Nutritional Recommendations for Physique Athletes

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.

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.

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.

Body Composition of Competitive Bodybuilders: A Systematic Review of Published Data and Recommendations for Future Work

ABSTRACT

Bauer, P, Majisik, A, Mitter, B, Csapo, R, Tschan, H, Hume, P, Martínez-Rodríguez, A, and Makivic, B. Body composition of competitive bodybuilders: a systematic review of published data and recommendations for future work. J Strength Cond Res 37(3): 726-732, 2023-The purpose of this review was to systematically summarize studies measuring the body composition of competitive bodybuilding athletes to provide recommended values for preparation and during competition. The protocol was preregistered with PROSPERO (CRD42020197921) and followed the guidelines of the Preferred Reported Items for Systematic Reviews and Meta-Analysis. A search of 5 electronic databases (PubMed, Web of Science, SportDiscus, CINAHL, and Scopus) was conducted to retrieve all relevant publications from January 1, 2000, up to June 13, 2021. Of 16 studies meeting the inclusion criteria, 6 presented longitudinal data on competition preparation and were discussed in detail. In the general preparation phase, body fat levels of bodybuilding athletes ranged between 15.3 and 25.2% (female) and from 9.6 to 16.3% (male). Close to competition, however, body fat levels were substantially lower, ranging from 8.1 to 18.3% for female and 5.8-10.7% for male athletes. All studies comparing relative body fat values at various time points during competition preparation found significant reductions between 30 and 60% in relative body fat, whereas lean mass was mostly maintained. Findings from the studies included in this review suggest that most bodybuilding competitors keep resistance training volume high while increasing aerobic training volume when preparing for competition. Findings on energy intake and macronutrient distribution were unclear and should be addressed in future studies. Further research, especially on contest preparation, is warranted and should include more details about training programs, nutritional strategies, psychosocial situation, anabolic androgen steroid, and supplement use as well as measurement protocols and preparation.

Dietary Intake, Serum Hormone Concentrations, Amenorrhea and Bone Mineral Density of Physique Athletes and Active Gym Enthusiasts

As the diet, hormones, amenorrhea, and bone mineral density (BMD) of physique athletes (PA) and gym enthusiasts (GE) are little-explored, we studied those in 69 females (50 PA, 19 GE) and 20 males (11 PA, 9 GE). Energy availability (EA, kcal·kgFFM−1·d−1 in DXA) in female and male PA was ~41.3 and ~37.2, and in GE ~39.4 and ~35.3, respectively. Low EA (LEA) was found in 10% and 26% of female PA and GE, respectively, and in 11% of male GE. In PA, daily protein intake (g/kg body mass) was ~2.9−3.0, whereas carbohydrate and fat intakes were ~3.6−4.3 and ~0.8−1.0, respectively. PA had higher protein and carbohydrate and lower fat intakes than GE (p < 0.05). Estradiol, testosterone, IGF-1, insulin, leptin, TSH, T4, T3, cortisol, or BMD did not differ between PA and GE. Serum IGF-1 and leptin were explained 6% and 7%, respectively, by EA. In non-users of hormonal contraceptives, amenorrhea was found only in PA (27%) and was associated with lower fat percentage, but not EA, BMD, or hormones. In conclusion, off-season dietary intakes, hormone levels, and BMD meet the recommendations in most of the PA and GE. Maintaining too-low body fat during the off-season may predispose to menstrual disturbances.

Serum and diet long-chain omega-3 fatty acid nutritional status in Chinese elite athletes

