V O L U ME 6 , ISS U E 5 MAY 2 0 2 2

MASS
M ONTHLY A PPL ICATIO N S IN
STRE N G TH SPO R T

E R I C 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 where he is also the Chief Science
Officer. Eric regularly publishes peer-reviewed articles in exercise science and nutrition journals on
physique and strength sport, in addition to contributing to the 3DMJ blog. 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 numerous strength sports.

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.
 Table of Contents

6
BY GR EG NUCKOL S

Do Female Lifters Need to Train Closer to Failure to

Maximize Hypertrophy and Strength Gains?
A recent study has been making the rounds on social media, and some people are
claiming it shows that female lifters should be training closer to failure than male lifters.
So, do the results of the study actually support this interpretation? Read on to find out.

18
BY MI CHAEL C. ZOUR DOS

Should You Change The Load During a Set?

Research on linear, weekly, and daily undulating periodization has attempted to
determine what frequency of training variation maximizes strength gains. However, a
new study goes a step further to examine if intraset variation is the ticket to success.

32
BY BEN HOUSE

Is Long-Term Weight Loss Impossible? A Concept Review

of the Challenges and Realities of Long-Term Weight Loss
Maintenance
Discussions surrounding weight loss often involve arguments between two distinct
camps: those who believe long-term weight loss is impossible (or even unethical),
and those who believe long-term weight loss is a simple matter of willpower. This
concept review explores this false dichotomy, while reviewing the challenges and
realities of long-term weight loss.

53
BY ER I C T R EXL ER

How Important Is Pre-Bed Protein Intake?

There is much debate about how important pre-bed protein intake is for promoting
hypertrophy, and how nighttime ingestion of whey protein might impact sleep quality.
A new study sheds light on both topics.

65
BY MI CHAEL C. ZOUR DOS

Does Your Perceived Recovery Relate to Performance?

The 0-10 perceived recovery status scale is practical and straightforward, which
enables easy implementation. But can lifters actually predict performance recovery
and make training prescription decisions from this scale? This article breaks down a
new study that sought to find out.
76
BY ER I C T R EXL ER

Dietary Fiber Manipulation for Lifters

Adequate fiber intake is important for a well-rounded diet, but a short-term low-fiber
diet can facilitate transient weight reduction for sports with weight classes. This article
discusses how to manipulate fiber intake to facilitate short-term weight cuts, while also
discussing the multifaceted benefits of fiber in a lifter’s diet.

87
BY GR EG NUCKOL S & ER IC TREX LER

Research Briefs
In the Research Briefs section, Greg Nuckols and Eric Trexler share quick
summaries of recent studies. Briefs are short and sweet, skimmable, and focused
on the need-to-know information from each study.

131
BY MI CHAEL C. ZOUR DOS

VIDEO: Intrasession Cooling

Many strategies are aimed at increasing rep performance. However, one of those
strategies, body cooling, doesn’t get a lot of press in the lifting world. This video
breaks down the efficacy of intrasession body cooling to increase rep performance
and provides details on how to implement the practice.

134
BY ER I C HEL MS

VIDEO: Principles of Exercise Selection

The principles underlying exercise selection, such as specificity and variety, are
so well established that conversations don’t include reference to specific studies.
Thus, these concepts are discussed conceptually rather than empirically, with
frequent disagreements as to how they apply. In this video we break down the
concepts with illustrative research, enhancing your ability to make well-informed
exercise selection decisions.
Letter From the Reviewers
M
ASS is celebrating its five-year anniversary! As we enter our sixth year, we’d like to
first express our gratitude to everyone who’s stuck with us for a long time. And, if
you signed up during the anniversary sale and this is your first issue, we’re thrilled
to have you as part of the growing MASS family.
A MASS anniversary is as opportune a time as any to inform you or remind you about a
couple of the resources on the member site that a lot of you may not be aware of. We try to
avoid jargon as much as is reasonable in our written articles, but we occasionally need to use
some technical terminology; if you’re unsure about the meaning of a word, or if you’d just like
to brush up on some foundational concepts, you should check out the MASS Glossary. Each
issue also includes a “missed the cut” section with cool studies that we didn’t write about, but
which may still interest you. If you’re not confident in your ability to read and interpret a study
for yourself, you should check out our Interpreting Research guide.
Starting with the video department, Eric Helms’s video this month covers the principles of
exercise selection, to ensure that you can pick the appropriate movements for your training goals.
Mike’s video discusses the impact of cooling interventions on training and exercise performance.
From the nutrition department, we have a guest article this month from Dr. Ben House,
discussing the feasibility and realities of long-term weight loss maintenance. Eric Trexler’s first
article covers the impact of dietary fiber manipulation on short-term weight loss, which may be
useful for athletes attempting to cut weight for any sport with weight classes. His second article
discusses the impact of pre-sleep protein intake on sleep outcomes and training adaptations.
From the training department, Mike’s first article covers the utility of the perceived recovery
scale for predicting objective performance recovery, and his second article discusses some
recent research investigating how frequently you should vary training loads to maximize
strength gains. Greg reviewed a recent study investigating whether female lifters need to train
closer to failure than male lifters to maximize strength gains.
Finally, our research briefs this month discuss the impact of food texture on energy intake,
the potential benefits of training with a partial range of motion, the impact of carbohydrate
intake on testosterone and cortisol levels, the impact of arching on muscle activation in the
bench press, the potential drawbacks of nutritional epidemiology, the point at which higher
training volumes yield diminishing returns, the effects of dehydration on pain perception, and
resistance training for longevity.
As always, if you have any questions or feedback about any of the content in this issue, feel
free to post in the Facebook group. We’ll do our best to answer any questions you have about
the topics we cover.
Sincerely,
The MASS Team
Eric Helms, Greg Nuckols, Mike Zourdos, and Eric Trexler

5
 Study Reviewed: Velocity-based Resistance Training: Do Women Need Greater Velocity Loss
to Maximize Adaptations? Rissanen et al. (2022)

Do Female Lifters Need to Train Closer

to Failure to Maximize Hypertrophy and
Strength Gains?
BY GREG NUCKOLS

A recent study has been making the rounds on social media, and
some people are claiming it shows that female lifters should be
training closer to failure than male lifters. So, do the results of the
study actually support this interpretation? Read on to find out.

6
 KEY POINTS
1. Four groups of subjects completed eight weeks of velocity-based training,
consisting of Smith machine squat and bench press: a group of males and a group
of females trained with a 20% velocity loss threshold, and a group of males and a
group of females trained with a 40% velocity loss threshold.
2. Gains in Smith machine squat and bench press 1RM, vastus lateralis cross-sectional
area, and countermovement jump height didn’t significantly differ between groups.
However, strength gains were non-significantly larger in the female 40% velocity loss
group than the female 20% velocity loss group.
3. It seems that the popular takeaway from this study is that female lifters need to train
closer to failure than male lifters. Based on the research comparing failure versus
non-failure strength training in female subjects, and the fact that the between-group
differences were non-significant and modest in magnitude, I don’t think that such an
interpretation is fully justified.

V
elocity-based training is a popular concentric velocity decreased by 40% from
topic in MASS, but you may no- the set’s fastest rep, and one group of male
tice something when perusing our subjects and one group of female subjects
velocity-based training archive: all of the terminated each set when their concentric ve-
longitudinal velocity-based training studies locity decreased by 20% from the set’s fast-
we’ve covered have been carried out with ex- est rep (of note, the “velocity-loss method”
clusively male subjects. There’s a reason for isn’t our favorite way to use velocity-based
that: virtually all of the longitudinal veloci- training [2], but it’s the most popular meth-
ty-based training research has been carried od used in the literature). Gains in squat and
out with exclusively male subjects. In theory, bench press 1RM, changes in vastus lateralis
the benefits of velocity-based training (or any and triceps cross-sectional area, and increas-
other approach to autoregulation) shouldn’t es in countermovement jump height didn’t
be influenced by sex, but as an empiricist, significantly differ between groups. Howev-
I always like to be able to supplant my as- er, the female 40% velocity loss group gained
sumptions with data. (non-significantly) more strength than the fe-
Fortunately, a recent study helps fill this gap male 20% velocity loss group, in contrast with
(1). Two groups of male subjects and two the male subjects in the present study, and in
groups of female subjects completed eight contrast with other velocity-based training
weeks of velocity-based training, consisting research on male subjects. So, does this mean
of Smith machine squat and bench press. One that female lifters need to train closer to fail-
group of male subjects and one group of fe- ure than male lifters if they want to maximize
male subjects terminated each set when their strength gains? Read on to find out.

7
Purpose and Hypotheses
Experimental Design
Male and female subjects were pair-matched
Purpose based on baseline back squat and bench press
The purpose of this study was to investigate strength, and divided into four groups: one
potential sex differences in strength, hyper- group of male subjects and one group of fe-
trophy, and power adaptations following ve- male subjects trained with 20% velocity loss,
locity-based resistance training using 20% and one group of male subjects and one group
versus 40% velocity loss targets. of female subjects trained with 40% velocity
loss. All four groups trained twice per week
Hypotheses for eight weeks, using a program consisting
The authors “hypothesized that neuromus- of Smith machine squat and Smith machine
cular adaptations might differ between sexes bench press, with the load and number of sets
and/or between upper- and lower-body exer- increasing over time. Subjects were instruct-
cises when using the same training program- ed to perform each concentric action as ex-
ming in [velocity-based resistance training].” plosively as possible, and mean propulsive
velocity was assessed with a linear position
Subjects and Methods transducer (3). Subjects in the 20% velocity
loss groups terminated each set when their
Subjects mean propulsive velocity decreased by 20%
45 subjects (23 males and 22 females) com- during a set (i.e., if a subject performed the
pleted this study. All subjects had at least one fastest rep of a set at 0.8 m/s, the researchers
year of back squat and bench press experi- would terminate the set when the subject’s
ence. More details about the subjects can be mean propulsive velocity dropped below
seen in Table 1. 0.64 m/s), and subjects in the 40% velocity
loss groups terminated each set when their
mean propulsive velocity decreased by 40%

8
during a set (i.e., if a subject performed the ing, subjects performed the eccentric with a
fastest rep of a set at 0.8 m/s, the researchers moderate velocity and moved the concentric
would terminate the set when the subject’s at maximal velocity, but they were also in-
mean propulsive velocity dropped below structed to pause the bar on their chest for ap-
0.48 m/s). Subjects rested for three minutes proximately one second between the eccen-
between sets. More details about the training tric and concentric phases.
program can be seen in Table 2.
Before the start of the training intervention, Findings
after four weeks of training, and at the end
As should be expected, subjects in the 40%
of the training intervention, the researchers
velocity loss groups completed more total reps
assessed Smith machine squat and bench
at a slower average velocity than subjects in
press 1RMs, countermovement jump height,
the 20% velocity loss groups (Table 2).
and vastus lateralis and triceps cross-section-
al area (via ultrasound). For all squat testing Squat and bench press strength gains didn’t
and training, subjects were required to “[de- significantly differ between groups. Howev-
scend] at a moderate velocity until the thighs er, the authors reported that the women in the
were below parallel,” and to perform the con- 40% velocity loss group tended to gain more
centric phase at maximal velocity without a strength in the squat (g = 0.56) and bench
pause between the eccentric and concentric press (g = 0.60) than the women in the 20%
phases. For all bench press testing and train- velocity loss group. For the male subjects,

9
strength gains didn’t meaningfully differ be- 20% and 40% velocity loss groups for the
tween the 40% and 20% velocity loss groups female subjects (Figure 3). Furthermore, tri-
(Figure 1). ceps cross-sectional area didn’t significantly
change over time in any of the groups.
Gains in countermovement jump height also

Criticisms and Statistical

didn’t significantly differ between groups
(Figure 2).
Musings
Changes in triceps and vastus lateralis
cross-sectional area also didn’t significantly I have one significant criticism of the present
differ between groups. Of note, the male sub- study, but , thankfully, this criticism doesn’t
jects in the 40% velocity loss group tended to impact any of the major takeaways.
experience a bit more vastus lateralis growth The major criticism is that the total number
than the males in the 20% velocity loss group of reps performed is presented three times
(g = 0.59), whereas gains were similar in the in this study, and all three presentations are

10
mutually exclusive. First, refer back to Ta- So, did the female subjects complete more
ble 2: in that table, it appears that the female total reps? Did the male subjects complete
subjects tended to complete more total reps more total reps? Or did both sexes complete
during the eight-week training period (an av- approximately the same amount of total reps?
erage of 833.4 total reps, versus an average of Honestly, I have no idea. For what it’s worth,
673.7 for the male subjects). However, with- I’d anticipate that either the female subjects
in the results section of the study, the authors would have completed more reps, or that both
report that “all men (i.e. VL20M + VL40M) sexes would have completed approximately
performed more repetitions than all women the same amount of reps. The average train-
(i.e. VL20W + VL40W) (p = 0.03).” These ing intensity in the present study was 70% of
two interpretations are mutually exclusive, 1RM; in general, women tend to have better
but it’s possible that the sentence in the re- strength endurance than men (i.e., they can
sults section was just a typo (i.e., it’s possi- complete more reps to failure at the same rel-
ble that it was supposed to say “all women ative intensity) at loads at or below ~70% of
performed more repetitions than all men.”). 1RM, whereas there don’t seem to be mean-
However, total reps performed are also re- ingful sex differences in strength endurance
ported in a figure (Figure 4). In the figure, with loads above ~70% of 1RM (4, 5).
it appears that the male and female subjects
completed about the same number of reps
in total – the females completed a few more
Interpretation
squat reps, and the males completed a few I wanted to review this study for two reasons:
more bench press reps. a) the vast majority of the research on veloci-

11
ty-based training has used male subjects, and the velocity loss method to terminate sets, is
b) I think some people may be coming away similarly effective for male and female lift-
from this study with stronger interpretations ers. To be clear, that’s not necessarily a sur-
than are warranted by the results. prising finding, but it’s still good to see.

Starting with the sex disparity in veloci- Moving on, I mostly wanted to review this
ty-based training research, the present study study because I’ve seen it discussed quite a
is just the second longitudinal velocity-based bit on social media, and most people seem to
training study with any female subjects, to be interpreting it as strong evidence that fe-
the best of my knowledge. A 2022 system- male lifters need to train closer to failure than
atic review by Baena-Marín and colleagues male lifters to maximize muscle growth and
recently summarized all of the longitudi- strength gains. First, the results of the present
nal research investigating the impact of ve- study clearly aren’t consistent with the idea
locity-based resistance training on strength, that female lifters need to train closer to fail-
jump, and sprint performance (6). Of the ure to maximize muscle growth: there wasn’t
22 studies included in the review, only one significant triceps growth in either group of
study by Dolezal and colleagues (7) included female lifters, and quad growth was similar
female subjects; of the 617 subjects includ- in both groups of female lifters (Figure 3).
ed in those 22 studies, 608 were male and 9 Second, the present study provides, at best,
were female. Overall, about 40% of the to- weak evidence for the idea that female lift-
tal research subjects within our field are fe- ers gain more strength when training close to
male (8), but within the velocity-based train- failure. The difference in strength gains be-
ing literature, female subjects accounted for tween the 20% and 40% velocity loss groups
just 1.46% of the total number of research
subjects (9). Now, there have been several
cross-sectional studies with female subjects
(for example, studies that are just aiming to
THE PRESENT STUDY
characterize load-velocity profiles), but lon- TENTATIVELY CONFIRMS
gitudinal velocity-based training research on
female subjects is sparse. It may have been
THAT VELOCITY-BASED
reasonable to assume that the results of ve- TRAINING, USING THE
locity-based training studies on male subjects
would generalize to female lifters – after all,
VELOCITY LOSS METHOD
the overall responses to resistance training are TO TERMINATE SETS, IS
very similar in both sexes – but it’s always
good to be able to move from the realm of as- SIMILARLY EFFECTIVE FOR
sumptions into the realm of empirical valida- MALE AND FEMALE LIFTERS.
tion. Overall, the present study (1) tentatively
confirms that velocity-based training, using

12
was modest (g = 0.56-0.60), and didn’t cross colleagues looked at the effects of training
the threshold for statistical significance. Af- to failure versus stopping shy of failure (10).
ter extracting the data from Figure 1 using Fifteen studies met the researchers’ inclu-
WebPlotDigitizer, I believe the p-value for sion criteria, but only two of the studies used
squat 1RM gains would have been 0.18 and a female-only cohort, and two of the studies
the p-value for bench press 1RM gains would used mixed-sex cohorts. None of these four
have been 0.15, if the two female groups studies found that training to failure result-
were just compared using t-tests. Now, sta- ed in significantly larger strength gains than
tistical significance isn’t everything, and we stopping shy of failure, and those four studies
shouldn’t commit the fallacy of assuming had effect estimates that were, overall, in line
that lack of statistical significance implies no with the effect estimates observed in studies
difference, but we also shouldn’t get carried on male subjects (Figure 5).
away based on a modest, nonsignificant dif-
ference in a relatively small study (it’s also Second, a 2020 meta-analysis by Hagstrom
worth noting that, as discussed here, velocity and colleagues sought to characterize the
loss thresholds manipulate both reps per set overall state of the literature examining the
and proximity to failure, somewhat muddy- impact of resistance training on hypertrophy
ing the water). and strength gains in female lifters (11). They
found that strength gains observed in studies
In a situation like this, I think it’s prudent to where subjects trained to failure (g = 1.70 for
ask: is there other evidence to suggest that upper body strength and g = 1.37 for low-
training close to failure is more beneficial er body strength) were virtually identical to
for strength gains in female lifters? If there’s the strength gains observed in studies where
a large body of evidence suggesting that fe- subjects didn’t train to failure (g = 1.71 for
male lifters need to train closer to failure to upper body strength and g = 1.45 for lower
maximize strength gains, I think it would be body strength). Now, you could certainly ar-
entirely fair to interpret the present study as gue that studies on subjects training to failure
further confirmation of a well-established wouldn’t necessarily have the same results as
phenomenon. However, if there’s not a large studies that merely involve training closer to
body of evidence suggesting that female lift-
failure. And, while that would be an entirely
ers need to train close to failure to maximize
fair point, I’d contend that the failure versus
strength gains, the results of the present study
non-failure body of literature is the best we
just aren’t strong enough for us to interpret it
have for establishing a set of baseline expec-
as a paradigm-shifting refutation of the status
tations. Since female lifters don’t seem to
quo. So, what does the rest of the research in
reliably gain more strength when training to
the area say?
failure versus stopping shy of failure, I don’t
I think there are two meta-analyses that can see a strong reason to expect that training
help us get a feel for the current state of the closer to failure would be more beneficial for
literature. First, a 2022 meta from Grgic and female lifters than male lifters. So, with that

13
14
 APPLICATION AND TAKEAWAYS
The present study suggests that velocity-based training with either 20% or 40%
velocity loss thresholds is similarly effective for promoting hypertrophy, strength gains,
and improvements in countermovement jump height in male and female lifters. It’s
possible that a 40% velocity loss threshold was slightly more effective than a 20%
velocity loss threshold for promoting strength gains in female lifters, but more research
is needed before we can state that with any reasonable degree of confidence.

in mind, I think it’s very premature to treat at both velocity-loss thresholds. Obviously,
the present study as a clear confirmation that more research is needed on the topic. I also
female lifters should train closer to failure think it’s worth keeping an eye out to see if
than male lifters. future studies suggest that female lifters need
to train closer to failure than male lifters in
Overall, my biggest takeaway from the pres-
order to maximize strength gains, since such
ent study is just that it can give us a bit more
results may require us to revisit the non-sig-
confidence that the rather large body of ve-
nificant differences in strength gains between
locity-based training research in male lifters
the female 20% and 40% velocity loss groups
likely generalizes to female lifters. Strength,
in the present study.
countermovement jump, and hypertrophy
outcomes were all pretty similar in both sexes
Next Steps
We just need more velocity-based training re-
search done with female lifters. Of all of the
SINCE FEMALE LIFTERS DON’T male velocity-based training studies conduct-
SEEM TO RELIABLY GAIN MORE ed to date, I personally like 2020 paper by
Dorrell and colleagues the most (which we
STRENGTH WHEN TRAINING previously reviewed in MASS; 12). A repli-
TO FAILURE VERSUS STOPPING cation of that study with female subjects and
a slightly longer training intervention would
SHY OF FAILURE, I DON’T SEE be excellent.
A STRONG REASON TO EXPECT
THAT TRAINING CLOSER TO
FAILURE WOULD BE MORE
BENEFICIAL FOR FEMALE
LIFTERS THAN MALE LIFTERS.

15
References
1. Rissanen J, Walker S, Pareja-Blanco F, Häkkinen K. Velocity-based resistance training:
do women need greater velocity loss to maximize adaptations? Eur J Appl Physiol. 2022
Mar 8. doi: 10.1007/s00421-022-04925-3. Epub ahead of print. PMID: 35258681.
2. Beck M, Varner W, LeVault L, Boring J, Fahs CA. Decline in Unintentional
Lifting Velocity Is Both Load and Exercise Specific. J Strength Cond Res. 2020
Oct;34(10):2709-2714. doi: 10.1519/JSC.0000000000003786. PMID: 32740288.
3. Mean propulsive velocity is similar enough to mean concentric velocity that it’s not
really worth disambiguating for this article. However, this study explores the differences,
if you’re interested in getting into the weeds.
4. Maughan RJ, Harmon M, Leiper JB, Sale D, Delman A. Endurance capacity of untrained
males and females in isometric and dynamic muscular contractions. Eur J Appl Physiol
Occup Physiol. 1986;55(4):395-400. doi: 10.1007/BF00422739. PMID: 3758040.
5. Hunter SK. Sex differences in human fatigability: mechanisms and insight to
physiological responses. Acta Physiol (Oxf). 2014 Apr;210(4):768-89. doi: 10.1111/
apha.12234. Epub 2014 Feb 25. PMID: 24433272; PMCID: PMC4111134.
6. Baena-Marín M, Rojas-Jaramillo A, González-Santamaría J, Rodríguez-Rosell D, Petro
JL, Kreider RB, Bonilla DA. Velocity-Based Resistance Training on 1-RM, Jump and
Sprint Performance: A Systematic Review of Clinical Trials. Sports (Basel). 2022 Jan
4;10(1):8. doi: 10.3390/sports10010008. PMID: 35050973; PMCID: PMC8822898.
7. Dolezal SM, Frese DL, Llewellyn TL. The Effects of Eccentric, Velocity-Based Training
on Strength and Power in Collegiate Athletes. Int J Exerc Sci. 2016 Nov 1;9(5):657-666.
PMID: 27990226; PMCID: PMC5154723.
8. Costello JT, Bieuzen F, Bleakley CM. Where are all the female participants in
Sports and Exercise Medicine research? Eur J Sport Sci. 2014;14(8):847-51. doi:
10.1080/17461391.2014.911354. Epub 2014 Apr 25. PMID: 24766579.
9. I’m not even sure the prior velocity-based training study with female subjects was even
a velocity-based training study. You can review it for yourself (it’s open-access), but I’m
pretty sure it was just a “normal” resistance training study where subjects were instructed
to lift moderate loads explosively, without any attempts made to even measure velocity.
10. Grgic J, Schoenfeld BJ, Orazem J, Sabol F. Effects of resistance training performed to
repetition failure or non-failure on muscular strength and hypertrophy: A systematic
review and meta-analysis. J Sport Health Sci. 2022 Mar;11(2):202-211. doi: 10.1016/j.
jshs.2021.01.007. Epub 2021 Jan 23. PMID: 33497853.

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11. Hagstrom AD, Marshall PW, Halaki M, Hackett DA. The Effect of Resistance Training
in Women on Dynamic Strength and Muscular Hypertrophy: A Systematic Review
with Meta-analysis. Sports Med. 2020 Jun;50(6):1075-1093. doi: 10.1007/s40279-019-
01247-x. PMID: 31820374.
12. Dorrell HF, Smith MF, Gee TI. Comparison of Velocity-Based and Traditional
Percentage-Based Loading Methods on Maximal Strength and Power Adaptations. J
Strength Cond Res. 2020 Jan;34(1):46-53. doi: 10.1519/JSC.0000000000003089. PMID:
30946276.

17
 Study Reviewed: The Effect of Three Different Resistance Training Programming Approaches
on Strength Gains and Jumping Performance. Hernandez-Davo and Sabido (2022)

Should You Change The Load During

a Set?
BY MICHAEL C. ZOURDOS

Research on linear, weekly, and daily undulating periodization

has attempted to determine what frequency of training variation
maximizes strength gains. However, a new study goes a step
further to examine if intraset variation is the ticket to success.

18
 KEY POINTS
1. Researchers split trained men and women into three groups. All groups
completed a six-week training program. One group varied strength-,
hypertrophy-, and power-type training every two weeks, another group rotated
training types each day, while a third group varied training styles within each set
during every session.
2. Both the intraset and daily variation groups tended to increase squat 1RM
(intraset: +20.5%; daily: +20.3%) and countermovement jump height (intraset:
+8.1%; daily: +9.5%) more than the weekly variation group (squat 1RM: +13.6%;
jump height: +4.4%). However, the only statistically significant group × time
interaction indicated that squat 1RM increased more in the intraset than in the
weekly group (p = 0.022).
3. Overall, this study showed that both intraset and daily fluctuation between
strength-, hypertrophy-, and power-type training led to greater strength gains
and jump height increases than varying training types every two weeks. However,
intraset variation did not further enhance strength gains compared to daily
variation. However, this article provides insight into how certain configurations of
intraset or intrasession variation could further augment strength.

D
iscussions about programming the The reviewed study from Hernandez-Davo et
powerlifts (squat, bench press, and al (1) had 42 lifters (34 men and 8 women)
deadlift) are usually centered around train the squat twice per week for six weeks
altering training variables from day to day or in one of three groups. One group varied be-
week to week. For example, it’s often debated tween strength- (85% of 1RM), hypertrophy-
whether a linear or undulating periodization (75% of 1RM), and power-type training (30%
model should be used. In other words: should of 1RM) every two weeks, a second group
training variables (i.e., volume and percent- varied the training types every day, while a
age of one-repetition maximum [1RM]) be third group varied the training types within
varied every mesocycle, every week, or ev- each set (intraset variation) during a work-
ery day? We recently reviewed a meta-analy- out. Specifically, the third group performed
sis (2), which concluded that daily undulating 4 (sets) × 10 (reps) each session. Lifters com-
periodization (i.e., varying training variables pleted the first two reps of each set with the
each workout) led to greater strength gains strength load, the next four with the power
than linear periodization (i.e., varying train- load, and the last four reps with the hyper-
ing variables every mesocycle, or 4-6 weeks). trophy load. Squat 1RM, countermovement
So, if daily variation leads to greater strength jump, and squat jump was assessed before
gains than variation from mesocycle to me- and after the training program. There were
socycle, what about going a step further and no significant differences between groups
varying training styles within each workout? for jumping metrics, but the daily and intra-

19
 Purpose and Hypotheses
set groups tended to increase countermove-
ment jump height more than the weekly
group. Squat 1RM also tended to increase Purpose
more in both the daily (+20.3%) and intraset The purpose of the reviewed study was to
(+20.5%) variation groups than in the week- compare changes in strength and jump per-
ly group (+13.6%); however, only the intra- formance between programs that varied
set group had a significantly greater increase between hypertrophy-, strength-, and pow-
than the weekly group (p = 0.022). Overall, er-type training every two weeks, every day,
these results suggest that squat 1RM strength or within each set in trained men and women.
benefits from frequent variation in training
Hypotheses  
variables. However, there is little research
examining the intraset variation of training The authors hypothesized that varying training
within each set would lead to the greatest chang-
variables; thus, there is much to discuss. This
es in both strength and jump performance.
article will aim to:

1. Review the present findings. Subjects and Methods

2. Discuss the feasibility of altering train- Subjects
ing types (hypertrophy, strength, and
42 individuals (34 men and 8 women) partici-
power) on a single exercise during a
pated in the present study. All lifters had trained
training session.
for at least one year prior to the study. Addition-
3. Discuss if intraset or intrasession varia- al subject characteristics can be seen in Table 1. 
tion of training types might be beneficial. Study Protocol
4. Provide practical examples of how lifters The presently reviewed study was a paral-
could implement within-session variation. lel-groups design that split 42 trained lifters

20
into three groups, which were counterbal- subjects could immediately go to the next
anced based on pre-study squat 1RM values. load during the set. For example, after per-
The three groups completed training inter- forming two reps at 85% of 1RM, subjects
ventions which rotated between hypertro- racked the bar, immediately went to the pow-
phy-, strength-, and power-type squat training er load, performed four reps, and then went to
over different time frames. One group varied the hypertrophy-loaded barbell.
training types every two weeks (weekly vari-
ation), another varied training types every Overall, each training group completed ex-
session (daily variation), and the last group actly 96 reps with the strength load, 192 reps
varied training types within each individual with the hypertrophy load, and 192 reps with
set (intraset). Squat 1RM, squat jump height, the power load (480 total reps). Notably, the
and countermovement jump height were test- study’s methods did not mention any infor-
ed before and after the training program. mation regarding load progression, which
I’ll discuss in the “Criticisms and Statistical
Training Groups Musings” section. Table 2 demonstrates the
In the weekly and daily variation groups, hy- variation of training types within each group.
pertrophy training was 6 × 8 at 75% of 1RM,
strength training was 6 × 4 at 85% of 1RM, Findings
and power training was 6 × 8 at 30% of 1RM.
These groups rotated training types in the or- 1RM Strength
der of strength, hypertrophy, then power, and Squat 1RM tended to increase more in both
rested for 150 seconds between all sets. the daily (+20.3%) and intraset (+20.5%)
The intraset group performed 4 × 10 each variation groups than in the weekly group
session. They squatted the first two reps with (+13.6%); however, only the intraset group
the strength load (85% of 1RM), the next had a significantly greater increase than the
four with the power load (30% of 1RM), and weekly group (p = 0.022). On the individu-
the last four reps with the hypertrophy load al level (Figure 1), all lifters increased their
(75% of 1RM). Subjects in this group rested squat 1RM in the daily and intraset varia-
for 150 seconds after all 10 reps before the tion groups, while two lifters experienced a
next set. However, three barbells were set up slight decrease in squat 1RM from pre- to
during each set, one with each load so that post-study.

