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
training is more time-efficient, but
that adding some single-joint train-
ing to your routine may increase mus-
cle growth a bit. However, not much
research has directly compared single
joint and multi-joint training on a set-
for-set basis. The present study com-
pared the effects of dumbbell biceps
curls and dumbbell rows on biceps hy-
pertrophy and strength in the biceps
curl and dumbbell row. Strength gains
were exercise-specific, and the curls
predictably led to more biceps hyper-
trophy. However, while the results of
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
single-joint training is needed will be
useful to most readers.
Purpose
The purpose of this study was to
compare hypertrophy and strength
gains after eight weeks of either biceps
curl or dumbbell row training.
Hypotheses
The authors hypothesized that curls
would lead to more elbow flexor hy-
pertrophy and that strength gains
would adhere to the principle of speci-
ficity (e.g. larger gains in dumbbell row
strength with the arm doing dumbbell
rows, and larger gains in biceps curl
strength in the arm doing biceps curls).
Subjects and Methods
Subjects
Ten untrained men volunteered for

7
 Table 1 Subject characteristics
Number Age (years)
10 men 29.2 ± 3.85
this study. They were all between 25 and
40 years old. More details about the sub-
jects can be seen in Table 1.
Experimental Design
This study employed a within-subject
unilateral design. In other words, for
each subject, one arm was assigned to do
curls, and the other arm was assigned to
do dumbbell rows; since all subjects were
right-handed, half of the subjects did
curls with their right arm and rows with
their left arm, and half of the subjects
did rows with their right arm and curls
with their left arm. This type of design
allows each subject to serve as their own
control, which removes a considerable
amount of between-group variance that
can result from sampling error or lifestyle
differences. For example, if one subject
has great genetics and a lifestyle that’s
very conducive to hypertrophy, both of
his arms will be affected by those factors;
with a typical parallel group design, that
subject would just be randomized to one
group and could drag the group mean
up in a way that doesn’t reflect the “true”
effect of the training intervention.
Initial testing involved muscle thick-
ness measurements of the elbow flexors
at three sites along the humerus (25%,
50%, and 75% of humerus length), and
Height (cm) Weight (kg) BMI (kg/m2)
178.30 ± 7.29 96.4 ± 17.93 30.19 ± 4.46
10RM strength for dumbbell curls and
dumbbell rows, performed with both
arms. Both exercises were performed
with a supinated (i.e. underhand) grip.
Muscle thickness and 10RM strength
measurements were repeated following
eight weeks of training.
The training consisted of two ses-
sions per week for eight weeks. Subjects
trained to failure on all sets, and loads
were adjusted so that failure occurred
between 8 and 12 reps on each set.
During the first four weeks, the subjects
performed four sets for each exercise
(i.e. four sets of curls with the right arm
and four sets of rows with the left arm)
with two minutes between sets. During
the second four weeks, the subjects per-
formed six sets for each exercise.
Findings
All of the researchers’ hypotheses were
correct. 10RM dumbbell row strength
increased more in the arms performing
dumbbell rows, and 10RM biceps curl
strength increased more in the arm do-
ing curls (p < 0.001 for both). Further-
more, elbow flexor thickness increased by
roughly twice as much (11.1% vs. 5.2%)
in the arm doing curls compared to the
arm doing rows (p = 0.009).
8
 Figure 1 Ten repetition changes normalized on dumbbell row exercise
60
p < 0.001
10RM Normalized
40
20
0 0
Single-joint Multijoint
Interpretation
Right off the bat, there’s one key detail
that bothers me a bit about this study: It
doesn’t clarify how technique was stan-
dardized for the two exercises. For some
exercises that doesn’t matter too much.
For example, if a study uses the bench
press, you can be pretty confident the
lifters at least touched their chest and
locked out each rep, unless stated oth-
erwise. But for curls and especially DB
rows, it’s not that straightforward. The
study states: “standard exercise tech-
niques were followed for each exercise
to guarantee proper form, and verbal
encouragement was provided during all
the tests for all subjects. All individuals
were instructed to avoid initial momen-
tum.” How was “proper form” defined?
At what level of “initial momentum” did
the researchers terminate a set? Were
there objective criteria? Questions like
that matter. I’m sure you’ve noticed that
Figure 2 Ten repetition changes normalized on biceps curl exercise
80 p < 0.001
60
10RM Normalized
40
20
Single-joint Multijoint
if you try to do DB rows super strictly,
the load you can use is severely compro-
mised compared to using just a small
amount of body English. One reason for
that phenomenon is that the lats’ shoul-
der extension moment arm quickly ap-
proaches zero as your elbows come in
line with your torso (i.e. as your shoul-
der flexion angle approaches zero; 2).
So, your lats go from being able to pro-
duce a lot of shoulder extension torque at
the start of a DB row to very, very little
shoulder extension torque as you reach
the top position of the lift. That issue is
compounded by the fact that the exter-
nal moment arm the lats are working
against is the longest as you approach the
top position; in other words, it’s an exer-
cise with a pretty bad resistance curve, all
things considered: It’s the hardest where
you’re the weakest, and the easiest where
you’re the strongest.
If the dumbbell doesn’t already have
9
some momentum, you can’t really grind
out those last few inches of a dumbbell
row. As such, just a little “cheating” al-
lows the DB row to be a generally ef-
Muscle thickness normalized
fective exercise, whereas super strict DB
rows can hardly challenge any muscula-
ture except for your lats (and only in a
very small portion of the range of mo-
tion) simply due to how weak your lats
are in a fully contracted position. In oth-
er words, how strict the researchers were
with DB row technique is a really im-
portant consideration, and I can’t pos-
sibly conceive of how they could have
been incredibly objective about it.
With that out of the way, I’d like to
make a hard left turn to briefly discuss
the philosophical aspects of experimen-
tal design. When you design an experi-
ment, you’re typically interested in an-
swering a somewhat general question.
In this case: “Does multi-joint training
cause as much hypertrophy in a partic-
ular muscle group as single-joint train-
ing that specifically targets that muscle
group?” However, it’s impossible to set
up a single experiment that answers that
general question. Answering that gen-
eral question would require assessing all
multi-joint exercises and all single-joint
exercises, which is completely infeasible
to tackle in a single experiment. Instead,
you substitute the general question for a
specific question that you hope will be a
sufficient stand-in for the general ques-
tion. In this case: “Do DB rows and DB
curls cause similar biceps hypertrophy?”
Figure 3 Elbow flexors thickness mean changes and SD
0.25 p < 0.009
0.20
0.15
0.10
0.05
0.00
Single-joint Multijoint
Is that a specific question that will get
us closer to answering the general ques-
tion we’re interested in? Absolutely! But
is that synonymous with and identical
to the general question itself ? Not at
all. As such, this study did find that DB
curls built more muscle than DB rows,
but the title of the study (“Single-Joint
Exercise Results in Higher Hypertro-
phy of Elbow Flexors than Multijoint
Exercise”) is a reach, as it implies that
answering the specific question implied
by the study design also answered the
general question alluded to in the title.
I’m not trying to pick on these authors;
virtually everyone does it. I just wanted
to point this out because a lot of people
are quick to skim titles and abstracts and
not think critically about what a study is
literally testing, rather than the general
questions it’s merely scratching the sur-
face of.
So now let’s actually dig into the re-
sults of this study. One thing about the
10
results of this study struck me as some-
what odd: Even though this study used
a within-subject unilateral design, the
subjects barely got stronger at all with
the exercises they weren’t directly train-
ing (i.e. the DB row arms barely in-
creased their curl strength, and vice ver-
sa). Since these were untrained subjects,
I’d expect considerable strength gains
for the untrained movements simply
due to the cross-education effect (a 2017
meta-analysis suggests that the average
strength gains in the untrained limb are
about 40% as large as those seen in the
trained limb: 3). In an untrained popu-
lation, the cross-education effect is large
enough that, for example, a leg train-
ing at 30% of 1RM can increase 1RM
strength just as much as a leg training
at 80% 1RM (4). Add in the fact that
DB rows should directly increase biceps
strength, at least a little, and I’m pretty
surprised that the arms doing rows saw
such pitifully small increases in biceps
curl 10RM (and vice versa). That’s not
a huge deal – it just caught my eye as
something unexpected.
At this point, I feel like I’ve almost
run the topic of multi-joint versus sin-
gle-joint training into the ground (see
our most recent article on the subject
here). I still wanted to review this study,
though, for two main reasons:
1. Surprisingly, it’s one of just two stud-
ies that compares multi-joint and
single-joint exercises straight up on a
set-for-set basis. The majority of the
other studies in this general body of
literature look at the effects of adding
single-joint training to a program of
multi-joint training.
2. Basically all of the prior studies look-
ing at the effects of single-joint versus
multi-joint training for arm growth
use pull-downs as the multi-joint ex-
ercise for the biceps. Throwing rows
into the mix adds a new wrinkle to
the literature.
In the most directly comparable study,
Gentil et al compared biceps curls to
pull-downs and found that they had
similar effects on biceps hypertrophy
(5). This present study found that curls
caused considerably more elbow flexor
hypertrophy than rows. This loops back
around to my discussion/rant of gen-
eral versus specific research questions.
Both studies were examining the gen-
eral question of multi-joint versus sin-
gle-joint training, and they were even
assessing the same muscle group, but the
choice of multi-joint exercise had a big
impact on the results of these two stud-
ies. Pull-downs seem to do a pretty good
job of causing biceps growth, while DB
rows are pretty lackluster.
With that in mind, I’d like to wrap up
by sharing some general thoughts about
when multi-joint exercises are likely to
do a pretty good job of growing a partic-
ular muscle group, and when other ex-
ercises, including single-joint exercises,
may be needed to maximize hypertro-
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
in play:
1. How long is the range of motion for
the target muscle?
2. Is the target muscle likely to limit
performance in the exercise you’ve
chosen?
Starting with range of motion, it’s clear
that the triceps contribute to the bench
press. However, if you bench with a wide
grip, your elbows don’t go through any-
thing even approaching their full range
of motion. Thus, while bench press can
clearly cause triceps growth, it’s un-
likely that it maximizes triceps growth.
Similarly, your quads clearly contribute
heavily to sumo deadlifts, but a sumo
deadlift doesn’t even approach full knee
range of motion, so while sumo deadlifts
can probably cause quad growth, it’s un-
likely that they maximize quad growth.
Conversely, shoulder press (unless you
take a weirdly wide grip) and close grip
bench do approach full range of motion
for the elbows, so they likely do a better
job of causing triceps growth than wide
grip bench, and may do as good of a job
of growing the triceps as isolation exer-
cises would (or at least come very close).
Similarly, machine hack squats take your
knees though something approaching
full range of motion, so they do a stellar
job at building the quads.
The second criteria – whether you’re
limited by the target muscle group – is
a little more individualized. For a clear
example from the literature: It’s not at
12
 Figure 6
resistance curve of the dumbbell row
Strength of the lats
Bottom
position
all uncommon to fail a set of pull-downs
because your biceps wore out (especially
for newer lifters), but it’s pretty unlikely
that you’ll fail a rep during a set of DB
rows because your biceps wore out. Thus,
the results of the presently reviewed
study and the prior Gentil et al study
make sense through this lens. Other ex-
ercises aren’t as straightforward. For ex-
ample, some people are virtually always
going to fail a set of squats because their
quads gave out, while other people start
relying very heavily on their hip exten-
sors once they get within spitting dis-
tance of failure; squats would likely be a
great quad exercise for the first person,
Mismatch between the strength curve of the lats and the shoulder flexion
External shoulder flexion
moment (difficulty)
Top
position
but not quite as effective for the second
person. Some people feel their chest give
out when they’re benching, while other
people feel the exercise much more in
their front delts and/or triceps; bench is
probably great for building the pecs of
people in the first category, while people
in the second category may instead need
to do DB bench press or flyes.
I actually think there’s a third princi-
ple, but it’s a special case that only se-
riously affects about three muscles that
most MASS readers would be interested
in: Am I dealing with a biarticular mus-
cle? In this case, the long head of the
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
groups affected. There’s some evidence
that your nervous system preferentially
recruits single-joint muscles when pos-
sible, only ramping up recruitment of
two-joint muscles as you significantly
fatigue (6, 7, 8), assuming you’re doing
a multi-joint exercise where the muscle
in question functions as both an agonist
and an antagonist. For example, in the
squat, your hamstrings help extend your
hip (good), but also try to flex your knee
(bad). The opposite is true of the rec-
tus femoris. We also see that squats do
a pretty lousy job of growing both the
hamstrings and rectus femoris (9, 10).
So, for biarticular muscles, I think it’s
wise to show them love with single-joint
exercises or exercises where both of the
muscle’s functions are agonistic. So, for
example, you’ll probably get more mile-
age from leg curls and RDLs (which are
essentially a single-joint exercise, as al-
most all of the movement should come
from your hips) for hamstrings growth
than any of the multi-joint exercises
you could throw at them. For the rectus
femoris, knee extensions and sissy squats
are your friend. For the long head of the
triceps, pure triceps exercises are good,
but a combination pullover/triceps ex-
tension is probably even better, since it
incorporates both functions of the long
head (shoulder extension and elbow ex-
tension).
Ultimately, I don’t think the question
“do multi-joint exercises cause as much
hypertrophy as single-joint exercises?” is
particularly useful. I think a better ques-
tion is, “For the muscle(s) I’m trying
to grow, what multi-joint exercises will
give me the most bang for my buck, and
would I rather do those exercises, or just
add single-joint training into my current
routine to target those specific muscles?”
Next Steps
I’d still like to see a study on sin-
gle-joint versus multi-joint training
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
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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-
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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
to discuss RPE as it relates to RIR
during a resistance training set.
While the RIR-based RPE scale is the
focus of this article, we should under-
stand that the concept of RPE has been
around since before the launch of Apple,
Inc. in the early 1970s. The original RPE
scale was created by Gunnar Borg and
was designed to gauge light, moderate,
and heavy efforts during aerobic training
(1). RPE, as most lifters use it today, is
