Knowledge, Prevalence, and Consequences of Dietary Supplements Intake among Iranian Bodybuilders.

Background: This study investigated the nutritional knowledge and prevalence of dietary supplements (DSs) among Iranian bodybuilders. Methods: This cross-sectional research study involved sampling 648 bodybuilding clubs in Iran. A researcher distributed questionnaires among clubs in various regions and analyzed categorical variables, DS, nutritional knowledge, and sports nutrition data from 160 bodybuilders aged 18 and above in Iran. The analysis was conducted using the results obtained from a quantitative questionnaire. Results: There was a significant relationship between DS use and gender (P = 0.001, r = 0.330, males > females), bodybuilding history (P = 0.045; r = 0.158), and exercise sessions/wk (P = 0.050, r = 0.156). Whey protein (45.6%) and branched-chain amino acid (33.7%), vitamin D (50%), caffeine (34.3%), and generally vitamin C (56.2%) were the most common DS used. The most information sources for bodybuilders regarding DS were fitness coaches (35.6%) and registered dietitians/nutritionists (34.3%). Drug stores (36.7%) and fitness coaches (19.3%) were the most prominent sources for purchasing DS. Increasing performance (54.3%), increasing the need for DS through exercise (53.6%), preventing injury, and improving recovery (36.2%) were the most important reasons to consume DS. Skin problems (21.0%), increased liver enzymes (10.8%), and hair loss (9.4%) were the most common side effects of DS use. Total nutritional knowledge (macronutrients, micronutrients, and sports nutrition) was 58.6%. Conclusions: This study concluded that fitness coaches and registered dietitians/nutritionists were the most common information sources for bodybuilders. It also revealed a moderate level of nutrition knowledge among bodybuilders. The most commonly used DS were vitamins C, D, and whey protein. Also, gender, bodybuilding history, and exercise sessions had a significant relationship with the prevalence of DS. However, the study also revealed some concerning findings; bodybuilders commonly experienced adverse side effects such as skin rashes, increased liver enzymes, and hair loss.

Changes in hormonal profiles during competition preparation in physique athletes.

PURPOSE: Physique athletes engage in rigorous competition preparation involving intense energy restriction and physical training to enhance muscle definition. This study investigates hormonal changes and their physiological and performance impacts during such preparation. METHODS: Participants included female (10 competing (COMP) and 10 non-dieting controls (CTRL)) and male (13 COMP and 10 CTRL) physique athletes. COMP participants were tested 23 weeks before (PRE), one week before (MID), and 23 weeks after the competition (POST). Non-dieting CTRL participants were tested at similar intervals. Measurements included body composition (DXA), muscle cross-sectional area (ultrasound), energy availability (EA) derived by subtracting exercise energy expenditure (EEE) from energy intake (EI) and dividing by fat-free mass (FFM), muscle strength, and various serum hormone concentrations (ACTH, cortisol, estradiol, FSH, IGF-1, IGFBP-3, insulin, and free and total testosterone and SHBG). RESULTS: During the diet, EA (p < 0.001), IGF-1 (p < 0.001), IGFBP-3 (p < 0.01), and absolute muscle strength (p < 0.01-0.001) decreased significantly in both sexes in COMP. Decreases in IGF-1 were also associated with higher loss in FFM. In males, testosterone (p < 0.01) and free testosterone (p < 0.05) decreased, while SHBG (p < 0.001) and cortisol (p < 0.05) increased. Insulin decreased significantly only in males (p < 0.001). Mood disturbances, particularly increased fatigue in males (p < 0.05), highlighted the psychological strain of competition preparation. All these changes were restored by increased EA during the post-competition recovery period. CONCLUSION: Significant reductions in IGF-1 and IGFBP-3 during competition preparation may serve as biomarkers for monitoring physiological stress. This study offers valuable insights into hormonal changes, muscle strength, and mood state during energy-restricted intense training.

Development of analytical method for determination of 1,3-dimethylamylamine in sports nutrition and bodybuilding supplements using pH-switchable deep eutectic solvents followed by high-performance liquid chromatography-diode array detector.

