Triathlon and Malnutrition

I watched the documentary Armstrong Lie.  I had some time to see it as a psychiatrist, teacher, coach, doctor, and researcher.  It is an eye-opening experience, no wonder we have the “global warming.”  Armstrong is right:

Lance Armstrong: "I grew up ... like a wild animal" http://www.businessinsider.com/lance-armstrong-biggest-mistakes-2015-12 …

I had a seven-year-old child who came with his parents because “he cries when the bad guy dies in the movie.” Many kids grew up like that and they become athletes. They have problems following rules and never acquire a helpful education to take care of themselves or their business (professional athletes).  Malnutrition is a consequence of this lack of education (unable to follow rules) and doping is a consequence to take a shortcut for something that is doable with education (to eat properly at the right time).  We have children who refuse to eat as indicated to keep the caloric intake as well as the vitamins and minerals to recover from training in order to continue training.  Parents complain about it but they do not do what is needed.  How to overcome this problem?  This is a unique problem for the athlete and his family.

In a matter of a month, hemoglobin can drop one point if the caloric-protein intake is not enough to keep up with growing up and training.  This is what we encounter with some of our athletes, close to 50% of our children are at the border of “normal” values for a CBC (complete blood count).  The erythrocytes are small and neutrophils count is low, even though the ferritin is above 35. This scenario happens when the calories do not reach 4,000 a day. 

Eufemiano Fuentes said that he was treating athletes and not doping them when he was charged of doping patients:

30 janv. 2013

Operación Puerto and Triathlon

I will paraphrase what Eufemiano Fuentes mentioned during his interrogatory in court for the English speaking readers.  I copy from the newspaper Marca.  There are videos related to the interrogatory in the same newspaper. 

Fuentes is questioning the way doping is considered because he believes that he was treating anemia.  It is interesting because the dilution of blood when training is well known and could mimic anemia.  He mentioned that he was giving the amount of blood needed to get to the normal level, always using the same subject’s blood.  This does not sound incorrect from the point of view of a medical doctor except for the fact that the problem can be solved differently by administering the right amount of nutrients at the right time; instead of the blood itself. Fuentes says that time was the limiting factor; he needed to have ready the competitor in a few days or perhaps weeks.  But he knew also that the administration of blood was doping for the UCI rules.  Fuentes questions that there is a hematocrit value of 50 as an upper limit; but there is no low value accepted by the UCI to be treated.  He took care of his athletes because there is a danger in practicing cycling at a professional level with a low hematocrit.