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CASE STUDIES International lournal of Sport Nutrition, 1994, 4, 54-69 O 1994 Human Kinetics Publishers, Inc. Nutritional Status of Nationally Ranked Elite Bodybuilders Susan M. Kleiner, Terry L. Bazzarre, and Barbara E. Ainsworth The nutritional status of 11 female and 13 male elite bodybuilders at the first drug-tested USA Championship was examined through food records kept by subjects. Diets were repetitive and monotonous, and average daily energy and protein contents were relatively similar for men and women. Percent calories from protein, fat, and carbohydrate were 39%, 12%, and 48% for females, and 40%, 11%, and 49% for males, respectively. Females consumed 0% vitamin D, 52% calcium, 76% zinc (as percents of RDA) and below the Estimated Safe and Adequate Dietary Allowance amounts for copper and chromium. Males consumed 46% of vitamin D RDA. Although dietary magnesium intakes were above the RDA, serum magnesium levels in females were below reference values, which should be investigated. Serum zinc levels were high in men and women. Eighty-one percent of females reported recurrent contest-related amenorrhea for 2 + 1 months precontest. Dietary intakes of men were adequate but the restrictive intakes of women may place them at risk for calcium, copper, and chromium deficiencies. Key Words: diet, mensbual status, competition, magnesium, calcium, vitamin D Research into the diets, training, health status, and health practices of bodybuilders has expanded during the last 5 years. However, the ability of scientists and cliniciansto compare results among studies is limited since subjects' training levels, competitive stature, and commitment to their sport vary greatly. Individuals described as bodybuilders but involved in recreational strength train- ing programs should not be compared to athletes competing at national bodybuild- ing events. Recent investigations have described the diets and health of training male and female bodybuilders (11, 20), but few have investigated these issues in elite competitors. Even fewer investigations have examined these issues in concert S.M. Kleiner is with Friedman-Kester and Kleiner, P.O. Box 367, Gates Mills, OH 44040-0367. T.L. Bazzarre is with the American Heart Association, National Center, Dallas, TX 75231. B.E. Ainsworth is with the Department of Physical Education, Exercise and Sport Science, and the Department of Nutrition, School of Public Health at UNC- Chapel Hill, Chapel Hill, NC 27519.

Bodybuilders and Protein

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Page 1: Bodybuilders and Protein

CASE STUDIES International lournal o f Sport Nutrition, 1994, 4, 54-69 O 1994 Human Kinetics Publishers, Inc.

Nutritional Status of Nationally Ranked Elite Bodybuilders

Susan M. Kleiner, Terry L. Bazzarre, and Barbara E. Ainsworth

The nutritional status of 11 female and 13 male elite bodybuilders at the first drug-tested USA Championship was examined through food records kept by subjects. Diets were repetitive and monotonous, and average daily energy and protein contents were relatively similar for men and women. Percent calories from protein, fat, and carbohydrate were 39%, 12%, and 48% for females, and 40%, 11%, and 49% for males, respectively. Females consumed 0% vitamin D, 52% calcium, 76% zinc (as percents of RDA) and below the Estimated Safe and Adequate Dietary Allowance amounts for copper and chromium. Males consumed 46% of vitamin D RDA. Although dietary magnesium intakes were above the RDA, serum magnesium levels in females were below reference values, which should be investigated. Serum zinc levels were high in men and women. Eighty-one percent of females reported recurrent contest-related amenorrhea for 2 + 1 months precontest. Dietary intakes of men were adequate but the restrictive intakes of women may place them at risk for calcium, copper, and chromium deficiencies.

Key Words: diet, mensbual status, competition, magnesium, calcium, vitamin D

Research into the diets, training, health status, and health practices of bodybuilders has expanded during the last 5 years. However, the ability of scientists and clinicians to compare results among studies is limited since subjects' training levels, competitive stature, and commitment to their sport vary greatly. Individuals described as bodybuilders but involved in recreational strength train- ing programs should not be compared to athletes competing at national bodybuild- ing events.

Recent investigations have described the diets and health of training male and female bodybuilders (11, 20), but few have investigated these issues in elite competitors. Even fewer investigations have examined these issues in concert

S.M. Kleiner is with Friedman-Kester and Kleiner, P.O. Box 367, Gates Mills, OH 44040-0367. T.L. Bazzarre is with the American Heart Association, National Center, Dallas, TX 75231. B.E. Ainsworth is with the Department of Physical Education, Exercise and Sport Science, and the Department of Nutrition, School of Public Health at UNC- Chapel Hill, Chapel Hill, NC 27519.

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with a competitive event. Kleiner et al. (1 1) evaluated the metabolic profiles, diets, and health practices of male and female bodybuilders competing at the 1988 National Physique Committee's Junior USA Bodybuilding Championship. More recently, Walberg-Rankin et al. (20) reported on the diets and weight changes of female bodybuilders before and after a regional competition. Bazzarre et al. (1) examined the vitamin C intake and lipid profiles of the same national competitors described in the present study.

