Diet gobbledygook

Nutrition is an area where misconceptions and prejudices reign. Despite an appalling lack of evidence, "experts" won't think twice about calling certain foods healthy or unhealthy, prescribing diets to lose weight, or telling athletes what they can and cannot eat. Unfortunately, the problem is not just limited to the popular press. It pervades training and coaching manuals, is endorsed by professional societies, and can be found in medical and scientific journals.

Let's get a few facts straight about food. Facts that are supported by real hard data, not someone's idea of how things should be done.

First, food quality in the Western World is exceptional. Food poisonings are extremely rare and very few illnesses are caused by tainted foods or water. Availability of good food and clean water have been major contributors to better average longevity. These contributions far exceed the contributions made by the medical profession, except for vaccines. It is probably fair to say that we live long lives primarily because of clean water, good quality food, and proper sewage systems.

Second, diets in the West are another matter altogether. Most Western diets are not healthy as evidenced by the obesity epidemic. The diets are too high in calories, too salty, and too high in carbohydrates. Food consumption in the West is no longer driven by hunger or need, but by desire. Too much food is available and too much time is spent eating and drinking, leading to excess intake. Most food items have also been manipulated to an artificial but highly desirable sweetness, saltiness, and spice level that is meant to promote overeating and is making food an addictive substance. Seasonal intake patterns have been removed leading to further excesses.

Thirdly, people are largely independent of their diet. Adults can survive and thrive on anything from an almost purely carnivorous to an almost purely vegan diet. And if properly conditioned, they can do effective work on pretty much any diet too. The contributions of diet to performance are minimal within a large parameter range. As long as there are no significant chronic deficits (and these are extremely hard to come by in the West), performance will not be impaired. Children are more sensitive, but even children rarely develop deficits in the US or Western Europe.

Fourth, there is no need for supplements, minerals, or vitamins apart from those present in natural foods. There is no evidence that such concoctions have any benefit whatsoever, and in many cases, serious adverse effects have been demonstrated. There are more problems with vitamin overdose than with lack of vitamins in the West. No supplement has ever been shown to be beneficial in a prospective study and many have been shown to promote the very illnesses they were supposed to cure. Despite being a multi-billion dollar industry that grows at double digit rates, the supplement industry serves no purpose other than consumerism. There is no scientific evidence that a "multi-vitamin" is good for you, but there is some evidence that it can harm you.

Despite all the hoopla and recommendations, performance in endurance events is not affected by diet and endurance events do not require a "special diet."  There are two important exceptions to this rule.

The first relates to having an upset stomach. Ignoring infectious causes, the most common culprit is slow digestion and uptake. That can happen when the workload is too high for too long or when the person is not well adjusted to the diet or both. You will not do well eating French fries while cycling unless you are used to doing so and unless you can reserve some of your cardiac output to digestion (i.e. you are not at your maximal heart rate for an extended period of time). In general, since fats take longer to digest, eating a lot of fat while exercising is not recommended but some people can do well eating fats and competitors have done well in RAAM eating cheeseburgers, pizza, and fries.

There are no performance or health advantages to a liquid diet. If the liquid diet is well balanced, there are no disadvantages either. It is a matter of personal preference.

Heavy workloads call for no food or easily digested items. Carbohydrates are the easiest to digest and result in the fastest energy delivery. Only anaerobic episodes or prolonged exercise require additional intake. You can easily run a marathon without eating or drinking and do very well too.

The type of activity also matters. Running is easily the most sensitive to eating and to eat while running requires training. Apart from high workloads and sweating that can lead to electrolyte imbalances (the gut is sensitive to electrolyte levels), running also causes bouncing and seems to promote diarrhea in sensitive individuals. Many elite distance runners experience an occasional embarrassing event. 

Running is almost entirely done on fatty acids derived from stored fats. There is no need to eat while running unless you run for more than a day on end.