Omega-3 polyunsaturated fatty acids (omega-3 PUFAs) are essential for improving the health and performance of athletes. The present study aimed to evaluate the nutritional status of omega-3 PUFAs in Chinese elite athletes by both dietary intake analysis and serum biomarker detection. A cross-sectional analysis of data from 54 elite athletes (24 men and 30 women) from Shanghai professional sports teams was conducted. A food frequency questionnaire (FFQ) was employed to analyze dietary intake, and gas chromatography-mass spectrometry (GC-MS/MS) was conducted to measure serum biomarkers of PUFAs. Correlation analysis was performed to investigate the relationships of PUFA biomarkers with diet, inflammation and oxidative stress. The results showed that the median intake of EPA + DHA among athletes was 132 mg/d, which is lower than the minimum value recommended by dietary guidelines (250 mg/d). The average serum EPA + DHA was 4.0 ± 1.1%, and the ratio of omega-6/omega-3 was 7.7 ± 1.7. Most (96.3%) of the athletes were below the targeted value of serum EPA + DHA, which is associated with a reduction in cardiovascular risk. Correlation analysis showed that the serum EPA + DHA was positively correlated with the long-term dietary intake of EPA + DHA and negatively correlated with inflammatory markers. In conclusion, the serum circulating EPA + DHA and omega-6/omega-3 ratio are effective biomarkers reflecting the nutritional status of PUFAs in athletes. Omega-3 PUFAs have a potential effect on inhibiting inflammatory markers. Hence, it is necessary for Chinese athletes to improve their suboptimal nutritional status of PUFAs through dietary intervention.

After the spotlight: are evidence-based recommendations for refeeding post-contest energy restriction available for physique athletes? A scoping review

Background: To date, there is limited consensus on post-contest recovery recommendations for natural physique athletes. The available literature emphasizes the negative consequences of extreme dieting associated with physique contests, yet offers only speculative suggestions to facilitate physiological recovery post-contest. This scoping review evaluates evidence-based recommendations for recovery in post-physique contests. Methods: The online search engines and databases Google Scholar, PubMed, and Scopus were searched systematically and 12 peer reviewed journal articles were included in the review. Results: Six key factors were identified that directly impacted on physiological recovery post-contest: (1) body composition, (2) recovery dietary intake, (3) resting metabolic rate (RMR) restoration, (4) endocrine measures recovery, (5) menstrual cycle recovery, and (6) psychological aspects of recovery. Conclusions: Three dietary strategies have been proposed to facilitate physiological recovery post-contest while bearing in mind body composition and future athlete outcomes; (1) a gradual increase in energy intake to maintenance requirements, (2) ad libitum eating, (3) an immediate return to maintenance energy requirements. Future research is required to determine the timeline in which full physiological recovery occurs post-contest and which strategies best support athlete health and performance during post-contest recovery.

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.

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

ABSTRACT

Hackett, DA. Training, supplementation, and pharmacological practices of competitive male bodybuilders across training phases. J Strength Cond Res 36(4): 963-970, 2022-Bodybuilding involves the pursuit of muscularity and leanness primarily through the use of progressive resistance training in combination with other practices such as manipulation of diet and use of ergogenic aids. This study aimed to compare the training practices and ergogenic aids used by competitive male bodybuilders across training phases. An online survey was completed by 235 competitive male bodybuilders with a median age of 26.0 (interquartile range 23.0-31.3) years. Results showed that most respondents performed split-routines (85.5%), 4-7 sessions per week (95.7%), trained major muscle groups twice a week (>50%), and session duration being 60-90 minutes (55.7%). Off-season resistance training sessions mostly comprised of targeting 2-3 muscle groups (56%), 2-3 exercises per muscle group (60.4%), 3-4 sets per exercise (73.2%), 7-12 repetition maximum (RM) per set (71.6%), and 61-180 seconds recovery between sets and exercises (80.5%). At the precompetition phase (6 weeks before competition), there was a decrease in the number of muscle groups trained per session (p = 0.027) and a greater number of repetitions performed per set (p < 0.001). A significant increase in the reported aerobic exercise volume was found during precompetition (<0.001). Performance enhancing drugs were used by 53.6% of respondents who did not compete in natural bodybuilding competitions. Dietary supplements were used by 95.7% of respondents with the most common being creatine monohydrate (80.4%) and whey protein (65.8%). Findings suggest that competitive bodybuilders follow resistance training practices consistent with the broad muscular hypertrophy recommendations but a notable shift in practices occur in the weeks before competition.

