The theory of planned behavior and dietary behaviors in competitive women bodybuilders.

BACKGROUND: Women bodybuilders build their ideal physique by manipulating their diet, supplement, and exercise regimens to extreme levels. Excess protein intake and dietary supplement use is ubiquitous in women bodybuilders preparing for a competition, i.e., in-season competitors, however the impetus for these two dietary behaviors are relatively unknown. The Theory of Planned Behavior (TPB) has been used to explain dietary behaviors. The purpose of the study was to examine how the TPB can explain protein intake and dietary supplement use in in-season competitors. METHODS: Using a cross-sectional design, an online questionnaire was developed, validated, and administered to collect dietary supplement use, TPB variables, and other measures from 112 in-season competitors. Protein intake was assessed using multiple 24-h dietary recalls. Associations between TPB and protein intake and dietary supplement use were determined with multiple regression analysis while adjusting for confounders. RESULTS: For protein intake: attitude, subjective norm, and perceived behavioral control explained 8% of the variance in intention; subjective norm independently predicted intention. Behavioral beliefs predicted attitude; subjective norm was predicted by trainer/coach, workout partners, and social media influencers. For dietary supplement use: intention explained 5% of the variance in dietary supplement use; attitude, subjective norm, and perceived behavioral control together explained 38% of the variance in intention. Attitudes towards dietary supplements use were predicted by five factors (not a waste of money, help improve physique, sustain energy levels, provide enough calories, help with recovery). Primary determinants of subjective norm were fellow competitors, social media influencers, and trainer/coach. Perceived behavioral control was predicted by three factors (ease of purchase, affordability to purchase, availability to purchase). CONCLUSIONS: TPB predicted dietary supplement use in women bodybuilders during in-season but there was little evidence for the prediction of protein intake using the TPB. Health professionals should develop effective interventions using strategies that align health education messages with in-season competitors' outcome beliefs and collaborate with their referent others to influence safer and effective dietary supplement use.

Death of an apprentice bodybuilder following 2,4-dinitrophenol and clenbuterol intake.

We present the case of a 17-year-old man, who died after 2,4-dinitrophenol (DNP) and clenbuterol consumption, which he likely took for physical enhancement. Forensic post-mortem examination revealed a yellowish skin colour and nonspecific signs of asphyxia. Analytical confirmation of the intoxication was obtained in blood and urine, with high levels of DNP and clenbuterol. Both of these substances are used by bodybuilders as DNP enhance lipolysis and clenbuterol has anabolic properties, but their toxicity is underestimated. DNP uncouples oxidative phosphorylation, leading to thermogenesis and even relatively small doses can cause fatal hyperthermia. Clenbuterol is a ß2 agonist that causes electrolyte disturbances (hypokalemia and hyperglycemia mostly) and death have been described through coronary vasospasm. Given the circumstances in which the body was found and toxicological results, we believe the cause of death to be fatal hyperthermia from DNP intake. These substances are illegal in many countries, but easily bought online. Through this availability, the last decades have seen an increase of fatal intoxications. Websites selling them are regularly closed by French public authorities and Interpol, but unfortunately it seems insufficient.

Effects of creatine supplementation on cardiac autonomic functions in bodybuilders.

Bodybuilder-type workouts may affect heart rate variability (HRV), which has considerable potential to assess the role of autonomic nervous system (ANS). A scientifically designed approach is necessary for bodybuilders to achieve better results while protecting their health. In this study, we aimed to investigate HRV parameters in bodybuilders compared to healthy control subjects and effects of creatine supplementation. A total of 48 male participants (16 controls, 16 supplement (-), 16 supplement (+)) were evaluated in our study. Bodybuilders who were taking creatine supplementation were enrolled in supplement (+) group. HRV parameters were measured from 24-hour Holter recordings of all participants. When mean heart rates were compared with control group (71.5 ± 12.6 beats/min), statistically significant difference was revealed in supplement (-) group (61.8 ± 6.8 beats/min; P = 0.022) unlike supplement (+) group (69.63 ± 14.1 beats/min; P = 0.650). HRV analyses revealed significant parasympathetic shift in supplement (-) group. No significant difference was demonstrated on HRV parameters, except high frequency (P = 0.029) in supplement (+) group. Conclusively, elevated parasympathetic modulation, which is favorable cardiovascular outcome of exercise, was demonstrated in bodybuilders. However, our study also revealed that creatine supplementation attenuates this favorable effect in ANS by limiting elevation of parasympathetic modulation. Although the sympathetic slight shift is attributed to creatine supplementation, it cannot be discriminated from the effects of over training.

