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- 6 days ago32 min
The Protein Scaries: What the Research Says About Your Kidneys, Cancer, Bones, and Body Fat
Every couple of years a new headline warns that the protein you eat is quietly hurting you. This year the target is your kidneys. Before that it was cancer, then your bones, then the claim that your body can only use twenty or thirty grams of protein at a meal. In this episode, Dr. Jordan Feigenbaum goes through the actual studies behind each scare: the kidney trials, the 2014 IGF-1 and cancer paper that started the panic, the acid-ash bone hypothesis, and the per-meal "cap." Each fear starts from a real mechanism, and each one was run straight to a frightening conclusion the clinical outcomes never supported.The take home is simple. For a healthy adult, protein is not the lever people think it is, and where a real signal exists (processed and red meat, or a kidney that is already diseased) it tracks the whole dietary pattern more than the protein number. The two things that actually decide your health here are whether you eat mostly real food and whether you train.Timestamps00:00 The protein scare cycle 01:23 The four fears 01:59 Kidneys: healthy kidneys under higher protein 06:22 Kidney disease: does cutting protein help? 09:38 Red meat and the dietary pattern, not protein 12:00 Muscle, aging, and lifting on a restricted diet 13:54 Cancer: IGF-1 and the 2014 study everyone cites 16:22 The age reversal, and what travels with protein 18:48 Bigger data, processed meat, and the IGF-1 tell 22:15 Bones and the acid-ash myth 25:13 The 30-gram cap 27:17 What protein actually does, and how much you need 32:20 The two questions that matterResources:Barbell Medicine coaching and templates: https://www.barbellmedicine.comPlus podcast subscription: https://www.barbellmedicine.com/shop/subscriptions/plus-podcast-subscription/Barbell Medicine Premium: https://www.barbellmedicine.com/shop/subscriptions/barbell-medicine-premium/Signal (book pre-order): https://www.barbellmedicine.com/shop/learning/signal/Our Protein Content:https://www.barbellmedicine.com/blog/protein-and-weight-loss/https://www.barbellmedicine.com/blog/protein-on-ozempic/https://www.barbellmedicine.com/blog/barbell-medicine-protein-recommendations/StudiesLevine et al. Cell Metabolism 2014. doi:10.1016/j.cmet.2014.02.006Naghshi et al. BMJ 2020. doi:10.1136/bmj.m2412 Devries et al. J Nutr 2018. doi:10.1093/jn/nxy197 Antonio et al. J Nutr Metab 2016. doi:10.1155/2016/9104792 Knight et al. Ann Intern Med 2003. doi:10.7326/0003-4819-138-6-200303180-00009 Klahr et al. (MDRD). NEJM 1994. doi:10.1056/NEJM199403313301301 Hahn, Hodson & Fouque. Cochrane 2020. doi:10.1002/14651858.CD001892.pub5 Obeid, Hiremath & Topf. Kidney360 2022. doi:10.34067/KID.0001002022 Lew et al. J Am Soc Nephrol 2017. doi:10.1681/ASN.2016030248Castaneda et al. Ann Intern Med 2001. doi:10.7326/0003-4819-135-11-200112040-00008 Bauer et al. (PROT-AGE). JAMDA 2013. doi:10.1016/j.jamda.2013.05.021Fenton et al. Nutrition Journal 2011. doi:10.1186/1475-2891-10-41Shams-White et al. Am J Clin Nutr 2017. doi:10.3945/ajcn.116.145110Witard et al. Am J Clin Nutr 2013. doi:10.3945/ajcn.112.055517 Macnaughton et al. Physiol Rep 2016. doi:10.14814/phy2.12893Trommelen et al. Cell Reports Medicine 2023. doi:10.1016/j.xcrm.2023.101324 Wycherley et al. Am J Clin Nutr 2012. doi:10.3945/ajcn.112.044321 Moore et al. JAMA Intern Med 2016. doi:10.1001/jamainternmed.2016.1548 Larsson et al. Cancer Med 2020. doi:10.1002/cam4.3345 Brenner, Meyer & Hostetter. NEJM 1982. doi:10.1056/NEJM198209093071104 Chan et al. PLoS One 2011. doi:10.1371/journal.pone.0020456Berryman et al. Am J Clin Nutr 2018. doi:10.1093/ajcn/nqy088 Morton et al. Br J Sports Med 2018. doi:10.1136/bjsports-2017-097608Our Sponsors:* Check out Chilipad and use my code BBM for a great deal: https://sleep.me* Check out CovePure and use my code CovePure.com/bbm for a great deal: https://covepure.com* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brands
