On January 16, 1904, the first large-scale bodybuilding competition in America took place at Madison Square Garden in New York City. The competition was promoted by Bernarr Macfadden, the father of physical culture and publisher of original bodybuilding magazines such as Health & Strength. The winner was Al Treloar, who was declared "The Most Perfectly Developed Man in the World".[5] Treloar won a $1,000 cash prize, a substantial sum at that time. Two weeks later, Thomas Edison made a film of Treloar's posing routine. Edison had also made two films of Sandow a few years before. Those were the first three motion pictures featuring a bodybuilder. In the early 20th century, Macfadden and Charles Atlas continued to promote bodybuilding across the world. Alois P. Swoboda was an early pioneer in America.
Due to the growing concerns of the high cost, health consequences, and illegal nature of some steroids, many organizations have formed in response and have deemed themselves "natural" bodybuilding competitions. In addition to the concerns noted, many promoters of bodybuilding have sought to shed the "freakish" perception that the general public has of bodybuilding and have successfully introduced a more mainstream audience to the sport of bodybuilding by including competitors whose physiques appear much more attainable and realistic.

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]

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]
The winner of the annual IFBB Mr. Olympia contest is generally recognized as the world's top male professional bodybuilder. Since 1950, the NABBA Universe Championships have been considered the top amateur bodybuilding contests, with notable winners such as Reg Park, Lee Priest, Steve Reeves, and Arnold Schwarzenegger. Winners generally go on to become professional athletes.
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