quite new when considering the histori-
cal context and actually out of step with
mainstream academics. Nonetheless, the
popularity of RIR-based RPE has ex-
ploded over the last 10+ years due to its
great utility and ease of use. However,
RPE tends to be viewed in a binary fash-
ion as either “RPE training is good” or
“RPE training is bad.” This binary view
tends to only take into account using
RPE for basic load prescription because
the ratings are subjective. The criticism
of subjectivity is fair; however, what
many still seem to be unaware of is that
the utility of RPE extends far beyond
basic load prescription. In this concept
review, I aim to provide detailed insight
into every possible way to use RPE in-
cluding: load prescription, autoregulat-
ing volume, predicting 1RM, tracking
progress over time, and weekly load/set/
rep progression, among other uses. This
article will provide specific practical ex-
amples in the form of tables for each
use, so that you can directly implement
these strategies into training programs
for yourself or your clients. This article
will also discuss some of the common
criticisms of RPE and how someone can
improve their rating accuracy. First, let’s
start with the aforementioned historical
context.
What’s a concept review?
A written concept review is similar to our
signature video reviews. The aim of this
article type is to review a cornerstone topic
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
thing, which was allowing aerobic exer-
cisers to gauge a general sense of light,
moderate, or heavy effort. However, for
resistance training, the application is
relatively limited. Fast forward to 2006
and the OMNI scale was created for re-
sistance exercise. The 1-10 OMNI scale
was very similar to the CR10 Borg Scale
except visual descriptors were added to
the “easy,” “moderate,” and “heavy” de-
scriptors. While the visual descriptors
were an improvement, these RPE scales
still lacked precision for resistance train-
ing. The two original Borg scales can be
seen in Tables 1 and 2.
20
Adapted from Borg (1) 1970
RPE = Rating of Perceived Exertion
The lack of precision of the Borg scales
for resistance training was first revealed
in the scientific literature in 2012 from
Hackett et al (3). Hackett had body-
builders perform 5 sets to failure at 70%
of 1RM on the squat and bench. After
10 reps on each set, the bodybuilders
recorded both a Borg RPE (i.e. light,
moderate, or heavy effort), noted how
many repetitions they felt they had left,
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
RPE = Rating of Perceived Exertion
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-
ter in 2001 (6). It’s a 0-10 scale typically
administered 30 minutes following ex-
ercise and asks the individual about their
global fatigue level using descriptors
such as: “easy,” “moderate,” “hard,” and
“maximal.” Let’s look at an example of
the utility of this scale in the context of
resistance training: If two programs pro-
duced the same long-term hypertrophy
and strength, but one produced a lower
session RPE, then it might make sense
to recommend the program that caused
less fatigue or even consider adding vol-
ume or intensity to the less-fatiguing
program (we’ve previously written about
this).
Recently, I’ve seen people suggest there
could be a difference in RPE and RIR.
In reality, if using the RIR-based RPE
scale, there isn’t a difference. They are
the same. However, historically, there
is indeed a difference, but this doesn’t
mean that the terminology of “RPE”
and “RIR” won’t have different conno-
tations to people even though the scale
treats them the same way. Toward the
end of this article, we will return to the
terminology and discuss how sometimes
it may be better to use one term over
the other, even if they are technically re-
ferring to the same thing. Now that we
understand the history, the remainder of
this article will focus on the exact usage
of the RIR-based RPE scale and will be
chock-full of practical examples.
Specific Ways to
Implement RPE
The remainder of this article will ex-
plain every way in which RPE can be
used so that you can implement it into
your training in the appropriate manner.
Before we get to each subsection, please
remember that RPE is just one form of
autoregulation, which is defined as gath-
ering feedback about training to make
informed decisions (7). For example, a
form of autoregulation outside of RPE
is flexible training templates. Addition-
ally, thanks to two recent studies, one
from Dr. Helms (8) and the other from
Graham and Cleather (9 – reviewed in
MASS), we know that autoregulating
training load with RPE/RIR over the
long-term is also a good idea for strength
when compared strictly to percentages.
Let’s get started with a breakdown of
each way to use RPE, starting with the
most basic.
Basic Load Prescription with RPE
The most basic way to implement RPE
is to simply replace percentage-based
load prescription with RPE-based load
prescription. For example, instead of pro-
gramming 4 sets of 8 at 70% on a com-
pound movement, you could program 4
sets of 8 at 6-8 RPE. This means that you
would simply choose a load that would
land you within the 6-8 RPE range. The
utility of this is that since strength fluc-
tuates daily due to various readiness fac-
21
 Table 4 Basic RPE loading example
Mesocycle 1
(About 4-6 weeks)
Day 1 3 x 10 @ 5-7 RPE
Day 2 4 x 8 @ 5-7 RPE
Day 3 5 x 6 @ 5-7 RPE
RPE = Rating of Perceived Exertion
tors (i.e. poor sleep, anxiety, scheduling
issues, etc.), using RPE allows you to
increase or decrease the load as needed.
In the same way, RPE also allows you to
lift heavier when you are feeling good.
In fact, the Helms (8) and Graham and
Cleather (9) studies found that allowing
lifers to choose a load based upon RPE
allowed subjects to train at a higher av-
erage intensity throughout the respective
8- and 12-week training studies, which
led to greater 1RM strength in various
compound movements.
Additionally, the number of reps that
can be performed at a given intensi-
ty is highly individual. Recent studies
have reported ranges of 6-28 (average =
16 ± 4) (10) and 6-26 (average = 14 ±
4) (11) reps performed on the squat at
70% of 1RM. Therefore, replacing per-
centages with RPE can account for the
between-individual differences. Even if
you like to use percentages as a coach,
using RPE in the first few weeks with a
new client (if they are well-trained and
reasonably accurate with RPE) will give
Mesocycle 2 Mesocycle 3 Mesocycle 4
(About 4-6 weeks) (About 4-6 weeks) (About 4-6 weeks)
3 x 8 @ 6-8 RPE 3 x 6 @7-9 RPE 3 x 5 @8-9.5 RPE
4 x 6 @ 6-8 RPE 4 x 4 @7-9 RPE 3 x 3 @8-9.5 RPE
5 x 4 @ 6-8 RPE 4 x 2 @7-9 RPE Single @9.5 RPE
you an idea of how many reps a lifter can
do at a certain percentage. Then, based
on how many reps are performed at a
specific load, you can now individualize
a percentage program. Table 4 shows a
basic RPE load prescription example.
Table 4 is just one example of a basic
RPE-based load prescription. The ex-
ample is quite practical, as it takes into
account long-term periodization and
programming strategies outlined here,
in that there is an overall decrease in
the number of repetitions (i.e. decrease
in volume) and an increase in RPE as
intensity increases from block to block.
When incorporating assistance work
with the main lifts in the above example,
I would generally follow a similar RPE
format, but keep the reps a bit higher so
that you are not doing triples and singles
on single-joint movements in the final
mesocycle. Overall, this example takes
into account day-to-day fluctuations in
strength levels, the individual ability to
perform reps, and it allows for intra-ses-
sion load adjustments. When adjusting
22
load intra-session, if you miss the RPE
target on a set, I think it’s good to have
a guide for how to adjust load. There-
fore, in Table 5, I have included the ta-
ble from Dr. Helms’s dissertation that
provides this load adjustment guide. You
don’t have to follow this table exactly,
but it provides the general idea of how
to change the load for the next set when
you miss the target RPE range. Lastly,
I find it a good idea to include an RPE
range as your target rather than an ex-
act RPE target when performing mul-
tiple sets with RPE-load prescription,
as it will become difficult to hit an exact
RPE target each time. Besides, it’s just
not that important to maintain an exact
proximity to failure; rather, it’s import-
ant to understand the intent of RPE,
which is generally to either be far from
failure, a few reps from failure, or at fail-
ure. A range saves you from having to
adjust the load every single set. Table 5
essentially stipulates that if your set is
within the RPE range, you can choose
what you would like to do for your next
set; however, for every 0.5 RPE points
outside of the range your set lands, then
you should adjust the load 2% up or
down for your next set. Table 5 uses an
example of a target RPE range of 6-8,
but of course this concept can be applied
with any target RPE range.
Autoregulating Volume (RPE Stop)
Autoregulation can also be imple-
mented to achieve the appropriate vol-
Table 5 Basic load adjustment chart if missing the RPE range
Actual RPE Next set load adjustment if assigned RPE range is 6-8
1 Increase load by 20%
2 Increase load by 16%
3 Increase load by 12%
4 Increase load by 8%
5 Increase load by 4%
6 Lifter’s choice
7 Lifter’s choice
7.5 Lifter’s choice
8 Lifter’s choice
8.5 Decrease load by 2%
9 Decrease load by 4%
9.5 Decrease load by 6%
10 Decrease load by 8%
Adapted from Helms et al. 2018
RPE = Rating of Perceived Exertion
ume. Using RPE to autoregulate volume
has been described using the term “RPE
stop.” You can implement RPE stops in
two ways: 1) to autoregulate the number
of reps in a set, or 2) to autoregulate the
number of sets in a session for a specific
exercise. These strategies are similar to
velocity loss (12), which we have dis-
cussed before.
To implement the first strategy and
autoregulate reps in a set with an RPE
stop, you would pick a percentage or an
exact weight and do as many reps as pos-
sible on each set but stop each set when
you reach a predetermined RPE. If aim-
ing to accumulate volume, you would
stop at about a 7-8RPE, and if training
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
(Autoregulating reps in a set)
1. Choose exercise (squat)
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
volume and to avoid fatigue spilling into next session)
individual volume needs (let’s use 4 sets)
Programming for the day
4 sets of squats at 70% of 1RM and stop each set
@6-8 RPE
stop a set at around a 9 RPE. I actually
think RPE stops have utility over veloc-
ity loss. Specifically, and as we pointed
out last month, if your first rep on a 70%
of 1RM squat set is 0.65 m/s, a 40% loss
puts you at 0.39 m/s, which probably
lands someone between a 5 and 8 RPE.
However, your first (or fastest rep veloc-
ity) will be lower on subsequent sets. So,
let’s say on your fourth set, your first rep
velocity is 0.55 m/s, then a 40% velocity
loss has you stopping the set at 0.33 m/s,
which is much closer to failure than the
0.39 m/s on the first set. Therefore, an
RPE stop will always have you stop the
set at the desired amount of RIR (as-
suming the RPE is accurate), and it is
inherently individualized, whereas in-
dividual velocity profiles must be deter-
RPE stop method 2
(Autoregulating total sets)
1. Choose exercise (squat)
2. Choose load (let’s use 70% of 1RM for volume)
3. Choose number of reps per set (let’s use 8)
4. Choose RPE to stop squatting for the day (let’s use
8.5, assuming this person can do more than 12 reps at
70%)
5. Choose a number of sets to cap the volume
(let’s use 5)
Programming for the day
Sets of 8 reps on squats at 70% of 1RM for as many
sets (up to 5) until an 8.5RPE is reached
mined, otherwise velocity can be misap-
plied across a group.
The second usage of an RPE stop is
to autoregulate total set volume. In this
model, we take a certain load (i.e. 70%
of 1RM) and perform 8 reps per set, but
without a predetermined number of sets.
Now, we would perform as many sets as
we can until we exceed a predetermined
RPE, let’s say an 8 RPE. I would recom-
mend capping the number of sets so that
you don’t end up performing 10 sets of
high rep squats one session if you have a
high work capacity. This might be 5 sets
for compound lifts when accumulating
volume (i.e. moderate reps and low-
er peak RPE) or 3 sets for compound
lifts when in an intensity block (i.e. low
24
 Table 7 Total reps and rest-pause example
Total reps and rest-pause
1. Choose exercise (dumbbell shoulder press)
2. Choose load (if you are in a volume block, maybe
choose something you can do for a 12-15RM)
3. Choose RPE to stop at per set (let’s use 8-9 RPE)
4. Choose total number of reps (let’s use 35)
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
amount of sets is also dependent on an
individual’s recovery. Table 6 shows an
example of both RPE stop methods.
Another advantage of RPE stops is
that they have built-in progressive over-
load. For example, in method one, if
your goal is volume you can just stick
with the same weight for a few weeks
and aim for more reps. Then, once you
hit a certain number of total reps across
all 4 sets (as per the example), you can
increase the load. In method two, if your
goal is 5 sets at an 8 RPE or less, you can
continue to perform this load each week
until you complete all 5 sets successfully,
then increase the load.
Total Reps and Rest-Pause with RPE
For assistance work, RPE can be just
as valuable as it is for the main lifts.
Results, reps after each set
Set 1
11 reps
Set 2
20 reps
Set 3
28 reps
Set 4
35 reps
Even though strictly using generalized
percentages isn’t great for programming
the main lifts, a lifter could create an in-
dividualized percentage chart. However,
for assistance work, we typically do not
know our 1RM; thus, we are left with
our perception of difficulty to determine
loading. For assistance work, you can
certainly use basic load assignment (Ta-
ble 4); however, a total rep or non-fail-
ure rest-pause strategy works well and
is similar to an RPE stop. For example,
if your 12RM on dumbbell bench press
is about 40kg, you could set a thresh-
old of 35 total reps and perform each
set to an 8-9 RPE until you reach the
threshold of 35 reps. In week 1 of your
training block, it might take you 4 sets
to reach the 35 reps. You could continue
each week with the same load until you
reach the 35 reps in 3 sets, then increase
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
load to achieve progressive overload. The
above example can also be used in the
rest-pause variety, just simply take 20-30
seconds between sets. Using RPE during
rest-pause allows you to avoid the typi-
cal failure training associated with rest-
pause training, so it should cause less fa-
tigue in the 48 hours following training
than going to failure (13). In reality, the
above examples are really variations of
RPE stops, but as this is a concept re-
view, I wanted to clearly explain every
possible RPE load assignment strategy.
Tracking Progress and Predicting a 1RM
Something I’ve hit on before in MASS
is that even if you don’t use RPE to
program load, you should still track it.
Tracking RPE would itself be scored as
an RPE 1, meaning it takes little to no
effort to do, and it provides you with a
gauge of progress over time. From one
week to the next, one block to the next,
or even year after year, you can look
back and say “I did 175kg for a single at
9 RPE and now I can do it at 5 RPE.”
This is clearly progress and you can track
it without having to consistently do fa-
tiguing 1RM tests. If you perform some
sort of fatiguing test after every training
block, then you might have to take a de-
load or elongated intro week following
the test. However, tracking RPE gives
you a metric of how successful the block
was from a strength (or volume perfor-
mance) perspective and even allows you
to gauge progress during the middle of
a training block by comparing RPEs at
a given load to RPEs at similar loads
during previous weeks. Table 8 gives
specific examples of how to track prog-
ress and predict a 1RM with RPE. The
first two columns of Table 8 originally
appeared in an article from Volume 2,
Issue 11, and the third row was newly
created for this article.
Progression Schemes with RPE.
Another often overlooked aspect of
RPE is achieving progressive overload.
We are oftentimes fixated on saying we
are going to increase 2.5kg each week on
a main lift; however, that is just not typ-

