Drugs and mixed martial arts at the Manchester Science Festival

Last week I talked at Blackwell's bookshop as part of the Manchester Science Festival (hence the dodgy photo). As usual a very keen and knowledgeable audience. Some interesting questions about drug use in pro. boxing and mixed martial arts. Here I am on side with Victor Conte, for once, about the need for more effective testing. His view is to focus on the pre fight period. For sure some consistency here would be good. But, as noted here,  as long as there is no off season testing even this might not be enough. It was a shame to see some unsubstantiated rumours about famous athletes getting an airing in the Q and A. But I guess not really surprising in the wake of the Lance Armstrong story. 

Next week on Nov 14 I get to do a hometown event in Colchester at the Minories Cafe as part of the Cafe Scientifique popular science movement. Should be fun. 

Click here for details of this event

Did the Wall Street Journal get it wrong about blood doping?

A bit of a dramatic title, but I feel the need to cleanse myself and change topic after talking about Lance Armstrong to the media all day yet again (following UCI confirming the stripping of his Tour titles). So instead I would like to visit a review of my book in the Wall Street Times by Will Carroll (http://online.wsj.com/article/SB10000872396390444464304577537371308904132.html). Let me say at the start that this is the most critical review of my book, but I love it all the same. Most of my other reviews pretty much recap the book in an opinion-free way. It is nice that they like it (of course I am an author I love praise!), but I didn’t feel I heard the reviewer’s voice and opinions. But the Wall Street Journal review reads a lot more like the George Orwell’s book reviews. At the end of it you have leant a lot about Orwell’s opinions, had a great read, but might have forgotten that a book was actually being reviewed. Great stuff.

Still, boring biochemist that I am, I do have to make one point about the science in the review that is inaccurate. In the book I talk about Eero Mantyranta, the Finnish cross-country skier who had a genetic anomaly that “naturally” enhanced the number of his red blood cells. Carroll says that “Under current testing protocols, genetic anomalies such as Mr. Mantyranta would be singled out the way that Lance Armstrong has been”. This is not the case. As the USADA report on Armstrong shows, Armstrong had a low number of young red blood cells in a series of 2009 and 2009 blood tests. On its own this is not evidence of doping. But suspicion is aroused when you compare the samples taken during the Tour to those taken before when there were a lot more young red cells. This comparison to a person’s own blood samples is at the heart of the athlete biological passport; here it suggested a period of time when, according to Prof. Chris Gore in the report, Armstrong must have had a blood transfusion.

What then about Eero Mantyranta? He would have a constant number of red blood cells; high but not varying. So he would not have been “singled out” by the biological passport. Of course there is a separate decision as to whether it is “fair” to have someone with such a genetic advantage compete (and he would have had problems with the 50% hematocrit limit in some competitions). But he would not have been suspected of doping if his blood was analysed carefully under today’s system.  

Did Lance Armstrong dope? The science says Yes

I said of the original USADA statement in my blog of August 24:

“I personally would like to know what was the basis for the USDA statement ‘Additionally, scientific data showed Mr. Armstrong’s use of blood manipulation including EPO or blood transfusions during Mr. Armstrong’s comeback to cycling in the 2009 Tour de France’ ”.

True to my request the scientific evidence against Armstrong is clearly presented, though somewhat buried in the report (only 6 of the 164 pages go into the tests). The controversy of the 1999 Tour de France EPO test is discussed of course. It pains an Englishman to admit that a Frenchman and Australian were right, but I think this is pretty unequivocal now. The French journalist, L'Equipe's Damien Ressio, correctly identified six positive samples as Armstrong’s [1] and the Australian blood doping expert, Michael Ashenden, got the details of the story spot on in this interview [2].

Interestingly Armstrong’s samples accounted for 46% of all the EPO positive samples found. It does look like he was taking EPO throughout whilst others hoped their pre-tour red blood cell increase would be enough to last the Tour.

