Original Research

Alterations in Body Composition, Resting Metabolic

Rate, Muscular Strength, and Eating Behavior in
Response to Natural Bodybuilding Competition
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Preparation: A Case Study

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Brad J. Schoenfeld,1 Andrew Alto,1 Jozo Grgic,2 Grant Tinsley,3 Cody T. Haun,4 Bill I. Campbell,5
Guillermo Escalante,6 Gul T. Sonmez,1 Gilda Cote,1 Aston Francis,1 and Eric T. Trexler7
1
Department of Health Sciences, CUNY Lehman College, Bronx, New York; 2Institute for Health and Sport (IHES), Victoria University,
Melbourne, Australia; 3Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas; 4Fitomics LLC,
Birmingham, Alabama; 5Exercise Science Program, University of South Florida, Tampa, Florida; 6California State University, San
Bernardino, San Bernardino, California; and 7Trexler Fitness LLC, Raleigh, North Carolina

Abstract
Schoenfeld, BJ, Alto, A, Grgic, J, Tinsley, G, Haun, CT, Campbell, BI, Escalante, G, Sonmez, GT, Cote, G, Francis, A, and Trexler,
ET. Alterations in body composition, resting metabolic rate, muscular strength, and eating behavior in response to natural body-
building competition preparation: A case study. J Strength Cond Res 34(11): 3124–3138, 2020—We carried out a prospective case
study in a high-level amateur natural male bodybuilder throughout preparation for 4 competitions and during the ensuing post-
contest recovery period. Laboratory testing was conducted monthly over a 1-year period, which included the following assess-
ments: B-mode ultrasound evaluation of muscle thickness (MT), multifrequency bioelectrical impedance analysis, blood pressure
and heart rate assessment, resting metabolic rate via indirect calorimetry, skinfold testing, vertical jump height, isometric lower-
body strength testing, and a 3-factor eating questionnaire. Blood work (including testosterone, thyroid hormone, sex hormone
binding globulin, glomerular filtration rate, blood urea nitrogen, aspartate aminotransferase, alanine aminotransferase, white blood
count, albumin to globulin ratio, and lipoprotein A) was obtained separately from an outside laboratory at 4 time points. We also
assessed the effectiveness of a carbohydrate (carb) deplete and carb load peaking strategy employed immediately before com-
petition. The subject employed a high-volume, high-frequency, whole-body training program throughout the study period. Average
daily nutritional intakes ranged from 1,953 to 3,415 kcal: 104–386 g carb; 253–263 g protein, and; 57–95 g lipid. Body fat was
reduced to very low levels (;5%) immediately before competition, but this corresponded with a loss of lean mass. Alterations in
metabolism, hormonal status, explosive strength, and psychological aspects of eating were observed during precontest prepa-
ration; however, all of these variables recovered quickly postcompetition. The implementation of a carb depleteand carb load
peaking strategy acutely increased MT and thus may be a viable precontest approach to maximize muscular aesthetics.
Key Words: physique competition, contest preparation, drug-free bodybuilding

Introduction effects of their efforts. However, the strategies employed by as-

piring competitors are varied, and the morphological, neuro-
Bodybuilding is a sport in which competitors are judged based on
muscular, physiological, and psychological responses to these
physique aesthetics. Criteria for judging include muscle size,
practices remain largely unexplored.
shape, symmetry, and definition, with the latter predicated on
Preparation for bodybuilding competition often leads to dele-
possessing very low levels of body fat. Although the use of ana-
terious modifications in postcontest physiological responses. In
bolic agents is rampant in many men’s bodybuilding competitions
particular, the combination of energy restriction and weight loss
(16,48), various organizations sanction contests in which rigor-
results in a phenomenon called adaptive thermogenesis, associ-
ous drug testing is employed to help safeguard that competitors
ated with a decline in both resting and nonresting energy expen-
are “natural.”
diture over and above what would be expected from the loss of
As a general rule, the precompetition period involves altering
body mass alone (31). Alterations in endocrine function and
training and nutritional practices to reduce body fat to low single-
perceptions of satiety also accompany these events (45), seem-
digit levels while simultaneously maintaining as much muscle
ingly as a survival-related defense mechanism. Conceivably, the
mass as possible. To determine areas for future research and de-
extremely low levels of body fat achieved by bodybuilders during
velop evidence-based guidelines on the topic, it is important to
contest preparation would exacerbate such effects, although the
acquire an understanding of how natural male bodybuilders go
literature is relatively scant on the topic. Moreover, the recovery
about accomplishing this complex task and the corresponding
from these anomalies following bodybuilding competition has
Address correspondence to Brad J. Schoenfeld, bradschoenfeldphd@gmail.com. not been well-characterized. In addition, alterations in
Journal of Strength and Conditioning Research 34(11)/3124–3138 performance-related variables may have implications into the
ª 2020 National Strength and Conditioning Association capacity to generate high levels of mechanical tension during