26

IT’S JUST NOT THAT
IMPORTANT TO MAINTAIN AN
EXACT PROXIMITY TO FAILURE;
RATHER, IT’S IMPORTANT TO
UNDERSTAND THE INTENT OF
RPE, WHICH IS GENERALLY
TO EITHER BE FAR FROM
FAILURE, A FEW REPS FROM
FAILURE, OR AT FAILURE.
ically feasible. If you are programming
load prescription with RPE like the ba-
sic RPE loading example (Table 4), then
progressive overload takes care of itself;
over time, you should be able to load more
on the bar to meet the prescribed RPE.
However, if you have a predetermined
load and you simply track RPE (Table
8) in a percentage-based program, then
you can use your RPE scores from each
session or each week to progress load,
sets, or reps for the following week. The
most basic way to use RPE to progress
load is creating an inverse relationship
between RPE and progress (i.e. the low-
er the RPE, the greater the increase in
load). Additionally, if you bench 100kg
for 3 sets of 10 reps at an average RPE of
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
continue adding sets until you complete
5 X 10 at an average RPE of 8 and then
increase the load on the bar and go back
to 3 sets (i.e. 3 X 10 at 102.5kg). There
are many other ways to do this, which
could be an article in and of itself. The
good news is that we already have it in
video form. You can watch the detailed
presentation of using RPE to achieve
progressive overload, and remember that
strategies laid out in the video are not
mutually exclusive.
To Implement a Flexible Template in the
Warm-Up
Using RPE to assess readiness is not
as popular as the strategies discussed
above, but it still has merit. A founda-
tional principle of using RPE for load
prescription is that it can take into ac-
count low daily readiness and high fa-
tigue. So, why not use RPE to account
for readiness in the warm-up? Specif-
ically, if you are going through a busy
time, then it might make sense to im-
plement a flexible training template.
In short, you might have three training
sessions per week in which you have a
heavy training day, a moderate day, and a
light day, but the order in which you do
them is flexible to meet your readiness
levels. You then need to have a metric
that you use to decide which training
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
scale, which is essentially a 1-10 Likert
scale with 1 being “poorly recovered and
expecting declined performance” and
10 being “well-recovered and expect-
ing improved performance.” In short, a
high rating on this scale suggests you
should do the heavy session that day,
while a low recovery rating indicates
you should do the light session. How-
ever, data have shown that pre-training
recovery ratings do not always correlate
with performance in that day’s session;
rather, RPE during the warm-up might
be a better indicator (14). Thus, if you
are using a flexible template, you could
simply warm up to a decent load (i.e.
80%-85% of 1RM) and take an RPE. If
your normal RPE at an 85% bench press
is 6 (4 RIR), and you record an 8 RPE
or higher, then you might opt for the
light day. If your RPE is 5-7, you might
opt for the moderate session, and if your
RPE is <5, you might opt for the heavy
session. I don’t think you have to be that
strict with it, and RPE is only going to
fluctuate so much, but – in general – it’s
probably better to decide which workout
you are going to do in a flexible template
after you start warming up rather than
before the warm-up. Table 9 presents a
“less-strict” version of using RPE during
the warm-up to choose session-type.
Final Thoughts
Before we finish up, we should address
the common critique of using RPE,
which is that the rating is subjective and
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.
In this case, if someone records a 200kg
squat at an 8 RPE while working up to
a single at 9 RPE, that would translate
to about a 220kg max. However, if the
200kg X 1 was actually a 9 RPE, this
calculation may erroneously cause the
lifter to attempt 210kg on the next set,
and it could be a true max or the lift-
er could even fail the attempt. While
there would be fatigue consequenc-
es to overshooting the RPE at such a
high intensity, it is highly unlikely that
someone experienced is that inaccurate
with RPEs during low-rep sets at heavy
loads. It’s more likely that some person-
ality types don’t lend well to program-
ming something like “singles at 9 RPE.”
Some lifters might simply rationalize a
way to max out when heavy singles are
programmed using RPE. In this case, as
a coach, I would just prescribe a heavy
load for a single that I know the lifter
can hit at an 8 RPE and give them an
option for a second rep to ensure failure
doesn’t occur. On the other hand, a lifter
might be too cautious when working up
and end up only working to an 8 RPE;
however, that is less consequential than
overshooting the RPE.
While RPEs are typically quite accu-
rate during low-rep/high-intensity sets,
RPEs can indeed be inaccurate during
high-rep sets. In fact, well-trained lift-
FURTHER, IF USING RPE
DURING MODERATE- TO
HIGH-REP SETS, THE POINT
ISN’T TO BE PERFECTLY
PRECISE. RATHER, THE
PURPOSE IS TO SIMPLY
BE WITHIN A RANGE (I.E.
5-8) TO ENSURE YOU
ARE AN APPROPRIATE
PROXIMITY FROM FAILURE.
ers were on average 5.15 ± 2.92 reps off
when asked to verbally call out an in-
tra-set RPE when they believed they
were at a 5 RPE (5 RIR), a 7 RPE (3
RIR), and 9 RPE (1 RIR), and then
continue to failure during a set at 70%
of 1RM on squats in which the average
reps performed were 16 ± 4 (11). That is
a considerable amount of error; however,
that was also overrating RPE, meaning
subjects actually had about 10 reps left,
which is far less consequential than un-
derrating RPE. Further, if using RPE
during moderate- to high-rep sets, the
point isn’t to be perfectly precise. Rath-
29
 APPLICATION AND TAKEAWAYS
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
range (i.e. 5-8) to ensure you are an ap-
propriate proximity from failure. Over-
all, as previously mentioned, RPE rat-
ings tend to be strikingly accurate in
well-trained lifters during low-rep sets
(15), and there is no evidence that ve-
locity provides a better gauge of RIR in
this case. During high-rep sets intended
to be shy of failure, I don’t see some de-
gree of inaccuracy to be too much of a
problem, especially if you are overrating
RPE. Besides, if you consider the large
variance of reps performed at moderate
intensities mentioned earlier (i.e. 6-28 at
70%), then a percentage program could
lead a lifter to a much greater program-
ming error than an RPE rating inaccu-
rately predicting RIR by just a few reps.
If you are unsure if your RPEs are ac-
curate, try rating an RPE after a few
reps and then continuing to failure to
see how precise you are. I would recom-
mend doing this with a weight ≥80% of
1RM on a compound movement when
you perceive you are at about a 7 RPE.
If you are a coach and a client is unsure
that there RPEs are accurate, you can
advise them to also gauge an intra-set
RPE before continuing a set to failure.
Additionally, as a coach, I would still
have a client rate RPE, even if you ar-
en’t using it to program or progress load,
and have them send you videos of those
lifts. Then, you can evaluate, although
not perfectly, if you think those RPEs
are accurate. Of course, you can always
validate RPE with velocity, but we do
not all have access to accurate velocity
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.
Blame for obesity shifts across
a gamut from fat, carbs, sugar,
processed foods, animal products, and
back again. As discussed (article here),
the battleground outcome of carbs
versus fat is the least promising at the
population level in terms of providing
a solution. Differences in low fat ver-
sus low carb interventions are clinically
insignificant at the group level (though
they often matter for individuals). This
is just one example of the failed attempts
to find a “smoking gun” in the obesity
epidemic. As you’ll see in my video this
month, weight management is better
accomplished with multi- versus sin-
gle-variable interventions. Rather than
a smoking gun, there is a firing squad
of mechanisms driving weight gain. In
this first causal analysis of processed
foods as a contributor to weight gain
(1), researchers examined a multitude of
mechanisms related to energy consump-
tion and body composition change. Re-
searchers used a tightly controlled met-
abolic ward trial that mimicked real-life
using a free-eating model. Specifically,
20 adults were presented diets dominat-
ed by processed or unprocessed foods for
two weeks apiece, and the diets as pre-
sented were matched for energy, macro-
nutrients, sugar, fat, and fiber. Howev-
er, the subjects were able to consume as

35
much as they desired of the food pre-
sented. During the processed diet, par-
ticipants ate faster and consumed more
energy, consuming greater amounts of
carbs and fat but similar protein com-
pared to the unprocessed diet; therefore,
they gained weight and fat mass when
consuming the processed diet, but lost
weight and fat mass while consum-
ing the unprocessed diet. Additionally,
hormone markers of hunger were low-
er compared to baseline during the un-
processed diet, and satiety was higher
during the unprocessed compared to the
processed diet. In this article, we’ll dis-
cuss which aspects of the diets could be
controlled by the researchers, and which
they could only control to some degree.
This discussion hints at the inherent is-
sues of processed diets, and why they
may be among the deadliest of the firing
squad.
Purpose and Hypotheses
Purpose
The purpose of this study was to de-
termine if processed foods play a causal
role in ad libitum (at will or, as desired,
“free eating”) energy intake, and subse-
quent changes in body mass.
Hypotheses
The authors did not present hypothe-
ses, but stated there is compelling indi-
rect evidence, albeit no direct causal ev-
idence, that processed diets might lead
to energy overconsumption and weight
gain.
Subjects and Methods
Subjects
20 (10 male, 10 female) weight-stable
adults (31.2 ± 1.6 years; BMI = 27 ± 1.5
kg/m2) participated in this randomized,
controlled, two-week crossover trial.
Methods
Participants lived in a metabolic ward
research center continuously for 28 days,
during which time they were randomly
allocated to either the processed or un-
processed diet condition for two weeks,
immediately followed by the opposite
condition. Hormone and metabolic data
from blood samples, body composition
measurements via DXA, 24-hour ener-
gy expenditure changes in a metabolic
chamber, average energy expenditure
from doubly labeled water, and viscer-
al fat changes from MRI were all col-
lected. Figure 1 provides an overview of
the study design and the timing of these
measurements.
Additionally, participants assessed as-
pects of their eating and food experience
via visual analog scales. They rated hun-
ger, fullness, satisfaction, eating capaci-
ty, familiarity, and pleasantness, and the
researchers tracked how much total food
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-

Energy (kcal/day) 1530 1565

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

Omega-3 fatty acids (g/1000 kcal) 0.3 4.0

Omega-6 fatty acids (g/1000 kcal) 9.6 21.9

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

Energy (kcal/day) 5435 5436

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)

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
Energy intake (kcal/d)

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
expenditure (kcal/day)

Physical activity
738 ± 29 771 ± 21 755 ± 18 771 ± 29 717 ± 21 744 ± 18 0.67
expenditure (kcal/day)