21
Jump Performance sion will be mentioned in a study’s methods
section, even if the description leaves a lot
Both squat jump and countermovement jump
to be desired. Typically, if the researchers
height significantly improved (p < 0.05) in
neglected to mention load progression, I’d
all groups, with no significant differences
still be inclined to assume that load progres-
between groups. Percentage increases and sion did occur. However, other details make
p-values for jumping performance can be me question if the load was progressed. For
seen in Table 3. example, the researchers stated that “all sub-
jects completed 480 repetitions.” This state-
Statistical Criticisms and ment means there were zero missed reps in
Musings the study. If load was progressed, somebody
almost certainly would have missed a rep.
The researchers did not mention how or However, even without load progression, it
if load was progressed during the training still seems unlikely that no reps were missed
study. Usually, some method of load progres- due to the large interindividual variation

22
in reps performed at a given percentage of fore, this interpretation will place the pres-
1RM. In other words, the stated protocols ently reviewed study’s findings in context
for hypertrophy (6 × 8 at 75% of 1RM) and with the existing literature, and break down
strength (6 × 4 at 85% of 1RM) with 150 sec- the reviewed study’s training protocol to de-
onds rest were pretty demanding; thus, it’s termine why intraset training variation may
surprising that no reps were missed during be effective.
the first week of training.
Although not significant, the daily variation
On the other hand, part of me thinks that load group in the present study had a 6.7% greater
must have progressed because the lifters had increase in squat 1RM than the weekly varia-
a starting strength of 1.76 × body mass and in- tion group. We recently reviewed a meta-anal-
creased their squat 1RM by 18.36% (weight- ysis from Moesgaard et al (2), which found
ed average of the three groups). That level of that daily undulating periodization (DUP) led
progression in trained individuals following to greater strength gains than linear periodiza-
only two training sessions per week for six tion. Therefore, the greater strength increases
weeks is impressive, especially without any in the daily versus the weekly variation group
progressive overload. are not surprising. However, for this interpre-
tation, I’m most interested in examining the
To be clear, I don’t know for sure whether
findings of the intraset group. For a full ex-
training load was progressed or not, and, while
planation on daily undulating periodization
an increase in strength of 18.36% in six weeks
(and daily undulating programming) versus
would be awesome for most MASS readers,
less-frequent variation, see here.
it’s not too abnormal for the scientific litera-
ture. In general, it’s just noteworthy that the The intraset variation group had a 6.7%
lifters missed zero reps throughout the entire greater increase in squat 1RM strength than
study, which also means that adherence to the the weekly variation group (p = 0.022), but
training sessions and the prescribed dosage 1RM in this group increased similarly to the
(i.e., completing all sets) was 100%. daily variation group. To my knowledge,
there isn’t any literature examining intraset
Interpretation variation in training. There is some research
examining intrasession variation, for which
The reviewed study from Hernandez-Davo the authors cited a meta-analysis from Bauer
and Sabido (1) suggests that daily or intraset et al (3) to support frequent variation in train-
variation between hypertrophy-, strength-, ing stimuli. However, the studies included
and power-type training led to greater in- were not very applicable. Specifically, Bauer
creases in squat strength than changing compared what he called “complex” training
training types every two weeks. While there to control (no training) or “alternative” train-
are many studies investigating daily versus ing groups. Complex training was defined
weekly training variation, the concept of in- as “training programs combining higher and
traset variation is far less-explored. There- lower load exercises in one workout.” Impor-

23
tantly, the individual studies did not compare the weekly undulating group only changed
training type (i.e., hypertrophy, strength, and reps and velocities each week. The first An-
power) variation in one workout to perform- tretter publication compared these training
ing only one training type. For example, the styles during the first six weeks of training
Bauer meta included a study from Veliz et (6), while the second publication compared
al (4), which compared squat 1RM gains the next three weeks of training (weeks 7-9)
among water polo players who performed in the same lifters (7). Leg press 1RM, iso-
only traditional water polo training + strength metric strength, jump squat performance, and
training versus players who only completed estimated thigh cross-sectional area tended
traditional water polo training. This study to increase in the lifters; however, there were
was flagged a “complex training” because no significant between-group differences for
athletes performed some exercises for 3 × these measures after six (6) or nine weeks (7)
4-6 reps in the strength training group, while of training. Thus, there isn’t anything to write
the participants also did abs for 4 × 20 reps. home about in the limited data on intrases-
Bauer also included a study from Torres-To- sion training variation.
rello et al (5), which compared strength train- Without much data on intraset or intrasession
ing, strength training + change of direction variation, we need to break down the intraset
training, and a control group. However, the group’s training protocol to determine why
lifting was the same in both groups that in- this strategy was successful. The intraset
cluded strength training, and the heaviest ses- group lifted 85% of 1RM in all 12 sessions,
sion was 3 × 4 reps at a load corresponding whereas the other two groups only used 85%
to a mean propulsive velocity of 1.00 m/s. In in four sessions each. Further, lifters in the
other words, although the authors used this intraset group only performed two reps with
meta in support of more frequent variation to 85% of 1RM, which likely equated to ~15-
enhance strength, the studies included in the 25% velocity loss or ~1-3 RIR as opposed
Bauer meta were not designed to answer the to a 35-45% velocity loss which may have
same research questions as the presently re- resulted in some failure training in the week-
viewed study.  ly variation group. Importantly, staying shy
Although the Bauer meta isn’t relevant, there of failure seems preferable for strength gains
are a pair of studies (6, 7) from Antretter et al (8, 9, 10, 11). When calculating velocity loss
and RIR, I also considered potential fatigue
examining the effects of intrasession variation
on sets two, three, and four due to the power
on performance and hypertrophy outcomes.
and hypertrophy work.
Both Antretter studies compared weekly un-
dulating periodization to the Hatfield system. Additionally, the order of training type vari-
The Hatfield system consisted of changing ation may have negatively affected strength
between different repetitions ranges (4-6, 12- gains in the weekly group compared to the
15, and 20-25 reps) and movement veloci- other groups. Linear periodization models
ties in the same workout, while subjects in typically progress from higher reps and low-

24
er loads (first week) to lower reps and higher movement velocity on the power reps, since
loads (last week). Thus, some say (12) peri- those reps were preceded by heavy strength
odization leads to greater strength gains than work. However, that also may not be the case,
non-periodized training due to the specifici- since PAP is typically elicited in resistance
ty of periodized training having its heaviest training after 5-10 minutes of rest (13,  14).
lifts in the final training week just before the Then, after what was likely not too fatiguing
strength test. In the presently reviewed study, power work, the lifters performed four reps
both the intraset and daily variation groups with 75% of 1RM before taking 2.5 minutes
performed strength work during the last two of interset rest. On average, 75% is a 10RM
weeks of the study; however, the weekly vari- load, so subjects take into account a little fa-
ation group only performed strength work in tigue from the preceding two reps at 85%,
weeks one and two. In fact, in the final two four reps at 30%, and un-racking and racking
weeks, the weekly variation group only per- of barbells probably had about 2-4 RIR after
formed power training, which meant no lift- the 75% sets. 
ing above 30% of 1RM. Therefore, I think
Countermovement jump performance in-
the frequency of heavy work, appropriate ve-
creased 5.1% and 3.7% more in the intraset
locity loss and per-set RIR, and performing
and daily groups, respectively, than in the
heavy work near the test day all contributed
weekly variation group, although there was
to similar strength gains between the intraset
not a statistically significant group × time
and daily variation groups.
interaction. The lesser gains in the weekly
The intraset group may have also complet- group may seem somewhat surprising since
ed their hypertrophy work at a lower ve- they performed only power training for the
locity loss and higher RIR than the other final two weeks before the post-study test,
groups. Specifically, only 2.5 minutes of which is in line with the principle of speci-
rest between 6 × 8 at 75% of 1RM (hyper- ficity. However, squatting with 30% of 1RM
trophy training) was bound to lead to failure is not nearly as specific to countermovement
in some individuals in the weekly and daily jump performance as squatting with 85% of
groups (although, if no progressive overload 1RM is to squat 1RM performance. Thus, it
was used, as suggested in the Criticisms and seems the overall training configuration fa-
Statistical Musings section, then perhaps the vored the intraset and daily variation groups
training wasn’t that demanding). However, in for jump performance. Pareja-Blanco et al
the intraset variation group, I don’t think the (9  -  MASS Review) previously reported
remaining eight reps in each set after the two greater increases in countermovement jump
85% reps were that fatiguing. The four power height in trained men who squatted sets to a
reps at 30% of 1RM, which followed the first 20% velocity loss than those who trained sets
two reps, wouldn’t be too stressful. It’s even to a 40% velocity loss over eight weeks. In the
possible that lifters experienced a postactiva- presently reviewed study, the lifters probably
tion potentiation (PAP) effect, and enhanced experienced a 15-25% velocity loss on the

25
85% sets in the intraset group, but a 35-45% sen terminology. This is because intrasession
velocity loss per set on the strength work in variation could be completed independent of
the weekly and daily variation groups. This intraset variation. Additionally, I think the in-
disparity in velocity loss (and per-set RIR) traset design used in the presently reviewed
clearly explains the greater, but not statisti- study is impractical for many. In the study,
cally significant, increase in countermove- three barbells were set up so the lifters could
ment jump height in the intraset group.  immediately go from one to the other to con-
tinue the set; however, this wouldn’t be pos-
Although hypertrophy wasn’t assessed in this
sible in most gym settings. Of course, some-
study, I would have hypothesized greater mus-
one (or their training partners) could quickly
cle growth in both the daily and intraset groups
change the weight on the barbell during the
compared to the weekly group, even though
set; however, this is cumbersome and could
the researchers presumably equated total vol-
add fatigue. Intrasession variation would be
ume. This hypothesis is because the week-
more feasible. For example, if someone had
ly group performed only low volume power
six sets of squats, they could perform two
training for the final two weeks of training
strength sets, two power sets, and two hyper-
before the post-study test, and previous data
trophy sets in a rotating fashion (i.e., strength,
have shown muscle size (15, 16 – MASS Re-
power, hypertrophy, repeat). One potential is-
view, 17 – MASS Review) to decrease slightly
sue would be that if a lifter trained three times
following one- two-week low volume tapering
per week, this setup would mean hypertrophy
periods. However, the lack of volume near the
training in each session. In this case, I would
post-study test is the only reason for this hy-
pothesis. I doubt the more frequent variation
of training types has an inherent advantage
for hypertrophy. Indeed, a meta-analysis from CONSTRUCTING A TRAINING
Moesgaard et al (2 - MASS Review) reported
no significant difference in muscle growth be- PROGRAM IS ALL ABOUT
tween DUP and linear periodization. This isn’t
to say that training variation isn’t important
PROGRAMMING FOR YOUR
for muscle hypertrophy. Rather, as I recently SPECIFIC GOAL, ACHIEVING
wrote  about, alternative types of periodiza-
tion or training variation may enhance muscle PROGRESSIVE OVERLOAD,
growth more than typical DUP or linear peri- AND MANAGING RECOVERY
odization paradigms. The alternative options
include volume cycling, variation of proximity TO TRAIN FREQUENTLY
to failure, and variation in exercise selection.
ENOUGH TO ALLOW FOR
Throughout this article, I’ve been careful to
refer to the “intraset” group as opposed to “in-
SUFFICIENT VOLUME.
trasession,” which was the researchers’ cho-

26
advise that the lifter stay shy of failure on This discussion also brings me to my next
their hypertrophy sets to ensure appropriate point, which is that intraset or intrasession
recovery (18 - MASS Review) for the follow- variation doesn’t have to include all three
ing session. Otherwise, I don’t see why this training types. Instead, a lifter could just per-
model would be worse than a DUP configu- form strength and hypertrophy work. I’m not
ration. Constructing a training program is all advocating against power/speed training; in
about programming for your specific goal, fact, its usefulness seems to be highly indi-
achieving progressive overload, and manag- vidual (19 - MASS Review). I’m just point-
ing recovery to train frequently enough to al- ing out that implementation doesn’t have to
low for sufficient volume. In other words, as be so rigid; it’s the concept that’s important.
long as an intraset or intrasession setup checks
those boxes, I think it would be a good training Of course, you can also have intrasession
plan. One example of a “mistake” would be to variation by performing heavy sets on a main
place hypertrophy sets or reps first in an intra- lift (e.g., squat) then hypertrophy-type train-
session or intraset variation configuration for ing on assistance movements (i.e., leg press,
someone looking to maximize strength since leg extension, leg curls, etc.), but the spirit
the hypertrophy sets (or reps) may fatigue the of the current study is to vary training types
individual for their strength work. on the same exercise. Table 4 provides three
examples of how a lifter might program in-
I don’t think that intraset or intrasession vari-
trasession (not intraset) variation on a main
ation has an inherent advantage for strength;
lift. These examples are:
I think the lifter could leverage the more
frequent heavy sets as an advantage. For 1. Varying all three training types.
example, a lifter could begin each session
2. Varying just strength and hypertrophy.
with low volume strength work (1-3 sets)
at a high load, then follow with power and/ 3. Performing low volume heavy singles be-
or hypertrophy training. One way to do this fore hypertrophy work.
is to use heavy singles (~90% of 1RM) in
each session, which we’ve discussed before As always, the table is just an example, and
(one,  two), then perform hypertrophy work. the loading options (i.e., percentages or RIR)
are not the only way to program. However, I
did choose RIR-based training for the hyper-
trophy work to allow flexibility in the load
IMPLEMENTATION choice, since fatigue from the strength and/
DOESN’T HAVE TO BE SO or power sets preceding the hypertrophy sets
may vary on an individual basis. Further, the
RIGID; IT’S THE CONCEPT magnitude of volume in the example should

THAT’S IMPORTANT. not be taken literally, as the number of sets

needed to maximize adaptations would vary
from person to person.

27
 Next Steps
In the two left-hand columns of Table 4, I var-
ied the number of sets evenly between the train-
ing types, but training type distribution does Since this study is the first on this topic, repli-
not have to be even. For example, if someone cation is the place to start. Although the pres-
is primarily interested in strength, they could ently reviewed study did equate for total reps
perform three strength sets, one power set, and between groups, it did not equate for proxim-
two hypertrophy sets, which would still quali- ity to failure (i.e., RIR and velocity loss was
fy as intrasession variation. I don’t know what not matched). Therefore, a follow-up study
the most appropriate ratio of strength to pow- that controls for proximity to failure would
er to hypertrophy is in a single session, and help determine if the frequent variation aid-
that ratio may not be static between sessions, ed the intraset group, or if the findings were
but the point is someone could do this. Also, if simply an artifact of more appropriate veloci-
training three days per week (using any exam- ty loss and RIR on the strength sets.
ple in Table 4), the lifter would be completely
fresh for a strength set three times per week.
In a DUP model the lifter would perform all
strength sets on the same day, meaning the
lifter would only be completely fresh for one
strength set the entire week. Would having
three sets completely fresh compared to one
set matter? I’m not entirely sure, but it doesn’t
seem like a bad thing.

28
 APPLICATION AND TAKEAWAYS
1. Hernandez-Davo and Sabido (1) found that varying between strength-,
hypertrophy-, and power-type training within each individual set or between
each session (daily variation) tended to lead to greater gains in squat 1RM and
countermovement jump height than changing training types every two weeks.
2. Although lifters in the intraset group gained more strength than those in the
weekly variation group, it’s important to highlight that the intrasession group did
not outperform the daily variation group.
3. Ultimately, changing training types intraset or intrasession is unlikely to provide an
inherently greater strength benefit than daily undulating periodization. However,
when configured appropriately, a lifter could configure a workout based upon
intrasession variation to allow a lifter to be fresher for heavy sets. Overall, when
configured appropriately, intrasession variation may be worth trying.

29
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19. Peltonen H, Walker S, Hackney AC, Avela J, Häkkinen K. Increased rate of force
development during periodized maximum strength and power training is highly
individual. European journal of applied physiology. 2018 May;118(5):1033-42.

31
 Is Long-Term Weight Loss Impossible? A
Concept Review of the Challenges and Realities
of Long-Term Weight Loss Maintenance
BY BEN HOUSE

Discussions surrounding weight loss often involve arguments

between two distinct camps: those who believe long-term weight
loss is impossible (or even unethical), and those who believe
long-term weight loss is a simple matter of willpower. This
concept review explores this false dichotomy, while reviewing the
challenges and realities of long-term weight loss.

32
 KEY POINTS
1. Long-term weight loss of 10% of one’s initial body weight looks to be possible,
but difficult. Short or long-term weight loss beyond 10-15% of one’s initial body
weight appears to be even more unlikely.
2. Even small amounts of weight loss may provide dramatic health benefits
in some populations, and 10-15 kg of weight loss could even result in the
remission of type 2 diabetes in some circumstances.
3. Most, if not all, of the long-term weight loss data reports significant amounts
of lean body mass loss, and thus the potential increased durability and health
effects of long-term body recomposition warrants investigation.

I
n our thirst for a simple narrative around To start, it is important to honor the gravity of
weight loss, it seems the internet has the potential problem we face, and nearly ev-
formed two camps that love to yell ery peer-reviewed article you read on weight
across one another. One camp believes that loss will start with some iteration of the para-
long-term weight loss is impossible, or even graph below.
unethical. The other camp seems to believe
Currently 91% of Americans have a waist cir-
that weight loss is easy and simple, and that
cumference that is more than half their height
obesity wouldn’t be an issue if people would
(1), and, by 2030, one in two Americans may
just try harder. In this concept review, I will
have obesity (2). Regardless of one’s current
attempt to wade through the messy middle of
health status, obesity increases the risk of
this false dichotomy so that MASS readers
developing type 2 diabetes by 400-900% (3)
can potentially have more informed conver-
and obesity has been independently linked to
sations with our community, and especially
an increased risk of cardiovascular disease
those who may be seeking weight loss.
(4, 5), non-alcoholic fatty liver (6), cancer
(7), and death (8). Furthermore, obesity may

Guest Reviewer: Ben House, PhD

Ben finished his Ph.D. and a multi-year metabolic health study within the
Nutritional Sciences Department at UT-Austin in 2016. House has numerous
publications in peer-reviewed scientific journals and has presented his work
at multiple international conferences. Ben played collegiate baseball and fell
in love with the barbell when he was 13. He has competed in multiple iron
sports and has been working in the nutrition and fitness space for almost two
decades. Over this time Ben has had the opportunity to work with thousands
of clients and consult with multiple professional and collegiate sports teams.
Ben is currently lifting, researching, teaching, and regularly writing for
Deconstruct Nutrition.

33
increase the risk of negative psychological maintenance” which was published in 2005
outcomes like depression (9), loneliness (10), in the American Journal of Clinical Nutrition.
and dementia (11). In this paper, successful weight loss mainte-
nance was defined as “individuals who have
Thus, it’s clear that the solution to one of the
intentionally lost at least 10% of their body
most pervasive and multifactorial (as demon-
weight and kept it off at least one year.”
strated in this obesity systems map) problems
of progress our species has ever faced is simple: Yet, if we read this paper we can see that we
just lose weight by being in a caloric deficit. are already in a game of pubmed telephone,
because the ~20% number seems to be de-
How Much to Lose and rived from earlier survey data. Additionally,

What are the Benefits

Wing and Phelan’s own data from the Na-
tional Weight Loss Registry presented within
and Risks? this paper could actually be framed in a more
positive light: the longer someone had main-
It does look like weight loss of greater than
tained weight loss, the less likely they were
5% of one’s initial body weight can improve
to gain weight in the subsequent year. Specif-
metabolic health (12, 13), and losing substan-
ically, the authors stated:
tial amounts of adipose tissue can even put
type 2 diabetes into remission (14). Losing “Individuals who had kept their weight off for
weight may also increase one’s quality of life 2 years or more had markedly increased odds
and disability-free years, while simultane- of continuing to maintain their weight over
ously decreasing the risk of premature death the following year. This finding is encourag-
(15, 16). According to the most recent me- ing because it suggests that, if individuals
ta-analysis (17), weight loss does not appear can succeed at maintaining their weight loss
to be associated with any negative mental for 2 years, they can reduce their risk of sub-
health outcomes; however, critical long-term sequent regain by nearly 50%.”
follow-up data are lacking. Currently as high
as 65% of the US population may be actively Experimental Data
on Weight Loss
trying to lose weight or maintain weight loss
(18), but it appears that only 20% of individ-
uals can successfully maintain weight loss Maintenance
long-term (19).
To dig deeper, let’s go through three more
And there it is! The 20% sentence, which has recent studies that will potentially give us a
now been cited so many times that it is wide- more nuanced appreciation for this topic, and
ly accepted as fact within the evidence-based the ~20% number, which seems to get thrown
nutrition and fitness community. That 20% around so often – and somewhat haphazardly
number comes from a paper by Wing and – in both the published literature and the evi-
Phelan (19) entitled, “Long-term weight loss dence-based fitness and nutrition community.

34
 The first study is Look AHEAD (21) which is
one of the largest and longest weight loss tri-
als to date, involving 5,145 subjects with type
2 diabetes with an average BMI of 35-36. The
methods of Look AHEAD are now deemed
the standard behavior therapy for obesity by
many. The subjects were allocated to one of
two intervention groups: an intensive lifestyle
intervention (ILI) group, or a control diabe-
tes support and education (DSE) group. The
weight loss intervention within the ILI group
was quite expansive with one individual and
three group sessions per month for the first six
months, along with meal replacements. Then
for the next six months, subjects had one in-
Each of these three studies has directly inves- dividual and two group meetings per month,
tigated the likelihood of long-term weight loss along with meal replacements. From the end
maintenance, and thus they do not suffer from of year one to year four, subjects had at least
the same degree of potential sampling bias as one on-site visit per month and a second con-
observational self-reported data (20). We will tact via telephone, mail, or e-mail. During
then finish this concept review with a discus- years four through eight, monthly individual
sion of the behaviors and strategies that seem visits were offered and there was one refresh-
to be related to long-term weight loss success. er group offering per year. Participants in the

35
 for each individual to lose 10% of their ini-
tial body weight). Figures 1 and 2 present the
main results for the ILI group as well as the
comparison DSE group.
The intensive multidisciplinary interven-
tion resulted in 50% of subjects maintaining
a weight loss of ≥5% at 8 years and 26.9%
maintaining ≥10% weight loss at 8 years.
This population was diagnosed with type 2 di-
abetes and 84.3% were living with obesity at
baseline. Thus, depending on your interpreta-
tion, these findings could be framed as a posi-
tive or a negative, but the study does show that,
with consistent effort and support, long-term
weight loss does seem to be possible.
Furthermore, if we stratify by weight loss in
the first year, things get a bit more interest-
ing. Almost 40% of those with ≥10% weight
loss at year 1 maintained it at year 8 (see Fig-
ure 3), and weight loss at one and two months
was predictive of weight loss success at year 4
and 8 (22). Additionally, the Look AHEAD
group just published the results two years af-
ter the conclusion of the original study, and,
perhaps surprisingly, both groups continued to
lose small amounts of weight on average (23).
However, these results could be confound-
ed by weight loss from aging and potentially
weight loss from long-term diabetic status.
DSE group were offered three 1-hour group To summarize, and put this in line with the
meetings per year for the first four years and 2005 Wing and Phelan definition for long-
then just one group session per year for the term weight loss, one could say that with a
subsequent four years. The full details of the
long-term intensive lifestyle intervention
methods, and the rationale behind them, can
around ~40% of individuals may be able to
be found here.
lose ≥10% of their initial body weight at
The main goal of the ILI was to induce 10% year 1, and of that cohort 40% may be able
weight loss on the individual level (that is, to maintain that ≥10% weight loss at year

36
8 (see the bottom graphic of Figure 3), with While the intensive intervention lasted only
26.9% of the total sample losing and main- 12 months, the researchers did collect fol-
taining ≥10% weight loss at year 8 (see the low-up data for two years after the interven-
bottom graphic of Figure 2). tion, as shown in Figures 5 and 6.

The most common and valid critique of Look As you can see in Figure 5, both groups lost
AHEAD is that almost no one would ever have substantial weight during their respective
access to this type of intervention. So, let’s interventions, and then regained weight, but
look at the Mind Your Health studies by For- with notable differences in weight loss main-
man and colleagues (24, 25, 26), which had tenance success at the 3-year mark (Figure
a different set-up. Mind Your Health essen- 6). Again these findings could be framed as
tially put the first year of the Look AHEAD a positive, in that long-term weight loss does
methods (SBT) up against Acceptance-based look to be possible at higher percentages
Behavioral Therapy (ABT). Participants with than Wing and Phelan found. Alternatively,
a starting average BMI of 37.4 completed 25 the findings could be framed negatively, in
sessions of group ABT or SBT over one year that, even with a gold-standard approach for
(the complete methods of the ABT approach weight loss, delivered by doctoral-level clini-
can be found here). The average weight loss cians with an average of 4.8 years of experi-
for both groups at one year is presented in ence in the group setting (which may perform
slightly better than one-on-one [27]) with
Figure 4.
acceptance based techniques (which may be
The ABT group lost significantly more weight the most effective weight loss intervention
on average (13.3%) after one year than the strategy according to a recent meta-analysis
SBT group (9.8%). Unlike the Look AHEAD [28]), only ~25% of the ABT group main-
study, there was no further intervention after tained 10% weight loss two years post-inter-
the first year of the Mind Your Health study. vention and “both groups regained about half

37
 clinically significant gains in quality of life
of their lost weight by month 24, and about between baseline and 36 months.”
three-quarters by month 36.” I also reached
out to the Mind Your Health research group Look AHEAD also saw potentially positive
to ask if they were planning on capturing any changes in depression metrics and preserva-
more data points on this cohort to potential- tion of physical health-related quality of life
ly see if weight loss maintenance stabilized during the trial (29), but these didn’t look to
after year 2, as has been hypothesized by the be durable (30). It is important to note that
the individuals most likely to see increases
National Weight Loss Registry and Look
in quality of life from weight loss are over-
AHEAD. Unfortunately, the 36 month obser-
weight or obese, and at risk for or on the dia-
vational data point was the conclusion of the
betes spectrum, as well as those with chronic
data collection process.
pain like knee osteoarthritis (14, 31, 32).
However you feel about the weight loss re-
The final study that I would like to review in
sults above, I think the most important find-
this portion is PREVIEW (33), which is an-
ing from this monumental effort is that the
other massive multicenter randomized trial
average subject seemed to be better off in the
which included the behavior change interven-
end, as indicated by the Quality of Life find-
tion PREMIT (34) (17 group visits over three
ings in this sample (see Figure 7). Specifical-
years). This study is in a prediabetic cohort
ly, the authors stated:
who were living with an average BMI of ~35
“Those randomized to ABT reported high- at baseline. PREVIEW included an 8-week
er quality of life at months 24 and 36 (even intensive weight loss phase utilizing the
when controlling for weight loss), and these Cambridge Weight Plan (a very low-calorie
differences were large. Moreover, twice as liquid diet) followed by 148 weeks of weight
many ABT as SBT participants experienced loss maintenance where subjects were ran-

38
 domized to one of four groups: High Protein
- Moderate Intensity Physical Activity (HP-
MI), High Protein - High Intensity Physical
Activity (HP-HI), Moderate Protein - Mod-
erate Intensity Physical Activity (MP-MI),
or Moderate Protein - High Intensity Physi-
cal Activity (MP-HI). The full methods can
be found here. I don’t want to get lost in the
nuances of the different weight loss mainte-
nance arms within this study, as they actually
didn’t end up being very different nutrition-
ally (the High Protein groups self-reported
eating 9 to 18 more grams of protein and still
only consumed about ~85-95 grams per day
[<1.0 g/kg] throughout the study, and differ-
ences in glycemic index between the diets
were statistically significant, but somewhat
trivial).
Figure 8 displays the metabolic changes and
weight loss among these groups, but the dif-
ferences between groups aren’t that notable.
Rather, the main finding from PREVIEW
was that, with this battery of methods, 47% of
those who completed the protocol maintained
weight loss of ≥5% after three years. Some
might view this relatively modest magnitude
of weight loss as disappointing, but only 3%
of this population progressed to type 2 diabe-
tes over three years, which is a potential 500
to 1000% reduction in the risk of progres-
sion from prediabetes to type 2 diabetes (35).
That’s getting upstream of the type 2 diabetes
problem that potentially increases health care
expenditures by $9,601 per person per year
(36), and appears to cause a significant loss
of life, with men and women losing an aver-
age of ~13 years from the age of diagnosis of
diabetes (37).