Unknown drug use is one of the confounding variables involved in investi- gations conducted on-site at bodybuilding competitions. The 1990 USA Body- building Championship sponsored by the National Physique Committee was the first national bodybuilding competition to require on-site random drug testing prior to the competition.

The purpose of this study was to describe the precompetition diets and health status of nationally ranked elite male and female bodybuilders. Menstrual status of the females was also described.

Methods

Following approval by the human subjects institutional review committee and the National Physique Committee, written informed consent was obtained from all subjects. Packets of research materials were mailed to all preregistered compet- itors for the 1990 USA Bodybuilding Championship sponsored by the National Physique Committee. Each packet contained an introductory cover letter, an explanation of the study, and detailed instructions for keeping 3-day food records.

Three-day food records were developed for collecting food intake informa- tion corresponding to Days 10,9, and 8 prior to the actual competition. Competi- tive bodybuilders often weigh their food and maintain detailed food and exercise diaries as part of their training regimes (authors' [S.K., T.B.] experience). Al- though using subjects who are untrained in keeping diet records can be a study limitation, the limitation to this study is diminished by the fact that these body- builders were generally in the habit of keeping personal diet records. The food records were turned in and evaluated on the morning of the official weigh-in and drug test. All food records were reviewed and verified with each subject by registered dietitians. Subjects also verbally recalled what they had already eaten that morning prior to weigh-in and study participation. The average daily nutrient content of each subject's diet was based on calculated results provided by the Case Western Reserve University Nutrient Data Base (Cleveland, OH), which contains USDA and manufacturers' food composition information. Food records are a more valid and reliable estimate of foodlnutrient intakes of individuals as well as groups (3, 4). In order to use the more valid and reliable food record method versus a food recall method, Days 10-8 were selected rather than the 3 days immediately prior to competition, when there would not have been time to verify the recorded information. The advantages and limitations of various meth- ods of collecting food intake information have been reviewed by Bazzarre and colleagues (3, 4).

A11 data other than dietary records were collected on-site the morning of the official weigh-in and drug testing period (approximately 24 hr prior to the preliminary competition). This was the first national bodybuilding competition in which an official drug (steroid) testing procedure was employed. Each subject

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56 1 Kleiner, Bazzarre, and Ainsworth

completed a series of questionnaires developed to obtain demographic data as well as information regarding training history, diet habits, supplement use, and medical history. All questionnaires were reviewed for completeness by the staff epidemiologist (B.A.). Two teams of trained male and female anthropometrists obtained all height, weight, skinfold, and circumference data for their respective gender groups. Skinfolds were measured by the same female anthr~~ometrist for all women, and by one of two male anthropometrists for all men, using Lange skinfold calipers (Cambridge, MD). All measurements were taken in rotational sequence on the right side of the body. Percent body fat was estimated according to gender-specific equations of Jackson et al. (9, 10) for the following skinfolds: triceps, subscapular, suprailiac, abdominal, anterior thigh, pectoral, and axilla.

Casual blood samples were collected into trace mineral-free vacutainers by trained phlebotomists. According to subject self-report, most if not all blood samples represented fasting conditions since the blood samples were collected on the morning of the official weigh-in. In fact, although exact numbers are not available, most blood samples represented 8 to 12 hr or longer fasting samples. Hematocrits were performed with the microhematocrit method described by Strumia et al. (18). Hemoglobins were measured with the Drabkin reagent (6) according to the procedure of Eilers (5) and using Sigma standard No. 525-18 (Sigma Chemical Co., St. Louis). Serum ferritin was determined by radioimmuno- assay (14). Zinc, copper, and magnesium were measured with an atomic absorp- tion spectrophotometer (Video 12E Model atomic absorption spectrophotometer, Thermo Jerrell Ash Corp., Waltham, MA).

Means, standard deviations, and ranges, as well as frequency distributions, were calculated in order to describe the population characteristics. Correlation coefficients could not be calculated to compare arnenorrheic versus eumenorrheic females due to the small sample size of eumenorrheic females. The SAS Statistical Analysis System (SAS Institute, Cary, NC) was used for all data analyses.

Results

Seventeen females and 17 males volunteered to participate, but only 11 females and 13 males donated blood samples. Demographic and anthropometric data for these subjects are summarized in Table 1. Males and females were very close in age, averaging about 30 years. Females on average were only 11 cm shorter than males but weighed 27 kg less than their male counterparts. This difference in somatotype is clearly demonstrated by a comparison of Body Mass Index (kg/m2) values of 20.7 for women and 27.4 for men. Body fat levels were remarkably low for both males and females.

