PHYSICAL ACTIVITY AND AGING.
EXPERIMENTAL AND CLINICAL DATA.
|| WEIGHT-LIFTING - BODY-BUILDING
Resistance exercise is an activity
performed by individuals interested in competition,
those who wish to improve muscle mass and strength
for other sports, and for individuals interested in
improving their strength and physical appearance.
In this review we present information suggesting that
phosphocreatine depletion, intramuscular acidosis
and carbohydrate depletion are all potential causes
of the fatigue during resistance exercise. In addition,
recommendations are provided for nutritional interventions,
which might delay muscle fatigue during this type
OBJECTIVE: The purpose of this
investigation was to document the effect of a 10-wk
precompetition bodybuilding diet and training, on
blood chemistry and body composition. PARTICIPANT:
One adult male, steroid and drug free, preparing for
a first competition. MEASURES: Average daily dietary
intake consisted of 2263 calories (71% protein, 16%
carbohydrate, 13% fats), with a protein intake of
5.0 gm.kg-1 body mass (BM). Initial body weight of
76.3 kgf (16% body fat) decreased to 63.4 kgf (4.4%
body fat). Blood samples for electrolytes, TP, Alb,
bilirubin, LDL-C, TG, UA, and amylase were normal.
HDL-C levels increased from 65 to 89 mg.dL-1. RESULTS:
Decreased glucose levels (< 50 mg.dL-1), indicated
hypoglycemia. Increased Mg, LD, and CK levels indicated
intense training. Increased inorganic phosphorus from
3.7 to 8.2 mg.dL-1 suggested lactic acidosis. Increased
BUN levels from 16 to 53 mg.dL-1 and creatinine from
1.1 to 1.8 mg.dL-1 may be attributed to a high protein
diet. However, heart muscle enzyme (CK-MB) was not
elevated. CONCLUSIONS: Substantial changes in body
composition and blood chemistry suggest adequate nutrition
be ensured, and caution taken to avoid excessive physiologic
stresses on the body during precompetition diet and
Excessive body building may
be dangerous. To promote athletic performance and
to improve physical appearance many of the body builders
abuse anabolic-androgenic steroids and other drugs.
The abuse of insulin as an anabolic medication in
this athletic community was followed by a case of
severe hypoglycaemia in a body builder. A 30-year
old male presented with cerebral symptoms of hypoglycaemia.
Directly before an international competition he tried
to stimulate muscle growth by using the hypoglycaemic
stimulus to the growth hormone. To achieve this he
injected 70 IE of a short-acting insulin subcutaneously,
resulting in severe hypoglycaemia. After the initial
administration of intravenous glucose by the paramedics,
he lost consciousness and showed signs of convulsions.
After orotracheal intubation by an emergency physician,
despite of ongoing infusion of glucose the blood glucose
concentration remained low as measured in the out-of-hospital
setting. Finally administration of additional glucose
and glucagon in the intensive care unit was able to
stabilize the metabolic system. In any case of severe
hypoglycaemia, repetitive measurements of blood glucose
even in the prehospital setting should be performed
to detect the hypoglycaemia especially if athletes
We conducted a survey of 624
commercially available supplements targeted towards
bodybuilding athletes. Over 800 performance claims
were made for these supplements. Supplements include
amino acids, boron, carnitine, choline, chromium,
dibencozide, ferulic acid, gamma oryzanol, medium
chain triglycerides, weight gain powders, Smilax compounds
and yohimbine. Many performance claims advertised
were not supported by published research studies.
In some instances, we found no research to validate
the claims; in other cases, research findings were
extrapolated to inappropriate applications. For example,
biological functions of some non-essential compounds
were interpreted as performance claims for the supplements.
Claims for others were based on their ability to enhance
hormonal release or activity. We suggest that more
research be conducted on this group of athletes and
their nutritional needs. Furthermore, the effectiveness
and safety of supplements merit further investigation.
