\tperformance.\nThe\tgrowing\tavailability\tand\tconsumption\tof\tenergy\tdrinks\twith\tcaffeine\tamong\tall\tage\tgroups\tis\tof\nconcern,\tespecially\tamong\tyoung\tathletes\tbecause\texcessive\n\tamounts\tof\tcaffeine\thave\tbeen\tshown\tto
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amounts\tof\tcaffeine\thave\tbeen\tshown\tto\ndisrupt\tadolescent\tsleep\tpatterns,\texacerbate\tpsychiatric\tdisease,\tcause\tphysiologic\tdependence,\nincrease\tthe\trisk\tof\tsubsequent\taddiction\tand\trisk-taking\tbehaviors,\traise\tblood\tpressure,\tand\tcause\ndehydration,\tvomiting,\tirregular\tand\trapid\theartbeat,\tconvulsions,\tcoma,\tand\tdeath.\tAltered\tsleep
|
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] |
patterns\tfrom\texcessive\tcaffeine\tuse\tcan\tlead\tto\tpoor\tperformance,\n\tdelayed\treaction\ttimes,\tand
|
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increased\trisk\tfor\tinjuries.\nEnergy\tdrinks\tconsumed\twith\talcohol\tare\tanother\tgrowing\tconcern\tamong\thealth\texperts,\tand\tin\n2010\tthe\tFDA\tdeclared\tcaffeine\tan\t“unsafe\tfood\tadditive”\tto\talcoholic\tbeverages,\teffectively\tbanning\npremixed\talcoholic\tenergy\tdrinks.
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premixed\talcoholic\tenergy\tdrinks.\nThere\tare\tconcerns\tand\tsafety\tissues\tregarding\tanother\tsimilar\tsupplement,\tcitrus\taurantium\tL.\n(bitter\torange)\n\textracts,\twhich\tare\talso\tused\tfor\tweight\tloss/weight\tmanagement,\tsports\nperformance,\tappetite\tcontrol,\tenergy,\tand\tmental\tfocus\tand\tcognition,\tand\twhich\tcontain\tp-
|
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synephrine\tas\tthe\tprimary\tprotoalkaloid,\tas\tthey\thave\tsimilar\tstructural\taspects\tas\tephedrine\t(\nStohs,\n2017\n).\nNitrates\tand\tbeet\tjuice\nSeveral\tstudies\tsuggest\tthat\tinorganic\tnitrates\tmay\talter\tthe\tphysiologic\tresponses\tto\texercise\n\tand\nenhance\tperformance\tby\tincreasing\tvasodilation\tand\tglucose\tuptake\tand\treducing\tblood\tpressure\nand\tthe\tO\n2
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] |
and\tthe\tO\n2\n\tcost\tof\tsubmaximal\texercise\t(\nPeeling\tet\tal,\t2018\n).\tBecause\tthe\tconsumption\tof\tnitrate\nsalts\tmay\tresult\tin\tthe\tproduction\tof\tharmful\tnitrogenous\tcompounds,\tresearchers\thave\texplored\nusing\tnatural\tnitrate-rich\tfoods\tsuch\tas\tbeetroot\tjuice\tand\tpowders.\tA\tdose\tof\tdietary\tnitrate,\napproximately
|
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0.02516653575003147,
0.05920112505555153,
0.07065939903259277,
0.1074349507689476,
-0.0461716465651989
] |
approximately\n\t0.5\tL\tof\tbeetroot\tjuice,\thas\tbeen\tshown\tto\tincrease\tplasma\tnitrite,\twhich\tpeaks\twithin\n3\thours\tand\tremains\televated\tfor\t6\tto\t9\thours\tbefore\treturning\tto\tbaseline\t(\nWylie\tet\tal,\t2013\n).\nIn\tone\tstudy,\tsupplementing\tthe\tdiet\twith\t0.5\tL\tof\tbeetroot\tjuice\tper\tday\tfor\t4\tto\t6\tdays\treduced
|
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] |
the\tsteady\tstate\tcost\tof\tsubmaximal\texercise\tby\t5%\tand\textended\tthe\ttime\tto\texhaustion\tduring\thigh-\nintensity\tcycling\n\tby\t16%,\twhich\thas\tbeen\tconfirmed\tin\tother\texercise\tpopulations,\tincluding\trowers\nand\tteam\tsports.\tAlthough\tthe\tmechanistic\tbases\tfor\tthe\teffects\tare\tunclear,\tevidence\tsuggests
|
