Barbell Medicine Podcast

In this episode, Dr. Jordan Feigenbaum and Dr. Austin Baraki dissect the federal government’s 2026 Food Pyramid Reset and its radical shift in nutrition policy. They explore the history of industry lobbying that shaped previous guidelines and evaluate whether the new emphasis on protein and animal fats aligns with current clinical evidence. Finally, the doctors provide the framework for the Barbell Medicine Dietary Guidelines, offering a practical, evidence-based framework for managing the modern food environment.

Timestamps
00:00 - Introduction: The 1992 Food Pyramid vs. the 2026 Reset
03:11 - A History of Lobbying: From the McGovern Committee to the USDA
09:44 - Big Food and Big Tobacco: How the American pantry was engineered
17:15 - The Good: Protein floors and the official war on ultra-processed foods
27:13 - The Bad: Saturated fat, beef tallow, and the dairy hall pass
44:02 - The Ugly: The 25-gram fiber gap and the retreat on alcohol guidelines
54:10 - Economic barriers and the Healthy Eating Index scores
01:06:18 - The Barbell Medicine Dietary Guidelines: A practical framework

Next Steps
For evidence-based resistance training programs: barbellmedicine.com/training-programs
For individualized medical and training consultation: barbellmedicine.com/coaching
Explore our full library of articles on health and performance: barbellmedicine.com/resources
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Key Learning Points
Environment over Willpower: Weight gain is an emergent process caused by an engineered food environment that adds nearly 500 passive calories to the average American's daily intake compared to 1977.
The New Protein Floor: The 2026 Reset finally acknowledges that the old 0.8g/kg RDA was a "survival dose." The new range of 1.2–1.6g/kg is a victory for skeletal muscle health, though doesn't really change intake for many (if they even read the guidelines).
Incoherent Fat Logic: There is a fundamental conflict in guidelines that recommend beef tallow and butter while simultaneously advising that saturated fat stay below 10% of total calories.
The Fiber Gap: By emphasizing animal proteins over legumes, the new guidelines risk widening the already massive fiber deficiency in the U.S.
The 10:1 Rule: For better metabolic health, aim for a carbohydrate-to-fiber ratio of 10:1 (acceptable) or 5:1 (elite).

References
Barbell Medicine Guidelines Coming Soon! 
https://www.youtube.com/watch?v=inCEbKyWYwg (Trial of Big Food)
https://pmc.ncbi.nlm.nih.gov/articles/PMC12027923/ 
https://www.govinfo.gov/content/pkg/CPRT-95SPRT98364O/pdf/CPRT-95SPRT98364O.pdf 
https://pubmed.ncbi.nlm.nih.gov/31462476/ 
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001050 
https://pubmed.ncbi.nlm.nih.gov/6841553/ 
https://pubmed.ncbi.nlm.nih.gov/7068846/ https://pubmed.ncbi.nlm.nih.gov/6841553/ 
https://pubmed.ncbi.nlm.nih.gov/7068846/ 
https://pmc.ncbi.nlm.nih.gov/articles/PMC10552423/ 
https://pubmed.ncbi.nlm.nih.gov/26980437/ 
https://pubmed.ncbi.nlm.nih.gov/26843151/ 
https://pmc.ncbi.nlm.nih.gov/articles/PMC10552423/ 
https://pubmed.ncbi.nlm.nih.gov/26980437/ 
https://pmc.ncbi.nlm.nih.gov/articles/PMC6124841/ 
https://pubmed.ncbi.nlm.nih.gov/28889851/
https://www.ers.usda.gov/data-products/chart-gallery/chart-detail?chartId=58372#:~:text=As%20their%20incomes%20rise%2C%20U.S.,of%20after%2Dtax%20income). 
https://www.ers.usda.gov/data-products/food-price-outlook/summary-findings#:~:text=Beef%20and%20veal%20prices%20are,higher%20than%20in%20August%202024. 
https://pmc.ncbi.nlm.nih.gov/articles/PMC4733413/ 
https://pubmed.ncbi.nlm.nih.gov/26843151/ 
https://www.barbellmedicine.com/blog/how-to-eat-a-healthy-diet/
https://www.barbellmedicine.com/resources/calorie-calculator/ 
https://www.barbellmedicine.com/resources/macronutrient-calculator/

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Fiber is the most underutilized tool in human nutrition. While the internet is currently buzzing about the new food pyramid and debating processed foods versus beef tallow, most people are missing the actual structural levers that dictate health and performance.
Today, we are launching the Barbell Medicine Fiber Action Plan to bridge the gap between clinical science and your next trip to the grocery store.
If you are a Barbell Medicine Plus subscriber, you can binge the entire 4-part audio series and download the full Action Plan right now in the Plus feed. If you are not a subscriber, head to the link below to sign up for early access to the Action Plan and exclusive content.
Join Barbell Medicine Plus: https://barbellmedicine.supercast.com/
In this series, we move beyond the simple soluble versus insoluble labels and discuss how fiber can lower cholesterol, manage blood sugar, and regulate satiety. Nutrition should not be a social media shouting match; it should be a deliberate strategy for your health. Stop guessing, get the guide, and let us get to work.