Lean mass sparing in resistance-trained athletes during caloric restriction: the role of resistance training volume

Many sports employ caloric restriction (CR) to reduce athletes’ body mass. During these phases, resistance training (RT) volume is often reduced to accommodate recovery demands. Since RT volume is a well-known anabolic stimulus, this review investigates whether a higher training volume helps to spare lean mass during CR. A total of 15 studies met inclusion criteria. The extracted data allowed calculation of total tonnage lifted (repetitions × sets × intensity load) or weekly sets per muscle group for only 4 of the 15 studies, with RT volume being highly dependent on the examined muscle group as well as weekly training frequency per muscle group. Studies involving high RT volume programs (≥ 10 weekly sets per muscle group) revealed low-to-no (mostly female) lean mass loss. Additionally, studies increasing RT volume during CR over time appeared to demonstrate no-to-low lean mass loss when compared to studies reducing RT volume. Since data regarding RT variables applied were incomplete in most of the included studies, evidence is insufficient to conclude that a higher RT volume is better suited to spare lean mass during CR, although data seem to favor higher volumes in female athletes during CR. Moreover, the data appear to suggest that increasing RT volume during CR over time might be more effective in ameliorating CR-induced atrophy in both male and female resistance-trained athletes when compared to studies reducing RT volume. The effects of CR on lean mass sparing seem to be mediated by training experience, pre-diet volume, and energy deficit, with, on average, women tending to spare more lean mass than men. Potential explanatory mechanisms for enhanced lean mass sparing include a preserved endocrine milieu as well as heightened anabolic signaling.

Weight loss practices and eating behaviours among female physique athletes: Acquiring the optimal body composition for competition

Little is known about weight loss practices and eating behaviours in female physique athletes. This study investigated the weight loss history, practices, and key influences during the pre-competition period in a large cohort of female physique athletes stratified by division and experience level. Eating attitudes and behaviours were assessed to identify whether athletes were at risk of developing an eating disorder. Using a cross-sectional research design, female physique athletes (n = 158) were recruited and completed an anonymous online self-reported survey consisting of two validated questionnaires: Rapid Weight Loss Questionnaire and Eating Attitudes Test-26. Irrespective of division or experience, female physique athletes used a combination of weight loss practices during the pre-competition phase. Gradual dieting (94%), food restriction (64%) and excessive exercise (84%), followed by body water manipulation via water loading (73%) were the most commonly used methods. Overall, 37% of female physique athletes were considered at risk of developing an eating disorder. Additionally, 42% of female physique athletes used two pathogenic weight control methods with 34% of Figure novice athletes indicating binge eating once a week or more. The coach (89%) and another athlete (73%) were identified as key influences on athletes' dieting practices and weight loss. The prevalence of athletes identified with disordered eating symptoms and engaging in pathogenic weight control methods is concerning. In future, female physique athletes should seek advice from registered nutritionists to optimise weight management practices and minimise the risk of developing an eating disorder.

Achieving an Optimal Fat Loss Phase in Resistance-Trained Athletes: A Narrative Review

Managing the body composition of athletes is a common practice in the field of sports nutrition. The loss of body weight (BW) in resistance-trained athletes is mainly conducted for aesthetic reasons (bodybuilding) or performance (powerlifting or weightlifting). The aim of this review is to provide dietary–nutritional strategies for the loss of fat mass in resistance-trained athletes. During the weight loss phase, the goal is to reduce the fat mass by maximizing the retention of fat-free mass. In this narrative review, the scientific literature is evaluated, and dietary–nutritional and supplementation recommendations for the weight loss phase of resistance-trained athletes are provided. Caloric intake should be set based on a target BW loss of 0.5–1.0%/week to maximize fat-free mass retention. Protein intake (2.2–3.0 g/kgBW/day) should be distributed throughout the day (3–6 meals), ensuring in each meal an adequate amount of protein (0.40–0.55 g/kgBW/meal) and including a meal within 2–3 h before and after training. Carbohydrate intake should be adapted to the level of activity of the athlete in order to training performance (2–5 g/kgBW/day). Caffeine (3–6 mg/kgBW/day) and creatine monohydrate (3–5 g/day) could be incorporated into the athlete’s diet due to their ergogenic effects in relation to resistance training. The intake of micronutrients complexes should be limited to special situations in which there is a real deficiency, and the athlete cannot consume through their diet.