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mitochondrial\tefficiency\tand\tcontractile\tfunction\tmay\tbe\tenhanced\t(\nWylie\tet\tal,\t2013\n).\tOther\tpositive\neffects\tinclude\tincreased\tNO\n2\n\tand\tvasodilation\tand\treduced\tVO\n2\n\tat\tless\tthan\tor\tequal\tto\tVO\n2\nmax\nintensity\twhile\timproving\n\tthe\trelationship\tbetween\twatts\trequired\tand\tVO\n2\n\tlevel,\tincreasing\ttime-to-\nexhaustion\tat\tless\tthan\tor\tequal\tto\tVO\n2
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] |
been\tshown\tto\tkeep\tplasma\tnitrite\n\televated\t(\nJones\tet\tal,\t2013\n).\tAlthough\tthere\tis\ta\tpossibility\tthat\nuncontrolled\thigh\tdoses\tof\tnitrate\tsalts\tmay\tbe\tharmful\tto\thealth,\tnatural\tsources\tfound\tin\tbeetroot,\nspinach,\tlettuce,\tand\tcelery\tare\tlikely\tto\tpromote\thealth.\nPerformance\tenhancement\tsubstances\tand\tdrugs:\tDoping\tin\tsport
|
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] |
Performance\tenhancement\tsubstances\tand\tdrugs:\tDoping\tin\tsport\nThe\tuse\tof\tperformance\tenhancement\tsubstances\tis\tnot\ta\tnew\tphenomenon\tin\tsports.\tAs\tearly\tas\n776\tbc\tthe\n\tGreek\tOlympians\twere\treported\tto\tuse\tsubstances\tsuch\tas\tdried\tfigs,\tmushrooms,\tand
|
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] |
strychnine\tto\tperform\tbetter.\tTheir\tuse\tis\tprevalent\tin\tamateur\tand\tprofessional\tathletes,\treceiving\neven\tgreater\tattention\twith\tuse\tby\thigh-profile\taccomplished\tathletes\tsuch\tas\tLance\tArmstrong,\ndisqualification\tof\tsome\tprofessional\tathletes\tfor\tfailed\tdrug\ttests,\tand\tthe\tseizure\tof\tcompanies\ncaught\twith\ttainted\n\tsupplements\t(\nPope\tet\tal,\t2014\n).
|
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] |
caught\twith\ttainted\n\tsupplements\t(\nPope\tet\tal,\t2014\n).\nSince\t2004,\tthe\tWADA\thas\thad\ta\tlist\tof\tbanned\tdrugs\tfor\tathletes\twho\tcompete\tand\ta\tstrategy\tto\ndetect\tdrugs\tsuch\tas\tanabolic\tsteroids,\terythropoietin\t(EPO),\thuman\tgrowth\thormone\t(HGH),\tand\ninsulin-like\tgrowth\tfactor\t(IGF-1).\tWADA\tannually\tupdates\tits\tprohibited\tlist\tof\tsupplements
|
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-0.027242323383688927,
-0.03160885348916054,
-0.07584789395332336,
0.036176424473524094,
0.09068945795297623,
-0.006225706078112125,
0.06166033446788788,
0.026042576879262924,
0.07976407557725906,
0.0749879777431488,
0.09130162745714188,
0.019424669444561005
] |
suspected\tof\t(1)\tillegally\tenhancing\tathletic\tperformance,\t(2)\trepresenting\tan\tactual\n\tor\tpotential\nhealth\trisk\tto\tthe\tathlete,\tor\t(3)\tviolating\tthe\tspirit\tof\tthe\tsport.\nAs\tthe\tnumber\tof\tindividuals\tparticipating\tin\tdifferent\tsports\tincreases,\tso\tdoes\tthe\tvariety\tof
|
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] |
doping\tagents.\tAccording\tto\tWADA,\tthe\trate\tof\tuse\thas\tbeen\tfairly\tconsistent,\tsuggesting\ta\nprevalence\tof\tapproximately\t2%\tof\telite\tathletes.\tRates\tderived\tfrom\tself-reports\thave\tranged\tfrom\n1.2%\tto\t26%.\tBetween\t10%\n\tand\t24%\tof\tmale\tathletes\thave\treported\tthey\twould\tuse\tdoping\tif\tit
|
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derivatives,\tand\ttheir\tactive\tmetabolites\tused\tto\tenhance\tathletic\tperformance\tand\tappearance.\tAAS\nuse\twas\treported\tin\tthe\t1950\tOlympics\tand\twas\tbanned\tin\t1976.\tSteroids\tmay\tbe\tused\tas\toral\tor\nintramuscular\tpreparations.\nThe\tlegal\tand\tillegal\tuse\tof\tthese\tdrugs\tis\tincreasing\tas\ta\tresult\tof\tsociety’s\tpreoccupation\twith