Since there are few objective variables by which the training levels of bodybuilding subject samples can be compared (such as V02max in other ath- letes), information about the training histories of bodybuilders is important. The training histories of these elite bodybuilders are reported in Table 2. On average, the men had been weight training and bodybuilding longer than the women, and had participated in and won more competitions. Both men and women competed in numerous events, but there was considerable variability in the number of competitions reported. The men reported competing in an average of 30 competi- tions (SD = 48), whereas the women reported a lifetime of 10 (SD = 8) competi-

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Table 1 Demographic and Anthropometric Characteristics of Elite Bodybuilders

Females (n = 11) Males (n = 13) M SD M SD

Age (years) 29 3 30 4 Height (cm) 160 7 171 7 Weight (kg) 53 6 80 12 Estimated % body fat 9 1 5 2

Table 2 Training Histories of Elite Bodybuilders

Females (n = 11) Males (n = 13) M SD M SD

Years weight training 7.3 2.5 11.9 4.4 Years bodybuilding 5.4 2.3 7.8 5.6 Number of competitions 10.4 8.0 30.8 48.2 Number of competitions won 3.4 2.1 9.9 15.2

tions. The number of successful competitions included both weight class and overall title wins.

Mean nutrient intakes from the 3-day precompetition diet records are de- scribed in Tables 3 and 4. Subjects reported that these 3 days represented diets followed rigorously for 8 to 10 weeks before every competition. Dietary intakes were highly variable between subjects, but the distributions of energy, protein, fat, and carbohydrate were remarkably similar between males and females. In general, daily energy intakes were 30 kcal/kg/day for women and 33 kcal/kg/ day for men. Protein consumption was 3 g/kg for both groups. These bodybuilders ate high-protein (39%-40% of calories), moderate carbohydrate (48%49%), and low-fat (1 1%-12%) diets as they approached competition day.

Dietary cholesterol consumption was generally low, in concordance with the low intakes of dietary fat. However, several subjects consumed amounts well above recommended daily intakes (300 mglday) for preventing heart disease (16). Although most bodybuilders ate only egg whites, those with higher choles- terol intakes also ate the yolks.

Consumption of whole grains, legumes, fruits, and vegetables was limited among these subjects. The low intakes of these fibrous foods accounted for the very low fiber intakes of subjects.

Total estimated vitamin A intake was high, most of which was from high intakes of beta carotene. Foods that contributed to these high intakes included yams, yellow squash, broccoli, tomatoes, and cantaloupe. Supplements were not included in these values. None of the subjects had any obvious yellowing of the

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Table 3 Daily Precompetition Nutrient Intakes of Elite Bodybuilders (Food Only)

Females (n = 11) Males (n = 13) M SD Range M SD Range

Energy % kcal protein

fat carbohydrate

Protein (g) % RDA

Fat (g) Carbohydrate (g) Cholesterol (mg) Fiber (g)

Note. Values >O but < 1 are designated as " 1."

skin (side effect of high beta carotene intake); however, subjects were tanned and were not physically examined for such symptoms.

There were several nutrients for which consumption fell below recom- mended levels, especially among the female athletes. According to the computer- ized analysis, none of the women had any vitamin D in their diets, and the men had an average intake of only 46% of the RDA. None of the women used any dairy products, and only one male drank milk. Since vitamin D-fortified dairy products are the main source of vitamin D in the American diet, the lack of dairy products accounted for this remarkable nutritional deficit.

Calcium consumption was also very low among the female contestants. Although the range was large, most women ate less than 50% of the RDA for calcium, and no one achieved 100% of the RDA. These low calcium intakes could also be accounted for by the lack of dairy products in the diet. The calcium that was present in the diet came predominantly from plant sources. Calcium intakes among men were generally closer to the RDA. Although the dietary sources of calcium were similar between the men and women, the volume of food consumed was much larger among the men than the women.

Iron consumption was close to or above the RDA for most of the women, and at or above the RDA for men. Because subjects consumed solely white versus dark flesh foods, zinc intakes were only 76% of the RDA for women and 95% of the RDA for men. Due to the restrictive nature of the precompetition diets, copper and chromium intakes of females fell below the Estimated Safe and Adequate Dietary Allowance ranges suggested by the RDA committee (15).

