You sadly have moved to the next notch on your lifting belt.

Tying your shoes you have to take a big breath before reaching down as the belly compression might make you pass out.

Yes, welcome to the large offseason life. The point when you are hoping a fat loss phase is around the corner.

When should we actually implement this phase?

We are competitors, so we must always keep in mind that we have to diet back down for a show at some point.

This ending offseason point should not leave you needing to diet for over 20 weeks to make that happen.

A round number might be we don’t want you 15-20% above your stage weight.

Dieting for longer than 20 weeks is going to be faced with challenges physically and mentally, that we really don’t want to do all in one shot.

Also we do have to consider the health aspect of gaining too much body fat especially compounded with PEDs.

This can very easily set up a recipe for living in a state of poor health, not ideal for muscle growth or fat loss.

When to do this phase?

This is when you reach that cusp of a peak offseason body weight and a body fat level that is beyond that 20 week mark.

You want a fat loss phase to reset the body fat limit and give you some runway to extend the offseason longer or move into a prep.

Now you could gain slower and not do the fat loss phase at all. I have tried this and more often than not gains are left on the table or you don’t progress at all.

Once you reach that peak mass, you want to hold it for a few weeks before doping into a deficit.

We can “cement” or “hold” the gains to not let that new tissue drop too quickly
We also want to pull back on PEDS to give the system a stress break and prepare for the fat loss phase.

We might have labs that need restorative work and we need a low PED amount to do so, which low PEDs might not favor well with a deficit to hold tissue.

This gives you a psychological break for constinet food pushing prior to going into a phase of food restriction.

You might also need time to heal up niggles/injuries to be optimal for a fat loss phase.

High blood pressure is said to be a silent killer as you don’t “feel” anything wrong when it is elevated.

You could make the same case from for chronic low grade inflammation.

In current and former anabolic androgenic steroid (AAS) users, visceral adipose tissue (VAT) accrual was an independent predictor of lower insulin sensitivity.

Users had lower body fat % than non users, but higher amounts of VAT.

Mechanisms are not known for decreases in insulin sensitivity, but may be through chronic low grade inflammation.

In users, we see elevated pro-inflammtory cytokine production in VAT and increase hepatic production of C-reactive protein levels indicating an inflammatory response.

AAS users have elevated CRP levels compared to non using counter parts

Low-grade systemic inflammation is a risk for:

• Atherosclerosis
• Dyslipidemia
• Hypertension
• Metabolic Syndrome
• Diabetes

Anabolic Steroid users share similar metabolic characteristics of obese/sedentary populations such as Metabolic Syndrome, thereby increasing risk of Cardiovascular disease.

Why Does This Happen?

• Overweight /obesity
• Overproduction of reactive oxygen species
• Advanced glycation end products (elevated blood glucose outcomes)
• Mitochondrial dysfunction
• Renin Angiotensin System (RAS) deregulation
• Visceral fat accumulation
• Defective cell autophagy

All the above are driven from ↑ food,↑ body weight, ↑ gear usage.

Combating inflammation and oxidation is an important aspect to managing long term health in supraphysiological PED usage. So, this brings to question what can we do to work on the mechanisms causing inflammation?

In a meta-analytic review paper, nutritional and pharmaceutical compounds were investigated for their impact on lower CRP levels. Six compounds were included as they met criteria to be promising, safe, tolerable, affordable and acceptable strategies for reducing chronic low grade inflammation.

Compounds Effects on CRP Reduction:

Probiotic -0.43 mg/L reduction
Angiotensin Receptor Blockers -0.2mg/L reduction
Omega 3 -0.17 mg/L reduction
Metformin -0.16mg/L reduction
Resveratrol and Vitamin D showed no reduction

Normal CRP levels is <1.0mg/L

When building health intervention protocols we need to look at the “why” and “how” of PEDs bring about poor health.

Through this we can investigate strategies that can work to mitigate those effects.

REFERENCES

Grace, Fergal & Davies, Bruce. (2004). Raised concentrations of C reactive protein in anabolic steroid using bodybuilders. British journal of sports medicine. 38. 97-8. 10.1136/bjsm.2003.005991.

