1
|
Brennan R, Wazaify M, Shawabkeh H, Boardley I, McVeigh J, Van Hout MC. A Scoping Review of Non-Medical and Extra-Medical Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Drug Saf 2021; 44:917-928. [PMID: 34331260 PMCID: PMC8370940 DOI: 10.1007/s40264-021-01085-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 11/26/2022]
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used medications worldwide and have analgesic, antipyretic and anti-inflammatory properties. Although NSAIDs are recognised as generally safe and effective, non-medical and extra-medical use of these products can occur. Unlike the use of illegal and many prescription drugs, which are subject to extensive research attention, inappropriate use of NSAIDs has been less well investigated. This scoping review collates and describes what is known regarding non-medical and extra-medical use of NSAIDs. In total, 72 studies were included in this scoping review. Three themes emerged from the review: (1) indicative profile of people who engage in non-medical or extra-medical use of NSAIDs; (2) antecedents for non-medical or extra-medical use; and (3) adverse health effects of non-medical and extra-medical use of NSAIDs. The review concluded that there is a need for enhanced patient education, including among sports people; pharmacovigilance in terms of clinician recognition of aberrance; and prescriber and pharmacist awareness of the potential for extra-medical and non-medical use and the related health harms.
Collapse
Affiliation(s)
- Rebekah Brennan
- School of Applied Social Studies, University College Cork, Cork, Ireland.
| | - Mayyada Wazaify
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Haneen Shawabkeh
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Ian Boardley
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Jim McVeigh
- Substance Use & Associated Behaviours, Department of Sociology, Manchester Metropolitan University, Manchester, UK
| | - Marie Claire Van Hout
- Faculty of Health, Public Health Institute, Liverpool John Moore's University, Liverpool, UK
| |
Collapse
|
2
|
Yargiç MP, Torgutalp ŞŞ, Erdagi K. Nonsteroidal anti-inflammatory drugs and paracetamol use in elite-level Olympic-style weightlifters: a survey study. J Sports Med Phys Fitness 2021; 61:991-996. [PMID: 33586925 DOI: 10.23736/s0022-4707.21.11604-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Although the high prevalence of analgesic use in various sports disciplines is well-known, it has not been reported among Olympic-style weightlifters yet. We aimed to determine the frequency of the nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol use in elite-level Olympic-style weightlifters, the weightlifters' attitudes towards NSAIDs and paracetamol use, and the total daily, weekly and monthly doses of NSAIDs and paracetamol. METHODS A total of 166 (46 female, 120 male) Olympic-style weightlifters enrolled for this study. Data was collected through an interviewer-administered questionnaire distributed during national championships. The Assessment of Spondyloarthritis International Society-NSAID equivalent score, total doses of acetylsalicylic acid and paracetamol were calculated daily, weekly, and monthly. RESULTS The mean age of participants was 18.9±4.7 years. Only 11.4% of athletes stated that they used the drug only when the physician prescribed it. More than half of the athletes (57.2%) stated that they used at least one of the analgesics the day before the competition day. The most common form reported by the athletes was the concomitant use of medications (31.3%). The mean total acetylsalicylic acid, NSAID and paracetamol doses of 95 athletes using analgesics were daily: 500.0±95.0 mg/105.0±71.4 mg/555.6±160.1 mg, weekly: 1166.0±899.4 mg/145.2±176.6 mg/1166.7±892.8 mg, and monthly: 3461.1±4940.7 mg/201.5±274.0 mg/2750.0±3841.9 mg, respectively. CONCLUSIONS The frequency of analgesic and anti-inflammatory medication use among the elite-level Olympic-style weightlifters is very high.