The second piece of evidence – and this is new – is the blood samples taken from Armstrong during his comeback. Again an Australian – in this case Chris Gore – analysed the data in detail. Endurance cycling, day after day, increases your plasma volume and decreases your red blood cell concentration. This happened to Lance Armstrong through the 2009 Giro. However, in the subsequent Tour de France, the situation was different. His plasma volume rose, as expected, on days 1-7 of the Tour, But rather miraculously this volume decreased over the next three days and the red cell count increased. The only sensible conclusion is that he had a blood transfusion on or around day 7.

Gore also concluded that in many of Armstrong’s blood samples there was a dramatic reduction in the number of young red blood cells. These young cells, called reticulocytes, are formed when you are in the process of making new mature red cells. If you transfuse blood to supermaximal levels, your body tells you to stop making new cells. Therefore there is a large decrease in the number of reticulocytes. Armstrong showed exactly this effect on a number of occasions. This is the relevant quote from the report "Prof. Gore concluded that the approximate likelihood of Armstrong’s seven suppressed reticulocyte values during the 2009 and 2010 Tours de France occurring naturally was less than one in a million”.

The final piece in the analytical jigsaw comes from the 2001 Tour de Suisse. Here there are a number of suspicious EPO samples attributed to Armstrong. UCI have not released this data for further discussion. So this part of the story remains unfinished business between USADA and UCI.

In short, I don’t thing Armstrong’s supporter’s can realistically claim that he has not failed a doping test. He may not have been officially sanctioned due to a test, but the circumstantial evidence is far more damning than several people I note in my book who have lost medals due to positive tests through no fault of their own e.g. the Rumanian gymnast, Andreea Răducan.

[1] http://autobus.cyclingnews.com/photos.php?id=photos/2005/interviews/damien_ressiot/cycling-usa-armstrong-fr-41

[2] http://velocitynation.com/content/interviews/2009/michael-ashenden

Lance Armstrong - was he just better at doping?

OK, I need to rename my book Run, Swim, Throw, CYCLE Cheat. For those of us in the field have a lot of homework to do - 1,000 pages of documentation from USADA that illustrates the widespread nature of Lance Armstrong’s doping [1]. So as I said in a previous blog, beyond the sheer volume of incriminating evidence, what is new, at least to a scientist?  I can’t claim to have read more than a few extracts yet (I have a life and my own teaching and research to do after all). But what I have read seems to support one of contentions from an earlier blog - Armstrong was better as he was doping more smartly and/or taking more risks. Certainly in 1999 when he won his first Tour he was using EPO throughout the event, whereas others probably stopped once the race began. Given that there was no validated EPO test in 1999 this is perhaps a little surprising – although it agrees with Michael Ashenden’s interpretation of the later analysis of Tour samples [2].

The alternative view is that Armstrong always had the capability of being the top cyclist, but he was held back by a lower ability to deliver oxygen than his rivals. Once he could equalize this by taking EPO and blood doping, he was able to outperform them in the mountains and win consistently. In this model all Armstrong’s US postal had to do was dope as well as the other teams. How to choose between these two theories? Was Armstrong the best doper or the best cyclist once everyone was doping? What we scientists really need is a side-by-side comparison of all the team’s doping strategies from 1999-2006. That’s not too much to ask surely…….

[1]        http://cyclinginvestigation.usada.org

[2]        http://velocitynation.com/content/interviews/2009/michael-ashenden

Doping, drugs and cheating at the Paralympic Games

I finally have some time to blog after some happy times spent at the Paralympics; the highlights of what I saw being Sarah Storey at the velodrome, Hannah Cockroft and Shelley Long in the Olympic Stadium and, of course, Shiyun Pan the swimmer in possession of the amazing one armed butterfly stroke which made me forget that it was a Brit he was beating on the way to his world record.

