Barbell Medicine Podcast

Once a month we answer Barbell Medicine Plus subscribers’ questions on the Direct Line. This is a free look at June’s episode. We start with GLP-1 drugs and muscle: why DEXA overstates the loss, what resistance training actually does, and whether creatine is worth taking. Then whether bulking and cutting does anything the scale can’t already tell you, how to get real benefit from one training hour a week, and what happens to your muscle, strength, tendons, and bone when you take time off, including why muscle memory brings it back faster than you built it.What we cover:• GLP-1s and muscle: the DEXA problem, resistance training, and creatine• Bulking vs cutting vs just maintaining, and a health-first way to choose• Training on one hour a week: the least that still moves the needle• How fast you lose muscle when you stop, and why it comes back fastThe full two-hour episode and every back episode are on Barbell Medicine Plus, which can bundled with Premium. Resources and full references below.Timestamps0:00 Intro + GLP-1 and the DEXA muscle-loss myth3:00 Do GLP-1s spare or waste muscle?8:03 Does creatine help on a GLP-1?10:45 Does bulking and cutting do anything?13:18 Health first: when to lose fat before gaining22:30 Training on one hour a week36:22 How fast you lose muscle when you stop43:19 Muscle memory: why it comes back48:25 The full episode on PlusResourcesBarbell Medicine coaching and templates: https://www.barbellmedicine.comhttps://www.barbellmedicine.com/shop/subscriptions/plus-podcast-subscription/https://www.barbellmedicine.com/shop/subscriptions/barbell-medicine-premium/Signal book pre-order: https://www.barbellmedicine.com/shop/learning/signal/https://www.barbellmedicine.com/blog/glp-1-muscle-loss/https://www.barbellmedicine.com/blog/creatine-on-ozempic-does-it-prevent-muscle-loss/https://www.barbellmedicine.com/blog/novice-intermediate-advanced-strength-training/Lundgren JR, et al. Healthy Weight Loss Maintenance with Exercise, Liraglutide, or Both Combined (S-LITE). N Engl J Med 2021;384:1719-1730. nejm.org · NEJMoa2028198T-REX trial: tirzepatide with or without resistance training (Univ. of Western Australia). Preliminary. ANZCTR ACTRN12623001236684Creatine + GLP-1 pilot (Univ. of Saskatchewan). Ongoing, results expected 2027. ClinicalTrials.gov NCT07625202Momma H, et al. Muscle-strengthening activities and lower risk/mortality in major non-communicable diseases. Br J Sports Med 2022. PubMed 35228201Wall BT, et al. 2014. Immobilization and disuse muscle atrophy (quadriceps −3.5% at 5 days, −8% at 14 days). PubMed 24168489Gaffney CJ, et al. 2021. Grip strength loss with short-term arm immobilization. PMC8107283Farthing JP, et al. 2009. Cross-education and preservation of the immobilized limb. PubMed 19150859Marusic U, et al. 2021. Bed rest: strength loss outpaces size loss. PMC8325614Yoshihara, et al. 2023. Sepsis-associated muscle wasting (−26% in a week). PMC10003568Warren GL, et al. 2017. Strength loss and recovery after muscle injury (meta-analysis). PMC5214801Hortobágyi T, et al. 1993. Short-term detraining in strength athletes. PubMed 8371654Gavanda S, et al. 2020. Training cessation in previously untrained adolescents. PMC7241623Lovell DI, et al. 2010. Detraining strength loss in older adults. PubMed 20140683Mujika I, Padilla S. 2001. Physiology of detraining (review). PubMed 11474330Smith K, et al. 2003. Two years of training, then detraining, in older adults. PubMed 12955872Staron RS, et al. 1991. Detraining and muscle cross-sectional area in women. PubMed 1827108Ivey FM, et al. 2000. Detraining across age and sex. PubMed 10795719Taaffe DR, et al. 2009. Training and detraining in older adults. PMC2756799Grgic J, et al. 2022. Muscle size loss with detraining (meta-analysis). PubMed 36360927Bosquet L, et al. 2013. Detraining effects on strength and power. PubMed 23347054Bruusgaard JC, et al. 2010. Myonuclei acquired by overload persist after detraining (muscle memory). PMC2930527Weakley J, et al. 2017. Day-to-day variation in strength performance. PubMed 28277425McGuigan MR, et al. 2004. Strength performance variability. PubMed 15320651Andreoli A, et al. 2009. DEXA precision and assumptions. PMC9263164Our Sponsors:* Check out Chilipad and use my code BBM for a great deal: https://sleep.me* Check out Chilipad and use my code sleep.me/BBM for a great deal: https://sleep.me* Check out CovePure and use my code CovePure.com/bbm for a great deal: https://covepure.com* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brands

