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	<title>Comments on: Forget Steroids, Drink Coffee</title>
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	<link>http://www.medminded.com/2009/04/forget-steroids-drink-coffee.html</link>
	<description>Musings on Health, Medicine, and the Art</description>
	<pubDate>Fri, 30 Jul 2010 15:31:00 +0000</pubDate>
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		<title>By: Luke</title>
		<link>http://www.medminded.com/2009/04/forget-steroids-drink-coffee.html/comment-page-1#comment-28</link>
		<dc:creator>Luke</dc:creator>
		<pubDate>Mon, 04 May 2009 04:33:05 +0000</pubDate>
		<guid isPermaLink="false">http://www.medminded.com/2009/04/forget-steroids-drink-coffee.html#comment-28</guid>
		<description>Interesting, I wonder if any long term negative effects have been found. I may try this myself but with distance running instead of cycling. Good post though worth the read.
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		<content:encoded><![CDATA[<p>Interesting, I wonder if any long term negative effects have been found. I may try this myself but with distance running instead of cycling. Good post though worth the read.</p>
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		<title>By: Aaron B. Hicks</title>
		<link>http://www.medminded.com/2009/04/forget-steroids-drink-coffee.html/comment-page-1#comment-27</link>
		<dc:creator>Aaron B. Hicks</dc:creator>
		<pubDate>Mon, 04 May 2009 04:32:42 +0000</pubDate>
		<guid isPermaLink="false">http://www.medminded.com/2009/04/forget-steroids-drink-coffee.html#comment-27</guid>
		<description>"One trial of 25 subjects with an average increase of 6% is hardly statistically significant."

I would have to look at the numbers again, but the SD for the first study was somewhere in the range of 2-3%.


"That being said I would still be willing to wager at least a third of those athletes actually tested worse after taking caffeine."

See SD above.


"If the racers were tested independently I would also suggest that the first test might have been an unintentional warmup for the second trial. Or been some type of benchmark by which the racers sought to beat on the second trial."

The first 1-hour ride was an intentional warm up/benchmark--none of the participants took caffeine or placebo at that time. During the second trial, half the riders took caffeine and the other half received placebo. Presumably, as you also suggested, all the riders were trying to beat their first performance. Those who took caffeine, however, saw greater improvements in their speed/distance traveled than those who took placebo.

And I agree, the studies were done on small scales, so their applicabilities might be limited, but all the results were consistent enough (despite the scale) to reach a level of statistical significance, p=0.05.


"why wouldn't every racer be on it until they add it to the list of illegal enhancments?"

Caffeine is still on the World Anti-Doping Agencies 'watched substance' list. It was only removed in 2004. The WADA acknowledges the potential for abuse, and many cyclists seem to see it the same way--the honorable cyclist presumably abstains for ethical reasons.


Below are the WADA's reasons for removing caffeine from the 'banned substance' list and moving it to the 'watch substance' list. From "WADA 'Play True' Q&amp;A: 2009 Anti-Doping List":

1. Since 2004, caffeine has been included in WADA's Monitoring Program. This program includes substances which are not prohibited in sport, but which WADA monitors in order to detect patterns of misuse in sport.
2. Arguments that led WADA's stakeholders to take caffeine off the List in 2004 included research indicating that caffeine is performance-decreasing above the 12 icrogram/ml threshold that was historically used in sport. In addition, caffeine is metabolized at very different rates in individuals. Many experts believe that caffeine is ubiquitous in beverages and food and that reducing the threshold in order to unmask cheaters might therefore create a serious risk of sanctioning athletes for social or diet consumption of caffeine.
3. With this background, and since no excessive abuse of caffeine was observed in 2008 as part of the monitoring of this substance, caffeine was kept off the 2009 List and will remain in WADA’s Monitoring Program.
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		<content:encoded><![CDATA[<p>&#8220;One trial of 25 subjects with an average increase of 6% is hardly statistically significant.&#8221;</p>
<p>I would have to look at the numbers again, but the SD for the first study was somewhere in the range of 2-3%.</p>
<p>&#8220;That being said I would still be willing to wager at least a third of those athletes actually tested worse after taking caffeine.&#8221;</p>
<p>See SD above.</p>
<p>&#8220;If the racers were tested independently I would also suggest that the first test might have been an unintentional warmup for the second trial. Or been some type of benchmark by which the racers sought to beat on the second trial.&#8221;</p>
<p>The first 1-hour ride was an intentional warm up/benchmark&#8211;none of the participants took caffeine or placebo at that time. During the second trial, half the riders took caffeine and the other half received placebo. Presumably, as you also suggested, all the riders were trying to beat their first performance. Those who took caffeine, however, saw greater improvements in their speed/distance traveled than those who took placebo.</p>
<p>And I agree, the studies were done on small scales, so their applicabilities might be limited, but all the results were consistent enough (despite the scale) to reach a level of statistical significance, p=0.05.</p>
<p>&#8220;why wouldn&#8217;t every racer be on it until they add it to the list of illegal enhancments?&#8221;</p>
<p>Caffeine is still on the World Anti-Doping Agencies &#8216;watched substance&#8217; list. It was only removed in 2004. The WADA acknowledges the potential for abuse, and many cyclists seem to see it the same way&#8211;the honorable cyclist presumably abstains for ethical reasons.</p>
<p>Below are the WADA&#8217;s reasons for removing caffeine from the &#8216;banned substance&#8217; list and moving it to the &#8216;watch substance&#8217; list. From &#8220;WADA &#8216;Play True&#8217; Q&#038;A: 2009 Anti-Doping List&#8221;:</p>
<p>1. Since 2004, caffeine has been included in WADA&#8217;s Monitoring Program. This program includes substances which are not prohibited in sport, but which WADA monitors in order to detect patterns of misuse in sport.<br />
2. Arguments that led WADA&#8217;s stakeholders to take caffeine off the List in 2004 included research indicating that caffeine is performance-decreasing above the 12 icrogram/ml threshold that was historically used in sport. In addition, caffeine is metabolized at very different rates in individuals. Many experts believe that caffeine is ubiquitous in beverages and food and that reducing the threshold in order to unmask cheaters might therefore create a serious risk of sanctioning athletes for social or diet consumption of caffeine.<br />
3. With this background, and since no excessive abuse of caffeine was observed in 2008 as part of the monitoring of this substance, caffeine was kept off the 2009 List and will remain in WADA’s Monitoring Program.</p>
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		<title>By: Jesse</title>
		<link>http://www.medminded.com/2009/04/forget-steroids-drink-coffee.html/comment-page-1#comment-26</link>
		<dc:creator>Jesse</dc:creator>
		<pubDate>Mon, 04 May 2009 04:32:04 +0000</pubDate>
		<guid isPermaLink="false">http://www.medminded.com/2009/04/forget-steroids-drink-coffee.html#comment-26</guid>
		<description>A valid study or not, my dad strongly agrees that caffeine is a performance enhancer. He always has a strong cup of coffee before playing squash or racquetball to keep him going on the court. On those rare days he didn't get his afternoon coffee, he has significantly less energy to play another game and he says he feels sluggish on the court. I've tried drinking coffee before a workout too and felt that my stamina increased as I was able to run faster for a longer duration on the treadmill..
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		<content:encoded><![CDATA[<p>A valid study or not, my dad strongly agrees that caffeine is a performance enhancer. He always has a strong cup of coffee before playing squash or racquetball to keep him going on the court. On those rare days he didn&#8217;t get his afternoon coffee, he has significantly less energy to play another game and he says he feels sluggish on the court. I&#8217;ve tried drinking coffee before a workout too and felt that my stamina increased as I was able to run faster for a longer duration on the treadmill..</p>
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		<title>By: Nicholas</title>
		<link>http://www.medminded.com/2009/04/forget-steroids-drink-coffee.html/comment-page-1#comment-25</link>
		<dc:creator>Nicholas</dc:creator>
		<pubDate>Mon, 04 May 2009 04:31:39 +0000</pubDate>
		<guid isPermaLink="false">http://www.medminded.com/2009/04/forget-steroids-drink-coffee.html#comment-25</guid>
		<description>Interesting, however I do not find it very conclusive.

