Dietary supplementation habits in international natural bodybuilders during pre-competition

Abstract

Bodybuilding is characterized by high-rates of sport supplementation. This is the first study to compare the supplementation patterns of winners (WB) and non-winners (NWB) among international natural bodybuilders during contest preparation. Fifty-six natural bodybuilders (5 women) (age = 28.85 ± 8.03 years; final body mass = 71.50 ± 10.28 kg), 19 WB (athletes who had achieved victory in an official natural bodybuilding championship at least once) and 37 NWB (athletes who never achieved victory), from 18 countries (55.36% from Spain) responded to this cross-sectional online survey related to their nutritional habits, strategies and supplementation practices. WB were significantly older (p = 0.024), completed more competitive seasons (p = 0.027) and participated in more competitions in the last contest year (p = 0.011). There were no significant differences between WB and NWB for years training for bodybuilding (p = 0.055), weeks of dieting for competition (p = 0.392), and body weight at the start (p = 0.553) and end (p = 0.330) of the season. Beverage and supplement consumption, purchasing patterns, and information sources did not differ between groups (p > 0.05). In conclusion, natural bodybuilding WB tended to be older and had more competitive experience, but shared similar supplementation protocols to NWB. Athletes' supplementation patterns were influenced by different sources of information. However, these natural bodybuilders mainly purchased their supplements through the internet without guidance from a coach or dietitian.

Full text

Heliyon 10 (2024) e26730
Available online 20 February 2024
2405-8440/© 2024 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
Research article
Dietary supplementation habits in international natural
bodybuilders during pre-competition
Pablo Jim´
enez-Martínez
a
,
b
, Carlos Alix-Fages
a
,
b
,
c
, Eric R. Helms
d
,
e
,
Sergio Espinar
a
,
f
, Henar Gonz´
alez-Cano
a
, Eneko Baz-Valle
a
,
g
, Danica Janicijevic
h
,
i
,
Amador García-Ramos
j
,
k
,
*
, Juan C. Colado
b
a
ICEN Institute, Madrid, Spain
b
Research Group in Prevention and Health in Exercise and Sport (PHES), University of Valencia, Valencia, Spain
c
Applied Biomechanics and Sport Technology Research Group, Autonomous University of Madrid, Madrid, Spain
d
Sport Performance Research Institute New Zealand (SPRINZ) at AUT Millennium, Auckland University of Technology, Auckland 0632, New
Zealand
e
Florida Atlantic University, Department of Exercise Science and Health Promotion, Muscle Physiology Laboratory, Boca Raton, FL, USA
f
Faculty of Health Sciences, Catholic University of Murcia, 30107 Murcia, Spain
g
University of País Vasco, Faculty of Physical Activity and Sports Sciences, Spain
h
Faculty of Sports Science, Ningbo University, Ningbo, China
i
Research Academy of Human Biomechanics, The Afliated hospital of medical school of Ningbo University, Ningbo University, Ningbo, China
j
Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
k
Department of Sports Sciences and Physical Conditioning, Universidad Cat´
olica de la Santísima Concepci´
on, Concepci´
on, Chile
ARTICLE INFO
Keywords:
Antidoping
Physical conditioning
Body composition
Ergogenic aids
Hypertrophy
ABSTRACT
Bodybuilding is characterized by high-rates of sport supplementation. This is the rst study to
compare the supplementation patterns of winners (WB) and non-winners (NWB) among inter-
national natural bodybuilders during contest preparation. Fifty-six natural bodybuilders (5
women) (age =28.85 ±8.03 years; nal body mass =71.50 ±10.28 kg), 19 WB (athletes who
had achieved victory in an ofcial natural bodybuilding championship at least once) and 37 NWB
(athletes who never achieved victory), from 18 countries (55.36% from Spain) responded to this
cross-sectional online survey related to their nutritional habits, strategies and supplementation
practices. WB were signicantly older (p =0.024), completed more competitive seasons (p =
0.027) and participated in more competitions in the last contest year (p =0.011). There were no
signicant differences between WB and NWB for years training for bodybuilding (p =0.055),
weeks of dieting for competition (p =0.392), and body weight at the start (p =0.553) and end (p
=0.330) of the season. Beverage and supplement consumption, purchasing patterns, and infor-
mation sources did not differ between groups (p >0.05). In conclusion, natural bodybuilding WB
tended to be older and had more competitive experience, but shared similar supplementation
protocols to NWB. Athletes’ supplementation patterns were inuenced by different sources of
information. However, these natural bodybuilders mainly purchased their supplements through
the internet without guidance from a coach or dietitian.