Comparison of Right Ventricle Systolic Function between Long-Term Anabolic-Androgenic Steroid User and Nonuser Bodybuilder Athletes: A Study of Two-Dimensional Speckle Tracking Echocardiography.

BACKGROUND: Right ventricular (RV) effects of long-term use of anabolic-androgenic steroids (AAS) are not clearly known. The aim of this study was to assess RV systolic functions by two-dimensional speckle tracking echocardiography (2DSTE) in AAS user and nonuser bodybuilders. METHODS: A total of 33 competitive male bodybuilders (15 AAS users, 18 AAS nonusers) were assessed. To assess RV systolic functions, all participants underwent standard two-dimensional and Doppler echocardiography, and 2DSTE. RESULTS: Interventricular septal thickness, left ventricle posterior wall thickness, relative wall thickness, and left ventricle mass index were significantly higher in AAS users than nonusers. While standard diastolic parameters were not statistically different between the groups, tissue Doppler parameters including RV E' and E'/A' were lower in AAS users than nonusers (10.1 ± 2.0 vs. 12.7 ± 2.1; P = 0.001, 1.1 ± 0.1 vs. 1.5 ± 0.4; P = 0.009, respectively). Tricuspid annular plane systolic excursion, RV fractional area change, and RV S' were in normal ranges. However, RV S' was found to be lower in users than nonusers (12.2 ± 2.2 vs. 14.6 ± 2.8, P = 0.011). RV free wall longitudinal strain and strain rate were decreased in AAS users in comparison with nonusers (-20.2 ± 3.1 vs. -23.3 ± 3.5; P = 0.012, -3.2 ± 0.1 vs. -3.4 ± 0.1; P = 0.022, respectively). In addition, there were good correlations between 2DSTE parameters and RV S', E', and E'/A'. CONCLUSION: Despite normal standard systolic echo parameters, peak systolic RV free wall strain and strain rate were reduced in AAS user bodybuilders in comparison with nonusers. Strain and strain rate by 2DSTE may be useful for early determination of subclinical RV dysfunction in AAS user bodybuilders.

Evolving paradigm of illnesses presented to medical Intensive Care Unit in body builders: Cases from tertiary care center.

Bodybuilding is the use of progressive resistance exercise to control and develop one's musculature. With the rise in number of persons adopting this activity, there is evolving paradigm of illnesses presented to intensive care in this population subset. Strict adherence to details of bodybuilding and avoidance of unsupervised medications are essential to prevent untoward effects.

Anabolic-androgenic steroids are linked to depression and anxiety in male bodybuilders: the hidden psychogenic side of anabolic androgenic steroids.