Can a simple one-second squeeze predict your risk of cardiovascular disease, cognitive decline, and all-cause mortality? Dr. Jordan Feigenbaum and Dr. Austin Baraki explore why grip strength has become the go-to metric for the longevity industry and why most people are interpreting the data incorrectly.Timestamps:[00:00] Intro: The Longevity Industry’s Thermometer Error[01:42] The Neuro-Axis: Anatomy of a Maximal Squeeze[06:43] The 35-3-5 Rule: Biomechanics of Grip[09:12] Asymmetries and Clinical Red Flags[17:31] Dynapenia vs. Sarcopenia: Why the Hand Fails First[18:41] Normative Data and the PURE Study Statistics[27:16] Genetics, Lean Body Mass, and Predictive Power[31:44] Absolute vs. Relative Grip Strength (The Metabolic Signal)[37:03] Bro-Science Beatdown: Neural Jitter and Training Readiness[42:19] The Extensor Training and "Grip Maxing" Myth[45:13] Programming: Systemic Training vs. Indirect Grip Work[48:10] The Straps Debate: Are You Killing Your Gains?[52:03] Final Verdict: Hierarchy and Health PrioritiesKey Takeaways:Grip is Systemic: Handgrip strength tests the integrity of the entire system, from the motor cortex in the brain down to the tendons and bones. It is a proxy for overall muscular quality and neurological health.Predictive Power: According to the PURE study, for every 5 kg decrease in grip strength, there is a 17% increased risk of cardiovascular death and a 7% increased risk of non-cardiovascular death.The Sarcopenia Floor: Clinical "red zones" for probable sarcopenia are <27 kg for men and <16 kg for women.Relative Strength Matters: Relative grip strength (Grip Strength ÷ BMI) is a more accurate predictor of hypertension, diabetes, and dyslipidemia than absolute grip strength alone.Don't Chase the Test: Direct grip training (crushers, etc.) obscures the predictive power of the test. To improve health, focus on indirect systemic resistance training (training the whole body) rather than "gaming" the thermometer.Next StepsFor evidence-based resistance training programs: barbellmedicine.com/training-programsFor individualized medical and training consultation: barbellmedicine.com/coachingExplore our full library of articles on health and performance: barbellmedicine.com/resourcesTo join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: https://barbellmedicine.supercast.com/RESOURCES:https://europepmc.org/article/med/1538102 https://pubmed.ncbi.nlm.nih.gov/12188074/#/ https://pmc.ncbi.nlm.nih.gov/articles/PMC6322506/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10777545/#/ https://pmc.ncbi.nlm.nih.gov/articles/PMC6322506/#/ https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0113637#/ https://pubmed.ncbi.nlm.nih.gov/31499496/#/ https://pubmed.ncbi.nlm.nih.gov/25982160/#/ https://www.sciencedirect.com/science/article/pii/S2095254620300752?via%3Dihub#/ https://pubmed.ncbi.nlm.nih.gov/27701433/#/ https://pmc.ncbi.nlm.nih.gov/articles/PMC5517526/#/ https://pubmed.ncbi.nlm.nih.gov/18271028/#/ https://pmc.ncbi.nlm.nih.gov/articles/PMC7344191/#/https://pmc.ncbi.nlm.nih.gov/articles/PMC7244054/#/ https://www.sciencedirect.com/science/article/abs/pii/S1388245710003561#/ https://pubmed.ncbi.nlm.nih.gov/25653226/#/https://pmc.ncbi.nlm.nih.gov/articles/PMC6306785/#/ https://pubmed.ncbi.nlm.nih.gov/27619723/#/ Our Sponsors:* Check out Chilipad and use my code BBM for a great deal: https://sleep.me* Check out Chilipad and use my code sleep.me/BBM for a great deal: https://sleep.me* Check out CovePure and use my code CovePure.com/bbm for a great deal: https://covepure.com* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brands

