MASS Volume 3, Issue 9

V O L U ME 3 , ISS U E 9 SEP T EMBER 2 0 1 9
MASS
M ONTHLY A PPL ICATIO N S IN
STRE N G TH SPO R T
E R IC H E LMS | G R E G N UCK O LS | MIC HAEL ZO URDO S | ERIC T REXL E R

The Reviewers
Eric Helms
Eric Helms is a coach, athlete, author, and educator. He is a coach for drug-free strength and
physique competitors at all levels as a part of team 3D Muscle Journey. Eric regularly publishes
peer-reviewed articles in exercise science and nutrition journals on physique and strength sport, in
addition to writing for commercial fitness publications. He’s taught undergraduate- and graduate-
level nutrition and exercise science and speaks internationally at academic and commercial
conferences. He has a B.S. in fitness and wellness, an M.S. in exercise science, a second Master’s
in sports nutrition, a Ph.D. in strength and conditioning, and is a research fellow for the Sports
Performance Research Institute New Zealand at Auckland University of Technology. Eric earned pro status as a natural
bodybuilder with the PNBA in 2011 and competes in the IPF at international-level events as an unequipped powerlifter.
Greg Nuckols
Greg Nuckols has over a decade of experience under the bar and a B.S. in exercise and sports
science. Greg earned his M.A. in exercise and sport science from the University of North Carolina
at Chapel Hill. He’s held three all-time world records in powerlifting in the 220lb and 242lb classes.
He’s trained hundreds of athletes and regular folks, both online and in-person. He’s written for
many of the major magazines and websites in the fitness industry, including Men’s Health, Men’s
Fitness, Muscle & Fitness, Bodybuilding.com, T-Nation, and Schwarzenegger.com. Furthermore,
he’s had the opportunity to work with and learn from numerous record holders, champion athletes,
and collegiate and professional strength and conditioning coaches through his previous job as Chief Content Director for
Juggernaut Training Systems and current full-time work on StrongerByScience.com.
Michael C. Zourdos
Michael (Mike) C. Zourdos, Ph.D., CSCS, has specializations in strength and conditioning and
skeletal muscle physiology. He earned his Ph.D. in exercise physiology from The Florida State
University (FSU) in 2012 under the guidance of Dr. Jeong-Su Kim. Prior to attending FSU, Mike
received his B.S. in exercise science from Marietta College and M.S. in applied health physiology
from Salisbury University. Mike served as the head powerlifting coach of FSU’s 2011 and 2012
state championship teams. He also competes as a powerlifter in the USAPL, and among his best
competition lifts is a 230kg (507lbs) raw squat at a body weight of 76kg. Mike owns the company
Training Revolution, LLC., where he has coached more than 100 lifters, including a USAPL open
division national champion.
Eric Trexler
Eric Trexler is a pro natural bodybuilder and a sports nutrition researcher. Eric has a PhD in Human
Movement Science from UNC Chapel Hill, and has published dozens of peer-reviewed research
papers on various exercise and nutrition strategies for getting bigger, stronger, and leaner. In
addition, Eric has several years of University-level teaching experience, and has been involved in
coaching since 2009. Eric is the Director of Education at Stronger By Science.
2
Letter from the Reviewers
W
elcome to the September issue of MASS (Volume 3, Issue 9). As always, this issue is
packed full of great content.
In this issue, Greg reviews a study suggesting that training to failure actually hinders
muscle hypertrophy, then takes an objective look at the role that failure plays in promoting muscle
growth. Greg also reviews a study comparing the effects of biceps curls and dumbbell rows on biceps
hypertrophy, and explains why the effects of adding in single-joint exercises for hypertrophy largely
depend on the exact exercises and muscles you’re talking about. Finally, Greg reviews a study com-
paring two training programs: one that is constant, and another with variations in load, volume, rest
intervals, and muscle actions. While this study suggested that variation wasn’t particularly beneficial,
Greg discusses when it makes sense to introduce variation into your program.
On the topic of training, Mike wrote a remarkably comprehensive piece about rating of perceived
exertion (RPE) for this month’s issue, which covers just about every way you could possibly use RPE
in your training. Mike also reviews a systematic review paper about sodium bicarbonate; while the
results generally suggested that sodium bicarbonate’s effects on high-intensity exercise were pretty
equivocal, Mike takes a close look at the literature and lets us know when sodium bicarbonate sup-
plementation may or may not be useful for lifters.
The Erics review a few nutrition articles this month as well. Eric Helms examines a recent study
on ultra-processed foods, complete with a detailed explanation of why people tend to over-consume
processed foods, and how to approach the balance of processed and unprocessed foods in your diet.
Eric Trexler reviews a study suggesting that intermittent fasting is equally effective for strength and
muscle gains compared to a regular feeding schedule, with some discussion on the pros and cons of
intermittent fasting. Finally, Eric Trexler reviews a systemic review about alcohol’s impact on recovery.
While the study suggested that alcohol has a pretty minimal impact on most aspects of recovery, Eric
looks at how dosage, sex, and type of exercise may have influenced the results, and how much alcohol
you can get away with before your training is likely to suffer.
This month also features the conclusions of two video series. In one, Eric Helms wraps up his series
on energy density with some practical information on how energy density relates to satiety, and how
to use this information to manage hunger and promote weight loss and weight maintenance. In the
other, Mike concludes his series on understanding the research process with some advice on how to
actually implement research findings into your training.
We hope you’ll really enjoy this issue. If you have any questions or feedback, you’re always welcome
to let us know in the MASS Facebook group.
The MASS Team

Eric Helms, Greg Nuckols, Mike Zourdos, and Eric Trexler
3
Table of Contents
6
BY G R EG NUCKOL S
When it Comes to Hypertrophy, Not All Multi-Joint Exercises are

Created Equal
Prior research has suggested that multi-joint exercises build muscle about as well as single-
joint exercises. However, a new study found that single-joint training built almost twice as
much muscle as multi-joint training. How can that be? Well, it depends on the details.
17
BY M I CHAEL C. ZOUR DOS
RPE and RIR: The Complete Guide

MASS and many others have discussed RPE at length. However, there are many uses of
RPE outside of just basic load prescription. This article gives a brief historical context and
then provides a section and example of every single way that RPE has been used in the
literature.
34
BY E RI C HEL MS
The Poptart Problem: Processed Foods and Overeating

It’s oft-repeated in our community that so long as energy, macros (especially protein),
and fiber are matched, the amount of processed food in your diet is inconsequential
for body composition. But is this true when it comes to how such a diet impacts your
habitual energy intake and ad libitum consumption of food?
48
BY E R I C T R EXL ER
Does Alcohol Impair Recovery from Resistance Exercise?

As an avid fan of beer and bourbon, the thought of choosing between gains and alcohol
is a troubling dilemma. But do we necessarily need to choose one over the other, or can
they peacefully coexist? Read this article to find out if your favorite alcoholic beverage is
impairing your recovery after resistance exercise.
59
BY G R EG NUCKOL S
Short-Term Variations in Training Stimulus Don’t Cause More Growth

We know that training volume is the main factor driving hypertrophy, but it’s commonly
believed that varying your training stimulus can also help promote additional growth. A
recent study adds to the stack of evidence suggesting that, at least in the short term,
variations in training stimulus don’t cause more growth.
4
71
BY M ICHAEL C. ZOUR DOS
Sodium Bicarbonate Benefits Continue to be Equivocal

A new systematic review tells us that sodium bicarbonate supplementation works
sometimes. This article dives deeper to explain why the results are equivocal and in what
specific situations supplementation may be useful for the lifter.
83
BY E R I C T R EXL ER
Does Intermittent Fasting Limit Strength and Muscle Gains?

Frequent meals used to be the norm for most fitness enthusiasts, but intermittent fasting
(also known as time-restricted feeding) has become popular in recent years. Despite its
popularity, a common concern is that fewer protein feedings per day may limit muscle
growth. Read this article to find out if time-restricted feeding inhibits strength and muscle
gains from resistance training.
95
BY G R EG NUCKOL S
Growing More by Avoiding Failure

It’s almost taken as an article of faith in some circles that training to failure builds more
muscle on a per-set basis than training shy of failure, but a new study found that training
well shy of failure caused more growth. A reexamination of the literature suggests that
the last few reps prior to failure may matter less than many people believe.
110
BY M I CHAEL C. ZOUR DOS
VIDEO: Understanding the Research Process, Part 3

After Parts 1 and 2, we now understand everything that goes into the research process,
all the way through publishing a study. But, what now? Now, the practitioner takes over.
Part 3 discusses how to think conceptually to implement research findings.
112
BY E RI C HEL MS
VIDEO: Energy Density: a Forgotten Component, Part 2

Eric Helms is back in part 2 of his series on energy density. In this video, he covers
how energy density fits into a multi-component model of satiety, data showing that a
combined approach to satiety management can be impressively effective for weight
loss and maintenance, and how to leverage energy density and other aspects of hunger
control as a practitioner and athlete.
5
Study Reviewed: Single-Joint Exercise Results in Higher Hypertrophy of
Elbow Flexors than Multijoint Exercise. Mannarino et al. (2019)
When it Comes to Hypertrophy,

Not All Multi-Joint Exercises are
Created Equal
BY G RE G NUC KO LS
Prior research has suggested that multi-joint exercises build muscle about
as well as single-joint exercises. However, a new study found that single-
joint training built almost twice as much muscle as multi-joint training.
How can that be? Well, it depends on the details.
6
KEY POINTS
1. Over eight weeks utilizing a within-subject unilateral design, dumbbell biceps
curls led to greater biceps hypertrophy than dumbbell rows.
2. These results stand in contrast to prior research suggesting that another multi-
joint exercise – pull-downs – caused about the same amount of biceps growth
as curls.
3. When discussing the topic of whether multi-joint training causes as much growth
as single-joint training, the question shouldn’t be about multi-joint training in
general. The question should be about the specific multi-joint exercises you want
to use and the specific muscle(s) you’re trying to train.
I Purpose and Hypotheses

have discussed single-joint versus
multi-joint training several times
in MASS. Thus far, the gener-
al message has been that multi-joint Purpose
training is more time-efficient, but The purpose of this study was to
that adding some single-joint train- compare hypertrophy and strength
ing to your routine may increase mus- gains after eight weeks of either biceps
cle growth a bit. However, not much curl or dumbbell row training.
research has directly compared single
joint and multi-joint training on a set- Hypotheses
for-set basis. The present study com- The authors hypothesized that curls
pared the effects of dumbbell biceps would lead to more elbow flexor hy-
curls and dumbbell rows on biceps hypertrophy and that strength gains
pertrophy and strength in the biceps would adhere to the principle of speci-
curl and dumbbell row. Strength gains ficity (e.g. larger gains in dumbbell row
were exercise-specific, and the curls strength with the arm doing dumbbell
predictably led to more biceps hyper- rows, and larger gains in biceps curl
trophy. However, while the results of strength in the arm doing biceps curls).
this study weren’t at all surprising, I do
think the discussion at the end of this
article on when multi-joint training
can maximize hypertrophy and when Subjects and Methods
single-joint training is needed will be
useful to most readers. Subjects
Ten untrained men volunteered for
7
Table 1 Subject characteristics
Number Age (years) Height (cm) Weight (kg) BMI (kg/m2)
10 men 29.2 ± 3.85 178.30 ± 7.29 96.4 ± 17.93 30.19 ± 4.46
this study. They were all between 25 and 10RM strength for dumbbell curls and
40 years old. More details about the sub- dumbbell rows, performed with both
jects can be seen in Table 1. arms. Both exercises were performed
with a supinated (i.e. underhand) grip.
Experimental Design Muscle thickness and 10RM strength
This study employed a within-subject measurements were repeated following
unilateral design. In other words, for eight weeks of training.
each subject, one arm was assigned to do The training consisted of two ses-
curls, and the other arm was assigned to sions per week for eight weeks. Subjects
do dumbbell rows; since all subjects were trained to failure on all sets, and loads
right-handed, half of the subjects did were adjusted so that failure occurred
curls with their right arm and rows with between 8 and 12 reps on each set.
their left arm, and half of the subjects During the first four weeks, the subjects
did rows with their right arm and curls performed four sets for each exercise
with their left arm. This type of design (i.e. four sets of curls with the right arm
allows each subject to serve as their own and four sets of rows with the left arm)
control, which removes a considerable with two minutes between sets. During
amount of between-group variance that the second four weeks, the subjects per-
can result from sampling error or lifestyle formed six sets for each exercise.
differences. For example, if one subject
has great genetics and a lifestyle that’s
very conducive to hypertrophy, both of Findings
his arms will be affected by those factors; All of the researchers’ hypotheses were
with a typical parallel group design, that correct. 10RM dumbbell row strength
subject would just be randomized to one increased more in the arms performing
group and could drag the group mean dumbbell rows, and 10RM biceps curl
up in a way that doesn’t reflect the “true” strength increased more in the arm do-
effect of the training intervention. ing curls (p < 0.001 for both). Further-
Initial testing involved muscle thick- more, elbow flexor thickness increased by
ness measurements of the elbow flexors roughly twice as much (11.1% vs. 5.2%)
at three sites along the humerus (25%, in the arm doing curls compared to the
50%, and 75% of humerus length), and arm doing rows (p = 0.009).
8
Figure 1 Ten repetition changes normalized on dumbbell row exercise Figure 2 Ten repetition changes normalized on biceps curl exercise
60 80 p < 0.001
p < 0.001
60
10RM Normalized
10RM Normalized
40
40
20
20
0 0
Single-joint Multijoint Single-joint Multijoint
Interpretation if you try to do DB rows super strictly,

Right off the bat, there’s one key detail the load you can use is severely compro-
that bothers me a bit about this study: It mised compared to using just a small
doesn’t clarify how technique was stan- amount of body English. One reason for
dardized for the two exercises. For some that phenomenon is that the lats’ shoul-
exercises that doesn’t matter too much. der extension moment arm quickly ap-
For example, if a study uses the bench proaches zero as your elbows come in
press, you can be pretty confident the line with your torso (i.e. as your shoul-
lifters at least touched their chest and der flexion angle approaches zero; 2).
locked out each rep, unless stated oth- So, your lats go from being able to pro-
erwise. But for curls and especially DB duce a lot of shoulder extension torque at
rows, it’s not that straightforward. The the start of a DB row to very, very little
study states: “standard exercise tech- shoulder extension torque as you reach
niques were followed for each exercise the top position of the lift. That issue is
to guarantee proper form, and verbal compounded by the fact that the exter-
encouragement was provided during all nal moment arm the lats are working
the tests for all subjects. All individuals against is the longest as you approach the
were instructed to avoid initial momen- top position; in other words, it’s an exer-
tum.” How was “proper form” defined? cise with a pretty bad resistance curve, all
At what level of “initial momentum” did things considered: It’s the hardest where
the researchers terminate a set? Were you’re the weakest, and the easiest where
there objective criteria? Questions like you’re the strongest.
that matter. I’m sure you’ve noticed that If the dumbbell doesn’t already have
9
some momentum, you can’t really grind Figure 3 Elbow flexors thickness mean changes and SD
out those last few inches of a dumbbell
row. As such, just a little “cheating” al- 0.25 p < 0.009
lows the DB row to be a generally ef-
Muscle thickness normalized

fective exercise, whereas super strict DB 0.20
rows can hardly challenge any muscula- 0.15

ture except for your lats (and only in a
very small portion of the range of mo- 0.10
tion) simply due to how weak your lats

0.05
are in a fully contracted position. In oth-
er words, how strict the researchers were 0.00
with DB row technique is a really im- Single-joint Multijoint

portant consideration, and I can’t pos-
sibly conceive of how they could have Is that a specific question that will get
been incredibly objective about it. us closer to answering the general ques-
With that out of the way, I’d like to tion we’re interested in? Absolutely! But
make a hard left turn to briefly discuss is that synonymous with and identical
the philosophical aspects of experimen- to the general question itself ? Not at
tal design. When you design an experi- all. As such, this study did find that DB
ment, you’re typically interested in an- curls built more muscle than DB rows,
swering a somewhat general question. but the title of the study (“Single-Joint
In this case: “Does multi-joint training Exercise Results in Higher Hypertro-
cause as much hypertrophy in a partic- phy of Elbow Flexors than Multijoint
ular muscle group as single-joint train- Exercise”) is a reach, as it implies that
ing that specifically targets that muscle answering the specific question implied
group?” However, it’s impossible to set by the study design also answered the
up a single experiment that answers that general question alluded to in the title.
general question. Answering that gen- I’m not trying to pick on these authors;
eral question would require assessing all virtually everyone does it. I just wanted
multi-joint exercises and all single-joint to point this out because a lot of people
exercises, which is completely infeasible are quick to skim titles and abstracts and
to tackle in a single experiment. Instead, not think critically about what a study is
you substitute the general question for a literally testing, rather than the general
specific question that you hope will be a questions it’s merely scratching the sur-
sufficient stand-in for the general ques- face of.
tion. In this case: “Do DB rows and DB So now let’s actually dig into the re-
curls cause similar biceps hypertrophy?” sults of this study. One thing about the
10
results of this study struck me as some- other studies in this general body of
what odd: Even though this study used literature look at the effects of adding
a within-subject unilateral design, the single-joint training to a program of
subjects barely got stronger at all with multi-joint training.
the exercises they weren’t directly train- 2. Basically all of the prior studies look-
ing (i.e. the DB row arms barely in- ing at the effects of single-joint versus
creased their curl strength, and vice ver- multi-joint training for arm growth
sa). Since these were untrained subjects, use pull-downs as the multi-joint ex-
I’d expect considerable strength gains ercise for the biceps. Throwing rows
for the untrained movements simply into the mix adds a new wrinkle to
due to the cross-education effect (a 2017 the literature.
meta-analysis suggests that the average
In the most directly comparable study,
strength gains in the untrained limb are
Gentil et al compared biceps curls to
about 40% as large as those seen in the
pull-downs and found that they had
trained limb: 3). In an untrained popu-
similar effects on biceps hypertrophy
lation, the cross-education effect is large
(5). This present study found that curls
enough that, for example, a leg train-
caused considerably more elbow flexor
ing at 30% of 1RM can increase 1RM
hypertrophy than rows. This loops back
strength just as much as a leg training
around to my discussion/rant of gen-
at 80% 1RM (4). Add in the fact that
eral versus specific research questions.
DB rows should directly increase biceps
Both studies were examining the gen-
strength, at least a little, and I’m pretty
eral question of multi-joint versus sin-
surprised that the arms doing rows saw
gle-joint training, and they were even
such pitifully small increases in biceps
assessing the same muscle group, but the
curl 10RM (and vice versa). That’s not
choice of multi-joint exercise had a big
a huge deal – it just caught my eye as
impact on the results of these two stud-
something unexpected.
ies. Pull-downs seem to do a pretty good
At this point, I feel like I’ve almost job of causing biceps growth, while DB
run the topic of multi-joint versus sin- rows are pretty lackluster.
gle-joint training into the ground (see
With that in mind, I’d like to wrap up
our most recent article on the subject
by sharing some general thoughts about
here). I still wanted to review this study,
when multi-joint exercises are likely to
though, for two main reasons:
do a pretty good job of growing a partic-
1. Surprisingly, it’s one of just two stud- ular muscle group, and when other ex-
ies that compares multi-joint and ercises, including single-joint exercises,
single-joint exercises straight up on a may be needed to maximize hypertro-
set-for-set basis. The majority of the phy.
11
Figure 5 Change in moment arms between the bottom and top positions of a dumbbell row
Moment arm
I think there are two general principles range of motion, so while sumo deadlifts
in play: can probably cause quad growth, it’s un-
1. How long is the range of motion for likely that they maximize quad growth.
the target muscle? Conversely, shoulder press (unless you
take a weirdly wide grip) and close grip
2. Is the target muscle likely to limit
bench do approach full range of motion
performance in the exercise you’ve
for the elbows, so they likely do a better
chosen?
job of causing triceps growth than wide
Starting with range of motion, it’s clear grip bench, and may do as good of a job
that the triceps contribute to the bench of growing the triceps as isolation exer-
press. However, if you bench with a wide cises would (or at least come very close).
grip, your elbows don’t go through any- Similarly, machine hack squats take your
thing even approaching their full range knees though something approaching
of motion. Thus, while bench press can full range of motion, so they do a stellar
clearly cause triceps growth, it’s un- job at building the quads.
likely that it maximizes triceps growth.
The second criteria – whether you’re
Similarly, your quads clearly contribute
limited by the target muscle group – is
heavily to sumo deadlifts, but a sumo
a little more individualized. For a clear
deadlift doesn’t even approach full knee
example from the literature: It’s not at
12
Figure 6 Mismatch between the strength curve of the lats and the shoulder flexion
resistance curve of the dumbbell row
External shoulder flexion

Strength of the lats
moment (difficulty)
Bottom Top
position position
all uncommon to fail a set of pull-downs but not quite as effective for the second
because your biceps wore out (especially person. Some people feel their chest give
for newer lifters), but it’s pretty unlikely out when they’re benching, while other
that you’ll fail a rep during a set of DB people feel the exercise much more in
rows because your biceps wore out. Thus, their front delts and/or triceps; bench is
the results of the presently reviewed probably great for building the pecs of
study and the prior Gentil et al study people in the first category, while people
make sense through this lens. Other ex- in the second category may instead need
ercises aren’t as straightforward. For ex- to do DB bench press or flyes.
ample, some people are virtually always I actually think there’s a third princi-
going to fail a set of squats because their ple, but it’s a special case that only se-
quads gave out, while other people start riously affects about three muscles that
relying very heavily on their hip exten- most MASS readers would be interested
sors once they get within spitting dis- in: Am I dealing with a biarticular mus-
tance of failure; squats would likely be a cle? In this case, the long head of the
great quad exercise for the first person, triceps, the hamstrings, and the rectus
13
APPLICATION AND TAKEAWAYS
Don’t rely on rows for biceps growth (duh). Rather, when your main goal is hypertrophy,
first consider which multi-joint exercises are likely to provide a large growth stimulus
for the muscle you’re targeting based on the range of motion for the target muscle,
and how likely it is that a given multi-joint exercise will be limited by the target muscle.
If a multi-joint exercise will do the trick, that will help make your workouts more time-
efficient, since the multi-joint exercise will train other muscles as well. If time efficiency
isn’t a concern, or if there aren’t any multi-joint exercises that can adequately train the
muscle you’re trying to target, feel free to use single-joint exercises.
femoris are the three muscles/muscle you could throw at them. For the rectus
groups affected. There’s some evidence femoris, knee extensions and sissy squats
that your nervous system preferentially are your friend. For the long head of the
recruits single-joint muscles when pos- triceps, pure triceps exercises are good,
sible, only ramping up recruitment of but a combination pullover/triceps ex-
two-joint muscles as you significantly tension is probably even better, since it
fatigue (6, 7, 8), assuming you’re doing incorporates both functions of the long
a multi-joint exercise where the muscle head (shoulder extension and elbow ex-
in question functions as both an agonist tension).
and an antagonist. For example, in the Ultimately, I don’t think the question
squat, your hamstrings help extend your “do multi-joint exercises cause as much
hip (good), but also try to flex your knee hypertrophy as single-joint exercises?” is
(bad). The opposite is true of the rec- particularly useful. I think a better ques-
tus femoris. We also see that squats do tion is, “For the muscle(s) I’m trying
a pretty lousy job of growing both the to grow, what multi-joint exercises will
hamstrings and rectus femoris (9, 10). give me the most bang for my buck, and
So, for biarticular muscles, I think it’s would I rather do those exercises, or just
wise to show them love with single-joint add single-joint training into my current
exercises or exercises where both of the routine to target those specific muscles?”
muscle’s functions are agonistic. So, for
example, you’ll probably get more mile-
age from leg curls and RDLs (which are Next Steps
essentially a single-joint exercise, as al-
most all of the movement should come I’d still like to see a study on sin-
from your hips) for hamstrings growth gle-joint versus multi-joint training
than any of the multi-joint exercises where the single-joint training replaces
some multi-joint sets instead of just be-
14
ing added on top of the same number
of multi-joint sets. For example, a study
could compare six sets of bench press
against three sets of bench, three sets of
triceps extensions, and three sets of flyes.
I think that would be more representa-
tive of how single-joint training is used
in real-world programming.
15
References
1. Mannarino P, Matta T, Lima J, Simão R, Freitas de Salles B.Single-Joint Exercise Results

in Higher Hypertrophy of Elbow Flexors Than Multijoint Exercise. J Strength Cond Res.
2019 Jul 1.
2. Ackland DC, Pak P, Richardson M, Pandy MG. Moment arms of the muscles crossing the
anatomical shoulder. J Anat. 2008 Oct;213(4):383-90.
3. Cirer-Sastre R, Beltrán-Garrido JV, Corbi F. Contralateral Effects After Unilateral Strength
Training: A Meta-Analysis Comparing Training Loads. J Sports Sci Med. 2017 Jun
1;16(2):180-186.
4. Nóbrega SR, Ugrinowitsch C, Pintanel L, Barcelos C, Libardi CA. Effect of Resistance
Training to Muscle Failure vs. Volitional Interruption at High- and Low-Intensities on
Muscle Mass and Strength. J Strength Cond Res. 2018 Jan;32(1):162-169.
5. Gentil P, Soares S, Bottaro M. Single vs. Multi-Joint Resistance Exercises: Effects on Muscle
Strength and Hypertrophy. Asian J Sports Med. 2015 Jun;6(2):e24057.
6. Zhang LQ, Nuber GW. Moment distribution among human elbow extensor muscles during
isometric and submaximal extension. J Biomech. 2000 Feb;33(2):145-54.
7. Robertson DG, Wilson JM, St Pierre TA. Lower extremity muscle functions during full
squats. J Appl Biomech. 2008 Nov;24(4):333-9.
8. Bryanton MA, Carey JP, Kennedy MD, Chiu LZ. Quadriceps effort during squat exercise
depends on hip extensor muscle strategy. Sports Biomech. 2015 Mar;14(1):122-38.
9. Pareja-Blanco F, Rodríguez-Rosell D, Sánchez-Medina L, Sanchis-Moysi J, Dorado C,
Mora-Custodio R, Yáñez-García JM, Morales-Alamo D, Pérez-Suárez I, Calbet JAL,
González-Badillo JJ. Effects of velocity loss during resistance training on athletic perfor-
mance, strength gains and muscle adaptations. Scand J Med Sci Sports. 2017 Jul;27(7):724-
735.
10. Kubo K, Ikebukuro T, Yata H. Effects of squat training with different depths on lower limb
muscle volumes. Eur J Appl Physiol. 2019 Jun 22.
16
Concept Review:
Using the RIR-Based RPE Scale in Your Training
RPE and RIR:

The Complete Guide
BY MICHAE L C . ZO URD O S
MASS and many others have discussed RPE at length. However, there are many
uses of RPE outside of just basic load prescription. This article gives a brief
historical context and then provides a section and example of every single way
that RPE has been used in the literature.
17
KEY POINTS
1. Although most of us know rating of perceived exertion (RPE) as a scale that
measures repetitions in reserve (RIR) during a set of resistance training, that is a
relatively new usage of the term.
2. There are many ways to use RPE outside of just basic load assignment. These
strategies include autoregulating volume, load progression over time, tracking
progress, and predicting a 1RM.
3. While there are limitations and valid critiques of using RPE, using the RIR-based
RPE scale requires little effort and comes at no cost. In most cases, even if RPEs
are not perfectly accurate, they are still quite useful.
I
n today’s fitness industry, we tend many still seem to be unaware of is that
to discuss RPE as it relates to RIR the utility of RPE extends far beyond
during a resistance training set. basic load prescription. In this concept
While the RIR-based RPE scale is the review, I aim to provide detailed insight
focus of this article, we should under- into every possible way to use RPE in-
stand that the concept of RPE has been cluding: load prescription, autoregulat-
around since before the launch of Apple, ing volume, predicting 1RM, tracking
Inc. in the early 1970s. The original RPE progress over time, and weekly load/set/
scale was created by Gunnar Borg and rep progression, among other uses. This
was designed to gauge light, moderate, article will provide specific practical ex-
and heavy efforts during aerobic training amples in the form of tables for each
(1). RPE, as most lifters use it today, is use, so that you can directly implement
quite new when considering the histori- these strategies into training programs
cal context and actually out of step with for yourself or your clients. This article
mainstream academics. Nonetheless, the will also discuss some of the common
popularity of RIR-based RPE has ex- criticisms of RPE and how someone can
ploded over the last 10+ years due to its improve their rating accuracy. First, let’s
great utility and ease of use. However, start with the aforementioned historical
RPE tends to be viewed in a binary fash- context.
ion as either “RPE training is good” or
“RPE training is bad.” This binary view What’s a concept review?
tends to only take into account using A written concept review is similar to our
RPE for basic load prescription because signature video reviews. The aim of this
the ratings are subjective. The criticism article type is to review a cornerstone topic
of subjectivity is fair; however, what in physiology or applied science research.
18
Brief History Table 1 Borg 6-20 Scale
Traditionally, RPE has been used in RPE Score Exertion Level
a different context than how the fitness

6
community uses it today. Originally,
Gunnar Borg created a 6-20 RPE scale 7 Very, very light
in 1970 (1), during Helms’s freshman 8

year of high school. The scale was created
9 Very light
for aerobic exercise, and the ratings were
intended to correspond with a runner’s 10
heart rate. For example, the idea was that 11 Fairly light
a rating of 6 would correspond to a heart
rate of 60 beats per minute, and 20 with 12
200 beats per minute; this range of 60 to 13 Somewhat hard
200 beats per minute roughly represents 14

a typical spectrum from resting to maxi-
mal heart rate. Therefore, the original it- 15 Hard
eration of RPE was to gauge effort levels 16
during aerobic exercise. Borg then added

17 Very hard
the C (category) R (Ratio) 10 (CR10)
scale in 1982 (2), which gauged effort 18
levels in a simpler 0-10 rating system. 19 Very, very hard

Both Borg scales accomplished the same
20
thing, which was allowing aerobic exer-
cisers to gauge a general sense of light, Adapted from Borg (1) 1970
RPE = Rating of Perceived Exertion
moderate, or heavy effort. However, for
resistance training, the application is
relatively limited. Fast forward to 2006 The lack of precision of the Borg scales
and the OMNI scale was created for re- for resistance training was first revealed
sistance exercise. The 1-10 OMNI scale in the scientific literature in 2012 from
was very similar to the CR10 Borg Scale Hackett et al (3). Hackett had body-
except visual descriptors were added to builders perform 5 sets to failure at 70%
the “easy,” “moderate,” and “heavy” de- of 1RM on the squat and bench. After
scriptors. While the visual descriptors 10 reps on each set, the bodybuilders
were an improvement, these RPE scales recorded both a Borg RPE (i.e. light,
still lacked precision for resistance train- moderate, or heavy effort), noted how
ing. The two original Borg scales can be many repetitions they felt they had left,
seen in Tables 1 and 2. and then continued the set to failure.
19
The bodybuilders estimated their reps Table 2 Borg CR10 scale
left until failure (what we now call RIR) RPE Score Exertion Level
with pretty good accuracy; however,
they tended to record moderate effort 0 Nothing at all
even when going to failure on the Borg 0.5 Extremely light/weak
scale. Thus, it was concluded that the

1 Very weak / light
Borg or “traditional RPE” scales lacked
utility for resistance training, as lift- 2 Weak / light
ers tend to gauge cardiovascular effort 3 Moderate

when looking at the descriptors (Tables
4 Somewhat strong
1 and 2 above) on traditional scales. Al-
though the Hackett study was the first 5 Strong (heavy)
time this concept had been broached 6

in the scientific literature, it would be
inaccurate to say that this was the first 7
time it had been presented in general. In 8 Very strong
fact, around the time of his gold medal

9
powerlifting performance at the World
Games, Mike Tuchscherer published 10 Extremely strong
the Reactive Training Systems Manual * Maximal

(4), in which he created the idea of hav-
ing RIR descriptors for RPE. Our labo- Adapted from Borg (2) 1982
ratory took the work of Tuchscherer and
Hackett et al and formalized the RIR- Table 3
based RPE scale within the scientific
RPE Score RIR / Description
literature in 2016 by validating it against
velocity (Table 3) (5). The idea, however, 10
originates with Mike T., and it’s import- 9.5 No RIR, but could increase load
ant to make sure he gets the credit. Fur- 9 1RIR
ther, this is an excellent example of how 8.5
the practical realm is sometimes ahead 8 2RIR
of science and how what is already done 7.5
in practice can, and sometimes should, 7 3RIR
impact scientific research. 5-6 4-6 RIR
Although not the focus of this concept 3-4
review, I would be remiss to exclude in 1-2
this historical discussion the usage of Adapted from Zourdos et al. (5) 2016
RPE = Rating of Perceived Exertion; RIR = Repetitions in Reserve
20
the session RPE scale. Session RPE was
brought to the forefront by Dr. Carl Fos- Specific Ways to
ter in 2001 (6). It’s a 0-10 scale typically Implement RPE
administered 30 minutes following ex- The remainder of this article will ex-
ercise and asks the individual about their plain every way in which RPE can be
global fatigue level using descriptors used so that you can implement it into
such as: “easy,” “moderate,” “hard,” and your training in the appropriate manner.
“maximal.” Let’s look at an example of Before we get to each subsection, please
the utility of this scale in the context of remember that RPE is just one form of
resistance training: If two programs pro- autoregulation, which is defined as gath-
duced the same long-term hypertrophy ering feedback about training to make
and strength, but one produced a lower informed decisions (7). For example, a
session RPE, then it might make sense form of autoregulation outside of RPE
to recommend the program that caused is flexible training templates. Addition-
less fatigue or even consider adding vol- ally, thanks to two recent studies, one
ume or intensity to the less-fatiguing from Dr. Helms (8) and the other from
program (we’ve previously written about Graham and Cleather (9 – reviewed in
this). MASS), we know that autoregulating
Recently, I’ve seen people suggest there training load with RPE/RIR over the
could be a difference in RPE and RIR. long-term is also a good idea for strength
In reality, if using the RIR-based RPE when compared strictly to percentages.
scale, there isn’t a difference. They are Let’s get started with a breakdown of
the same. However, historically, there each way to use RPE, starting with the
is indeed a difference, but this doesn’t most basic.
mean that the terminology of “RPE”
and “RIR” won’t have different conno- Basic Load Prescription with RPE
tations to people even though the scale The most basic way to implement RPE
treats them the same way. Toward the is to simply replace percentage-based
end of this article, we will return to the load prescription with RPE-based load
terminology and discuss how sometimes prescription. For example, instead of pro-
it may be better to use one term over gramming 4 sets of 8 at 70% on a com-
the other, even if they are technically re- pound movement, you could program 4
ferring to the same thing. Now that we sets of 8 at 6-8 RPE. This means that you
understand the history, the remainder of would simply choose a load that would
this article will focus on the exact usage land you within the 6-8 RPE range. The
of the RIR-based RPE scale and will be utility of this is that since strength fluc-
chock-full of practical examples. tuates daily due to various readiness fac-
21
Table 4 Basic RPE loading example
Mesocycle 1 Mesocycle 2 Mesocycle 3 Mesocycle 4

(About 4-6 weeks) (About 4-6 weeks) (About 4-6 weeks) (About 4-6 weeks)
Day 1 3 x 10 @ 5-7 RPE 3 x 8 @ 6-8 RPE 3 x 6 @7-9 RPE 3 x 5 @8-9.5 RPE
Day 2 4 x 8 @ 5-7 RPE 4 x 6 @ 6-8 RPE 4 x 4 @7-9 RPE 3 x 3 @8-9.5 RPE
Day 3 5 x 6 @ 5-7 RPE 5 x 4 @ 6-8 RPE 4 x 2 @7-9 RPE Single @9.5 RPE
tors (i.e. poor sleep, anxiety, scheduling you an idea of how many reps a lifter can
issues, etc.), using RPE allows you to do at a certain percentage. Then, based
increase or decrease the load as needed. on how many reps are performed at a
In the same way, RPE also allows you to specific load, you can now individualize
lift heavier when you are feeling good. a percentage program. Table 4 shows a
In fact, the Helms (8) and Graham and basic RPE load prescription example.
Cleather (9) studies found that allowing Table 4 is just one example of a basic
lifers to choose a load based upon RPE RPE-based load prescription. The ex-
allowed subjects to train at a higher av- ample is quite practical, as it takes into
erage intensity throughout the respective account long-term periodization and
8- and 12-week training studies, which programming strategies outlined here,
led to greater 1RM strength in various in that there is an overall decrease in
compound movements. the number of repetitions (i.e. decrease
Additionally, the number of reps that in volume) and an increase in RPE as
can be performed at a given intensi- intensity increases from block to block.
ty is highly individual. Recent studies When incorporating assistance work
have reported ranges of 6-28 (average = with the main lifts in the above example,
16 ± 4) (10) and 6-26 (average = 14 ± I would generally follow a similar RPE
4) (11) reps performed on the squat at format, but keep the reps a bit higher so
70% of 1RM. Therefore, replacing per- that you are not doing triples and singles
centages with RPE can account for the on single-joint movements in the final
between-individual differences. Even if mesocycle. Overall, this example takes
you like to use percentages as a coach, into account day-to-day fluctuations in
using RPE in the first few weeks with a strength levels, the individual ability to
new client (if they are well-trained and perform reps, and it allows for intra-ses-
reasonably accurate with RPE) will give sion load adjustments. When adjusting
22
load intra-session, if you miss the RPE Table 5 Basic load adjustment chart if missing the RPE range
target on a set, I think it’s good to have Actual RPE Next set load adjustment if assigned RPE range is 6-8
a guide for how to adjust load. There- 1 Increase load by 20%
fore, in Table 5, I have included the ta- 2 Increase load by 16%
ble from Dr. Helms’s dissertation that 3 Increase load by 12%
provides this load adjustment guide. You 4 Increase load by 8%
don’t have to follow this table exactly, 5 Increase load by 4%
but it provides the general idea of how 6 Lifter’s choice
to change the load for the next set when 7 Lifter’s choice
you miss the target RPE range. Lastly, 7.5 Lifter’s choice
I find it a good idea to include an RPE
8 Lifter’s choice
range as your target rather than an ex-
8.5 Decrease load by 2%
act RPE target when performing mul-
tiple sets with RPE-load prescription,
9 Decrease load by 4%
as it will become difficult to hit an exact 9.5 Decrease load by 6%
RPE target each time. Besides, it’s just 10 Decrease load by 8%
not that important to maintain an exact Adapted from Helms et al. 2018
proximity to failure; rather, it’s import-

ant to understand the intent of RPE,
which is generally to either be far from ume. Using RPE to autoregulate volume
failure, a few reps from failure, or at fail- has been described using the term “RPE
ure. A range saves you from having to stop.” You can implement RPE stops in
adjust the load every single set. Table 5 two ways: 1) to autoregulate the number
essentially stipulates that if your set is of reps in a set, or 2) to autoregulate the
within the RPE range, you can choose number of sets in a session for a specific
what you would like to do for your next exercise. These strategies are similar to
set; however, for every 0.5 RPE points velocity loss (12), which we have dis-
outside of the range your set lands, then cussed before.
you should adjust the load 2% up or To implement the first strategy and
down for your next set. Table 5 uses an autoregulate reps in a set with an RPE
example of a target RPE range of 6-8, stop, you would pick a percentage or an
but of course this concept can be applied exact weight and do as many reps as pos-
with any target RPE range. sible on each set but stop each set when
you reach a predetermined RPE. If aim-
Autoregulating Volume (RPE Stop) ing to accumulate volume, you would
Autoregulation can also be imple- stop at about a 7-8RPE, and if training
mented to achieve the appropriate vol- with low volume at high intensities (i.e.
2-4 reps at 85-90% of 1RM), you may
23
Table 6 RPE stop examples
RPE stop method 1 RPE stop method 2

(Autoregulating reps in a set) (Autoregulating total sets)
1. Choose exercise (squat) 1. Choose exercise (squat)
2. Choose load (let’s use 70% of 1RM for volume) 2. Choose load (let’s use 70% of 1RM for volume)
3. Choose RPE to stop at per set (let’s use 6-8 for

3. Choose number of reps per set (let’s use 8)
volume and to avoid fatigue spilling into next session)
4. Choose RPE to stop squatting for the day (let’s use

8.5, assuming this person can do more than 12 reps at
individual volume needs (let’s use 4 sets)
70%)
5. Choose a number of sets to cap the volume

(let’s use 5)
Programming for the day Programming for the day

4 sets of squats at 70% of 1RM and stop each set Sets of 8 reps on squats at 70% of 1RM for as many
@6-8 RPE sets (up to 5) until an 8.5RPE is reached
stop a set at around a 9 RPE. I actually mined, otherwise velocity can be misap-
think RPE stops have utility over veloc- plied across a group.
ity loss. Specifically, and as we pointed The second usage of an RPE stop is
out last month, if your first rep on a 70% to autoregulate total set volume. In this
of 1RM squat set is 0.65 m/s, a 40% loss model, we take a certain load (i.e. 70%
puts you at 0.39 m/s, which probably of 1RM) and perform 8 reps per set, but
lands someone between a 5 and 8 RPE. without a predetermined number of sets.
However, your first (or fastest rep veloc- Now, we would perform as many sets as
ity) will be lower on subsequent sets. So, we can until we exceed a predetermined
let’s say on your fourth set, your first rep RPE, let’s say an 8 RPE. I would recom-
velocity is 0.55 m/s, then a 40% velocity mend capping the number of sets so that
loss has you stopping the set at 0.33 m/s, you don’t end up performing 10 sets of
which is much closer to failure than the high rep squats one session if you have a
0.39 m/s on the first set. Therefore, an high work capacity. This might be 5 sets
RPE stop will always have you stop the for compound lifts when accumulating
set at the desired amount of RIR (as- volume (i.e. moderate reps and low-
suming the RPE is accurate), and it is er peak RPE) or 3 sets for compound
inherently individualized, whereas in- lifts when in an intensity block (i.e. low
dividual velocity profiles must be deter-
24
Table 7 Total reps and rest-pause example
Total reps and rest-pause Results, reps after each set
Set 1
1. Choose exercise (dumbbell shoulder press)
11 reps
2. Choose load (if you are in a volume block, maybe Set 2

choose something you can do for a 12-15RM) 20 reps
Set 3
3. Choose RPE to stop at per set (let’s use 8-9 RPE)
28 reps
Set 4
4. Choose total number of reps (let’s use 35)
35 reps
To do the above rest-pause style just take 20-30 seconds between sets and this will serve as a really efficient time saving
strategy when needed.
RM = repetition maximum
reps and high peak RPE). Of course, the Even though strictly using generalized
amount of sets is also dependent on an percentages isn’t great for programming
individual’s recovery. Table 6 shows an the main lifts, a lifter could create an in-
example of both RPE stop methods. dividualized percentage chart. However,
Another advantage of RPE stops is for assistance work, we typically do not
that they have built-in progressive over- know our 1RM; thus, we are left with
load. For example, in method one, if our perception of difficulty to determine
your goal is volume you can just stick loading. For assistance work, you can
with the same weight for a few weeks certainly use basic load assignment (Ta-
and aim for more reps. Then, once you ble 4); however, a total rep or non-fail-
hit a certain number of total reps across ure rest-pause strategy works well and
all 4 sets (as per the example), you can is similar to an RPE stop. For example,
increase the load. In method two, if your if your 12RM on dumbbell bench press
goal is 5 sets at an 8 RPE or less, you can is about 40kg, you could set a thresh-
continue to perform this load each week old of 35 total reps and perform each
until you complete all 5 sets successfully, set to an 8-9 RPE until you reach the
then increase the load. threshold of 35 reps. In week 1 of your
training block, it might take you 4 sets
Total Reps and Rest-Pause with RPE to reach the 35 reps. You could continue
each week with the same load until you
For assistance work, RPE can be just
reach the 35 reps in 3 sets, then increase
as valuable as it is for the main lifts.
25
Table 8 Using RPE to predict daily 1RM or gauge progress
Method Training example Application Outcome
1 rep @9RPE is about 95%. Thus, 157.5 kg can be concluded as the

Predicting intensity or a daily 1RM 150kg squat for 1 rep @9RPE
divide 150 / 0.95 daily 1RM
We can conclude progress and

Gauging strength progress over After 8 weeks of training, 150kg is
150kg squat for 1 rep @9RPE projected 1RM went from 157.5 kg
time squatted for 1 rep @7RPE
to 172.5 kg
After 4 weeks of training, 6 sets of

Completed 3 sets of 8 at 105kg on
Gauging volume progress over time 8 at 105kg was completed with a volume progress and greater
squat without exceeding 8
last set RPE of 7 hypertrophy should follow over time
the total reps threshold or increase the This is clearly progress and you can track
load to achieve progressive overload. The it without having to consistently do fa-
above example can also be used in the tiguing 1RM tests. If you perform some
rest-pause variety, just simply take 20-30 sort of fatiguing test after every training
seconds between sets. Using RPE during block, then you might have to take a de-
rest-pause allows you to avoid the typi- load or elongated intro week following
cal failure training associated with rest- the test. However, tracking RPE gives
pause training, so it should cause less fa- you a metric of how successful the block
tigue in the 48 hours following training was from a strength (or volume perfor-
than going to failure (13). In reality, the mance) perspective and even allows you
above examples are really variations of to gauge progress during the middle of
RPE stops, but as this is a concept re- a training block by comparing RPEs at
view, I wanted to clearly explain every a given load to RPEs at similar loads
possible RPE load assignment strategy. during previous weeks. Table 8 gives
specific examples of how to track prog-
Tracking Progress and Predicting a 1RM ress and predict a 1RM with RPE. The
Something I’ve hit on before in MASS first two columns of Table 8 originally
is that even if you don’t use RPE to appeared in an article from Volume 2,
program load, you should still track it. Issue 11, and the third row was newly
Tracking RPE would itself be scored as created for this article.
an RPE 1, meaning it takes little to no
effort to do, and it provides you with a Progression Schemes with RPE.
gauge of progress over time. From one Another often overlooked aspect of
week to the next, one block to the next, RPE is achieving progressive overload.
or even year after year, you can look We are oftentimes fixated on saying we
back and say “I did 175kg for a single at are going to increase 2.5kg each week on
9 RPE and now I can do it at 5 RPE.” a main lift; however, that is just not typ-
26
9, then you can repeat this until your av-
erage RPE is 8, and then add load or add
a set. In the previous example, you could
IT’S JUST NOT THAT continue adding sets until you complete
IMPORTANT TO MAINTAIN AN 5 X 10 at an average RPE of 8 and then
increase the load on the bar and go back
EXACT PROXIMITY TO FAILURE; to 3 sets (i.e. 3 X 10 at 102.5kg). There
are many other ways to do this, which
RATHER, IT’S IMPORTANT TO could be an article in and of itself. The
UNDERSTAND THE INTENT OF good news is that we already have it in
video form. You can watch the detailed
RPE, WHICH IS GENERALLY presentation of using RPE to achieve
progressive overload, and remember that
TO EITHER BE FAR FROM strategies laid out in the video are not
FAILURE, A FEW REPS FROM mutually exclusive.
FAILURE, OR AT FAILURE. To Implement a Flexible Template in the

Warm-Up
Using RPE to assess readiness is not
ically feasible. If you are programming as popular as the strategies discussed
load prescription with RPE like the ba- above, but it still has merit. A founda-
sic RPE loading example (Table 4), then tional principle of using RPE for load
progressive overload takes care of itself; prescription is that it can take into ac-
over time, you should be able to load more count low daily readiness and high fa-
on the bar to meet the prescribed RPE. tigue. So, why not use RPE to account
However, if you have a predetermined for readiness in the warm-up? Specif-
load and you simply track RPE (Table ically, if you are going through a busy
8) in a percentage-based program, then time, then it might make sense to im-
you can use your RPE scores from each plement a flexible training template.
session or each week to progress load, In short, you might have three training
sets, or reps for the following week. The sessions per week in which you have a
most basic way to use RPE to progress heavy training day, a moderate day, and a
load is creating an inverse relationship light day, but the order in which you do
between RPE and progress (i.e. the low- them is flexible to meet your readiness
er the RPE, the greater the increase in levels. You then need to have a metric
load). Additionally, if you bench 100kg that you use to decide which training
for 3 sets of 10 reps at an average RPE of day to do. The most common readiness
27
Table 9
RPE Choice of session-type
>8
7-8 Light session
7 Moderate or light session
6 Moderate session
5 Heavy or moderate session
<5 Heavy session
5 = this individual’s normal RPE at 85% of 1RM
metric is the perceived recovery status or higher, then you might opt for the
scale, which is essentially a 1-10 Likert light day. If your RPE is 5-7, you might
scale with 1 being “poorly recovered and opt for the moderate session, and if your
expecting declined performance” and RPE is <5, you might opt for the heavy
10 being “well-recovered and expect- session. I don’t think you have to be that
ing improved performance.” In short, a strict with it, and RPE is only going to
high rating on this scale suggests you fluctuate so much, but – in general – it’s
should do the heavy session that day, probably better to decide which workout
while a low recovery rating indicates you are going to do in a flexible template
you should do the light session. How- after you start warming up rather than
ever, data have shown that pre-training before the warm-up. Table 9 presents a
recovery ratings do not always correlate “less-strict” version of using RPE during
with performance in that day’s session; the warm-up to choose session-type.
rather, RPE during the warm-up might
be a better indicator (14). Thus, if you
are using a flexible template, you could Final Thoughts
simply warm up to a decent load (i.e. Before we finish up, we should address
80%-85% of 1RM) and take an RPE. If the common critique of using RPE,
your normal RPE at an 85% bench press which is that the rating is subjective and
is 6 (4 RIR), and you record an 8 RPE may be inaccurate. Some people’s ratings
28
may indeed be inaccurate, but how much
does that matter? Well, it can matter a
lot if someone is attempting to use RPE
to autoregulate a heavy double or single.
FURTHER, IF USING RPE
In this case, if someone records a 200kg DURING MODERATE- TO
squat at an 8 RPE while working up to
a single at 9 RPE, that would translate HIGH-REP SETS, THE POINT
to about a 220kg max. However, if the
200kg X 1 was actually a 9 RPE, this ISN’T TO BE PERFECTLY
calculation may erroneously cause the
lifter to attempt 210kg on the next set, PRECISE. RATHER, THE
and it could be a true max or the lift-
er could even fail the attempt. While PURPOSE IS TO SIMPLY
there would be fatigue consequenc-
es to overshooting the RPE at such a
BE WITHIN A RANGE (I.E.
high intensity, it is highly unlikely that
someone experienced is that inaccurate
5-8) TO ENSURE YOU
with RPEs during low-rep sets at heavy ARE AN APPROPRIATE
loads. It’s more likely that some person-
ality types don’t lend well to program- PROXIMITY FROM FAILURE.
ming something like “singles at 9 RPE.”
Some lifters might simply rationalize a
way to max out when heavy singles are ers were on average 5.15 ± 2.92 reps off
programmed using RPE. In this case, as when asked to verbally call out an in-
a coach, I would just prescribe a heavy tra-set RPE when they believed they
load for a single that I know the lifter were at a 5 RPE (5 RIR), a 7 RPE (3
can hit at an 8 RPE and give them an RIR), and 9 RPE (1 RIR), and then
option for a second rep to ensure failure continue to failure during a set at 70%
doesn’t occur. On the other hand, a lifter of 1RM on squats in which the average
might be too cautious when working up reps performed were 16 ± 4 (11). That is
and end up only working to an 8 RPE; a considerable amount of error; however,
however, that is less consequential than that was also overrating RPE, meaning
overshooting the RPE. subjects actually had about 10 reps left,
While RPEs are typically quite accu- which is far less consequential than un-
rate during low-rep/high-intensity sets, derrating RPE. Further, if using RPE
RPEs can indeed be inaccurate during during moderate- to high-rep sets, the
high-rep sets. In fact, well-trained lift- point isn’t to be perfectly precise. Rath-
29
1. RPE is just one of many tools to implement the concept of autoregulation. In its
most basic form, RPE can be utilized to prescribe daily training load, which takes
into account the limitations of percentages such as daily readiness and the large
between-lifter variation in reps that can be performed at a given percentage of
1RM.
2. Although RPE is most commonly used to prescribe load (i.e. 3 sets of 5 at 7-9RPE)
it can also be used to autoregulate volume (RPE Stops), program assistance work,
progress weekly load, sets, or reps, and simply be used to track progress over
time. The utility of RPE is widespread and not limited to the narrow box we usually
put it in.
3. The common critique that RPE is subjective, and thus not perfectly accurate, is
correct. However, the point isn’t to always be perfectly accurate. Further, using
RPE to predict RIR is quite accurate, based upon the existing literature, during low-
rep and high-intensity sets, which is when accuracy is most important.
er, the purpose is to simply be within a curate, try rating an RPE after a few
range (i.e. 5-8) to ensure you are an ap- reps and then continuing to failure to
propriate proximity from failure. Over- see how precise you are. I would recom-
all, as previously mentioned, RPE rat- mend doing this with a weight ≥80% of
ings tend to be strikingly accurate in 1RM on a compound movement when
well-trained lifters during low-rep sets you perceive you are at about a 7 RPE.
(15), and there is no evidence that ve- If you are a coach and a client is unsure
locity provides a better gauge of RIR in that there RPEs are accurate, you can
this case. During high-rep sets intended advise them to also gauge an intra-set
to be shy of failure, I don’t see some de- RPE before continuing a set to failure.
gree of inaccuracy to be too much of a Additionally, as a coach, I would still
problem, especially if you are overrating have a client rate RPE, even if you ar-
RPE. Besides, if you consider the large en’t using it to program or progress load,
variance of reps performed at moderate and have them send you videos of those
intensities mentioned earlier (i.e. 6-28 at lifts. Then, you can evaluate, although
70%), then a percentage program could not perfectly, if you think those RPEs
lead a lifter to a much greater program- are accurate. Of course, you can always
ming error than an RPE rating inaccu- validate RPE with velocity, but we do
rately predicting RIR by just a few reps. not all have access to accurate velocity
If you are unsure if your RPEs are ac- devices. If you do have access to an accu-
30
rate velocity device, then just about ev-
erything written in this article can also
be accomplished with velocity.
Over the past year, I’ve seen some peo-
ple prefer to simply rate RIR as opposed
to rating RPE. If you are at a 5 RPE or
higher (1-5 RIR), then that is perfect-
ly fine. Terminology is just terminology;
it’s the intent and implementation that
matters. So, if someone prefers to just
use the right side of the scale in Table 3
(i.e. RIR), then that will work just fine,
as the terms are interchangeable when
the RPE is at least 5. However, in the
literature, even the RIR-based scale
uses RPE on the low end of the scale,
as scores ≤4 RPE quantify effort and are
not associated with an RIR. It is difficult
to determine a precise RIR when so far
from failure. It is also possible that even
though RPE and RIR are intended to
be interchangeable when close to failure,
the term RIR simply resonates more
with some. So, whichever terminolo-
gy someone prefers is fine. They are the
same thing in the context of this specific
scale.
31
References
1. Borg G. Perceived exertion as an indicator of somatic stress. Scand j rehabil med. 1970;2:92-
8.
2. Borg GA. Psychophysical bases of perceived exertion. Med sci sports exerc. 1982 Jan
1;14(5):377-81.
3. Hackett DA, Johnson NA, Halaki M, Chow CM. A novel scale to assess resistance-exercise
effort. Journal of sports sciences. 2012 Sep 1;30(13):1405-13.
4. Tuchscherer M. The Reactive Training Manual: Developing your own custom training pro-
gram for powerlifting. Reactive Training Systems. 2008;15.
5. Zourdos MC, Klemp A, Dolan C, Quiles JM, Schau KA, Jo E, Helms E, Esgro B, Duncan
S, Merino SG, Blanco R. Novel resistance training–specific rating of perceived exertion scale
measuring repetitions in reserve. The Journal of Strength & Conditioning Research. 2016
Jan 1;30(1):267-75.
6. Foster C, Florhaug JA, Franklin J, Gottschall L, Hrovatin LA, Parker S, Doleshal P, Dodge
C. A new approach to monitoring exercise training. The Journal of Strength & Conditioning
Research. 2001 Feb 1;15(1):109-15.
7. Ormsbee MJ, Carzoli JP, Klemp A, Allman BR, Zourdos MC, Kim JS, Panton LB. Efficacy
of the repetitions in reserve-based rating of perceived exertion for the bench press in expe-
rienced and novice benchers. The Journal of Strength & Conditioning Research. 2019 Feb
1;33(2):337-45.
8. Helms ER, Byrnes RK, Cooke DM, Haischer MH, Carzoli JP, Johnson TK, Cross MR,
Cronin JB, Storey AG, Zourdos MC. RPE vs. Percentage 1RM loading in periodized pro-
grams matched for sets and repetitions. Frontiers in physiology. 2018 Mar 21;9:247.
9. Graham T, Cleather DJ. Autoregulation by” Repetitions in Reserve” Leads to Greater Im-
provements in Strength Over a 12-Week Training Program Than Fixed Loading. Journal of
strength and conditioning research. 2019 Apr.
10. Cooke DM, Haischer MH, Carzoli JP, Bazyler CD, Johnson TK, Varieur R, Zoeller RF,
Whitehurst M, Zourdos MC. Body Mass and Femur Length Are Inversely Related to Rep-
etitions Performed in the Back Squat in Well-Trained Lifters. The Journal of Strength &
Conditioning Research. 2019 Mar 1;33(3):890-5.
11. Zourdos MC, Goldsmith JA, Helms ER, Trepeck C, Halle JL, Mendez KM, Cooke DM,
Haischer MH, Sousa CA, Klemp A, Byrnes RK. Proximity to Failure and Total Repetitions
Performed in a Set Influences Accuracy of Intraset Repetitions in Reserve-Based Rating of
Perceived Exertion. Journal of strength and conditioning research. 2019 Feb.
12. Pareja‐Blanco F, Rodríguez‐Rosell D, Sánchez‐Medina L, Sanchis‐Moysi J, Dorado
C, Mora‐Custodio R, Yáñez‐García JM, Morales‐Alamo D, Pérez‐Suárez I, Calbet JA,
González‐Badillo JJ. Effects of velocity loss during resistance training on athletic perfor-
32
mance, strength gains and muscle adaptations. Scandinavian journal of medicine & science in
sports. 2017 Jul;27(7):724-35.
13. Pareja-Blanco F, Rodríguez-Rosell D, Aagaard P, Sánchez-Medina L, Ribas-Serna J, Mo-
ra-Custodio R, Otero-Esquina C, Yáñez-García JM, González-Badillo JJ. Time Course of
Recovery From Resistance Exercise With Different Set Configurations. Journal of strength
and conditioning research. 2018 Jul.
14. Zourdos MC, Dolan C, Quiles JM, Klemp A, Jo E, Loenneke JP, Blanco R, Whitehurst M.
Efficacy of daily one-repetition maximum training in well-trained powerlifters and weight-
lifters: a case series. Nutrición Hospitalaria. 2016;33(2):437-43.
15. Sousa CA. Assessment of Accuracy of Intra-set Rating of Perceived Exertion in the Squat,
Bench Press, and Deadlift (Doctoral dissertation, Florida Atlantic University).
33
Study Reviewed: Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain:
An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Hall et al. (2019)
The Poptart Problem: Processed

