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Barbell Medicine Podcast

Barbell Medicine
Barbell Medicine Podcast
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  • 🔓 PLUS PREVIEW: When to Push Through Pain, Pre-Exhaustion Training, and Conquering Cravings
    Episode Summary This is a preview of our subscriber-only Ask Us Anything episode, where Dr. Jordan Feigenbaum and Dr. Austin Baraki tackle the most persistent problems in training and nutrition. Hear the science behind managing pain in the gym—determining the threshold for acceptable discomfort versus a true programming error. They also analyze why short-term study findings often fail in the real world, cover the science of pre-exhaust training, and give practical advice on the psychology of managing dietary cravings when transitioning to a healthier diet. Takeaways Pain Threshold: Learn the 3/10 rule for pain in training: low-level, self-limiting discomfort is common, but anything more should be addressed.Programming Fix: Recurrent pain (e.g., every 5-6 weeks) is often a programming issue caused by a lack of training tolerance, not a technique fault. The solution is modifying the total load, not just changing your form.Training Philosophy: Stop "pushing" harder every session. The best way to progress is to wait for fitness to show up (the lift feels easier) before increasing the load.Pre-Exhaust Science: Find out why techniques like leg extensions before squats are suboptimal for both strength and hypertrophy because they compromise the necessary total training load.Cravings Are Transient: The intense difficulty experienced when switching from ultra-processed, hyper-palatable foods to home-cooked meals is normal (hedonic adaptation) and transient. Understanding that this discomfort will fade is key to long-term adherence.⏱️ Preview Timestamps00:00 Introduction & Plus Subscriber Offer00:40 How Often Should I Feel Pain in Training? (Pain Threshold & Training Tolerance)09:31 The Science of Pre-Exhaust Training (Why it compromises total load)16:54 Managing Dietary Cravings When Switching Habits (Hedonic Adaptation)27:49 Conclusion: Barbell Medicine Plus Offer🔓 Unlock the Full Episode & Exclusive BenefitsThe topics above are only a fraction of what's covered in the full Ask Us Anything episode, which also includes:How to structure high-intensity conditioning intervals and why heart rate is often a poor metric.The science behind Powerlifting peaking and tapering for non-elite athletes.The latest, large-scale meta-analysis on Vitamin D and respiratory infections and why the real-world benefit is highly modest.A full discussion on the discrepancy between short-term studies and real-world results in diet and exercise.Subscribe Today to Barbell Medicine PlusWhen you join Barbell Medicine Plus, you get the full ad-free episode, access to our bonus content library, and major discounts:25% off all courses and seminars15% off consultations10% off all our programsWant to support the show and get early, ad-free access to all episodes plus exclusive bonus content? Subscribe to Barbell Medicine Plus and get ad-free listening, product discounts, and more. Try it free for 30-days.Unsure which training plan is right for you? Take the free Barbell Medicine Template Quiz to be matched with the ideal program for your goals and experience level.For media, support, or general questions, please contact us at [email protected]It is normal and acceptable for lifters to experience low-level, self-limiting discomfort during training. The threshold for acceptable pain is generally considered to be less than 3/10 on the pain scale, provided the discomfort is not sharp, does not cause fear, and is gone within 24 to 48 hours.The real warning sign is recurrent pain—when the same tweak flares up every 5 to 6 weeks. This is typically not a technique fault but a programming issue—the lifter is demanding more from their body than their current training tolerance allows. The solution is usually to reduce the overall training load, modify the volume/intensity, and rebuild capacity gradually.www.barbellmedicine.com/blog/training-with-pain-a-practical-approachwww.barbellmedicine.com/blog/the-barbell-medicine-guide-to-tendinopathy Shrier, I. (2004). Does stretching help prevent injuries? Clinical Journal of Sports Medicine. DOI: {10.1097/00042752-200405000-00002} (Review discussing prior injury as a key risk factor).Gabbett, T. J. (2016). The training—injury prevention paradox: should athletes be training smarter and harder? British Journal of Sports Medicine. DOI: {10.1136/bjsports-2016-096319} (Discusses role of prior injury and training load).Siewe et al. (2014). Injuries in powerlifting: how common are they and what are their causes? Sports Medicine - Open. DOI: {10.1186/s40798-014-0016-x} (Epidemiology and common injury sites in powerlifting).Calhoon, N. L., & Fry, A. C. (1999). Injury rates and profiles of elite competitive weightlifters. Journal of Strength and Conditioning Research. DOI: {10.1519/00124278-199902000-00010} (Injury rates in weightlifting).Raske, Å., & Norlin, R. (2002). Injury incidence and prevalence among elite weight and powerlifters. Scandinavian Journal of Medicine & Science in Sports. DOI: {10.1034/j.1600-0838.2002.01188.x} (Injury sites in powerlifting).Nijs et al. (2014). Treatment of central sensitization in patients with chronic musculoskeletal pain: new insights and practical implications. Physical Therapy. DOI: {10.2522/ptj.20130360} (Discusses non-mechanical factors like stress on pain).Pre-ExhaustionThe technique of pre-exhastion training (e.g., leg extensions before squats) is generally suboptimal for both strength and hypertrophy.Compromised Load: Pre-fatiguing the muscle compromises the ability to perform the subsequent compound lift with