In this work, an easy, safe, simple, and efficient pH-switchable deep eutectic solvents (DESs)-based liquid phase microextraction followed by high-performance liquid chromatography-diode array detector analysis was developed for the determination of 1,3-dimethylamylamine (DMAA). The switchability of the obtained DESs was investigated by changing the pH. Then the best-selected DES was characterized and the application of the selected DES in the extraction of DMAA from sports nutrition and bodybuilding supplements was investigated. The DES synthesized from l-menthol: oleic acid in a molar ratio of 1:2 had the highest efficiency in the extraction of the target compound. Under the optimum conditions, (50 µL of DES, 100 µL of 4 mol/L KOH, 100 µL of 4 mol/L HCl, extraction time of 40 s and without salt addition) the calibration graph was linear in the range of 0.05-100 µg/kg and limit of detection was 0.02 µg/kg. The relative standard deviations including intra-day and inter-day for 10.0 µg/kg of DMAA in real samples were 2.7% (n = 7) and 5.3% (n = 7), respectively. The enrichment factor and percentage extraction recovery of the method were 283 and 85%, respectively. The relative recoveries for DMAA in different samples were in the range of 90%-109%.

A quasi-experimental study on the energy expenditure, exercise intensity, and rating of perceived exertion of a male bodybuilding posing training.

NOVELTY: This study is novel in classifying bodybuilding posing training as vigorous intensity exercise using metabolic equivalents (METs) and heart rate (HR) responses. It provides empirical evidence showing that posing training meets the vigorous intensity benchmarks, with METs and %HRmax values comparable to established vigorous exercise standards. The research highlights the novel finding that stimulant usage and the peak week phase of preparation significantly influence physiological responses and perceived exertion in bodybuilders. Specifically, athletes using stimulants and those in peak week displayed higher ratings of perceived exertion (RPE) and maximum heart rates, indicating that these factors notably affect the intensity and perceived difficulty of posing training.

Autonomic Rebound Following Maximal Exercise in Bodybuilders and Recreationally Active Participants.

The off-season for natural bodybuilders (BB) is characterized by increased training loads and fluctuations in caloric intake, which may lead to insufficient recovery. The autonomic nervous system (ANS) plays a pivotal role in recovery. The purpose of this study was to evaluate resting ANS activity and recovery following a maximal exercise bout in off-season BB and compare them to those of recreationally active individuals. Fifteen males participated; 7 recreationally active (RA) (24.6 ± 2.1 years, 81.1 ± 10.8 kg) and 8 BB (21.8 ± 2.9 years, 89.3 ± 13.0 kg). Each performed a graded exercise test. Heart rate variability (HRV) was measured at rest and during a 45 min recovery period. HRV was analyzed as: root mean square of successive differences (lnRMSSD), standard deviation of normal-to-normal sinus beats (lnSDNN), high frequency (lnHF), low frequency (lnLF), and the ratio of low frequency to high frequency (lnLF/lnHF). A one-way ANOVA showed no differences for any resting marker of HRV, HR, and HR recovery. A significant depression in all markers of HRV was observed in the BB group at the 15 min point, and no recovery was observed before 45 min when compared to RA. The results of this study demonstrated depressed HRV recovery following the graded exercise test in BB when compared to the RA group.

Neuropsychiatric manifestations due to anticholinergic agents and anabolic steroids ingestion: A case series and literature review.

Anticholinergic toxicity is a common occurrence in the emergency room, making it crucial for emergency clinicians to have a good understanding of this toxidrome. The neuropsychiatric effects of anticholinergic agents and anabolic steroids (ASs) can manifest as symptoms like anxiety, agitation, dysarthria, confusion, seizures, visual hallucinations, bizarre behavior, delirium, psychosis, and coma. When dealing with a conscious patient who has ingested an anticholinergic substance, a detailed history of ingestion can aid clinicians in making an accurate diagnosis. However, the lack of information about the substances consumed can complicate diagnosis. In cases where the exposure is unknown, clinicians should consider anticholinergic poisoning in patients showing signs of altered mental status and physical examination findings consistent with anticholinergic toxicity. We report four cases presenting a range of symptoms, including neuropsychiatric manifestations, following the ingestion of the same bodybuilding powders with anticholinergic properties. All four patients consumed yellow and white powders at the same time and in the same place. Laboratory analysis revealed that yellow powder and white powder contained ASs and cyproheptadine, respectively.