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 Natural Bodybuilding Competition Preparation (2020) 34:11
training, which has been proposed as a crucial factor in hyper-
trophic intracellular signaling (49).
Several case studies have sought to elucidate training and nu-
tritional approaches of male bodybuilders during the pre- and
postcompetition period, as well as the associated acute and
chronic responses to these regimens (23,33,37,38). However,
given the wide diversity of approaches, there is a need for addi-
tional reports to better comprehend the nuances of the topic.
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Moreover, the aforementioned studies have not assessed data
relevant to various outcomes of interest, including site-specific
measures of muscle growth, explosive strength, and the effects of
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dietary manipulation on the psychometrics of eating behavior; the
acquisition of which can help to shed further insight on pre-
competition responses. Importantly, no previously published case
study has endeavored to investigate the effect of “peaking”
strategies widely used by bodybuilders; specifically, carbohydrate
(carb) depletion and loading schemes intended to promote acute
muscle swelling immediately before competition. The purpose of
this prospective case study was to investigate the effects of pre-
and postcompetition training and nutritional practices in an ex-
perienced male bodybuilder on markers of body composition,
resting metabolic rate (RMR), muscular strength, resting hor-
mones, eating behavior, and peaking strategies while competing
in multiple contests over a 1-year period.
Methods
Experimental Approach to the Problem
Testing sessions were conducted on a monthly basis with assess-
ments carried out at approximately the same time of day (;10
AM). For each visit, the subject reported to the laboratory after an
overnight ($8-hour) food and fluid fast, and abstained from ex-
ercise for at least 48 hours before testing. Additional visits were
conducted within the week before a specific competition day to
assess the effects of peaking strategies. The subject performed the
following assessments in this exact order: B-mode ultrasound
evaluation of muscle thickness (MT), multifrequency bioelectrical
impedance analysis (MF-BIA), blood pressure (BP) and heart rate
(HR) assessment, RMR via indirect calorimetry, skinfold testing,
vertical jump height, isometric lower-body strength testing, and a
3-factor eating questionnaire. Immediately after testing for body
composition and RMR, the subject was allowed a 15-minute
break with ad libitum access to food and water as desired.
Subjects
This was a case study of a 25-year-old white amateur male body-
builder who had been weight training for approximately 10 years.
The investigation was conducted over an 8-month precompetition
period (April 2019 to November 2019) leading up to competition in
4 national-level bodybuilding contests and then followed up over a
4-month postcompetition period (December 2019 to March 2020).
Approval for the study was obtained from the college Institutional
Review Board at Lehman College, Bronx, NY. Written informed
consent was obtained from the subject before beginning the study.
Procedures
Dietary Intake and Supplementation. The subject was asked to
maintain daily logs documenting energy and macronutrient intake,
as well as dietary supplementation. The subject entered all food
intake into an Excel spreadsheet. Descriptive statistics were calcu-
lated to summarize dietary habits throughout the study period.
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Training Program. The subject was asked to maintain daily logs
documenting his resistance and aerobic training regimens. De-
scriptive statistics were calculated to summarize training practices
throughout the study period.
Body Composition and Anthropometry. Subject’ height was
measured using a Detecto Physician Scale (Cardinal Scale
Manufacturing Company, Webb City, MO). Assessment of fat
mass, fat-free mass (FFM), segmental body mass, and body water
content was carried out using an InBody 770 MF-BIA unit (Bio-
space Co. Ltd., Seoul, Korea) according to the manufacturer’s
instructions. The subject was asked to void immediately before
the test. Before each measurement, the subject’s palms and soles
were cleaned with an electrolyte tissue. The subject then stood on
the MF-BIA unit, placing the soles of his feet on the electrodes.
The instrument derived the subject’s body mass, and his age and
sex were manually entered into the display by the researcher. The
subject then grasped the handles of the unit ensuring that the palm
and fingers of each hand made direct contact with the electrodes,
and extended and abducted his arms approximately 20°. Analysis
of body composition was determined by the unit with the subject
remaining as motionless as possible.
Skinfold measurements were obtained by a trained researcher
on the right side of the body with the subject standing using the 7-
site formula as per Jackson et al. (20). The following 7 anatomical
sites were measured using a calibrated Lange caliper: chest,
midaxillary, triceps, subscapular, abdomen, suprailiac, and thigh.
Measurements were made in duplicate at each site and recorded
to the nearest 0.5 mm; if values differed by more than 2 mm, a
third measurement was obtained and the 2 closest readings av-
eraged to arrive at a final value. The Siri 2-compartment equation
was then used to estimate body composition (41).
Resting Energy Expenditure and Cardiovascular Assessments.
The subject was instructed to rest quietly for 5 minutes and then
had his HR and BP measured manually by a trained researcher.
These measures were done in triplicate, with the final value cal-
culated as the average of the 3 obtained readings. Heart rate was
obtained by palpating for the radial artery at the wrist, and beats
per minute were derived from 30 seconds of sampling (beats per
30 seconds 3 2 5 beats per minute). Blood pressure was mea-
sured via standard auscultation on the left arm with the stetho-
scope placed proximal to the brachial artery.
After completion of cardiovascular assessments, the subject
rested quietly for 5 minutes and then underwent testing for RMR
using a Cosmed FitMate (Cosmed, Rome, Italy), which has been
shown to have a very high correlation with the gold-standard
Douglas bag measurement (r 5 0.97) for the calculation of RMR
(32) and has been validated for this purpose in a population of
muscular physique athletes (43). The subject wore a facemask
attached to a turbine flow meter to allow sampling of expired air.
The assessment of RMR lasted 15 minutes, with the unit self-
calibrating immediately before the assessment and at the 5- and
10-minute intervals. The subject was instructed to relax, breathe
normally, and remain motionless throughout the duration of the
test. We discarded the data acquired during the first 5 minutes of
the test and used the final 10 minutes of data to obtain the final
RMR value (6). Temperature and lighting were controlled from
session to session to ensure consistency.
Muscle Thickness. Ultrasound imaging was used to obtain mea-
surements of MT. The reliability and validity of ultrasound in
determining MT has been reported to be very high when
 Natural Bodybuilding Competition Preparation (2020) 34:11
compared with the “gold standard” magnetic resonance imaging
(35). A trained ultrasound technician performed all testing using a
B-mode ultrasound imaging unit (Model E1; SonoScape, Co.,
Ltd, Shenzhen, China). The technician applied a water-soluble
transmission gel (Aquasonic 100 Ultrasound Transmission gel;
Parker Laboratories, Inc., Fairfield, NJ) to each measurement site,
and a 5-MHz ultrasound probe was placed perpendicular to the
tissue interface without depressing the skin. When the quality of
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the image was deemed satisfactory, the technician saved the image
to a hard drive and obtained MT dimensions by measuring the
distance from the subcutaneous adipose tissue-muscle interface to
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the muscle-bone interface. Measurements were taken on the right
side of the body at 4 sites: (a) elbow flexors, (b) elbow extensors,
(c) midthigh (a composite of the rectus femoris and vastus inter-
medius), and (d) lateral thigh (a composite of the vastus lateralis
and vastus intermedius). For the anterior and posterior upper
arm, measurements were obtained 60% distal between the lateral
epicondyle of the humerus and the acromion process of the
scapula; mid- and lateral anterior thigh measurements were
obtained 50% between the lateral condyle of the femur and
greater trochanter of the quadriceps femoris. To further ensure
the accuracy of measurements, 3 images were obtained for each
site and then averaged to obtain a final value. Values of all 4 sites
were combined to achieve a measure of total MT; values for the
elbow flexors and elbow extensors were combined to achieve a
measure of upper arm MT; values for the mid- and lateral thigh
were combined to achieve a measure of quadriceps MT.
On one occasion during a peaking week, ultrasound testing
was performed immediately following a 3-day carb depletion
phase and then 2 days after a carb loading phase. For testing of the
carb loading phase, ultrasound measures were obtained in the
fasted state and then approximately 1-hour after consuming a
carb-rich meal (Figure 1).
Isometric Muscle Strength. The strength assessment was carried
out using isometric dynamometry testing (Biodex System 4; Bio-
dex Medical Systems, Inc., Shirley, NY). After familiarization
with the dynamometer and protocol, the subject was seated in the
chair and performed unilateral isometric actions of the knee ex-
tensors on his dominant limb.
During each trial, the subject sat with his back flush against the
seat back pad and maintained a hip joint angle of 85° with the
center of his lateral femoral condyle aligned with the axis of ro-
tation of the dynamometer. The dynamometer arm length was
adjusted to allow the shin pad to be secured with straps proximal
to the medial malleoli. The subject was strapped in across the
Figure 1. Timeline for data collection during the peaking phase. CHO 5
carbohydrate.
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ipsilateral thigh, hips, and torso to help prevent extraneous
movement during performance and was instructed to hold onto
handles for greater stability. Testing was carried out at a knee
joint angle of 70° (24).
Each maximum voluntary contraction trial lasted 5 seconds,
followed by 30-second rest, for a total of 4 trials. The subject
was verbally encouraged to produce maximal force through-
out each bout. The highest peak net extension moment from
the 4 trials was used for analysis. Percent changes in strength
were examined over time relative to baseline and month 8
when the final competition occurred. Simple linear regression
was completed with time in months on the x-axis and strength
in Newton meters on the y-axis to examine changes over time
and to elucidate trends in the changes in strength per month
relative to baseline and month 8. The slope coefficient (b) from
this analysis was interpreted as change per month, and the R2
value as the coefficient of determination for these changes over
time.
Vertical Jump Height Assessment. A vertical jump test was used to
assess jump height, a proxy measurement for explosive strength
(25). The subject was instructed on proper performance of the
countermovement jump. Performance was carried out as follows:
the subject began by assuming a shoulder-width stance with the
body upright and arms at sides. When ready for the movement, he
descended into a semisquat position and then forcefully reversed
direction, jumping as high as possible before landing with both
feet on the ground.
Assessment of jump performance was carried out using a Just
Jump mat (Probotics, Huntsville, AL), which was attached to a
handheld computer that records flight time and thereby ascertains
the jump height. The subject stood on the mat and performed 3
maximal-effort countermovement jumps with a 1-minute rest
period between each trial. The highest jump was recorded as the
final value. Percent changes in jump height were examined over
time relative to baseline and month 8 when the final competition
occurred.
Blood Biomarkers. Blood work regarding the subject’s bodily
protein (PRO), mineral, and hormonal status was collected by an
independent physician and subsequently analyzed by an outside
laboratory (LabCorp, Burlington, NC). The collections occurred
at 4 time points: Baseline (T0), immediately before competition
(TPre), 30-day postcompetition (T30), and 90-day post-
competition (T90). The biomarkers assessed included glucose
(Glu), glomerular filtration rate (GFR), lipoprotein A (LipA),
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total testosterone (TT), serum sex hormone–binding globulin

(SHBG), triiodothyronine (T3), thyroxine (T4), thyroid-
stimulating hormone (TSH), aspartate aminotransferase (AST),
alanine aminotransferase (ALT), blood urea nitrogen (BUN),
white blood cell count (WBC), and albumin to globulin ratio
(AGR). The subject provided the complete results of the blood
work to the researchers once available.
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Three-Factor Eating Questionnaire. The 3-Factor Eating Ques-

tionnaire Revised 18-item version was completed at each assess-
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ment. This survey assesses 3 different components of eating

behavior: restrained eating, uncontrolled eating, and emotional
eating. As per Tinsley et al. (42), raw scores were converted to a
0–100 scale to account for the varied number of items for each of
the components of eating behavior.