|
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] |
increasing\tmuscle\tstrength,\tsize,\tand\tlibido.\tOriginally\tdesigned\tfor\ttherapeutic\tuses\tto\tprovide\nenhanced\tanabolic\tpotency,\tnontherapeutic\tuse\tof\tAAS\tis\tincreasing\tamong\tadolescents\tand\tfemales.\nAnecdotal\tevidence\tsuggests\twidespread\tuse\tof\tanabolic\tsteroids\tamong\tathletes\t(20%\tto\t90%),\nespecially
|
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] |
especially\n\tat\tthe\tprofessional\tand\telite\tamateur\tlevels.\tUse\tamong\thigh\tschool\tboys\tis\tapproximately\n5%\tto\t10%;\trates\tamong\tcollege\tathletes\tare\tslightly\thigher.\nAnabolic\teffects\n\tof\tAAS\tinclude\tincreased\tmuscle\tmass;\tincreased\tbone\tmineral\tdensity;
|
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increased\tblood\tcell\tproduction;\tdecreased\tbody\tfat;\tincreased\theart,\tliver,\tand\tkidney\tsize;\tvocal\ncord\tchanges;\tand\tincreased\tlibido.\tAnabolic\tsteroids\tincrease\n\tprotein\tsynthesis\tin\tskeletal\tmuscles\nand\treverse\tcatabolic\tprocesses;\thowever,\tincreased\tmuscle\tmass\tand\tstrength\tare\tobserved\tonly\tin
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0.061603885143995285,
0.0904904454946518,
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athletes\twho\tmaintain\ta\thigh-protein,\thigh-calorie\tdiet\tduring\tsteroid\tadministration.\t\nAndrogenic\neffects\n\tare\tthe\tdevelopment\tof\tsecondary\tsexual\tcharacteristics\tin\tmen,\tchanges\tin\tgenital\tsize\tand\nfunction,\tand\tgrowth\tof\tauxiliary\tpubic\tand\tfacial\thair.\tSome\n\tadverse\teffects\tassociated\twith\tsteroid\nuse\tare\tirreversible,\tespecially\tin\twomen.
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Although\tsteroid\tuse\thas\tsome\tvalid\tmedical\tuses\t(e.g.,\tthe\ttreatment\tof\tdelayed\tpuberty,\tor\tbody\nwasting\tresulting\tfrom\tdisease),\tit\talso\thas\tadverse\tphysical\tand\temotional\tconsequences\tin\nadolescents,\tsuch\tas\tarrested\tbone\tgrowth,\tinternal\torgan\tdamage,\tfeminization\tin\tmales,\tand\nmasculinization\tin\tfemales.\tIt
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] |
masculinization\tin\tfemales.\tIt\n\talso\tis\tassociated\twith\tother\thigh-risk\tbehaviors,\tsuch\tas\tthe\tuse\tof\nother\tillicit\tdrugs,\treduced\tinvolvement\tin\tschool,\tpoor\tacademic\tperformance,\tengaging\tin\nunprotected\tsex,\taggressive\tand\tcriminal\tbehavior,\tand\tsuicidal\tideation\tand\tattempted\tsuicide.\nErythropoietin
|
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] |
Erythropoietin\nEPO\tis\tused\tcommonly\tto\tpromote\tthe\tbody’s\tproduction\tof\tred\tblood\tcells\tin\tpatients\twith\tbone\nmarrow\tsuppression,\tsuch\n\tas\tpatients\twith\tleukemia,\tthose\twho\tare\treceiving\tchemotherapy,\tor\nthose\twith\trenal\tfailure\t(see\t\nChapters\t34\n\tand\t\n35\n).\tIn\tathletes,\tinjections\tincrease\tthe\tserum
|
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] |
Chapters\t34\n\tand\t\n35\n).\tIn\tathletes,\tinjections\tincrease\tthe\tserum\nhematocrit\tand\toxygen-carrying\tcapacity\tof\tthe\tblood,\tand\tthus\tenhance\tVo\n2\nmax\tand\tendurance.\nEPO\tuse\tas\tan\tergogenic\taid\tis\tdifficult\tto\tdetect\tbecause\tit\tis\ta\thormone\tproduced\tby\tthe\tkidneys,\nalthough\tnewer\tblood\ttests\tcan\tdetect\tits
