|
The mainstream media made up their collective minds about what killed Steve Bechler before they even heard any of the facts. Don't be fooled. Read the truth written by scientists from Baylor University!
By: Richard B. Kreider, Ph.D., FACSM, EPC, FASEP
Mike Greenwood, PhD, CSCS*D
Lori Greenwood, PhD, ATC, LAT
Brian Leutholtz, PhD, FACSM
Exercise & Sport Nutrition Lab Center for Exercise, Nutrition & Preventive Health Research Baylor University
Important: This was written February 21, 2003 in response to media inquiries they received in their lab. Note that they have NO patents on ephedra or financial interest in supplement companies who sell ephedra supplements.
Reprinted with permission. This is available at http://www3.baylor.edu/HHPR/ESNL.
As active researchers in the area of exercise physiology, sport nutrition, strength and conditioning, and sports medicine, we would like to make the following comment and observations regarding the current controversy about the supposed link of ephedra supplementation to the tragic death of Baltimore Orioles pitcher Steve Bechler due to multiple organ failure, as a result of heat stroke, on Feb.17, 2003.
The Facts Regarding The Incident
-
Heat stroke fatalities are preventable if proper
screening, conditioning, acclimatization, and precautions are
employed to ensure that athletes train safely in hot and humid
environments.
-
The local coroner and members of Orioles management
have suggested that Mr. Bechler's death was related and/or caused
by the possible consumption of a dietary supplement containing the
herb ephedra.
-
These reports have caused a flurry of reports in
the media questioning the safety of ephedra supplementation and
calls to ban the use of ephedra in Major League Baseball and/or
sale of ephedra in over the counter dietary supplements.
-
At this point, toxicology reports have yet to
confirm that Mr. Bechler had taken an ephedra supplement prior to
practice.
-
Clinical studies published in peer-reviewed
journals have indicated that ephedrine and herbal ephedra
supplementation can significantly promote weight loss with no
major side effects in overweight but otherwise healthy
individuals. There is also evidence that taking ephedra and
caffeine during training may help promote greater fat loss. Most
studies show that ephedra or ephedrine has no ergogenic benefit in
and of itself. Claims that ephedra is a "performance enhancing
substance" is not supported by the scientific literature.
However, there is data showing that caffeine has ergogenic value
and that there may be some ergogenic value of ingesting
supplements that have ephedra and caffeine.
-
Many over-the-counter medications (e.g., cold
medications) contain ephedrine alkaloids (e.g., pseudoephedrine,
etc.) at higher concentrations than found in nutritional
supplements containing ephedra.
-
Closer examination of contributing factors related to Mr. Bechler's death reveals that even if Mr. Bechler did
consume the supplement, it was probably the least of the
contributing factors leading to his death... and it may not have been
a factor at all.
Bechler's Risk Factors For Heat Stroke
According to reports in the media, Mr. Bechler had the following risk factors for heat stroke:
-
a prior history of heat illness episodes while in high school - which heightens the probability of reoccurring incidents;
-
a family history of sudden death following
exercise (his half-brother died of an aneurysm at the age of 20
after overheating from playing baseball);
-
a history of hypertension and liver problems;
-
he had not eaten solid food for a day or two, in
an apparent attempt to lose weight;
-
he was apparently not adequately acclimatized to
training in the heat and humidity of South Florida;
-
it appeared that he was wearing two or three
layers of clothing during workouts, again, in an attempt to lose
weight;
-
he was overweight and did not have a high enough
fitness level to make it through conditioning drills; and,
-
he was allowed to exercise until he collapsed
with a core temperature reportedly of 106° F before being
removed from the field.
It has been extensively documented that untrained,
overweight, and unacclimatized people who perform excessive
exercise in heat/humidity are at great risk of heat illness and
heat stroke... particularly if they have become dehydrated and are
trying to lose weight quickly.
What Could Have Prevented This?
These pre-existing conditions raise serious
questions as to the appropriate medical screening, conditioning,
and supervision of Mr. Bechler participating in spring
conditioning drills as follows:
-
Were team athletic trainers and conditioning
specialists aware of Mr. Bechler's prior history of heat illness
or stroke? If they were aware, why weren't additional exercise
precautions taken to ensure that he was adequately trained,
acclimatized, hydrated, and fed prior to his participation in
intense conditioning drills?
-
Media reports indicate that Mr. Bechler had a
prior history of reporting to camp overweight and out of shape.
If this is the case, was Mr. Bechler given appropriate training
and dietary counseling and/or placed on a pre-camp conditioning
and nutrition program to make sure he reported in good
condition?