Collapse
Affiliation(s)
- Melda P Yargiç
- Department of Sports Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Şerife Ş Torgutalp
- Clinic of Sports Medicine, Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Turkey -
| | - Kenan Erdagi
- Department of Physical Education and Sport, Ahmet Kelesoglu Faculty of Education, Necmettin Erbakan University, Konya, Turkey
| |
Collapse
|
3
|
Semen KO, van der Doelen RHA, van der Lugt M, van Dam DGHA, Reimer J, Stassen FRM, Janssen L, Janssen PKC, Janssen MJW, Bast A, le Noble JLML. Non-steroidal anti-inflammatory drugs increase urinary neutrophil gelatinase-associated lipocalin in recreational runners. Scand J Med Sci Sports 2020; 30:1888-1895. [PMID: 32585737 PMCID: PMC7540343 DOI: 10.1111/sms.13755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 10/18/2019] [Accepted: 06/16/2020] [Indexed: 12/22/2022]
Abstract
Objectives To study the effects of running with/without the use of pain killers on urinary neutrophil gelatinase‐associated lipocalin (uNGAL) and other parameters of kidney function in recreational runners. Methods Participants of the 10‐ and 21.1‐km Weir Venloop race were enrolled and their urine samples collected before and after the run. Urine dipstick and other conventional tests used to assess kidney function were performed. The presence of ibuprofen, diclofenac, naproxen, and/or paracetamol was assessed by LC‐MS/MS. uNGAL was measured with a two‐step chemiluminescent immunoassay. Results NSAIDs/analgesics were detected in urine of 5 (14.4%) 10‐km runners and 13 (28.9%) 21.1‐km runners. Only half‐marathon participants showed significant increases in uNGAL (pre: 11.7 [7.1‐34.3] ng/mL; post: 33.4 [17.4‐50.4] ng/mL; P = .0038). There was a significant effect of NSAID/analgesic use on uNGAL increase (F2, 76 = 4.210, P = .004). Post hoc tests revealed that uNGAL increased significantly in runners who tested positive for ibuprofen/naproxen compared to runners who did not use any medications (P = .045) or those who tested positive for paracetamol (P = .033). Running distance had a significant influence on the increase in uNGAL (F1, 53 = 4.741, P < .05), specific gravity (F1, 60 = 9.231, P < .01), urinary creatinine (F1, 61 = 10.574, P < .01), albumin (F1, 59 = 4.888, P < .05), and development of hematuria (χ2(4) = 18.44, P = .001). Conclusions Running distance and use of ibuprofen/naproxen were identified as risk factors for uNGAL increase in recreational runners.
Collapse
Affiliation(s)
| | - Rick H A van der Doelen
- Department of Clinical Chemistry, VieCuri Medical Center Noord-Limburg, Venlo, The Netherlands
| | - Monique van der Lugt
- Emergency Department, VieCuri Medical Center Noord-Limburg, Venlo, The Netherlands
| | - Davy G H A van Dam
- Department of Internal Medicine, VieCuri Medical Center Noord-Limburg, Venlo, The Netherlands
| | | | - Frank R M Stassen
- Department of Medical Microbiology, NUTRIM - School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Loes Janssen
- Department of Epidemiology, VieCuri Medical Center Noord-Limburg, Venlo, The Netherlands
| | - Paddy K C Janssen
- Department of Clinical Pharmacy, VieCuri Medical Center Noord-Limburg, Venlo, The Netherlands.,Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marcel J W Janssen
- Department of Clinical Chemistry, VieCuri Medical Center Noord-Limburg, Venlo, The Netherlands
| | - Aalt Bast
- Campus Venlo, Maastricht University, Venlo, The Netherlands.,Department of Pharmacology and Toxicology, Maastricht University, Maastricht, The Netherlands
| | - Jos L M L le Noble
- Department of Pharmacology and Toxicology, Maastricht University, Maastricht, The Netherlands.,Department of Intensive Care, VieCuri Medical Center Noord-Limburg, Venlo, The Netherlands
| |
Collapse
|
4
|
Rosenbloom CJ, Morley FL, Ahmed I, Cox AR. Oral non-steroidal anti-inflammatory drug use in recreational runners participating in Parkrun UK: Prevalence of use and awareness of risk. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2020; 28:561-568. [DOI: 10.1111/ijpp.12646] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 05/17/2020] [Accepted: 05/20/2020] [Indexed: 11/26/2022]
Abstract
Abstract
Objective
Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used in endurance running and by elite athletes. We examined the pattern of use of NSAIDs, the purpose of use and knowledge of the adverse effects of NSAID use in a population of recreational runners at Parkrun UK.