* Corresponding author. Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada. Camino de Alfacar, 21,
18071 Granada, Spain.
E-mail address: amagr@ugr.es (A. García-Ramos).
Contents lists available at ScienceDirect
Heliyon
journal homepage: www.cell.com/heliyon
https://doi.org/10.1016/j.heliyon.2024.e26730
Received 9 September 2023; Received in revised form 16 February 2024; Accepted 19 February 2024

Heliyon 10 (2024) e26730
2
1. Introduction
Sport supplements are legal dietary compounds which in conjunction with a healthy and balanced diet are used to improve
wellbeing and athletic performance, increase muscle mass, or decrease body fat [1,2]. Supplement ingestion prevalence varies widely
between different sport disciplines (i.e., 11–100%) [3]. Bodybuilding athletes are a principal consumer of supplements evidenced by
the large number and variety of supplements used by this population [4,5]. For example, authors of prior research on bodybuilders in
the metropolitan area of Naples, Italy reported that 81.31% of that study bodybuilders use supplements, and of those users 65.52% are
male and 34.48% female. Furthermore, 35.51% of these bodybuilders reported performance-enhancing hormone use (males =
71.05%, females =28.05%) and 97.37% of the hormone-using bodybuilders also reported consuming dietary supplements [5].
Although positive correlations between supplement and banned substance use was documented in athletes, whether the use of dietary
supplements plays a causal role in increasing the likelihood of using banned substances is not yet fully clear [6,7].
In response to the high rates of drug use among bodybuilders, “natural” or drug-tested bodybuilding competitions emerged in the
late 1970’s [8], which has grown in popularity in recent years [9]. As an aesthetics-based sport, bodybuilding performance is dictated
by having low fat levels, high levels of muscle mass, and muscular symmetry. This is commonly accomplished through adherence to
training regimens primarily centered on free weight exercises, representing a tness trend that has garnered substantial popularity
around the globe [10,11]. Drug-controls are generally based on World Anti-Doping Agency (WADA) criteria (i.e., urine and/or blood
evaluations) and/or polygraph analyses [12]. Natural bodybuilding athletes are subjected to strict regulations which dictates
competitive sanctions if doping-tests are failed [13].
Natural bodybuilders commonly use sports supplements like creatine, protein powder, amino acids (i.e., branched-chain amino
acids, glutamine or essential amino acids), vitamins and stimulants such as found in “pre-workouts” that contain caffeine and other
ingredients [14]. Depending on the specic product or ingredient, sports supplements are formulated to exert benets through
multiple mechanisms such as enhancing rates of muscle protein synthesis, supporting exercise metabolism, enhancing muscle
contractility, reducing perceived exertion, improving mood state or by providing health-related benets [15,16]. However, sport
nutrition recommendations for dietary supplement use differ between educational bodies [1,16]. These variations may, in part, be
attributed to the differences between sports disciplines and the specic performance demands of each sport and what might mean-
ingfully enhance it (e.g., team sports or weightlifting) [17]. Thus, statements related to other sports should be cautiously interpreted,
and bodybuilding specic guidelines are likely needed.
Moreover, new supplement design trends are constantly emerging which attempt to exploit plausible ergogenic pathways. For
example: (a) anti-fatigue agents such as capsaicinoids which may modulate strength endurance, work performed or nociception
[18–20]; (b) nitric oxide precursors such as nitrates or citrulline malate which may enhance strength and power [21]; (c) relaxation
and/or sleep-care agents such as lavender, ashwagandha or melatonin [22,23], (d) “fat burners” which contain substances which may
play a role in lipolysis, β-oxidation, or enhance metabolic rate such as caffeine, p-synephrine, green tea extract or yohimbine [16,
24–26]. Further, multi-ingredient formulas are frequently marketed to provide added ergogenic effects due to purported synergistic
ingredient interactions (e.g., nitrates and citrulline are proposed to stimulate different NOS-pathways) [27].