Excess body fat is a major liability when exercising in hot/humid
climates because it increases the insulation properties of the
body which in turn reduces the amount of body heat that can be
released through perspiration. Fatal heat strokes occur 3.5 more
times in obese populations than any other population.
-
Why didn't pre-participation medical screening
identify the risk factors to heat stroke described above?
Complete pre-participation
exercise stress tests and/or fitness/sprint tests would have
indicated that Mr. Bechler was not in sufficient physical
condition to perform intense training. Further, that he was not
adequately acclimatized to exercise in the heat. According to
media reports, Orioles coaches knew that his conditioning was
"not good".
If this is the case, then how was he allowed to
participate in intense conditioning training? Medical screening
should have also revealed a history of hypertension and liver
problems. These are all contraindications to performing
excessive exercise particularly in hot/humid environments.
-
Where was the supervision to notice signs of heat illness in Mr.
Bechler? Media reports indicate that he was dizzy, he was only
able to perform 60% of the conditioning drills, and that he
collapsed on the field. These are all signs and symptoms of
heat intolerance and/or heat illness. It is the responsibility
of athletic trainers and strength and conditioning specialists
to make sure that athletes safely engage in physical activity.
If athletes are showing signs of abnormal responses to exercise,
it is the responsibility of coaches, team physicians, athletic
trainers and/or strength and conditioning specialists to pull
the athlete out of conditioning drills... not the athletes.
-
Did the athletic trainers, team physicians, and/or strength and
conditioning specialists know that Mr. Bechler evidently was not
eating solid food? Training camp is not an appropriate time for
athletes to diet. Allowing athletes to train when they are
dehydrated and/or not well fed is dangerous. Athletes who
report to camp overweight should be given proper nutritional
counseling about safe and effective ways to lose weight.
-
Team physicians , athletic trainers, and strength
and conditioning coaches should know what supplements athletes
are taking so they can counsel them about whether or not they
are safe, legal, effective, and/or appropriate to take at a
given time during training. In this case, a supplement bottle
was purportedly found in Mr. Belcher's locker yet team officials
were supposedly unaware of him taking supplements. This is
troubling given that he had pre-existing medical conditions that
were contraindicated for use of the purported supplement.
The Link To Ephedra Doesn't Make Sense!
The supposed link that ephedra supplementation
caused or contributed to heat stroke does not make sense from a
physiological standpoint for the following reasons:
-
Some of Mr. Bechler's teammates claimed that he
usually took three supplement capsules (1.5 servings) in the
morning. According to that product's label, that would have
provided 30 mg of herbal ephedra. This is one third of the dose
shown in long-term clinical trials to be safe.
-
There is no scientific or medical evidence to
indicate that ephedra/caffeine supplementation significantly
increases thermal stress (increases core temperature 2-3 degrees
above normal) during exercise, that it promotes dehydration, or
increases the incidence of heat illness.
-
The thermogenic effects of ephedra and caffeine
are relatively small, typically increasing resting caloric
expenditure by 5-10 kcals per hour. One oral dose of
ephedra/caffeine usually lasts less than 3 hours. Therefore,
the total caloric (i.e., heat) load would be 15 ... 30 calories in
a 2-3 hour period following ingestion of one serving of an
ephedra containing supplement. While this may be sufficient to
promote a gradual weight loss (if one took 2-3 servings per day
for 2-6 months), it would have minimal, if any, affects of core
body temperature.
-
In contrast, athletes commonly expend 600-1,200
kcals per hour during intense exercise or 1,800 ... 3,600 calories
during an intense 3 hour practice. The thermal load of exercise
generally increases core body temperature by 2-3 degrees when
properly regulated.
-
The primary way heat from exercise is dissipated
is through evaporation of sweat. Exercise in humid environments
decreases the ability of sweat to evaporate making it more
difficult to regulate body temperature. When the humidity is
very high (i.e., > 70%), sweat may not fully evaporate which
increases susceptibility to heat disorders. Humidity is higher
in morning and evening hours. This is the primary rationale why
intense exercise should be avoided during humid conditions
and/or additional precautions should be employed to supervise
athletes training or performing in hot/humid environments.
-
The media scare linking Mr. Bechler's heatstroke
death with ephedra places emphasis on the unknown (pending
toxicology results), and ignores known and obvious contributing
factors already detailed here.
Unfortunately, these media reports may mislead some
to conclude that simply prohibiting athletes from taking ephedra
supplements will eliminate the risk of heat fatalities.