|
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] |
although\tnewer\tblood\ttests\tcan\tdetect\tits\n\tuse.\tTypically,\tathletes\twith\televated\thematocrit\thave\tbeen\nbanned\tfrom\tendurance\tsports\tfor\tsuspected\tEPO\tmisuse;\thowever,\tdespite\tits\tban\tby\tthe\tIOC,\tit\tis\nstill\tcommonly\tabused.\tDrastically\thigh\thematocrit\tcombined\twith\texercise-induced\tdehydration\tcan
|
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] |
lead\tto\tthick\tor\tviscous\tblood,\twhich\tcan\tlead\tto\tcoronary\tor\tcerebral\tvascular\tocclusions,\theart\nattack,\tor\tstroke.\tEPO\talso\tcan\tcause\televated\n\tblood\tpressure\tor\televated\tpotassium\tlevels.\nHuman\tgrowth\thormone\t(HGH)\n\thas\tmany\tfunctions\tin\tthe\tbody,\tand\tit\tis\tproduced\tnaturally
|
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] |
has\tmany\tfunctions\tin\tthe\tbody,\tand\tit\tis\tproduced\tnaturally\nthroughout\tlife.\tIt\tstimulates\tprotein\tsynthesis,\tenhances\tcarbohydrate\tand\tfat\tmetabolism,\thelps\tto\nmaintain\tsodium\tbalance,\tand\tstimulates\tbone\tand\tconnective\ttissue\tturnover.\tHGH\tproduction\ndecreases\twith\tage\tafter\tthe\tpeak\tgrowth\tyears.\tThe\tamount\tsecreted\tis
|
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] |
affected\tby\tdiet,\tstress,\nexercise,\tnutrition,\tand\tmedications.\tHGH\tis\tbanned\tby\tthe\tIOC;\thowever,\tit\tcontinues\tto\tbe\tused\tby\nathletes.\tPotential\tside\teffects\tinclude\tskin\tchanges,\tdarkening\tof\tmoles,\tadverse\teffects\ton\tglucose\nand\tlipid\tmetabolism,\tand\tthe\tgrowth\tof\tbones\tas\tevidenced\tby\tdevelopment\tof\ta\tprotruding\tjaw\tand\nboxy\tforehead.
|
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boxy\tforehead.\nProhormones\tand\tsteroids\nProhormones\tare\tpopular\tamong\n\tbodybuilders,\tmany\tof\twhom\tbelieve\tthat\tthese\tprohormones\tare\nnatural\tboosters\tof\tanabolic\thormones.\tAndrostenedione,\t4-androstenediol,\t19-nor-4-\nandrostenedione,\t19-nor-4-androstenediol,\t7-keto\tdehydroepiandrosterone\t(DHEA),\tand\t7-keto
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] |
DHEA\tare\tnaturally\tderived\tprecursors\tto\ttestosterone\tand\tother\tanabolic\tsteroids.\nAndrostenedione\nAndrostenedione\tis\ta\tprehormone,\tan\tinactive\tprecursor\tto\n\tfemale\testrogen\tand\tmale\ttestosterone.\nIt\thas\tabout\tone-seventh\tof\tthe\tactivity\tof\ttestosterone\tand\tis\ta\tprecursor\tthat\tdirectly\tconverts\tto
|
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] |
testosterone\tby\ta\tsingle\treaction.\tIt\tis\tproduced\tnaturally\tin\tthe\tbody\tfrom\teither\tDHEA\tor\t17-alpha-\nhydroxyprogesterone.\tSome\tresearchers\thave\tfound\tthat\ttaking\tandrostenedione\televates\ntestosterone\tmore\tthan\tDHEA\tdoes;\thowever,\tthe\tinduced\tincrease\tlasts\tonly\n\tseveral\thours\tand
|
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several\thours\tand\nremains\tat\tpeak\tlevels\tfor\tjust\ta\tfew\tminutes.\tAcute\tor\tlong-term\tadministration\tof\ttestosterone\nprecursors\tdoes\tnot\teffectively\tincrease\tserum\ttestosterone\tlevels\tand\tfails\tto\tproduce\tany\nsignificant\tchanges\tin\tlean\tbody\tmass,\tmuscle\tstrength,\tor\tperformance\timprovement\t(\nSmurawa\tand\nCongeni,\t2007\n).