Statistical Analyses
For isometric strength, simple linear regression was completed
with time in months on the x-axis and strength in Newton meters
on the y-axis to examine changes over time and to elucidate trends
in the changes in strength per month relative to baseline and
month 8. The slope coefficient (b) from this analysis was inter-
preted as change per month, and the R2 value as the coefficient of
determination for these changes over time. Similarly, jump height
was assessed by simple linear regression using the same formula
with time in months on the x-axis and jump height (in inches) on
the y-axis to examine changes over time and to elucidate trends in
the changes in jump height per month relative to baseline and
month 8. These analyses were performed in a Google Sheet
(Google, LLC, Mountain View, CA). Exploratory Kendall’s rank
correlation analyses were carried out via R version 3.5.1 (The R
Foundation for Statistical Computing, Vienna, Austria) to ex-
plore the correlation between FFM (measured via MF-BIA) and
performance outcomes. The remaining outcomes were assessed
by visual inspection of data and using basic mathematical
formulas.
Results
The subject competed in a total of 4 drug-tested bodybuilding
contests during the study period, with all events taking place in
months 7 and 8. In these 4 contests, he placed second in 3 of them
and third in the other. Months 1–6 were spent in precompetition
preparation; months 9–12 focused on postcompetition recovery.
The following represents his response and adaptations across the
1-year time. Figure 2 displays a photograph of the subject taken
on the morning of one of his contests.
Training Program
A summary of the resistance training program performed by the
athlete is provided in Table 1. We had a full training diary for
months from April 2019 to February 2020. For March 2019 and
March 2020, we only had data on 10 and 2 exercise sessions,
respectively. In the months with full available data, the number of
performed training sessions per month ranged from 18 to 26. The
number of sessions performed per month was kept consistent
throughout the analyzed period, with no considerable variation
from one month to another. Of the 255 recorded training ses-
sions, 25 were reported to be “deload” sessions, with the majority
of them (10 sessions) performed in April of 2019.
Figure 2. Competition photograph of the subject.
Weekly training frequency ranged from 3 to 7 days per week; a
training frequency of 5–6 times per week was used for the ma-
jority of weeks. The athlete generally trained using whole-body
training routines (all/most of the major muscle groups trained in
the same session). During deload training sessions, the number of
muscle groups trained was reduced (for example, only legs and
shoulders). In the months leading up to the competition (i.e., from
July to November), none of the training sessions were considered
as deload sessions.
The median number of exercises performed per session ranged
from 6 (recorded in April of 2019) to 16 (recorded in February of
2020). In most months, the median number of exercises per-
formed per session ranged from 10 to 14, and this was consistent
throughout the analyzed period. The number of exercises per-
formed per muscle group per session is summarized in Table 1.
Generally, large muscle groups such as legs, back, and chest were
trained with the most exercises per session. Muscle groups such as
shoulders, arms, and abdominals were generally trained with
fewer exercises per session (in most cases, 2–3 exercises per
muscle group, per session). A combination of multijoint and
single-joint exercises was constantly used in training.
Working sets were generally carried out to repetitions in re-
serve (RIR) 1, RIR 2, or RIR 3. In general, when the athlete was
training with RIR 1, the number of exercises per session was
lower. When the number of exercises was higher, sets were gen-
erally carried out to RIR 3. During the deload sessions, sets were
carried out to RIR 4.
Even though the number of sets per exercise ranged from 1 to
10 sets, in the majority of exercises, the number of sets ranged
from 3 to 4. The athlete trained using a wide repetition range,
namely, from 3 to 30 repetitions per exercise. In the majority of
exercises, repetitions ranged from 6 to 15; a very high number of
repetitions was generally performed only for single-joint exer-
cises, whereas a lower number of repetitions was generally per-
formed for multijoint exercises. This was kept consistent
throughout each phase.

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 Natural Bodybuilding Competition Preparation (2020) 34:11

Table 1
Summary of the training program.
No. of training sessions Weekly training No. of exercises No. of exercises per No. of sets Repetition
Month (no. of deload sessions) frequency per session body group per exercise range
March 2019* 10 (3) 4–6 6–16 (median: 14) Legs: 1–9 3–6 3–30
Chest: 0–2
Back: 0–4
Shoulders: 0–3
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Triceps: 0–2
Biceps: 0–2
Abs: 0–1
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April 2019 21 (10) 3–6 3–11 (median: 6) Legs: 0–6 1–6 6–25
Chest: 0–2
Back: 0–4
Shoulders: 0–3
Triceps: 0–2
Biceps: 0–2
Abs: 0–2
May 2019 26 (0) 4–6 7–15 (median: 11) Legs: 0–7 1–6 6–30
Chest: 0–3
Back: 0–6
Shoulders: 0–3
Triceps: 0–2
Biceps: 0–3
Abs: 0–2
June 2019 20 (4) 3–6 2–15 (median: 11) Legs: 0–8 1–6 6–25
Chest: 0–3
Back: 0–4
Shoulders: 0–3
Triceps: 0–3
Biceps: 0–2
Abs: 0–2
July 2019 23 (0) 5–6 7–16 (median: 12) Legs: 0–9 1–9 6–30
Chest: 0–3
Back: 0–5
Shoulders: 0–5
Triceps: 0–3
Biceps: 0–2
Abs: 0–3
August 2019 22 (0) 3–5 6–23 (median: 14) Legs: 1–10 1–7 6–25
Chest: 0–7
Back: 0–7
Shoulders: 0–5
Triceps: 0–2
Biceps: 0–4
Abs: 0–3
September 2019 22 (0) 6 9–20 (median: 14) Legs: 1–7 1–10 6–30
Chest: 0–4
Back: 0–4
Shoulders: 0–4
Triceps: 0–3
Biceps: 0–3
Abs: 0–1
October 2019 18 (0) 3–5 4–16 (median: 10) Legs: 0–7 1–10 8–30
Chest: 0–4
Back: 0–3
Shoulders: 0–3
Triceps: 0–3
Biceps: 0–2
Abs: 0–2
November 2019 20 (0) 3–7 5–18 (median: 10) Legs: 0–7 1–10 6–30
Chest: 0–5
Back: 0–4
Shoulders: 0–4
Triceps: 0–3
Biceps: 0–3
Abs: 0–1

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 Natural Bodybuilding Competition Preparation (2020) 34:11 | www.nsca.com

Table 1
Summary of the training program. (Continued)
No. of training sessions Weekly training No. of exercises No. of exercises per No. of sets Repetition
Month (no. of deload sessions) frequency per session body group per exercise range
December 2019 23 (2) 3–7 3–33 (median: 13) Legs: 0–13 1–10 6–30
Chest: 0–7
Back: 0–7
Shoulders: 0–4
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Triceps: 0–3
Biceps: 0–6
Abs: 0–1
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January 2020 25 (5) 4–6 9–16 (median: 13) Legs: 0–9 1–5 6–30
Chest: 0–4
Back: 0–5
Shoulders: 0–3
Triceps: 0–3
Biceps: 0–3
Abs: 0–1
February 2020 25 (1) 5–6 8–21 (median: 16) Legs: 0–8 2–6 3–30
Chest: 0–4
Back: 0–7
Shoulders: 0–3
Triceps: 0–3
Biceps: 0–3
Abs: 0–1
*Training diary started on March 21, 2019 and finished on March 4, 2020.