39
I cannot cover all the intricacies of these stud- long-term weight loss trials that started with
ies or their methods in this concept review, normal weight populations at baseline. How-
but they are all worth reading in their entirety. ever, I would hypothesize that the likelihood
Each of these studies shows us that long-term of maintaining similar weight loss percentag-
weight loss in the range of 5 to 10% is possi- es in such cases would be similar, or possibly
ble over 3 to 8 years, and these findings are even worse, depending on the motivations for
in line with the consensus from recent me- weight loss and the final degree of leanness
ta-analyses and systematic reviews (38, 39), attained.
which highlight that long-term weight loss
success is difficult, yet possible. A Potential Path Forward
All of the studies referenced above were in for Practitioners
overweight or obese populations, and it is
important to acknowledge that dieting down At this point, depending on your experience
into “normal” BMI ranges (<25) from “obese” with this topic, you may be quite disappointed
BMI ranges (≥30) seems to be quite unlike- and pessimistic about long-term weight loss.
ly even in the short-term. For example, the I think that viewpoint is valid, and, given the
group that lost the most weight from the stud- relatively low long-term success rate, I think
ies above was the ABT group from the second it is most helpful to look at the risk versus
Mind Your Health study (25). This group av- reward ratio of the behaviors that seem to be
eraged 13.3% weight loss at one year which most predictive of long-term weight loss suc-
roughly equates to about 25 to 30 lbs and a cess. Here are perhaps the top five from the
BMI drop from ~37 to ~32. The probability National Weight Loss Registry (44) and the
of people living with even class I obesity (a most representative recent systematic review
BMI of 30 to 34.9) and dieting down into a (39).
normal BMI range (<25) is likely as low as • High amounts of physical activity
0.8 to 0.4% (40), with long-term successful
maintenance of this degree of weight loss • Improved diet quality
being just as unlikely (41). Notably, appear- • Consistent routines
ance-based goals and unrealistic expecta-
tions upon the onset of weight loss have been • Self-efficacy for weight management
found to be related to a higher likelihood of • Consistent self-monitoring practices
attrition (42).
Each one of these bullets could easily be an
Furthermore, regardless of the targets set, additional MASS article, but, as a coach, I
weight loss in these specific populations looks think focusing on the processes related to
to top out at an average of 10-15% of initial long-term success is probably more fruitful
body weight at one year (43). Understand- than adopting a mostly outcome-focused ap-
ably, given how most of the long-term weight proach. In my opinion, the first four bullets
loss studies are funded, I am not aware of any don’t really have much of a downside, and

40
I believe any downsides can be significantly and increased medical care costs as they age
blunted with quality coaching. For example, (3). Furthermore, according to the CDC, the
a potential downside of improved diet quality average American adult gains 0.5 to 1 kg per
is an unneeded and likely unhelpful dichoto- year, and just preventing this weight gain is
mous relationship with food, which, in the an enormous benefit at the population and
general population, tends to be combined with individual level (53). Importantly, exercise
seemingly equally unhelpful avoidance goals alone can likely stop or slow this weight gain.
around different food items (the downsides
Furthermore, depending on the rate of weight
are reviewed in Dr. Helms’ video series which
loss and the individual’s initial body compo-
starts here). In contrast, try flipping this to an
sition, as much as 46% of lost weight with-
approach-oriented mindset; although increas-
out exercise could be muscle (54, 55). This is
ing fruit and vegetable intake doesn’t look to
the first time we have mentioned body com-
independently cause weight loss (45), getting
position, but to put the results above in per-
up to five to seven fruit and vegetable servings
spective, the Look AHEAD subjects in both
per day (46) and around ~25 to 30 grams of
groups lost about 3-kg of lean body mass
fiber (47) can significantly improve health and
over 8 years (Figure 9) without dedicated re-
reduce the risk of all-cause mortality, as well
sistance training (56).
as help with satiety (which is consistently re-
lated to long-term weight loss success). Look AHEAD was terminated early “based
on a futility analysis that found no significant
I could talk about all of these factors for way
differences between the ILI and the DSE
too long and this article is already pushing
groups on the study’s primary outcome, a
it on page limits, so let’s finish this off by
composite of death from cardiovascular caus-
discussing two topics that are near and dear
es, nonfatal myocardial infarction or stroke,
to most MASS readers’ hearts – physical ac-
or hospitalization for angina.” (23) There are
tivity and muscle.
likely many reasons this was the case, but, in
There is a very real, sizable decrease in all- my opinion, it is critically important to frame
cause mortality risk at every BMI category this null/negative long-term health finding
from increased physical activity (48), and with the asterisk that, in the ILI group, 41%
the maintenance of muscle mass may be of the lost weight at year 1 was lean body
able to significantly blunt the negative health mass (LBM) and almost all of the weight lost
impacts of obesity (49, 50). We don’t have at year 8 was from LBM. There may have
direct evidence yet, but higher amounts of been other benefits to the Look AHEAD in-
exercise can very likely contribute to the tervention, like a potential increase in disabil-
maintenance of a transient, metabolically ity-free years (16), but one could ironically
healthy overweight or obese phenotype (51, argue that this intervention may have been
52). In contrast, without exercise, these indi- “too little too late.”
viduals will likely continue a progression to-
That 46% muscle loss number sounds pretty
wards a higher likelihood of chronic disease

41
bad, but muscle loss on a diet without exer- and gain the weight back as fat, leaving them
cise and with too little protein could spike to worse off than when they started from a met-
~75% if one is sleep deprived and/or psycho- abolic health standpoint, and potentially at an
logically stressed (57). Additionally, weight increased risk for sarcopenia each time they
regain after diet-induced muscle loss may complete this weight loss weight regain cycle.
result in something called a fat overshoot Dr. Eric Trexler has discussed this thought
(58). A fat overshoot (Figure 10) is where process in MASS here.
someone would potentially gain more fat
A potential “fringe benefit” of exercise during
than they originally had to get back to their
weight loss is that preservation of muscle can
original level of muscle mass, and individu-
help maintain one’s resting metabolic rate
als who lose more muscle mass on a diet may
while in a caloric deficit (although it’s im-
be more prone to weight regain and increased
portant to acknowledge that there is some de-
hunger (59).
bate about whether or not this confers an in-
If weight regain after weight loss is some- dependent advantage to maintaining weight
where in the range of ~75%, that means, loss) (60). Furthermore, “compromised mus-
without exercise, people could lose muscle cle function has been identified as an inde-

42
 deficit (via a reduction in energy intake and
not solely via an increase in energy output
via increased exercise), contain some form of
resistance training (66).
I am less confident that high-intensity interval
training (HIIT) or aerobic exercise alone can
spare lean body mass in a significant caloric
deficit (67). Personally, it wouldn’t be a bet
I would place, although a few studies have
shown muscle mass preservation when diet
was combined with aerobic exercise or HIIT
(68, 69), and these modalities may result in
muscle hypertrophy in untrained subjects that
are not in an active weight loss phase (70), al-
pendent predictor of hospitalization, disabil-
though this is debated (71).
ity, and death” (61), so progressively losing
muscle and gaining back body fat from yo-yo Yet, just two to three days of circuit training
dieting is ill-advised (62). If MASS readers per week can maintain and potentially in-
are curious about how much muscle (usual- crease muscle mass while in a caloric deficit,
ly quantified via fat-free mass index) may especially in untrained subjects (66, 72). Fur-
be related to an increased risk of all-cause thermore, diet coupled with exercise looks
mortality, this has recently been investi- to be even more effective than diet alone
gated in prospective observational cohorts for weight loss (73), and resistance training
here. However, I have qualms with how that seems to be the most effective of these tools
data was analyzed, and our own analysis of for preserving or gaining muscle (74), and
NHANES (which is currently in preparation) maintaining/increasing resting metabolic rate
found the breakpoint for all-cause mortality, long-term (75).
while controlling for body fat percentage and
The most common self-identified barrier to
age, occurred at a fat-free mass index of ~14
long-term weight loss success seems to be
for females and ~17 for males.
hunger (76), and one of the largest hurdles
Unfortunately, no matter how you spin it, a in maintaining long-term weight loss looks to
caloric deficit has been found to increase be the potentially relentless upregulation in
muscle protein breakdown, significantly appetite (77). We don’t have a lot of direct,
blunt muscle protein synthesis, and poten- long-term evidence related to body recompo-
tially lead to anabolic resistance (63, 64). sition, but increasing our muscle mass would
Further, the majority of the studies that I am likely allow us to consume slightly more cal-
aware of that maintain lean body mass (65), ories (78), and increasing muscle mass via
while putting people in a significant caloric exercise can only be expected to have pos-

43
 APPLICATION AND TAKEAWAYS
1. Long-term weight loss is difficult, but possible in those with a BMI ≥25 seeking
weight loss, and under fairly intense behavioral interventions perhaps ~25% of
individuals may be able to maintain ≥10% weight loss beyond two years.
2. Even small amounts of weight loss in some individuals may provide dramatic
health benefits, and 10-15 kg of weight loss can result in the remission of type 2
diabetes in some circumstances.
3. High amounts of movement and physical activity may be the most consistent
strategy related to long-term weight loss success, and, without it, dieters will
very likely lose muscle and could be worse off in the end. Theoretically, long-
term body recomposition interventions may allow people to maintain a significant
body-fat reduced state with less effort, but, weight loss aside, increasing physical
activity and maintaining muscle mass has the ability to improve health and well-
being across all BMI categories.

itive effects on our health and the health of is one of, if not the most consistent behav-
our muscular tissue itself (79). While gaining ior related to long-term weight loss success
muscle has only a modest effect on maintain- (39, 44, 81). It is possible that high amounts
ing or increasing RMR (60, 72), this effect of physical activity may independently be
may enable us to eat more calories than we able to mitigate weight regain (82), although
otherwise could in a body-fat-reduced state, not all studies have found this level of ben-
which is potentially an enormous deal. Even efit (33, 83). The studies that don’t report a
if I am wrong about all this calorie and hun- benefit seem to implement lower amounts of
ger stuff, at the very least it would allow peo- physical activity and struggle with adherence
ple to maintain less overall weight loss with issues, which has been thoroughly reviewed
the same amount of fat loss. For example, if here. As many may have realized, I have now
over a one-year period someone gained 5 kg perhaps effectively managed to bait-and-
of lean body mass and lost 10 kg of fat mass switch us into thinking about maintaining
that would put them at a net body weight loss a process (higher levels of movement and
of only 5 kg, and in theory they could poten- resistance training) instead of an outcome
tially be burning ~20 more kcals in relation (weight). While long-term adherence to exer-
to RMR (80), and we currently have no real cise does certainly have hurdles, having the
idea of what effect we might see on total daily resources and support to move our bodies
energy expenditure (TDEE). Dr. Eric Trexler against gravity is something that I think ev-
has discussed the nuances of exercise and ap- eryone in the nutrition and fitness space, and
petite here and metabolic adaptation here. especially MASS readers, can rally behind.
In summary, high levels of physical activity

44
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Study Reviewed: Evening Whey Protein Intake, Rich in Tryptophan, and Sleep in Elite Male
Australian Rules Football Players on Training and Nontraining Days. Ferguson et al. (2022)

How Important Is Pre-Bed Protein

Intake?
BY ERIC TREXLER

There is much debate about how important pre-bed protein

intake is for promoting hypertrophy, and how nighttime ingestion
of whey protein might impact sleep quality. A new study sheds
light on both topics.

53
 KEY POINTS
1. The presently reviewed study evaluated the effects of a whey protein supplement
(containing 1g of tryptophan), compared to an isocaloric placebo (containing
0.1g of tryptophan), on sleep quantity and quality in Australian Football League
athletes.
2. Compared to the isocaloric, low-tryptophan placebo, whey protein
supplementation did not significantly impact any of the sleep outcomes assessed.
3. Protein before bed is unlikely to dramatically impact your sleep, but researchers
have yet to conclusively demonstrate that the pre-bed window is a uniquely
advantageous protein feeding opportunity for promoting hypertrophy, or that
slower-digesting proteins meaningfully outperform faster-digesting proteins in this
scenario.

M
uscle growth is all about shifting Having said that, it’s important to recognize
the balance of muscle protein syn- that protein balance isn’t the only factor to
thesis and breakdown; if synthesis consider when discussing nighttime protein
exceeds breakdown over the long run, muscle intake. Dietary protein sources tend to con-
protein accretion occurs, and the muscle gets tain an amino acid called tryptophan, which
bigger. Consuming protein increases muscle is a precursor to both melatonin and sero-
protein synthesis and decreases muscle pro- tonin. High levels of melatonin and serotonin
tein breakdown, but these changes are tran- promote the onset of sleep, so one might in-
sient, which is why we need multiple protein fer that a big dose of protein before bed is
feedings throughout the day to maximize hy- sure to enhance sleep quality. However, it’s
pertrophy. Based on the transient nature of not quite that simple. Dietary protein sources
post-meal changes in protein synthesis and also tend to contain a variety of other “large
breakdown, there is a great deal of focus on neutral amino acids,” such as phenylalanine,
determining the optimal frequency and timing methionine, and the branched chain amino
of protein feedings. Researchers have sug- acids. That’s important, because these large
gested that a pre-bed protein dose might be neutral amino acids compete with tryptophan
advantageous for supporting muscle growth for the transporter that shuttles them from
(2), as this represents one final daily opportu- the bloodstream to the brain. As a result, a
nity to tilt the scales in favor of protein syn- dose of tryptophan might not actually boost
thesis. However, this suggestion is (for now) brain levels of serotonin or melatonin if it is
largely speculative, as the few studies pub- co-ingested with a bunch of other large neu-
lished in this area yield insufficient evidence tral amino acids. This potential dilemma of
for drawing confident conclusions about the balancing tryptophan and other large neutral
impact of pre-bed protein. amino acids in late-night protein sources has

54
been discussed in multiple previous MASS improve sleep outcomes through increased
articles (one, two), but there isn’t a lot of di- tryptophan availability and melatonin syn-
rect evidence investigating the topic. thesis.”
The presently reviewed study (1) evaluat-
ed the effects of a whey protein supplement Subjects and Methods
(containing 1g of tryptophan), compared to Subjects
an isocaloric placebo, on sleep quantity and
The presently reviewed study was completed
quality in Australian Football League athletes.
by 15 elite male Australian Football League
Supplements were consumed three hours be-
athletes (mean ± standard deviation: 22.2 ±
fore bedtime; while it may be a stretch to call
3.6 years; 87.3 ± 9.2 kg; 188.3 ± 8.1 cm).
this a “pre-bed” protein serving, this timing
Data were collected during the preseason pe-
was selected to accommodate the timeline
riod, extending from January to March, with
for tryptophan absorption and accumulation.
experimental interventions occurring on both
Whey protein did not significantly impact
training days and nontraining days. The re-
sleep outcomes, and results were similar on
searchers clarified that they carefully selected
training days and nontraining days. While the
intervention days to ensure consistency with
tryptophan content of the supplement failed to
regards to training schedules and training
yield a significant benefit for sleep outcomes,
loads. Football training occurred from 9:30
the presence of other large neutral amino acids
to 12:30, and strength training occurred from
also failed to yield a significant detriment to
14:00 to 15:00. Training load was calculated
sleep outcomes. This article will dive into the
by multiplying the session rating of perceived
evidence related to pre-sleep protein sources
exertion (session RPE, on a scale from 1-10)
and sleep quality, while also taking the discus-
by the session duration (in minutes).
sion a bit further to discuss how important pre-
sleep protein intake really is. Methods
The general design of this experiment was
Purpose and Hypotheses fairly simple: an experimental beverage was
Purpose consumed about 3 hours before bedtime,
either on a training day or nontraining day,
The purpose of the presently reviewed study and subsequent effects on sleep quantity
was to “investigate the effect of evening and quality were evaluated. This was a dou-
whey protein supplementation, rich in trypto- ble-blinded, placebo-controlled, crossover
phan, on sleep in elite male [Australian Foot- study design in which participants completed
ball League] players.” all four intervention conditions (in a random-
Hypotheses ized order) and served as their own controls.
The four different conditions were as follows:
The researchers hypothesized that “the whey
protein supplement, rich in tryptophan, would 1. Protein supplement (55g of whey protein,

55
 containing 1g of tryptophan) on a training a wrist activity monitor (Actical MiniMitter,
day by Philips Respironics), in conjunction with a
sleep diary submitted via phone application.
2. Placebo on a training day
The study was designed to assess the effects
3. Protein supplement on a nontraining day
of evening protein ingestion on a variety of
4. Placebo on a nontraining day sleep-related variables of interest, which in-
cluded bedtime, wakeup time, time in bed,
The protein beverage contained 1,656.4kJ, sleep onset latency (the time between bed-
55g protein, 11.4g fat, 6.8g saturated fat, time and sleep onset), sleep duration, sleep
16.5g carbohydrate, 10.6g sugar, and 1.0g efficiency (the percentage of time in bed that
tryptophan, whereas the placebo beverage was spent sleeping), wake after sleep onset
contained 1,652.4kJ, 6.5g protein, 33.6g fat, (the total time spent awake during the sleep
24.3g saturated fat, 16.6g carbohydrate, 11.1g period), and time moving (the time spent
sugar, and 0.1g tryptophan. Both beverages moving during sleep). These data were ana-
were isocaloric and similar in taste, color, lyzed using analyses of covariance (ANCO-
carbohydrate, and sugar content. Beverages VAs), with models adjusted to account for
were provided by research staff in a blinded covariates including age, prior night’s sleep
manner, and participants were instructed to duration, and training load (session RPE ×
consume them three hours before bed, and at session duration).
least 30 minutes after dinner.
Each study condition began with a 5-day Findings
pre-intervention period. This period allowed First, the authors reported some descriptive
researchers to gather updated baseline dietary data based on the habitual patterns observed
intake and sleep data, which was used to during the 5-day pre-intervention periods.
standardize daily dietary intakes, meal times, On training days, participants habitually con-
and supplement timing during the subsequent sumed an average of 226.8 ± 53.5 g of pro-
intervention period. Dietary intakes were tein (2.6 ± 0.7 g/kg of body mass), and the
tracked using a phone application, along with average habitual bedtime was 23:18 ± 01:12.
photos of foods and beverages consumed, On these days, it generally took participants
with all data reviewed and analyzed by a about 18.8 ± 10.0 min to fall asleep, and they
sports dietitian. The researchers provided slept for a duration of 7.9 ± 1.1 hr with a
meals for the night prior to each intervention sleep efficiency of around 90.0 ± 5.6%. On
(and each intervention day) to match habitual nontraining days, participants habitually con-
pre-intervention dietary habits, and provided sumed an average of 205.9 ± 64.8 g of pro-
caffeine doses that generally matched each tein (2.4 ± 0.7 g/kg of body mass), and the
participant’s habitual intake, while restrict- average habitual bedtime was 22:54 ± 1:06.
ing caffeine intake after 4pm to prevent sleep On these days, it generally took participants
disruption. Sleep patterns were tracked using about 20.8 ± 13.1 min to fall asleep, and they

56
 Criticisms and Statistical
slept for a duration of 7.1 ± 0.8 hr with a sleep
efficiency of around 89.7 ± 4.3%.
Musings
Now, moving on to the primary results: as
I find it a bit curious that the researchers opted
shown in Table 1, supplementation (protein
to use one-way ANCOVAs for the statistical
versus placebo) did not significantly impact
analyses in this study. There were two fac-
any of the sleep outcomes assessed. These tors being examined in this research design:
non-significant results were observed for supplementation (protein versus placebo),
both training days and nontraining days. and type of day (training versus nontraining).

57
With that in mind, I think a two-way (2 × 2) the exact mechanism by which BCAAs are
ANCOVA would’ve been the ideal statisti- thought to attenuate central fatigue by reduc-
cal approach for this paper. I point this out ing serotonin synthesis during exercise. As a
because it caught my eye (and might have result, it’s also somewhat intuitive to assume
caught the eye of some MASS readers), but that pre-bed whey protein should impair sleep
it’s ultimately not a huge deal, and I’m doubt- quality. Back in Volume 4, Issue 3 of MASS,
ful that two-way ANCOVAs would’ve led to Dr. Helms covered the impact of macronu-
substantially different conclusions related to trient distribution on sleep quality. While re-
the primary research question. sults suggested that high-protein diets have
generally neutral-to-positive effects on sleep,
Interpretation the impact of ingesting a high-BCAA, rapid-
ly absorbed protein (like whey) prior to bed
From my perspective, there are three perti- was unclear at the time.
nent questions when it comes to pre-bed pro-
tein feeding: About two years have passed since that ar-
ticle was published, and more data have
1. Will pre-bed protein consumption have become available. The presently reviewed
a positive, negative, or neutral impact on study reported that a whey protein beverage
sleep? providing 1g of tryptophan did not positive-
2. For individuals interested in supporting ly or negatively impact sleep to a statistical-
hypertrophy, is the pre-bed window a ly significant degree. This is consistent with
uniquely advantageous protein feeding a previous MASS article, in which a whey
opportunity? protein beverage containing about 0.4g of
tryptophan also had non-significant effects
3. Does the rate of protein digestion or ab- on sleep quality and quantity (3). That par-
sorption influence the effects of pre-bed ticular study also investigated ɑ-lactalbumin
protein feeding on body composition? supplementation, which contained a substan-
Question #1 is an interesting one, because tial amount of BCAAs in addition to 1.9g of
you could theoretically suggest that whey tryptophan. Despite delivering such a large
protein should both improve and hinder sleep tryptophan dose, the ɑ-lactalbumin interven-
quality. On the one hand, whey protein has tion still failed to significantly alter indices of
a decent amount of tryptophan, which is a sleep quality and quantity.
sleep-promoting precursor to serotonin and A recent meta-analysis (4) reported that tryp-
melatonin. As such, it’s intuitive to assume tophan, especially when dosed over 1g, has
that pre-bed whey protein should improve a favorable, statistically significant impact
sleep quality. On the other hand, whey pro- on sleep quality (more specifically, reduced
tein contains plenty of branched-chain amino time awake after sleep onset). However, the
acids (BCAAs), which compete with trypto- previously mentioned studies have report-
phan for transportation into the brain. This is ed non-significant effects of protein supple-

58
ments providing 0.4-1.9g of tryptophan on three). In short: muscle protein synthesis is
sleep quality, which may relate to the sub- transiently stimulated after we consume a
stantial amount of BCAAs contained within bolus of protein, and a few hours later, we
these supplements. Based on the evidence have another opportunity to restimulate this
available, it seems unlikely that typical di- process. Based on this general understand-
etary protein sources are going to influence ing of the temporal aspects of protein inges-
the ratio of tryptophan to other large neu- tion, some have speculated that it would be
tral amino acids in the blood to a degree that advantageous to spread protein as widely as
would meaningfully improve or impair sleep possible throughout the day (that is, utiliz-
duration or quality. As such, typical dietary ing the broadest feeding window possible),
protein sources containing a combination which would allow for more discrete protein
of tryptophan and BCAAs don’t appear to feedings. Along these lines, eating strategies
meaningfully influence sleep outcomes when that limit protein feeding opportunities (such
consumed before bed. In contrast, trypto- as one-meal-a-day or time-restricted feeding
phan supplementation (in the absence of the with very narrow feeding windows) appear
BCAAs found in a typical high-protein meal) to be suboptimal for supporting hypertrophy
may enhance sleep quality, especially in dos- goals (one, two). Of course, you could ar-
es greater than 1g. gue against this concept based on some em-
pirical evidence. It seems that consuming at
Now, let’s move on to question #2. In previ-
least three large, distinct servings of protein
ous MASS articles, we’ve discussed the ins
throughout the day is advantageous for pro-
and outs of protein distribution (one, two,
moting hypertrophy, but there doesn’t appear
to be much benefit of going from three serv-
ings up to six servings per day. So, what do
TYPICAL DIETARY PROTEIN the longitudinal studies directly investigat-
ing the effect of pre-bed protein feeding on
SOURCES CONTAINING changes in body composition tell us?
A COMBINATION OF Surprisingly, not that much. This is an area

TRYPTOPHAN AND in which longitudinal studies assessing hy-

pertrophy outcomes are lacking. Proponents
BCAAS DON’T APPEAR TO of pre-bed protein ingestion often point to a
study by Snijders et al (5), which found that
MEANINGFULLY INFLUENCE pre-bed supplementation with a casein-based
SLEEP OUTCOMES WHEN protein beverage (containing 27.5g of pro-
tein) led to significantly better gains in muscle
CONSUMED BEFORE BED. size and strength over 12 weeks of resistance
training. However, it’s important to note that
protein was being compared to a noncaloric

59
placebo, rather than being compared to a sim- much confidence in that observation given
ilar protein dose consumed at a different time the lack of statistical significance.
of day. As a result, this study was really as-
A fairly similar approach was taken in a
sessing the impact of adding one extra daily
study by Joy et al (7). Participants were in-
protein feeding and bumping total daily pro-
structed to consume 35g of casein either di-
tein intake from 1.3g/kg/day to 1.9g/kg/day,
rectly before bed or earlier in the day (at least
rather than directly assessing the importance six hours before bed), which brought both
of protein timing in proximity to bedtime. groups to a total daily protein intake of 1.8g/
In contrast, there are some studies that direct- kg/day. Throughout the 10-week study, par-
ly compare pre-bed protein intake to a simi- ticipants completed a prescribed resistance
lar amount of protein consumed at a different training program and recorded their dietary
time of day. In one such study (6), Antonio intake using a phone app. As shown in Ta-
and colleagues instructed participants to con- ble 3, statistically significant hypertrophy
sume 54g of casein, either before bed (within occurred, but there were no statistically sig-
90 minutes) or in the morning, which boost- nificant differences between groups. In this
ed total daily protein intake from ~1.8g/kg/ study, hypertrophy outcomes leaned slightly
day to ~2.4g/kg/day. Throughout the 8-week in favor of the early protein group rather than
study, participants resumed their typical re- the pre-bed protein group, but once again, we
sistance training programming and recorded shouldn’t get too invested in these types of
their dietary intake using a phone app. As non-significant observations.
shown in Table 2, neither protein intervention As summarized in a 2019 review paper by
(morning or evening) had a statistically sig- Snijders and colleagues (2), the pre-bed time
nificant impact on body composition. Some window is a perfectly viable time to consume
have pointed out that the absolute increase in protein, and this is a great time to add anoth-
fat-free mass was larger in the evening group er protein dose if you’re struggling to con-
than the morning group, but we can’t put too sume sufficient protein throughout the day.

60
However, as the research currently stands, etary protein sources containing a combina-
there is insufficient evidence to suggest that tion of tryptophan and BCAAs don’t seem to
this is a particularly unique opportunity to meaningfully enhance sleep quantity or qual-
promote hypertrophy. There is definitely rea- ity when consumed before bed, and there’s no
son to believe that aiming for at least 1.6g/ need to force feed a late-night protein serving
kg/day of protein, spread across at least three if you’ve already hit your daily protein target
discrete boluses per day, is helpful for max- and spread it across three or more meals.
imally promoting hypertrophy. However, Given that there’s insufficient evidence to
there isn’t sufficient evidence to suggest that suggest that the pre-bed feeding window is
adding a protein dose before bed will have particularly “special” in terms of supporting
a large impact on hypertrophy if you’ve al- hypertrophy, question #3 (pertaining to the
ready got your bases covered in terms of total optimal pre-bed protein source) doesn’t seem
protein intake and distribution. So, you can quite as interesting. It’s commonly assumed
confidently consume protein before bed to that casein is preferable to whey protein,
facilitate hitting your targets for daily protein based on the fact that casein is digested and
boluses and total daily protein intake without absorbed more slowly than whey. While some
fear of sleep disruption. However, typical di- propose that this will lead to more positive

61
 the same as it is for protein source decisions
made earlier in the day: attempting to micro-
THERE’S NO NEED TO manage protein digestion speed is probably a

FORCE FEED A LATE-NIGHT fruitless endeavor.