Actual diets representing the food patterns followed by these athletes before competition are illustrated in Tables 5-9. The minority of subjects (25%) con- sumed relatively varied diets (Tables 5 and 8). Most subjects (75%) ate diets more closely resembling the repetitive and monotonous diets described in Tables 6, 7, and 9. Many of the subjects ate a limited selection of vegetables. When

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Table 5 Self-selected Diet of an Elite Male Bodybuilder

Time of Day Quantity Description

2.5 cups 5 pkg 1 large 8 vol oz 1 pkg 1 large 6 vol oz

8 large

1.33 average 2 wt oz 3 slice 1 tbsp 16 vol oz 1 large

1 large

4 wt oz

1 large

16 wt oz 2 tbsp 2 cups

Oatmeal, regular or quick, cooked with salt Sugar substitute, Sweet 'n Low Banana, raw Skim milk, fluid, with vitamins A and D Instant breakfast powder, vanilla, Carnation

Banana, raw Tea, instant unsweetened lemon-flavor powder Egg white, fresh and frozen, cooked

Raisin bagel, water Chicken (boneless) canned Whole wheat bread Mustard, regular, prepared, yellow Tap water

Banana, raw

Banana, raw Turkey, light meat without skin, roasted, serving wt

Apple with skin, raw, edible portion, approximately 3Pb Cod, Atlantic, cooked with dry heat Teriyaki sauce, San-J Broccoli, chopped, boiled, drained

Note. Average 3-day intake = 2,687 kcal. Percent of total kcal from protein = 39, from fat = 12, and from carbohydrate = 49.

vegetables were part of the diet, usually two different vegetables were eaten in large quantities (1-3 cups) at every meal, every day. One subject even ate baby food because he assumed that it took less energy to digest it.

Sixty percent of the men and 100% of the women used dietary supplements, although their use of supplements was lower than reported in previous studies (11-13). Few subjects took more than three different preparations. Among 19 subjects, 19 different supplement preparations were taken (Table 10). Multivita- min-mineral tablets and amino acids were the most popular, followed by an array of others including protein powder, herbal formulas, vitamin C, calcium- magnesium tablets, medium-chain triglyceride oil, megapaks, and potassium. Because many of the products do not have standard nutrient labels, information on actual nutrient content was not available. Hence, supplement data are not included in the dietary analyses.

In an earlier study, two of these authors (S.K., T.B.) collected blood samples to study mineral levels in competitive males and a nonsignificant number of competitive female subjects (1 1). The present study repeated some of the same

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Table 6 Repetitive Self-selected Dietary Intake of an Elite Male Bodybuilder

Time of Day Quantity Description

7:00 a.m. 8 wt oz 1 tbsp 0.063 tsp 2 cups

12:00 p.m. 8 wt oz 1 tbsp 0.063 tsp 2 cups

8:00 p.m. 8 wt oz 1 tbsp 0.063 tsp 2 cups

All day 4 ¶t 3 cups

Chicken (roaster) breast half, without skin, roasted Vinegar, cider Pepper, black Rice, white enriched long grain, cooked with salt

Chicken (roaster) breast half, without skin, roasted Vinegar, cider Pepper, black Rice, white enriched long grain, cooked with salt

Chicken (roaster) breast half, without skin, roasted Vinegar, cider Pepper, black Rice, white enriched long grain, cooked with salt

Water, bottled, Poland Springs Coffee, regular, brewed

Note. Average 3-day intake = 2,649 kcal. Percent of total kcal from protein = 35, from fat = 11, and from carbohydrate = 54.

Table 7 Monotonous Self-selected Dietary Intake of an Elite Male Bodybuilder

Time of Day Quantity Description

8:00 a.m. 6.5 wt oz Tuna, light, canned in water, drained solids 1200 p.m. 6.5 wt oz Tuna, light, canned in water, drained solids 4:00 p.m. 6.5 wt oz Tuna, light, canned in water, drained solids 6:00 p.m. 6.5 wt oz Tuna, light, canned in water, drained solids 9:00 p.m. 6.5 wt oz Tuna, light, canned in water, drained solids

Note. Average 3-day intake = 1,930 kcal. Percent of total kcal from protein = 97, from fat = 3, and from carbohydrate = 0.

blood mineral studies on a larger sample of elite males and females (Table 11). A11 mean values were virtually within reference ranges. Hematocrit values were slightly high among females (Hct = 0.44) and magnesium levels were slightly low (Mg = 0.79 mmolb). Hemoglobin levels were slightly low, especially among the males (Hb females = 122 g/L; males = 130 g/L). Serum zinc was slightly elevated in both males and females (Zn females = 22.9 pmoVL; males = 23.8 pmolb).

Medical questionnaires addressed menstrual function in the female contes- tants. Eighty-two percent, or 9 subjects, reported amenorrheic episodes that

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Table 8 Self-selected Dietary Intake of an Elite Female Bodybuilder - - -- - - -

Time of Day Quantity Description

11:30 a.m. 6 large 0.4 g 1 vol oz 7 wt oz 6 vol oz 2 tsp 2 pkg 1 tbsp 1 tbsp

6:00 p.m. 0.5 cup 0.2 cup 0.2 0.2 cup 0.2 cup 0.2 cup 1 tbsp 1 tbsp 0.5 pkg 0.5 pkg 6 wt oz 12 vol oz