Foods and Overeating
BY E RI C HE LMS
It’s oft-repeated in our community that so long as energy, macros

(especially protein), and fiber are matched, the amount of processed food
in your diet is inconsequential for body composition. But is this true when
it comes to how such a diet impacts your habitual energy intake and ad
libitum consumption of food?
34
KEY POINTS
1. In a metabolic ward, 20 adults were presented diets consisting of unprocessed or
“ultra-processed” food matched for energy, macronutrients, sugar, fat, and fiber for
two weeks each. However, while presented with diets matched for these variables,
during each diet, participants could consume as much as they wanted.
2. During the processed diet, participants ate ~500kcal per day more than during the
unprocessed diet, increasing body mass and fat mass from baseline, while during
the unprocessed diet, they lost body mass and fat mass. More carbohydrate and
fat were consumed at lunch and breakfast, absolute protein intake remained stable,
and both diets had similar energy densities. However, specific foods had higher
energy density, which the researchers controlled (perhaps unsuccessfully due to
using liquid) by dissolving fiber in the processed diet beverages.
3. Participants ate processed foods faster and the satiety hormone PYY increased
and the hunger hormone ghrelin decreased compared to baseline during the
unprocessed diet. Further, PYY was significantly higher during the unprocessed
compared to the processed diet. Thus, processed foods are consumed in excess
for multiple reasons: they’re eaten faster, suppress appetite less, and require more
energy be consumed to achieve a similar protein and food mass – both shown to
regulate energy intake – as compared to unprocessed foods.
T
he diet wars have intensified. gle-variable interventions. Rather than
Blame for obesity shifts across a smoking gun, there is a firing squad
a gamut from fat, carbs, sugar, of mechanisms driving weight gain. In
processed foods, animal products, and this first causal analysis of processed
back again. As discussed (article here), foods as a contributor to weight gain
the battleground outcome of carbs (1), researchers examined a multitude of
versus fat is the least promising at the mechanisms related to energy consump-
population level in terms of providing tion and body composition change. Re-
a solution. Differences in low fat ver- searchers used a tightly controlled met-
sus low carb interventions are clinically abolic ward trial that mimicked real-life
insignificant at the group level (though using a free-eating model. Specifically,
they often matter for individuals). This 20 adults were presented diets dominat-
is just one example of the failed attempts ed by processed or unprocessed foods for
to find a “smoking gun” in the obesity two weeks apiece, and the diets as pre-
epidemic. As you’ll see in my video this sented were matched for energy, macro-
month, weight management is better nutrients, sugar, fat, and fiber. Howev-
accomplished with multi- versus sin- er, the subjects were able to consume as
35
much as they desired of the food pre- idence, that processed diets might lead
sented. During the processed diet, par- to energy overconsumption and weight
ticipants ate faster and consumed more gain.
energy, consuming greater amounts of
carbs and fat but similar protein com-
pared to the unprocessed diet; therefore, Subjects and Methods
they gained weight and fat mass when
consuming the processed diet, but lost Subjects
weight and fat mass while consum- 20 (10 male, 10 female) weight-stable
ing the unprocessed diet. Additionally, adults (31.2 ± 1.6 years; BMI = 27 ± 1.5
hormone markers of hunger were low- kg/m2) participated in this randomized,
er compared to baseline during the un- controlled, two-week crossover trial.
processed diet, and satiety was higher
during the unprocessed compared to the Methods
processed diet. In this article, we’ll dis-
Participants lived in a metabolic ward
cuss which aspects of the diets could be
research center continuously for 28 days,
controlled by the researchers, and which
during which time they were randomly
they could only control to some degree.
allocated to either the processed or un-
This discussion hints at the inherent is-
processed diet condition for two weeks,
sues of processed diets, and why they
immediately followed by the opposite
may be among the deadliest of the firing
condition. Hormone and metabolic data
squad.
from blood samples, body composition
measurements via DXA, 24-hour ener-
Purpose and Hypotheses gy expenditure changes in a metabolic
chamber, average energy expenditure
from doubly labeled water, and viscer-
Purpose
al fat changes from MRI were all col-
The purpose of this study was to de- lected. Figure 1 provides an overview of
termine if processed foods play a causal the study design and the timing of these
role in ad libitum (at will or, as desired, measurements.
“free eating”) energy intake, and subse-
Additionally, participants assessed as-
quent changes in body mass.
pects of their eating and food experience
via visual analog scales. They rated hun-
Hypotheses
ger, fullness, satisfaction, eating capaci-
The authors did not present hypothe- ty, familiarity, and pleasantness, and the
ses, but stated there is compelling indi- researchers tracked how much total food
rect evidence, albeit no direct causal ev- was consumed, which foods were con-
36
Figure 1 Overview of study design
2 weeks inpatient ultra-processed diet 2 weeks inpatient unprocessed diet
Randomize
2 weeks inpatient unprocessed diet 2 weeks inpatient ultra-processed diet
DLW Fasted DXA MRI 24hr OGTT

blood MRS Chamber
Twenty adults were confined to the metabolic ward at the NIH Clinical Center, where they were randomized to consumed either an ultra-processed or
unprocessed diet for 2 consecutive weeks followed immediately by the alternate diet. Every week, subjects spent 1 day residing in a respiratory chamber to
measure energy expenditure, respiratory quotient, and sleeping energy expenditure. Average energy expenditure during each diet period was measured by
the doubly laced water (DLW) method. Body composition was measured by dual-energy X-ray absorptiometry (DXA) and liver fat was measured by magnetic
resonance imaging / spectroscopy (MRI/MRS). Glucose concentrations were measured following a 75 g oral glucose tolerance test (OGTT).
sumed at which meals, and the rate that of each presented food as they pleased,
the participants consumed their food. meaning the actual diets consumed were
Participants were given three meals dai- free to differ substantially. Briefly, the
ly and told to eat as much as they want- NOVA system is a peer-reviewed pub-
ed, with each meal period lasting up to lished system using a checklist to group
60 minutes. Subjects also had access to foods according to the extent and purpose
snacks. The subjects were presented food of industrial processing. This includes
for each meal; if the subjects ate all of the processes and ingredients used to man-
food they were presented, they would have ufacture ultra-processed foods which are
consumed approximately 3900kcal/day, designed to create low-cost, long shelf-
and the diets would have been matched life, ready-to-consume, hyper-palatable
for energy, macronutrients, fiber, total products likely to displace unprocessed or
sugar, sodium, and energy density, differ- minimally processed foods. How much of
ing only by the percentage of energy from the presented diets were consumed, and
processed or unprocessed foods as defined whether additional food was consumed
by the NOVA classification (2). The sub- via snacks, was ad libitum. Diet specifics
jects were free to eat as much or as little are shown in Table 1.
37
Table 1
Findings
Diet composition of the average 7-day rotating menu presented to the sub-
jects during the ultra-processed and unprocessed diet periods
Ultra-processed diet Unprocessed diet
Energy, energy macronutrient compo- Three daily meals
Energy (kcal/day) 3905 3871
sition, energy distribution across meals, Carbohydrate (%) 49.2 46.3
hunger and satiety scores, and eating Fat (%) 34.7 35.0
speed are shown in Figure 2. In short, Protein (%) 16.1 18.7
during the processed diet, participants Energy density (kcal/g) 1.024 1.028
Non-beverage energy density (kcal/g) 1.957 1.057
ate ~500kcal more on average per day Sodium (mg/1000 kcal) 1997 1981
(also shown in Table 2) and ate at a Fiber (g/1000 kcal) 21.3 20.7
faster rate, while rating hunger and sa- Sugars (g/1000 kcal) 34.6 32.7
tiety similarly on both diets. Additional Saturated fat (g/1000 kcal) 13.1 7.6
Omega-3 fatty acids (g/1000 kcal) 0.7 1.4
calories were consumed during the un- Omega-6 fatty acids (g/1000 kcal) 7.6 7.2
processed diet via carbohydrate and fat, Energy from unprocessed (%)* 6.4 83.3
while reaching the same protein intake. Energy from ulta-processed (%)* 83.5 0
The subjects primarily consumed more Snacks (available all day)
at breakfast and lunch during the un-

Carbohydrate (%) 47.0 50.3
processed diet, while energy intake at Fat (%) 44.1 41.9
dinner was similar in both diets. Protein (%) 8.9 7.8
Energy density (kcal/g) 2.80 1.49
Body weight increased during the pro- Sodium (mg/1000 kcal) 1454 78
cessed diet but decreased during the Fiber (g/1000 kcal) 12.1 23.3
unprocessed diet (Figure 3). There was Sugars (g/1000 kcal) 24.8 95.9
a strong, significant association between Saturated fat (g/1000 kcal) 7.7 4.4
energy intake relative to baseline and

increases in body weight. Body fat was Energy from unprocessed (%)* 0 100
the only significant body composition Energy from ulta-processed (%)* 75.9 0
change, and changes in lean mass ap- Daily meals + snacks
proached significance. However, as I’ll

Carbohydrate (%) 48.6 47.4
discuss in the interpretation, the non- Fat (%) 37.4 37.0
significant “lean mass” gains were likely Protein (%) 14.0 15.6
dominated by changes in body water and Energy density (kcal/g) 1.247 1.126
were pretty variable between individuals,

Non-beverage energy density (kcal/g) 2.147 1.151
Sodium (mg/1000 kcal) 1,843 1,428
while changes in body fat were signifi- Fiber (g/1000 kcal) 18.7 21.4
cant and consistent across individuals. Sugars (g/1000 kcal) 31.9 51.0
Saturated fat (g/1000 kcal) 11.5 6.7
Blood measurements followed the Omega-3 fatty acids (g/1000 kcal) 0.6 2.2
changes in body mass (see Table 3), such Omega-6 fatty acids (g/1000 kcal) 8.1 11.5
that markers clearly indicated or trend- Energy from unprocessed (%)* 4.6 88.1
ed toward showing a shift into a calo- Energy from ulta-processed (%)* 81.3 0
* = the calculated energy percentages refer to the fraction of diet calories contributed from groups 1 and 4 of the NOVA
classification system: (1) unprocessed or minimally processed, (2) processed culinary ingredients, (3) processed foods,
and (4) ultra-processed foods
38
Figure 2 Ad libitum food intake, appetite scores, and eating rate
A B
3600 Ultra-processed
P = 0.0001
3400 3500
Unprocessed
Energy intake (kcal/d)

3200 3000
490 ± 34
3000 2500
492 ± 31
2800 2000 1102 ± 75
2600 1500 872 ± 60
2400 1000
1387 ± 105
1106 ± 82
2200 500
2000 0
0 2 4 6 8 10 12 14 Ultra-processed Unprocessed
Days on diet Carbohydrate Fat Protein
C D
1200 100
P = 0.003
1000 P = 0.008 80
800
VAS rating
60
600
40
400
200 20
0 0
Breakfast Lunch Dinner Snack Pleasantness Familiarity
Ultra-processed Unprocessed Ultra-processed Unprocessed
E F
100
100 P < 0.0001
80
80 P < 0.0001
Meal eating rate
VAS rating
60 60
40 40
20
20
0
0
Hunger Fullness Satisfaction Eating
Capacity grams per min kcal per min
Ultra-processed Unprocessed Ultra-processed Unprocessed
(A) Energy intake was consistently higher during the ultra-processed diet. Data are expressed as mean ± SE
(B) Average energy intake was increased during the ultra-processed diet because of increased intake of carbohydrate and fat, but not protein. Data are expressed as mean ± SE, and p values are from
paired, two-sided t-tests
(C) Energy consumed at breakfast and lunch was significantly greater during the ultra-processed diet, but energy consumed at dinner and snacks was not significantly different between the diets.
Data are expressed as mean ± SE, and p values are from paired, two-sided t-tests
(D) Both diets were rated similarly on visual analog scales (VASs) with respect to pleasantness and familiarity. Data are expressed as mean ± SE
(E) Appetitive measures were not significantly different between the diets. Data are expressed as mean ± SE
(F) Meal eating rate was significantly greater during the ultra-processed diet. Data are expressed as mean ± SE, and p values are from paired, two-sided t-tests
rie deficit during the unprocessed diet.

During the unprocessed diet, insulin and Interpretation
leptin were lower versus baseline and the The broad interpretation of this study
processed diet (while not reaching the is pretty straightforward. A diet largely
cut-off for significance), and T3 (thyroid dominated by processed foods is less fill-
hormone) was significantly lower, while ing, easier to eat quickly, and more likely
free fatty acids were significantly higher to result in greater consumption of total
(indicating body fat was metabolized). calories, largely driven by a lower pro-
tein content per calorie and higher ener-
39
Table 2 Energy expenditure and food intake during the respiratory chamber and doubly labled water periods
Ultra-processed
Ultra-processed Ultra-processed Unprocessed diet Unprocessed diet Unprocessed diet
diet (2-week p Valuea
diet (Week 1) diet (Week 2) (week 1) (week 2) (2-week average)
average)
Respiratory chamber days
Energy intake (kcal/day) 2715 ± 86 2588 ± 66 2651 ± 53 2657 ± 86 2597 ± 66 2627 ± 53 0.75
Food quotient 0.850 ± 0.002 0.856 ± 0.003 c

0.853 ± 0.002 0.846 ± 0.002 0.843 ± 0.003 0.845 ± 0.002 0.002
Energy expenditure
2328 ± 28 2344 ± 29 2336 ± 19 2320 ± 28 2248 ± 29c 2284 ± 19 0.056
(kcal/day)
24h respiratory quotient 0.907 ± 0.005 0.899 ± 0.005 0.903 ± 0.003 0.875 ± 0.005 0.869 ± 0.005 0.872 ± 0.003 < 0.0001
Sleeping energy
1515 ± 28 1550 ± 33 1532 ± 19 1516 ± 27 1535 ± 33 1525 ± 19 0.81
expenditure (kcal/day)
Sedentary energy
1590 ± 21 1573 ± 30 1581 ± 17 1549 ± 21 1530 ± 30 1540 ± 17 0.084
Physical activity
738 ± 29 771 ± 21 755 ± 18 771 ± 29 717 ± 21 744 ± 18 0.67
Doubly labled water periodb
Energy intake (kcal/day) 3099 ± 87 2865 ± 64c 2963 ± 74 2555 ± 82 2486 ± 64 2491 ± 74 0.0003
Food quotient 0.851 ± 0.002 0.854 ± 0.002c 0.854 ± 0.002 0.852 ± 0.002 0.856 ± 0.002c 0.855 ± 0.002 0.93
Adjusted respiratory
0.903 ± 0.01 0.902 ± 0.009 0.901 ± 0.007 0.847 ± 0.01 0.836 ± 0.009 0.842 ± 0.007 < 0.0001
quotient
Daily CO2 production

468 ± 13 505 ± 19 477 ± 6.9 444 ± 13 388 ± 19 420 ± 6.9 0.0001
(L/day)
Daily energy expenditure

2496 ± 83 2693 ± 80 2546 ± 39 2497 ± 79 2309 ± 85 2375 ± 39 0.0064
(kcal/day)
Daily physical activity

1.502 ± 0.002 1.509 ± 0.003 1.5055 ± 0.002 1.507 ± 0.002 1.505 ± 0.003 1.5065 ± 0.002 0.71
METs (via accelerometry)
a = p values refers to the comparison between the 2-week average values for ultra-processed versus unprocessed diets
b = n=19 because one subject’s doubly labeled water failed quality control for the calculated deuterium dilution space
c = p < 0.05 comparing means for week 2 with week 1 within each diet period; mean ± SE
gy density. However, to know what this 3. Interesting nuances of the findings.

means in terms of practice, and to un-
derstand the nuanced “whys” behind the The difference between factually correct
outcomes, there is a lot more to examine. information and useful information
To unpack it all, I think it’s helpful to While less common these days, there
first break it down into the topics I’ll go was a time in the “evidence-based II-
over in this interpretation: FYM (if it fits your macros) community”
1. The difference between factually that the common response to any ques-
correct information and useful in- tioning of certain foods being “accept-
formation. able” for health, fitness, fat loss, or body-
2. Why processed diets result in building would be met with a statement
“spontaneous” weight gain, and un- along the lines of: “diet quality doesn’t
processed diets result in “sponta- matter for body composition change if
neous” weight loss. macros (mainly protein), calories, fiber,
and (sometimes) sugar (depending on
40
Figure 3 Body weight and composition changes
A B
Ultra-processed Unprocessed 6
Ultra-processed - unprocssed
1.5
5
Body weight change (kg)
∆ Body weight (kg)

1 4
0.5 3
r = 0.8
2
0 p < 0.0001
1
-0.5
0
-1 -1
-1.5 -2
0 2 4 6 8 10 12 14 -500 0 500 1000 1500 2000
Days on diet ∆ Energy intake (kcal / d)

Ultra-processed - Unprocessed
C C
Ultra-processed Unprocessed ∆ Body weight ∆ Fat mass ∆ Fat-free mass
0.6
1.5 P = 0.009
Fat mass change (kg)
Fat mass change (kg)

0.4
1
0.2 P = 0.0015
0.5
0
0
-0.2
-0.5
P = 0.05
-0.4
-1
-0.6
-1.5 P = 0.007
0 2 4 6 8 10 12 14
Ultra-processed Unprocessed
Days on diet
(A) The ulta-processed diet led to increased body weight over time whereas the unprocessed diet led to progressive weight loss. Data are expressed as mean ± SE
(B) Differences in body weight change between the ultra-processed and unprocessed diets were highly correlated with the corresponding energy intake differences. Data are expressed as mean ± SE
(C) Body fat mass increased over time with the ultra-processed diet and decreased with the unprocessed diet. Data are expressed as mean ± SE
(D) Body weight, body fat, and fat-free mass changes between the beginning and end of each diet period. Data are expressed as mean ± SE, and p values are from paired, two-sided t-tests
who was talking) are matched (with the ergy and/or macros.
occasional caveat of also taking a mul- However, most people don’t, and at
tivitamin).” Now, this is factually true, least in the long term, shouldn’t be in a
at least mostly, and at least in the short constant state of tracking macros or cal-
term. I can think of strange diet setups ories. As discussed in my video series on
where certain essential fatty acids, ami- flexible dieting (video one, two, three),
no acids, and micronutrients are lacking tracking can be used as an instructive
and eventually cause problems, but I di- tool, but it should be temporary, as there
gress. Despite being a factual statement, are potential pitfalls from primarily re-
I don’t think this is a very useful state- lying on external cues for regulating
ment. This factually true statement only energy intake. In the real world, gen-
has applicability if all these variables are eral population gym-goers largely find
controlled, meaning you are tracking en-
41
Table 3 Fasting blood measurements at baseline and at the end of the ultra-processed and unprocessed diet periods
p Value, p Value, p Value,