- 1 weeks ago31 min
Is It Really Just Calories In, Calories Out? Metabolism, Insulin, Hormones and Why Counting Fails
Is weight loss really just Calories in, Calories out? The equation is true, but "just count your Calories" is bad advice for most people, and almost every objection to it is pointing at something real. In part two of our energy balance series, Jordan Feigenbaum takes the biggest "it's not Calories, it's ___" claims (metabolism, thyroid, cortisol, PCOS, insulin, the type of food) and tests each against the best evidence. The verdict: none of them breaks the equation. Every one is a hand on a lever that moves Calories in or Calories out, not a hole in the math.In this episode: why your metabolism does not crash at 40, how small real metabolic adaptation actually is after weight loss, why hypothyroid weight is mostly water, what the cortisol and PCOS (now PMOS) data show, how absorption and cooking move Calories only at the edges, why even dietitians miscount their own intake, and why the carbohydrate-insulin model fails three tests, including the GLP-1 drugs that raise insulin and still produce the biggest weight loss we have ever approved.Part two of three: willpower, Calories in Calories out, then GLP-1 drugs. Next week: are GLP-1s cheating?Timestamps0:00 Is it really just calories in, calories out?0:18 The willpower episode and the through-line2:10 Thermodynamics: what sets both sides2:41 Your metabolism is three things4:05 Claim 1: my metabolism crashed4:24 No cliff at 40: the doubly labeled water study5:33 Real metabolic adaptation after weight loss6:56 Why your food diary lies7:49 Claim 2: it's my hormones8:07 Thyroid: mostly water9:36 Cortisol: explains about 1 percent11:12 PCOS is now PMOS13:06 Menopause14:18 Claim 3: a calorie isn't a calorie16:48 Absorption: nuts, cooking, eggs19:44 Why calorie counting fails21:12 Claim 4: it's not Calories, it's insulin22:02 Testing the carbohydrate-insulin model25:52 The GLP-1 drugs that should end it28:34 The whole list, claim by claim29:53 What to actually do30:42 Next week: are GLP-1s cheating?Resources:Barbell Medicine coaching and templates: https://www.barbellmedicine.comhttps://www.barbellmedicine.com/shop/subscriptions/plus-podcast-subscription/https://www.barbellmedicine.com/shop/subscriptions/barbell-medicine-premium/Signal book pre-order: https://www.barbellmedicine.com/shop/learning/signal/Pontzer et al., Science 2021. https://doi.org/10.1126/science.abe5017Muller et al., Am J Clin Nutr 2015. https://doi.org/10.3945/ajcn.115.109173Lichtman et al., N Engl J Med 1992. https://doi.org/10.1056/NEJM199212313272701Karmisholt et al., J Clin Endocrinol Metab 2011. https://doi.org/10.1210/jc.2010-1521Lee et al., Endocr Pract 2014. https://doi.org/10.4158/EP14072.ORvan der Valk et al., Obes Rev 2022. https://doi.org/10.1111/obr.13376Nikokavoura et al., Diabetes Metab Syndr Obes 2015. https://doi.org/10.2147/DMSO.S85134Greendale et al., JCI Insight 2019. https://doi.org/10.1172/jci.insight.124865Lejeune et al., Am J Clin Nutr 2006. https://doi.org/10.1093/ajcn/83.1.89Bray et al., JAMA 2012. https://doi.org/10.1001/jama.2011.1918Novotny et al., Am J Clin Nutr 2012. https://doi.org/10.3945/ajcn.112.035782Baer et al., J Nutr 2016. https://doi.org/10.3945/jn.115.217372Baer et al., Br J Nutr 2012. https://doi.org/10.1017/S0007114511002649Evenepoel et al., J Nutr 1998. https://doi.org/10.1093/jn/128.10.1716Hall et al., Cell Metabolism 2019. <a href="https://doi.org/10.1016/j
- 2 weeks ago1h 42m
Is Obesity a Willpower Problem? The Biology of Weight, Diets, and GLP-1s
