Sports pharmacology and dietetics. Sports pharmacology and dietetics Sports pharmacology and dietetics read online

The content of the article:

It must be said right away that sports pharmacology and dietology are now developing quite rapidly, although pharmacology for athletes does not officially exist. There is no such discipline in any educational institution. The reason for this is quite understandable. After all, if you start teaching sports pharmacology, write study guides, then it will be clear to everyone that doping does not exist.

Features of the use of drugs in sports

Athletes use drugs that allow them to survive under high loads. What the body drinks during intensive training is unnatural for it. IN human body there are no genes due to which it is possible to build up a huge mass of muscle tissue, and people do not have a predisposition to develop high endurance, speed, etc.

Now we are talking about professional sports, and all the achievements obtained by athletes are unnatural. This should be well understood. Without the use of appropriate pharmacological preparations, people will not be able to achieve high results, since the body of each person has a genetically laid border.

Now sports pharmacology and dietetics are at the mercy of sports doctors. At the same time, it should be noted that they represent the least enlightened part of the entire medical community, but logically, everything should be exactly the opposite. It's most likely a matter of natural selection. Doctors practicing in clinics are responsible for people's lives, and one can recall more than one case of scandal that arose due to the death of a patient.

It is much easier for sports doctors in this regard. Such a burden of responsibility does not hang over them, since they have to work with healthy people. This is how natural selection works, and sports doctors often become those people who are willing to earn little, but do nothing and not respond. Of course, this situation requires a radical change.

What should be changed

It’s worth starting with the fact that the very concept of “doping” was canceled. But this step sports federations and committees does not seem real. After all, teams and athletes convicted of using illegal drugs pay fines and considerable ones. Thus, it is necessary to create a procedure for challenging the decisions of anti-doping commissions in court, as well as to legitimize the change in penalties in the direction of reduction. Such a step will solve almost half of the existing problem.

After all, when Main coach The team deliberately forces all athletes to use a low-effective drug that is easily detected during the competition, and then allows all their athletes to be tested, of course, the drug will be detected, and the athletes will be disqualified. The coach then simply resigns.

In this case, there is practically no doubt that he was paid a decent amount. It's no secret that much more can be paid for the defeat of the team than for the victory. It remains to be seen who gets paid for this.

The next step should be the recognition of sports pharmacology at the official level. It should become one of the compulsory disciplines in medical and physical education institutions of higher education. It is necessary to accumulate information step by step, systematize it and subsequently apply it for the benefit of the health of athletes, and not to the detriment. After that, society will change its position regarding sports pharmacology and nutrition.

It is important for everyone to understand that sports pharmacology cannot be separated from clinical pharmacology. In those moments when an athlete needs help with an injury or any other, then the usual clinical studies are carried out first, the task of which is to diagnose the problem and its causes. The same is done for ordinary people.

Diseases are transmitted from parents to each person, and humanity at this stage of its development cannot avoid this. Any parental disease is inherited, and only one question remains, how quickly will it manifest itself?

Every intense training in any sport needs pharmacological support. Without this, athletes will simply lose their health without achieving results. Sports pharmacology and dietetics should be selected only after a thorough clinical study of the athlete. At the same time, it is necessary not only to focus on achieving results in the future, but also to cure existing diseases, or at least try to postpone the time of their development if they were inherited.

The fusion of clinical and sports medicine is long overdue. Without such a step, it is not possible to correct the current situation. Some time ago, sports pharmacology could be said to be dead. At present, they have come to life, but its further fate depends only on us. There are only two options for the development of events.

If everything is left unchanged, then athletes will continue to suffer from inexperienced sports doctors prescribing drugs, while not knowing all their properties and effects on the body. Teams and athletes will, as before, pay huge fines.

If you start taking action, then the concept of "doping" will disappear sooner or later. Public opinion should also contribute to this. Only when ordinary people understand that doping does not exist, then sports functionaries will have to change something.

Watch a video about sports pharmacology:

Already in ancient times, athletes paid
significant attention to nutrition and its impact on
health and physical form. Of course, among
sports
competitions
dominated
light
V
antique
athletics.
time
Necessary
note that then Athletics was part
struggle for survival: the slow will not get
food, the weak will not protect the family.
Whatever it is, when it comes to
Greece, everything is calculated in millennia. That's
story
Greek
cuisine
has
more
four thousand years. Note that ancient Greek
the doctor under the word "diet" understood not what is possible
eat, and when what can you eat, since the Greek
the word "diet" meant a way of life, a regime, including

sports nutrition
branch of nutritional science,
aimed at providing
nutritional support
athletes of various qualifications
youth sports
and ending with top-level sports
skill and ex-athletes

The purpose of mastering the discipline

The purpose of mastering the discipline "Sports Dietetics" is
providing future specialists in physical education and sports
knowledge in the field of nutrition of athletes, designed to replenish
energy
expenses,
having
place
V
processes
vital activity
And
specific
sports
work,
to realize the plastic provision of body functions and
admission
substances
speakers
V
roles
regulators
metabolic processes. It is equally important to identify the main
principles on which the basic nutrition of athletes should be built,
and the possibility of targeted effects of food products on
indicators physical performance and maintaining health
athletes.

learning goals

be able to analyze diets and identify
typical nutritional errors, consumption deficiencies
main products
master the skills of compiling a diet
for a healthy person
master the skills of planning and combining
individual and family diets
master the skills of keeping a food diary and
other methods of accounting for nutrition (meals)
understand the products on the market
and in stores, be able to form your own (personal)
consumer basket, plan a grocery
budget
formulate diets and diets
in accordance with energy consumption, activities
and daily tasks,
individual features
learn the basic concepts of health, rational
nutrition and be able to put into practice the principles
healthy lifestyle

Competencies of the student, formed as a result of mastering the discipline "Sports Dietetics"

Mastering the course "Sports Dietetics" allows the student to contribute to
mastery of the following competencies:
the ability to improve and develop their intellectual and
general cultural level;
the ability to independently master new research methods, to
change
scientific
And
scientific and pedagogical
profile
his
professional activity;
ability and willingness to use in professional activities
innovative technologies, modern facilities and scientific methods
research;
ability for continuous self-education
ability
And
willingness
organize
And
conduct
training sessions;
ability and willingness to use modern technologies, means and
methods of training athletes and evaluate the effectiveness of their application;
ability and willingness to adjust the training and
competitive load based on the control of the athlete's condition;
ability and willingness to use effective means
restoration and improvement of sports performance
ability and willingness to develop and implement programs
pre-competitive, competitive preparation and post-competitive
activities

As a result of mastering the discipline "Sports dietology" the student must:

- to know the functions of the basic nutrition of athletes, its
value for improving metabolic
bases of sports working capacity;
- be able to estimate energy costs and
changes in plastic exchange when performing
physical activity and calculate the amount
nutrients
necessary
For
compensation
changes in the body;
- have the skills to effectively use
ergogenic diet to increase the level
physical
performance
And
conservation
athletes' health.

The structure and content of the discipline "Sports Dietetics"

IN
educational
course
set out
biochemical foundations of nutrition
human,
come to light
differences
nutrition
athletes and people not involved in
sports.
At
discussion
features
nutrition of athletes draws attention to
principles of organizing basic nutrition and
ergogenic
dietetics.
Specially
considered
chemical
compound
And
efficiency
applications
basic
And
ergogenic nutrients sports nutrition,
their impact on athletic performance
taking into account
age
And
gender,
noted
the need to take into account the relationship of nutrition
with periodization sports training.

The program of the course "Sports Dietetics"

BALANCED DIET. Modern ideas about rational nutrition. Are common
principles of rational nutrition of athletes.
ENERGY EXCHANGE. Energy costs and energy value of food. Exchange
energy and metabolism. Methods for calculating the daily energy consumption of athletes.
PROTEINS. The importance of proteins in human nutrition. Functions of proteins in the body. The role of amino acids
in metabolism.
FATS. Importance of fats in human nutrition. Functions and metabolism of fats in the body.
neutral fats. Polyunsaturated fatty acids. Phospholipids. Cholesterol. food
the value of fats.
CARBOHYDRATES. Importance of carbohydrates in human nutrition. Functions of carbohydrates in the body.
Classification of carbohydrates. Mono-, di- and polysaccharides. Alimentary fiber. Picture of
glycemic index.
VITAMINS. Classification. role in metabolism. Characteristics of the main groups
water-soluble and fat-soluble vitamins. Need for vitamins. Common
deficits. Exogenous and endogenous causes of vitamin deficiency.
MINERALS. Classification. The role of minerals in the body. Macro and microelements. Water and mineral exchange. Athlete's diet.
HEALTHY FOOD. Modern ideas about healthy eating. Nutrigenomics and
nutrigenetics - a new era of nutrition.
NUTRITION OF ATHLETES. Basic principles of nutrition for athletes. Power value as
adaptation factor during physical exertion. Evaluation of the nutritional status of athletes.
BIOLOGICALLY ACTIVE ADDITIVES. Products of increased biological value.
Special sports nutrition products..
NUTRITION DURING DIFFERENT PERIODS OF PREPARATION OF ATHLETES. Nutrition for athletes
taking into account the specifics training process and the period of the annual training cycle.
METHODS FOR ASSESSING THE ACTUAL NUTRITION OF ATHLETES. Food diary. Are common
principles of keeping a food diary. Control and analysis of the diet according to the food diary.
The use of computer technology for the organization and evaluation of rational nutrition
athletes.
FOOD AND FITNESS. Catering during health-improving physical
culture (fitness, bodybuilding, aerobics).

The book covers in detail the methods and means of modern pharmacological support of the training process and the principles of rational nutrition of athletes. The presentation is carried out taking into account the specialization and qualifications of athletes, their gender and age characteristics, the period of preparation and the direction of the loads. Apart from medicines, a description and recommendations on the use and dosage of products of increased nutritional value and biologically active food additives (BAA) are given. The necessary attention is paid to the pharmacocorrection of a number of borderline and pathological conditions typical for athletes: overstrain syndrome, "athletic" heart syndrome, climate zone maladjustment, sports immunodeficiencies, injuries, etc.

The manual is intended for sports doctors, coaches, students and teachers of medical universities.

Publisher: Williams, Dialectika, 2008

ISBN 978-5-8459-1389-0

Number of pages: 256.

The contents of the book "Sports pharmacology and dietology":