So what are the similarities and differences in doping between the Olympics and Paralympics? Much is the same. Power and strength are key requirements for many Paralympians. So not surprising there were bans for users of steroids and human growth hormone [1]. Just as in the Olympics there were variations in the length of sentences. An athlete claiming that the green tea he took contained an unlabeled banned diuretic received a nine-month ban and missed the Games [2]. Yet someone who inadvertently took a banned substance in a nasal decongestant had a more limited three month ban; this finished a few days before the games [3] and she ended up winning a silver medal, coincidentally creating one of the moments of the games as the two British athletes fighting for the bronze medal in that event tried - and failed - to cross the line together to share the remaining medal [4].

So much, so similar. However, the two unfounded allegations of cheating that created media storms illustrated some of the differences between the two Games. Whilst the voices raised against the Olympic Chinese swimmer Ye Shiwen focussed on biochemical enhancements, those against the Paralympic 200m runner Alan Oliveira related to his equipment. Allegations of “technological doping” seem more prevalent in the Paralympics where naturally equipment is a bigger issue for more athletes. The French though remained equal opportunity accusers of the “unfair” advantages conferred on Team GB and Paralympics GB by their bikes and wheelchairs of [5].

More seriously are concerns about classifications. In the Olympics suh arguments are rare; after all the only classes are those based on gender and weight. Weight is readily quantifiable and, fortunately, accusations of males competing as females are rare. However, in the Paralympics allegations of athletes trying to cheat the classifications are more widespread [6]. Concerns about the fact that other athletes have unfair advantages seem to have triggered a more laissez faire attitude to cheating. Take the practice of “boosting”. Some Paralympians with spinal injuries lack the ability to raise their blood pressure when they start to exercise. This can limit performance. Therefore this pressure is “boosted” by extreme action; for example breaking a toe or blocking a catheter [7]. Boosting is dangerous and consequently banned. However, in an anonymous questionnaire study up to 17% of disables male athletes admitted to trying this [8]. This value is much higher than would ever be the case for an equivalent study on drug use. It seem likely that disabled athletes, in part, feel that boosting is justified if they perceive that others in their classification have a blood pressure response they lack. Rather like Ben Johnson’s excuse that everyone was doping so it made no difference if he did.  

As many have noted with regards to Pistorius’s outburst, this level of conflict can all seen as a positive sign that the Paralympics have come of age as an elite sport. However, there is still one area that I think progress needs to be made. As long as the equipment needed to compete is expensive, many countries will be excluded from competing meaningfully; this includes many of the 25,000 people per year who become amputees as a result of land mines. Still perhaps it is a bit churlish to ask the Paralympics to being about world peace and economic regeneration as well as changing our attitudes to people with disabilities …..

Talking about sports doping and Lance Armstrong at the Edinburgh International Book Festival

(the picture on the right is of Alex Hynes playing in a beautiful church on the Royal Mile) 

Last Monday I had the honour of talking about “Run, Swim, Throw, Cheat” at the Edinburgh International Book Festival. Although I have travelled to Edinburgh frequently to the Science Festival in spring or to various scientific conferences, this is the first time I have been in the festival in the summer since 1982 when I acted in a Hampton School production of Strindberg’s “The Father”. I portrayed a soldier and had 23 lines in total. The Scotsman newspaper was not impressed – it rated us 2/10. Undaunted the following year we renamed our company Hampton 20% Theatre! Anyway given this less than auspicious history, it was perhaps as well that I returned to the festival talk about science rather than act. After the talk I explored the fringe with my 17-year-old thespian daughter. We say five shows in eight hours; the rigour of fringing seemed to be the same as 30 years ago, though if anything the quality of the productions was better.

The talk seemed to go well  - I even managed not to mess up my red wine blood doping demonstration for once. As ever there were a lot of interesting questions. Again Lance Armstrong came up a few times. On my return the Essex Uni. Human Performance Unit Director Dave Parry reminded me of an interview with Michael Ashenden where the controversial 1999 EPO positive tests are discussed in a lot of detail. If you have the time it makes fascinating reading; at one stage it informs on a previous blog of mine that suggested that Armstrong might be better at doping than his rivals (maybe as he was less scared about being caught?).

Anyway the article in full can be found here:

http://velocitynation.com/content/interviews/2009/michael-ashenden