Given the constantly changing supplement market, and the distinction between untested and natural bodybuilders, further research
is needed to better understand supplementation practices of natural bodybuilders. Furthermore, previous studies have mainly
considered small sample sizes (i.e., mostly case-studies) in specic geographical regions but not in international areas [28]. Moreover,
there are not previous specic studies focused on the supplementation patterns of natural bodybuilders, in this sense, prior research
only assessed this topic as a complementary, but not as the main aim of the study. This fact may bias the number of substances asked in
the surveys and the questions performed concerning the habits of the athletes. For this reason, although supplementation rates in
bodybuilders are high, the current knowledge about the acquisition, consumption and classication of the supplements purchased and
ingested by this population is still lacking. Accordingly, larger international samples of athletes competing in drug-free federations
need to be aggregated and delineated based on competition success, to better understand the landscape of supplement use in natural
bodybuilding. Therefore, the aim of this study was to describe and compare for the rst time the supplement intake patterns of a
sample of international natural bodybuilders delineated based on their competition success.
2. Materials and methods
2.1. Participants
Fifty-six participants in the discipline of natural bodybuilding were included in this study, with ve of them being women. The
participants were stratied into two groups: the “winners” (WB), consisting of 19 natural bodybuilders who had achieved victory in an
ofcial natural bodybuilding championship at least once during their athletic careers (age range 26–37, weight: 72 ±14.5) and “non-
winners” (NWB) comprised of 37 natural bodybuilders who had not secured a championship victory (age range 22–31, weight: 73 ±
8.6). For inclusion in the research study, participants were required to meet the following criteria: (I) they must have been afliated
with a natural bodybuilding federation that conducts drug testing at least once in their career, (II) achieved a ranking within the top 10
in some ofcial competitive event, and (III) undergone drug testing, either through polygraph, blood, or urine analysis, either before or
after their competitive engagements. The exclusionary criterion entailed the use of prohibited substances. Of the 51 male athletes, 26
competed in the men’s physique division and 25 in the men’s bodybuilding category. All the female competitors reported competing in
the bikini division. Competitors classied their nationality as: (a) Spanish =31; (b) Ecuadorian =4; (c) Ukrainian =2; (d) Chilean =2;
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(e) American =2; (f) Peruvian =2; (g) Polish =2; (h) New Zealander =1; (i) Australian =1; (j) Macedonian =1; (k) Italian =1; (l)
French =1; (m) Portuguese =1; (n) Mexican =1; (o) Colombian =1; (p) Nigerian =1; (q) Singaporean =1; (r) German =1. The
participants’ rankings in international ofcial competitions were veried by means of communication with their respective governing
natural bodybuilding federations. This survey study was approved by the ethics committee of the Catholic University of Murcia (Code:
CE012209) in accordance with the Helsinki Declaration. All participants gave their informed consent to use their responses for
research purposes and indicated their agreement to one of the online survey items.
2.2. Study design
A quantitative, cross-sectional design was employed to explore the practical problem of supplementation intake behaviors among
natural bodybuilders on a global scale. This was achieved by extending invitations to a diverse cohort of natural bodybuilders to
complete a tailored survey regarding their supplement consumption patterns, facilitated through the dissemination of advertisements
on social media platforms.
Upon clicking links or navigating to the survey URL, the respondents were presented with an information sheet stating the purpose
of the study, the nature of the questions, and the fact that the survey was anonymous. The survey consisted of 21 questions that can be
divided into following categories.
−1 single-choice consent question,
−3 demographic questions (nationality, age and weight),
−5 dichotomous questions (yes-no questions regarding prohibited substances),
−4 multiple-choice questions (with respect to the acquisition of supplements),
−1 categorical question (regularity of consuming various non-alcoholic beverages),
−5 closed-ended single-response questions (regarding bodybuilding training history, weeks of dieting and water consumption habits
prior competition),
−2 open-ended single-response (most signicant accomplishment in natural bodybuilding).
Control questions were included in the survey to prevent duplicates or inaccuracies of the responses. For this purpose, reformulated
questions of the main identifying items were included throughout the survey. For example, participants were asked regarding their
most signicant natural bodybuilding accomplishment twice (see questions 12 and 21 of Appendix 1). If inaccurate information was
detected, the record was removed. After data collection, a manual search for duplicates was also performed. Results were reported
jointly and separately for WB and NWB.