• 11 Introduction
• 13 From the publishing house "Dialectics"
• 15 Chapter 1
  • 15 1.1. Classification, rationale and principles for the use of non-pinging pharmacological agents in modern sports medicine
  • 17 1.2. The main pharmacological preparations and dietary supplements in sports highest achievements
  • 25 1.3. General features and features of pharmacological support of physical performance in representatives various groups sports
  • 35 1.5. Pharmacological support of the stages and periods of training of athletes in the macrocycle
    • 35 1.5.1. Preparation period
    • 35 1.5.2. Competitive period
    • 38 1.5.3. Transition period
  • 38 1.6. Recommendations for individual schemes of pharmacological support of sports training
• 41 Chapter 2
  • 41 2.1. The main provisions of the nutrition of athletes
  • 42 2.2. Characteristics of the main food components and features of their use in sports nutrition
    • 42 2.2.1. Proteins and features of their consumption in sports nutrition
    • 44 2.2.2. Fats and features of their consumption in sports nutrition
    • 46 2.2.3. Carbohydrates and features of their consumption in sports nutrition
    • 50 2.2.4. Vitamins and mineral elements and features of their consumption in sports nutrition
    • 57 2.2.5. Water as an indispensable component of the diet of athletes
  • 60 2.3. Common features and nutritional characteristics of representatives of various groups of sports
  • 70 2.4. Principles of basic nutrition and ergogenic diet
    • 70 2.4.1. Features of the basic nutrition of athletes
    • 72 2.4.2. Features of the ergogenic diet
  • 76 2.5. Energy value, the content of the main nutrients and daily layouts of products in the exemplary diets of athletes, taking into account the periods and stages of their preparation
  • 84 2.6. The use of dietary manipulation to correct the body weight of athletes
  • 86 2.7. The validity of the use of products of increased biological value, specialized sports nutrition products and dietary supplements to improve performance
    • 86 2.7.1. Products of increased biological value
    • 88 2.7.2. Special sports nutrition products
• 93 Chapter 3
  • 93 3.1. general characteristics, classification of dietary supplements and recommendations for their use in the practice of sports training to improve performance
  • 101 3.2. Dietary supplement of an adaptogenic nature
  • 102 3.3. Dietary supplement of actoprotective action
  • 105 3.4. Antioxidant dietary supplement
  • 107 3.5. Dietary supplements containing polyunsaturated fatty acids
  • 109 3.6. Anabolic dietary supplement
  • 117 3.7. Dietary supplements used as plastic substrates
  • 122 3.8. BAA to improve energy supply
  • 127 3.9. BAA of restorative action
  • 128 3.10. BAA of bioregulatory action
  • 132 3.11. General rules the use of dietary supplements depending on the nature of the loads
• 135 Chapter 4. Pharmacotherapy of some borderline and pathological conditions in athletes
  • 135 4.1. Methodological aspects of pharmacological correction of overvoltage in athletes
  • 144 4.2. Pharmacotherapy of sports medical pathology
    • 145 4.2.1. Sports sickness (overtraining)
    • 146 4.2.2. Myocardial dystrophy
    • 148 4.2.3. Hepatic pain syndrome
    • 149 4.2.4. Bronchial asthma (physical effort)
    • 151 4.2.5. physical allergies
  • 152 4.3. Pharmacological correction of climate zone disadaptation
    • 153 4.3.1. Pedagogical and organizational means of accelerating the adaptation of the body to new conditions
    • 154 4.3.2. Medico-biological means of accelerating the adaptation of the athlete's body to new conditions
  • 156 4.4. Treatment of sports injury with pharmacological drugs
  • 163 4.5. Pharmacological correction of osteoarthritis
    • 163 4.5.1. Symptom-modifying drugs
    • 164 4.5.2. Structure-modifying drugs
    • 166 4.5.3. External means
    • 167 4.5.4. Glucocorticoids
    • 168 4.5.5. Dietary supplements in the complex treatment of chronic diseases of the musculoskeletal system
• 171 Chapter 5 sportswear
  • 172 5.1. Influence of pharmacological preparations on immunological reactivity
  • 174 5.2. Pharmacological correction of sports (secondary) immunodeficiencies
  • 181 5.3. Immunological deficiency of athletes and indications for the use of immunotropic agents
• 189 Chapter 6
  • 189 6.1. Etiology, pathogenesis, ECG manifestations, clinical features
  • 197 6.2. Morphology of the “athletic” heart
  • 201 6.3. Features of the ECG in athletes
    • 202 6.3.1. Physiological hypertrophy
    • 205 6.3.2. Pathological hypertrophy
    • 205 6.3.3. ECG at various stages of athletes' training
  • 210 6.4. The state of the autonomic nervous system
  • 211 6.5. Clinical characteristics of the "athletic" heart
    • 211 6.5.1. Pathological "athletic" heart
    • 212 6.5.2. Acute overexertion of the heart
    • 213 6.5.3. Chronic overexertion of the heart
    • 214 6.5.4. The state of the cardiovascular system after the cessation of training
    • 215 6.5.5. Athletic heart and connective tissue dysplasia
  • 219 6.6. Pharmacotherapy of cardiac dysfunction in athletes
• 225 Chapter 7. Principles of pharmacological correction of dysfunction of the male and female organisms
  • 225 7.1. Erectile dysfunctions in athletes and principles of their pharmacological correction
  • 230 7.2. Morphofunctional capabilities of women in the process of long-term and acute adaptation to extreme loads modern sports and main approaches to its pharmacological correction
  • 238 7.3. Pharmacological correction of premenstrual syndrome in female athletes
• 241 Conclusion
• 242 List of accepted abbreviations
• 245 Literature