|
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Smurawa\tand\nCongeni,\t2007\n).\nAdverse\treactions\toccur\tin\tmale\tand\tfemale\tathletes,\tincluding\tmuscle\ttightness\n\tand\tcramps,\nincreased\tbody\tweight,\tacne,\tGI\tproblems,\tchanges\tin\tlibido,\tamenorrhea,\tliver\tdamage,\tand\tstunted\ngrowth\tin\tadolescents.\tConsumption\tof\ta\tprohormone\tsupplement\tcan\talter\ta\tpatient’s\thypothalamic-
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increased\tcardiovascular\tdisease\trisk.\tTherefore\ttaking\tandrostenedione\tmay\tbe\tirresponsible\nbecause\tof\tthe\tpotential\trisks\tassociated\twith\tlong-term\tuse.\tUntil\tthere\tis\tscientific\tsupport\tfor\tits\nuse,\tandrostenedione\tshould\tnot\tbe\tsold\tunder\tthe\tassumption\tthat\tit\tis\teither\tan\teffective\n\tor\ta\tsafe
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] |
or\ta\tsafe\nathletic\tergogenic\taid.\tClearly,\tadolescents\tand\twomen\tof\tchildbearing\tage\tshould\tnot\tuse\tit.\tIn\t1998\nandrostenedione\twas\tadded\tto\tthe\tlist\tof\tbanned\tsubstances\tby\tthe\tIOC\tand\tseveral\tamateur\tand\nprofessional\torganizations,\tincluding\tthe\tNFL\tand\tthe\tNCAA.\nDehydroepiandrosterone\t(DHEA)
|
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] |
Dehydroepiandrosterone\t(DHEA)\n\tis\ta\tweak\tandrogen\tand\tproduct\tof\tdehydroandrosterone-3-\nsulfate\t(DHEA-S)\tand\tis\tused\tto\televate\ttestosterone\n\tlevels.\tIt\tis\ta\tprecursor\tto\tmore\tpotent\ntestosterone\tand\tdihydrotestosterone.\tAlthough\tDHEA-S\tis\tthe\tmost\tabundant\tcirculating\tadrenal
|
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] |
hormone\tin\thumans,\tits\tphysiologic\trole\tis\tpoorly\tunderstood.\tDHEA\thas\tbeen\tlabeled\tthe\t“fountain\nof\tyouth”\thormone\tbecause\tits\tlevels\tpeak\tduring\tearly\tadulthood.\tThe\tdecline\twith\taging\thas\tbeen\nassociated\twith\tincreased\tfat\taccumulation\tand\trisk\tof\theart\n\tdisease.\tSeveral\tstudies\thave\tsuggested
|
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] |
disease.\tSeveral\tstudies\thave\tsuggested\na\tpositive\tcorrelation\tbetween\tincreased\tplasma\tlevels\tof\tDHEA\tand\timproved\tvigor,\thealth,\tand\nwell-being\tin\tpersons\twho\trange\tin\tage\tfrom\t40\tto\t80\tyears.\tBy\tdecreasing\tcortisol\toutput\tfrom\tthe\nliver\tby\t50%,\tDHEA\tcould\thave\tan\tanabolic\teffect.