high intensity and high volume, thereby reducing the total training load. This directly hurts both muscle growth (less mechanical tension) and strength (less high-fidelity force production).Limited Use Case: This technique is primarily useful in rehab (as a load-limiting or desensitization tool) or for highly specific muscular endurance challenges (e.g., preparing for certain high-rep CrossFit workouts).https://www.barbellmedicine.com/blog/how-to-exercise-when-you-have-no-time/ (training load preservation)Schoenfeld, B. J., et al. (2018). Differential effects of attentional focus strategies during long-term resistance training. European Journal of Sport Science. DOI:10.1080/17461391.2018.1500632 (Discusses mind-muscle connection effectiveness).Schoenfeld, B. J. (2010). The mechanisms of muscle hypertrophy and their application to resistance training. Journal of Strength and Conditioning Research. DOI: 10.1519/JSC.0b013e3181e840f3(Reviews mechanical tension as the primary driver).Fisher, J. P., et al. (2013). The effects of pre-exhaustion, exercise order, and rest intervals in resistance training. Journal of Applied Sports Science Reports. DOI: 10.1016/j.jassr.2013.06.002 (Discusses pre-exhaustion's impact on load).Gentil, P., et al. (2007). Effect of exercise order on upper-body strength and muscle thickness in untrained men. Journal of Strength and Conditioning Research. DOI: 10.1519/R-20415.1 (Found pre-exhaustion did not enhance hypertrophy over traditional training).CravingsSwitching from ultra-processed, hyper-palatable foods (e.g., pizza, fast food) to a whole-food, home-cooked diet involves temporary challenges due to hedonic adaptation (the brain is adapting away from high food reward).The difficulty of managing cravings is complex. Switching is often easier when the body is in an energy surplus (biologically supported).The tension and cravings intensify when the lifter moves into a calorie deficit, activating biological defense mechanisms (hormonal signaling increases hunger). Recognizing that the acute cravings are transient is crucial for maintaining self-efficacy and adherence, as it reinforces the belief that the new, healthier habit will eventually become easier.https://www.barbellmedicine.com/blog/how-to-eat-a-healthy-diet/ https://www.barbellmedicine.com/blog/how-to-train-while-losing-weight/ https://www.youtube.com/watch?v=oYeh1xTnlxU&themeRefresh=1 https://www.barbellmedicine.com/blog/does-your-metabolism-change-with-weight-loss/  Rosenbaum, M., & Leibel, R. L. (2010). Adaptive thermogenesis in humans. International Journal of Obesity. DOI: {10.1038/ijo.2010.184}Considine, R. V. (2012). Leptin and the regulation of body weight. The Journal of Clinical Investigation. DOI: {10.1172/JCI65051}Sumithran, P., et al. (2011). Long-term persistence of hormonal adaptations to weight loss. New England Journal of Medicine. DOI: {10.1056/NEJMoa1005813}Finlayson, G., et al. (2011). The role of palatability in appetite regulation. Journal of Physiology and Behavior. DOI: {10.1016/j.physbeh.2011.08.016} Lally, P., et al. (2010). How are habits formed: modelling habit formation in the real world. European Journal of Social Psychology. DOI: {10.1002/ejsp.674}Baumeister, R. F., et al. (1998). Ego depletion: Is the active self a limited resource? Journal of Personality and Social Psychology. DOI: {10.1037/0022-3514.74.5.1252}Spiegel, K., et al. (2004). Brief sleep restriction alters the neuroendocrine profile of ghrelin and leptin. Annals of Internal Medicine. DOI: {10.7326/0003-4811-141-11-200412070-00008}Our Sponsors:* Check out Express VPN: https://expressvpn.com/BBM* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com* Check out Factor and use my code bbm50off for a great deal: https://www.factor75.com* Check out Rosetta Stone and use my code TODAY for a great deal: https://www.rosettastone.com* Check out Uncommon Goods: https://uncommongoods.com/bbm* Check out Washington Red Raspberries: https://redrazz.orgSupport this podcast at — https://redcircle.com/barbell-medicine-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
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  • Q&A: Cholesterol Lowering, Volume vs. Intensity For Hypertrophy Volume, Zone 2 Efficiency, and More
    Barbell Medicine Q&A: Cholesterol, Hypertrophy Volume, and Training EfficiencyEpisode SummaryIn this Q&A session, Dr. Jordan Feigenbaum addresses listener questions on optimizing training, managing health metrics, and navigating supplement use. Key topics include the latest evidence on cholesterol management (statins vs. PCSK9 inhibitors), why routine Vitamin D supplementation is usually unnecessary, and the mechanics of hypertrophy, emphasizing that volume is superior to intensity once a functional threshold is met. Dr. Feigenbaum also offers practical coaching advice on dynamic volume regulation, the importance of efficiency in the deadlift, and why training models like Pilates do not offer the same benefits as traditional strength work.⏱️ Episode Timestamps00:00 Introduction00:43 Cholesterol Lowering Medication (Statins vs. PCSK9 Inhibitors)03:27 Volume vs. Intensity for Hypertrophy06:48 Regulating Training Volume and the 5% Rule11:43 Barbell Medicine Supplement Philosophy and Safety14:14 Pilates as a Training Modality16:31 Is Zone 2 Cardio Really That Amazing?