The second problem is weight. Weight is the number one enemy of the endurance athlete. It matters less in some sports, such as swimming or track riding, but it is totally detrimental to other sports such as running.

There is overwhelming evidence to support the notion that carbohydrate-rich diets promote weight gain. Diets rich in fats (the French diet is very fat-laden) often lead to the lowest steady weight and are best to induce weight loss. This is contrary to the prevailing view of the medical establishment and nearly every nutrition science publication. Yet it has been repeatedly demonstrated in large studies.

The prevailing "medical" view however, is not based on science, but appears rooted in prejudice, as many investigational journalists have clearly illustrated.

Diets high in fats, even saturated fats, do not cause weight gain. They also do not cause or contribute to heart disease, diabetes, or metabolic syndrome. If anything, carbohydrate rich diets are the more likely culprit. However, before pointing the finger at any diet, it is good to remember that genetics plays a much bigger role than diet does. And the worst part of a diet is the quantity of calories consumed, not the composition of the diet per se.

Bon Appetit to all.

Calories and energy (once again)

The other day I was offered an energy drink sample "without calories." It happened at the expo for a major race. I was in a good mood, the drink tasted fine and the sales person was upbeat. So I decided to ask a stupid question: how can the drink have energy without calories? The friendly sales person did not get the joke. He seriously tried to help me by talking about carbohydrates, fats, and the like. It fell short.

Desperate, and suspecting he missed something important, he referred me to his expert colleague who pondered the same question. We had a bit of a back and forth and the "expert" finally agreed there was a minor problem "in my way of looking at things."

Well, he said, look at it this way, the drink does not contain energy, it releases your energy. There you go. My energy was trapped in my body. It could even make me fat if I was not careful. My body was good at storing energy, yet when it came to using it, it underperformed. No wonder we have so many obese people?

My energy was screaming to be released, apparently in vain. And that is why his company had developed this miraculous drink. So I could use the energy stored in my body. It is amazing what one can hear at health expos. Athletes must be very gullible indeed.

Energy and no calories. The trick? Caffeine.

At the risk of spoiling the fun, I want to just clarify a few issues.  A calorie is a unit of energy, much like a inch (or a meter) is a unit of length and a pound (or a kilogram) is a unit of weight. When you say a food contains energy but no calories you make no sense. It is like saying my arm is long but has no inches, or my backpack is heavy but has no pounds. If a drink has zero calories it has no energy. Ergo, it is not an energy drink.

Nobody requires special stuff to burn energy. We do it continuously. It is essential to life. If you cut off my energy supply I die. Right away. Every cell in a body needs a continuous energy supply. You cut it off and it's game over. Not all cells are equally demanding however, and some can use energy anaerobically (i.e. without oxygen). Ironically enough, the cells that transport oxygen (the red blood cells) are anaerobic cells. No fair stealing the cargo!

Here is another trick question that is often asked in physiology exams: how long does it take for your brain to die when there is no glucose? Hint: Brains are very energy intensive and they can only use glucose under normal conditions.

Most people think it takes a while. A few hours maybe? So, let's ask the question a different way, how long does it take for your brain to die without oxygen? That is better you say, everyone knows it takes only a few minutes (three minutes is often used). 

Have you ever wondered what your brain does with the oxygen? It oxidizes sugar (glucose). No sugar is equivalent to no oxygen. 

What throws people off is that everyone knows you have to breathe all the time to stay alive, but you don't have to eat nearly as frequently -although some seem to have missed the latter rule. The reason you don't need to eat all the time is because you can store substrate (fuel) but not oxygen.

There is glucose floating around in your blood all the time. The level of glucose is constant and your liver keeps it that way. It is a tightly regulated system and only your brain can use glucose at any time. The rest of your body has to do with fatty acids.

To keep glucose levels constant, your liver has access to plenty of stored glucose in the form of glycogen. If the glycogen runs out, the liver can regenerate sugar from protein. It can keep going like that for a day or two. Fortunately, that is rarely called for and most people eat 3-4 meals a day to replenish the stores.

