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- 2 days ago1h 25m
Huberman’s Protocols Book: Scientifically Reviewed byTwo Doctors
Andrew Huberman’s new book, Protocols, says each of its routines “can work the first time, and every time,” and says of its lifting program, “I’ve seen it work for everyone I’ve suggested it to.” Wild! Dr. Feigenbaum read the book and pulled the studies it cites for the protocols that crossover with Barbell Medicine: training each muscle once a week to failure, cold plunges, pushing morning cortisol up with licorice root and grapefruit, drinking water on a schedule, an 11-supplement sleep stack, and nicotine pouches for focus.Dr. Baraki guesses what the book recommends before we get to what the cited studies found. In a few places the paper under the sentence says the opposite of the sentence. It should go without saying, nothing here is about Dr. Huberman personally. We’re rating what the book tells you to do.Timestamps00:00 Huberman’s Protocols and what it promises 01:23 Who this book is for, and how a book like this gets made 07:30 The games, and training each muscle once a week to failure 21:53 Cold plunge, dopamine, and brown fat 30:21 Cortisol: licorice root, grapefruit, and morning light 37:49 Drinking water before coffee 47:52 The 11-supplement sleep stack and CBT for insomnia 55:57 Nicotine pouches for focus 59:46 Lightning round: real line from the book or made up? 1:10:49 Final score and whether we’d give this book to our moms 1:12:57 What we’d recommend insteadResources:Where should my priorities be to improve my health? https://www.barbellmedicine.com/blog/where-should-my-priorities-be-to-improve-my-health/ Scott Carney’s audit of Protocols: https://sgcarney.substack.comNicotine Mystery Case- Episode 285: https://podcasts.apple.com/nz/podcast/episode-285-nicotine/id1199780143?i=1000651894798 Buy the book, Signal: https://www.barbellmedicine.com/shop/learning/signal/Free Vital 5 Action PlanNew Barbell Medicine Hybrid 5K and 10K Run + Lift ProgramsBaz-Valle E, Balsalobre-Fernández C, Alix-Fages C, Santos-Concejero J. A systematic review of the effects of different resistance training volumes on muscle hypertrophy. J Hum Kinet. 2022;81:199-210. doi:10.2478/hukin-2022-0017Pedersen H, Iversen VM, Vereide V, et al. High-frequency resistance training improves maximal lower-limb strength more than low frequency. Eur J Sport Sci. 2024;24(5):557-565. doi:10.1002/ejsc.12055Currier BS, D'Souza AC, Singh MAF, et al. American College of Sports Medicine position stand. Resistance training prescription for muscle function, hypertrophy, and physical performance in healthy adults: an overview of reviews. Med Sci Sports Exerc. 2026;58(4):851-872. doi:10.1249/MSS.0000000000003897Pelland JC, Remmert JF, Robinson ZP, Hinson SR, Zourdos MC. The resistance training dose response: meta-regressions exploring the effects of weekly volume and frequency on muscle hypertrophy and strength gains. Sports Med. 2026;56(2):481-505. doi:10.1007/s40279-025-02344-wRefalo MC, Helms ER, Trexler ET, Hamilton DL, Fyfe JJ. Influence of resistance training proximity-to-failure on skeletal muscle hypertrophy: a systematic review with meta-analysis. Sports Med. 2023;53(3):649-665. doi:10.1007/s40279-022-01784-yRobinson ZP, Pelland JC, Remmert JF, et al. Exploring the dose-response relationship between estimated resistance training proximity to failure, strength gain, and muscle hypertrophy: a series of meta-regressions. Sports Med. 2024;54(9):2209-2231. doi:10.1007/s40279-024-02069-2Isenmann E, Kaluza D, Havers T, et al. Resistance training alters body composition in middle-aged women depending on menopause: a 20-week control trial. BMC Womens Health. 2023;23(1):526. doi:10.1186/s12905-023-02671-yŠrámek P, Šimečková M, Janský L, Šavlíková J, Vybíral S. Human physiological responses to immersion into water of different temperatures. Eur J Appl Physiol. 2000;81(5):436-442. doi:10.1007/s004210050065Buijze GA, Sierevelt IN, van der Heijden BC, Dijkgraaf MG, Frings-Dresen MH. The effect of cold showering on health and work: a randomized controlled trial. PLoS One. 2016;11(9):e0161749. doi:10.1371/journal.pone.0161749Søberg S, Löfgren J, Philipsen FE, et al. Altered brown fat thermoregulation and enhanced cold-induced thermogenesis in young, healthy, winter-swimming men. Cell Rep Med. 2021;2(10):100408. doi:10.1016/j.xcrm.2021.10040