⭐ Get More Value: Exclusive Content and ResourcesWant to support the show and get early, ad-free access to all episodes plus exclusive bonus content? Subscribe to Barbell Medicine Plus and get ad-free listening, product discounts, and more. Try it free for 30-days.Unsure which training plan is right for you? Take the free Barbell Medicine Template Quiz to be matched with the ideal program for your goals and experience level.For media, support, or general questions, please contact us at [email protected]⚕️ Section I: Clinical and Healthspan OptimizationCholesterol Management: The Lower is Better PhilosophyThe core principle of managing atherogenic risk is that the risk of heart disease is proportional to the overall lifetime exposure (level $\times$ duration) to atherogenic lipoproteins, specifically LDL, triglycerides, and particles tagged with Apolipoprotein B (ApoB). These particles constitute the "atherogenic load."Lowering this load is beneficial, and the data suggests that lower is better for cardiovascular health. While powerful medications like PCSK9 inhibitors offer an immense magnitude of cholesterol lowering and are proven for both primary and secondary prevention of major adverse cardiac events, the general population will often achieve substantial risk reduction with statins or statin/ezetimibe combinations, which are more accessible and cost-effective.This approach is validated by observing individuals with genetic mutations who maintain low cholesterol levels throughout their lives—they demonstrate the lowest risk of heart disease, period. Therefore, for active lifters seeking to optimize healthspan and longevity, the goal should be active management and mitigation of this exposure. This requires understanding how to interpret blood work for active lifters and working with a physician to find the most appropriate and sustainable treatment plan, which may include setting targets to lower LDL cholesterol to near-neonatal levels.Vitamin D Supplementation: Questioning the Routine RecommendationRoutine, widespread Vitamin D supplementation for the general, otherwise healthy population is generally not recommended due to a lack of strong evidence showing that replacing low levels improves actual health outcomes. While low Vitamin D levels frequently coexist with various medical conditions, simply replacing the vitamin doesn't mitigate the primary disease trajectory.The potential risks of routine supplementation, though low, include supplement contamination and the risk of overdosing (leading to unwanted calcium deposits). Unless an individual has a specific medical condition (like chronic kidney disease, severe malabsorption issues, or high risk of fall and fracture due to osteoporosis), the benefits of routine supplementation are questionable. Barbell Medicine favors interventions where the clinical benefit is clearly demonstrated to improve meaningful health outcomes, not just laboratory values.🏋️ Section II: Hypertrophy and Training Load OptimizationVolume is the Dose: The Hypertrophy PrincipleThe relationship between resistance training and hypertrophy (muscle growth) is a dose-dependent relationship on volume, provided a functional threshold is met. This threshold means training must involve a load greater than approximately 30% of a lifter's one-rep maximum (1RM) and be taken relatively close to failure (around 4-5 repetitions left in reserve, RIR).Advising low volume training to failure, as some influencers do, is sub-optimal for muscle growth because it generates insufficient total training load. Once a lifter has achieved this functional threshold, volume is superior to intensity. High training volume is optimal for muscle growth, and only when volume has been maximized does pulling the intensity lever (training even closer to failure) provide an additional, albeit smaller, benefit.Optimal hypertrophy and how to structure a strength program for longevity relies on maximizing training load—the total volume of effective work—within the constraints of a person's time and physiological tolerance.Dynamic Volume Regulation and The 5% RuleCoaching requires dynamic volume regulation—adjusting the training plan based on a person's current performance and recovery status. One method is to use RPE (Rate of Perceived Exertion) caps to autoregulate volume within a session. For example, prescribing back-off sets that terminate once the prescribed RPE is reached means a lifter performs more work on a good day and less work on a slow day, ensuring sufficient training stimulus without causing excessive fatigue or burnout.For long-term progression, true strength gain must exceed day-to-day performance fluctuations. A strength gain greater than $\pm 5\%$ over a multi-week period is considered a "real" or minimal clinically important difference in strength. Tracking this trend, rather than session-to-session RPE, is how a coach determines whether to increase the overall training load, which is necessary to continue achieving fitness adaptations.🧘 Section III: Training Modalities and ApplicationsDeadlift Technique: Efficiency Over Absolute NeutralityThe belief that any slight movement in the thoracic or lumbar spine during a heavy deadlift is uniquely injurious is not supported by evidence. The human body is highly adaptable, provided the training load is progressed gradually.The primary coaching concern is not achieving an absolute "neutral spine" (which is difficult to define and rarely achieved in heavy lifting) but maintaining efficiency. Excessive spinal movement can compromise the lockout, making the lift harder than necessary. Coaching should focus on improving the efficiency of the lift to maximize the load that can be lifted strongly, not reducing an overstated injury risk.Pilates: Recreation, Not Resistance TrainingPilates is generally not a valuable addition to an individual's training if the goal is to drive the primary adaptations of resistance training: increases in strength, hypertrophy, muscle function, or bone mineral density.Pilates is simply not designed to apply the necessary loading stress to the musculoskeletal system to achieve these benefits. It is best viewed as an enjoyable recreational activity or accouterment, not a replacement for "real exercise." For individuals seeking true physical adaptations, the focus should remain on evidence-based resistance training for older adults and other populations that meet or exceed the established physical activity guidelines.Zone 2 Cardio: Efficiency and ApplicationWhile Zone 2 cardio is popular, it is not a panacea. Evidence shows that vigorous physical activity (higher intensity work, Zone 3/Zone 4) is actually more efficient for disease risk reduction than moderate intensity (Zone 2).Zone 2 work is most useful for individuals performing high volumes of conditioning (three or more hours per week), as it allows them to accumulate volume without causing undue systemic fatigue. For most people performing less than 150 minutes of moderate-to-vigorous activity per week, incorporating more vigorous work is the most time-efficient way to achieve health benefits.Our Sponsors:* Check out Express VPN: https://expressvpn.com/BBM* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com* Check out Factor and use my code bbm50off for a great deal: https://www.factor75.com* Check out Rosetta Stone and use my code TODAY for a great deal: https://www.rosettastone.com* Check out Uncommon Goods: https://uncommongoods.com/bbm* Check out Washington Red Raspberries: https://redrazz.orgSupport this podcast at — https://redcircle.com/barbell-medicine-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
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  • Episode #374: Mental Strategies: Neuroscience, Visualization, and Developing Resilience with Anne-Sophie Fluri
     Mental Strategies: Neuroscience, Visualization, and Developing ResilienceEpisode Summary: Training Your Brain for Performance and HealthDr. Jordan Feigenbaum welcomes Anne-Sophie Fluri, a neuroscientist with a background in experimental neuroscience and Parkinson's disease research, who now runs Brain Wave, focusing on mental fitness and performance workshops.This episode leverages Anne-Sophie's expertise to discuss powerful mental strategies applicable to life, stress management, and athletic performance. The conversation provides an evidence-based breakdown of meditation (what it is and what it isn't), the neurological mechanisms behind visualization (process vs. outcome imagery), and how these practices contribute to mental resilience and improved self-efficacy—a core component of the Barbell Medicine definition of health.⏱️ Episode Timestamps[00:00] Introduction, Guest Background, and Barbell Medicine Plus Offer[00:41] What is Anne-Sophie currently focusing on at Brain Wave[04:41] Meditation: What it is (and isn't) & Training Attentional Focus[08:31] Why people start meditating (Sleep issues, anxiety, stress relief)[12:28] Legitimate Health Benefits of Meditation (Focus, stress, health behaviors)[19:35] Meditation in Sport and Performance Enhancement[23:14] How to Start Meditating Today (Apps, YouTube, and the 5-minute approach)[33:30] II. Visualization: Mental Imagery and Performance Rehearsal[35:04] Visualization in Sport (F1, Michael Phelps, and mentally rehearsing failure)[37:02] Process vs. Outcome Visualization & Multi-sensory Engagement[43:03] How to Start Visualization Practices (Aphantasia caveat)[46:47] The Power of Immediacy and Mind-Muscle Connection[56:48] III. Mental Resilience: Self-Efficacy and the Six Components⭐ Get More Value: Exclusive Content and ResourcesWant to support the show and get early, ad-free access to all episodes plus exclusive bonus content? Subscribe to Barbell Medicine Plus and get ad-free listening, product discounts, and more. Try it free for 30-days.Unsure which training plan is right for you? Take the free Barbell Medicine Template Quiz to be matched with the ideal program for your goals and experience level.For media, support, or general questions, please contact us at [email protected] I. Meditation: Training Focus and Battling DistractionDr. Feigenbaum and Anne-Sophie begin by clarifying that meditation is not about emptying the mind or achieving spiritual transcendence. It is a simple mental practice used to train attention and awareness by focusing on an anchor (breath, sound, sensation). When the mind inevitably wanders, the practice is to bring focus back to the anchor.The True Benefits of Training AttentionWhile many people turn to meditation for sleep issues and stress relief, the strongest evidence points to its benefit as a tool to train focused attention.Focus is a Skill: Anybody can be told to "focus" on their training or work, but meditation provides the concrete skill development needed to counter distraction. Focusing on a mundane anchor like breathing forces the brain (which seeks productive activity) to practice recentering.Positive Externalities: Meditation’s primary value may be its "knock-on effects." By helping manage or reduce stress, it creates the self-awareness necessary to participate in other health-promoting behaviors (like eating mindfully, exercising, or making healthier decisions).Sports Application: Athletes, from powerlifters to soccer players, can use this training to focus on the task at hand and minimize distraction from external noise (crowds) or internal noise (self-doubt, fear of failure). II. Visualization: Mental Rehearsal for PerformanceVisualization, or mental imagery, is a form of meditation used to create mental images of desired outcomes or processes. Research suggests this practice can have a direct carry-over to performance by activating overlapping areas in the brain as if the action were happening in real life.Process, Outcome, and SafetyProcess Visualization: This is ideal for technical tasks (like a squat or a race car lap). The athlete visualizes the step-by-step execution of the task (e.g., foot placement, bar path, gear changes), creating a "brain