One trial of 25 subjects with an average increase of 6% is hardly statistically significant. Without knowing the standard deviation its hard to say exactly what the data is telling us. That being said I would still be willing to wager at least a third of those athletes actually tested worse after taking caffeine. I mean consider that in any given trial involving a measure of time you will NEVER finish exactly the same. Hence an increase of only 6% for 25 athletes without knowing the control settings to me is difficult data to pull any conclusions from.

Average is a very misleading adjective in studies this small, it implies that all did better but most of the time it is a false implication. Statistical manipulation is a crime and this looks pretty suspect.

Also I am not fond of the way the trials were set up. What time were the races, 8am and 3pm? I would imagine the morning run to naturally be a bit slower because it's 8am. Additionally were the participants together. Cycling is a pace sport not a straight race, as in you only ride as fast as you need to in order to win, saving energy for a strong finish. Perhaps the second race had a different dynamic after the racers had some interaction.

If the racers were tested independently I would also suggest that the first test might have been an unintentional warmup for the second trial. Or been some type of benchmark by which the racers sought to beat on the second trial.

Im not doubting that caffeine effects our bodies in a multitude of ways but I am questioning the validity of this study. Furthermore the idea that caffeine could give a racer the edge in a grueling stamina competition such as the Tour De France seems a bit far fetched. If 6% is the real edge then why wouldn't every racer be on it until they add it to the list of illegal enhancments?
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		<content:encoded><![CDATA[<p>Interesting, however I do not find it very conclusive.</p>
<p>One trial of 25 subjects with an average increase of 6% is hardly statistically significant. Without knowing the standard deviation its hard to say exactly what the data is telling us. That being said I would still be willing to wager at least a third of those athletes actually tested worse after taking caffeine. I mean consider that in any given trial involving a measure of time you will NEVER finish exactly the same. Hence an increase of only 6% for 25 athletes without knowing the control settings to me is difficult data to pull any conclusions from.</p>
<p>Average is a very misleading adjective in studies this small, it implies that all did better but most of the time it is a false implication. Statistical manipulation is a crime and this looks pretty suspect.</p>
<p>Also I am not fond of the way the trials were set up. What time were the races, 8am and 3pm? I would imagine the morning run to naturally be a bit slower because it&#8217;s 8am. Additionally were the participants together. Cycling is a pace sport not a straight race, as in you only ride as fast as you need to in order to win, saving energy for a strong finish. Perhaps the second race had a different dynamic after the racers had some interaction.</p>
<p>If the racers were tested independently I would also suggest that the first test might have been an unintentional warmup for the second trial. Or been some type of benchmark by which the racers sought to beat on the second trial.</p>
<p>Im not doubting that caffeine effects our bodies in a multitude of ways but I am questioning the validity of this study. Furthermore the idea that caffeine could give a racer the edge in a grueling stamina competition such as the Tour De France seems a bit far fetched. If 6% is the real edge then why wouldn&#8217;t every racer be on it until they add it to the list of illegal enhancments?</p>
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