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For decades, the health and fitness industry has blamed rising obesity rates on a lack of individual willpower and "poor choices." However, a landmark lawsuit in San Francisco argues that the modern food environment is a public nuisance engineered by food giants using a literal tobacco playbook. By manipulating "Bliss Points" and dismantling the natural food matrix, these companies have created an environment where healthy choices are the path of highest resistance. Understanding the shift from personal responsibility to environmental accountability is the first step in reclaiming your health.
Next Steps
For evidence-based resistance training programs: barbellmedicine.com/training-programs
For individualized medical and training consultation: barbellmedicine.com/coaching
Explore our full library of articles on health and performance: barbellmedicine.com/resources
To join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: https://barbellmedicine.supercast.com/

Timestamps
00:00 - The San Francisco Lawsuit vs. Big Food
01:46 - Legal Shift: Personal Choice vs. Public Nuisance
08:02 - Probabilistic Automaticity: Why Environment Wins
13:40 - The 500-Calorie Shift: The Rise of Energy Toxicity
16:11 - The Tobacco Playbook & The Bliss Point
22:33 - The Potato Continuum & The Food Matrix
28:09 - Yale Food Addiction Scale (YFAS) Data
33:48 - The BMJ Umbrella Review on UPF Risks
52:35 - Practical Strategy: Playing Offense at Home

Key Points 
The Public Nuisance Shift: Why legal strategy is moving away from "individual choice" toward holding corporations accountable for creating a toxic health environment.
Probabilistic Automaticity: Human willpower hasn't decreased since the 1970s; instead, the probability of making a "bad" choice has been engineered to increase through environmental cues.
The Bliss Point: How food scientists precisely calibrate salt, sugar, and fat to create a transient "nirvana" that mutes the brain's satiety signals.
The Potato Continuum: A framework for understanding how processing transforms a simple, satiating food into an energy-dense, hyper-palatable "drug."
Food Addiction Data: Why 14% of adults meeting the Yale Food Addiction Scale criteria suggests a systemic design flaw in our food supply, not a character flaw in the consumer.
The Tobacco Playbook: The historical link between cigarette manufacturers buying food companies and the subsequent optimization of addictive "mouthfeel" and delivery systems.

Clinical Pearls

Master Your Micro-Environment: Spend your "willpower budget" only once—at the grocery store. If hyper-palatable foods aren't in your pantry, they cannot exploit your fatigue at 9 p.m.
Prioritize the Food Matrix: Aim for foods high in protein and fiber that have "built-in stoplights," rather than ultra-processed items where the matrix has been dismantled.
Distraction-Free Feeding: Eliminate "subconscious eating" by removing screens during meals, allowing your brain to accurately register hormonal satiety signals like leptin and ghrelin.

References:
https://sfcityattorney.org/san-francisco-city-attorney-chiu-sues-largest-manufacturers-of-ultra-processed-foods/ 
https://www.lawforhoas.com/civil-code-section-3479-nuisance-defined 
https://www.naag.org/our-work/naag-center-for-tobacco-and-public-health/the-master-settlement-agreement/ 
https://pmc.ncbi.nlm.nih.gov/articles/PMC3667220/
https://pubmed.ncbi.nlm.nih.gov/22551473/ 
https://linkinghub.elsevier.com/retrieve/pii/S0195666325000819
https://psycnet.apa.org/record/2006-22447-006 
Maimati 2018 
Stephen 2020 
Machado 2019 
Young 2002
Zlatevska 2014 
https://pubmed.ncbi.nlm.nih.gov/37250387/ 
https://pmc.ncbi.nlm.nih.gov/articles/PMC6550161/
https://pubmed.ncbi.nlm.nih.gov/30040431/ 
https://pubmed.ncbi.nlm.nih.gov/31105044/ 
https://pubmed.ncbi.nlm.nih.gov/37813420/ 
https://ajcn.nutrition.org/article/S0002-9165(22)00584-6/fulltext 
https://pubmed.ncbi.nlm.nih.gov/38418082/ 
https://www.fao.org/3/ca5644en/ca5644en.pdf
https://www.mdpi.com/2674-0311/3/3/25 
Powell 2013 
Bhutani 2018 
Fernandez 2021

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A 23-year-old soldier presents with hypertensive urgency and acute kidney injury. He thought he was doing everything right for his health—so what caused his system to fail? Dr. Feigenbaum and Dr. Baraki break down the clinical evidence and the surprising lab results.

