Training, Supplementation, and Pharmacological Practices of Competitive Male Bodybuilders Across Training Phases

Effects of inspiratory muscle training on 1RM performance and body composition in professional natural bodybuilders

Background

The effect of inspiratory muscle training on upper limbs One Rep Maximum (1RM) in professional natural bodybuilders is still unclear. Our aim of this study is to investigate the effects of a 6 weeks inspiratory muscle training on 1RM results.

Methods

This study included 14 athletes, that had participated in international bodybuilding competitions. Each athlete had been training for minimum of 5 years and at least 5 h per week. The participants were randomly divided into two groups: inspiratory muscle training (IMT) and control (CON) groups. The IMT group and CON group consisted of seven subjects. While the control group continued with the normal training regime, the IMT group additionally performed inspiratory muscle training with the resistance setting of the PowerBreathe® Classic device set to 40% of the participant's MIP. Prior to and during the 6-week training period, the bench press 1 RM, anthropometry, pulmonary function tests, and maximal inspiratory (MIP) and expiratory (MEP) pressure measurements were obtained. A nutrition protocol developed by a qualified dietician was implemented for each athlete.

Results

The mean maximal strength of the respiratory muscle training group changed by 14.39%, whereas that of the control group changed by 9.43% (p = 0.012). The changes in the mean FVC (p = 0.000), FEV1 (p = 0.001), PEF (p = 0.064), MIP (p = 0.001), and maximal expiratory pressure (p = 0.017) were greater in the IMT group. The mean circumferences of the shoulder (p = 0.004), chest (p = 0.008), arm (p = 0.004), and neck (p = 0.003) improved more in the IMT group than in the CON group. A reduction in abdominal measurement was observed in the IMT group (p = 0.039), whereas no notable discrepancy was identified in body fat percentage (p = 0.295).

Conclusion

In conclusion we identified that the addition of progressive loading inspiratory muscle training for competition preparation programs in professional natural bodybuilders will further improve their respiratory function, respiratory muscle strength, maximal strength, and muscle development. This research provides valuable insights into how IMT influences bodybuilding training outcomes, potentially guiding future interventions and program designs to better support strength development and body composition in bodybuilding training contexts.

An examination of the associations between nutritional peaking strategies in physique sport and competitor characteristics

BACKGROUND

Physique athletes are subjectively judged on their on-stage esthetic per their competition division criteria. To succeed, competitors look to acutely enhance their appearance by manipulating nutritional variables in the days leading up to competition, commonly referred to as peak week (PW). Despite their documented wide adoption, PW strategies lack experimental evidence. Further, the relationship between the specific strategies and the characteristics of the competitors who implement them are unknown. The aim of this research was to examine the effect of competitor characteristics on the specific nutritional peaking strategies implemented, the length of these strategies, and the range of daily carbohydrate (CHO) intakes during these strategies.

METHODS

A 58-item survey was developed to gather information on peak week nutrition and training practices of physique athletes. A total of 160 respondents above the age of 18 who had competed in the last 5 years completed the nutrition section. The topics analyzed for this paper included competitor demographics, peaking strategies utilized, and PW CHO intakes. Competitor demographics are presented with the use of descriptive statistics. Associations between competitor demographics and peaking strategies implemented, peaking strategy length, and daily CHO intake ranges were assessed using multiple logistic regression, multiple ordinal logistic regression, and linear mixed models, respectively.

