Follow-up to the Egg Conundrum

So the last blog post generated a lot of hits and I appreciate all the comments you left.  I think it’s led to a fair discussion on the specifics (or rather, the lack of specific info available) about the CVAC pod device.  Many of you who left comments asked questions about altitude training and the differences between hyperbaric and hypobaric chambers.

In summary, altitude training involves training at high altitudes, where the oxygen content is lower than it is at sea-level.  Due to the stress this causes on the person, the athlete’s body will naturally start to produce more red blood cells, which increases his/her oxygen-carrying capacity.  This is helpful for the athlete’s endurance and it is common for athletes to undergo altitude training before competition.

  • Hypobaric chambers (hypoxic therapy) simulate the conditions of altitude training. Subject is placed into a low-oxygen chamber, which increases red blood cell production.
  • Hyperbaric chambers use oxygen in a high-pressure atmospheric setting.  The increased air pressure allows the person’s lungs to gather more oxygen.  The oxygen is then dissolved into the blood and circulates in the body, which speeds up the recovery/healing process for an athlete.

CVAC Systems, the manufacturer of the pod device, claims its technology is different from both hypobaric and hyperbaric therapy.  I tried searching for more scientific research that might support the company’s claims.  So far, there is little research available, apart from a small study that was conducted in 2009 that did not look at the device’s effects on athletic performance.

The video link here is a company presentation that the CEO Allen Ruszkowski gave at the DEMO Fall Convention for Emerging Technology in 2011.  The presentation focuses mostly on the CVAC pod’s potential to prevent or alleviate symptoms of Type 2 diabetes.  At present, however, the CVAC pod is only marketed for improving fitness.  The company’s website provides a list of physical therapy clinics (all based in the U.S.) that offer sessions in the CVAC pod.  The following is from the FAQ section on the Lunar Health & Wellness Clinic’s website:

 Is a CVAC pod the same as a hyperbaric chamber?

Answer: No, the two are not the same. A primary difference between the two lies in the use of low pressure (vacuum) and the use of high pressure. The hyperbaric chamber provides a high-pressure environment to flood the body with oxygen. The CVAC process involves a low-pressure (vacuum) environment.

How does the CVAC process compare to intermittent hypoxic training (IHT)?

Answer: The CVAC process and intermittent hypoxic training (IHT) compare only because each methodology may be employed to potentially induce the high-altitude adaptation response.

IHT involves exposure to a constant hypoxic environment. The CVAC process provides a dynamically changing environment that employs very short-duration exposures to hypoxia. The breathed, less-dense atmosphere (fresh air) that is produced during a CVAC session is natural, and does not employ chemical means or nitrogen/oxygen separators.

Judging from the information, it appears the CVAC pod is a far more advanced version of hypoxic therapy (aka a more advanced hypobaric chamber).

One interesting tidbit came from CVAC Systems’ company website.  The inventor of the CVAC pod technology, Carl Linton Jr., first tested the CVAC technology on racehorses.  According to his profile,

In 1989, I began using racehorses to evaluate CVAC’s performance. I learned a lot about what happened with a horse’s physiology as I changed altitude points … A general improvement in wind and recovery was seen in all the horses, and most of them could be removed from steroids.  Blood iron levels, hemoglobin, and hematocrit counts improved in all the horses that were tested.

Then there was ‘Kopper Kitty,’ a stakes-bred racehorse that was injured to the point where she had no monetary value, but her trainer decided to give her a last chance, with CVAC. An initial blood sample showed below-normal iron and hemoglobin values. After one month of sessions, a subsequent blood test showed a 20 percent increase in those levels, into the upper band of ‘normal.’

 Again, these quotes come from the company website and there is no reference to scientific studies that support these claims.  Still, the purported effects of the pod on a racehorse’s hemoglobin and hematocrit levels (two measures that cycling’s anti-doping authorities monitor to detect blood doping), along with the implied claim that CVAC technology was more effective than steroids, raises a red flag that calls for WADA to take a closer look.