Baseline Ultra-processed diet ultra-processed vs. Unprocessed diet unprocessed vs. ultra-processed vs.
baseline diet baseline diet unprocessed diet
Leptin (ng/mL) 44.3 ± 1.7 45.1 ± 1.7 0.75 40.4 ± 1.7 0.11 0.058
Active ghrelin (pg/mL) 61.4 ±3.5 54.1 ± 3.5 0.15 48.3 ± 3.5 0.01 0.24
PYY (pg/mL) 28.9 ± 1.9 25.1 ± 1.9 0.15 34.3 ±1.9 0.047 0.001
FGF-21 (pg/mL) 397 ± 59 289 ± 59 0.21 362 ± 59 0.67 0.39
Adiponectin (mg/L) 7.3 ± 0.7 8.0 ± 0.7 0.43 4.6 ±0.7 0.007 0.0007
Resistin (ng/mL) 13.5 ± 0.4 12.4 ± 0.4 0.05 12.1 ± 0.4 0.01 0.49
Active GLP-1 (pg/mL) 1.88 ± 0.19 1.25 ± 0.19 0.027 1.57 ±0.19 0.26 0.25
Total GIP (pg/mL) 79.7 ± 5.4 67.9 ± 5.4 0.13 64.3 ± 5.4 0.052 0.64
Active GIP (pg/mL) 27.4 ± 2.8 20.0 ± 2.8 0.07 18.2 ± 2.8 0.025 0.65
Glucagon (pmol/L) 12.0 ± 0.8 11.0 ± 0.8 0.42 9.8 ±0.8 0.07 0.29
Hgb A1C (%) 4.98 ± 0.03 5.02 ± 0.03 0.28 5.00 ± 0.03 0.55 0.64
Glucose (mg/dL) 90.5 ±0.9 88.6 ± 0.9 0.16 88.0 ± 0.9 0.06 0.62
Insulin (µU/mL) 11.9 ± 0.9 11.3 ±1.0 0.64 8.9 ± 1.0 0.03 0.09
C-peptide (ng/mL) 2.19 ± 0.06 2.14 ± 0.06 0.62 1.94 ± 0.06 0.01 0.032
HOMA-IR 2.8 ± 0.3 2.5 ± 0.3 0.50 1.9 ± 0.3 0.03 0.14
HOMA-beta 152 ± 10 159 ± 11 0.63 129 ± 10 0.13 0.053
Total cholesterol (mg/dL) 155 ± 3 152 ± 3 0.54 137 ± 3 0.0002 0.001
HDL cholesterol (mg/dL) 58.2 ± 0.8 55.0 ± 0.9 0.01 48.3 ± 0.8 < 0.0001 < 0.0001
LDL cholesterol (mg/dL) 82 ± 3 84 ± 3 0.61 77 ± 3 0.21 0.085
Triglycerides (mg/dL) 72 ± 3 62 ± 3 0.02 59 ± 3 0.003 0.45
Free fatty acids (µmol/L) 409 ± 40 384 ± 40 0.67 556 ± 40 0.013 0.004
Uric acid (mg/dL) 4.9 ± 0.8 4.5 ± 0.8 0.0007 4.9 ± 0.8 0.55 0.004
TSH (µIU/mL) 2.2 ± 0.1 2.6 ± 0.1 0.054 2.5 ± 0.1 0.24 0.42
Free T3 (pg/mL) 3.17 ± 0.06 3.20 ± 0.06 0.72 3.03 ± 0.06 0.11 0.051
Free T4 (ng/dL) 1.19 ± 0.02 1.22 ± 0.02 0.36 1.27 ± 0.02 0.019 0.13
T3 (ng/dL) 113 ± 2 112 ± 2 0.80 104 ± 2 0.011 0.019
T4 (µg/dL) 6.8 ± 0.1 6.9 ± 0.1 0.70 6.8 ± 0.1 0.91 0.79
PAI-1 (ng/mL) 4.0 ± 0.5 4.6 ± 0.5 0.42 4.7 ± 0.5 0.34 0.89
hsCRP (mg/L) 2.7 ± 0.3 2.4 ± 0.3 0.48 1.5 ± 0.3 0.014 0.072
Mean ± SE
tracking tedious and unsustainable, in processed diet can be just as effective as

my experience. Thus, unless your goal an unprocessed one so long as all nutri-
is not intended to be sustained (for ex- tional variables like calories and macros
ample, a contest preparation resulting in are controlled? Not really, because in
stage leanness), the behaviors utilized reality, those variables generally won’t
shouldn’t be unsustainable either, and be controlled. The only utility of that
99% of people aren’t going to track their statement I can see is if you’re talking to
macros for the rest of their lives. someone who is actually afraid of specif-
So again, is it useful to know that a ic processed foods and thinks for some
insidious magical reason they are harm-
42
ful at any frequency or dose. In that case, Another reason processed diets lead to
I could see the value in letting someone food overconsumption in the real world
know that occasionally having a Snick- is due to a phenomenon known as pro-
ers bar in the context of a healthy diet is tein leverage theory. Simply put, satiety
absolutely fine. Moreso, even if someone is lower and hunger is higher until a cer-
does track habitually, the knowledge that tain threshold of protein is consumed
a processed diet could work isn’t really in an ad libitum setting. Thus, because
helpful. Indeed, it could cause problems, processed foods are so densely packed
as following such a diet would make with carbohydrates and fat, you end up
the qualitative difficulty of maintaining consuming more total calories to reach
a deficit via a processed diet higher. If the same level of protein. Indeed, some
people find the same level of satiety and research indicates a part of the reason
hunger occurs when eating an additional processed diets are fattening is because
500kcals (as was shown in this study), they have proportionally less protein per
it’s logical to assume they’d feel hungri- calorie (4). In this study, it seems the ad
er on a processed diet when eating the libitum intake of the participants during
same amount of calories they’d other- the processed diet was primarily via car-
wise consume on an unprocessed diet. bohydrate- and fat-dominant foods, but
there was a remarkably tight ad libitum
Why processed diets result in “sponta- intake of protein during both diets; be-
neous” weight gain, and conversely, why cause the participants ate more carbs
unprocessed diets result in “spontaneous” and fats while eating the processed diet
weight loss to achieve this same protein intake, more
In the real world, energy density is total calories had to be eaten.
higher on processed diets. If you’re think- If anything, I think the energy density,
ing “what is energy density?”, watch my fiber, and protein differences in the real
video series on it that I just concluded world would make this effect more pro-
in this issue (Part 1 here). While the re- nounced. Yes, I think the 500kcal differ-
searchers attempted to control for ener- ence observed in this study is probably a
gy density, it probably couldn’t be prop- conservative estimation of the true dif-
erly accounted for because processed ference in the real world, because in the
foods are simply so much higher in en- real world, there aren’t researchers trying
ergy density. Thus, an attempt was made to match the energy density, protein, and
by adding fiber to the beverages of the fiber intakes of what’s presented to you.
processed diet, but unfortunately, fluids On top of these mechanisms, while
aren’t as well “recognized” by the body the processed diet wasn’t rated as more
for inducing satiety (3). palatable or tasty or satisfying, it was
43
eaten more quickly and the hormonal could only explain, at most, 50% of the
responses indicated less satiation and difference in energy intake between
more hunger during the processed diet. groups. Thus, all in all, energy density,
This could be due to mouthfeel and tex- eating speed, and hormonal differenc-
ture of processed foods making it eas- es explain the remaining differences
ier to eat them more quickly, and thus, (and perhaps other unmeasured factors).
more calories can be consumed before The good news is that unprocessed di-
satiety “sets in.” It’s also possible that the ets rock. They result in effortless fat loss;
questions related to hunger and satiety eating a whole food diet for the aver-
weren’t sensitive or targeted enough to age person will result in higher levels of
represent the qualitative eating experi- satiety, less hunger, and subsequently a
ence differences between diets. Another lower energy intake, thus leading to fat
perspective to consider is that the goal of loss. This will of course only last so long,
a food manufacturer is to encourage the but your “settling point” of adiposity will
consumption of the food they manufac- almost certainly be lower when consum-
ture. This is actually not accomplished ing an unprocessed versus a processed
by making something super hedonical- diet. If you aren’t sure what that looks
ly satisfying, but rather tasty, but not so like, think lots of fruits, vegetables, lean
tasty to cross the threshold into satis- proteins, and (in general) a diet domi-
faction, which discourages further con- nated by single ingredient foods. I know,
sumption (an example would be high groundbreaking stuff.
fructose corn syrup, which is only slightly
sweeter than regular sugar; as most have Interesting nuances of the findings
a 55/45 breakdown of fructose to glucose There were some outcomes which, at
versus the 50/50 split of standard sugar). first glance, seem like head scratchers.
Thus, the qualitative descriptors in this For example, in a 2010 study, energy ex-
study of “pleasantness” and “familiarity” penditure was shown to be lower acute-
and “satisfaction” might not have picked ly after consuming a processed versus
this up. Nonetheless, based on hormonal an unprocessed sandwich. Yep, another
data, the participants were more full and knock against processed diets is they
less hungry eating the unprocessed diet, might reduce the energy-out side of the
and they also ate slower, which might equation, likely via a reduction in the
have allowed more time for these hor- thermic effect of food and the cost to
monal signals to be received, resulting in get the metabolizable energy content of
earlier meal cessation and lower calorie the food (5). Because they’ve undergone
consumption. substantial industrial processing, our
According to the authors, protein body doesn’t need to expend as many
44
Table 4
Group 1: Unprocessed or mini- Group 2: Processed culinary
Group 3: Processed foods Group 4: Ultra-processed foods
mally processed ingredients
Examples: fresh, frozen, or dried

fruits and vegetables; pasta made
Examples: sodas, sweet and salty
Examples: canned fruits and packaged snacks, chicken nuggets,
herbs, fresh or dried; meat, poul- Examples: salt, sugar, honey, cook-
vegetables; salted nuts; salted,
ing oils, butter, corn, starch, vine-
cured, or smoked meats; cheeses; frozen meals, breakfast cereals,
gar, baking soda
freshly made bread; beer energy bars, packaged cakes and
cuts, chilled or frozen; eggs; un-
sweets
tea, water
Source: Monteiro et al, 2016; NOVA
calories to actually digest and metab- Another interesting finding was that
olize highly processed food. However, while the only significant body com-
in the present study, energy expendi- position changes were changes in body
ture was higher during the processed fat, changes in lean mass were almost
diet, almost reaching the cut off for significant. There was a nonsignificant,
significance (p = 0.06). While this ap- small drop in lean mass during the
pears contradictory, I don’t think it is. unprocessed diet and a small increase
In the prior study, the response to a cal- during the processed diet. However, for
orie-matched meal was assessed, but in one, there is an obligatory loss or gain
the present study, the researchers mea- of lean mass when fat mass changes, as
sured the energy expenditure response adipose tissue is not completely com-
to an entire diet for 14 days, compared posed of fat mass and has some lean tis-
to another diet that was 500kcals high- sue as part of its structure (7). Further,
er. Thus, in the present study, we are these changes in lean mass were signifi-
likely just observing the ramping up of cantly associated with changes in sodi-
energy expenditure in response to a cal- um intake (r = 0.63; p = 0.004), likely
orie surplus, which has been shown as a indicating that changes in extracellu-
normal response to overfeeding (6), and lar fluid shifts appeared as lean tissue
likely an attempt by the body to main- changes, contributing to this outcome.
tain metabolic homeostasis (something As a final, unfortunate, nuanced note
that is easily overcome at a population on this study, the cost of the processed
level by our obesogenic environment in diet per kcal was ~50% less than the un-
the modern world). So unfortunately, processed diet. Meaning, it’s cheaper to
processed diets may still very well re- get your energy from processed foods,
duce energy expenditure when calorie which doesn’t bode well for society-lev-
matched compared to unprocessed di- el behavior change.
ets.
45
1. Processed diets resulted in significant increases in ad libitum consumption of
energy. In spite of eating ~500kcal more when consuming a processed diet,
participants in this study felt the same level of hunger and satiation on both diets,
and subsequently gained body fat on the processed diet.
2. This is primarily due to the following combined aspects of processed diets: they
have a higher energy density, less protein per calorie, less fiber per calorie, they
are more likely to be eaten quickly, and subsequently, they are less satiating. Also,
it’s cheaper to get the same amount of calories from processed foods versus
unprocessed, though that didn’t factor into the results of this study.
3. On the flip side, unprocessed, whole food diets result in significant decreases
in energy consumption and subsequently, fat loss. This is due to lower energy
density, more protein per calorie, more fiber per calorie, slower eating times, and
subsequently, more satiation. The downside is that whole food is more expensive.
4. As a final note, to help with application, check out Table 4 with the NOVA
classification system so you can get a better idea of how processed and
unprocessed foods are categorized.
Next Steps tributors to an individual’s adiposity to

then provide individualized counseling
I would love to see this field of research are the directions I’d like to see future
expanded into a more applicable phase. research go. Essentially, if we know that
Much of Hall’s research is groundbreak- processed diets – even in a controlled re-
ing, but stems from the research bat- search setting that likely dampens their
tleground between carbs versus fat and effect on overeating – result in substan-
carbs versus calories, which are – in my tially more ad libitum food intake, what
opinion – largely unproductive. No, the can we do to make it more likely that
insulin model of obesity isn’t correct (8); people will eat unprocessed diets?
yes, energy balance ultimately dictates
changes in body mass (9). But, unfor-
tunately, elucidating these points rarely
provides anything actionable. Qualita-
tive interviews around barriers to adopt-
ing unprocessed diets, assessments of
how to intervene to change behavior,
and developing diagnostic tools to as-
sess which behaviors are the largest con-
46
References
1. Hall KD, Ayuketah A, Brychta R, Cai H, Cassimatis T, Chen KY, Chung ST, Costa E, Courville A,
Darcey V, Fletcher LA. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An
Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell metabolism. 2019 May 16.
2. Monteiro CA, Cannon G, Levy RB, Moubarac JC, Louzada ML, Rauber F, Khandpur N, Cediel G,
Neri D, Martinez-Steele E, Baraldi LG. Ultra-processed foods: what they are and how to identify
them. Public health nutrition. 2019 Apr;22(5):936-41.
3. DellaValle DM, Roe LS, Rolls BJ. Does the consumption of caloric and non-caloric beverages with
a meal affect energy intake? Appetite. 2005 Apr 1;44(2):187-93.
4. Steele EM, Raubenheimer D, Simpson SJ, Baraldi LG, Monteiro CA. Ultra-processed foods, pro-
tein leverage and energy intake in the USA. Public health nutrition. 2018 Jan;21(1):114-24.
5. Barr S, Wright J. Postprandial energy expenditure in whole-food and processed-food meals: impli-
cations for daily energy expenditure. Food & nutrition research. 2010 Jan 1;54(1):5144.
6. Levine JA, Eberhardt NL, Jensen MD. Role of nonexercise activity thermogenesis in resistance to
fat gain in humans. Science. 1999 Jan 8;283(5399):212-4.
7. Abe T, Dankel SJ, Loenneke JP. Body Fat Loss Automatically Reduces Lean Mass by Changing the
Fat-Free Component of Adipose Tissue. Obesity (Silver Spring, Md.). 2019 Mar;27(3):357.
8. Hall KD, Guyenet SJ, Leibel RL. The carbohydrate-insulin model of obesity is difficult to reconcile
with current evidence. JAMA internal medicine. 2018 Aug 1;178(8):1103-5.
9. Hall KD, Guo J. Obesity energetics: body weight regulation and the effects of diet composition.
Gastroenterology. 2017 May 1;152(7):1718-27.
47
Study Reviewed: The Effects of Alcohol Consumption on Recovery Following
Resistance Exercise: A Systematic Review. Lakicevic. (2019)
Does Alcohol Impair Recovery

from Resistance Exercise?
BY E RI C T RE X LE R
As an avid fan of beer and bourbon, the thought of choosing between gains
and alcohol is a troubling dilemma. But do we necessarily need to choose
one over the other, or can they peacefully coexist? Read this article to
find out if your favorite alcoholic beverage is impairing your recovery after
resistance exercise.
48
KEY POINTS
1. Surprisingly, there is a decent number of studies that show no meaningful effect
of pretty heavy alcohol consumption (~8 standard drinks for an 80kg person) on
recovery from resistance exercise (1).
2. Studies that do show alcohol to impair recovery tend to be performed in males,
use particularly strenuous exercise protocols, and use alcohol doses above 0.5g/
kg of body mass.
3. Regardless of short-term recovery, heavy alcohol intake has unfavorable effects
on protein synthesis, sleep quality, and a number of hormones, so consistent
intake of high doses is a bad move for those who wish to optimize health, body
composition, or performance.
A
lcohol consumption is extremely fairly minimal impacts on the other bio-
common, with the average adult logical, physical, and performance mea-
consuming an estimated 4.3 li- sures assessed.
ters of pure ethanol per year (2). While As someone who loves beer and bour-
alcoholic beverages have historical, cul- bon, this conclusion certainly caught my
tural, and social significance, alcohol is attention. So, is the news as good as it
still, essentially, a weak poison. Aside sounds? Can we finally abandon the idea
from the risk of acute toxicity, exces- of choosing between our alcohol and our
sive alcohol intake is associated with a gains? Generally speaking, probably not.
wide range of negative health outcomes Read on to find out why.
affecting organs and tissues through-
out the body. As such, many individu-
als interested in health, fitness, or per- Purpose and Hypotheses
formance tend to believe that alcohol
consumption is disadvantageous and Purpose
may impair their ability to perform or
The authors stated that the purpose
recover from training. The current study
of this paper was, “To understand the
(1) sought to review the literature in-
effects of alcohol consumption during
vestigating alcohol’s effects on recovery
recovery, on muscle function, following
from resistance exercise. While alcohol
resistance exercise.”
was found to cause unfavorable chang-
es in cortisol, testosterone, and rates of
Hypotheses
muscle protein synthesis, you might be
surprised to hear that the authors found The authors didn’t clearly state a hy-
relatively heavy alcohol intake to have pothesis. However, the introduction sec-
49
tion discusses alcohol’s links to hormone cise and alcohol intoxication. Articles
disturbances, immune dysfunction, and exploring recovery after endurance type
muscle atrophy, so you can infer that of training have been eliminated.”
they expected alcohol to significantly
impair recovery. Alcohol doses
Just to be clear, studies in this area of
research use some surprisingly substan-
Methods tial alcohol doses. Most studies dosed
ethanol at about 1g/kg of body mass.
Design A “standard drink” varies from country
to country, but is often considered to be
A systematic review is a unique type around 10g of ethanol. So, an 80kg par-
of research project, in which you aim to ticipant would be putting down about
summarize all of the studies on a giv- eight standard drinks; this is ethically
en topic in a systematic way. In order to justifiable for the researchers and should
make the approach systematic, you spec- be sufficient to get the job done, but it’s
ify a number of things before the project worth noting that a study on the real-life
starts, including the research question, drinking habits of actual rugby players
exactly how the relevant literature will found that many of them consumed up-
be identified and collected, and the types wards of 20 standard drinks in a single
of studies that can be included. post-game drinking episode (3).
Procedures
A list of key search terms related to the Findings
research question was compiled, which
While meta-analyses calculate a
the researchers used to search the larg-
pooled effect size and perform statisti-
est research databases containing rel-
cal analyses on the data, this is not done
evant literature. Typically, systematic
in all systematic reviews. For the current
reviews will have some pretty specific
study, no quantitative analyses were per-
criteria about which studies will be in-
formed. After collectively reviewing the
cluded in the analysis and which studies
individual studies, the authors concluded
will be excluded from consideration. In
that most of the biological, physical, and
this particular review, they left the crite-
performance measures were unaffected
ria very broad. The authors stated that
by alcohol consumption after resistance
studies would be included in the review
exercise. However, they noted that corti-
“only if they used a specific measure of
sol was increased, along with reductions
performance or biomarker, that consid-
in testosterone and rates of muscle pro-
ered recovery following resistance exer-
50
tein synthesis, which would be problem- consumption. Four studies assessed the
atic for long-term training adaptations effects of alcohol on cortisol responses
with consistent alcohol use. (4, 5, 6, 7); results were not particular-
ly reliable from study to study, but gen-
erally indicated a trend toward higher
Interpretation cortisol levels, which mirrors the alcohol
Systematic reviews sit at the top of literature that exists beyond the realm of
the evidence-based hierarchy of infor- acute resistance exercise (2).
mation quality, but they still need to be The same four studies that evaluated
evaluated critically. In this case, while I cortisol also evaluated testosterone (4,
commend the authors for putting out 5, 6, 7). Again, there was a lack of con-
information on a scant topic, there was sistency across studies, which is under-
room for improvement from a techni- standable in a group of studies with low
cal perspective. Most notably, the search sample sizes (ranging from 8 to 10 sub-
missed at least one lower-dose alcohol jects per study). While one study showed
paper with really informative findings, acutely increased testosterone levels (7),
and the authors seemed to miss the fact the others showed no effect or reduced
that some studies provided doses scaled levels (4, 5, 6). Small, transient elevations
to total body mass, while others scaled in testosterone may be observed due to a
doses to fat-free mass. They also included temporary reduction of testosterone ox-
studies in which the “resistance exercise” idation in the liver while alcohol is be-
was a real or a simulated game of rugby, ing metabolized, particularly with low-
which I won’t devote much attention to. er alcohol doses, but the larger body of
Nonetheless, this review gathered up a alcohol literature indicates that alcohol
bunch of relevant alcohol studies for us, reduces testosterone production and in-
which serves as a great starting point for creases the conversion of androgens to
reviewing the topic in detail. estrogens (2).
Before we get into performance, let’s Finally, the singular study within this
get the biological stuff out of the way, review that measured muscle protein
because it’s pretty straightforward. Sev- synthesis found reduced rates with al-
eral of the studies evaluated creatine cohol ingestion, even when the alcohol
kinase levels following the combina- was co-ingested with protein (8). While
tion of resistance exercise and alcohol. a lower testosterone-to-cortisol ratio
Resistance exercise reliably increased and blunted muscle protein synthesis
creatine kinase in these studies, which are certainly counterproductive for pro-
is fully expected, and this elevation was moting long-term training adaptations,
not meaningfully increased by alcohol they won’t necessarily impact the abili-
51
Table 1 Changes in muscular performance following strenuous eccentric exercise
Peak torque (Nm) Average peak torque (Nm)
OJ ALC OJ ALC
ISO
Pre 313.5 ± 56.5 311.8 ± 58.0 278.8 ± 46.1 271.8 ± 49.6
36h 245.0 ± 21.2a 206.9 ± 21.2a, c 235.1 ± 45.6a 198.5 ± 46.5a
60h 273.6 ± 50.7a, b 229.1 ± 57.3a, c 244.1 ± 42.8 210.4 ± 52.8a
CON
Pre 273.9 ± 50.1 274.0 ± 54.4 233.1 ± 46.8 245.5 ± 55.2
36h 199.2 ± 45.0a 163.4 ± 45.9a, c 182.4 ± 69.2a 132.5 ± 39.6a, c
60h 237.9 ±44.5a, b 190.8 ±40.7a, b, c 216.1 ± 65.6b 160.7 ± 40.2a, b, c
ECC
Pre 346.9 ± 68.8 353.0 ± 73.8 317.9 ± 69.1 325.1 ± 77.6
36h 283.5 ± 74.1a 235.9 ± 45.8a, c 263.4 ± 77.5 217.4 ± 45.5a, c
60h 323.3 ± 66.8b 289.3 ± 66.9a, b 303.7 ± 73.8b 261.4 ± 46.1a, b, c
Isometric (ISO), concentric (CON), and eccentric (ECC) force measurements made before, 36h and 60h after 300 eccentric
contractions of the quadriceps under control (OJ) and alcohol (ALC) conditions. All values are mean ± SD.
Differences between time points were evaluated by post-hoc pairwise comparison.
a = Significantly different from the pre-exercise value, p < 0.05
b = Significantly different from preceding value, p < 0.05
c = Significantly different from OJ treatment, p< 0.05
ty to recover from a single workout. So, following up on recovery measures af-

these findings are generally bad news for ter the fact. Poulson et al (9) measured
the typical athlete or lifter, but they don’t single-joint isokinetic and isometric
necessarily answer the research question strength before, during, 24 hours af-
posed in this review. ter, and 48 hours after alcohol inges-
Two studies in the review actual- tion. Surprisingly, actively being drunk
ly evaluated the effects of intoxication didn’t meaningfully affect the strength
on strength outcomes, in addition to outcomes assessed. Results also indicat-
52
ed no suppression of voluntary muscle
activation, and no evidence of impaired
recovery. Clarkson and Reichsman (10) THE LIMITED DATA AVAILABLE
also provided their alcohol dose prior to SUGGEST THAT SOME MODERATE TO
the onset of exercise testing, and simi-
larly found no effect of alcohol intake
HEAVY DRINKING MAY NOT TOTALLY
on the parameters measured. Notably, SABOTAGE YOUR RECOVERY FROM A
these studies assessed very simple, un- PRIOR WORKOUT, OR YOUR STRENGTH
skilled strength tasks; as a given athletic
task increases in terms of its metabolic
PERFORMANCE THE FOLLOWING DAY.
demand, skill level, or thermoregulatory RECOVERY IMPAIRMENTS SEEM TO BE
challenge, the likelihood of performance LARGER IN MALES THAN FEMALES, AND
impairment from alcohol intoxication is
elevated.
SIGNIFICANT IMPAIRMENTS APPEAR TO
When it comes to the studies most di- BE MORE LIKELY WHEN THE MAGNITUDE
rectly addressing the research question at OF MUSCLE DAMAGE FROM EXERCISE
hand, Barnes and colleagues have done a IS HIGH, AND WHEN THE ALCOHOL
few of the most informative studies. In
one such study (11), 11 males ingest- DOSE IS GREATER THAN 0.5G/KG.
ed 1g/kg of alcohol after 300 maximal
eccentric contractions of the leg exten-
sors. As indicated in the Table 1, vari- outcomes were unaffected (4).
ous parameters of force recovery were Levitt et al (14) attempted to repli-
impaired. The same lab group replicated cate the protocol used by Barnes et al
their findings in a separate study (12), (11, 12), in which high-dose alcohol
which followed the same general proto- impaired strength recovery in males, in
col in a sample of 10 male subjects. a sample of females. Contrary to the
However, alcohol did not impair re- research carried out in males, alcohol
covery in the same protocol when the al- (dosed at 1.09g/kg of fat-free mass) did
cohol dose was reduced to 0.5g/kg (13), not appear to impair recovery in females.
which is more consistent with light or McLeay et al (15) used the same muscle
moderate drinking for most folks (Ta- damage protocol and an alcohol dose of
ble 2). The same group also investigated 0.88 g/kg of total body mass, and again,
the effect of alcohol (1g/kg) on recov- the recovery impairment induced by al-
ery after a simulated rugby match, and cohol failed to reach statistical signifi-
while counter-movement jump recovery cance in females. This apparent sex dif-
was impaired, several other performance ference is not necessarily conclusive yet,
53
Table 2 Changes in torque (N m) over time following strenuous eccentric exercise
Pre 36 h 60 h
Peak ISO
OJ 301.4 ± 48.9 -40.1 ± 44.0* -17.1 ± 45.2
ALC 284.2 ±49.8 -37.5 ± 45.3 -19.1 ± 59.1
Peak CON
OJ 265.1 ± 50.3 -54.9 ± 47.1* -35.3 ± 41.4
ALC 249.5 ± 50.4 -42.4 ± 51.9* -31.5 ± 41.4
Peak ECC
OJ 336.5 ± 77.3 -20.6 ± 89.6 15.9 ± 66.0
ALC 330.9 ± 81.7 -49.4 ± 51.9* -20.4 ± 55.4
Average ISO
OJ 269.7 ± 39.0 -33.2 ±35.9* -15.4 ± 45.2
ALC 264.4 ± 37.7 -35.3 ± 45.1 -18.8 ± 54.7
Average CON
OJ 239.5 ± 31.2 -46.1 ± 42.8* -30.2 ± 36.3
ALC 236.1 ± 37.9 -51.7 ± 45.2* -34.4 ± 42.1†
Average ECC
OJ 308.4 ± 76.9 -51.4 ± 76.0 17.4 ± 77.3†
ALC 310.3 ± 70.1 -54.7 ± 46.1* -24.8 ± 51.6
Data presented as mean ± SD.