2.3. Statistical analysis
Descriptive data of the variables are presented as means and standard deviation (SD). Median and interquartile range were used as
descriptive values for non-normal data instead. The homogeneity of the data variance (Levene’s test) was conrmed (p >0.05) and a
Kolmogorov-Smirnov test was performed to determine normality. To detect differences between WB and NWB, Mann-Whitney U tests
were used in the cases where data were not normally distributed: I) age, II) years training for bodybuilding, III) years competing in
bodybuilding (i.e., number of competitive seasons), IV) number of competitions performed in the last competitive year, V) weeks of
dieting for competition, VI) body weight at the start and VII) end of preparation for competing, and, VIII) liters of water usually
consumed during preparation. Response differences between WB and NWB for categorical variables related to doping, sweetener,
beverage and supplement use were analyzed using the Pearson Chi-squared test. Statistical signicance was set at p <0.05. Where the
Pearson Chi-squared test was implemented, Cramer’s V was implemented as a measure of the strength of association between the
variables and represented in absolute values [29]. The magnitude of the association was evaluated using the following scale: very weak
(0–0.049); weak (0.05–0.099); moderate (0.10–0.149); strong (0.15–0.249); very strong (≥0.25) [30]. The magnitude of the differ-
ences was reported for each categorical variable as the percentage difference between WB and NWB. For non-normal variables,
Common Language Effect Size (CLES) was calculated as the magnitude of the proportion of observations in a group that are greater
than observations in the other group. CLES does not provide cut-off ranges, however, higher values reveal a larger median magnitude
Table 1
Comparison of participants’ characteristics between winning (WB) and non-winning (NWB) natural bodybuilders.
Variable WB NWB Mann-Whitney U Test Effect Size (CLES)
Age (years) 31 (26, 37) 27 (22, 31) p =0.024* 0.67
Training experience (years) 9.0 (5.0, 12) 6.0 (2.7, 10) p =0.055 0.59
Competitive experience (years) 3.0 (1.0, 4.0) 2.0 (1.0, 2.0) p =0.027* 0.63
Number of contests last year 3.0 (1.0, 4.0) 2.0 (1.0, 2.0) p =0.011* 0.72
Diet duration (weeks) 24 (16, 24) 20 (16, 24) p =0.392 0.53
Body mass at diet onset (kg) 85 (65, 92) 86 (74, 88) p =0.553 0.52
Body mass at competition (kg) 72 (57, 78) 73 (68, 77) p =0.330 0.57
Water consumption (liters) 4.0 (3.0, 5.0) 4.0 (3.0, 6.0) p =0.710 0.51
Median (interquartile range). CLES; Common Language Effect Size.
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Heliyon 10 (2024) e26730
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of the effects between the groups. Statistical analyses were performed using the software package SPSS (IBM SPSS version 25.0,
Chicago, IL, USA).
3. Results
A post hoc analysis derived an achieved power of 0.88, considering a statistical signicance level of 0.05, a sample size of 56
participants, 1 degree of freedom, and a substantial effect size indicated by a noncentrality parameter of 10 (G*Power 3.1.9.4, Franc
Faul, Kiel University, Germany). No signicant differences were found between WB and NWB for years training for bodybuilding (p =
0.055), weeks of dieting for competition (p =0.392), body weight at the start (p =0.553) and end (p =0.330) of contest preparation
and liters of water usually consumed during the contest preparation phase (p =0.710) (Table 1). However, signicant differences were
found for age (p =0.024), number of competitive seasons (p =0.027) and number of competitions performed in the last competitive
year (p =0.011). The probability that the WB group exhibited a more dedicated and rigorous competition approach than NWB group,
with longer training and competitive experience, an extended diet duration, increased water consumption, and lower body weight at
the start and end of the preparation period, exceeded 50% (all CLES ≥0.51).
No signicant differences between WB and NWB were found for the use of any supplement (p range =0.089 to 0.982) or sweeteners
(p =0.900). Furthermore, the magnitude of associations was inconsistent ranging from very weak to strong (Cramer’s V range:
0.00–0.23), while the probability of substantial differences was relatively low, with all CLES values being less than 22% (Table 2).
There were no signicant differences between WB and NWB for any beverage intake (p range =0.470 to 0.871). Additionally, the
magnitude of associations was inconsistent and ranged from very weak to strong (Cramer’s V range: 0.00–0.19), while the magnitude
of the differences can be considered low (CLES ≤16.9%) (Table 3).
No signicant differences between WB and NWB were found for where competitors obtained the supplements (p range =0.488 to
0.789), who recommended or prescribed them (p range =0.202 to 0.757) or where they obtained information about the supplements
(p range =0.185 to 0.778). The magnitude of associations ranged from very weak to strong (Cramer’s V range: 0.04–0.18). The
magnitudes of the differences can be considered low (CLES ≤15.4 %) (Table 4).