- 1 weeks ago57 min
A 22-Year-Old Athlete and a Form Nobody Would Sign (Mystery Case)
A 22 year old soccer player with no symptoms walks into a clinic for a routine sports physical and walks out being told to quit his sport.Dr. Baraki takes this mystery case blind and we hand him the pieces one at a time: the EKG, the echocardiogram, the cardiac MRI, the Holter monitor, the treadmill test and the genetic panel. Half of them come back completely normal. Play along and commit to an answer before the reveal, because there is a point in this case where most people would change theirs.Then, the discussion about whether the restriction he was given was the right call, what the evidence on that says today compared with what it said for the previous 40 years, and why two doctors looking at the same numbers can reasonably land in different places.And then screening. Should an EKG should be mandatory for amateur athletes? All this and more, on this episode of the Barbell Medicine Podcast.Timestamps00:00 A 22-year-old needs a form signed02:16 The history and exam05:49 Reading his EKG 13:13 The echo and the MRI18:26 The rest of the workup, and Austin commits to a diagnosis24:02 Patient course27:54 What his care team decided29:45 How much the heart changes with training36:45 A second case that went differently41:52 Should a finding like this end a career45:47 Should an EKG be mandatory for amateur athletes55:59 What would actually move the needleResourcesBuy the book, Signal: https://www.barbellmedicine.com/shop/learning/signal/Free Vital 5 Action PlanNew Barbell Medicine Hybrid 5K and 10K Run + Lift ProgramsBarbell Medicine coaching and templates: https://www.barbellmedicine.comGet early access, ad-free listening, and exclusive content here: https://barbellmedicine.supercast.com/1. Marques JP, Freitas A, Abecasis J. Beware of regression of electrocardiographic abnormalities on detraining: it may not always mean "athlete's heart." Rev Port Cardiol (Engl Ed). 2021;40(10):801.e1-801.e6. doi:10.1016/j.repce.2021.10.012. PMID 34857120.2. Pelliccia A, Maron BJ, Culasso F, et al. Clinical significance of abnormal electrocardiographic patterns in trained athletes. Circulation. 2000;102(3):278-284. doi:10.1161/01.cir.102.3.278. PMID 10899089.3. Papadakis M, Carre F, Kervio G, et al. The prevalence, distribution, and clinical outcomes of electrocardiographic repolarization patterns in male athletes of African/Afro-Caribbean origin. Eur Heart J. 2011;32(18):2304-2313. doi:10.1093/eurheartj/ehr140. PMID 21613263.4. Schnell F, Riding N, O'Hanlon R, et al. Recognition and significance of pathological T-wave inversions in athletes. Circulation. 2015;131(2):165-173. doi:10.1161/CIRCULATIONAHA.114.011038. PMID 25583053.5. Olivotto I, Oreziak A, Barriales-Villa R, et al. Mavacamten for treatment of symptomatic obstructive hypertrophic cardiomyopathy (EXPLORER-HCM): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2020;396(10253):759-769. doi:10.1016/S0140-6736(20)31792-X. PMID 32871100.6. Maron MS, Masri A, Nassif ME, et al. Aficamten for symptomatic obstructive hypertrophic cardiomyopathy. N Engl J Med. 2024;390(20):1849-1861. doi:10.1056/NEJMoa2401424. PMID 38739079.7. Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med. 2002;346(11):793-801. doi:10.1056/NEJMoa011858. PMID 11893790.8. Ommen SR, Mital S, Burke MA, et al. 2020 AHA/ACC guideline for the diagnosis and treatment of patients with hypertrophic cardiomyopathy: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2020;142(25):e558-e631. doi:10.1161/CIR.0000000000000937. PMID 33215931.9. Lopes LR, Ho CY, Elliott PM. Genetics of hypertrophic cardiomyopathy: established and emerging implications for clinical practice. Eur Heart J. 2024;45(30):2727-2734. doi:10.1093/eurheartj/ehae421. PMID 38984491.10. Ingles J, Goldstein J, Thaxton C, et al. Evaluating the clinical validity of hypertrophic cardiomyopathy genes. Circ Genom Precis Med. 2019;12(2):e002460. doi:10.1161/CIRCGEN.119.002
- 2 weeks ago48 min
