Over most of the past century, the motto of the Olympic games has been “Citius, Altius, Fortius,” which is Latin for Faster, Higher, Stronger. In recent years the term “Communiter,” the Latin word for ‘together,’ has been added to the motto. Even though the Olympic games are the most competitive of sports events, they do have the paradoxical effect of bringing together people from all over the world for a peaceful demonstration of athletic prowess. Participants agree to, and for the most part abide by, rules that briefly suspend national, ethnic, religious, and cultural animosities.
Individual excellence is identified by the competition, even though nations sponsoring the individuals and their teams take credit for their citizen or recruited participants. Obviously, the national origin or affiliation of a Michael Phelps or Leon Marchand has nothing to do with their swimming abilities. Similarly, the gravity defying gymnastic abilities of Simone Biles are unrelated to her nationality. Nonetheless, it is refreshing to witness people from different countries striving for supremacy without resorting to bloodshed.
One of the many rules enforced by the sponsors of the games is that participants may not use certain “performance-enhancing” agents or maneuvers. Agents that are routinely banned include amphetamines (‘pep pills’), anabolic (muscle building) steroids, and hormones (e.g., testosterone, human growth hormone, etc). Over the decades, many athletes have tried to circumvent this rule by using drugs that are difficult to detect or by adopting measures that do not involve drug use. One such measure is ‘doping,’ the transfusing of red blood cells just before an event to boost oxygen delivery to muscles or the administration of hormones, such as erythropoietin [EPO], that boost red blood cell production. High red blood cell counts improve an individual’s endurance and gives him or her an advantage in sports, such as cross country skiing, that require lengthy exertions.
As hormone and genetic testing have improved over the past half century, competitive sport authorities have been faced with a new dilemma: hormonal and genetic abnormalities that give athletes a natural competitive advantage. One of the first Olympic gold medalists to raise this issue was Eero Mantyranta. This Finnish cross-country skier won seven Olympic medals in the 1960s. Routine testing of his blood uncovered an anomaly that suggested he had cheated. Whole blood is composed of red blood cells (RBCs), white blood cells, clotting elements, and some largely fluid elements. Up to 45 percent of the whole blood is typically made up of red blood cells. The percent of RBCs in Mantyranta’s whole blood was more than 60 percent. Investigations of him and several individuals related to him revealed that they had a genetic mutation in a cell receptor that increased their red blood cell production. He had not cheated to win the competition, but he did have an undeniable advantage over other competitors who lacked the red blood cell enhancing gene.
Similar hormonal and genetic issues have plagued competitors in women’s sports. In 2009, Caster Semenya, then 18, beat other women in the 800 meter race by so large a margin that several of her rivals insisted that she was actually a man pretending to be a woman. Blood tests revealed that she had excessively high levels (for a woman) of the male hormone, testosterone. Again, it was genes, not cheating, that gave her a competitive advantage. The hormone that her genes allowed to reach levels atypical for nearly all women enhanced her muscle production and, consequently, her speed.
Our genes and diet and activity and exposure to millions of outside influences determine whether we are fast or agile or strong or just couch potatoes. In many competitive sports, there is a concerted effort to level the playing field, and in others, there is a bidding war for the most atypical individuals. Heavy weight boxers do not compete against welter weight boxers. In contrast, the baseball player who can frequently hit a ball coming at him at more than ninety miles per hour or who can pitch that ball at more than ninety miles per hour is eagerly sought after.
Olympic competition demonstrates that even at the highest level of athletic achievement there are likely to be ‘outliers’ with genetic advantages we never imagined existed. Perhaps Leon Marchand swam faster, farther, and better than other men in the pool because of an unidentified receptor on his muscles that decreased the response to nerve impulses by a few milliseconds. Perhaps Simone Biles can magically remain suspended in the air as she launches herself off the ground by virtue of a protein in her ligaments that we lesser humans do not produce. As we learn about what separates us ordinary mortals from those who are faster, stronger, or more agile, we may discover that training in and commitment to a sport are less connected to performance than is our genetic code.
Nations and special interests will inevitably screen potential athletes for each gene providing a natural performance advantage as soon as that gene is identified. Relatives and descendants of the Finnish skier Eero Mantyranta who have migrated across the border with Russia must have attracted the attention of national leaders in Finland and Russia eager to cultivate more gold-winning Olympians. The results of genetic testing of Simone Biles will fetch a high price if she has an anomalous gene that explains her extraordinary athletic abilities. Interest in identifying the genetic signatures of super-athletes, like Michael Phelps, Nadia Comaneci, Florence Griffith Joyner, etc., may soon further the competitive gap between the highly-trained Olympic athletes and the genetically-advantaged Olympic athletes. How our future Olympic committees deal with the dilemma posed by our genetic diversity will reveal more about committee members than might any genetic test.
Dr. Lechtenberg is an Easton resident who graduated from Tufts University and Tufts Medical School in Massachusetts and subsequently trained at The Mount Sinai Hospital and Columbia-Presbyterian Medical Center in Manhattan. He worked as a neurologist at several New York Hospitals, including Kings County and The Long Island College Hospital, while maintaining a private practice, teaching at SUNY Downstate Medical School, and publishing 15 books on a variety of medical topics. He worked in drug development in the U.S., as well as in England, Germany, and France.