4. Discussion
This study provides information concerning the supplementation patterns (i.e., from acquisition to ingestion) of an international
sample of natural bodybuilding athletes, predominantly from Spain (55.36%). The primary study ndings can be summarized as
follows: (I) there were no discernible variations in supplementation patterns between WB and NWB natural bodybuilders, (II) creatine
and whey protein stood out as the most widely favored supplements in both WB and NWB groups, (III) athletes in the WB category
Table 2
Comparison of the use of supplements and sweeteners between winning (WB) and non-winning (NWB) natural bodybuilders during contest
preparation.
Variable WB (%) NWB (%) Pearson Chi-squared test Cramer’s V Magnitude of the difference (%)
Ashwagandha 31.6 43.2 p =0.397 0.11 −11.6
BCAAs 26.3 29.7 p =0.789 0.04 −3.4
Beta-alanine 21.1 10.8 p =0.300 0.14 11.7
Caffeine 57.9 54.1 p =0.784 0.04 3.8
Capsaicin 5.3 5.4 p =0.982 0.00 −0.1
Carbohydrates 31.6 29.7 p =0.887 0.19 1.9
Citrulline 21.1 18.9 p =0.849 0.02 2.2
Creatine 94.7 91.9 p =0.696 0.05 2.8
EAAs 31.6 40.5 p =0.512 0.08 −8.9
EGCG 15.8 27.0 p =0.346 0.20 −11.2
Fat Burners 63.2 48.6 p =0.303 0.13 14.6
Joint-Health Supplement 21.1 27.0 p =0.625 0.06 −5.9
Lavender 10.5 8.1 p =0.764 0.09 2.4
Magnesium 36.8 29.7 p =0.589 0.07 7.1
Melatonin 57.9 37.8 p =0.153 0.19 20.1
Minerals 26.3 29.7 p =0.789 0.04 −3.4
Multivitamin 73.7 59.5 p =0.293 0.14 14.2
Nitrates 5.3 10.8 p =0.491 0.09 −5.5
Omega 3 63.2 67.6 p =0.744 0.04 −4.4
P-Synephrine 15.8 37.8 p =0.089 0.23 −22.0
Pre-Workouts 68.4 56.8 p =0.397 0.11 11.6
Protein/Oat Bars 21.1 29.7 p =0.488 0.09 −8.6
Sweeteners 63.2 64.9 p =0.900 0.01 −1.7
Vitamin C 36.8 32.4 p =0.741 0.04 4.4
Vitamin D 42.1 45.9 p =0.784 0.03 −3.8
Whey Protein 94.7 89.2 p =0.491 0.09 5.5
Yohimbine 10.5 5.4 p =0.481 0.09 5.1
Fat burners and pre-workout categories refer to multi-ingredient formulas.
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Heliyon 10 (2024) e26730
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exhibited older age, more extensive competitive experience, and greater involvement in competitions over the past year compared to
their NWB counterparts, and (IV) the supplement acquisition process mirrored one another in both groups, with online purchases being
the prevailing method, while athletes primarily made supplement decisions after consulting their trainers. These ndings suggest that
competitive success is more closely linked to an athlete’s competitive experience than their supplement habits.
The supplementation consumption patterns did not differ between the WB and NWB groups. However, notable percentage dif-
ferences were observed between the two groups regarding the use of Melatonin (20.1% more in the WB group) and P-Synephrine
(22.0% more in the NWB group). And although our study shows that 57.9% of WB used Melatonin and 37.8% of NWB used P-
Table 3
Comparison of beverage intake between winning (WB) and non-winning (NWB) natural bodybuilders during contest preparation.
