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- 🇨🇦CA · Health & Fitness#1685K to 30K
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4.7K to 19K🎙 Daily cadence·427 episodes·Last published yesterday - Monthly Reach
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6.2K to 25K
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From 12 epsHosts
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Recent episodes
Is Creatine Causing Your Shin Pain? + Splitting Training, Endometriosis for Lifters | Direct Line · May 2026
May 19, 2026
33m 59s
What’s Actually Driving Your Testosterone Down? | Signal Ep 3
May 12, 2026
59m 29s
Progressive Loading Part 3: Why the Novice / Intermediate / Advanced Framework Doesn't Work, and What to Do Instead
May 5, 2026
1h 51m 28s
Is Your Testosterone Actually Low? Why Higher Testosterone Doesn't Do What You Think | Signal Ep 2
Apr 28, 2026
1h 01m 45s
Direct Line April 2026: Stopping Ozempic and Lifting With Osteopenia
Apr 21, 2026
38m 39s
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| Date | Episode | Topics | Guests | Brands | Places | Keywords | Sponsor | Length | |
|---|---|---|---|---|---|---|---|---|---|
| 5/19/26 | Is Creatine Causing Your Shin Pain? + Splitting Training, Endometriosis for Lifters | Direct Line · May 2026 | This is the free preview of the May 2026 Direct Line, our monthly AMA for Barbell Medicine Plus subscribers. Three reader questions answered in full.We open with a mid-30s woman with bilateral shin pain and exertional foot numbness who started creatine a month ago and is asking whether the supplement is the cause. We walk through the compartment syndrome literature, the 2025 case report being passed around online and misinterpreted, what creatine actually does to total body water (and what it doesn’t), the four compartment pressure studies that exist, the Waterman 2013 demographic data on who actually gets chronic exertional compartment syndrome, and the workup we would actually run if this person walked into clinic.Next, whether splitting your resistance training across the day affects strength and hypertrophy. We cover BBM’s general heuristic on frequency as a distribution tool for training load, the Schoenfeld meta-analyses on frequency (2016 and 2019), the wrinkle on cardiorespiratory fitness and exercise snacks, and where we go off the reservation compared to a strict evidence-based read.We close with endometriosis for the lifter, including the seven-year average diagnostic delay, the 2022 ESHRE guideline shift away from required laparoscopy, what the menstrual cycle and performance literature actually says (McNulty 2020), why the anti-inflammatory diet narrative is mostly noise, the iron and protein levers that matter, post-operative return-to-lifting timelines, the meet-timing question, and Austin’s clinical case walk on supplement stacks and GLP-1 anti-inflammatory effects. A dedicated full episode on endometriosis is coming this summer.The full unabridged Direct Line covers ten more questions, including where the GLP-1 strength trials actually are, why DEXA misleads on muscle mass loss, how we arrived at the Vital 5 weightings, the salt sermon for strongman, running shoes for casual runners, hernias and crunches in older lifters, the Bristol Stool Chart, Austin on coaching his residents, and a fresh reading list. Full episode on BBM Plus.Timestamps:Question 1 · Creatine and shin pain01:2713:21Question 2 · Splitting your workout across the day13:2120:29Question 3 · Endometriosis for the lifter20:29What we cover:The clinical workup for chronic exertional compartment syndrome and why creatine is rarely the culprit. The Schoenfeld frequency literature and why training load matters more than the day it’s distributed across. Endometriosis basics including diagnostic delay, prevalence, and the 2022 ESHRE guideline change. Why most endometriosis “diets” don’t have evidence behind them, and which nutrition levers actually matter (iron, protein, energy availability). Post-operative return to training, meet-timing options, supplement stacks, and the role of GLP-1 receptor agonists in chronic anti-inflammatory effects.Resources:Subscribe to BBM Plus for the full unabridged Direct Line: https://barbellmedicine.supercast.com/Barbell Medicine coaching and templates: https://www.barbellmedicine.com/Signal book pre-order: https://www.barbellmedicine.com/shop/learning/signal/Waterman B.R. et al. 2013. Risk factors for chronic exertional compartment syndrome in a physically active military population. Am J Sports Med 41(11):2545-2552.https://pubmed.ncbi.nlm.nih.gov/24036570/Powers M.E. et al. 2003. Creatine supplementation increases total body water without altering fluid distribution. J Athl Train 38(1):44-50.https://pubmed.ncbi.nlm.nih.gov/12937471/Antonio J. et al. 2021. Common questions and misconceptions about creatine supplementation (ISSN position). J Int Soc Sports Nutr 18(1):13.https://pubmed.ncbi.nlm.nih.gov/33557850/Bruneau A. et al. 2025. Creatine supplementation associated with chronic exertional compartment syndrome: case report. [TO ADD: PMID once indexed]Schoenfeld B.J. et al. 2016. Effects of resistance training frequency on measures of muscle hypertrophy: a systematic review and meta-analysis. Sports Med 46(11):1689-1697.https://pubmed.ncbi.nlm.nih.gov/27102172/Schoenfeld B.J. et al. 2019. How many times per week should a muscle be trained to maximize hypertrophy? J Sports Sci 37(11):1286-1295.https://pubmed.ncbi.nlm.nih.gov/30558493/ESHRE Endometriosis Guideline Development Group. 