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... utrition, and compliance. Throughout the entire study, weekly training hours and regimens between groups in the three experiments remained comparable. The same was true for nutritional intake. Urinalysis revealed compliance within the groups: Urine samples from the AAS users contained steroid metabolites, and samples of the CO group did not.
Discussion AAS-induced changes. Experienced strength athletes who use a self-composed course of AAS for 8 weeks exhibited increased total body weight and total lean body mass compared with those who did strength training alone; total fat mass remained unaffected. Among regional body segments (arms, legs, and trunk) in these athletes, only arm weight increased significantly. However, lean mass was significantly increased in all regional body parts, and these findings are reflected in the increased arm and leg circumferences. Increases were for the most part still present 6 weeks after drug cessation. These findings are relevant because until now scientific data concerning AAS effects on anthropometry and body composition were equivocal.
From cross-sectional studies, one might infer that AAS-using strength athletes differ in body composition from non using athletes (6, 7). These observations have been supported by longitudinal studies. The most pronounced effects on body weight and lean body mass were found in athletes who self-administered several AAS simultaneously in high doses (8, 9). Such regimens may increase body weight by an average of about 5. 2 kg (11. 4 lb). Lean body mass increases may be even larger, especially after long-term administration (8, 10). The present study indicates that the use of a single AAS seems to induce less remarkable effects than multiple-drug regimens (9, 11 - 13).
This is in line with an observation of Forbes (14), who had previously described a positive relationship between the total dose of AAS used and the increase of lean body mass. On the other hand, research (9, 11, 15, 16) that compared the effects of different doses of a single AAS indicates that such a relationship might be less ambiguous than that proposed by Forbes. Previous methods and DEXA. One factor that may have contributed to the consistent results is the method used to determine body composition. No alterations were seen in studies (17 - 20) that investigated body composition with underwater weighing. In these studies, the effect of a single drug was analyzed, but, unfortunately, no reports are available on underwater weighing assessment of body composition in multiple-drug-using athletes.
Although previous studies assessed the traditional two-compartment model either with seinfeld measurements or with underwater weighing, our study employed DEXA to assess a three-compartment model for body composition alterations. DEXA was designed primarily to estimate bone mineral content and density in humans (21). Determination of body composition by DEXA is based on the difference in attenuation of x-rays between soft and bone tissue as well as the difference in attenuation between fat and lean tissue. This method provides a three-compartment model that divides the body into total bone mineral content, bone-free lean mass, and fat mass.
An advantage of DEXA over hydro densitometry is that DEXA appears to be less affected by hydration status (21, 22). This may be an important advantage in estimating body composition in athletes since hydration status may be affected by training. Assessing regional body changes. Because of the documented DEXA accuracy for total and regional body dimension measurement (5, 23) and the AAS potential for inducing regional changes in body composition, strength athletes may have particular interest in both DEXA and AAS. DEXA measurements in this study reveal an increase in bone-free lean mass of all body parts measured in bodybuilders using AAS.
One interesting finding was that the increase in the bone-free mass of the arms was approximately twice that in the leg or trunk (14 % versus about 7 %). This finding could not be attributed to differences in training regimens because the training diaries revealed comparable regimens in both groups. On the other hand, in another study (16) the administration a single anabolic steroid (nandrolone decanoate) induced the largest gain of bone-free lean mass in the legs and trunk. Since both studies are complementary, one possibility might be that different AAS regimens may affect specific areas more than others. Although evidence has shown that AAS increases lean body mass (24 - 26), no one has determined what constitutes the change in lean mass. Previous research associated AAS-induced lean body mass alterations with increments of blood volume and water retention (12, 27, 28).
In a recent study (W. Van Marken Lichtenbelt etal, manuscript submitted for publication), we were able to investigate the effects of AAS on body composition with a four-compartment model. That study revealed that total body water increased from AAS use but that the ratio between extracellular and intracellular water remained unaffected. In addition, lean mass hydration status was not influenced by AAS. Thus, the most likely explanation for the gain of lean mass can be explained by muscle increase rather than from water retention. Dispelling steroid-use myths.
Among strength athletes, long-term AAS administration is generally believed to produce better results than short-term use. Additionally, these athletes claim that after long-term AAS use the gains in body composition parameters will persist longer than after short-term administration. These beliefs are not supported by the present study. The effects on body composition and anthropometric variables after short- and long-term AAS use were comparable. The same applied for residual changes seen after drug withdrawal. Therefore, we conclude that duration of AAS administration in itself is not the key factor for optimal and longstanding effects on body composition.
Health hazards. From a medical point of view, long-term AAS administration is of great concern (29). Several investigators (9, 30, 31) have reported that AAS use induces an unfavorable lipoprotein profile and thus increases the risk for cardiovascular diseases. Recent research has demonstrated that duration of AAS use has a strong impact on the lipoprotein profile changes (33).
Extended AAS administration provokes more dramatic side effects on the lipoprotein profile compared with short-term AAS use, and the time required for full reversal of these side effects was prolonged after long-term use (F. Hartgens et al, manuscript submitted for publication). Consequently, long-term users are more prone to have cardiovascular events. Most strength athletes are convinced that after drug abstinence the effects on body composition will persist for some time. Our results show that 6 weeks after drug withdrawal the changes of circumferences were still significantly increased over baseline values, though slight decreases were seen compared with values at the end of AAS use. Many AAS users take, on average, two to three courses in 1 year (6, 32).
Their approach is to start a new AAS course when they assume that the side effects have disappeared but the desired effects on body composition and strength are still present to some extent. There are indications that such procedures may be effective (6), but the effects of such procedures on health status are unknown and remain of great concern. Summary This study has demonstrated that in athletes the administration of a self-composed, 8 -week course of AAS combined with strength training increased body weight, lean body mass, and limb circumferences more than did strength training alone. Arm mass, but not trunk and leg mass, was increased by AAS use. DEXA analysis showed that AAS stimulated the bone-free lean mass of all body parts, but the effects on the arms were the most pronounced. Fat mass was not affected by AAS use.
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