Núm. 58 (2015)
REVISIONES/ REVIEWS

Aspectos ergonutricionales e interacciones fármaco-alimentarias en el alpinismo / Nutritional Ergogenics Aspects And Drug-Food Interactions In Mountaineering. pp. 387-404

Publicado octubre 1, 2015

Resumen

Área 11. MEDICINA DEL DEPORTE / SPORT MEDICINE

Entre los principales factores limitantes del rendimiento en el alpinismo destacan el agotamiento de los depósitos de glucógeno muscular y catabolismo proteico elevado, desequilibrio hidroelectrolítico y Mal Agudo de Montaña (MAM). Ante esta situación de gran estrés que se vive en las altitudes elevadas y en estancias superiores a las 3 semanas, se hace imprescindible una óptima alimentación. Aún así, en ocasiones el MAM en los alpinistas es inevitable y en estos casos se hace uso de fármacos para afrontar dicha situación, que si no se realiza bajo un control riguroso, la suplementación puede poner en peligro la salud del alpinista por las posibles interacciones que se dan con los alimentos o ayudas ergonutricionales ingeridas.

PALABRAS CLAVE: alpinismo, nutrición, ayudas ergonutricionales, fármacos, interacciones.

ABSTRACT

The main factors limiting climbing performance are the following: muscle glycogen depletion, increased protein catabolism, fluid and electrolyte imbalance and acute mountain sickness (AMS). In this situation of high stress at high altitudes and at stances longer than 3 weeks, the diet it is essential. In the case of AMS, it is also essential the use of drugs, if it is not used in proper conditions, such supplementation could endanger the health of the mountaineer because of the possible interactions with the food and the nutritional ergogenics aids.

KEY WORDS: mountaineering, nutrition, nutritional ergogenics sports, drugs, interactions.

Citas

Álvares TS, Meirelles CM, Bhambhani YN, Paschoalin VM, Gomes PS. L-Arginine as a potential ergogenic aid in healthy subjects. Sports Med. 2011;41(3):233-48.

Anderson J, Roach J. Nutrient-drug interactions and food. Food and nutrients series. 2008;9 361.

Bailey DM, Davies B (2001). Acute mountain sickness; prophylactic benefits of antioxidant vitamin supplementation at high altitude. High Alt Med Biol;2:21 -9.

Bailey DM, Davies B, Milledge JS, Richards M, Williams SRP, Jordinsom M, Calam J. Elevated plasma cholecystokinin at high altitude: metabolic implications for the anorexia of acute mountain sickness. High Altitude Medicine & Biology, 2000; 1(1):9-23.

Bailey DM, Dehnert C, Luks AM, Menold E, Castell C, Schendler G. High-altitude pulmonary hypertension is associated with a free radical-mediated reduction in pulmonary nitric oxide bioavailability. J Physiol. 2010;588(Pt 23):4837-47.

Baillie JK, Thompson AA, Irving JB, Bates MG, Sutherland AI, Macnee W. Oral antioxidant supplementation does not prevent acute mountain sickness: double blind, randomized placebo-controlled trial. QJM,2009;102(5):341-8.

Beard J, Tobin B. Iron status and exercise. Am J Clin Nutr. 2000;72(2):594S-7S.

Beedie CJ, Foad AJ. The placebo effect in sports performance: a brief review. Sports Med. 2009; 39(4):313-29.

Bescos R, Rodriguez FA, Iglesias X, Ferrer MD, Iborra E, Pons A. Acute Administration of Inorganic Nitrate Reduces V˙O2peak in Endurance Athletes. Medicine, science in sports and exercise. 2011;43(10):1979-86.

Bishop D. Dietary supplements and team-sport performance. Sports Med. 2010;40(12):995-1017.

Borm N, Van Roo JD, Pesce C, Courtney DM, Malik S, Lazio MP. Prior altitude experience of climbers attempting to summit aconcagua. High Alt Med Biol. 2011;12(4):387-91.

Bourrilhon C, Lepers R, Philippe M, Beers PV, Chennaoui M, Drogou C. Influence of protein- versus carbohydrate-enriched feedings on physiological responses during an ultraendurance climbing race. Horm Metab Res. 2010; 42(1):31-7.