Completely Plant-Based Diets That Meet Energy Requirements for Resistance Training Can Supply Enough Protein and Leucine to Maximize Hypertrophy and Strength in Male Bodybuilders: A Modeling Study.

Despite increasing awareness of plant-based diets for health and athletic performance, athletes are cautioned that careful dietary monitoring is necessary. Whether commonly consumed plant-based diets are nutritionally adequate for maximal muscular hypertrophy remains unknown. This modeling study assessed the nutrient composition of completely plant-based diets scaled to the caloric demands of maximal muscle mass and strength development in adult male bodybuilders. To model calorie requirements, anthropometric data from bodybuilders were input into the Tinsley resting metabolic rate prediction equation, and an appropriate physical activity factor and calorie surplus were applied. Dietary data from a large cohort following completely plant-based diets were then scaled to meet these needs. Modeled intakes for nutrients of interest were calculated as 1.8 g/kg/day of protein and 2.75 g/meal of leucine, which surpass mean requirements for maximal increases in muscle mass and strength and muscle protein synthesis, respectively. Daily levels for all micronutrients, except vitamin D, also exceeded requirements. Saturated fat levels were aligned with dietary guidelines, although sodium levels exceeded recommended limits. Consumption of larger portions of commonplace plant-based diets, scaled to meet the energy demands of maximal accrual of muscle mass and strength, satisfied protein and leucine requirements without the need for additional planning.

The dichotomy between health and drug abuse in bodybuilding.

Aim: The aim of the present study was to investigate the expansion and prevalence of anabolic steroid use by examining the divergent effects between health and drug abuse and to create more awareness around the harmful consequences of these drugs when administered at abusive levels. Methods: A focused and concise literature search was conducted, and 101 high-quality articles were included in the review. Results: The findings underscore the adverse health risks of steroid abuse, emphasizing the stark contrast between health and drug abuse. Conclusions: While steroids and other performance-enhancing drugs can yield muscle growth, strength and even fat loss, abusing these substances can lead to adverse health outcomes. Furthermore, within the fitness subculture, particularly in the realm of bodybuilding, steroid abuse fosters an atmosphere of cheating and deception, frequently downplaying or ignoring the negative and sometimes deadly consequences it brings.

Excessive androgen exposure and risk of malignancies: A cohort study.

BACKGROUND: A link between androgen use and the risk of cancers, especially prostate and breast cancer, has been suggested. The knowledge about a possible association is limited. OBJECTIVE: The study aimed to investigate cancer incidence rates, particularly those related to prostate and breast cancer, in male androgen users and compare them to a control group. METHODS: We included male androgen users identified through a nationwide anti-doping testing program in Danish fitness centers from 2006 to 2018. We paired each case with 50 male controls of the same age, selected randomly. The cohort was followed from baseline and until 2023. The outcome was the incidence of prostate cancer, breast cancer, or any cancer excluding non-melanoma skin cancer. RESULTS: The study included 1,189 androgen users and 59,450 controls, with a mean age of 27 years at enrolment. During the follow-up period with a mean length of 11 years, 13 androgen users, and 612 controls were diagnosed with cancer. This resulted in an incidence rate ratio of 1.05 (95% CI: 0.55-1.81). None of the androgen users were diagnosed with prostate or breast cancer. DISCUSSION AND CONCLUSION: Male androgen users did not face an increased short-term risk of cancer, neither overall nor related to prostate or breast cancer. Our study indicates that the absolute risk of malignancies in androgen users is comparable to that in the background population. However, we cannot exclude androgens as a cancer risk factor due to the limited sample size, relatively short follow-up period, and subject age.