The subject aimed to perform 30 minutes of daily walks as his
main form of cardiovascular exercise. During peak weeks, the
duration of walking was altered to accommodate peaking strat-
egies as shown in Table 2.
Nutrition Program
Complete nutrition log data were available for 332 days of the
335-day observation period. The subject consumed 1–6 meals per
day, with a mean of 4.6 meals per day (median 5 5 meals per day).
The average PRO dose per meal was 60.8 g.
Over the first 2 weeks of the intervention, average daily intakes
were 2,986 kcal, 316 g carbohydrate (CHO), 301 g PRO, and 61
g fat. Based on an initial body mass of 99.5 kg, these equate to
30.0 kcal·kg21, 3.2 g·kg21 CHO, 3.0 g·kg21 PRO, and 0.6 g·kg21
fat. The lowest sustained energy intake, defined as the lowest
2-week rolling average for energy intake, began at day 178 of
observation. During this period, average daily intakes were
1,953 kcal, 104 g CHO, 253 g PRO, and 57 g fat. Based on the
laboratory body mass measurement taken in closest proximity to
these dates (92.1 kg), these equate to 21.2 kcal·kg21, 1.1 g·kg21
CHO, 2.7 g·kg21 PRO, and 0.6 g·kg21 fat.
The highest sustained energy intake, defined as the highest 2-
week rolling average for energy intake, began at day 228 of ob-
servation. During this period, which coincided with the days
immediately preceding and following the final competition of the
year, average daily intakes were 3,415 kcal, 386 g CHO, 263 g
PRO, and 95 g fat. Based on the laboratory body mass mea-
surement taken in closest proximity to these dates (89.2 kg), these
equate to 38.3 kcal·kg21, 4.3 g·kg21 CHO, 2.9 g·kg21 PRO, and
1.1 g·kg21 fat. Energy intake remained elevated following the
competitive season; for the final 2 weeks of the observation pe-
riod, average daily intakes were 2,963 kcal, 322 g CHO, 280 g
PRO, and 63 g fat. Based on the final body mass measurement
taken in the laboratory (97.9 kg), these equate to 30.3 kcal·kg21,
3.3 g·kg21 CHO, 2.9 g·kg21 PRO, and 0.6 g·kg21 fat. Complete
daily data for intakes of total energy, CHO, PRO, and fat are
presented in Figure 3.
To assess the effects of a CHO-loading protocol, assessments
were performed in a depleted state (day 206), then repeated fol-
lowing the loading protocol (day 208). The subject began a 3-day
depletion protocol on day 203, in which caloric intake was
dropped to 1,474–1,642 kcal per day (20–46 g CHO per day).
This was followed by a 2-day loading phase, in which caloric
intake was increased to 3,374–3,537 kcal per day, with the in-
crease in calories largely attributable to increases in CHO
(449–483 g CHO per day). Daily intakes of total kilocalories,
CHO, PRO, and fat during the depletion and loading protocol are
presented in Figure 4.
The subject reported maintaining consistent use of dietary
supplements throughout the entire observation period. Supple-
ments consumed included vitamin D (5,000 IU per day), a men’s
formula multivitamin including 600 mg of KSM-66 Ashwa-
gandha root extract (1 serving per day; TruMulti Men’s; PES-
cience, Largo, FL), fish oil (capsule form; 3 g per day, yielding 900
mg of omega-3 fatty acids; Costco Wholesale Corporation, Issa-
quah, WA), creatine anhydrous (capsule form; 3 g per day; Tru-
Creatine; PEScience), green tea extract (400 mg, yielding 200 mg
of epigallocatechin gallate per day; NOW FOODS, Bloo-
mingdale, IL), and 1.5 servings of a commercially available multi-
ingredient supplement before workouts (High Volume; PES-
cience). Notable ingredients in the pre-workout supplement in-
cluded L-citrulline (4,000 mg per serving), arginine nitrate (2,000
mg per serving), agmatine sulfate (1,000 mg per serving), and a
propriety blend including taurine, glycerol, and Ferula asafoetida
extract. The subject also reported consuming 2 very large cups of
coffee in the morning pretraining (;4–5 AM), 2 sugar-free energy
drinks during the day (Monster Zero; Monster Energy, Corona,
CA), and occasional caffeine-containing diet sodas. The estimated
total caffeine from these drinks amounted to approximately
500–1,000 mg per day. The subject discontinued consumption of
all caffeinated beverages during peak weeks.

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 Natural Bodybuilding Competition Preparation (2020) 34:11

Table 2 precontest/dieting phase, 46% was from the body fat compart-
Peak-week cardiovascular schedule (contest was held on the ment and 54% from the FFM compartment. During the 4-month
ensuing Saturday).*† postcompetition period, body mass increased by 8.7 kg from the
Peak-week 1 lowest body mass during the competition season (corresponding
Saturday 70 min to a gain of 9.7% of body mass). Of this gain, approximately 53%
Sunday 40 min was gained as fat mass and 47% was gained as FFM.
Monday 70 min Body composition assessment between the 2 methods, skin-
Tuesday 40 min folds and MF-BIA, were largely in agreement. Body fat levels were
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Wednesday 30 min both under 10% for the entirety of the 12-month intervention.
Thursday 15 min Also, trends of body fat change during the precontest or dieting
Friday Off phase (months 1–6), the competitive season (months 7–8), and
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Peak-week 2
postseason (months 9–12) were largely agreeable between
Saturday 75 min
methods. Table 3 summarizes the skinfold and MF-BIA month-
Sunday 75 min
Monday 75 min to-month body composition changes.
Tuesday 40 min Exploratory Kendall’s rank correlation analyses indicated that
Wednesday 30 min FFM (measured via MF-BIA) was positively associated with
Thursday 15 min vertical jump height (t 5 0.60; p 5 0.01) but negatively associ-
Friday Off ated with isometric strength (t 5 20.60; p 5 0.01). However,
Peak-week 3 these values should be interpreted with a great deal of caution
Saturday 75 min because these bivariate relationships are inherently confounded
Sunday 75 min by longitudinal changes in a wide range of training and nutrition
Monday 75 min
variables throughout the observation period.
Tuesday 75 min
Muscle thickness measurements remained relatively constant over
Wednesday Off
Thursday 10 min the first several months of precompetition preparation, and they even
Friday 20 min showed a modest increase over the first month (;3%) despite a loss
Peak-week 4 of body mass. Muscle thickness remained above baseline through
Saturday 90 min month 5 and then began to rapidly decline in month 6 (1 month
Sunday 90 min before the first competition), reaching its lowest level in month 8 (at
Monday 90 min the midpoint of the competitions) where values were ;7% below
Tuesday 30 min baseline. Measures of MT quickly recovered during the post-
Wednesday 30 min competition period. In the first month after competition (month 9),
Thursday 15 min
values were up approximately 3% from their nadir. By month 10,
Friday Off
MT values had essentially returned to baseline levels, despite a lower
*Third peak with our main carb up being Wednesday/Thursday. overall body mass compared with baseline (approximately 23 kg
†Sa-T: 75 minutes; W: 0 minutes; Th: 10 minutes; F: 20 minutes; October 26, 2019; Fourth peak; difference). Values increased modestly in month 11 (;2%) and then
Sa-M: 90 minutes; T: 30 minutes; W: 30 minutes; Th: 15 minutes; F: 0 minute.
regressed slightly in month 12, albeit remaining marginally higher
than at baseline. Figure 5 depicts MT changes across the study period.
Body Composition
With respect to the individual limb muscles, upper arm MT
Body mass declined by 10.3 kg from baseline to the competitive was modestly elevated at months 2–3 (;1–2%) and then grad-
season low. This was equivalent to a 10.4% loss of body mass ually declined from months 4–8, culminating in an approximately
during this period. Of the total body mass lost during the 6% loss; decreases were greater in the biceps compared with the

Figure 3. Complete daily data for intakes of total energy, carbohydrate (CHO), protein (PRO), and fat over the study period.

