Precontest Strategies of a Male Bodybuilder

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1 International Journal of Sport Nutrition, 1991, 1, Precontest Strategies of a Male Bodybuilder Suzanne Nelson Steen New England Deaconess Hospital The dietary strategies of a 25-year-old bodybuilder were studied as he prepared for a contest. Food records were kept over a dmonth period that included the off-season, weight reduction phase, and week of a contest. Mean caloric intake during the off-season was 4,193 kcal(49 kcallkg). Average intake per kg body weight was 8.7 glkg carbohydrate and 2.8 glkg protein. During the weight reduction phase of training, mean caloric intake was 3,020 kcal (37 kcallkg). Carbohydrate intake averaged 6.1 glkg and protein averaged 2.7 glkg. The RDA was met for all micronutrients without any need for supplementation. Beginning at 3 weeks before the contest, dietary intake changed dramatically and haddock, rice, or potato were eaten every 2 hours. Protein intake averaged 4 glkg. Carbo-loading was practiced the week precontest to enhance muscularity. During all phases the subject used anabolic steroids and consumed various supplements. During the offseason he took a high potency multivitaminlmultimineral daily and grams of amino acids when "needed." As the competition drew closer, numerous additional supplements were taken. In light of these many unhealthy practices, alternative strategies should be negotiated with the athlete that are realistic, and changes should be implemented slowly. The bodybuilder works toward achieving physical perfection by developing maximum muscular development, definition, and vasculature (3,4,5,6). During the first phase of training, the bodybuilder focuses on building strength and bulk while consuming a diet high in calories, protein, and carbohydrate but low in fat. In the weeks prior to the contest, calories and fat are restricted to reduce body fat accumulated by the previous "bulking" phase. Just prior to competing, several dietary manipulations are used to achieve the desired physique. The purpose of this evaluation was to illustrate the dietary, exercise, and drug regimens practiced by a male bodybuilder while preparing for a contest. Subjects and Procedure Methods A 25-year-old white male was studied as he prepared for a major East Coast bodybuilding contest. He stood crn (67 in.); he weighed 86 kg (190 lbs) Suzanne Nelson Steen is with the Center for the Study of Nutrition and Medicine, New England Deaconess Hospital, 1 Autumn St., Boston, MA

2 70 / Steen during the off-season and competed at 76 kg (168 lbs.) as a middleweight. He held a Level I1 classification, according to the National Physique Committee (NPC) system which governs amateur bodybuilding. (Competitors are divided into three levels, with Level I being the highest.) Food intake In order to illustrate how dietary intake is manipulated by a bodybuilder in preparation for a contest, the subject kept food records on three separate occasions over a 6-month period. This included 5 days at 6 months (off-season), at 3 months (weight reduction phase), and the week of a contest (precontest). Off-season was defined as after the contest to 6 months before the next contest. The weight reduction phase was defined as being from 5 months before the contest until competitive weight was reached. According to the subject, it was ideal to reach competitive weight the week before the contest. Because the subject had been following a restrictive diet prescribed by a more advanced bodybuilder, he was experienced in keeping food records and carefully monitored intake on his own. As a result, he required little instruction on how to keep the records and already used a food weighing scale and a measuring cup to record food items and beverages. In addition to recording all foods and beverages consumed, supplements, ergogenic aids, and drugs were also specified. Completed food records were detailed and precise. Food records were coded by a trained nutritionist and analyzed by the University of Massachusetts Nutrient Data bank for calories, carbohydrate, protein, fat, cholesterol, fiber, and the following micronutrients: vitamins A, C, E, B-6, B-12, thiamin, riboflavin, niacin, folacin, calcium, phosphorus, iron, zinc, sodium, potassium, and magnesium. Daily averages were calculated with and without supplements and were compared to the recommended dietary allowances (RDAs). Training patterns were recorded during the off-season, weight reduction phase, and precontest. Food intake Results Mean caloric intake during the off-season was 4,193 kcal, and percentage of calories from macronutrients was 72% carbohydrate, 5% fat, and 23% protein. Energy intake averaged 49 kcallkg. Carbohydrate intake averaged 8.7 glkg and protein averaged 2.8 glkg (Table 1). The subject followed a rigid monotonous dietary regimen. The types of food consumed were strictly limited to combinations that included chicken, turkey, tuna packed in water, egg whites, brown rice, pasta, whole grain cereal, vegetarian beans, banana baby food, tea, and water. These foods were eaten in special combinations five times during the day. Despite the restricted dietary plan, all nutrients exceeded the RDA (Table 2). However, the fortified, enriched whole grain cereal was the primary source of several vitamins and minerals. Alcoholic beverages were rarely consumed. During the weight reduction phase of training, the subject aimed to lose the body fat accumulated during the bulking phase of his training. Three months prior to the contest he had achieved a loss of 5 kg (1 1 lbs) in 6 weeks and weighed 81.4 kg. To lose weight, he reduced the portions of the foods consumed during the off-season and eliminated all dairy products (perceived to be high in fat) and