PROTEIN SERVING IF Next Steps

YOU’VE ALREADY HIT YOUR From my perspective, it’d be nice to get
some additional clarity on two related (but
DAILY PROTEIN TARGET distinct) research questions. First, I’d like to
AND SPREAD IT ACROSS see more studies that compare the effects of a
given protein dose, either consumed pre-bed
THREE OR MORE MEALS. or early in the day, on hypertrophy. Ideally,
such studies would recruit healthy, resis-
tance-trained participants consuming at least
1.6g/kg/day of total protein across 3-6 meals,
muscle protein balance by promoting muscle
and hypertrophy would be assessed via direct
protein synthesis (and reducing muscle pro-
muscle measurements, such as ultrasound,
tein breakdown) over a longer span of time
CT, or MRI imaging. I’d also like to see re-
throughout the night, I personally don’t find
search comparing the effects of isonitroge-
this argument to be particularly compelling.
nous, pre-bed doses of proteins with different
When we consume a bolus of dietary protein,
absorption rates on longitudinal hypertrophy
muscle protein synthesis is transiently elevat-
outcomes. Comparing whey protein to casein
ed, then falls back to baseline, even if blood
protein would probably be most relevant to
amino acid levels remain markedly elevated
the typical lifter, but it’d be feasible (and po-
above baseline. The time courses of muscle
tentially more interesting) to compare protein
protein synthesis rates and changes in blood
beverages that have been intentionally select-
amino acid levels are effectively decoupled,
ed (or even modified) to have an even larg-
so it’s hard to suggest that choosing a “slow-
er discrepancy in absorption speed. I suspect
er” pre-bed protein source will materially
that an extra protein dose would have simi-
impact muscle protein balance. Along these
lar effects when consumed in the morning or
lines, Witard and colleagues have pointed out
evening, as long as the diet contains a simi-
that the time course of muscle protein syn-
lar number (preferably ≥3) of large, discrete
thesis differs when comparing faster proteins
protein boluses throughout the day, and that
and slower proteins, but the cumulative ef-
fast and slow proteins would have similar ef-
fect over time is quite similar, as long as pro-
fects when consumed prior to bed.
tein synthesis is measured over a sufficiently
long period of time (8). So, when it comes
to selecting a pre-bed protein source (if you
choose to consume one), my perspective is

62
 APPLICATION AND TAKEAWAYS
It’s important to consume sufficient amounts of total daily protein, and splitting that
protein among 3-6 daily servings seems to be most advantageous for supporting
hypertrophy. If one of those servings is consumed in close proximity to bedtime,
that’s totally fine, but it doesn’t appear to be critical for optimizing body composition.
The typical high-protein meal is going to have a combination of tryptophan and other
large neutral amino acids, but is unlikely to skew circulating amino acid ratios enough
to meaningfully improve or impair sleep quality or quantity. Finally, it has become
common to recommend protein sources with slow digestion and absorption rates
prior to bed; while following this advice would yield no major downsides, there’s
insufficient evidence to suggest that it makes a meaningful difference.

63
References
1. Ferguson C, Aisbett B, Lastella M, Roberts S, Condo D. Evening Whey Protein Intake,
Rich in Tryptophan, and Sleep in Elite Male Australian Rules Football Players on
Training and Nontraining Days. Int J Sport Nutr Exerc Metab. 2022 Mar 1;32(2):82-88.
2. Snijders T, Trommelen J, Kouw IWK, Holwerda AM, Verdijk LB, van Loon LJC. The
Impact of Pre-sleep Protein Ingestion on the Skeletal Muscle Adaptive Response to
Exercise in Humans: An Update. Front Nutr. 2019 Mar 6;6:17.
3. Miles KH, Clark B, Fowler PM, Gratwicke MJ, Martin K, Welvaert M, et al.
ɑ-Lactalbumin Improves Sleep and Recovery after Simulated Evening Competition in
Female Athletes. Med Sci Sports Exerc. 2021 Dec;53(12):2618–27.
4. Sutanto CN, Loh WW, Kim JE. The impact of tryptophan supplementation on sleep
quality: a systematic review, meta-analysis, and meta-regression. Nutr Rev. 2022 Jan
10;80(2):306–16.
5. Snijders T, Res PT, Smeets JSJ, van Vliet S, van Kranenburg J, Maase K, et al.
Protein Ingestion before Sleep Increases Muscle Mass and Strength Gains during
Prolonged Resistance-Type Exercise Training in Healthy Young Men. J Nutr. 2015
Jun;145(6):1178–84.
6. Antonio J, Ellerbroek A, Peacock C, Silver T. Casein Protein Supplementation in Trained
Men and Women: Morning versus Evening. Int J Exerc Sci. 2017;10(3):479–86.
7. Joy JM, Vogel RM, Shane Broughton K, Kudla U, Kerr NY, Davison JM, et al. Daytime
and nighttime casein supplements similarly increase muscle size and strength in response
to resistance training earlier in the day: a preliminary investigation. J Int Soc Sports Nutr.
2018 May 15;15(1):24.
8. Witard OC, Wardle SL, Macnaughton LS, Hodgson AB, Tipton KD. Protein
Considerations for Optimising Skeletal Muscle Mass in Healthy Young and Older Adults.
Nutrients. 2016 Mar 23;8(4):181.

64
Study Reviewed: The Validity of Perceived Recovery Status as a Marker of Daily Recovery
Following a High-Volume Back-Squat Protocol. Tolusso et al. (2022)

Does Your Perceived Recovery

Relate to Performance?
BY MICHAEL C. ZOURDOS

The 0-10 perceived recovery status scale is practical and

straightforward, which enables easy implementation. But can
lifters actually predict performance recovery and make training
prescription decisions from this scale? This article breaks down a
new study that sought to find out.

65
 KEY POINTS
1. Researchers examined the relationship between perceived recovery status (0-10
scale) and the recovery of vertical jump and barbell velocity at 24, 48, and 72 hours
following a training session of eight sets of 10 reps at 70% of 1RM in trained men.
2. There were strong relationships between PRS scores with the recovery of both
vertical jump height (r = 0.843; p < 0.001) and squat velocity at 70% of 1RM
(r = 0.805; p < 0.001). However, the researchers noted that the strength of the
relationships varied between individuals and that specific PRS ratings were related
to different magnitudes of performance recovery between individuals.
3. Overall, this study showed that lifters’ perception of recovery was related to
performance following a high-volume training session. Therefore, coaches and
lifters can use the PRS as a general gauge of performance recovery, but should be
cautious about predicting exact performance levels from specific PRS scores.

W
hen a simple and practical training The presently reviewed study from Tolusso et
tool is introduced into the litera- al (1) had trained men rate their baseline PRS
ture, it tends to gain traction even and tested their baseline vertical jump height
if the supporting evidence is underwhelming. and squat velocity at 70% of 1RM. After the
One such example is the perceived recovery baseline tests, lifters performed 8 (sets) × 10
status (PRS) scale as a measure of readiness (reps) at 70% of 1RM on the squat. Then, 24,
used to autoregulate training. The PRS scale, 48, and 72 hours later, the lifters provided a
which was initially published in 2011 by Lau- PRS score and retested vertical jump and bar-
rent et al (2), ranges from 0 (very poorly re- bell velocity to examine if PRS ratings cor-
covered) to 10 (very well recovered). Laurent related with performance recovery. The PRS
and colleagues had men and women perform ratings were significantly correlated with re-
24 sprints at baseline and 24, 48, and 72 hours covery of both jump height (r = 0.843; p <
later, and assessed PRS before each bout of 0.001) and barbell velocity at 70% of 1RM
sprints. Laurent found that PRS scores were (r = 0.805; p < 0.001). Despite the general
inversely related (r = -0.63) to the change relationship observed between PRS and per-
in 30m sprint performance (i.e., higher PRS formance recovery at the group level, the re-
scores related to faster sprint times) across all searchers cautioned that a specific rating on
sessions. Over a decade later, no study has in- the PRS scale may not signal the same degree
vestigated if PRS scores are associated with of recovery between individuals. As such, a
nuanced discussion of the utility of the PRS
the recovery of resistance training perfor-
scale is required. This article will aim to:
mance. Yet, many lifters (myself included)
have used the PRS to assess daily readiness 1. Review the origin and literature to date on
and guide flexible training templates.  the PRS scale.

66
 Subjects and Methods
2. Discuss the present findings in context
with the existing literature.
3. Examine the importance of the individual Subjects
nature of PRS ratings. 11 men with at least five years of resistance
training experience participated in the pres-
4. Discuss how recovered one needs to be on
ently reviewed study. Further subject details
the PRS scale to maintain performance.
are in Table 1. 
5. Provide an example of how the PRS scale
Study Protocol
can be used as a readiness measure to
guide a flexible training program. Subjects completed this study over five ses-
sions. During the first session, subjects were
Purpose and Hypotheses familiarized with the PRS scale and per-
formed a squat 1RM test. The experimental
Purpose procedures were conducted during sessions
The purpose of the reviewed study was to 2-5. The researchers did not provide the time
examine the relationship between PRS rat- span between the familiarization session and
ings with vertical jump height recovery and the second session; however, sessions 2-5
squat velocity in the three days following a were each separated by exactly 24 hours.
high-volume squat workout in trained men. During session two, subjects provided a PRS
score, then researchers assessed baseline
Hypotheses   vertical jump and average concentric veloc-
No hypotheses were provided. The research- ity during a 70% of 1RM squat. Research-
ers cited data showing that PRS scores are ers used the average height of three vertical
related to performance recovery following jump attempts for analysis. The mean veloc-
high volume sprinting. However, they were ity of two single-repetition attempts at a load
also clear to note that no previous study had of 70% of 1RM was used for squat velocity.
examined the relationship between PRS and Subjects then performed a high volume dam-
recovery following resistance training. aging workout of 8 × 10 on the squat. The
researchers then assessed PRS scores, verti-
cal jump height, and squat velocity at 70% of
1RM 24, 48, and 72 hours later. A completed

67
timeline of procedures can be seen in Table 2 if someone failed after 7 reps, they would
and the PRS scale is shown in Table 3. have rested for 30 seconds and then tried to
complete the final three reps. If a lifter could
Load Adjustments
not complete all 10 reps after three tries with
The researchers made specific modifica- the 30-second rest interval, the load was de-
tions to the training load when subjects could creased by 10% for the following set. If all 80
not complete 10 reps in a set. Specifically, reps (8 sets of 10 reps) were not completed
if someone failed to complete 10 reps, that after eight sets, then a set was added at the
person rested for 30 seconds, then attempted end, in which the lifter performed reps until
to complete the remaining reps. For example, reaching 80 total reps.

68
Outcome Measures recovery relative to baseline at each time point)
of jump height and squat velocity values.
The researchers analyzed the relationship be-
tween PRS scores and the “raw” (absolute)
jump height and squat velocity values during Findings
the recovery period and the relationship be- There was a significant relationship between
tween PRS scores and the recovery (percentage the raw PRS score over the 72-hour recovery

69
period for both the raw vertical jump height us if lifters who failed sets more frequently,
(r = 0.843; p < 0.001) and squat average con- and required a greater load reduction, also
centric velocity (r = 0.800; p < 0.001). There experienced more fatigue. It then would have
was also a significant relationship between the been possible to examine if PRS was a bet-
recovery of PRS (i.e., PRS percent recovery) ter predictor of vertical jump and barbell ve-
during the 72-hour recovery period and the re- locity recovery in individuals with more (or
covery of both vertical jump height (r = 0.843; less) fatigue. However, well done by the re-
p < 0.001) and squat average concentric ve- searchers for clearly stating both the load ad-
locity (r = 0.805; p < 0.001). The raw values justment protocol and the number of subjects
and percent recovery at each time point can be who failed sets.
seen in Table 4. Figure 1 shows the individual
recovery trends for each subject.
Interpretation
Criticisms and Statistical In the context of resistance training, the main

Musings
reason to discuss the PRS scale is to deter-
mine if it can be used as a readiness indicator
I have no criticisms, and would like to praise to guide flexible training templates. In oth-
some of the reporting. As described earlier, er words, the endgame is for a lifter to rate
subjects performed a fatiguing training ses- their PRS and then choose the day’s training
sion of 8 × 10 on the squat at 70% of 1RM. In prescription based on that score. If you are
a high-volume session such as this, it would not familiar with the concept of the PRS (or
be expected that some subjects would miss a readiness indicator) to guide flexible tem-
reps. Although research doesn’t often re- plates, please read  here  or  here  before con-
port how many subjects missed reps or how tinuing. Ultimately, to determine if the PRS
the exercise prescription “dosage” (3) was can be used to guide flexible programming,
modified, Tolusso et al. (1) stated that five we must first establish the relationship be-
out of the 11 subjects required a load reduc- tween PRS and the recovery of performance
tion. In other words, five subjects failed to following a training session. The reviewed
complete 10 reps in a set, and at least one of study from Tolusso et al (1) is the first to
these subjects failed to complete 10 reps on observe that the PRS scale is positively cor-
at least four sets. We often lament research related with recovery of resistance training
that doesn’t point out details regarding pro- performance (i.e., barbell velocity) following
gram modifications, so it’s worth praising a high-volume lifting session. Although the
the authors when these details are described. presently reviewed study is the first to exam-
Ideally, the researchers could have reported ine the PRS and performance recovery from
the number of reps each individual complet- resistance training, other research has report-
ed and how much load was adjusted for each ed a tenuous relationship between the PRS
person. This information coupled with the in- and daily 1RM strength (4). Therefore it is
dividual recovery data (Figure 1) would tell premature to recommend the PRS scale as a

70
readiness indicator to guide flexible training these studies did not reveal if the PRS is sen-
templates. This interpretation will review the sitive to changes in recovery status following
state of the literature on the PRS scale to de- lower volume, less fatiguing protocols.
termine its utility in resistance training. 
Dr. Helms’ Ph.D. (6) investigated the PRS as
Although the presently reviewed study is part of a longitudinal study. Specifically, Dr.
the first to examine the relationship between Helms compared strength and muscle thick-
PRS scores and recovery of resistance train- ness changes between RIR-based loading and
ing performance following a high-volume percentage-based programs over eight weeks
lifting session, there are a handful of oth- in trained men. Both groups rated their PRS
er relevant studies. The PRS scale was first before each training session. There were no
studied by Laurent et al (2) over a decade significant differences between groups in
ago. Men and women performed 24 sprints at strength or muscle growth, but the RIR group
baseline and 24, 48, and 72 hours later. The experienced a greater increase in PRS scores
subjects’ PRS scores, assessed post-warm-up (1.1 ± 1.1) than the percentage group (0.3 ±
each day, were significantly related to the re- 1.0) from the week before the taper (week 7)
covery of sprint times (r = 0.63, p < 0.01). to during the taper (week 8). Although this
This original study from Laurent shows proof difference was not significant (p = 0.09),
of concept, but doesn’t cement the PRS as a this finding does suggest that individuals are
readiness indicator to guide resistance train- fresher when using autoregulated RIR-based
ing programs. Sikorski et al (5) followed loading versus rigid percentage-based load-
Laurent’s study by examining the relation- ing. While it is logical that autoregulating
ship between PRS scores and creatine kinase training would lead to greater training read-
(a biomarker of muscle damage) at baseline iness than fixed percentage-based loading,
and 48 hours following a demanding training Helms’ findings do not validate the use of
protocol. The training protocol consisted of PRS to guide training. However, since nei-
3 × 10-12 RM with only 1-minute rest inter- ther group was performing training that was
vals for nine exercises, including the squat, consistently to failure or that would classify
bench press, and deadlift. Sikorski found that as really high volume, this result does sug-
the absolute values (relationship between raw gest that the PRS may be sensitive enough to
PRS and raw creatine kinase values) were pick up on small changes in recovery status. 
significantly correlated (R2 = -0.59) 48 hours Although Tolusso et al (1) reported a relation-
post-training. In other words, lower PRS ship between PRS and recovery on the group
scores were related to higher creatine kinase level, it’s imperative to state that individual-
levels. Both the Laurent and Sikorski studies ization must be considered when applying the
found that PRS scores were related to recov- PRS scale. In fact, the researchers stated that
ery (of performance or muscle damage), but “Practitioners are cautioned that the relation-
this relationship was observed following re- ship between PRS and performance recovery
ally  high-volume, fatiguing training. Thus, is individualized, and equivalent PRS scores

71
between individuals are not indicative of sim- PRS after a pre-training stimulus (i.e. war-
ilar recovery.” In other words, the strength mup or caffeine).
of the relationship between PRS and perfor-
As alluded to earlier, many have adopted the
mance recovery may be different between in-
PRS as a metric to guide a flexible training
dividuals. This is illustrated well in Figure 1.
program (in which a lifter has various op-
For example, 24 hours post-training, subjects
tions for the day’s training prescription). The
in panel A and panel K each recorded a PRS
lifter can choose the prescription based on
of 3. However, the panel K subject experi-
how they feel before the training session. A
enced a ~40% decrease in barbell velocity,
simple implementation of this is a prescrip-
while the panel A subject experienced only a tion of heavy, moderate, and light days. The
~10% decrease in barbell velocity. Therefore, lifter can complete all three types of training
as Tolusso et al noted, two lifters recorded within the week, or four sessions of each type
the same PRS at the same time point, but the within a month, or meet some other criteria.
magnitude of recovery differed. Therefore, if Importantly, the order in which the sessions
a coach uses the PRS scale, they must learn are completed is not predetermined. The PRS
the degree of recovery associated with a spe- scale (or another readiness measure) comes
cific PRS in each client.  into play as the metric used to determine the
Another study investigated if PRS scores lifter’s choice for each session. For example,
were related to daily 1RM squat performance the lifter would choose the heavy session
in a case series of three individuals who max with a PRS of 8-10, the light session with a
squatted for 36 out of 37 consecutive days. PRS of 0-4, and the moderate session with
Each day the lifters provided a PRS score a PRS of 5-7. A flexible template is much
before and after consuming caffeine prior more nuanced than this brief overview, but a
to training. The researchers found that PRS short explanation will suffice, as I have writ-
was only significantly and positively relat- ten about it at length on various occasions
ed to daily 1RM performance in one of the (one, two). Using the PRS to guide a flexible
three lifters. One other note from this study program is logical, but I’m not sure we have
is that the relationship between post-caffeine sufficient evidence to suggest that the PRS
PRS and 1RM performance was stronger in can be used to precisely predict performance.
each lifter than pre-caffeine PRS and 1RM In other words, I don’t think we can say a
PRS of 6 is related to exactly 3% (or what-
performance. Interestingly, Laurent et al (2)
ever value) better performance than a PRS of
found that post-warm-up PRS scores were
5. Using the scale in that way wouldn’t be
significantly related to sprint performance,
reliable between individuals, and may not be
but pre-warm-up PRS scores were not. The
reliable within individuals either. 
two takeaways are that the relationship be-
tween PRS and performance is individual, One other note about the PRS scale is that rat-
and, if someone is going to use PRS as a ings are not only anchored to a descriptor of
measure of readiness, it seems best to rate recovery, but also an expected performance

72
outcome (Table 3), which could be confusing As this article concludes, I want to note that I
in practice. In Laurent’s initial PRS study, the decided to refrain from writing a comprehen-
performance descriptor made sense, because sive guide on readiness indicators, because
the athletes performed the exact same train- I’ve already done that. Please read  this arti-
ing each session. Thus, the athletes were con- cle, which reviews the data on various scales,
sidering if performance was expected to be questionnaires, and performance tasks used
“increased,” “similar,” or “decreased” com- as readiness indicators. Overall, the PRS is
pared to their most recent performance of the a simple tool related to recovery following a
same exact training. However, if using the highly fatiguing training session. However, it
PRS before each session to guide a flexible should be stressed that, just because the PRS
program, it’s important to establish what the is related to recovery following highly fatigu-
lifter is comparing their performance expec- ing training does not necessarily mean that
tations to, since each training session won’t the PRS is a good measure of readiness when
be the same. Expected performance could be physical fatigue from training is not high. The
compared to a previous 1RM or the most re- PRS is a good tool, but coaches and lifters
cent similar training session, but, in any case, shouldn’t use it rigidly. In other words, can we
the comparison should be specified. assume performance differences between a 5
or a 6 PRS? In my opinion, a 1-point change
In defense of the PRS, it did correlate with my in a PRS score is unlikely to lead to a con-
favorite readiness indicator, vertical jump, in sistent performance difference, and the degree
the presently reviewed study. Vertical jump is of performance change per change in PRS
the rare indicator that actually correlates with score is likely to be individually dependent.
performance recovery on a major exercise. In conclusion, it’s okay to use the PRS scale
Specifically, Watkins et al (7) tested vertical as a guide to generally gauge recovery from
jump at baseline, then had subjects perform high-volume training, but there isn’t evidence
four sets of squats to failure at 80% of 1RM. to suggest that a specific PRS value indicates
The researchers tested the subjects’ vertical full readiness to train on the group level.
jump 48 hours later, and subjects performed
another four sets to failure at 80% of 1RM. A
significant correlation (r = 0.65) was observed
Next Steps
between decreases in vertical jump height and In this article on readiness indicators, I sug-
decreases in squat volume. In other words, gested a two-step process in the next steps.
Watkins reported that a 2.5cm decrease in First, research should examine if any readi-
vertical jump height was associated with 5.6 ness indicators are related to performance.
fewer reps performed on the squat. Therefore, Second, a longitudinal study should use a
since PRS was related to vertical jump recov- readiness indicator that is significantly related
ery in the present study (r = 0.843), PRS may to performance to guide a flexible program.
be related to resistance training volume per- Since this study showed a significant rela-
formance and not just submaximal velocity. tionship between the PRS and performance

73
 APPLICATION AND TAKEAWAYS
1. Tolusso et al (1) found that, following a high-volume squat session consisting of
8 × 10 at 70% of 1RM, lifters’ PRS scores were significantly related (r > 0.80; p <
0.05) to the recovery of vertical jump and barbell velocity for at least 72 hours.
2. Despite the relationships between PRS and performance recovery, the authors
cautioned that a specific PRS score might relate to different magnitudes of
performance recovery between individuals.
3. Ultimately, the goal of the PRS is to be used as a readiness indicator to guide
flexible training templates. While the PRS could be used to guide a flexible
template, coaches and lifters should be cautious about attempting to make
precise training decisions based on the PRS. In other words, it is better practice
to use a generally high or low PRS to decide between a heavy or light day rather
than to split hairs and choose different loading between a 5 or a 6 PRS score.

recovery, we can now move on to part two

and use the PRS to guide a flexible training
program. Specifically, a longitudinal study
could be conducted comparing a flexible pro-
gram guided by the PRS, a flexible program
guided simply by how subjects feel but with
no formal rating, and a group that does fixed
order training (i.e., not flexible). There are
many ways in which this study could be de-
signed and many readiness metrics that could
be used, but the above is a good start.

74
References
1. Tolusso DV, Dobbs WC, MacDonald HV, Winchester LJ, Laurent CM, Fedewa MV,
Esco MR. The Validity of Perceived Recovery Status as a Marker of Daily Recovery
Following a High-Volume Back-Squat Protocol. International Journal of Sports
Physiology and Performance. 2022 Mar 7;1(aop):1-7.
2. Laurent CM, Green JM, Bishop PA, Sjökvist J, Schumacker RE, Richardson MT,
Curtner-Smith M. A practical approach to monitoring recovery: development of a
perceived recovery status scale. The Journal of Strength & Conditioning Research. 2011
Mar 1;25(3):620-8.
3. Fairman C, Nilsen TS, Newton RU, Taaffe DR, Spry N, Joseph D, Chambers SK,
Robinson ZP, Hart NH, Zourdos MC, Focht BC. Reporting of resistance training dose,
adherence, and tolerance in exercise oncology. Medicine and Science in Sports and
Exercise. 2020 Feb;52(2):315-322.
4. 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
weightlifters: a case series. Nutrición Hospitalaria. 2016;33(2):437-43.
5. Sikorski EM, Wilson JM, Lowery RP, Joy JM, Laurent CM, Wilson SM, Hesson
D, Naimo MA, Averbuch B, Gilchrist P. Changes in perceived recovery status scale
following high-volume muscle damaging resistance exercise. The Journal of Strength &
Conditioning Research. 2013 Aug 1;27(8):2079-85.
6. 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. Frontiers in physiology. 2018:247.
7. Watkins CM, Barillas SR, Wong MA, Archer DC, Dobbs IJ, Lockie RG, Coburn JW,
Tran TT, Brown LE. Determination of vertical jump as a measure of neuromuscular
readiness and fatigue. The Journal of Strength & Conditioning Research. 2017 Dec
1;31(12):3305-10.

75
Study Reviewed: A Short-Term Low-Fiber Diet Reduces Body Mass in Healthy Young Men:
Implications for Weight-Sensitive Sports. Foo et al. (2022)

Dietary Fiber Manipulation for

Lifters
BY ERIC TREXLER

Adequate fiber intake is important for a well-rounded diet, but a

short-term low-fiber diet can facilitate transient weight reduction
for sports with weight classes. This article discusses how to
manipulate fiber intake to facilitate short-term weight cuts, while
also discussing the multifaceted benefits of fiber in a lifter’s diet.

76
 KEY POINTS
1. The presently reviewed study assessed the effects of adopting a short-term (4-day),
low-fiber (<10g/day) diet on body weight, appetite, stool frequency, stool type, and
stool softness.
2. Fiber restriction led to a statistically significant reduction in body weight (-0.58 ± 0.83
kg, or -0.74 ± 0.99 % of body mass), but also significantly increased hunger while
reducing stool frequency and stool softness. Nonetheless, 18/19 participants said the
diet was tolerable, and 16/19 were willing to repeat it.
3. Dropping fiber 2-3 days before your weigh-in should give you the bulk of the weight
reduction benefits while minimizing unpleasant side effects. Extending this to 4-5
days could lead to slightly more weight loss, but also increase the likelihood of
experiencing unpleasant effects. Either way, this strategy is reserved for short-term
weight cuts, and should not be continued for long periods of time.

