LAHORE: Four known bodybuilders died during the first two weeks of April in Lahore and nearby towns of Gujranwala and Sialkot, triggering a wave of fear and calls for investigation.

Three of these deaths were reportedly by sudden heart failure and these left a trail of questions about how the so-called health clubs operate today and what kind of food supplements they frequently recommend. The biggest concern is whether these supplements were exposing them to the danger of heart failure.

Most of the regular and recognised bodybuilders’ associations deny encouraging usage of muscle-developing steroids, but they do concede there may be individual clubs and trainers, helped by unregulated steroid market, spreading the usage and exposing the users to different health risks.

Some of these clubs and trainers hide behind the fact that in none of these cases the cause of death was confirmed to have been related to the intake of steroids. Simply, no autopsies were performed. There are others, however, who plead for using these deaths as an opportunity to clean up the unregulated and chaotic health clubs’ market, making it safer for youth.

“Dietary regime is essential to the bodybuilding business and that also precisely the risk point,” explains Tipu Sultan, who patronises Body Builders Association of Gujranwala Division. One of their body builders, Matloob Haider, died recently of heart failure. Because the diet is so essential to muscle building, food supplements (frequently steroids) naturally come into play. Because there is hardly any trained and educated dietician at most centres and it is a totally unregulated market where everything and anything is available for money, the risk only multiplies for young people, he said.

“A lot of water is required with the usage of steroids. However, water is sometimes prohibited by bodybuilding coaches because it softens human muscles. All these factors put together cause huge risk. If the government can check shisha clubs, why can’t it act against these health clubs?

“One of these bodybuilders who died recently had competed at Lahore in the last week of March,” said an official of the association. The competition was delayed for more than five hours and the athletes had to wait that many additional hours without water, to avoid taking the stage with limp, shrunk-up muscles.

The diet regime of these guys includes all things known for, what is said in local parlance, to keep the body ‘hot’ – fish, beef, mutton and eggs. The intake needs a dietary balance and lots of water to keep body temperature normal. Add steroids to this regime, and it is a lethal concoction, especially if water intake is less than the required quantity; it only causes further stress, and in extreme situations, organ failure, especially of heart, he explained.

“Since no one knows – if ever -- what quantities of these steroids need to be taken according to the body weight, the risk only increases,” he told Dawn. “So much so that the body fattening steroids that are administered to cattle and horses are sometimes reportedly consumed by these bodybuilders at huge risks.”

No one actually knows what caused the death of the four bodybuilders in quick succession in recent days. But the issue of steroids’ use is one that shouldn’t have required the dark speculations that the bodybuilding and health clubs and those who work out there are being subjected to now. There is – has been for long – a dire need for the government to regulate these places, have qualified trainers overseeing them, have dieticians and ensure regular dope tests there to discourage the consumption of steroids. Parallel to this process should be scanning of steroids market. Who is importing them? What is being imported? Who is selling these substances and, most importantly, how – whether they are being sold at physicians’ prescription or clubs have these available on their premises.

Published in Dawn, April 22nd, 2016