3 Precontest Strategies of a Bodybuilder 1 71 Table 1 Nutrient Intake of a Male Bodybuilder Off-Season, Weight Reduction Phase, and Precontest Nutrient Off-season (5 days) Wt. reduction (5 days) Precontest (6 days) Weight (kg) Energy (kcal) kcallkg Protein (g) glkg 010 of total kcal Carbohydrate (g) glkg 010 of total kcal Fat (g) 010 of total kcal Cholesterol (mg) fiber (g) f f65 (378% RDA) f f f f f f 86 - (348% RDA) f " 310 f79 (492% RDA) f f f fl Table 2 Micronutrient Intake of a Bodybuilder Off-Season, Weight Reduction Phase, and Precontest (without supplements) Nutrient Off-season 010 RDA Wt. reduction 010 RDA Precontest 010 RDA Vitamin A (RE) 3750 f 3265 Vitamin C (mg) 152 f 37 Vitamin E (mg) 18 f (mg) B-12 (mcg) 7fl 10 f 2 Riboflavin (mg) 6 f 0.8 Thiamin (mg) 5 f 0.9 Niacin equ (mg) Folacin (mcg) 750 f 70 Iron (mg) 54 f 4 Zinc (mg) 48 f 4 Calcium (mg) 1747 f 118 Phosphorus (mg) 4337 f 519 Magnesium (mg) 1123 f 60 Sodium (mg) 3035 f 667 Potassium (rng) 8080 f 1321

4 72 l Steen refined sugar. Mean caloric intake was 3,020 kcal (37 kcallkg), and percentage of calories from carbohydrate was 65 %, from protein, 29 %, and from fat, 6 %. Carbohydrate intake averaged 6.1 glkg and protein averaged 2.7 glkg (Tables 1 and 2). As calories were restricted further, the bodybuilder reported feeling irritable and difficult to get along with. During the latter part of this phase, he said, "personal relationships are impossible to cope with. " Beginning 3 weeks before the contest, his dietary strategy changed dramatically and food was eaten evely 2 hours (at least 10 times a day). He would set his alarm clock to wake him during the night in order to eat. According to the bodybuilder, this was to "ensure that all food was metabolized after being eaten, and that no food was stored as fat." Again, foods were eaten in certain combinations: "no more than 60 grams of carbohydrate per meal, and no carbs 3 hours before bed. " In addition, elimination of all fat from the diet was considered crucial in order to further promote the loss of subcutaneous body fat. He believed this helped emphasize the size, shape, and vasculature of the skeletal muscle, giving the desired cut look sought by bodybuilders. Another strategy to enhance muscularity was to promote temporary swelling of the muscles the day of the contest by carbohydrate loading. Carbohydrate stores were depleted Monday through Wednesday by consuming haddock as the source of protein (because it was "low in fat"), and potato or rice for carbohydrate. In addition, grams of amino acids were taken. As shown in Table 3, his attempt at glycogen supercompensation was limited by a carbo-loading phase Thursday through Saturday in which he attained modest levels of carbohydrate intake between %. Sodium and water were both restricted during this phase to cause dehydration, which he believed would "make the skin paper thin and tight over the musculature to give definition." Fluid intake was severely restricted to 2 cups of distilled water per day for the first 3 days and 8 oz each day thereafter until the day of the contest. Before the contest he only sipped distilled water. Sodium was also restricted "to promote dehydration." During this final phase the bodybuilder expressed feeling within himself, angry, hostile, and irritable. The day after the contest he consumed 5,360 kcal as 42% carbohydrate, 45% fat, and 13% fat. Some of the foods and beverages consumed included nachos, steak, cheese fries, sausage pizza, chocolate mousse, and beer. Table 3 Precontest Carbo-Loading Regimen of a Male Bodybuilder Sat. Nutrient Mon. Tues. Wed. Thurs. Fri. contest Energy (kcal) 2,065 1,809 2,020 1,289 2,218 2,218 Protein (%) Carbohydrate (%) Fat (%)