Methods
An online observational non-interventional cross-sectional survey of Parkrun UK participants being over the age of 18, on Parkrun UK’s mailing list, and residing in the UK.
Key Findings
Runners (n = 806) had a high use of NSAIDs in the past 12 months (87.8%). The average age of respondents was 48.39 years. There was a significant association between those taking an oral NSAID in the last twelve months and those with a sporting injury (χ2 = 10.89, df = 1, n = 797, P = 0.001). Ibuprofen was the most commonly used NSAID (81.1%). A third of runners had experienced an adverse drug reaction associated with NSAIDs, usually gastrointestinal. Half of runners used NSAIDs with no advice, and patient information leaflets were the most common source for those that had advice. Ninety-four per cent of runners would like more information on the harms and benefits of NSAIDs.
Conclusions
Some recreational runners have a high use of NSAIDs, which is chronic in nature and a potential health risk. Recreational runners want more information on the harms and benefits of NSAIDs. Race event organizers should provide evidence-based advice on the use of NSAIDs.
Collapse
Affiliation(s)
- Craig James Rosenbloom
- Centre for Sports and Exercise Medicine, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Faye L Morley
- School of Pharmacy, University of Birmingham, Birmingham, UK
| | - Imran Ahmed
- School of Pharmacy, University of Birmingham, Birmingham, UK
| | | |
Collapse
|
5
|
Semen KO, Weseler AR, Janssen MJW, Drittij-Reijnders MJ, le Noble JLML, Bast A. Effects of Monomeric and Oligomeric Flavanols on Kidney Function, Inflammation and Oxidative Stress in Runners: A Randomized Double-Blind Pilot Study. Nutrients 2020; 12:E1634. [PMID: 32492913 PMCID: PMC7353060 DOI: 10.3390/nu12061634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/15/2020] [Accepted: 05/28/2020] [Indexed: 12/11/2022] Open
Abstract
Nonsteroidal anti-inflammatory drugs are frequently used by athletes in order to prevent musculoskeletal pain and improve performance. In combination with strenuous exercise, they can contribute to a reduction of renal blood flow and promote development of kidney damage. We aimed to investigate whether monomeric and oligomeric flavanols (MOF) could reduce the severity of kidney injuries associated with the intake of 400-mg ibuprofen followed by the completion of a half-marathon in recreational athletes. In this double-blind, randomized study, the original MOF blend of extracts from grape seeds (Vitis vinifera L.) and pine bark (Pinus pinaster L.) or placebo were taken for 14 days preceding the ibuprofen/half-marathon. Urine samples were collected before and after the ibuprofen/half-marathon, and biomarkers of kidney injury, inflammation and oxidative stress were assessed. Intake of MOF significantly reduced the incidence of post-race hematuria (p = 0.0004) and lowered concentrations of interleukin (IL)-6 in the urine (p = 0.032). Urinary neutrophil-associated lipocalin, creatine, albumin, IL-8 and malondialdehyde tended to decrease. The supplementation with MOF in recreational runners appears to safely preserve kidney function, reduce inflammation and promote antioxidant defense during strenuous exercise and intake of a single dose of ibuprofen.