Should trouble arise, there is another fallback mechanism. The liver can produce ketones from fat. Although you can and do make fat from sugar there is no way back.

During times of starvation, your brain can switch to ketones and stay alive. At the same time, your metabolism is throttled back too. All these combined give you several weeks to months worth of survival if needed. 

However, as any diabetic can tell you, if your blood sugar (glucose) level drops by even a small amount, you can go in coma and die rather quickly. The reason diabetics know this is because they have access to a rather powerful drug called insulin. And they have to measure their insulin carefully because insulin can play havoc with your glucose levels in a heartbeat. All diabetics experience hypoglycemia at least once in their lives. It is a rather unpleasant and potentially deadly experience that requires quick intervention lest it be fatal.

The latter also explains why so-called "hypoglycemic" attacks in otherwise normal individuals who do not inject insulin, are nonsense. Nonsense too are the prescriptions not to eat sugars before exercise lest you suffer from a bout hypoglycemia minutes later. Some extend this to simple sugars (versus the "healthier" complex carbohydrates) or to sugars and coffee. All of it is nonsense.

It is often explained in the following way: you eat too much sugar so you get an insulin response with an overshoot and then you start shaking and feel weak because of hypoglycemia. Unfortunately, there is no evidence for it whatsoever. Although it may sound plausible, it is not. Blood glucose levels are not to be messed with. Remember, no glucose is equivalent to no oxygen. No room for sloppy behavior here. No room for "a bit of an overshoot."

Not convinced? Ever seen evidence of people going in coma with convulsions after eating too much candy?  It does not happen. If it did, the US population would decrease rather quickly.

As for the complex carbs, it is another popular myth. Complex carbs are absorbed as simple sugars. It takes marginally longer to do, but the difference is irrelevant.  Carbohydrate breakdown in the gut is incredibly fast. Furthermore, as far as the blood is concerned, the only "visible" sugar here is glucose.

No evidence for fiber either. Absorption with or without fiber appears equally quick. Some have shown evidence that the presence of fiber may accelerate uptake instead of slowing it down.

In short, all the talk about glycemic index is pseudoscience. It is not even clear that the stated glycemic index of a particular food item is accurate.

There is only one thing to remember about carbohydrate. Too much makes you fat. And it does so because it is easy to eat carbs and to keep eating them. If you only eat carbs you are very likely to over-eat. And that is not good. Put some cream cheese on your bagel !

Shaving off seconds

Quite a bit of work has been done on the 40 kilometer (roughly 25 mile) time-trial. Although I would not consider 25 miles on a bicycle an endurance event, something can be learned from these studies. Twenty five miles is long enough so most power generation is done aerobically and therefore the findings are to some extent applicable to longer distances.

Time trials (TT) are easier to study than mass start races, where team tactics, skill, experience, drafting benefits, and other hard to measure variables easily cloud the picture. TT studies can be found in many publications and I won't repeat them here except to highlight a few rather self-evident facts. You may wonder why someone would care about things that are self-evident, but in this day and age there is so much information (read advertising) out there that many people forget the basics.

Not surprisingly, training provides the biggest gains, exceeding those of lighter bikes, aerodynamic frames, and other gadgets. Furthermore, the less "base" you have, the bigger the effects of training will be. If you are an experienced cat 1 cyclist, training will help but not nearly as much as when you are a novice or rookie. Still, elite riders can expect as much as 3% gain from a good program. That is certainly significant enough to make a difference. One would expect the gains of training to be even bigger for longer distances. Clearly, a 100+ mile ride requires training. You cannot "buy" your way into such an event.

Weight matters but only when you climb. You need to do a fair amount of climbing before you can see the benefits. For a short 25 mile time-trial, that means you need a pretty steep average grade, well in excess of 5%, but over a distance of 112 miles, things add up rather quickly. When it comes to weight, every little elevation change matters. Those numerous 15 ft "bumps" on the road may not show on the map, but when you add them all up, they can easily become a serious climb by the time you are done.