Titula_Spotr-farma-dieta.indd 1 04/01/2008 17:44:52 titula_Spotr-farma-dieta.indd 2 04/01/2008 17:44:52 T.V. Gishchak, N.A. Gorchakova, L.M. Gunina, F.A. Jordanskaya, V.A. Kozlovsky, Yu.V. Marushko, S.A. Oleinik, E.A. Rozhkova, R.D. Seifulla, I.S. Chekman, Yu.S. Chistyakova “Dialectics” Moscow St. Petersburg Kiev 2008 titula_Spotr-farma-dieta.indd 3 04/01/2008 17:44:52 LBC (Ch)75.0 O-53 UDC 613.72 Computer publishing house “Dialectics” Head. edited by A.V. Sleptsov Compiled by: T.V. Gishchak, N.A. Gorchakova, L.M. Gunina, F.A. Jordanskaya, V.A. Kozlovsky, Yu.V. Marushko, S.A. Oleinik, E.A. Rozhkova, R.D. Seifulla, I.S. Chekman, Yu.S. Chistyakova Edited by S.A. Oleinik, L.M. Gunina Reviewer: Doctor of Medical Sciences, Professor E.B. Shustov For general questions, please contact the Dialectika publishing house at: [email protected], http://www.dialektika.com Oleinik, S.A. etc. O-53 Sports pharmacology and dietetics. - M. : OOO I.D. Williams”, 2008. - 256 p. : ill. ISBN 978-5-8459-1389-0 (Russian) The book covers in detail the methods and means of modern pharmacological support of the training process and the principles of rational nutrition for athletes. The presentation is carried out taking into account the specialization and qualifications of athletes, their gender and age characteristics, the period of preparation and the direction of the loads. In addition to medicines, descriptions and recommendations are given on the use and dosage of products of increased nutritional value and biologically active food additives (BAA). The necessary attention is paid to the pharmacocorrection of a number of borderline and pathological conditions typical for athletes: overstrain syndrome, “athletic” heart syndrome, climate zone maladjustment, sports immunodeficiencies, injuries, etc. The manual is intended for sports doctors, coaches, students and teachers of medical universities. BBK (Ch)75.0 All titles software products are registered trademarks of their respective companies. No part of this publication may be reproduced for any purpose in any form or by any means, electronic or mechanical, including photocopying and recording on magnetic media, unless written permission is given by Dialectika Publishing House. ". Copyright © 2008 by Dialektika Computer Publishing. All rights reserved including the right of reproduction in whole or in part in any form. ISBN 978-5-8459-1389-0 (rus.) Sport pharm&diet.indb means for maintaining and increasing physical performance 15 Chapter 2. Fundamentals of sports dietetics as one of the ergogenic factors 41 Chapter 3. Biologically active (dietary) supplements and their role in improving physical performance 93 Chapter 4. Pharmacotherapy of certain borderline and pathological conditions in athletes 135 Chapter 5. Correction of the immune system of athletes to maintain sports form 171 Chapter 6. “Sports” heart syndrome and its pharmacological correction 189 Chapter 7. Principles of pharmacological correction of dysfunction of the male and female organisms 225 Conclusion 241 List of accepted abbreviations 242 Literature 245 Sport pharm&diet.indb 5 07.04 .2008 18:42:25 Contents Introduction From the publishing house "Dialectika" 11 13 Chapter 1. Pharmacological means to maintain and increase physical performance 15 1.1. Classification, rationale and principles for the use of non-pinging pharmacological agents in modern sports medicine 15 1.2. The main pharmacological preparations and dietary supplements in elite sports 17 1.3. General features and features of pharmacological support of physical performance in representatives of various groups of sports 25 1.5. Pharmacological provision of stages and periods of training of athletes in the macrocycle 35 1.5.1. Preparatory period 1.5.2. Competitive period 1.5.3. Transition period 35 35 38 1.6. Recommendations for individual schemes of pharmacological provision of sports training 38 Chapter 2. Fundamentals of sports dietetics as one of the ergogenic factors 41 2.1. The main provisions of the nutrition of athletes 41 2.2. Characteristics of the main food components and features of their use in sports nutrition 42 2.2.1. Proteins and features of their consumption in sports nutrition 2. 2.2. Fats and features of their consumption in sports nutrition 2.2.3. Carbohydrates and features of their consumption in sports nutrition 2.2.4. Vitamins and mineral elements and features of their consumption in sports nutrition 2.2.5. Water as an indispensable component of the diet of athletes Sport pharm&diet.indb 6 42 44 46 50 57 04/07/2008 18:42:25 Contents 7 2.3. Common features and nutritional characteristics of representatives of various groups of sports 60 2.4. Principles of basic nutrition and ergogenic diet 70 2.4.1. Features of the basic nutrition of athletes 2.4.2. Features of the ergogenic diet 70 72 2.5. Energy value, the content of the main nutrients and daily layout of products in the exemplary diets of athletes, taking into account the periods and stages of their training 76 2.6. The use of dietary manipulations to correct the body weight of athletes 84 2.7. The validity of the use of products of increased biological value, specialized sports nutrition products and dietary supplements to improve performance 86 2.7.1. Products of increased biological value 2.7.2. Special sports nutrition products 86 88 Chapter 3. Biologically active (dietary) supplements and their role in improving physical performance 93 3.1. General characteristics, classification of dietary supplements and recommendations for their use in the practice of sports training to improve performance 93 3.2. BAA of an adaptogenic nature 101 3.3. BAA of actoprotective action 102 3.4. Antioxidant dietary supplement 105 3.5. Dietary supplements containing polyunsaturated fatty acids 107 3.6. Anabolic dietary supplements 109 3.7. BAA used as plastic substrates 117 3.8. BAA to improve energy supply 122 3.9. BAA of restorative action 127 3.10. BAA of bioregulatory action 128 3.11. General rules for the use of dietary supplements depending on the nature of the load 132 Sport pharm&diet.indb 7 04/07/2008 18:42:25 8 Contents Chapter 4. Pharmacotherapy of certain borderline and pathological conditions in athletes 135 4.1. Methodological aspects of pharmacological correction of overvoltage in athletes 135 4.2. Pharmacotherapy of sports medical pathology 144 4.2.1. Sports disease (overtraining) 4.2.2. Myocardial dystrophy 4.2.3. Hepatic pain syndrome 4.2.4. Bronchial asthma (physical effort) 4.2.5. Physical allergies 4.3. Pharmacological correction of climate zone disadaptation 145 146 148 149 151 152 4.3.1. Pedagogical and organizational means of accelerating the adaptation of the organism to new conditions 153 4. 3.2. Medico-biological means of accelerating the adaptation of the athlete's body to new conditions 154 4.4. Treatment of a sports injury with pharmacological preparations 156 4.5. Pharmacological correction of osteoarthritis 163 4.5.1. Symptom-modifying drugs 4.5.2. Structure-modifying drugs 4.5.3. External means 4.5.4. Glucocorticoids 4.5.5. Dietary supplements in the complex treatment of chronic diseases of the musculoskeletal system 163 164 166 167 168 Chapter 5. Correction of the immune system of athletes to maintain sports form 171 5.1. Influence of pharmacological preparations on immunological reactivity 172 5.2. Pharmacological correction of sports (secondary) immunodeficiencies 174 5.3. Immunological insufficiency of athletes and indications for the use of immunotropic agents 181 Sport pharm&diet.indb 8 04/07/2008 18:42:25 9 Contents Chapter 6. Sports heart syndrome and its pharmacological correction 189 6.1. Etiology, pathogenesis, ECG manifestations, clinical features 189 6.2. Morphology of the “sporty” heart 197 6.3. Features of the ECG in athletes 201 6.3.1. Physiological hypertrophy 6.3.2. Pathological hypertrophy 6.3.3. ECG at different stages of athletes' training 202 205 205 6.4. State of the autonomic nervous system 210 6.5. Clinical characteristics of the “athletic” heart 211 6.5.1. Pathological "athletic" heart 6.5.2. Acute heart strain 6.5.3. Chronic heart strain 6.5.4. The state of the cardiovascular system after the cessation of training 6.5.5. Sports heart and connective tissue dysplasia 6.6. Pharmacotherapy of cardiac dysfunction in athletes 211 212 213 214 215 219 Chapter 7. Principles of pharmacological correction of male and female dysfunction 225 7.1. Erectile dysfunctions in athletes and the principles of their pharmacological correction 225 7.2. Morphological and functional capabilities of women in the process of long-term and acute adaptation to extreme loads of modern sports and the main approaches to its pharmacological correction 230 7.3. Pharmacological correction of premenstrual syndrome in athletes 238 Conclusion 241 List of accepted abbreviations 242 Literature 245 nogo pharmacological providing for maintaining and increasing physical performance, accelerating the processes of adaptation to superintense physical activity, especially in elite sports, preventing overtraining and sports injuries. The huge variety of existing means of pharmacological support of physical performance necessitates their systematization and knowledge of the mechanisms of influence and the main points of application. Pharmacology of sports medicine (or sports pharmacology) is a relatively new, but very actively progressing direction in clinical and experimental pharmacology in recent years. Sports pharmacology is aimed at the development, study and practical implementation of drugs and biologically active dietary supplements to increase the adaptation of athletes to superintense physical activity, and one of the main tasks of this discipline is to identify and correct factors that limit the physical performance of athletes (Seifulla, 1998). Methods of pharmacological support motor activity should take into account the specialization and qualifications of athletes, their gender and age characteristics and be applied depending on the period of training and the direction of the loads. In connection with the improvement and tightening of doping controls, it is extremely important that medications and nutritional supplements, which are very widely used in sports, do not contain substances on the WADA Prohibited List (World anti-doping agency), while providing a pronounced ergogenic effect. Unfortunately, many issues of pharmacological support sports activities and improving physical performance around the world have become “a closely guarded secret” (Didur, 2002), which explains the current lack of reliable and objective information in the specialized literature. At present, the system of training in sports, especially the highest achievements, is characterized by exceptionally high training and competitive loads, which are accompanied by high level emotional- Sport pharm&diet.indb 11 04/07/2008 18:42:26 12 Introduction of nal stress. It is quite natural that such high loads are the most powerful factor in mobilizing the functional reserves of the body, stimulating intensive adaptation processes, increasing endurance, strength, speed abilities and, of course, growth sports results. At the same time, rational nutrition plays an important role in increasing physical performance, preventing fatigue and accelerating recovery processes after physical exertion. Therefore, modern elite sport is characterized by an increased role of dietary factors in the system of means and methods that ensure a high level of performance of an athlete throughout his career. Changing the structure of the training process required special attention to the issues of catering at different stages of the annual training cycle and during the competition. The introduction of two- and three-time workouts has significantly changed the diet of highly qualified athletes, and the improvement of training methods has led to a significant increase in the energy consumption of the body. Identification of metabolic features in the process of assimilation of nutrients at the cellular and subcellular level made it possible to determine the athlete's needs for individual components of the diet, to establish their optimal ratios necessary to increase physical performance, accelerate the processes of adaptation to loads and the influence of negative environmental factors, and activate the processes of body recovery . There was a need to adequately compensate for the expended energy by increasing the energy value of nutrition, which, in turn, necessitated the creation of specialized nutrition for athletes, the development of special products of increased nutritional value and biologically active (dietary) food additives (BAA) as important nutritional factors of ergogenic orientation . Thus, in modern sports medicine science and practice, there is a merger of pharmacology and dietology, the main points of which are highlighted in this manual. Finally, a number of borderline and pathological conditions that are typical for athletes require specific pharmacological correction: overstrain syndrome, climate zone maladjustment, sports immunodeficiencies, sports injuries, osteoarthritis, sports heart syndrome, erectile dysfunction in men, menstrual irregularities and premenstrual syndrome in women. The main approaches to the pharmacological correction of these conditions are also presented on the pages of this book. The manual is intended for sports doctors, coaches, students and teachers of medical universities. The authors will gratefully accept critical comments and constructive suggestions from readers. Sport pharm&diet.indb 12 07.04.2008 18:42:26 13 Introduction From Dialectika publishing house You, the reader of this book, are its main critic. We value your opinion and want to know what we did right, what could have been done better, and what else you would like to see published by us. We are interested in any of your comments to us. We are waiting for your comments and look forward to them. You can send us a paper or e-mail, or simply visit our web server and leave your comments there. In a word, in any way convenient for you, let us know if you like this book, and also express your opinion on how to make our books more interesting for you. When sending a letter or message, do not forget to include the title of the book and its authors, as well as your return address. We will carefully read your opinion and be sure to take it into account when selecting and preparing for publication of new books. Our email addresses: E-mail: WWW: [email protected] http://www.dialektika.com Our mailing addresses: in Russia: in Ukraine: Sport pharm&diet.indb 13 127055, Moscow, st. Lesnaya, 43, building 1 03150, Kiev, PO Box 152 04/07/2008 18:42:26 Sport pharm&diet.indb 14 04/07/2008 18:42:26 Chapter 1 Pharmacological agents to maintain and increase physical performance 1.1. Classification, justification and principles of application of non-pinging pharmacological agents in modern sports medicine Pharmacological correction is aimed at improving the physical performance of athletes and their adaptation to increasing physical and psycho-emotional stress; it solves various therapeutic, preventive and pedagogical problems. In other words, the tasks of sports pharmacology are: correction of metabolic disorders to maintain and increase the physical performance of athletes; increasing the adaptive stability and immunological resistance of the body to the action of intense and prolonged physical exertion and psychological stress; correction of adaptation to the temporary and zone stay of an athlete in various geographical areas, primarily with an unfavorable climate; optimization of recovery processes after loads of various directions, volume and intensity; prevention (and, if necessary, treatment) of overvoltage and diseases associated with the influence of physical activity. Sport pharm&diet.indb 15 07.04.2008 18:42:26 16 CHAPTER 1 Such a range of tasks dictates the need to use a large number of pharmacological agents that affect the most diverse links of metabolism in the athlete's body. Pharmacological preparations used in the practice of sports training, according to the mechanism of action and influence on certain metabolic processes (Makarova, 2003), are divided as follows. 