2022. ESHRE guideline: endometriosis. Hum Reprod Open 2022(2):hoac009.https://pubmed.ncbi.nlm.nih.gov/35350465/McNulty K.L. et al. 2020. The effects of menstrual cycle phase on exercise performance in eumenorrheic women: systematic review and meta-analysis. Sports Med 50(10):1813-1827.https://pubmed.ncbi.nlm.nih.gov/32661839/Our Sponsors:* Check out FIGS and use my code wearfigs.com for a great deal: https://wearfigs.com* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy | 33m 59s | ||||||
| 5/12/26 | What’s Actually Driving Your Testosterone Down? | Signal Ep 3 | Most cases of low testosterone in modern men are not a problem with the testes. The number is downstream of body composition, sleep, and energy availability. The wellness-clinic algorithm walks past every one of them.Jordan and Austin walk through what actually drives men’s testosterone down, the mechanisms behind it, and the modifiable levers that bring it back up. MOSH, the leptin and Kisspeptin pathway, the aromatase loop, the sleep apnea picture most clinics never ask about, the GLP-1 and weight-loss data on testosterone recovery, the low energy availability case that hits high-volume lifters harder than they realize, and the closing question of when a standard-dose TRT prescription actually functions as a PED.This is Episode 3 of our four-part Signal book launch series. Mark, the patient we have been threading from Episode 1, finally gets his diagnosis revealed.Timestamps00:00 The 9x stat and Mark's diagnosis revealed 02:10 How body fat suppresses testosterone (MOSH) 07:26 Primary vs secondary causes, and Klinefelter 11:35 Leptin and the Kisspeptin pathway 14:38 Mark: the body-composition picture 16:10 The 40-inch-waist case 20:01 Weight loss, GLP-1s, and does Ozempic raise testosterone? 24:21 T4DM: adding testosterone to lifestyle 28:35 Sleep, OSA, and Mark's diagnosis 38:39 TRT in untreated sleep apnea 41:47 Can you train your testosterone down? (LEA / EHMC) 50:12 Replacement dose vs PED 55:47 Four takeaways 57:46 Episode 4 preview and book pre-orderWhat we cover:• How body fat suppresses testosterone at two different points in the HPG axis, and why the loop is self-reinforcing• The leptin and Kisspeptin pathway most clinics never address• Mark’s case: a 45-year-old with a 240 ng/dL afternoon draw, no workup, and an immediate prescription• Primary versus secondary causes, and why Klinefelter syndrome is the under-recognized one to not miss• Weight loss dose-response: how much testosterone climbs on lifestyle alone, with GLP-1 agonists, and after bariatric surgery• T4DM: why adding testosterone to a structured weight-loss program produced no extra quality-of-life benefit over placebo• One week of sleep restriction drops testosterone by about 15 percent in healthy young men; eight days of military field exercises drop it by 50 percent• Why CPAP for obstructive sleep apnea reliably improves symptoms but does not always move the lab number• The opposite extreme: low energy availability, relative energy deficiency in sport, and the exercise-hypogonadal male condition• The lifter calculus: when a textbook replacement dose is functionally a PED in a chronically underfueled traineeResources mentioned:Signal book pre-order: https://barbellmedicine.com/signal Training Plateau Action Plan (free): https://www.barbellmedicine.com/training-plateau-action-plan/ Barbell Medicine programs and coaching: https://www.barbellmedicine.com/ Episode 1 (Is the Testosterone Crisis Real?) Episode 2 (Is Your Testosterone Actually Low?Referenced studies:Wu F.C.W. et al. 2010. Identification of late-onset hypogonadism in middle-aged and elderly men (EMAS). N Engl J Med 363(2):123-135. https://pubmed.ncbi.nlm.nih.gov/20554979/ Travison T.G. et al. 2011. The natural history of symptomatic androgen deficiency in men. J Am Geriatr Soc. https://pubmed.ncbi.nlm.nih.gov/18454751/ Corona G. et al. 2013. Body weight loss reverts obesity-associated hypogonadotropic hypogonadism: systematic review and meta-analysis. Eur J Endocrinol 168(6):829-843. https://pubmed.ncbi.nlm.nih.gov/23482592/ Kounatidis D. et al. 2025. The impact of GLP-1 receptor agonists on erectile function. Biomolecules 15(9):1284. https://doi.org/10.3390/biom15091284 Grossmann M. et al. 2024. Testosterone treatment, weight loss, and health-related quality of life and psychosocial function in men: 2-year RCT (T4DM QoL arm). J Clin Endocrinol Metab 109(8):2019-2028. https://pubmed.ncbi.nlm.nih.gov/38311835/ Leproult R., Van Cauter E. 2011. Effect of 1 week of sleep restriction on testosterone levels in young healthy men. JAMA 