Case Study: The Effect of 32 Weeks of Figure-Contest Preparation on a Self-Proclaimed Drug-Free Female’s Lean Body and Bone Mass

Abstract

To achieve the criterion appearance before competing in a physique competition, athletes undergo preparatory regimens involving high-volume intense resistance and aerobic exercise with hypocaloric energy intake. As the popularity of "drug-free" competition increases, more athletes are facing this challenge without the recuperative advantage provided by performance-enhancing drugs. Consequently, the likelihood of loss of lean body and/or bone mass is increased. The purpose of this investigation was to monitor changes in body composition for a 29-year-old self-proclaimed drug-free female figure competitor during a 32-week preparatory regimen comprising high-volume resistance and aerobic exercise with hypocaloric energy intake. We used dual-energy x-ray absorptiometry (DXA) to evaluate regional fat and bone mineral density. During the initial 22 weeks, the subject reduced energy intake and engaged in resistance (4-5 sessions/week) and aerobic (3 sessions/week) training. During the final 10 weeks, the subject increased exercise frequency to 6 (resistance) and 4 (aerobic) sessions/week while ingesting 1130-1380 kcal/day. During this 10-week period, she consumed a high quantity of protein (~55% of energy intake) and nutritional supplements. During the 32 weeks, body mass and fat mass decreased by 12% and 55%, respectively. Conversely, lean body mass increased by 1.5%, an amount that exceeded the coefficient of variation associated with DXA-derived measurement. Total bone mineral density was unchanged throughout. In summary, in preparation for a figure competition, a self-proclaimed drug-free female achieved the low body-fat percentage required for success in competition without losing lean mass or bone density by following a 32-week preparatory exercise and nutritional regimen.

Physical health and symptoms of relative energy deficiency in female fitness athletes

“…3,[11][12][13] These athletes keep track of their total energy and macronutrient intake, eat fibrous foods, follow a high-protein diet, and diet for several weeks to allow for a slow rate of BW loss. 3,[11][12][13][14][15][16][17] The athletes also prepare meals for several days ahead, eat frequently during the day, and make sure to adjust meal intake according to the exercise sessions. [12][13][14][15] Additionally, they emphasize resistance exercise, [13][14][15][16][17] which specifically may be favorable in reducing the detrimental effect of dieting and low BW on lean body mass and BMD.…”

“…3,[11][12][13][14][15][16][17] The athletes also prepare meals for several days ahead, eat frequently during the day, and make sure to adjust meal intake according to the exercise sessions. [12][13][14][15] Additionally, they emphasize resistance exercise, [13][14][15][16][17] which specifically may be favorable in reducing the detrimental effect of dieting and low BW on lean body mass and BMD. 5,[13][14][15][16][17][18][19] However, FA are understudied with regard to physical and mental health variables, like the ones identified as symptoms of RED-s. 1,3,7 Previous studies of athletes in bodybuilding sports reveal issues with binge eating, and report on a high prevalence of previous eating disorders, specifically among females.…”

“…[12][13][14][15] Additionally, they emphasize resistance exercise, [13][14][15][16][17] which specifically may be favorable in reducing the detrimental effect of dieting and low BW on lean body mass and BMD. 5,[13][14][15][16][17][18][19] However, FA are understudied with regard to physical and mental health variables, like the ones identified as symptoms of RED-s. 1,3,7 Previous studies of athletes in bodybuilding sports reveal issues with binge eating, and report on a high prevalence of previous eating disorders, specifically among females. 3 Recent findings in groups of fitness athletes are indications of a continued, strict dieting behavior beyond the competitive season, not to enhance performance, but to comply with the modern lean and fit body ideal.…”

“…3,4 Hence, there are reasons for concern for the health of these athletes. At the time, only four case studies [14][15][16][17] and four cohort publications [18][19][20][21] report on health outcomes in females related to dieting for fitness sport participation. Among the publications with post-competition measures, 14,17,20,21 changes in BW and composition were reported to be temporary, with return to or above baseline 14,17,20 or normal, healthy levels 21 within 1-4 months post-dieting.…”

“…Among the publications with post-competition measures, 14,17,20,21 changes in BW and composition were reported to be temporary, with return to or above baseline 14,17,20 or normal, healthy levels 21 within 1-4 months post-dieting. Unfortunately, shortages in these studies are either lack of reports on BMD, 14,16,17,21 lack of psychometric outcomes, 14,15,21 lack of post-competition measures, 15,16 or lack of comparisons to a healthy reference group not participating in this sport. [14][15][16][17]20,21 Furthermore, site-specific BMD, such as spine BMD and proximal femur BMD, is more prone to the negative effect from low BW or dieting, while total BMD is less likely to reflect early changes.…”