In this episode, Dr. Jordan Feigenbaum and Dr. Austin Baraki dissect the federal government’s 2026 Food Pyramid Reset and its radical shift in nutrition policy. They explore the history of industry lobbying that shaped previous guidelines and evaluate whether the new emphasis on protein and animal fats aligns with current clinical evidence. Finally, the doctors provide the framework for the Barbell Medicine Dietary Guidelines, offering a practical, evidence-based framework for managing the modern food environment.Timestamps00:00 - Introduction: The 1992 Food Pyramid vs. the 2026 Reset03:11 - A History of Lobbying: From the McGovern Committee to the USDA09:44 - Big Food and Big Tobacco: How the American pantry was engineered17:15 - The Good: Protein floors and the official war on ultra-processed foods27:13 - The Bad: Saturated fat, beef tallow, and the dairy hall pass44:02 - The Ugly: The 25-gram fiber gap and the retreat on alcohol guidelines54:10 - Economic barriers and the Healthy Eating Index scores01:06:18 - The Barbell Medicine Dietary Guidelines: A practical frameworkNext StepsFor evidence-based resistance training programs: barbellmedicine.com/training-programsFor individualized medical and training consultation: barbellmedicine.com/coachingExplore our full library of articles on health and performance: barbellmedicine.com/resourcesTo join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: https://barbellmedicine.supercast.com/Key Learning PointsEnvironment over Willpower: Weight gain is an emergent process caused by an engineered food environment that adds nearly 500 passive calories to the average American's daily intake compared to 1977.The New Protein Floor: The 2026 Reset finally acknowledges that the old 0.8g/kg RDA was a "survival dose." The new range of 1.2–1.6g/kg is a victory for skeletal muscle health, though doesn't really change intake for many (if they even read the guidelines).Incoherent Fat Logic: There is a fundamental conflict in guidelines that recommend beef tallow and butter while simultaneously advising that saturated fat stay below 10% of total calories.The Fiber Gap: By emphasizing animal proteins over legumes, the new guidelines risk widening the already massive fiber deficiency in the U.S.The 10:1 Rule: For better metabolic health, aim for a carbohydrate-to-fiber ratio of 10:1 (acceptable) or 5:1 (elite).ReferencesBarbell Medicine Guidelines Coming Soon! https://www.youtube.com/watch?v=inCEbKyWYwg (Trial of Big Food)https://pmc.ncbi.nlm.nih.gov/articles/PMC12027923/ https://www.govinfo.gov/content/pkg/CPRT-95SPRT98364O/pdf/CPRT-95SPRT98364O.pdf https://pubmed.ncbi.nlm.nih.gov/31462476/ https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001050 https://pubmed.ncbi.nlm.nih.gov/6841553/ https://pubmed.ncbi.nlm.nih.gov/7068846/ https://pubmed.ncbi.nlm.nih.gov/6841553/ https://pubmed.ncbi.nlm.nih.gov/7068846/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10552423/ https://pubmed.ncbi.nlm.nih.gov/26980437/ https://pubmed.ncbi.nlm.nih.gov/26843151/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10552423/ https://pubmed.ncbi.nlm.nih.gov/26980437/ https://pmc.ncbi.nlm.nih.gov/articles/PMC6124841/ https://pubmed.ncbi.nlm.nih.gov/28889851/https://www.ers.usda.gov/data-products/chart-gallery/chart-detail?chartId=58372#:~:text=As%20their%20incomes%20rise%2C%20U.S.,of%20after%2Dtax%20income). https://www.ers.usda.gov/data-products/food-price-outlook/summary-findings#:~:text=Beef%20and%20veal%20prices%20are,higher%20than%20in%20August%202024. https://pmc.ncbi.nlm.nih.gov/articles/PMC4733413/ https://pubmed.ncbi.nlm.nih.gov/26843151/ https://www.barbellmedicine.com/blog/how-to-eat-a-healthy-diet/https://www.barbellmedicine.com/resources/calorie-calculator/ https://www.barbellmedicine.com/resources/macronutrient-calculator/Our Sponsors:* Check out Chilipad and use my code BBM for a great deal: https://sleep.me* Check out Chilipad and use my code sleep.me/BBM for a great deal: https://sleep.me* Check out CovePure and use my code CovePure.com/bbm for a great deal: https://covepure.com* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brands

