Dietary influences on cardiovascular disease risk in anabolic steroid-using and nonusing bodybuilders.

Abstract

Recent studies have described an association between high-risk lipoprotein profiles and anabolic steroid abuse by athletes. However, none have included a comprehensive evaluation of diet as a confounding variable. The risk of cardiovascular disease (CVD) and its associations with drug abuse, dietary patterns, and training regimens were evaluated in 18 steroid-using (SU) and 17 non-steroid-using (NSU; no history of drug use or greater than or equal to 1 year drug-free) male bodybuilders. CVD risk was also evaluated in 10 control males. Fasting serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL) and HDL subfractions 2 and 3, low-density (LDL) and very-low-density (VLDL) lipoprotein cholesterol, apoproteins (APO) A-1 and B, and triglycerides (TG) were analyzed at baseline (greater than or equal to 6 months drug-free) and the peak of steroid self-administration in SU. NSU were tested at similar times. Baseline CVD risk factor ratios (TC/HDL) were elevated (greater than 4.97) in 44% of SU and 24% of NSU. When baseline LDL and HDL values were compared to National Cholesterol Education Program CVD risk guidelines, these percentages stayed the same. At the peak of steroid administration significant changes were observed in LDL (22% increase), HDL (63% decrease), HDL-2 (86% decrease), HDL-3 (54% decrease), and TC/HDL (85% increase). No similar measures were observed among NSU or controls. Diets of all bodybuilders were similar, and included a daily intake of 5739 (+/- 2500) kcal, 324 (+/- 163) g protein, 637 (+/- 259) g carbohydrate, 214 (+/- 109) g fat, 5 (+/- 8) g alcohol, 1413 (+/- 1151) mg cholesterol, and a P/S ratio of 0.6 (+/- 0.3). Significant relationships between dietary fats and serum lipids were observed in the NSU. Polyunsaturated fatty acids were correlated with TG and VLDL (r = 0.69; p = 0.01), and TC/HDL (r = 0.06; p = 0.04). Total fats were correlated with TG (r = 0.57; p = 0.05), HDL-3 (r = -0.62; p = 0.04), and VLDL (r = 0.57; p = 0.05), and saturated fats with HDL-3 (r = -0.59; p = 0.055). Diet was moderately associated with lipoproteins in SU, but steroids had a much greater influence on CVD risk. Despite disease promoting diets NSU had relatively average CVD risk that may be attributed to protective effects of rigorous training.

Serum Lipoprotein Patterns in Long-Term Anabolic Steroid Users

“…Lipoprotein data from the present study show reduced levels ofHDL-C and cholesterol/HDL-C ratio that substantiate previous reports (Baldo-Enzi & Stolley, 1979;Frolich, Kullmer, Urhausen, Bergmann, & Kindermann, 1989;Kleiner et al, 1989;Lenders et al, 1988;Webb et al, 1984). These significant alterations in the lipid profile were maintained even after at least 8 weeks of abstinence.…”

“…In addition, Kleiner, Calabrese, Fielder, Naito, and Skibinski (1989) showed significant differences in lipoprotein and apolipoprotein values when comparing nonusers to users who had abstained from steroid use for at least 6 months. The average duration of prior steroid use in this group was 3 years.…”

Anabolic steroid abuse and toxicology

“…The lipid changes are independent of diet. 49 In a six week comparison between stanozolol and testosterone oenanthate, depressions of HDL(C) and LDL(C) were greater with stanozolol than testosterone oenanthate. The reason for this difference is not clear.5o…”

Recent Developments in the Toxicology of Anabolic Steroids

“…Kleiner et al (1989) studied 35 bodybuilders, of whom 18 used anabolic steroids and 17 were controls. Energy consumption varied between 2451 and 19 760 cal daily and no specific dietary influence on lipid patterns emerged in either group or between groups.…”