Timestamps
[00:00] Introduction to the Case: The Fit Soldier’s Failure
[01:07] Welcome and Mystery Case Framework
[02:05] Patient History: The River and the GI Symptoms
[03:53] Building the Differential: Infection vs. Dehydration
[08:20] Initial Workup and the Hypercalcemia Discovery
[14:14] The Medical Student’s Reveal: Supplement Reconciliation
[18:05] Final Diagnosis: Severe Hypervitaminosis D
[22:20] Metastatic Calcification and Permanent Vascular Damage
[25:23] The Mechanism of Jaw Pain: Bone Resorption
[28:34] Science Review: Debunking the Pilz (2011) Study
[32:27] Fat-Soluble vs. Water-Soluble Risks
[43:06] The Free Vitamin D Hypothesis
[48:06] Updated 2024 Endocrine Society Guidelines
[55:16] Final Thoughts: Vitamin D and the Endurance Population

Next Steps
For evidence-based resistance training programs: barbellmedicine.com/training-programs
For individualized medical and training consultation: barbellmedicine.com/coaching
Explore our full library of articles on health and performance: barbellmedicine.com/resources
To join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: https://barbellmedicine.supercast.com/

Key Learning Points 
The Testosterone Fallacy: Meta-analyses confirm that Vitamin D supplementation has no significant effect on testosterone levels in men who are not clinically deficient.
The Fat-Soluble Risk: Unlike water-soluble vitamins, Vitamin D is stored in adipose tissue, meaning toxicity can persist for months or years after cessation.
Metastatic Calcification: Severe Vitamin D toxicity causes calcium phosphate to deposit in arterial walls, potentially turning flexible vessels into rigid pipes.
2024 Endocrine Guideline Shift: Updated medical standards now recommend against routine Vitamin D screening and universal high-target levels for healthy adults.
The Natural Blind Spot: Patients often fail to categorize supplements as "medication," leading to dangerous diagnostic delays when clinicians do not ask specifically about over-the-counter products.
The Mechanism of Bone Pain: Toxic Vitamin D levels can drive aggressive bone resorption, effectively "stealing" calcium from the skeleton and causing severe pain.

Clinical Pearls 

Screening Protocol: Avoid routine Vitamin D blood testing for healthy, asymptomatic adults under 75 unless a specific condition like malabsorption or osteoporosis is present.
Dosing Guidelines: For the general population, stick to the daily recommended intake (600–800 IU) rather than using high-dose bolus therapy or chasing a serum level of 30 ng/mL.
Medication Reconciliation: Always disclose all "natural," "herbal," or "gym-based" supplements to your medical provider, as these can interact with other medications or cause direct toxicity.

Timestamps
[00:00] Introduction to the Case: The Fit Soldier’s Failure
[01:07] Welcome and Mystery Case Framework
[02:05] Patient History: The River and the GI Symptoms
[03:53] Building the Differential: Infection vs. Dehydration
[08:20] Initial Workup and the Hypercalcemia Discovery
[14:14] The Medical Student’s Reveal: Supplement Reconciliation
[18:05] Final Diagnosis: Severe Hypervitaminosis D
[22:20] Metastatic Calcification and Permanent Vascular Damage
[25:23] The Mechanism of Jaw Pain: Bone Resorption
[28:34] Science Review: Debunking the Pilz (2011) Study
[32:27] Fat-Soluble vs. Water-Soluble Risks
[43:06] The Free Vitamin D Hypothesis
[48:06] Updated 2024 Endocrine Society Guidelines
[55:16] Final Thoughts: Vitamin D and the Endurance Population

References
https://pmc.ncbi.nlm.nih.gov/articles/PMC9478588/ 
https://link.springer.com/article/10.1007/s12020-020-02482-3 
https://pubmed.ncbi.nlm.nih.gov/32446600/ 
https://pubmed.ncbi.nlm.nih.gov/21154195/ 
https://academic.oup.com/jcem/article/109/8/1907/7685305?login=false 
https://academic.oup.com/edrv/article/45/5/625/7659127 
https://academic.oup.com/milmed/article/189/1-2/e417/7218964  

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Biohackers and longevity clinics claim peptides are a side-effect-free sniper rifle for fat loss and injury recovery, but the reality is often buried in failed clinical trials and regulatory bans. Many popular compounds like BPC-157 have never undergone a single randomized controlled trial in humans, despite their reputation for Wolverine-like healing. This episode dismantles the hype surrounding the gray market, exposing the significant risks of immunogenicity and heavy metal contamination. Learn why modern load management and evidence-based medicine beat a research chemical bought with Bitcoin every time.

