Muscle growth is more difficult to achieve in older adults than younger adults because of biological aging, which leads to many metabolic changes detrimental to muscle growth; for instance, by diminishing growth hormone and testosterone levels. Some recent clinical studies have shown that low-dose HGH treatment for adults with HGH deficiency changes the body composition by increasing muscle mass, decreasing fat mass, increasing bone density and muscle strength, improves cardiovascular parameters, and affects the quality of life without significant side effects.[46][47][unreliable medical source?][48]
Some bodybuilders use drugs such as anabolic steroids and precursor substances such as prohormones to increase muscle hypertrophy. Anabolic steroids cause hypertrophy of both types (I and II) of muscle fibers, likely caused by an increased synthesis of muscle proteins. They also provoke undesired side effects including hepatotoxicity, gynecomastia, acne, the early onset of male pattern baldness and a decline in the body's own testosterone production, which can cause testicular atrophy.[43][44][45] Other performance-enhancing substances used by competitive bodybuilders include human growth hormone (HGH), which can cause acromegaly.
The bulking and cutting strategy is effective because there is a well-established link between muscle hypertrophy and being in a state of positive energy balance.[19] A sustained period of caloric surplus will allow the athlete to gain more fat-free mass than they could otherwise gain under eucaloric conditions. Some gain in fat mass is expected, which athletes seek to oxidize in a cutting period while maintaining as much lean mass as possible.
Many other important bodybuilders in the early history of bodybuilding prior to 1930 include: Earle Liederman (writer of some of bodybuilding's earliest books), Zishe Breitbart, Georg Hackenschmidt, Emy Nkemena, George F. Jowett, Finn Hateral (a pioneer in the art of posing), Frank Saldo, Monte Saldo, William Bankier, Launceston Elliot, Sig Klein, Sgt. Alfred Moss, Joe Nordquist, Lionel Strongfort ("Strongfortism"),[6] Gustav Frištenský, Ralph Parcaut (a champion wrestler who also authored an early book on "physical culture"), and Alan P. Mead (who became an impressive muscle champion despite the fact that he lost a leg in World War I). Actor Francis X. Bushman, who was a disciple of Sandow, started his career as a bodybuilder and sculptor's model before beginning his famous silent movie career.
In the modern bodybuilding industry, the term "professional" generally means a bodybuilder who has won qualifying competitions as an amateur and has earned a "pro card" from their respective organization. Professionals earn the right to compete in competitions that include monetary prizes. A pro card also prohibits the athlete from competing in federations other than the one from which they have received the pro card.[12] Depending on the level of success, these bodybuilders may receive monetary compensation from sponsors, much like athletes in other sports.
In the early 2000s, the IFBB was attempting to make bodybuilding an Olympic sport. It obtained full IOC membership in 2000 and was attempting to get approved as a demonstration event at the Olympics, which would hopefully lead to it being added as a full contest. This did not happen and Olympic recognition for bodybuilding remains controversial since many argue that bodybuilding is not a sport.[11]
Some Bodybuilders often split their food intake into 5 to 7 meals of equal nutritional content and eat at regular intervals (e.g. every 2 to 3 hours). This approach serves two purposes: to limit overindulging in the cutting phase, and to allow for the consumption of large volumes of food during the bulking phase. Eating more frequently does not increase basal metabolic rate when compared to 3 meals a day.[38] While food does have a metabolic cost to digest, absorb, and store, called the thermic effect of food, it depends on the quantity and type of food, not how the food is spread across the meals of the day. Well-controlled studies using whole-body calorimetry and doubly labeled water have demonstrated that there is no metabolic advantage to eating more frequently.[39][40][41]
The first U.S. Women's National Physique Championship, promoted by Henry McGhee and held in Canton, Ohio in 1978, is generally regarded as the first true female bodybuilding contest—that is, the first contest where the entrants were judged solely on muscularity.[13] In 1980, the first Ms. Olympia (initially known as the "Miss" Olympia), the most prestigious contest for professionals, was held. The first winner was Rachel McLish, who had also won the NPC's USA Championship earlier in the year. The contest was a major turning point for female bodybuilding. McLish inspired many future competitors to start training and competing. In 1985, a movie called Pumping Iron II: The Women was released. It documented the preparation of several women for the 1983 Caesars Palace World Cup Championship. Competitors prominently featured in the film were Kris Alexander, Lori Bowen, Lydia Cheng, Carla Dunlap, Bev Francis, and McLish. At the time, Francis was actually a powerlifter, though she soon made a successful transition to bodybuilding, becoming one of the leading competitors of the late 1980s and early 1990s.