Sunday Morning Protocol 2049: A Halloween Story About Optimization
A Halloween story about a man who does every wellness protocol, then an honest grading of each one. Dr. Jordan Feigenbaum tells the story of Dale Mercer, Unit 4471, who lives through a fully optimized Sunday in the year 2049: morning light panels, cold plunges, a 31-capsule supplement tray, grey-market peptides, methylene blue, an eccentric-only lifting machine, a protein IV timed to the anabolic window, sleep and readiness scores, a glucose sensor, mouth tape, Zone 2 with lactate pricks, and a 174-degree sauna.Then Jordan grades each one on a zero-to-five pumpkin scale. He covers what the studies actually tested, where the evidence is thin or tied to the companies selling the product, and the few places with real risk, like methylene blue with antidepressants and mouth taping with a blocked nose. The takeaway is plain: lift weights in a challenging way, do conditioning that improves your fitness, sleep enough, and eat a health-promoting diet in the right amount. Most of the rest is optional.The story is inspired by Rick Sieman's 1973 motorcycle magazine column "Sunday Morning Ride … 1984."Timestamps 00:00 WELLNESS ad 00:26 Sunday Morning Protocol 2049 11:23 Where this episode came from, and the pumpkin scale 12:45 Morning sunlight and cold plunges19:44 Supplements: magnesium, lion's mane, NAD, antler velvet, creatine 25:21 Peptides and methylene blue 30:27 Eccentric overload, slow tempo, and the anabolic window 34:40 Sleep trackers, HRV readiness scores, and CGMs 41:56 Mouth tape, Zone 2, and saunas 47:44 What actually worksResourcesBuy the book, Signal: https://www.barbellmedicine.com/shop/learning/signal/Free Vital 5 Action PlanNew Barbell Medicine Hybrid 5K and 10K Run + Lift ProgramsBarbell Medicine coaching and templates: https://www.barbellmedicine.comGet early access, ad-free listening, and exclusive content here: https://barbellmedicine.supercast.com/Creatine: Benefits, Side Effects & Safe Consumption: https://www.barbellmedicine.com/blog/what-is-creatine/Barbell Medicine Guide to Protein: https://www.barbellmedicine.com/blog/barbell-medicine-protein-recommendations/How to Measure, Use and Improve Your Heart Rate Variability: https://www.barbellmedicine.com/blog/heart-rate-variability-hrv/Burke TM, Markwald RR, Chinoy ED, et al. Combination of light and melatonin time cues for phase advancing the human circadian clock. Sleep. 2013;36(11):1617-1624. doi:10.5665/sleep.3110Auger RR, Burgess HJ, Emens JS, Deriy LV, Thomas SM, Sharkey KM. Clinical practice guideline for the treatment of intrinsic circadian rhythm sleep-wake disorders: advanced sleep-wake phase disorder (ASWPD), delayed sleep-wake phase disorder (DSWPD), non-24-hour sleep-wake rhythm disorder (N24SWD), and irregular sleep-wake rhythm disorder (ISWRD). An update for 2015: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2015;11(10):1199-1236. doi:10.5664/jcsm.5100van Maanen A, Meijer AM, van der Heijden KB, Oort FJ. The effects of light therapy on sleep problems: a systematic review and meta-analysis. Sleep Med Rev. 2016;29:52-62. doi:10.1016/j.smrv.2015.08.009Thompson A, Batterham AM, Jones H, Gregson W, Scott D, Atkinson G. The practicality and effectiveness of supplementary bright light for reducing jet-lag in elite female athletes. Int J Sports Med. 2013;34(7):582-589. doi:10.1055/s-0032-1331160Pjrek E, Friedrich ME, Cambioli L, et al. The efficacy of light therapy in the treatment of seasonal affective disorder: a meta-analysis of randomized controlled trials. Psychother Psychosom. 2020;89(1):17-24. doi:10.1159/000502891Burns AC, Saxena R, Vetter C, Phillips AJK, Lane JM, Cain SW. Time spent in outdoor light is associated with mood, sleep, and circadian rhythm-related outcomes: a cross-sectional and longitudinal study in over 400,000 UK Biobank participants. J Affect Disord. 2021;295:347-352. doi:10.1016/j.jad.2021.08.056Manson JE, Cook NR, Lee IM, et al. Vitamin D supplements and prevention of cancer and cardiovascular disease. N Engl J Med. 2019;380(1):33-44. doi:10.1056/NEJMoa1809944Srámek P, Simecková M, Janský L, Savlíková J, Vybíral S. Human physiological resp
- 3 weeks ago1h 5m
How Much Cardio Should You Do? How Much is Too Much?