The best way to reduce bicycle weight in a race is not to buy a lighter frame, but to watch what you lug around. First take a look at your saddle bag. There is no need to carry a laptop computer with you in a race. There is also no need to carry enough supplies to cross the Kalahari in summer.

Two large full water bottles will add 3 pounds (1.3 kg), more than many frame fork combinations. While that may make sense on a long training ride in the hot sun, it is rather silly in a race or event, where you can get fresh, cold water every 10 miles or so. Grabbing a bottle will not slow you down significantly once you learn how to do it properly. But carrying extra weight will not just slow you down, it will also tire you out.

On the flats, aerodynamics matter the most. In mass start events, that means drafting. While most people can draft in a headwind, few seem to understand that you need to ride in a echelon to draft in a crosswind. This obvious fact seems common knowledge in Europe, but it is rare to see American riders ride that way. For time-trails and triathlons you need to resort to aero equipment as drafting is not allowed.

The gains from a proper aero position and frame can be quite significant. Some estimates for a 40K TT are as high as 2.5 minutes. Furthermore, these gains tend to be the same irrespective of your level of training. First and foremost, good aero means nothing flaps around in the wind. Watch that race-number. You can easily waste 10-20 W! That is a huge drag, even for an elite cyclist. The second thing to watch out for is items stuck to your frame. That $5 pump can easily nullify the gains from a $3,000 frame. If you "need" the pump, then be sensible enough to save the money on the frame.

Lastly, it may surprise some, but caffeine, the only legal performance enhancing drug saves anywhere from 1 to 1.5 minutes over a 40K distance. That is more than half as much as your aero-frame, at a much better price point. 

Sugary drinks help too, but much less so. When it comes to sugary drinks (or carbohydrates), there is no significant difference between the various brands. Just as long as you supply the calories. In general, you should not exceed 300-400 calories per hour as that is the limit of what people can absorb in a race. There is little benefit from "long-acting" or "slowly digesting" carbs during a race. You need the energy right then and there. During a race is not the time to start storing energy or digesting food.

VO2 max

I am sure that by now you heard of VO2max or maximal oxygen capacity. To some it is the "new new thing." The ultimate measurement. It probably helps that the standard method for measuring VO2max is a rather involved lab procedure that uses a breathing apparatus. It also helps that the name is a rather exotic sounding amalgamation of letters and numbers. Furthermore it refers to oxygen by its chemical symbol O2 and there is something to be said for that too. Pass the H2O please !

VO2max measures how much oxygen you can use to perform "work." It is expressed in liters of oxygen per minute or in milliliters (1/1000 of  a liter) of oxygen per kilogram of body weight per minute. It is largely limited by how much blood your heart can pump around and not, as most seem to think, by how much lung volume you have.

The value is obtained by measuring oxygen consumption at maximal effort. In general, a step-wise approach on a treadmill or static cycle is used, where exercise intensity increases until a maximum is reached. All the while you breathe through an apparatus that measures your actual oxygen consumption (difference in O2 between inhaled and exhaled air). Needless to say, such efforts are not recommended for people with cardiovascular problems.

A very good approximation can be had by measuring your best time to run a fixed distance. Or, as many seem to prefer, running for a fixed amount of time and measuring the distance covered. The two are equivalent but I guess the latter is "preferred" because it is a bit more tricky to do?

Let's just stick to the 5K and assume you are an average person (i.e. not to heavy and not too skinny). Warm up properly and run your 5K as hard as you can but at a steady pace. I chose 5K because it is easier to run a fixed pace for a short distance. But we need at least 5K -some argue 15 minutes- and most people need to run for at least 15 minutes to become fully aerobic. So if you are in the fastest group, you may want to run a 10K instead.

