KIN 424 RED-S, doping, diving

definition and cause of RED-S

• Impaired physiological functioning caused by relative energy deficiency

  • Metabolic rate 

  • Menstrual function

  • Bone health 

  • Immunity

  • Protein synthesis 

  • Cardiovascular health

EEE

the additional energy expended above that of daily living during the exercise bout 

• In women healthy physiological function = 45 kcal/kg FFM/day 

• Low Energy availability < 30 kcal/kgFFM/day 

• Difficult to calculate 

energy availability equation

energy intake (EI)(kcal) - exercise energy expenditure (EEE)(kcal) / fate free mass (ffm) (kg)

health consequences of RED-S

• Munstral function 

• Bone health 

• Cardiovascular 

• Phychological 

performance consequences of RED-S

• Decrease muscle strength 

• Decrease coordination 

• Depression 

• Impaired judgement 

prevention of RED-S

• Education 

• Screening 

presentation of RED-S

• Weightloss 

• Lack of normal growth and development 

• Lack of normal growth 

• Endocrine dysfunction 

• Mood Changes 

treatment of RED-S

• Eating patterns want them to restore normal body weight 

• Red and yellow require immediate medical evaluation and treatment 

• Multidisciplinary - sport dietician, physician 

• Resistance to training increased with sevarity 

definition of doping

• The use or attempted use of prohibited substances 

• Use or attempted use by an athlete of a prohibited substance or a prohibited method 

• Failing without compelling justification to submit to sample collection 

classes of methods and substances

• anabolic agents

• beta agonists

• hormone antagonists

• salbutamol and pharmacogenomics

• oxygen transfer

• gene doping

anabolic agents

- Anabolic affect and anticatabolic effect 

- Human growth hormone, erythropoetin, insulin

beta agonists

- Asthma medication 

salbutamol and pharmacogenomics

enhances endurance

enhancement of oxygen transfer

homologous blood doping: - not using your own blood

autologous blood doping: - using your own blood

erythropoietin: - creates more blood cells

gene doping

• viral injections

• non-viral

blood passport programme

• Measurements of athletes blood taken over time to find normal ranges of key variables 

• Helps detect doping. EPO

• Can be cheated 

Describe the risks around supplements and foodstuffs

• Substitution of ingredients 

• Adulteration: intentional debasing of food quality 

  • Economic audlteration = cheaper ingredients 

  • Pharmaceutical audlteration = active drugs 

• Food stuffs 

  • Athletes need to be advised that certain foods or drinks can contain prohibited substances 

• IOC needle policy 

  • Needle for substances administration prohibited need medical exception 

boyle’s law

• Pressure of a given mass is inversely proportional to its volume 

henry’s law

• The amount of gas that dissolves in a liquid is directly related to its pressure 

what are the different types of squeezes

• Ear Squeeze 

  • Pressure difference between middle and outer ear

• Risk Factors 

  • Ear infection 

  • Upper respiratory tract infection 

  • Difficulty clearing ears 

• Sinus Squeeze 

  • If poor communication to nose 

  • Congestion, edema, bleeding 

  • Pain

• Mask squeezes

  • ​​from wearing mask while diving

  • Rising up too fast can increase pressure in mask

  • Can affect vision

• Dental squeeze

• Suit squeeze

  • From tightness of suit

shallow water blackout

o   normal dive: - dive after normal breathing

• as you hold breath underwater, O2 levels drop while CO2 levels rise

• CO2 levels determine trigger for need to breathe

• CO2 levels rise to threshold before O2 levels drop to threshold of blackout

o   Hypocapnia dive: - hyperventilation before diving

• Hyperventilation reduces CO2 levels which helps hold breath for longer

• O2 levels begin to drop as CO2 levels rise

• CO2 levels have been reduced so it will take longer to reach threshold to trigger urge to breathe

• O2 levels will reach blackout level before CO2 levels increase enough to trigger breathing

how is asthma related to diving

• Asthma causes air way obstruction 

• Airway obstruction can cause gas trapping 

• Gas trapped at depth can expand on ascent 

• Generally if symptom free they can dive 

• Should not dive if asthma is brought on by water or cold exercise 

• No good evidence that asthmatics are at increased risk of barotrauma

Hyperbaric exposures

SCUBA diving: - open circuit

• Each breath is only used once

• The expired gasses will be released

• Creates bubbles in water

Rebreathers: - closed circuit

• Each breath is used more than once —> expired gases aren’t released

• Rarely used

Umbilical divers: - air supply comes from the surface

• Connected to above water

Hyperbaric chamber exposure

Breathhold / free diving: - single breath

• Competition, recreational, commercial

decompression sickness

• Happens during ascent/depressurization 

• Due to gas bubbles being formed and trapped in blood 

• muscoskeletal DCS

• neurological DCS

• cutaneous DCS

decompression sickness symptoms

• Squeezes, joint pain, numbeness, cough, dyspnoea, vision loss, headaches, itchiness, mottled skim

decompression sickness risk factors

• Rate of ascent, not following diving charts, dehydration, obesity 

decompression sickness prevention

• Use dive charts and computers -> do not exceed limits 

decompression sickness treatment

• Pre hospital -> oxygen, treat near drowning, fluids, emergency evac, hyperbaric chamber -> hospital 

AGE

• Arterial gas embolism 

• 5% will die 

• 50% will have complete recovery

AGE symptoms

• Cerebral - numbness, weakness

• Cardiovascular - myocardial infraction, cardiac arrest 

AGE treatment

• Prehospital - oxygen, emergency evac, treat near drowning if necessary, fluids, hospital 

Decompression Illness

INCLUDES: DCS & AGE

Immersion Pulmonary Edema

• Occurs in healthy swimmers 

• From increase in partial arterial pressure -> causes leaks 

Immersion Pulmonary Edema symptoms

• Platypnoea, chest tightness, cough, dyspnea, hypoxemia, death 

Immersion Pulmonary Edema risk factors

• Cold, exercise, heavy exertion in cold water 

Immersion Pulmonary Edema treatment

• Pharmacological medication 

Pulmonary barotrauma:

 - lung pressure injury that can occur from rate of ascent

o   Alveoli expands and can rupture

o   Causes air bubbles to enter blood vessels

o   Can enter chest cavity where it can cause lung to collapse

o   Gas trapping can cause this