5 Precontest Strategies of a Bodybuilder / 73 Supplement Use During the off-season the subject took one high-potency multivitamin/multimineral daily (Solotron). When he felt it was needed, he consumed grams of amino acids (Unipro). As the competition drew closer and his food intake decreased in order to facilitate weight loss, his use of supplements increased. Additional supplements and amounts included B-12 (600 mcg), zinc (50 mg), vitamin A (1,000 IU), vitamin C (1,500 mg), vitamin D (125 IU), vitamin E (200 mg), calcium carbonate (1,000 mg), potassium (2,000 mg), iron (10 mg), magnesium (150 mg), biotin (20 mcg), and folacin (200 mcg). As shown in Table 4, these amounts exceeded the RDAs and reached pharmacological doses. To "burn fat," choline (2,500 mg), inosito1(1,500 mg), and 1-methionine (1,000 mg) were taken daily for 6 weeks prior to the competition. Amino acids (100 g) were also taken daily for 6 weeks prior to the competition. Three digestive enzymes were taken with each meal for 3 weeks preceding the contest. Table 4 Percentage of Recommended Dietary Allowances for Nutrient Intake Plus Supplements in a Male Bodybuilder Percentage of the RDA Micronutrient Off-season Wt. reduction Precontest Vitamin A Vitamin E Vitamin C Thiamin Riboflavin Niacin Folacin B Iron Calcium Phosphorus Magnesium Zinc Drug Regimen During the off-season the subject took six different anabolic steroids, either orally or by injection. He was reluctant to reveal the dosages but did agree to specify the frequency of use and the benefit he felt that each drug provided. In addition to the anabolic steroids, he ingested one tablet of Nolvedex every day to stimulate pituitary secretion. Ibupropen (400 mg) was taken every day for pain. (See Table 5.1

6 74 1 Steen Table 5 Drug Regimen Used by ;a Male Bodybuilder Drug Frequency Rationale for use Off-season Nandrolone decanoate (injection) Testosterone cypionate (injection) Anadral-50 (tablets) Winsteral-V (injection) Winsteral (tablets) Equipoise (injection) Nolvedex (tablet) Precontest Winsteral-V (injection) Halatestine (injection) Equipoise (injection) Nolvedex (tablet) Every 4 days Every 2 days Every day Every 2 days Every day Every 2-3 days Every day Every 2 days Every day Every 2-3 days Every day Repairs muscle, holds fluid Builds size, strength Holds fluid, strength, size Less water retention, strength brings out vasculature Same as above Less water retention Stimulates pituitary Less water retention, strength brings out vascular Less water retention Less water retention Stimulates pituitary During the off-season the subject trained 4 days a week for 2 to hours each day. He trained 4 days on and 1 day off, focusing on different muscle groups. A typical 4 days of training included the following: Monday: chest, calves, abdomen Tuesday: lower back, triceps, hamstrings Wednesday: shoulders, biceps, calves, abdomen Thursday: quads, forearms Friday: off Depending on the muscle group, the bodybuilder performed sets and 8-12 repetitions for each set. On Monday and Tuesday he rode a stationary bike for minutes. At 3 months, weight training was similar to the off-season regimen. Aerobic activity was increased during this phase, as the stationary bike was used every day for 30 minutes. Precontest weight training started 2 months prior to competition. During this time, workout decreased to hours a day. As opposed to earlier training when heavier weight and less repetitions were used, lighter weights and more repetitions were used. Depending on the muscle group, the subject performed 5-8 sets and repetitions for each. The stationary bike was used every other day during this time. He trained 3 days on and 1 day off. A typical 3 days included the following:

7 Monday: chest, lower back, biceps, forearms Tuesday: upper back, hamstrings, abdomen Wednesday: triceps, shoulders Thursday: off Precontest Strategies of a Bodybuilder / 75 The week of the contest (Saturday), all weight training stopped on Tuesday. Weightlifting involving the legs stopped the Sunday before the contest. Discussion and Plan The bodybuilder based his dietary strategies on a combination of advice from successful bodybuilders, articles in bodybuilding magazines, and information from "nutrition stores." As a result he had many misconceptions about nutrition and believed in several myths. A computerized metabolic analysis performed at his training center revealed that he was a "middle metabolizer. " Many decisions about when and what to eat were based on this analysis. For example, he believed that if he ate more frequently, food would not be stored as fat. This rationale was most evident during the weeks before the contest when he ate every 2 hours. The bodybuilder believed very strongly in the diet he followed. His belief system was reinforced by other successful bodybuilders who used similar dietary manipulations. Because of his strong belief system and reinforcement by peers, nutrition education had to be handled carefklly. Although many of the strategies he used to manipulate performance potential for the most part had no physiological basis, he had been successful despite these strategies: he placed third in the contest. In addition, some of the information acquired over the years was correct. Therefore it was important to initiate a discussion about sports nutrition based on his current level of knowledge and to avoid putting him on the defensive by challenging his beliefs. Specifically, the strategy was to gain his confidence, reframe his current belief system by pointing out positive aspects of his diet, sort out misinformation and fads, emphasize key issues that would affect performance and health, and negotiate alternatives. Positive aspects of the diet were that it was low in fat, egg whites were being eaten instead of yolks, and complex carbohydrate intake was more than adequate for a nonendurance athlete. By reducing portions, he had been able to lose weight. However, this weight loss was not easy for him to achieve, and he often resorted to fasting for a day or two "to lose weight and get back on track. " The bodybuilder was very concerned about his fat intake for appearance reasons. A common practice among athletes trying to achieve a low body weight is to consume a high protein/low fat diet, in the belief that only dietary fat is converted to fat and that excess protein is excreted. However, by narrowly restricting food intake to a few foods and eliminating certain food groups completely (e.g., dairy foods), nutritional adequacy is compromised. The bodybuilder admitted he had difficulty following the diet because it was monotonous, and as a result he frequently lapsed into "bingeing on forbidden fat foods." We discussed the importance of adding more variety to his diet by incorporating more vegetables, whole grain breads (which he thought were fattening), homemade low sodium soups, and low fat dairy products to supply needed nutrients for optimal training, performance, and health. Of course, the