How much cardio should you do, and does more of it ever become harmful? Cardiorespiratory fitness keeps improving with training load and nobody has found a ceiling. Getting fitter keeps lowering mortality risk as far out as anyone has measured. The one dose dependent harm that survives scrutiny is atrial fibrillation, and it shows up around six to seven hours a week of hard endurance training sustained for years.This episode goes through the Danish jogging study behind the “fast running is as deadly as sitting on the couch” headlines and why two deaths in forty people can’t carry it, the much larger datasets that found no harm signal, and what changes when somebody measures fitness on a treadmill instead of asking people about minutes. Then atrial fibrillation, coronary calcium and heart scarring in lifelong endurance athletes, the sudden cardiac arrest numbers from 29 million race finishers, whether cardio interferes with lifting, fuel handling, weight loss and metabolic compensation, and bone density in cyclists. It closes with a rewritten version of the cardio guidelines, including volume, intensity, progression, and the fitness and health targets the real guidelines leave out.Timestamps00:00 The jogging J-curve and the headlines02:42 The Danish study, its confidence interval, and what a MET measures08:02 Better measurement: 15 check-ins and fitness on a treadmill12:51 Atrial fibrillation: the dose, the mechanism, and stroke risk22:06 Coronary calcium and heart scarring in masters athletes25:58 The marathon death story and cardiac arrest rates29:08 How much training it takes to keep getting fitter34:12 Does cardio interfere with your lifting gains39:52 Flux, the athlete's paradox, and liver fat44:12 Cardio, weight loss, and metabolic compensation51:13 Bone density in cyclists and energy availability57:51 Writing the cardio guidelinesResourcesBuy the book, Signal: https://www.barbellmedicine.com/shop/learning/signal/Free Vital 5 Action PlanNew Barbell Medicine Hybrid 5K and 10K Run + Lift ProgramsBarbell Medicine coaching and templates: https://www.barbellmedicine.comGet early access, ad-free listening, and exclusive content here: https://barbellmedicine.supercast.com/1. Schnohr P, O'Keefe JH, Marott JL, Lange P, Jensen GB. Dose of jogging and long-term mortality: the Copenhagen City Heart Study. J Am Coll Cardiol. 2015. doi:10.1016/j.jacc.2014.11.0232. Arem H, Moore SC, Patel A, et al. Leisure time physical activity and mortality: a detailed pooled analysis of the dose-response relationship. JAMA Intern Med. 2015. doi:10.1001/jamainternmed.2015.05333. Lee DH, Rezende LFM, Joh HK, et al. Long-term leisure-time physical activity intensity and all-cause and cause-specific mortality: a prospective cohort of US adults. Circulation. 2022. doi:10.1161/CIRCULATIONAHA.121.0581624. Mandsager K, Harb S, Cremer P, Phelan D, Nissen SE, Jaber W. Association of cardiorespiratory fitness with long-term mortality among adults undergoing exercise treadmill testing. JAMA Netw Open. 2018. doi:10.1001/jamanetworkopen.2018.36055. Ekelund U, Tarp J, Steene-Johannessen J, et al. Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis. BMJ. 2019. doi:10.1136/bmj.l45706. Saulicz A, Abernethy D, Wraith D. Can too much exercise kill you? A systematic review of the risk of a cardiovascular event or death from long term strenuous exercise. Eur J Epidemiol. 2026. doi:10.1007/s10654-025-01353-37. Morganroth J, Maron BJ, Henry WL, Epstein SE. Comparative left ventricular dimensions in trained athletes. Ann Intern Med. 1975.8. Davies CL, Pallikadavath S, March DS, et al. Physical activity, atrial fibrillation and the dose-response relationship: a systematic review and meta-analysis. Eur J Prev Cardiol. 2026. doi:10.1093/eurjpc/zwag5359. Molina L, Mont L, Marrugat J, et al. Long-term endurance sport practice increases the incidence of lone atrial fibrillation in men: a follow-up study. Europace. 2008. doi:10.1093/europace/eun07110. Javed W, Botis I, Tomoaia R, et al. Clinical and cardiovascular magnetic resonance characteristics of veteran male endurance athletes with atrial fibrillation: VENTOUX-
- Oct 8, 20261h 6m
How Much Lifting is Enough? How Much is Too Much?
