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.
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]

Sandow was so successful at flexing and posing his physique that he later created several businesses around his fame, and was among the first to market products branded with his name. He was credited with inventing and selling the first exercise equipment for the masses: machined dumbbells, spring pulleys, and tension bands. Even his image was sold by the thousands in "cabinet cards" and other prints. Sandow was a perfect "Gracilian", a standard of ideal body proportions close to those of ancient Greek and Roman statues. Men's physiques were then judged by how closely they matched these proportions.
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.
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]

In natural contests, the testing protocol ranges among organizations from lie detectors to urinalysis. Penalties also range from organization to organization from suspensions to strict bans from competition. It is also important to note that natural organizations also have their own list of banned substances and it is important to refer to each organization's website for more information about which substances are banned from competition. There are many natural bodybuilding organizations; some of the larger ones include: MuscleMania, Ultimate Fitness Events (UFE), INBF/WNBF, and INBA/PNBA. These organizations either have an American or worldwide presence and are not limited to the country in which they are headquartered.


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]

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]
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]
Overtraining occurs when a bodybuilder has trained to the point where his workload exceeds his recovery capacity. There are many reasons why overtraining occurs, including lack of adequate nutrition, lack of recovery time between workouts, insufficient sleep, and training at a high intensity for too long (a lack of splitting apart workouts). Training at a high intensity too frequently also stimulates the central nervous system (CNS) and can result in a hyperadrenergic state that interferes with sleep patterns.[52] To avoid overtraining, intense frequent training must be met with at least an equal amount of purposeful recovery. Timely provision of carbohydrates, proteins, and various micronutrients such as vitamins, minerals, phytochemicals, even nutritional supplements are acutely critical. A mental disorder, informally called “bigorexia” (by analogy with anorexia), may account for overtraining in some individuals. Sufferers feel as if they are never big enough or muscular enough, which forces them to overtrain in order to try and reach their goal physique.[53]
During the 1950s, the most successful and most famous competing bodybuilders[according to whom?] were Bill Pearl, Reg Park, Leroy Colbert, and Clarence Ross. Certain bodybuilders rose to fame thanks to the relatively new medium of television, as well as cinema. The most notable[according to whom?] were Jack LaLanne, Steve Reeves, Reg Park, and Mickey Hargitay. While there were well-known gyms throughout the country during the 1950s (such as Vince's Gym in North Hollywood, California and Vic Tanny's chain gyms), there were still segments of the United States that had no "hardcore" bodybuilding gyms until the advent of Gold's Gym in the mid-1960s. Finally, the famed Muscle Beach in Santa Monica continued its popularity as the place to be for witnessing acrobatic acts, feats of strength, and the like. The movement grew more in the 1960s with increased TV and movie exposure, as bodybuilders were typecast in popular shows and movies.[citation needed]
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