The Truth About Immortals

The recent months have
been terrible with sudden and premature deaths in several known young
celebrities who were into extreme forms of bodybuilding. The surprising deaths
which occurred were in the so-called “most fit of the lot”, the
bodybuilders with pounds of muscle in their bodies. What is well known in
medical science is that muscles are healthy, muscles are proteins and this might
be the reason for everyone to believe that all the famous musclemen are healthy
and going to make it till 100 years of age at least. However, this seems to be otherwise
based on the incidents that happened this week were at least 2 prominent
personalities with good muscle built and young age on their side suddenly died
leaving no clue as to what has happened. Their death was blamed on illnesses
currently prevailing in the locality such as dengue, chikungunya, etc., but based
on the nature of these common and short illnesses, it is highly unlikely that
these illnesses may have been the sole cause
of sudden death in these individuals.

Further, as a healthcare
practitioner who has treated 4-5 reputed bodybuilders and has been very
attentive to every detail of theirs, all that I have understood was that there
is a very keen competition at the top and certain expectations when you desire
to annex the title. Therefore, when we take a closer look at the life of these
individuals, it is not so surprising to know that they often have no holds
barred approach to get into shape and to
wrest titles as Mr. City, Mr. State or so,  and they pack the best of muscle and the six-pack
abs that can get any normal person into an inferiority complex. But the real
questions to ponder are - “Are these muscles really good?” and “Do
they prolong life?”. These are the questions that need an answer.

One of the most important
criteria that is required to build these muscles is the intake of fat percentage, which should be considerably less
than even the normal body composition levels. Now the most pertinent question
is how does a bodybuilder get that much muscle and reduce the fat to such bare
low levels?. Organizations such as the World Health Organization (WHO) and
other healthcare agencies advice a, a balanced diet and largely agree that out
of recommended total daily calorie intake, carbohydrates should constitute
around 40-60% and fat should constitute around 20-30% and protein 15-20% of
total daily calorie intake (See Table 1 for recommendations on % of total daily
calorie intake from well-known organizations).

Table 1: Recommendations
on % of total daily calorie intake from well-known organizations.

ADA: American Diabetes
Association

EASD:  European
Association for the Study of Diabetes

These bodybuilders are often
advised to take only 5-10 % of fat intake and increase the the daily intake of
proteins even above the recommended levels, to increase the muscle built which
often leads to undesired consequences in most of them. These musclemen often
consider using various food supplements which are rich in protein such as whey
protein, eggs, creatine, non-vegetarian foods etc, and render a promise to
increase the muscle mass to make them the cynosure of eyes for the onlookers.
However, these food supplements when taken in excess amounts for prolonged
duration can cause severe health safety concerns as it is a well-known fact
that a high protein diet is one of the causes of deterioration in kidney
function, therefore, one can easily imagine the consequences of such types of
extreme dietary changes.

Another resource that is
considered by these bodybuilders is the use of medications to build muscles and
burn the fat such as anabolic steroids, growth factors, ACTH injections, IGF-1,
Testosterone, etc which are mainly used to drive more amino acids, fats, and
carbohydrates into the cells allowing the body to stack 30, 40, 50 pounds of
muscle. There may be many more of such hormones and chemicals being used by these
bodybuilders under the methods being used by them to aid in burning body fat and amassing muscle. The
main reasons for the bodybuilders to choose these medications or high protein
diets, are lack of awareness and being desperate to achieve the winning goal. The
most famous perception prevailing in this tribe is “the bigger the better”
and millions of followers of popular bodybuilders think the same way.

What are anabolic
steroids? Anabolic steroids are class C manufactured drugs that mimic the
effects of the male hormone testosterone and can only be sold by pharmacists
under a prescription from a registered medical practitioner. They have limited
medical uses and aren't to be confused with corticosteroids, a different type
of steroid drug that's commonly prescribed for a variety of conditions. However,
anabolic steroids are sometimes taken without medical advice to increase muscle
mass and improve athletic performance. If used in this way, they can cause
serious side effects and addiction. In professional sport, most organizations have
banned anabolic steroid use and test competitors for banned steroids.