RESULTS

From the sampled population, ages 24-39 years (71.2%), male (68.8%), natural (65%), and amateur (90%) were the most common characteristics from their respective categories, while mean competition preparation length was 20.35 ± 8.03 weeks (Males: 19.77 ± 7.56 weeks, Females: 21.62 ± 8.93 weeks), competition preparation body mass loss was 11.5 ± 5.56 kg (M: 12.7 ± 5.76 kg, F: 7.16 ± 3.99 kg), and competition body mass was 72.09 ± 15.74 kg (M: 80.15 ± 11.33 kg, F: 54.34 ± 7.16 kg). For males, the highest and lowest daily CHO intake during PW were 489.63 ± 224.03 g (6.22 ± 2.93 g/kg body mass) and 148.64 ± 152.01 g (1.94 ± 2.17 g/kg), respectively, while for females these values were 266.73 ± 131.23 g (5.06 ± 2.67 g/kg) and 94.42 ± 80.72 g (1.81 ± 1.57 g/kg), respectively. CHO back loading (45%) and water loading (40.6%) were the most popular peaking strategies, while the most prevalent peaking strategy length was 7 days (27.2%). None of the competitor characteristics predicted the use of CHO-based peaking strategies nor peaking strategy length. For non-CHO-based strategies, drug-enhanced competitors were more likely to restrict water than non-drug enhanced, while males and professional competitors had greater odds of loading sodium than females and amateurs, respectively. Finally, when comparing the disparity in highest and lowest CHO intakes during peak week, sex was the only significant factor.

CONCLUSIONS

The results of this survey provide further information on the nutritional peaking strategies implemented by competitors. Certain characteristics were identified as predictors of sodium loading and water restriction, and the range of daily PW CHO intake. Contrastingly, no associations were found for CHO-based peaking strategies or peaking strategy length. While our analyses may be underpowered, and thus results should be interpreted with caution, it appears the nutritional peaking strategies implemented by physique competitors are seemingly complex and highly individual.

Muscle Hypertrophy and Strength Adaptations to Systematically Varying Resistance Exercises

We compared the effects of varied and constant resistance exercises on muscular adaptations in young women. Seventy young women (21.8 ± 3.4 yrs, 62.0 ± 12.3 kg, 162.3 ± 5.7 cm) were randomly divided into two groups: constant resistance exercises (CON-RE, n = 38) or varied resistance exercises (VAR-RE, n = 32). The resistance training (RT) was performed thrice a week over 10 weeks. CON-RE performed a 45º leg press and stiff-leg deadlift in every training session, while VAR-RE performed 45º leg press and stiff-leg deadlift in the first training session of the week, hack squat and prone leg curl in the second, and Smith machine squat and seated-leg curl in the third. Both groups performed two sets of 10-15 repetitions maximum per resistance exercise. We measured the muscle thickness of the thigh's anterior, lateral, and posterior aspects by ultrasonography at different muscle sites (proximo-distal). Muscular strength was analyzed from the one-repetition maximum (1RM) tests in the 45° leg press and leg extension (non-trained exercise). The muscle thickness increased similarly in both groups for all muscles and sites (CON-RE: +7.8-17.7% vs. VAR-RE: +7.5-19.3%, p > .05). The 1RM increased similarly in both groups (CON-RE: +24.4-32.1% vs. VAR-RE: +29.0-30.1%, p > .05). Both RT routines resulted in virtually similar muscular strength gains and hypertrophy. Therefore, both strategies should be considered for the improvement of strength and muscle growth.

A Survey of Resistance Training Practices Among Physique Competitors During Peak Week

ABSTRACT

Homer, KA, Cross, MR, and Helms, ER. A survey of resistance training practices among physique competitors during peak week. J Strength Cond Res 38(10): 1745-1752, 2024-Physique athletes are ranked by their on-stage presentation of muscle size, proportionality, and leanness. To acutely maximize muscle size, competitors manipulate resistance training (RT) variables in the days before the contest, commonly referred to as peak week (PW). Resistance training manipulations during PW may act synergistically with nutrition strategies such as carbohydrate loading. However, because little information exists on changes made to RT during PW, the purpose of this research was to determine the current practices of physique athletes and whether competitor characteristics were predictive of the RT variables manipulated. A total of 104 responses to the RT section of a survey on PW nutrition and training were analyzed through a series of multiple logistic regression models to examine the relationship between RT manipulations and competitor characteristics. Furthermore, to determine the magnitude of differences between PW and the week before PW (WBPW) for these variables, a McNemar-Bowker test, paired t-tests, and Wilcoxon signed-rank tests were conducted for nominal, continuous, and discrete outcomes, respectively. For all statistical analyses, p <0.05 was deemed significant. Competitors generally adjusted RT in a variety of ways, where proximity-to-failure was the most frequently manipulated and training frequency was the least; however, no competitor characteristic predicted any of the RT variables manipulated. Within those who manipulated RT variables during PW, frequency, volume, and intensity decreased while repetition ranges of compound exercises increased, empirically confirming that competitors seek to reduce training stress during PW. Such findings can be incorporated in future experimental designs examining the efficacy of peaking strategies to enhance the generalizability of results.