Variable Frequency WB (%) NWB (%) Pearson Chi-squared test Cramer’s V Magnitude of the difference (%)
Coffee <1/month 26.3 18.9 p =0.76 0.08 7.4
1-3/month 5.3 2.7 p =0.79 0.06 2.6
1/week 5.3 21.6 p =0.31 0.19 −16.3
2-4/week 5.3 8.1 p =0.89 0.05 −2.8
5-6/week 5.3 5.4 p =0.54 0.00 −0.1
1/day 10.5 16.2 p =0.80 0.08 5.7
2-3/day 31.6 21.6 p =0.62 0.10 10.0
4-5/day 10.5 5.4 p =0.88 0.09 5.1
Tea <1/month 73.7 56.8 p =0.34 0.16 16.9
1-3/month 10.5 8.1 p =0.84 0.04 2.4
1/week 0 8.1 p =0.51 0.17 −8.1
2-4/week 5.3 8.1 p =0.89 0.05 −2.8
5-6/week 0 2.7 p =0.73 0.09 −2.7
1/day 5.3 10.8 p =0.84 0.09 −5.5
2-3/day 5.3 0 p =0.73 0.19 5.3
4-5/day 0 5.4 p =0.79 0.13 −5.4
Energy drinks <1/month 57.9 43.2 p =0.45 0.14 14.7
1-3/month 10.5 8.1 p =0.84 0.04 2.4
1/week 10.5 16.2 p =0.86 0.08 −5.7
2-4/week 10.5 13.5 p =0.92 0.04 −3.0
5-6/week 10.5 8.1 p =0.84 0.04 2.4
1/day 0 2.7 p =0.72 0.09 −2.7
2-3/day 0 5.4 p =0.79 0.13 −5.4
4-5/day 0 2.7 p =0.72 0.09 −2.7
Soda <1/month 84.2 75.7 p =0.73 0.09 −8.5
1-3/month 15.8 8.1 p =0.67 0.11 7.7
1/week 0 5.4 p =0.79 0.13 −5.4
2-4/week 0 5.4 p =0.79 0.13 −5.4
5-6/week 0 0 p =# # 0
1/day 0 2.7 p =0.72 0.09 −2.7
2-3/day 0 2.7 p =0.72 0.09 −2.7
4-5/day 0 0 p =# # 0
Diet soda <1/month 78.9 73 p =0.86 0.06 5.9
1-3/month 15.8 5.4 p =0.4 0.17 10.4
1/week 0 5.4 p =0.79 0.13 −5.4
2-4/week 0 5.4 p =0.79 0.13 −5.4
5-6/week 0 2.7 p =0.72 0.09 −2.7
1/day 0 2.7 p =0.72 0.09 −2.7
2-3/day 5.3 0 p =0.73 0.19 5.3
4-5/day 0 2.7 p =0.72 0.09 −2.7
+6/day 0 2.7 p =0.72 0.09 −2.7
Alcohol <1/month 89.5 78.4 p =0.51 0.14 11.1
1-3/month 10.5 13.5 p =0.92 0.04 −3.0
1/week 0 2.7 p =0.72 0.09 −2.7
2-4/week 0 0 p =# # 0
5-6/week 0 0 p =# # 0
1/day 0 2.7 p =0.72 0.09 −2.7
2-3/day 0 0 p =# # 0
4-5/day 0 0 p =# # 0
+6/day 0 2.7 p =0.72 0.09 −2.7
Juice <1/month 57.9 45.9 p =0.57 0.11 12.0
1-3/month 15.8 16.2 p =0.73 0 −0.4
1/week 5.3 18.9 p =0.33 0.18 −13.6
2-4/week 5.3 8.1 p =0.89 0.05 −2.8
5-6/week 5.3 2.7 p =0.54 0.16 2.6
1/day 0 2.7 p =0.72 0.09 −2.7
2-3/day 10.5 2.7 p =0.80 0.068 7.8
4-5/day 0 2.7 p =0.72 0.09 −2.7
#, not dened value.
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Synephrine supplements, curiously the study of Chappell et al. [13] has not even listed them as one of the 12 most common sup-
plements used by the high-level natural bodybuilders. A possible explanation for the varying supplementation habits observed among
participants could be the geographical differences, with our study predominantly involving Spanish participants and the study by
Chappell et al. [13] focusing on British participants. Similar results were found when it comes to beverage intake. Nonetheless, a higher
prevalence of the natural bodybuilders who consume beverages less than once per months was observed among natural bodybuilders
belonging to the WB group compared to natural bodybuilders in the NWB group, as detailed in Table 3. This suggests greater discipline
in avoiding unnecessary calorie intake during the pre-contest phase among WB participants. Also, excessive beverage intake was
generally less present in WB compared to NWB group. Therefore, while supplementation patterns were largely similar, the disparity in
Melatonin and P-Synephrine use and the greater discipline in beverage intake among WB bodybuilders suggest slightly distinct ap-
proaches to pre-contest preparation compared to NWB counterparts.