Collapse
Affiliation(s)
- Khrystyna O. Semen
- Campus Venlo, Faculty of Science and Engineering, Maastricht University, 5911 BV Venlo, The Netherlands;
| | - Antje R. Weseler
- Department of Pharmacology and Toxicology, Faculty of Health, Medicine, and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands; (A.R.W.); (M.-J.D.-R.); (J.L.M.L.l.N.)
| | - Marcel J. W. Janssen
- Department of Clinical Chemistry and Haematology, VieCuri Medical Center Noord Limburg, 5912 BL Venlo, The Netherlands;
| | - Marie-José Drittij-Reijnders
- Department of Pharmacology and Toxicology, Faculty of Health, Medicine, and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands; (A.R.W.); (M.-J.D.-R.); (J.L.M.L.l.N.)
| | - Jos L. M. L. le Noble
- Department of Pharmacology and Toxicology, Faculty of Health, Medicine, and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands; (A.R.W.); (M.-J.D.-R.); (J.L.M.L.l.N.)
- Department of Intensive Care, VieCuri Medical Center Noord Limburg, 5912 BL Venlo, The Netherlands
| | - Aalt Bast
- Campus Venlo, Faculty of Science and Engineering, Maastricht University, 5911 BV Venlo, The Netherlands;
- Department of Pharmacology and Toxicology, Faculty of Health, Medicine, and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands; (A.R.W.); (M.-J.D.-R.); (J.L.M.L.l.N.)
| |
Collapse
|
6
|
Belinchón-deMiguel P, Tornero-Aguilera JF, Dalamitros AA, Nikolaidis PT, Rosemann T, Knechtle B, Clemente-Suárez VJ. Multidisciplinary Analysis of Differences Between Finisher and Non-finisher Ultra-Endurance Mountain Athletes. Front Physiol 2019; 10:1507. [PMID: 31920712 PMCID: PMC6914837 DOI: 10.3389/fphys.2019.01507] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 11/28/2019] [Indexed: 12/31/2022] Open
Abstract
Ultra-endurance races are one of the most physically and psychologically demanding sports, depending performance on several elements. The aims of the present study were (i) to analyze differences in selected psychophysiological parameters between finisher and non-finisher ultra-endurance mountain athletes, and (ii) to analyze modifications in psychophysiological parameters before and after an ultra-endurance mountain event. Selected psychophysiological variables were assessed in 46 finishers and 24 non-finishers in two over 100 km ultra-endurance races were examined. We found how an ultra-endurance mountain race produced dehydration, a decrease in systolic blood pressure, weight and leg strength muscle values, as well as an increase in heart rate and rate of perceived exertion values. Finishers presented lower systolic blood pressure, weight, body mass index, half marathon time and fluid intake before competition day compared to non-finishers. In addition, body mass index, pre-race hydration, and performance in lower distance races were predictors of performance in these ultra-endurance mountain races.
Collapse
Affiliation(s)
- Pedro Belinchón-deMiguel
- Departamento de Enfermería, Facultad de Siencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, Spain
| | | | - Athanasios A Dalamitros
- Department of Physical Education & Sport Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Pantelis T Nikolaidis
- School of Health and Caring Sciences, University of West Attica, Egaleo, Greece.,Exercise Physiology Laboratory, Nikaia, Greece
| | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland.,Gesundheitszentrum St. Gallen, St. Gallen, Switzerland
| | - Vicente Javier Clemente-Suárez
- Facultad de Ciencas del Deporte, Universidad Europea de Madrid, Madrid, Spain.,Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla, Colombia
| |
Collapse
|
7
|
Whatmough S, Mears S, Kipps C. Serum sodium changes in marathon participants who use NSAIDs. BMJ Open Sport Exerc Med 2018; 4:e000364. [PMID: 30588325 PMCID: PMC6280910 DOI: 10.1136/bmjsem-2018-000364] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2018] [Indexed: 11/04/2022] Open
Abstract
Introduction The primary mechanism through which the development of exercise-associated hyponatraemia (EAH) occurs is excessive fluid intake. However, many internal and external factors have a role in the maintenance of total body water and non-steroidal anti-inflammatory medications (NSAIDs) have been implicated as a risk factor for the development of EAH. This study aimed to compare serum sodium concentrations ([Na]) in participants taking an NSAID before or during a marathon (NSAID group) and those not taking an NSAID (control group). Methods Participants in a large city marathon were recruited during race registration to participate in this study. Blood samples and body mass measurements took place on the morning of the marathon and immediately post marathon. Blood was analysed for [Na]. Data collected via questionnaires included athlete demographics, NSAID use and estimated fluid intake. Results We obtained a full data set for 28 participants. Of these 28 participants, 16 took an NSAID on the day of the marathon. The average serum [Na] decreased by 2.1 mmol/L in the NSAID group, while it increased by 2.3 mmol/L in the control group NSAID group (p=0.0039). Estimated fluid intake was inversely correlated with both post-marathon serum [Na] and ∆ serum [Na] (r=-0.532, p=0.004 and r=-0.405 p=0.032, respectively). Conclusion Serum [Na] levels in participants who used an NSAID decreased over the course of the marathon while it increased in those who did not use an NSAID. Excessive fluid intake during a marathon was associated with a lower post-marathon serum [Na].