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Figure 4. Daily intakes of total kilocalories, carbohydrate (CHO), protein (PRO), and fat during the depletion and loading
protocol.

triceps. In the first month after competition (month 9), upper arm
MT increased by approximately 3%, reached baseline levels by
month 11 and modestly declined in month 12. The quadriceps
exhibited a similar increase in MT over the first month (;3%),
and these gains remained fairly well-preserved until month 5. By
month 6, MT of the quadriceps had returned to baseline and then
rapidly declined during months 7 and 8 (;9%), corresponding
with the dates of the contests. As with the upper arms, measures of
quadriceps MT quickly recovered during the postcompetition
period. In the first month after competition (month 9), quadriceps
MT increased by 4%, and by month 10, values were slightly
above baseline levels and further increased by 3–4% during
months 11 and 12.
lowest point corresponding to the onset of his first competition
and then trended upward during the postcompetition period.
The baseline RMR value of 2,214 kcal per day was maintained
within 25 kcal per day during the first 2 months of assessments.
During the following 2 evaluations, RMR was 85–90 kcal per day
below baseline. The RMR continued to decrease in magnitude until
low values of 1,804 and 1,770 kcal per day (i.e., 410–444 kcal per day
below baseline) were observed in months 7 and 8. Thereafter, RMR
began increasing toward the baseline value over the following 2
months, with RMR values of 175–212 kcal per day below baseline.
The final 2 RMR assessments, conducted in months 11 and 12, in-
dicated that RMR was higher than baseline by 173–186 kcal per day
(Figure 6).

Physiological Variables Performance Variables

The mean value for HR over the 12-month period was 54.2 6 5.2,
with a range of 46–64 b·min21. The mean value for systolic BP
was 108.9 6 6.8, and diastolic BP 69.5 6 7.7, with ranges of
98–118 and 58–80, respectively. Both resting HR and BP tended
to decrease as the subject got closer to competition, with the
From baseline to the month of the first competition (in month 7),
maximum isometric strength of the knee extensors increased by
48%, whereas maximum vertical jump height decreased by 17%.
Relative to baseline, strength was 26% higher in the month of the
second competition (in month 8) and maximum vertical jump

Table 3
Changes in body mass, body fat %, and FFM.*
Month Body mass (kg) Skinfold bodyfat % : MF-BIA bodyfat % : Skinfold FFM (kg) : MF-BIA FFM (kg) :
1 99.5 8.2 9.5 91.3 90.0
2 98.7 6.5 21.7 8.6 20.9 92.3 11.0 90.2 10.2
3 97.7 5.5 21.0 7.6 21.0 92.3 0 90.3 10.1
4 98 6.6 11.1 8.2 10.6 91.5 20.8 90.0 20.3
5 96.5 5.3 21.3 9.1 10.9 91.4 20.1 87.7 22.3
6 94.2 4.9 20.4 7.7 21.4 89.6 21.8 86.9 20.8
7† 92.1 4.4 20.5 8.3 10.6 88.0 21.6 84.5 22.4
8† 89.2 4.4 0 5.6 22.7 85.3 22.7 84.2 20.3
9 92.2 4.5 10.1 7.7 12.1 88.1 12.8 85.1 10.9
10 96.5 ‡ ‡ 9.2 11.5 ‡ ‡ 87.6 12.5
11 96.6 6.1 8.7 20.5 90.7 88.2 10.6
12 97.9 ‡ ‡ 9.8 11.1 ‡ ‡ 88.3 10.1
*FFA 5 fat-free mass; MF-BIA 5 multifrequency bioelectrical impedance analysis.
†Months 7–8 constituted the competitive season (included 4 competitions).
‡No skinfold data available for months 10 and 12.

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 Natural Bodybuilding Competition Preparation (2020) 34:11
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Figure 5. Muscle thickness changes over the study period.
height was 18% lower. By the end of the case study’s duration in
month 12, strength was 15% higher than baseline and maximum
vertical jump height was 4% lower than baseline. Based on the
slope coefficients from a simple linear regression analysis of
strength and jump height data from baseline to month 8 (when the
second competition occurred), maximum strength tended to in-
crease by 22 N·m each month (b 5 22.2, R2 5 0.41), whereas
jump height tended to decrease by 0.6 inches each month (b 5
20.61; R2 5 0.93). After the competitions, strength decreased by
9% from month 8 to month 12 and jump height increased by
18%. Based on simple linear regression, jump height tended to
increase by 1.4 inches per month from month 8–12 (b 5 1.4; R2 5
0.79) and strength tended to decrease by 15.7 N·m each month
from month 8–12 (b 5 15.7; R2 5 0.70).
Blood Biomarkers
The results for the blood biomarkers are presented as T0, TPre,
T30, and T90. Although the blood work collected included a
Figure 6. Resting metabolic rate (RMR) changes over the study period.
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comprehensive panel of tests (i.e., complete blood count, meta-
bolic panel, etc.), we opted to focus on the following biomarkers:
Glu, GFR, LipA, TT, SHBG, T3, T4, TSH, AST, ALT, BUN,
WBC, AGR. These biomarkers were chosen because they are the
most relevant for a dieting physique competitor, fell out of the
normal range at some point during the testing period, and are
frequently hypothesized by many to reflect impaired kidney or
liver function as a result of consuming a high PRO diet. All results
are presented in Table 4.
Eating Behavior
The score for cognitive restraint increased steadily from a score
of 61 at the initial assessment to a score of 89 at month 8.
During the following 2 months, cognitive restraint scores were
reduced sharply, demonstrating a low score of 22 in month 10
but then increased during the final 2 months. The final score of
56 was similar to the baseline value. The scores for un-
controlled eating followed a similar trajectory, with values
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Table 4
Blood biomarker results.*
Measure Reference range T0 TPre T30 T60
Glu (mg·dl21) 65–99 89 81 82 88
GFR (ml·min21·1.73 m22) .59 100 86 87 86
LipA (nmol·L21) ,75 73 68.7 66.8 75.0‡
TT (ng·dl21) 264–916 543 197† 595 702
SHBG (nmol·L21) 16.5–55.9 43.1 56.3‡ 42.5 46.1
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T3 (ng·ml21) 2.0–4.4 3.0 1.400† 2.700 3.300

T4 (ng·ml21) 0.82–1.77 1.010 0.930 0.910 1.160
TSH (mIU·ml21) 0.45–4.500 1.60 1.33 1.020 1.630
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AST (IU·L21) 0–40 73‡ 49‡ 49‡ 37

ALT (IU·L21) 0–44 47‡ 87‡ 68‡ 36
BUN (mg·dl21) 6–20 24‡ 23‡ 22‡ 17
WBC (1,000·ml21) 3.4–10.8 3.6 2.6‡ 3.4 4.0
AGR 1.2–2.2 1.8 2.3‡ 2.1 1.9
*T0 5 baseline; TPre 5 immediately before competition; T30 5 30 days after competition; T60 5 60 days after competition; Glu 5 glucose; GFR 5 glomerular filtration rate; LipA 5 lipoprotein A; TT 5 total
testosterone; SHBG 5 serum sex hormone–binding globulin; T3 5 triiodothyronine; T4 5 thyroxine; TSH 5 thyroid-stimulating hormone; AST 5 aspartate aminotransferase; ALT 5 alanine aminotransferase;
BUN 5 blood urea nitrogen; WBC 5 white blood cell count; AGR 5 albumin to globulin ratio.
†Value below reference range.
‡Value above reference range.

