20 sept. 2019

Triathlon and Off-Score II


We have a previous post regarding this subject, but looking at comments in www.slowtwitch.com  related to anemia and how low hemoglobin is in some triathletes prompt us to write again about this subject.  The slowtwitch forum mentions a nonprofessional athlete who suffered an incident that made him bleed 8/29/18:

taking iron supps for 6 weeks now as I thought my H&H values, and iron were low when tested 6 weeks back. I have sent latest info to doc(online blood test order yesterday) asking for how to proceed/what to check. Doc wasn't really concerned 6 weeks ago, but I was as I didn't enjoy be tired/weak/fatigued/short of breath all the time. This is now 1 year(8/29/18) post heart slicing and dicing. Any thoughts from ST docs and "docs"?

Off-Score is calculated taking into consideration the average hemoglobin in a cycling population:

The UCI pilot project Following a meeting which took place in Paris in October 2007, between WADA, the French sporting authorities and the cycling family, UCI launched in 2008 a pilot project for the implementation of the hematological module of the Athlete’s Passport (Zorzoli & Rossi, 2010).
Since then, more than 800 athletes per year were enrolled in the program. UCI signed contracts with several sample collection providers in order to face the high demand of in- and out-of-competition tests. At the beginning samples were only analyzed in the group of laboratories that have been involved with the nostart tests for many years, because they were already participating to the same external quality control program that WADA has chosen (Swiss Center for Quality Control) and were all using the same technology. Progressively, as other WADA accredited laboratories were fulfilling the requirements to conduct hematological passport tests, UCI only relied on these laboratories for three major reasons: - The samples could be directly analyzed for the detection of forbidden substances or methods; - Decreased costs with sample transport when collection included both urine and blood; - Ease of the laboratory with technical and legal aspects related to anti-doping procedures (documentation package; chain of custody; testifying in court).
The experts were chosen by the UCI and WADA. All qualified in the field of hematology (either clinical or laboratory), sports medicine, exercise physiology or blood doping. Each week, 10 to 15 updated profiles were sent by the APMU to the experts for review. In these profiles the Bayesian adaptive model has identified the Hb or Off-hr score abnormal with a 99% probability (either for the single measurement as a function of previous results or for the complete sequence) or with normal or lower levels of probability.

The main problem in any research looking for answers related to a particular population is the sample.  In this case the professional cyclists.
Extrapolating the data to triathletes is not a big problem, hours of training are long, endurance sports for sure.  But let’s take a look at what Vincent Luis has for breakfast.

This kind of breakfast make you anemic in a few weeks.  No wonder why Vincent and his teammates had a bad performance in Lausanne; perhaps with the exception of Mario Mola (small frame).  The average hemoglobin is very low because of the nutrition or bad illness.  Well-nourished individuals will have suspicions Off-Scores if we compare them to athletes eating the way Vincent Luis does.  We have information from a newspaper on Javier Gómez’s hematocrit values:
37% hematocrit the lowest, 42% average.  This talks about deficiencies in nutrients. 
The average hemoglobin and hematocrit from African nations are lower compared to the Europeans.  This is not related to ethnic differences because athletes like Bekele have values similar to the Europeans in the 90th percentile.
In summary, malnourishment exist in triathlon.  300 protein's calories per day could make the difference between being anemic or having a homoglobin above 14 for females.  

The Off-Score is based on malnourished athletes which represent the control group.  Is there a booth that takes complaints based on evidence?