1. Means that contribute to the creation of optimal conditions for accelerating the natural processes of post-exercise recovery by improving the functional state of the organs of natural detoxification - the urinary and hepatobiliary systems (detoxicants, antioxidants, rehydrators, hepatotropic agents, primarily cholekinetics and hepatoprotectors) and artificially accelerating the processes of post-exercise recovery due to metabolism, excretion and binding of toxic metabolites (sorbents, hepatoprotectors, immunomodulators, antioxidants; vitamins, macro- and microelements, including vitamin-mineral complexes; agents for improving renal blood flow). 2. Means that meet the increased needs of the body in conditions of intense muscular activity in the main food ingredients (vitamins, macro- and microelements, including vitamin-mineral complexes; protein metabolism regulators or plastic substrates - amino acids and protein hydrolysates; regulators of carbohydrate and lipid metabolism , anabolic agents). 3. Means to improve the tolerance of training and competitive loads (antioxidants, antihypoxants, adaptogens, including biogenic stimulants, anabolic agents; funds for correcting energy supply; neuropsychic status regulators (psychomotor stimulants, sedative and nootropic drugs, neuroprotectors); funds for the correction of microcirculation and the rheological state of the blood (disaggregants); stimulants of hematopoiesis; immunomodulators; drugs that directly regulate the acid-base balance of the body - pH). It should be borne in mind that any pharmacological agents, the action of which is aimed at increasing physical performance and “optimizing” recovery processes (according to M.D. Didur, optimization can include both acceleration and physiological normalization of the speed of their course), are little or completely ineffective. if the athlete has pre-pathological conditions or diseases that occur subclinically, as well as in the absence of adequate dosing of physical activity. Without reliable regular medical-biological and pedagogical testing, it is very difficult to correctly dose physical activity that simultaneously meets the tasks of a certain training period (stage) and the capabilities of the athlete's body. Sport pharm&diet.indb 16 07.04.2008 18:42:26 Pharmacological means to maintain and increase physical performance 17 As a result, what is the nature of the influence on the effectiveness of the training process. It should also take into account contraindications to the use of various pharmacological agents, their interaction, possible side effects. With regard to pharmacological agents to increase physical performance indicators, it is necessary to pay attention to such parameters of drug action as urgent, cumulative and delayed effects, as well as the differentiation of the effect on power, capacity, efficiency and feasibility. It is very important to evaluate the effectiveness of the used pharmacological agents depending on the period (stage) of the training cycle and specialization, the level of sports qualification, the nature of the energy supply of training and competitive loads, the initial functional state of the athlete's body, as well as anthropometric and sex-age characteristics. Taking into account all of the above, it is clear that the appointment of pharmacological means to increase sports performance should be carried out jointly by a sports doctor and a coach, and the assessment of the effectiveness of use should be under constant medical, biological and pedagogical control. It is important that the use of a complex of ergogenic pharmacological agents is expedient and most effective if it is not constant, but is used during preparation microcycles, and drugs and biologically active additives vary according to the tasks. Based on this, the training methodology should remain the main link in achieving optimal physical performance, and pharmacological correction should be an auxiliary, albeit a very important component. And, of course, it should be remembered that only registered drugs can be prescribed to an athlete, as well as drugs that are not prohibited for use by the IOC Medical Commission (not related to the WADA-2008 Prohibited List). 1.2. The main pharmacological preparations and dietary supplements in elite sport Adaptogens are natural low-toxic biologically active substances (drugs and dietary supplements) that increase the body's resistance to adverse (extreme) environmental factors, such as physical and psychological stress, stress, hypoxia, heat , cold, Sport pharm&diet.indb 17 04/07/2008 18:42:26 18 CHAPTER 1 overcoming climatic zone zones, etc. The non-specific action of adaptogens is determined by an increase in resistance to the harmful effects of a wide range of factors of physical, chemical and biological nature. Adaptogens have a positive effect on the processes of excitation and inhibition in the central nervous system , thereby having a normalizing effect on the body, regardless of the direction of unwanted changes. Biogenic stimulants, the exact chemical structure of which has not been finally established, are fundamentally different from adaptogens. They have a stimulating effect on the body as a whole, as well as on reparative and sexual functions. Biogenic stimulants are prepared from animal or vegetable raw materials, registered as drugs or biologically active food supplements. Nootropic drugs are drugs that have a direct activating effect on the ability to learn, improve mental activity and memory (mnestic effect), including motor, and also increase the resistance of brain tissues to stress (neuroprotectors). A characteristic property of nootropic drugs is their antihypoxic activity. Nootropics stimulate the learning process, facilitate the transfer of information between the hemispheres of the brain, normalize cerebral circulation, enhance energy processes in the brain, increase the ability to master new complexly coordinated motor skills. Antihypoxants improve the utilization of oxygen by the body and reduce the need for it in organs and tissues, increasing resistance to hypoxia. The prophylactic use of antihypoxants can be considered as a measure aimed at accelerating the recovery process of athletes. Antioxidants either directly scavenge free radicals or stimulate the body's own antioxidant system. The obligatory inclusion of this group of drugs in the complex pharmacological correction is due to their proven properties of correcting disturbed energy metabolism and increasing physical performance. Plastic drugs - pharmacological drugs, biologically active substances and dietary supplements, which at all stages of sports training affect biosynthetic processes, especially the synthesis of nucleic acids and proteins in the body of athletes. The anabolic process provides an increase in plastic resources (restoration of proteins, carbohydrates and fats that have decayed during the life process). Permitted anabolic drugs include some pharmacological drugs, animal products (including bee products - they are described below), homeopathic remedies, dietary supplements. Beekeeping products are mainly presented in Ukraine today as Apilac tablets - a preparation made from dried royal jelly. Sport pharm&diet.indb 18 04/07/2008 18:42:26 Pharmacological agents for maintaining and increasing physical performance 19 One tablet taken in the morning once a day contains 10 mg of the active ingredient. In other countries, royal jelly preparations are produced that are not registered in Ukraine, such as Apiserum (France), Apifortil (Germany), Longivex (Canada), Lacapnis (Bulgaria), Epirginol, Fitadone, Melcalcin (Romania). It should be noted that fresh royal jelly is more effective than dried royal jelly. In Romania, Apigum chewing gum is produced. Pollen products not registered in Ukraine, such as the dietary supplement Politabs-sport, are recommended for weightlifting and to speed up recovery in other sports. According to French scientists, flower pollen accelerates growth and weight gain, increases appetite. Pollen never causes allergies and the formation of antibodies in the body. In Russia, flower pollen is produced in tablets weighing 0.4 g under the name "Cernilton", which is used 2 tablets three times a day before meals. Flower pollen is also produced in granules. The minimum daily dose should be at least 2.5 g. It is impossible to take flower pollen and royal jelly inside, because they are destroyed by digestive juices in the stomach. Therefore, these funds are taken only sublingually (under the tongue), where they are absorbed into the bloodstream, bypassing the gastrointestinal tract. Means of energy action (energizers), including macroergs - biologically active substances, which, on the one hand, are themselves donors of energy products (ATP, glucose, creatine, L-carnitine, etc.), and on the other hand, indirectly increase the endogenous content in the body of biomacromolecules that are involved in muscle contraction (hormones, metabolites of the tricarboxylic acid cycle, and many others). Means of energy action contribute to the restoration and creation of energy depots, increase glycogen stores, accelerate the transport of fatty acids from the cytoplasm to mitochondria. ATP, creatine phosphate and glucose are energy sources in the anaerobic-aerobic performance zone. With prolonged physical work, they activate glycolysis. Certain food products, homeopathic remedies, a number of pharmacological preparations, dietary supplements, products of increased biological value: honey, perga, nuts, pollen and preparations from them - can affect bioenergetics muscle contraction , they significantly increase the physical performance of athletes. Immunomodulators are used to maintain an adequate state of the body's immune system, the protective properties of which are often reduced during intense physical and psycho-emotional stresses inherent in elite sports. Immunosuppression is also caused by frequent changes in climatic and time zones. Suppression of the immune system indirectly affects physical performance (not to mention susceptibility to infections). It is preferable to use low-toxic herbal preparations as immunomodulators. Sport pharm&diet.indb 19 07.04.2008 18:42:26 20 CHAPTER 1 Enterosorbents have become an integral component of maintaining physical performance, as they bind and remove from the body toxic substances accumulated during intense muscular work that can adversely affect the cardiovascular, respiratory, immune system and hematopoiesis. Hematological homeostasis in the body is supported by hematopoietic stimulants, as well as means for improving microcirculatory processes and the rheological state of the blood (disaggregants). This group of pharmacological agents stimulates erythropoiesis, increasing the number of erythrocytes - hemoglobin carrier cells, and also ensures normal blood flow in small blood vessels, maintaining oxygen transport at a level adequate to physical activity. The main representatives of the listed groups of non-pinging pharmacological agents used in sports medicine to improve performance include the following drugs and dietary supplements (Table 1.1). Table 1.1. The main groups of drugs used at the stages of athletes' training Name of the pharmacological group Pharmaceuticals and dietary supplements 1 General tonics, adaptogens Common ginseng, Rhodiola rosea (golden root), Manchurian Aralia, Zamaniha (high echinopanax), Leuzea safflower-like (maral root), Eleutherococcus prickly, Schisandra chinensis, *RUS OLYMPIC (Russia, dietary supplement), *Alivit (drug containing flower pollen), *Elton, *Leveton, *Fitoton, *Adapton, Pantokrin, Tsygapan, liquid aloe extract, Solcoseryl, Actovegin, Mummy, sea buckthorn oil , rosehip oil 2 Metabolic nootropics Aminolone (Gammalon), Ginkgo biloba and preparations based on it (Memoplant, Bilobil, Tanakan, etc.), Phezam, Glycine, Cerebrolysin, Picamilon, *Ligam, Actovegin, Nootropil (Piracetam), Encephabol, Phenibut, Sodium hydroxybutyrate, *Neuro-butal, Pantogam Neuroprotectors Acetyl-L-carnitine (L-carnitine), Phosphatidyl-serine, Pentoxifylline, Vinpocetine (Vincamine), Nicergoline, Vinkonat, Nimodipine (Cinnarizine, Flunarizine), Mexidol and other antioxidants ( Dibunol, *Exifon, *Tyrilazide mesylate, *Pyritinol, *Meclofenoxate, Aterovit, Tocopherol acetate), Glycine, *Biotredin (cytochrome C), Mexidol, *Mexicor, Cardonat, Reamberin, Limontar, Melatonin, Quercetin, Corvitin Sport pharm&diet.indb 20 07. 04.2008 18:42:26 Pharmacological means for maintaining and increasing physical performance 21 Continuation of the table. 1.1 Pharmacological group name Pharmaceuticals and dietary supplements 5 Antioxidants Ceruloplasmin, Dibunol (ionol), Tocopherol acetate, *Epadol, Essentiale-forte, Lipin, YantarIn, glutamic acid, Actovegin, Kratal, Vitam, Cardioplant, *Exifon, *Tirilazide mesylate, *Pyritinol , *Meclofenoxate, Aterovit, *TAD-600 (Tationine), *Biotad, *Epargreciovit 6 Vitamins Vitamins A and B, vitamin C, vitamin D, vitamin E, Calcium pantothenate, folic acid, nicotinic acid and Nicotinamide (PP vitamin) , Rutin and Askorutin Minerals *BioManganese, *Zincas and Zincas forte, Zincteral, *BioZinc, Zincite, *Zincuprin ol and *Zincuprin forte, *BioCopper, *Oligogal Selenium, Selenium-Active, Triovit, *Selenohel, *Oxytex, *Asmag forte, * Biomagnesium, Magne B6, Magnesol, * Magnerot, * Chromohel, Chromium picolinate, Sorbifer durulex, * Maltofer, Tardiferon, FerroFolgamma, * Bio Potassium, * Potassium-normin, Calcium gluconate, Calcium lactate, Vitrum Calcium +, Vitamin D3, CalciumD3 Nycomed, Calcium-Sandoz forte, *Iodine-Active Vitamin complexes Biovital, Van-e-day maximum, Vitamount for women and Vitamount for men, Vitamax-plus with antioxidants, Vitamin-15 Solko, Vitalux, Vitrum and Vitrum plus, Geriavit Farmaton, Geriamin, Glutamevit, Kvadevit, * GumetR, Duovit, Ipkavit-M, * Epargresiovit Vitamin and mineral complexes Kal-s-Vita, Beresh Plus drops, * Kobidek N, Materna, Mistermin, Multibionta plus calcium and magnesium, Multibionta Junior, Nutrisan, Ol-Amin Oligovit, Pedivit Forte, Plenil, Polivit geriatric, Supradin Roche, Triovit, Walsh Polivit for adults, Upsavit Multivitamin, Fenyuls, Ferro-vital, Ferromax, Ferro-Folgamma, Centrum, Endur VM, Unicap M 7 Immunomodulators Interferon , Laferon, Cycloferon, * Proleukin, Levamisole, Immunal, Ribomunil, Bronchomunal, Echinacea, T-activin, Thymogen , * Layflak, Aminon, Alvezin, Ekdisten and preparations containing leuzea safflower extract (Leveton, Adapton), * Dymatize Super amino 4800, * Aminoven Infant (Aminoven Infan), Riboxin (* Inosie-F), Energomax Tribulus, * Tribesterone 1500 (TribeSterone 1500), *Bemitil, Antihot, Energomax Carnimin, Energomax Pantogan, *SintraEC (SyntraEC), Max-Amino, amino acids (USA, dietary supplement) 9 Macroergic *Ezafosfina (Esafosfina, Italy, Biomedica Foscama, drug), * Repolar (Repolar, Italy, Biomedica Foscama, dietary supplement), * Dimephosphone, * Phosfaden (Adenosine monophosphate, Adenil, Fosfostimol), Neoton (Phosphocreatine, Neoton), ATP-LONG Sport pharm&diet.indb 21 07. 04.2008 18:42:26 22 CHAPTER 1 End of the table. 