memory" that shortens the decision-making process during competition.Outcome Visualization: Visualizing the moment of success (winning the competition, achieving a PR) can flood the brain with motivating chemicals and endorphins, bridging the gap between present reality and future possibility. However, caution is advised: for some, feeling the outcome too intensely can lead to lower motivation because the brain feels satisfied without doing the work.Mind-Muscle Connection: Visualization during a lift may be the mechanism behind the highly sought-after "mind-muscle connection." By actively diverting focused attention toward the specific muscle groups being activated, athletes may recruit a greater amount of muscle tissue, improving activation and potentially long-term gains. III. Mental Resilience and the Definition of HealthAnne-Sophie defines mental resilience mechanistically: the ability to return to an original form after force or pressure is applied. This aligns closely with the Barbell Medicine definition of health (from Huber, 2011) as the ability to adapt and self-manage in the face of social, physical, and emotional challenges.Self-Efficacy and ControlMental resilience is directly linked to self-efficacy (confidence in one's ability to exert control over one's life). Those with high self-efficacy feel in control, have good insight into their circumstances, and feel they have the resources to change the outcome.The key components of mental resilience include:Health: Physical health, sleep, and nutrition.Vision: Having a clear goal and direction for the future.Tenacity: The ability to keep going after setbacks.Composure: Self-regulation and staying level-headed under stress.Collaboration: Social support and community.The Path to ResilienceTo develop mental resilience, Anne-Sophie recommends developing self-awareness and reflection through regular practice:Practice Self-Awareness: Meditation improves the connectivity between the prefrontal cortex (executive function) and the amygdala (emotional center), allowing you to approach problems with a more level head and less emotional reactivity.Start Mono-tasking: Stop multitasking (which is actually just costly task switching) and start mono-tasking. Turn mundane activities (cooking, cleaning) into opportunities for mindfulness—focusing on one task and actively paying attention to the senses involved. This is the best nootropic for memory and cognition.Consistency: Structural changes in the brain (neuroplasticity) and lasting behavioral changes are seen after at least eight weeks of consistent practice (20–40 minutes daily).Connect With Anne-Sophie Fluri and Barbell MedicineGuest Substack: Read Anne-Sophie’s neuroscience insights and thought pieces at Rewire Me with Anne-Sophie (rewireme.substack.com).Guest Instagram: Follow Anne-Sophie for "not so serious content" and wellness trend critiques: @coochiebygucci (instagram.com/coochiebygucci).Support the Show & Save: Join Barbell Medicine Plus for ad-free listening and discounts on all courses and consultations!Our Sponsors:* Check out Express VPN: https://expressvpn.com/BBM* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com* Check out Factor and use my code bbm50off for a great deal: https://www.factor75.com* Check out Rosetta Stone and use my code TODAY for a great deal: https://www.rosettastone.com* Check out Uncommon Goods: https://uncommongoods.com/bbm* Check out Washington Red Raspberries: https://redrazz.orgSupport this podcast at — https://redcircle.com/barbell-medicine-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
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  • Q&A Deep Dive: Measuring Fat Loss, Testosterone vs. GainzZz, the Carnivore Diet, and More
    🎙️ Q&A Deep Dive: The Critical Cutoff for Fat Loss, Safety, and Strength📝 Episode Summary: BMI, Training Safety, and Evidence-Based NutritionIn this mini-sode, Dr. Jordan Feigenbaum answers core questions on performance and health. The discussion centers on replacing arbitrary body fat percentages with clinical, evidence-based metrics for determining when a lifter should start a fat loss phase, emphasizing BMI and waist circumference.Dr. Feigenbaum also provides critical safety information on heavy barbell training for older men, addresses the mythology of testosterone and its role in strength gains, outlines a strategy for losing weight without losing strength through modest deficits and high protein, and critiques the common use cases for stretching and the risks of the popular carnivore diet.⏱️ Episode Timestamps[00:00] Introduction & Barbell Medicine Plus Offer[00:43] Body Fat Percentage vs. Clinical Metrics for a Cut (BMI and Waist Circumference)[07:22] The Clinical Use of Stretching and Injury Risk (Entry point for pain)[09:51] Losing Weight Without Losing Strength (Modest deficit & high protein)[13:19] Heavy Barbell Training and Heart Problems in Older Men (Cardiac safety)[15:00] Favorite Testosterone Factoid and Relative Strength Gains (Androgen receptor saturation)[17:18] The Problem with the Carnivore Diet (Saturated fat and fiber risks)⭐ Get More Value: Exclusive Content and ResourcesWant to support the show and get early, ad-free access to all episodes plus exclusive bonus content? Subscribe to Barbell Medicine Plus and get ad-free listening, product discounts, and more. Try it free for 30-days.Unsure which training plan is right for you? Take the free Barbell Medicine Template Quiz to be matched with the ideal program for your goals and experience level.For media, support, or general questions, please contact us at [email protected]⚕️ Section I: Body Composition and the Fat Loss TriggerReplacing Body Fat Percentage with Clinical MarkersDr. Feigenbaum critiques the common practice of using arbitrary body fat