Competitive bodybuilders undergo strict dietary and training practices to achieve an extremely lean and muscular physique. The purpose of this study was to identify and describe different dietary strategies used by bodybuilders, their rationale, and the sources of information from which these strategies are gathered. In-depth interviews were conducted with seven experienced (10.4 ± 3.4 years bodybuilding experience), male, natural bodybuilders. Participants were asked about training, dietary and supplement practices, and information resources for bodybuilding strategies. Interviews were transcribed verbatim and analyzed using qualitative content analysis. During the off-season, energy intake was higher and less restricted than during the in-season to aid in muscle hypertrophy. There was a focus on high protein intake with adequate carbohydrate to permit high training loads. To create an energy deficit and loss of fat mass, energy intake was gradually and progressively reduced during the in-season via a reduction in carbohydrate and fat intake. The rationale for weekly higher carbohydrate refeed days was to offset declines in metabolic rate and fatigue, while in the final “peak week” before competition, the reasoning for fluid and sodium manipulation and carbohydrate loading was to enhance the appearance of leanness and vascularity. Other bodybuilders, coaches and the internet were significant sources of information. Despite the common perception of extreme, non-evidence-based regimens, these bodybuilders reported predominantly using strategies which are recognized as evidence-based, developed over many years of experience. Additionally, novel strategies such as weekly refeed days to enhance fat loss, and sodium and fluid manipulation, warrant further investigation to evaluate their efficacy and safety.

Objectives The global COVID-19 pandemic produced large-scale health and economic complications. Older people and those with comorbidities are particularly vulnerable to this virus, with nursing homes and long term care facilities (LTCF) experiencing significant morbidity and mortality associated with COVID-19 outbreaks. The aim of this rapid systematic review was to investigate measures implemented in LTCF to reduce transmission of COVID-19 and their effect on morbidity and mortality of residents, staff and visitors. Setting Long-term care facilities. Participants Residents, staff and visitors of facilities. Primary and secondary outcome measures Databases (PubMed, EMBASE, CINAHL, Cochrane Databases and repositories and MedRXiv prepublished database) were systematically searched from inception to 27 July 2020 to identify studies reporting assessment of interventions to reduce transmission of COVID-19 in nursing homes among residents, staff or visitors. Outcome measures include facility characteristics, morbidity data, case fatalities and transmission rates. Due to study quality and heterogeneity, no meta-analysis was conducted. Results The search yielded 1414 articles, with 38 studies included. Reported interventions include mass testing, use of personal protective equipment, symptom screening, visitor restrictions, hand hygiene and droplet/contact precautions, and resident cohorting. Prevalence rates ranged from 1.2% to 85.4% in residents and 0.6% to 62.6% in staff. Mortality rates ranged from 5.3% to 55.3% in residents. Conclusions Novel evidence in this review details the impact of facility size, availability of staff and practices of operating between multiple facilities, and for-profit status of facilities as factors contributing to the size and number of COVID-19 outbreaks. No causative relationships can be determined; however, this review provides evidence of interventions that reduce transmission of COVID-19 in LTCF. PROSPERO registration number CRD42020191569.

Nutrition education programmes for athletes aim to enhance nutrition knowledge and more importantly support positive dietary change to enhance performance, health and well-being. This systematic review assessed changes in the dietary intakes of athletes in response to nutrition education programmes. A search was conducted which included studies providing quantitative dietary intake assessment of athletes of any calibre aged between 12 and 65 years in response to a nutrition education programme. Standardised differences (effect sizes) were calculated (when possible) for each dietary parameter. The search yielded 6285 papers with twenty-two studies (974 participants (71·9 % female)) eligible for inclusion. Studies described athletes competing at high school (n3) through to college level or higher (n19). Study designs were either single arm with an intervention-only group (twelve studies;n241) or double arm including an intervention and control group (ten studies;n689). No control groups received an alternative or ‘sham’ intervention. Face-to-face lectures (9/22) and individual nutrition counselling (6/22) were the most common education interventions. Non-weighed, 3-d diet records (10/22) were the most frequently utilised dietary assessment method. Although 14/22 studies (n5 single andn9 double) reported significant change in at least one nutrition parameter, dietary changes were inconsistent. Poor study quality and heterogeneity of methods prohibit firm conclusions regarding overall intervention success or superior types of educational modalities. Of note, carbohydrate intakes ‘post-intervention’ when assessed often failed to meet recommended guidelines (12/17 studies). Given the substantial investment made in nutrition education interventions with athletes, there is a need for well-designed and rigorous research to inform future best practice.

This study aimed to describe the body composition and physiological changes which take place during the in‐season and recovery periods of a group of natural bodybuilders. Natural male bodybuilders (n = 9) were assessed 16 (PRE16), 8 (PRE8), and 1 (PRE1) week(s) before, and 4 (POST4) weeks after a bodybuilding competition. Assessments included body composition, resting metabolic rate (RMR), serum hormones, and 7‐day weighed food and training diaries. Change in parameters was assessed using repeated‐measures analysis of variance. Dietary protein intake remained high throughout the study period (2.8–3.1 g kg⁻¹ d⁻¹). Fat mass (FM) was significantly reduced from PRE16 to PRE1 (8.8 ± 3.1 vs. 5.3 ± 2.4 kg, P < .01). There was a small decrease in lean mass (LM) from PRE8 to PRE1 (71.8 ± 9.1 vs. 70.9 ± 9.1 kg, P < .05). No changes in RMR were observed (P > .05). Large reductions in total and free testosterone (16.4 ± 4.4 vs. 10.1 ± 3.6 nmol L⁻¹, P < .05; 229.3 ± 72.4 vs. 116.8 ± 76.9 pmol L⁻¹, P < .05), and insulin‐like growth factor‐1 (IGF‐1) (27.0 ± 7.7 vs. 19.9 ± 7.6 nmol L⁻¹, P < .05) occurred between PRE16 and PRE1. LM and IGF‐1 increased from PRE1 to POST4 (70.9 ± 9.1 vs. 72.5 ± 8.5 kg, P < .05; 19.9 ± 7.6 vs. 25.4 ± 9.3 nmol L⁻¹, P < .05). Despite substantial reductions in FM, participants maintained almost all of their LM. The reduction in anabolic hormone concentration is likely attributable to the prolonged negative energy balance, despite a high dietary protein intake.