Regular intake of
anabolic steroids can lead to physical and psychological changes in both men
and women, as well as potentially dangerous medical conditions. Some of the
adverse effects of excessive use of anabolic steroids in men include reduced sperm
count, infertility, shrunken testicles, erectile dysfunction, baldness, breast
development, increased risk of prostate cancer severe acne, stomach pain, etc. In
women, anabolic steroids can cause facial hair growth and unwanted body hair, loss
of breasts, swelling of the clitoris, deepened voice, an increased sex drive, problems
with the menstrual cycle, hair loss and severe acne, etc. In addition, both men and
women who take anabolic steroids can develop any of the following medical
conditions:

-       
heart attack or stroke,

-       
liver or kidney problems or failure,

-       
high blood pressure (hypertension),

-       
blood clots,

-       
fluid retention and,

-       
high cholesterol. 

-       
psychological effects like aggressive
behavior, mood swings, etc.

As anabolic steroids are
often injected, there are risks associated with sharing needles as well. These
are the same risks associated with recreational drug use and include damage
to veins, leading to ulcers or gangrene, hepatitis B and C and HIV transmission, etc. Like many other substances, anabolic steroids are addictive which means the
person can crave the drug- require more to get the same effect, and have
withdrawal symptoms when the person suddenly stops taking them. A person who is
addicted to anabolic steroids will want to keep using them despite experiencing
unpleasant physical, health, and/or psychological side effects. When doctors
prescribe steroid medication for various other approved medical treatments,
they always advise using them under complete medical supervision and coming off
the medication slowly by gradually reducing the dose to avoid withdrawal
symptoms. However, this kind of medical supervision often lacks among the
bodybuilders who use these medications as off-label use for building muscles.

These bodybuilders would
walk with the confidence of the fittest, confidence showing both in their behavior
and their body language making the people around them think they are the
healthiest. However, the fact is that these bodybuilders who go for extreme
bodies may often not be as fit as it appears to be.

 They may have multiple risk factors (cardiac
and non-cardiac) which include the following:

1.              
Premature coronary artery disease and
coronary calcification secondary to hormonal treatment, excess of calories, and
higher amount of dense calorie intake.

2.              
Soft plaques getting into the arteries
causing a rupture of the plaque with sudden occlusion of the blood vessel with
resultant sudden myocardial infarction.

3.              
Kidney damage is secondary to supplements
like creatinine which builds muscles to extreme levels but with the toxic
effects on the kidneys increasing the chances of kidney failure.

4.              
Switching over to lactate metabolism with
more generation of ketones, free radicals during these endurance exercises
leading to subendothelial damage which often leads to premature aging and
premature atherosclerosis and premature MI, arrhythmias, and death.

5.              
The majority of these bodybuilders who are
into partying have further health issues due to the binge of alcoholism, and
calorie-rich foods which they think they can digest easily owing to the heavy
workout they perform on daily basis.

6.              
Taking large doses of anabolic steroids to cause
heart to become enlarged reducing its efficiency and gradual cardiac damage
culminating in an extremely low ejection fraction  (systolic dysfunction) due to dilated
cardiomyopathy in many of these bodybuilders.

7.              
By the time the bodybuilders cross into
the 4th decade of life, many of them may develop hypertension and diabetes due
to the use of unreasonable amounts of steroids, hormonal treatments, unbalanced
diet, excess dietary supplements, excess alcohol intake etc.

8.              
Medical fitness test to rule out
pre-existing illnesses (cardiac or non-cardiac) in these individuals pursuing
the profession of bodybuilding is not done. This leads to some individuals at
risk coming into this field further increasing their health risks.

9.              
Periodic (or yearly medical check-up) in
these individuals with extreme endurance sport is also not done and many
bodybuilders end up developing cardiac abnormalities that are not picked up
within time which further adds to the enhanced health risk in these individuals.

It is now well known that
endurance exercise only up to a certain limit is known to benefit and impart
long life, and that too only if supplemented by healthy and mindful eating. A
very heavy, prolonged (endurance) exercise may cause more harm than good. It is
also necessary to be beware of the dubious or unregistered doctors, dieticians,
educators, products and medications, etc. which seem to cause physical benefits
but are responsible for an array of internal damage which can endanger both
internal organs and life too.

Overall, the best of
muscles are always not the healthiest ones or are not going to make you live
longer than the common population. In many instances, these bodybuilders with
their dubious means of increasing muscle mass may be more diseased internally
than we think and these muscles and the inappropriate means they use to develop
them can spell doom for them.