Social conditions such as poverty, social isolation and inability to get or prepare preferred foods can cause unintentional weight loss, and this may be particularly common in older people.[42] Nutrient intake can also be affected by culture, family and belief systems.[27] Ill-fitting dentures and other dental or oral health problems can also affect adequacy of nutrition.[27]

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.

Site enhancement oil, often called "santol" or "synthol" (no relation to the Synthol mouthwash brand), refers to oils injected into muscles to increase the size or change the shape. Some bodybuilders, particularly at the professional level, inject their muscles with such mixtures to mimic the appearance of developed muscle where it may otherwise be disproportionate or lacking.[55] This is known as "fluffing".[56][57] Synthol is 85% oil, 7.5% lidocaine, and 7.5% alcohol.[56] It is not restricted, and many brands are available on the Internet.[58] The use of injected oil to enhance muscle appearance is common among bodybuilders,[59][60] despite the fact that synthol can cause pulmonary embolisms, nerve damage, infections, sclerosing lipogranuloma,[61] stroke,[56] and the formation of oil-filled granulomas, cysts or ulcers in the muscle.[60][62][63] Rare cases might require surgical intervention to avoid further damage to the muscle and/or to prevent loss of life.[64]

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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]
Weight training aims to build muscle by prompting two different types of hypertrophy: sarcoplasmic and myofibrillar. Sarcoplasmic hypertrophy leads to larger muscles and so is favored by bodybuilders more than myofibrillar hypertrophy, which builds athletic strength. Sarcoplasmic hypertrophy is triggered by increasing repetitions, whereas myofibrillar hypertrophy is triggered by lifting heavier weight.[23] In either case, there is an increase in both size and strength of the muscles (compared to what happens if that same individual does not lift weights at all), however, the emphasis is different.

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]


In competitive bodybuilding, bodybuilders aspire to develop and maintain an aesthetically pleasing body and balanced physique.[16][17] In prejudging, competitors do a series of mandatory poses: the front lat spread, rear lat spread, front double biceps, back double biceps, side chest, side triceps, Most Muscular (men only), abdominals and thighs. Each competitor also performs a personal choreographed routine to display their physique. A posedown is usually held at the end of a posing round, while judges are finishing their scoring. Bodybuilders usually spend a lot of time practising their posing in front of mirrors or under the guidance of their coach.
In the 1970s, bodybuilding had major publicity thanks to the appearance of Arnold Schwarzenegger, Franco Columbu, Lou Ferrigno, and others in the 1977 docudrama Pumping Iron. By this time, the IFBB dominated the competitive bodybuilding landscape and the Amateur Athletic Union (AAU) took a back seat. The National Physique Committee (NPC) was formed in 1981 by Jim Manion,[7] who had just stepped down as chairman of the AAU Physique Committee. The NPC has gone on to become the most successful bodybuilding organization in America and is the amateur division of the IFBB. The late 1980s and early 1990s saw the decline of AAU-sponsored bodybuilding contests. In 1999, the AAU voted to discontinue its bodybuilding events.
In the UK, up to 5% of the general population is underweight, but more than 10% of those with lung or gastrointestinal diseases and who have recently had surgery.[29] According to data in the UK using the Malnutrition Universal Screening Tool ('MUST'), which incorporates unintentional weight loss, more than 10% of the population over the age of 65 is at risk of malnutrition.[29] A high proportion (10–60%) of hospital patients are also at risk, along with a similar proportion in care homes.[29]
^ Mangano, Kelsey M.; Sahni, Shivani; Kiel, Douglas P.; Tucker, Katherine L.; Dufour, Alyssa B.; Hannan, Marian T. (February 8, 2017). "Dietary protein is associated with musculoskeletal health independently of dietary pattern: the Framingham Third Generation Study". The American Journal of Clinical Nutrition. 105 (3): 714–722. doi:10.3945/ajcn.116.136762. PMC 5320406. PMID 28179224 – via ajcn.nutrition.org.
^ Mangano, Kelsey M.; Sahni, Shivani; Kiel, Douglas P.; Tucker, Katherine L.; Dufour, Alyssa B.; Hannan, Marian T. (February 8, 2017). "Dietary protein is associated with musculoskeletal health independently of dietary pattern: the Framingham Third Generation Study". The American Journal of Clinical Nutrition. 105 (3): 714–722. doi:10.3945/ajcn.116.136762. PMC 5320406. PMID 28179224 – via ajcn.nutrition.org.
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. https://www.facebook.com/Business-Insights-Health-Fitness-2340476989604625/
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