Sidenote: In the last entry, I wrote briefly about lax anti-doping standards in tennis.  I thought it would be relevant to point out here that in 2009, the ITF conducted only 21 tests for EPO.  Not one of those tests was an out-of-competition control.  EPO is a hormone that the kidney naturally produces to regulate red blood cell production.  If injected subcutaneously or intravenously, EPO increases red blood cell production and is thus a banned performance-enhancing drug.  Given that ITF testing data covers both male and female tennis players, the 21 EPO tests for all of 2009 is an extremely low number.  The ITF does not offer any data about the number of EPO tests administered in 2010.  Again, this invokes the theme that anti-doping efforts in tennis are weak in comparison to other sports.  Bonnie D. Ford of ESPN questioned the ITF about the low number of EPO tests and the ITF replied they were focusing more on detecting steroids and stimulants, rather than EPO.  This raises the question of whether the ITF has sufficient resources to conduct a thorough anti-doping program and whether the current testing program is sufficient to catch potential blood doping violations.

Due to micro-dosing and new forms of EPO that are undetectable after 6-12 hours, cycling monitors the hematocrit and hemoglobin levels in an athlete’s blood in order to combat blood doping.  Cycling’s recent introduction of the “biological passport system” is a breakthrough achievement for anti-doping.  A thorough introduction to the scientific and legal components of the biological passport system can be found here.  Basically, the bio-passport is a long-term blood profile of an athlete.  Labs track minute changes in an athlete’s blood by looking at specific biological markers.  The bio-passport can detect blood doping even after a banned drug has left the athlete’s body, because the passport looks for abnormal shifts in an athlete’s blood parameters after a doping incident.  The Court of Arbitration for Sports has already used the results of the bio-passport to suspend athletes for doping.  One question raised by two physiologists (they run the website The Science of Sport) about the CVAC pod, was whether the physiological effects of the CVAC pod would be great enough to trigger the bio-passport systems.  Since the CVAC pod is not a drug, the only way to test for unfair advantage is by looking at the physiological effects the device has on an athlete’s blood profile.  Testing through the bio-passport system could provide a clearer answer.

Just last year, the UK Anti-Doping Agency announced they will adopt the biological passport system in order to monitor British athletes before next year’s Olympics.  This July, swimming’s governing body FINA announced the adoption of the bio-passport as well.   Although the administrative costs of running a bio-passport program are considerably high, the biological passport is an anti-doping paradigm that tennis should consider.  At the bare minimum, the ITF should at least be testing more frequently for EPO, both in- and out-of-competition.

On that note, the publicity that the CVAC pod has generated also merits a definitive response from both the ITF and WADA, in the form of a reliable study that tests whether or not the CVAC pod can unfairly benefit an athlete’s performance.  For all we know, the CVAC pod may be nothing more than a placebo and not much more effective than a basic oxygen tent.  Until more studies are completed, however, it is impossible to judge.


About mariposaxprs

I play favorites with Juan Martin Del Potro, Rafael Nadal, Roger Federer, David Ferrer, Feliciano Lopez, Gilles Simon and the long line of mercurial talent that drives me to despair in front of the screen at odd hours during the week.
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10 Responses to Follow-up to the Egg Conundrum

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  9. So in humans, “EPO is a hormone that the kidney naturally produces to regulate production. If injected subcutaneously or intravenously, EPO increases red blood cell production and is thus a banned performance-enhancing drug.” As for the horses, their “blood iron levels, hemoglobin, and hematocrit counts improved in all the horses that were tested.” So in other words, they both do the same thing by increasing red blood cell production? So isn’t that “egg” cheating?

    • mariposaxprs says:

      Well, there’s no evidence so far that the “egg” does anything out of the ordinary. The marketing behind the device, however, raises many questions. If the company claims the device is twice as effective as blood doping, that’s certainly a good reason to look into the effects the device has on athletic performance. When it comes to this device and what it can/cannot do, everything is a bit unclear at the moment..

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