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 of activitywza.

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 training.

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 are concerned.

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 authorities.

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 aspects.

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 steroid abuse.

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.