305(21):2173-2174. https://pubmed.ncbi.nlm.nih.gov/21632481/ Penev P.D. 2007. Association between sleep and morning testosterone levels in older men. Sleep 30(4):427-432. https://pubmed.ncbi.nlm.nih.gov/17520785/ Wittert G. 2014. The relationship between sleep disorders and testosterone in men. Asian J Androl 16(2):262-265. https://pubmed.ncbi.nlm.nih.gov/24435056/ Alemany J.A. et al. 2008. Effects of dietary protein content on IGF-I, testosterone, and body composition during 8 days of severe energy deficit and arduous physical activity. J Appl Physiol 105(1):58-64. https://pubmed.ncbi.nlm.nih.gov/18450989/ Mountjoy M., Sundgot-Borgen J.K., Burke L.M. et al. 2018. IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update. Br J Sports Med 52:687-697. https://pubmed.ncbi.nlm.nih.gov/29773536/ Areta J.L. et al. 2021. Low energy availability: history, definition and evidence of its endocrine, metabolic and physiological effects in prospective studies in females and males. Eur J Appl Physiol 121(1):1-21. https://pubmed.ncbi.nlm.nih.gov/33095376/ Mäestu J. et al. 2010. Anabolic and catabolic hormones and energy balance of the male bodybuilders during the preparation for the competition. J Strength Cond Res 24(4):1074-1081. https://pubmed.ncbi.nlm.nih.gov/20300023/ Hooper D.R. et al. 2018. Treating exercise-associated low testosterone (EHMC). Phys Sportsmed 46(4):427-434. https://pubmed.ncbi.nlm.nih.gov/30074435/ Hackney A.C. 2020. Hypogonadism in exercising males: dysfunction or adaptive-regulatory adjustment? Front Endocrinol 11:11. https://pubmed.ncbi.nlm.nih.gov/32082252/Our Sponsors:* Check out FIGS and use my code wearfigs.com for a great deal: https://wearfigs.com* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy | 59m 29s | ||||||
| 5/5/26 | Progressive Loading Part 3: Why the Novice / Intermediate / Advanced Framework Doesn't Work, and What to Do Instead✨ | progressive loadingstrength training+4 | Dr. Austin Baraki | Progressive LoadingDamas 2016 deuterium study | — | strength trainingnovice lifters+6 | — | 1h 51m 28s | |
| 4/28/26 | Is Your Testosterone Actually Low? Why Higher Testosterone Doesn't Do What You Think | Signal Ep 2✨ | testosteronehealth evaluation+4 | Dr. Austin Baraki | — | — | testosteronelow testosterone+5 | — | 1h 01m 45s | |
| 4/21/26 | ![]() Direct Line April 2026: Stopping Ozempic and Lifting With Osteopenia✨ | GLP-1 cessationweight regain+3 | — | Barbell MedicineSURMOUNT-4+10 | — | GLP-1weight loss+5 | — | 38m 39s | |
| 4/14/26 | Is the Testosterone Crisis Real? The Numbers Behind the Headlines | Signal Ep 1✨ | testosteronehealth+4 | — | Barbell Medicine | — | testosterone crisislab tests+3 | Factorbbm50off | 40m 36s | |
| 4/7/26 | Medical Mystery: The Man Who Got Weaker When He Started Training✨ | medical mysteryexercise and health+4 | — | STOMP trialSAMSON trial+4 | — | rhabdomyolysismuscle strength+5 | — | 1h 15m 46s | |
| 3/31/26 | Overtraining Syndrome: Causes, Diagnosis, and What's Actually Going On✨ | overtraining syndromediagnosis+3 | Jordan FeigenbaumAustin Baraki | Barbell Medicine | — | overtraining syndromesystematic review+3 | — | 1h 36m 05s | |
| 3/24/26 | Episode #391: VO2 Max vs. Cardiorespiratory Fitness, GLP-1 Costs, and the 10,000-Step Myth | Direct Line March 2026 (Free)✨ | VO2 MaxCardiorespiratory Fitness+4 | Dr. Baraki | GLP-1 medicationsBarbell Medicine+2 | — | VO2 MaxCardiorespiratory Fitness+6 | — | 30m 34s | |
| 3/17/26 | Episode #390: Why Your Waist Matters More Than Your Weight — The Science of Visceral Fat✨ | visceral fatmetabolic risk+4 | Dr. Jordan Feigenbaum | Barbell Medicine | — | visceral fatBMI+5 | — | 44m 34s | |
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| 3/9/26 | Episode #389: Your Liver Enzymes Are Elevated — But It Might Not Be Your Liver✨ | liver enzymesexercise impact+3 | Dr. Austin Baraki | Barbell Medicine | — | liver biopsyblood draw+7 | — | 1h 01m 32s | |
| 2/26/26 | Episode #388: Muscle Imbalances, Red Meat Risk, and the Science of Body Fat Set Points✨ | muscle imbalancesred meat risk+3 | Dr. Austin Baraki | Barbell Medicine | — | muscle imbalancesred meat+5 | — | 34m 04s | |
| 2/20/26 | Episode #387: The Valsalva Maneuver- Blood Pressure & Safety in Lifting✨ | Valsalva maneuverblood pressure+3 | — | Barbell Medicine | — | Valsalva maneuverblood pressure spikes+3 | — | 1h 12m 09s | |
| 2/13/26 | Episode #386: Longevity Myths- Biological Clocks, GLP-1 Muscle Loss, and What Actually Predicts Lifespan✨ | longevitybiological clocks+5 | Dr. Austin Baraki | Barbell Medicine | — | longevity industryDNA methylation+5 | — | 2h 00m 17s | |