Brinker F. Herb and drug contraindication and interaction, 2. A ed. Sandy, Ore: Ecleric institute, inc; 2001.

Brutsaert TD, Hernandez-Cordero S, Rivera J, Viola T, Hughes G, Haas JD. Iron supplementation improves progressive fatigue resistance during dynamic knee extensor exercise in iron-depleted, nonanemic women. Am J Clin Nutr. 2003;77(2):441-8.

Centro regional de farmacovigilancia de Castilla y León. Interacciones entre plantas medicinales y medicamentos. Boletín de la tarjeta amarilla. 2006;22:1-3.

Chu KS, Doherty TJ, Parise G, Milheiro JS, Tarnopolsky MA. A moderate dose of pseudoephedrine does not alter muscle contraction strength or anaerobic power. Clin J Sport Med. 2002;12(6):387-390.

Clarke ND, Maclaren DP, Reilly T, Drust B. Carbohydrate ingestion and pre-cooling improves exercise capacity following soccer-specific intermittent exercise performed in the heat. Eur J Appl Physiol. 2011;111(7):1447-55.

Córdova A. Los inmunomoduladores frente a la inflamación y daño muscular originados por el ejercicio. Apunts Med Esport. 2010;45(168):265-70.

De Rosa J, Luluaga S. La Dieta Mediterránea. Prevención Cardiovascular “Al Alcance de la Mano”. Rev Fed Arg Cardiol. 2011;40(4):316-22.

Drug information for the health care professionals (USPDI). 23 a. ed. USA: Rand Mc Nally; 2003.

Duclos M. Glucocorticoids: a doping agent?. Endocrinol Metab Clin North Am. 2010;39(1):107-26.

Dumont L, Mardirosoff C, Tramer MR. Efficacy and harm of pharmacological prevention of acute mountain sickness: quantitative systematic review. BMJ. 2000; (321): 267-272.

Duplain H, Sartori C, Lepori M, Egli M, Allemann Y, Nicod P, Scherrer U. Exhaled nitric oxide in high-altitude pulmonary edema: role in the regulation of pulmonary vascular tone and evidence for a role against inflammation. Am J Respir Crit Care Med. 2000; 162:221-24.

Ferraz AC, Almendra RG, Sonagli M, Borges C, Araujo P. Chronic ω-3 fatty acids supplementation promotes beneficial effects on anxiety, cognitive and depressive-like behaviors in rats subjected to a restraint stress protocol. Behav Brain Res. 2011;16;219(1):116-22.

Filaire E, Massart A, Rouveix M, Portier H, Rosado F, Durand D. Effects of 6 weeks of n-3 fatty acids and antioxidant mixture on lipid peroxidation at rest and postexercise. Eur J Appl Physiol. 2011;111(8):1829-39.

Fisher-Wellman K, Bloomer RJ. Acute exercise and oxidative stress: a 30 year history. Dynamic Medicine. 2009;8(1):1-25.

Garnés AF, Mas OC. Ayudas ergogénicas en el deporte. Efdeportes. 2005;10(86).

Gertsch JH, Seto TB, Mor J. Ginkgo biloba for the prevention of severe acute mountain sickness (AMS) starting one day before rapid ascent. High Alt Med Biol. 2002;3:29-37.

Gertsch JH, Lipman GS, Holck PS, Merritt A, Mulcahy A, Fisher RS. Prospective, double-blind, randomized, placebo-controlled comparison of acetazolamide versus ibuprofen for prophylaxis against high altitude headache: the Headache Evaluation at Altitude Trial (HEAT). Wilderness Environ Med. 2010; 21(3):236-43.

Gillies H, Derman WE, Noakes TD, Smith P, Evans A, Gabriels G. Pseudoephedrine is without ergogenic effects during prolonged exercise. J Appl Physiol. 1996;81(6):2611-7.

Gómez-Zorita S y Urdampilleta A. Influencia de la dieta y la actividad físico-deportiva sobre el efecto de los fármacos Revista Española de Medicina del Deporte. 2013; 30(1):34-42.