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,
I could see the value in letting someone
know that occasionally having a Snick-
ers bar in the context of a healthy diet is
absolutely fine. Moreso, even if someone
does track habitually, the knowledge that
a processed diet could work isn’t really
helpful. Indeed, it could cause problems,
as following such a diet would make
the qualitative difficulty of maintaining
a deficit via a processed diet higher. If
people find the same level of satiety and
hunger occurs when eating an additional
500kcals (as was shown in this study),
it’s logical to assume they’d feel hungri-
er on a processed diet when eating the
same amount of calories they’d other-
wise consume on an unprocessed diet.
Why processed diets result in “sponta-
neous” weight gain, and conversely, why
unprocessed diets result in “spontaneous”
weight loss
In the real world, energy density is
higher on processed diets. If you’re think-
ing “what is energy density?”, watch my
video series on it that I just concluded
in this issue (Part 1 here). While the re-
searchers attempted to control for ener-
gy density, it probably couldn’t be prop-
erly accounted for because processed
foods are simply so much higher in en-
ergy density. Thus, an attempt was made
by adding fiber to the beverages of the
processed diet, but unfortunately, fluids
aren’t as well “recognized” by the body
for inducing satiety (3).
Another reason processed diets lead to
food overconsumption in the real world
is due to a phenomenon known as pro-
tein leverage theory. Simply put, satiety
is lower and hunger is higher until a cer-
tain threshold of protein is consumed
in an ad libitum setting. Thus, because
processed foods are so densely packed
with carbohydrates and fat, you end up
consuming more total calories to reach
the same level of protein. Indeed, some
research indicates a part of the reason
processed diets are fattening is because
they have proportionally less protein per
calorie (4). In this study, it seems the ad
libitum intake of the participants during
the processed diet was primarily via car-
bohydrate- and fat-dominant foods, but
there was a remarkably tight ad libitum
intake of protein during both diets; be-
cause the participants ate more carbs
and fats while eating the processed diet
to achieve this same protein intake, more
total calories had to be eaten.
If anything, I think the energy density,
fiber, and protein differences in the real
world would make this effect more pro-
nounced. Yes, I think the 500kcal differ-
ence observed in this study is probably a
conservative estimation of the true dif-
ference in the real world, because in the
real world, there aren’t researchers trying
to match the energy density, protein, and
fiber intakes of what’s presented to you.
On top of these mechanisms, while
the processed diet wasn’t rated as more
palatable or tasty or satisfying, it was
43
eaten more quickly and the hormonal
responses indicated less satiation and
more hunger during the processed diet.
This could be due to mouthfeel and tex-
ture of processed foods making it eas-
ier to eat them more quickly, and thus,
more calories can be consumed before
satiety “sets in.” It’s also possible that the
questions related to hunger and satiety
weren’t sensitive or targeted enough to
represent the qualitative eating experi-
ence differences between diets. Another
perspective to consider is that the goal of
a food manufacturer is to encourage the
consumption of the food they manufac-
ture. This is actually not accomplished
by making something super hedonical-
ly satisfying, but rather tasty, but not so
tasty to cross the threshold into satis-
faction, which discourages further con-
sumption (an example would be high
fructose corn syrup, which is only slightly
sweeter than regular sugar; as most have
a 55/45 breakdown of fructose to glucose
versus the 50/50 split of standard sugar).
Thus, the qualitative descriptors in this
study of “pleasantness” and “familiarity”
and “satisfaction” might not have picked
this up. Nonetheless, based on hormonal
data, the participants were more full and
less hungry eating the unprocessed diet,
and they also ate slower, which might
have allowed more time for these hor-
monal signals to be received, resulting in
earlier meal cessation and lower calorie
consumption.
According to the authors, protein
could only explain, at most, 50% of the
difference in energy intake between
groups. Thus, all in all, energy density,
eating speed, and hormonal differenc-
es explain the remaining differences
(and perhaps other unmeasured factors).
The good news is that unprocessed di-
ets rock. They result in effortless fat loss;
eating a whole food diet for the aver-
age person will result in higher levels of
satiety, less hunger, and subsequently a
lower energy intake, thus leading to fat
loss. This will of course only last so long,
but your “settling point” of adiposity will
almost certainly be lower when consum-
ing an unprocessed versus a processed
diet. If you aren’t sure what that looks
like, think lots of fruits, vegetables, lean
proteins, and (in general) a diet domi-
nated by single ingredient foods. I know,
groundbreaking stuff.
Interesting nuances of the findings
There were some outcomes which, at
first glance, seem like head scratchers.
For example, in a 2010 study, energy ex-
penditure was shown to be lower acute-
ly after consuming a processed versus
an unprocessed sandwich. Yep, another
knock against processed diets is they
might reduce the energy-out side of the
equation, likely via a reduction in the
thermic effect of food and the cost to
get the metabolizable energy content of
the food (5). Because they’ve undergone
substantial industrial processing, our
body doesn’t need to expend as many
44
 Table 4
Group 1: Unprocessed or mini- Group 2: Processed culinary
mally processed
Examples: fresh, frozen, or dried
fruits and vegetables; pasta made
herbs, fresh or dried; meat, poul- Examples: salt, sugar, honey, cook-
ing oils, butter, corn, starch, vine-
gar, baking soda
cuts, chilled or frozen; eggs; un-
tea, water
Source: Monteiro et al, 2016; NOVA
calories to actually digest and metab-
olize highly processed food. However,
in the present study, energy expendi-
ture was higher during the processed
diet, almost reaching the cut off for
significance (p = 0.06). While this ap-
pears contradictory, I don’t think it is.
In the prior study, the response to a cal-
orie-matched meal was assessed, but in
the present study, the researchers mea-
sured the energy expenditure response
to an entire diet for 14 days, compared
to another diet that was 500kcals high-
er. Thus, in the present study, we are
likely just observing the ramping up of
energy expenditure in response to a cal-
orie surplus, which has been shown as a
normal response to overfeeding (6), and
likely an attempt by the body to main-
tain metabolic homeostasis (something
that is easily overcome at a population
level by our obesogenic environment in
the modern world). So unfortunately,
processed diets may still very well re-
duce energy expenditure when calorie
matched compared to unprocessed di-
ets.
Group 3: Processed foods Group 4: Ultra-processed foods
ingredients
Examples: sodas, sweet and salty
Examples: canned fruits and packaged snacks, chicken nuggets,
vegetables; salted nuts; salted,
cured, or smoked meats; cheeses; frozen meals, breakfast cereals,
freshly made bread; beer energy bars, packaged cakes and
sweets
Another interesting finding was that
while the only significant body com-
position changes were changes in body
fat, changes in lean mass were almost
significant. There was a nonsignificant,
small drop in lean mass during the
unprocessed diet and a small increase
during the processed diet. However, for
one, there is an obligatory loss or gain
of lean mass when fat mass changes, as
adipose tissue is not completely com-
posed of fat mass and has some lean tis-
sue as part of its structure (7). Further,
these changes in lean mass were signifi-
cantly associated with changes in sodi-
um intake (r = 0.63; p = 0.004), likely
indicating that changes in extracellu-
lar fluid shifts appeared as lean tissue
changes, contributing to this outcome.
As a final, unfortunate, nuanced note
on this study, the cost of the processed
diet per kcal was ~50% less than the un-
processed diet. Meaning, it’s cheaper to
get your energy from processed foods,
which doesn’t bode well for society-lev-
el behavior change.
45
 APPLICATION AND TAKEAWAYS
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
common, with the average adult
consuming an estimated 4.3 li-
ters of pure ethanol per year (2). While
alcoholic beverages have historical, cul-
tural, and social significance, alcohol is
still, essentially, a weak poison. Aside
from the risk of acute toxicity, exces-
sive alcohol intake is associated with a
wide range of negative health outcomes
affecting organs and tissues through-
out the body. As such, many individu-
als interested in health, fitness, or per-
formance tend to believe that alcohol
consumption is disadvantageous and
may impair their ability to perform or
recover from training. The current study
(1) sought to review the literature in-
vestigating alcohol’s effects on recovery
from resistance exercise. While alcohol
was found to cause unfavorable chang-
es in cortisol, testosterone, and rates of
muscle protein synthesis, you might be
surprised to hear that the authors found
relatively heavy alcohol intake to have
fairly minimal impacts on the other bio-
logical, physical, and performance mea-
sures assessed.
As someone who loves beer and bour-
bon, this conclusion certainly caught my
attention. So, is the news as good as it
sounds? Can we finally abandon the idea
of choosing between our alcohol and our
gains? Generally speaking, probably not.
Read on to find out why.
Purpose and Hypotheses
Purpose
The authors stated that the purpose
of this paper was, “To understand the
effects of alcohol consumption during
recovery, on muscle function, following
resistance exercise.”
Hypotheses
The authors didn’t clearly state a hy-
pothesis. However, the introduction sec-

49
tion discusses alcohol’s links to hormone
disturbances, immune dysfunction, and
muscle atrophy, so you can infer that
they expected alcohol to significantly
impair recovery.
Methods
Design
A systematic review is a unique type
of research project, in which you aim to
summarize all of the studies on a giv-
en topic in a systematic way. In order to
make the approach systematic, you spec-
ify a number of things before the project
starts, including the research question,
exactly how the relevant literature will
be identified and collected, and the types
of studies that can be included.
Procedures
A list of key search terms related to the
research question was compiled, which
the researchers used to search the larg-
est research databases containing rel-
evant literature. Typically, systematic
reviews will have some pretty specific
criteria about which studies will be in-
cluded in the analysis and which studies
will be excluded from consideration. In
this particular review, they left the crite-
ria very broad. The authors stated that
studies would be included in the review
“only if they used a specific measure of
performance or biomarker, that consid-
ered recovery following resistance exer-
cise and alcohol intoxication. Articles
exploring recovery after endurance type
of training have been eliminated.”
Alcohol doses
Just to be clear, studies in this area of
research use some surprisingly substan-
tial alcohol doses. Most studies dosed
ethanol at about 1g/kg of body mass.
A “standard drink” varies from country
to country, but is often considered to be
around 10g of ethanol. So, an 80kg par-
ticipant would be putting down about
eight standard drinks; this is ethically
justifiable for the researchers and should
be sufficient to get the job done, but it’s
worth noting that a study on the real-life
drinking habits of actual rugby players
found that many of them consumed up-
wards of 20 standard drinks in a single
post-game drinking episode (3).
Findings
While meta-analyses calculate a
pooled effect size and perform statisti-
cal analyses on the data, this is not done
in all systematic reviews. For the current
study, no quantitative analyses were per-
formed. After collectively reviewing the
individual studies, the authors concluded
that most of the biological, physical, and
performance measures were unaffected
by alcohol consumption after resistance
exercise. However, they noted that corti-
sol was increased, along with reductions
in testosterone and rates of muscle pro-
50
tein synthesis, which would be problem-
atic for long-term training adaptations
with consistent alcohol use.
Interpretation
Systematic reviews sit at the top of
the evidence-based hierarchy of infor-
mation quality, but they still need to be
evaluated critically. In this case, while I
commend the authors for putting out
information on a scant topic, there was
room for improvement from a techni-
cal perspective. Most notably, the search
missed at least one lower-dose alcohol
paper with really informative findings,
and the authors seemed to miss the fact
that some studies provided doses scaled
to total body mass, while others scaled
doses to fat-free mass. They also included
studies in which the “resistance exercise”
was a real or a simulated game of rugby,
which I won’t devote much attention to.
Nonetheless, this review gathered up a
bunch of relevant alcohol studies for us,
which serves as a great starting point for
reviewing the topic in detail.
Before we get into performance, let’s
get the biological stuff out of the way,
because it’s pretty straightforward. Sev-
eral of the studies evaluated creatine
kinase levels following the combina-
tion of resistance exercise and alcohol.
Resistance exercise reliably increased
creatine kinase in these studies, which
is fully expected, and this elevation was
not meaningfully increased by alcohol
consumption. Four studies assessed the
effects of alcohol on cortisol responses
(4, 5, 6, 7); results were not particular-
ly reliable from study to study, but gen-
erally indicated a trend toward higher
cortisol levels, which mirrors the alcohol
literature that exists beyond the realm of
acute resistance exercise (2).
The same four studies that evaluated
cortisol also evaluated testosterone (4,
5, 6, 7). Again, there was a lack of con-
sistency across studies, which is under-
standable in a group of studies with low
sample sizes (ranging from 8 to 10 sub-
jects per study). While one study showed
acutely increased testosterone levels (7),
the others showed no effect or reduced
levels (4, 5, 6). Small, transient elevations
in testosterone may be observed due to a
temporary reduction of testosterone ox-
idation in the liver while alcohol is be-
ing metabolized, particularly with low-
er alcohol doses, but the larger body of
alcohol literature indicates that alcohol
reduces testosterone production and in-
creases the conversion of androgens to
estrogens (2).
Finally, the singular study within this
review that measured muscle protein
synthesis found reduced rates with al-
cohol ingestion, even when the alcohol
was co-ingested with protein (8). While
a lower testosterone-to-cortisol ratio
and blunted muscle protein synthesis
are certainly counterproductive for pro-
moting long-term training adaptations,
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
the typical athlete or lifter, but they don’t
necessarily answer the research question
posed in this review.
Two studies in the review actual-
ly evaluated the effects of intoxication
on strength outcomes, in addition to
ter the fact. Poulson et al (9) measured
single-joint isokinetic and isometric
strength before, during, 24 hours af-
ter, and 48 hours after alcohol inges-
tion. Surprisingly, actively being drunk
didn’t meaningfully affect the strength
outcomes assessed. Results also indicat-

