Society is increasingly concerned with having the “perfect body”. Nine out of ten athletes use nutritional supplements and follow diets without medical advice. Dr. Arenas, an expert in Nephrology, assures that being able to buy these substances freely and considering them “natural” favors their use, but she assures that this does not mean that they are “free of danger”.
Dietary dogmas of sport that lack scientific evidence
Although athletes have to follow a special diet, appropriate to their level of exercise, the abuse over long periods of significant amounts of some substances without control, has negative consequences for health, both in the short and long term.
This is the case of high-protein diets, which, if the maximum amounts of proteins that can be ingested and the time of consumption are not taken into account, end up generating toxins that damage the functioning of the colon, the gastric mucosa and the kidney.
Although our organism is capable of metabolizing and adequately eliminating common dietary substances, such as choline or L-carnitine, if they are consumed in adequate doses. The abuse in their intake, in order to lose fat, generates an imbalance of the intestinal flora with overgrowth of bacteria specialized in their digestion, causing more toxins and less carnitine to be generated. These toxins accelerate cardiovascular disease and the progression of kidney disease, and kidney transplant recipients may have an early return to hemodialysis. As an example, the quantities of L-carnitine consumed by some athletes would be equivalent to the daily intake of more than a kilo and a half of beef.
Vitamins and minerals, such as vitamin A, Niacin, Zinc and selenium, which are natural substances present in our diet can also become toxic to our body if consumed at high doses and for prolonged periods, and generate nausea, vomiting, diarrhea, increased liver enzymes and / or peptic ulcer.
Performance enhancing drugs and various substances
When a person starts taking nutritional supplements freely to improve their physique and exercise capacity, they run the risk of falling into the consumption of drugs and various “not so natural” performance-enhancing substances. Liver and kidney complications requiring hospitalization and dialysis have increased in the last four years. This increase is related to the consumption of anabolic steroids, which causes liver failure and increased bilirubin, and diseases such as acute biliary nephropathy and tubulointerstitial nephropathy. A large number of bodybuilders, due to the abuse of these substances, develop a kidney disease called focal segmental glomerulosclerosis, which is a scarring of the kidneys that causes them to lose protein in the urine and stop functioning. This is caused by an overload of the kidneys, similar to what happens in morbidly obese patients, but more severe.
Anabolic steroids also produce other side effects, such as acne, sexual or personality alterations. They also produce an increase in blood calcium, which can also be harmful. The risk of death among these chronic users of anabolic steroids is 4.6 times higher than in the normal age-adjusted population.
Another treatment consumed by athletes is Clenbuterol, a drug used to treat acute asthma, but which also has anabolic properties that increase muscle mass, and is therefore used in bodybuilding. However, cases of arrhythmias and alterations of potassium, magnesium and phosphate, which can lead to sudden death, have been described. Creatine is also frequently used to increase muscle mass and improve athletic performance. Creatine has the ability to increase creatinine levels, although without impairing renal function. The problem is that, in this context, elevated creatinine levels in the analysis can mean creatine supplementation or real kidney damage, so it is necessary that the nephrologist is the one who analyzes the situation and differentiate between the two issues.
Uncontrolled sport also carries other risks, such as exertional rhabdomyolysis, which results from muscle damage and the release of intracellular muscle components that leak into the circulation causing pain. Rhabdomyolysis causes two major problems:
- Severe rhabdomyolysis with life-threatening complications.
- Mild-moderate recurrent rhabdomyolysis with constant elevation of CPK, which requires a study to determine metabolic defects.
Training decreases the possibility of suffering rhabdomyolysis, but it can affect, causing renal damage, even trained athletes if certain conditions such as lack of acclimatization to heat, profuse sweating, lack of adequate hydroelectric replacement or high environmental temperature are present. A healthy person undergoing extreme exercise may develop rhabdomyolysis, as has been described after spinning classes.
Today, one in ten gym-goers consume these substances and are convinced that the benefits of these substances outweigh the drawbacks. Many of them risk taking them without medical supervision, combine them with other substances and take doses far in excess of what the body can assimilate. This obsession with the cult of the body is an emerging pathology generated by the new values that society places on the physical.