Do bodybuilders use evidence-based nutrition strategies to manipulate physique?

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

Life course outcomes and developmental pathways for children and young people with harmful sexual behaviour

Most outcome studies for children and young people who have displayed harmful sexual behaviour have focused on sexual recidivism as their primary outcome measure. Relatively little is known about broader life outcomes for children displaying such behaviours, nor about the processes involved with longer-term developmental success or failure. This paper examines long-term life course outcomes for 69 adults in the UK who presented with abusive sexual behaviour as children. Between 10 and 20 years after their childhood sexual behaviour problems, few in the sample had sexually reoffended, but general life course outcomes were much less positive. A range of individual, relational and social/environmental factors appeared to be associated with successful and unsuccessful outcomes. Successful outcomes were associated with stable partner relationships, wider supportive relationships, and educational opportunity and achievement. The findings highlight the importance of broad-based, developmental interventions in assisting those with childhood sexual behaviour problems to live successfully

Exploring potential for occupational therapy practice models within areas of social deprivation: a qualitative inquiry within a community-centred food cooperative

Background A health inequalities gap exists between wealthy and deprived areas. Community-level occupation-focused interventions may support citizens and address inequities within their environments. Since the global financial crash of 2008 and fiscal policy changes within the United Kingdom, there has been a rise in food insecurity. Community volunteer initiatives have responded by providing for their residents. The aim of this study was to explore how occupational therapists may be agents for social change through exploring perspectives of members and volunteers from a community food cooperative in an area of social deprivation. Methods Eight semi-structured interviews were conducted with cooperative members and volunteers within a food cooperative established to address food insecurity in a local community. Data were analysed using thematic analysis. Results We found three main themes: It’s Not a Foodbank, Shared Hardship and a cross-cutting theme of Community. The results suggest occupation-focused responses can support the development of community and collective occupations thereby contributing solutions to shared problems. Conclusion A community-centred, rights-based approach has supported local community need where socio-economic disadvantage and health inequalities were identified. Scope exists for occupational therapists to work genuinely with (not for) communities to address occupational injustice through collective occupation

Intersection of diet and exercise with the gut microbiome and circulating metabolites in male bodybuilders : A pilot study

Diet, exercise and the gut microbiome are all factors recognised to be significant contributors to cardiometabolic health. However, diet and exercise interventions to modify the gut microbiota to improve health are limited by poor understanding of the interactions between them. In this pilot study, we explored diet–exercise–microbiome dynamics in bodybuilders as they represent a distinctive group that typically employ well-defined dietary strategies and exercise regimes to alter their body composition. We performed longitudinal characterisation of diet, exercise, the faecal microbial community composition and serum metabolites in five bodybuilders during competition preparation and post-competition. All participants reduced fat mass while conserving lean mass during competition preparation, corresponding with dietary energy intake and exercise load, respectively. There was individual variability in food choices that aligned to individualised gut microbial community compositions throughout the study. However, there was a common shift from a high protein, low carbohydrate diet during pre-competition to a more macronutrient-balanced diet post-competition, which was associated with similar changes in the gut microbial diversity across participants. The circulating metabolite profiles also reflected individuality, but a subset of metabolites relating to lipid metabolism distinguished between pre- and post-competition. Changes in the gut microbiome and circulating metabolome were distinct for each individual, but showed common patterns. We conclude that further longitudinal studies will have greater potential than cross-sectional studies in informing personalisation of diet and exercise regimes to enhance exercise outcomes and improve health

Pharmacological, psychological, and non-invasive brain stimulation interventions for treating depression after stroke