BACKGROUND: The prevalence of anabolic-androgenic steroids (AAS) use is on the rise among athletes and bodybuilders worldwide. In addition to the well-documented adverse effects on hepatic, renal, and reproductive functions, there is an increasing recognition of psychiatric complications associated with AAS use. This study aimed to investigate psychiatric morbidity among male bodybuilders who are AAS users. METHODS: In this cross-sectional study, 25 male bodybuilders using AAS (mean age 31.2 ± 8.9 years) were compared with a control group of 25 healthy male bodybuilders matched in age (31.3 ± 5.5 years). The demographic, hormonal, and biochemical parameters of the participants were recorded. The impact of AAS use on psychiatric morbidity was assessed using the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) in both groups. RESULTS: The BDI and BAI scores were significantly higher in male bodybuilders using anabolic-androgenic steroids (p < 0.0001). While the control group showed no instances of anxiety, seven individuals in the AAS user group reported mild anxiety. No participants in the control group exhibited depression, whereas seven AAS users displayed depressive symptoms (4 mild, 3 moderate). Correlations were observed between lactate dehydrogenase (LDH) levels and BAI scores, creatinine levels and both BAI and BDI scores, as well as between estradiol levels and BDI. CONCLUSION: The study concluded that AAS use among male bodybuilders is associated with elevated levels of depression and anxiety. Our findings suggest a potential correlation between anxiety and depression levels and the levels of creatinine, LDH, and estradiol in AAS users.

Androgenic-anabolic steroids use among bodybuilders in western Iran: application of ridge logistic regression model.

INTRODUCTION: Nowadays, the use of androgenic-anabolic steroids (AAS) by competitive and non-competitive bodybuilders and its side effects have become a major public health problem. Many studies have focused on determining the role and severity of various factors in AAS use, but the existence of collinearity between the factors leads to the non-significance of important factors. The study aimed to determine factors affecting the androgenic-anabolic steroids use in Iranian bodybuilders. METHOD: This descriptive-analytical study was performed on 280 male bodybuilders (142 non-competitive and 138 competitive bodybuilders) in Hamadan, west of Iran, in 2016. The participations were recruited a multistage sampling method. A self-administrated questionnaire was used, which included parts such as intrapersonal, interpersonal, and behavioral factors affecting on AAS use. To solve the consequences of collinearity was used ridge logistic regression model (RLRM) in R.3.5.1 software. RESULTS: The mean age of bodybuilders was 25.21 years (SD = 6.31). The prevalence rate of AAS use among non-competitive and competitive bodybuilders was 27.5% and 34.1%, respectively. Factors such as age, time of starting bodybuilding, attitude, physical self-concept, behavioral intention, coach and friend use AAS, alcohol consumption, and supplement use were associated with AAS use among non-competitive and competitive bodybuilders. CONCLUSION: The results of the study indicated that a combination of intrapersonal, interpersonal and behavioral factors was effective on the androgenic-anabolic steroids use among Iranian bodybuilders. Adequate education about the side effects of AAS and improvement of individual skills seem to be helpful in reducing AAS use.

Chronic anabolic androgenic steroid administration reduces global longitudinal strain among off-cycle bodybuilders.

BACKGROUND: Supra-physiologic doses of anabolic androgenic steroids (AAS) lead to multiple cardiovascular complications. The long-term clinical effect of AAS overuse on cardiac structure and function, which persists during off-cycle periods, remains unclear. METHODS: A total of 15 sedentary subjects and 79 bodybuilders (26 AAS non-users and 53 AAS-users), matched for age and male gender, were assessed in a cross-sectional design for echocardiography measures. AAS-users were included during an off-cycle phase, abstained from AAS for at least 1 month. 2D standard M-mode and speckle tracking echocardiography were used to measure cardiac dimensions and functions. RESULTS: Inter-ventricular septum and posterior wall thickness were significantly higher among chronic off-cycle AAS-users compared to AAS non-users and sedentary group. Off-cycle AAS-users showed lower E/A ratio of the diastolic function. Left ventricular systolic function was not affected in terms of ejection fraction, but significant subclinical systolic dysfunction, assessed by GLS, was observed for chronic off-cycle AAS-users compared to AAS non-users (GLS = -16.8% vs. -18.5%, respectively; p = 0.001). Diameter of left atrium and right ventricle were significantly enlarged among off-cycle AAS-user bodybuilders (p = 0.002 and 0.040). TAPSE and RV S', and cardiac vasculature of aorta were comparable in all groups. CONCLUSIONS: This study demonstrates that during off-cycle phase, AAS-users show long-term impaired GLS, even after considerable AAS abstain, despite normal LVEF. It highlights the importance of following GLS to predict hypertrophy and heart failure events, and not relying on LVEF alone. In addition, the hypertrophic effect of chronic AAS consumption is transitional during AAS washout periods.