Anabolic steroid consumption among gym-goers in Amman: knowledge, attitudes, and behaviors

Background

The use of Anabolic-androgenic steroids (AAS) among gym members has become a significant concern due to their impact on physical training and performance. Research worldwide indicates a notable prevalence of AAS use among athletes and gym attendees, often involving substances that are neither safe nor legal.

Objectives

This study aims to determine the prevalence of AAS use among gym attendees in Amman, Jordan, and to explore the knowledge, attitudes, and behaviors associated with AAS use.

Methods

The study involved 399 participants from 35 randomly selected gyms in the metropolitan area of Amman, Jordan. A cluster sampling technique was used to select a diverse and representative sample of gym attendees. Data was collected using a self-administered questionnaire that assessed AAS use, knowledge, attitudes, and behavioral factors. Statistical analyses were conducted using chi-square tests to explore the relationships between AAS use and categorical variables, while logistic regression was employed to identify predictors of AAS use.

Results

The analysis revealed significant associations between AAS use and various factors, including knowledge, attitudes, behavioral factors, and demographic variables such as gender, age, exercise frequency, reasons for exercise, and total exercise duration. The study identified key predictors of AAS use among gym attendees in Amman, highlighting the importance of demographic and behavioral factors.

Conclusion

The findings underscore the need for targeted interventions to address misconceptions and promote safer practices among gym-goers in Amman. The study provides critical insights that can guide the development of strategies, policy adjustments, and educational initiatives aimed at reducing AAS misuse and fostering a healthier gym culture in the region.

Longitudinal Changes in Dietary Supplement Use among United States Military Personnel: The US Military Dietary Supplement Use Study

Previous studies investigating temporal changes in dietary supplement (DS) use have used representative samples but have not followed the same cohort over time. This study investigated longitudinal patterns of changes in DS use and factors associated with discontinuing DS use in a single group of active-duty United States military service members (SMs). SMs (n = 5778) completed two identical questionnaires on their DS use and demographic/lifestyle characteristics an average ± standard deviation 1.3 ± 0.2 years apart. Prevalences of reported DS use ≥1 times/week in the baseline (BL) and follow-up (FU) phases were: any DS, BL = 77%, FU = 78%; multivitamins/multiminerals (MVM), BL = 50%, FU = 48%; individual vitamins/minerals, BL = 33%, FU 35%; proteins/amino acids, BL = 43%, FU = 39%; combination products, BL = 44%, FU = 37%; prohormones, BL = 5%, FU = 4%; herbal products, BL = 23%, FU = 21%; joint health products, BL = 12%, FU = 12%; fish oils, BL = 25%, FU = 23%; other DSs, BL = 17%, FU = 17%. Among BL users, the proportions reporting use in the FU phase were: any DS 88%, MVM 74%, protein/amino acids 70%, individual vitamin/minerals 62%, combination products 62%, fish oils 61%, joint health products 57%, herbal products 50%, other DSs 50%, and prohormones 37%. Higher odds of discontinuing any DS use in the follow-up were associated with female gender, younger age, higher BMI, and less weekly resistance training. Overall, prevalence of DS use was relatively consistent in the two phases; however, the cohort changed their use patterns in the follow-up with some discontinuing use and others initiating use, thus maintaining use prevalence over the period. These findings have implications for repeated cross-sectional DS studies where different samples are followed over time.

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.

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.

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.