Goulet ED. Glycerol-induced hyperhydration: a method for estimating the optimal load of fluid to be ingested before exercise to maximize endurance performance. J Strength Cond Res. 2010;24(1):74-8.

Hackett P H, Roach R C. High-altitude illness. N Engl J Med. 2001; (345): 107-114.

Hetzler RK, Stickley CD, Kimura IF, LaBotz M, Nichols AW, Nakasone KT et al. The effect of dynamic intermittent hypoxic conditioning on arterial oxygen saturation. Wilderness Environ Med Spring 2009; 20:26-32.

Hodges K, Hancock S, Currell K, Hamilton B, Jeukendrup AE. Pseudoephedrine enhances performance in 1500-m runners. Med Sci Sports Exerc. 2006;38(2):329-33.

Kechijan D. Optimizing nutrition for performance at altitude: a literature review. J Spec Oper Med, Winter. 2011; 11(1):12-7.

Kern BD, Robinson TL. Effects of β-alanine supplementation on performance and body composition in collegiate wrestlers and football players. J Strength Cond Res. 2011,;25(7):1804-15.

Koehler K, Huelsemann F, de Marees M, Braunstein B, Braun H, Schaenzer W. Case study: simulated and real-life energy expenditure during a 3-week expedition. Int J Sport Nutr Exerc Metab. 2011;21(6):520-6.

Kreider RB, Wilborn CD, Taylor L, Campbell B, Almada AL, Collins R. ISSN exercise & sport nutrition review: research & recommendations. J Int Soc Sports Nutr. 2010;2:7.

Larsen JJ, Hansen JM, Olsen NV, Galbo H, Dela F. The effect of altitude hypoxia on glucose homeostasis in men. The journal of physiology, 1997; 504(1):241-9.

Legaz Arrese A. Atletismo Español: Análisis básico de la pseudoanemia, anemia ferropénica y anemia megaloblástica. Revista Internacional de Medicina y Ciencias de la Actividad Física y el Deporte 2000;1(1):65-83.

Luks AM, McIntosh SE, Grissom CK, Auerbach PS, Rodway GW, Schoene RB. Wilderness Medical Society (2010). Wilderness Medical Society consensus guidelines for the prevention and treatment of acute altitude illness. Wilderness Environ Med. 2010;21(2):146-55.

Machado PM, Tavares MG. Dietary long-chain omega-3 fatty acids and anti-inflammatory action: potential application in the field of physical exercise. Nutrition. 2004;20(2):243.

Mariggiò MA, Falone S, Morabito C, Guarnieri S, Mirabilio A, Pilla R. Peripheral blood lymphocytes: a model for monitoring physiological adaptation to high altitude. High Alt Med Biol, Winter. 2010;11(4):333-42.

Mariscal-Arcas M, Carvajal C, Monteagudo C, Lahtinen J, Fernandez de Alba MC, Feriche B. Nutritional anlysis of diet at base camp of a seven thousand-metre mountain in the himalayas. Revista Andaluza de Medicina del Deporte.2010; 3(4):127-132.

Medline Plus [portal en internet]. Disponible en: http://www.nlm.nih.gov/medlineplus/spanish/

Millet GP, Roels B, Schmitt L, Woorons X, Richalet JP. Combining hypoxic methods for peak performance.Sports Med. 2010;40(1):1-25.

Napoli AM, Milzman DP, Damergis JA, Machan J. Physiologic affects of altitude on recreational climbers. Am J Emerg Med. 2009; 27(9):1081-4.

Palacios N, Franco L, Manonelles P, Manuz B, Villgas JA. Consenso sobre bebidas para el deportista. Composición y pautas de reposición de líquidos. Documento de consenso de la Federación Española de Medicina del Deporte. Revista Esp Med Deport.2008; 15(126): 245-258.

Pardo R, Alvarez Y, Barral D, Farré M. Cafeína: un nutriente, un fármaco, o una droga de abuso. Adicciones. 2007;19(3): 225-38.

Pesce C, Leal C, Pinto H, Gonzalez G, Maggiorini M, Schneider M, Bartsch P. Determinants of acute mountain sickness and success on Mount Aconcagua (6962 m). High Alt Med Biol 2005; (6): 158-166.