Collapse
Affiliation(s)
- Steven Whatmough
- Institute of Sport, Exercise and Health, University College London, London, UK
| | | | - Courtney Kipps
- Institute of Sport, Exercise and Health, University College London, London, UK
| |
Collapse
|
8
|
Wilson PB. A Randomized Double-Blind Trial of Ginger Root for Reducing Muscle Soreness and Improving Physical Performance Recovery Among Experienced Recreational Distance Runners. J Diet Suppl 2018; 17:121-132. [PMID: 30299178 DOI: 10.1080/19390211.2018.1492484] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/08/2018] [Accepted: 06/18/2018] [Indexed: 10/28/2022]
Abstract
Previous studies indicate that ginger root has pain-relieving properties, but these effects have not been thoroughly examined in the context of distance running. The purpose of this randomized, double-blind, placebo-controlled trial was to determine whether ginger root supplementation reduces muscle soreness and dysfunction from downhill running. Thirty-two runners (10 women, 22 men) were pair-matched and randomized to 1.425 g/day of ginger root or placebo for 5 days. A 40-minute downhill (-7.5%) run was completed on day 3. Before supplementation and at various points throughout a 5-day protocol, muscle soreness, pain-pressure threshold, vertical jump, and 1.5-mile run performance were evaluated. Differences between treatments were assessed using magnitude-based inferential statistics. Soreness while jogging likely increased to a lesser degree with ginger root from baseline to immediately postrun (Cohen's d = -0.69; 90% confidence limit [CL] [-1.50, 0.12]) and from baseline to day 5 (d = -0.72; 90% CL [-1.61, 0.16]). Ginger root had a possible small benefit on vertical jump from baseline to day 5 (d = 0.24; 90% CL [0.05, 0.44]) but likely no meaningful impact on 1.5-mile run performance. Trivial or unclear effects were found for most other outcomes. No significant differences in adverse events were observed between treatments. Ginger root possibly has moderate beneficial effects on running-induced soreness but likely irrelevant effects on recovery of physical performance. Ginger represents one option for runners looking to temporarily reduce pain, although more studies are warranted to clarify its safety profile and its effects on long-term training adaptation.