Deloading Practices in Strength and Physique Sports: A Cross-sectional Survey.

BACKGROUND: This study explored the deloading practices of competitive strength and physique athletes. A 55-item anonymised web-based survey was distributed to a convenience-based, cross-sectional sample of competitive strength and physique athletes (n = 246; males = 181 [73.6%], females = 65 [26.4%]; age = 29.5 ± 8.6 years) who had 8.2 ± 6.2 years of resistance training and 3.8 ± 3.1 years of competition experience. RESULTS: All athletes deloaded within training with energy and fatigue management being the main reasons to do so. The typical duration of a deload was 6.4 ± 1.7 days, integrated into the training programme every 5.6 ± 2.3 weeks. Deloading was undertaken using a proactive, pre-planned strategy (or in combination with an autoregulated approach) and undertaken when performance stalled or during periods of increased muscle soreness or joint aches. Athletes reported that training volume would decrease (through a reduction in both repetitions per set and sets per week), but training frequency would remain unchanged during deloads. Additionally, athletes reported that training intensity (load lifted) would decrease, and effort would be reduced (facilitated through an increase in repetitions in reserve). Athletes would generally maintain the same exercise selection during deloading. For athletes that supplemented deloading with additional recovery modalities (n = 118; 48%), the most reported strategies were massage, static stretching and foam rolling. CONCLUSION: Results from this research might assist strength and physique athletes and coaches to plan their deloading. Future research should empirically investigate the findings from this study to further evaluate the potential utility of deloading in strength and physique sports.

Peak Week Carbohydrate Manipulation Practices in Physique Athletes: A Narrative Review.

BACKGROUND: Physique athletes are ranked by a panel of judges against the judging criteria of the corresponding division. To enhance on-stage presentation and performance, competitors in certain categories (i.e. bodybuilding and classic physique) achieve extreme muscle size and definition aided by implementing acute "peaking protocols" in the days before competition. Such practices can involve manipulating nutrition and training variables to increase intramuscular glycogen and water while minimising the thickness of the subcutaneous layer. Carbohydrate manipulation is a prevalent strategy utilised to plausibly induce muscle glycogen supercompensation and subsequently increase muscle size. The relationship between carbohydrate intake and muscle glycogen saturation was first examined in endurance event performance and similar strategies have been adopted by physique athletes despite the distinct physiological dissimilarities and aims between the sports. OBJECTIVES: The aim of this narrative review is to (1) critically examine and appraise the existing scientific literature relating to carbohydrate manipulation practices in physique athletes prior to competition; (2) identify research gaps and provide direction for future studies; and (3) provide broad practical applications based on the findings and physiological reasoning for coaches and competitors. FINDINGS: The findings of this review indicate that carbohydrate manipulation practices are prevalent amongst physique athletes despite a paucity of experimental evidence demonstrating the efficacy of such strategies on physique performance. Competitors have also been observed to manipulate water and electrolytes in conjunction with carbohydrate predicated on speculative physiological mechanisms which may be detrimental for performance. CONCLUSIONS: Further experimental evidence which closely replicates the nutritional and training practices of physique athletes during peak week is required to make conclusions on the efficacy of carbohydrate manipulation strategies. Quasi-experimental designs may be a feasible alternative to randomised controlled trials to examine such strategies due to the difficulty in recruiting the population of interest. Finally, we recommend that coaches and competitors manipulate as few variables as possible, and experiment with different magnitudes of carbohydrate loads in advance of competition if implementing a peaking strategy.

Bodybuilders and high-level meat consumers' behavior towards rabbit, beef, chicken, turkey, and lamb meat: A comparative review.