52
ed no suppression of voluntary muscle
activation, and no evidence of impaired
recovery. Clarkson and Reichsman (10)
also provided their alcohol dose prior to
the onset of exercise testing, and simi-
larly found no effect of alcohol intake
on the parameters measured. Notably,
these studies assessed very simple, un-
skilled strength tasks; as a given athletic
task increases in terms of its metabolic
demand, skill level, or thermoregulatory
challenge, the likelihood of performance
impairment from alcohol intoxication is
elevated.
When it comes to the studies most di-
rectly addressing the research question at
hand, Barnes and colleagues have done a
few of the most informative studies. In
one such study (11), 11 males ingest-
ed 1g/kg of alcohol after 300 maximal
eccentric contractions of the leg exten-
sors. As indicated in the Table 1, vari-
ous parameters of force recovery were
impaired. The same lab group replicated
their findings in a separate study (12),
which followed the same general proto-
col in a sample of 10 male subjects.
However, alcohol did not impair re-
covery in the same protocol when the al-
cohol dose was reduced to 0.5g/kg (13),
which is more consistent with light or
moderate drinking for most folks (Ta-
ble 2). The same group also investigated
the effect of alcohol (1g/kg) on recov-
ery after a simulated rugby match, and
while counter-movement jump recovery
was impaired, several other performance
THE LIMITED DATA AVAILABLE
SUGGEST THAT SOME MODERATE TO
HEAVY DRINKING MAY NOT TOTALLY
SABOTAGE YOUR RECOVERY FROM A
PRIOR WORKOUT, OR YOUR STRENGTH
PERFORMANCE THE FOLLOWING DAY.
RECOVERY IMPAIRMENTS SEEM TO BE
LARGER IN MALES THAN FEMALES, AND
SIGNIFICANT IMPAIRMENTS APPEAR TO
BE MORE LIKELY WHEN THE MAGNITUDE
OF MUSCLE DAMAGE FROM EXERCISE
IS HIGH, AND WHEN THE ALCOHOL
DOSE IS GREATER THAN 0.5G/KG.
outcomes were unaffected (4).
Levitt et al (14) attempted to repli-
cate the protocol used by Barnes et al
(11, 12), in which high-dose alcohol
impaired strength recovery in males, in
a sample of females. Contrary to the
research carried out in males, alcohol
(dosed at 1.09g/kg of fat-free mass) did
not appear to impair recovery in females.
McLeay et al (15) used the same muscle
damage protocol and an alcohol dose of
0.88 g/kg of total body mass, and again,
the recovery impairment induced by al-
cohol failed to reach statistical signifi-
cance in females. This apparent sex dif-
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-
cluding female participants (2). Authors
have speculated that the difference could
relate to the protective effect of estrogen
on muscle damage (14), but it could also
relate to some dosing difficulties. For a
given dose of alcohol, whether it’s an ab-
solute dose or scaled to total body mass,
blood alcohol content rises higher in fe-
males than males (16). To accommodate

54

EVEN IF YOU CAN PULL
YOURSELF TOGETHER AND GET
THROUGH YOUR TRAINING
SESSION THE DAY AFTER
A SINGLE NIGHT OF HEAVY
DRINKING, THE EFFECTS
OF HEAVY ALCOHOL INTAKE
SUGGEST THAT FREQUENT
INDULGENCE IS A BAD IDEA.
this difference, researchers have either
used smaller doses or scaled the dosages
to fat-free mass, typically yielding doses
around 0.8-0.9 g/kg. However, females
also have more rapid blood alcohol
clearance than males, for a given blood
alcohol concentration (16). So, while
male studies typically use ~1.0 g/kg or
higher, these dosing accommodations
may make the resulting dose insufficient
to interfere with recovery in females.
Levitt et al also evaluated the effects
of alcohol on recovery from a more typ-
ical (and less extreme) resistance exer-
cise protocol in men, with no recovery
impairment observed (17). As such, the
relative rigor of the damage-inducing
exercise protocol seems to be impactful;
while Barnes et al identified significant
recovery impairments with pretty seri-
ous bouts of eccentric exercise, studies
using less rigorous exercise protocols
have failed to observed alcohol-induced
recovery impairments (5, 9, 10).
If you’re really hungover going into a
workout, you’re probably not going to
have a good time, and you probably won’t
perform well on skillful or physically
demanding tasks. But, the limited data
available suggest that some moderate to
heavy drinking may not totally sabotage
your recovery from a prior workout, or
your strength performance the follow-
ing day. Recovery impairments seem to
be larger in males than females, and sig-
nificant impairments appear to be more
likely when the magnitude of muscle
damage from exercise is high, and when
the alcohol dose is greater than 0.5g/kg.
If your workout isn’t brutal or your alco-
hol dose isn’t too high, you’ll probably
have a good chance of being fine for the
next day’s workout.
However, even if you can pull yourself
together and get through your train-
ing session the day after a single night
of heavy drinking, the effects of heavy
alcohol intake suggest that frequent in-
dulgence is a bad idea. “Alcoholic skel-
etal myopathy” is a term describing the
loss of muscle mass, which can be as
high as a loss of 20% of total body mass,
related to chronic excessive alcohol con-
sumption (18). Heavy alcohol intake,
both acutely and chronically, results in
55
 APPLICATION AND TAKEAWAYS
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
signaling pathways that control muscle
growth and atrophy. Similarly, alcohol
ingestion can induce leucine resistance,
which describes a state in which the nor-
mal muscle protein synthetic response
to leucine ingestion is blunted. Alcohol
has also been shown to induce numerous
unfavorable changes to hormone lev-
els, including cortisol, estrogen, human
growth hormone, luteinizing hormone,
testosterone, and melatonin (2).
Speaking of melatonin, a lesser-known
effect of alcohol intake is disruption of
sleep. While alcohol generally reduces
sleep onset latency (that is, helps you
fall asleep more quickly), it tends to alter
sleep quality and architecture in nega-
tive ways (19). Slow wave sleep is in-
creased in the first half of the night, but
rapid eye movement (REM) sleep is de-
creased. Sleep is generally disrupted in
the second half of the night, which often
causes wakefulness or very low-quality
sleep. So, while alcohol may seem like it
helps you get to sleep, it often reduces
total sleep time and overall sleep quality,
particularly at higher doses.
Next Steps
It’d be nice to see a longitudinal train-
ing study evaluating the effects of light
or moderate alcohol intake (a few drinks
per week, give or take) on changes in
strength and body composition. Howev-
er, given the available evidence, it seems
safe to conclude that no alcohol is the
most prudent approach, moderate alco-
hol is probably fine, and heavy, habitual
alcohol intake is detrimental. A single
night of somewhat heavy drinking isn’t
likely to derail your entire training pro-
gram, and you might even recover in
time for the next workout, but it’s not
something you want to do on a regular
basis.

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
confusion” is behind us, many
people still think that short-
term variations in training stimulus will
net them more muscle growth. For ex-
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
every Monday and sets of 10-12 every
Thursday. While that’s more structured
than a full-on “muscle confusion” ap-
proach to training, will it actually lead to
more muscle growth than keeping train-
ing variables constant?
A recent study sought to answer that
question. Using a within-subject unilat-
eral design, one leg did the same workout
every training session for eight weeks,
while the other leg cycled through four
different workouts that varied the load
used, the rest interval between sets, the
number of sets performed, and the mus-
cle action performed (i.e. eccentric-on-
ly reps instead of normal reps). Quad
growth was similar in both conditions,
adding more evidence to the consid-
erable body of research showing that
short-term variations in training vari-
ables neither increase nor decrease hy-
pertrophy.
Purpose and Hypotheses
Purpose
The purpose of this study was to exam-
ine whether regularly changing training
variables would lead to more hypertro-
phy and greater muscle protein synthesis
in resistance-trained men than holding
training variables constant.
Hypotheses
The authors hypothesized that constant
and variable resistance training would
lead to similar hypertrophy on a group
level, that variability between individu-
als would be larger than the within-in-
dividual variability (using a within-sub-
ject unilateral design), and that protein

60
synthesis rates would “correspond” (I as-
sume they’re implying “correlate”) with
changes in muscle cross-sectional area.
Subjects and Methods
Subjects
The subjects were 20 young men with
an average of 2.5 years of training ex-
perience and no current musculoskeletal
limitations.
Experimental Design
Much like the multi-joint versus sin-
gle-joint study I reviewed this month,
this study employed a within-subject
unilateral design. This means that each
subject performed both programs used
in this study, with their right leg as-
signed to one condition and their left
leg assigned to the opposite condition.
The legs were counterbalanced based
on limb dominance, meaning 10 of the
subjects performed the “varied” protocol
with their dominant leg and the “con-
stant” protocol with their nondominant
leg, while the programs assigned to each
leg were reversed for the other 10 sub-
jects.
Training took place over eight weeks,
with two training sessions per week, and
with the workouts for both conditions
performed in each session. For the con-
stant condition, training consisted of
four sets of unilateral leg press and four
sets of unilateral knee extensions in each
session. Loads were adjusted so that the
subjects failed each set between 9 and
12 reps, and they were allotted two min-
utes of rest between sets. For the varied
condition, the subjects cycled through
four different workouts: one with lower
loads (4 x 25-30RM with 2 minutes of
rest), one with more sets (6 sets of uni-
lateral leg press and knee extension, still
for sets of 9-12 with 2 minutes of rest),
one with eccentric-only training (sets
of 10 with 110% of the loads used for
the leg in the constant condition, still for
4 sets with 2 minutes of rest), and one
with longer rest intervals (4 x 9-12RM,
with 4 minutes between sets).
Ultrasound scans of the vastus later-
alis were performed before and after
the eight-week training intervention to
measure changes in muscle cross-sec-
tional area. After the training program
was finished, the subjects completed one
more training session used to measure
integrated myofibrillar protein synthe-
sis. They drank chemically labeled water
before the workout, and muscle biopsies
were taken before the workout, 24 hours
post-workout, and 48 hours post-work-
out to assess the rate at which the chem-
ical tracer was being incorporated into
muscle proteins. For this session, each
subject performed the “constant” proto-
col with one leg, and five subjects apiece
performed each of the “varied” protocols.
To assess the differences in with-
in-subject versus between-subject vari-
ability, the researchers calculated the
61
 Figure 1 Rate of progression of volume load
16000
Volume Load (kg)
14000
12000
10000
8000
1 2 3 4
difference in percent increase in vastus
lateralis cross-sectional area within each
subject and the coefficient of variation
for change in vastus lateralis cross-sec-
tional area within each condition. So, for
example, if subject A had an increase in
cross-sectional area of 5% in one quad
and 4% in the other, their within-subject
difference would be 5%-4% = 1%. If the
change in vastus lateralis cross-sectional
area in a group was 5 ± 2cm, the coeffi-
cient of variation would be 2cm/5cm =
40%.
Findings
Total volume load (sets x reps x load)
was higher in the varied group compared
to the constant group. However, the
Slopes P = 0.819
Elevation P < 0.0001
Constant
Varied
5 6 7 8 9 10 11 12 13 14 15 16
Weeks
number of weekly sets performed (16
for constant and 18 for varied) was simi-
lar, which is probably a more meaningful
metric than volume load if you’re inter-
ested in hypertrophy, as we’ve previously
discussed in MASS. The rate of progres-
sion of volume load, which should be a
pretty good proxy for strength gains in
this study, was similar in both groups (p
= 0.819).
Both conditions caused significant in-
creases in vastus lateralis cross-sectional
area, but there weren’t significant differ-
ences between conditions (p = 0.473).
The within-subject variability for hy-
pertrophy was quite low: only about
0.9%. However, the between-subject
variability was pretty high for both con-
ditions: 37% for constant and 38% for
62
varied. This means the between-subject
variability was about 42 times greater
than the within-subject variability, at
least according to this paper. That may
not be the correct way to quantify these
differences, however, as discussed below.
Integrated myofibrillar muscle protein
synthesis during the two days following
the final training session was greater in
the varied condition than the constant
condition. For all four workouts, mean
differences favored the varied condi-
tion over the constant condition, but
the difference was only significant for
the workout that involved doing more
sets. However, since there were only five
subjects for each comparison, I think
the MPS findings warrant a reasonable
amount of skepticism. However, as with
hypertrophy, within-subject variation
(0.08%) was substantially lower than be-
tween-subject variation (3.5% for con-
stant and 3.1% for varied), amounting to
a ~41-fold difference.
Interpretation
Just as a note about the results before
diving into this interpretation: the ~40-
fold reported difference between with-
in-subject and between-subject vari-
ability probably overstates things, as it’s
a bit tenuous to compare the mean be-
tween-leg differences for individuals to
the group-level coefficients of variation.
Using an extreme example, the smallest
increase in cross-sectional area for any
Figure 2 Changes in cross-sectional area
14
Change in cross-sectional area (%)
12
10
8
6
4
2
0
Constant Varied
limb in this study was a bit more than
2%, and the largest increase was a bit less
than 14%. So, comparing the worst to the
best result, there’s a difference of 12%.
The mean difference between legs was
about 1%, so the largest between-subject
difference in this study was about 12x
greater than the average within-subject
difference. That’s considerable, but it’s
nowhere close to a 40-fold difference.
Comparing the within-subject differ-
ences to the group-level standard devi-
ations would have made for better direct
comparisons, as a standard deviation is
the average difference between individ-
ual results and the group mean. If that
was the comparison made in the study,
the variability within groups would have
been about 3x greater than the variabil-
ity between individuals, which is still a
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,
the results of this study are right at home
in the literature: Frequently varying the
training stimulus doesn’t seem to lead to
more hypertrophy, at least in the short to
medium term.
However, I don’t think we should rule
out the idea that variations in training
stimulus can lead to more hypertrophy. I
think the important variable is the time
scale you’re working with. For example,
we reviewed a study in a prior issue of
MASS in which powerlifters experi-
enced a substantial amount of hyper-
trophy – primarily type I fiber hypertro-
phy – after a brief exposure to low-load
training with blood flow restriction,
while another group of powerlifters just
doing normal, heavy front squats didn’t
experience much hypertrophy (10). For
these powerlifters, who probably didn’t
do much (if any) training in the 20+ rep
range for years at a time, a very novel
stimulus was able to cause considerable
growth in a relatively short period of
time, while training they were more ac-
customed to didn’t cause much growth.
Thus, I think it’s likely that very novel
stimuli can boost hypertrophy. Howev-
er, I think that likely applies to types of
training that you haven’t done in months
or years, not variations in training that
you cycle through over a period of weeks.
I’m not sure where the line is, however.
Do you need to stick with one type of
training for three months before a very
different style of training will boost hy-
pertrophy? Or do you need to stick with
one type of training for three years be-
fore a very different style of training
will boost hypertrophy? I honestly don’t
know.
One thing that struck me about this
paper is how low the within-subject
variance was. The figure in the study
(Figure 2) doesn’t quite make it clear, in
my opinion. I re-graphed the data as a
scatterplot, with each point representing
a single subject. Growth of the constant
leg is the x-value for each point, and
growth of the varied leg is the y-value.
As you can see, all of the points fall very
close to the black line, which is repre-
sentative of identical growth between
legs. The two red lines indicate this
study’s definition of a meaningful dif-
ference (two typical errors), and as you
can see, all of the data points fall within
those boundaries. Compare that to the
between-subject variance, where the top
responders grew almost 7x more than
the worst responders, with growth rang-
ing from ~2% to ~14%. In other words,
some people just simply responded bet-
ter to training, regardless of the training
program they used, and the individual
impact of the training programs mat-
tered way less than the inherent vari-
ability between individuals.
However, I don’t want to make it seem
like programming doesn’t matter at
all on an individual basis. Volume was
similar in both of the programs used in
this study, and rep ranges were similar
65
 Figure 4 Individual changes in VL CSA after constant vs. varied loading
18.0%
16.0%
14.0%
12.0%
Varied Loading
10.0%
8.0%
6.0%
4.0%
2.0%
0.0%
0.0% 2.0% 4.0% 6.0% 8.0% 10.0%
Constant Loading
for the majority of the sessions, so it’s
unsurprising that each individual got
pretty similar results for both their legs.
However, in a prior study from the same
lab using a similar experimental design
(within-subject unilateral design), dif-
ferences in volume and frequency led to
considerably more within-subject vari-
ability (11). An older study by Beaven
et al using a crossover design also found
that individuals could experience large
gains on one program and small or non-
existent gains on another program with
a different intensity and rep range (12).
So, programming can absolutely make
a large difference for individual lift-
ers; however, I think the general point
stands. The variability between individ-
ual responses to different programs is
considerably smaller than the variability
in general responsiveness to training be-
tween individuals (15).
One interesting thing to note was
that even after eight weeks of training,
muscle protein synthesis was higher in
the varied condition than the constant
condition. However, overall hypertro-
phy was similar. Why might that be?
One plausible explanation is that vary-
ing the training stimulus didn’t allow the
lifters’ muscles to fully habituate to any
one particular stimulus, leading to slight
elevations in muscle damage compared
to the constant condition. Previous re-
search has suggested that elevated mus-
12.0% 14.0% 16.0%
cle damage can increase muscle protein
synthesis without actually causing more
growth, since some of the protein syn-
thesis is directed toward repairing dam-
aged proteins rather than constructing
new proteins (13). Another possible
explanation is that the varied condition
would have actually caused more growth
over time, but the training duration was
too short and the sample was too small
to detect such a difference. However,
since there wasn’t even a nonsignificant
difference in hypertrophy that seemed
to be noticeably leaning in favor of the
varied condition, I think that’s unlikely.
This study also reported some correla-
tions that I didn’t feel were worth report-
ing for the most part. While they were
statistically significant, the r2 values were
low (between 0.09-0.22), which makes
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
a high specific tension would be bene-
ficial for power athletes, so that finding
made sense, but it wasn’t clear why a low
specific tension would be beneficial for
bodybuilders. However, if having mus-
cles that are naturally relatively large and
relatively weak is predictive of future hy-
pertrophy, that finding would make way
more sense. I’m still not sure why that
would be the case physiologically, but it’s
at least interesting enough to mention.
However, I wouldn’t recommend going
around proclaiming that being naturally
muscular and naturally weak is the per-
fect combo for hypertrophy just yet; as
mentioned, the strength of the correla-
tions in this study leave something to be
desired for anyone interested in making
predictions. I would be interested in fu-
ture studies reporting the relationship
between pre-training strength and sub-
sequent hypertrophy, though.
Next Steps
I’d be really interested in seeing a study
that directly tested whether novelty af-
fects hypertrophy. The target study pop-
ulation could be people who have done
the vast majority of their training for the
past year with low reps (6 or fewer) and
people who have done the vast majority