percentage thresholds (e.g., 25% for men) to recommend a fat loss phase, citing the lack of robust evidence correlating these numbers to disease risk and the poor accuracy of most measurement methods for tracking individual change.Instead, the decision to recommend a cut for the average recreational lifter should rely on three objective, clinical criteria:BMI > 30: A Body Mass Index of 30 or over is highly specific for excess adiposity. Outside of anabolic-using athletes (a statistical aberration), this is a "do not pass go" line in the sand.Waist Circumference: For men, a waist circumference above 37 inches (particularly in those of European descent) is a stronger marker of visceral fat and increased risk.Adiposity-Based Chronic Disease (ABCD): The presence of medical conditions linked to excess body fat, such as high blood pressure (strength training and hypertension guidelines), dyslipidemia, or elevated fasting blood sugar.Strategy for Losing Weight While Retaining StrengthThe goal of losing weight without losing strength (e.g., 105 kg to 97 kg) is achievable through careful moderation of training and diet:Calorie Deficit: Maintain a modest calorie deficit (under 200 calories) below maintenance. Going too fast risks losing more muscle mass.Protein Intake: Keep protein high, targeting 1.4–1.6 g/kg of body weight per day.Training Resilience: Research shows humans are resilient to maintaining performance in a short-to-medium-term energy deficit, provided the training is correctly moderated in both dose and formulation (prioritizing quality over high volume). Avoid overly restrictive diets like keto, which are detrimental to strength and muscle retention.🏋️ Section II: Training Safety and HormonesHeavy Barbell Training and Heart Health in Older MenThe concern that heavy barbell training for men in their late 40s or 50s could cause heart problems (e.g., PACs or other abnormalities) is directly refuted by evidence.Resistance Training is Safe: Cardiac adaptations from resistance training are overwhelmingly beneficial (lowering blood pressure, improving blood lipids).Volume is the Risk Factor: The "extreme exercise hypothesis" suggesting exercise can be harmful is associated with ultra-endurance training (very high volume endurance work), not resistance training, as you simply cannot accumulate that level of volume.Health Benefits Offset Risk: The vast health improvements from lifting (managing physician guidelines for lifting with high blood pressure and metabolic health) tend to offset any minor risks, such as the slightly increased incidence of AFib sometimes seen in very high-volume endurance athletes.Debunking the Testosterone MythThe idea that high testosterone levels within the normal range are the primary ceiling for muscle and strength gains is a myth.Relative Gains are Equal: Men and women exposed to the same training stimulus gain the same relative amount of strength and muscle mass.Receptor Saturation: This occurs because androgen receptors are already saturated at relatively low T levels. Increasing natural T levels from the normal range is unlikely to be clinically significant for performance.Natural Optimization: Focus on fixing the primary drivers of low T: address obesity, manage chronic medical conditions, and ensure high-quality sleep.🔬 Section III: Evidence-Based Training and NutritionThe Problem with the Carnivore DietWhen the carnivore diet is typically followed, it is not consistent with a health-promoting dietary pattern:Saturated Fat: It often results in excessively high consumption of saturated fat from animal sources (butter, red meat), which is not health-promoting when it accounts for a large percentage of daily calories (e.g., 20%).Fiber Deficiency: It drastically limits vegetable matter, resulting in very low dietary fiber, which is linked to poorer long-term health outcomes.The True Role of StretchingDespite common belief, stretching and mobility work do not decrease injury risk or reduce soreness. Their application should be limited:Sport Specificity: Use stretching to achieve mobility necessary for specific sports (e.g., figure skating).Pain Entry Point: Use stretching as a gentle regression or entry point to exercise for individuals dealing with significant pain, such as the initial phases of managing pain-free strength training low back stenosis.Our Sponsors:* Check out Express VPN: https://expressvpn.com/BBM* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com* Check out Factor and use my code bbm50off for a great deal: https://www.factor75.com* Check out Rosetta Stone and use my code TODAY for a great deal: https://www.rosettastone.com* Check out Uncommon Goods: https://uncommongoods.com/bbm* Check out Washington Red Raspberries: https://redrazz.orgSupport this podcast at — https://redcircle.com/barbell-medicine-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
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  • Episode #373: Deadlift Data- The Truth About Sumo vs. Conventional, New Study Finds Hard Cardio 9x Better, and Ozempic's Muscle Secret