S
hort-term weight cuts aren’t a sustain- of material within the gastrointestinal tract,
able fat loss strategy, but they have a but there isn’t a ton of research documenting
time and a place. If you compete in a the magnitude of weight reduction associated
physique-based sport or a sport with weight with short-term fiber restriction.
classes, there are circumstances in which
The presently reviewed study (1) sought to
dropping a few pounds over the span of a
few days might be advantageous. Short-term quantify the effects of adopting a short-term
weight cuts have been discussed multiple low-fiber (<10g/day) diet. After a 7-day
times in MASS (one, two, three), and the baseline period in which study participants
most impactful aspect of a short-term weight (n = 19) maintained their habitual diet and
cut (by far) is the manipulation of fluid bal- exercise habits, they switched over to an in-
ance. This is commonly achieved by water dividualized low-fiber diet for four days. Di-
loading (2), which is followed by an abrupt ets were designed to match habitual intakes
drop in water intake in combination with for total energy, carbohydrate, protein, fat,
some type of strategy to induce excess sweat- alcohol, fluid, and sodium, while reducing
ing, such as sauna or hot baths (3). However, daily fiber intake by an average of 22g/day
water intake and sweat rate are not the only (from ~30g/day to ~8g/day). Body weight
modifiable factors involved with a short-term dropped during the low-fiber diet; while the
cut. It’s also common to restrict carbohydrate largest drop occurred within the first two
intake, which leads to water loss via glyco- days, the drop became statistically significant
gen depletion, in addition to fiber restric- (compared to the baseline period) on day 4.
tion. Theoretically, fiber restriction should However, there were some drawbacks to the
decrease body weight by reducing the mass low-fiber approach; fiber reduction led to a

77
statistically significant increase in hunger, Methods
along with reductions in stool frequency and This study utilized a single-group, pre-post
stool softness. As such, this article will dis- design. Participants completed a 7-day base-
cuss the pros and cons of fiber reduction, and line observation period, during which they
explain how to utilize fiber restriction during consumed their normal habitual diet. This pe-
a short-term weight cut in order to maximize riod served as an opportunity to gather base-
benefits and minimize downsides. line data and information about the partici-
pants’ habitual diet and exercise habits. After
Purpose and Hypotheses that, the participants began a 4-day, low-fiber
(<10g/day) intervention period. Diets during
Purpose
the intervention period were individualized
The purpose of the presently reviewed study to match each participant’s day-to-day and
was “to examine the effect of [low-fiber di- meal-to-meal intakes of total energy, carbo-
ets] on acute changes in [body mass].” hydrate, protein, fat, alcohol, fluid, and sodi-
Hypotheses um. However, daily fiber intake was reduced
by an average of 22g/day, dropping from
The researchers hypothesized that a low-fiber
~30g/day to ~8g/day. Individual habitual ex-
diet would result in an acute body mass loss
ercise habits were also replicated during the
of around 0.5kg, or ~0.5-1.0% of initial body
intervention period.
mass.
Primary outcomes of interest included di-
Subjects and Methods etary intake, body weight, appetite, stool fre-
quency, stool type, and stool softness. Body
Subjects weight was measured daily (in the morn-
Twenty recreationally active male participants ing) using a bathroom scale, with the value
volunteered for the presently reviewed study. immediately reported to the research team
Participants performed at least 150-300 week- via phone message. Weight was measured
ly minutes of moderate intensity physical ac- throughout the first 5 days of the baseline pe-
tivity or 75-150 weekly minutes of high inten- riod, all 4 days of the intervention period, and
sity physical activity, and none of them had at the end of the study (the day after the 4th
any food allergies or gastrointestinal diseases. intervention day). Food intake was tracked
One participant was excluded after enrollment, every day by sending pictures and descrip-
based on the fact that they had abnormally tions of all foods and beverages consumed to
high loss of body mass during the interven- the research team, who analyzed intakes us-
tion (more than 2 standard deviations above ing a food analysis software. After each bow-
the group mean). As a result, the researchers el movement, participants submitted a Bristol
were able to analyze data from 19 participants Stool Form Scale to the research team, which
(mean ± SD: age, 32 ± 10 years; height, 1.79 ± allowed the researchers to monitor stool fre-
0.07 meters; body mass , 77.5 ± 8.1 kg). quency, type, and softness. Throughout the

78
 Findings
intervention, participants reported the dura-
tion and session rating of perceived exertion
(session RPE) of all exercise bouts, and also Fiber intake was reduced by 22.8 ± 8.5 g/day
completed appetite questionnaires after each during the low-fiber intervention, but no oth-
er dietary variables were significantly differ-
of their main meals throughout the day. Fi-
ent from intakes during the baseline period.
nally, participants completed a questionnaire
Similarly, exercise habits were successful-
at the end of the study, which was designed to ly replicated during the intervention period.
assess the overall tolerability of the low-fiber Body weight dropped significantly over the
diet intervention. course of the intervention (Figure 1); while

79
this difference became statistically signifi- low-fiber intervention than on day 4 of the
cant on days 4 and 5, the largest drop in body baseline period.
weight occurred during the first two days.
Unsurprisingly, participants documented sig-
As shown in Figure 2, there was a pretty nificantly higher subjective hunger scores
substantial amount of weight loss variability and significantly lower fullness scores during
among individuals, both expressed as absolute the low-fiber diet. Of the 19 total partici-
weight loss (in kg) and relative weight loss (in pants, 13 reported feeling hungrier outside
% of initial body weight). Change in fiber in- of meals, and six reported adverse events in-
take was inversely associated with change in cluding stomach cramps, sleep disturbances,
absolute weight (r = -0.495, p = 0.031) and rel- bloating, and mood alterations. Nonetheless,
18 of the 19 participants said that the diet was
ative weight (r = -0.489, p = 0.034), but change
tolerable in the end-of-study survey, and 16
in fiber only accounted for about a quarter of
of them said they’d be willing to do it again
the variance in weight change.
in the future.
During the low-fiber diet, stool frequency
dropped significantly from 2 bowel move- Interpretation
ments per day to 1, on average. In addition,
a significant drop in stool softness was ob- There is one specific finding from the pres-
served in the low-fiber condition (Figure 3), ently reviewed study that caught me by sur-
prise. I would have expected change in fiber
and harder stool types (more specifically,
intake to be positively correlated with change
types 1 and 2 on the Bristol Stool Scale) were
in body weight, but a negative correlation was
more frequently observed on day 4 of the
observed. I was truly puzzled by it, but Greg
proposed a very plausible explanation: an ex-
cessive magnitude of fiber reduction might
have led to constipation for some of the par-
ticipants with higher baseline fiber intakes,
which would lead to a greater mass of con-
tent within their gastrointestinal tracts. This
hypothesis is compatible with the group-level
change in stool types, and could potentially
explain the paradoxical relationship by which
fiber restriction led to group-level weight loss,
but greater fiber restriction was associated
with less weight loss. Of course, it’s also pos-
sible that this unexpected correlation is spuri-
ous in nature; correlations can be quite volatile
and unreliable in small samples, as explained
and demonstrated in a previous MASS article.

80
Aside from that small bit of confusion, the rest on cutting strategies for making weight. Of
of the results are pretty straightforward. Fiber course, as Dr. Helms mentions in his video,
reduction, as hypothesized, induces a small extreme caution is advised whenever you’re
drop in body mass, almost certainly due to a implementing a strategy that involves heat
reduction in “residue” in the gastrointestinal exposure or alteration of hydration status, so
tract. As the authors of the present study not- please keep that in mind. Personally, I’m not
ed, typical gut transit times (that is, the time a big fan of very aggressive weight cuts that
it takes for our food to work its way through involve severe water restriction or sweat-in-
our digestive system) is about two days on av- ducing strategies requiring heat exposure, so
erage, but can range from 10-96 hours. This I generally advise lifters to limit their short-
timeline is very compatible with the observed term cuts to no more than 2-3% of initial
findings, and might also explain some of the body mass, which shouldn’t require particu-
variability observed in rates of weight loss larly extreme measures to accomplish.
over the observation period. Given that previous MASS articles have dis-
An astute reader might rightfully point out cussed weight cutting strategies in detail,
that the magnitude of weight reduction in this including how to implement them and what
study was quite small. If you’re cutting for a magnitude of total weight loss to expect, you
big powerlifting meet, it’s very possible that might be wondering if the presently reviewed
dropping about 0.74% of your initial body study brings anything new to the table. In
weight won’t be sufficient for your needs. my opinion, it offers some very valuable in-
However, it’s important to keep in mind that sights. First, it provides further clarification
fiber reduction is only one small component for the independent effect of fiber restriction
of a multifaceted approach to short-term on short-term weight reduction, in a scenar-
weight reduction. Fiber restriction should io that keeps other pertinent dietary factors
reduce the amount of residual content in the (such as carb intake, sodium intake, and fluid
gastrointestinal tract, carb restriction should intake) controlled. Second, it provides further
lead to some loss of water weight via glyco- clarification for the time course of anticipat-
gen depletion, and water loading (followed ed weight reduction during fiber restriction.
by an abrupt drop in water intake) leads to As Dr. Helms mentioned in his video back in
additional water losses. As Greg explained in Volume 1 of MASS, the majority of weight
loss induced from fiber restriction is likely to
a previous MASS article, a lifter ought to be
happen within the first couple of days. The
able to lose about 3% of their body weight
presently reviewed findings generally sup-
(roughly) using these strategies in combina-
port this observation, but also suggest that
tion, and may be able to lose up to 5.7% of
further weight reduction is observed as the
their body weight if they include a sweat-in-
timeline is extended a couple more days.
ducing strategy like sauna or hot baths. To see
how these strategies work together, be sure If you’re wondering if the extra days of fiber
to check out Dr. Helms’ very practical video restriction are actually worth it, that brings me

81
to the third valuable contribution from this
study: it clarifies the drawbacks of maintain-
ing a low-fiber diet, even for a short stretch of YOU MAY GET THE
time. The low-fiber diet led to unfavorable al-
terations in bowel movements, with a reduc- MAJORITY OF WEIGHT
tion in bowel movement frequency and a shift
toward stool types 1 and 2, which are harder REDUCTION BENEFITS
in texture and more indicative of constipa-
tion. It’s practically relevant to consider that
WHILE ATTENUATING
these changes in stool type and texture were UNPLEASANT SIDE EFFECTS
more pronounced later in the 4-day fiber re-
striction period, which suggests that you may BY IMPLEMENTING
A 2-3 DAY FIBER
get the majority of weight reduction benefits
while attenuating unpleasant side effects by
implementing a 2-3 day fiber restriction peri-
od. Bowel movements aside, fiber restriction
RESTRICTION PERIOD.
also led to significantly greater hunger scores
and lower fullness scores, which is a fairly
straightforward consequence of limiting a which may be useful to athletes competing
satiety-promoting dietary component like fi- in sports with weight classes. However, the
ber. This is important to consider, given that authors of the presently reviewed study stat-
a short-term weight cut will not only involve ed: “We call for caution and openly express
fiber restriction, but also tends to involve car- our stand against the use of [low-fiber diets]
bohydrate restriction and overall energy re- chronically in healthy individuals.” In other
striction, making hunger a noteworthy (and words, short-term fiber reduction is a viable
unpleasant) challenge during the process. Of strategy, but lifters shouldn’t use this study
course, with 18/19 participants calling the in- as permission to ditch fiber altogether. I don’t
tervention “tolerable,” 16/19 willing to do it believe we’ve ever dug deep into the benefits
again, and only a handful of minor adverse of dietary fiber within the pages of MASS,
events reported, we shouldn’t overstate the and until recently, there wasn’t much of a
reason to; fiber has generally been accepted
unpleasant side effects observed in this study.
as a healthful and important component of a
Nonetheless, this study helps to clarify the
well-balanced diet, with minimal pushback
magnitude of weight loss expected from fi-
or disagreement. However, current trends in
ber restriction, the time course of anticipated
the nutrition world are giving rise to contrari-
weight changes, and the pros and cons of ex-
an arguments suggesting that fiber is useless,
tending this period beyond a couple of days.
or even deleterious. To be clear, these argu-
So, it appears that short-term fiber reduction ments are being made by influencers on the
can be a helpful part of a transient weight cut, fringes of the diet and fitness industry, not by

82
reputable organizations or governing bodies outcomes are actually caused by fiber intake,
in the academic field of nutrition. Nonethe- and which outcomes are merely associated
less, people are increasingly encountering a with fiber intake. For some outcomes (like
fairly unprecedented number of anti-fiber ar- gastric cancers or glycemic control), fairly
guments, so it’s a good time to explore what straightforward mechanistic links can be pro-
scientific research tells us about dietary fiber. posed. For other outcomes (such as immune
function, chronic inflammation levels, and
Despite some of the loud, contrarian perspec-
depression risk), it’s very possible that some
tives about fiber that you might see on social
of the benefits are related to other components
media, the actual research paints an extremely
of an overall health-promoting dietary pat-
favorable picture. As reviewed by Anderson
tern, which tends to be high in fiber. For ex-
et al (4), high fiber intake is associated with
ample, imagine that you were providing pure-
lower risk for coronary heart disease, stroke,
ly qualitative nutritional advice to someone
hypertension, diabetes, obesity, and certain
who was interested in feeling and performing
gastrointestinal diseases. In a separate review
their best, while optimally supporting their
paper, Barber et al (5) point out that fiber is
health. In this scenario, you might suggest
inversely associated with all-cause mortality,
that they seek out a variety of fruits and veg-
along with mortality from cardiovascular dis-
etables, which would cover a large portion of
ease and all cancers. There are also several
their micronutrient needs while adding in a
plausible mechanisms by which fiber could
variety of phytonutrients that have been asso-
impact outcomes related to cardiometabol-
ciated with better performance and recovery.
ic health, cancer, and gastrointestinal func-
tion. For example, fiber improves glycemic
control and blood lipid profiles, and it also
increases fecal mass while reducing transit A VARIED, HEALTH-
time through the gastrointestinal tract. Fiber
intake has even been associated with less ob- FOCUSED DIETARY
PATTERN OFTEN INCLUDES
vious outcomes, such as better immune func-
tion, lower chronic inflammation levels, and
lower risk of depression (5). While it’s uncer-
tain if fiber plays a causal role in promoting
PLENTY OF FIBER
these favorable outcomes, it’s possible that
fiber is impacting these outcomes by promot-
ALONGSIDE A WIDE RANGE
ing more favorable diversity of the gut mi- OF HEALTH-PROMOTING
crobiome and increasing the production of
short-chain fatty acids and other metabolites MICRONUTRIENTS AND
with wide-ranging physiological effects.
PHYTONUTRIENTS.
When looking at population-level correla-
tions, it’s a bit difficult to determine which

83
You might also suggest that they add in some for the management of some gastrointesti-
nuts and seeds to get some fat into their diet, nal conditions, and individuals with relevant
incorporate some beans and legumes to boost medical conditions should work with a quali-
their protein intake, and consume enough car- fied medical practitioner to navigate the suc-
bohydrates to fuel their training, with a large cessful implementation of short-term periods
portion of that carbohydrate coming from of fiber restriction. In the absence of gastro-
minimally processed food sources. As people intestinal pathologies, a good starting point
become mindful of their dietary habits and for daily fiber intake is about 14g of fiber per
start making adjustments that are more com- 1,000kcals in the diet. Dieters can individual-
patible with common guidelines, they tend to ize from there based on gastrointestinal com-
bump their fiber intake without intentionally fort, satiety, stool frequency and consistency,
making the decision to do so. I’m quite confi- and personal preference.
dent that fiber has some independent, positive
health benefits, but a varied, health-focused Next Steps
dietary pattern often includes plenty of fiber
alongside a wide range of health-promoting While there isn’t a ton of research in this area,
micronutrients and phytonutrients. Sorting it seems that effective approaches to tran-
out causation can be difficult in this scenario, sient, short-term weight reduction generally
but the multifaceted benefits of this type of involve some combination of carb restriction,
eating pattern make it very hard to promote a fiber restriction, water loading, and (within
fiber-restricted diet as an optimal long-term safe ranges) some degree of modest fluid re-
dietary approach. striction and sweat induction. However, the
available research has yet to conclusively an-
It’s worth noting that fiber restriction is a swer two pertinent questions for the purposes
strategy used to attenuate symptoms during of many MASS readers: how much weight
flare-ups for a select number of gastrointesti- (as a percentage of body mass) can be lost
nal conditions. However, even in these clin- without impairing maximal strength during a
ical scenarios, Vanhauwaert and colleagues high-skill barbell movement, and, if an acute
(6) note that “Upon achieving remission, the impairment is experienced, how much time
amount of fiber should be systematically in- is needed to refuel and restore performance?
creased until achieving the recommended In addition, as Greg pointed out in a previous
amount of fiber in a healthy diet.” In fact, article, performance responses to weight cut-
Anderson et al suggest that dietary fiber can ting appear to be quite variable; with this in
have a beneficial impact for individuals with mind, I hope that future studies in this area
a wide range of gastrointestinal conditions will examine the variability among individu-
including gastroesophageal reflux disease, al responses, rather than focusing exclusively
duodenal ulcer, diverticulitis, and hemor- on group-level averages. Until research gives
rhoids (4). As such, fiber restriction is still us more insight into these questions, best
viewed as a transient, short-term strategy practices would involve erring on the side of

84
 APPLICATION AND TAKEAWAYS
Dietary fiber is associated with a huge list of positive health outcomes, and a lifter only
stands to benefit from adopting a health-promoting eating pattern that features plenty
of fiber, micronutrients, and phytonutrients coming from a diverse selection of food
sources. Having said that, short-term fiber reduction can be a helpful part of a transient
weight cut, which may be useful to athletes competing in sports with weight classes.
In this type of scenario, fiber restriction can be combined with some combination of
carb restriction, fiber restriction, water loading, and (within safe ranges) some degree
of modest fluid restriction and sweat induction, in order to transiently lose up to 3-5%
of one’s initial body mass. Dropping fiber 2-3 days before a weigh-in should provide
the bulk of the weight reduction benefits while minimizing unpleasant side effects.
However, individual responses can vary substantially, so it’s always a good idea to
err on the conservative side when it comes to cutting weight, and to practice your
weight cutting strategy before you use it for an important competition. In addition,
extreme caution is advised whenever you’re implementing a strategy that involves heat
exposure or alteration of hydration status.

caution (that is, avoiding large and extreme-

ly aggressive weight cuts), and experiment-
ing with the process before using short-term
weight reduction strategies for an important
competition.

85
References
1. Foo WL, Harrison JD, Mhizha FT, Langan-Evans C, Morton JP, Pugh JN, et al. A Short-
Term Low-Fiber Diet Reduces Body Mass in Healthy Young Men: Implications for
Weight-Sensitive Sports. Int J Sport Nutr Exerc Metab. 2022 Mar 21;1–9. ePub ahead of
print.
2. Reale R, Slater G, Cox GR, Dunican IC, Burke LM. The Effect of Water Loading on
Acute Weight Loss Following Fluid Restriction in Combat Sports Athletes. Int J Sport
Nutr Exerc Metab. 2018 Nov 1;28(6):565–73.
3. Connor J, Egan B. Comparison of hot water immersion at self-adjusted maximum
tolerable temperature, with or without the addition of salt, for rapid weight loss in mixed
martial arts athletes. Biol Sport. 2020;38(1):89–96.
4. Anderson JW, Baird P, Davis RH, Ferreri S, Knudtson M, Koraym A, et al. Health
benefits of dietary fiber. Nutr Rev. 2009 Apr;67(4):188–205.
5. Barber TM, Kabisch S, Pfeiffer AFH, Weickert MO. The Health Benefits of Dietary
Fibre. Nutrients. 2020 Oct 21;12(10):E3209.
6. Vanhauwaert E, Matthys C, Verdonck L, De Preter V. Low-Residue and Low-Fiber Diets
in Gastrointestinal Disease Management. Adv Nutr. 2015 Nov 10;6(6):820–7.

86
 Research Briefs
BY GREG NUCKOLS & ERIC TREXLER

In the Research Briefs section, Greg Nuckols and Eric

Trexler shares quick summaries of recent studies. Briefs
are short and sweet, skimmable, and focused on the need-
to-know information from each study.

88 Partial Range of Motion Training Has its

Place

93 Harder Foods for an Easier Diet

How Does Benching with an Arch Affect

98 Excitation of the Prime Movers in the Bench
Press?

102 Revisiting Macronutrient Distribution for

Testosterone Optimization

107 When Does Training Volume Reach the

Point of Diminishing Returns?

112 French Fries: Completely Vindicated and Back

on the Menu

119 What is the Optimal Dose of Resistance

Training for Longevity

126 Even Mild Dehydration May Increase

Subjective Pain and Fatigue During Exercise

87
 Study Reviewed: The Efficacy of Partial Range of Motion Deadlift Training: A Pilot Study.
Gillingham and DeBeliso. (2022)

Partial Range of Motion Training Has its Place

BY GREG NUCKOLS

Most of the recent MASS content discuss- of partial-ROM training. However, in prac-
ing partial range of motion (ROM) training tice, most lifters who employ partial-ROM
has focused on the impact of range of mo- training also do quite a bit of full-ROM train-
tion on muscle growth. For strength, we ing. For example, a lifter may do plenty of
discuss the impact of range of motion less full-ROM bench press and deadlift, but also
frequently, because a) fewer recent studies perform some board presses and block pulls.
have specifically investigated the impact So, while there’s a broad consensus about
of range of motion on strength gains and b) the general effects of partial-ROM training
there’s already a pretty broad consensus on on strength development, there are also some
the topic. Our general understanding of the unanswered questions, experimental findings
topic is that strength gains are specific to the that contradict the consensus view, and com-
range of motion being trained – partial-ROM mon use cases for partial-ROM training that
training generally improves partial-ROM have received little research attention.
strength more than full-ROM training does,
and full-ROM training generally improves With all of that in mind, a recent study by
full-ROM strength more than partial-ROM Gillingham and DeBeliso (1) adds to our un-
training does. However, that pattern doesn’t derstanding of the effects of partial-ROM
always hold true. For example, we previous- training, because it addresses the topic from
ly reviewed a study showing that full-ROM a unique angle. In this study, two groups of
bench press training actually increased par- collegiate wrestlers (with at least one year of
tial-ROM bench press strength to an even lifting experience in a collegiate strength and
greater extent than partial-ROM bench press conditioning program) completed a six-week
training (2). Furthermore, studies comparing pre-season training program. Training took
partial-ROM and full-ROM training typical- place three days per week, and subjects in
ly involve comparisons between training pro- both groups performed a variety of exercis-
grams consisting solely of full-ROM training es (including bench press, hang cleans, back
versus training programs consisting solely squats, and various accessory exercises) that

88
were programmed identically for both groups, Table 1. Full- and partial-ROM deadlift 1RMs
but deadlift training differed between groups. were assessed before and after the six-week
One group only trained the deadlift with a full- training period.
ROM (with each deadlift workout consisting Neither group significantly increased their
of two sets of deadlifts), while the other group full-ROM deadlift 1RM. However, the group
performed one full-ROM set of deadlifts, fol- only doing full-ROM training experienced a
lowed by three heavy, partial-ROM sets of a non-significant decrease in deadlift strength
single rep. The partial-ROM sets were per- (-5.3 ± 13.4kg), while the group doing both
formed in a power rack; repetitions began with full- and partial-ROM training experienced a
the bar resting on the safety pins, which were non-significant increase in deadlift strength
set ~1 inch above the lifters’ kneecaps. Details (4.5 ± 12.2kg). Furthermore, only the group
about the deadlift programming can be seen in doing both full- and partial-ROM training

89
significantly increased its partial-ROM 1RM, ily derived from studies where partial-ROM
and gains in partial-ROM deadlift strength training is performed in isolation. Only one
significantly differed between groups. You other study (that I’m aware of) has compared
can see these results in Tables 2 and 3. full-ROM training to a combination of full-
ROM and partial-ROM training. In that study
Overall, this study paints an optimistic pic-
by Bayzler and colleagues (3), one group of
ture for partial-ROM training, but let’s first
subjects only trained full-ROM squats, while
acknowledge the drawbacks. While nominal
another group did a combination of full-ROM
strength gains favored the group doing both
squats and half squats. Much like the pres-
full- and partial-ROM training, the difference
was only significant for gains in partial-ROM ent study, gains in full-ROM squat strength
deadlift strength. So, assuming your top didn’t significantly differ between groups,
priority is maximizing full-ROM deadlift but the nominal increase in full-ROM squat
strength, these aren’t slam dunk findings strength tended to be larger in the group do-
suggesting that you’ll definitely gain more ing a combination of full- and partial-ROM
full-ROM deadlift strength if you do some training. In both of these studies, a combi-
partials. Furthermore, you could contend that nation of full- and partial-ROM training re-
the training interventions weren’t equated sulted in full-ROM strength gains that were
between groups: is one set of 3-5 full-ROM at least as large as those obtained by doing
reps directly comparable to three heavy par- only full-ROM training. A less conservative
tial-ROM singles? I personally think the (but totally defensible) interpretation is that
training interventions were similar enough to these two studies suggest that a combination
allow for a valid comparison (if anything, I of full-ROM and partial-ROM training may
think three heavy rack pulls at ~110% of my be more beneficial for developing full-ROM
full-ROM deadlift 1RM would be easier than strength than a diet of exclusively full-ROM
a set of 5 deadlifts at 85% of 1RM), but I can training.
also understand if you’re more skeptical. I personally wouldn’t argue that a combina-
However, I think the most pessimistic case tion of full- and partial-ROM training is supe-
you could make from these data is that the rior to exclusively full-ROM training per se.
combination of partial- and full-ROM dead- Rather, I simply think this study pushes back
lift training is superior for improving par- against the popular idea that partial-ROM
tial-ROM deadlift strength, and at least as training (through short muscle lengths) is
efficacious as full-ROM deadlift training for just ego lifting, and that full-ROM training
improving full-ROM deadlift strength. This is always better than partial-ROM training
would seem to stand in contrast with the gen- for developing strength through a full range
eral consensus that full-ROM training is su- of motion. I think partial-ROM training has
perior to partial-ROM training for improving its place in strength programming, but I think
full-ROM strength; however, you need to re- it should be used tactically. For example,
member that the general consensus is primar- someone who never struggles locking out

90
bench presses probably won’t get much from lifters getting involved with research. While
a heavy diet of four-board presses, and some- most lifters who do partial-ROM training use
one who never struggles with their deadlift a combination of both full- and partial-ROM
lockout probably won’t get much out of block training, most researchers (with the exception
pulls or rack pulls above knee height. How- of Bazyler and colleagues; 3) have opted for
ever, someone who does struggle with their testing the effects of partial-ROM training
bench press or deadlift lockout may benefit in isolation. Gillingham’s experience helped
from partial-ROM training, and clinging to him design a more ecologically valid study for
the orthodoxy of only doing full-ROM train- testing the effects of partial-ROM training, in
ing may hamper their strength development. a way that mirrors how partial-ROM training
Furthermore, I think this study illustrates the is typically used in practice. This is similar to
pitfalls of black-and-white thinking. While a prior study I reviewed by Antretter and col-
full-ROM training is generally superior to leagues (4), which compared periodized and
partial-ROM training for developing full- nonperiodized training from a unique angle.
ROM strength in isolation, that doesn’t mean Markus Antretter is a successful bodybuild-
that partial-ROM can’t still be used produc- er, and Fred Hatfield’s popular training meth-
tively as one piece of a broader training pro- ods were the inspiration for the study. Ulti-
gram. mately, most longitudinal training studies are
supposed to be translational studies, which
Just to wrap things up, I want to give a brief
can help validate (or fail to validate) train-
shoutout to the lead author of the present
ing methods, and which can help improve the
study: the great Brad Gillingham. He’s one
training practices of people “in the trenches.”
of the all-time greats in powerlifting, with 14
However, when study protocols drift too far
USAPL national championships and 6 IPF
from the ways people actually train, research
world championships. As far as I’m aware,
can start to lose its translational value. I think
he’s also pulled more 800-pound deadlifts in
that input from serious athletes and success-
competition than any other lifter, by a pret-
ful coaches can help improve the translation-
ty large margin. The group of subjects in the
al value of training studies by ensuring that
present study performing a combination of
study protocols better reflect how people ac-
full- and partial-ROM training was (roughly)
tually train, so that the research can be more
following the approach to deadlift training
valuable to practitioners.
that Gillingham used to become one of the
greatest deadlifters of all time. So, props to
Brad Gillingham for actually testing the train- References
ing methods he promotes in a controlled set- 1. Gillingham B, DeBeliso M. The Efficacy
ting (his accolades alone would be sufficient of Partial Range of Motion Deadlift
to sell most people on the efficacy of his train- Training: A Pilot Study. International
ing methods). More importantly, I think this Journal of Sports Science. Vol. 12 No.
study illustrates one of the benefits of serious 1, 2022, pp. 14-22. doi: 10.5923/j.
sports.20221201.03.

91
2. Martínez-Cava A, Hernández-Belmonte
A, Courel-Ibáñez J, Morán-Navarro R,
González-Badillo JJ, Pallarés JG. Bench
Press at Full Range of Motion Produces
Greater Neuromuscular Adaptations
Than Partial Executions After Prolonged
Resistance Training. J Strength Cond
Res. 2022 Jan 1;36(1):10-15. doi:
10.1519/JSC.0000000000003391. PMID:
31567719.
3. Bazyler CD, Sato K, Wassinger CA,
Lamont HS, Stone MH. The efficacy of
incorporating partial squats in maximal
strength training. J Strength Cond Res.
2014 Nov;28(11):3024-32. doi: 10.1519/
JSC.0000000000000465. PMID:
24662234.
4. Antretter M, Färber S, Immler L, Perktold
M, Posch D, Raschner C, Wachholz F,
Burtscher M. The Hatfield-system versus
the weekly undulating periodised resistance
training in trained males. International
Journal of Sports Science and Coaching.
2017 December.