1.1 The name of the pharmacological group Pharmaceuticals and dietary supplements Other energy- L-carnitine (as well as *Elkar® and *Carnifit®, which are respectively 20% and 10% solutions of L-carnitine), *SWOLE, *Neovis (NEOVIS, NEOVIS Plus and NEOVIStres), Coenzyme Q10, “Coenzyme Q10 Super Potency”, *Nitrix (Nitrix, BSN and Nitrox II, Sci Fit), *Methoxy-7 (Methoxy-7), *Ipriflavone (Ipriflavone) , Panangin (asparkam), Actovegin-forte (solcoseryl), Mildronate, succinic acid preparations such as YantarIn and YantariInDetox, Sodium succinate (a salt of succinic acid; its Russian counterparts: *mitomite, *yantovit, *enerlit), *Isostar (Isostar ), Speed ​​Booster and Speed ​​Booster plus one (Speed ​​Booster), *Series “Fit Active” and “Fit Active with L-carnitine” (Feet Active, Feet Active with L-Karnitine), *Target Max (Сell Max), adaptogens of vegetable and animal origin 10 11 12 Enterosorbents Atoxil, *Attapulgite, Belosorb-P, *Karbedon® and *Karbedon®M, *Panzisorb, Polysorb MP, *Silard, *Ensoral, Enterosgel, Enterosorbent Other means of restorative orientation Stimol, *Aerobitin, * Secretagog-1, * ZMA (ZMA), Antilactate Disaggregants Xanthinol nicotinate (Complamin), Pentoxifylline (Agapurin, Trental), Cavinton, Lipin, Instenon, Ticlopidin, Clopidogrel, Dipyridamole (Curantil), * Abciximab, * Eptifibatide (Integrilin), *Tirofiban (Agrostat), *Lamifiban, *Prefolik Stimulators of hematopoiesis (erythropoiesis) Ceruloplasmin, Ritmokor; multivitamin complexes; preparations containing iron (aloe syrup with iron, Ferroplex, Tardiferon, * Fefol-vit, Hemofer, * Feramid, Venofer, iron fumarate, Ferbitol, * Ferkoven, Ferrum-lek, * Ferakryl, * Ferlatum, * Ferlixide); beekeeping products Hepatotropic preparations Antral, Galstena, Gepabene, Hepar Compositum, Hepatofalkplanta, Heptral, Zixorin, lipoic acid, Legalon, Leprotek, Silymarin-Hexal®, Thiotriazolin, Flamin, Phospholip, Cholagogum, Holiver, Hofitol, Citrarginine, Essentiale and Essentiale forte Note . An asterisk marks funds that are not registered in Ukraine. The most preferred for use in modern practice of sports training are the following drugs. 1. Among the general tonic and adaptogens - Schisandra chinensis, which has a pronounced psychostimulating effect; products based on Leuzea safflower (maral root) and RUS OLYMPIC, which have an anabolic effect due to the presence of ecdysteroids in their composition; Gygapan, which is also a source of trace elements; Solcoseryl, which has a reparative effect, and Actovegin, which has Sport pharm & diet.indb 22 07. 04.2008 18:42:26 Pharmacological agents for maintaining and increasing physical performance 23 2. 3. 4. 5. 6. 7. 8. antihypoxic effect. Means of this group have practically no contraindications, the development of psychomotor agitation is possible from undesirable effects (especially typical for Schisandra chinensis), so it is advisable to take them in the morning. Among the metabolic nootropic drugs are ginkgo biloba and preparations based on it (Memoplant, Bilobil, Tanakan, etc.), hallmark which is a pronounced positive effect on cerebral circulation, as well as a direct antioxidant effect); Glycine, which has a sedative effect; Phenibut, which has a sedative and anti-stress effect; Sodium oxybutyrate, which has a sedative and hypnotic effect, and with prolonged use, anabolic effect; Neurobutal (a distinctive feature is the improvement of “fighting” qualities, an increase in aggressiveness). Among neuroprotectors, the most preferred are Acetyl-L-carnitine, Pentoxifylline, Vinpocetine (Vincamine, Nicergoline, Vinkonat), Mexidol and other antioxidants, primarily Dibunol, *Exifon, *Tyrilazide mesylate, *Pyritinol. Among the few representatives of the class of actoprotectors are Optimizer (Ukraine, dietary supplement, actoprotector of emergency action), Bemitil (*Bemaktor), Antihot (the most effective actoprotector of accumulative action), *Tomerzol. Bemitil and Antihot are especially effective against the background of a high-carbohydrate diet and the simultaneous use of Eleutherococcus preparations and branched hydrocarbon chain amino acids (BCAAs); incompatible with barbiturates. In general, drugs in this group have very low toxicity. Among the antihypoxants are * Olifen (Gipoxen), Cytomac (Cytochrome C), Mexidol (* Mexicor), Limontar, Quercetin (Corvitin). Among the antioxidants that are representatives of different pharmacological groups of drugs are Ceruloplasmin (a drug for intravenous drip), Dibunol (Ionol), Tocopherol acetate, Aevit, *Epadol, YantarIn, *Exifon, *Tirilazide mesylate, *Pyritinol, *TAD-600 and *Biotad containing reduced glutathione, *Epargresiovit (in the form of a solution for injection). Among vitamin preparations - vitamins of groups A and B, vitamin C, vitamin D, vitamin E, calcium pantothenate, folic acid, nicotinic acid and nicotinamide (vitamin PP), rutin and ascorutin. Vitamin preparations have low toxicity, but it should be remembered that toxic effects of fat-soluble vitamins (A and D) are possible, so their recommended doses should not be exceeded! Among the mineral complexes - *BioManganese, *Zinkas and Zinkas forte, Zincteral, *BioZinc, Zincite, *Tsinkuprin and *Tsinkuprin forte, *BioCopper, *Selenohel, *Oxytex, *Asmag forte, *BioMagnesium, Magne B6, Sport pharm&diet.indb 23 07.04.2008 18:42:26 24 CHAPTER 1 9. 10. 11. 12. 13. 14. Sport pharm&diet.indb 24 BioKalium, Vitrum Calcium +, vitamin D3, Calcium-D3 Nycomed, Calcium-Sandoz forte, * Iodine-Active; among vitamin complexes - Biovital, Van-e-day maximum, Vitamount for women and Vitamount for men, Vitamax plus with antioxidants, Vitamin-15 Solko, Vitrum and Vitrum plus, Duovit, * Epargresiovit. It should be remembered that some trace elements (zinc, manganese, cobalt, copper, iron, nickel, selenium) exhibit a toxic effect in case of an overdose, so the recommended doses should not be exceeded. Monopreparations of microelements should preferably be prescribed under the control of the content of the corresponding microelements in the blood. Among the vitamin-mineral complexes are Cal-s-vita (Switzerland), Beresh Plus drops, * Kobidek N, Supradin Roche, Ferro-foilgamma, Centrum. When prescribing these drugs, one should be aware of the danger of an overdose of fat-soluble vitamins and some trace elements! Among the immunomodulators are Interferon, Laferon (Biopharma, Ukraine) and Cycloferon, * Proleukin, Immunal, Ribomunil, Bronchomunal, Echinacea, Immunoton, T-activin. Among the means of plastic action - Potassium orotate, Fructose, Aminosol, Lipofundin, *Bodiform, *Detox+, *Layflak, Aminon, Alvezin, "RUS OLYMPIC", *Dymatize Super amino 4800, *Aminoven Infant (Aminoven Infant), *SintraES ( SyntraEC), * Inosie-F (more effective than all other inosine preparations), Energomax Tribulus, * Tribesterone 1500 (TribeSterone 1500), * Bemitil, Antihot, Energomax Carnimin, Energomax Pantogan, BCSA-Extra. Among macroergs - * Ezafosfina, Neoton (Phosphocreatine, Neoton), * Repolar (Repolar), * Phosphaden (Adenosine mono-phosphate, Adenil, Fosfostimol), ATP-LONG. Other energizing agents include L-carnitine (as well as *Elkar® and *Karnifit®, which are 20% and 10% L-carnitine solutions, respectively), *SWOLE, *Neovis (NEOVIS, NEOVIS plus and NEOVIStres) , Coenzyme Q10, Coenzyme Q10 Super Potency, * Nitrix (Nitrix, BSN and Nitrox II, Sci Fit), * Methoxy-7 (Methoxy-7), * Ipriflavone (Ipriflavone), Mildronate, succinic acid-based products, such as YantarIn and YantariIn-Detox, * Isostar (Isostar), * Speed ​​Booster and Speed ​​Booster one (Speed ​​Booster, Weider), * Series "Fit Active" and "Fit Active with L-carnitine" (Feet Active, Feet Active with L -Karnitine), *Target Max (Сell Max). Among the enterosorbents are Enterosgel (a highly effective enterosorbent based on silicon oxide), Belosorb-P, *Karbedon® and *Karbedon®-M, *Ensoral (all four preparations are fifth-generation carbon enterosorbents), *Panzisorb (a combined preparation of a carbon enterosorbent with digestive enzymes ). There are practically no contraindications to the use of enterosorbents, but the course, 07.04.2008 18:42:27 Pharmacological agents for maintaining and increasing physical performance 25 15. 16. 17. trace elements. Among the restorative agents are Stimol, Antilactate, * Aerobitin (Aerobithin), * Secretagog-1 (Secretogog one), * ZMA (ZMA). Stimol, Antilactate and Aerobitin are especially effective for athletes who specialize in cyclic sports, while Secretagog-1 and ZMA are effective “night” restorers. There are practically no contraindications to the use of drugs in this group. Among the antiplatelet agents are Ticlopidin, Clopidogrel, acetylsalicylic acid, *Abciximab, *Eptifibatide (Integrilin), *Tirofiban (Agrostat), *Lamifiban, *Prefolic, Trental. It should be remembered that among preparations of acetylsalicylic acid (aspirin), it is better to give preference to Canadian-made products. Among the stimulants of hematopoiesis (erythropoiesis) - Ceruloplasmin, * Ferlixit, preparations containing iron (aloe syrup with iron, Tardiferon, * Fefol-Vit, Hemofer, * Feramid, Venofer, iron fumarate, Ferbitol, * Ferkoven, Ferrum-lek, * Ferakril , *Ferlatum, *Ferlixit). The combination of Ceruloplasmin with iron preparations (for example, with Ferlixit) is rational. Hemopoiesis stimulants should be used under hematological control. Among hepatotropic drugs - Antral, Galstena, Citrarginine (participates in the neutralization of ammonia), Hepabene, Hepar compositum (homeopathic drug), Hepatofalk-plant, Heptral (has, in addition to hepatoprotective, antidepressant properties), Zixorin (an inducer of the system of microsomal liver enzymes involved in detoxification of xenobiotics), lipoic acid, Legalon, Leprotek, Silymarin Hexal®, Thiotriazolin, Flamin, Phospholip, Cholagogum, Holiver, Hofitol, Essentiale and Essentiale forte (phospholipid hepatoprotectors). It is rational to combine two or three hepatoprotectors with different mechanisms of action. When prescribing funds from this group, it is especially necessary to take into account not only sports specialization and the period of training, but also the individual characteristics of each athlete: for example, phospholipid hepatoprotectors are contraindicated in cholestasis. 1.3. General features and features of pharmacological support of physical performance among representatives of various groups of sports Physical activity in accordance with the classifications of sports (by the nature of activity, duration of work, belonging to team or individual competitions) is divided into five main groups or groups Olympic sports sports (Platonov, 2004). Sport pharm&diet.indb 25 04/07/2008 18:42:27 26 CHAPTER 1 Cyclic Views sports require a predominant display of endurance. They combine high-speed endurance with good coordination of movements. Cyclic sports include athletics, swimming, rowing, kayaking and canoeing, cycling, short track, and winter views- skating, ski race. The main functional system is the cardio-respiratory (cardiovascular and respiratory system), providing - the neuromuscular apparatus. These sports require metabolic support, appropriate specialized nutrition and drinking (maintenance of water balance), especially during marathon distances, when energy sources switch from carbohydrate (macroergic phosphates, glycogen, glucose) to lipid ones and a real threat of body dehydration is created. Significant importance both in predicting and in the process of correcting working capacity with the help of pharmacological preparations is the control of hormonal status. From pharmacological agents, first of all, energy sources are needed: high-energy phosphates, glycogen and glucose, metabolites of the Krebs cycle, as well as means of plastic action, vitamin-mineral complexes. speed sports, distinctive feature which is explosive, short in time and very intense physical activity. Speed-strength sports include weightlifting, track and field jumping and throwing, winter sports - ski jumping. The main functional system is the neuromuscular apparatus, which provides - the cardio-respiratory system. All throwers and weightlifters require special control over specialized nutrition and a shift from the catabolic phase of metabolism to the anabolic phase without the use of prohibited steroids and somatotropin, which is achieved by using anabolic agents, macroergic phosphates and other energizers, plastic substrates. Mandatory are also drugs or dietary supplements, the action of which is focused on reducing the intensity of lipid peroxidation processes (antioxidants), and adaptogens of plant origin, which contain physiologically active substances of antioxidant action. Combat sports, a characteristic feature of which, when expending energy, is an unstable, cyclical level of physical activity, depending on the specific conditions of the rivalry and sometimes reaching very high intensity. TO martial arts include boxing, fencing, freestyle wrestling, Greco-Roman wrestling, judo, taekwondo. The main functional system is the neuromuscular apparatus, which provides - the cardio-respiratory system. Sport pharm&diet.indb 26 04/07/2008 18:42:27 Pharmacological agents for maintaining and increasing physical performance 27 Effective is the use of permitted anabolic agents (Ekdisten and others) and sources of complete protein. It should also be borne in mind that these sports in most cases are quite traumatic, which can cause microcirculation and metabolic disorders in the brain, therefore, nootropic drugs and antiplatelet agents, such as Pentoxifylline (Trental), Clopidogrel, Dipyridamole, should be used as protectors ( Curantil), Tirofiban (Agrostat), Prefolic (Italy, the drug is not registered in Ukraine), etc., as well as the new generation drug Abciximab (ReoPro), which is a monoclonal antibody obtained by a biotechnological method and has a pronounced affinity for platelet receptors, which ensures powerful, very fast and long antiaggregatory effect (not registered in Ukraine). playing sports, or sport games, are characterized by a high physical and neuropsychological load, the presence of complex coordination movements, elements of martial arts against the background of intense game thinking with a significant load on the upper and lower limbs, as well as the constant alternation of intense muscle activity and rest. Game types include basketball, badminton, baseball, softball, handball, football, water polo, field hockey, ice hockey, table tennis, beach volleyball, curling. The main functional system is the cardio-respiratory system, providing - the neuromuscular apparatus, the visual analyzer, as well as operational game thinking. The tasks of pharmacological support are related to the correction of recovery processes, energy compensation, improvement of metabolic processes in the brain with the help of vitamin complexes, nootropic drugs, adaptogens of plant and animal origin, as well as antioxidants. Complicated coordination sports are based on the finest elements of movement, which require considerable endurance and attention, as well as on the combination of the dynamic mode of work of some muscles with the static efforts of others. Complex coordination types include sports gymnastics, artistic gymnastics, diving, trampolining, trap shooting, bullet shooting, archery, synchronized swimming, sailing, rowing slalom, equestrian; winter views - figure skating, freestyle, bobsleigh, skiing, luge, snowboarding, skeleton. Of great importance is the increase in mental stability with the help of herbal preparations of a calming effect (valerian, hawthorn without alcohol components, Picamilon), the use of nootropic drugs, vitamin complexes, products containing a large number of energy substrates (liver, egg yolk, seafood, bee products, creamy and vegetable oils, etc.). Regardless of the specialization of an athlete, maintaining and improving their physical performance is key point to achieve high sports results. Sport pharm&diet.indb 27 07.04.2008 18:42:27 28 CHAPTER 1 The factors that limit the performance of athletes include a wide variety of organic and functional conditions, which are accompanied by a lack of metabolites, oxygen, changes in acid-base balance, a decrease in the reactivity of the immune system, a violation of prooxidant- antioxidant balance, changes in microcirculation and aggregate state of blood. For the correct selection of pharmacological agents in case of violation of certain aspects of the functioning of the athlete's body, you can use the following table (Table 1.2). Table 1.2. Parameters that limit human performance, and the principles of their pharmacological correction Parameters Mechanisms for reducing performance and recovery Physical performance. Means for correction Depression of the central and peripheral nervous systems Central fatigue, decrease in conditioned reflex activity, speed of movement formation Sharply reduced. Adaptogens, nootropics, vitamins Insufficient functioning of the endocrine system Metabolic imbalance (carbohydrates, proteins, fats, immunoglobulins, water, electrolytes and others) Limited. Vitamins, antioxidants, special nutrition Reduced function of the cardiovascular system, cardiac arrhythmia, microcirculation in small coronary vessels, myocardial contractility, peripheral vascular tone (with overstrain, overtraining) Decrease in blood flow, transport of oxygen (hypoxia) and nutrients to working muscles Absent or reduced . Cardioprotectors (inosine, creatine phosphate, triphosphadenine), antiarrhythmic drugs, beekeeping products and others Weakening of respiratory function (with excessive physical exertion) Lack of oxygen in the blood and tissues (hypoxia) Reduced. Respiratory analeptics of a non-pinging structure (ammonia), antihypoxants (Hypoxen, Cytochrome C), antioxidants (vitamin E, etc.), adaptogens Violation of microcirculation Decreased blood supply Sharply reduced. intensively working muscles, Antiplatelet agents, antispasmodics, tissue hypoxia, phosphodiesterase and adenosine receptor inhibitors Changes in rheological properties and blood clotting Decrease in blood flow rate, up to stasis during microthrombosis, hypercoagulation, thromboembolic conditions Sport pharm&diet.indb 28 Significantly reduced. Anticoagulants of direct and indirect action, fibrinolytic drugs, antispasmodics, nootropics 07. 