ISO = isometric, CON = concentric, ECC = eccentric torque (N m), OJ = control, ALC = alcohol treatment
* = p < 0.05, significant different from pre-exercise value
† = p < 0.05, significant difference from preceding value
as there is a general lack of studies in- relate to some dosing difficulties. For a
cluding female participants (2). Authors given dose of alcohol, whether it’s an ab-
have speculated that the difference could solute dose or scaled to total body mass,
relate to the protective effect of estrogen blood alcohol content rises higher in fe-
on muscle damage (14), but it could also males than males (16). To accommodate
54
while Barnes et al identified significant
recovery impairments with pretty seri-
ous bouts of eccentric exercise, studies
EVEN IF YOU CAN PULL using less rigorous exercise protocols
YOURSELF TOGETHER AND GET have failed to observed alcohol-induced
recovery impairments (5, 9, 10).
THROUGH YOUR TRAINING If you’re really hungover going into a
SESSION THE DAY AFTER workout, you’re probably not going to
have a good time, and you probably won’t
A SINGLE NIGHT OF HEAVY perform well on skillful or physically
demanding tasks. But, the limited data
DRINKING, THE EFFECTS available suggest that some moderate to
OF HEAVY ALCOHOL INTAKE heavy drinking may not totally sabotage
your recovery from a prior workout, or
SUGGEST THAT FREQUENT your strength performance the follow-
ing day. Recovery impairments seem to
INDULGENCE IS A BAD IDEA. be larger in males than females, and sig-
nificant impairments appear to be more
likely when the magnitude of muscle
this difference, researchers have either damage from exercise is high, and when
used smaller doses or scaled the dosages the alcohol dose is greater than 0.5g/kg.
to fat-free mass, typically yielding doses If your workout isn’t brutal or your alco-
around 0.8-0.9 g/kg. However, females hol dose isn’t too high, you’ll probably
also have more rapid blood alcohol have a good chance of being fine for the
clearance than males, for a given blood next day’s workout.
alcohol concentration (16). So, while
male studies typically use ~1.0 g/kg or However, even if you can pull yourself
higher, these dosing accommodations together and get through your train-
may make the resulting dose insufficient ing session the day after a single night
to interfere with recovery in females. of heavy drinking, the effects of heavy
alcohol intake suggest that frequent in-
Levitt et al also evaluated the effects dulgence is a bad idea. “Alcoholic skel-
of alcohol on recovery from a more typ- etal myopathy” is a term describing the
ical (and less extreme) resistance exer- loss of muscle mass, which can be as
cise protocol in men, with no recovery high as a loss of 20% of total body mass,
impairment observed (17). As such, the related to chronic excessive alcohol con-
relative rigor of the damage-inducing sumption (18). Heavy alcohol intake,
exercise protocol seems to be impactful; both acutely and chronically, results in
55
1. Lower doses of alcohol (≤ 0.5g/kg) don’t seem to meaningfully impair recovery
from resistance exercise, but studies suggest that higher doses (≥ 1g/kg) may.
2. The likelihood of impaired recovery seems to be increased if you’re male, you’re
trying to recovery from particularly strenuous exercise, or your alcohol dose is
high.
3. Regular ingestion of high alcohol doses is a bad idea for recovery and
performance, as alcohol has unfavorable effects on muscle protein synthesis,
sleep quality, and a number of important hormones. So, enjoy your alcohol in
moderation, especially when you have an important workout or competition the
next day.
unfavorable effects on a wide range of sleep. So, while alcohol may seem like it
signaling pathways that control muscle helps you get to sleep, it often reduces
growth and atrophy. Similarly, alcohol total sleep time and overall sleep quality,
ingestion can induce leucine resistance, particularly at higher doses.
which describes a state in which the nor-
mal muscle protein synthetic response
to leucine ingestion is blunted. Alcohol Next Steps
has also been shown to induce numerous It’d be nice to see a longitudinal train-
unfavorable changes to hormone lev- ing study evaluating the effects of light
els, including cortisol, estrogen, human or moderate alcohol intake (a few drinks
growth hormone, luteinizing hormone, per week, give or take) on changes in
testosterone, and melatonin (2). strength and body composition. Howev-
Speaking of melatonin, a lesser-known er, given the available evidence, it seems
effect of alcohol intake is disruption of safe to conclude that no alcohol is the
sleep. While alcohol generally reduces most prudent approach, moderate alco-
sleep onset latency (that is, helps you hol is probably fine, and heavy, habitual
fall asleep more quickly), it tends to alter alcohol intake is detrimental. A single
sleep quality and architecture in nega- night of somewhat heavy drinking isn’t
tive ways (19). Slow wave sleep is in- likely to derail your entire training pro-
creased in the first half of the night, but gram, and you might even recover in
rapid eye movement (REM) sleep is de- time for the next workout, but it’s not
creased. Sleep is generally disrupted in something you want to do on a regular
the second half of the night, which often basis.
causes wakefulness or very low-quality
56
References
1. Lakićević N. The Effects of Alcohol Consumption on Recovery Following Resistance Exercise: A
Systematic Review. J Funct Morphol Kinesiol. 2019 Sep;4(3):41.
2. Barnes MJ. Alcohol: impact on sports performance and recovery in male athletes. Sports Med. 2014
Jul;44(7):909–19.
3. Prentice C, Stannard SR, Barnes MJ. The effects of binge drinking behaviour on recovery and per-
formance after a rugby match. J Sci Med Sport. 2014 Mar;17(2):244–8.
4. Barnes MJ, Mundel T, Stannard SR. The effects of acute alcohol consumption on recovery from a
simulated rugby match. J Sports Sci. 2012;30(3):295–304.
5. Haugvad A, Haugvad L, Hamarsland H, Paulsen G. Ethanol Does Not Delay Muscle Recovery but
Decreases Testosterone/Cortisol Ratio. Med Sci Sports Exerc. 2014 Nov;46(11):2175–83.
6. Murphy AP, Snape AE, Minett GM, Skein M, Duffield R. The effect of post-match alcohol ingestion
on recovery from competitive rugby league matches. J Strength Cond Res. 2013 May;27(5):1304–12.
7. Vingren JL, Hill DW, Buddhadev H, Duplanty A. Postresistance exercise ethanol ingestion and
acute testosterone bioavailability. Med Sci Sports Exerc. 2013 Sep;45(9):1825–32.
8. Parr EB, Camera DM, Areta JL, Burke LM, Phillips SM, Hawley JA, et al. Alcohol ingestion im-
pairs maximal post-exercise rates of myofibrillar protein synthesis following a single bout of concur-
rent training. PloS One. 2014;9(2):e88384.
9. Poulsen MB, Jakobsen J, Aagaard NK, Andersen H. Motor performance during and following acute
alcohol intoxication in healthy non-alcoholic subjects. Eur J Appl Physiol. 2007 Nov;101(4):513–23.
10. Clarkson PM, Reichsman F. The effect of ethanol on exercise-induced muscle damage. J Stud Alco-
hol. 1990 Jan 1;51(1):19–23.
11. Barnes MJ, Mündel T, Stannard SR. Acute alcohol consumption aggravates the decline in muscle
performance following strenuous eccentric exercise. J Sci Med Sport. 2010 Jan;13(1):189–93.
12. Barnes MJ, Mündel T, Stannard SR. Post-exercise alcohol ingestion exacerbates eccentric-exercise
induced losses in performance. Eur J Appl Physiol. 2010 Mar;108(5):1009–14.
13. Barnes MJ, Mündel T, Stannard SR. A low dose of alcohol does not impact skeletal muscle perfor-
mance after exercise-induced muscle damage. Eur J Appl Physiol. 2011 Apr;111(4):725–9.
14. Levitt DE, Luk H-Y, Duplanty AA, McFarlin BK, Hill DW, Vingren JL. Effect of alcohol after
muscle-damaging resistance exercise on muscular performance recovery and inflammatory capacity
in women. Eur J Appl Physiol. 2017 Jun 1;117(6):1195–206.
15. McLeay Y, Stannard SR, Mundel T, Foskett A, Barnes M. Effect of Alcohol Consumption on Re-
covery From Eccentric Exercise Induced Muscle Damage in Females. Int J Sport Nutr Exerc Metab.
2017 Apr;27(2):115–21.
16. Mishra L, Sharma S, Potter JJ, Mezey E. More Rapid Elimination of Alcohol in Women as Com-
pared to Their Male Siblings. Alcohol Clin Exp Res. 1989;13(6):752–4.
17. Levitt D, Idemudia N, Cregar C, Duplanty A, Hill D, Vingren J. Alcohol after Resistance Exercise
Does not Affect Muscle Power Recovery. J Strength Cond Res. 2018; ePub ahead of print.
57
18. Kimball SR, Lang CH. Mechanisms Underlying Muscle Protein Imbalance Induced by Alcohol.
Annu Rev Nutr. 2018 21;38:197–217.
19. Colrain IM, Nicholas CL, Baker FC. Alcohol and the sleeping brain. Handb Clin Neurol.
2014;125:415–31.
58
Study Reviewed: Myofibrillar Protein Synthesis and Muscle Hypertrophy
Individualized Responses to Systematically Changing Resistance Training
Variables in Trained Young Men. Damas et al. (2019)
Short-Term Variations in Training

Stimulus Don’t Cause More Growth
BY G RE G NUC KO LS
We know that training volume is the main factor driving hypertrophy, but
it’s commonly believed that varying your training stimulus can also help
promote additional growth. A recent study adds to the stack of evidence
suggesting that, at least in the short term, variations in training stimulus
don’t cause more growth.
59
KEY POINTS
1. Over eight weeks, using a within-subject unilateral design (meaning each subject
served as their own control), researchers compared the effects of keeping
programming variables constant against regular variations in load, volume, rest
intervals, and muscle actions.
2. Hypertrophy was similar in both conditions, suggesting that regularly varying
your training stimulus neither hinders nor enhances muscle growth.
3. However, this doesn’t mean that the idea of growing more due to a novel stimulus
is totally off the table.
W
hile the heyday of “muscle adding more evidence to the consid-
confusion” is behind us, many erable body of research showing that
people still think that short- short-term variations in training vari-
term variations in training stimulus will ables neither increase nor decrease hy-
net them more muscle growth. For ex- pertrophy.
ample, instead of doing sets of 8-10 for
a given muscle group on Monday and
Thursday, maybe you’ll do sets of 6-8 Purpose and Hypotheses
every Monday and sets of 10-12 every
Thursday. While that’s more structured Purpose
than a full-on “muscle confusion” ap- The purpose of this study was to exam-
proach to training, will it actually lead to ine whether regularly changing training
more muscle growth than keeping train- variables would lead to more hypertro-
ing variables constant? phy and greater muscle protein synthesis
A recent study sought to answer that in resistance-trained men than holding
question. Using a within-subject unilat- training variables constant.
eral design, one leg did the same workout
every training session for eight weeks, Hypotheses
while the other leg cycled through four The authors hypothesized that constant
different workouts that varied the load and variable resistance training would
used, the rest interval between sets, the lead to similar hypertrophy on a group
number of sets performed, and the mus- level, that variability between individu-
cle action performed (i.e. eccentric-on- als would be larger than the within-in-
ly reps instead of normal reps). Quad dividual variability (using a within-sub-
growth was similar in both conditions, ject unilateral design), and that protein
60
synthesis rates would “correspond” (I as- session. Loads were adjusted so that the
sume they’re implying “correlate”) with subjects failed each set between 9 and
changes in muscle cross-sectional area. 12 reps, and they were allotted two min-
utes of rest between sets. For the varied
condition, the subjects cycled through
Subjects and Methods four different workouts: one with lower
loads (4 x 25-30RM with 2 minutes of
Subjects rest), one with more sets (6 sets of uni-
The subjects were 20 young men with lateral leg press and knee extension, still
an average of 2.5 years of training ex- for sets of 9-12 with 2 minutes of rest),
perience and no current musculoskeletal one with eccentric-only training (sets
limitations. of 10 with 110% of the loads used for
the leg in the constant condition, still for
Experimental Design 4 sets with 2 minutes of rest), and one
with longer rest intervals (4 x 9-12RM,
Much like the multi-joint versus sin-
with 4 minutes between sets).
gle-joint study I reviewed this month,
this study employed a within-subject Ultrasound scans of the vastus later-
unilateral design. This means that each alis were performed before and after
subject performed both programs used the eight-week training intervention to
in this study, with their right leg as- measure changes in muscle cross-sec-
signed to one condition and their left tional area. After the training program
leg assigned to the opposite condition. was finished, the subjects completed one
The legs were counterbalanced based more training session used to measure
on limb dominance, meaning 10 of the integrated myofibrillar protein synthe-
subjects performed the “varied” protocol sis. They drank chemically labeled water
with their dominant leg and the “con- before the workout, and muscle biopsies
stant” protocol with their nondominant were taken before the workout, 24 hours
leg, while the programs assigned to each post-workout, and 48 hours post-work-
leg were reversed for the other 10 sub- out to assess the rate at which the chem-
jects. ical tracer was being incorporated into
muscle proteins. For this session, each
Training took place over eight weeks,
subject performed the “constant” proto-
with two training sessions per week, and
col with one leg, and five subjects apiece
with the workouts for both conditions
performed each of the “varied” protocols.
performed in each session. For the con-
stant condition, training consisted of To assess the differences in with-
four sets of unilateral leg press and four in-subject versus between-subject vari-
sets of unilateral knee extensions in each ability, the researchers calculated the
61
Figure 1 Rate of progression of volume load
16000
Slopes P = 0.819
Volume Load (kg)
14000
Elevation P < 0.0001
12000
Constant
Varied
10000
8000
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Weeks
difference in percent increase in vastus number of weekly sets performed (16

lateralis cross-sectional area within each for constant and 18 for varied) was simi-
subject and the coefficient of variation lar, which is probably a more meaningful
for change in vastus lateralis cross-sec- metric than volume load if you’re inter-
tional area within each condition. So, for ested in hypertrophy, as we’ve previously
example, if subject A had an increase in discussed in MASS. The rate of progres-
cross-sectional area of 5% in one quad sion of volume load, which should be a
and 4% in the other, their within-subject pretty good proxy for strength gains in
difference would be 5%-4% = 1%. If the this study, was similar in both groups (p
change in vastus lateralis cross-sectional = 0.819).
area in a group was 5 ± 2cm, the coeffi- Both conditions caused significant in-
cient of variation would be 2cm/5cm = creases in vastus lateralis cross-sectional
40%. area, but there weren’t significant differ-
ences between conditions (p = 0.473).
Findings The within-subject variability for hy-

pertrophy was quite low: only about
Total volume load (sets x reps x load) 0.9%. However, the between-subject
was higher in the varied group compared variability was pretty high for both con-
to the constant group. However, the ditions: 37% for constant and 38% for
62
varied. This means the between-subject
Figure 2 Changes in cross-sectional area
variability was about 42 times greater
than the within-subject variability, at
least according to this paper. That may 14
Change in cross-sectional area (%)

not be the correct way to quantify these
12
differences, however, as discussed below.
10
Integrated myofibrillar muscle protein
synthesis during the two days following 8
the final training session was greater in
the varied condition than the constant 6
condition. For all four workouts, mean 4
differences favored the varied condi-
tion over the constant condition, but 2
the difference was only significant for
0
the workout that involved doing more Constant Varied
sets. However, since there were only five
subjects for each comparison, I think
the MPS findings warrant a reasonable limb in this study was a bit more than
amount of skepticism. However, as with 2%, and the largest increase was a bit less
hypertrophy, within-subject variation than 14%. So, comparing the worst to the
(0.08%) was substantially lower than be- best result, there’s a difference of 12%.
tween-subject variation (3.5% for con- The mean difference between legs was
stant and 3.1% for varied), amounting to about 1%, so the largest between-subject
a ~41-fold difference. difference in this study was about 12x
greater than the average within-subject
difference. That’s considerable, but it’s
Interpretation nowhere close to a 40-fold difference.
Comparing the within-subject differ-
Just as a note about the results before
ences to the group-level standard devi-
diving into this interpretation: the ~40-
ations would have made for better direct
fold reported difference between with-
comparisons, as a standard deviation is
in-subject and between-subject vari-
the average difference between individ-
ability probably overstates things, as it’s
ual results and the group mean. If that
a bit tenuous to compare the mean be-
was the comparison made in the study,
tween-leg differences for individuals to
the variability within groups would have
the group-level coefficients of variation.
been about 3x greater than the variabil-
Using an extreme example, the smallest
ity between individuals, which is still a
increase in cross-sectional area for any
big difference, but nothing like a 40-fold
63
Figure 3 Myofibrillar protein synthesis following final training session
* = significant difference (p<0.05)
A
2.0
* B
2.0
*
1.5 1.5
synthesis (%·day-1)
Myofibrillar protein
1.0 1.0
0.5 0.5
0.0 0.0
Constant Varied Constant Varied Constant Varied Constant Varied Constant Varied
load sets eccentric rest
difference. Thanks to Eric Trexler for since the protocols largely seemed to be
pointing out this issue during the review stacked in favor of the varied condition.
process for this article. The results of this study shouldn’t be
One of the first things that jumped out too surprising, given the current state of
to me when reading this study was that the literature. In a study on gymnasts,
the protocols were stacked in favor of varying between high load and low load
the varied condition. Current evidence training every two weeks didn’t cause
suggests that training with low loads is more hypertrophy than doing just high
similarly effective for hypertrophy when load or just low load training (7). When
compared with higher loads (2), but the comparing linear and undulating peri-
other three conditions – doing more odization approaches (i.e. keeping reps
sets (3), resting longer between sets (4), ranges constant for weeks at a time ver-
and doing eccentric training (5) – have sus varying rep range week-to-week or
all been suggested to cause more mus- within each week), it doesn’t seem that
cle growth (6). So, while I sometimes either approach is superior for hypertro-
feel like studies are designed almost as phy, according to a recent meta-analysis
a strawman – testing a weak version of (8). Finally, in the study by Schoenfeld et
one concept against a strong version of al that many people point to as evidence
another concept, as we previously dis- in favor of varying rep ranges within
cussed in the context of periodization – each week (9), there actually weren’t sig-
I think this study tested a steelman of nificant differences for any of the mea-
the case for varying training. If there was sures; effect sizes were just slightly larger
going to be a study where varying train- for the varied program for a couple mus-
ing over short time scales was going to cles, though the between-group differ-
cause more hypertrophy, it was this study, ences were trivial for the elbow flexors
64
and small for the elbow extensors. So, pertrophy? Or do you need to stick with
the results of this study are right at home one type of training for three years be-
in the literature: Frequently varying the fore a very different style of training
training stimulus doesn’t seem to lead to will boost hypertrophy? I honestly don’t
more hypertrophy, at least in the short to know.
medium term. One thing that struck me about this
However, I don’t think we should rule paper is how low the within-subject
out the idea that variations in training variance was. The figure in the study
stimulus can lead to more hypertrophy. I (Figure 2) doesn’t quite make it clear, in
think the important variable is the time my opinion. I re-graphed the data as a
scale you’re working with. For example, scatterplot, with each point representing
we reviewed a study in a prior issue of a single subject. Growth of the constant
MASS in which powerlifters experi- leg is the x-value for each point, and
enced a substantial amount of hyper- growth of the varied leg is the y-value.
trophy – primarily type I fiber hypertro- As you can see, all of the points fall very
phy – after a brief exposure to low-load close to the black line, which is repre-
training with blood flow restriction, sentative of identical growth between
while another group of powerlifters just legs. The two red lines indicate this
doing normal, heavy front squats didn’t study’s definition of a meaningful dif-
experience much hypertrophy (10). For ference (two typical errors), and as you
these powerlifters, who probably didn’t can see, all of the data points fall within
do much (if any) training in the 20+ rep those boundaries. Compare that to the
range for years at a time, a very novel between-subject variance, where the top
stimulus was able to cause considerable responders grew almost 7x more than
growth in a relatively short period of the worst responders, with growth rang-
time, while training they were more ac- ing from ~2% to ~14%. In other words,
customed to didn’t cause much growth. some people just simply responded bet-
Thus, I think it’s likely that very novel ter to training, regardless of the training
stimuli can boost hypertrophy. Howev- program they used, and the individual
er, I think that likely applies to types of impact of the training programs mat-
training that you haven’t done in months tered way less than the inherent vari-
or years, not variations in training that ability between individuals.
you cycle through over a period of weeks. However, I don’t want to make it seem
I’m not sure where the line is, however. like programming doesn’t matter at
Do you need to stick with one type of all on an individual basis. Volume was
training for three months before a very similar in both of the programs used in
different style of training will boost hy- this study, and rep ranges were similar
65
Figure 4 Individual changes in VL CSA after constant vs. varied loading considerably smaller than the variability
in general responsiveness to training be-
18.0% tween individuals (15).
16.0%
One interesting thing to note was
that even after eight weeks of training,
14.0%
muscle protein synthesis was higher in
12.0% the varied condition than the constant
condition. However, overall hypertro-
Varied Loading
10.0%
phy was similar. Why might that be?
8.0%
One plausible explanation is that vary-
ing the training stimulus didn’t allow the
6.0%
lifters’ muscles to fully habituate to any
4.0% one particular stimulus, leading to slight
elevations in muscle damage compared
2.0%
to the constant condition. Previous re-
0.0% search has suggested that elevated mus-
0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 16.0%
Constant Loading cle damage can increase muscle protein
synthesis without actually causing more
growth, since some of the protein syn-
for the majority of the sessions, so it’s
thesis is directed toward repairing dam-
unsurprising that each individual got
aged proteins rather than constructing
pretty similar results for both their legs.
new proteins (13). Another possible
However, in a prior study from the same
explanation is that the varied condition
lab using a similar experimental design
would have actually caused more growth
(within-subject unilateral design), dif-
over time, but the training duration was
ferences in volume and frequency led to
too short and the sample was too small
considerably more within-subject vari-
to detect such a difference. However,
ability (11). An older study by Beaven
since there wasn’t even a nonsignificant
et al using a crossover design also found
difference in hypertrophy that seemed
that individuals could experience large
to be noticeably leaning in favor of the
gains on one program and small or non-
varied condition, I think that’s unlikely.
existent gains on another program with
a different intensity and rep range (12). This study also reported some correla-
So, programming can absolutely make tions that I didn’t feel were worth report-
a large difference for individual lifting for the most part. While they were
ers; however, I think the general point statistically significant, the r2 values were
stands. The variability between individ- low (between 0.09-0.22), which makes
ual responses to different programs is me think they may just be noise, and if
66
they’re not noise, they’re still probably Figure 5 Individual changes in VL CSA after higher vs. lower frequencies
not meaningful. However, two correla-
tions in tandem caught my eye. Hyper- 30.0%
trophy was positively associated with

pre-training muscle cross-sectional area, 25.0%
and negatively associated with volume

load. This study didn’t measure 1RMs, so 20.0%
volume load is the only proxy we have for

the subjects’ strength (since the rep rang-
Lower Frequency
15.0%
es were the same for each subject, stron-
ger subjects would have higher volume
loads). In other words, you were likely to 10.0%
grow more if your muscles were relatively

large and also if your muscles were rela- 5.0%
tively weak. This reminded me of a 2015

study that found that the muscle fibers 0.0%
0.0% 5.0% 10.0% 15.0% 20.0% 25.0%
of power athletes have a higher specific

tension (force per unit of cross-sectional -5.0%
Higher Frequency
area) than those of untrained controls,
while the muscle fibers of bodybuilders From Damas et al. (2019b)
had a lower specific tension than those

of untrained controls (14). It’s clear why tions in this study leave something to be
a high specific tension would be bene- desired for anyone interested in making
ficial for power athletes, so that finding predictions. I would be interested in fu-
made sense, but it wasn’t clear why a low ture studies reporting the relationship
specific tension would be beneficial for between pre-training strength and sub-
bodybuilders. However, if having mus- sequent hypertrophy, though.
cles that are naturally relatively large and
relatively weak is predictive of future hy-
pertrophy, that finding would make way Next Steps
more sense. I’m still not sure why that I’d be really interested in seeing a study
would be the case physiologically, but it’s that directly tested whether novelty af-
at least interesting enough to mention. fects hypertrophy. The target study pop-
However, I wouldn’t recommend going ulation could be people who have done
around proclaiming that being naturally the vast majority of their training for the
muscular and naturally weak is the per- past year with low reps (6 or fewer) and
fect combo for hypertrophy just yet; as people who have done the vast majority
mentioned, the strength of the correla-
67
Short-term variations in training variables are unlikely to increase hypertrophy.
However, that doesn’t mean they’re totally worthless. As we’ve discussed previously,
undulating programming may lead to larger strength gains, and many lifters just
enjoy frequent variations in training compared to keeping all variables constant for
a long period of time. We’re seeing that frequent variation isn’t better for growth,
but it’s also not worse. That gives you flexibility to use variation as you see fit,
depending on whether you prefer more variety or more consistency.
of their training with high reps (12 or

more). The subjects could be assigned to
either a familiar group (low rep trainees
still training with low reps, and high rep
trainees still training with high reps) or
a novel group (low rep trainees training
with high reps, and high rep trainees
training with low reps). If the groups
experienced similar hypertrophy, that
would supply evidence against novelty
mattering much at all, but if the novel
group experienced more hypertrophy, it
would suggest that novelty does matter,
but only if training variables are changed
after being held constant for a consider-
able period of time.
68
References
1. Damas F, Angleri V, Phillips SM, Witard OC, Ugrinowitsch C, Santanielo N, Soligon SD, Costa
LAR, Lixandrão ME, Conceição MS, Libardi CA.Myofibrillar protein synthesis and muscle hyper-
trophy individualised responses to systematically changing resistance training variables in trained
young men. J Appl Physiol (1985). 2019 Jul 3.
2. Schoenfeld BJ, Grgic J, Ogborn D, Krieger JW. Strength and Hypertrophy Adaptations Between
Low- vs. High-Load Resistance Training: A Systematic Review and Meta-analysis. J Strength Cond
Res. 2017 Dec;31(12):3508-3523.
3. Schoenfeld BJ, Ogborn D, Krieger JW. Dose-response relationship between weekly resistance train-
ing volume and increases in muscle mass: A systematic review and meta-analysis. J Sports Sci. 2017
Jun;35(11):1073-1082.
4. Schoenfeld BJ, Pope ZK, Benik FM, Hester GM, Sellers J, Nooner JL, Schnaiter JA, Bond-Wil-
liams KE, Carter AS, Ross CL, Just BL, Henselmans M, Krieger JW. Longer Interset Rest Periods
Enhance Muscle Strength and Hypertrophy in Resistance-Trained Men. J Strength Cond Res. 2016
Jul;30(7):1805-12.
5. Schoenfeld BJ, Ogborn DI, Vigotsky AD, Franchi MV, Krieger JW. Hypertrophic Effects of Con-
centric vs. Eccentric Muscle Actions: A Systematic Review and Meta-analysis. J Strength Cond Res.
2017 Sep;31(9):2599-2608.
6. It should be noted that, while eccentric muscle actions tend to cause more hypertrophy than con-
centric actions, there’s not a ton of research looking at whether eccentric-only training causes more
hypertrophy than full reps with both eccentric and concentric muscle actions. My hunch is that
conventional training and eccentric-only training cause similar hypertrophy, though some people
argue that eccentric-only training can cause more growth. If, in fact, eccentric-only training and
conventional training have similar hypertrophic effects, then the extended rest interval and higher
set volume volume workouts would be the only two workouts that should theoretically be better for
the varied condition over the conventional condition.
7. Fink J, Kikuchi N, Yoshida S, Terada K, Nakazato K. Impact of high versus low fixed loads and
non-linear training loads on muscle hypertrophy, strength and force development. Springerplus.
2016 May 20;5(1):698.
8. Grgic J, Mikulic P, Podnar H, Pedisic Z. Effects of linear and daily undulating periodized resistance
training programs on measures of muscle hypertrophy: a systematic review and meta-analysis. PeerJ.
2017 Aug 22;5:e3695.
9. Schoenfeld BJ, Contreras B, Ogborn D, Galpin A, Krieger J, Sonmez GT. Effects of Varied Ver-
sus Constant Loading Zones on Muscular Adaptations in Trained Men. Int J Sports Med. 2016
Jun;37(6):442-7.
10. Bjørnsen T, Wernbom M, Kirketeig A, Paulsen G, Samnøy L, Bækken L, Cameron-Smith D, Ber-
ntsen S, Raastad T. Type 1 Muscle Fiber Hypertrophy after Blood Flow-restricted Training in Pow-
erlifters. Med Sci Sports Exerc. 2019 Feb;51(2):288-298.
11. Damas F, Barcelos C, Nóbrega SR, Ugrinowitsch C, Lixandrão ME, Santos LMED, Conceição MS,
Vechin FC, Libardi CA. Individual Muscle Hypertrophy and Strength Responses to High vs. Low
69
Resistance Training Frequencies. J Strength Cond Res. 2019 Apr;33(4):897-901.
12. Beaven CM, Cook CJ, Gill ND. Significant strength gains observed in rugby players after specific
resistance exercise protocols based on individual salivary testosterone responses. J Strength Cond
Res. 2008 Mar;22(2):419-25.
13. Damas F, Libardi CA, Ugrinowitsch C. The development of skeletal muscle hypertrophy through
resistance training: the role of muscle damage and muscle protein synthesis. Eur J Appl Physiol.
2018 Mar;118(3):485-500.
14. Meijer JP, Jaspers RT, Rittweger J, Seynnes OR, Kamandulis S, Brazaitis M, Skurvydas A, Pišot
R, Šimunič B, Narici MV, Degens H. Single muscle fibre contractile properties differ between
body-builders, power athletes and control subjects. Exp Physiol. 2015 Nov;100(11):1331-41.
15. It should be noted that the subjects in this study were intermediate-ish. Tailoring a program to the
individual likely becomes increasingly more important as training status increases. For a novice or
intermediate lifter, two different – but overall decent – programs may work similarly well for an
individual, but for an advanced lifter, subtle programming variations may be the difference between
making some progress and either stalling or regressing.
70
Study Reviewed: The Impact of Sodium Bicarbonate on Performance in Response to Exercise
Duration in Athletes: A Systematic Review. Hadzic and Eckstein et al. (2019)
Sodium Bicarbonate Benefits