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 Study Reviewed: Texture-Based Differences in Eating Rate Influence Energy Intake for
Minimally-Processed and Ultra-Processed Meals. Teo et al. (2022)

Harder Foods for an Easier Diet

BY ERIC TREXLER

The Paleo diet unnecessarily excludes plenty energy balance. Over the years, MASS has
of foods based on the appeal to nature fallacy. covered a wide range of related topics, such
However, vocal Paleo proponents often bring as hedonic aspects of food intake regulation,
attention to one observation that is hard to the impact of food processing on energy in-
dispute: the modern food environment tends take, the relationship between energy density
to be quite obesogenic, and the foods we see and energy intake (one, two), the relationship
in certain grocery store aisles are quite differ- between certain macronutrients and satiety,
ent from foods we might have encountered and the effects of certain foods and beverag-
as a hunter-gatherer. We have unprecedented es on satiety. At a basic level, these lines of
access to foods of varying texture, mouth- inquiry equip us with more knowledge about
feel, flavor, and energy density, with food how to navigate the modern obesogenic food
options ranging from entirely unprocessed environment in an informed manner, with-
to ultra-processed. The Paleo approach is to out needing to lean on excessively restrictive
avoid all food sources that have been made rules and guidelines. Taken one step further,
possible by the food science advancements they give us clues about how to construct a
of the last few thousand years, a strategy that diet that makes body weight manipulation a
strikes me as a bit heavy-handed, as it might little bit easier.
not necessarily be ideal for comprehensive
For example, someone struggling to gain
micronutrient coverage, and it promotes a
weight can leverage these different food and
degree of rigid cognitive restraint that I con-
meal characteristics to create a diet that uses
sider excessive.
palatable meals to provide plenty of calories
An alternative approach is to seek a deeper un- without extinguishing their appetite. Con-
derstanding of how various processing meth- versely, someone struggling to lose weight
ods influence eating habits, and how various (or maintain a reduced body weight) can use
food characteristics impact satiety regula- this information to design a diet that maxi-
tion, hedonic aspects of eating behaviors, and mally promotes satiety on a tight calorie bud-

93
get, while avoiding foods or meals that may to eat until they felt “comfortably full.” Sub-
provoke the desire for overconsumption. jects completed a number of questionnaires
In short, we’re looking for relatively easy related to outcomes like appetite and sensory
ways to passively support our likelihood of ratings of each meal, but primary outcomes
successful body composition manipulation, of interest included the mass of food eaten in
or (at minimum) avoid dietary choices that the test meals (in grams), the amount of ener-
make an uphill battle even harder. gy consumed in the test meals (in kcals), and
the amount of energy consumed in subsequent
One food characteristic that we haven’t spent
much time discussing is texture (hard ver- meals (after each test meal).
sus soft). Fortunately, a new study provides The highlights of this study’s findings are
some simple and practical guidance regard- pretty straightforward and intuitive. Look-
ing the influence of food texture on energy ing at the mass of food consumed (in grams),
intake. The presently reviewed study (1) uti- soft-textured meals led to significantly great-
lized a crossover design with 50 participants er food intake than hard-textured meals (Fig-
(48% male; 24.4 ± 3.1 years old; BMI = 21.3 ure 1). This was facilitated by a faster eating
± 1.9 kg/m2) who had BMI values between rate (grams of food consumed per minute),
18.5 and 24.9, were not pregnant, were not which was highest in the soft + ultra-pro-
actively trying to lose weight, and were not cessed meal, lower in the soft + minimally
using any medications known to affect appe- processed meal, and lowest in the hard-tex-
tite or energy metabolism. Each participant tured meals. Looking at the amount of total
consumed four different ad libitum test meals energy consumed (in grams), both texture
on four separate occasions, with each of the and processing were quite impactful. Energy
meals differing based on the texture and the consumed was highest in the soft + ultra-pro-
degree of processing. The four meals in- cessed meal, followed (in order) by soft +
cluded: 1) soft-textured and minimally pro- minimally processed, hard + ultra-processed,
cessed; 2) soft-textured and ultra-processed; and hard + minimally processed (Figure 1).
3) hard-textured and minimally processed; 4) The same pattern was observed for the rate
hard-textured and ultra-processed. of energy intake (kcal/min) in each test meal.
On the day of each laboratory visit, partic- Despite greater energy intakes in the softer
ipants broke their overnight fast with a stan- and more highly processed meals, post-meal
dardized breakfast four hours before the test satiety ratings were not significantly differ-
meal. Participants also received a standardized ent among the four different test meals, and
mid-morning drink two hours before the text energy intake in subsequent meals was not
meal, which was consumed at lunch time. Par- significantly impacted. In other words, par-
ticipants were given each meal with 250mL of ticipants did not feel significantly more full
water, and food portions were matched for total after the higher-calorie meals, nor did they
energy among all four test meals. Participants compensate for lower-calorie meals by eating
were given 20 minutes to eat, and instructed more later in the day.

94
The results of the presently reviewed study These insights about eating speed are infor-
line up nicely with the results of a study (2) mative and useful, but not exactly new. As
reviewed by Dr. Helms back in Volume 3 of reviewed by Forde (3), several studies have
MASS, while also taking the findings a step suggested that a slower eating rate can pas-
further. The previous study by Hall and col- sively reduce ad libitum energy intake, with
leagues found that, in very tightly controlled a 20% change in eating rate impacting ener-
conditions, participants ate significantly more gy intake by up to 10-13%. While Forde ac-
food mass and total energy on an ultra-pro- knowledges several ways to promote a slow-
cessed diet when compared to a less-processed er eating pace, alteration of meal texture (soft
diet. While more total food and energy was versus hard) is one of the more promising
consumed, satiety levels did not significantly strategies discussed in their review. While
differ between the diets. Eating rate was also slower eating rates could potentially reduce
significantly faster in the ultra-processed diet energy intake by allowing more time for sati-
condition, which led Hall and colleagues to ety-related hormone responses after meal ini-
speculate that “Perhaps the oro-sensory prop- tiation and influencing outcomes related to at-
erties of the ultra-processed foods (e.g., soft- tention and memory during and after the meal
er food that was easier to chew and swallow) (4), harder meal textures may also influence
led to the observed increased eating rate and energy intake by impacting the sensory expe-
delayed satiety signaling thereby resulting in rience of eating. A harder meal texture often
greater overall intake” (2). Hall and colleagues involves more time spent chewing, which in-
also acknowledged that higher energy density creases our sensory exposure to the flavors
of foods presented in the ultra-processed diet and aromas of the food (5). This is also true
condition may have played a role in promoting when it comes to minimally processed food
higher total energy intake. options, which tend to have different textur-

95
al characteristics than their highly processed food, prepared and eaten in different ways,
counterparts. We can drink a smoothie con- can lead to substantially different satiety re-
taining an apple far more rapidly than we can sponses. While it’s tempting to oversimpli-
eat an apple; while the smoothie rushes by fy satiety recommendations by, for example,
our taste buds in the blink of an eye with each comparing one macronutrient versus another,
large gulp of the drink, an apple takes time to we lose a lot of very useful nuance when we
chew, and our exposure to its flavor and aro- do that. It’s common for fitness professionals
ma is substantially prolonged. As explained to field questions about which foods or which
by de Graaf and Kok (5), this plays a large macronutrients promote satiety, and I’m in-
role in the consistent observation that solid creasingly convinced that these are the wrong
foods tend to be more satiating (per calorie) questions to ask. As I mentioned back in Vol-
than liquids. ume 4, we can say that “increasing protein”
Of course, there are exceptions to just about generally has a positive impact on satiety, but
every rule, and soup is the major exception we can’t delude ourselves into thinking that a
when it comes to the low satiety levels com- very palatable whey protein beverage is the
monly associated with liquids. Studies con- same as an isonitrogenous boiled chicken
sistently report high satiety levels following breast when it comes to appetite regulation.
soup consumption, and de Graaf and Kok ar- Rather than focusing exclusively on food
gue that this observation is probably related sources or macronutrients, we should prob-
to how we consume soup. It’s generally eaten ably be focusing on a broader set of charac-
with a spoon, which slows down the eating teristics associated with satiety responses to a
process, and this process can be slowed even given meal.
further if the soup happens to be quite hot. In my most recent MASS article about sati-
In support of this hypothesis, they point to ety and appetite regulation, I concluded that:
a fascinating study (6) in which researchers “Some practical strategies that may support
compared satiety responses to eating an ap- higher satiety levels during energy restriction
ple, drinking apple juice, or consuming apple involve eating more slowly, avoiding hyper-
juice with a spoon, as if it were a soup. While palatable meals, and structuring your meals
satiety ratings were higher for eating an ap- with high protein, fiber, and water content, low
ple than drinking apple juice, consuming the energy density, and plenty of unprocessed or
apple juice with a spoon increased satiety rat-
minimally processed foods.” I also mentioned
ings to a level that was comparable with eat-
that adopting an acceptance-oriented approach
ing an apple.
to hunger can be a very valuable tool while
This observation reinforces a broader point dieting (7). The presently reviewed study, and
about satiety that is very important: the fit- the related literature we’ve covered in this re-
ness industry is all too eager to provide over- search brief, suggest that we can add a couple
simplified “fullness hacks,” but satiety is of extra tools to the satiety tool box. Evidence
complex and multifaceted. The same exact suggests that incorporating some harder food

96
textures into our diet may passively encourage and the control of food intake. Nat Rev
slower eating rates. In addition, if mechanisms Endocrinol. 2010 May;6(5):290–3.
related to attention, memory, and the senso- 6. Mattes R. Soup and satiety. Physiol Behav.
ry experience of the meal are truly driving 2005 Jan 17;83(5):739–47.
a portion of the relationship between slower
7. Lillis J, Kendra KE. Acceptance and
eating rates and lower energy intake, then we Commitment Therapy for weight control:
can probably maximize these effects by eating Model, evidence, and future directions. J
more mindfully, avoiding distractions while Context Behav Sci. 2014 Jan;3(1):1–7.
eating, and taking time to savor the aromas
and flavors of our meal. In summary, there are
several practical dietary modifications that can
increase (or decrease) satiety, but there’s a lot
more involved than trading one macronutrient
for another.

References
1. Teo PS, Lim AJ, Goh AT, Janani R, Choy
JYM, McCrickerd K, et al. Texture-based
differences in eating rate influence energy
intake for minimally-processed and ultra-
processed meals. Am J Clin Nutr. 2022
Mar 14; ePub ahead of print.
2. Hall KD, Ayuketah A, Brychta R, Cai
H, Cassimatis T, Chen KY, et al. Ultra-
Processed Diets Cause Excess Calorie
Intake and Weight Gain: An Inpatient
Randomized Controlled Trial of Ad
Libitum Food Intake. Cell Metab. 2019
02;30(1):67-77.e3.
3. Forde CG. From perception to ingestion;
the role of sensory properties in energy
selection, eating behaviour and food intake.
Food Qual Prefer. 2018 Jun 1;66:171–7.
4. Hawton K, Ferriday D, Rogers P, Toner
P, Brooks J, Holly J, et al. Slow Down:
Behavioural and Physiological Effects of
Reducing Eating Rate. Nutrients. 2018 Dec
27;11(1):50.
5. de Graaf C, Kok FJ. Slow food, fast food

97
 Study Reviewed: Upper Extremity Muscle Activity and Joint Loading Changes Between the
Standard and Powerlifting Bench Press Techniques. Cudlip et al. (2022)

How Does Benching with an Arch Affect Excitation

of the Prime Movers in the Bench Press?
BY GREG NUCKOLS

An arched, powerlifting-style bench press were given two minutes of rest between sets.
clearly looks different from a standard flat- During all sets of bench press, electrodes
backed bench press, but do the resulting tech- were affixed to the subjects’ pecs (with sep-
nique differences affect muscle excitation? arate electrodes for the sternal and clavicu-
A recent study by Cudlip and colleagues in- lar heads), triceps, lats, and side deltoids to
vestigated this question (1) by examining the assess EMG amplitudes (a proxy for muscle
impact of arching in the bench press on elec- excitement). All EMG readings were normal-
tromyographic (EMG) responses of the pecs ized against EMG amplitudes obtained during
(both heads), triceps, lats, and side delts. maximal voluntary contractions (MVCs) for
each muscle. Both mean EMG (the average
Researchers recruited 20 college-aged males
normalized EMG amplitude observed during
who were all experienced benchers (average
each rep) and peak EMG (the highest normal-
1RM = 133.4kg; range = 102.3-165.9kg).
ized EMG amplitude observed during each
Notably, all subjects had experience bench-
rep) were analyzed.
ing with both a flat-backed technique and an
arched technique. Subjects completed a single The researchers found that, unsurprisingly,
testing session consisting of six sets of bench EMG amplitudes for all muscles were high-
press, completed in a randomized order: sets er with heavier loads than lighter loads. Fur-
with 25%, 50%, and 75% of 1RM performed thermore, when pooling EMG results with all
with a flat-backed technique and sets with three loads, side delt EMG was slightly (but
25%, 50%, and 75% of 1RM performed with significantly; p<0.05) higher with the flat-
an arched technique. This isn’t made clear backed technique, while lat and triceps EMG
in the study, but I believe subjects just per- were significantly higher with the arched
formed a single rep with each weight and technique (Figure 1). There was only one sig-
technique. Subjects were instructed to move nificant technique × load interaction effect:
the bar with a controlled cadence (2-second the relationship between load and lat EMG
eccentric and 2-second concentric), and they differed between lifting techniques (Figure

98
2). With the flat-backed technique, lat EMG (who bench with an arch) read MASS, I fig-
increased as loads increased. With the arched ured that, if nothing else, it was worth mak-
technique, lat EMG stayed pretty consistent, ing a note of these results. Second, I’ve seen
regardless of load (suggesting that with an it suggested that arching effectively turns
arched technique, some baseline degree of lat the bench press into a decline press; there-
excitation is required to merely maintain an fore, benching with an arch should prioritize
arch). Notably, pec EMG didn’t significantly lower pec (sternal head) activation, and de-
differ between techniques. crease upper pec (clavicular head) activation.
I mostly wanted to discuss this study for two However, the data don’t seem to support this
reasons. First, there’s very little research supposition: upper and lower pec EMG were
comparing the flat-backed vs. arched bench similar with both techniques, suggesting that
press techniques. Since a lot of powerlifters benching with an arch probably isn’t priori-

99
100
 References
tizing the lower pecs and neglecting the up-
per pecs (at least, relative to the flat-backed
bench press). 1. Cudlip AC, Maciukiewicz JM, Pinto BL,
Dickerson CR. Upper extremity muscle
I’m personally not going to get worked up activity and joint loading changes between
about the differences in lat and side delt EMG the standard and powerlifting bench press
between the two techniques observed in the techniques. J Sports Sci. 2022 Mar 2:1-9.
present study. Neither muscle is a prime mov- doi: 10.1080/02640414.2022.2046937.
er in the bench press, and it’s unlikely that Epub ahead of print. PMID: 35236248.
either muscle will ever limit bench press per- 2. Vigotsky AD, Halperin I, Trajano GS,
formance for most lifters, so I simply don’t Vieira TM. Longing for a Longitudinal
think the observed EMG differences actually Proxy: Acutely Measured Surface EMG
matter. However, the fact that triceps EMG Amplitude is not a Validated Predictor of
Muscle Hypertrophy. Sports Med. 2022
was higher with the arched technique is a bit
Feb;52(2):193-199. doi: 10.1007/s40279-
surprising. My best guess is that the differ- 021-01619-2. Epub 2022 Jan 10. PMID:
ences in triceps EMG may reflect addition- 35006527.
al technique differences the lifters adopted.
While an arched bench press doesn’t require
a lifter to bench with their elbows tucked
(which would tend to increase triceps usage),
and a flat-backed bench press doesn’t require
a lifter to bench with their elbows flared
(which would tend to decrease triceps usage),
most lifters do tend to tuck their elbows a bit
more when benching with an arch, and flare
their elbows a bit more when adopting a flat-
backed technique. If I had to take a guess,
that would be my tentative explanation for
the difference in triceps EMG observed be-
tween techniques in the present study.
As with all EMG studies, standard caveats
apply: EMG isn’t a direct measure of muscle
activation, and we don’t know if higher EMG
amplitudes are predictive of greater muscle
growth or larger strength gains (2).

101
 Study Reviewed: Low-Carbohydrate Diets and Men’s Cortisol and Testosterone: Systematic
Review and Meta-Analysis. Whittaker et al. (2022)

Revisiting Macronutrient Distribution for

Testosterone Optimization
BY ERIC TREXLER

Testosterone receives a lot of attention in carb (≤35% of calories coming from carbs)
the evidence-based fitness world, and it’s to a high-carb (>35%) diet; 5) had a gap of
not hard to figure out why. A quick, super- at least 20 units between the percentage of
ficial comparison of drug-tested versus un- calories from carbs in the low-carbohydrate
tested bodybuilders or strength athletes con- and high-carbohydrate diets (for example,
firms that anabolic hormones can have quite 25% carbohydrate versus 45% carbohydrate
the impact, within certain dosing ranges. As diets); 6) implemented interventions lasting
mentioned in a previous MASS article, it at least 24 hours in duration; 7) were not con-
takes some pretty substantial changes in tes- founded by carbohydrate loading, exogenous
tosterone levels to really move the needle in hormone use, phytoestrogen intake, prescrip-
terms of strength or hypertrophy. However, tion medications, or large changes in body
that hasn’t stifled any interest in exploring mass (≥3kg). They justified the 3kg thresh-
nutritional modifications that may influence old for weight change based on an anticipat-
testosterone levels, ranging from supplemen- ed weight reduction of up to 1.4kg (due to
tation with purported testosterone boosters to glycogen loss) upon transitioning to a very
alterations in macronutrient intake. low-carbohydrate diet.
The presently reviewed meta-analysis (1) 27 studies made the cut, with a total of 309
sought to quantify the effects of low-carbohy- participants (age: 27.3 ± 4.7 years [n = 309];
drate diets on testosterone and cortisol levels weight: 78.6 ± 7.1 kg [n = 303]; BMI: 24.8 ±
in healthy adult men. First, they completed 1.6 kg/m2 [n = 246]). Dietary interventions
a systematic literature search and screening ranged from 2 days to 8 weeks in duration,
process to gather up all of the relevant studies and 95% of participants were physically ac-
that 1) investigated interventions altering the tive during the dietary interventions. During
carbohydrate content of the diet; 2) measured interventions, low-carb diets led to 1.5kg of
blood testosterone or cortisol levels; 3) sam- weight loss (versus 0.1kg in the high-carb di-
pled healthy adult males; 4) compared a low- ets), but diets were fairly similar in terms of

102
average energy intake (2,873kcal/day in low- This meta-analysis caused quite a stir in the
carb versus 2,866kcal/day in high-carb). Av- fitness world when it was first published, with
erage carb intake was 12% of calories in low- the most common interpretation being that
carb diets and 58% of calories in high-carb low-carb diets tank resting testosterone lev-
diets, and low-carb diets tended to be higher els. However, when we take a closer look at
in fat, protein, and cholesterol, but lower in the results, we see that this interpretation re-
fiber and sugar. quires more nuance. Overall, the findings re-
vealed a significant impact of low-carb diets
Short-term diets (<3 weeks) led to signifi-
on resting testosterone levels when compared
cantly increased resting cortisol levels, but
to higher-carb diets, with low-carb diets lead-
this finding probably has limited utility, as the
ing to lower testosterone levels (standardized
effect was not apparent in the longer studies
mean difference [SMD] = -0.48, p= 0.01).
(at least 3 weeks in duration). Low-carb diets
However, the researchers broke things down
also led to greater post-exercise cortisol lev-
further by independently analyzing low-
els following long-duration (≥20 minutes)
carb diets with high protein intakes (≥35%
exercise, but this probably isn’t a huge deal
of calories from protein) versus those with
for the typical MASS reader. Cortisol plays
moderate protein intakes (<35%). When pro-
an important role in liberating stored energy
tein intake was moderate (which included a
substrates to use during exercise, with acute,
total subsample of 129 participants across 10
transient cortisol elevations promoting in-
studies), findings were non-significant (SMD
creased gluconeogenesis and lipolysis. So, the
= -0.31, p = 0.17). When protein intake was
observed post-exercise cortisol elevations are
high, there was a large, statistically signifi-
a pretty straightforward consequence of low
cant effect (SMD = -1.08, p < 0.01). Results
carbohydrate availability. People often worry
for resting cortisol and resting testosterone
about cortisol because of concerns that it will
levels are summarized in Table 1.
have a catabolic effect, but evidence fails to
support the idea that large post-exercise cor- While this finding might cause some concern
tisol elevations are bad for gains (2). Along among low-carb dieters, there are a few im-
the same lines, I won’t focus on the results portant limitations to keep in mind. First, this
related to exercise-induced testosterone fluc- high-protein-low-carb subsample was very
tuations reported in this meta-analysis, as the small, with only 26 total participants across
literature suggests that these fluctuations are 3 studies. In one of these studies (4), the in-
of minimal importance to practically relevant tervention effect seemed quite large, but the
outcomes (3). In summary, the cortisol-relat- difference between baseline testosterone lev-
ed findings of this meta-analysis enhance (or, els before the intervention diets was nearly as
at minimum, reinforce) our understanding of large as the testosterone drop that was attribut-
physiology, but don’t yield any conclusions ed to carbohydrate restriction. This is a huge
that are particularly actionable or applicable limitation, particularly in a crossover study in
for the typical MASS reader. which participants served as their own con-

103
trols. In another one of these studies (5), the fat, and 44% protein) to the high-carb (70%
dietary intervention was only 3 days long, carbohydrate, 20% fat, and 10% protein) diet
and the low-carb diet wasn’t representative of for only 10 days. Removing this participant
what we’d typically observe in the real world would decrease the size of the effect in this in-
(5% carbohydrate, 50% fat, and 45% protein). dividual study by roughly a third.
Ketogenic diets often approach this level of
carbohydrate restriction, but this is normally Let’s briefly set those limitations aside, sus-
done within the context of much higher fat pend any skepticism, and accept the conclu-
intake. In the third study (6), data were only sion that low-carb diets tank resting testoster-
available for 7 participants, who underwent a one levels at face value. Intuitively, the next
diet intervention of only 10 days in duration. step is to address a very important question:
In addition, averages are highly impacted by what are you going to do about it? As previ-
outliers when sample sizes are small, and one ously reviewed in MASS, there is also evi-
participant approximately doubled their rest- dence indicating that fat restriction can lead
ing testosterone level when they switched to reductions in testosterone levels (7), and
from the low-carb (35% carbohydrate, 21% protein restriction is the worst dietary option

104
on the table for lifters interested in increasing When you’re pursuing a fairly aggressive fat
strength and muscle mass. When distilling loss goal with a lower daily calorie target,
some practical applications from this liter- you’ll run into some situations in which ener-
ature, we have to consider two distinct sce- gy availability isn’t quite sufficient. You’d still
narios: when energy availability is sufficient, begin constructing your diet by setting a pro-
and when energy availability is insufficient. tein target; it could still be around 1.6-2.2g/kg
of body mass (or 2-2.75g/kg of fat-free mass),
When daily calorie targets are high and ener-
but you might opt to go as high as 3.1g/kg of
gy availability is sufficient, you’d begin con-
fat-free mass if you’re particularly lean or di-
structing your diet by setting a protein target
eting particularly aggressively (9). When it
of 1.6-2.2g/kg of body mass (if you’re like
comes to balancing carbs and fats to preserve
me and you prefer to scale to fat-free mass,
testosterone levels, there’s really no winning
this would be roughly 2-2.75g/kg of fat-free
(although you can probably make a tough sit-
mass, give or take). If you wanted to avoid
uation tougher). When calories are low, insuf-
the potential testosterone-suppressing effects
ficient energy availability is the key driver of
of extreme fat reduction and extreme carb re-
testosterone reductions, and there’s no amount
duction, you could simply set your fat target
of fancy macronutrient footwork that can cir-
to somewhere in the range of 20-35% of to-
cumvent this. I do suspect that you might ex-
tal calories, or roughly 0.7-1.5g/kg of body
acerbate this issue by excessively restricting
mass, and let the rest of your calories come
fat, which is a somewhat speculative conclu-
from carbohydrate. For reasons related to diet
sion based on the mechanistic relationship be-
palatability, diet sustainability, hormone syn-
tween lipid-derived compounds and synthesis
thesis, essential fatty acid intake, and fat-sol-
of sex hormones (8). In these scenarios, I typ-
uble vitamin absorption, it’s hard to justify
ically recommend a daily fat intake target no
setting your fat target substantially below this
lower than 0.5-0.7g/kg of body mass, with the
range, especially when your calorie target is
remainder of calories coming from carbohy-
high enough to support adequate energy avail-
drate. This approach is not intended to prevent
ability. The ranges I present are intended to
reductions in testosterone (which, at a certain
represent the “safest bet” for optimally sup-
point, become inevitable), but merely aims to
porting testosterone levels based on the avail-
avoid exacerbating reductions in testosterone
able evidence, but it’s important to recognize
to an unnecessary degree.
that the testosterone-related consequences
of exceeding this boundary are very modest. In conclusion, we now have meta-analyses
We have reviewed research reporting modest suggesting that excessive fat restriction (7)
testosterone reductions in response to keto- and excessive carbohydrate restriction (1)
genic diets with higher fat targets and lower both decrease resting testosterone levels in
carbohydrate targets, but the broader body of young, healthy men. If supporting high tes-
evidence reveals fairly mixed impacts of ke- tosterone levels is a high priority for you,
togenic diets on testosterone levels (8). then it seems a fairly moderate macronutrient

105
distribution could be considered “best prac- induced muscle hypertrophy. PloS One.
tice.” This type of diet might involve, for ex- 2013;8(10):e78636.
ample, a protein target of 2-2.75g/kg of fat- 4. Jaffe DA, Hewit JK, Sawyer JC, Cholewa
free mass, 20-35% of calories coming from JM, Bedard AJ, Matthews TD, Thompson
fat, and the rest of the day’s calories coming BA, Headley SAE. Effects of Short-
from carbohydrate. Nonetheless, deviating Term Macronutrient Redistribution on
Performance Parameters in Resistance
from these “best practice” recommendations
Trained Males. Biomed J Sci & Tech Res.
doesn’t necessarily lead to dire consequenc- 2018;9(2):6948–52.
es. Diet-related testosterone fluctuations typ-
ically aren’t large enough to have a dramatic 5. Langfort JL, Zarzeczny R, Nazar K,
Kaciuba-Uscilko H. The effect of low-
impact on strength or hypertrophy, and even
carbohydrate diet on the pattern of
ketogenic diets, which represent a fairly large hormonal changes during incremental,
departure from the recommended macronu- graded exercise in young men. Int J Sport
trient distribution, have pretty modest and Nutr Exerc Metab. 2001 Jun;11(2):248–57.
inconsistent effects on resting testosterone
6. Anderson KE, Rosner W, Khan MS,
levels. With this in mind, it probably doesn’t New MI, Pang SY, Wissel PS, et al. Diet-
make a lot of sense to let testosterone-related hormone interactions: protein/carbohydrate
considerations drive your decisions regard- ratio alters reciprocally the plasma levels
ing macronutrient distribution. More perti- of testosterone and cortisol and their
nent factors include getting enough protein respective binding globulins in man. Life
Sci. 1987 May 4;40(18):1761–8.
to support hypertrophy, getting enough fat to
support general health, and getting enough 7. Whittaker J, Wu K. Low-fat diets and
carbohydrate to fuel the amount of moder- testosterone in men: Systematic review
ate-to-high intensity exercise you’re doing. and meta-analysis of intervention studies.
J Steroid Biochem Mol Biol. 2021
Jun;210:105878.
References 8. Valenzuela PL, Castillo-García A, Lucia
1. Whittaker J, Harris M. Low-carbohydrate A, Naclerio F. Effects of Combining a
diets and men’s cortisol and testosterone: Ketogenic Diet with Resistance Training
Systematic review and meta-analysis. Nutr on Body Composition, Strength, and
Health. 2022 Mar 7; ePub ahead of print. Mechanical Power in Trained Individuals:
A Narrative Review. Nutrients. 2021 Sep
2. West DWD, Phillips SM. Associations of 1;13(9):3083.
exercise-induced hormone profiles and
gains in strength and hypertrophy in a large 9. Helms ER, Zinn C, Rowlands DS, Brown
cohort after weight training. Eur J Appl SR. A systematic review of dietary protein
Physiol. 2012 Jul;112(7):2693–702. during caloric restriction in resistance
trained lean athletes: a case for higher
3. Mitchell CJ, Churchward-Venne intakes. Int J Sport Nutr Exerc Metab. 2014
TA, Bellamy L, Parise G, Baker SK, Apr;24(2):127–38.
Phillips SM. Muscular and systemic
correlates of resistance training-

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 Study Reviewed: A Systematic Review of the Effects of Different Resistance Training Volumes
on Muscle Hypertrophy. Baz-Valle et al. (2022)

When Does Training Volume Reach the Point of

Diminishing Returns?
BY GREG NUCKOLS

Back in 2017, Schoenfeld and colleagues designed to investigate the impact of training
published a meta-regression suggesting that volume on muscle growth. With that in mind,
there was a roughly linear dose-response rela- Baz-Valle and colleagues recently performed
tionship between training volume and muscle a meta-analysis looking at the impact of
growth, up to ~10 sets per muscle group per training volume on muscle growth, beyond
week: performing 10+ sets per week resulted the upper bound of the original Schoenfeld
in more muscle growth than performing 5-9 meta-regression (1). Specifically, they want-
sets per week, and performing 5-9 sets per ed to compare the effects of weekly training
week resulted in more muscle growth than volumes of 12-20 sets per muscle group per
performing <5 sets per week (2). However, week versus weekly training volumes of >20
when that meta-regression was published, ev- sets per muscle group per week. To be in-
eryone understood that this roughly dose-re- cluded in the meta-analysis, a study had to
sponse relationship couldn’t be extrapolat- meet these criteria:
ed infinitely. Logically, there must be some
1. The study needed to include at least one
point at which further increases in training
group training the quads, biceps, and/or
volume don’t result in more muscle growth.
triceps with 12-20 sets per muscle group
However, the vast majority of the research
per week, and at least one group training
to that point had only investigated relatively
the quads, biceps, and/or triceps with >20
low training volumes (<10 sets per week) so
sets per muscle group per week.
we lacked the data that would be required to
determine the point of diminishing returns. 2. The study needed to use the same train-
ing intensities for all groups; weekly set
In recent years, however, more and more
volume was the only difference in training
studies have investigated the effects of train-
prescription between groups.
ing volumes exceeding 10 sets per week. In
fact, these days, 20+ sets per week isn’t un- 3. The training interventions needed to last
common for a “high volume” group in a study at least 6 weeks.