| 2/6/26 | ![]() How-To Fix Your Stalled Progress (Strength Edition) | Lifting more weight doesn't always mean you've gotten stronger. In this foundational session, Dr. Jordan Feigenbaum and Dr. Austin Baraki introduce the Fitness-Fatigue Model to explain why "stalled" progress is often just a temporary masking of strength by accumulated fatigue. By learning to differentiate between a lack of fitness adaptation and a lack of recovery, you can avoid the "panic pivot" and maintain the long-term signal necessary for elite-level gains.Supercast Sign-UpFor the 6-part audio series and Training Plateau Action Plan, sign-up for Barbell Medicine Plus:https://barbellmedicine.supercast.com/Key Learning PointsThe Fitness-Fatigue Model: Understand the physiological duality of every workout—while a session builds your "fitness" (potential), it also creates "fatigue" that temporarily suppresses your performance.Strength vs. Effort: Performance must be measured relative to RPE. If the weight on the bar increases but the RPE climbs disproportionately (e.g., jumping from RPE 8 to RPE 10 for a 5lb gain), your absolute strength has not actually improved.Noise vs. Signal: A one-week stall is statistical "noise." Constant program hopping in response to a single bad session destroys the cumulative stimulus (the "signal") required for actual tissue adaptation.The Root Cause Audit: Determining the "Why" behind a plateau.Lack of Fitness: The stimulus is no longer sufficient to drive a new adaptation (Needs more volume/intensity).Lack of Recovery: The fatigue is overwhelming the adaptation (Needs a deload or volume reduction).Autoregulation as a Diagnostic Tool: Using RPE not just to prescribe load, but to "interrogate" your current state of recovery and readiness.Timestamps[00:00] Intro: Introducing the Barbell Medicine Plus Exclusive Series[02:15] The Thought Experiment: 310x6 @ 8 vs. 315x6 @ 10[05:30] Deep Dive: Defining the Fitness-Fatigue Model[09:45] Interpreting the Stall: Is it a Stimulus Problem or a Recovery Problem?[14:20] The Danger of "Short-Termism": Why Panicking Destroys the Signal[18:50] Introduction to the 6-Part Audio Course & Actionable PDFPearlsThe Pivot Rule: Never change a successful program based on a single week of data. Look for a 3-week trend of stagnant or declining performance (at the same RPE) before initiating a program pivot.Peaking Mechanics: Most "peaking" protocols do not build new strength; they simply reduce fatigue to reveal the strength you've already built.The stimulus-Recovery Trap: If you feel "beat up" but the weights are moving well, you likely don't need a deload yet. If you feel "great" but the weights are stuck, you likely need a stronger stimulus.Our Sponsors:* Check out FIGS and use my code wearfigs.com for a great deal: https://wearfigs.com* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy | 23m 09s | ||||||
| 1/30/26 | Episode #385- Why Grip Strength Predicts Death (And Why You Shouldn't Train It) | 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 FIGS and use my code wearfigs.com for a great deal: https://wearfigs.com* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy | 53m 17s | ||||||
| 1/23/26 | Episode 384: The Paralyzed Personal Trainer (Mystery Case) | Dr. Feigenbaum and Dr. Baraki walk through the clinical workup of a 24 year old male presented with persistent weakness in his foot following weight loss of 22 pounds in two weeks. What could've possibly caused this?The discussion pivots to the science of how fast one should lose weight. While athletes should prioritize slow loss to preserve performance and lean mass, the data for individuals with obesity suggests that the speed of loss may be less critical than protein intake and resistance training.Timestamps:00:00 - The Case of the Paralyzed Personal Trainer 03:48 - How Doctors Build a Differential for Weakness 12:08 - Interpreting Negative Labs and MRI Results 15:04 - Identifying Foot Drop and Nerve Distribution 20:53 - Understanding Nerve Conduction and EMG Studies 26:06 - The Diagnosis: Slimmers Paralysis Explained 32:56 - Are GLP-1 Medications Increasing Nerve Injury Risks? 35:01 - Rapid vs Slow Weight Loss: Muscle Mass and Performance 41:27 - The Truth About Metabolic Adaptation and Weight Regain 52:33 - New Research on Weight Regain After Stopping Medications 58:32 - Clinical Recommendations for Sustainable Weight Management Key Learning Points (SPOILER ALERT)Slimmer’s Paralysis (Dieting Palsy): Discover how rapid fat loss depletes the protective structural fat pads at the fibular head, leaving the common peroneal nerve vulnerable to compression.The "Two-Hit" Model: Understand how the combination of biological depletion (rapid weight loss) and mechanical provocation (aggressive stretching or squatting) triggers focal weakness.Speed vs. Quality for Athletes: Evidence suggests that for trainees, a slower weight loss rate of $\sim$0.7% of body weight per week is superior for maintaining lean mass compared to faster rates.Metabolic Adaptation as a Signature of Success: Why a reduction in resting metabolic rate is an unavoidable adaptive response to weight loss and not necessarily a predictor of future weight regain.Diagnosing Focal Weakness: A step-by-step look at how clinicians differentiate between lumbar spine issues and peripheral nerve entrapment using physical exams and electrodiagnostic testing.Resources:Case: https://pubmed.ncbi.nlm.nih.gov/39809480/ https://pubmed.ncbi.nlm.nih.gov/29503139/ https://pmc.ncbi.nlm.nih.gov/articles/PMC12157737/ https://pmc.ncbi.nlm.nih.gov/articles/PMC11273815/ https://pubmed.ncbi.nlm.nih.gov/32576318/ https://pubmed.ncbi.nlm.nih.gov/20443094/ https://pubmed.ncbi.nlm.nih.gov/24372837/ https://pubmed.ncbi.nlm.nih.gov/25459211/ https://www.bmj.com/content/392/bmj-2025-085304 Our Sponsors:* Check out FIGS and use my code wearfigs.com for a great deal: https://wearfigs.com* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy | 1h 03m 59s | ||||||