04.2008 18:42:27 Pharmacological agents for the maintenance and increase of physical performance 29 Continuation of the table. 1.2 Parameters Shifts in acid-base balance to the acidic side Decreased energy supply to working muscles Mechanisms for reducing performance and recovery Changes in blood buffer capacity, acidosis Lack of glycogen, ATP, creatine phosphate, L-carnitine, lipids, proteins Physical performance. Means for correction Moderately reduced. Preparations that shift the pH to the alkaline side (sodium bicarbonate), alkaline mineral water Significantly reduced. Carbohydrate saturation, L-carnitine, bee products, PPBC Functional deficiency of vitamins, trace elements, electrolytes, water (dehydration) During high physical exertion, the concentration of fat- and water-soluble vitamins, electrolytes, microelements and water decreases (especially in a marathon) Reduced. Vitamins and their complexes with electrolytes and microelements, adaptogens, preparations based on leuzea and tribulus Inhibition of cellular respiration in working muscles Disturbance of electron transport in the respiratory chain, synthesis of macroergs, uncoupling of respiration and phosphorylation Reduced. Adaptogens, fat- and water-soluble vitamins, nootropics, specialized drinks Initiation of free-radical processes during superintense loads and the action of prooxidants Formation of hydroperoxides, toxic products, impaired functional lability of cell membranes and bioenergetic mechanisms Reduced. Antioxidants, antihypoxants, adaptogens, vitamins E and C Decreased immunological reactivity (cellular and humoral immunity) Risk factor for the development of banal infections, autoimmune processes Reduced. Immunomodulators, combined adaptogens, vitamins, biogenic stimulants, bee products (propolis, pollen) Decreased function of the liver, kidneys Hepatic pain syndrome, and other organs due to state-reactive pancreatitis, overtraining hypertrophy, liver trophy, impaired excretory function of the kidneys, etc. Reduced. Hepatoprotectors, antioxidants, PPBC, anti-inflammatory drugs, antibiotics Use of pharmacological drugs that inhibit metabolism Reduced. Cancellation of drugs that reduce physical performance, restoration of metabolism Sport pharm&diet.indb 29 Violation of the transport of electrons in the respiratory chain of mitochondria, ATP and creatine phosphate synthesis 07.04.2008 18:42:27 30 CHAPTER 1 1.2 Parameters Unbalanced nutrition of athletes. Reducing the calorie content of the diet Mechanisms for reducing performance and recovery Physical performance. Means for correction Violation of the ratios of the main food ingredients, imbalance of proteins, fats, carbohydrates, electrolytes, trace elements and vitamins Reduced. Correction of nutrition of athletes in accordance with energy costs and the period of sports training Thus, any pharmacological preparation recommended by a doctor must correspond to a certain column of the table. So, for example, antioxidants, immunomodulators and macroergic phosphates are located in different columns. It is advisable to create combined drugs that affect several factors that limit performance, as well as the processes of adaptation and recovery. The use of pharmacological agents is closely tied to the period, stage, micro- and macrocycle of sports training and therefore has its own specifics. Sports training in the annual cycle usually begins after the competition with a transitional (recovery) period. This is followed by the general preparatory stage of the preparatory (basic) period of training, when the athlete must increase the overall physical strength, speed, endurance. Then special physical training begins, which is characterized by the improvement of the skills necessary in a particular sport. Immediately before the competition, already developed skills are improved and consolidated. During the competition, the level of physical and emotional stress reaches its maximum. At this time, it is necessary to create all conditions for the fulfillment of the task set by the coach, and, if necessary, for urgent recovery, if starts (fights, fights) follow one after another at short intervals. There is a certain specificity of carrying out restoration activities related to the time until the next start. Planned recovery is extended in time, which makes it possible to use sports bases, rehabilitation centers, sanatoriums or medical institutions for this purpose. Restorative measures are aimed at freeing the athlete's body from the accumulated ballast metabolic products. Emergency recovery is usually carried out within a day or even a few hours, and therefore requires rapid implementation in the conditions where the competition takes place. Sport pharm&diet.indb 30 07.04.2008 18:42:27 Pharmacological agents for maintaining and increasing physical performance 31 Pharmacological support in these schemes is different. For example, with urgent recovery, protein-carbohydrate-lipid mixtures, vitamins and trace elements, Esophosphine, Repolar, Neoton, Reaton and parenteral nutrition can be used. For convenience, all recovery tools are divided into two groups - tactical and strategic. Tactical means - biologically active substances that allow solving today's problems, i.e. promptly restore the athlete after a heavy physical and nervous load. These means include vitamins and their complexes, energy products, carbohydrate-protein-lipid mixtures, carbohydrate saturation, bee products, adaptogens of plant and animal origin, hepatoprotectors, nootropics, immunomodulators, antioxidants, etc. Strategic means ensure the fulfillment of planned tasks - conservation muscle mass , maintaining a high tone and desire to train, as well as to participate in competitions with an attitude to win. These drugs include non-doping anabolics of plant or animal origin, enterosorbents, energy drugs, actoprotectors, as well as nootropics, neuroprotectors and psychomodulators that are not on the WADA Prohibited List. When developing schemes of pharmacological support, one should take into account the correction of factors that limit sports performance. This streamlines the regimen and reduces the number of drugs used for existing indications for use. Depending on the cycle of the training process, certain tasks of pharmacological support prevail. In the transitional period, the main tasks are the release of toxins accumulated in the body after intense physical work, as well as the removal of overvoltage (for medical reasons). For this purpose, vitamins and their complexes, macro- and microelements, immunomodulators, antioxidants, enterosorbents and other drugs are used. In the preparatory period (general and special preparatory stages) with intensive physical work, the main emphasis is on strengthening and supporting anabolic processes and immunity in the body with the help of adaptogens, plastic drugs, immunomodulators, antioxidants, protein-rich nutrition. In the competitive period, the tasks of pharmacological support are subordinated to the creation and timely replenishment of the energy depot in the athlete's body, the fight against an increase in the concentration of free radicals, and the prevention of injuries and diseases. Pharmacological agents are also used that affect the formation of high-energy phosphates (creatine preparations, ATP-LONG, Neoton, Reaton, Ezafosfin, etc.) and parenteral nutrition rich in carbohydrates (carbohydrate saturation). Creation of Sport pharm&diet.indb 31 04/07/2008 18:42:27 32 CHAPTER 1 of the energy depot provides for the use of high-carbohydrate or lipid-rich foods in the diet, depending on the specifics of the work performed, as well as foods of increased biological value. In conclusion, it should be emphasized that there are no universal biologically active drugs that could increase the performance of any athlete. This is due to the fact that sports differ significantly in terms of the level of physical activity, the duration and power of the work performed, the accuracy of the task, the need for concentration and many other qualities, therefore, the individualization of the developed pharmacological support schemes should be based on the study of the main parameters of the biochemical and hematological homeostasis of athletes taking into account gender and age differences, their psychophysical characteristics, it should be tied to the sport, to the stage and period of sports training. Depending on the energy supply of sports groups, the power of loads and the level of lactate in the blood, various means of pharmacological support can also be used (Table 1.3, Markov et al., 2006). There are no universal schemes for the use of non-pinging pharmacological agents of an ergogenic orientation; however, there are developed general approaches to the creation of such schemes, which, of course, should be individualized depending on the tasks facing the athlete, the stage of preparation, the degree of training, the state of health and objective indicators of the homeostasis of the athlete's body. Below (Table 1.4) is an approximate list of recommended medicines and dietary supplements for the preparation of individual pharmacological programs in the annual cycle of training by type of sports activity. These drugs are widely used in world practice and do not contain doping ingredients, although not all of them, unfortunately, are currently registered in Ukraine. It is not recommended to use more than five to seven drugs and dietary supplements at the same time, and with the obligatory consideration of their compatibility. Assign funds in the annual cycle of training should take into account the cyclicity (course appointment) and tolerance to them, since the body of athletes adapts to the uniformly used means of recovery, therefore, variable, individual complexes depending on the sport, period (stage) of sports training. Sport pharm&diet.indb 32 04/07/2008 18:42:27 Sport pharm&diet.indb 33 04/07/2008 18:42:27 Psychostimulants, corticosteroid hormones and ACTH, carbohydrate saturation, bee products (honey, pollen, propolis), adaptogens, vitamins , Creatine phosphate, L-carnitine, etc. Psychoenergizers; means that enhance anabolic processes; pituitary and adrenal hormones; carbohydrate-protein-lipid mixtures, carbohydrate saturation; vitamins and microelements; bee products, hydrobionts; plant and animal adaptogens 7–12 6–9 4–6 Up to 4 Glycolytic (glycolysis in muscles, acceleration of glucose transport into the cell) lasting from 30 s to 1.5 minutes Submaximal power Mixed aerobic-anaerobic with a predominance of anaerobic processes, lasting from 1 .5 to 10 minutes. Speed ​​endurance: middle-distance running, game and speed-strength types High power With a predominance of aerobic processes, lasting from 15–20 minutes. Middle distance running, cross-country skiing, skating, swimming, etc. Average power Aerobic, lasting several hours. All sports with an overwhelming manifestation of endurance (marathon distances) Moderate power Medications that enhance anabolic processes corticosteroids, growth hormone, ACTH, insulin with glucose, L-carnitine, acetyl-L-carnitine, vitamins and trace elements, bee products, carbohydrate saturation, vegetable adaptogens and animal origin Psychostimulants, psychoenergizers, drugs of energy action - ATP, Neoton, glucose with vitamin C; carbohydrate saturation, beekeeping products, adaptogens, vitamins, antioxidants Groups of used pharmacological preparations and dietary supplements 7–12 Lactate, mmol/l Anaerobic, lasting 10–20 s. Short work: sprint, speed-strength, team sports, martial arts Maximum power Energy supply of sports activities, duration and power of the work performed Table 1.3. Pharmacological means to improve sports performance in different groups kinds of sports depending on energy supply, duration and load power 34 CHAPTER 1 Table 1.4. An approximate list of recommended medicines and dietary supplements for compiling individual schemes of pharmacological support by types of sports activities and stages of preparation Preparatory period Competitive period I. Cyclic sports Aerobic focus: Supradin, Antihot, Energomax Reishi multivitamin, Aerobitin, Stimol, vitamins C, E and groups B, Epadol, Olifen, Carnitine, Inosie-F, Riboxin, Panangin (Asparkam), Potassium orotate, Solcoseryl, Essentiale, Immunal, Legalon, Schisandra chinensis, Ensoral based on them, safflower-like leuzea and products based on it (Ekdisten), Rhodiola rosea, Creapur, Crea-energy, Ezophosphina, Neoton, Repolar, fructose-mineral-vitamin drinks Aerobic-anaerobic glycolytic focus: vitamin-mineral complexes with a predominant content of group vitamins B and E, Cygapan, Epadol, YantarIn, Mildronate, Inosie-F, Riboxin, Panangin (Asparkam), Actovegin, Olifen, Mexidol (Mexicor), ginkgo biloba and products based on it, Nootropil, Picamilon, RUS-OLIMPIK, Reaton, Ezafosfina, Aminoven Infant, fructose-mineral-vitamin drinks II. Speed-strength types Vitamins A, C, E, Epadol, Actovegin, Creapur, Crea-energy, Neovis, Potassium orotate, Riboxin, Inosie-F, products containing amino acids, Aminoven Infant, Ekdisten, ginkgo biloba and products based on it, Nootropil, Picamilon, Panangin (Asparkam), Solcoseryl, Nitrix, ZMA, Secretogog-1 Epadol, RUS-OLYMPIC, Nitrix, Cygapan, Creapur, Crea-energy, Inosie-F, Panangin (Asparkam), Energomax Tribulus, Actovegin, fructose- amino-acid-mineral-vitamin drinks, “Speed-Booster” series III. Combat sports Vitamins C, E, Epadol, Energomax Reishi vitamin / trace elements, Esophosphina, Riboxin, Inosie-F, Panangin (Asparkam), Solcoseryl, Ekdisten, Nootropil, Picamilon, Phezam, Atcephen, Lipofundin, Aminoven Infant, Schisandra chinensis, Essentiale, Heptral, Karsil, Olifen, Echinacea, Immunoton, Ferlixit, Trental, Ticlopidin Energomax Tribulus, RUS-OLIMPIK, Metoxy 7, Secretogog-1, Schisandra chinensis, Actovegin, Magnerot, Inosie-F, Neurobutal, Repolar, Panangin (Asparkam), Creapur , Reaton, Creaenergy, Neurobutal, Epadol, beekeeping products and products based on them IV. Game types Vitamins C, E, Epadol, Energomax Reishi vitamin / trace elements, Solcoseryl, Inosie-F, Magnerot, BioKalium, Potassium-normin, ATP-LONG, Regidron, Ekdisten, Rhodiola rosea, Interferon (Laferon), Immunal, Reaton, Biotad , SWOLLE, Legalon, Essentiale, Nootropil, Picamilon, ginkgo biloba and preparations based on it, Phezam, Ticlopidin, Enterosgel Sport pharm&diet.indb 34 Duovit, Supradin, Epadol, YantarIn, RUSOLIMPIK, Ezophosphina, Repolar, Nootropil, Neurobutal, Actovegin, Eleutherococcus , Acetyl L-carnitine, Biotredin, Panangin, Quercetin, Reaton, Isostar 07. 