How much resistance training do you actually need, and is there a point where more stops helping? We trace the "lift weights twice a week" recommendation back to the 1989 study it came from, which found that three days beat two, and to the citation loop that turned it into a guideline anyway. Then we go through the evidence on whether lifting is dangerous, including the heart, injury rates, and the J-shaped mortality curve, and work out where the dose-response actually saturates for strength, muscle mass, bone mineral density, and how your body handles fuel.The short answer is that almost every number in this literature marks where a benefit starts, and very little of it goes far enough to show where a benefit stops. We finish by writing the resistance training guideline the way we think it should be written, with target outcomes, a training dose, and testable targets.Timestamps 00:00 Where the "lift weights twice a week" rule came from 04:18 What actually counts as resistance training 06:56 Does lifting make your heart wall thicker 15:34 Anabolic steroids and the heart 19:16 Injury rates and cardiac arrest at the gym 22:03 How the lifting J-curve got made 28:05 ACSM audits its own recommendation 31:11 Strength: where the plateau actually sits 35:49 Why grip strength can't answer this 41:43 Muscle mass versus muscle function 44:50 Bone, and the turkey wing that settled the dose 49:50 Fuel handling, insulin sensitivity, and the clock 1:00:46 The 2018 guidelines, and how I would write themResourcesBuy the book, Signal: https://www.barbellmedicine.com/shop/learning/signal/New Barbell Medicine Hybrid 5K and 10K Run + Lift ProgramsBarbell Medicine coaching and templates: https://www.barbellmedicine.comGet early access, ad-free listening, and exclusive content here: https://barbellmedicine.supercast.com/Braith RW, Graves JE, Pollock ML, Leggett SL, Carpenter DM, Colvin AB. Comparison of 2 vs 3 days/week of variable resistance training during 10- and 18-week programs. Int J Sports Med. 1989;10(6):450-454. doi:10.1055/s-2007-1024942. PMID 2628366.American College of Sports Medicine. Position stand: the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness in healthy adults. Med Sci Sports Exerc. 1990;22(2):265-274. PMID 2355825.Sandercock GRH, Moran J, Cohen DD. Who is meeting the strengthening physical activity guidelines by definition: a cross-sectional study of 253,423 English adults? PLoS One. 2022;17(5):e0267277. doi:10.1371/journal.pone.0267277. PMID 35507575.Shakespear-Druery J, De Cocker K, Biddle SJH, Gasevic D, Bennie JA. Assessment of muscle-strengthening exercise in public health surveillance for adults: a systematic review. Prev Med. 2021;148:106566. doi:10.1016/j.ypmed.2021.106566. PMID 33878352.Zhang Y, Lee DH, Rezende LFM, et al. Long-term resistance training with all-cause and cause-specific mortality: assessing dose-response and joint associations with aerobic physical activity. Br J Sports Med. 2026;60(12):874-883. doi:10.1136/bjsports-2025-110503. PMID 42230125.Morganroth J, Maron BJ, Henry WL, Epstein SE. Comparative left ventricular dimensions in trained athletes. Ann Intern Med. 1975;82(4):521-524. doi:10.7326/0003-4819-82-4-521. PMID 1119766.Naylor LH, George K, O'Driscoll G, Green DJ. The athlete's heart: a contemporary appraisal of the Morganroth hypothesis. Sports Med. 2008;38(1):69-90. doi:10.2165/00007256-200838010-00006. PMID 18081368.Myerson SG, Montgomery HE, World MJ, Pennell DJ. Left ventricular mass: reliability of M-mode and 2-dimensional echocardiographic formulas. Hypertension. 2002;40(5):673-678. doi:10.1161/01.hyp.0000036401.99908.db. PMID 12411461.Pelliccia A, Maron BJ, Spataro A, Proschan MA, Spirito P. The upper limit of physiologic cardiac hypertrophy in highly trained elite athletes. N Engl J Med. 1991;324(5):295-301. doi:10.1056/NEJM199101313240504. PMID 1824720.Spirito P, Pelliccia A, Proschan MA, et al. Morphology of the "athlete's heart" assessed by echocardiography in 947 elite athletes representing 27 sports. Am J Cardiol. 1994;74(8):802-806. doi:10.1016/0002-9149(94)90439-1. PMID 7942554.Pelliccia A, Spataro A, Caselli G, Maron BJ. Absence of left ventricular wall thickening in athletes engaged in intense power training. Am J Cardiol. 1993;72(14):1048-1054. doi:10.1016/0002-9149(93)90861-6. PMID 8213586.Spence AL, Naylor LH, Carter HH, et al. A prospective randomised longitudinal MRI study of left ventricula
- Oct 2, 202657 min
Where did the advice to not lift heavy weights come from?
