Sideline Consult

Health Risks at the Rio Olympics, by a Doctor Who Was There

Bert R. Mandelbaum, MD, DHL (Hon)

Disclosures

August 18, 2016

Tailoring Acclimatization to the Individual

Another key strategy for coping with heat is acclimatization. Just as teams practice at high altitudes if they plan to compete in such an environment, so should they practice in climates similar or more extreme in heat and humidity to those in which they will compete. If you're going to play in 95-degree heat, you have to train in 98-degree heat.

These concepts matter not just in athletics but also in many nonsports professions, such as farming and the military.

Sports give us an opportunity to witness the challenges of rehydrating properly. Even in the National Basketball Association this past season, where trainers and team doctors were on hand, some players suffered from dehydration. One reason may be the variation from one individual to another; athletes in their 20s may need different rehydration from athletes in their 30s, and men may differ from women.

Measuring urine's specific gravity can reveal a lot about proper rehydration. But athletes who don't have a urine-specific gravity test at their disposal can get a rough estimate of their hydration levels by looking at the color of their urine: Too dark suggests dehydration.

Performance-Enhancing Drugs

Another medical issue that has attracted attention in the Rio Games is doping. I oversaw the drug tests for soccer, but the incidence of using performance-enhancing drugs is very low in that sport, and athletes are very cooperative.

Elsewhere, this year has seen almost unprecedented controversy over performance-enhancing drugs, with Russia's entire track and field and weightlifting teams banned from Olympic competition.

I'm sure we haven't seen the end of the problem. Performance-enhancing drugs are like viruses: As soon as you get control of one, another comes along. And some fans say openly that they want to see athletes doping because they love the alpha male hyped up on steroids.

Fortunately, most athletes don't share that point of view. Most of them sincerely take to heart the Olympic ethos in which participation is more important than winning.

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