Obesity roughly tripled in about 60 years, and the genes didn't change in that time. So if body weight isn't a willpower problem, what is it? Dr. Jordan Feigenbaum and Dr. Austin Baraki walk through what actually sets your weight: the adoption and twin studies behind the genetics, the "defended range" your biology fights to hold, the food environment that does most of the eating for you, and where GLP-1 medications actually work. Along the way — why diets regain after you white-knuckle them, what The Biggest Loser six-year data show about resting metabolism, and four willpower myths worth retiring. Hosted by Dr. Jordan Feigenbaum and Dr. Austin Baraki, co-founders of Barbell Medicine.Timestamps00:00 Cold open: Danny Cahill and The Biggest Loser01:03 What we mean by "willpower"05:48 Obesity tripled in ~60 years: the one number06:31 Adoption and twin studies: genes vs. household09:37 Set point vs. the defended range10:37 Gene–environment mismatch14:03 In the clinic: a lifelong weight history19:18 Losing weight vs. keeping it off20:26 Appetite doesn't reset (Sumithran)25:52 Metabolic adaptation and the Biggest Loser data34:07 Part 2: eating on autopilot35:10 Portion size runs the meal39:12 What changed in the food supply40:42 Same genes, new environment: Pima and immigrants43:20 Why ultra-processed food is easy to overeat50:28 Processing vs. calories: the Hall ward study52:36 When the brain changes eating: gourmand syndrome1:00:01 Why the willpower story stuck1:01:08 Taft, Churchill, and the intelligence myth1:02:43 Does intelligence predict weight? (sibling study)1:11:16 Are GLP-1s cheating? What they actually do1:15:10 Beyond the scale: muscle, health, nutrition1:24:21 Myth-busting: lightning round1:39:04 Three takeaways: what to actually do1:41:00 Danny Cahill, revisited Resources Barbell Medicine coaching and templates: https://www.barbellmedicine.comhttps://www.barbellmedicine.com/shop/subscriptions/plus-podcast-subscription/https://www.barbellmedicine.com/shop/subscriptions/barbell-medicine-premium/Signal book pre-order: https://www.barbellmedicine.com/shop/learning/signal/Coaching, programs & templates: https://www.barbellmedicine.com/Prevalence of Overweight, Obesity, and Severe Obesity Among Adults Age 20 and Older: United States, 1960-1962 Through August 2021-August 2023. NCHS Health E-Stats. 2024. https://www.cdc.gov/nchs/data/hestat/hestat111.htmObesity and Severe Obesity Prevalence in Adults: United States, August 2021-August 2023. NCHS Data Brief No. 508. Hyattsville, MD: National Center for Health Statistics; 2024. https://www.cdc.gov/nchs/products/databriefs/db508.htmHill JO, Peters JC. Environmental contributions to the obesity epidemic. Science. 1998;280(5368):1371-1374. https://doi.org/10.1126/science.280.5368.1371Morton RW, Murphy KT, McKellar SR, et al. A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults. Br J Sports Med. 2018;52(6):376-384. https://doi.org/10.1136/bjsports-2017-097608Stunkard AJ, Sorensen TIA, Hanis C, et al. An adoption study of human obesity. N Engl J Med. 1986;314(4):193-198. https://doi.org/10.1056/NEJM198601233140401Stunkard AJ, Harris JR, Pedersen NL, McClearn GE. The body-mass index of twins who have been reared apart. N Engl J Med. 1990;322(21):1483-1487. https://doi.org/10.1056/NEJM199005243222102Speakman JR, Levitsky DA, Allison DB, et al. Set points, settling points and some alternative models: theoretical options to understand how genes and environments combine to regulate body adiposity. Dis Model Mech. 2011;4(6):733-745. https://doi.org/10.1242/dmm.008698Kalm LM, Semba RD. They starved so that others be better fed: remembering Ancel Keys and the Minnesota Experiment. J Nutr. 2005;135(6):1347-1352. https://d
- 3 weeks ago49 min
Direct Line (Free): GLP-1 Muscle Loss and Creatine, Bulking vs Cutting, One-Hour Training, & Detraining