Nearly every warning you've heard about lifting weights was written down before anybody checked it. We trace where those warnings came from, starting with a Harvard student in 1854 and ending with a curve on a graph that's being used today to argue you can lift too much.Along the way: the men who built themselves with barbells and then sold the public five-pound dumbbells, because iron was expensive to mail and a booklet cost pennies. The muscle-bound myth, which nobody could define when a graduate student surveyed 45 physiologists about it. The 1961 report that took the deep squat out of every branch of the American military, measured with a device its author built himself and never validated. The claim that lifting stunts a child's growth, which no professional body ever actually made. And the argument women got, which was never about injury at all.Timestamps:0:00 Intro2:33 2,500 years of people picking up heavy things7:24 George Windship and the Health Lift10:56 Blaikie's truck horse and the muscle-bound myth14:59 Bernarr Macfadden19:39 Charles Atlas and Dynamic Tension27:01 Carl Klein, a homemade device, and the parallel squat30:57 Thomas Delorme and three sets of ten35:20 Kids, growth plates, and where the stunting idea came from41:43 Women, "you'll get bulky," and Dudley Sargent in 191250:05 Pregnancy, from 1949 to a 2025 barbell study53:40 The pattern, and the curve on next week's graphResources:Buy the book, Signal: https://www.barbellmedicine.com/shop/learning/signal/New Barbell Medicine Hybrid 5K and 10K Run + Lift ProgramsBarbell Medicine coaching and templates: https://www.barbellmedicine.com1. Downs DS, Chasan-Taber L, Evenson KR, Leiferman J, Yeo S. Physical activity and pregnancy: past and present evidence and future recommendations. Res Q Exerc Sport. 2012;83(4):485-502. doi:10.1080/02701367.2012.10599138. PMID 23367811.2. McMurray RG, Mottola MF, Wolfe LA, Artal R, Millar L, Pivarnik JM. Recent advances in understanding maternal and fetal responses to exercise. Med Sci Sports Exerc. 1993;25(12):1305-1321. PMID 8107536.3. Smith KM, Campbell CG. Physical activity during pregnancy: impact of applying different physical activity guidelines. J Pregnancy. 2013;2013:165617. doi:10.1155/2013/165617. PMID 23476778.4. American College of Obstetricians and Gynecologists. Physical activity and exercise during pregnancy and the postpartum period. ACOG Committee Opinion No. 804. Obstet Gynecol. 2020;135(4):e178-e188. doi:10.1097/AOG.0000000000003772. PMID 32217980.5. American Academy of Pediatrics Committee on Sports Medicine and Fitness. Strength training by children and adolescents. Pediatrics. 2001;107(6):1470-1472. doi:10.1542/peds.107.6.1470. PMID 11389279.6. Stricker PR, Faigenbaum AD, McCambridge TM; Council on Sports Medicine and Fitness. Resistance training for children and adolescents. Pediatrics. 2020;145(6):e20201011. doi:10.1542/peds.2020-1011. PMID 32457216.7. Gardiner EN. Athletics of the Ancient World. Clarendon Press; 1930:54. See also Gardiner EN. Olympia: Its History and Remains. Clarendon Press; 1925.8. Heffernan C. The Bybon stone and ancient strength. Physical Culture Study. 2021. Accessed September 2026. https://physicalculturestudy.com.9. Pausanias. Description of Greece. 6.14.5. Jones WHS, trans. Loeb Classical Library. Harvard University Press.10. Quintilian. Institutio Oratoria. 1.9.5. Butler HE, trans. Loeb Classical Library. Harvard University Press.11. Heffernan C. Milo of Croton and the invention of progressive overload. Physical Culture Study. 2026. Accessed September 2026. https://physicalculturestudy.com. See also H.J. Lutcher Stark Center for Physical Culture and Sports, University of Texas at Austin, Milo Bar-Bell Company holdings.12. Liddell HG, Scott R. A Greek-English Lexicon. 9th ed. Clarendon Press; entry γυμνάσιον. Thucydides. History of the Peloponnesian War. 1.6. Crawley R, trans.13. Tomlinson RA. Gymnasium. In: Oxford Classical Dictionary. Oxford University Press; 2015. doi:10.1093/acrefore/9780199381135.013.2963. See also Stavrou D. The Greek Gymnasium [thesis]. University of Leicester; 2016:38.14. Xenophon. Constitution of the Lacedaimonians. 1.4. Marchant EC, trans. Loeb Classical Library. Harvard University Press.15. Plutarch. Life of Lycurgus. 14. Perrin B, trans. Loeb Classical Library. Harvard University Press.16. Ollier
- Sep 24, 202637 min
Is It Safe to Train When the Air Is Full of Wildfire Smoke?