9:00 p.m. 3 wt oz 1 tsp 0.5 slice 12 vol oz

10:30 p.m. 6 large 1.5 cups 1 pkg 12 vol oz 1.33 medium 3 wt oz 6 vol oz 24 vol oz 12 vol oz 1 pkg 3 tsp

Egg white, fresh and frozen, cooked Mazola, no-stick Onion (yellow), raw, chopped Potato, baked, flesh and skin Coffee, regular, brewed Coffee whitener, nondairy, powdered Sugar substitute, Sweet 'n Low Catsup, regular Raisin, seedless

Lettuce, iceberg, raw, shredded or chopped Tomato, raw, chopped or diced Carrot, raw, grated or shredded Onion (white), raw, chopped Cucumber, raw, pared, slices Broccoli, raw, chopped or whole spear Italian dressing, low calorie, 3 kcalltsp Vinegar, distilled Sugar substitute, Sweet 'n Low Spaghetti, enriched, cooked without salt Haddock, cooked with dry heat Tap water

Tuna, light, canned in water, drained solids Mustard, regular, prepared, yellow Pita bread, round, whole Tap water Egg white, fresh and frozen, cooked Oatmeal, regular or quick, cooked with salt Sugar substitute, Sweet 'n Low Tap water Nectarine, raw, edible portion Chicken (roaster) breast half, without skin, roasted Cranbeny juice cocktail with vitamin C Water, bottled, Poland Springs Coffee, regular, brewed Sugar substitute, Sweet 'n Low Coffee whitener, nondairy, powdered

Note. Average 3-day intake = 1,610 kcal. Percent of total kcal from protein = 40, from fat = 9, and from carbohydrate = 51.

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Table 9 Very Low Calorie, Monotonous, Self-selected Dietary Intake of an Elite Female Bodybuilder

Time of Day Quantity Description

9:00 a.m. 1 average 1 medium 1.5 wt oz 1 tsp

12:30 p.m. 1 average 1 medium 1.5 wt oz 1 tsp

3:30 p.m. 1 average 1 medium 1.5 wt oz 1 tsp

9:00 p.m. 1 average 1 medium 1.5 wt oz 1 tsp

All day 150 vol oz

Rice cake, plain, Chico San Tomato, red, raw, slicelwedge Turkey, light meat without skin, roasted, sewing wt French dressing, low calorie, 1 kcalltsp Rice cake, plain, Chico San Tomato, red, raw, slicelwedge Turkey, light meat without skin, roasted, serving wt French dressing, low calorie, 1 kcalltsp Rice cake, plain, Chico San Tomato, red, raw, slicelwedge Turkey, light meat without skin, roasted, sewing wt French dressing, low calorie, 1 kcalltsp Rice cake, plain, Chico San Tomato, red, raw, slicelwedge Turkey, light meat without skin, roasted, sewing wt French dressing, low calofie, 1 kcalltsp Water, bottled, Poland Springs

Note. Average 3-day intake = 431 kcal. Percent of total kcal from protein = 52, from fat = 14, and from carbohydrate = 34.

occurred around contest time, referred to here as "contest-related amenorrhea." The amenorrhea lasted 2 + 1 months prior to competition. Contest-related arnenor- rhea recurred prior to each contest in which the subjects participated throughout the year. When asked why they thought that their periods stopped during this time, subjects attributed their amenorrhea to physical and psychological stress, low-fat diets, and low body fat.

One way to investigate possible causes of amenorrhea is to statistically correlate variables associated with amenorrhea with the occurrence of either abnormal or normal menstrual function. The sample of eumenorrheic females in this study was too small to conduct statistical correlations. However, the identified variables were separated out between amenorrheic and eumenorrheic individuals to identify any large numerical differences (Table 12). None were apparent.

Diets, as shown in Tables 5-9, were somewhat varied and well-balanced, were repetitive but adequate in calories, or were very monotonous and/or very low calorie.

Discussion The subjects in this study were nationally ranked elite athletes. Success at this competition would lead an athlete into professional competition. The age range for these competitors is typical for elite bodybuilders, who are relatively older

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Table 10 Precompetition Nutritional Supplements Used by Elite Bodybuilders

Type of supplement Number of subjects using supplement

Multivitamin-mineral Amino acids Protein powder Herbal formulas Carnitine Vitamin C Calcium + magnesium Potassium MCT oil Multi megapak Chromium picolinate Vitamin E Niacin Vitamin B complex Zinc Vitamin B,, Carboplex Caprylic acid Whole meal supplement

than competitive athletes in other sports. Estimated body fat levels are compara- tively lower than those previously reported (8, 11, 12, 19, 20) and reflect the elite competitive stature of these subjects.