Once a month we answer Barbell Medicine Plus subscribers’ questions on the Direct Line. This is a free look at June’s episode. We start with GLP-1 drugs and muscle: why DEXA overstates the loss, what resistance training actually does, and whether creatine is worth taking. Then whether bulking and cutting does anything the scale can’t already tell you, how to get real benefit from one training hour a week, and what happens to your muscle, strength, tendons, and bone when you take time off, including why muscle memory brings it back faster than you built it.What we cover:• GLP-1s and muscle: the DEXA problem, resistance training, and creatine• Bulking vs cutting vs just maintaining, and a health-first way to choose• Training on one hour a week: the least that still moves the needle• How fast you lose muscle when you stop, and why it comes back fastThe full two-hour episode and every back episode are on Barbell Medicine Plus, which can bundled with Premium. Resources and full references below.Timestamps0:00 Intro + GLP-1 and the DEXA muscle-loss myth3:00 Do GLP-1s spare or waste muscle?8:03 Does creatine help on a GLP-1?10:45 Does bulking and cutting do anything?13:18 Health first: when to lose fat before gaining22:30 Training on one hour a week36:22 How fast you lose muscle when you stop43:19 Muscle memory: why it comes back48:25 The full episode on PlusResourcesBarbell Medicine coaching and templates: https://www.barbellmedicine.comhttps://www.barbellmedicine.com/shop/subscriptions/plus-podcast-subscription/https://www.barbellmedicine.com/shop/subscriptions/barbell-medicine-premium/Signal book pre-order: https://www.barbellmedicine.com/shop/learning/signal/https://www.barbellmedicine.com/blog/glp-1-muscle-loss/https://www.barbellmedicine.com/blog/creatine-on-ozempic-does-it-prevent-muscle-loss/https://www.barbellmedicine.com/blog/novice-intermediate-advanced-strength-training/Lundgren JR, et al. Healthy Weight Loss Maintenance with Exercise, Liraglutide, or Both Combined (S-LITE). N Engl J Med 2021;384:1719-1730. nejm.org · NEJMoa2028198T-REX trial: tirzepatide with or without resistance training (Univ. of Western Australia). Preliminary. ANZCTR ACTRN12623001236684Creatine + GLP-1 pilot (Univ. of Saskatchewan). Ongoing, results expected 2027. ClinicalTrials.gov NCT07625202Momma H, et al. Muscle-strengthening activities and lower risk/mortality in major non-communicable diseases. Br J Sports Med 2022. PubMed 35228201Wall BT, et al. 2014. Immobilization and disuse muscle atrophy (quadriceps −3.5% at 5 days, −8% at 14 days). PubMed 24168489Gaffney CJ, et al. 2021. Grip strength loss with short-term arm immobilization. PMC8107283Farthing JP, et al. 2009. Cross-education and preservation of the immobilized limb. PubMed 19150859Marusic U, et al. 2021. Bed rest: strength loss outpaces size loss. PMC8325614Yoshihara, et al. 2023. Sepsis-associated muscle wasting (−26% in a week). PMC10003568Warren GL, et al. 2017. Strength loss and recovery after muscle injury (meta-analysis). PMC5214801Hortobágyi T, et al. 1993. Short-term detraining in strength athletes. PubMed 8371654Gavanda S, et al. 2020. Training cessation in previously untrained adolescents. PMC7241623Lovell DI, et al. 2010. Detraining strength loss in older adults. PubMed 20140683Mujika I, Padilla S. 2001. Physiology of detraining (review). PubMed 11474330Smith K, et al. 2003. Two years of training, then detraining, in older adults. PubMed 12
- Jun 26, 20261h 43m
Menopause Part 4: Training, Protein, Cortisol, Hormone Therapy, & Bone Density