Parts of the country now get a few weeks of wildfire smoke every year, and the obvious question is whether there is a point where the air is bad enough that the workout costs you more than it gives you. We went and looked. There is a real number, it comes from about 1.5 million people, and it is not the number that gets quoted.This is a free preview of Direct Line, our monthly ask-us-anything for Barbell Medicine Plus subscribers. Two of this month's twelve questions are here in full.First: training in wildfire smoke. What PM2.5 is, why the AQI on your phone and the number in the paper are not the same quantity, where the 90-minutes-at-100-micrograms figure comes from and why it is softer than it sounds, what happened when six cities modeled telling people to stay inside, and why your breathing rate during a set of squats matters more than you would think.Second: the effective reps model. A subscriber noticed that if a set only counts when you are within five reps of failure, the triceps in a heavy bench press should not count, and if you are going to count that as a fractional set for the triceps, then a warm-up set counts for the chest. Both cannot be true. We go through the meta-regression on proximity to failure, the 67-study analysis that tested whether an indirect set should count as one, as half, or as zero, and where we actually put our sets.Join Barbell Medicine Plus today: https://barbellmedicine.supercast.com/Buy the book, Signal: https://www.barbellmedicine.com/shop/learning/signal/New Barbell Medicine Hybrid 5K and 10K Run + Lift ProgramsBarbell Medicine coaching and templates: https://www.barbellmedicine.comTimestamps1:47 The question: is there a point where the air is too bad to train?2:37 What PM2.5 actually is3:05 AQI vs micrograms, and why your phone disagrees with the paper3:50 Where the "90 minutes" number comes from4:54 Austin: what breathing this air does to your lungs9:14 1.5 million adults: does dirty air cancel the benefit of exercise?10:44 Six cities modeled staying indoors. Mortality did not improve.11:22 Lifting vs cycling: breathing rate is the whole mechanism12:33 Indoor air during a wildfire, and what filtration does not fix13:24 Is wildfire smoke worse than city pollution?14:38 What we would actually tell a patient18:35 The question: hard sets, fractional sets, and the five-rep rule19:18 Reps in reserve, hard sets, and fractional sets defined20:19 The meta-regression: no threshold, just a line21:13 Do indirect sets count as half a set?23:08 Would you rather: every set at 5 RIR, or every set to failure?25:22 Why you get worse at judging RIR the further you are from failure28:42 The numbers we use: RPE 7 to 9 for hypertrophy, 4 to 6 for strength29:20 Austin: individual variation dwarfs all of this33:28 Why nobody can measure training load in the weight roomResourcesTainio M, de Nazelle AJ, Götschi T, et al. Can air pollution negate the health benefits of cycling and walking? Prev Med. 2016;87:233-236. doi:10.1016/j.ypmed.2016.02.002. PMID 27156248Ku PW, Steptoe A, Hamer M, et al. Does ambient PM2.5 reduce the protective association of leisure-time physical activity with mortality? A systematic review, meta-analysis, and individual-level pooled analysis of cohort studies involving 1.5 million adults. BMC Med. 2025;23(1):647. doi:10.1186/s12916-025-04496-y. PMID 41310726Giallouros G, Kouis P, Papatheodorou SI, Woodcock J, Tainio M. The long-term impact of restricting cycling and walking during high air pollution days on all-cause mortality: health impact assessment study. Environ Int. 2020;140:105679. doi:10.1016/j.envint.2020.105679. PMID 32353667Sun S, Cao W, Qiu H, et al. Benefits of physical activity not affected by air pollution: a prospective cohort study. Int J Epidemiol. 2020;49(1):142-152. doi:10.1093/ije/dyz184. PMID 31504557Robles P, Araujo T, Brooks D, et al. Cardiorespiratory responses to short bouts of resistance training exercises in individuals with chronic obstructive pulmonary disease: a comparison of exercise intensities. J Cardiopulm Rehabil Prev. 2017;37(5):356-362. doi:10.1097/HCR.0000000000000282. PMID 28858033Liang Y, Sengupta D, Campmier MJ, Lunderberg DM, Apte JS, Goldstein AH. Wildfire smoke impacts on indoor air quality assessed using crowdsourced data in California. Proc Natl Acad Sci U S A. 2021;118(36):e2106478118. doi:10.1073/pnas.2106478118. PMID 34465624Aguilera R, Corringham T, Gershunov A, Benmarhnia T. Wildfire smoke impacts respiratory health more th