Compared to nationally ranked junior competitors (1 I), the women in this study ate considerably fewer calories in their precompetition diets (30 kcal/kg/day vs. 39 kcalkglday). The women in this study were also shorter (160 cm vs. 166 cm) and lighter in weight (53 kg vs. 57 kg) and had less body fat (9% vs. 10%). Among male competitors, the elite bodybuilders in this study consumed more calories than their counterparts in the previous junior bodybuilding study (2,620 kcal vs. 2,015 kca1)-although their heights and weights were similar (171 cm vs. 170 cm; 80 kg vs. 80 kg)-but they were less fat (4.9% vs. 6.0%).

The distribution of protein, fat, and carbohydrate as a percent of calories in the diet was similar among the males and females in this study and compared well with the data collected previously (1 1). Walberg et al. (19) suggested that a hypocaloric, high-protein, high-carbohydrate diet may be effective for main- taining lean body mass in preparation for competition. These bodybuilders ate more than three times the RDA for protein, whereas Walberg's subjects ate twice the RDA.

The unvaried nature of the precompetition diet was reflected by the unbal- anced vitamin and mineral content. The nutrient intakes of most competitors met the RDA, but several very important nutrients were lacking in the diets. D i e t q

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Table 11 Precompetition Serum Mineral Levels of Elite Bodybuilders

Females (n = 11) Males (n = 13) M SD M SD

Hematocrit reference range

Hemoglobin, g/L reference range

Ferritin, pg/L reference range

Zinc, pmol/L reference range

Copper, pmol/L reference range

Magnesium, mmol/L reference range

Table 12 Differences Between Nutrient Intakes, Total Serum Cholesterol, and Percent Body Fat in Amenorrheic Versus Eumenorrheic Elite Bodybuilders

Amenorrheic (n = 9) Eumenorrheic (n = 2) M Range Subject 1 Subject 2

Energy (kcal) 1,588 Protein (g) 147 Fat (g) 19 Calcium (mg) 387 Iron (mg) 17.6 Zinc (mg) 8.8 Total serum cholesterol (mg%) 139 Percent body fat 9.4

vitamin D was the most noticeably absent nutrient. This lack was due to the avoidance of all dairy products in the diets of all but one male bodybuilder. However, all of the subjects used tanning booths to darken their skin tone for competition. Since vitamin D can be manufactured by the body in the presence of ultraviolet light, we suspect that the vitamin D status of these subjects was within normal limits.

Very few nutritional supplements were used by these athletes. In fact, these elite athletes used fewer dietary supplements than other bodybuilders competing at lower ranks (12). Multivitamin-mineral tablets and amino acids were the most popular. Although the female contestants consumed only 76% of the RDA for

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zinc, most multivitamin-mineral tablets used by these athletes contained at least 100% of the RDA for zinc. Any dietary zinc deficit should have been made complete by the supplement. Additionally, higher than normal serum zinc levels were indicative of adequate, if not high, dietary zinc (Table 11).

Most of the supplements did not contain much calcium, and few contained copper and chromium. Low calcium intakes among women are of concern due to positive correlations between poor calcium nutriture and increased risk of osteoporosis (15). Investigations into maintenance of bone mineral mass have found that those individuals with higher lifetime calcium intakes have greater bone mass as they age. The assumption has been made that those individuals who attain higher peak bone mass can maintain healthier levels of bone density with age, even though bone loss still occurs (15). Since the female subjects were below the age range at which peak bone mass is achieved (30-35 years), poor calcium intakes might prevent the attainment of peak bone mass potential.

It is common for bodybuilders to avoid dairy products. The rationale used to explain this behavior is that milk is high in sodium, and the extra sodium will make bodybuilders hold water, keeping them from looking "ripped," or as lean and muscularly defined as possible. In fact, relative to other common foods in the precompetition diet of a bodybuilder, such as eggs and tuna, milk is not high in sbdium, &d it is an excellent source of protein, another important nutrient in the precompetition diet. Practitioners should explain to bodybuilding clients that 1 cup of skim milk contains 126 mg of sodium, 8.4 g of protein, 86 kcal, and 302 mg of calcium. The whites of three large eggs, a popular food in the diet of a bodybuilder, contain 150 mg of sodium, 10.2 g of protein, 48 kcal, and only 12 mg of calcium (17). Thus, sodium in skim milk should not be a concern of bodybuilders, who may need to consume this excellent, nonfat source of calcium.

For those bodybuilders who cannot or will not drink milk, nonfat yogurts should be recommended. They are equally high in calcium and often do not cause the intestinal problems that some people experience from milk. If lactose intolerance is a problem enzyme replacement products should be recommended.

Female subjects also reported a contest-related amenorrhea that lasts for 1 to 3 months and recurs prior to each competition. Since many of the women compete in several contests annually, they may be amenorrheic for many months throughout the year and may therefore have low levels of circulating estrogen. Estrogen is required for the mobilization of calcium into the bone mineral matrix. This possible repeated lack of estrogen could cause an additionally significant bone mineral deficit.