Is there really a “menopause-specific” way to train, eat, and supplement — or is most of it marketing? In the finale of our 4-part menopause series, Drs. Jordan Feigenbaum and Austin Baraki go straight to the evidence on building muscle and bone before, during, and after the transition.We cover whether menopause blunts your response to lifting (the Isenmann 2023 head-to-head trial and the 2026 meta-analysis of ~4,000 women say it doesn’t), the one-index-card prescription that actually works. Then we work through the loudest claims in the space — cortisol “wrecking” your fat loss, anabolic resistance, the protein and creatine hype, hormone therapy as a cure-all, and “you need a different paradigm” — steelmanning each before we push back. We close with the strongest case in the whole space: heavy lifting for bone density (the LIFTMOR trial), the pelvic-floor evidence, your three biggest fears answered, and how to tell a good coach or clinician from a bad one.Claims discussed are associated with Stacey Sims, Mary Claire Haver, Mindy Pelz, and the broader functional-medicine space. We push back on the claims, not the people.Timestamps:0:00 The 90-year-olds who tripled their strength 1:10 Why this matters: heart disease and falls, not vanity 2:28 Can women still build muscle after menopause? (Isenmann 2023) 7:31 Does menopause blunt your gains? The 2026 meta-analysis 8:49 Is it menopause, or just individual variation? 14:42 The estrogen "shield" and the mechanical override 18:31 Does hormone therapy replace training? (the 2021 estradiol trial) 22:44 What actually works: the whole prescription 24:18 Program details: frequency, volume & insulin sensitivity 30:22 Nutrition: protein and the 2026 review 35:06 Creatine, vitamin D & calcium 43:29 Anabolic resistance: mostly overstated 47:22 Clinical case: the supplement-stack patient 52:23 A short history of wrong advice for women 53:38 Claim 1: "Lift heavy or lose your bones" (Stacey Sims) 1:01:09 Claim 2: the cortisol myth 1:15:18 Clinical case: the cortisol-anxious patient 1:18:20 Claim 3: "It's all hormonal, HRT fixes it" (Mary Claire Haver) 1:20:45 Testosterone in women: what it does and doesn't do 1:21:51 Claim 4: "Menopause needs its own paradigm" & the SWAN data 1:24:48 Bone density done right: the LIFTMORE trial 1:33:07 Does heavy lifting wreck your pelvic floor? 1:38:59 Your three biggest fears, answered 1:40:44 Green flags & red flags Resources:Menopause Series Part 1 : https://www.youtube.com/watch?v=yzk0IkTy0WMMenopause Series Part 2 — https://www.youtube.com/watch?v=YKAlamIOiwU Menopause Series Part 3 — https://www.youtube.com/watch?v=jzoNMQaBAcI Hypercortisolism episode - https://open.spotify.com/episode/7tDdUi8dDFWjMYx0fRJdOz Barbell Medicine coaching and templates: https://www.barbellmedicine.comSignal book pre-order: https://www.barbellmedicine.com/shop/learning/signal/Isenmann (2023) https://doi.org/10.1186/s12905-023-02671-yIsenmann (2026) https://doi.org/10.1016/j.jsams.2026.01.004Fiatarone (1990) https://doi.org/10.1001/jama.1990.03440220053029Fiatarone (1994) https://doi.org/10.1056/NEJM199406233302501Dam (2021) https://doi.org/10.3389/fphys.2020.596130Markofski (2015) https://doi.org/10.1016/j.exger.2015.02.015Orsatti (2022) https://doi.org/10.1016/j.exger.2022.111904Walter (2026) https://doi.org/10.1186/s40798-025-00954-2dos Santos (2021) https://doi.org/10.3390/nu13113757Myung (2021) https://doi.org/10.3390/nu13020368Dote-Montero (2021) https://doi.org/10.1111/sms.13999Ravussin (2015) https://doi.org/10.1093/gerona/glv05
- Jun 12, 20261h 43m
Menopause Part 3: Body Composition, Bone, Brain, & the Fitness Changes (The Data vs the Influencers)
Most women in 2026 are told menopause affects everything, the weight, the belly fat, the bones, the heart, the brain, and that the fix is hormones, supplements, and a proprietary protocol. The data tell a different story. Menopause does some of it, but not all of it.In this episode, Dr. Jordan Feigenbaum and Dr. Austin Baraki, with OB-GYN Dr. Loraine Baraki at the clinical handoffs, put real numbers on what menopause actually changes, e.g. body composition, the cardiometabolic shift around the final menstrual period, bone, cognition and sleep — and on the single biggest modifiable lever against what actually kills postmenopausal women.This is Episode 3 of Barbell Medicine's four-part menopause series.Timestamps:01:23 Intro 02:45 Body composition & the SWAN study 04:16 How much weight gain is really menopause? 