107
4. The subjects needed to have at least one versus 20+ sets per week on quad growth, bi-
year of training experience, and be be- ceps growth, and triceps growth. The results
tween 18-35 years old. of these meta-analyses can be seen in Figure 1.
5. The study needed to directly assess hy- As you can see, 20+ sets per week resulted
pertrophy. In other words, it needed to in significantly more triceps growth than 12-
measure changes in muscle thicknesses or 20 sets per week (SMD = 0.50; p < 0.05).
cross-sectional areas, rather than merely Quad growth also tended to be greater with
assessing changes in fat-free mass. 20+ sets per week than 12-20 sets per week
(SMD = 0.20), but the difference wasn’t sta-
6. The study needed to be published in a
tistically significant. Finally, biceps growth
peer-reviewed journal.
wasn’t meaningfully different between the
Six studies met these inclusion criteria. two weekly volume categories.
They’re summarized in Table 1. From this
The present meta-analysis is a bit of a Ror-
figure, you can see why the 2017 Schoenfeld
schach test. You could use it to credibly ar-
meta was unable to provide recommenda-
gue that 20+ sets per muscle group per week
tions for volumes exceeding 10 sets per week
are generally advisable for people aiming to
– five of the six studies investigating relative-
maximize hypertrophy. All pooled effect siz-
ly high training volumes were published in
es at least leaned in favor of higher volumes
2017 or later (and we’ve reviewed three of
producing more muscle growth, and the dif-
those five studies in MASS; one, two, three).
ference in triceps growth cleared the thresh-
After identifying these studies, the research- old for statistical significance. Furthermore,
ers performed a series of random effects me- the study with the longest training interven-
ta-analyses comparing the effects of 12-20 tion (the study by Radaelli and colleagues

108
lasted 24 weeks [3]; all other studies lasted parison may have been influenced by how
6-8 weeks) reported the largest effect sizes the researchers accounted for training vol-
in favor of higher training volumes, which ume. In the present meta-analysis (1), a set
may suggest that the rest of the studies un- of a compound lift that targets a particular
derestimate the “true” superiority of higher muscle was counted as a set of training vol-
training volumes. However, you could also ume for that particular muscle. So, for exam-
use the present meta-analysis to credibly ar- ple, sets of pressing exercises were counted
gue that 12-20 sets per week are plenty, and as sets of triceps training, sets of rows and
drifting up toward 20+ sets per week is likely pull-downs were counted as sets of biceps
unnecessary. Two of the three comparisons training, etc. We know that pressing exer-
reported trivial effect sizes (SMD ≤ 0.20), cises and single-joint triceps exercises target
and the statistically significant triceps com- the triceps differently (4), and we also know

109
that single-joint exercises sometimes result in (1). In other words, if you double your train-
more muscle growth for a particular muscle ing volume from 4 sets per muscle group per
than compound exercises that train the same week to 8 sets per muscle group per week,
muscle (5). So, it’s possible that >20 sets of your rate of muscle growth might approxi-
triceps training only results in more triceps mately double. However, if you double your
growth than 12-20 sets of triceps training training volume from 15 sets per week to 30
when a hefty proportion of your triceps train- sets per week, you probably won’t double
ing comes from pressing exercises, because your rate of muscle growth; maybe your rate
the stimulus provided to the triceps per set is of muscle growth would only increase by
slightly submaximal. If that line of thinking 20%. Basically, doing more than 20 sets per
is correct, it’s therefore possible that 12-20 muscle group per week may help you grow a
sets of direct triceps training (skullcrush- bit more, but you’ll need to weigh the costs
ers, push-downs, etc.) would be sufficient to and benefits for yourself. If you’re fine do-
maximize muscle growth, and doing >20 sets ing twice as much work for slightly better re-
would provide no additional benefit. sults, then more power to you; however, if
you value efficiency (maximizing results per
My personal take is somewhere in the mid-
unit of time and effort invested into training),
dle. I think this meta-analysis, on the whole,
weekly volumes in the 12-20 set range may
suggests that doing >20 sets per muscle group
be more appropriate.
per week will likely lead to a bit more mus-
cle growth than doing 12-20 sets per muscle More importantly, though, I’d encourage you
group per week, but I also think it suggests to use this meta-analysis as a starting point
that ~20 sets per muscle per week is approxi- for your own troubleshooting. Knowing the
mately the average point of rapidly diminish- amount of training volume that works the
ing returns for trained lifters (the threshold best, on average, for the subjects in the six
for novice lifters is likely quite a bit lower). studies included in this meta-analysis is per-
To be clear, diminishing returns aren’t zero fectly fine, but we also know that individual
returns; rather, “diminishing returns” implies volume needs can vary considerably, and per-
that it takes more and more of a particular in- sonalizing training volume tends to produce
put (training volume, in this case) to move better results than one-size-fits-all prescrip-
the needle on your desired outcome (muscle tions (6). Research provides us with a starting
growth). Remember, the Schoenfeld meta-re- point, but directed self-experimentation is
gression suggested that there was a roughly necessary to optimize training volume for the
linear dose-response relationship between individual. You may find that you need con-
training volume and muscle growth with rel- siderably more or considerably less training
atively low training volumes (<10 sets per volume than the average person to maximize
week; 2), but the present meta-analysis sug- your results. If you’re not making progress
gests that with higher set volumes, the mar- and you feel worn down, there’s no harm in
ginal benefit of each additional set is smaller reducing your training volume, even if that

110
means doing less volume than the research 10.1519/JSC.0000000000003550. PMID:
suggests you “should” be doing. Conversely, 32149887.
if you’re not making progress and you still 5. Mannarino P, Matta T, Lima J, Simão
feel fresh most of the time, there’s no harm in R, Freitas de Salles B. Single-Joint
increasing your training volume, even if that Exercise Results in Higher Hypertrophy
means doing more volume than the research of Elbow Flexors Than Multijoint
suggests you “should” need. Exercise. J Strength Cond Res. 2021
Oct 1;35(10):2677-2681. doi: 10.1519/
JSC.0000000000003234. PMID:
References 31268995.
1. Baz-Valle E, Balsalobre-Fernández C, 6. Scarpelli MC, Nóbrega SR, Santanielo N,
Alix-Fages C, Santos-Concejero J. A Alvarez IF, Otoboni GB, Ugrinowitsch
Systematic Review of The Effects of C, Libardi CA. Muscle Hypertrophy
Different Resistance Training Volumes Response Is Affected by Previous
on Muscle Hypertrophy. J Hum Kinet. Resistance Training Volume in Trained
2022 Feb 10;81:199-210. doi: 10.2478/ Individuals. J Strength Cond Res. 2022
hukin-2022-0017. PMID: 35291645; Apr 1;36(4):1153-1157. doi: 10.1519/
PMCID: PMC8884877. JSC.0000000000003558. PMID:
32108724.
2. Schoenfeld BJ, Ogborn D, Krieger JW.
Dose-response relationship between
weekly resistance training volume and
increases in muscle mass: A systematic
review and meta-analysis. J Sports
Sci. 2017 Jun;35(11):1073-1082. doi:
10.1080/02640414.2016.1210197. Epub
2016 Jul 19. PMID: 27433992.
3. Radaelli R, Fleck SJ, Leite T, Leite RD,
Pinto RS, Fernandes L, Simão R. Dose-
response of 1, 3, and 5 sets of resistance
exercise on strength, local muscular
endurance, and hypertrophy. J Strength
Cond Res. 2015 May;29(5):1349-58. doi:
10.1519/JSC.0000000000000758. PMID:
25546444.
4. Brandão L, de Salles Painelli V, Lasevicius
T, Silva-Batista C, Brendon H, Schoenfeld
BJ, Aihara AY, Cardoso FN, de Almeida
Peres B, Teixeira EL. Varying the Order of
Combinations of Single- and Multi-Joint
Exercises Differentially Affects Resistance
Training Adaptations. J Strength Cond
Res. 2020 May;34(5):1254-1263. doi:

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 Study Reviewed: French-Fried Potatoes Consumption and Energy Balance: A Randomized
Controlled Trial. Smith et al. (2022)

French Fries: Completely Vindicated and Back on the

Menu
BY ERIC TREXLER

Observational studies have reported asso- years; weight: 75.6 ± 15.4 kg; BMI: 26.1 ± 4.2
ciations indicating that consumption of tree kg/m2) were randomized in equal proportions
nuts, including almonds, is correlated with to one of three interventions: 1) 300kcal/day
favorable impacts on body weight, body of almonds (roasted and salted); 2) 300kcal/
composition, and several risk factors related day of standard white potato french fries; or
to cardiovascular disease and metabolic syn- 3) 300kcal/day of white potato french fries
drome (2). Conversely, observational studies seasoned with a mixture of herbs and spices.
have suggested that potato consumption is These food items were provided to partici-
associated with unfavorable changes relat- pants in pre-packaged, 300kcal servings, and
ed to body composition and cardiometabolic participants were instructed to incorporate the
outcomes (3), particularly when consumed experimental food servings into their typical
in fried forms (4). Based on observational dietary habits for the duration of the 30-day
studies, one would intuitively assume that an intervention. In other words, the study didn’t
intervention that adds 300kcals worth of al- aim to induce 300kcal/day of “overfeeding,”
monds to an individual’s diet, with no other but merely wanted participants to consume
dietary controls, restrictions, or guidelines, these foods without any other intentional
would yield more favorable body composi- modifications to their diet.
tion and cardiometabolic changes than adding
The most concise way to present these find-
300kcals worth of french fries. However, we
ings is by lumping the potato conditions (reg-
should always seek to corroborate observa-
ular french fries and seasoned french fries)
tional findings with controlled interventions
together, such that both potato interventions
whenever it’s feasible to do so, and that’s ex-
are grouped together and simultaneously
actly what the researchers did in the presently
compared to the almond intervention. You
reviewed study (1).
might be surprised to learn that changes in fat
In this randomized controlled trial, 180 par- mass, measured via DXA, were not signifi-
ticipants (sex: 67.8% female; age: 30.4 ± 8.7 cantly different when comparing potatoes to

112
 a very concise concept review. This broader
discussion has (from my perspective) four
important components, which we’ll explore
in order: 1) how researchers quantify vari-
ables in observational studies; 2) what inde-
pendent variables in observational studies ac-
tually represent; 3) how researchers account
for confounding variables in observational
studies; and 4) how we contextualize and ap-
ply findings from observational studies. Af-
ter exploring these components, we’ll have
a better understanding of why randomized
controlled trials sometimes fail to corrobo-
rate the findings of observational studies, and
how we can sort through contradictory evi-
dence from different types of research.
How Do Researchers Quantify Variables in
almonds (almonds: +230.87 ± 114.01g; po- Observational Studies?
tatoes: +123.73±86.09g; p=0.443). Changes When you come across an observational
in fat mass (in grams) are presented for each study, the first thing to consider is how the
group in Figure 1. When looking at various variables of interest are actually quantified.
outcomes related to glycemic control, results This is particularly relevant in the field of nu-
were statistically non-significant for fasting trition, where accurate quantification of food
glucose (p = 0.985), fasting insulin (p = 0.082), intake is a massive challenge. If you’re doing
insulin resistance (measured via HOMA-IR; a randomized controlled trial in a metabolic
p=0.080), or glycated hemoglobin (HbA1c; p ward, then the process is easy enough: pre-
= 0.269). In summary, there wasn’t much of pare food for the participants, watch them eat
a difference between intentionally increasing it, and weigh whatever goes uneaten. In this
almond intake and intentionally increasing scenario, you have a remarkably precise es-
potato intake, even when potatoes were con- timate of their true dietary intakes during the
sumed in the form of french fries. study period. However, in nearly all other ap-
proaches to nutrition research, there’s some
The utility of this research brief is not restrict-
estimation error involved.
ed to a head-to-head comparison of almonds
and french fries. Rather, this study lends it- You might ask people to complete a retrospec-
self to a broader (and very useful) discussion tive diet log, documenting all of their food and
of how we interpret and apply findings from beverage intakes from the day or the week pri-
observational studies, so the present article is or. The fact that it’s retrospective may reduce
basically a blend between a research brief and the likelihood that participants change their

113
eating behaviors in response to being “under comes to estimating nutrient intakes in obser-
observation,” but also introduces potential er- vational study designs.
ror, as our memories can be imperfect. You
What Do Independent Variables Actually
may ask people to complete a prospective diet
Represent in Observational Studies?
log, in which you ask them to log food over
the course of the next day or week. This mini- The presently reviewed study found that
mizes errors and inaccuracies due to lapses in french fries were pretty benign, whereas
memory, but participants may eat differently plenty of observational studies have asso-
when they’re being observed or completing an ciated fried potato intake with a variety of
atypical logging task that they aren’t used to. deleterious outcomes. Within this context,
it’s important to carefully consider what
In addition, participants might be susceptible
“fried potato intake” actually represents
to “social desirability bias,” in which study
within an observational study design. It’s
participants report habits or behaviors that
very likely that the health-related habits of
might be viewed as favorable by the individu-
a person who eats a lot of french fries very
als reading or scoring the food log or question-
frequently are quite different from someone
naire. For example, a study participant might
who eats french fries rarely and in limited
be more inclined to over-report their intake
quantities. For example, a study by Qi et al
of leafy greens and under-report their intake
found that people who consume more fried
of fried foods and sugar-sweetened beverag-
foods are more likely to smoke, spend more
es, in order to seem like they’re making more
time watching television, consume more
health-conscious choices. sugar-sweetened beverages, consume more
In other studies, it’s common to see question- daily calories, have lower “healthy eating
naires that aim to quantify general nutrition index” values, and complete less physical
habits, which are then used to estimate actual activity (5). Whenever we look at associa-
nutrient intakes. For example, a food frequen- tions between a single food or ingredient and
cy questionnaire might ask you how frequently health outcomes, we have to carefully con-
you’ve been eating fatty fish over the last cou- sider the overall dietary pattern that is asso-
ple of months, then use this to estimate your ciated with that food or ingredient. It would
average daily intake of eicosapentaenoic acid be shortsighted to make inferences about a
(EPA) and docosahexaenoic acid (DHA), the particular food item without considering the
omega-3 fatty acids found in fish oil. While types of meals and eating environments in
these types of questionnaires undergo pretty which it’s most commonly consumed.
rigorous validation processes, there’s obvious- We also have to consider the idea of “healthy
ly a substantial amount of estimation error in- user bias” in nutrition research. The gener-
volved with these retrospective questionnaires al population is constantly bombarded with
assessing fairly broad and imprecise nutrition information about which habits appear to be
tendencies. So, whichever route you take as a healthy, and which appear to be unhealthy.
researcher, there are major challenges when it In theory, observing the most impactful be-

114
haviors that differ between individuals expe- aggregate, differ over a wide range of charac-
riencing positive or negative health outcomes teristics and behaviors. In many cases, differ-
should help us separate health-promoting ences in the consumption of a particular food
behaviors from health-impairing behaviors. or dietary ingredient can be accompanied by
However, once a behavior is categorized differences across a huge list of variables,
and publicized as being “healthy,” health-fo- such as smoking status, alcohol consumption,
cused individuals (who are often in good socioeconomic status, physical activity level,
health already) tend to adopt the behavior. vegetable consumption, and many more. So,
Over the last several years, much of the tree we might find that fried foods are associat-
nut marketing in the United States has fo- ed with negative health outcomes, but if we
cused on framing nuts (like almonds) as ex- don’t do something to deal with these other
tremely healthy foods. In fact, the Harvard variables, it would be very hard to confident-
Health blog included almonds (and other ly state that fried foods are independently
nuts) on their top 10 list of “superfoods” in contributing to the relationship between fried
a post from 2020 (note: due to the transitive food intake and negative health outcomes.
property, I am now considering french fries
That’s where covariates come into play. In
a superfood based on the presently reviewed
much of the observational research, you’ll
study). As a general rule, we have to be care-
find statistical models that use covariates
ful when interpreting observational studies
to adjust for a ton of “other” variables that
involving things that are widely believed to
might be influencing the observed relation-
be healthy; it’s quite possible that people are
ship between the independent variable of in-
healthy because they engage in the behavior,
terest (for example, french fry intake) and the
but it’s also quite possible that they engage in
outcome variable of interest (for example,
the behavior because they’re healthy. Given
weight gain). When you add covariates to
the fact that dietary choices represent voli-
the model, you can quantify the relationship
tional actions, it can be very challenging to
between these covariates and the outcome of
determine which choices are actually driving
interest, which allows you to mathematically
positive outcomes, and these difficulties can isolate the independent relationship between
sometimes lead us astray when leaning heav- the independent variable of interest and the
ily on observational data. outcome. For example, you might want to
How Do Researchers Account for Confound- look at the relationship between fried food
ing Variables in Observational Studies? intake and weight gain, after adjusting for
things like sugar-sweetened beverage intake,
As I alluded to previously, we can’t assume
physical activity, sedentary time, healthy eat-
that the only difference between a frequent
ing index score, and so on.
french fry consumer and an infrequent french
fry consumer is the frequency with which they That’s great, and statistically advisable, but
consume french fries. In reality, we’re prob- we shouldn’t place an unwarranted degree of
ably talking about groups of people who, in faith in the idea that covariates will always

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save the day. As thoroughly described in a variables, and building appropriate statistical
previous MASS article, you can run into sit- models, it can be very difficult to confidently
uations in which the relationship between a identify, isolate, and quantify meaningful re-
covariate and the independent variable of in- lationships among variables. So, let’s move
terest is very strong, and this can become a on to the final component of this conversa-
problem. For example, if you are doing a study tion, which addresses how to navigate these
that compares values between males and fe- discrepancies when attempting to interpret
males, but you use body mass as a covariate, and apply the available evidence.
and all of the males in the sample happen to
How Should We Contextualize and Apply
weigh substantially more than the females in
Findings From Observational Studies?
the sample, what exactly does the variable
“sex” represent after adjustment? If there’s a The hierarchy of evidence isn’t an abstract,
very strong relationship between one or more theoretical concept designed to fuel philo-
of your covariates and your independent vari- sophical debates; it’s a practical tool that we
able, you run the risk of “canceling out” the can use, like a compass that guides us through
independent variable’s relationship with the research interpretation. The forms of research
outcome variable, or applying so much statis- near the top of the hierarchy (randomized
tical adjustment that it’s hard to tangibly de- controlled trials, systematic reviews, and me-
fine what your independent variable actually ta-analyses) are more generalizable and less
represents. All of that is to say, covariates are prone to bias than those near the bottom of
important, and a nuanced statistical model of- the hierarchy. Randomized controlled trials
ten needs them. However, these adjustments give us straightforward opportunities to draw
aren’t foolproof; they can sometimes fail to confident inferences about causation, and
accomplish what they set out to accomplish, meta-analyses of randomized controlled tri-
als take our confidence a step further. How-
and can sometimes have unintended conse-
ever, that doesn’t mean that we’re necessarily
quences that make interpretation challenging.
ordering these types of research from “best”
This is yet another complication of observa-
to “worst.” Each type of research has its own
tional research that has the potential to lead
unique set of pros and cons, and should be
us astray in our interpretation of findings.
interpreted accordingly. For example, case
Now that we’ve covered the first three com- studies have very low generalizability and
ponents of this conversation, it should be high susceptibility to bias, but they allow for
clear that observational research is useful, but a level of depth and detail that’s hard to repli-
has noteworthy limitations, and we shouldn’t cate in other forms of research. Randomized
be totally shocked when there are discrep- controlled trials allow for an exceptional de-
ancies between observational research and gree of control over confounding variables,
randomized controlled trials. Due to major but are often unable to address questions
challenges in quantifying variables effective- that require very extended study timelines,
ly, minimizing the impact of confounding or questions in which applying a potentially

116
dangerous intervention in a treatment group discarded and assumed to be spurious. None-
or withholding standard care in a control theless, randomized controlled trials are still
group would be unethical. They also tend to the gold standard for establishing causation,
be very time, labor, and resource intensive, and the previously discussed limitations of
so controlled trials generally don’t occur un- observational research can sometimes pre-
til observational research has hinted at a test- clude us from drawing robust inferences with
able, worthwhile hypothesis. As a result, we a high probability of successful application.
sometimes have to answer questions without As such, any observational study should be
randomized controlled trials available, which interpreted with these important limitations
increases our reliance on observational re- in mind, and we shouldn’t be shocked when
search for insight. an observational correlation fails to pan out
when it’s put to the test in a randomized con-
Observational studies have some shortcom- trolled trial.
ings, but they allow researchers to explore
questions that might otherwise be hard to In a perfect world, we’d have enough research
address due to ethical constraints, the time available to triangulate the findings from sev-
required for a particular medical condition eral types of studies when interpreting re-
or outcome to develop or manifest, or the search. The best case scenario occurs when we
need for very large sample sizes. Whether have enough consistent evidence to put vari-
they’re smaller-scale cross-sectional stud- ous forms of evidence together to form a co-
ies or larger-scale epidemiological studies, hesive understanding of a topic. For example,
observational studies play an important role there might be a particular dietary ingredient
in establishing scientific knowledge. In fact, that seems to correlate with positive outcomes
observational studies have more utility than a in large-scale observational studies that imple-
lot of fitness and nutrition professionals give ment appropriate statistical techniques. There
them credit for. It’s commonly said that cor- might also be mechanistic studies using human
relation does not necessarily imply causation, cells or animal models that point to a very spe-
and that is true. However, this common phrase cific mechanism that would plausibly explain
is often used in a manner that dramatically this correlation, and randomized controlled
overstates the limitations of observational re- trials in humans demonstrating that increased
search. In reality, much effort has been put intake of this ingredient improves health out-
comes to a clinically relevant degree in tightly
into developing advanced research methods
controlled experimental conditions. Howev-
and statistical techniques for attenuating var-
er, when we have an incomplete body of evi-
ious forms of bias that can obscure or dis-
dence, or a contradictory body of evidence, we
tort causative relationships among variables
have to use the hierarchy of evidence to guide
within observational data (6). In light of the
our interpretation.
statistical advancements that have been made
over the last several decades, high-quality ob- In the absence of randomized controlled tri-
servational findings shouldn’t be carelessly als, observational studies have to be inter-

117
preted very carefully, with a thorough under- and quantity in chronic disease. BMJ. 2018
standing of their limitations. In most cases, Jun 13;361:k2340.
the conclusions we draw from these obser- 4. Aljuraiban GS, Pertiwi K, Stamler J, Chan
vational studies will be considered tentative, Q, Geleijnse JM, Van Horn L, et al. Potato
pending further verification from higher lev- consumption, by preparation method and
els of the hierarchy of evidence. If a well-run meal quality, with blood pressure and body
randomized controlled trial contradicts the mass index: The INTERMAP study. Clin
Nutr. 2020 Oct;39(10):3042–8.
observational research in a given area, as was
observed in the presently reviewed study, we 5. Qi Q, Chu AY, Kang JH, Huang J,
shouldn’t be terribly surprised based on the Rose LM, Jensen MK, et al. Fried food
consumption, genetic risk, and body mass
multifaceted challenges involved with nutri-
index: gene-diet interaction analysis in
tional epidemiology. In such a scenario, we three US cohort studies. BMJ. 2014 Mar
ought to place more confidence in the robust- 19;348:g1610.
ness and generalizability of the controlled
6. Hammerton G, Munafò MR. Causal
trial’s findings, while keeping an eye out for
inference with observational data: the need
successful (or unsuccessful) replication in fu- for triangulation of evidence. Psychol Med.
ture trials and revisiting our conclusions as 2021 Mar;51(4):563–78.
more data become available. For more infor-
mation and resources related to interpretation
and application of research, be sure to check
out our article on the basics of research in-
terpretation, and our two-part video series on
evidence-based practice (one, two).