Skeletal muscle mass in competitive physique-based athletes (bodybuilding, 212 bodybuilding, bikini, and physique divisions): A case series

OBJECTIVES

(1) To examine the muscle thickness of various muscle groups of the body to estimate the absolute and relative skeletal muscle mass (SM) in competitive physique-based athletes (Bodybuilding, 212 Bodybuilding, Bikini, and Physique divisions) and (2) to compare values across various divisions of competition and to resistance trained and non-resistance trained individuals.

METHODS

Eight competitive physique-based athletes (2 M and 6 F), two recreationally resistance trained (1 M and 1 F) and two non-resistance trained (1 M and 1 F) participants had muscle thickness measured by ultrasound at nine sites on the anterior and posterior aspects of the body. SM was estimated from an ultrasound-derived prediction equation and SM index was used to adjust for the influence of standing height (i.e., divided by height squared).

RESULTS

SM values ranged from 19.6 to 60.4 kg in the eight competitive physique-based athletes and 16.1 to 32.6 kg in the four recreationally resistance trained and non-resistance trained participants. SM index ranged from 7.2 to 17.9 kg/m2 in the eight competitive physique-based athletes and 5.8 to 9.3 kg/m2 in the four recreationally resistance trained and non-resistance trained participants.

CONCLUSION

Overall, varying magnitudes of SM and SM index were present across competitors and their respective divisions of bodybuilding. The Men's Open Bodybuilder in the present study had greater values of total SM and SM index compared to previously published values in the literature. Our data provides insight into the extent of SM present in this population and further extends the discussion regarding SM accumulation in humans.

Research trends and hotspots of exercise for people with sarcopenic: A bibliometric analysis

This study aimed to analyze the trends and themes in exercise and sarcopenia research using a bibliometric approach. The Web of Science citation database was used to identify papers published on exercise and sarcopenia. The retrieved data on institutions, journals, countries, authors, journal distribution, and keywords were analyzed scientometric ally using CiteSpace and VOSviewer. 2895 papers were included according to our specified inclusion criteria eventually. The data showed an upward trend in the number of published articles on exercise and sarcopenia. The countries with the highest number of publications were the United States, Japan, and England; research institutions were mainly composed of universities in Europe and the United States, and high-producing authors formed major collaborative teams, but cross-geographical and cross-institutional collaboration was not apparent; research was closely focused on 3 aspects: resistance exercise, resistance combined with other forms of exercise, and exercise combined with nutritional supplementation, of which resistance exercise was a particular focus; and recently, the research hotspots were mainly the effects of exercise on grip strength. The most cited articles were consensus guidelines published by the working group on sarcopenia in the elderly from different continents. The prevention and rehabilitation of sarcopenia in the elderly are gaining attention. Current primary exercise therapies for sarcopenia and exercise combined with nutritional supplementation have significant advantages and the potential to delay muscle decay. This suggests a promising area for future research that could benefit from further advances.

Muscle Swelling of the Triceps Surae in Response to Straight-Leg and Bent-Leg Calf Raise Exercises in Young Women

ABSTRACT

Kassiano, W, Costa, B, Kunevaliki, G, Soares, D, Stavinski, N, Francsuel, J, Carneiro, MAS, Tricoli, I, Nunes, JP, Ribeiro, AS, and Cyrino, ES. Muscle swelling of the triceps surae in response to straight-leg and bent-leg calf raise exercises in young women. J Strength Cond Res 37(7): e438-e443, 2023-Triceps surae muscle swelling in response to different resistance exercises remains to be determined. This study compared the effects of straight-leg (STRA-leg) calf raise vs. bent-leg (BENT-leg) calf raise exercises on triceps surae muscle swelling. Seventeen young women (23.7 ± 4.0 years; 67.4 ± 16.0 kg; and 163.5 ± 7.2 cm) performed 2 resistance training sessions; in one, they performed the STRA-leg calf raise, and in another, they performed the BENT-leg calf raise. A randomized, cross-over, and counterbalanced design was adopted for this investigation. The subjects performed 4 sets of 20 repetitions maximum until concentric muscular failure. The muscle thickness of the gastrocnemius medial (GM), gastrocnemius lateral (GL), and soleus (SOL) was taken through B-mode ultrasound before and immediately after the calf raise exercises. STRA-leg calf raise elicited greater increases in muscle thickness of GM (+8.8% vs. -0.9%, p < 0.001) and GL (+14.5% vs. +7.0%, p < 0.001) than BENT-leg calf raise. Conversely, BENT-leg calf raise elicited greater increases in SOL muscle thickness than STRA-leg calf raise (+15.4% vs. +7.7%, p < 0.001). From a practical perspective, the STRA-leg calf raise should be preferred if the aim is stimulating the 3 muscles that comprise the triceps surae, whereas the BENT-leg calf raise should be prioritized if the target muscle is the SOL.