06:55 The answer: about 1.5 kg 08:14 Subcutaneous vs visceral fat 11:08 Why waist beats weight (and body-fat %) 17:21 Does menopause crash your metabolism? 19:02 Clinic: MHT for body composition 23:51 Dr. Loraine Baraki — MHT, weight & testosterone 27:29 The cardiometabolic shift: cholesterol at the FMP 30:18 Insulin resistance & metabolic syndrome 33:12 Blood pressure & 10-year heart risk 34:54 Clinic: the "estrogen crisis" lipid panic 39:13 Bone: the advice vs the data 40:34 Why DXA misses most fractures 41:24 LIFTMOR: lifting heavy with low bone density 44:47 The LIFTMOR results 46:53 Lifting vs Pilates, and falls 52:17 Clinic: "Should I be deadlifting?" 56:14 Cognition & brain fog 57:50 Why brain fog is mostly a sleep problem 59:17 Clinic: brain fog, night sweats, broken sleep 1:03:06 Depression & dementia in midlife 1:05:43 Does hormone therapy protect the brain? 1:08:53 Clinic: "Am I getting early dementia?" 1:13:19 Dr. Loraine Baraki — the timing hypothesis & the brain1:16:15 What actually kills postmenopausal women 1:17:31 Fitness: the biggest mortality lever 1:20:21 Strength, power & grip 1:25:15 Clinic: where to start when you're overwhelmed 1:30:41 The detraining problem 1:32:38 Trained vs untrained: what's recoverable 1:34:53 The actual plan 1:39:48 TakeawaysResources:Subscribe to BBM Plus for the full unabridged Direct Line: https://barbellmedicine.supercast.com/Barbell Medicine coaching and templates: https://www.barbellmedicine.com/Signal book pre-order: https://www.barbellmedicine.com/shop/learning/signal/Body composition & metabolism Greendale et al., SWAN body composition, JCI Insight 2019: https://doi.org/10.1172/jci.insight.124865 Lovejoy et al., visceral fat across the transition, Int J Obes 2008: https://doi.org/10.1038/ijo.2008.25 Pontzer et al., daily energy expenditure across life, Science 2021: https://doi.org/10.1126/science.abe5017 Karppinen et al., metabolism in midlife women, Eur J Prev Cardiol 2023: https://doi.org/10.1093/eurjpc/zwad177CardiometabolicMatthews et al., lipid changes & the menopause transition, JACC 2009: https://doi.org/10.1016/j.jacc.2009.10.009Janssen et al., menopause & metabolic syndrome (SWAN), Arch Intern Med 2008: https://doi.org/10.1001/archinte.168.14.1568 El Khoudary et al., AHA Scientific Statement on midlife women, Circulation 2020: https://doi.org/10.1161/CIR.0000000000000912BoneGreendale et al., SWAN bone loss across the FMP, JBMR 2012: https://doi.org/10.1002/jbmr.534 Siris et al., undiagnosed low BMD & fractures (NORA), JAMA 2001: https://doi.org/10.1001/jama.286.22.2815 Watson et al., LIFTMOR, JBMR 2018: https://doi.org/10.1002/jbmr.3284
- Jun 5, 202631 min
Menopause, Part 2: The 2,000-Year-Old Lie About Women and Exercise
The story goes that hard exercise is risky for women, and that the idea is ancient. Both halves fall apart on contact. In this solo episode, Dr. Jordan Feigenbaum follows the claim that physical effort harms the female body across twenty centuries, and shows that almost every version of it arrived as a verdict first, with the science bolted on afterward.It runs from antiquity to the present: what Galen actually wrote, why Sparta trained its women on purpose, the Victorian “vital force” panic and Edward Clarke’s claim that studying would sterilize girls, the doctor who prescribed bed rest to women and the wilderness to men, and the 1928 Olympic 800m that was erased for 32 years over a collapse that never happened. Then the correction: the research that finally tested heavy training in older women and women with low bone mass, and what it found. The episode closes on 2026, where the guidelines say lift and the menopause market often says don’t.What we cover• Why the “ancient Greeks” origin story for the no-hard-exercise rule doesn’t hold up.