Continue to be Equivocal
BY MIC HAE L C . ZO URD O S
A new systematic review tells us that sodium bicarbonate

supplementation works sometimes. This article dives deeper to
explain why the results are equivocal and in what specific situations
supplementation may be useful for the lifter.
71
KEY POINTS
1. This systematic review included 35 studies that tested the effects of sodium
bicarbonate supplementation on intermittent exercise performance.
2. Overall, ~66% of the studies (23 out of 35) showed at least some performance
improvement for sodium bicarbonate; however, only one study was on resistance
training.
3. More resistance training studies exist than were included in this systematic review
and the results continue to be equivocal. To benefit from sodium bicarbonate
supplementation, it seems that high volume training sessions with short rest
intervals are necessary; however, even in this case, it is unrealistic to expect a huge
performance boost. There is also a risk of gastrointestinal distress with sodium
bicarbonate supplementation, which all practitioners should be aware of before
partaking.
P
reviously, we reviewed the first efit for at least some performance met-
study examining long-term so- ric. Further, there seemed to be slight-
dium bicarbonate supplementa- ly more support for exercise durations
tion and lifting performance. The results lasting <4 minutes than for those lasting
from Siegler et al (2) did not show that >4 minutes. Importantly, only one resis-
sodium bicarbonate increased strength tance training study was included in the
over 10 weeks, despite successfully in- systematic review although many others
ducing alkalosis before each training do exist. This article will put the results
session. Interestingly, sodium bicarbon- of this systematic review into context
ate has consistently elicited alkalosis and will dive deeper into the resistance
(i.e. increase pH) by expelling hydrogen training studies that the systematic re-
ions (H+), which delays the incidence of view failed to include. Further, this arti-
metabolic acidosis, yet performance re- cle will discuss why equivocal results ex-
sults tend to be inconsistent. This article ist and exactly when sodium bicarbonate
breaks down a systematic review (1) that supplementation might have utility for
evaluated 35 studies using sodium bicar- the lifter.
bonate across various types of intermit-
tent exercise performance (i.e. running,
rowing, swimming, and lifting, among Purpose and Hypotheses
others). The results were mixed, as 17 of
the 35 studies evaluated showed a clear Purpose
benefit for bicarbonate supplementation The purpose of this systematic review
and 23 of the 35 studies showed a ben- was to examine if both acute and chron-
72
Table 1 Systematic review inclusion criteria
Study was a single- or double-blind randomized control trial
Study used athletes
Could have been on any sport or either sex (i.e. the authors did not
exclude particular sports or men or women)
Study was placebo-controlled and it could have used sodium
bicarbonate alone or in conjunction with another supplement
Exercise/performance was a main outcome
Inclusion criteria from Hadzic and Eckstein et al. 2019 (1)
ic sodium bicarbonate supplementation tistical analysis on the studies that meet

increase exercise performance. Further, the inclusion criteria, whereas a system-
the authors aimed to determine sodi- atic review conducts no stats and pro-
um bicarbonate’s effects on performance vides more general feedback such as “X
in exercise performance tests lasting >4 percentage of studies showed a positive
minutes and those lasting <4 minutes. response.”
Hypotheses Search Criteria and Inclusion

No hypotheses were provided, which To include studies in this review, the
is typical in a systematic review. authors searched PubMed using the
following terms: “sodium bicarbonate”
and “athlete and performance or exer-
Subjects and Methods cise and recovery.” This search original-
ly returned 775 titles on PubMed and
What is a Systematic Review? then the authors ultimately included 35
A systematic review does not have studies based upon the inclusion criteria
subjects since it is a review and not an in Table 1. When analyzing the studies,
original research study. Further, a sys- the authors simply looked at the main
tematic review is not the same as a me- results (i.e. p-values) and concluded a
ta-analysis. Many systematic reviews “yes” if sodium bicarbonate improved
double as meta-analyses, but this one performance, a “no” if it did not improve
did not. A meta-analysis conducts a sta- performance, or a “yes/no” if the supple-
73
ment improved some performance mea- Table 2 Main results
sures but not others. The authors also
broke the studies down into two cate- Studies Included Results
gories: 1) performance outcomes lasting 35 total studies

17 = Yes
>4 minutes, and 2) performance out- All Studies
12 = No
comes lasting <4 minutes. This review 6 = Yes/No
also examined both acute and chronic 15 total studies

supplementation studies. One study was >4 minutes
6 = Yes
7 = No
included twice as it examined both acute 2 = Yes/No
and chronic supplementation. In total,

20 total studies
only 5 studies examined chronic sodium <4 minutes
11 = Yes
5 = No
bicarbonate supplementation and the 4 = Yes/No
other 31 examined acute supplementa-
Yes = A benefit for sodium bicarbonate;
tion. No = No benefit for sodium bicarbonate; Yes/No = Mixed results
Findings (3), showed that sodium bicarbonate

supplementation increased squat reps to
The overall results were fairly mixed, failure, but not bench press reps across 3
but I would say they tended to suggest sets at 80% of 1RM.
a benefit for sodium bicarbonate. Over-
all, 17 of the 35 studies (~49%) reported Chronic Studies
significance for all outcome measures in Far less data on chronic sodium bicar-
favor of sodium bicarbonate; however, an bonate supplementation exist compared
additional 6 studies reported at least one to acute data. This systematic review
performance measure to be improved included five chronic supplementation
with supplementation. Thus, 23 of 35 studies, and the results were mixed. Two
studies (~66%) reported at least some showed improved performance, both
benefit when using sodium bicarbonate. for exercise tasks lasting <4 minutes (4,
The benefit was slightly more frequent 5), while two studies showed no benefit
when the performance test lasted <4 for supplementation (6, 7). Finally, one
minutes versus >4 minutes. A more spe- study from Joyce et al (8) showed some
cific breakdown of the results is in Table metrics of “CrossFit like performance”
2. to be improved, while other metrics
Curiously, only one study on resistance were not improved during exercise last-
training was included, even though ing exactly 4 minutes. Additionally, the
many others exist (more on that later). supplementation period did not need to
The included study, from Duncan et al be long to be considered chronic. For
74
example, the Joyce study administered cluded showed at least one performance
0.1 g/kg 3 times per day for 3 days then metric improved for studies >4 minutes
tested 2 x 200 meter swimming perfor- (Table 2). Importantly, no study in-
mance, and that was considered chronic cluded in the systematic review showed
supplementation. that sodium bicarbonate supplementa-
tion significantly harmed performance.
Dosage and Timing It should be noted, however, that the
The dosages administered ranged from approach the systematic review used –
0.1-0.3 g/kg with 0.3 g/kg being used in simply counting the number of studies
all acute studies except for one. The tim- in which sodium bicarbonate “worked”
ing of ingestion was anywhere from 60 or “didn’t work” based upon the p-values
to 120 minutes prior to the exercise test – could be referred to as “vote counting.”
in all but two acute studies. Therefore, The vote counting approach is simple
0.3 g/kg, 60 to 120 minutes pre-exercise but quite limited (thanks to Eric Trex-
was the most common supplementation ler for noting this point). Specifically, a
protocol. couple of underpowered studies might
show only a modest benefit for sodium
bicarbonate and fail to reach statistical
Interpretation significance, resulting in the conclusion
that the treatment did not work. How-
The totality of the results from this
ever, when the data across all studies are
systematic review, which covered a wide
pooled together, the benefit for sodium
range of performance tests (i.e. running,
bicarbonate could become much clearer.
rowing, swimming, and lifting, among
The vote counting strategy just judges
others), paints a mixed picture for sodi-
studies individually and only based upon
um bicarbonate. However, I would say
the reported p-values, so its approach is
that the results tend to be on the posi-
limited.
tive side, as 23 out of 35 studies showed
at least one metric of performance to be The fact that results tended to favor so-
improved with supplementation. Ad- dium bicarbonate isn’t too surprising, as
ditionally, the findings suggest slightly four out of five other meta-analyses/sys-
more consistency for sodium bicarbon- tematic reviews on sodium bicarbonate
ate to improve exercise performance and some type of intermittent exercise
lasting <4 minutes versus those lasting performance show a small benefit for
>4 minutes. Specifically, 75% of the stud- supplementation (9, 10, 11, 12). The only
ies analyzed showed at least one perfor- meta-analysis not showing a benefit was
mance metric improved for <4-minute recently published by Lopes-Silva et al
exercise tasks, while 53% of studies in- and was solely related to repeated sprint
75
performance (13). However, Lopes-Sil-
va led one of the other meta-analyses on
the topic, and that one showed a small MULTIPLE SETS WITH
benefit for sodium bicarbonate on Win-
gate peak power (12), but only when SHORT REST INTERVALS,
supplementation was chronic. Impor-
tantly, the repeated sprint meta-analysis
POTENTIALLY USING
examined some sprint sessions that were COMPOUND MOVEMENTS,
between 20 and 30 minutes long, while a
Wingate test only lasts 30 seconds. Thus, PROBABLY CREATE THE
the results of Lopes-Silva’s meta-analy-
ses seem to be in line with the current BEST CONDITIONS FOR
systematic review indicating that short-
er duration exercise benefits more con-
SODIUM BICARBONATE TO
sistently from sodium bicarbonate than IMPROVE PERFORMANCE.
longer duration exercise. Even though
the totality of data is not a slam dunk for
sodium bicarbonate, it is fairly positive
found that 0.3 g/kg 60 minutes before
– especially when we consider how few
training both induced alkalosis and in-
supplements have clear and consistent
creased reps to failure on the squat, leg
performance benefits.
press, and leg extension. Duncan et al in
Curiously, the current systemat- 2014 (3), the study included in the pres-
ic review included only one resistance ent systematic review, found split results.
training study; however, many more Specifically, Duncan observed that 0.3
crossover design, placebo-controlled g/kg administered 60 minutes prior to
resistance training studies exist. Simi- training increased reps to failure across 3
lar to the current systematic review, the sets at 80% of 1RM in the squat, but not
resistance training data are mixed. Old- in the bench press. Although the perfor-
er studies from Webster et al (14) and mance results are mixed, the dosage (0.3
Portington et al (15) found that acute g/kg) in all studies was consistent and
sodium bicarbonate ingestion of 0.3 g/ successful at inducing alkalosis. Impor-
kg 105 minutes prior to lifting induced tantly, all of the above studies used short
alkalosis (i.e. increased blood pH) but (30-60 seconds), inter-set rest intervals.
did not improve reps performed to fail-
The only study to examine chronic
ure at 70% of the leg press and 85% of
sodium bicarbonate supplementation
the leg extension, respectively. Howev-
on lifting performance is from Siegler
er, more recently in 2013, Carr et al (16)
et al (2), which we previously reviewed.
76
seemed to more appropriately create the
condition for sodium bicarbonate to be
effective, as both used multiple sets with
IT MIGHT MAKE SENSE TO TRY short inter-set rest on compound move-
SODIUM BICARBONATE ON ments. As briefly touched on in the in-
troduction, the mechanism of action of
A NON-TRAINING DAY FIRST sodium bicarbonate is to accumulate
bicarbonate outside the muscle, which
TO SEE IF YOU EXPERIENCE causes an efflux of H+ out of the muscle
ANY SIDE EFFECTS. (10, 11). Therefore, in situations where
metabolic acidosis (i.e. low pH) is a
prominent cause of fatigue (i.e. intermit-
tent exercise), starting with blood alka-
In short, Siegler et al found that taking losis (i.e. high pH) increases the amount
0.3 g/kg of sodium bicarbonate prior to of time it might take for pH to decrease
training did not aid performance versus to acidic levels, meaning increased time
a placebo. Further, Siegler also measured to fatigue.
acute performance and found that so-
dium bicarbonate did not increase max The equivocal nature of the sodium
reps during one set of as many reps as bicarbonate and performance literature
possible over 30 seconds at 40% of 1RM could be attributable to a few things.
on the leg extension. However, Siegler First, the protocols implemented across
did find that alkalosis was induced pri- studies are quite different, which was
or to every single session during the 10 touched on above with the difference
weeks due to sodium bicarbonate inges- between the Webster/Portington stud-
tion. The max reps for 30 seconds over ies versus the more recent Carr/Duncan
only one set may be key to why Siegler studies. This means multiple sets with
did not observe a benefit, as there was short rest intervals, potentially using
likely no need to buffer H+. I speculat- compound movements, probably create
ed about this during the review of the the best conditions for sodium bicar-
Siegler study, but it really comes down bonate to improve performance. Sodium
to creating a condition for sodium bicar- bicarbonate will almost certainly induce
bonate to be effective. When consider- alkalosis, but if you take five minute rests
ing the older studies from Webster and between sets, then it’s unlikely you’ll see
Portington in the 1990s, neither used a performance benefit, as you are giving
free weight compound movements. The yourself ample time to buffer H+. An in-
more recent Carr and Duncan studies, teresting point, though, is that training
which observed a performance benefit, with short rest intervals doesn’t yield
77
Figure 1 Relationship between increases in blood bicarbonate and improved performance
12
Improved performance
Increase in blood bicarbonate
Unchanged performance
8
(mmol·L-1)
0
Individual study data points
From Heibel et al. 2018 (18).

Each dot represents an individual study. Once an increase in blood bicarbonate of about 5 mmol/L the increase in exercise performance becomes more consistent.
greater hypertrophy than long rest in- you only have 25-30 minutes to train. In
tervals, so it is probably not advisable to this case, you might need to modify the
train that way (17). However, the data squat to 6 sets of 8 at 130 kg with 1-2
showing long rest intervals to be supe- minutes rest and change the assistance
rior to short rest intervals for hyper- work to rest-pause (i.e. 20-30 sec rest) to
trophy are equated for sets; thus, if you finish in time. This situation would cre-
take shorter rest but add sets to equate ate a condition where bicarbonate might
for total volume, I bet that hypertrophy work if taken about 60 minutes prior to
would be the same. This theory means training. This is not an overwhelming
there may be a place for short rest in- endorsement of sodium bicarbonate for
tervals when in a time crunch, and this lifting; it’s just to say that we shouldn’t
is when bicarbonate supplementation close the door on it when considering
might come in handy. For example, let’s practical situations that may arise.
say you are scheduled to perform 5 sets Another explanation for the equivocal
of 8 at 150kg on the squat and then 5 results around resistance training is that
sets on two lower body assistance move- there may be an individual response rate
ments. That usually takes you about 60 to sodium bicarbonate. Specifically, in-
minutes (including warm-up) when you creasing bicarbonate in the blood is es-
take 5-minute rest intervals, but today
78
1. The totality of evidence paints a mixed picture for sodium bicarbonate and
performance improvement.
2. Importantly, the recent studies surrounding sodium bicarbonate and lifting
performance have tended to show an improvement for reps to failure. These studies
have created a condition where metabolic acidosis is a primary driver of fatigue.
3. While sodium bicarbonate is not close to being in the same category as creatine or
caffeine, it may have some utility. If you have a training session in which you need
to take short rest intervals and perform a lot of moderate- to high-repetition sets,
then 0.3 g/kg of sodium bicarbonate 60 minutes prior to training may successfully
buffer H+ and improve your ability to perform repetitions. However, everyone should
be aware of the potential gastrointestinal distress that may occur with sodium
bicarbonate supplementation.
sential to causing an efflux of H+ from supplementation. Gastrointestinal dis-

the muscle. However, some individuals tress is quite individual, and some don’t
may increase blood bicarbonate more report it at all; however, there are nu-
than others with the same dosage. This, merous reports of vomiting, diarrhea,
in part, explains why 0.3 mg/kg has seen and nausea with sodium bicarbonate, so
more consistent results than 0.1 mg/kg, recommending above 0.3 g/kg would be
as the higher dosage is more likely to in- irresponsible (19). Alternative extracel-
crease blood bicarbonate by at least 0.5 lular buffers such as sodium citrate do
mmol/L, which seems to be the mini- exist and have been suggested to have a
mum threshold to cause sufficient H+ lower incidence of gastrointestinal dis-
efflux to matter. Figure 1, which is re- tress; however, this isn’t supported by a
drawn from a recent review from Heibel large body of literature. Further, while
et al (18), clearly shows studies which some studies do show performance
observed a greater increase in blood benefits with sodium citrate (20), a me-
bicarbonate have seen a more consis- ta-analysis reported an unclear effect of
tent performance improvement. At first sodium citrate on intermittent perfor-
glance, it may seem logical to say “just mance (10), and to my knowledge, there
take more” to ensure that alkalosis is en- is no data showing sodium citrate im-
hanced enough to improve performance, proves lifting performance. Additionally,
but this likely isn’t the answer, as signif- supplementing with sodium bicarbonate
icant gastrointestinal distress can be a means that you are taking in a large ex-
serious issue with sodium bicarbonate tra dosage of sodium, so it might make
79
sense to decrease sodium intake in your
regular diet.
In summary, as with many supple-
ments, the data on sodium bicarbonate
supplementation are equivocal, just as
the systematic review presents. I would
say, however, that under certain con-
ditions, sodium bicarbonate tends to
work more consistently than many oth-
er supplements. If you decide to use it,
be sure that your training session has a
condition created where the supplement
may be effective and understand that
gastrointestinal distress may occur. One
potential way to minimize potential GI
distress is to split the 0.3 mg/kg dose of
sodium bicarbonate into three doses of
0.1 mg/kg with at least an hour between
doses. Therefore, it might make sense to
try sodium bicarbonate on a non-train-
ing day first to see if you experience any
side effects.
Next Steps
Next, we need another long-term
study. Although the previously reviewed
Siegler et al (2) study was long term,
that study only used the leg extension
for one set to failure. Therefore, a pla-
cebo-controlled training study with
multiple high rep sessions per week on
compound movements with short rest
intervals would create the condition we
need to see if sodium bicarbonate may
be useful over the long-term.
80
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2019 Jun;18(2):271.
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bicarbonate supplementation does not manifest into greater training adaptations after 10-weeks of
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5. Oliveira LF, de Salles Painelli V, Nemezio K, Gonçalves LS, Yamaguchi G, Saunders B, Gual-
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The effect of a new sodium bicarbonate loading regimen on anaerobic capacity and wrestling perfor-
mance. Nutrients. 2018 Jun;10(6):697.
8. Joyce S, Minahan C, Anderson M, Osborne M. Acute and chronic loading of sodium bicarbonate in
highly trained swimmers. European journal of applied physiology. 2012 Feb 1;112(2):461-9.
9. Matson LG, Tran ZV. Effects of sodium bicarbonate ingestion on anaerobic performance: a me-
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search. 2012 Jul 1;26(7):1975-83.
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Wingate test performance: a systematic review and meta-analysis. Journal of sports sciences. 2019
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82
Study Reviewed: Time-Restricted Feeding Plus Resistance Training in Active
Females: A Randomized Trial. Tinsley et al. (2019)
Does Intermittent Fasting Limit