Dietary Intake and Supplement Use in Competitive Women Bodybuilders.

(1) Background: Women bodybuilders use extreme diets, dietary supplementation, and training regimes to sculpt their physiques. Women's participation in bodybuilding competitions has increased since the 1980s. Currently, studies on their dietary intake and supplement use are limited. Their dietary intake may be of poor quality and low in several micronutrients, while supplement use appears to be omnipresent. Thus, the aim of this study was to examine and compare the dietary intake, supplement use, and diet quality of in-season and off-season women bodybuilders. (2) Methods: In a cross-sectional design, we compared dietary intake, supplement use, and diet quality between seasons in women bodybuilders (n = 227). An online questionnaire was developed, validated, and administered to assess all non-dietary and supplement variables. The Automated Self-Administered 24 h Dietary Assessment Tool was used to collect four 24 h dietary recalls. The Healthy Eating Index-2015 (HEI-2015) was used to calculate diet quality. The analysis of covariance and Welch's t-tests were used to assess the differences between in-season and off-season women bodybuilders' dietary intake, supplement, and HEI-2015 variables. (3) Results: In-season competitors reported consuming significantly less energy, carbohydrates, and fat but more protein than off-season competitors. All competitors consumed excess protein, while in-season competitors consumed excess fat and off-season competitors consumed less energy than the physique athlete nutrition recommendations. All competitors' micronutrient intakes were above the Dietary Reference Intakes. Supplements were used by all competitors, and the mean number used was similar between seasons. The HEI-2015 scores were not significantly different between seasons yet were below the US Dietary Guidelines for Americans. (4) Conclusion: Women bodybuilders would benefit from health education to achieve physique athlete nutrition recommendations, improve diet quality, and safe/efficacious supplement use to reach physique goals and improve overall health.

Spontaneous Rupture of the Extensor Pollicis Longus in a Semi-professional Bodybuilder.

Spontaneous rupture of the extensor pollicis longus is a rare injury. Distal radius fractures and rheumatisms are the principal causes, but there is an increase in cases related to some professional or sports activities. We report a case of a semi-professional bodybuilder who presented with a full loss of interphalangeal thumb extension and retropulsion following trivial trauma of the left wrist. Ultrasound confirmed the diagnosis of spontaneous rupture of extensor pollicis longus, and MRI revealed a very rare and aggressive anatomical variant of Lister's tubercle. The patient underwent a transfer of the extensor indicis propius, which is the most popular technique used for hyperextension and retropulsion restitution. Aggressive anatomical forms of Lister's tubercle can explain the frequent occurrence of spontaneous rupture of extensor pollicis longus in patients who practice sports or professions with a repetitive movement of the wrist.

Bilateral Biceps Curl Shows Distinct Biceps Brachii and Anterior Deltoid Excitation Comparing Straight vs. EZ Barbell Coupled with Arms Flexion/No-Flexion.