Nutrition, Training, Supplementation, and Performance-Enhancing Drug Practices of Male and Female Physique Athletes Peaking for Competition

ABSTRACT

Escalante, G, Barakat, C, Tinsley, GM, and Schoenfeld, BJ. Nutrition, training, supplementation, and performance-enhancing drug practices of male and female physique athletes peaking for competition. J Strength Cond Res XX(X): 000-000, 2023-The purpose of this descriptive investigation was threefold: (a) to assess the nutrition, training, supplement, and performance-enhancement drug practices of male and female physique competitors 30 days before competition; (b) to examine the specific water and macronutrient manipulation performed by competitors during the last 3 days before competition; and (c) to assess physiological responses to precontest preparation including body composition, body fluids, resting heart rate, and blood pressure. Competitors reported performing moderately high volume, moderate to high repetition, split-body resistance training programs performed on most days of the week; the programs included the use of a variety of advanced training methods. A majority of competitors included cardio to expedite fat loss, and most reported performing cardio in a fasted state despite a lack of objective evidentiary support for the practice. Competitors substantially restricted calories and consumed protein in amounts well above research-based guidelines (>3 g·kg-1·d-1); carbohydrate and lipid intake were highly variable. Water was substantially reduced in the final 3 days before competition. Competitors used a variety of dietary supplements throughout the study period, many of which are not supported by research. Both male and female competitors reported using performance enhancing drugs (∼48 and ∼38%, respectively) including testosterone derivatives, selective androgen receptor modulators, and human growth hormone. More research is warranted to elucidate safer and more effective peak week practices for physique competitors.

Influence of Resistance Training Proximity-to-Failure on Skeletal Muscle Hypertrophy: A Systematic Review with Meta-analysis

BACKGROUND AND OBJECTIVE

This systematic review with meta-analysis investigated the influence of resistance training proximity-to-failure on muscle hypertrophy.

METHODS

Literature searches in the PubMed, SCOPUS and SPORTDiscus databases identified a total of 15 studies that measured muscle hypertrophy (in healthy adults of any age and resistance training experience) and compared resistance training performed to: (A) momentary muscular failure versus non-failure; (B) set failure (defined as anything other than momentary muscular failure) versus non-failure; or (C) different velocity loss thresholds.

RESULTS

There was a trivial advantage for resistance training performed to set failure versus non-failure for muscle hypertrophy in studies applying any definition of set failure [effect size=0.19 (95% confidence interval 0.00, 0.37), p=0.045], with no moderating effect of volume load (p=0.884) or relative load (p=0.525). Given the variability in set failure definitions applied across studies, sub-group analyses were conducted and found no advantage for either resistance training performed to momentary muscular failure versus non-failure for muscle hypertrophy [effect size=0.12 (95% confidence interval -0.13, 0.37), p=0.343], or for resistance training performed to high (>25%) versus moderate (20-25%) velocity loss thresholds [effect size=0.08 (95% confidence interval -0.16, 0.32), p=0.529].

CONCLUSION

Overall, our main findings suggest that (i) there is no evidence to support that resistance training performed to momentary muscular failure is superior to non-failure resistance training for muscle hypertrophy and (ii) higher velocity loss thresholds, and theoretically closer proximities-to-failure do not always elicit greater muscle hypertrophy. As such, these results provide evidence for a potential non-linear relationship between proximity-to-failure and muscle hypertrophy.