8 76 / Steen bodybuilder's response was that he could make up what was missing through supplementation. The most convincing arguments for adding more variety to his diet were (a) possible toxicity problems with excess supplements (he thought he had experienced tingling after taking certain supplements), (b) cost of supplements, and (c) monotony of the diet. Because appearance was not a factor during the off-season, we negotiated fat intake to 20% of total calories to allow for a greater range of food choices. Before calculating the most effective strategy for the bodybuilder to lose weight gradually in preparation for the next contest, he was encouraged to have his body fat measured by underwater weighing at a local university. A trainer had measured him using metal calipers at his club; he had ranged from 10 to 16% body fat. Given the difficulties he had in losing weight for the contest, combined with the increase in his weight 3 weeks after the contest to 89.5 kg (197 lbs), he was considering competing at a higher weight (light heavyweight). Because of his firm belief that extra dietary fat above 10% would be visible, and as a result would reduce muscular definition, the month before a contest his fat intake was calculated to be less than 10%. Protein intake ranged from 23 to 64% of total calories. This translated into g per kilogram, which is above the range currently considered appropriate for individuals attempting to increase muscle strength and size by strength training ( glkg) (8). A brief discussion about the composition of muscle and additional protein needs did little to sway the bodybuilder's belief that large quantities of protein were necessary for muscular development. After much discussion, he admitted that his perceived protein needs were probably "a mental thing." We negotiated protein to a level that he felt comfortable with, which was 2.0 glkg during the off-season and weight reduction phases and 2.5 glkg (vs. 4.0 glkg) during the precontest phase. After several myths were dispelled, which included that amino acids provided protein but no calories and that they burned fat, he agreed to obtain his protein primarily from low fat meats and dairy products, fish, and vegetable protein combinations. He was surprised to learn that most amino acid supplements provide 200 to 500 mg of amino acids per pill, while an ounce of chicken meat supplies 7,000 mg of amino acids (1). To obtain the "extra" protein he needed for a psychological boost without increasing fat intake, he agreed to try adding 113 cup milk powder for 10 grams of high quality protein. He was told that this strategy provided other key nutrients such as calcium and riboflavin. As shown in Table 4, supplement use was extreme and exceeded pharmacological doses (10 times the RDA) for many vitamins and minerals. After the bodybuilder explained why he was taking certain supplements, each vitamin and mineral was defined in terms of function and the potential for toxicity was emphasized. Several myths about vitamins and minerals were discussed, for example, that all vitamins not used by the body are excreted, that B-vitamins provide energy, that biotin repairs muscle, and that iron gives strength. The computer analysis was useful in illustrating that vitamins do not of themselves provide energy but instead function to release energy from foods, and that taking more does not release more energy. Having the subject bring the bottles of supplements he was taking helped to facilitate a discussion about the different ingredients. Interestingly, he had never read the labels. After recognizing what was in certain pills, such as alfalfa, watercress, and parsley, he became skeptical about some of the effects they claimed to have.

9 Precontest Strategies of a Bodybuilder / 77 The computerized dietary analysis showed that he exceeded the RDA far all vitamins and minerals during the off-season and weight reduction phase based upon his food intake alone. He agreed to reduce his supplement intake during this part of training because of potential toxicity problems to a multivitamin/ multimineral that was greater than % RDA. Precontest Diet The purpose of the precontest diet was to "shock the system to achieve maximum size, definition, and vasculature." The bodybuilder believed that carbohydrate loading was the best way to achieve these objectives (7). Underlying this practice is the rationale that glycogen is stored in the muscle along with water, which can promote a feeling of muscle stiffness (2). The diet he followed was designed with the advice of other bodybuilders and consisted of fish, potato, and rice. He admitted that the diet was difficult to follow and that there were several negative aspects to this plan including the fact that he smelled of fish, the diet was boring, and it made him tired and grouchy. A modified carbohydrate loading regimen was proposed as an alternative to the diet he typically followed (2). During this regimen he agreed to consume a mixed diet (40% from carbohydrate) for the first 3 days prior to the contest as he tapered his training, followed by a 60% carbohydrate diet for the last 3 days prior to the contest. Even with these changes he was still concerned that he would be at a disadvantage if he did not take additional vitamins and minerals beyond the multivitamin/multimineral ("everyone else does"). As a result, he planned to take additional supplements the 3 weeks precontest. He was encouraged to try the new regimen during the off-season, to allow time for adjustments. Concern was expressed for possible fluid and electrolyte imbalances the week precontest resulting from purposeful dehydration. Potential stress on the kidneys from limited fluid intake, in conjunction with the large amounts of protein being consumed, was also addressed. The bodybuilder had a dilemma as to whether it was more advantageous to dehydrate to have "paper-thin skin," thus enhancing definition, or to drink additional water to maximize the feeling of hardness in the muscle. While most of the suggested dietary changes were agreeable to the bodybuilder, the precontest strategy was the most difficult to alter. He was very concerned about breaking the traditional pattern of intake followed by bodybuilders because he was afraid of losing the competitive edge. Trying to convince him that eating every 2 hours was probably not advantageous was a chal- 1enge.This dietary practice had been recommended by other bodybuilders, based on his metabolism type, to prevent fat gain. Even though this unusual routine provided no apparent nutritional or health risk, he was encouraged to try eating every 4 hours as an alternative, in order to improve his mental state which he said was severely deteriorated during this time. Drug Regimen The bodybuilder emphatically stated that anabolic steroids are "just part of the diet." He was aware of the potential medical and psychological complications of taking steroids, as his father was a physician. However, the risks did not deter him. In fact he was scheduled for an operation within the month for gynecomas-