Strength and Muscle Gains?
BY E RI C T RE X LE R
Frequent meals used to be the norm for most fitness enthusiasts, but
intermittent fasting (also known as time-restricted feeding) has become popular
in recent years. Despite its popularity, a common concern is that fewer protein
feedings per day may limit muscle growth. Read this article to find out if time-
restricted feeding inhibits strength and muscle gains from resistance training.
83
KEY POINTS
1. Over eight weeks, resistance-trained females had similar body composition and
performance improvements with time-restricted feeding or a standard feeding
schedule (1). The addition of HMB may have slightly enhanced fat loss, but its
effects were pretty minimal.
2. Notably, training occurred in the fed state, and the researchers ensured that
participants had sufficient total daily protein intake (1.6g/kg). These may be
important considerations for promoting strength and hypertrophy in the context
of time-restricted feeding.
3. These results suggest that time-restricted feeding with an eight-hour feeding
window is a suitable strategy for lifters, with no adverse effects on strength or
muscle mass, when total daily protein intake is sufficient and training occurs in
the fed state.
M
eal frequency has had some ups opportunities to stimulate muscle pro-
and downs in the fitness indus- tein synthesis via dietary protein intake,
try. For decades, frequent meals thereby limiting muscle growth while
were touted as a strategy to boost meta- bulking, or the retention of muscle while
bolic rate, although this theory has been losing weight.
soundly rejected by scientific evidence A recent study (1), however, suggests
(2). In more recent years, the pendulum that time-restricted feeding could be a
has swung in the other direction, and in- suitable eating strategy for lifters. Over
termittent fasting strategies with narrow eight weeks, resistance-trained females
feeding windows have become popular. completed supervised resistance training
Time-restricted feeding involves con- and adhered to a typical eating schedule
suming all of the day’s calories within or a time-restricted (eight-hour) eating
a set time window, often between four schedule, with or without additional
to eight hours in duration. Evidence has β-hydroxy β-methylbutyrate (HMB)
suggested that this approach can in- supplementation. Both eating schedules
crease satiety and reduce calorie intake facilitated similar improvements in body
(3), but concerns persist. Muscle protein composition and a whole host of perfor-
synthesis is stimulated following protein mance outcomes, with minimal effects
intake, and studies have suggested that of HMB. Read on to find out if time-re-
it cannot be re-stimulated for three or stricted feeding might be a viable strat-
more hours (4). In theory, time-restrict- egy for you.
ed feeding would limit the number of
84
Purpose and Hypotheses Subjects and Methods
Purpose Subjects
The authors stated that the purpose of Resistance-trained females between
this study was, “To compare the phys- 18 and 30 years old participated in this
iological and performance effects of study. All of them had been resistance
time-restricted feeding, with or with- training at least two to four times per
out HMB supplementation during week for at least a year, and the average
fasting periods, to a control diet re- training experience was about five years.
quiring breakfast consumption during Participants were also required to be be-
progressive resistance training in resis- tween 15 and 33% body-fat. 40 subjects
tance-trained females.” In the interest were assigned to groups, and 24 of them
of transparency, the authors did a great finished the entire trial with sufficient
job clarifying that they were primarily adherence.
focused on fat loss, lean mass accretion,
and hypertrophy, whereas other out- Design
comes (such as exercise performance, This eight-week study consisted of
metabolic rate, and a variety of phys- three groups. Two groups did time-re-
iological variables) were of secondary stricted feeding, consuming all of their
importance. calories in an eight-hour window from
noon to 8 p.m. One of these groups con-
Hypotheses sumed 3g/day of calcium HMB, while
A clear hypothesis was not stated, but the other got a placebo. The third group
based on the summary of time-restrict- was instructed to eat breakfast as soon
ed feeding research in the introduction as possible upon waking, resulting in a
section, one could assume that they ex- “typical” eating window, and they also
pected time-restricted feeding and the took a placebo throughout. Participants
control diet to yield relatively similar completed supervised resistance train-
outcomes for fat loss and muscle gain. ing workouts three times per week, al-
Based on the way the HMB findings ternating between upper-body sessions
were discussed in the paper, it would and lower-body sessions, with workouts
also appear that the authors were gen- occurring in the fed state for all groups.
erally skeptical and likely hypothesized
that HMB would yield no additional Diet and Exercise
benefit in comparison to a placebo. Prior to the study, subjects received
some basic guidance for their diets, in-
85
Figure 1 Body composition changes in the current study
12
CD * *
TRF
8
TRFHMB
*
4
*
*
∆ (%)
-4
-8
*
BM FM FFM BF% MTEF MTKE
Percent changes (mean ± SE) displayed as differences between W0 and W8 values relative to W0 values for each variable.
Asterisks with brackets indicate significant changes in all groups (i.e., time main effects), with nonsignificant differences
between groups, based on mixed model analysis and follow-up tests. BF%, body fat percentage; BM, body mass;
CD, control diet; FM, fat mass; FFM, fat-free mass; MTEF, ultrasound muscle thickness of elbow flexors;
MTKE, ultrasound muscle thickness of knee extensors; TRF, time-restricted feeding;
TRFHMB, time-restricted feeding plus β-hydroxy β-methylbutyrate supplementation.
cluding a target caloric intake that was comes, as you might infer from the 17
intended to create a small caloric deficit. supplementary tables (seriously) that
Subjects were given protein powder to didn’t make it into the paper. The pri-
help them achieve a daily protein intake mary outcomes of interest included fat
of at least 1.4g/kg per day (all groups mass, fat-free mass, body-fat percentage,
ended up around 1.6g/kg). They also and muscle thickness of the biceps and
gave subjects food scales, which enabled quads. Performance outcomes included
the researchers to collect weighed diet counter-movement vertical jump, iso-
logs at certain points in the study. metric and isokinetic squats, and one-rep
max and repetitions to fatigue on bench
Outcomes press and leg press. Additional measure-
This study evaluated a ton of out- ments included resting metabolic rate,
86
Figure 2 Performance changes in the current study
250
CD *
TRF
200 TRFHMB
150
∆ (%)
* * * *
100 *
* *
50
*
* *
0
RFD100ms
RFD200ms
RFD100ms
RFD200ms
RFD30ms
RFD50ms
RFD30ms
RFD50ms
1RMBP
1RMLP
RTFBP
RTFLP
PFCON
PFECC
JH
120º 150º
Percent changes (mean + SE) displayed as differences between W0 and W8 values relative to W0 values for each variable. Asterisks with brackets indicate
significant changes in all groups (i.e., time main effects), with nonsignificant differences between groups, based on mixed model analysis and follow-up tests.
120°, 120° knee angle for isometric squat testing; 150°, 150° knee angle for isometric squat testing; 1RMBP, 1-repetition maximum on bench press;
1RMLP, 1-repetition maximum on leg press; CD, control diet; JH, jump height; PFCON, peak concentric force on mechanized squat;
PFECC, peak eccentric force on mechanized squat; RFD, rate of force development (durations over which RFD values were calculated are shown in subscripts);
RTFBP, repetitions to failure on bench press; RTFLP, repetitions to failure on leg press; TRF, time-restricted feeding;
TRFHMB, time-restricted feeding plus β-hydroxy β-methylbutyrate supplementation
blood pressure, arterial stiffness, blood respectively. There may have been slight-
biomarkers, physical activity levels, and ly more fat loss in the time-restricted
multiple questionnaires. group with HMB (-0.7kg) compared to
time-restricted feeding without HMB
(-0.4kg) and the control diet (+0.4kg).
Findings There’s no need to do a deep dive on the
Time-restricted feeding was very statistics, but there are a few key things
well-tolerated, with very few and very to mention about these findings. The au-
minimal side effects reported. The thors used linear mixed models, which
time-restricted feeding window ended can be interpreted as a slightly more nu-
up being about 7.5 hours, and the con- anced (and in my opinion, better) version
trol diet window was about 13 hours. All of analysis of variance (ANOVA). An
groups experienced similar hypertrophy unavoidable result of this analysis is that
and performance improvements, which standard errors should be approximately
are presented in Figure 1 and Figure 2, equal in all groups. So, any standard er-
87
rors in this paper that seem “unusually
similar” are not problematic or indicative
of any shady statistical trickery. In addi- BASED ON THE AVAILABLE
tion, they completed two separate anal-
yses: per protocol, and intent-to-treat. EVIDENCE, IT WOULD APPEAR
Whenever you see that data were ana- THAT TIME-RESTRICTED
lyzed in two different ways, you might
be suspicious that the authors were fish- FEEDING IS A TOTALLY VIABLE
ing around for certain results. However,
this is very common practice in biomed-
APPROACH FOR LIFTERS
ical research. Per-protocol analysis only INTERESTED IN MAINTAINING
considers participants who completed
the full intervention with sufficient ad- OR INCREASING THEIR MUSCLE
herence, while intent-to-treat includes MASS, PROVIDED THAT THEY
everyone who was assigned to a group.
The intent-to-treat analysis was treated USE AN EIGHT-HOUR FEEDING
as the “primary” analysis, which is pretty
standard.
WINDOW WITH SUFFICIENT
TOTAL DAILY PROTEIN INTAKE.
Interpretation
When reading this study, the first When evaluating the intermittent fast-
word that comes to mind is “thorough.” ing literature, there are two very different
The authors took a very detail-oriented approaches. In the research world, the
approach, resulting in findings that we term “intermittent fasting” often refers
can have a lot of confidence in. They to diet patterns in which subjects actu-
checked urine HMB levels, monitored ally fast for a couple of days each week.
physical activity levels, supervised all Rather than shifting the daily feeding
training, and provided scales so subjects window, these approaches involve fast-
could complete weighed food diaries. ing for the entire day. Meta-analyses
They even stratified subjects by body-fat have shown that these approaches are no
percentage and habitual breakfast con- more effective for weight loss than tra-
sumption before assigning groups, just ditional caloric restriction (5, 6, 7), and
to make sure groups were fairly similar such prolonged fasting periods are not
in terms of their initial body compo- ideal for individuals engaged in frequent
sition and eating windows. All in all, a training.
very strong study. In the research world, more practical in-
88
termittent fasting protocols that involve synthesis. Research has shown that re-
narrow daily feeding windows are called sistance training prolongs the time in
“time-restricted feeding” interventions. which protein synthesis is elevated after
Tinsley, the lead author of the current protein intake (9) and amplifies the an-
paper, published a time-restricted feed- abolic effect of protein feeding for up to
ing study with less favorable results back 24 hours after a workout (10). Based on
in 2017 (3). They used male participants the available evidence, it would appear
and implemented a four-hour time win- that time-restricted feeding is a totally
dow rather than eight, and findings sug- viable approach for lifters interested in
gested that the time-restricted feeding maintaining or increasing their muscle
strategy attenuated fat-free mass gains mass, provided that they use an eight-
and performance improvements to a hour feeding window with sufficient
small degree. However, protein intake in total daily protein intake. This gener-
the time-restricted group (1.0g/kg) was al conclusion mirrors the findings of a
lower than the control group (1.4g/kg) meta-analysis on pre- and post-exercise
and well below the optimal level for in- protein timing by Schoenfeld et al (11);
dividuals involved in resistance exercise. for individuals engaged in resistance
In a separate study with an eight-hour training, total daily protein intake ap-
feeding window and sufficient daily pears to be more important than highly
protein intake (>1.8g/kg), fat-free mass, nuanced protein timing strategies.
muscle thickness, and performance re- Along with sufficient total protein in-
sponses were pretty similar between the take, there is a second caveat to mention
time-restricted feeding and control diet here: the timing of workouts. In the cur-
groups (8). rent study, “time-restricted feeding” was
To be fair, there is a valid reason to essentially breakfast skipping, with all
suspect that time-restricted feeding meals occurring between noon and 8:00
would be suboptimal for muscle gain p.m. A recent study, which Eric Helms
or retention. After ingesting protein, previously reviewed in MASS, investi-
muscle protein synthesis is elevated for gated the performance effects of break-
about two to three hours. It starts re- fast-skipping (12). Participants com-
turning back to baseline levels, despite pleted two separate testing sessions (one
the fact that blood amino acids are still after breakfast, one after an overnight
high, and attempts to re-stimulate pro- fast), in which they completed four sets
tein synthesis during this timeframe ap- to failure on squat and bench press. Un-
pear to be pretty ineffective (4). How- surprisingly, subjects completed signifi-
ever, resistance training causes huge and cantly fewer repetitions for both exercis-
sustained increases in muscle protein es in the fasted state. The subjects were
89
all habitual breakfast consumers, so the
results may not necessarily carry over to
people who are accustomed to skipping TIME-RESTRICTED FEEDING
breakfast, but it would seem reasonable
to conclude that training in the fed state OFTEN CAUSES GREATER
is generally the safest bet for most lift- FAT LOSS THAN CONTROL
ers. While the current study by Tins-
ley et al found no adverse performance DIETS WHEN CALORIES
effects of time-restricted feeding, they
ensured that training occurred within
ARE NOT MATCHED,
the eight-hour feeding window. This WHEREAS DIFFERENCES ARE
would seem like an advisable strategy
for lifters and other athletes who wish NEGLIGIBLE WHEN CALORIC
to utilize time-restricted feeding. INTAKE IS MATCHED UNDER
Results of the current study indicate
a modest benefit of time-restricted TIGHTLY CONTROLLED
feeding for fat loss, but I’m inclined EXPERIMENTAL CONDITIONS.
to interpret this trend very cautiously.
The figure showing fat mass changes
(Figure 1), expressed as percentages,
appears to show meaningful differenc- fullness and reduces food intake, to the
es at first glance. However, closer ex- point that subjects in a controlled feed-
amination of the raw data reveals that ing study routinely struggled to finish
fat mass was increased by 0.4kg in the their prescribed dinner (13). With even
control diet and was reduced by 0.7 a small amount of estimation error on
and 0.4kg in the time-restricted groups food diaries and a little hunger reduc-
with and without HMB. In the grand tion, the observed differences in fat
scheme of things, these differences are mass may simply be attributable to a
pretty negligible, and are small enough small degree of relative under-eating in
to potentially be related to some pretty time-restricted groups. This would ex-
straightforward methodological details. plain why time-restricted feeding often
The group with the most notable fat loss causes greater fat loss than control diets
consumed about 100 fewer calories per when calories are not matched, whereas
day than the other groups, and nutri- differences are negligible when caloric
ent intakes were self-reported via food intake is matched under tightly con-
diaries. Previous studies have shown trolled experimental conditions (14).
that time-restricted feeding increases Due to some controversial papers that
90
1. In resistance-trained females, time-restricted feeding with an eight-hour feeding
window did not impair training-induced improvements in body composition or
performance. These results are similar to a previous study in male subjects, so
the limited data available suggest that time-restricted feeding is a viable strategy
for both sexes.
2. The current results may not necessarily hold true under conditions with
substantially shorter feeding windows (less than eight hours), insufficient protein
intake, lack of a proper training stimulus, or fasted training sessions.
3. When it comes to supporting strength and hypertrophy gains from training, total
daily protein intake appears to be far more important that highly specific meal
timing strategies. So, lifters should be able to capitalize on the benefits of time-
restricted feeding (increased satiety, greater schedule flexibility) without worrying
about sabotaging their gains.
have been previously published, HMB may have been a slight benefit of HMB
has become a bit of a punchline in the for fat loss; in the per-protocol analysis,
world of supplement research. Howev- a significant interaction was observed,
er, that’s not a good reason to discount and only the time-restricted feeding
the entire body of HMB research, so with HMB group had a statistically
it’s important to approach this study significant reduction in fat mass. This is
with an open mind. HMB and oth- not the first HMB study to make such
er leucine metabolites have minimal an observation, but others have some
effects on protein synthesis and don’t notable methodological limitations,
seem to do much for healthy, reason- such as extremely short study duration
ably well-trained subjects that are con- (three days) (17) and the use of unre-
suming plenty of energy (15). However, liable body composition measurement
HMB has anti-catabolic properties and devices (18). As noted previously, the
has attenuated the loss of fat-free mass magnitude of fat loss differences in the
in subjects prone to muscle loss, such current study could easily be explained
as cancer patients and immobilized in- by modest variability in energy intake
dividuals (16). With this in mind, it’s and minor estimation errors, and the
pretty unsurprising that HMB had no majority of HMB research to date has
effects on fat-free mass, hypertrophy, or failed to document meaningful fat loss
performance in the current study. Inter- benefits. So, while the observed trend
estingly, the results suggest that there is interesting, I’m hesitant to conclude
91
the HMB has any fat loss effects that
are large enough to consider meaning-
ful.
Next Steps
It’d be interesting to see a study inves-
tigating time-restricted feeding during
an intervention aimed at inducing some
more dramatic body composition chang-
es. For example, in a serious bulking pro-
tocol in which lean mass is gained rap-
idly, can time-restricted feeding support
this magnitude of hypertrophy? In an
intense weight loss phase where the risk
of muscle loss is increased, can time-re-
stricted feeding support the maintenance
of muscle mass? It’d also be interesting
to follow up on the slight fat loss benefit
observed with HMB; I’m skeptical that
HMB is a promising fat loss aid, but it’d
be great to have more research to repli-
cate or refute the observed finding.
92
References
1. Tinsley GM, Moore ML, Graybeal AJ, Paoli A, Kim Y, Gonzales JU, et al. Time-restricted feeding
plus resistance training in active females: a randomized trial. Am J Clin Nutr. 2019; ePub ahead of
print.
2. La Bounty PM, Campbell BI, Wilson J, Galvan E, Berardi J, Kleiner SM, et al. International Society
of Sports Nutrition position stand: meal frequency. J Int Soc Sports Nutr. 2011 Mar 16;8:4.
3. Tinsley GM, Forsse JS, Butler NK, Paoli A, Bane AA, La Bounty PM, et al. Time-restricted feeding
in young men performing resistance training: A randomized controlled trial. Eur J Sport Sci. 2017
Mar;17(2):200–7.
4. Mitchell WK, Phillips BE, Hill I, Greenhaff P, Lund JN, Williams JP, et al. Human skeletal muscle
is refractory to the anabolic effects of leucine during the postprandial muscle-full period in older
men. Clin Sci Lond Engl 1979. 2017 Oct 27;131(21):2643–53.
5. Cioffi I, Evangelista A, Ponzo V, Ciccone G, Soldati L, Santarpia L, et al. Intermittent versus con-
tinuous energy restriction on weight loss and cardiometabolic outcomes: a systematic review and
meta-analysis of randomized controlled trials. J Transl Med. 2018 Dec;16(1):371.
6. Harris L, Hamilton S, Azevedo LB, Olajide J, De Brún C, Waller G, et al. Intermittent fasting in-
terventions for treatment of overweight and obesity in adults: a systematic review and meta-analysis.
JBI Database Syst Rev Implement Rep. 2018 Feb;16(2):507–47.
7. Headland M, Clifton PM, Carter S, Keogh JB. Weight-Loss Outcomes: A Systematic Review and
Meta-Analysis of Intermittent Energy Restriction Trials Lasting a Minimum of 6 Months. Nutri-
ents. 2016 Jun;8(6).
8. Moro T, Tinsley G, Bianco A, Marcolin G, Pacelli QF, Battaglia G, et al. Effects of eight weeks of
time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflamma-
tion, and cardiovascular risk factors in resistance-trained males. J Transl Med. 2016 Oct;14(1):290.
9. Churchward-Venne TA, Burd NA, Mitchell CJ, West DWD, Philp A, Marcotte GR, et al. Sup-
plementation of a suboptimal protein dose with leucine or essential amino acids: effects on my-
ofibrillar protein synthesis at rest and following resistance exercise in men. J Physiol. 2012 Jun
1;590(11):2751–65.
10. Burd NA, West DWD, Moore DR, Atherton PJ, Staples AW, Prior T, et al. Enhanced amino acid
sensitivity of myofibrillar protein synthesis persists for up to 24 h after resistance exercise in young
men. J Nutr. 2011 Apr 1;141(4):568–73.
11. Schoenfeld BJ, Aragon AA, Krieger JW. The effect of protein timing on muscle strength and hyper-
trophy: a meta-analysis. J Int Soc Sports Nutr. 2013 Dec 3;10:53.
12. Bin Naharudin MN, Yusof A, Shaw H, Stockton M, Clayton DJ, James LJ. Breakfast Omission
Reduces Subsequent Resistance Exercise Performance. J Strength Cond Res. 2019 Jul;33(7):1766.
13. Stote KS, Baer DJ, Spears K, Paul DR, Harris GK, Rumpler WV, et al. A controlled trial of reduced
meal frequency without caloric restriction in healthy, normal-weight, middle-aged adults. Am J Clin
Nutr. 2007 Apr;85(4):981–8.
14. Sutton EF, Beyl R, Early KS, Cefalu WT, Ravussin E, Peterson CM. Early Time-Restricted Feeding
Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in
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Men with Prediabetes. Cell Metab. 2018 Jun 5;27(6):1212-1221.e3.
15. Teixeira FJ, Matias CN, Monteiro CP, Valamatos MJ, Reis JF, Tavares F, et al. Leucine Metabo-
lites Do Not Enhance Training-induced Performance or Muscle Thickness. Med Sci Sports Exerc.
2019;51(1):56–64.
16. Holeček M. Beta‐hydroxy‐beta‐methylbutyrate supplementation and skeletal muscle in healthy and
muscle‐wasting conditions. J Cachexia Sarcopenia Muscle. 2017 Aug;8(4):529–41.
17. Hung W, Liu T-H, Chen C-Y, Chang C-K. Effect of β-hydroxy-β-methylbutyrate Supplementa-
tion During Energy Restriction in Female Judo Athletes. J Exerc Sci Fit. 2010 Jun 1;8(1):50–3.
18. Thomson JS, Watson PE, Rowlands DS. Effects of nine weeks of beta-hydroxy-beta- methylbutyrate
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2009 May;23(3):827–35.
94
Study Reviewed: Skeletal Muscle Fiber Adaptations Following Resistance Training
Using Repetition Maximums or Relative Intensity. Carroll et al. (2019)
Growing More by
Avoiding Failure
BY G RE G NUC KO LS
It’s almost taken as an article of faith in some circles that training

to failure builds more muscle on a per-set basis than training shy of
failure, but a new study found that training well shy of failure caused
more growth. A reexamination of the literature suggests that the last
few reps prior to failure may matter less than many people believe.
95
KEY POINTS
1. In a 10-week training study, one group of highly trained subjects used a program
based on rep maxes that involved going to failure for every exercise, while another
group used a program based on relative intensity that involved training with
somewhat lighter loads while avoiding failure.
2. Measures of fiber hypertrophy and whole-muscle hypertrophy favored the relative
intensity group when avoiding failure.
3. While these results contrast with some prior literature, it’s worth reexamining the
impact of training to failure on muscle growth. Many people believe that the last few
reps before failure are the ones that are most important for hypertrophy, but that’s
far from clear based on the research we have.
I
n recent months, the concept of more, when examining the research we
“effective reps” has gained a lot of have on training at different proximi-
traction in the “evidence-based fit- ties to failure, it becomes clear that the
ness” community. The basic idea is that “effective reps” model has some holes,
the last few reps prior to failure are the and may be a little too specific for its
ones that really matter for hypertrophy. own good.
A natural implication is that, as long as
you’re not overtraining, training clos-
er to failure should yield more muscle Purpose and Hypotheses
growth on a set-by-set basis than stop-
ping further from failure. Purpose
However, a recent finding calls that The purpose of this study was to com-
supposition into question. Over 10 pare the outcomes of programming
weeks, subjects either trained based on with rep maxes or relative intensity.
rep maxes (taking the last set of each Specifically, the authors were inter-
exercise to failure) or based on relative ested in muscle fiber hypertrophy and
intensity (never going to failure, and whole-muscle hypertrophy of the quads
generally staying several reps shy of and changes in signaling proteins.
failure), and the researchers assessed fi-
ber hypertrophy and whole-muscle hy- Hypotheses
pertrophy. Both fiber and whole-mus- The authors hypothesized that pro-
cle hypertrophy tended to be larger gramming with relative intensity would
in the relative intensity group, which lead to more hypertrophy due to supe-
stayed further from failure. Further- rior fatigue management.
96
Table 1 Resistance training programs
Relative intensity Repetition Maximum Zone
Training block Week Sets x Reps Day 1 + 2 Day 3
1 3 x 10 80.0% 70.0% 3 x 8-12
Strength-Endurance 2 3 x 10 85.0% 75.0% 3 x 8-12
3 3 x 10 90.0% 80.0% 3 x 8-12
4 3x5 85.0% 70.0% 3 x 4-6
5 3x5 87.5% 72.5% 3 x 4-6

Max-Strength*
6 3x5 92.5% 75.0% 3 x 4-6
7 3x5 80.0% 65.0% 3 x 4-6
Overreach 8 5x5 85.0% 75.0% 5 x 4-6
9 3x3 87.5% 67.5% 3 x 2-4

Speed-Strength
10 3x2 85.0% 65.0% 3 x 1-3
* = Symbolizes down set at 60% of working weight (Relative Intensity only)
Subjects and Methods strength phase, an overreaching week,

and a speed-strength phase to taper.
Both groups lifted three days per week
Subjects and performed a basic sprint training
18 trained male subjects volunteered program two days per week.
for the study, but 3 subjects dropped For the group using relative intensity,
out, leaving a final sample of 15 sub- the training load each day was assigned
jects. The subjects had an average of 7.7 using a percentage of the weight the
years of training experience and very subject should have been able to han-
high isometric mid-thigh pull strength dle for the sets and reps prescribed. For
(4404N on average, which is equivalent example, if the subject was supposed to
to 449kg or 991lb). do 3 sets of 5 reps, the heaviest weight
they could possibly use for 3 sets of 5
Experimental design
would be 100% relative intensity, and a
The subjects were randomized into load 20% lighter would be 80% relative
two groups. One group (n = 7) trained intensity. So, the actual load used at a
using relative intensity with assigned given relative intensity depends on the
sets and reps, while the other group sets and reps assigned. A relative inten-
(n = 8) trained using repetition maxi- sity of 80% will correspond to a light-
mums. The broad training program was er load for 3 sets of 10 than for 3 sets
similar for both groups. Training lasted of 5. The group using relative intensi-
10 weeks, starting with a strength en- ty trained at higher relative intensities
durance phase, followed by a maximal during the first two lifting days of each
97
Table 2 Training Exercises for All Subjects
Training Block Day 1 Day 2 Day 3
• clean grip mid-thigh pull

• back squat • back squat
•
• overhead press, • overhead press
deadlift
Strength-Endurance • bench press • bench press
• barbell bent-row
• dumbbell tricep • dumbbell tricep
• dumbbell bent lateral
extension extension
raise

• clean pull
• push press • push press
Max-Strength •
• incline bench press • incline bench press
deadlift
• weighted dips • weighted dips
• pull-ups
• clean grip counter-

movement shrug
• clean pull
• push press • push press
Overreach •
• dumbbell step up • dumbbell step up
deadlift
• bench press • bench press
• single arm dumbbell
bent-row
• back squat + rocket • back squat + rocket

jump jump
• clean grip counter-
Speed-Strength • push press • push press
movement shrug
• bench press + med ball • bench press + med ball
• vertical med ball toss
chest pass chest pass
week (80-92.5%) and at lower relative completed more or fewer reps on their
intensities during the last lifting day of last set than their repetition maximum
each week (65-80%). zone called for, load was adjusted up
The group training with repetition or down for the next session. Details
maximums, on the other hand, fol- of the training program can be seen in
lowed essentially the same training Table 1.
program, except they trained at 100% In practice, relative intensities were
relative intensity for every session. So, based on estimated reps in reserve af-
for example, if they were supposed to ter the first and last set in each workout
do 3 sets of 8-12 reps, they’d use a load using Table 3.
that would allow them to reach failure Before and after the training inter-
after performing between 8 and 12 reps vention, the researchers biopsied the
on set three, but they probably didn’t go vastus lateralis (your outside quad mus-
to failure on the first two sets. If they cle) of the subjects to assess changes in
98
Table 3 Load Determination Using Set-rep Best
Prescribed
set-rep
% of set-rep
best
Reps left after Reps left after
last set
fiber cross-sectional area and chang-
70% 7-8 5-6 es in mTOR, AMPK, and myosin
75%
80%
6-7
6-7
5-6
4-5
heavy chain proteins. These biopsies
82.5% 5-6 4 were taken at least 72 hours before the
85% 5-6 3-4
5 x 10
87.5% 4-5 3 pre-training performance assessments
90%
92.5%
4-5
3-4
2-3
2
(discussed in a prior MASS article) and
95% 3-4 1-2 at least 72 hours after the final training
100%
70%
2-3
8-10
0
6-8
session. The researchers also used ultra-
75% 7-8 6-7 sound to assess changes in anatomical
cross-sectional area and muscle thick-
80% 6-7 5-6
82.5% 5-6 5
3 x 10
85% 5-6 4-5
ness of the vastus lateralis.
87.5% 4-5 4
90% 4-5 3-4
92.5% 3-4 2-3
Findings
95% 3-4 1-2
100% 2-3 0
70% 6-8 5-6
75% 5-6 5 Changes in type I fiber cross-sec-
80% 5 4-5
82.5% 4-5 4 tional area, type II fiber cross-section-
5x5
85% 4 3-4
al area, and anatomical cross-sectional
87.5% 3-4 3
90% 3 2-3 area all tended to be larger in the rela-
92.5%
95%
2-3
2-3
2
1-2
tive intensity group, but the differences
100% 1-2 0 weren’t statistically significant. How-
70%
75%
5-6
5
5-6
4-5
ever, the difference was significant for
80% 4-5 4 changes in anatomical cross-sectional
82.5% 4 3-4
85% 3-4 3 area (p < 0.05; again, favoring the rela-
3x5
87.5%
90%
3-4
3
2-3
2
tive intensity group). For all four mea-
92.5% 2-3 1-2 sures of hypertrophy, the within-group
95%
100%
2
1-2
1
0
increase was significant (p < 0.05) for
70% 5 5 the relative intensity group, but there
was only a significant within-group in-
75% 4-5 4-5
80% 4 4
82.5% 3-4 3-4
crease for muscle thickness in the rep
85% 3 3
3x3
87.5% 2-3 2-3 max group. These changes can be seen
90%
92.5%
2-3
2
2
1-2
in Figure 1 (2).
95%
100%
1-2
1
1
0
After 10 weeks of training, resting
70% 4-5 4 mTOR levels decreased similarly in
75%
80%
4
3-4
3-4
3
both groups, though the difference was
82.5% 3 2-3 only statistically significant in the rela-
85% 2-3 2-3
3x2
87.5% 2 1-2 tive intensity group because the change
90%
92.5%
1-2
1
1-2
1
was much more uniform. There were no
95% 1 0-1
100% 1 0
99
Figure 1 Hypertrophy in both groups and between-group effect sizes
A B
d = 0.27 (small) d = 0.99 (large)
8000 8000
*
Type II Fiber CSA (µm2)

Type I Fiber CSA (µm2)
6000 6000
4000
* 4000
2000 2000
0 0
Relative intensity Repetition maximum Relative intensity Repetition maximum
pre post pre post
Changes in (A) type I and (B) type II cross-sectional area pre- to post-intervention.
* = Significance for relative intensity group, p < 0.05
A d = 0.27 (small) B d = 0.42 (small)

50
* 3.5 * †
Muscle thickness (cm)
Anatomical CSA (cm2)
3.0
40
2.5
30 2.0
20 1.5
1.0
10
0.5
0 0.0
Relative intensity Repetition maximum Relative intensity Repetition maximum
pre post pre post
Changes in (A) anatomical cross-sectional area and (B) muscle thickness measured by ultrasonography pre- to post-intervention.
* = Significance for relative intensity group, p < 0.05; † = significance for RM group, p < 0.05
other statistically significant changes in

