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Caffeine Loading for Athletes: Side Effects Outweigh Benefits

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Do large doses of caffeine--in the form of coffee, colas or tablets--help recreational athletes perform longer and better?

Possibly, but because caffeine overconsumption has been linked to irregular heartbeat and dehydration, experts generally discourage overuse.

Caffeine can be effective in improving endurance and performance in activities lasting 90 minutes or more, exercise experts say. “But there are side effects,” said Steve Farrell, associate director of continuing education for the Institute for Aerobics Research in Dallas.

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Caffeine, a diuretic, speeds dehydration and, in some people, overconsumption can lead to cardiac arrhythmias or irregular heartbeat. “We don’t endorse its use (for performance improvement),” he said.

Nor does the U.S. Olympic Committee, which considers excess caffeine a banned substance, a spokesman said. To test positive, an athlete would need to drink six to eight cups of coffee three hours before testing.

It appears “to stimulate the release of fats into the blood, which the muscles can use for energy in place of glycogen, thereby sparing it for later use,” according to the Tufts University Diet & Nutrition Letter. However, potential benefits of extra caffeine are limited to endurance athletes, such as marathon runners or swimmers, the newsletter said.

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Drinking a single cup of coffee before a workout probably has little or no effect, Farrell said. “But I don’t see any need for the average recreational athlete to use large amounts of caffeine.”

Rodney Bassett, an exercise physiologist at Centinela Hospital’s National Athletic Fitness Institute in Culver City, said recreational athletes have more to gain from proper diet and training than caffeine dosing.

It’s All in Your Head

Asked how they’re feeling, hypochondriacs often reply--ad nauseam. To them, a headache suggests a brain tumor; a chest twinge, certain death.

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In a given week, at least 10% of the population expresses some degree of hypochondriasis, an abnormal anxiety about one’s health sometimes accompanied by imaginary illness reports Dr. Robert Kellner, in the current issue of the journal Psychosomatics.

Hypochondriasis affects men and women equally, but “women are more likely to see a doctor about physical complaints for which there are no medical explanations,” said Dr. Arthur Barsky, a Harvard Medical School associate professor of psychiatry also studying the subject.

Those with a history of illness are more likely to be hypochondriacs, said Kellner, a professor and vice chairman of the department of psychiatry at the University of New Mexico, Albuquerque.

Why do hypochondriacs agonize over symptoms, real or imagined?

They are “often lonely, isolated people,” Barsky said, and “complaining is a way to set up a social interaction.” Those afflicted have a tendency for high anxiety and depression, which can make their hypochondriasis worse in the presence of unexplained bodily symptoms, Kellner said.

“They may also feel symptoms more acutely,” said Barsky, who is studying the possibility that hypochondriacs’ nervous systems may be “tuned” differently.

To some extent, attention and understanding can help. “Try to sort out what’s really bothering the person,” Barsky said. “At some point, it’s not helpful to support the idea. It’s a medical problem if there’s no basis.”

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Professional counseling is also recommended. “With psychotherapy, 50% or more can put hypochondriasis behind them,” Kellner said.

Call for Prenatal Care

In 1986, more than 8% of women who gave birth in Los Angeles County received no prenatal care or didn’t receive any until the third trimester of pregnancy, according to the county Department of Health Services.

In an effort to change that, the department--working with community service organizations--has launched a new telephone service for pregnant women. Referrals to both public and private doctors are available through Healthline, (213) 250-8055, Monday through Friday, 8 a.m. to 5 p.m. Operators are multilingual.

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