increasing from the baseline score of 15 to a peak value of 56 at
month 8. Thereafter, scores dropped transiently to baseline
levels but remained higher than baseline at the final 2 assess-
ments with scores of 30–37.
Peaking Strategies
Immediately before competition, the subject engaged in a peaking
strategy that involved a 3-day carb deplete phase whereby CHO
intake was reduced to ,50 g per day and then dramatically in-
creased carbs to .450 g per day. The effects of this strategy
showed an appreciable effect on MT, with an increase of ap-
proximately 5% in the arm muscles and approximately 2% in the
quadriceps when measured in the fasted state after 2 days of carb
loading. Reassessment of MT 1-hour later following a carb-rich
meal (;50 g) did not show additional effects on MT in any of the
muscles studied.
Discussion
We prospectively followed a young, male bodybuilder through-
out his precompetition and early postcompetition periods over a
12-month timeframe. Our findings produced several novel and
notable insights into the practices and responses observed during
this process. We will discuss each of the studied outcomes below.
The training program used by the subject was characterized by
very high training frequency and training volume. Specifically, the
subject generally trained using whole-body training routines and
a training frequency of 5–6 times per week, at least for most
weeks. This approach is in contrast to the findings from a survey
of 127 competitive male bodybuilders. In the aforementioned
survey, all of the bodybuilders reported using split-training rou-
tines (16). Furthermore, this approach is not in line with the re-
sults from a recent meta-analysis that showed that training
frequency is likely not a major determinant of resistance training
increases in muscle size (39). However, it should be noted a large
majority of competitive male bodybuilders included in the survey
by Hackett et al. reported using steroids (i.e., they were not
“natural”), and none of the studies included in the meta-analysis
on training frequency were conducted among competitive
bodybuilders.
Besides training frequency, volume was also very high. The
median number of exercises in most weeks ranged from 10 to 14,
and the number of sets in the majority of exercises was from 3 to 4
sets. The high training volume routines adopted by the subject is in
accordance with the current scientific evidence because training
volume is identified as a major determinant of muscle hypertrophy
(12), although the overall magnitude of weekly volume was above
that generally prescribed in the literature for natural bodybuilding
competitors (18). Competitive bodybuilders also report training
with 3–6 sets per exercise (16). Interestingly—and likely because of
the high-volume routines—sets were generally not performed to the
point of momentary muscular failure. Instead of training to failure,
an RIR approach was used (51), whereby sets were generally per-
formed for an RIR of 1–3. Per set repetition range was from 3 to 30,
even though in the majority of exercise sets, the repetition range
was from 6 to 15. This is similar to the repetition range used by
competitive male bodybuilders; 77% of 127 bodybuilders that who
included in the previously mentioned survey, reported using repe-
tition ranges from 7 to 12. The training program used by the athlete
was fairly consistent throughout the whole year.
It should be noted that controlled research on the topics of
volume and frequency has generally been carried out during pe-
riods of caloric maintenance or surplus. It thus remains unclear
how these variables may affect the maintenance or development
of FFM during periods of chronic negative energy balance. This is
an important potential area for future research to fill gaps in the
current literature.
Previous nutritional recommendations for physique athletes
(36) advise bodybuilders to consume 1.8–2.7 g·kg21·d21 of PRO
or up to 3.5 g·kg21·d21 for bodybuilders aiming to mitigate
hunger. The recommendations also suggest that dietary fat should
contribute 10–25% of caloric intake and that athletes should aim
to consume enough carb to sufficiently optimize training perfor-
mance (preferably in the 2–5 g·kg21·d21 range), while acknowl-
edging that carb must sometimes be sacrificed to achieve the
desired level of leanness. Although the guidelines highlight the
lack of conclusive evidence tying specific meal frequency strate-
gies to meaningful body composition enhancements, they rec-
ommend a moderate approach to meal frequency and provide
example PRO distribution strategies for scenarios with both 4
meals per day and 5 meals per day (36).