For decades, the health and fitness industry has blamed rising obesity rates on a lack of individual willpower and "poor choices." However, a landmark lawsuit in San Francisco argues that the modern food environment is a public nuisance engineered by food giants using a literal tobacco playbook. By manipulating "Bliss Points" and dismantling the natural food matrix, these companies have created an environment where healthy choices are the path of highest resistance. Understanding the shift from personal responsibility to environmental accountability is the first step in reclaiming your health.Next StepsFor evidence-based resistance training programs: barbellmedicine.com/training-programsFor individualized medical and training consultation: barbellmedicine.com/coachingExplore our full library of articles on health and performance: barbellmedicine.com/resourcesTo join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: https://barbellmedicine.supercast.com/Timestamps00:00 - The San Francisco Lawsuit vs. Big Food01:46 - Legal Shift: Personal Choice vs. Public Nuisance08:02 - Probabilistic Automaticity: Why Environment Wins13:40 - The 500-Calorie Shift: The Rise of Energy Toxicity16:11 - The Tobacco Playbook & The Bliss Point22:33 - The Potato Continuum & The Food Matrix28:09 - Yale Food Addiction Scale (YFAS) Data33:48 - The BMJ Umbrella Review on UPF Risks52:35 - Practical Strategy: Playing Offense at HomeKey Points The Public Nuisance Shift: Why legal strategy is moving away from "individual choice" toward holding corporations accountable for creating a toxic health environment.Probabilistic Automaticity: Human willpower hasn't decreased since the 1970s; instead, the probability of making a "bad" choice has been engineered to increase through environmental cues.The Bliss Point: How food scientists precisely calibrate salt, sugar, and fat to create a transient "nirvana" that mutes the brain's satiety signals.The Potato Continuum: A framework for understanding how processing transforms a simple, satiating food into an energy-dense, hyper-palatable "drug."Food Addiction Data: Why 14% of adults meeting the Yale Food Addiction Scale criteria suggests a systemic design flaw in our food supply, not a character flaw in the consumer.The Tobacco Playbook: The historical link between cigarette manufacturers buying food companies and the subsequent optimization of addictive "mouthfeel" and delivery systems.Clinical PearlsMaster Your Micro-Environment: Spend your "willpower budget" only once—at the grocery store. If hyper-palatable foods aren't in your pantry, they cannot exploit your fatigue at 9 p.m.Prioritize the Food Matrix: Aim for foods high in protein and fiber that have "built-in stoplights," rather than ultra-processed items where the matrix has been dismantled.Distraction-Free Feeding: Eliminate "subconscious eating" by removing screens during meals, allowing your brain to accurately register hormonal satiety signals like leptin and ghrelin.References:https://sfcityattorney.org/san-francisco-city-attorney-chiu-sues-largest-manufacturers-of-ultra-processed-foods/ https://www.lawforhoas.com/civil-code-section-3479-nuisance-defined https://www.naag.org/our-work/naag-center-for-tobacco-and-public-health/the-master-settlement-agreement/ https://pmc.ncbi.nlm.nih.gov/articles/PMC3667220/https://pubmed.ncbi.nlm.nih.gov/22551473/ https://linkinghub.elsevier.com/retrieve/pii/S0195666325000819https://psycnet.apa.org/record/2006-22447-006 Maimati 2018 Stephen 2020 Machado 2019 Young 2002Zlatevska 2014 https://pubmed.ncbi.nlm.nih.gov/37250387/ https://pmc.ncbi.nlm.nih.gov/articles/PMC6550161/https://pubmed.ncbi.nlm.nih.gov/30040431/ https://pubmed.ncbi.nlm.nih.gov/31105044/ https://pubmed.ncbi.nlm.nih.gov/37813420/ https://ajcn.nutrition.org/article/S0002-9165(22)00584-6/fulltext https://pubmed.ncbi.nlm.nih.gov/38418082/ https://www.fao.org/3/ca5644en/ca5644en.pdfhttps://www.mdpi.com/2674-0311/3/3/25 Powell 2013 Bhutani 2018 Fernandez 2021Our Sponsors:* Check out Chilipad and use my code BBM for a great deal: https://sleep.me* Check out Chilipad and use my code sleep.me/BBM for a great deal: https://sleep.me* Check out CovePure and use my code CovePure.com/bbm for a great deal: https://covepure.com* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brands