Connections between Different Sports and Ergogenic Aids-Focusing on Salivary Cortisol and Amylase

Athletes are exposed to a tremendous amount of stress, both physically and mentally, when performing high intensity sports with frequent practices, pushing numerous athletes into choose to use ergogenic aids such as caffeine or β-alanine to significantly improve their performance and ease the stress and pressure that is put onto the body. The beneficial or even detrimental effects of these so-called ergogenic aids can be appreciated through the use of numerous diagnostic tools that can analyze various body fluids. In the recent years, saliva samples are gaining more ground in the field of diagnostic as it is a non-invasive procedure, contains a tremendous amount of analytes that are subject to pathophysiological changes caused by diseases, exercises, fatigue as well as nutrition and hydration. Thus, we describe here the current progress regarding potential novel biomarkers for stress and physical activity, salivary α-amylase and salivary cortisol, as well as their use and measurement in combination with different already-known or new ergogenic aids.

Peak week recommendations for bodybuilders: an evidence based approach

Bodybuilding is a competitive endeavor where a combination of muscle size, symmetry, "conditioning" (low body fat levels), and stage presentation are judged. Success in bodybuilding requires that competitors achieve their peak physique during the day of competition. To this end, competitors have been reported to employ various peaking interventions during the final days leading to competition. Commonly reported peaking strategies include altering exercise and nutritional regimens, including manipulation of macronutrient, water, and electrolyte intake, as well as consumption of various dietary supplements. The primary goals for these interventions are to maximize muscle glycogen content, minimize subcutaneous water, and reduce the risk abdominal bloating to bring about a more aesthetically pleasing physique. Unfortunately, there is a dearth of evidence to support the commonly reported practices employed by bodybuilders during peak week. Hence, the purpose of this article is to critically review the current literature as to the scientific support for pre-contest peaking protocols most commonly employed by bodybuilders and provide evidence-based recommendations as safe and effective strategies on the topic.

The role of age in the physiological adaptations and psychological responses in bikini-physique competitor contest preparation: a case series

The increased popularity of the bikini-physique competitions has not translated to greater research identifying the influence of age on adaptations during contest preparation. The purpose of this case series was to observe how age may influence the adaptations normally seen during preparation and the exploration of newer protocols to address adaptations more relative to the judging standards. Over a 16-week pre-contest preparation, a 32-y bikini competitor (BC) and 44-y master's bikini competitor (MBC) visited the laboratory bi-weekly to observe changes in body fat mass (BF), lean body mass (LBM), bone mineral density (BMD), total body water (TBW); exploratory measures of deltoid cross-sectional area (DeltCSA), gluteus maximus muscle thickness (GMMT), and subcutaneous adipose tissue thickness (SAT); reproductive hormones estradiol (E2), luteinizing hormone (LH), and energy balance hormones triiodothyronine (T3), leptin and ghrelin; hydration status during contest preparation and the week of competition; resting metabolic rate (RMR); psychometric data related to perceived anxiety, stress, and body image were assessed. No differences between BC and MBC were observed in BF, LBM, BMD, and TBW. Both competitors showed a small loss in LBM. Both BC and MBC showed a contrasting increase in DeltCSA and a loss in GMMT. MBC showed to be slightly more dehydrated (1.025 vs 1.021 g·mL- 1) than BC. Both competitors maintained a euhydration status the day of the competition. No time differences were found between BC and MBC during RMR. BC showed a higher mean difference RMR compared to MBC (2.66 ± 0.75 kcal·kgLBM- 1·d- 1). MBC showed a higher mean difference in LH concentration (84.6 ± 6.01 IU·L- 1), which may be explained by perimenopausal status. MBC had a higher mean difference concentration of leptin (2.51 ± 0.24 ng·mL- 1·kgFM- 1), which was unperturbed by fat loss may be interrelated LH. BC self-reported a higher mean energy intake (15.07 ± 3.43 kcal·kgLBM- 1·d- 1) and higher aerobic training volume (93.26 ± 40.68 min·d). BC and MBC showed similar composition changes, slightly differing metabolic rates, and differing hormonal LH and leptin responses. This finding is in contrast to previous work showing both LH inhibition and leptin diurnal disturbance in younger, female athletes with low energy availability. The exploratory measures may have some benefit for bikini-physique competitors related to the judging criteria. Age did not seem to play a role in contest preparation adaptations.