04.2008 18:42:27 Pharmacological means to maintain and increase physical performance 35 End of the table. 1.4 Preparatory period Competitive period V. Competitive species Mildronate, L-carnitine, Jezafosfina, Biotad, Ritmokor, Supradin, Schisandra chinensis, Lipin, Limontar, Eleutheroccus, Nootropil, Actovegin, Pentoxifylline, Phezam, Picamilon, Ceruloplasmin, Holiver, Hofitol, Heptral Jezafosfina , Biotad, Repolar, Metoxy 7, Phosphaden, Reaton, Schisandra chinensis, Nootropil, Actovegin, Mexidol (Mexicor), vitamins A and E, Olifen, Antral, Gepabene, Glutargin Note. Several representatives of one group of pharmacological agents are given, which should be prescribed by a sports doctor, taking into account the individual characteristics of the athlete and the microcycle of training. 1.5. Pharmacological provision of stages and periods of training of athletes in the macrocycle 1.5.1. Preparatory period In the preparatory period, both at the general and at the special preparatory stage, with intensive physical work, the main emphasis is on strengthening and supporting anabolic processes and the state of the body's immune system with the help of adaptogens, plastic drugs, enriched protein nutrition, immunomodulators , antioxidants. Means for correcting microcirculation and the rheological state of the blood, antianemic drugs, in particular iron preparations, are useful. The psycho-emotional state is corrected with the help of nootropics (Tables 1.5 and 1.6). 1.5.2. Competitive period In the competitive period, the tasks of pharmacological support are subordinated to the creation and timely replenishment of the energy depot in the athlete's body and the fight against an increase in the concentration of free radicals. The creation of an energy depot is carried out with the help of a specialized rich in carbohydrates (carbohydrate saturation) or lipids, depending on the specifics of the work performed, and parenteral nutrition (amino acid preparations, lipids). Products of increased biological value are used (honey, bee bread, nuts, pollen and preparations from them), as well as pharmacological agents that affect the formation of ATP, creatine phosphate, etc. In a simplified form, recommendations for the recovery of athletes contain, for example, the following schemes: for representatives speed-strength sports - Potassium orotat in combination with Inozie F; Carnitine and Cobamamide (vitamin B12 preparation (for throwers); the same in combination with vitamin E (for weightlifters); during the period of increase training loads - Glutamic acid, potassium and magnesium aspartate, Lecithin, Eleutherococcus extract and vitamin C (Table 1.7). Sport pharm&diet.indb 35 04/07/2008 18:42:27 Sport pharm&diet.indb 36 04/07/2008 18:42:27 ++ ++ + ++ ++ – + + – – – + – ++ ++ + ++ ++ Vitamin-Energy- Macro-mineral tonics ergi complexes ++ ++ Plastic substrates ++ ++ ++ ++ + Nootropics + + – ++ + + + – + – Antiantioxidants poxants + ++ + ++ + + ++ + + ++ ++ ++ ++ + + ++ – + + Vitamin and mineral complexes ++ ++ Plastic substrates + – – ++ – Energy tonics – – – ++ ++ Macroergic + ++ ++ ++ ++ Adaptogens + + + ++ + + Nootropics + – + + – Antioxidants Groups of pharmacological agents + + ++ + ++ Antihypoxants Note. Sign “–” means not used, “+” means it is desirable, “++” means it is mandatory. Cyclic Speed-Power Complicated Coordination Martial Arts Game Groups of Sports Table 1.6. Pharmacological support of the special preparatory stage of the preparatory period – + – + + + + + ++ ++ + + + ++ ++ – – – + + Antiaggregants – + – + – Antiaggregants pharmacological agents Note. Sign “–” means not used, “+” means it is desirable, “++” means it is mandatory. Cyclic Speed-Power Complicated Coordination Martial Arts Game Groups of Sports Table 1.5. Pharmacological support of the general preparatory stage of the preparatory period Sport pharm&diet.indb 37 07.04.2008 18:42:28 – – – – Speed-strength Complicated coordination Martial arts Game + – – – – Vitamin and mineral complexes + + + ++ ++ Energy tonics + + + ++ + + ++ ++ + ++ ++ Macroergics Adaptogens ++ ++ ++ + + Nootropics Groups of pharmacological agents + + – + + + + Speed-strength Complicated coordination Martial arts Game ++ + – + ++ Energy tonics + + + + + Enterosorbents + + ++ ++ + Adaptogens – – + – Nootropics + + + Antioxidants Groups of pharmacological agents Note. Sign “–” means not used, “+” means it is desirable, “++” means it is mandatory. + Vitamin and mineral complexes Cyclic Groups of sports Table 1.8. Pharmacological provision of the transitional period + - - - ++ Antihypoxants - - - - + + + + + + Antihypoxants tropic ++ ++ Antioxidants Note. Sign “–” means not used, “+” means it is desirable, “++” means it is mandatory. – Plastic Substrates Cyclic Groups of Sports Table 1. 7. Pharmacological provision of the competitive period + + + + + Immunomodulators + – – – – Antiaggregants 38 CHAPTER 1 1.5.3. Transitional period In the transitional (recovery) period, the main tasks are to get rid of toxic metabolic products accumulated in the body during intense physical work, with the help of drugs with antioxidant and hepatotropic orientation, as well as to relieve overstrain for medical reasons. For this purpose, vitamins and their complexes, macro- and microelements, immunomodulators, antioxidants, adaptogens and other drugs are used (Table 1.8). 1.6. Recommendations for individual schemes of pharmacological support of sports training When drawing up a plan for the medical and biological support of an athlete in a particular group of sports, the following must be done. Choose individual schemes taking into account functional features, sports and psycho-emotional qualities. Determine the function of the athlete's body that needs to be corrected and normalize it with the help of pharmacological preparations, dietary supplements and a reasonable diet. invert Special attention on energy supply, respiratory function associated with the consumption, transport and consumption of oxygen, the state of the content of free radicals in the body, the functions of the immune system, nervous and endocrine systems, as well as natural detoxification organs (liver, kidneys), with the help of which accumulated toxic metabolic products. Do not overload the athlete's body with substrates and enzymes that are responsible for the formation of energy-rich products that provide movement (Neoton, ATP, Glucose, vitamins, microelements, etc.), since their excess will be removed from the body as unnecessary and unused, which will require additional energy necessary for the body with increased muscular work. Take into account the dynamics of the intensity of physical activity in the annual cycle of the athlete's training and link the pharmacological support program to the fulfillment of the tasks set by the coach (general and special physical training, pre-competitive and competitive activities), as well as to micro-, meso- and macrocycles, taking into account days of rest (without taking pharmacological agents). Sport pharm&diet.indb 38 07.04.2008 18:42:28 Pharmacological means to maintain and increase physical performance 39 Remember that different athletes, when using the same pharmacological agents, the effect on the body can vary significantly. This also applies to the mechanism of action (pharmacodynamics), and bioavailability, and biotransformation (pharmacokinetics). The individual susceptibility of athletes to the same drug will also be different. If it is necessary to influence the parameters of the athlete's physical performance, first of all, it is necessary to identify the factors limiting performance in order to influence them with the help of drugs and dietary supplements. The management of this process and its scientific and methodological substantiation are usually called performance monitoring and pharmacological correction of human performance, including recovery and adaptation to physical activity. Sport pharm&diet.indb 39 04/07/2008 18:42:28 Sport pharm&diet.indb 40 04/07/2008 18:42:28 Chapter 2 Fundamentals of sports dietetics as one of the ergogenic factors 2.1. The main provisions of the organization of nutrition of athletes The medical and biological means of restoring and improving the physical performance of athletes, in addition to pharmacological preparations, include “rational nutrition, vitaminization, the use of dietary supplements and products of increased biological value” (Seifulla, 2003). It should be noted that rational nutrition is in the first place among those named, therefore, the competent use of its common features and characteristics among athletes specializing in various types, is an important characteristic of preparation for competitions. The needs of athletes for basic nutrients (nutrients) differ markedly from the needs of individuals who are not systematically affected by intense physical activity. This is due to the fact that the energy costs in many sports exceed the energy costs of ordinary people by three to six times. In athletes on days of intense training and competition, they usually exceed 5000–6000 kcal. The need for certain food components depends on age, body weight, gender, type of sports activity, climatic conditions, season. With modern training and competitive loads daily energy costs sometimes reach 8,000 kcal (and in some cases - tournament games, cross-country skiing, marathon running - exceed 10,000 kcal), which requires special approaches in compiling balanced diets. At the same time, it is necessary not only to replenish the amount of calories from proteins, fats, carbohydrates, but also to provide the diet with a sufficient amount of vitamins, micro- and macroelements, which play a huge role in maintaining physical performance. The main problem in the nutrition of athletes is that with traditional meals (breakfast, lunch, afternoon tea, dinner) it is impossible to consume the necessary amount of food to cover the daily energy expenditure on intense training and competition days. Therefore, quite often athletes experience a deficiency of certain nutrients, difficulties in certain types of energy transformations and / or in an increase in the proper level of overall energy supply. In this case, there is an increased risk of developing fatigue and a state of overtraining, reducing resistance to diseases and the effects of adverse factors (adaptation). 2.2. Characteristics of the main nutritional components and features of their use in sports nutrition The athlete receives the predominant part of the substances necessary for the normal functioning of the body with food. A properly constructed diet allows an athlete to balance the amount of drugs and synthesized additives necessary to replenish energy and plastic substrates, enzymes and coenzymes. The main nutrients that make up the diet are proteins, fats, carbohydrates, vitamins, minerals. 2.2.1. Proteins and features of their consumption in sports nutrition Proteins in the diet of athletes usually account for no more than 10–15% of the energy received from food. But the main purpose of proteins is not limited to meeting energy needs. Proteins are the main building material in the body, necessary for the growth and maintenance of the structural integrity of actively functioning organs and tissues. Proteins are also necessary for the construction of digestive enzymes, they are involved in the formation of antibodies in the body's immune defense system. Proteins are polymeric compounds made up of amino acids. Amino acids (there are 24 in total), of which the proteins of the human body are built, are divided into two groups - interchangeable and irreplaceable. Most of the amino acids (arginine, aspartic acid, glutamic acid, histidine, glycine, tyrosine, proline, serine, alanine, cystine), which are involved in metabolism and are part of proteins, can be supplied with food or synthesized in the body in the process of metabolism from other amino acids. coming in excess. They are called non-essential amino acids. Some amino acids (valine, isoleucine, leucine, lysine, methionine, threonine, tryptophan, phenylalanine) cannot be synthesized in the body and must be supplied with food. These are essential amino acids. Sport pharm&diet.indb 42 07.04.2008 18:42:28 43 Fundamentals of sports dietetics as one of the ergogenic factors Through nutrition, the body of athletes must receive the entire set of essential amino acids, since their lack in food leads to a weakening of body functions and the development of disease states. To ensure the supply of amino acids in the required quantities and optimal ratios, food should be varied in terms of the content of proteins of both animal and vegetable origin. Closest to amino acid composition muscle tissue human amino acid composition of whey proteins, and in terms of the content of essential amino acids and branched chain amino acids (eng. BCAA) - valine, leucine and isoleucine - whey proteins are superior to all other proteins of animal and vegetable origin. Branched-chain amino acids during their metabolism are the main initiating factors in the elimination of energy deficiency and create conditions for the favorable flow of energy-dependent synthetic processes, including the formation of glycogen. The daily protein requirement for athletes averages about 1.5 g of protein per 1 kg of body weight. However, it should be noted that due to differences in the metabolic activity and functions of individual amino acids, it is difficult to ensure their optimal ratio in food. Because of this, as well as the individual characteristics of metabolism, various amino acid preparations and mixtures are widely used in the nutrition of athletes, in which the optimal ratios of all essential amino acids are observed. In addition, athletes who specialize in different types sports, amino acid requirements may vary depending on the intensity of the exercise and body weight. In table. 2.1 such data are given, for example, for game types sports. Table 2.1. Recommended consumption rates (in grams) of essential branched-chain amino acids in the basic nutrition of athletes specializing in team sports Body weight, kg Leucine Valine Isoleucine 40 2.4 2.0 0.8 50 3.0 2.5 1.0 60 3.6 3.0 1.2 70 4.2 3.5 1.4 80 4.8 4.0 1.6 90 5.4 4.5 1.8 100 6.0 5.0 2.0 110 6.6 5.5 2.2 120 7.2 6.0 2.4 Sport pharm&diet.indb 43 07.04.2008 18:42:28 44 CHAPTER 2 specific structural and enzymatic proteins determines the achieved training effect of the load, which is directly related to the increase in sports performance indicators. Together with the increased expenditure on the performance of muscular work, the processes of disintegration of specific protein structures that carry the main load during work are activated in the body, and the breakdown products of proteins are formed - peptides, peptones and amino acids. About 35% of the resulting amino acids are removed from the body during decay and excretion, and the remaining 65% enter the general amino acid fund of the body. Replenishment of amino acids removed from the body is carried out through the specialized nutrition of athletes, in which all essential amino acids must be present. However, without the use of specific endogenous anabolizers and complete protein nutrition, it is difficult to achieve a significant increase in protein synthesis and fix the training effect caused by the applied load, since the body's own proteins are not always able to provide the biochemical basis for the adaptive effect of training. Based on the above facts, it can be argued that in order to increase the effectiveness of training in the nutrition of athletes, a variety of protein products both plant and animal origin, as well as specially selected amino acid mixtures together with anabolic (non-doping) non-hormonal activators. 