67
 APPLICATION AND TAKEAWAYS
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
study examining long-term so-
dium bicarbonate supplementa-
tion and lifting performance. The results
from Siegler et al (2) did not show that
sodium bicarbonate increased strength
over 10 weeks, despite successfully in-
ducing alkalosis before each training
session. Interestingly, sodium bicarbon-
ate has consistently elicited alkalosis
(i.e. increase pH) by expelling hydrogen
ions (H+), which delays the incidence of
metabolic acidosis, yet performance re-
sults tend to be inconsistent. This article
breaks down a systematic review (1) that
evaluated 35 studies using sodium bicar-
bonate across various types of intermit-
tent exercise performance (i.e. running,
rowing, swimming, and lifting, among
others). The results were mixed, as 17 of
the 35 studies evaluated showed a clear
benefit for bicarbonate supplementation
and 23 of the 35 studies showed a ben-
efit for at least some performance met-
ric. Further, there seemed to be slight-
ly more support for exercise durations
lasting <4 minutes than for those lasting
>4 minutes. Importantly, only one resis-
tance training study was included in the
systematic review although many others
do exist. This article will put the results
of this systematic review into context
and will dive deeper into the resistance
training studies that the systematic re-
view failed to include. Further, this arti-
cle will discuss why equivocal results ex-
ist and exactly when sodium bicarbonate
supplementation might have utility for
the lifter.
Purpose and Hypotheses
Purpose
The purpose of this systematic review
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 authors aimed to determine sodi-
um bicarbonate’s effects on performance
in exercise performance tests lasting >4
minutes and those lasting <4 minutes.
the inclusion criteria, whereas a system-
atic review conducts no stats and pro-
vides more general feedback such as “X
percentage of studies showed a positive
response.”

Hypotheses Search Criteria and Inclusion

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

The overall results were fairly mixed,
but I would say they tended to suggest
a benefit for sodium bicarbonate. Over-
all, 17 of the 35 studies (~49%) reported
significance for all outcome measures in
favor of sodium bicarbonate; however, an
additional 6 studies reported at least one
performance measure to be improved
with supplementation. Thus, 23 of 35
studies (~66%) reported at least some
benefit when using sodium bicarbonate.
The benefit was slightly more frequent
when the performance test lasted <4
minutes versus >4 minutes. A more spe-
cific breakdown of the results is in Table
2.
Curiously, only one study on resistance
training was included, even though
many others exist (more on that later).
The included study, from Duncan et al
supplementation increased squat reps to
failure, but not bench press reps across 3
sets at 80% of 1RM.
Chronic Studies
Far less data on chronic sodium bicar-
bonate supplementation exist compared
to acute data. This systematic review
included five chronic supplementation
studies, and the results were mixed. Two
showed improved performance, both
for exercise tasks lasting <4 minutes (4,
5), while two studies showed no benefit
for supplementation (6, 7). Finally, one
study from Joyce et al (8) showed some
metrics of “CrossFit like performance”
to be improved, while other metrics
were not improved during exercise last-
ing exactly 4 minutes. Additionally, the
supplementation period did not need to
be long to be considered chronic. For

74
example, the Joyce study administered
0.1 g/kg 3 times per day for 3 days then
tested 2 x 200 meter swimming perfor-
mance, and that was considered chronic
supplementation.
Dosage and Timing
The dosages administered ranged from
0.1-0.3 g/kg with 0.3 g/kg being used in
all acute studies except for one. The tim-
ing of ingestion was anywhere from 60
to 120 minutes prior to the exercise test
in all but two acute studies. Therefore,
0.3 g/kg, 60 to 120 minutes pre-exercise
was the most common supplementation
protocol.
Interpretation
The totality of the results from this
systematic review, which covered a wide
range of performance tests (i.e. running,
rowing, swimming, and lifting, among
others), paints a mixed picture for sodi-
um bicarbonate. However, I would say
that the results tend to be on the posi-
tive side, as 23 out of 35 studies showed
at least one metric of performance to be
improved with supplementation. Ad-
ditionally, the findings suggest slightly
more consistency for sodium bicarbon-
ate to improve exercise performance
lasting <4 minutes versus those lasting
>4 minutes. Specifically, 75% of the stud-
ies analyzed showed at least one perfor-
mance metric improved for <4-minute
exercise tasks, while 53% of studies in-
cluded showed at least one performance
metric improved for studies >4 minutes
(Table 2). Importantly, no study in-
cluded in the systematic review showed
that sodium bicarbonate supplementa-
tion significantly harmed performance.
It should be noted, however, that the
approach the systematic review used –
simply counting the number of studies
in which sodium bicarbonate “worked”
or “didn’t work” based upon the p-values
– could be referred to as “vote counting.”
The vote counting approach is simple
but quite limited (thanks to Eric Trex-
ler for noting this point). Specifically, a
couple of underpowered studies might
show only a modest benefit for sodium
bicarbonate and fail to reach statistical
significance, resulting in the conclusion
that the treatment did not work. How-
ever, when the data across all studies are
pooled together, the benefit for sodium
bicarbonate could become much clearer.
The vote counting strategy just judges
studies individually and only based upon
the reported p-values, so its approach is
limited.
The fact that results tended to favor so-
dium bicarbonate isn’t too surprising, as
four out of five other meta-analyses/sys-
tematic reviews on sodium bicarbonate
and some type of intermittent exercise
performance show a small benefit for
supplementation (9, 10, 11, 12). The only
meta-analysis not showing a benefit was
recently published by Lopes-Silva et al
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

IT MIGHT MAKE SENSE TO TRY
SODIUM BICARBONATE ON
A NON-TRAINING DAY FIRST
TO SEE IF YOU EXPERIENCE
ANY SIDE EFFECTS.
In short, Siegler et al found that taking
0.3 g/kg of sodium bicarbonate prior to
training did not aid performance versus
a placebo. Further, Siegler also measured
acute performance and found that so-
dium bicarbonate did not increase max
reps during one set of as many reps as
possible over 30 seconds at 40% of 1RM
on the leg extension. However, Siegler
did find that alkalosis was induced pri-
or to every single session during the 10
weeks due to sodium bicarbonate inges-
tion. The max reps for 30 seconds over
only one set may be key to why Siegler
did not observe a benefit, as there was
likely no need to buffer H+. I speculat-
ed about this during the review of the
Siegler study, but it really comes down
to creating a condition for sodium bicar-
bonate to be effective. When consider-
ing the older studies from Webster and
Portington in the 1990s, neither used
free weight compound movements. The
more recent Carr and Duncan studies,
which observed a performance benefit,
seemed to more appropriately create the
condition for sodium bicarbonate to be
effective, as both used multiple sets with
short inter-set rest on compound move-
ments. As briefly touched on in the in-
troduction, the mechanism of action of
sodium bicarbonate is to accumulate
bicarbonate outside the muscle, which
causes an efflux of H+ out of the muscle
(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-
losis (i.e. high pH) increases the amount
of time it might take for pH to decrease
to acidic levels, meaning increased time
to fatigue.
The equivocal nature of the sodium
bicarbonate and performance literature
could be attributable to a few things.
First, the protocols implemented across
studies are quite different, which was
touched on above with the difference
between the Webster/Portington stud-
ies versus the more recent Carr/Duncan
studies. This means multiple sets with
short rest intervals, potentially using
compound movements, probably create
the best conditions for sodium bicar-
bonate to improve performance. Sodium
bicarbonate will almost certainly induce
alkalosis, but if you take five minute rests
between sets, then it’s unlikely you’ll see
a performance benefit, as you are giving
yourself ample time to buffer H+. An in-
teresting point, though, is that training
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
 APPLICATION AND TAKEAWAYS
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
may increase blood bicarbonate more
than others with the same dosage. This,
in part, explains why 0.3 mg/kg has seen
more consistent results than 0.1 mg/kg,
as the higher dosage is more likely to in-
crease blood bicarbonate by at least 0.5
mmol/L, which seems to be the mini-
mum threshold to cause sufficient H+
efflux to matter. Figure 1, which is re-
drawn from a recent review from Heibel
et al (18), clearly shows studies which
observed a greater increase in blood
bicarbonate have seen a more consis-
tent performance improvement. At first
glance, it may seem logical to say “just
take more” to ensure that alkalosis is en-
hanced enough to improve performance,
but this likely isn’t the answer, as signif-
icant gastrointestinal distress can be a
serious issue with sodium bicarbonate
tress is quite individual, and some don’t
report it at all; however, there are nu-
merous reports of vomiting, diarrhea,
and nausea with sodium bicarbonate, so
recommending above 0.3 g/kg would be
irresponsible (19). Alternative extracel-
lular buffers such as sodium citrate do
exist and have been suggested to have a
lower incidence of gastrointestinal dis-
tress; however, this isn’t supported by a
large body of literature. Further, while
some studies do show performance
benefits with sodium citrate (20), a me-
ta-analysis reported an unclear effect of
sodium citrate on intermittent perfor-
mance (10), and to my knowledge, there
is no data showing sodium citrate im-
proves lifting performance. Additionally,
supplementing with sodium bicarbonate
means that you are taking in a large ex-
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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bicarbonate supplementation does not manifest into greater training adaptations after 10-weeks of
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7. Durkalec-Michalski K, Zawieja E, Podgórski T, Zawieja B, Michałowska P, Łoniewski I, Jeszka J.
The effect of a new sodium bicarbonate loading regimen on anaerobic capacity and wrestling perfor-
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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-
ta-analytic review. International Journal of Sport Nutrition and Exercise Metabolism. 1993 Mar
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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
and downs in the fitness indus-
try. For decades, frequent meals
were touted as a strategy to boost meta-
bolic rate, although this theory has been
soundly rejected by scientific evidence
(2). In more recent years, the pendulum
has swung in the other direction, and in-
termittent fasting strategies with narrow
feeding windows have become popular.
Time-restricted feeding involves con-
suming all of the day’s calories within
a set time window, often between four
to eight hours in duration. Evidence has
suggested that this approach can in-
crease satiety and reduce calorie intake
(3), but concerns persist. Muscle protein
synthesis is stimulated following protein
intake, and studies have suggested that
it cannot be re-stimulated for three or
more hours (4). In theory, time-restrict-
ed feeding would limit the number of
opportunities to stimulate muscle pro-
tein synthesis via dietary protein intake,
thereby limiting muscle growth while
bulking, or the retention of muscle while
losing weight.
A recent study (1), however, suggests
that time-restricted feeding could be a
suitable eating strategy for lifters. Over
eight weeks, resistance-trained females
completed supervised resistance training
and adhered to a typical eating schedule
or a time-restricted (eight-hour) eating
schedule, with or without additional
β-hydroxy β-methylbutyrate (HMB)
supplementation. Both eating schedules
facilitated similar improvements in body
composition and a whole host of perfor-
mance outcomes, with minimal effects
of HMB. Read on to find out if time-re-
stricted feeding might be a viable strat-
egy for you.