- Sep 17, 20262h 1m
Do You Need a Calorie Surplus to Build Muscle? | Dr. Eric Helms
Most lifters have been told they need to eat in a Calorie surplus to build muscle. That rule has always come with a list of exceptions: unless you're new, unless you're carrying extra body fat, unless you're coming back from time off. Dr. Eric Helms joins Dr. Jordan Feigenbaum to work out what the rule is actually tracking, starting from a question with a real number attached: what does a pound of muscle cost to build? And then, do you need to be in a surplus to build muscle? Timestamps:0:00 The rule, and its exceptions2:08 Where "you need a surplus" came from7:12 Heuristics versus theories11:40 Hypertrophy, maintenance, deficit and surplus defined14:58 Body fat as a savings account18:24 How fast anyone can actually build muscle23:39 What sets the ceiling: stimulus, not genetics26:37 Microgravity, astronauts, and a 20 kg barbell31:49 What constrains growth if steroids don't break the ceiling36:44 If training sets the ceiling, what does energy do38:45 What 1 kg of muscle costs to build44:05 Why 3,500 Calories doesn't tell you what to eat44:55 REDs and the dual intervention model47:51 The 2000s bulking studies51:34 Garthe 2013: elite athletes and a 500 Calorie surplus58:30 Protein: 1.6 versus 2.5 g/kg1:03:31 What starvation research shows the body protects1:10:29 Vargas-Molina: maintenance versus deficit1:19:17 What to do if you're lean1:39:34 What would prove this wrong1:57:57 Three bucketsResources:Buy the book, Signal: https://www.barbellmedicine.com/shop/learning/signal/New Barbell Medicine Hybrid 5K and 10K Run + Lift ProgramsBarbell Medicine coaching and templates: https://www.barbellmedicine.comNikolaidis MG, Paschalis V, Margaritelis NV. The energetic cost of building human skeletal muscle. bioRxiv. Preprint posted online August 17, 2026. doi:10.64898/2026.08.17.745156Rozenek R, Ward P, Long S, Garhammer J. Effects of high-calorie supplements on body composition and muscular strength following resistance training. J Sports Med Phys Fitness. 2002;42(3):340-347.Garthe I, Raastad T, Refsnes PE, Koivisto A, Sundgot-Borgen J. Effect of two different weight-loss rates on body composition and strength and power-related performance in elite athletes. Int J Sport Nutr Exerc Metab. 2011;21(2):97-104.Garthe I, Raastad T, Refsnes PE, Sundgot-Borgen J. Effect of nutritional intervention on body composition and performance in elite athletes. Eur J Sport Sci. 2013;13(3):295-303. doi:10.1080/17461391.2011.643923Helms ER, Zinn C, Rowlands DS, Brown SR. A systematic review of dietary protein during caloric restriction in resistance trained lean athletes: a case for higher intakes. Int J Sport Nutr Exerc Metab. 2014;24(2):127-138. doi:10.1123/ijsnem.2013-0054Slater GJ, Dieter BP, Marsh DJ, Helms ER, Shaw G, Iraki J. Is an energy surplus required to maximize skeletal muscle hypertrophy associated with resistance training. Front Nutr. 2019;6:131. doi:10.3389/fnut.2019.00131Murphy C, Koehler K. Energy deficiency impairs resistance training gains in lean mass but not strength: a meta-analysis and meta-regression. Scand J Med Sci Sports. 2022;32(1):125-137. doi:10.1111/sms.14075Helms ER, Spence A, Sousa C, et al. Effect of small and large energy surpluses on strength, muscle, and skinfold thickness in resistance-trained individuals: a parallel groups design. Sports Med Open. 2023;9(1):102. doi:10.1186/s40798-023-00651-yMountjoy M, Ackerman KE, Bailey DM, et al. 2023 International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs). Br J Sports Med. 2023;57(17):1073-1097. doi:10.1136/bjsports-2023-106994Speakman JR, Hall KD. Models of body weight and fatness regulation. Philos Trans R Soc Lond B Biol Sci. 2023;378(1888):20220231. doi:10.1098/rstb.2022.0231Vargas-Molina S, García-Palumbo A, García-Sillero M, et al. Comparison of two nutritional protocols in body re-composition of resistance-trained participants. Eur J Appl Physiol. 2026;126(7):4019-4030. doi:10.1007/s00421-026-06209-6Our Sponsors:* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.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://redcir
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