In bodybuilders' diets, protein plays a crucial role in supporting muscle growth and repairing damaged muscle tissue. These individuals meet their protein needs by combining dietary sources with supplements. Animal-based proteins are often preferred over plant-based proteins because they are believed to better support muscle protein synthesis. This review explores the meat consumption patterns of bodybuilders and high-level meat consumers, focusing on rabbit, beef, chicken, turkey, and lamb. We describe and compare the types of meat bodybuilders commonly consume and provide an overview of protein supplements, including meat-based options, plant-based alternatives, and whey-based products. Our aim is to gain insight into the dietary preferences of bodybuilders and high-level meat consumers, considering their nutritional requirements and the potential effect on the meat industry. We conducted an extensive search across various databases, including Scopus, Web of Science, PubMed, and Google Scholar. We found that individual choices vary based on factors such as attitudes, trust, taste, texture, nutritional content, ethical considerations, and cultural influences. Nutritional factors, including protein content, amino acid profiles, and fat levels, significantly influence the preferences of bodybuilders and high-level meat consumers. However, it is crucial to maintain a balance by incorporating other essential nutrients such as carbohydrates, healthy fats, vitamins, and minerals to ensure a complete and balanced diet. The findings from this review can inform strategies and product development initiatives tailored to the needs of bodybuilders and discerning meat enthusiasts.

Alimentation and nutrition applied to the new fitness disciplines in Italian gym.

Background: The energy balance between inputs and outputs is essential to avoid a reduction in performance, recovery difficulties, hormonal problems, an increased risk of fatigue, injuries and illnesses. Aim: The purpose of the study is to evaluate whether the energy intake assumed by non-professional sportsmen of the new fitness disciplines on the basis of the guidelines present in the literature, meets the needs required by their sporting activity. Methods: The sample consist of 20 non-competitive adult sportsmen (n.10 females; n.10 males) that were voluntarily enrolled in a gym, belonging to the various fitness disciplines: bodybuilders (n = 2); calisthenics (n = 3); crossfitters (n = 15). The subjects underwent an anamnestic-nutritional interview and used a photographic atlas to estimate the energy intake in the training day (in terms of macronutrients, micronutrients and H2O). Results: The results of the study reported: a lower energy intake, the breakdown of macronutrients was suitable for the nutritional indications reported by bibliographic sources, with the exception for protein intake that was higher than the other macronutrients; a lower intake of fibers, mono/polyunsaturated fatty acids; an higher intake of simple sugars, proteins and H2O, and by a normal parameters of carbohydrates, fats and saturated fatty acids. Conclusions: Generally the study has shown that the sample energy intake is extremely low in the training day. Therefore, it is useful to educate sportsmen, coaches and families in order to avoid deficiencies/excess of calories and nutrients which may not be functional for the sporting activity performed.

Evidências de validade da escala shape de imagem corporal em fisiculturistas / Evidence of the validity of the body image shape scale in physiculturists

RESUMO Nas competições de fisiculturismo são analisados a proporção, a definição, a simetria e o volume muscular, o que faz da incansável busca pelo corpo perfeito pelos atletas, uma insatisfação com a imagem corporal. Por isso, este trabalho objetivou-se em elaborar e validar uma escala de silhuetas específica para atletas de fisiculturismo feminino e masculino (Escala Shape), que aconteceu em três fases. 1) Elaboração de onze desenhos de imagem corporal que representassem as categorias de competição; 2) Concordância (teste de Kappa) entre especialistas/profissionais de fisiculturismo nacionais e internacionais na ordenação dos desenhos em ordem crescente e progressiva de muscularidade; 3) Aplicação e validação da Escala Shape em atletas amadores e profissionais ativos e filiados à Federações Nacionais e Internacionais de Fisiculturismo em ambos os sexos. Participaram da pesquisa 180 atletas (50 mulheres e130 homens). A escala apresentou adequada confiabilidade de estabilidade temporal (Kappa teste-reteste≥0,95). O instrumento apresentou validade de critério ao mostrar que atletas de categorias de competição distintas escolheram silhuetas compatíveis com suas categorias (p<0,001). Conclusão: a Escala Shape feminina e masculina apresentou evidências de confiabilidade e validade para a amostra, podendo ser utilizada para avaliar a satisfação com a imagem corporal de fisiculturistas de diferentes categorias.