84
Purpose and Hypotheses Subjects and Methods
Purpose
The authors stated that the purpose of
this study was, “To compare the phys-
iological and performance effects of
time-restricted feeding, with or with-
out HMB supplementation during
fasting periods, to a control diet re-
quiring breakfast consumption during
progressive resistance training in resis-
tance-trained females.” In the interest
of transparency, the authors did a great
job clarifying that they were primarily
focused on fat loss, lean mass accretion,
and hypertrophy, whereas other out-
comes (such as exercise performance,
metabolic rate, and a variety of phys-
iological variables) were of secondary
importance.
Hypotheses
A clear hypothesis was not stated, but
based on the summary of time-restrict-
ed feeding research in the introduction
section, one could assume that they ex-
pected time-restricted feeding and the
control diet to yield relatively similar
outcomes for fat loss and muscle gain.
Based on the way the HMB findings
were discussed in the paper, it would
also appear that the authors were gen-
erally skeptical and likely hypothesized
that HMB would yield no additional
benefit in comparison to a placebo.
Subjects
Resistance-trained females between
18 and 30 years old participated in this
study. All of them had been resistance
training at least two to four times per
week for at least a year, and the average
training experience was about five years.
Participants were also required to be be-
tween 15 and 33% body-fat. 40 subjects
were assigned to groups, and 24 of them
finished the entire trial with sufficient
adherence.
Design
This eight-week study consisted of
three groups. Two groups did time-re-
stricted feeding, consuming all of their
calories in an eight-hour window from
noon to 8 p.m. One of these groups con-
sumed 3g/day of calcium HMB, while
the other got a placebo. The third group
was instructed to eat breakfast as soon
as possible upon waking, resulting in a
“typical” eating window, and they also
took a placebo throughout. Participants
completed supervised resistance train-
ing workouts three times per week, al-
ternating between upper-body sessions
and lower-body sessions, with workouts
occurring in the fed state for all groups.
Diet and Exercise
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
intended to create a small caloric deficit.
Subjects were given protein powder to
help them achieve a daily protein intake
of at least 1.4g/kg per day (all groups
ended up around 1.6g/kg). They also
gave subjects food scales, which enabled
the researchers to collect weighed diet
logs at certain points in the study.
Outcomes
This study evaluated a ton of out-
comes, as you might infer from the 17
supplementary tables (seriously) that
didn’t make it into the paper. The pri-
mary outcomes of interest included fat
mass, fat-free mass, body-fat percentage,
and muscle thickness of the biceps and
quads. Performance outcomes included
counter-movement vertical jump, iso-
metric and isokinetic squats, and one-rep
max and repetitions to fatigue on bench
press and leg press. Additional measure-
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-
tion, they completed two separate anal-
yses: per protocol, and intent-to-treat.
Whenever you see that data were ana-
lyzed in two different ways, you might
be suspicious that the authors were fish-
ing around for certain results. However,
this is very common practice in biomed-
ical research. Per-protocol analysis only
considers participants who completed
the full intervention with sufficient ad-
herence, while intent-to-treat includes
everyone who was assigned to a group.
The intent-to-treat analysis was treated
as the “primary” analysis, which is pretty
standard.
Interpretation
When reading this study, the first
word that comes to mind is “thorough.”
The authors took a very detail-oriented
approach, resulting in findings that we
can have a lot of confidence in. They
checked urine HMB levels, monitored
physical activity levels, supervised all
training, and provided scales so subjects
could complete weighed food diaries.
They even stratified subjects by body-fat
percentage and habitual breakfast con-
sumption before assigning groups, just
to make sure groups were fairly similar
in terms of their initial body compo-
sition and eating windows. All in all, a
very strong study.
BASED ON THE AVAILABLE
EVIDENCE, IT WOULD APPEAR
THAT TIME-RESTRICTED
FEEDING IS A TOTALLY VIABLE
APPROACH FOR LIFTERS
INTERESTED IN MAINTAINING
OR INCREASING THEIR MUSCLE
MASS, PROVIDED THAT THEY
USE AN EIGHT-HOUR FEEDING
WINDOW WITH SUFFICIENT
TOTAL DAILY PROTEIN INTAKE.
When evaluating the intermittent fast-
ing literature, there are two very different
approaches. In the research world, the
term “intermittent fasting” often refers
to diet patterns in which subjects actu-
ally fast for a couple of days each week.
Rather than shifting the daily feeding
window, these approaches involve fast-
ing for the entire day. Meta-analyses
have shown that these approaches are no
more effective for weight loss than tra-
ditional caloric restriction (5, 6, 7), and
such prolonged fasting periods are not
ideal for individuals engaged in frequent
training.
In the research world, more practical in-
88
termittent fasting protocols that involve
narrow daily feeding windows are called
“time-restricted feeding” interventions.
Tinsley, the lead author of the current
paper, published a time-restricted feed-
ing study with less favorable results back
in 2017 (3). They used male participants
and implemented a four-hour time win-
dow rather than eight, and findings sug-
gested that the time-restricted feeding
strategy attenuated fat-free mass gains
and performance improvements to a
small degree. However, protein intake in
the time-restricted group (1.0g/kg) was
lower than the control group (1.4g/kg)
and well below the optimal level for in-
dividuals involved in resistance exercise.
In a separate study with an eight-hour
feeding window and sufficient daily
protein intake (>1.8g/kg), fat-free mass,
muscle thickness, and performance re-
sponses were pretty similar between the
time-restricted feeding and control diet
groups (8).
To be fair, there is a valid reason to
suspect that time-restricted feeding
would be suboptimal for muscle gain
or retention. After ingesting protein,
muscle protein synthesis is elevated for
about two to three hours. It starts re-
turning back to baseline levels, despite
the fact that blood amino acids are still
high, and attempts to re-stimulate pro-
tein synthesis during this timeframe ap-
pear to be pretty ineffective (4). How-
ever, resistance training causes huge and
sustained increases in muscle protein
synthesis. Research has shown that re-
sistance training prolongs the time in
which protein synthesis is elevated after
protein intake (9) and amplifies the an-
abolic effect of protein feeding for up to
24 hours after a workout (10). Based on
the available evidence, it would appear
that time-restricted feeding is a totally
viable approach for lifters interested in
maintaining or increasing their muscle
mass, provided that they use an eight-
hour feeding window with sufficient
total daily protein intake. This gener-
al conclusion mirrors the findings of a
meta-analysis on pre- and post-exercise
protein timing by Schoenfeld et al (11);
for individuals engaged in resistance
training, total daily protein intake ap-
pears to be more important than highly
nuanced protein timing strategies.
Along with sufficient total protein in-
take, there is a second caveat to mention
here: the timing of workouts. In the cur-
rent study, “time-restricted feeding” was
essentially breakfast skipping, with all
meals occurring between noon and 8:00
p.m. A recent study, which Eric Helms
previously reviewed in MASS, investi-
gated the performance effects of break-
fast-skipping (12). Participants com-
pleted two separate testing sessions (one
after breakfast, one after an overnight
fast), in which they completed four sets
to failure on squat and bench press. Un-
surprisingly, subjects completed signifi-
cantly fewer repetitions for both exercis-
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
breakfast, but it would seem reasonable
to conclude that training in the fed state
is generally the safest bet for most lift-
ers. While the current study by Tins-
ley et al found no adverse performance
effects of time-restricted feeding, they
ensured that training occurred within
the eight-hour feeding window. This
would seem like an advisable strategy
for lifters and other athletes who wish
to utilize time-restricted feeding.
Results of the current study indicate
a modest benefit of time-restricted
feeding for fat loss, but I’m inclined
to interpret this trend very cautiously.
The figure showing fat mass changes
(Figure 1), expressed as percentages,
appears to show meaningful differenc-
es at first glance. However, closer ex-
amination of the raw data reveals that
fat mass was increased by 0.4kg in the
control diet and was reduced by 0.7
and 0.4kg in the time-restricted groups
with and without HMB. In the grand
scheme of things, these differences are
pretty negligible, and are small enough
to potentially be related to some pretty
straightforward methodological details.
The group with the most notable fat loss
consumed about 100 fewer calories per
day than the other groups, and nutri-
ent intakes were self-reported via food
diaries. Previous studies have shown
that time-restricted feeding increases
TIME-RESTRICTED FEEDING
OFTEN CAUSES GREATER
FAT LOSS THAN CONTROL
DIETS WHEN CALORIES
ARE NOT MATCHED,
WHEREAS DIFFERENCES ARE
NEGLIGIBLE WHEN CALORIC
INTAKE IS MATCHED UNDER
TIGHTLY CONTROLLED
EXPERIMENTAL CONDITIONS.
fullness and reduces food intake, to the
point that subjects in a controlled feed-
ing study routinely struggled to finish
their prescribed dinner (13). With even
a small amount of estimation error on
food diaries and a little hunger reduc-
tion, the observed differences in fat
mass may simply be attributable to a
small degree of relative under-eating in
time-restricted groups. This would ex-
plain why time-restricted feeding often
causes greater fat loss than control diets
when calories are not matched, whereas
differences are negligible when caloric
intake is matched under tightly con-
trolled experimental conditions (14).
Due to some controversial papers that
90
 APPLICATION AND TAKEAWAYS
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
has become a bit of a punchline in the
world of supplement research. Howev-
er, that’s not a good reason to discount
the entire body of HMB research, so
it’s important to approach this study
with an open mind. HMB and oth-
er leucine metabolites have minimal
effects on protein synthesis and don’t
seem to do much for healthy, reason-
ably well-trained subjects that are con-
suming plenty of energy (15). However,
HMB has anti-catabolic properties and
has attenuated the loss of fat-free mass
in subjects prone to muscle loss, such
as cancer patients and immobilized in-
dividuals (16). With this in mind, it’s
pretty unsurprising that HMB had no
effects on fat-free mass, hypertrophy, or
performance in the current study. Inter-
estingly, the results suggest that there
may have been a slight benefit of HMB
for fat loss; in the per-protocol analysis,
a significant interaction was observed,
and only the time-restricted feeding
with HMB group had a statistically
significant reduction in fat mass. This is
not the first HMB study to make such
an observation, but others have some
notable methodological limitations,
such as extremely short study duration
(three days) (17) and the use of unre-
liable body composition measurement
devices (18). As noted previously, the
magnitude of fat loss differences in the
current study could easily be explained
by modest variability in energy intake
and minor estimation errors, and the
majority of HMB research to date has
failed to document meaningful fat loss
benefits. So, while the observed trend
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.
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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
“effective reps” has gained a lot of
traction in the “evidence-based fit-
ness” community. The basic idea is that
the last few reps prior to failure are the
ones that really matter for hypertrophy.
A natural implication is that, as long as
you’re not overtraining, training clos-
er to failure should yield more muscle
growth on a set-by-set basis than stop-
ping further from failure.
However, a recent finding calls that
supposition into question. Over 10
weeks, subjects either trained based on
rep maxes (taking the last set of each
exercise to failure) or based on relative
intensity (never going to failure, and
generally staying several reps shy of
failure), and the researchers assessed fi-
ber hypertrophy and whole-muscle hy-
pertrophy. Both fiber and whole-mus-
cle hypertrophy tended to be larger
in the relative intensity group, which
stayed further from failure. Further-
more, when examining the research we
have on training at different proximi-
ties to failure, it becomes clear that the
“effective reps” model has some holes,
and may be a little too specific for its
own good.
Purpose and Hypotheses
Purpose
The purpose of this study was to com-
pare the outcomes of programming
with rep maxes or relative intensity.
Specifically, the authors were inter-
ested in muscle fiber hypertrophy and
whole-muscle hypertrophy of the quads
and changes in signaling proteins.
Hypotheses
The authors hypothesized that pro-
gramming with relative intensity would
lead to more hypertrophy due to supe-
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 grip mid-thigh pull