The present study investigated the excitation of the biceps brachii and anterior deltoid during bilateral biceps curl performed using the straight vs. EZ barbell and with or without flexing the arms. Ten competitive bodybuilders performed bilateral biceps curl in non-exhaustive 6-rep sets using 8-RM in four variations: using the straight barbell flexing (STflex) or not flexing the arms (STno-flex) or the EZ barbell flexing (EZflex) or not flexing the arms (EZno-flex). The ascending and descending phases were separately analyzed using the normalized root mean square (nRMS) collected using surface electro-myography. For the biceps brachii, during the ascending phase, a greater nRMS was observed in STno-flex vs. EZno-flex (+1.8%, effect size [ES]: 0.74), in STflex vs. STno-flex (+17.7%, ES: 3.93) and in EZflex vs. EZno-flex (+20.3%, ES: 5.87). During the descending phase, a greater nRMS was observed in STflex vs. EZflex (+3.8%, ES: 1.15), in STno-flex vs. STflex (+2.8%, ES: 0.86) and in EZno-flex vs. EZflex (+8.1%, ES: 1.81). The anterior deltoid showed distinct excitation based on the arm flexion/no-flexion. A slight advantage in biceps brachii excitation appears when using the straight vs. EZ barbell. Flexing or not flexing the arms seems to uniquely excite the biceps brachii and anterior deltoid. Practitioners should consider including different bilateral biceps barbell curls in their routine to vary the neural and mechanical stimuli.

Biceps Brachii and Brachioradialis Excitation in Biceps Curl Exercise: Different Handgrips, Different Synergy.

The current study analyzed the excitation of biceps brachii, brachioradialis, and anterior deltoid during bilateral biceps curl performed with different handgrips. Ten competitive bodybuilders performed bilateral biceps curl in non-exhaustive 6-rep sets using 8-RM with the forearm in supinated, pronated, and neutral positions. The ascending and descending phase of each variation was separately analyzed using the normalized root mean square collected using surface electromyography. During the ascending phase, (i) biceps brachii excitation was greater with the supinated compared to the pronated [+19(7)%, ES: 2.60] and neutral handgrip [+12(9)%, ES: 1.24], (ii) the brachioradialis showed greater excitation with the supinated compared to the pronated [+5(4)%, ES: 1.01] and neutral handgrip [+6(5)%, ES: 1.10], (iii) the anterior deltoid excitation was greater with the pronated and neutral handgrip compared to the supinated condition [+6(3)% and +9(2)%, ES: 2.07 and 3.18, respectively]. During the descending phase, the anterior deltoid showed greater excitation in the pronated compared to the supinated handgrip [+5(4)%, ES: 1.02]. Changing the handgrips when performing biceps curl induces specific variations in biceps brachii and brachioradialis excitation and requires different anterior deltoid interventions for stabilizing the humeral head. Practitioners should consider including different handgrips in the biceps curl routine to vary the neural and mechanical stimuli.

Cutaneous Manifestations of Anabolic-Androgenic Steroid Use in Bodybuilders and the Dermatologist's Role in Patient Care.

Young adults have been increasingly facing pressure to achieve an appealing athletic physique, often influenced by social media influencers on platforms like Instagram. This viewpoint highlights the association between image-centric social media, dissatisfied body image, the use of anabolic-androgenic steroids (AAS) to achieve desired results, and the overlooked dermatological side effects of AAS, including acne and acne fulminans. We underscore the importance of recognizing acne fulminans as an indicator of possible AAS abuse and encourage dermatologists to actively identify and address AAS use to improve their patients' well-being.

Anabolic-androgenic steroids abuse-induced seizures: A case report in a young male bodybuilder.

None.

Resting metabolic rate in bodybuilding: Differences between indirect calorimetry and predictive equations.

BACKGROUND & AIMS: Estimating resting metabolic rate (RMR) is one of the main determinants of an athlete's energy needs. This study aimed to investigate the RMR of bodybuilding athletes using indirect calorimetry (IC) and compare it with predictive formulas proposed in the scientific literature. METHODS: 71 volunteers divided into four experimental groups: active control group for women (CGW; n = 16); active control group for men (CGM; n = 17); bodybuilder women (BBW; n = 13); and bodybuilder men (BBM; n = 25) were evaluated. The body composition was performed using the bioelectrical impedance (BIA), and the RMR was measured using an IC. The data obtained from the BIA instrument were used to calculate the RMR of all volunteers using six equations. Data normality was tested, and the unpaired t-test compared anthropometric parameters, body composition, and RMR. The Bland-Altman (B&A) plot was used to analyze the agreement between IC, BIA, and predictive equations, and the difference between the methods was calculated. An analysis of covariance (ANCOVA) with Bonferroni post hoc was used for RMR analysis and adjusted for body weight and skeletal muscle mass. RESULTS: The main findings indicated that the Johnstone equation showed a large discrepancy underestimating the RMR of BBW and BBM when compared to IC, and the De Lorenzo and Tinsley equations (a) approached the more accurate analysis method of measuring RMR in BBW and BBM, respectively. CONCLUSION: Professionals who work with bodybuilding and performance will be able to use the present study to improve their nutrition support.