Premature Death in Bodybuilders: What Do We Know?

Premature deaths in bodybuilders regularly make headlines and are cited as evidence that bodybuilding is a dangerous activity. A wealth of research has revealed elite athletes typically enjoy lower mortality rates than non-athletes, but research on bodybuilder lifespan is surprisingly limited. Anabolic androgenic steroid (AAS) use is commonly cited as a key contributor to morbidity and premature mortality in bodybuilders, but this area of research is highly nuanced and influenced by numerous confounders unique to bodybuilding. It is quite possible that bodybuilders are at elevated risk and that AAS use is the primary reason for this, but there remains much unknown in this realm. As global participation in bodybuilding increases, and healthcare providers play a more active role in monitoring bodybuilder health, there is a need to identify how numerous factors associated with bodybuilding ultimately influence short- and long-term health and mortality rate. In this Current Opinion, we discuss what is currently known about the bodybuilder lifespan, identify the nuances of the literature regarding bodybuilder health and AAS use, and provide recommendations for future research on this topic.

Dead Bodybuilders Speaking from the Heart: An Analysis of Autopsy Reports of Bodybuilders That Died Prematurely

This study analyzed publicly available autopsy reports of male bodybuilders under the age of 50 who reportedly died from cardiovascular-related events. A general Google search with the terms "dead bodybuilders" was performed on 10 February 2022. Six reports were available for review and analysis. Bodybuilders had the following means: age (±SD) = 36 ± 7.1 years; height 1.82 ± 0.02 m; weight = 103.8 ± 5.3 kg; weight of heart = 575 ± 134.4 g; and left ventricular myocardium thickness (n = 3) = 16.3 ± 3.5 mm. The bodybuilders analyzed had a mean heart weight that is 73.7% heavier than the reference man (575 g vs. 332 g). Similarly, 100% of the autopsies reported left ventricular myocardium thickness of 16.3 ± 3.5 mm; this is 125% thicker than normative data for men. While abuse of AASs for prolonged periods of time may contribute to some of the cardiac abnormalities present in these bodybuilders, it should be noted that cardiac hypertrophy, including left ventricular hypertrophy, has also been reported in drug-free strength athletes. Each autopsy report included cardiovascular abnormalities within the cause of death. Association does not mean causation, but nonetheless bodybuilders should be aware of potential contributing cardiovascular risks with AAS abuse.

Prevalence of Dietary Supplement Use among Athletes Worldwide: A Scoping Review

Athletes represent a major part of dietary supplement users. This scoping review aims to explore the prevalence of dietary supplement use among athletes worldwide, most commonly used supplements, sources of information on dietary supplements and their reasons for use of these supplements. PubMed, CINAHL, MEDLINE, and PsycInfo were searched for original research articles. Studies were included if they involved athletes, identified the prevalence of dietary supplement use, and were published after 2017. A total of 26 articles were reviewed. Prevalence of dietary supplement use varied among articles, but sex-based differences related to the types of used dietary supplements existed. Generally, the findings were consistent in terms of reasons for use and sources of information. Unfortunately, the lack of homogeneity regarding the definition of dietary supplements, definition of use, reporting timeframes, and data collection methods complicates the attempt to compare the findings among studies.

Self-Reported Training and Supplementation Practices Between Performance-Enhancing Drug-User Bodybuilders Compared with Natural Bodybuilders