Many U.S. diets provide less than the Estimated Safe and Adequate Dietary ~llowanc' for copper k d chromium (15). These female bodybuilders consumed below the recommended ranges for both nutrients. The best food sources for copper are organ meats, seafoods, nuts, and seeds. There is also copper in tap water (0.014 mg/8 oz.) (17). The best dietary sources of chromium are calf's liver, cheese, and wheat germ. Since none of these foods are part of a female bodybuilder's precompetition diet, it may be prudent to supplement the diet with appropriate amounts of copper and chromium.

The serum mineral levels were generally within normal ranges. Unless nutritional status is severely compromised, the strong control mechanisms for the maintenance of homeostasis will allow for only minimal fluctuations of blood mineral levels. However, hemoglobin levels were slightly lower than normal in

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men and magnesium levels were slightly low in females. These serum magnesium levels are very similar to measurements collected in 2 junior female bodybuilders studied previously (1 1). In those 2 subjects, serum magnesium values were 0.78 mmol/L and 0.74 mmol/L. Now that data have been collected from a larger sample of women, these data may indicate either marginal magnesium status or a disruption in magnesium homeostasis in elite female bodybuilders. Since it has been documented that bodybuilders abuse laxatives and diuretics to "make weight" prior to competitions (1 1, 13), these low magnesium values may reflect a perturbation of electrolyte status due to drug abuse. It would be prudent to review the hazards involved with over-the-counter drug abuse with any competi- tive clients who must make weight prior to a competition, and to monitor any physiological anomalies that may be explained by electrolyte imbalance.

Hematocrit values were in the upper range of the reference values for both men and women. Serum zinc values were slightly elevated above reference values for men and women. These readings may be true values, or they may be inflated due to partial dehydration prior to contest weigh-in.

Seventy-five percent of the subjects ate repetitive, monotonous diets. Sub- jects explained that once they knew the calorie, carbohydrate, protein, fat, and sodium contents of a few foods, they just kept repeating those foods in their diets, instead of having to figure out the nutrient content of many foods. Inevitably, most bodybuilders turn to lean white poultry and fish, one main carbohydrate source, one or two vegetables, and purified water as the staples of their precompe- tition diets. If they compete successfully, they contribute some of their success to this diet, and the pattern becomes holy.

It has become difficult to compare results of studies investigating the diets and nutritional requirements of strength training athletes due to the nonspecific descriptions of the subjects andfor the mixing of types of strength trainers within one study. A summary of studies investigating various parameters among strength training athletes described the broad definitions used to categorize the sample subjects (2). Strength training athletes included bodybuilders, power lifters, and other athletes who strength train. Some were identified as steroid users or nonus- ers. When reported, estimated percent body fats ranged from 6% to 14% in males, and 10% to 14% in females, indicating a large variability in training status. Only a few studies reported dietary data. Since it is clear that the training goals and regimes of power lifters and bodybuilders are very different, recent studies have begun to limit the subjects to one category of strength trainers, such as body- builders only, or power lifters only. This consistency has enhanced the ability of practitioners to practically interpret the research literature. Although the train- ing status of research subjects continues to fall within a large range, this variability allows for the collection of data across the broad range of the bodybuilding population. However, studies need to clearly define the training status of the subjects so that results can be compared and contrasted.

Summary and Conclusions

All bodybuilders strive to become leaner, more muscular, and more muscularly defined. Virtually all follow extreme diet and training regimes in preparation for competition. Depending on athletes' levels of competitive success, their physical fitness, physiques, diets, and training patterns differ greatly. The results of this

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study of drug-tested competitors may differ from those of non-drug-tested compet- itors, as the use of anabolic steroids close to competition time may influence dietary intakes and nutritional status.

The elite bodybuilders competing at this national event were extremely lean and generally followed very rigid diets and training programs for 2-3 months prior to contest. Although both men and women had very strict dietary habits, the men appeared to be at less nutritional risk than the women. Their decreased risk was due to the relatively larger number of calories, and therefore nutrients, consumed by the men compared to the women.

The restrictive nature of the diets of the women was disconcerting. Diets were deficient in vitamin D, calcium, zinc, copper, and chromium. Vitamin D nutriture is probably not at risk due to exposure to UV light from tanning booths. Zinc nutriture is probably not at risk because of common vitamin-mineral supplementation. Calcium nutriture is certainly at risk. The high incidence of recurrent contest-related amenorrhea observed in this population, along with other practices that may complicate calcium metabolism, such as high-protein diets and possible anabolic steroid abuse, begs the question of overall bone mineral status. In light of data describing the bone mineral densities of other amenorrheic female athletes as resembling the osteoporotic changes seen in postmenopausal women, this question certainly deserves more investigation (7).