It is novel that the highest rates of supplement consumption in both groups were exhibited particularly for the products with
scientic support such as creatine (~92–95%) and whey protein (~89–95%) [16]. It is plausible that natural bodybuilding athletes are
increasingly gravitating towards supplements with a more robust scientic foundation. For instance, whey protein and protein bars
have been reported as an effective tool for maintaining muscle mass and controlling hunger [5], while creatine is reported to be
suitable for increasing phosphocreatine reserves to mitigate the low availability of carbohydrates, possibly allowing athletes to
minimize the loss of training volume and intensity [31]. It is possible that the same factor contributed to the high prevalence of caffeine
supplementation reported in both groups (>50%). Interestingly, the reported rates of creatine use in the present study are even higher
than what has been reported in prior research [32]. These ndings collectively suggest that supplement strategies do not signicantly
differ between more and less successful natural bodybuilding athletes.
Consistent with previous research comparing amateur and professional Spanish athletes [28], our ndings reveal a lack of dis-
parities in the consumption of beverages and sweeteners between the WB and NWB groups. As previous research supports, body-
builders do not usually include tea, coffee or other beverages during their pre-contest phase [13], however, sweeteners are reported as
a popular choice among bodybuilders [28]. Conicting ndings have been discussed in peer-reviewed literature concerning the effects
of non-nutritive sweeteners for weight loss and weight loss management [33]. One potential rationale for the elevated utilization of
sweeteners is the necessity for bodybuilders to adhere to severely restricted caloric intakes (e.g., <30 kcal/kg of lean body mass) during
contest preparation [28]. This restrictive regimen may prompt them to seek non-nutritive sweeteners as a strategy to substitute calories
and address cravings, potentially elucidating the elevated prevalence of non-nutritive sweetener consumption. This approach is novel
and further research is needed to corroborate it.
While no disparities were detected in terms of supplementation practices, beverage consumption, or sweetener intake between the
two groups, individuals in the WB group exhibited advanced age, greater competitive experience, and a more substantial level of
participation in competitions during the most recent competitive year compared to their NWB counterparts. Moreover, the probability
that the WB group demonstrated a more committed and rigorous approach to competition compared to the NWB group, evidenced by
extended training experience, prolonged dietary measures, heightened water intake, and reduced initial and nal body weight, sur-
passed the 50% threshold (all CLES ≥0.51). Previous study have reported similar tendency, showing differences in total muscle mass
and age between professional and amateur elite natural bodybuilders [28]. The fact that the more successful natural bodybuilders are
older than less successful is not surprising having in mind the muscle protein synthesis after resistance training is limited in comparison
to athletes taking exogenous testosterone [34,35]. Additionally, muscle protein synthesis responses are shorter and peak earlier in
trained subjects which may potentially limit protein accretion and consequently muscle growth in the long-term [35]. Therefore, the
present study suggests for the rst time that success in natural bodybuilding is more determined by the experience of the athletes than
the nutritional ergogenic substances consumed.
Regarding supplement acquisition patterns, the most frequent pattern was that athletes (I) purchased their supplements on the
Table 4
Supplement purchasing location, information sources in winners (WB) and non-winning (NWB) bodybuilders during contest preparation.
Topic Variable WB
(%)
NWB
(%)
Pearson Chi-
squared test
Cramer’s
V
Magnitude of the
difference (%)
How did you get the supplements? Internet 78.9 70.9 p =0.488 0.09 8.0
Medical clinic or dietitian’s ofce 5.3 2.7 p =0.625 0.07 2.6
Gym 5.3 10.8 p =0.491 0.09 −5.5
Supplement Store 26.3 29.7 p =0.789 0.04 −3.4
Supermarket 5.3 2.7 p =0.625 0.07 2.6
Myself 57.9 52.2 p =0.757 0.04 5.7
Who recommended or prescribed the
supplement?
Personal trainer 42.1 35.1 p =0.610 0.07 7.0
Healthcare professional 10.5 2.7 p =0.218 0.17 7.8
Friend from the gym or supplement
store
0 8.1 p =0.202 0.17 −8.1
Where did you obtain information about
the supplements?
