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Biomedical subjects

C E Yesalis

Publications and source records attributed to C E Yesalis.

At least 19 recordsLinked to original sources
PubMed2001

Use of steroids for self-enhancement: an epidemiologic/societal perspective.

Humans are basically competitive. For centuries, athletes have used various substances to enhance performance, increase strength, and prolong endurance. In the early 1940s, research indicating that testosterone improved a sense of well-being, appearance, and sexual performance led to the use of anabolic steroid hormones by a select few athletes. Today, even among high school students, the use of androgenic steroid hormones is prevalent, with 1% to 2% of adolescent girls and 4% to 6% of adolescent boys having used an anabolic steroid at least once. An estimated 1 million people in the United States are current of former users of anabolic-androgenic steroid hormones, with men having a higher prevalence of use than women. Androgenic steroid use has been associated with the use of other illicit drugs, cigarette smoking, and alcohol use. Nevertheless, anabolic-androgenic steroid hormones appear to have legitimate uses in certain patients. In HIV-infected, hypogonadal men, anabolic steroid hormones optimize muscle strength and muscle mass when combined with resistance exercise. Although a large number of people have used these drugs for many years, no studies of the long-term health effects have been done. However, when taken in supraphysiologic doses, these drugs are known to cause a wide range of acute adverse effects. When used in less then supraphysiologic doses in eugonadal or hypogonadal HIV-infected patients, these drugs reverse HIV-related hypogonadism, muscle wasting, and perhaps lipodystrophy. Provided that the oral preparations are not used and patients are closely monitored, anabolic-androgenic steroid hormones offer HIV-infected patients a better quality of life and an improved sense of well-being.

Adolescent↗
PubMed2000

Doping among adolescent athletes.

The use of drugs to enhance physical performance and appearance has been observed for thousands of years. Today individuals, including adolescents, continue to employ a wide variety of drugs in the hope of improving their athletic performance and looking better. Unfortunately, beyond the assessment of anabolic-androgenic steroid (AAS) use, very little is known regarding the use, safety and efficacy of other performance-enhancing drugs and nutritional supplements among adolescents. Most studies report that 3-12% of adolescent males admit to using an AAS at some time during their life. Among adolescent females, studies find that 1-2% report having used steroids. The current strategy for dealing with performance-enhancing drug use by adolescents is multi-faceted and primarily involves education and prevention strategies, interdiction and drug testing programmes. However, the demand for performance-enhancing drugs has been created by our societal fixation on winning and physical appearance. In order to alter the current use of performance-enhancing drugs by adolescents, we as a society must come to grips with our addiction to sport and the importance we place on winning and appearance. We must change our values.

Adolescent↗
PubMed2000

Risk factors associated with anabolic-androgenic steroid use among adolescents.

To identify risk factors associated with anabolic-androgenic steroid (AAS) use among adolescents, computerised and manual literature searches were performed and the resultant local, state, national and international reports of illicit AAS use by adolescents that referenced risk factors were reviewed. Results indicate that adolescent AAS users are significantly more likely to be males and to use other illicit drugs, alcohol and tobacco. Student athletes are also more likely than non-athletes to use AAS, and football players, wrestlers, weightlifters and bodybuilders have significantly higher prevalence rates than students not engaged in these activities. Currently, only a partial profile can be created to characterise the adolescent AAS user. Further research will be needed before associations can be made with a reasonable degree of confidence regarding risk factors such as athletic participation, ethnicity, socioeconomic status and educational level. More importantly, to improve prevention and intervention strategies, a better understanding of the process involved in initiating AAS use is needed, including vulnerability factors, age of initiation and the use of other illicit drugs.

Adolescent↗
PubMed1999

Anabolic-androgenic steroid use among high school football players.

Eight-hundred seventy-three Indiana high school football players were surveyed to investigate the use of anabolic-androgenic steroids (AAS). Subjects were varsity football players that were randomly selected from 27 high schools throughout Indiana. Out of a possible 1,325 subjects, 873 or 66% participated in the study. Subjects completed a 50 item questionnaire that measured demographic information, perceived use of AAS, reasons for use, and how AAS are taken. The results indicate that 6.3% of Indiana high school football players were current or former AAS users. The average age at time of first use of AAS was 14 years and 15% began taking before the age of ten. Almost half of respondents indicated they could obtain AAS if they so desired, and that other athletes, physicians, and coaches were listed as sources for AAS. Athletic trainers can play a vital role in disseminating accurate information about AAS abuse, including the long-term adverse health risks. These messages should begin with students and athletes as early as the fourth and fifth grades and delivered as often as possible throughout the school years.