ABSTRACT

Li, J, Davies, TB, and Hackett, DA. Self-reported training and supplementation practices between performance-enhancing drug-user bodybuilders compared with natural bodybuilders. J Strength Cond Res XX(X): 000-000, 2022-This study aimed to examine whether the training and supplementation practices differ between performance-enhancing drug (PED)-using bodybuilders (BB) and natural BB. One hundred eighty-seven competitive male bodybuilders with a median age of 27.0 years completed an online survey. Of this sample, 40 respondents reported using PED (PED-user) and 147 respondents reported to be natural. Compared with natural BB, PED-user BB reported greater off-season body weight (p < 0.001) and weight loss before a competition (p < 0.001). In the off-season, PED-user BB performed a greater number of exercises per muscle group (p < 0.001), number of repetition maximum (RM) per set (p < 0.01), and less recovery between the sets (p < 0.01). During the precompetition phase, the natural BB increased their number of RM; however, the PED-user BB still reported using a greater number of RM per set (p = 0.02), exercises per muscle group (p < 0.001), and less recovery time between the sets (p < 0.01). Both the PED-user BB and natural BB reported greater aerobic exercise frequency (p < 0.001) and session duration (p < 0.001), although PED-user BB performed a greater number of aerobic exercise sessions (p = 0.04) and at a higher intensity (p < 0.01). Advanced training techniques, including negatives, partial repetitions, preexhaustion sets, and timed repetitions, were more popular among PED-user BB (p < 0.05). Creatine monohydrate usage was more popular among natural BB (p < 0.001), whereas branched-chain and essential amino acids were more popular among PED-user BB (p ≤ 0.001). Findings suggest that PED-user BB perform more metabolically demanding resistance training sessions, more strenuous aerobic training during the precompetition phase, and may have different supplementation preferences compared with natural BB.

Nutritional and Non-Nutritional Strategies in Bodybuilding: Impact on Kidney Function

Bodybuilders routinely engage in many dietary and other practices purported to be harmful to kidney health. The development of acute kidney injury, focal segmental glomerular sclerosis (FSGS) and nephrocalcinosis may be particular risks. There is little evidence that high-protein diets and moderate creatine supplementation pose risks to individuals with normal kidney function though long-term high protein intake in those with underlying impairment of kidney function is inadvisable. The links between anabolic androgenic steroid use and FSGS are stronger, and there are undoubted dangers of nephrocalcinosis in those taking high doses of vitamins A, D and E. Dehydrating practices, including diuretic misuse, and NSAID use also carry potential risks. It is difficult to predict the effects of multiple practices carried out in concert. Investigations into subclinical kidney damage associated with these practices have rarely been undertaken. Future research is warranted to identify the clinical and subclinical harm associated with individual practices and combinations to enable appropriate and timely advice.

Changes in Intra-to-Extra-Cellular Water Ratio and Bioelectrical Parameters from Day-Before to Day-Of Competition in Bodybuilders: A Pilot Study

The present study analyzed the effects from day-before to day-of bodybuilding competition on intracellular water (ICW), extracellular water (ECW), total body water (TBW), and bioimpedance analysis (BIA) parameters (resistance, R; reactance, Xc; and derived scores) in bodybuilding athletes. We assessed anthropometry and BIA (foot-to-hand; tetrapolar; 50 kHz) in 11 male bodybuilders (29 ± 4 year-old; 81 ± 8 kg; 172 ± 7 cm; 27 ± 2 kg/m²) both on the pre-competition day and on the contest day. Results revealed significant increases in ICW (31.6 ± 2.9 to 33.1 ± 2.8 L), with concomitant decreases in ECW (19.8 ± 1.8 to 17.2 ± 1.4 L) and TBW (51.4 ± 4.6 to 50.3 ± 4.2 L) from the day-before competition to contest day, which resulted in relatively large increases in the ICW/ECW ratio (1.60 ± 0.03 to 1.92 ± 0.01 L). Moreover, significant increases in R (391 ± 34 to 413 ± 33 ohm), Xc (64 ± 7 to 70 ± 6 ohm), and phase angle (9.3 ± 0.6 to 9.6 ± 0.7 degree) were observed between time periods. The phase angle scores reported on show-day of 9.6 and 11.2 appear to be the highest group mean and individual values observed in the literature to date. In conclusion, the strategies carried out on the final day of peak-week bodybuilding preparation lead to changes in BIA parameters and body water, with fluids shifting from the extra- to the intracellular compartment.