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]
Carbohydrates play an important role for bodybuilders. They give the body energy to deal with the rigors of training and recovery. Carbohydrates also promote secretion of insulin, a hormone enabling cells to get the glucose they need. Insulin also carries amino acids into cells and promotes protein synthesis.[26] Insulin has steroid-like effects in terms of muscle gains.[27] It is impossible to promote protein synthesis without the existence of insulin, which means that without ingesting carbohydrates or protein—which also induces the release of insulin—it is impossible to add muscle mass.[28] Bodybuilders seek out low-glycemic polysaccharides and other slowly digesting carbohydrates, which release energy in a more stable fashion than high-glycemic sugars and starches. This is important as high-glycemic carbohydrates cause a sharp insulin response, which places the body in a state where it is likely to store additional food energy as fat. However, bodybuilders frequently do ingest some quickly digesting sugars (often in form of pure dextrose or maltodextrin) just before, during, and/or just after a workout. This may help to replenish glycogen stored within the muscle, and to stimulate muscle protein synthesis.[29]
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.
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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