| 1/16/26 | Episode #383: Scientific Populism vs. Consensus - The 2026 Food Pyramid | 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 FIGS and use my code wearfigs.com for a great deal: https://wearfigs.com* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy | 1h 16m 00s | ||||||
| 1/13/26 | ![]() Trailer: The Fiber Action Plan is Here | Fiber is the most underutilized tool in human nutrition. While the internet is currently buzzing about the new food pyramid and debating processed foods versus beef tallow, most people are missing the actual structural levers that dictate health and performance.Today, we are launching the Barbell Medicine Fiber Action Plan to bridge the gap between clinical science and your next trip to the grocery store.If you are a Barbell Medicine Plus subscriber, you can binge the entire 4-part audio series and download the full Action Plan right now in the Plus feed. If you are not a subscriber, head to the link below to sign up for early access to the Action Plan and exclusive content.Join Barbell Medicine Plus: https://barbellmedicine.supercast.com/In this series, we move beyond the simple soluble versus insoluble labels and discuss how fiber can lower cholesterol, manage blood sugar, and regulate satiety. Nutrition should not be a social media shouting match; it should be a deliberate strategy for your health. Stop guessing, get the guide, and let us get to work.Our Sponsors:* Check out FIGS and use my code wearfigs.com for a great deal: https://wearfigs.com* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy | 2m 20s | ||||||
| 1/8/26 | Episode 382: The Trial of Big Food | 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 FIGS and use my code wearfigs.com for a great deal: https://wearfigs.com* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy | 1h 02m 18s | ||||||
| 1/1/26 | Episode #381: How a Supplement Sent a Soldier to the Hospital- A Medical Mystery | A 23-year-old soldier presents with hypertensive urgency and acute kidney injury. He thought he was doing everything right for his health—so what caused his system to fail? Dr. Feigenbaum and Dr. Baraki break down the clinical evidence and the surprising lab results.Timestamps[00:00] Introduction to the Case: The Fit Soldier’s Failure[01:07] Welcome and Mystery Case Framework[02:05] Patient History: The River and the GI Symptoms[03:53] Building the Differential: Infection vs. Dehydration[08:20] Initial Workup and the Hypercalcemia Discovery[14:14] The Medical Student’s Reveal: Supplement Reconciliation[18:05] Final Diagnosis: Severe Hypervitaminosis D[22:20] Metastatic Calcification and Permanent Vascular Damage[25:23] The Mechanism of Jaw Pain: Bone Resorption[28:34] Science Review: Debunking the Pilz (2011) Study[32:27] Fat-Soluble vs. Water-Soluble Risks[43:06] The Free Vitamin D Hypothesis[48:06] Updated 2024 Endocrine Society Guidelines[55:16] Final Thoughts: Vitamin D and the Endurance PopulationNext 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 Points The Testosterone Fallacy: Meta-analyses confirm that Vitamin D supplementation has no significant effect on testosterone levels in men who are not clinically deficient.The Fat-Soluble Risk: Unlike water-soluble vitamins, Vitamin D is stored in adipose tissue, meaning toxicity can persist for months or years after cessation.Metastatic Calcification: Severe Vitamin D toxicity causes calcium phosphate to deposit in arterial walls, potentially turning flexible vessels into rigid pipes.2024 Endocrine Guideline Shift: Updated medical standards now recommend against routine Vitamin D screening and universal high-target levels for healthy adults.The Natural Blind Spot: Patients often fail to categorize supplements as "medication," leading to dangerous diagnostic delays when clinicians do not ask specifically about over-the-counter products.The Mechanism of Bone Pain: Toxic Vitamin D levels can drive aggressive bone resorption, effectively "stealing" calcium from the skeleton and causing severe pain.Clinical Pearls Screening Protocol: Avoid routine Vitamin D blood testing for healthy, asymptomatic adults under 75 unless a specific condition like malabsorption or osteoporosis is present.Dosing Guidelines: For the general population, stick to the daily recommended intake (600–800 IU) rather than using high-dose bolus therapy or chasing a serum level of 30 ng/mL.Medication Reconciliation: Always disclose all "natural," "herbal," or "gym-based" supplements to your medical provider, as these can interact with other medications or cause direct toxicity.Timestamps[00:00] Introduction to the Case: The Fit Soldier’s Failure[01:07] Welcome