Collapse
Affiliation(s)
- Patrick B Wilson
- Human Movement Sciences, Old Dominion University, Norfolk, VA, USA
| |
Collapse
|
9
|
Chlíbková D, Ronzhina M, Nikolaidis PT, Rosemann T, Knechtle B. Non-steroidal Anti-inflammatory Drug Consumption in a Multi-Stage and a 24-h Mountain Bike Competition. Front Physiol 2018; 9:1272. [PMID: 30246809 PMCID: PMC6139357 DOI: 10.3389/fphys.2018.01272] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 08/21/2018] [Indexed: 12/04/2022] Open
Abstract
Purpose: Excessive or inappropriate non-steroidal anti-inflammatory drug (NSAID) use during ultra-endurance events could cause potential risk to athletes’ health. Reports on NSAID consumption in mountain bikers or ultra-mountain bikers are scarce. Therefore, the aim of this study was to investigate the prevalence of NSAID consumption immediately before, during and immediately after a mountain bike (MTB) race and to compare NSAID consumption in two different MTB competitions. Methods: This observational study took place at a three-stage MTB race (SMTB) (n = 63) and at a 24-h MTB race (24MTB) (n = 68), both held in the Czechia in 2017. NSAID consumption was evaluated via self-reported electronic questionnaires. Results: Of all finishers (n = 131), fourteen (10%) consumed NSAID at least once during the competition day (immediately before, during or immediately after the race). The number of NSAID consumers was the same in both competitions. Nevertheless, only three athletes (2%), all of them from the 24MTB, consumed NSAID during the race and 5% of all mountain bikers reported consumption after the race. In contrast to the SMTB, the intake reported by the 24MTB participants was quite homogeneous in terms of the timing of NSAID consumption. The NSAID users were older (p = 0.043) than the non-users. Ibuprofen was most commonly used by 79% of all consumers. Conclusion: The prevalence of NSAID use was higher in the older participants and seems to be lower in comparison with results from studies about runners, ultra-runners and triathletes suggesting that it is determined by the discipline (i.e., cycling). On the other hand, the timing of NSAID consumption was probably affected by the competition character (e.g., MTBS or 24MTB). Future studies should focus on a larger sample size of cyclists from various disciplines.
Collapse
Affiliation(s)
- Daniela Chlíbková
- Centre of Sports Activities, Brno University of Technology, Brno, Czechia
| | - Marina Ronzhina
- Department of Biomedical Engineering, Brno University of Technology, Brno, Czechia
| | | | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| |
Collapse
|
10
|
Novel Factors Associated With Analgesic and Anti-inflammatory Medication Use in Distance Runners: Pre-race Screening Among 76 654 Race Entrants-SAFER Study VI. Clin J Sport Med 2018; 28:427-434. [PMID: 29944515 DOI: 10.1097/jsm.0000000000000619] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Analgesic/anti-inflammatory medication (AAIM) increases the risk of medical complications during endurance races. We determined how many runners use AAIM before or during races, AAIM types, and factors associated with AAIM use. DESIGN Cross-sectional study. SETTING 21.1-km and 56-km races. PARTICIPANTS Seventy-six thousand six hundred fifty-four race entrants. METHODS Participants completed pre-race medical screening questions on AAIM use, running injury or exercise-associated muscle cramping (EAMC) history, and general medical history. MAIN OUTCOME MEASURES Analgesic/anti-inflammatory medication use, types of AAIM (% runners; 95% confidence interval), and factors associated with AAIM use (sex, age, race distance, history of running injury or EAMC, and history of chronic diseases) [prevalence ratio (PR)]. RESULTS Overall, 12.2% (12.0-12.5) runners used AAIM 1 week before and/or during races (56 km = 18.6%; 18.0-19.1, 21.1 km = 8.3%; 8.1-8.6) (P < 0.0001). During races, nonsteroidal anti-inflammatory drugs (NSAIDs) (5.3%; 5.1-5.5) and paracetamol (2.6%; 2.4-2.7) were used mostly. Independent factors (adjusted PR for sex, age, and race distance; P < 0.0001) associated with AAIM use were running injury (2.7; 2.6-2.9), EAMC (2.0; 1.9-2.1), cardiovascular disease (CVD) symptoms (2.1; 1.8-2.4), known CVD (1.7; 1.5-1.9), CVD risk factors (1.6; 1.5-1.6), allergies (1.6; 1.5-1.7), cancer (1.3; 1.1-1.5), and respiratory (1.7; 1.6-1.8), gastrointestinal (2.0; 1.9-2.2), nervous system (1.9; 1.7-2.1), kidney/bladder (1.8; 1.6-2.0), endocrine (1.5; 1.4-1.7), and hematological/immune (1.5; 1.2-1.8) diseases. CONCLUSIONS 12.2% runners use AAIM before and/or during races, mostly NSAIDs. Factors (independent of sex, age, and race distance) associated with AAIM use were history of injuries, EAMC, and numerous chronic diseases. We suggest a pre-race screening and educational program to reduce AAIM use in endurance athletes to promote safer races.