Adolescent↗
PubMed1998

Anabolic-androgenic steroid abuse and performance-enhancing drugs among adolescents.

Adolescents use a wide variety of drugs and supplements, including anabolic steroids, to improve their sports performance and physical appearance. Prevalence rates for steroid use generally range between 4% and 12% among male adolescents and between 0.5% and 2% for female adolescents. Although the short-term health effects of anabolic steroids such as effects on the liver, serum lipids, reproductive and cardiovascular systems, and moods and behavior have been increasingly studied, the long-term health effects are not well known. Steroid users are more likely to be boys, participate in strength-related sports, and use other illicit drugs. The effects of many other potential risk factors have not been fully elucidated, however. Assessment of anabolic steroid abuse includes physical and mental status and laboratory examinations. Steroid cessation, supportive therapy, and adjunctive pharmacotherapies are all employed in treating steroid abuse and dependence.

Adolescent↗
PubMed1997

Trends in anabolic-androgenic steroid use among adolescents.

OBJECTIVE: To examine the trends in anabolic steroid use among adolescents in the United States between 1988 and 1996. DESIGN: Computerized and manual literature searches were performed, and the resultant local, state, and national cross-sectional surveys of illicit anabolic steroid use by adolescents were reviewed. Trends in steroid use were evaluated using state and national studies administered in multiple periods. Various sampling procedures were employed, and all surveys used anonymous questionnaires. The national studies used for this analysis included the Monitoring the Future (MTF) study, the national component of the Youth Risk and Behavior Surveillance System, and the National Household Survey on Drug Abuse. SETTING: Most of the surveys described were self-administered in school classrooms. The National Household Survey on Drug Abuse was administered in the respondent's home. PARTICIPANTS: Most survey respondents were junior high an high school male and female students aged 12 to 18 years. RESULTS: Individual state studies (ie, a single point in time) provide evidence of continued steroid use throughout the United States despite educational and legal interventions. The findings of multiyear state-level studies show a decrease in lifetime steroid use rates between 1988 and 1994 for male and female adolescents, although no tests of statistical significance were conducted. At the national level, a significant decline (P < .01) in lifetime steroid use has taken place from 1989 to 1996 for male and female students (MTF data). However, since 1991, lifetime steroid use by male students, as measured by 2 of the 3 national surveys, has been generally stable. The third survey, MTF, shows a significant decrease (P < .05) in use from 1991 to 1996. Likewise, from 1991-1996 use of anabolic steroids during the past year (MTF data) was stable for 10th and 12th grade males; use among eighth grade males decreased significantly (P < .01). Since 1991, data from the 3 national surveys indicate an increase in lifetime anabolic steroid use among adolescent females, although only 1 of these increases is statistically significant. Furthermore, past year use of steroids (MTF data) increased for females in the 8th (P < .05), 10th (P < .05), and 12th (ns) grades. CONCLUSIONS: A long-term comparison of anabolic steroid use (from 1989-1996) indicates that use among adolescent males and females has decreased significantly (P < .05). However, for females the low point in lifetime steroid use was reached in 1991, with subsequent significant (P < .05) increases in use being reported in several national data sets. For adolescent males, after declining sharply between 1989 and 1991, steroid use has generally been stable since 1991. Moreover, based on the 1995 estimates of high school students and Youth Risk and Behavior Surveillance System data, approximately 375,000 adolescent males and 175,000 adolescent females in public and private schools in the United States used anabolic steroids at least once in their lives. These results suggest that prevention, intervention, and regulatory efforts to reduce steroid use at the local, state, and national levels should be reassessed, especially those efforts that focus on adolescent female steroid use.

Adolescent↗
PubMed1996

Psychological and behavioural effects of endogenous testosterone and anabolic-androgenic steroids. An update.