• back squat • back squat
• 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
• back squat • back squat
• 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

• clean grip mid-thigh pull
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
intensities during the last lifting day of
each week (65-80%).
The group training with repetition
maximums, on the other hand, fol-
lowed essentially the same training
program, except they trained at 100%
relative intensity for every session. So,
for example, if they were supposed to
do 3 sets of 8-12 reps, they’d use a load
that would allow them to reach failure
after performing between 8 and 12 reps
on set three, but they probably didn’t go
to failure on the first two sets. If they
completed more or fewer reps on their
last set than their repetition maximum
zone called for, load was adjusted up
or down for the next session. Details
of the training program can be seen in
Table 1.
In practice, relative intensities were
based on estimated reps in reserve af-
ter the first and last set in each workout
using Table 3.
Before and after the training inter-
vention, the researchers biopsied the
vastus lateralis (your outside quad mus-
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
intensity group, but the increases in iso-
metric mid-thigh pull force were pretty
similar between groups. However, the
increases seemed to be more consistent
and predictable in the relative intensity
group.
One thing noted in the prior study
was the training strain (variability in
session RPE scores multiplied by av-
erage session RPE scores) was higher
in the rep max group, and we’ve previ-
ously discussed in MASS how training
to failure takes longer to recover from.
So, is it possible that the results of this
study – less growth in the rep max
group – are the result of overtraining?
Or, at minimum, finding oneself on the
downslope of the volume-growth in-
verted U relationship?
Just looking at the details of the
training programs, I think that’s un-
likely. For most of the study, the sub-
jects were doing just six sets of direct
quad work per week, via three sets of
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
dumbbell step-ups (performed in just
one block) and clean pulls, but those
aren’t exercises that are really going to
fry your quads. Add to that the fact that
the rep max group was generally only
taking their last set to failure, and I
have a hard time buying that six sets of
direct quad training, involving just two
weekly sets to failure, with a little an-
cillary quad stimulation, is sufficient to
overtrain the quads. Furthermore, jump
performance held steady and isometric
mid-thigh pull strength increased by al-
most 15% in the rep max group, further
suggesting they weren’t overtrained.
So, what gives?
First, I think it’s worth backing up
and examining the prior literature that
has looked at the effects of training at
different proximities to failure. We’ve
previously reviewed three such studies
in MASS. One study by Nobrega et al
found that training to failure versus “vo-
litional interruption” didn’t lead to dif-
ferences in hypertrophy when training
with either 30% or 80% of 1RM (4); it
should be noted, however, that the “vo-
litional interruption” group was basical-
ly training to failure, but just stopping
when they thought they couldn’t get
another rep rather than actually failing
their last rep. Another by Martorelli et
al found that training to failure doing

102
biceps curls for 3 sets to failure tended
to cause more hypertrophy than doing
either 3 or 4 sets of 7 with 70% of 1RM
(5). Finally, a study by Pareja-Blanco et
al found that squatting with within-set
velocity reductions of 40% (which re-
sulted in most sets being close to fail-
ure, and quite a few sets being taken to
failure) or 20% (which resulted in fewer
total reps, and sets generally stopping far
from failure) caused similar increases in
both fiber cross-sectional area and quad
muscle volume (6). Adding to these
studies we’ve previously reviewed, a
study by Geissing et al found that train-
ing to failure caused larger gains in lean
mass than training to self-determined
rep maxes (7; though that strikes me as
somewhat odd – wouldn’t “rep maxes”
also imply going to failure or very close
to failure?). Another study by Goto et
al found that doing 3-5 sets of 10 with
10RM loads caused more hypertrophy
than doing those same sets of 10, but
taking a 30-second rest in the middle of
each set (i.e. doing 2 mini sets of 5 for
each set, and not going to failure; 8). A
study by Sampson found that training
the biceps either to failure or ~2 reps shy
of failure resulted in similar hypertrophy
over 12 weeks (9). Finally, one of Eric
Helms’ PhD thesis studies found that
two groups training with significantly
different amounts of reps in reserve (one
group was generally going 1-3 reps clos-
er to failure) had similar pec and quad
growth over 8 weeks (10).
So, right off the bat, we can see that
results in the literature are all over the
place. Thus far, four studies (Nobrega,
Pareja-Blanco, Sampson, and Helms)
have found pretty similar hypertrophy
when training at different proximities
to failure, and three (Martorelli, Goto,
and Geissing) have found more growth
when training to failure versus non-fail-
ure. However, I think we can toss out
two studies for our purposes here. As
mentioned, in the Nobrega study (4), the
“volitional interruption” group was basi-
cally training to zero reps in reserve but
not actually failing the final rep, so I don’t
think it’s the sort of comparison we’re in-
terested in. The Geissing study (7) is also
a bit hard to parse; we know that lifters
are good at knowing how close to failure
they are if they have three or fewer reps
in reserve, but apparently the “self-deter-
mined rep max” group made virtually no
gains, while the “momentary muscular
failure” group made pretty large gains? If
that’s true, that would imply that going
until you actually fail a rep is the real key
to hypertrophy, which seems unlikely.
Furthermore, that study used single-set
training, which makes it less useful for
the vast majority of lifters who do mul-
tiple sets of each exercise. However, that
still leaves us with three studies finding
similar hypertrophy at different proxim-
ities to failure, and two studies finding
greater hypertrophy when training to
failure versus not going to failure.
One key detail to note, however, is that
103
the Helms study and the Pareja-Blan-
co study both used trained lifters, while
the other remaining studies all used un-
trained subjects. Thus, both studies with
trained lifters found similar hypertrophy
in spite of different proximities to failure,
while two of the studies on untrained
lifters (Goto and Martorelli) found that
going to failure caused more growth,
and only one (Sampson) found similar
hypertrophy with different proximities
to failure. So, based on the literature we
have, it seems that training to failure or
closer to failure may be more important
for untrained lifters, while trained lifters
may have a little more leeway.
Why might that be?
Well, we need to start by theorizing
about what causes muscle growth in the
first place. There’s been a lot of discus-
sion about this recently, with one of the
popular suggestions being the idea of
“effective reps.” In fact, this model has
become so popular and ubiquitous on-
line, it seems that a lot of people just ac-
cept it as if it’s proven fact. This model
implies that the last five reps before fail-
ure are the ones that are the most cru-
cial for hypertrophy. However, I think
the experimental evidence suggests that
the “effective reps” model leaves some-
thing to be desired. When the Pare-
ja-Blanco, Helms, and Sampson stud-
ies all had substantial differences in the
number of “effective reps” each group
was exposed to, and when the presently
reviewed study found more hypertrophy
in the group doing fewer “effective reps,”
it’s clear that the “effective reps” mod-
el is missing something. In fact, we can
roughly calculate the number of “effec-
tive reps” in both of the programs in the
present study. Using the reps in reserve
ranges provided in the relative intensi-
ty chart, the relative intensity group did
somewhere between 34 and 66 “effective
reps” of squats, while the rep max group
did about 234, meaning the relative in-
tensity group was only averaging 1.7-3.3
“effective reps” per squat session (which,
in the “effective reps” model, should be
equivalent to just doing one set of 2 or 3
reps to failure), while the rep max group
was averaging 11.7. In fact, most of the
lower intensity Day 3 workouts for the
relative intensity group would have had
0 “effective reps,” and would thus be con-
sidered a complete waste of time from a
hypertrophy standpoint (11).
I propose that we apply Occam’s razor
(22): look for the simplest explanation
given what we know. We know – or at
least have very good reason to suspect –
that a muscle fiber needs to be recruit-
ed and exposed to tension for it to grow
(12). We also know – or at least have
very good reason to suspect – that some
level of acute local fatigue is required to
maximize growth. Otherwise, people
would get jacked from doing maximal
singles, and there would be no reason
that doing more sets would cause more
growth than a single set to failure. So,
that’s what I propose we consider: re-
104
cruitment and fatigue. I’m not propos-
ing anything more specific (i.e. a specific
level of fatigue), because we don’t have
sufficient evidence to justify anything
more specific.
Through that lens, I think it’s logi-
cal that untrained lifters may need to
go closer to failure than trained lifters
to maximize hypertrophy. One adapta-
tion to heavy resistance training is that
synchronous recruitment of motor units
improves (13). In other words, from the
first rep of a set, you can “switch on”
more motor units. We know that mo-
tor unit recruitment increases as a lifter
fatigues throughout a set, such that all
motor units are eventually recruited by
at least the point of failure (14), but like-
ly a few reps shy of failure (15). However,
due to improvements in synchronous re-
cruitment, I think it’s likely that trained
lifters can reach the point of full motor
unit recruitment earlier in a set than un-
trained lifters do, especially when trying
to lift explosively (16). Furthermore, it
should be clear that trained lifters can
induce more metabolic fatigue on a per-
rep basis than untrained lifters. Energy
demands of training scale linearly with
work rate, so if you double the weight
on the bar, you double the energy de-
mands. However, mitochondrial densi-
ty generally doesn’t increase with resis-
tance training, nor does capillary density
(measured as capillaries per unit of mus-
cle cross-sectional area, though there’s
sometimes an increase in capillaries per
fiber). So, energy demands go up, but
the ability to meet those demands aer-
obically doesn’t change much, meaning
the anaerobic contributions to energy
expenditure increase, promoting greater
metabolic fatigue on a per-rep or per-set
basis. So, with both of those consider-
ations in mind, I don’t think it’s shock-
ing that untrained lifters seem to ben-
efit more from training to failure than
trained lifters do.
However, all of this rambling about
hypertrophy in general still doesn’t quite
explain the results of this specific study:
more hypertrophy when training fur-
ther from failure. The coward’s way out
would just be to chalk it up to sampling
error and call it a day, or to go back and
delete the third paragraph of this inter-
pretation section to leave open the op-
tion of overtraining. However, that’s not
what I’m going to do. No, I’m going to
propose that the key may be a part of the
training program that’s easy to overlook:
the sprint training.
I’m sure most MASS readers are aware
of the interference effect: the idea that
doing combined strength training and
conditioning work tends to lead to less
muscle growth and smaller strength
gains than just doing strength training.
It’s a concept we’ve covered a few times
in MASS (one, two, three, four). How-
ever, not all studies support the existence
of the interference effect. In fact, some-
times, the results swing the opposite di-
rection. I’m aware of four studies where
105
 APPLICATION AND TAKEAWAYS
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-
trophy than only resistance training. Two
of them used isokinetic exercise for the
resistance training, so it’s hard to know
how the training protocol compared to
traditional resistance training (17, 18).
However, the other two were by Ka-
zior et al (19) and Mikkola et al (20). In
both studies, the majority of the training
wasn’t performed to failure (18 of 21 ses-
sions in Kazior et al, and 14 of 21 weeks
in Mikkola et al). It’s possible that do-
ing most of the resistance training shy of
failure is what allowed concurrent train-
ing to lead to more hypertrophy in these
two studies, while it generally leads to
less growth in the majority of the litera-
ture. It’s possible that conditioning work
and non-failure resistance training are
synergistic (as long as the volume of the
conditioning work isn’t excessive), while
conditioning work and resistance train-
ing to failure are antagonistic.
The last piece of this study to touch on
is the change in protein levels. I’m really
not sure how relevant changes in rest-
ing levels of mTOR and AMPK are; the
changes (or lack thereof ) were also sim-
ilar between groups, so I’m just going to
punt on those findings.The authors of the
study even note that most studies look at
post-training changes in these proteins,
rather than resting levels, so there’s not
even much literature to get one’s bear-
ings. However, if I’m understanding the
results correctly, the changes in levels of
the various myosin isoforms would re-
flect density changes. In other words,
this study found disproportionate my-
ofibrillar hypertrophy occurred (that is,
an increase in density of contractile pro-
teins), primarily in the relative intensity
group, as opposed to the disproportion-
ate sarcoplasmic hypertrophy reported
in the study we recently reviewed by
Haun et al (21). Since most of the train-
ing in the presently reviewed study in-
volved sets of five or fewer, since volume
was relatively low, and since the increas-
es in myosin density were greater in the
relative intensity group, these findings
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
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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

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 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.”

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 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.

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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
1. Schoenfeld BJ, Pope ZK, Benik FM, Hester GM, Sellers J, Nooner JL, Schnaiter JA, Bond-Wil-
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.

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 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.

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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.

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 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

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 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

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 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.

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