Social Networks 31.6 16.2 p =0.185 0.18 15.4
Personal trainer 47.4 51.4 p =0.778 0.04 −4.0
Healthcare professional 5.3 8.1 p =0.696 0.05 −2.8
Friend, workout partner, or
supplement store clerk
10.5 2.7 p =0.218 0.17 7.8
Research reviews 36.8 48.6 p =0.400 0.11 −11.8
Peer reviewed research 36.8 43.2 p =0.645 0.06 −6.4
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Heliyon 10 (2024) e26730
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internet, (II) made the decision on their own to purchase their supplements, and (III) and learned about the supplements from their
personal trainer or coach. Few studies have been published concerning the purchasing habits of bodybuilders, identifying that they
mostly inquire about sport supplements at the gym (71.30%) followed by on the internet (64.99%) [5]. By contrast, in the present
study most of the bodybuilders (70.9–78.9%) declared that they bought products from the internet followed by in a supplement store
(26.3–29.7%). These divergent ndings might be due to regional differences in the studied population, or because natural body-
builders were specically targeted. Intriguingly, although supplements were mainly “self-prescribed” (52.20%–57.90%) or suggested
by personal trainers (47.4%–51.4%), a variety of other information sources were reported by athletes including social networks,
research reviews and peer-reviewed scientic articles (16.2%–51.4%).
An important practical recommendation based on the study’s ndings is that success in natural bodybuilding is closely tied to
athletes’ competitive experience and training history. Therefore, athletes should prioritize long-term dedication to the sport, as this has
a more substantial impact than specic supplementation strategies. Additionally, a deeper understanding of supplementation habits
may lead to competition success and can help athletes to adjust their diets and supplementation more effectively, aiming for better
results. However, although a positive shift towards seeking more scientically based information about supplement benets was
noted, athletes should increase their consultation with healthcare providers, as they were rarely approached for information and
supplement recommendations (in less than 10% of the occasions). In summary, a holistic approach combining long-term commitment
and informed supplementation choices is key for success in natural bodybuilding.
The present survey has specic limitations that should be mentioned. Firstly, although this was an international sample of natural
bodybuilders, it was predominantly from Spain with limited representation for other countries, with an overall modest sample size.
Secondly, the sample was almost entirely male limiting generalizability of the present ndings to female competitors, and to dissimilar
or underrepresented regions. Thirdly, despite not being the main purpose of the study, neither qualitative nutritional analyses nor
quantitative analyses of specic supplement ingredient doses were recorded. For this reason, it is unclear if the introduction of
nutritional reports may have altered the interpretation of the current ndings. Fourthly, although control questions were included to
prevent inconsistencies in the responses, the anonymous nature of this survey makes possible to induce inaccuracies. Finally, this study
has a cross-sectional design, which captures a single point in time and may limit its ability to provide a comprehensive understanding
of athletes’ supplementation practices over their entire athletic careers and the potential relationship with long-term performance
outcomes.
5. Conclusions
The present study suggests that there are not specic supplementation protocols that are associated with natural bodybuilding
competitive success. Rather, age (and perhaps training experience), competitive experience in bodybuilding and the number of shows
per season an athlete has experienced are the primary factors which differ between WB and NWB. Notably, athletes’ supplementation
patterns are highly inuenced by different sources of information, but rarely by healthcare providers. Natural bodybuilders mainly
purchase their supplements through the internet, primarily via their own cognizance, without direct advice to do so from others.
Overall, the ergogenic nutritional habits of natural bodybuilders seem to be less important than the experience of the athletes to
achieve success in the competition.
Funding
No funding was received for this study.
Ethics statement
The study protocol adhered to the tenets of the Declaration of Helsinki and was approved by the Institutional Review Board
(Catholic University of Murcia; Code: CE012209).
Data availability statement
The nal database can be downloaded through the following link: https://osf.io/cey6p/?view_
only=506feea394b5478899a03afcba05f79a.
CRediT authorship contribution statement
Pablo Jim´
enez-Martínez: Writing – original draft, Project administration, Methodology, Formal analysis, Conceptualization.
Carlos Alix-Fages: Writing – original draft, Supervision, Data curation, Conceptualization. Eric R. Helms: Formal analysis, Data
curation. Sergio Espinar: Formal analysis, Data curation. Henar Gonz´
alez-Cano: Formal analysis, Data curation. Eneko Baz-Valle:
Formal analysis, Data curation. Danica Janicijevic: Writing – review & editing, Methodology. Amador García-Ramos: Writing –
review & editing, Supervision. Juan C. Colado: Writing – original draft, Methodology, Data curation.
P. Jim´
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Heliyon 10 (2024) e26730
8
Declaration of competing interest
The authors declare that they have no known competing nancial interests or personal relationships that could have appeared to
inuence the work reported in this paper.
Acknowledgements
We would like to thank to the participants of this study.
Appendix A. Supplementary data
Supplementary data to this article can be found online at https://doi.org/10.1016/j.heliyon.2024.e26730.
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