    The Rundown: Deadlift Data, Intensity Science, and Semaglutide's Muscle EffectEpisode Summary: Weighing Records, Efficiency, and RegulationIn this episode of The Rundown, Dr. Jordan Feigenbaum and Dr. Austin Baraki dive deep into the latest data and breaking news spanning strength, longevity, and health policy. They kick off the discussion by analyzing world record powerlifting data to dissect the perennial sumo versus conventional deadlift debate and the impact of specialized equipment.Next, they tackle controversial new science on exercise intensity, revealing that vigorous physical activity may be far more efficient for disease risk reduction than the traditional 1:2 ratio suggests. They examine a new, complex consensus statement from the ACSM on exercise intensity domains. Finally, the hosts analyze new clinical data on the anti-obesity medication semaglutide (Ozempic/Wegovy), assessing its impact on muscle function during weight loss, and they weigh in on China’s new mandate requiring influencer certifications for sensitive topics, as well as the critical issue of lead in protein powder. ⏱️ Timestamps[00:20] I. Deadlift Data DEBUNKED: World records, the stiff bar vs. deadlift bar delta, and the conventional vs. sumo distribution in elite powerlifting.[17:14] II. Intensity Science: Is Harder Way Better?: New data shows vigorous activity is 4x-9x more efficient than moderate activity for health outcomes.[30:51] The ACSM’s New Intensity Definitions: Critique of the confusing new "Metabolic Threshold" and RIR-based resistance training domains.[41:40] III. Medical Updates: The Fox P3 Nobel Prize: How a genetic immune switch (regulatory T-cells) impacts autoimmune disease and muscle repair.[49:32] Semaglutide and Muscle Preservation: The SEMALEAN study data showing 80% fat loss, 20% lean mass loss, and improved handgrip strength.[01:00:26] China's Influencer Certification Mandate: Discussion on government control, misinformation, and the limits of expertise on social media.[01:07:00] Lead in Protein Powder: Why incidental lead is unavoidable, the risk of contamination (especially in plant-based powders), and how to ensure supplement safety.⭐ Get More Value: Exclusive Content and ResourcesWant to support the show and get early, ad-free access to all episodes plus exclusive bonus content? Subscribe to Barbell Medicine Plus and get ad-free listening, product discounts, and more. Try it free for 30-days.Unsure which training plan is right for you? Take the free Barbell Medicine Template Quiz to be matched with the ideal program for your goals and experience level.For media, support, or general questions, please contact us at [email protected] Takeaways & Actionable InsightsDeadlift Data is Nuanced: Top raw powerlifting deadlifts (on a stiff bar) show a near-even split between sumo and conventional pullers, suggesting that lift style remains primarily an anthropometric and individual preference, rather than one being universally "superior."Intensity Efficiency: New research suggests that one minute of vigorous activity may be equivalent to four to nine minutes of moderate activity for disease risk reduction, highlighting the superior efficiency of higher intensity exercise (though volume remains critical).Semaglutide Muscle Quality: New data on semaglutide shows that despite absolute lean mass loss (expected with any rapid weight loss), muscle function (handgrip strength) improved over 12 months, challenging the hyperbole surrounding sarcopenia risk associated with GLP-1 agonists.Supplement Safety: Due to the risk of heavy metal accumulation (like lead and cadmium), particularly in plant-based powders, consumers should only purchase protein powders that are manufactured in a GMP accredited facility and are third-party tested and batch tested. I. Strength & Records: The Deadlift Debate and Barbell SpecificityThe episode begins with a deep dive into the deadlift, inspired by a video of an impressive 420 kg (924 lb) pull on a stiff bar—a significantly harder feat than lifting the same weight on a flexible deadlift bar. The hosts use this to frame the differences between competition equipment (stiff bar vs. deadlift bar) and lift style (sumo vs. conventional).Equipment and PerformanceThe data suggests a substantial delta—as much as 67.5 kg (148 lbs)—between the heaviest pulls on a deadlift bar versus a stiff bar. This difference is attributed not only to the bar's smaller diameter (improving grip) but also its increased deflection (reducing the initial height of the pull).Dr. Feigenbaum emphasizes that the benefits of lifting more weight with a specific style or equipment are concentrated on that lift alone. Training specificity is key: a style that allows you to deadlift more does not inherently make your legs stronger for a leg press, running faster, or jumping higher. Therefore, outside of competition, stylistic preference and injury risk management should dictate your choice. For instance, determining Should I conventional or sumo deadlift for low back pain? is a highly individualized choice based on mechanics and comfort, not maximizing absolute load.Sumo vs. Conventional DataAnalyzing the top 100 raw deadlifts in the IPF (a tested federation using stiff bars) reveals that the sumo versus conventional deadlift debate is not a "slam dunk" for either style. The results are split: 52% of top men use sumo, and 48% use conventional. For women, it was 65% sumo and 35% conventional. This data suggests that elite lifters, who certainly experiment, often revert to the style that works best for their unique anthropometry and leverages. The process of progressive resistance training older adults or any new lifter requires a coach to act as a "guide to the Sorting Hat"—sampling different styles and assistance exercises to find the technique that unlocks the individual's highest training capacity.If you are looking to optimize your lifting technique and maximize your potential with an evidence-based approach, our Training Programs provide structured guidance. For those dealing with specific issues, learn to modify your approach with our Rehab Templates like the Lower Back Rehab Template at barbellmedicine.com/rehab-templates.If you are looking to optimize your lifting technique and maximize your potential with an evidence-based approach, our Training Programs provide structured guidance. For those dealing with specific issues, learn to modify your approach with our Rehab Templates like the Lower Back Rehab Template. II. New Intensity