Forensic Perspective of Unintentional Doping, Cardiovascular Health, and the Role of Nutrition in Competitive Sports
Abstract
Unintentional doping, often caused by contaminated supplements or misinterpreted therapeutic prescriptions, poses significant health, ethical, and regulatory challenges in competitive sports. Understanding the cardiovascular risks associated with performance-enhancing substances (PESs) and the preventive role of nutrition requires integrated analysis. A systematic review was conducted in accordance with PRISMA guidelines. Searches of comprehensive bibliographic databases yielded studies published between 2015 and November 2025. Inclusion criteria encompassed peer-reviewed research on doping prevalence, cardiovascular outcomes, nutritional strategies, and supplement regulation. Data extraction focused on prevalence estimates, odds ratios (ORs), hazard ratios (HRs), and effect sizes for nutritional interventions. Quality assessment employed GRADE and risk-of-bias tools. From 1320 records screened, 60 studies were included in the qualitative synthesis and 31 in the meta-analysis. Surveys using indirect questioning estimated that 30-45% of elite athletes may engage in doping, while official anti-doping reports indicated that approximately 20-25% of confirmed rule violations are classified as unintentional. Supplement contamination accounted for 10-15% of unintentional cases. PES use significantly increased cardiovascular risk (HR for arrhythmias and myocardial infarction up to 3.5). Nutritional strategies-such as carbohydrate loading, optimized protein intake, omega-3…
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