Carbohydrate refeed does not modify GVT-performance following energy restriction in bodybuilders

Bodybuilding is a sport in which competitors' physiques are judged on their muscular size, symmetry, and leanness, as displayed in a number of different poses. In the pre-competitive period, bodybuilders attempt to reduce body fat stores as much as possible while maintaining fat-free mass (FFM). This is achieved via a sustained negative energy balance, generally induced by a combination of decreased energy intake and increased energy expenditure. This study aimed to assess the ability of bodybuilders to resist fatigue during resistance exercise based German Volume Training (GVT), as well as the affective response after carbohydrate refeed following four weeks of moderate or severe energy restriction. Eleven male bodybuilders (28.4 ± 2.3 years old) with experience in competitions were randomized into two groups: Moderate Energy Restriction (MER; n = 6) or Severe Energy Restriction (SER; n = 5). On the 2nd day (during energy restriction) and 7th day (during refeed) of the fourth week, both groups completed two leg press protocols involving the GVT method. After the first and last workout protocol subjects were assessed for muscle soreness using the visual-analog scale (VAS), rating of perceived exertion (RPE), affective response, lactate, and creatine kinase. Anthropometric analysis indicated that a reduction of 3.7 and 3.2% in body mass corresponded to a loss of 16.0 and 17.6% of fat mass for the MER and SER groups, respectively, with both groups maintaining FFM. Blood CK and VAS values were reduced only in SER. Our results suggest that a carbohydrate refeed may help to attenuate the perception of muscle soreness and maintain exercise performance, especially when severe energy restriction is combined with an intense training protocol such as GVT.

Metabolic Adaptations to Weight Loss: A Brief Review

ABSTRACT

Martínez-Gómez, MG and Roberts, BM. Metabolic adaptations to weight loss: A brief review. J Strength Cond Res XX(X): 000-000, 2021-As the scientific literature has continuously shown, body mass loss attempts do not always follow a linear fashion nor always go as expected even when the intervention is calculated with precise tools. One of the main reasons why this tends to happen relies on our body's biological drive to regain the body mass we lose to survive. This phenomenon has been referred to as "metabolic adaptation" many times in the literature and plays a very relevant role in the management of obesity and human weight loss. This review will provide insights into some of the theoretical models for the etiology of metabolic adaptation as well as a quick look into the physiological and endocrine mechanisms that underlie it. Nutritional strategies and dietetic tools are thus necessary to confront these so-called adaptations to body mass loss. Among some of these strategies, we can highlight increasing protein needs, opting for high-fiber foods or programming-controlled diet refeeds, and diet breaks over a large body mass loss phase. Outside the nutritional aspects, it might be wise to increase the physical activity and thus the energy flux of an individual when possible to maintain diet-induced body mass loss in the long term. This review will examine these protocols and their viability in the context of adherence and sustainability for the individual toward successful body mass loss.

Effects of Two Months of Very Low Carbohydrate Ketogenic Diet on Body Composition, Muscle Strength, Muscle Area, and Blood Parameters in Competitive Natural Body Builders