Here are some good values (for 5K run, in ml/kg/min):

Time VO2M Speed Pace

13 minutes 82.1 14.3 mph 4:11 minute mile

15 minutes 69.6 12.4 mph 4:49

17 minutes 60.2 11.0 mph 5:28

19 minutes 52.9 9.8 mph 6:06

21 minutes 47 8.9 mph 6:45

23 minutes 42 8.1 mph 7:24

25 minutes 38.3 7.5 mph 8:02 minute mile

Average for males and females in the "general population" is 48 and 39 respectively. Top runners and cyclists are anywhere between 70 and 90 for males and 50 and 70 for females.

VO2max is generally seen as the best measure of cardiovascular fitness and aerobic power. It does not measure how much anaerobic power you can produce and so it is quite useless for sprinters, and practitioners of sports where anaerobic power is key, like soccer, basketball, football, etc.

For simplicity's sake, aerobic exercise is all exercise that is steady over long periods of time (tens of minutes to hours), or increases/decreases gradually over time to a new set point. Any rapid increase in energy output bypasses the aerobic system. High intensity efforts, such as climbing steep hills on a bike also use a fair amount of anaerobic power.

There are individual differences as to what constitutes a rapid increase, and training matters a lot. The better trained you are the more aerobic you will be in everything you do. But even the best trained individuals resort to some anaerobic power production and anything that takes place in under a minute or is very intense is almost invariably anaerobic. The same applies to all initial exercise (before warm-up).

VO2max is an important parameter for endurance athletes, and top performers in running, cycling, swimming, cross-country skiing, rowing and canoeing have a high VO2 max. But VO2max does not tell the whole story and some athletes with lower measured VO2max have done better than others with higher readings.

Bottom line: Human performance in real life situations is not something you can capture in one number and your performance in the race matters more than the results of a fancy test.

Key parameters

America loves numbers. There are numbers everywhere you look. From sport statistics to the "seven habits of *you name it*  people," to the score of the latest vintage wine. Magazines abound with twelve special foods you should eat, ten tips to lose weight, and seven steps to success.

Numbers are compact and easy to remember. A numbered list brings structure where none existed before. Being quantitative is the hallmark of a scientific method. Science is based on numbers. Hard data they call it, and that is true provided the numbers are meaningful. To be meaningful, the numbers have to be obtained through repeated and accurate measurements in carefully controlled conditions. The trouble is, none of the numbers I listed before were obtained in this manner. They are deceptive numbers used to hide qualitative assessments and personal opinions. They give you the impression of precision, accuracy and reproducibility where none exists. Meaningless numbers like that are as plentiful as weeds in an untended garden.

Some numbers are used to describe and compare fitness and training. Triathletes seem obsessed with such variables, but other athletes are taking notice as well. Often these individuals go to great lengths and spend serious amounts of money to have someone make a few measurements for them. It "helps" that health clubs and gyms see profits in making and interpreting such measurements. Unfortunately, the readings are often made in incorrect ways and more attention is paid to fitting a schedule and the availability of equipment than to what is actually being measured.

Not only are the data at best quite shaky, they are almost always used in incorrect ways. That is not necessarily the fault of the person performing the tests. These people are often quite dedicated and strive for accuracy. However, ignorance, tight testing schedules, and profit motives all conspire to derail good intentions. Quite often only a single value is obtained under sub-optimal conditions. No time for repeats, sorry folks! 

Even more frequently that single value is then treated as a true reflection of reality without any consideration for variability and measurement error. The "true" value is then used in non-sensical comparisons to reach conclusions or draw inferences that are totally unwarranted and unsupported. Some will go as far as designing entire training regimens based on such questionable tests. These highly "customized" training regimens generally command high prices leading consumers to believe that they must be valuable.

Before you get too carried away, rest assured that there is nothing better than you best 10K time to assess your cardiovascular fitness. It is easy to measure, highly reproducible and you can do it anytime and almost anywhere. And in case you care, with the help of simple lookup tables you can get a very accurate estimate of your VO2 max and all the bragging rights that it entails.