Collapse
|
11
|
Martinez S, Aguilo A, Rodas L, Lozano L, Moreno C, Tauler P. Energy, macronutrient and water intake during a mountain ultramarathon event: The influence of distance. J Sports Sci 2017; 36:333-339. [PMID: 28322630 DOI: 10.1080/02640414.2017.1306092] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Adequate dietary strategies are essential for the successful participation in ultra-endurance races. The aim of this study was to evaluate and compare the energy and water intakes of participants during three different mountain ultra-endurance runs. The study took place at the "Ultra Mallorca Serra de Tramuntana" (Mallorca, Spain), an ultra-endurance mountain event with runners participating either in a 44-km (Marathon, n = 51), a 67-km (Trail, n = 109) or a 112-km (Ultra, n = 53) run competition. Participants in the study answered a questionnaire focused on the nutritional intake within an hour after finishing the competition. Mean energy intake during the competitions was 183 kcal · h¯1, with an average carbohydrate intake of 31 g · h¯1 (52.1% of participants consumed less than 30 g · h¯1). No significant differences between competitions were found in these parameters. However, a higher percentage of energy from lipids in participants in the Trail and the Ultra was found (P = 0.034). Furthermore, significant differences were observed in water intake per hour of competition (P = 0.039), with the lowest value for the intake during the Ultra competition. In conclusion, the majority of the participants in the study present low carbohydrate intakes. However, fluid intake seems to be adequate. Different distances did not significantly influence the participants' nutritional strategies.
Collapse
Affiliation(s)
- Sonia Martinez
- a Research Group on Evidence, Lifestyles & Health, Department of Nursing and Physiotherapy, Research Institute on Health Sciences , University of the Balearic Islands , Palma de Mallorca , Spain
| | - Antoni Aguilo
- a Research Group on Evidence, Lifestyles & Health, Department of Nursing and Physiotherapy, Research Institute on Health Sciences , University of the Balearic Islands , Palma de Mallorca , Spain
| | - Lluis Rodas
- b Research Group on Evidence, Lifestyles & Health, Department of Fundamental Biology and Health Sciences, Research Institute on Health Sciences , University of the Balearic Islands , Palma de Mallorca , Spain
| | - Leticia Lozano
- a Research Group on Evidence, Lifestyles & Health, Department of Nursing and Physiotherapy, Research Institute on Health Sciences , University of the Balearic Islands , Palma de Mallorca , Spain
| | - Carlos Moreno
- a Research Group on Evidence, Lifestyles & Health, Department of Nursing and Physiotherapy, Research Institute on Health Sciences , University of the Balearic Islands , Palma de Mallorca , Spain
| | - Pedro Tauler
- b Research Group on Evidence, Lifestyles & Health, Department of Fundamental Biology and Health Sciences, Research Institute on Health Sciences , University of the Balearic Islands , Palma de Mallorca , Spain
| |
Collapse
|
12
|
Martínez S, Aguiló A, Moreno C, Lozano L, Tauler P. Use of Non-Steroidal Anti-Inflammatory Drugs among Participants in a Mountain Ultramarathon Event. Sports (Basel) 2017; 5:sports5010011. [PMID: 29910371 PMCID: PMC5969007 DOI: 10.3390/sports5010011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 01/11/2017] [Accepted: 01/24/2017] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to evaluate and compare the prevalence of non-steroidal anti-inflammatory drugs (NSAID) consumption immediately before, during and immediately after three mountain ultra-endurance runs that differed in their course distance. This observational study took place at the Ultra Mallorca Serra de Tramuntana (Mallorca, Spain), an ultra-endurance mountain event with runners participating either in a 112-km (Ultra, n = 58), a 67-km (Trail, n = 118) or a 44-km (Marathon, n = 62) run competition. Participants in the study answered, within an hour after finishing the competition, a questionnaire focused mainly on NSAIDs consumption. Among study participants, 48.3% reported taking NSAIDs at least for one of the time-points considered: before, during and/or immediately after the competition, with more positive responses (having taken medication) found for the Ultra (60.3%) than for the Trail (49.2%) and the Marathon (35.5%). Among consumers, the Ultra participants reported the lowest intake before and the highest during the race, while participants in the Marathon reported similar consumption levels before and during the race. In conclusion, a high prevalence of NSAID consumption was found among athletes participating in an ultra-endurance mountain event. Competition duration seemed to determine both the prevalence and the chronological pattern of NSAID consumption.