Background Depression is an important morbidity associated with stroke that impacts on recovery yet often undetected or inadequately treated. This is an update and expansion of a Cochrane Review first published in 2004 and updated in 2008. Objectives Primary objective • To determine whether pharmacological therapy, non‐invasive brain stimulation, psychological therapy, or combinations of these interventions reduce the prevalence of diagnosable depression after stroke Secondary objectives • To determine whether pharmacological therapy, non‐invasive brain stimulation, psychological therapy, or combinations of these interventions reduce levels of depressive symptoms, improve physical and neurological function and health‐related quality of life, and reduce dependency after stroke • To assess the safety of and adherence to such treatments Search methods We searched the Specialised Registers of Cochrane Stroke and Cochrane Depression Anxiety and Neurosis (last searched August 2018), the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 1), in the Cochrane Library, MEDLINE (1966 to August 2018), Embase (1980 to August 2018), the Cumulative Index to Nursing and Alllied Health Literature (CINAHL) (1982 to August 2018), PsycINFO (1967 to August 2018), and Web of Science (2002 to August 2018). We also searched reference lists, clinical trial registers (World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) to August 2018; ClinicalTrials.gov to August 2018), and conference proceedings, and we contacted study authors. Selection criteria Randomised controlled trials comparing (1) pharmacological interventions with placebo; (2) one of various forms of non‐invasive brain stimulation with sham stimulation or usual care; (3) one of various forms of psychological therapy with usual care and/or attention control; (4) pharmacological intervention and various forms of psychological therapy with pharmacological intervention and usual care and/or attention control; (5) non‐invasive brain stimulation and pharmacological intervention with pharmacological intervention and sham stimulation or usual care; (6) pharmacological intervention and one of various forms of psychological therapy with placebo and psychological therapy; (7) pharmacological intervention and non‐invasive brain stimulation with placebo plus non‐invasive brain stimulation; (8) non‐invasive brain stimulation and one of various forms of psychological therapy versus non‐invasive brain stimulation plus usual care and/or attention control; and (9) non‐invasive brain stimulation and one of various forms of psychological therapy versus sham brain stimulation or usual care plus psychological therapy, with the intention of treating depression after stroke. Data collection and analysis Two review authors independently selected studies, assessed risk of bias, and extracted data from all included studies. We calculated mean difference (MD) or standardised mean difference (SMD) for continuous data, and risk ratio (RR) for dichotomous data, with 95% confidence intervals (CIs). We assessed heterogeneity using the I² statistic and certainty of the evidence according to GRADE. Main results We included 49 trials (56 comparisons) with 3342 participants. Data were available for: (1) pharmacological interventions with placebo (with 20 pharmacological comparisons); (2) one of various forms of non‐invasive brain stimulation with sham stimulation or usual care (with eight non‐invasive brain stimulation comparisons); (3) one of various forms of psychological therapy with usual care and/or attention control (with 16 psychological therapy comparisons); (4) pharmacological intervention and various forms of psychological therapy with pharmacological intervention and usual care and/or attention control (with two comparisons); and (5) non‐invasive brain stimulation and pharmacological intervention with pharmacological intervention and sham stimulation or usual care (with 10 comparisons). We found no trials for the following comparisons: (6) pharmacological intervention and various forms of psychological therapy interventions versus placebo and psychological therapy; (7) pharmacological intervention and non‐invasive brain stimulation versus placebo plus non‐invasive brain stimulation; (8) non‐invasive brain stimulation and one of various forms of psychological therapy versus non‐invasive brain stimulation plus usual care and/or attention control; and (9) non‐invasive brain stimulation and one of various forms of psychological therapy versus sham brain stimulation or usual care plus psychological therapy. Treatment effects observed: very low‐certainty evidence from eight trials suggests that pharmacological interventions decreased the number of people meeting study criteria for depression (RR 0.70, 95% CI 0.55 to 0.88; 1025 participants) at end of treatment, and very low‐certainty evidence from six trials suggests that pharmacological interventions decreased the number of people with less than 50% reduction in depression scale scores at end of treatment (RR 0.47, 95% CI 0.32 to 0.69; 511 participants) compared to placebo. No trials of non‐invasive brain stimulation reported on meeting study criteria for depression at end of treatment. Only one trial of non‐invasive brain stimulation reported on the outcome <50% reduction in depression scale scores; thus, we were unable to perform a meta‐analysis for this outcome. Very low‐certainty evidence from six trials suggests that psychological therapy decreased the number of people meeting the study criteria for depression at end of treatment (RR 0.77, 95% CI 0.62 to 0.95; 521 participants) compared to usual care/attention control. No trials of combination therapies reported on the number of people meeting the study criteria for depression at end of treatment. Only one trial of combination (non‐invasive brain stimulation and pharmacological intervention) therapy reported <50% reduction in depression scale scores at end of treatment. Thus, we were unable to perform a meta‐analysis for this outcome. Five trials reported adverse events related to the central nervous system (CNS) and noted significant harm in the pharmacological interventions group (RR 1.55, 95% CI 1.12 to 2.15; 488 participants; very low‐certainty evidence). Four trials found significant gastrointestinal adverse events in the pharmacological interventions group (RR 1.62, 95% CI 1.19 to 2.19; 473 participants; very low‐certainty evidence) compared to the placebo group. No significant deaths or adverse events were found in the psychological therapy group compared to the usual care/attention control group. Non‐invasive brain stimulation interventions and combination therapies resulted in no deaths. Authors' conclusions Very low‐certainty evidence suggests that pharmacological or psychological therapies can reduce the prevalence of depression. This very low‐certainty evidence suggests that pharmacological therapy, psychological therapy, non‐invasive brain stimulation, and combined interventions can reduce depressive symptoms. Pharmacological intervention was associated with adverse events related to the CNS and the gastrointestinal tract. More research is required before recommendations can be made about the routine use of such treatments

Effect of Training Phase on Physical and Physiological Parameters of Male Powerlifters

Longitudinal research on training and dietary practices of natural powerlifters is limited. This study investigated the effect of phases of training on physical and physiological parameters in male natural powerlifters. Nine participants completed testing at two time points: (i) preparatory phase (~3 months prior to a major competition) and (ii) competition phase (1–2 weeks from a major competition). No significant changes between training phases were found for muscle strength and power. A trend for significance was found for decreased muscle endurance of the lower body (−24.4%, p = 0.08). A significant increase in leg lean mass was found at the competition phase (2.3%, p = 0.04), although no changes for other body composition measures were observed. No change was observed for any health marker except a trend for increased urinary creatinine clearance at the competition phase (12.5%, p = 0.08). A significant reduction in training volume for the lower body (−75.0%, p = 0.04) and a trend for a decrease in total energy intake (−17.0%, p = 0.06) was observed during the competition phase. Despite modifications in training and dietary practices, it appears that muscle performance, body composition, and health status remain relatively stable between training phases in male natural powerlifters