The use of food supplements by the general public
is poorly quantified, and little information on this
subject is available in the medical literature. We
surveyed 12 recent issues of popular health and bodybuilding
magazines (1) to quantify the number of advertisements
for food supplements, the number of products advertised,
and the number and type of ingredients in these products;
(2) to identify the purported health benefits of these
products; and (3) as a preliminary effort to identify
areas for future research. We counted 89 brands, 311
products, and 235 unique ingredients, the most frequent
of which were unspecified amino acids; the most frequently
promoted health benefit was muscle growth. We also
found many unusual or unidentifiable ingredients,
and 22.2% of the products had no ingredients listed
in their advertisements. Health professionals may
not be aware of how popular food supplements are or
of a particular supplement's potential effects or
side effects. In addition, patients may be reluctant
to discuss their use of these products with traditional
medical practitioners. We recommend that routine history
taking include specific questions about patients'
use of food supplements and that any possible adverse
effects or side effects be reported to public health
In preparing for competitive
body building, body builders--in addition to continuous
and hard muscle training--engage in stringent dietetic
manipulations: the first few months of hypercaloric
nutrition, rich in proteins, are devoted to the build-up
of muscle mass. A second phase of reduced caloric
intake is designed reduce subcutaneous fat, while,
during the last week of preparations, extreme carbohydrate
intake aims at loading muscles with glycogen. Simultaneously,
sodium and water restriction results in extracellular
and therefore subcutaneous volume deficit and better
"definition" of muscle contours and structure.
In the course of these dietetic manipulations a young
body builder develops hypokalemia, hypophosphatemia,
rhabdomyolysis and flaccid tetraparesis. The disturbances
are pathophysiologically predictable.
Recent studies in different
countries have shown an increase in anabolic steroid
consumption among young people and the harm caused
by indiscriminate use. In Brazil, research on steroid
abuse is scarce. The present study examines the risk
perception of health problems associated with anabolic
steroid consumption among young working-class adults
engaged in body-building practices in a poor neighborhood
in the city of Salvador, Bahia. The methodology involved
an anthropological approach based on qualitative research
techniques consisting of ethnography, in-depth interviews,
and a focus group with steroid users. The data describe
the most common substances consumed and highlight
the lack of information among interviewees concerning
potential related health hazards, showing that for
many steroid consumers the quest for muscle-mass development
to achieve an idealized body supersedes the risk of
harmful side effects. The results indicate the need
for culturally sensitive measures to prevent steroid
abuse among youth.
This case report describes
a 26-year-old body builder who had practiced several
months of intramuscular self-injection of walnut oil.
Apparently this is a normal procedure amongst body-builders.
Our patient complained of swelling and tenderness
overlying an injection site. Injections of oil may
cause foreign body reactions, leading to tumours named
according to the injected material; e.g. paraffinoma,
oleoma. Systemic distribution has been reported to
result in pulmonary complications.
AIDS: The loss of lean body
mass (LBM) that is commonly associated with wasting
syndrome has been linked to death in HIV disease.
Bioelectrical Impedance Analysis (BIA) is a simple,
inexpensive and painless technique used to assess
body composition. The test gives a good reading of
body cell mass, fat mass, and body water, and can
be used to detect loss of LBM when it first occurs.
BIA is a useful tool in managing and preventing wasting.
Other factors that influence LBM include testosterone
levels and anabolic steroids. Anabolic steroids, synthetic
analogs of testosterone, are a Class III regulated
drug. The use of anabolic steroids is controversial,
and abuse by athletes led to the drugs being banned
for many uses. A list of approved steroids, their
actions, and potential problems associated with their
use is included. Another table rates the major steroids
for their effectiveness in AIDS therapy.
A questionnaire, designed to
elict information about training programs, experience
and injury profile, was administered to 358 bodybuilders
and 60 powerlifters. This was followed by a clinical
orthopedic and radiological examination. The upper
extremity, particulary the shoulder and elbow joint,
showed the highest injury rate. More than 40% of all
injuries occurred in this area. The low back region
and the knee were other sites of elevated injury occurrences.
Muscular injuries (muscle pulls, tendonitis, sprains)
were perceived to account for 83.6% of all injury
types. Powerlifting showed a twice as high injury
rate as bodybuilding, probably of grounds of a more
uniform training program. Weight-training should be
associated with a sports-related medical care and
supervised by knowledgeable people, who can instruct
the athletes in proper lifting techniques and protect
them from injury which can result from incorrect weight-training.