any of the proteins assessed, likely due Interpretation
to high variance and the small sample If this study sounds familiar to long-
size. However, type IIX myosin tended time MASS readers, it’s because this is
to increase in both groups, and the in- the second paper published from a sin-
crease tended to be a bit larger for the gle study. We reviewed the first paper (3)
relative intensity group. Furthermore, back in Volume 2, Issue 8 if you’d like to
type IIA and type I myosin both tend- check it out. That study focused on per-
ed to increase in the relative intensity formance changes, namely jump height,
group but not the rep max group. Nei- isometric mid-thigh pull strength, and
ther group experienced any meaningful rate of force development. It found that
change in AMPK. the increases in jump height and ear-
ly rate of force development (0-50 ms)
100
Figure 2 Fold-change results from immunoblotting
5
Relative intensity Repetition maximum
3
Fold-Change
1
*
0
-1
-2
mTOR AMPK MHC2X MHC2A MHC1
mTOR = mammalian target of rapamycin; AMPK = adenosine monophosphate kinase; MHC = myosin heavy-chain isoforms
* = significance for relative intensity group, p < 0.05
were considerably larger in the relative to failure takes longer to recover from.
intensity group, but the increases in iso- So, is it possible that the results of this
metric mid-thigh pull force were pretty study – less growth in the rep max
similar between groups. However, the group – are the result of overtraining?
increases seemed to be more consistent Or, at minimum, finding oneself on the
and predictable in the relative intensity downslope of the volume-growth in-
group. verted U relationship?
One thing noted in the prior study Just looking at the details of the
was the training strain (variability in training programs, I think that’s un-
session RPE scores multiplied by av- likely. For most of the study, the sub-
erage session RPE scores) was higher jects were doing just six sets of direct
in the rep max group, and we’ve previ- quad work per week, via three sets of
ously discussed in MASS how training squats on Monday and Friday. Sure,
101
Figure 3
1000
#
900 #
#
800
#
Training Strain (AU)
#
700
#
600
500
#
Relative Intensity
400
Rep max
300
200
100
0
1 2 3 4 5 6 7 8 9 10
Week
# = significant difference
your quads get some stimulation from First, I think it’s worth backing up
dumbbell step-ups (performed in just and examining the prior literature that
one block) and clean pulls, but those has looked at the effects of training at
aren’t exercises that are really going to different proximities to failure. We’ve
fry your quads. Add to that the fact that previously reviewed three such studies
the rep max group was generally only in MASS. One study by Nobrega et al
taking their last set to failure, and I found that training to failure versus “vo-
have a hard time buying that six sets of litional interruption” didn’t lead to dif-
direct quad training, involving just two ferences in hypertrophy when training
weekly sets to failure, with a little an- with either 30% or 80% of 1RM (4); it
cillary quad stimulation, is sufficient to should be noted, however, that the “vo-
overtrain the quads. Furthermore, jump litional interruption” group was basical-
performance held steady and isometric ly training to failure, but just stopping
mid-thigh pull strength increased by al- when they thought they couldn’t get
most 15% in the rep max group, further another rep rather than actually failing
suggesting they weren’t overtrained. their last rep. Another by Martorelli et
So, what gives? al found that training to failure doing
102
biceps curls for 3 sets to failure tended So, right off the bat, we can see that
to cause more hypertrophy than doing results in the literature are all over the
either 3 or 4 sets of 7 with 70% of 1RM place. Thus far, four studies (Nobrega,
(5). Finally, a study by Pareja-Blanco et Pareja-Blanco, Sampson, and Helms)
al found that squatting with within-set have found pretty similar hypertrophy
velocity reductions of 40% (which re- when training at different proximities
sulted in most sets being close to fail- to failure, and three (Martorelli, Goto,
ure, and quite a few sets being taken to and Geissing) have found more growth
failure) or 20% (which resulted in fewer when training to failure versus non-fail-
total reps, and sets generally stopping far ure. However, I think we can toss out
from failure) caused similar increases in two studies for our purposes here. As
both fiber cross-sectional area and quad mentioned, in the Nobrega study (4), the
muscle volume (6). Adding to these “volitional interruption” group was basi-
studies we’ve previously reviewed, a cally training to zero reps in reserve but
study by Geissing et al found that train- not actually failing the final rep, so I don’t
ing to failure caused larger gains in lean think it’s the sort of comparison we’re in-
mass than training to self-determined terested in. The Geissing study (7) is also
rep maxes (7; though that strikes me as a bit hard to parse; we know that lifters
somewhat odd – wouldn’t “rep maxes” are good at knowing how close to failure
also imply going to failure or very close they are if they have three or fewer reps
to failure?). Another study by Goto et in reserve, but apparently the “self-deter-
al found that doing 3-5 sets of 10 with mined rep max” group made virtually no
10RM loads caused more hypertrophy gains, while the “momentary muscular
than doing those same sets of 10, but failure” group made pretty large gains? If
taking a 30-second rest in the middle of that’s true, that would imply that going
each set (i.e. doing 2 mini sets of 5 for until you actually fail a rep is the real key
each set, and not going to failure; 8). A to hypertrophy, which seems unlikely.
study by Sampson found that training Furthermore, that study used single-set
the biceps either to failure or ~2 reps shy training, which makes it less useful for
of failure resulted in similar hypertrophy the vast majority of lifters who do mul-
over 12 weeks (9). Finally, one of Eric tiple sets of each exercise. However, that
Helms’ PhD thesis studies found that still leaves us with three studies finding
two groups training with significantly similar hypertrophy at different proxim-
different amounts of reps in reserve (one ities to failure, and two studies finding
group was generally going 1-3 reps clos- greater hypertrophy when training to
er to failure) had similar pec and quad failure versus not going to failure.
growth over 8 weeks (10). One key detail to note, however, is that
103
the Helms study and the Pareja-Blan- in the group doing fewer “effective reps,”
co study both used trained lifters, while it’s clear that the “effective reps” mod-
the other remaining studies all used un- el is missing something. In fact, we can
trained subjects. Thus, both studies with roughly calculate the number of “effec-
trained lifters found similar hypertrophy tive reps” in both of the programs in the
in spite of different proximities to failure, present study. Using the reps in reserve
while two of the studies on untrained ranges provided in the relative intensi-
lifters (Goto and Martorelli) found that ty chart, the relative intensity group did
going to failure caused more growth, somewhere between 34 and 66 “effective
and only one (Sampson) found similar reps” of squats, while the rep max group
hypertrophy with different proximities did about 234, meaning the relative in-
to failure. So, based on the literature we tensity group was only averaging 1.7-3.3
have, it seems that training to failure or “effective reps” per squat session (which,
closer to failure may be more important in the “effective reps” model, should be
for untrained lifters, while trained lifters equivalent to just doing one set of 2 or 3
may have a little more leeway. reps to failure), while the rep max group
Why might that be? was averaging 11.7. In fact, most of the
lower intensity Day 3 workouts for the
Well, we need to start by theorizing
relative intensity group would have had
about what causes muscle growth in the
0 “effective reps,” and would thus be con-
first place. There’s been a lot of discus-
sidered a complete waste of time from a
sion about this recently, with one of the
hypertrophy standpoint (11).
popular suggestions being the idea of
“effective reps.” In fact, this model has I propose that we apply Occam’s razor
become so popular and ubiquitous on- (22): look for the simplest explanation
line, it seems that a lot of people just ac- given what we know. We know – or at
cept it as if it’s proven fact. This model least have very good reason to suspect –
implies that the last five reps before fail- that a muscle fiber needs to be recruit-
ure are the ones that are the most cru- ed and exposed to tension for it to grow
cial for hypertrophy. However, I think (12). We also know – or at least have
the experimental evidence suggests that very good reason to suspect – that some
the “effective reps” model leaves some- level of acute local fatigue is required to
thing to be desired. When the Pare- maximize growth. Otherwise, people
ja-Blanco, Helms, and Sampson stud- would get jacked from doing maximal
ies all had substantial differences in the singles, and there would be no reason
number of “effective reps” each group that doing more sets would cause more
was exposed to, and when the presently growth than a single set to failure. So,
reviewed study found more hypertrophy that’s what I propose we consider: re-
104
cruitment and fatigue. I’m not propos- fiber). So, energy demands go up, but
ing anything more specific (i.e. a specific the ability to meet those demands aer-
level of fatigue), because we don’t have obically doesn’t change much, meaning
sufficient evidence to justify anything the anaerobic contributions to energy
more specific. expenditure increase, promoting greater
Through that lens, I think it’s logi- metabolic fatigue on a per-rep or per-set
cal that untrained lifters may need to basis. So, with both of those consider-
go closer to failure than trained lifters ations in mind, I don’t think it’s shock-
to maximize hypertrophy. One adapta- ing that untrained lifters seem to ben-
tion to heavy resistance training is that efit more from training to failure than
synchronous recruitment of motor units trained lifters do.
improves (13). In other words, from the However, all of this rambling about
first rep of a set, you can “switch on” hypertrophy in general still doesn’t quite
more motor units. We know that mo- explain the results of this specific study:
tor unit recruitment increases as a lifter more hypertrophy when training fur-
fatigues throughout a set, such that all ther from failure. The coward’s way out
motor units are eventually recruited by would just be to chalk it up to sampling
at least the point of failure (14), but like- error and call it a day, or to go back and
ly a few reps shy of failure (15). However, delete the third paragraph of this inter-
due to improvements in synchronous re- pretation section to leave open the op-
cruitment, I think it’s likely that trained tion of overtraining. However, that’s not
lifters can reach the point of full motor what I’m going to do. No, I’m going to
unit recruitment earlier in a set than un- propose that the key may be a part of the
trained lifters do, especially when trying training program that’s easy to overlook:
to lift explosively (16). Furthermore, it the sprint training.
should be clear that trained lifters can I’m sure most MASS readers are aware
induce more metabolic fatigue on a per- of the interference effect: the idea that
rep basis than untrained lifters. Energy doing combined strength training and
demands of training scale linearly with conditioning work tends to lead to less
work rate, so if you double the weight muscle growth and smaller strength
on the bar, you double the energy de- gains than just doing strength training.
mands. However, mitochondrial densi- It’s a concept we’ve covered a few times
ty generally doesn’t increase with resis- in MASS (one, two, three, four). How-
tance training, nor does capillary density ever, not all studies support the existence
(measured as capillaries per unit of mus- of the interference effect. In fact, some-
cle cross-sectional area, though there’s times, the results swing the opposite di-
sometimes an increase in capillaries per rection. I’m aware of four studies where
105
Going to failure or very close to failure seems to be important for maximizing
hypertrophy (on a per-set basis, at least) in untrained lifters, but trained lifters may
be able to get away with (and even benefit from) stopping further from failure,
though more research is needed in this area. At least on heavy compound exercises
(especially squats and deadlifts), it’s probably wise to stop a few reps shy of failure,
and you may not be missing out on any growth by doing so. If you’re afraid that
avoiding failure may be leaving some extra gains untapped, save failure for single-
joint exercises.
concurrent training led to more hyper- ing levels of mTOR and AMPK are; the
trophy than only resistance training. Two changes (or lack thereof ) were also sim-
of them used isokinetic exercise for the ilar between groups, so I’m just going to
resistance training, so it’s hard to know punt on those findings.The authors of the
how the training protocol compared to study even note that most studies look at
traditional resistance training (17, 18). post-training changes in these proteins,
However, the other two were by Ka- rather than resting levels, so there’s not
zior et al (19) and Mikkola et al (20). In even much literature to get one’s bear-
both studies, the majority of the training ings. However, if I’m understanding the
wasn’t performed to failure (18 of 21 ses- results correctly, the changes in levels of
sions in Kazior et al, and 14 of 21 weeks the various myosin isoforms would re-
in Mikkola et al). It’s possible that do- flect density changes. In other words,
ing most of the resistance training shy of this study found disproportionate my-
failure is what allowed concurrent train- ofibrillar hypertrophy occurred (that is,
ing to lead to more hypertrophy in these an increase in density of contractile pro-
two studies, while it generally leads to teins), primarily in the relative intensity
less growth in the majority of the litera- group, as opposed to the disproportion-
ture. It’s possible that conditioning work ate sarcoplasmic hypertrophy reported
and non-failure resistance training are in the study we recently reviewed by
synergistic (as long as the volume of the Haun et al (21). Since most of the train-
conditioning work isn’t excessive), while ing in the presently reviewed study in-
conditioning work and resistance train- volved sets of five or fewer, since volume
ing to failure are antagonistic. was relatively low, and since the increas-
The last piece of this study to touch on es in myosin density were greater in the
is the change in protein levels. I’m really relative intensity group, these findings
not sure how relevant changes in rest- lend further support to my supposition
that training with lower volumes, few-
106
er reps, and training further from failure
are more likely to promote myofibrillar
rather than sarcoplasmic hypertrophy.
Next Steps
I’d personally like to see more research
fleshing out my hypothesis that condi-
tioning work and non-failure resistance
training are synergistic. A study could in-
volve four groups: one group only doing
resistance training to failure, one group
only doing resistance training with 2-5
reps in reserve, one group doing condi-
tioning plus resistance training to failure,
and one group doing conditioning plus
resistance training with 2-3 reps in re-
serve. Regardless of the outcomes, such
a study would help flesh out the efficacy
of training to failure, and whether that
relationship is moderated by additional
conditioning work.
I’d also like to see this study replicat-
ed while increasing volume rather than
intensity. The training protocol in this
study was designed like a strength pro-
gram rather than a hypertrophy program
(both in terms of exercises and progres-
sion of loads). Instead of going from
3x10 to 3x5 to 3x2-3, we could have
more confidence in the real-world ap-
plicability of these results if the training
progressed block-to-block from 3x10 to
4x10 to 5x10, and used more exercises
that one would commonly use in a hy-
pertrophy program.
107
References
1. Carroll KM, Bazyler CD, Bernards JR, Taber CB, Stuart CA, DeWeese BH, Sato K, Stone MH.
Skeletal Muscle Fiber Adaptations Following Resistance Training Using Repetition Maximums or
Relative Intensity. Sports (Basel). 2019 Jul 11;7(7).
2. It’s possible that the between-group effect size for type II fibers may be too large here. As is common,
the between-group effect size reported in the text was calculated in a non-standard way. When recal-
culating them, I had to use a table in the text that definitely had at least one typo, and may have had
two. The definite typo is that post-training muscle thickness is reported as 3.62cm for the relative
intensity group, but looking at the graph, it’s clear that it’s 2.62. For the type II fibers, pre-training
type II CSA for the relative intensity group is reported as 4079. Looking at the graph, I also don’t
think that’s correct. If it was actually 4879 (basically the same as the rep max group, which is how it
looks on the graph), then the between-group effect size for type II fiber hypertrophy would actually
be d = 0.30.
3. Carroll KM, Bernards JR, Bazyler CD, Taber CB, Stuart CA, DeWeese BH, Sato K, Stone MH.
Divergent Performance Outcomes Following Resistance Training Using Repetition Maximums or
Relative Intensity. Int J Sports Physiol Perform. 2018 May 29:1-28.
4. Nóbrega SR, Ugrinowitsch C, Pintanel L, Barcelos C, Libardi CA. Effect of Resistance Training
to Muscle Failure vs. Volitional Interruption at High- and Low-Intensities on Muscle Mass and
Strength. J Strength Cond Res. 2018 Jan;32(1):162-169.
5. Martorelli S, Cadore EL, Izquierdo M, Celes R, Martorelli A, Cleto VA, Alvarenga JG, Bottaro M.
Strength Training with Repetitions to Failure does not Provide Additional Strength and Muscle
Hypertrophy Gains in Young Women. Eur J Transl Myol. 2017 Jun 27;27(2):6339.
6. Pareja-Blanco F, Rodríguez-Rosell D, Sánchez-Medina L, Sanchis-Moysi J, Dorado C, Mora-Cus-
todio R, Yáñez-García JM, Morales-Alamo D, Pérez-Suárez I, Calbet JAL, González-Badillo JJ.
Effects of velocity loss during resistance training on athletic performance, strength gains and muscle
adaptations. Scand J Med Sci Sports. 2017 Jul;27(7):724-735.
7. Gieβsing J, Fisher J, Steele J, Rothe F, Raubold K, Eichmann B. The effects of low-volume resistance
training with and without advanced techniques in trained subjects. J Sports Med Phys Fitness. 2016
Mar;56(3):249-58.
8. Goto K, Ishii N, Kizuka T, Takamatsu K. The impact of metabolic stress on hormonal responses and
muscular adaptations. Med Sci Sports Exerc. 2005 Jun;37(6):955-63.
9. Sampson JA, Groeller H. Is repetition failure critical for the development of muscle hypertrophy and
strength? Scand J Med Sci Sports. 2016 Apr;26(4):375-83.
10. Helms ER, Byrnes RK, Cooke DM, Haischer MH, Carzoli JP, Johnson TK, Cross MR, Cronin JB,
Storey AG, Zourdos MC. RPE vs. Percentage 1RM Loading in Periodized Programs Matched for
Sets and Repetitions. Front Physiol. 2018 Mar 21;9:247.
11. To calculate the “effective rep” range for the relative intensity group, I went with the highest and
lowest number of “effective reps” that could have occurred, given the reps in reserve ranges provided
in the study. So, for example, if doing 3x10 with a relative intensity of 90%, you’d be aiming for 4-5
reps in reserve on the first set and 3-4 reps in reserve on the last set. On the low end, you could have
108
5 reps in reserve for the first two sets (0 “effective reps”) and 4 reps in reserve for the final set (1
“effective rep”). On the high end, you could have 4 reps in reserve for the first set (1 “effective rep”)
and 3 reps in reserve on the second and third sets (2 “effective reps” for each session). Thus, the total
number of “effective reps” could be anywhere between 1 and 5. For the rep max group, I just assumed
set 1 was stopped with 2 reps in reserve (3 “effective reps”), the second to last set was stopped with 1
rep in reserve (4 “effective reps”), and the final set was taken to failure (5 “effective reps”).
12. The whole signaling cascade whereby mechanical signals eventually lead to muscle protein synthesis
seems to be kicked off by a protein called focal adhesion kinase. It’s activated when the membrane
or a fiber is stressed, which likely only happens to a significant degree when that fiber is recruited.
Though fibers could experience some level of tension due to lateral force transmission within the
muscle, it’s unknown whether that can cause enough stress to the sarcolemma to activate focal ad-
hesion kinase.
13. Bandy WD, Lovelace-Chandler V, McKitrick-Bandy B. Adaptation of skeletal muscle to resistance
training. J Orthop Sports Phys Ther. 1990;12(6):248-55.
14. Morton RW, Sonne MW, Farias Zuniga A, Mohammad IYZ, Jones A, McGlory C, Keir PJ, Potvin
JR, Phillips SM. Muscle fibre activation is unaffected by load and repetition duration when resis-
tance exercise is performed to task failure. J Physiol. 2019 Jul 11.
15. Sundstrup E, Jakobsen MD, Andersen CH, Zebis MK, Mortensen OS, Andersen LL. Muscle ac-
tivation strategies during strength training with heavy loading vs. repetitions to failure. J Strength
Cond Res. 2012 Jul;26(7):1897-903.
16. van den Tillaar R, Andersen V, Saeterbakken AH. Comparison of muscle activation and kinematics
during free-weight back squats with different loads. PLoS One. 2019 May 16;14(5):e0217044.
17. Lundberg TR, Fernandez-Gonzalo R, Tesch PA. Exercise-induced AMPK activation does not in-
terfere with muscle hypertrophy in response to resistance training in men. J Appl Physiol (1985).
2014 Mar 15;116(6):611-20.
18. Lundberg TR, Fernandez-Gonzalo R, Gustafsson T, Tesch PA.Aerobic exercise does not compro-
mise muscle hypertrophy response to short-term resistance training. J Appl Physiol (1985). 2013 Jan
1;114(1):81-9.
19. Kazior Z, Willis SJ, Moberg M, Apró W, Calbet JA, Holmberg HC, Blomstrand E. Endurance
Exercise Enhances the Effect of Strength Training on Muscle Fiber Size and Protein Expression of
Akt and mTOR. PLoS One. 2016 Feb 17;11(2):e0149082.
20. Mikkola J, Rusko H, Izquierdo M, Gorostiaga EM, Häkkinen K. Neuromuscular and cardiovascular
adaptations during concurrent strength and endurance training in untrained men. Int J Sports Med.
2012 Sep;33(9):702-10.
21. Haun CT, Vann CG, Osburn SC, Mumford PW, Roberson PA, Romero MA, Fox CD, Johnson CA,
Parry HA, Kavazis AN, Moon JR, Badisa VLD, Mwashote BM, Ibeanusi V, Young KC, Roberts
MD. Muscle fiber hypertrophy in response to 6 weeks of high-volume resistance training in trained
young men is largely attributed to sarcoplasmic hypertrophy. PLoS One. 2019 Jun 5;14(6):e0215267.
22. I also propose we start calling it Ptolemy’s razor. Ptolemy was writing almost 1300 years before
William of Ockham when he stated: “We consider it a good principle to explain the phenomena by
the simplest hypothesis possible.” That’s also more similar to the common usage of the term than
Ockham’s statement: “Plurality must never be posited without necessity.”
█
109
VIDEO: Understanding the
Research Process, Part 3
BY MIC HAE L C . ZO URD O S
After Parts 1 and 2, we now understand everything that goes into the
research process, all the way through publishing a study. But, what now?
Now, the practitioner takes over. Part 3 discusses how to think conceptually
to implement research findings.
Click to watch Michael's presentation.
110
Relevant MASS Videos
1. Understanding the Research Process Part 1. (Volume 3 Issue 7)
2. Understanding the Research Process Part 2. (Volume 3 Issue 8)
3. Nuckols G. When to Trust the Results of a Study. MASS Volume 2, Issue 10.
4. The MASS Team. The Basics of Interpreting Research: A How to Guide for Each Section.
References
liams KE, Carter AS, Ross CL, Just BL. Longer interset rest periods enhance muscle strength and
hypertrophy in resistance-trained men. Journal of strength and conditioning research. 2016 Jul
1;30(7):1805-12.
2. Zourdos MC, Jo E, Khamoui AV, Lee SR, Park BS, Ormsbee MJ, Panton LB, Contreras RJ, Kim
JS. Modified daily undulating periodization model produces greater performance than a tradi-
tional configuration in powerlifters. The Journal of Strength & Conditioning Research. 2016 Mar
1;30(3):784-91.
3. Ferreira DV, Gentil P, Ferreira-Junior JB, Soares SR, Brown LE, Bottaro M. Dissociated time course
between peak torque and total work recovery following bench press training in resistance trained
men. Physiology & behavior. 2017 Oct 1;179:143-7.
111
VIDEO: Energy Density: A
Forgotten Component, Part 2
BY E RI C HE LMS
Eric Helms is back in part 2 of his series on energy density. In this video, he covers
how energy density fits into a multi-component model of satiety, data showing
that a combined approach to satiety management can be impressively effective for
weight loss and maintenance, and how to leverage energy density and other aspects
of hunger control as a practitioner and athlete.
Click to watch Eric's presentation.
112
References
1. Roberts SB, Urban LE, Das SK. Effects of dietary factors on energy regulation: Consideration of
multiple-versus single-dietary-factor models. Physiology & behavior. 2014 Jul 1;134:15-9.
2. Nguyen V, Cooper L, Lowndes J, Melanson K, Angelopoulos TJ, Rippe JM, Reimers K. Popcorn
is more satiating than potato chips in normal-weight adults. Nutrition journal. 2012 Dec;11(1):71.
3. Vadiveloo M, Parker H, Raynor H. Increasing low-energy-dense foods and decreasing high-ener-
gy-dense foods differently influence weight loss trial outcomes. International Journal of Obesity.
2018 Mar;42(3):479.
4. Larsen TM, Dalskov SM, van Baak M, Jebb SA, Papadaki A, Pfeiffer AF, Martinez JA, Handjie-
va-Darlenska T, Kunešová M, Pihlsgård M, Stender S. Diets with High or Low Protein Content
and Glycemic Index for Weight-Loss Maintenance. The New England journal of medicine. 2010
Nov 25;363(22):2102.
5. Arguin H, Tremblay A, Blundell JE, Després JP, Richard D, Lamarche B, Drapeau V. Impact of
a non-restrictive satiating diet on anthropometrics, satiety responsiveness and eating behaviour
traits in obese men displaying a high or a low satiety phenotype. British Journal of Nutrition. 2017
Nov;118(9):750-60.
113
Just Missed the Cut
Every month, we consider hundreds of new papers, and they can’t all be included
in MASS. Therefore, we’re happy to share a few pieces of research that just missed
the cut. It’s our hope that with the knowledge gained from reading MASS, along
with our interpreting research guide, you’ll be able to tackle these on your own.
• Nagao et al. A Biomechanical Comparison of Successful and Unsuccessful Snatch

Attempts among Elite Male Weightlifters
• da Silva et al. Acute Effects of Inter-Set Rest Period Foam Rolling on Repetition
Performance in Strength Training
• Pastor et al. Antioxidant Supplementation and Adaptive Response to Training: A
Systematic Review
• Angleri et al. Are resistance training systems necessary to avoid a stagnation and
maximize the gains muscle strength and hypertrophy?
• Zacharia et al. Changes in Muscle Power and Muscle Morphology with Different
Volumes of Fast Eccentric Half-Squats
• Ferland and Comtois. Classic Powerlifting Performance: A Systematic Review
• Wetmore et al. Cluster Set Loading in the Back Squat: Kinetic and Kinematic
Implications
• Latella et al. Differences in Strength Performance Between Novice and Elite Athletes:
Evidence From Powerlifters
• Valenzuela et al. Does Beef Protein Supplementation Improve Body Composition
and Exercise Performance? A Systematic Review and Meta-Analysis of Randomized
Controlled Trials
• Isenmann et al. Ecdysteroids as non-conventional anabolic agent: performance
enhancement by ecdysterone supplementation in humans
• Hormoznejad et al. Effect of BCAA supplementation on central fatigue, energy
metabolism substrate and muscle damage to the exercise: a systematic review with
meta-analysis
• Massaro et al. Effect of Cocoa Products and Its Polyphenolic Constituents on Exercise
Performance and Exercise-Induced Muscle Damage and Inflammation: A Review of
Clinical Trials
• Wessner et al. Effects of acute resistance exercise on proteolytic and myogenic
markers in skeletal muscles of former weightlifters and age-matched sedentary
controls
• Kubo et al. Effects of squat training with different depths on lower limb muscle
114
volumes
• Lopes-Silva et al. Isolated ingestion of caffeine and sodium bicarbonate on repeated
sprint performance: A systematic review and meta-analysis
• Paoli et al. Mind-muscle connection: effects of verbal instructions on muscle activity
during bench press exercise
• Morton et al. Muscle fibre activation is unaffected by load and repetition duration
when resistance exercise is performed to task failure
• Iraki et al. Nutrition Recommendations for Bodybuilders in the Off-Season: A Narrative
Review
• Sheridan et al. Presence of Spotters Improves Bench Press Performance: A Deception
Study
• Lim et al. Resistance Exercise-induced Changes in Muscle Metabolism are Load-
dependent
• Chandrasekaran et al. Science of sleep and sports performance – a scoping review
• Palmer et al. Strategies to Counter Weight Loss-Induced Reductions in Metabolic
Rate
• Ibbott et al. The Effect of Self-Paced and Prescribed Interset Rest Strategies on
Performance in Strength Training
• Lehecka et al. The effects of gluteal squeezes compared to bilateral bridges on gluteal
strength, power, endurance, and girth
• Cui et al. The longitudinal association between alcohol consumption and muscle
strength: A population-based prospective study
115
Thanks for
reading MASS.
The next issue will be released to
subscribers on October 1.
Graphics by Katherine Whitfield, and layout design by Lyndsey Nuckols.
116

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V O L U ME 3 , ISS U E 9 SEP T EMBER 2 0 1 9

E R IC H E LMS | G R E G N UCK O LS | MIC HAEL ZO URDO S | ERIC T REXL E R

The MASS Team

When it Comes to Hypertrophy, Not All Multi-Joint Exercises are

RPE and RIR: The Complete Guide

The Poptart Problem: Processed Foods and Overeating

Does Alcohol Impair Recovery from Resistance Exercise?

Short-Term Variations in Training Stimulus Don’t Cause More Growth

Sodium Bicarbonate Benefits Continue to be Equivocal

Does Intermittent Fasting Limit Strength and Muscle Gains?

Growing More by Avoiding Failure

VIDEO: Understanding the Research Process, Part 3

VIDEO: Energy Density: a Forgotten Component, Part 2

When it Comes to Hypertrophy,

I Purpose and Hypotheses

Number Age (years) Height (cm) Weight (kg) BMI (kg/m2)

10 men 29.2 ± 3.85 178.30 ± 7.29 96.4 ± 17.93 30.19 ± 4.46

Interpretation if you try to do DB rows super strictly,

Muscle thickness normalized

rows can hardly challenge any muscula- 0.15

tion) simply due to how weak your lats

with DB row technique is a really im- Single-joint Multijoint

External shoulder flexion

1. Mannarino P, Matta T, Lima J, Simão R, Freitas de Salles B.Single-Joint Exercise Results

RPE and RIR:

Traditionally, RPE has been used in RPE Score Exertion Level

a different context than how the fitness

in 1970 (1), during Helms’s freshman 8

200 beats per minute; this range of 60 to 13 Somewhat hard

200 beats per minute roughly represents 14

eration of RPE was to gauge effort levels 16

during aerobic exercise. Borg then added

levels in a simpler 0-10 rating system. 19 Very, very hard

even when going to failure on the Borg 0.5 Extremely light/weak

scale. Thus, it was concluded that the

ers tend to gauge cardiovascular effort 3 Moderate

time this concept had been broached 6

time it had been presented in general. In 8 Very strong

fact, around the time of his gold medal

the Reactive Training Systems Manual * Maximal

ant to make sure he gets the credit. Fur- 9 1RIR

ther, this is an excellent example of how 8.5

the practical realm is sometimes ahead 8 2RIR

of science and how what is already done 7.5

in practice can, and sometimes should, 7 3RIR

impact scientific research. 5-6 4-6 RIR

Although not the focus of this concept 3-4

review, I would be remiss to exclude in 1-2

Mesocycle 1 Mesocycle 2 Mesocycle 3 Mesocycle 4

Day 1 3 x 10 @ 5-7 RPE 3 x 8 @ 6-8 RPE 3 x 6 @7-9 RPE 3 x 5 @8-9.5 RPE

Day 2 4 x 8 @ 5-7 RPE 4 x 6 @ 6-8 RPE 4 x 4 @7-9 RPE 3 x 3 @8-9.5 RPE

RPE = Rating of Perceived Exertion

a guide for how to adjust load. There- 1 Increase load by 20%

fore, in Table 5, I have included the ta- 2 Increase load by 16%

ble from Dr. Helms’s dissertation that 3 Increase load by 12%

provides this load adjustment guide. You 4 Increase load by 8%

don’t have to follow this table exactly, 5 Increase load by 4%

but it provides the general idea of how 6 Lifter’s choice

as it will become difficult to hit an exact 9.5 Decrease load by 6%