Endogenous testosterone levels have been linked to aggressive behaviour in both animals and humans. Studies administering moderate doses of exogenous testosterone for contraceptive and clinical purposes reveal essentially no adverse effects on male sexual and aggressive behaviour. However, investigations and case reports of athletes, usually involving higher doses, demonstrate an association between anabolic-androgenic steroid use and affective and psychotic syndromes and psychological dependence. Efforts to study the psychological and behavioural effects of anabolic-androgenic steroids are complicated by a variety of methodological limitations. Only 3 prospective, blinded studies demonstrating aggression or adverse overt behaviour resulting from anabolic-androgenic steroid use have been reported. With estimates of over 1 million past or current users in the US, an extremely small percentage of individuals using anabolic-androgenic steroids appear to experience mental disturbances severe enough to result in clinical treatment and medical case reports. Even among those so affected, the roles of previous psychiatric history, genetic susceptibility to addictions or mental disorders, environmental and peer influences, and individual expectations remain unclear.

Aggression↗
PubMed1995

Anabolic-androgenic steroids. Current issues.

The use of drugs to enhance physical performance has been observed for thousands of years. Today, individuals continue to use a variety of substances, including anabolic-androgenic steroids, in the hope of enhancing their performance and appearance. Rumours persist regarding the incidence of the nonmedical use of anabolic steroids by athletes and nonathletes: however, true estimates are now available based on the results of systematic surveys. Although the vast majority of the athletic community accepts that anabolic steroids enhance performance and appearance, the extent to which this occurs and the factors influencing such effects remain incompletely understood and documented. Refinement of our knowledge of the ergogenic effects of anabolic steroids is not without merit; however, the existing scientific evidence coupled with an overwhelming number of anecdotal accounts argues against devoting significant resources to this area of investigation at present. The short term health effects of anabolic steroids have been increasingly studied and reviewed, and while anabolic steroid use has been associated with several adverse and even fatal effects, the incidence of serious effects thus far reported has been extremely low. The long term effects of anabolic steroid use are generally unknown. Unfortunately, the lack of scientific information on long term health effects has impeded, if not precluded, the formation of effective health education and drug abuse prevention strategies. Consequently, efforts should be expanded in the areas of prevention and education.

Adolescent↗
PubMed1994

Weight training. A potential confounding factor in examining the psychological and behavioural effects of anabolic-androgenic steroids.

Psychological and behavioural changes are associated with anabolic-androgenic steroid (AAS) use. Changes in personality, moods and self-esteem following weight training have also been reported. The fact that nearly all AAS users are also dedicated weight trainers has often been overlooked in studies examining the relationship between AAS use and behavioural change. A triad may exist between AAS use, weight training and behavioural change (including dependence). It is also possible that changes frequently attributed to AAS use may also reflect changes resulting from the concurrent use of other substances such as alcohol, and from dietary manipulation including food supplements. Weight training and related practices should be considered potential confounding factors in future studies designed to examine the psychological and behavioural effects of AAS.

Affect↗
PubMed1994

Desire for weight gain and potential risks of adolescent males using anabolic steroids.

This study examined the perceptions of adolescent males regarding their physical strength, health status, and desire to gain weight and their perceptions of anabolic steroid use. Subjects were 12th-grade boys (N = 3403), drawn from a pool of 150 high schools nationwide, who completed a health questionnaire. Analysis indicated 47.0% (n = 1475) who wanted to gain weight, perceived themselves as of less than average strength and having good health, and were sports participants. Also, among those who desired weight gain, about 24% (n = 345) were not sure about the most dangerous health risks associated with anabolic steroid use, and 16% (n = 221) did not want to see the use of anabolic steroids in sports stopped. The findings indicate that adolescent boys, who desired weight gain and currently abstained from anabolic steroid use, might be at risk for becoming users.

Adolescent↗
PubMed1993

Anabolic-androgenic steroid use in the United States.

