Caffeine to be restricted again?

The World Anti-Doping Agency is considering returning caffeine to sport's list of restricted performance-enhancing substances. The move comes after a storm of publicity in Australia around national rugby team captain George Gregan, who has said he uses caffeine tablets to give him a boost during games.

But WADA president Dick Pound says that the negative publicity around the use of caffeine in Australian sport is not why it's considering restricting caffeine use.

"The interesting thing in this debate is not that a lot of Australian players and athletes have come out saying they have taken caffeine," he told the Sydney Morning Herald, "but that the [Australian Institute of Sport] says it is performance enhancing." Pound added that the AIS has research to back up its claims and has published literature on how to use it most effectively.

"Having heard this, [we] will take another look at it."

However, caffeine has always been considered to be a performance-enhancing substance, and when WADA decided to remove caffeine and the stimulant pseudoephedrine from the banned list at the end of 2003 many coaches and sports scientists were disturbed. Kevin Tabotta, now Cycling Australia High Performance Manager, said at the time, "I can't see why they've done it. It would have been better to maintain the drugs at the current levels. As a coach of young riders I can say that in spite of whatever a doping body thinks or says, these products are banned because they're performance-enhancing - end of story."

WADA takes into account three things when deciding to restrict use of a substance or method by sportspeople: whether it is performance-enhancing, whether it represents a risk to the health of the athlete and whether it is against the spirit of sport. Two of those criteria must be met for a substance to be banned. Realistically, it seems that a banned substance must be both performance-enhancing and a health risk if WADA is not to get into undergraduate philosophical arguments about what constitutes "the spirit of sport".

Caffeine, of course, is the stimulant contained in coffee, tea and soft drinks such as Coca-Cola. As such it's one of the world's most used drugs, and until the beginning of 2004 its use was restricted in cycling, as in most sports. A moderate quantity - the equivalent of drinking a few cups of coffee - was permitted, but beyond a certain limit riders were considered to be doping. Sanctions, however, were typically light, not least because athletes would invariably claim they'd had one dopia espresso too many before the race.

When caffeine was removed from the banned list WADA published no explanation for the decision on its website, despite a comment in the minutes of a June 18 2002 meeting of its HMR Committee that explanation of decisions about removing substances from the list was essential.

Dick Pound is now implying that caffeine was removed from the banned list because it was not thought to be performance-enhancing. But in late 2003, Dr Dave Martin, a senior sport physiologist with the Australian Institute of Sport told Cyclingnews that a Dutch study had indicated that caffeine and pseudoephedrine could enhance performance.

The AIS' guidelines to caffeine use were published in 2004, and it seems unbelievable that it was not aware of research referred to by the AIS when WADA decided to lift the restrictions on caffeine in late 2003.

The AIS guidelines suggest use of relatively small amounts of caffeine, 70-150mg, rather than the traditional larger doses, and advise that there is no evidence of increasing dose causing increased performance benefits. That's the amount of caffeine in a cup of coffee (40-110mg for brewed coffee) or a 600ml bottle of Coca-Cola (78mg). "Evidence of specific health problems is equivocal," says the AIS, but "long-term intake of large amounts of caffeine (>500 mg per day) are generally discouraged by health authorities."

Since January 1 2004, caffeine has been on a list of substances whose use WADA is "monitoring" - apparently by reading the newspapers. The current lack of restriction on caffeine will be reviewed in September and the earliest a change would come into force would be January 2006.

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