A review of the effects of
anabolic-androgenic steroids (AAS) on muscle strength,
body weight and lean body mass in body-building men
is presented. In about half of the placebo-controlled
studies, a significant effect on the above mentioned
response variables is found. In all cases where an
effect was achieved, the drug used was methandrostenolone
or stanozolol. Whether this is connected with a special
quality of these AAS or whether the negative results
achieved with the other AAS are caused by type 2 error
is not yet known. The use of AAS as ergogenic drugs
must be deprecated because of their marginal effects,
the risks of side effects and the unsporting, unethical
The effects of androgenic-anabolic
steroids on neuromuscular power and body composition
were studied in nine volunteers experienced with progressive-resistance
weight training. By use of double-blind procedures,
testosterone cypionate, nandrolone decanoate, and
sesame oil (placebo) were administered in a repeated-measures
design that counterbalanced treatment order. Duration
of each treatment condition was 3 wk. Supplemental
protein was provided, and dietary records were maintained
throughout the study. Subjects were trained with progressive-resistance
weight-training exercises. Isokinetic dynamometer
testing revealed that peak torque output was not significantly
changed between treatments in 7 out of 10 isolated-joint
actions. The hydrostatic weighing results revealed
insignificant differences in lean body mass and percent
body fat. Significant changes in some treatment means
of three peak torque output tests were insufficient
to identify any consistent treatment alterations.
Since protein and caloric intake was sufficient to
elicit anabolic effects from the steroid treatments
and weight-training program, the lack of significant
results could not be attributed to dietary considerations.
Subjects reported subjective feelings of increased
strength after administration of anabolic agents,
which may partially account for their widespread use.
In conclusion, anabolic steroids did not substantially
change body composition or the objective power measurements
used in this study.
The use of anabolic drugs by
athletes who wish to increase lean body mass and improve
muscular strength is widespread, especially among
elite weight-trained athletes. The current regimens
used for steroid doping include combinations of injectable
and oral preparations of steroids at doses 10 to 40
times greater than those prescribed therapeutically.
Most of the scientific studies of steroid use by healthy
male athletes have used steroid doses substantially
lower than those used by many athletes. Analysis of
these studies suggests that most persons will gain
an average of 2.2 kg of lean body weight during steroid
administration but that there exist great individual
differences in strength changes induced by steroids.
Approximately 50% of the investigations show significant
improvements in strength measurements with steroid
treatment, whereas the remainder show indefinite effects.
There is no substantial evidence to support the use
of anabolic steroids for improving aerobic work capacity.
Anabolic steroids cause interrupted growth and virilization
in children, birth defects in the unborn, severe virilization
in women, and testicular atrophy and reduced blood
levels of gonadotropins and testosterone in adult
males. In addition, the oral preparations of anabolic
steroids are associated with liver dysfunction, including
carcinoma and peliosis hepatis, and a number of other
disorders including unpredictable changes in mood,
aggression, and libido. Although there have been only
rare reports of severe or life-threatening side effects
in athletes who have abused steroids, such side effects
may not appear obvious until 20 years or more of widespread
OBJECTIVE: To assess the effects
of anabolic-androgenic steroids on human muscle strength.
DATA SOURCES: A MEDLINE search for the period from
January 1966 to April 1990, supplemented by manual
searches of previous reviews, produced 30 studies
in which subjects received more than one dose of the
study steroid and in which changes in muscular strength
were measured. STUDY SELECTION: Of the 30 studies,
14 were not included in the detailed data summary
because they did not use a placebo control, did not
randomize subjects to groups, or did not make objective
strength measurements, or because percent change in
strength data could not be abstracted. DATA EXTRACTION:
Details of study design, reporting of results, and
the adequacy and correctness of statistical methods
were tabulated. Percent improvement in strength for
the largest muscle group studied was computed, using
the difference between results for the placebo and
for the steroid-treated groups. DATA SYNTHESIS: Previously
trained athletes show slightly greater improvements
in strength in the anabolic-androgenic steroid-treated
group than in the placebo group, with a median difference
of 5% across the nine studies (range, 1.2% to 18.7%).
A meta-analysis of the three studies with enough information
to compute effect size showed a mean difference of
1.0 standard deviations (95% CI, 0.49 to 1.5). However,
the poor overall quality of the studies in terms of
design, sample size, and analysis; the lack of a dose-response
effect across the narrow range of dosages tested;
and the tendency for differences to be smaller in
the larger studies throw these results into question.
No evidence was found to support enhanced muscle strength
with steroid use in eight studies in untrained normal
volunteers. CONCLUSIONS: Anabolic steroids may slightly
enhance muscle strength in previously trained athletes.
No firm conclusion is possible concerning the efficacy
of anabolic steroids in enhancing overall athletic
performance. Results for the low steroid dosages studied
in the published reports cannot be generalized to
steroid-using athletes taking megadose regimens.