• How a Victorian energy-budget idea became a medical case against women lifting and studying.• The real story of the 1928 Olympic women’s 800m and the 32-year ban.• The strong women who were relabeled as freaks or exceptions instead of counted.• What Fiatarone’s nonagenarians and LIFTMOR actually showed about lifting heavy later in life.• The cortisol panic, the fasting scare, and cycle syncing, examined against the data.• Why the cautious messaging now comes from the market, not the medical guidelines.Timestamps00:00 The 1928 Olympic “massacre” that never happened03:37 Antiquity: what the Greeks actually said06:50 The Victorians and “vital force”10:02 Mary Putnam Jacobi tests the claim, and is ignored11:53 1928 in full: who killed the women’s 800m13:53 The double standard, and Alice Milliat15:39 The strong women history relabeled20:26 The correction: what the evidence shows22:27 LIFTMOR: lifting heavy with low bone mass24:35 2026: guidelines, the market, and cortisol28:34 Cycle syncing, and naming the pattern30:40 What to take awaySubscribe to BBM Plus for the full unabridged Direct Line: https://barbellmedicine.supercast.com/Barbell Medicine coaching and templates: https://www.barbellmedicine.com/Signal book pre-order: https://www.barbellmedicine.com/shop/learning/signal/ReferencesCahn S. Coming on Strong: Gender and Sexuality in Twentieth-Century Women's Sport. Harvard University Press; 1994.Clarke EH. Sex in Education; or, A Fair Chance for the Girls. Boston: James R. Osgood and Company; 1873.Colenso-Semple LM, McKendry J, Lim C, et al. Menstrual cycle phase does not influence muscle protein synthesis or whole-body myofibrillar proteolysis in response to resistance exercise. J Physiol. 2025. PMID: 39630025.Daly W, Hackney AC. Is exercise cortisol response of endurance athletes similar to levels of Cushing's syndrome? J Sports Med Phys Fitness. 2019. PMID: 31371847.Eastell R, Rosen CJ, Black DM, Cheung AM, Murad MH, Shoback D. Pharmacological management of osteoporosis in postmenopausal women: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2019;104(5):1595-1622. PMID: 30907953.Fiatarone MA, Marks EC, Ryan ND, Meredith CN, Lipsitz LA, Evans WJ. High-intensity strength training in nonagenarians: effects on skeletal muscle. JAMA. 1990;263(22):3029-3034. PMID: 2342214.Fiatarone MA, O'Neill EF, Ryan ND, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med. 1994;330(25):1769-1775.Galen. On the Preservation of Health (De Sanitate Tuenda). 2nd century CE. Various translations.Jacobi MP. The Question of Rest for Women During Menstruation. New York: G.P. Putnam's Sons; 1877. (Awarded the Harvard Boylston Prize.)Latella C, Teo WP, Spathis J, et al. Using powerlifting athletes to determine strength adaptations across ages in males and females: a longitudinal growth modelling approach. Sports Med. 2024;54(3):753-774.Maudsley H. Sex in mind and in education. Fortnightly Review. 1874;15:466-483.Plutarch. Life of Lycurgus. Approx. 75 CE. Various translations.Schultz J. Qualifying Times: Points of Change in U.S. Women's Sport. Urbana: University of Illinois Press; 2014.Sinaki M, Mikkelsen BA. Postmenopausal spinal osteoporosis: flexion versus extension exercises. Arch Phys Med Rehabil. 1984;65(10):593-596. PMID: 6487063.Soranus of Ephesus
- May 29, 20261h 26m
Menopause, Part 1: What It Actually Is and the 24-Year WHI Correction
