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.

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.

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

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

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

UNASSIGNED: Anabolic-androgenic steroids (AASs) are often used by men for bodybuilding and to improve sports performance. The use is not limited to professional competitive athletes, but many amateur men.
UNASSIGNED: The objective of this study was to assess and systematically review the effects of AAS on male fertility parameters, spermiogram, testosterone, follicle-stimulating hormone (FSH) and luteinising hormone (LH) and to review reversibility and other morbidity impacting fertility.
UNASSIGNED: Eligibility criteria - We included studies mentioning data about adult males using supraphysiologic doses of AAS for sports performance or appearance enhancement, with comparison data from general population or matched controls if available reporting fertility parameters and sexual performance. Information sources - A systematic literature search was performed using PubMed, MEDLINE, EMBASE, Google Scholar and World of Science. Controlled clinical trials randomised or nonrandomised (if available), case series with or without matched controls, case reports, cross-sectional surveys, reports on follow-up of subjects caught in doping test and their fertility parameters when reported. Risk of bias/quality assessment - The quality assessment of the included studies was performed using the Newcastle-Ottawa Scale.
UNASSIGNED: Included studies - Thirty-two studies were included. There were 12 cohort studies, 5 case-control studies, 9 cross-sectional surveys and 6 case reports. The study population comprised 9371 individuals, of which 2671 were AAS users. Synthesis of results - AAS users had reduced levels of FSH and LH than the naïve population. These levels remained low for 3-6 months after stopping AAS. One year after stopping AAS, the users and naïve population had insignificant differences in FSH and LH values. The total testosterone (TT) levels were comparable in users and naïve populations at baseline, 3 months and 6 months after stopping, but at 1 year, TT values were lower in AAS users. Sperm concentration in AAS users and naïve population was similar, but sperm motility was lower in AAS users. The testicular size was lower in AAS users. The erectile function improved with AAS use, but on withdrawal, there was decreased libido and erectile dysfunction. Most AAS users need additional medications to mitigate detrimental effects on fertility. Description of the effect - AAS use negatively impacted the gonadotrophin levels and had lower sperm motility and testicular size. Strength - Comprehensive review of 32 publications, study population of 9371 individuals, of which 2671 were AAS users, meta-analysis of reproductive hormones, semen parameters and testis size.
UNASSIGNED: The limitations are small sample size of most of the studies, polypharmacy, lack of information on dosing and high heterogeneity.
UNASSIGNED: AAS use is detrimental for sperm motility and has a partially reversible negative impact on male fertility. Users must be cautioned about its negative impact on libido and erectile function.Registration: PROSPERO Registration No. CRD42023411294.

Bodybuilding is an increasingly popular sport in the United States. Across fields of psychology, history, sociology, and anthropology, bodybuilding has been examined as being related to, or as manifestly being, a pathology. Extant work on men who are bodybuilders are often built on the assumption that narcissism, self-doubt, and insecurity are the driving forces for men\'s involvement. The present study sought to examine the experiences of eleven men who have competed in bodybuilding competitions. In contrast to the dominant academic discourse on bodybuilding as an embodiment of toxic masculinity or as a reaction to underlying feelings of inferiority, the study participants described friendly, supportive competition contexts. That such feelings were found backstage, as opposed to in a gym, strengthens the need for a more nuanced distinction between bodybuilding as a culture, and bodybuilding as a sport. This study disrupts dominant narratives of bodybuilding as pathological and contributes to work on the construction of gender and masculinity in sport. The present work suggests a scholarly approach to men\'s bodybuilding in an open and nuanced manner that does not focus on pathologizing bodybuilding or competition.

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

BACKGROUND: this observational and cross-sectional study aimed to describe training, pharmacological ergogenic aids, dehydration, and nutrition strategies during a peak week in competitive bodybuilders and monitor changes that occurred across this period.
METHODS: Ten amateur bodybuilders were followed during a peak week phase and one day post-contest. Training, diet, dehydration protocol, anabolic steroid use, and nonsteroidal agents were recorded, prescribed, and supervised by the same coach in charge. Body composition, resting metabolic rate, and circumferences were assessed by the research team.
RESULTS: Overall, during the peak week phase, the use of anabolic steroids, diuretics, and other pharmacological aids was high among athletes, and the dose and frequency were similar between competitors. Despite the use of supraphysiological doses of drugs, bodybuilders displayed a statistical reduction of lean mass markers, resting metabolic rate, and fat mass markers, possibly influenced by the performance of high volumes of aerobic exercise combined with dietary energy restriction.
CONCLUSIONS: The main findings of this study display that the coach in charge of Brazilian bodybuilders applied the same anabolic steroid, diuretic, and other pharmacological protocols for all competitors. Moreover, the protocols employed by bodybuilders did not fully attenuate the loss of lean mass during the peak week period.

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.
OBJECTIVE: 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.
RESULTS: 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.