Altan Onat; Günay Can; Gülay Hergenç (2008). Serum C-reactive protein is an independent risk factor predicting cardiometabolic risk. , 57(2), 207–214.doi:10.1016/j.metabol.2007.09.002

McCullough D, Webb R, Enright KJ, et al. How the love of muscle can break a heart: Impact of anabolic androgenic steroids on skeletal muscle hypertrophy, metabolic and cardiovascular health. Rev Endocr Metab Disord. 2021;22(2):389-405. doi:10.1007/s11154-020-09616-y

Custodero C, Mankowski RT, Lee SA, Chen Z, Wu S, Manini TM, Hincapie Echeverri J, Sabbà C, Beavers DP, Cauley JA, Espeland MA, Fielding RA, Kritchevsky SB, Liu CK, McDermott MM, Miller ME, Tracy RP, Newman AB, Ambrosius WT, Pahor M, Anton SD. Evidence-based nutritional and pharmacological interventions targeting chronic low-grade inflammation in middle-age and older adults: A systematic review and meta-analysis. Ageing Res Rev. 2018 Sep;46:42-59. doi: 10.1016/j.arr.2018.05.004. Epub 2018 May 25. PMID: 29803716; PMCID: PMC6235673.

What Standard Do We Hold Coaching Too? 

In reality, there is no governing body for online coaching.

Nothing equivalent to a medical board, federal administration, or even organizational education standard.

Myself and John talk about elevating the standard at which we hold coaching because with no governing body it is our responsibility as coaches in the industry to move the industry forward.

With that being said, today I am going to go over some expectations we should all have for coaches in our industry that are managing YOUR physique progress and ultimately long term health.

Health Metrics for Longevity

The portion of the coaching process that I want to look at today is metric tracking. 

This is a topic that is very important as it is the objective side of the decision tree when it comes to coaching.

So the question is, what metrics are important?

Health metrics would be at the top of my importance list.

Common metrics we would see under this category would include blood pressure, blood glucose, and possibly even resting heart rate; I put this at the top of the list as it often shows the difference between coaches who care for you as a person over the long term of your competitive career and those who just see a physique to put on stage.

This would also include a space to upload lab work so that we can see how the metrics trend over time as you get deeper into your bodybuilding career.

Client Check in Metrics for Objectivity

From there, I would begin to head into some of the more obvious metrics such as body weight trend, logbook/performance progressions, step counts, and nutritional adherence that will make up the bulk of the basic objective metrics for decision making.

Contextual information, such as sleep metrics, digestion, etc are important to have as well, as they may allow us to dive deeper into your overall health.

For example, one night of bad sleep could result in blood pressure elevation, fasted blood glucose elevation, jump up in the scale weight, and even a bad day in the gym for logbook progressions.

The Art of Coaching with Subjective Metrics

And last but not least, subjective metrics would be the last concept to consider in the metric tracking project.

This portion will often include a description on clients current desire to train, an open ended section for clients  to go into detail on things that happened during the week, place to upload their progress pictures, and a questions section for them to drop questions to the coach on the process that they may have.

This is the section that starts to pull out the “art of coaching” into the client’s process.

It’s the combination of the subjective information alongside the objective that should guide decision making.

Not from a script.

Not because that is how they do it.

True situational decision making based on all of the information above.

Metric tracking may not be the end all be all for coaching, but it is a large part of it that I think we should take into consideration and unfortunately, is not done in every coach/client relationship out there.

The scale didn’t move, I think I look even softer!

I am following the plan, so what gives?!

As we move through a calorie deficit and body fat decreases our bodies start to adapt to preserve body fat and energy.

We have decreases in anabolic hormones and increases in catabolic and hunger signaling hormones, drops in metabolic rate, decreases in cost of exercise and this can add up to a fat loss stall out.

So what to do if you are stalling from all these adaptations?

We need an accurate assessment to then make the right diagnosis of the situation.

Then what to do is the easy part.

Are You Accurate?

Have you accurately tracked food

No diet slip up or add ins

You are not getting lazy and sitting around more ie lowering energy output

Is the Scale Fooling You?

Scale is not changing but you are visually leaner

Digestion issues?

Poor sleep?

Inflamed from training?

PED changes?

Menstrual changes?

Change in routine (when you weigh, eat, drink)?

Patience is Key!

How long has the recent plan been implemented?

When was the last body weight change?

What are some action steps to take if truly stalled?

Refeed Day

One test to see if you are stalled in fat loss is to give yourself a high carbohydrate refeed day.

Sometimes fat loss is occurring; you just have not seen the scale change yet to reflect it.

One day with higher carbohydrates can increase insulin levels, drop cortisol levels, and in turn drop water that is being retained.

Then the next day you are at a new low body weight.

Low Days

You know fat loss is not moving along and you tested a refeed day in the last tip.

You are left with the decisions of reducing food, increasing cardio, and/or adding in fat burners. My first pick in this situation is to pull food down as long as you have enough food to do so with.

