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      Russian roulette with unlicensed fat-burner drug 2,4-dinitrophenol (DNP): evidence from a multidisciplinary study of the internet, bodybuilding supplements and DNP users

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          Abstract

          Background

          2,4-Dinitrophenol (DNP) poses serious health-risks to humans. The aims of this three-stage multidisciplinary project were, for the first time, to assess the risks to the general public from fraudulent sale of or adulteration/contamination with DNP; and to investigate motives, reasons and risk-management among DNP-user bodybuilders and avid exercisers.

          Methods

          Using multiple search-engines and guidance for Internet research, online retailers and bodybuilding forums/blogs were systematically explored for availability of DNP, advice offered on DNP use and user profiles. Ninety-eight pre-workout and weight-loss supplements were purchased and analysed for DNP using liquid-chromatography-mass-spectrometry. Psychosocial variables were captured in an international sample of 35 DNP users (26.06 ± 6.10 years, 94.3 % male) with an anonymous, semi-qualitative self-reported survey.

          Results

          Although an industrial chemical, evidence from the Internet showed that DNP is sold ‘as is’, in capsules or tablets to suit human consumption, and is used ‘uncut’. Analytical results confirmed that DNP is not on the supplement market disguised under fictitious supplement names, but infrequently was present as contaminant in some supplements (14/98) at low concentration (<100mcg/kg). Users make conscious and ‘informed’ decisions about DNP; are well-prepared for the side-effects and show nonchalant attitude toward self-experimentation with DNP. Steps are often taken to ensure that DNP is genuine. Personal experience with performance- and appearance enhancing substances appears to be a gateway to DNP. Advice on DNP and experiences are shared online. The significant discrepancy between the normative perception and the actual visibility suggests that DNP use is-contrary to the Internet accounts-a highly concealed and lonesome activity in real life. Positive experiences with the expected weight-loss prevail over the negative experiences from side effects (all but two users considered using DNP again) and help with using DNP safely is considered preferable over scare-tactics.

          Conclusion

          Legislation banning DNP sale for human consumption protects the general public but DNP is sold ‘as is’ and used ‘uncut’ by determined users who are not dissuaded from experimenting with DNP based on health threats. Further research with stakeholders’ active participation is imperative for targeted, proactive public health policies and harm-reduction measures for DNP, and other illicit supplements.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s13011-015-0034-1) contains supplementary material, which is available to authorized users.

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          Most cited references61

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          Revised standards for statistical evidence.

          Recent advances in Bayesian hypothesis testing have led to the development of uniformly most powerful Bayesian tests, which represent an objective, default class of Bayesian hypothesis tests that have the same rejection regions as classical significance tests. Based on the correspondence between these two classes of tests, it is possible to equate the size of classical hypothesis tests with evidence thresholds in Bayesian tests, and to equate P values with Bayes factors. An examination of these connections suggest that recent concerns over the lack of reproducibility of scientific studies can be attributed largely to the conduct of significance tests at unjustifiably high levels of significance. To correct this problem, evidence thresholds required for the declaration of a significant finding should be increased to 25-50:1, and to 100-200:1 for the declaration of a highly significant finding. In terms of classical hypothesis tests, these evidence standards mandate the conduct of tests at the 0.005 or 0.001 level of significance.
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            What We Know and Don't Know About Online Word-of-Mouth: A Review and Synthesis of the Literature

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              Controlled-release mitochondrial protonophore reverses diabetes and steatohepatitis in rats.

              Nonalcoholic fatty liver disease (NAFLD) is a major factor in the pathogenesis of type 2 diabetes (T2D) and nonalcoholic steatohepatitis (NASH). The mitochondrial protonophore 2,4 dinitrophenol (DNP) has beneficial effects on NAFLD, insulin resistance, and obesity in preclinical models but is too toxic for clinical use. We developed a controlled-release oral formulation of DNP, called CRMP (controlled-release mitochondrial protonophore), that produces mild hepatic mitochondrial uncoupling. In rat models, CRMP reduced hypertriglyceridemia, insulin resistance, hepatic steatosis, and diabetes. It also normalized plasma transaminase concentrations, ameliorated liver fibrosis, and improved hepatic protein synthetic function in a methionine/choline-deficient rat model of NASH. Chronic treatment with CRMP was not associated with any systemic toxicity. These data offer proof of concept that mild hepatic mitochondrial uncoupling may be a safe and effective therapy for the related epidemics of metabolic syndrome, T2D, and NASH.

                Author and article information

                Contributors
                A.Petroczi@kingston.ac.uk
                k1230202@kingston.ac.uk
                iltafsyed@hotmail.com
                C.Jenkinson@bham.ac.uk
                rachael.new@hants.gov.uk
                Ricky.James@kingston.ac.uk
                grjtaylor@icloud.com
                D.Naughton@kingston.ac.uk
                Journal
                Subst Abuse Treat Prev Policy
                Subst Abuse Treat Prev Policy
                Substance Abuse Treatment, Prevention, and Policy
                BioMed Central (London )
                1747-597X
                14 October 2015
                14 October 2015
                2015
                : 10
                : 39
                Affiliations
                [ ]Faculty of Science, Engineering and Computing, Kingston University London, Penrhyn Road, Kingston upon Thames, Surrey, KT1 2EE United Kingdom
                [ ]University of Birmingham, Birmingham, UK
                [ ]Hampshire County Council-Scientific Services, Hampshire, UK
                Article
                34
                10.1186/s13011-015-0034-1
                4607104
                26466580
                b38f1151-4812-4df3-84e6-4145510f7eae
                © Petróczi et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 8 May 2015
                : 25 September 2015
                Categories
                Research
                Custom metadata
                © The Author(s) 2015

                Health & Social care
                supplement,bodybuilding,weight-loss,health risk,sport,dnp,exercise,illicit drug,body fat,lc-ms/ms
                Health & Social care
                supplement, bodybuilding, weight-loss, health risk, sport, dnp, exercise, illicit drug, body fat, lc-ms/ms

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