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 Natural Bodybuilding Competition Preparation (2020) 34:11
The subject’s dietary strategies were largely congruent with
these guidelines. For example, mean and median meal frequency
values suggest that the subject typically consumed 4–5 meals per
day. When reviewing macronutrient values for the first 2 weeks,
final 2 weeks, highest sustained intakes, and lowest sustained
intakes, fat intake ranged from 18 to 26% of energy intake.
During the same time frames, PRO intake ranged from 2.7 to
3.0 g·kg21·d21; carb intake generally ranged from 3.2 to
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4.3 g·kg21·d21 but dropped to 1.1 g·kg21·d21 during the most
restrictive phase of the diet.
During the preparation phase, a number of transient in-
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creases in caloric intake were observed, largely because of in-
creases in carb. These transient increases occurred
approximately once per week and are in line with previous
research documenting regular “refeeds” used by competitive
bodybuilders (29). Refeeds fall under the umbrella of nonlinear
fat loss strategies (36) in which caloric intake is cyclically in-
creased, typically via increases in carb, in hopes of transiently
replenishing glycogen stores, increasing leptin levels, allowing
for more dietary flexibility, and mitigating the effects of met-
abolic adaptation to weight loss (45). Byrne et al. (4) reported
that oscillating between 2-week dieting phases (in an energy
deficit) and 2-week maintenance phases (in energy balance)
enhanced fat loss outcomes in men with obesity and also
appeared to attenuate the adaptive reduction of resting energy
expenditure induced by weight loss. More recently, Campbell
et al. (5) found that weekly, 2-day refeeds resulted in slightly
more favorable retention of FFM and RMR during weight loss
in resistance-trained individuals. Although the single-day
refeeds in the current study were likely sufficient for enhanc-
ing glycogen replenishment and dietary flexibility, our findings
did not show complete mitigation of unfavorable changes re-
lated to metabolic rate or body composition because detri-
mental effects were seen in both outcomes over the
precompetition period. That said, it is not clear whether the
strategy may have prevented these negative effects from being
even greater.
The subject used several dietary supplements that are
commonly ingested by competitive physique athletes, in-
cluding creatine, multivitamins, vitamin D, omega-3 fatty
acids, green tea extract, and multi-ingredient preworkout
supplements (8). As noted by recent nutritional guidelines for
physique athletes (36), creatine and a variety of nitric oxide
precursors, including L -citrulline (47), are potentially advis-
able supplementation strategies for bodybuilders. In addition,
multivitamin supplementation might be warranted, particu-
larly when the diet becomes more restrictive and achieving
sufficient micronutrient intakes becomes comparatively more
challenging (36). The same justification would logically ex-
tend to supplementation with fish oil or other sources of
omega-3 fatty acids, and potentially to vitamin D, particu-
larly when exposure to sunlight is limited or the individual
lives at high latitude. Notably, vitamin D has been shown to
enhance strength performance (44), particularly in individ-
uals with low baseline vitamin D levels. Although green tea
extract is often consumed as a fat loss supplement, there is
currently insufficient evidence to suggest that it imparts
practically meaningful fat loss benefits (21). In addition, the
subject’s multivitamin formula also contained ashwagandha
extract; although there is some evidence suggesting that ash-
wagandha supplementation can favorably affect body com-
position and strength (50), its independent effects cannot be
conclusively evaluated within the current case study, and
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there is not yet a large enough body of evidence to draw firm
conclusions regarding its efficacy for these outcomes.
The desired goal during the precompetition period is to reduce
body fat to extremely low levels while maintaining muscle mass.
The subject was successful in achieving this objective over the first
several months of precompetition preparation. Measures of MT
and lean mass modestly increased over the first 3 months, in-
dicating that body recomposition occurred in a highly trained
individual despite carrying single-digit body fat levels. However,
MT and lean mass ultimately declined thereafter, which coincided
with a marked reduction in caloric intake and body mass;
neither intense regular RT, consumption of a high-PRO diet
(.2.5 g·kg21·d21), or structured dietary refeeds were able to offset
these losses. Thus, it can be inferred that these anabolic strategies
were insufficient to overcome the highly catabolic effects of per-
sistent low energy intake combined with single-digit body fat levels
in this natural bodybuilder. Once energy consumption was sub-
stantially increased following competition, both MT and lean mass
rapidly increased, indicating an anabolic supercompensation me-
diated by a restoration of caloric consumption.
Assessment of lean mass changes in natural male bodybuilders
over the course of competition preparation is limited in the lit-
erature. Somewhat consistent with our findings, Rossow et al.
(38) reported a lean mass loss of approximately 4% over a 6-
month precompetition period in a 26-year-old natural male
bodybuilder with a baseline body mass of 88 kg; the competitor
regained the majority of his lean mass within 2 months after
contest, but it then fluctuated downward in the ensuing 4 months
of recovery. Robinson et al. (37) also demonstrated similar re-
sults, reporting an approximately 6% reduction in lean mass as
measured by skinfolds in a 21-year-old amateur competitor with
a baseline body mass of 86 kg. It should be noted that the period
of study in Robinson et al. (37) was just 14 weeks, but given that
the subject in our study achieved the majority of his losses across
the 3 months before competition, the timing was relatively similar
between studies.
Regarding body weight and body fat changes, our observations
are similar to other published case studies in male bodybuilders
undergoing contest preparation. We observed a loss of 10.3 kg of
absolute body mass, whereas others have reported body mass
reductions ranging from 9.1 to 15.3 kg body weight
(23,33,37,38) during contest preparation. Similarities are also
observed when equating the percentage of body weight loss rel-
ative to baseline weight. The current case study subject reduced
body weight by 10.4%, and others have reported reductions
ranging from 10.7 to 13.6% (33,37,38).
A striking area of difference when comparing the subject in the
present case study with other similar case study reports was the
initial body fat percentage starting point. Our subject was very
lean before initiating his contest preparation phase, with a body
fat percentage of approximately 9%. In contrast, Pardue et al.
(33) reported an initial body fat of 13.8%, Rossow et al. (38)
reported an initial body fat of 14.8%, and Kistler et al. (23)
reported a relatively high body fat level of 17.5%. Although there
was a clear diversity of body fat percentage ranges among these
male bodybuilders as they initiated their dieting phases or contest
preparation, body fat percentages ultimately were very homoge-
nous by the time each competitor achieved their competition-level
physique, with values ranging from 4.4 to 7.4%. Given the very
low body fat levels from which our subject started his dieting
phase, it would not be surprising to observe large losses of FFM in
an attempt to achieve even lower body fat levels. This was not the
case, however. Of the total reduction in body mass that was
 Natural Bodybuilding Competition Preparation (2020) 34:11
achieved during the contest preparation phase, approximately
half was from FFM stores with the other half from fat mass.
The subject’s maximum isometric strength increased from
baseline to month 8—when the final competitions occurred—
despite significant reductions in body mass. Although increases in
strength during periods of significant weight loss may seem un-
likely, others have reported increases in strength during weight
loss interventions that include resistance exercise (13,27). For
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example, Garthe et al. (13) reported significant increases in 1
repetition maximum (1RM) strength in multiple exercises in
resistance-trained subjects who completed a short-term weight
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loss intervention involving a rate of weight loss similar to the rate
experienced by the subject in this case study. Longland et al. (27)
also reported significant increases in leg press and bench press
1RM in previously untrained subjects after 4 weeks of substantial
calorie restriction combined with resistance training that also
coincided with significant reductions in body mass. In the study
from Longland et al. (27), subjects who consumed relatively
higher PRO intakes (2.4 vs. 1.2 g·kg21·d21) lost significantly
more body fat and gained significantly more lean body mass.
Considering these findings, the combination of regular resistance
exercise and relatively high PRO consumption by the subject in
this case study likely explains the improvement in strength, at
least in part. However, it stands to reason that the observed in-
crease in strength could also be explained by the subject im-
proving in the test itself given its monthly frequency. Intriguingly,
isometric strength decreased by approximately 9% in the months
following competition. Although the reasons for this drop off
remain undetermined, it may be explained at least, in part, by the
subject reaching an overtrained state after a grueling precontest
preparatory period. Overtraining is known to bring about per-
formance decrements, and a general loss of motivation to com-
pete (26). Because maximal isometric contractions require a high
motivation to produce force, overtraining conceivably could have
negatively influenced results. Future case studies should endeavor
to directly measure potential markers of overtraining to better
understand the postcompetition response during natural body-
building contest preparation.
Although maximum isometric strength of the knee extensors
increased during the precompetition period, maximum vertical
jump height decreased by 17% relative to baseline. One potential
explanation of this observation could be related to a lack of the
inclusion of jumping exercises during training sessions based on
the subject’s training log. That is, the subject’s training involved
more similar, nonballistic exercises to the strength test, whereas
ballistic and plyometric exercises appeared to be absent in the
subject’s training. Additionally, select evidence suggests that
performance attributes supportive of maintaining or improving
maximum vertical jump height (e.g., maximum rate of force de-
velopment) are more sensitive to fatigue than maximum isometric
strength (19). Although the exact reasons this trend was observed
are unclear, it seems plausible that a lack of regular jumping in
training and cumulative fatigue from dieting and relatively high-
volume resistance training resulted in decrements in jump height
over time.
The pattern of RMR changes observed in the present in-
vestigation is consistent with prior research in physique athletes,
although a limited number of prior investigations have reported
RMR changes throughout a recovery period. The relative mag-
nitudes of RMR reduction and recovery in the present in-
vestigation are very similar to the changes observed in our
previous report of an experienced female figure athlete (42). In
that investigation, the lowest RMR value was 17% below
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| www.nsca.com
baseline and occurred between 2 competitions. At the end of the
recovery period, the final RMR value was 7% above the baseline
value. In the present investigation, the lowest RMR value was
20% below baseline, with the final RMR value in the recovery
phase approximately 8% greater than the baseline value. Other
data have also indicated a complete recovery of RMR in physique
athletes during the 4-to-6 weeks following competition (46).
Taken together, these limited data indicate the presence of large
but transient reductions in RMR during contest preparation with
the potential for recovery of RMR, or even elevation beyond
baseline values, when energy intake is restored in the post-
competition months.
The subject implemented a peak week strategy, which is
common among bodybuilders (7). Manipulation of carb intake
and sodium-potassium balance are among the most common
dietary fluctuations during peak week. Carbohydrate manipula-
