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 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 high levels of muscle growth and repair achieved by bodybuilders require a specialized diet. Generally speaking, bodybuilders require more calories than the average person of the same weight to provide the protein and energy requirements needed to support their training and increase muscle mass. In preparation of a contest, a sub-maintenance level of food energy is combined with cardiovascular exercise to lose body fat. Proteins, carbohydrates and fats are the three major macronutrients that the human body needs in order to build muscle.[24] The ratios of calories from carbohydrates, proteins, and fats vary depending on the goals of the bodybuilder.[25]
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.
To combat steroid use and in the hopes of becoming a member of the IOC, the IFBB introduced doping tests for both steroids and other banned substances. Although doping tests occurred, the majority of professional bodybuilders still used anabolic steroids for competition. During the 1970s, the use of anabolic steroids was openly discussed, partly due to the fact they were legal.[9] In the Anabolic Steroid Control Act of 1990, U.S. Congress placed anabolic steroids into Schedule III of the Controlled Substances Act (CSA). In Canada, steroids are listed under Schedule IV of the Controlled Drugs and Substances Act, enacted by the federal Parliament in 1996.[10]
The high levels of muscle growth and repair achieved by bodybuilders require a specialized diet. Generally speaking, bodybuilders require more calories than the average person of the same weight to provide the protein and energy requirements needed to support their training and increase muscle mass. In preparation of a contest, a sub-maintenance level of food energy is combined with cardiovascular exercise to lose body fat. Proteins, carbohydrates and fats are the three major macronutrients that the human body needs in order to build muscle.[24] The ratios of calories from carbohydrates, proteins, and fats vary depending on the goals of the bodybuilder.[25]
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]
Bodybuilding developed in the late 19th century, promoted in England by German Eugen Sandow, now considered as the "Father of Bodybuilding". He allowed audiences to enjoy viewing his physique in "muscle display performances". Although audiences were thrilled to see a well-developed physique, the men simply displayed their bodies as part of strength demonstrations or wrestling matches. Sandow had a stage show built around these displays through his manager, Florenz Ziegfeld. The Oscar-winning 1936 musical film The Great Ziegfeld depicts the beginning of modern bodybuilding, when Sandow began to display his body for carnivals.
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