Dietary data indicated that copper and chromium nutriture may also be at risk in these women. Serum magnesium levels were low, and since dietary intakes were adequate, further causes such as over-the-counter drug abuse should be questioned in all competitive subjects and clients.

Bodybuilders are eager to find new and better methods of dieting and building muscle. In particular, female bodybuilders are concerned about their health as well as their competitive success. Creating the most competitive diet may require a skilled selection of low-fat, nutrient-dense foods and the use of nutritional supplements. In order to assist competitors, practitioners must offer advice that will help the athletes achieve competitive success as well as health maintenance.

References

1. Bazzarre, T.L., S.M. Kleiner, and B.E. Ainsworth. Vitamin C intake and lipid profiles of competitive male and female bodybuilders. Int. J. Sport Nutr. 2:260-271, 1992.

2. Bazzme, T.L., S.M. Kleiner, and M.D. Litchford. Nutrient intake, body fat and lipid profiles of competitive male and female bodybuilders. J. Am. Coll. Nutr. 9:136-142, 1990.

3. Bazzarre, T.L., and M.P. Meyers. The collection of food intake data in cancer epidemi- ology studies. Nutr. Cancer 1:22-45, 1979.

4. Bazzarre, T.L., and J.A. Yuhas. Comparative evaluation of methods of collecting food intake data for cancer epidemiology studies. Nutr. Cancer 5201-214, 1983.

5. Drabkin, D.L. The standardization of hemoglobin measurement. Am. J. Med. Sci. 217:710-711, 1949.

6. Drabkin, D.L., and J.H. Austin. Spectrophotometric studies: II. Preparation from washed cells: Nitric oxide, hemoglobin, and sulfhemoglobin. J. Biol. Chem. 11251- 55, 1935.

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7. Drinkwater, B.L., K. Nilson, C.H. Chesnut, W.J. Bremner, S. Shanholtz, and M.B. Southworth. Bone mineral content of amenorrheic and eumenorrheic athletes. N. Engl. J. Med. 31 1:277-281, 1984.

8. Heyward, V.H., W.M. Sandoval, and B.C. Colville. Anthropometic, body composition and nutritional profiles of bodybuilders during training. J. Appl. Sport Sci. Res. 3:22- 29, 1989.

9. Jackson, A.S., and M.L. Pollock. Generalized equations for predicting body density of men. Br. J. Nutr. 40:497-504, 1978.

10. Jackson, A.S., M.L. Pollock, and A. Ward. Generalized equations for predicting body density of women. Med. Sci. Sports Exerc. 12:175-182, 1980.

1 1 . Kleiner, S.M., T.L. Bazzarre, and M.D. Litchford. Metabolic profiles, diet, and health practices of championship male and female bodybuilders. J. Am. Diet. Assoc. 90:962- 967, 1990.

12. Kleiner, S.M., L.H. Calabrese, and K.M. Fiedler. Dietary influences on cardiovascular disease risk in anabolic steroid-using and nonusing bodybuilders. J. Am. Coll. Nutr. 8:109-119, 1989.

13. Kleiner, S.M., L.H. Calabrese, and K.M. Fiedler. Metabolic Risks Due to Precompeti- tion Food Practices of Bodybuilders. (Abstract). International Conference on Exercise, Fitness, and Health, Toronto, May 1988.

14. Luxton, A.W., W.H.C. Walker, J. Gauldie, M.A.M. Ali, and C. Pelletier. A radioimmu- noassay for serum femtin. Clin. Chem. 23:683-689, 1977.

15. National Academy of Sciences. Recommended Dietary Allowances (10th ed.). Wash- ington, DC: Food and Nutrition Board, 1989.

16. National Cholesterol Education Program. Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Choles- terol in Adults. Arch. Int. Med. 148:36-69, 1988.

17. Pennington, J.A.T. Bowes and Church's Food Values of Portions Commonly Used (15th ed.). New York: Harper & Row, 1989.

18. Strumia, M.M., A.B. Sample, and E.D. Hart. An improved microhematocrit method. Am. J. Clin. Pathol. 24:1016-1024, 1954.

19. Walberg, J.L., M.K. Leidy, D.J. Sturgill, D.E. Hinkle, S.J. Ritchey, and D.R. Sebolt. Macronutrient content of a hypoenergy diet affects nitrogen retention and muscle function in weight lifters. Int. J. Sports Med. 9:261-266, 1988.

20. Walberg-Rankin, J., C.E. Edmonds, and F.C. Gwazdauskas. Diet and weight changes of female bodybuilders before and after competition. Int. J. Sport Nutr. 3:87-102, 1993.

Acknowledgments

The authors thank Procter & Gamble for their generous support of this project, the sponsors and competitors of the National Physique Committee 1990 USA Bodybuilding Championship, Kathy Jones, and the many individuals who assisted with the collection of research data. This paper was presented at the 1991 annual meeting of the American College of Nutrition.