OBJECTIVE: To estimate the size of the anabolic-androgenic steroid (AAS) user population in the United States, to examine characteristics of AAS users, and to explore the association between AAS use and the use of other illicit drugs as well as self-reported aggressive behaviors. DESIGN: A cross-sectional study using data from the 1991 National Household Survey on Drug Abuse. STUDY POPULATION: The survey covered the population aged 12 years and older living in households in the United States. The results of the survey were based on personal interviews combined with self-administered questionnaires from 32,594 respondents. These respondents were randomly selected by means of a stratified multistage area sample of the household population. RESULTS: Estimates based on data from the National Household Survey on Drug Abuse indicated that there are more than 1 million current or former AAS users in this country, with more than half of the lifetime user population being 26 years of age or older. More than 300,000 individuals used AAS in the past year. Males had higher levels of AAS use during their lifetime than females (0.9% and 0.1%, respectively; P < .01). The median age of first use of AAS for the study population was 18 years; for 12- to 17-year-olds, the median age of initiation was 15 years. Among 12- to 34-year-olds, AAS use was significantly and positively associated with the use of other illicit drugs (P < .05), cigarettes (12- to 17-year-olds only; P < .01), and alcohol (P < .01). Furthermore, AAS use is highly correlated with self-reported aggressive behavior (P < .01) and crimes against property (P < .01). CONCLUSIONS: These results indicate that AAS use impacts a large number of men and women from various racial and age groups across the nation. While causal inferences cannot be made regarding the associations between AAS use and use of other drugs as well as antisocial behavior, these findings should enhance our ability to profile the typical AAS user.

Adolescent↗
PubMed1993

Changes in body size of elite high school football players: 1963-1989.

An examination of the heights and weights of members of the Parade Magazine's High School All-American Football Teams from 1963-1971 indicates no significant changes in the Body Mass Index of these elite athletes whereas an increased pattern in Body Mass Index was noted within this group from 1972-1989. The large increases in Body Mass Index after 1971 among the All-American high school football players raise interesting research questions; in particular, what portion of these gains can be attributed to improved nutrition and training techniques and what portion is the result of use of performance enhancing drugs such as anabolic steroids?

Adolescent↗
PubMed1992

Anabolic-androgenic steroids and the adolescent.

This article has reviewed some of the hormonal and behavioral maturation that occurs during adolescence, which are characterized by remarkable physical changes and behavioral vulnerability. Risk taking of many varieties is common and drugs (including anabolic-androgenic steroids) form a part of the prevailing culture in many places. These steroids probably are not severe health hazards when taken intermittently and in low to moderate doses. The 17-alkylated derivatives are clearly the more likely to cause hepatotoxicity. Thus, the scare tactics formerly used (severe constitutional side effects) are doomed to failure. The tenuous link between these drugs and objective behavioral and addictive effects must be strengthened before health strategies based on this issue can be validated. Clearly, the lack of scientific information has impeded, if not precluded, the formulation of an effective health education strategy. The most potent deterrent to the use of steroid drugs by athletes must be the moral issue of fair play and maintaining a "level playing field." We strongly support directed research in these areas and hope that the credibility of the scientific community can be regained after its faulted "stop steroid use" campaigns based on the lack of steroid efficacy in bringing about desired results or on their dire consequences have been replaced with credible evidence to refute their use on these and other grounds.

Adolescent↗
PubMed1992

[Anabolic steroids in athletes].

The use of anabolic-androgenic steroids (AS) to enhance appearance as well as physical/physiological capacities has increased dramatically over the past four decades in all age groups from early adolescence to adulthood. Although higher AS use rates are reported by elite and competitive athletes, a significant number of recreational athletes appear to be using AS. The scientific literature is inconsistent and at times at odds with the conventional wisdom and empirical experiences of the athletic community regarding the ergogenic effects of AS. However, individuals experienced in weight training, with an adequate diet, and who continue training during AS administration seem to consistently increase their strength and lean mass over what would have been expected from training alone. Previous research documenting deleterious but transient and mostly asymptomatic acute changes in physiology, risk factors and behavior has been inconclusive regarding the long term health impact. The abuse of AS constitutes a special challenge to society. AS are not euphorigenic or mood altering immediately following administration, as are other illicit drugs; the appetite for AS has been created predominantly by our societal fixations on winning and physical appearance. Consequently any successful intervention in this area must go beyond education, law enforcement and drug testing, and attempt to change a social environment which currently encourages the use of AS.

Anabolic Agents↗