Caffeine still the key to legal performance enhancing

It began with a sharp pain somewhere deep in the medulla oblongata, moved directly behind both eye sockets, then quickly played havoc with the cerebral cortex. Minutes later, the smell of freshly ground Palombini beans still in the air, it was gone.

So much for giving up coffee for Lent. And that was even before lunchtime on Wednesday.

For centuries already it’s been blessed by kings, banned by popes, chewed on by the Aztecs, and more recently stirred into the half-time drinks of the Liverpool football team. And now most of us, it seems, are happily hooked on caffeine. Only for some athletes it’s becoming a more worrying addiction.

It was one of the more revealing features of a recent New York Times interview with Mona Nemmer, Liverpool's head of nutrition, who was hand-picked by Jürgen Klopp from her previous role with Bayern Munich.

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“Slowly, almost imperceptibly, Nemmer has changed habits,” it explained. “Instead of a candy pick-me-up at half-time, Lallana, Milner and Jordan Henderson now have a slug of apple juice laced with caffeine.”

Given Liverpool’s recent run of form, Nemmer clearly needs to up the dose, although when it comes to caffeine use in any endurance exercise, enough is rarely enough.

Caffeine drinks, caffeine gels, caffeine bars, caffeine powders, caffeine pills. Fancy a piece of my new caffeine chewing gum?

This happened hasn’t by accident. For the past 30 years, caffeine’s effect on endurance has been widely examined, and the only surprising thing is that people still question the performance-enhancing benefits.

‘Improves performance’

"There is so much data on this that it's unbelievable," Dr Mark Tarnopolsky, of McMaster University in Canada, also told the New York Times a few years ago. "It's just unequivocal that caffeine improves performance. It's been shown in well-respected labs in multiple places around the world."

Two quick sample studies: cyclists drinking coffee with a caffeine dose of 4.45mg/kg, or 400mg total, improved their work load by 7.4 per cent; runners given the same dose improved their 1,500m time by 4.2 seconds. Not bad for drink made from the shrub of a tree.

Another study suggested that 600 mg of caffeine improved mental alertness as much as 20mg of amphetamine – and that’s no small edge, no matter what the sport.

No wonder the World Anti-Doping Agency (Wada) used to consider caffeine an illegal performance enhancing drug, at least in doses above 1,200 mg, around eight cups of coffee. It was, other words, considered doping.

That all changed in 2004, when Wada removed it from the banned list, partly because some studies pointed towards a decreased performance, mainly due to dehydration. More likely, it was no longer possible to justify a ban on the most popular social drink in the world, or at least to try police it. Just like that, it was no longer considered doping.

Caffeine’s popularity, meanwhile, continues to soar. Some 90 per cent of Americans now consider themselves coffee drinkers. Here, we spend around €375 million annually on the right to exorcise a little tiredness.

Unlike tea leaves, and the seeds and fruit of some 60 other plants believed to elevate mood and decrease fatigue, many of the effects are caffeine are exercise-specific, especially in the long run or cycle.

It was discovered by a German chemist, Friedrich Ferdinand Runge, in 1819, who termed it caffeine to mean “something found in coffee”, although it’s the metabolites of caffeine that athletes are interested in: theobromine is a vasodilator and increases oxygen and nutrient flow to the muscles; theophylline acts as a smooth muscle relaxant, opening the bronchioles and affecting an increase in cardiac rate and efficiency; paraxanthine increases lipolysis by releasing glycerol and fatty acids into the blood to be used as a fuel by muscles.

Heart efficiency

Caffeine, in other words, can increase the use of fat as fuel, opens the lungs, and improves heart efficiency. At high doses, however, the side-effects can include increased heart-rate, dizziness, insomnia, and chronic use can jar the blood pressure.

It’s not harmless, and you only have to read the label of any popular sporting supplement to realise how much higher the doses are becoming.

No wonder Wada are worried again, and have now placed caffeine back on the 2017 Monitoring Program: what this means is they’ve started to monitor caffeine levels in anti-doping samples taking during competition, and will then decide whether there is enough evidence to suggest it’s use is either being a) abused or b) dangerous – and will then decide whether or not it needs to be put back on the banned list.

Should we be surprised by what they find? Not if those so-called Sunday Times revelations are anything to go by, because the only truthfully shocking part of the story about what Alberto Salazar was feeding the likes of Mo Farah and Galen Rupp were the actual substances: L-carnitine? Vitamin D? They were popular on the US college circuit about 25 years ago, their performance-enhancing qualities no more or less effective than caffeine.

Delivering them by injection or prolonged infusion enters more unethical territory, and the allegations of Salazar administering testosterone or thyroid medication are a lot more disturbing. But further questions raised about Salazar's practices on Thursday by the French newspaper L'équipe, which claimed Rupp took 21 different legal vitamins over the span of four days last April, had some people asking: is that all?

The bigger question is here surrounds the ethics of using any performance enhancing substance, on the basis of it not being banned, and whether or not that so-called grey area can ever be removed. Especially given how addicted so many of us now clearly are.