Drug-induced acute pancreatitis in a bodybuilder: a case report.

BACKGROUND: Unregulated use of a variety of drugs and supplements by bodybuilders and athletes is common and can lead to severe adverse complications. Only a small proportion of acute pancreatitis cases are drug induced, and case reports are essential for identifying potential drug-related risks for pancreatitis. Here we present the first case report published of acute pancreatitis linked to recreational use of anabolic-androgenic steroids, subcutaneous growth hormone, and clenbuterol in a previously healthy male after excluding all other causes of pancreatitis. CASE PRESENTATION: A 31-year-old Arab male bodybuilder presented with acute abdominal pain associated with nausea and sharp pain radiating to the back. The patient was not using tobacco or alcohol but was using multiple drugs related to bodybuilding, including anabolic-androgenic steroids, subcutaneous growth hormone, clenbuterol, and multiple vitamin supplements. Laboratory studies revealed a normal white blood cell count, elevated C-reactive protein, minimally elevated aspartate aminotransferase and total bilirubin with normal remaining liver tests, and elevated amylase and lipase. The patient had no hypertriglyceridemia or hypercalcemia, and had had no recent infections, abdominal procedures, trauma, or scorpion exposure. Imaging and laboratory investigations were negative for biliary disease and IgG4 disease. Abdominal computed tomography revealed hepatomegaly and diffuse thickening and edema of the body and tail of the pancreas with peripancreatic fat stranding. An abdominal ultrasound showed slight hepatomegaly with no evidence of cholelithiasis. Genetic testing for hereditary pancreatitis-related mutations was negative. A diagnosis of drug-induced acute pancreatitis was made, and he was treated with aggressive intravenous hydration and pain management. The patient has avoided further use of these drugs and supplements and had no further episodes of pancreatitis during 1 year of follow-up. CONCLUSIONS: This case describes a patient with drug-induced acute pancreatitis after the intake of anabolic-androgenic steroids, subcutaneous growth hormone, and clenbuterol, where all other common causes of acute pancreatitis were excluded. Clinicians should be alert to the possibility of drug-induced acute pancreatitis occurring in bodybuilders and athletes using similar drug combinations.

A case of severe side effect due to muscle oil injections in combination with chemotherapy in a former bodybuilder.

This case report presents an acute painful skin reaction several years after injection of site-enhancing oils (SEO) induced by chemotherapy. This case exemplifies the long-term dangerous side effects of the use of SEO, however treatable with prednisolone.

The Effect of Athletes' Probiotic Intake May Depend on Protein and Dietary Fiber Intake.