In 1889 a French physiologist injected himself with guinea pig and dog testicle extract and published a claim of self-rejuvenation in The Lancet. That announcement kicked off a 200-year medicalization of menopause that ran through leeches and bromides, Premarin, the 2002 Women's Health Initiative, and the contemporary menopause-content space. In Episode 1 of our three-part menopause series, Dr. Jordan Feigenbaum and Dr. Austin Baraki walk through what menopause actually is at the hormonal level, which midlife symptoms are menopause-driven and which are not, the KNDy neuron mechanism behind hot flashes (and the new medication that blocks it), and the 24-year follow-up on the WHI that substantially revised the original conclusions. OB-GYN Dr. Loraine Baraki walks the clinical workup, the lab panel she actually orders, and how she handles patients arriving with DUTCH panels and compounded hormone protocols.If you have heard contradictory things about menopause hormone therapy from your primary care, your menopause coach, and your sister, that is not your fault. The evidence base has been revised in significant ways since the 2002 publication, and most patient-facing summaries are out of date.Timestamps00:00 Cold open: 200 years of menopause medicine03:23 Welcome and roadmap04:20 The HPG axis, follicles, and the FSH lag09:11 STRAW+10 staging and the timing of perimenopause13:47 Austin: the 49-year-old with a hormone panel20:00 Loraine: the OB-GYN workup28:00 Symptom attribution: what menopause actually causes33:46 Austin: the all-estrogen patient37:58 VMS duration and the KNDy mechanism (Avis, SKYLIGHT)43:53 Austin: who actually gets fezolinetant47:22 The WHI 24-year correction (Manson, Chlebowski, Boardman)01:00:15 Modern prescribing today01:06:52 Where the menopause-content space gets it right and wrong01:11:50 Testosterone, compounded bioidenticals, and DUTCH panels01:24:13 TakeawaysWhat we coverThe HPG axis and the estrogen shield: what is happening across the 35-year reproductive era and what changes at perimenopause.STRAW+10 staging: how long perimenopause actually lasts and where most women fall in the timeline. Symptom attribution: hot flashes and genitourinary syndrome are menopause. Weight gain, sleep, and joint pain are mostly other things.The KNDy neuron mechanism behind hot flashes and the new pharmacology that blocks it (fezolinetant, elinzanetant).The Women's Health Initiative: what the trial actually tested, what the 2002 result said, and what 24 years of follow-up have shown since then. The estrogen-alone arm reduced breast cancer incidence by 22% and mortality by 40% over 20 years.The timing hypothesis: hormone therapy started within 10 years of the final menstrual period vs more than 10 years out.Modern prescribing today: transdermal estradiol plus micronized progesterone, and why the formulations matter.Where the contemporary menopause-content space gets it right and wrong: the undertreatment problem, the zone-of-chaos framing, and the testosterone-for-everything marketing.Testosterone in women: one guideline-supported indication.Compounded bioidenticals and DUTCH panels.ResourcesSubscribe to BBM Plus for the full unabridged Direct Line: https://barbellmedicine.supercast.com/Barbell Medicine coaching and templates: https://www.barbellmedicine.com/Signal book pre-order: https://www.barbellmedicine.com/shop/learning/signalManson JE et al. 18-year mortality from the WHI. JAMA, 2017. https://pubmed.ncbi.nlm.nih.gov/28898378/Chlebowski RT et al. WHI estrogen-alone arm at 20 years. JAMA, 2020. https://pubmed.ncbi.nlm.nih.gov/32706854/ Boardman HMP et al. Hormone therapy for cardiovascular prevention. Cochrane, 2015. https://pubmed.ncbi.nlm.nih.gov/25754617/Avis NE et al. Duration of VMS in the SWAN cohort. JAMA Intern Med, 2015. https://pubmed.ncbi.nlm.nih.gov/25686030/Lederman S et al. SKYLIGHT 1, fezolinetant. The Lancet, 2023. https://pubmed.ncbi.nlm.nih.gov/36924778/Johnson KA et al. SKYLIGHT 2, fezolinetant. JCEM, 2023. https://pubmed.ncbi.nlm.nih.gov/37410020/USPSTF. Hormone therapy for primary prevention. JAMA, 2022. https://pubmed.ncbi.nlm.nih.gov/36318127/Davis SR et al. Global Consensus on testosterone in women. JCEM, 2019. https://pubmed.ncbi.nlm.nih.gov/31498871/Our Sponsors:* Check out FIGS and use my code wearfigs.com for a great deal: https://wearfigs.com* Check out
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