Next Steps
For evidence-based resistance training programs: barbellmedicine.com/training-programs
For individualized medical and training consultation: barbellmedicine.com/coaching
Explore our full library of articles on health and performance: barbellmedicine.com/resources
To join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: https://barbellmedicine.supercast.com/

Key Points
The FDA Category 2 Crackdown: Federal regulators restricted many peptides because of the risk of immunogenicity where the body creates antibodies that attack its own proteins.
BPC-157 Has Zero Human Data: Despite being marketed for tendon repair, there is not a single published human randomized controlled trial for this molecule.
The MK-677 Prediabetes Tax: While it increases lean mass, human trials show zero improvement in strength or power while frequently causing insulin resistance.
Retatrutide as the Weight Loss Godzilla: This triple agonist is achieving nearly 29 percent weight loss in trials by increasing energy expenditure through thermogenesis.
Sourcing and Safety Realities: A study of 44 research chemicals found that only 18 actually contained the labeled compound, with many containing heavy metals.
The 40-Amino-Acid Rule: The legal distinction between a peptide and a protein is based on size, which dictates how the FDA regulates these substances and how your body absorbs them.

 Timestamps

00:03 Intro: The CJC-1295 Heart Attack Case
05:39 Defining a Peptide: The 40-Amino-Acid Bright Line
15:14 GH Secretagogues: CJC-1295 and Ipamorelin
23:51 MK-677: The Oral Hunger Mimetic and Prediabetes Risk
32:56 BPC-157 and the Lack of Human Data
38:12 Immunogenicity: Why the FDA Banned BPC-157
49:46 Retatrutide: The Triple Agonist Weight Loss Godzilla
01:11:24 Summary: Peptides vs. Anabolic Steroids
01:16:12 The Sourcing Spectrum: Pharmaceutical vs. Research Chemicals

Clinical Pearls

Use load management and progressive resistance training as the primary intervention for tendon and muscle injuries rather than unproven peptides.
If choosing to use metabolic modulators, monitor fasting blood glucose and insulin sensitivity to avoid drug-induced prediabetes or metabolic dysfunction.
Avoid the research chemical gray market entirely due to the high prevalence of under-dosing, contamination, and incorrect active ingredients found in third-party testing.
Resources
https://pubmed.ncbi.nlm.nih.gov/16352683/
https://pubmed.ncbi.nlm.nih.gov/18347346/
https://pmc.ncbi.nlm.nih.gov/articles/PMC2657499/
https://pubmed.ncbi.nlm.nih.gov/9849822/
https://pubmed.ncbi.nlm.nih.gov/10496658/
https://pubmed.ncbi.nlm.nih.gov/21298258/
https://pubmed.ncbi.nlm.nih.gov/18981485/
https://pubmed.ncbi.nlm.nih.gov/9467542/
https://pubmed.ncbi.nlm.nih.gov/18981485/
https://pubmed.ncbi.nlm.nih.gov/20554713/
https://pubmed.ncbi.nlm.nih.gov/39813152/
Duzel 2007
Strinic 2017
Sikiric 1993
He 2022
https://pmc.ncbi.nlm.nih.gov/articles/PMC2289708/
https://pubmed.ncbi.nlm.nih.gov/10469335/
https://pubmed.ncbi.nlm.nih.gov/23050815/
https://pubmed.ncbi.nlm.nih.gov/20536454/
https://pubmed.ncbi.nlm.nih.gov/29986520/
https://pmc.ncbi.nlm.nih.gov/articles/PMC4508379/
https://pubmed.ncbi.nlm.nih.gov/41090431/
https://pubmed.ncbi.nlm.nih.gov/38858523/
https://pubmed.ncbi.nlm.nih.gov/20445536/
https://pmc.ncbi.nlm.nih.gov/articles/PMC3136748/#R41
https://pubmed.ncbi.nlm.nih.gov/25738459/
https://pubmed.ncbi.nlm.nih.gov/33473109/
https://pmc.ncbi.nlm.nih.gov/articles/PMC5826726/
https://pubmed.ncbi.nlm.nih.gov/31599840/
https://pubmed.ncbi.nlm.nih.gov/18206919/
https://pmc.ncbi.nlm.nih.gov/articles/PMC5820696/

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