and Mystery Case Framework[02:05] Patient History: The River and the GI Symptoms[03:53] Building the Differential: Infection vs. Dehydration[08:20] Initial Workup and the Hypercalcemia Discovery[14:14] The Medical Student’s Reveal: Supplement Reconciliation[18:05] Final Diagnosis: Severe Hypervitaminosis D[22:20] Metastatic Calcification and Permanent Vascular Damage[25:23] The Mechanism of Jaw Pain: Bone Resorption[28:34] Science Review: Debunking the Pilz (2011) Study[32:27] Fat-Soluble vs. Water-Soluble Risks[43:06] The Free Vitamin D Hypothesis[48:06] Updated 2024 Endocrine Society Guidelines[55:16] Final Thoughts: Vitamin D and the Endurance PopulationReferenceshttps://pmc.ncbi.nlm.nih.gov/articles/PMC9478588/ https://link.springer.com/article/10.1007/s12020-020-02482-3 https://pubmed.ncbi.nlm.nih.gov/32446600/ https://pubmed.ncbi.nlm.nih.gov/21154195/ https://academic.oup.com/jcem/article/109/8/1907/7685305?login=false https://academic.oup.com/edrv/article/45/5/625/7659127 https://academic.oup.com/milmed/article/189/1-2/e417/7218964 Our Sponsors:* Check out FIGS and use my code wearfigs.com for a great deal: https://wearfigs.com* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy | 57m 07s | ||||||
| 12/26/25 | Episode #380: The Peptide Market Audit: Injury Healing or Biohacking Hype? | Biohackers and longevity clinics claim peptides are a side-effect-free sniper rifle for fat loss and injury recovery, but the reality is often buried in failed clinical trials and regulatory bans. Many popular compounds like BPC-157 have never undergone a single randomized controlled trial in humans, despite their reputation for Wolverine-like healing. This episode dismantles the hype surrounding the gray market, exposing the significant risks of immunogenicity and heavy metal contamination. Learn why modern load management and evidence-based medicine beat a research chemical bought with Bitcoin every time.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/Key PointsThe FDA Category 2 Crackdown: Federal regulators restricted many peptides because of the risk of immunogenicity where the body creates antibodies that attack its own proteins.BPC-157 Has Zero Human Data: Despite being marketed for tendon repair, there is not a single published human randomized controlled trial for this molecule.The MK-677 Prediabetes Tax: While it increases lean mass, human trials show zero improvement in strength or power while frequently causing insulin resistance.Retatrutide as the Weight Loss Godzilla: This triple agonist is achieving nearly 29 percent weight loss in trials by increasing energy expenditure through thermogenesis.Sourcing and Safety Realities: A study of 44 research chemicals found that only 18 actually contained the labeled compound, with many containing heavy metals.The 40-Amino-Acid Rule: The legal distinction between a peptide and a protein is based on size, which dictates how the FDA regulates these substances and how your body absorbs them. Timestamps00:03 Intro: The CJC-1295 Heart Attack Case05:39 Defining a Peptide: The 40-Amino-Acid Bright Line15:14 GH Secretagogues: CJC-1295 and Ipamorelin23:51 MK-677: The Oral Hunger Mimetic and Prediabetes Risk32:56 BPC-157 and the Lack of Human Data38:12 Immunogenicity: Why the FDA Banned BPC-15749:46 Retatrutide: The Triple Agonist Weight Loss Godzilla01:11:24 Summary: Peptides vs. Anabolic Steroids01:16:12 The Sourcing Spectrum: Pharmaceutical vs. Research ChemicalsClinical PearlsUse load management and progressive resistance training as the primary intervention for tendon and muscle injuries rather than unproven peptides.If choosing to use metabolic modulators, monitor fasting blood glucose and insulin sensitivity to avoid drug-induced prediabetes or metabolic dysfunction.Avoid the research chemical gray market entirely due to the high prevalence of under-dosing, contamination, and incorrect active ingredients found in third-party testing.Resourceshttps://pubmed.ncbi.nlm.nih.gov/16352683/https://pubmed.ncbi.nlm.nih.gov/18347346/https://pmc.ncbi.nlm.nih.gov/articles/PMC2657499/https://pubmed.ncbi.nlm.nih.gov/9849822/https://pubmed.ncbi.nlm.nih.gov/10496658/https://pubmed.ncbi.nlm.nih.gov/21298258/https://pubmed.ncbi.nlm.nih.gov/18981485/https://pubmed.ncbi.nlm.nih.gov/9467542/https://pubmed.ncbi.nlm.nih.gov/18981485/https://pubmed.ncbi.nlm.nih.gov/20554713/https://pubmed.ncbi.nlm.nih.gov/39813152/Duzel 2007Strinic 2017Sikiric 1993 He 2022https://pmc.ncbi.nlm.nih.gov/articles/PMC2289708/https://pubmed.ncbi.nlm.nih.gov/10469335/https://pubmed.ncbi.nlm.nih.gov/23050815/https://pubmed.ncbi.nlm.nih.gov/20536454/https://pubmed.ncbi.nlm.nih.gov/29986520/https://pmc.ncbi.nlm.nih.gov/articles/PMC4508379/https://pubmed.ncbi.nlm.nih.gov/41090431/https://pubmed.ncbi.nlm.nih.gov/38858523/https://pubmed.ncbi.nlm.nih.gov/20445536/https://pmc.ncbi.nlm.nih.gov/articles/PMC3136748/#R41https://pubmed.ncbi.nlm.nih.gov/25738459/https://pubmed.ncbi.nlm.nih.gov/33473109/https://pmc.ncbi.nlm.nih.gov/articles/PMC5826726/ https://pubmed.ncbi.nlm.nih.gov/31599840/https://pubmed.ncbi.nlm.nih.gov/18206919/https://pmc.ncbi.nlm.nih.gov/articles/PMC5820696/ Our Sponsors:* Check out FIGS and use my code wearfigs.com for a great deal: https://wearfigs.com* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy | 1h 21m 47s | ||||||