All without spending a dime!

Gadgets

In the early days of cycle computers you would buy a small device that read out speed, average speed, distance, and possibly cadence. Why people wanted cadence was always beyond me but that is another matter. One thing about those early devices -Avocet was a major brand then- was that they were easy to install, reliable, and had a very long battery life. They were essentially trouble-free. You installed them and you did not need to worry about them for at least another year or two. 

The data from these computers was accurate and reproducible. It was also useful and easy to interpret. However, as time went by companies saw the potential to increase their profits by adding more data, more storage, more features, and more "analysis." Today's cycle computers are overstuffed toys, full of unnecessary functions. These toys are also overly expensive, but provide little value other than entertainment. All come with often overlooked but major hidden costs.

The devices are tricky to install and tricky to use; they are often unreliable and work poorly under real life conditions; the data is frequently lacking or inaccurate and even more frequently not reproducible. Many functions are based on formulas or lookup tables and may not apply to you. And worst of all, battery life is just about non-existent. You are lucky if the device has enough juice for one long ride. Some GPS devices die within six hours.

The new gadgets also have several readouts leading some people to switch between screens instead of paying attention to the road. I have personally witnessed several accidents where riders hit the deck because they were fiddling with their cycle computers. Not only is there a data overload, most devices also suffer from very poor interface design. We may have to wait until Steve Jobs turns his attention to the cycle computer before things will change.

Newer gadgets also allow the user to download values. This ensures hours of additional wasteful  entertainment. Given the poor quality of the recorded data, one wonders how useful analysis can be. Some device makers are apparently aware of this problem and they sneakily "correct" the data coming from your gadget. In most cases they do so without warning you or without giving you the option to disable the "feature." Nearly all download programs smooth the data. Smoothing can be helpful but in many instances it is the instantaneous changes that have the highest information content. However, given the noisy nature of the data, it is probably just as well that these are smoothed out.

Some companies go even further. Most GPS devices will correct your recorded position when it happens to lie in the scenery instead of on the road. One can argue that this is a good thing. But what does it tell you about your speed or distance? If these are "corrected" too, then what did your expensive gadget really do for you?

One of the first "hot" features added was the altimeter. Altimeters work with pressure sensors that need to be nulled before every ride. Unless you are a airline pilot with access to air traffic control, that is easier said than done. Blame the interface, or the complex routine needed to reset the device; or the difficulty of finding out what the barometric pressure is at the time of the ride. Whatever the reason, the fact is that most people don't bother resetting their altimeters before a ride. What that means is that their data are off by a sizable margin. Never mind the temperature sensitivity. As the ride progresses and the temperature changes -quite common on the California coast- the meter starts drifting over time, making all readings completely useless. 

While most cyclists are aware of these problems, few seem to care.

It gets even better when you add a heart rate monitor. Not only can you pick up other people's readings unless you have a coded transmitter, you can also skip beats or record extra beats due to poor connections. The efficiency changes with skin moisture and can fail with no sweat or too much sweat. Movement of the strap can easily cause artifacts or missed readouts and many devices pickup EMG signals from the chest muscles. The latter is much more of a problem for runners who move their arms than for cyclists who often sit quite still. Even so, about half the time your readout is incorrect or unreliable for one reason or another. And it happens more frequently when you go hard. Needless to say that is also the time when the information is most valuable.

Once again experience shows that most users are aware of the problems but that does not seem to affect their enthusiasm for using the device. Nearly everyone I have talked to told me their heart rate monitor does not work properly from time to time. All have learned to ignore very low or very high readings, and most have developed some "intuition" for correct readouts.

Heart rate monitors have alarms to alert you when you cross a preset threshold. It is quite common to run by someone whose heart rate monitor is acting up and beeping furiously. Much like the neighborhood car alarm that everyone ignores, the owner of the device has long since stopped paying attention to the beeps. But he or she still uses the device in every race.