Many non-competitive bodybuilders choose not to adopt this conventional strategy, as it often results in significant unwanted fat gain during the "bulking" phase. The attempt to increase muscle mass in one's body without any gain in fat is called clean bulking. Competitive bodybuilders focus their efforts to achieve a peak appearance during a brief "competition season".[citation needed] Clean bulking takes longer and is a more refined approach to achieving the body fat and muscle mass percentage a person is looking for. A common tactic for keeping fat low and muscle mass high would be to have higher calorie and lower calorie days to maintain a balance between gain and loss. Many clean bulk diets start off with a moderate amount of carbs, moderate amount of protein, and a decently low amount of fats. "Gaining lean muscle means going for leaner cuts of meat, like flank steaks and fillets, chicken, and, of course, fish," says White[who?]. "Enjoy your meat with some starch: rice, beans, quinoa, whole-grain couscous, or sweet potato, for example".[20] To maintain a clean bulk it is important to reach calorie goals every day. Macronutrient goals will be different for each person, but, it is ideal to get as close as possible.
Contrary to certain rumors that animal-based protein is more suitable to trigger muscle growth than plant-based protein, a study by Mangano et al. (2017) could not provide any evidence for this. In contrast, if combined properly, plant-based protein can even have a higher biological quality. A combination of one part wheat protein (e.g. seitan) and two parts soy protein (e.g. tofu) has thus been favored by many bodybuilders. Some bodybuilders, such as Patrik Baboumian and Robert Cheeke, follow a strict vegan diet.[37]

Some Bodybuilders often split their food intake into 5 to 7 meals of equal nutritional content and eat at regular intervals (e.g. every 2 to 3 hours). This approach serves two purposes: to limit overindulging in the cutting phase, and to allow for the consumption of large volumes of food during the bulking phase. Eating more frequently does not increase basal metabolic rate when compared to 3 meals a day.[38] While food does have a metabolic cost to digest, absorb, and store, called the thermic effect of food, it depends on the quantity and type of food, not how the food is spread across the meals of the day. Well-controlled studies using whole-body calorimetry and doubly labeled water have demonstrated that there is no metabolic advantage to eating more frequently.[39][40][41]
In the modern bodybuilding industry, the term "professional" generally means a bodybuilder who has won qualifying competitions as an amateur and has earned a "pro card" from their respective organization. Professionals earn the right to compete in competitions that include monetary prizes. A pro card also prohibits the athlete from competing in federations other than the one from which they have received the pro card.[12] Depending on the level of success, these bodybuilders may receive monetary compensation from sponsors, much like athletes in other sports.
In the last week leading up to a contest, bodybuilders usually decrease their consumption of water, sodium, and carbohydrates, the former two to alter how water is retained by the body and the latter to reduce glycogen in the muscle. The day before the show, water is removed from the diet, and diuretics may be introduced, while carbohydrate loading is undertaken to increase the size of the muscles through replenishment of their glycogen. The goal is to maximize leanness and increase the visibility of veins, or "vascularity". The muscular definition and vascularity are further enhanced immediately before appearing on stage by darkening the skin through tanning products and applying oils to the skin to increase shine. Some competitors will eat sugar-rich foods to increase the visibility of their veins. A final step, called "pumping", consists in performing exercises with light weights or other kinds of low resistance (for instance two athletes can "pump" each other by holding a towel and pulling in turn), just before the contest, to fill the muscles with blood and further increase their size and density.
Many non-competitive bodybuilders choose not to adopt this conventional strategy, as it often results in significant unwanted fat gain during the "bulking" phase. The attempt to increase muscle mass in one's body without any gain in fat is called clean bulking. Competitive bodybuilders focus their efforts to achieve a peak appearance during a brief "competition season".[citation needed] Clean bulking takes longer and is a more refined approach to achieving the body fat and muscle mass percentage a person is looking for. A common tactic for keeping fat low and muscle mass high would be to have higher calorie and lower calorie days to maintain a balance between gain and loss. Many clean bulk diets start off with a moderate amount of carbs, moderate amount of protein, and a decently low amount of fats. "Gaining lean muscle means going for leaner cuts of meat, like flank steaks and fillets, chicken, and, of course, fish," says White[who?]. "Enjoy your meat with some starch: rice, beans, quinoa, whole-grain couscous, or sweet potato, for example".[20] To maintain a clean bulk it is important to reach calorie goals every day. Macronutrient goals will be different for each person, but, it is ideal to get as close as possible.
Sandow organized the first bodybuilding contest on September 14, 1901, called the "Great Competition". It was held at the Royal Albert Hall in London. Judged by Sandow, Sir Charles Lawes, and Sir Arthur Conan Doyle, the contest was a great success and many bodybuilding enthusiasts were turned away due to the overwhelming amount of audience members.[4] The trophy presented to the winner was a gold statue of Sandow sculpted by Frederick Pomeroy. The winner was William L. Murray of Nottingham. The silver Sandow trophy was presented to second-place winner D. Cooper. The bronze Sandow trophy — now the most famous of all — was presented to third-place winner A.C. Smythe. In 1950, this same bronze trophy was presented to Steve Reeves for winning the inaugural NABBA Mr. Universe contest. It would not resurface again until 1977 when the winner of the IFBB Mr. Olympia contest, Frank Zane, was presented with a replica of the bronze trophy. Since then, Mr. Olympia winners have been consistently awarded a replica of the bronze Sandow.
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