ABSTRACT In bodybuilding competitions, proportion, definition, symmetry and muscle volume are analyzed, which makes the tireless search for the perfect body by athletes, a dissatisfaction with body image. Therefore, this work aimed to develop and validate a specific silhouette scale for female and male bodybuilding athletes (Shape Scale), which took place in three phases. 1) Elaboration of eleven body image drawings that represented the competition categories; 2) Agreement (Kappa test) between national and international bodybuilding specialists/professionals in ordering the drawings in ascending and progressive order of muscularity; 3) Application and validation of the Shape Scale in active amateur and professional athletes affiliated to National and International Bodybuilding Federations in both sexes. 180 athletes (50 women and 130 men) participated in the research. The scale showed adequate temporal stability reliability (Kappa test-retest≥0.95). The instrument showed criterion validity by showing that athletes from different competition categories chose silhouettes compatible with their categories (p<0.001). Conclusion: the female and male Shape Scale showed evidence of reliability and validity for the sample, and can be used to assess satisfaction with the body image of bodybuilders from different categories.

[Collapsing Glomerulopathy Secondary to Anabolic Steroids for Bodybuilding: A Case Series].

The abuse of anabolic androgenic steroids (AAS) for competitive (and non-competitive) purposes for bodybuilding practice is increasingly common. The consequences of these substances on the various organs are only partially known. Cases of FSGS following the use of AAS have been reported in the literature, even with evolution to ESKD. We describe three cases of bodybuilding athletes who presented alterations in renal function indices after taking AAS for a long time. Three renal biopsies were performed with histological diagnosis of FSGS collapsing variant. We examine the lesions observed on histological examination. Two athletes had rapid progression of renal disease requiring replacement therapy. The third one continues conservative treatment for chronic renal failure. We discuss the risks related to the intake of doping substances and how bodybuilders are exposed to different causes of kidney damage: anabolic steroids, supplements, and a high-protein diet.

Bilateral simultaneous quadriceps ruptures in an elite bodybuilder: A case report of treatment success.

Tendon injuries in weightlifters is known to be associated with steroid use. Bilateral simultaneous quadriceps tendon rupture (BSQTR) is extremely rare with few cases reported in literature in young athletes. Unlike patellar tendon ruptures, they are more common in older age individuals. These injuries can jeopardize an athlete's career. In this paper, we report a very rare case of BSQTR in an elite bodybuilder who sustained a high mechanism trauma while squatting heavyweights. He sustained bilateral anterior cruciate ligament (ACL) injury and a left ankle fracture. All injuries were treated surgically except for the left ACL as it was asymptomatic on follow-up. The challenge in this case was to treat his injuries and to regain his baseline functional status in the shortest period of time. Following treatment, the patient had a satisfactory clinical outcome with focused rehabilitation. Despite the devastating trauma, the patient was able to progress throughout the treatment plan and has regained his baseline functional status in less than 18 months and has resumed his competitive bodybuilding career. From the available literature, this is the first case to be reported with such combined injuries that was treated and showed a satisfactory outcome in a short period of time.

Bodybuilding: A Comprehensive Review of Performance-Enhancing Substance Use and Public Health Implications.

The use of performance-enhancing substances in bodybuilding is a well-known and long-standing issue. This comprehensive review article provides a detailed overview of the history of performance-enhancing substance use in bodybuilding, the types of substances commonly used, and the short-term and long-term health effects associated with their use. Additionally, the article discusses the regulation of performance-enhancing substances in various countries and the role of healthcare professionals in preventing substance use. The article also highlights the impact of substance use on society and the importance of prevention and intervention strategies. Finally, the article emphasizes the role of policymakers in addressing performance-enhancing substance use, including the development of regulations, penalties for violating rules, and the provision of resources for prevention and intervention programs. Overall, this review article sheds light on the dark side of bodybuilding and provides insight into the public health implications of performance-enhancing substance use.