10 78 / Steen tia, which was a direct result of steroid use. When asked about the side effects, he reported acne, decreased libido, and fluctuations in temperature. When these symptoms occurred, he cut back for awhile until they subsided. However, he did not attribute any personality changes to drug use. These emotional changes, he claimed, were the result of dieting for such a long period of time. He was encouraged to have blood tests (lipid profile, hemoglobin, hematocrit, RBCIWBC count, etc.) to evaluate whether the prolonged use of drugs had caused any hematologicap abnormalities with potential adverse health consequences. Conclusion The present case study illustrates the dietary strategies, training patterns, and drug regimen used by a bodybuilder in preparation for a contest. These manipulations are similar to previous reports (3, 4, 5, 6). As is evident from this case, the bodybuilder used several unusual dietary practices that may place him at risk for immediate and future medical problems. In light of these many unhealthy practices, the nutritionist must decide which issues are most important to address from a health standpoint and in terms of the athlete's performance potential. It is important to keep in mind that an athlete is often more motivated to make a change based on a performance argument rather than a health argument. For the athlete who relies heavily on supplements, a placebo effect must be considered. Certainly the use of drugs should be discouraged and the risks emphasized. Alternative strategies should be negotiated with the athlete that are realistic, and changes should be implemented slowly. It is hoped that reframing the bodybuilder's belief system will lead to positive changes in training and diet that will help him achieve his performance potential. References 1. Coleman, E. Protein fmds, but not protein supplements. Sport Med. Dig. 12(3):3, Costill, D.L. Carbohydrates for exercise: Dietary demands for optimal performance. Int. J. Sports Med. 9: 1-18, Faber, M., A.J.S. Bendade, and M. van Eck. Dietary intake anthropometric measurements, and blood lipid values in weight training athletes (body builders). Int. J. Sports Med. 7: , Hickson, J.F., T.E. Johnson, W. Lee, and R.J. Sidor. Nutrition and the pre-contest preparations of a male bodybuilder. J. Am. Dietet. Assoc. 90(2), , Weiner, S.M., T.L. Bazzarre, and M.D. Litchford. Metabolic profiles diet and health practices of championship male and female bodybuilders. J. Am. Dietet. Assoc. 90(7) : , Weiner, S.M., L.H. Calabrese, K.M. Fiedler, H.K. Naito, and C.I. Skibinski. Dietary influences on cardiovascular disease risk in anabolic steroid-using and nonusing bodybuilders. J. Am. Coll. Nutr. 8:109, Kroculick, S.T. Carb loading: How to look full and ripped on contest day. Bronman 47(12): 152, Lemon, P.W.W. Protein and exercise: Update Med. Sci. Sports Exer. 19: Suppl. S179-SIN, 1987.

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