The present paper aimed to systematically review case studies on physique athletes to evaluate longitudinal changes in measures of body composition, neuromuscular performance, chronic hormonal levels, physiological adaptations, and psychometric outcomes during pre-contest preparation. We included studies that (1) were classified as case studies involving physique athletes during the pre-contest phase of their competitive cycle; (2) involved adults (18+ years of age) as participants; (3) were published in an English-language peer-reviewed journal; (4) had a pre-contest duration of at least 3 months; (5) reported changes across contest preparation relating to measures of body composition (fat mass, lean mass, and bone mineral density), neuromuscular performance (strength and power), chronic hormonal levels (testosterone, estrogen, cortisol, leptin, and ghrelin), physiological adaptations (maximal aerobic capacity, resting energy expenditure, heart rate, blood pressure, menstrual function, and sleep quality), and/or psychometric outcomes (mood states and food desire). Our review ultimately included 11 case studies comprising 15 ostensibly drug-free athletes (male = 8, female = 7) who competed in various physique-oriented divisions including bodybuilding, figure, and bikini. The results indicated marked alterations across the array of analyzed outcomes, sometimes with high inter-individual variability and divergent sex-specific responses. The complexities and implications of these findings are discussed herein.

Bodybuilding is a sport where coaches commonly recommend a variety of nutrition and exercise protocols, supplements, and, sometimes, performance-enhancing drugs (PEDs). The present study sought to gain an understanding of the common decisions and rationales employed by bodybuilding coaches. Focusing on coaches of the more muscular divisions in the National Physique Committee/IFBB Professional League federations (men’s classic physique, men’s bodybuilding, women’s physique, women’s bodybuilding) for both natural and enhanced athletes, coaches were recruited via word of mouth and social media, and 33 responded to an anonymous online survey. Survey responses indicated that participant coaches recommend three-to-seven meals per day and no less than 2 g/kg/day of protein regardless of sex, division, or PED usage. During contest preparation, participant coaches alter a natural competitor’s protein intake by −25% to +10% and an enhanced competitor’s protein intake by 0% to +25%. Regarding cardiovascular exercise protocols, approximately two-thirds of participant coaches recommend fasted cardiovascular exercise, with the common rationale of combining the exercise with thermogenic supplements while considering the athlete’s preference. Low- and moderate-intensity steady state were the most commonly recommended types of cardiovascular exercise among participant coaches; high-intensity interval training was the least popular. Creatine was ranked in the top two supplements for all surveyed categories. Regarding PEDs, testosterone, growth hormone, and methenolone were consistently ranked in the top five recommended PEDs by participant coaches. The results of this study provide insight into common themes in the decisions made by bodybuilding coaches, and highlight areas in which more research is needed to empirically support those decisions.

This systematic review and meta-analysis compared the differential effects of resistance training (RT), aerobic training (AT), and concurrent training (CT) on body mass and body fat loss in metabolically healthy individuals. A systematic search of PubMed, SportDiscus, and Web of Science databases for randomized controlled trials published between January 1980 and January 2023, comparing RT, AT, and CT in healthy adults was conducted. Primary outcomes of interest included changes in fat mass and body fat percentage; secondary outcomes were body mass and fat-free mass (FFM). Sub-analyses on intervention duration (< or ≥ 10 weeks), CT timing (aerobic and resistance exercises done on the same day versus different days within a week), and workload matching (equating workloads between AT, RT, and CT), were conducted. Study protocols followed PRISMA 2020 guidelines and were pre-registered on PROSPERO (CRD42023396530). In total, 36 studies with 1564 participants were included in the systematic review, with only 31 studies included in the meta-analysis due to missing data. For studies lasting at least 10 weeks, AT outperformed RT in reducing body mass (mean difference (MD) = -1.82 kg [95% CI = -2.72 to -0.93]; p < 0.001) and fat mass (MD = -1.06 kg [95% CI = -1.88 to -0.24]; p = 0.01) but led to less FFM retention (MD = - 0.88 kg [95% CI = -1.73 to -0.03], p = 0.04). CT reduced significantly more fat mass compared to RT (MD: -1.09 kg [95% CI = -0.27 to -1.91]; p = 0.009). No significant differences were found between CT, AT, and RT in altering body fat percentage (p > 0.05). For studies shorter than 10 weeks, no significant differences were noted across exercise modalities (p > 0.05). Under conditions where AT, RT, and CT workloads were matched, similar fat mass, body mass, body fat percentage, and FFM changes were observed between exercise modalities (p > 0.05). Similar body mass and body fat percentage loss was observed between same-day and different-day CT (p > 0.05); body fat mass loss only differed in a single study (n = 1) when comparing RT to different-day CT (aerobic and resistance exercises done on different days within a week). While there are no differences in percent body fat loss between exercise modes, AT and CT are more effective than RT alone in reducing absolute fat mass; however, RT neither improved nor impeded fat mass loss when incorporated into CT. Combining aerobic and resistance exercises on the same-day or different-day does not appear to influence the effectiveness of CT. When exercise interventions are short in duration (<10 weeks), there does not appear to be a difference in fat loss between exercise modalities. These results support the concurrent use of aerobic and resistance exercises for fat mass reduction, as well as an emphasis on workload and duration when programming exercise for fat loss.

Introduction: The purpose of this report was to document a novice, natural, female, physique athlete’s physiological and psychological responses to a 6-month preparation and 1-month post-competition period. Methods: The athlete’s protocol throughout preparation was a high-protein caloric deficit with ~2 refeed days per week, as well as resistance and cardiovascular training. The athlete self-reported bodyweight and adherence via a weekly electronic survey. Once monthly during preparation, compositional, physiological, and psychological assessments were administered by a technician. Blood samples were drawn at the beginning of preparation and during the week of competition. Results: Bodyweight decreased throughout preparation (51.9 to 46.7kg; Δ5.2kg) and further post-competition (46.3kg, R2=0.96), with a similar decrease in body fat percentage (17.2 to 12.3%; Δ4.9%) and fat-free mass (42.9 to 41.0kg; Δ1.9kg) during preparation. Mild somatic (8/30) and depressive (5/27) symptoms manifested approximately 1-month prior to competition. Depressive (7/27) and anxiety (5/21) symptoms peaked post-competition but were not clinically significant. This aligned with a peak in emotional eating post-competition (5/12) and an increase in the athlete’s previously elevated cortisol levels (761.76 to 839.04nmol/L). Conclusions: The present report may be the first empirical documentation of a female physique competitor reducing fat-free mass during contest preparation and what is anecdotally known as “post-show blues.”