Collapse
Affiliation(s)
- Sonia Martínez
- Research Group on Evidence, Lifestyles & Health, Department of Nursing and Physiotherapy, Research Institute on Health Sciences (IUNICS), University of the Balearic Islands, 07122 Palma de Mallorca, Spain.
| | - Antoni Aguiló
- Research Group on Evidence, Lifestyles & Health, Department of Nursing and Physiotherapy, Research Institute on Health Sciences (IUNICS), University of the Balearic Islands, 07122 Palma de Mallorca, Spain.
| | - Carlos Moreno
- Research Group on Evidence, Lifestyles & Health, Department of Nursing and Physiotherapy, Research Institute on Health Sciences (IUNICS), University of the Balearic Islands, 07122 Palma de Mallorca, Spain.
| | - Leticia Lozano
- Research Group on Evidence, Lifestyles & Health, Department of Nursing and Physiotherapy, Research Institute on Health Sciences (IUNICS), University of the Balearic Islands, 07122 Palma de Mallorca, Spain.
| | - Pedro Tauler
- Research Group on Evidence, Lifestyles & Health, Department of Fundamental Biology and Health Sciences, Research Institute on Health Sciences (IUNICS), University of the Balearic Islands, 07122 Palma de Mallorca, Spain.
| |
Collapse
|
13
|
Wilson PB. Ginger (Zingiber officinale) as an Analgesic and Ergogenic Aid in Sport: A Systemic Review. J Strength Cond Res 2015; 29:2980-95. [PMID: 26200194 DOI: 10.1519/jsc.0000000000001098] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Ginger is a popular spice used to treat a variety of maladies, including pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used by athletes to manage and prevent pain; unfortunately, NSAIDs contribute to substantial adverse effects, including gastrointestinal (GI) dysfunction, exercise-induced bronchoconstriction, hyponatremia, impairment of connective tissue remodeling, endurance competition withdrawal, and cardiovascular disease. Ginger, however, may act as a promoter of GI integrity and as a bronchodilator. Given these potentially positive effects of ginger, a systematic review of randomized trials was performed to assess the evidence for ginger as an analgesic and ergogenic aid for exercise training and sport. Among 7 studies examining ginger as an analgesic, the evidence indicates that roughly 2 g·d(-1) of ginger may modestly reduce muscle pain stemming from eccentric resistance exercise and prolonged running, particularly if taken for a minimum of 5 days. Among 9 studies examining ginger as an ergogenic aid, no discernable effects on body composition, metabolic rate, oxygen consumption, isometric force generation, or perceived exertion were observed. Limited data suggest that ginger may accelerate recovery of maximal strength after eccentric resistance exercise and reduce the inflammatory response to cardiorespiratory exercise. Major limitations to the research include the use of untrained individuals, insufficient reporting on adverse events, and no direct comparisons with NSAID ingestion. While ginger taken over 1-2 weeks may reduce pain from eccentric resistance exercise and prolonged running, more research is needed to evaluate its safety and efficacy as an analgesic for a wide range of athletic endeavors.
Collapse
Affiliation(s)
- Patrick B Wilson
- Nebraska Athletic Performance Laboratory, University of Nebraska-Lincoln, Lincoln, Nebraska
| |
Collapse
|