Phillips GC. Glutamine: the nonessential amino acid for performance enhancement. Curr Sports Med Rep. 2007;6(4):265-8.

Pradas de la fuente F. Efectos del EXPLI y sobre el rendimiento deportivo y los riesgos del entrenamiento físico de larga duración. Tésis doctoral Universidad de Granada. 2007.

Ranchordas MK, Burd N, Senchina DS, Burke LM, Stear SJ, Castell LM. Nutritional supplements: dietary supplements, sports nutrition foods and ergogenic aids for health and performance-Part 29. Br J Sports Med. 2012;46(2):155-6.

Rodriguez NR, DiMarco NM, Langley S. American Dietetic Association; Dietetians of Canada; American College of Sports Medicine. Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and athletic performance. J Am Diet Assoc. 2009;109(3):509-27.

Roelands B, Buyse L, Pauwels F, Delbeke F, Deventer K, Meeusen R. No effect of caffeine on exercise performance in high ambient temperature. Eur J Appl Physiol. 2011; 111(12):3089-95.

Sawhney, RC, Malhotra AS, Singh T. Glucoregulatory hormones in man at high altitude. European Journal of Applied Physiology, 1991; 62, 286-91.

Schommer K, Bärtsch P. Basic medical advice for travelers to high altitudes. Dtsch Arztebl Int, 2011; 108(49):839-47; quiz 848.

Shukla V, Singh SN, Vats P, Singh VK, Singh SB, Banerjee PK. Ghrelin and leptin levels of sojourners and acclimatized lowlanders at high altitude. Nutr Neurosci 2005; 8:161-165.

Simopoulos AP. Omega-3 fatty acids and athletics. Curr Sports Med Rep.2007;6(4):230-6.

Smith JD, Cianflone K, Martin J, Poirier P, Broderick TL, Noël M. Plasma adipokine and hormone changes in mountaineers on ascent to 5300 meters. Wilderness Environ Med. 2011; 22(2):107-14.

Urdampilleta, Martínez-Sanz JM, González-Muniesa. Intervención dietético-nutricional en la prevención de la deficiencia de hierro. Nutr. clín. diet. hosp. 2010;30(3):27-41.

Urdampilleta A, Alvarez-Herms J, Martinez-Sanz JM, Corbi F, Roche E. Readaptación Física en futbolistas mediante vibraciones mecánicas e hipoxia. Revista Internacional de Medicina y Ciencias de la AF y el Deporte, 2012. ISSN:1577-0354.

Urdampilleta A, Gómez-Zorita S, Martínez-Sanz JM, Roche E. La eficacia de un programa de ejercicios de alta intensidad en hipoxia intermitente para la mejora de la fuerza-resistencia. Revista Española de Educación Física y Deportes. 2012, 397(2):63-74.

Urdampilleta A, Vicente-Salazar N, Martínez-Sanz JM. Necesidades proteicas en los deportistas y pautas diétetico-nutricionales para la ganancia de masa muscular. Rev Esp Nutr Hum Diet. 2012;16(1):25-35.

Urdampilleta A y Martínez-Sanz. Riesgos médico-nutricionales y planificación dietética en el alpinismo. Mot. Eur. J. Hum. Mov.2012.28:35-66.

Vademecum. [Portal en internet]. Disponible en: http://www.vademecum.es/

Vuyk J, Van Den Bos J, Terhell K, De Bos R, Vletter A, Valk P. Acetazolamide improves cerebral oxygenation during exercise at high altitude. High Alt Med Biol. 2006; 7(4):290-301.

Wagner PD. Operation Everest II. High Alt Med Biol. 2010;11(2):111-9.

Westerterp KR, Kayser B, Wouters L, Le Trong JL, Richalet JP. Energy balance at high altitude of 6542 m. J Appl Physiol 1994; 77:862-866.

Westerterp KR. Energy and water balance at high altitude. News Physiol Sci. 2001; 16:134-7.

Zaccaria M, Ermolao A, Bonvicini P, Travain G, Varnier M. Decreased serum leptin levels during prolonged high altitude exposure. European Journal of applied physiologi. 2004; 92(3):249-53.