Background: Ketogenic diet (KD) is a nutritional approach that restricts daily carbohydrates, replacing most of the reduced energy with fat, while maintaining an adequate quantity of protein. Despite the widespread use of KD in weight loss in athletes, there are still many concerns about its use in sports requiring muscle mass accrual. Thus, the present study sought to investigate the influence of a KD in competitive natural body builders. Methods: Nineteen volunteers (27.4 ± 10.5 years) were randomly assigned to ketogenic diet (KD) or to a western diet (WD). Body composition, muscle strength and basal metabolic rate were measured before and after two months of intervention. Standard blood biochemistry, testosterone, IGF-1, brain-derived neurotrophic factor (BDNF) and inflammatory cytokines (IL6, IL1β, TNFα) were also measured. Results: Body fat significantly decreased in KD (p = 0.030); whilst lean mass increased significantly only in WD (p < 0.001). Maximal strength increased similarly in both groups. KD showed a significant decrease of blood triglycerides (p < 0.001), glucose (p = 0.001), insulin (p < 0.001) and inflammatory cytokines compared to WD whilst BDNF increased in both groups with significant greater changes in KD (p < 0.001). Conclusions: KD may be used during body building preparation for health and leaning purposes but with the caution that hypertrophic muscle response could be blunted.

Case Study: Body Composition Changes Resulting from a Nutritional Intervention on a Professional Vegan Powerlifter

Powerlifting is a weight-class strength sport where achieving low fat mass (FM) and high fat-free mass (FFM) is desirable to improve performance. Recent studies have evaluated the nutritional considerations of different eating patterns, such as vegan diets (VD), in athlete populations. VD are a challenge for athletes who want to attain body composition changes. The aim of this case study is to report on the body composition changes and subjective feelings of a male professional vegan powerlifter following VD for six weeks. The body mass of the powerlifter decreased from 79.3 to 77.4 kg (2.39%). Along with this, FM decreased from 15.0 to 11.4 kg (24%). Conversely, FFM increased from 64.3 to 66.0 kg (2.64%). Moreover, the powerlifter communicated no subjective feelings of low energy availability during training sessions. The VD might compromise adherence in a nutritional intervention which aims to improve body composition due to the nutritional requirements for fat loss. Therefore, more appropriate health assessments, including blood and psychological tests, are required for professional athletes. This short-term VD intervention was satisfactory for improving body composition and no adverse outcomes were reported.

Alterations in Body Composition, Resting Metabolic Rate, Muscular Strength, and Eating Behavior in Response to Natural Bodybuilding Competition Preparation: A Case Study

Schoenfeld, BJ, Alto, A, Grgic, J, Tinsley, G, Haun, CT, Campbell, BI, Escalante, G, Sonmez, GT, Cote, G, Francis, A, and Trexler, ET. Alterations in body composition, resting metabolic rate, muscular strength, and eating behavior in response to natural bodybuilding competition preparation: A case study. J Strength Cond Res 34(11): 3124-3138, 2020-We carried out a prospective case study in a high-level amateur natural male bodybuilder throughout preparation for 4 competitions and during the ensuing postcontest recovery period. Laboratory testing was conducted monthly over a 1-year period, which included the following assessments: B-mode ultrasound evaluation of muscle thickness (MT), multifrequency bioelectrical impedance analysis, blood pressure and heart rate assessment, resting metabolic rate via indirect calorimetry, skinfold testing, vertical jump height, isometric lower-body strength testing, and a 3-factor eating questionnaire. Blood work (including testosterone, thyroid hormone, sex hormone binding globulin, glomerular filtration rate, blood urea nitrogen, aspartate aminotransferase, alanine aminotransferase, white blood count, albumin to globulin ratio, and lipoprotein A) was obtained separately from an outside laboratory at 4 time points. We also assessed the effectiveness of a carbohydrate (carb) deplete and carb load peaking strategy employed immediately before competition. The subject employed a high-volume, high-frequency, whole-body training program throughout the study period. Average daily nutritional intakes ranged from 1,953 to 3,415 kcal: 104-386 g carb; 253-263 g protein, and; 57-95 g lipid. Body fat was reduced to very low levels (∼5%) immediately before competition, but this corresponded with a loss of lean mass. Alterations in metabolism, hormonal status, explosive strength, and psychological aspects of eating were observed during precontest preparation; however, all of these variables recovered quickly postcompetition. The implementation of a carb depleteand carb load peaking strategy acutely increased MT and thus may be a viable precontest approach to maximize muscular aesthetics.