Science and Public HealthThe hosts scrutinize a new analysis that calls into question the long-held public health guideline that one minute of vigorous physical activity (VPA) is equivalent to two minutes of moderate physical activity (MPA).Vigorous vs. Moderate Activity RatiosAnalyzing accelerometer data from over 73,000 adults over eight years, the researchers found the efficiency gap to be much larger than 1:2. VPA was significantly more efficient for disease risk reduction:All-Cause Mortality: 1 minute VPA = 4 minutes MPACardiovascular Disease Mortality: 1 minute VPA = 7.8 minutes MPAType 2 Diabetes: 1 minute VPA = 9 minutes MPAThe METs Conundrum and Talk TestThe hosts theorize that this massive disconnect may be an artifact of using Metabolic Equivalents (METs)—a highly flawed, one-size-fits-all measure—to categorize exercise. The key insight is that for exercise to be effective, it must be hard enough to count as exercise for the individual. What is moderate for a fit person may be high intensity for a person with COPD.Instead of relying on confusing MET scores or new, complex jargon like the ACSM's new "metabolic threshold" domains, the most practical tool for the public is the Talk Test.Practical Recommendation: Exercise at an intensity where you can only speak a few words before needing to take a breath (around Ventilatory Threshold 1, or Zone 2). This is hard enough to drive cardiorespiratory adaptations (at least 60% of max heart rate) but sustainable enough to accumulate necessary volume.To integrate effective cardio into your regimen, whether you're managing systemic health or seeking peak performance, visit our Barbell Medicine Resources Page for hundreds of articles and guides on evidence-based strength training and health, including practical tips on measuring exercise intensity.⚕️ III. Medical & Wellness UpdatesSemaglutide and Muscle PreservationThe discussion addresses the widespread concern about muscle loss (sarcopenia) while using GLP-1 receptor agonists (like semaglutide) for weight management. The SEMALEAN study provided critical data:Weight Loss: Patients lost an average of 12.7% of body weight over 12 months.Lean Mass Loss: The calculated ratio of fat mass loss to lean mass loss was approximately 80% fat / 20% lean mass (close to the expected 75/25 ratio for diet-only interventions).Muscle Function: Crucially, handgrip strength—a key measure of muscle function—significantly improved over 12 months, despite no prescribed exercise.Dr. Baraki emphasizes that muscle quality and function are more important than absolute mass changes, especially when excess fat affects muscle quality. The improvement in function directly counters the hysteria about drug-induced sarcopenia. However, for those with conditions like diabetic neuropathy, careful monitoring and strength program modifications for diabetic neuropathy are essential to maximize benefits while protecting tissue.The takeaway is that resistance training remains the single most important intervention to preserve and build muscle function during weight loss, making these anti-obesity medications and strength training a powerful combined therapy.Influencer Regulation and Heavy Metal RiskThe episode concludes with two policy topics:China's Influencer Mandate: The hosts critique China's new requirement for influencers discussing sensitive topics (medicine, law, finance) to possess formal, certified degrees. While acknowledging the societal need to combat misinformation, they express concern that such government mandates set a dangerous precedent for free speech and online discourse, potentially limiting the dissemination of valuable information by experienced non-credentialed individuals.Lead in Protein Powder: Following viral consumer reports, the hosts clarify that trace amounts of lead are unavoidable in all food products. However, contamination is a real risk. Consumers, particularly those using plant-based proteins (which accumulate more heavy metals from the soil), must prioritize third-party tested products. The FDA/EU limits are clinically derived, but California's Prop 65 uses an ultra-conservative, non-clinically derived threshold.Protect your health and investment: If you choose to supplement, ensure your protein powder is manufactured in a GMP-accredited facility and is batch tested by a third party for contaminants like lead, cadmium, and arsenic. If you need personalized coaching guidance for complex medical conditions, including managing strength training and hypertension guidelines or managing joint issues like osteoarthritis or spondylolysis, consult our Coaching Page.Links to Papers/Topics Covered:https://www.instagram.com/reel/DPH6K28kZ3t/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA== https://www.nature.com/articles/s41467-025-63475-2 https://journals.lww.com/acsm-msse/pages/articleviewer.aspx?year=2025&issue=11000&article=00025&type=Fulltext https://www.nature.com/articles/d41586-025-03193-3https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.70141?af=R https://marketing4ecommerce.net/en/china-influencers-training/ https://www.consumerreports.org/lead/protein-powders-and-shakes-contain-high-levels-of-lead-a4206364640/Our Sponsors:* Check out Express VPN: https://expressvpn.com/BBM* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com* Check out Factor and use my code bbm50off for a great deal: https://www.factor75.com* Check out Rosetta Stone and use my code TODAY for a great deal: https://www.rosettastone.com* Check out Uncommon Goods: https://uncommongoods.com/bbm* Check out Washington Red Raspberries: https://redrazz.orgSupport this podcast at — https://redcircle.com/barbell-medicine-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
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