2.2.2. Fats and features of their consumption in sports nutrition Fats are the second most important source of energy in the body after carbohydrates. They account for 20 to 30% total consumed energy. Fats are used not only as a substrate for energy transformations, but also serve as a necessary element in the construction of cell membranes, and also regulate the activity of certain hormones and enzymes that catalyze key metabolic reactions in the body. Fats are made up of glycerol and fatty acids. When they are mobilized from intracellular fat depots (the process of lipolysis), they are broken down into their constituent parts. Fats are divided into saturated and unsaturated, depending on the degree of saturation of their fatty acids (food sources of various fats are presented in Table 2.2). Fats of animal origin are characterized by a high content of saturated (limiting) fatty acids and are used mainly for energy purposes. Vegetable fats contain large amounts of unsaturated (unsaturated) fatty acids, which are used to build cell membranes and perform catalytic functions. Sport pharm&diet.indb 44 04/07/2008 18:42:28 45 Fundamentals of sports dietetics as one of the ergogenic factors Table 2.2. Dietary Fat Sources Cholesterol Sources Saturated Fat Sources Eggs, Liver, Meat, Poultry, Eggs, Meats, Poultry, Fish, Marine Dairy Products, Dairy Products, Palm Oil, Owl Coconuts, Palm Nut Oils, Hydrogenated Oils (Margarine) Sources of Unsaturated Fats Vegetables oils - olive, sunflower, soybean, corn, peanut oil; avocados, as well as fish that live in cold waters Saturated and unsaturated fatty acids differ not only in their chemical and physical properties, but also in biological activity and value for the body. Saturated fatty acids are significantly inferior in biological properties to unsaturated fatty acids. The most pronounced biological properties are the so-called polyunsaturated fatty acids - linoleic, linolenic and arachidonic acids. They are not synthesized in the human body (which is why they are sometimes called vitamin F) and form a group of so-called essential fatty acids, i.e. vital to humans. These acids differ from true vitamins in that they do not have the ability to enhance metabolic processes, but the body's need for them is much higher than for true vitamins. The food consumed by athletes should contain a large amount of unsaturated fatty acids, which are easily included in the metabolic processes during physical exertion and are necessary to maintain the structural integrity of cell membranes. Saturated fatty acids usually account for no more than 10% of the total calories received from burning fat in the body. Athletes' food should contain the required amount of easily digestible fats of dairy and vegetable origin. In addition, it should contain products rich in essential fatty acids - linoleic and linolenic, arachidonic, easily included in metabolic processes during physical activity and necessary to maintain the structural integrity of cell membranes. The use of fats as an energy material is especially important in situations where the duration of play activity exceeds 1.5 hours, as well as in conditions of low ambient temperature, when fats are used for thermoregulation. However, it should be borne in mind that for the full use of fats as an energy material in the tissues, a high oxygen tension must be maintained, otherwise there will be an accumulation of underoxidized products of fat metabolism, which is associated with the development of chronic fatigue during long work . Despite the fact that fat is an important energy substrate, it should not be consumed in excessive amounts, as this leads to a feeling of heaviness in the stomach, which causes Sport pharm&diet.indb 45 07.04.2008 18:42:28 46 CHAPTER 2 drowsiness, disrupts adequate absorption of carbohydrates. Because fats are digested more slowly than proteins and carbohydrates, pre-competition meals should be low in fat. Thus, it is quite possible to satisfy the need for fats through the use of natural products. But in the nutrition of athletes, special food mixtures are often used that contain easily digestible fats of vegetable and animal origin, as well as fatty acids and activators of fat metabolism in tissues. In sports nutrition products, medium chain triacylglycerols (MCTs) are often used, which are obtained by partial hydrolysis of polyunsaturated fatty acids and have all their inherent properties. They provide twice as much energy as proteins and carbohydrates, and at the same time are the least involved in the formation of body fat. 2.2.3. Carbohydrates and features of their consumption in sports nutrition Adequate provision of bioenergetic processes is primarily associated with carbohydrates, the content of which in the diet of athletes usually ranges from 60 to 70% of the total amount of energy supplied to the body with food. The daily intake of carbohydrates with food should be from 500 to 1000 g for athletes - an average of about 10 g per 1 kg of body weight (Table 2.3). Table 2.3. Daily requirement for carbohydrates (in grams) depending on body weight and duration of training sessions Body weight, kg Total daily duration of training sessions, hours 500 600 700 800 900 70 500 600 700 800 900 1000 80 600 700 800 900 1000 1100 90 700 800 900 1000 1100 1200 100 800 900 10 00 1100 1200 1300 110 900 1000 1100 1200 1300 1400 120 1000 1100 1200 1300 1400 1500 The dose should include both simple sugars (glucose, fructose, sucrose) and complex polymeric forms of carbohydrates (starch, fiber). Sport pharm&diet.indb 46 07.04.2008 18:42:28 47 Fundamentals of sports dietetics as one of the ergogenic factors Their ratio in consumed foods may vary depending on the nature of the forthcoming muscle work. In the food used before performing intensive, but relatively short-term work, simple sugars (glucose, fructose) in an easily digestible form (fruit juices, drinks, jellies) should be presented to a greater extent. In the diet prior to the performance of a game activity of variable or moderate intensity, along with simple sugars, complex polymeric forms of carbohydrates (fiber, starch) should also be presented. A common problem in the diet of athletes who specialize in those sports that require a large expenditure of energy is an insufficient amount of carbohydrate food and an excess of fat. Such a diet is not justified primarily due to the fact that the body's energy reserves mainly consist of fats and proteins, and only to a small extent - of carbohydrates (Table 2.4). Table 2.4. Athletes' energy source reserves Name of tissue energy source reserves Approximate amount of total energy source reserves: Time during which the energy source can provide performance during: days of walking minutes of marathon running grams kJ days of fasting 9000 337 000 34 10.8 4018 Liver glycogen 90 1500 0.15 0.05 18 Muscle glycogen 350 6000 0.6 0.20 71 Blood and extracellular fluid glucose 20 320 0.03 0.01 4 8800 150 000 15 4.8 1800 nutrition of athletes is determined by the role of muscle glycogen, which ensures performance in both aerobic and anaerobic glycolytic modes. The time of work in these regimes until exhaustion is directly related to the initial glycogen store in the working muscles, which consumed food of 2800 kcal/day. With a low-carbohydrate diet, 1200 kcal/day is supplied from carbohydrates, and with a high-carb diet, 2300 kcal/day. At the same time, the maximum duration of work is highest with a diet enriched with carbohydrates (Table 2.5). Sport pharm&diet.indb 47 04/07/2008 18:42:28 48 CHAPTER 2 Table 2.5. Dependence of the maximum duration of work on the carbohydrate component of the diet of athletes Indicator Duration of work to failure at oxygen consumption of 75% of the maximum, min Diet Low-carbohydrate Mixed High-carbohydrate 57 114 167 energy cannot be considered The best way meet the body's carbohydrate needs. A single consumption of a large amount of carbohydrates creates a high “sugar” load on the pancreas, which produces insulin, which is necessary for the absorption of carbohydrates in tissues. At the same time, most of the carbohydrates that enter the body during digestion are directed to the creation of intracellular reserves of carbohydrates in the form of glycogen, and part, due to their high concentration in the blood, is excreted from the body through the kidneys. In such a situation, if the muscle load falls on a period of time far removed from a meal (after three to four hours), the most loaded organs and tissues may experience relative hypoglycemia (a decrease in sugar concentration) due to the impossibility of rapid mobilization of carbohydrates from intracellular depots. . Therefore, athletes under intense training and competitive loads are advised, along with carbohydrate intake at breakfast, lunch and dinner, to distribute most of their daily dose to intermediate meals in the form of fruits and fruit juices, specially prepared carbohydrate drinks, tea, coffee, chocolate, cookies. and so on. Consuming a significant amount of simple carbohydrates, especially glucose, causes a sharp increase in blood sugar levels. In addition, the systematic intake of an excess amount of easily digestible carbohydrates into the body can cause the development of diabetes mellitus, and an excess of simple carbohydrates in a significant amount contributes to the increased development of adipose tissue. Elevated levels of insulin in the blood helps to accelerate this process, since in this case, insulin has a powerful stimulating effect on fat synthesis. Carbohydrates supplied with food are converted into glycogen, which is deposited in tissues and forms a depot of carbohydrates, from which, if necessary, the body draws glucose, which is used to provide energy for various physiological functions. The main organs in which significant amounts of glycogen are deposited are the liver and skeletal muscles. For a complete recovery after intensive physical activity it is necessary to replenish glycogen stores in the liver and muscles. Glycogen resynthesis is a rather slow process (only 5% per hour), which takes about 48 04/07/2008 18:42:28 Sport pharm&diet.indb Basics of sports diet as one of the ergogenic factors 49 20 hours and requires a large amount of carbohydrates. The exception is the first two hours after training (the so-called protein-carbohydrate window), during which the recovery rate increases to 7-8%. Ukrainian scientists (Levin, Nour, 1996) have developed rational nutrition schemes, which are additional incentives for the creation of muscle glycogen stores by a combination of diet and training loads. The reason for this was the fact that athletes, in whose diet a high-carbohydrate diet replaced a protein-fat diet, combined with heavy training loads, had greater stores of muscle glycogen compared to a conventional mixed diet that preceded the use of a high-carbohydrate one. On the basis of these data suggesting the stimulation of an increase in glycogen stores above normal levels after a period of hard training with a sharply depleted diet, a “classic technique” was developed to achieve “supercompensation” of muscle glycogen. It consisted in such sequential actions within the training microcycle. 1. Two training sessions with a high load intensity are carried out to deplete muscle glycogen stores. 2. Over the next three days, planned training sessions are held against the background of a protein-fat diet. 3. During the next three days of relative rest or significant reduction in load, a typical high-carbohydrate diet (contains 90% carbohydrates) is used. This method of carbohydrate supercompensation is recommended to be used in the precompetitive microcycle. However, in its practical use, certain problems may arise associated with the individual characteristics of athletes. In particular, some of them do not tolerate extremely low (with a protein-fat diet) or extremely high (90%) carbohydrate content in dietary patterns. Therefore, before using such a scheme of supercompensation of muscle glycogen before the competition, its effectiveness (tolerability) for specific athletes should be checked at the preliminary stages of training. If an athlete does not tolerate this extreme version of muscle glycogen supercompensation, a milder modified version of the impact on the body in the last pre-competitive microcycle can be used. This modified plan to stimulate muscle glycogen supercompensation consists of exercising at 70–75% of maximal oxygen consumption, decreasing from 90 to 40 minutes over three days, on a relatively low-carbohydrate diet (50% carbs, about 350 g per day). After that, within two days, the duration of training loads is reduced Sport pharm&diet.indb 49 04/07/2008 18:42:28 50 CHAPTER 2 to 20 minutes, but with a diet richer in carbohydrates (70% carbohydrates, about 500–600 per day) and then finally follows the pre-competition rest day with the same high-carbohydrate diet. General rules for the use of carbohydrates in sports 1. Use foods high in carbohydrates in the diet in small portions throughout the day, since a high-carbohydrate diet, compared to a regular diet, increases glycogen stores in the liver and muscles by 45%. 2. Take carbohydrate-protein drinks such as Gainer (gainers), containing complex carbohydrates, one to two hours before training session, which will increase the reserves of glycogen and amino acids before exercise. 3. Consume an energy drink like Carbo (5-10% carbohydrate content) during a training session, at the rate of 0.5-1.0 liters for every hour of training, which will increase the efficiency in a training session by 30-35% and significantly reduce the breakdown of muscle protein and use it for energy needs. 4. Take a carbohydrate-protein drink such as Mass Gain, containing complex carbohydrates, immediately after a training session, which will maximize the replenishment of glycogen stores depleted during the training session and accelerate the recovery processes in the muscles. 2.2.4. Vitamins and mineral elements and features of their consumption in sports nutrition Along with the main nutrients - proteins, fats and carbohydrates - in the nutrition of athletes, it is necessary to provide for the timely and complete replenishment of the need for vitamins and microelements, which are used in active enzyme complexes and ensure the maintenance of the active properties of biological membranes . Vitamins are essential for normal life organic compounds with high biological activity, which are not synthesized in the body and must be supplied with food. Vitamins are divided into two groups - water-soluble and fat-soluble. There is also a group of vitamin-like compounds (Table 2.6). Almost all vitamins are directly or indirectly involved in protein synthesis in the body, so they must be present in the diet of athletes or in sufficient quantities food additives. The main food sources of vitamins are vegetables, fruits, vegetable and animal oils, meat, milk (Table 2.7). Sport pharm&diet.indb 50 07.04.2008 18:42:29 51 Fundamentals of sports dietetics as one of the ergogenic factors Table 2.6. Classification of vitamins Water-soluble Fat-soluble Vitamin-like B1 - thiamine A - retinol P - bioflavonoids B2 - riboflavin D - calciferols B13 - orotic acid B3 - pantothenic acid E - tocopherols B15 - pangamic acid PP - nicotinic acid Bt - carnitine B6 - pyridoxine N - choline B12 - cyanocobalamin F - lipoic acid Bc - folic acid U - methylmethionine H - biotin C - ascorbic acid Table 2.7. Vitamin content in foods Name of vitamins Sources β-carotene, carotenoids Carrots, dark green leafy vegetables, tomatoes, oranges, orange-colored fruits and berries (apricots, sea buckthorn) B1 (thiamine) Black bread, grain bread and other unrefined cereal products, legumes, pork, potatoes, vegetables, nuts, liver B2 (riboflavin) Whole milk and dairy products, cheese, meat, liver, eggs, green leafy vegetables B6 (pyridoxine) Brown bread, meat, poultry, liver, fish, potatoes, vegetables, whole milk and dairy products, eggs, bananas, nuts VZ (pantothenic acid) Brown bread and other unrefined foods