Instead, we should be stressing the importance of
properly educating athletes, coaches and athletic trainers about
the risks of training in hot and humid environments when
participants are poorly conditioned, have not acclimatized to the
heat and humidity, have engaged in dehydration practices, have
medical histories that should have raised warning flags, and have
not been sufficiently supervised.
"It seems that Major League Baseball and others want
to blame ephedra for the death of Mr. Bechler, rather than admit
that they may have been negligent in screening, conditioning, and
supervising their athletes."
The tragedy is that if Mr. Bechler had been
properly screened and conditioned; if he had acclimatized properly
to high heat and humidity conditions; if he had been adequately
supervised; and if he had been properly educated about diet,
weight loss, and the use of dietary supplements, he may be alive
today.
In our view, this is another example of poor
supervision and screening of athletes and not an issue of
inappropriate use of a dietary supplement.
Tips to Prevent Heat Illness and Stroke in Athletes
-
Conduct a comprehensive medical examination to
examine past history and risk factors to heat illness.
-
Make sure the athlete is adequately trained to
participate in high intensity exercise prior to the start of
conditioning.
-
Acclimatize the athlete to training in hot/humid
environments by beginning with brief and low intensity exercise
sessions and progressing up to longer and more intense training
sessions during the first few days of training.
-
Make sure the athlete is eating a healthy and
nutritious diet and is well-hydrated prior to the start of each
practice.
-
Monitor ambient environmental conditions
(temperature, humidity, heat index, etc) and adjust workout
intensity, duration, and frequency as necessary to reduce risk to
athletes.
-
Monitor pre- and post practice weight changes.
Ingest 3 cups of water or sports drink for every pound lost during
practice.
-
Do not allow athletes who lost more than 3% of
their body weight to practice again until their weight is up to
acceptable ranges.
-
Do not allow athletes to wear excessive clothing
which can impede sweat evaporation and therefore reduce cooling.
-
Provide frequent and planned water/sports drink
breaks during practice. Ensure that the athlete drinks 1-2 cups
of water or sports drink every 15-20 minutes during exercise in
the heat/humidity.
-
Watch for signs of heat illness including cramping,
dry mouth, fatigue, dizziness, loss of concentration, palor,
vomiting, cessation of sweating, dry and hot skin, and inability
to maintain exercise workloads.
-
Do not excessively train athletes in hot/humid
environments. The higher the intensity of training, the greater
amount of heat produced. This means that if it is very hot/humid,
practices should be rescheduled and/or involve less intense
training. Athletes should be pulled from conditioning drills if
they are unable to perform them and not allowed to train until
they collapse.
-
Provide appropriate medical supervision at a
supervisor to athlete ratio that will allow signs and symptoms of
heat illness to be immediately recognized.
-
Provide prompt medical care when signs are observed
of abnormal responses to exercise in the heat.
-
Have emergency procedures well defined so that
prompt medical attention can be provided in the event heat illness
is observed.
 View A Printable Page
Should Ephedra Be Regulated? Get The Truth Here!
Get the FACTS about the safety of ephedra at EphedraFacts.com.
Prof. Richard Kreider, a specialist in exercise physiology and sport nutrition, is chairman of the Department of Health, Human Performance and Recreation at Baylor University. He founded the Exercise & Sport Nutrition Lab and the Center for Exercise, Nutrition, and Preventive Health Research.
Prof. Mike Greenwood, a specialist in strength and
conditioning and former NCAA Division I Baseball Coach, is Professor
of Musculoskeletal Physiology and Nutrition in the Department of
Health, Human Performance and Recreation at Baylor University.
Prof. Lori Greenwood, a certified athletic trainer
and sports medicine specialist, is Associate Professor and Director
of the Graduate Athletic Training and Sports Medicine Program in the
Department of Health, Human Performance and Recreation at Baylor University.
Prof. Brian Leutholtz, a specialist in clinical exercise physiology, exercise assessment and programming, sport nutrition, and weight loss, is a Visiting Professor in the Department of Health, Human Performance and Recreation at Baylor University.
* The comments provided above represent the scientific opinions of the authors and do not necessarily reflect those of Baylor University and/or professional organizations that the authors may belong. Publication of this position statement on Bodybuilding.com does not mean that their lab, the coauthors, or the professional organizations they represent endorse the content, articles, or products sold on Bodybuilding.com.
Recommend this article to a friend by e-mail here!
 Back To 's Main Page
Back To The Articles Main Page.
Related Articles
Ephedra Update For Dummies!
Big Cat's Corner! Latest Research.
Ephedra, The FDA And Codex Alimentarius... Get The Truth Here!
|
|
Discounts & Deals - Sign Up!
(5 characters minimum)