|
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liver\tby\t50%,\tDHEA\tcould\thave\tan\tanabolic\teffect.\nDHEA\tsupplementation\tdoes\tnot\tincrease\ttestosterone\tlevels\tor\tincrease\tstrength\tin\tmen,\tbut\tit\nmay\tincrease\ttestosterone\n\tlevels\tin\twomen\twith\ta\tvirilizing\teffect.\tBecause\tDHEA\tcan\ttake\tseveral\ndifferent\thormonal\tpathways,\tthe\tone\tthat\tit\tfollows\tdepends\ton\tseveral\tfactors,\tincluding\texisting
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] |
levels\tof\tother\thormones.\tIt\tcan\ttake\tseveral\troutes\tin\tthe\tbody\tand\tinteract\twith\tcertain\tenzymes\nalong\tthe\tsex-steroid\tpathway.\tThus\tit\tcan\tturn\tinto\tless\tdesirable\tbyproducts\tof\ttestosterone,\nincluding\tdihydrotestosterone,\n\twhich\tis\tassociated\twith\tmale-pattern\tbaldness,\tprostate\nenlargement,\tand\tacne.
|
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] |
enlargement,\tand\tacne.\nThe\tbenefits\tof\ttaking\tDHEA\tfor\tsports\tperformance\thave\tnot\tbeen\tclearly\testablished,\tand\tthe\neffects\tof\tchronic\tDHEA\tingestion\tare\tnot\tknown.\tLong-term\tsafety\thas\tnot\tbeen\testablished,\tand\nthere\tare\tconcerns\tthat\tchronic\tuse\tin\tmen\tmay\tworsen\tprostate\thyperplasia\tor\teven\tpromote
|
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23\nNutrition\tand\tbone\thealth\nKaren\tChapman-Novakofski,\tPhD,\tRDN,\tLDN,\tRickelle\tRichards,\tPhD,\tMPH,\tRDN\nKEY\tTERMS\n7-dehydrocholesterol\n25-hydroxy\tvitamin\tD\t(calcidiol)\n1,\t25-dihydroxy\tvitamin\tD\n3\n\t(calcitriol)\nbisphosphonates\nbone\tdensitometry\nbone\tmineral\tcontent\t(BMC)\nbone\tmineral\tdensity\t(BMD)\nbone\tmodeling\nbone\tremodeling\nbone\tresorption
|
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bone\tmodeling\nbone\tremodeling\nbone\tresorption\ncalcium\thomeostasis\ncalcitonin\ncancellous\tbone\ncollagen\ncortical\tbone\nestrogen\tagonists\nestrogen\treceptor\t(ER)\nhydroxyapatite\nhyponatremia\nosteoblast\nosteocalcin\nosteoclast\nosteocytes\nosteoid\nosteomalacia\nosteopenia\nosteoporosis\nparathyroid\thormone\t(PTH)\npeak\tbone\tmass\t(PBM)\nprimary\tosteoporosis
|
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parathyroid\thormone\t(PTH)\npeak\tbone\tmass\t(PBM)\nprimary\tosteoporosis\nsarcopenia\nsecondary\tosteoporosis\nselective\testrogen\treceptor\tmodulator\t(SERM)\ntrabecular\tbone\nIntroduction\nAdequate\tnutrition\tis\tessential\tfor\tthe\tdevelopment\tand\tmaintenance\tof\tthe\tskeleton.\tAlthough\ndiseases\tof\tthe\tbone\tsuch\tas\tosteoporosis\tand\t\nosteomalacia
|
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] |
diseases\tof\tthe\tbone\tsuch\tas\tosteoporosis\tand\t\nosteomalacia\n\t(a\tcondition\tof\timpaired\tmineralization\ncaused\tby\tvitamin\tD\tand\tcalcium\tdeficiency)\thave\tcomplex\tcauses,\tthe\tdevelopment\tof\tthese\ndiseases\tcan\tbe\tminimized\tby\tproviding\tadequate\tnutrients\tthroughout\tthe\tlife\tcycle.\tOf\tthese\ndiseases,\tosteoporosis
|
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] |
diseases,\tosteoporosis\n\tis\tthe\tmost\tcommon\tand\tdestructive\tof\tproductivity\tand\tquality\tof\tlife.\tAs\ttrue\nof\tmany\tchronic\tdiseases,\tsigns\tand\tsymptoms\tof\tosteoporosis\tbecome\tmore\tevident\tin\tolder\tage.\nAs\tmore\tadults\treach\tolder\tages,\tosteoporosis\twith\tresulting\thip,\twrist,\tand\tvertebral\tfractures\thas
|
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