| 12/23/25 | Ozempic & Alcohol, The Trap Bar Myth, and A Medical Mystery | Barbell Medicine AMA Teaser | Experiencing a pins-and-needles sensation on a run or fearing the straight bar deadlift shouldn't be your fitness journey's bingo card. Many trainees abandon effective habits due to false narratives regarding physiological signals or myths regarding back safety. We break down the clinical reality of exercise-induced sensations, the ethics of modern metabolic medicine, and why your choice of imlpement is more about preference than peril.Resources and 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/TopicsThe Hemodynamic Itch: Why vasodilation and increased blood flow to capillaries can cause mechanical stimulation of nerve endings during a run.Exercise-Induced Anaphylaxis: The critical difference between benign "runner’s itch" and a systemic medical emergency involving hives and hemodynamic instability.Medical Paternalism: Why withholding GLP-1 medications from patients who drink alcohol is a flawed clinical approach that ignores aggregate health risk reduction.The Seatbelt Analogy: Treating one health risk (obesity) is objectively better than leaving it untreated, even if other risks (alcohol) remain constant.The EMG Trap: Why electrical muscle activity data is a poor predictor of long-term strength and hypertrophy outcomes compared to longitudinal studies.Biomechanical Distribution: How the trap bar shifts load toward the quadriceps while the straight bar emphasizes the hamstrings and erectors without changing "safety."Clinical PearlsIdentify Red Flags: If itching is accompanied by wheezing, nausea, or dizziness, stop exercise immediately and seek emergency medical care.Prioritize Habituation: For benign runner’s itch, consistent training typically leads to physiological adaptation and symptom resolution within a few weeks.Shared Decision-Making: When choosing between deadlift variations, select the tool that aligns with your specific goals—use the straight bar for powerlifting prep and the trap bar for general strength or power development.Timestamps00:00 – Intro to the Direct Line AMA series00:43 – The Mystery of "Runner’s Itch": Mechanisms and Hemodynamics04:19 – Case Study: 24-year-old Marine and Exercise-Induced Anaphylaxis06:22 – Summary: Benign Itching vs. Cholinergic Urticaria vs. Anaphylaxis07:24 – GLP-1 Receptor Agonists and Heavy Alcohol Use10:57 – Beyond the Stomach: How GLP-1s Impact Brain Reward Pathways15:32 – Avoiding Paternalism in Medicine: Shared Decision-Making18:12 – The Great Deadlift Debate: Trap Bar vs. Straight Bar21:31 – Why EMG Data is Often Misleading for Trainees24:54 – Debunking the "Save Your Back" MythOur Sponsors:* Check out FIGS and use my code wearfigs.com for a great deal: https://wearfigs.com* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy | 30m 30s | ||||||
| 12/20/25 | START HERE: The Cholesterol Action Plan Series | Welcome to the Barbell Medicine Cholesterol Action Plan. Cardiovascular disease is the #1 killer globally. We just released a massive 6-part audio series and written guide to fix that.It covers ApoB vs LDL, the CAC score paradox, the P:S diet ratio, and Plaque Regression.The full series is available INSTANTLY for Barbell Medicine Plus subscribers.If you're not a subscriber, start here:https://barbellmedicine.supercast.com/ Our Sponsors:* Check out FIGS and use my code wearfigs.com for a great deal: https://wearfigs.com* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy | 2m 25s | ||||||
| 12/16/25 | Episode 379: Menopause Myths, Cortisol Belly, & The Truth About IUDs | The wellness industry wants you to believe that menopause renders you fragile, fasting creates "cortisol belly," and birth control is silently destroying your skeletal health. These claims aren't just scientifically inaccurate; they act as "nocebo" barriers that scare women away from effective training and healthcare.We brought in the heavy artillery—Dr. Lauren Colenso-Semple, Dr. Loraine Baraki, and Dr. Spencer Nadolsky—to dissect the physiology behind these viral fears. Discover why your body remains resilient through hormonal transitions and why lifestyle or GLP-1s is a false dichotomy, Dr. Colenso-Semple: @drlaurencs1Dr. Loraine Baraki: @loraine_barbellmedicineDr. Spencer Nadolsky: @drnadolskyKey Learning PointsThe Menopause "Cliff" Myth: Menopause does not destroy your ability to recover or adapt to exercise.1 While aging may require programming adjustments, your muscles do not stop responding to tension and progressive overload simply because estrogen levels change.Cortisol Fear-mongering: There is no evidence that intermittent fasting or skipping breakfast causes pathological "cortisol belly" or visceral fat storage in women. Fasting is simply a tool for Calorie restriction, not a hormonal wrecking