tion strategies typically involve consuming very low amounts of
carbs for several days in an attempt to deplete muscle glycogen
stores and then consuming high amounts of carbs for several days
to allow for glycogen supercompensation. Given that each gram
of glycogen attracts approximately 3–4 g of water (40), this ap-
proach theoretically maximizes muscle size while pulling sub-
cutaneous water into the muscle, thereby achieving the full,
defined appearance coveted by bodybuilders.
Although fat, PRO, and sodium intake remained relatively
stable, carb intake was significantly restricted for 3 days, and
potassium intake also fell abruptly. In the days following this
depletion phase, carb intake was drastically increased, along with
a more subtle increase in fat intake, and restoration of potassium
intake to typical levels. Our results suggest that the subject suc-
cessfully manipulated intramuscular glycogen storage, increasing
MT of the extremities by 2–5% after a 2-day carb loading phase
(.450 g per day) following 3 days of carb depletion (,50 g
per day).
Previously, Bamman et al. (3) charted body composition
changes in 6 male bodybuilders who employed carb loading 72
hours before competition. Ultrasonographic analysis assessed
24–48 hours precompetition revealed an approximately 5%
increase in biceps brachii MT when compared with values
observed 6 weeks prior. Given the large gap between testing
sessions, it therefore cannot be determined whether the results
were to the result of carb loading or other training or nutrition
factors employed during the intervening testing period. Our
study lends support to the hypothesis that the findings by
Bamman et al. (3) were in fact at least in part resultant to the
peaking strategy. Recently, de Moraes et al. (9) tracked nu-
tritional peaking during the week before competition in 24
bodybuilders. Results showed that competitors who practiced
carb loading displayed an approximately 3% increase in upper
arm thickness compared with no change in those who did not
employ the peaking strategy. It should be noted that subjects in
the study by de Moraes et al. (9) did not compete in drug-tested
competitions; thus, it is unclear how the use of anabolic agents
may have affected results. Furthermore, although de Moraes
et al. reported that the process of precompetition carb de-
pletion and loading was found to increase both objective and
subjective measures of muscularity (9), gastrointestinal side
effects were observed. Overall, it would appear that several
days of carb depletion followed by a brief carb loading period
is a viable strategy to enhance body aesthetics immediately
before physique competition. Competitors implementing such
strategies should tailor their approach to minimize the likeli-
hood of inducing gastrointestinal discomfort.
 Natural Bodybuilding Competition Preparation (2020) 34:11
Contest preparation typically requires a prolonged caloric
deficit to induce losses in fat mass, but the energy restriction
combined with low levels of body fat result in decreased levels of
TT and thyroid hormones, such as T3, T4, and TSH
(11,28,30,38). In this investigation, TT and T3 dropped between
baseline and immediately before competition from 543 to
197 ng·dl21 for TT and from 3.0 to 1.4 ng·ml21 for T3; this is
similar to previous investigations on natural male bodybuilders
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undergoing contest preparation (28,30,38). Although both TT
and T3 levels dropped below the normal reference range imme-
diately before the competition, they returned to baseline values
CX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8KKGKV0Ymy+78= on 11/03/2023
(or higher) within 30 days after the competition and remained
within the normal range 90 days after competition. Seemingly,
this can be largely explained by the increased calorie intake that
occurred after the competition.
Serum sex hormone–binding globulin, which has not been
previously reported in male bodybuilders undergoing contest
preparation to the authors’ knowledge, increased slightly
above the normal reference range to 56.3 nmol·L21 immedi-
ately before competition. High levels of SHBG indicate that
there is likely less free testosterone available to the tissues be-
cause more testosterone is bound to SHBG. High levels of
SBHG combined with low TT levels likely indicate that there is
minimal free testosterone available, which may in turn impede
muscle growth and workout recovery (15). Appropriate peri-
workout nutrition may become more important closer to
competition because it may prove to mitigate losses in FFM
and help enhance workout recovery when less free testosterone
is available to the tissues.
A comprehensive metabolic panel consists of a panel of blood
tests that serve as a baseline medical screening tool to provide an
overview of liver function, kidney function, electrolyte and fluid
balance, and diabetic and parathyroid status. Levels of GFR,
BUN, AST, and ALT are part of this comprehensive metabolic
panel and were reported in this investigation. Specifically,
GFR levels remained within the normal reference range
(.59 ml.min21·1.73 m22) at each time point; however, BUN,
AST, and ALT levels were elevated at T0 (BUN 5 24 mg·dl21,
AST 5 73 IU·L21, ALT 5 47 IU·L21), TPre (BUN 5 23 mg·dl21,
AST 5 49 IU·L21, ALT 5 87 IU·L21), and T30 (BUN 5
22 mg·dl21, AST 5 49 IU·L21, ALT 5 68 IU·L21) and returned to
the normal reference range at T90 (BUN 5 17 mg·dl21, AST 5
37 IU·L21, ALT 5 36 IU·L21). Although these values may seem
alarming, they should be interpreted with caution in asymptom-
atic individuals because abnormally high values for BUN, AST,
ALT, and creatinine have been reported among athletes who
frequently exercise strenuously and are not necessarily indicative
of abnormal kidney or liver function (1,14,34); in fact, the in-
tensity and duration of the exercise and the amount of time
elapsed between the exercise and laboratory testing may influence
the level of abnormality reported on these tests (34). Furthermore,
because GFR levels remained relatively stable and within the
normal reference range for all periods, there were no signs that the
subject’s renal function were compromised over the 12-month
period despite his high daily PRO intake ($2.7 g·kg21·d21); this
is in contrast to some literature that states that a high PRO diet
(defined as .1.2 g·kg21·d21) may induce significant changes in
renal health and function (22).
The Glu, T4, and TSH levels reported in the results did not
fluctuate substantially during the contest preparation phase or the
recovery phase. Furthermore, none of these biomarkers were out
of the normal reference range at any point in time. Similarly, none
of the blood biomarkers collected (data not reported herein) from
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Copyright © 2020 National Strength and Conditioning Association. Unauthorized reproduction of this article is prohibited.
the complete blood count, metabolic panel, and hemoglobin A1c
tests fluctuated substantially enough to fall out of the normal
reference range at any point in time.
Other blood biomarkers that were out of the normal reference
range for a given period were WBC, AGR, and LipA. Specifically,
WBC levels were suppressed (WBC 5 2.6 1,000·ml21), and AGR
was elevated (AGR 5 2.3) at TPre and LipA was elevated (LipA 5
75 nmol·L21) at T90. The low WBC levels immediately before the
competition are likely related to the fat loss (10) and high volume
and intensity of training (2) required to be successful in the sport
of bodybuilding. Albumin to globulin ratio can increase if the
levels of albumin increase, the levels of globulin decrease, or both
occur simultaneously. In the case of this subject, both albumin
and globulin levels remained within the normal reference range,
but the albumin levels rose toward the higher end of normal to 4.9
g·dl21 whereas the globulin levels simultaneously dropped to-
ward the lower end of normal to 2.1 g·dl21 at TPre; this produced
the AGR of 2.3, which was slightly above the normal reference
range of 1.2–2.2. Because an elevated AGR ratio can be linked to
low thyroid activity, this is likely the case becauseT3 levels were
also suppressed at TPre. Finally, LipA levels were within the
normal reference range between T0 and T30 but rose to 75
nmol·L21 at T90 (this is the low-end threshold of the abnormal
range for LipA levels). Because LipA levels have been reported to
increase with a higher fat intake (17), it is possible that the sub-
jects’ consumption of a higher amount of dietary fat after com-
petition may have contributed to the finding.
To our knowledge, only one previous investigation has used the
3-factor eating questionnaire in a female physique athlete (42). In
this prior work, cognitive restraint increased during the early
phases of the contest preparation period, with scores remaining
above baseline throughout the remainder of the assessments, in-
cluding the recovery period. In contrast, while the physique athlete
in the present study also demonstrated an increase in cognitive
restraint during the preparation period, this was followed by a
precipitous drop following competition. Scores remained below
baseline for the final 4 assessments, although the score at the final
assessment approached the baseline value (56 vs. 61 at baseline). In
terms of uncontrollable eating, the prior case study indicated that
the lowest value was observed 3 days before the competitor’s first
competition, with elevated values after the first competition and
during the recovery period following the second competition (42).
In contrast, the present subject reported increasing uncontrollable
eating scores during the contest preparation period, with the
highest value observed between his second and third competitions
(month 8). Thereafter, uncontrollable eating scores decreased
slightly but remained at or above the baseline value for the re-
mainder of assessments. Although it is virtually certain that sub-
stantial individual differences are present for these questionnaire-
based assessments, it is also possible that sex-based differences
could occur. However, conclusions cannot presently be drawn on
this point because of the availability of only 2 case studies in-
vestigating the use of this eating questionnaire in physique athletes.
This study provides detailed assessments of changes in body
composition, RMR, muscular strength, hormonal markers, and
eating behavior in response to natural bodybuilding competition
preparation in a high-level amateur natural male bodybuilder
using a case study approach. Studies such as this are important
given the limited access to natural bodybuilders, as well as the
relatively finite nature of the population. Thus, they allow us to
understand what this population of athletes is doing in practice,
thereby providing insights for future controlled research. That
said, there are some inherent limitations of case studies to
 Natural Bodybuilding Competition Preparation (2020) 34:11
consider. The main limitation of this type of research that it has
limited external validity (i.e., lack of generalization of results to
the broader population). Additionally, the nutrition and training
approach of the subject analyzed in this particular study might
not necessarily represent the approach used by other athletes
(i.e., the individual might be atypical of the larger population).
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Practical Applications
The present case study provides comprehensive insights into
CX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8KKGKV0Ymy+78= on 11/03/2023
the morphological, neuromuscular, physiological, and psy-
chological responses to natural bodybuilding contest prepa-
ration in a young male competitor. We show that although
body recomposition can be achieved in the early phases of the
precontest process, ultimately lean mass is sacrificed as the
competitor decreases energy intake and reduces body fat to
very low levels; the combination of a high PRO intake, dietary
refeeds, and intense resistance training was unable to preserve
lean tissue during this period. Nutritional and body compo-
sition changes were accompanied by marked alterations in
hormone levels, metabolism, explosive strength, and psycho-
logical views toward eating; however, all of these variables
recovered quickly postcompetition. The implementation of a
carb deplete and carb load peaking strategy was successful in
acutely enhancing muscle size and thus represents a poten-
tially beneficial precontest approach. These findings, when
put into context with an emerging body of research into the
practices of competitive natural bodybuilders, can help prac-
titioners refine prescription of precontest training and nutri-
tional programs to optimize results while minimizing
deleterious side effects.
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