Studies investigating exercise-induced gut microbiota have reported that people who exercise regularly have a healthy gut microbial environment compared with sedentary individuals. In contrast, recent studies have shown that high protein intake without dietary fiber not only offsets the positive effect of exercise on gut microbiota but also significantly lowers the relative abundance of beneficial bacteria. In this study, to resolve this conundrum and find the root cause, we decided to narrow down subjects according to diet. Almost all of the studies had subjects on an ad libitum diet, however, we wanted subjects on a simplified diet. Bodybuilders who consumed an extremely high-protein/low-carbohydrate diet were randomly assigned to a probiotics intake group (n = 8) and a placebo group (n = 7) to find the intervention effect. Probiotics, comprising Lactobacillus acidophilus, L. casei, L. helveticus, and Bifidobacterium bifidum, were consumed for 60 days. As a result, supplement intake did not lead to a positive effect on the gut microbial environment or concentration of short-chain fatty acids (SCFAs). It has been shown that probiotic intake is not as effective as ergogenic aids for athletes such as bodybuilders with extreme dietary regimens, especially protein and dietary fiber. To clarify the influence of nutrition-related factors that affect the gut microbial environment, we divided the bodybuilders (n = 28) into groups according to their protein and dietary fiber intake and compared their gut microbial environment with that of sedentary male subjects (n = 15). Based on sedentary Korean recommended dietary allowance (KRDA), the bodybuilders' intake of protein and dietary fiber was categorized into low, proper, and excessive groups, as follows: high-protein/restricted dietary fiber (n = 12), high-protein/adequate dietary fiber (n = 10), or adequate protein/restricted dietary fiber (n = 6). We found no significant differences in gut microbial diversity or beneficial bacteria between the high-protein/restricted dietary fiber and the healthy sedentary groups. However, when either protein or dietary fiber intake met the KRDA, gut microbial diversity and the relative abundance of beneficial bacteria showed significant differences to those of healthy sedentary subjects. These results suggest that the positive effect of exercise on gut microbiota is dependent on protein and dietary fiber intake. The results also suggest that the question of adequate nutrition should be addressed before supplementation with probiotics to derive complete benefits from the intervention.

Distribution of α-actinin-3 rs1815739 and angiotensin-1 converting enzyme InDel polymorphisms in Turkish bodybuilders.

The determination of the genetic profiles of successful athletes and the effects of these genetic parameters on athletic performance is gaining increasing interest. The majority of studies assessing the genetics of athletes usually analyse the most well-known genetic variations in athletes associated with the different specialties. The aim of the present study was to analyse the ACE InDel and ACTN3 rs1815739 polymorphisms in Turkish bodybuilders. A total of 11 male bodybuilders were recruited and genotyped for these polymorphisms. The respective percentage of the ACE II, ID and DD genotypes were 18, 73 and 9. For the ACTN3 genotype, the respective frequencies were 55 and 45 for the RX and RR genotypes. No XX genotype was detected. The allelic counts were 12 (55%) for I and 10 (45%) for the D alleles of ACE; and 12 (55%) and 10 (45%) for R and X alleles, respectively, for the ACTN3 genotype. Additionally, 5 athletes had ID + RX genotypes in terms of ACE InDel and ACTN3 rs1815739 polymorphisms, respectively. These results indicate the importance of endurance related alleles of ACE and ACTN3 in bodybuilders. The results of the present are in agreement with previous studies, highlighting a potential association between specific polymorphisms and the endurance-related nature of bodybuilders. Further studies with larger cohorts are required to understand the association between these polymorphisms and specific parameters performance in bodybuilders.

Acute myocardial infarction in young newbie bodybuilder using multiple steroid and protein supplements.

Coronary artery disease (CAD), the major reason of deaths worldwide is generally known as a disease of the elderly, however it is grasping the youth too. The most common etiology of young CAD is lifestyle changes, smoking, and development of other comorbid conditions such as diabetes and hypertension at an early age. There has been an upward trend in youngsters regarding consciousness about their body build and thus use of various protein supplements and anabolic steroids for faster results. The present case reports a young patient presenting with severe retrosternal left-sided chest pain for 15-20 min to the emergency department. His electrocardiogram was suggestive of acute anterolateral wall ST segment elevation myocardial infarction for which he underwent urgent coronary angiography and percutaneous coronary intervention. His personal history revealed a significant use of steroids, proteins, and other supplements in supraphysiological doses for instant body building efforts without any other significant past medical, surgical, or family history. He showed good recovery and was strongly recommended to stop steroids and protein supplements. In conclusion, supraphysiological doses of protein supplements, anabolic steroids, and other nutritional products bear a risk factor for CAD. .