Ultimately the real problem here is not that devices give random incorrect readings. When used properly these tools can be quite informative. The trouble is that most people don't take the time to learn to use them properly. But they still rely on the "information" or defer to the meter. And in the process they no longer pay attention to their body.

Listening to your body is one of the most valuable skills you can develop as an endurance athlete. And one of the best ways to do so is to train without gadgets. Save the devices for a few tests that you can use to track your progress on a regular basis. At other times, you are better off with just a plain old wired speedometer. It will save weight and batteries too.

Science and medicine in sports

Sport science papers often leave a lot to be desired. Despite all the hoopla about the scientific method, I found the field to be severely lacking in rigor. While I understand that it is difficult to work with human subjects and that good controls are hard to come by, the authors often fail to take into account how biased their samples are, and how poorly reproducible their findings turn out to be.

Working with the best athletes poses extra challenges. First of all, these individuals have personal goals that may not align with the study goals. They are likely to be secretive if a potential edge is expected. Nobody wants to be a control subject in a double blind study and few will participate unless it is expected to benefit them. But more importantly, top athletes do not have the time and the energy to spend on a rigorous research study. Their careers are short, and unless they are at the very top of a highly popular sport, they may have trouble making enough money to support the remainder of their life.

Readers, especially those of popular magazines are equally uncritical. They are eager to find an edge or know about a breakthrough. Breakthroughs are by their nature extremely rare and not responsive to publication deadlines. Yet everyone is eager to find an edge and many do find what they think is an edge. In such cases, they rarely want to verify their results. They do not want others to find out, and perhaps they are loath to burst their bubble too.

It doesn't stop there. The sports arena is one of remarkable contradictions. The quest for performance enhancing methods and substances is ever greater, and many companies tout the performance enhancing value of their products. They often resort to scientific-looking results to do so. Yet as soon as something is proven to enhance performance, it is immediately outlawed and its users are branded cheats and run the risk of being banned from further competition. 

It is curious to see how amateur athletes will take supplements and vitamins, yet complain when their idols use performance-enhancing "cheats." It is as if everybody knows that the magic potions don't work, or are illegal if they do, yet at the same time, everybody wants something to perform better. 

The rationale for these taboos is totally shaky. It usually comes down to some vague unproven claim of adverse health effects. The authorities do not want competitors to get hurt? Yet they do allow certain methods but outlaw others, although the final results are identical.

Eg. high altitude chambers, infusion of red blood cells, and erytropoietin all strive to increase the oxygen carrying capacity of blood. That leads to better performance. In many subjects these methods can be equally effective, yet while the first one is legal and extensively used by Olympic training centers -including the US center in Colorado-, the latter two are illegal and will cause the subject being barred from competition for a minimum of two years. So while everyone applauds the US Olympians who spend their waking hours in high-altitude tents, these same people will vilify others who resorted to "blood doping" or injecting EPO. 

This bipolar attitude has created a whole subculture of illegal performance enhancing substances and a similar subculture of testing for such substances. And while studies clearly show that some individuals can take these illegal substances without testing positive, while others cannot, the establishment continues to discriminate between the two, to uphold its "moral high ground."

History has shown that this attitude is unproductive. The "cheats" will continue to cheat and will not be deterred. Instead they will go and find newer ways to evade the rules. The game of cat and mouse can go on forever. In the process tons of money is wasted on needless testing and law enforcement while a whole subculture of providers, who stand to gain more the more illegal their products are, develops and thrives.

Perhaps the worst effect is that people are experimenting with powerful drugs without any medical or scientific oversight. No new knowledge is gained from this large scale experiment. Yet knowledge about performance enhancement would benefit society as a whole.

Instead, people get hurt, careers are destroyed, money is wasted, legal issues are raised, while nobody seems to care. This is a war of ideologies, a witch hunt that ultimately benefits nobody but the drug pushers and the odd consumer who is lucky enough to get away with it or be in a sport where nobody cares very much (like baseball).