Bump up Cardio

A 10% increase in calorie expenditure can get fat loss moving again.

If 10% for you is 200 calories this can be done by increasing your step count by 4000 steps per day.

4000 steps is about 2 miles walking, which depending on body weight is around 100kcal burned.

Add in the Fat Burner

But wait!

You might pull your serum lab markers to assess thyroid function before deploying a fat loss agent.

We might need to optimize hormone function.

If all checks out a thermogenic agent could be deployed.

Deload/Diet Break

If you have tried all fat loss stall busting techniques, feeling physically and psychologically burned out, it’s okay to move into a diet break period.

Just raise food up, back off cardio some and let some of the stress dissipate.

At J3 University I teach the decision making process to this issue.

As much as I know John loves the idea of being a ninja, the last thing we want to see is more bodybuilders dying from the silent killer of blood pressure.

We know that over the long term, a lot of bodybuilders who have mismanaged their health markers, especially blood pressure, end up dying from heart and/or kidney issues that stem from chronic exposure to high blood pressure across their bodybuilding careers.

In fact, some data out of the University of Copenhagen showed “compared with the former abusers and the controls, the ongoing abusers’ average day and night BPs were significantly higher.”(Rasmussen)

Knowing this, making an effort to manage blood pressures for ourselves and our clientele is an important aspect to manage alongside a practitioner in order to get the best long term health outcomes for our clientele.

Well we know we need to manage it, but how do blood pressure medications fit into our management systems?

To start, we may need to look at what blood pressure medication options we have, how the work, and what typically causes blood pressure elevation in bodybuilders?

For the classes of blood pressure medications, we have 4 main ones that are the most common to use and how they lower blood pressure below: 

1. Angiotensin Receptor Blockers (ARB’s)/Angiotensin Converting Enzyme (ACE) Inhibitors: These act via angiotensin inhibition to lower blood pressure. 
2. Diuretics: Increased sodium/water excretion to lower blood volume and lower blood pressure. 
3. Beta-blockers: Lower the effects of epinephrine it lowers the speed and force at which the heart beats to lower blood pressure. 
4. Calcium Channel Blockers: Blocks calcium from entering the cells of heart and arteries to relax and open blood vessels, and in turn, lower blood pressure. 

When we look at PED usage effects on the cardiovascular system, we see that PED’s negative effects are often mediated via the renin-angiotensin-aldosterone-system (RAAS).

”Testosterone can increase renal artery BP probably via potentiating the renin-angiotensin-aldosterone system…promoting water and sodium reabsorption” (Davani-Davari).

We can further look into this net influence of androgens on RAAS into oxidative stress, inflammatory cytokines, and even apoptosis that leads to kidney fibrosis, however, the line of logic above is where most people will typically go towards ARBs or ACE Inhibitors.

Logically, this would make the most sense to influence blood pressure here as this is where PED’s have the greatest influence in elevating blood pressure.  

For some people, however, using one class of drug (monotherapy) will not be enough to bring blood pressure down to the blood pressure targets we should be aiming for.

This is where dual therapy can be very beneficial.

In fact, we have data that shows the efficacy of dual therapy over monotherapy with Telmisartan and Amlodipine (calcium channel blocker) to support this line of thought as well (Guthrie).

Ultimately, the goal should be to manage blood pressure as needed to maintain good blood pressure ranges that will limit the risk over the long term for cardiovascular and kidney health to keep us bodybuilding for longer.

Work with your cardiologists and coach to find the right medications for you in order to manage your blood pressure values, and ultimately live a longer, healthier life.

Citations

1. Rasmussen JJ, Schou M, Madsen PL, Selmer C, Johansen ML, Hovind P, Ulriksen PS, Faber J, Gustafsson F, Kistorp C. Increased blood pressure and aortic stiffness among abusers of anabolic androgenic steroids: potential effect of suppressed natriuretic peptides in plasma? J Hypertens. 2018 Feb;36(2):277-285. doi: 10.1097/HJH.0000000000001546. PMID: 28863033.
2. Davani-Davari D, Karimzadeh I, Khalili H. The potential effects of anabolic-androgenic steroids and growth hormone as commonly used sport supplements on the kidney: a systematic review. BMC Nephrol. 2019 May 31;20(1):198. doi: 10.1186/s12882-019-1384-0. PMID: 31151420; PMCID: PMC6545019.
3. Guthrie RM. Review: a single-pill combination of telmisartan plus amlodipine for the treatment of hypertension. Postgrad Med. 2011 Nov;123(6):58-65. doi: 10.3810/pgm.2011.11.2495. PMID: 22104454.