ball.IUDs & Bone Density: Levonorgestrel IUDs (hormonal) work primarily via local action on the uterus, not systemic suppression. Contrary to viral claims, they do not "eat your bones," and most users continue to ovulate and produce protective estrogen.The "Masking" Fallacy: Amenorrhea (lack of period) on an IUD is a known, harmless side effect of a thinned uterine lining. It is rarely "masking" a dangerous underlying condition like premature ovarian insufficiency.Birth Control & Performance: Population-level data shows that hormonal contraceptives do not clinically impair strength or athletic performance. While they increase SHBG and lower free testosterone, women are not "little men" dependent solely on testosterone for performance.GLP-1 Agonists (Ozempic/Mounjaro): Using medication to treat the appetite dysregulation of obesity is not "cheating." Muscle loss on these drugs is primarily a function of the Caloric deficit, not the drug itself, and can be mitigated with resistance training.Get More Value: Exclusive Content and ResourcesWant to support the show and get early, ad-free access to all episodes plus exclusive bonus content? Subscribe to Barbell Medicine Plus and get ad-free listening, product discounts, and more. Try it free for 30-days.Unsure which training plan is right for you? Take the free Barbell Medicine Template Quiz to be matched with the ideal program for your goals and experience level.For media, support, or general questions, please contact us at support@barbellmedicine.comClinical Pearls & TakeawaysProgramming for Menopause: Stop treating menopause as a disability. Continue to lift heavy (RPE 6-9) and perform conditioning. If recovery lags, adjust volume (sets/reps) before blaming hormones.Protein Simplified: Ignore the complex "ideal body weight" math. Aim for ~1.6g/kg of total body weight, or simply add one extra serving of protein (like a shake) to your current daily intake.Medical Decisions: Do not remove an IUD or avoid birth control solely due to social media fear-mongering about bone density or "low T." These choices should be based on your contraceptive needs and symptom management (e.g., PCOS, endometriosis).Timestamps00:00 Intro: The "Fragile Female" Narrative01:00 Does Menopause Destroy Recovery?11:00 Muscle Fiber Types: Fact vs. Fiction24:00 Fasting, "Cortisol Belly," and Visceral Fat34:00 Protein Intake: Survival vs. Optimal41:40 Dr. Lorraine Baraki: Do IUDs Cause Bone Loss?50:00 Birth Control, Acne, and Athletic Performance59:00 Dr. Spencer Nadolsky: The Truth About GLP-1s & Muscle Loss01:05:00 Final Verdict: You Are Not FragileReferencesThomas, Ewan et al. “The effect of resistance training programs on lean body mass in postmenopausal and elderly women: a meta-analysis of observational studies.” Aging clinical and experimental research vol. 33,11 (2021): 2941-2952. doi:10.1007/s40520-021-01853-8 TWORoberts, Brandon M et al. “Sex Differences in Resistance Training: A Systematic Review and Meta-Analysis.” Journal of strength and conditioning research vol. 34,5 (2020): 1448-1460. doi:10.1519/JSC.0000000000003521Khalafi, Mousa et al. “The effects of exercise training on body composition in postmenopausal women: a systematic review and meta-analysis.” Frontiers in endocrinology vol. 14 1183765. 14 Jun. 2023, doi:10.3389/fendo.2023.1183765Staron, R S et al. “Fiber type composition of the vastus lateralis muscle of young men and women.” The journal of histochemistry and cytochemistry : official journal of the Histochemistry Society vol. 48,5 (2000): 623-9. doi:10.1177/002215540004800506 Hunter, Sandra K. “The Relevance of Sex Differences in Performance Fatigability.” Medicine and science in sports and exercise vol. 48,11 (2016): 2247-2256. doi:10.1249/MSS.0000000000000928Nuzzo, James L. “Narrative Review of Sex Differences in Muscle Strength, Endurance, Activation, Size, Fiber Type, and Strength Training Participation Rates, Preferences, Motivations, Injuries, and Neuromuscular Adaptations.” Journal of strength and conditioning research vol. 37,2 (2023): 494-536. doi:10.1519/JSC.0000000000004329Verdell, J. Tyler MD; Acker, Matthew MD. Does the LNG-IUD decrease BMD in adolescent females?. Evidence-Based Practice 23(4):p 10-11, April 2020. | DOI: 10.1097/EBP.0000000000000601Jäger, Ralf et al. “International Society of Sports Nutrition Position Stand: protein and exercise.” Journal of the International Society of Sports Nutrition vol. 14 20. 20 Jun. 2017, doi:10.1186/s12970-017-0177-8Tan, Yimei et al. “Effect of GLP-1 receptor agonists on bone mineral density, bone metabolism markers, and fracture risk in type 2 diabetes: a systematic review and meta-analysis.” Acta diabetologica vol. 62,5 (2025): 589-606. doi:10.1007/s00592-025-02468-5Our Sponsors:* Check out FIGS and use my code wearfigs.com for a great deal: https://wearfigs.com* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com* Check out Quince and use my code quince.com/bbm for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy | 1h 06m 11s | ||||||
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