References
1. Smith DL, Hanson RL, Dickinson SL,
Chen X, Goss AM, Cleek JB, et al. French-
fried potatoes consumption and energy
balance: a randomized controlled trial. Am
J Clin Nutr. 2022 Feb 18; ePub ahead of
print.
2. O’Neil CE, Fulgoni VL, Nicklas TA. Tree
Nut consumption is associated with better
adiposity measures and cardiovascular and
metabolic syndrome health risk factors in
U.S. Adults: NHANES 2005–2010. Nutr J.
2015 Jun 28;14:64.
3. Ludwig DS, Hu FB, Tappy L, Brand-Miller
J. Dietary carbohydrates: role of quality

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 Study Reviewed: Muscle-Strengthening Activities are Associated with Lower Risk and
Mortality in Major Non-Communicable Diseases: A Systematic Review and Meta-Analysis of
Cohort Studies. Momma et al. (2022)

What Is the Optimal Dose of Resistance Training for

Longevity?
BY GREG NUCKOLS

Most of the research we cover in MASS in- municable diseases (1). The researchers start-
vestigates topics related to performance and ed with a systematic literature search, aiming
body composition (MASS does stand for to identify all of the studies that met these in-
Monthly Applications in Strength Sport, af- clusion criteria:
ter all), but many MASS readers are also in-
1. The study needed to employ a prospective
terested in training for health and longevity.
observational design.
We all know that resistance training is gen-
erally “good for you” in a broad sense, but 2. The study needed to have a minimum fol-
we rarely drill down into the specifics. Spe- low-up period of 2 years.
cifically, we rarely consider how much resis-
3. The study needed to examine the rela-
tance training is required to reap the maximal
tionship between resistance training and
health benefits. It may be tempting to assume
the outcomes of interest (mortality and
that if some is good, more is better, but I think
non-communicable disease rates) both in-
we all intuit that there can’t be an indefinite
dependently and in combination with aer-
linear relationship between resistance train-
obic activities.
ing volume and all-cause mortality; I don’t
think anyone believes that lifting for 6 hours 4. The study needed to be published in En-
per day is optimal for health and longevity. glish.
So, what does the dose-response relationship
After extracting the relevant data from the
between resistance training volume and mor-
seven studies meeting these inclusion cri-
tality look like? A recent meta-analysis ad-
teria, the researchers conducted a series of
dressed this very question.
random-effects meta-analyses and meta-re-
The meta-analysis by Momma and colleagues gressions. The first set of meta-analyses in-
aimed to quantify the relationships between vestigated the binary relationship between
weekly resistance training duration and a) resistance training status and the outcomes of
all-cause mortality and b) rates of non-com- interest (i.e., “do people who engage in re-

119
sistance training have a lower all-cause mor- that this is a very reliable relationship. You
tality rate than people who don’t engage in can see these results in Figure 1.
resistance training?”). The meta-regressions
The dose-response meta-regressions suggest
investigated the non-linear dose-response re-
that ~30-60 minutes of resistance training
lationship between weekly resistance training
per week is associated with the largest risk
duration and the outcomes of interest. Final-
ly, the last set of meta-analyses compared the reduction for all-cause mortality, cardio-
effects of aerobic training alone, resistance vascular disease incidence, and cancer rates
training alone, and a combination of resis- (Figure 2). Furthermore, for these three out-
tance and aerobic training on the outcomes comes, there appear to be no risk reductions
of interest. (and possible increases in risk) for individ-
uals performing more than 130-140 minutes
Starting with the binary meta-analyses, peo- of resistance training per week. On the other
ple who performed resistance training had hand, diabetes risk seems to progressively
significantly (p < 0.05) lower rates of all- decrease as the total duration of weekly re-
cause mortality, cardiovascular disease, total sistance training increases, though the rate at
cancer, and diabetes than people who did not
which risk decreases begins to flatten out at
perform resistance training (with average risk
durations exceeding 60 minutes per week.
reductions of 12-17%). Importantly, the point
estimates of every study suggested that resis- Finally, a combination of aerobic and re-
tance training was associated with lower risk sistance training was associated with lower
for all outcomes of interest, demonstrating mortality and disease risk than either aerobic

120
or resistance training in isolation. These dif- of people in a variety of circumstances. For
ferences were significant in some cases (all- example, if a friend, family member, or po-
cause mortality and cardiovascular disease tential client is interested in getting into re-
mortality), and non-significant in others (total sistance training, they may be concerned that
cancer mortality and colon cancer incidence). they’ll need to live in the gym to reap nota-
However, all of these comparisons were based ble benefits. However, you can tell them that
on just two or three studies, so we should in- they’ll likely reap most of the health benefits
terpret these results pretty tentatively. with just 30-60 minutes of resistance training
per week, thus massively reducing the per-
Depending on your perspective, these re-
ceived barrier to starting. Similarly, plenty of
sults may be seen as either very hopeful (“it
serious lifters find it hard to keep up their de-
doesn’t take much resistance training to reap
sired training schedule due to changes in life
the health benefits!”) or somewhat scary (“oh
circumstances (for example, starting a new
no! I do more than 140 minutes of resistance
job with punishing hours, or having kids).
training per week. Am I in trouble?”). I’ll
They may want to keep lifting for health
start by addressing the hopeful perspective.
reasons, but they aren’t sure if cutting their
Overall, this meta-analysis offers a perspec- weekly training time from 4 hours to 1 hour
tive that may be really helpful for a variety will result in a resistance training dose that’s

121
even worthwhile. Again, this meta-analysis meta-analysis suggests that such a training
suggests that just 30-60 minutes of resistance dose may actually be associated with higher
training per week is associated with a host all-cause mortality risk, cardiovascular dis-
of positive health and longevity outcomes, ease risk, and total cancer risk. So, how con-
meaning that a considerable reduction in cerned should you be?
training volume will still result in a worth-
I’d like to be able to say that you don’t need
while and meaningful dose of training.
to be concerned at all (that would certainly
Conversely, I suspect that most MASS read- fit my biases), but this isn’t the first time that
ers probably engage in resistance training for such a relationship has been observed. For
more than 130-140 minutes per week. This example, Kamada and colleagues found that

122
all-cause mortality rates were lowest in older cal knee-jerk response when confronted with
women performing around 82 minutes of re- associations: if an association supports what
sistance training per week, with increased risk you want to believe, it’s probably meaningful
observed in women performing more than and indicative of underlying causality, but if
146 minutes of resistance training per week an association doesn’t support what you want
(2). Similarly, Liu and colleagues found that to believe, it’s probably a spurious or con-
cardiovascular disease events, morbidity, and founded correlation that can be disregarded. I
mortality were lowest in people performing would caution against disregarding the possi-
two resistance training sessions per week, ble increases in mortality and disease risk ob-
with potential increases in risk for people served in this meta-analysis, though. Doing
performing four or more resistance training so would probably just be the result of lazy,
sessions per week (3). Patel and colleagues motivated reasoning (which we try to avoid
had similar findings: all-cause mortality and in MASS), and this is probably not a topic
cancer risk were lowest in people who per- where we’re likely to see any high-quality,
formed >0 and <2 hours of resistance train- long-term randomized controlled trials. First,
ing per week, while cardiovascular disease there are logistical constraints: you’d need
risk was lowest in people who performed >0 to be able to recruit a large enough cohort of
hours and <1 hour of resistance training per subjects, and maintain a low enough dropout
week (4). Now, to be fair, these three studies rate over a long enough period of time for the
were all included in the present meta-analy- results to be worthwhile. Second, there are
sis, but it is worth noting that the J-shaped ethical constraints: if you have reason to be-
relationship between resistance training dose lieve that a high dose of resistance training
and mortality risk doesn’t appear to merely will increase all-cause mortality risk, you’ll
be an artifact that only appears when pool- probably have a hard time getting ethical ap-
ing a bunch of different studies together; it proval for an RCT that aims to confirm that
also appears independently in a variety of high levels of resistance training cause mor-
different cohorts (subjects from the Wom- tality rates to increase. So, given these con-
en’s Health Study, the Aerobics Center Lon- straints, we probably need to seriously grap-
gitudinal Study, and the Cancer Prevention ple with observational data, because that’s
Study-II Nutrition Cohort). probably the best data we’re going to get.
However, it’s also worth mentioning that the With all of that said, there’s one major reason
studies included in the present meta-analy- to be skeptical that these results will gener-
sis were all observational in nature. In other alize to all MASS readers: the studies in this
words, they tell us the relationships between meta-analysis mostly used older subjects. It’s
resistance training dose and mortality/disease entirely possible that the optimal dose of re-
risk, but they can’t tell us that the resistance sistance training for older adults is a lot lower
training dose causes the observed reductions than the optimal dose of resistance training
and elevations in risk. I think there’s a typi- for younger adults. For example, oxidative

123
stress and generalized inflammation like- it’s entirely possible that people start working
ly contribute to biological aging, and older out like crazy after they’ve been told they’re
adults have higher levels of oxidative stress at high risk for disease or imminent death. In
and generalized inflammation (5). Resistance other words, doing a lot of resistance training
training causes oxidative stress and inflam- might causally reduce your risk of disease or
mation in a dose-dependent manner, but this early death, but it might also be associated
is generally a good thing – those stressors are with increased risk, because the people who
triggers for training-induced adaptations, and are doing a ton of resistance training system-
they also trigger your body to ramp up en- atically differ from the people doing a bit less
dogenous antioxidant production so that you resistance training.
can better handle future stressors (resulting
To be clear, I just think we need to approach
in net reductions in inflammation and oxi-
the findings of this meta-analysis carefully,
dative stress at rest (6). However, excessive
and give them serious consideration. I don’t
training doses can induce too much oxidative
think we should go with the (completely un-
stress and inflammation, setting the stage for
derstandable) knee-jerk response of assuming
a variety of deleterious outcomes (which we
that these associations are all spurious, but I
tend to collectively refer to as “overtrain-
certainly don’t think we should catastroph-
ing” (7). It’s entirely possible – likely, even
ize resistance training for older adults. Until
– that the threshold between productive train-
more research is published, I’m in wait-and-
ing-induced stress and unproductive train-
see mode.
ing-induced stress is considerably lower in
older adults than younger adults. As a result, So, here are my personal takeaways from this
a pretty low training dose (30-60 minutes meta-analysis:
per week) may provide the average optimal
1. Most of the health benefits of resistance
amount of stress for older adults (resulting
training can be realized with a surprising-
in net decreases in inflammation and oxida-
ly low dose: just 30-60 minutes per week.
tive stress), with a larger-but-still-reasonable
However, higher doses may be beneficial
training dose (130-140 minutes per week)
for diabetes prevention.
representing an excessive stressor for many
older trainees, thus contributing to a net ac- 2. A combination of resistance and aerobic
celeration of biological aging, secondary to a training likely reduces rates of all-cause
net increase in general inflammation and ox- mortality and non-communicable disease
idative stress. Don’t take this explanation too than resistance training alone.
literally, though – it’s just one of many po-
3. Older adults may want to be careful about
tential explanations for the present findings.
doing more than ~2-2.5 hours of resis-
There are also other non-causal explanations tance training per week. At minimum, it
for the dose-response relationships observed may be something worth discussing with
in the present meta-analysis. For example, your doctor.

124
4. For younger adults, it’s unknown if rel- pathological considerations. Am J
atively high resistance training doses are Physiol Regul Integr Comp Physiol.
associated with deleterious health or mor- 2007 Jan;292(1):R18-36. doi: 10.1152/
ajpregu.00327.2006. Epub 2006 Aug 17.
tality outcomes.
PMID: 16917020.

References 6. Ismaeel A, Holmes M, Papoutsi E, Panton

L, Koutakis P. Resistance Training,
1. Momma H, Kawakami R, Honda T, Antioxidant Status, and Antioxidant
Sawada SS. Muscle-strengthening activities Supplementation. Int J Sport Nutr Exerc
are associated with lower risk and mortality Metab. 2019 Sep 1;29(5):539-547. doi:
in major non-communicable diseases: a 10.1123/ijsnem.2018-0339. PMID:
systematic review and meta-analysis of 30859847.
cohort studies. Br J Sports Med. 2022 Feb 7. Smith LL. Cytokine hypothesis of
28:bjsports-2021-105061. doi: 10.1136/ overtraining: a physiological adaptation
bjsports-2021-105061. Epub ahead of print. to excessive stress? Med Sci Sports
PMID: 35228201. Exerc. 2000 Feb;32(2):317-31. doi:
2. Kamada M, Shiroma EJ, Buring JE, 10.1097/00005768-200002000-00011.
Miyachi M, Lee IM. Strength Training PMID: 10694113.
and All-Cause, Cardiovascular Disease,
and Cancer Mortality in Older Women:
A Cohort Study. J Am Heart Assoc. 2017
Oct 31;6(11):e007677. doi: 10.1161/
JAHA.117.007677. PMID: 29089346;
PMCID: PMC5721806.
3. Liu Y, Lee DC, Li Y, Zhu W, Zhang R,
Sui X, Lavie CJ, Blair SN. Associations of
Resistance Exercise with Cardiovascular
Disease Morbidity and Mortality. Med Sci
Sports Exerc. 2019 Mar;51(3):499-508.
doi: 10.1249/MSS.0000000000001822.
PMID: 30376511; PMCID: PMC7385554.
4. Patel AV, Hodge JM, Rees-Punia
E, Teras LR, Campbell PT, Gapstur
SM. Relationship Between Muscle-
Strengthening Activity and Cause-Specific
Mortality in a Large US Cohort. Prev
Chronic Dis. 2020 Aug 6;17:E78. doi:
10.5888/pcd17.190408. PMID: 32762807;
PMCID: PMC7417019.
5. Kregel KC, Zhang HJ. An integrated
view of oxidative stress in aging: basic
mechanisms, functional effects, and

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 Study Reviewed: Hypohydration but Not Menstrual Phase Influences Pain Perception in
Healthy Women. Tan et al. (2022)

Even Mild Dehydration May Increase Subjective Pain

and Fatigue During Exercise
BY ERIC TREXLER

Research has suggested that even mild hypo- The presently reviewed study (1) investigat-
hydration (~1% reduction of body mass due ed the impact of mild hypohydration on pain
to water loss) increases pain sensitivity during sensitivity in a crossover trial, with two visits
the cold pressor test (2), which involves occurring in the early follicular phase, and the
dunking your hand into ice water to acutely other two visits occurring in the mid-luteal
induce pain. While the cold pressor test may phase of the menstrual cycle. One visit within
not be perfectly reflective of the type of pain each menstrual phase was completed in a eu-
experienced during vigorous exercise, other hydrated state, and the other was completed
research has reported that dehydrated athletes in a hypohydrated state. Hypohydration was
reported lower subjective vigor and higher induced by restricting intake of fluids and
ratings of fatigue and pain compared to euhy- foods with high water content for 24 hours
drated athletes during an ultra-endurance cy- prior to hypohydration visits; this resulted in
cling event (3). Nonetheless, ultra-endurance a weight reduction of ~0.9% of body mass,
events are still quite different from the repet- and hydration status was verified via serum
itive pattern of forceful muscle actions asso- osmolality and urine specific gravity testing.
ciated with resistance exercise. Furthermore,
The study was completed by 17 healthy, eu-
much of the research exploring pain sensitiv-
menorrheic women who had not used hor-
ity and hypohydration has been carried out
monal contraceptives within the prior six
using male samples. This is important be-
months (age: 28 ± 8 years; height: 1.63 ±
cause hormones that fluctuate throughout the
0.07 meters; weight: 65.0 ± 10.8 kg). Pain
menstrual cycle influence fluid balance. Giv-
was induced by an ischemic pain test using
en that total body water fluctuates throughout
the Submaximal Effort Tourniquet Proce-
the menstrual cycle, it’s possible that suscep-
dure. A pneumatic cuff was applied to the
tibility to mild hypohydration and associated
participant’s upper arm (just above the elbow
increases in pain sensitivity may vary across
joint), and the arm was raised for 30 seconds
the menstrual cycle.
to promote venous drainage. After that, the

126
cuff was inflated to a pressure of 250mmHg age of 13%. Hypohydration also increased
(which is generally sufficient for arterial oc- post-exercise pain unpleasantness by an av-
clusion), the arm was lowered to rest on a erage of 12%, while reducing pain tolerance
table with the elbow fixed at a 90 degree an- (the duration of the ischemic test, prior to vo-
gle, and participants completed 25 gripping litional termination) by about 8%. In all three
actions at 30% of their maximal hand grip cases, findings were statistically significant
force. Each contraction was held for 2 sec- (p < 0.05). Menstrual cycle phase significant-
onds, followed by 2 seconds of rest, and sub- ly impacted thirst ratings (with higher thirst
jective post-exercise pain was assessed using ratings observed in the mid-luteal phase), but
a visual analog scale. After the contractions, did not significantly impact pain outcomes or
participants rested (with the cuff still applied significantly modify the relationship between
and inflated) until they could no longer tol- hypohydration and pain outcomes. Hypohy-
erate the ischemic pain and terminated the dration significantly increased thirst ratings,
ischemia test. To assess the impact of acute and acute water ingestion significantly re-
water ingestion, participants consumed wa- duced thirst, with a large effect observed in
ter (5mL/kg of baseline body mass) after the the hypohydrated condition compared to the
first ischemia test, rested for 30 minutes, and euhydrated condition. Nonetheless, acute
repeated the testing as described. water ingestion did not significantly influ-
ence pain tolerance, and unexpectedly led to
Results indicated that mild hypohydration
increases in ratings of pain intensity and pain
(~0.9% loss of body mass) increased self-re-
unpleasantness. Group-level and individu-
ported post-exercise pain sensitivity, as mea-
al-level pain tolerance data are presented in
sured by a visual analog scale, by an aver-
Figure 1; while there does appear to be one

127
noteworthy outlier for this outcome, I don’t sarily conclude that your vitamin C intake is
suspect this observation meaningfully im- perfect because you don’t have scurvy yet, or
pacts our interpretation of the collective re- that your hydration level is adequate because
sults from this study. you haven’t noticed any overt symptoms of
severe dehydration. There’s ample justifica-
Within the evidence-based fitness space, I
tion (4) for the suggestion that regular exer-
think there’s an interesting discrepancy be-
cisers should aim for micronutrient intakes
tween how we tend to discuss factors that have
that optimize health and function, rather than
direct versus indirect effects on our progress.
bare minimums to stave off severe malnutri-
For example, you can find countless articles
and discussions exploring every detail of pro- tion, and hydration should be approached in
tein intake: amino acid profile, digestibility, a similar manner.
absorption speed, frequency, timing, daily A growing body of research, including the
targets, and so on. The same can be said for presently reviewed study, indicates that even
carbohydrates, with plenty of discussion sur- mild hypohydration can significantly in-
rounding starches, sugars, fibers, glycemic crease pain perception across a broad range of
index, glycemic load, peri-workout timing, pain-inducing tasks, including (but not limit-
relationships between exercise intensity and ed to) tasks involving exercise. Based on the
carbohydrate demands, and so on. People as- evidence available, this observation seems to
sess the adequacy of their protein intake based apply irrespective of menstrual cycle phase
on hypertrophy optimization, and assess the or biological sex. In addition, hypohydration
adequacy of their carb intake based on perfor- (3.2% weight loss) was found to significantly
mance optimization; the conversation is about increase fatigue perception following leg ex-
maximization and optimization, not the pre- tension exercise and to significantly reduce
vention of malnutrition symptoms. repetitions (by about 28%) completed during
There’s a huge divergence when we shift our a leg extension test using 85% of maximal
focus toward the boring stuff, like micronu- voluntary isometric contraction torque (5).
trients and hydration. On one hand, this di- In the same study, isometric peak torque was
vergence could be viewed as a positive thing; not significantly impacted by hypohydration;
I generally discourage people from obsessing however, as Greg noted in a previous MASS
over small stuff, and the inclination to get article, it’s common for studies to use sim-
wrapped up in the minor details of nutrition is ple, single-joint muscle actions when assess-
pretty pervasive. I think a lot of strategies that ing the impact of hypohydration on maximal
fall under the “biohacking” umbrella promote strength. Hypohydration has generally been
an unjustified degree of fixation on extremely found to negatively impact tasks that involve
minor details of nutrition, and often put forth endurance, repeated efforts, and technical
speculative solutions with limited evidence sport-specific skills (5); as a result, I suspect
to support practically meaningful effects. On that even mild hypohydration could nega-
the other hand, I don’t think we should neces- tively impact the repeated actions observed

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in a typical resistance training session or the substantially based on environment, exercise
highly skilled movements involved in com- habits, and inter-individual differences. My
petitive strength sports. In addition, the im- personal approach is to begin with 3-4 liters
pact of hypohydration on subjective indices per day (per common guidelines for the gen-
of mood state, fatigue, and pain may inflate eral population), while aiming to maintain
perceived exertion, which could potentially a suitable urine color throughout the entire
have a noteworthy impact on autoregulated day. If you’re doing a ton of exercise in the
training programs that rely on ratings of per- heat, spending much of the day in a hot en-
ceived exertion to dictate program changes. vironment, or you just have a naturally high
In summary, there are plenty of reasons to pri- sweat rate, then 3-4 liters might not get the
oritize hydration in order to optimize training job done, and that’ll become quickly appar-
and performance. In addition, research sug- ent based on your thirst response and the col-
gests that mild hypohydration is extremely or and volume of your urine.
common among athletes (6), and that drink- Note that “throughout the entire day” is an im-
ing to merely attenuate thirst is often an in- portant detail in the hydration conversation;
sufficient strategy for replacing sweat losses there is a temporal component to hydration
from exercise (7). As a result, it makes sense status, and drinking a gallon of water per day
to allocate a little bit of attention to hydra- doesn’t do much good if you’re staring at the
tion status if your aim is to optimize your jug most of the day, then chugging it at night
performance (and subjective experience) in to hit your daily target. In such a scenario, you
the gym. Fortunately, supporting optimal hy- spent most of your day dehydrated, despite
dration status isn’t particularly complicated achieving a total daily intake of one gallon.
or challenging. Best practices would involve making an ef-
For the general population, fluid intake guide- fort to consume at least a glass or two of wa-
lines typically recommend ~4 liters per day ter upon waking, and maintaining euhydration
for males and ~3 liters per day for females. throughout the entire day rather than playing
The discrepancy between sexes is largely re- “catch-up” in the evening. Similarly, it’s not
lated to differences in body size and fat-free a bad idea to have another glass or two of wa-
mass, but these rough recommendations are ter prior to exercise, as sweat losses are likely
typically suitable for the general population. to accelerate when exercise is initiated. The
It’s also important to recognize that these val- magnitude of sweat loss during exercise will
ues reflect total fluid intake; for most people vary substantially from person to person and
on balanced diets, around 20% of total fluid scenario to scenario, but an easy target to sup-
intake comes from food, with the remaining port adequate hydration is to consume enough
80% coming from beverages. It’s difficult to fluid to replace sweat losses. If you’re losing
make one-size-fits-all hydration recommen- (or gaining) a significant amount of weight
dations, as hydration can be hard to quantify from before your workout to after, you’ll want
in real-world settings, and sweat rates vary to revise your hydration strategy in order to

129
 References
maintain approximate weight stability. Final-
ly, if you’re losing considerable amounts of
sweat during exercise, you might also con- 1. Tan B, Philipp MC, Che Muhamed
sider adding some electrolytes to your bever- AM, Mündel T. Hypohydration but not
age, as we lose both water and electrolytes in menstrual phase influences pain perception
sweat. However, this strategy probably isn’t in healthy women. J Appl Physiol. 2022
Mar 1;132(3):611–21.
particularly relevant unless you’re doing very
high-volume endurance exercise, training in 2. Ogino Y, Kakeda T, Nakamura K, Saito
a very hot environment, or consuming a rela- S. Dehydration enhances pain-evoked
activation in the human brain compared
tively electrolyte-depleted diet.
with rehydration. Anesth Analg. 2014
In conclusion, evidence suggests that mild Jun;118(6):1317–25.
hypohydration is common among athletes (in 3. Moyen NE, Ganio MS, Wiersma LD,
addition to the general population), and that Kavouras SA, Gray M, McDermott BP,
it can increase subjective pain and fatigue et al. Hydration status affects mood state
during exercise while impairing performance and pain sensation during ultra-endurance
for a variety of exercise tasks. Most individ- cycling. J Sports Sci. 2015;33(18):1962–9.
uals are able to maintain an euhydrated state 4. Tardy AL, Pouteau E, Marquez D, Yilmaz
with 3-4 liters per day of water intake, but in- C, Scholey A. Vitamins and Minerals
dividualization is important due to differences for Energy, Fatigue and Cognition: A
in sweat losses from person to person. It’s not Narrative Review of the Biochemical and
Clinical Evidence. Nutrients. 2020 Jan
particularly hard to monitor and maintain eu- 16;12(1):228.
hydration, but mild hypohydration may go en-
tirely unnoticed if you aren’t paying attention 5. Barley OR, Chapman DW, Blazevich
AJ, Abbiss CR. Acute Dehydration
to it. Best practices for optimizing hydration
Impairs Endurance Without Modulating
status involve prioritizing fluid throughout Neuromuscular Function. Front Physiol.
the entire day (which would include making 2018 Nov 2;9:1562.
an effort to consume some fluid shortly after
6. Chapelle L, Tassignon B, Rommers N,
waking), monitoring thirst perception, urine
Mertens E, Mullie P, Clarys P. Pre-exercise
output, and urine color throughout the day, hypohydration prevalence in soccer
consuming some pre-exercise fluid to pro- players: A quantitative systematic review.
mote adequate hydration during your work- Eur J Sport Sci. 2020 Jul;20(6):744–55.
out, and replacing enough fluid during and
7. McDermott BP, Anderson SA, Armstrong
immediately after your workout to maintain a LE, Casa DJ, Cheuvront SN, Cooper L, et
relatively stable body weight. By implement- al. National Athletic Trainers’ Association
ing these very simple approaches, you can Position Statement: Fluid Replacement for
individualize your fluid intake to meet your the Physically Active. J Athl Train. 2017
hydration needs in a manner that is easy and Sep;52(9):877–95.
virtually free of cost.

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 VIDEO: Intrasession Cooling
BY MICHAEL C. ZOURDOS

Many strategies are aimed at increasing rep performance. However, one of

those strategies, body cooling, doesn’t get a lot of press in the lifting world.
This video breaks down the efficacy of intrasession body cooling to increase
rep performance and provides details on how to implement the practice.
Click to watch Michael's presentation.

131
Relevant MASS Videos and Articles
1. Be Cool…Literally. Volume 3 Issue 10.

References
2. Nybo L, Nielsen B. Hyperthermia and central fatigue during prolonged exercise in humans.
Journal of applied physiology. 2001 Sep 1;91(3):1055-60.
3. Douzi W, Dugué B, Vinches L, Al Sayed C, Hallé S, Bosquet L, Dupuy O. Cooling during
exercise enhances performances, but the cooled body areas matter: A systematic review with meta-
analyses. Scandinavian journal of medicine & science in sports. 2019 Nov;29(11):1660-76.
4. Latella C, Grgic J, Van der Westhuizen D. Effect of Interset Strategies on Acute Resistance
Training Performance and Physiological Responses: A Systematic Review. The Journal of
Strength & Conditioning Research. 2019 Jul 1;33:S180-93.
5. Bacon NT, Wingo JE, Richardson MT, Ryan GA, Pangallo TC, Bishop PA. Effect of two
recovery methods on repeated closed-handed and open-handed weight-assisted pull-ups. The
Journal of Strength & Conditioning Research. 2012 May 1;26(5):1348-52.
6. Galoza P, Sampaio-Jorge F, Machado M, Fonseca R, Silva PA. Resistance exercise inter-set
cooling strategy: effect on performance and muscle damage. International journal of sports
physiology and performance. 2011 Dec 1;6(4):580-4.
7. Kwon YS, Robergs RA, Kravitz LR, Gurney BA, Mermier CM, Schneider SM. Palm cooling
delays fatigue during high-intensity bench press exercise. Medicine & Science in Sports &
Exercise. 2010 Aug 1;42(8):1557-65.
8. Kwon YS, Robergs RA, Mermier CM, Schneider SM, Gurney AB. Palm cooling and heating
delays fatigue during resistance exercise in women. The Journal of Strength & Conditioning
Research. 2015 Aug 1;29(8):2261-9.
9. Grahn DA, Cao VH, Nguyen CM, Liu MT, Heller HC. Work volume and strength training
responses to resistive exercise improve with periodic heat extraction from the palm. The Journal
of Strength & Conditioning Research. 2012 Sep 1;26(9):2558-69.
10. Caruso JF, Barbosa A, Erickson L, Edwards R, Perry R, Learmonth L, Potter WT. Intermittent
palm cooling’s impact on resistive exercise performance. International journal of sports
medicine. 2015 Oct;94(10):814-21.
11. 10. Gianoni RL, Pereira PE, Azevedo PH. Different cooling strategies between sets for 30
seconds does not have beneficial effect on resistance exercise with blood flow restriction.
Journal of Physical Education. 2020 Apr 9;31.
12. Esteves GJ, Garcia RA, Azevedo PH. Different Cooling Strategies Applied During Inter-Set
Rest Intervals in High-Intensity Resistance Training. International Journal of Exercise Science.
2021;14(2):295.

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13. Yamane M, Ohnishi N, Matsumoto T. Does Regular Post-exercise Cold Application Attenuate
Trained Muscle Adaptation? Int J Sports Med. 2015 Jul;36(8):647-53.
14. Fyfe JJ, Broatch JR, Trewin AJ, Hanson ED, Argus CK, Garnham AP, Halson SL, Polman
RC, Bishop DJ, Petersen AC. Cold water immersion attenuates anabolic signaling and skeletal
muscle fiber hypertrophy, but not strength gain, following whole-body resistance training.
Journal of Applied Physiology. 2019 Nov 1;127(5):1403-18.
15. Roberts LA, Raastad T, Markworth JF, Figueiredo VC, Egner IM, Shield A, Cameron-Smith D,
Coombes JS, Peake JM. Post-exercise cold water immersion attenuates acute anabolic signalling
and long-term adaptations in muscle to strength training. The Journal of physiology. 2015 Sep
15;593(18):4285-301.

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 VIDEO: Principles of Exercise
Selection
BY ERIC HELMS

The principles underlying exercise selection, such as specificity and variety,

are so well established that conversations don’t include reference to specific
studies. Thus, these concepts are discussed conceptually rather than
empirically, with frequent disagreements as to how they apply. In this video we
break down the concepts with illustrative research, enhancing your ability to
make well-informed exercise selection decisions.
Click to watch Eric's presentation.

134
Relevant MASS Videos and Articles
1. VIDEO: The Power of Choice: Self-Determination and Exercise Selection. Volume 1, Issue 9.
2. VIDEO: Understanding Specificity. Volume 4, Issue 3.
3. Variety is the Spice of Life: If You Want Well-Rounded Triceps Growth, You Need Both
Compound and Single-Joint Exercises. Volume 4, Issue 5.
4. Do You Need to Incline Press to Build your Upper Chest? Volume 4, Issue 11.
5. VIDEO: Exercise Type and Proximity to Failure and Fatigue/Damage. Volume 5, Issue 3.
6. Does Exercise Variety Affect Regional Hypertrophy Responses?. Volume 5, Issue 3.
7. VIDEO: Minimum Effective Dose Training Part 1.Volume 5, Issue 8.
8. Squats are Great, but Bodybuilders Need More. Volume 5, Issue 9.

References
1. Rossi, F. E., Schoenfeld, B. J., Ocetnik, S., Young, J., Vigotsky, A., Contreras, B., et al. (2018).
Strength, body composition, and functional outcomes in the squat versus leg press exercises.
The Journal of sports medicine and physical fitness, 58(3), 263–270.
2. Androulakis-Korakakis, P., Michalopoulos, N., Fisher, J. P., Keogh, J., Loenneke, J. P.,
Helms, E., et al. (2021). The Minimum Effective Training Dose Required for 1RM Strength in
Powerlifters. Frontiers in sports and active living, 3, 713655.
3. Chua, L. K., Dimapilis, M. K., Iwatsuki, T., Abdollahipour, R., Lewthwaite, R., & Wulf, G.
(2019). Practice variability promotes an external focus of attention and enhances motor skill
learning. Human movement science, 64, 307–319.
4. Fonseca, R. M., Roschel, H., Tricoli, V., de Souza, E. O., Wilson, J. M., Laurentino, G. C., et
al. (2014). Changes in exercises are more effective than in loading schemes to improve muscle
strength. Journal of strength and conditioning research, 28(11), 3085–3092.
5. Chilibeck, P. D., Calder, A. W., Sale, D. G., & Webber, C. E. (1998). A comparison of strength
and muscle mass increases during resistance training in young women. European journal of
applied physiology and occupational physiology, 77(1-2), 170–175.
6. de Camargo, J., Braz, T. V., Batista, D. R., Germano, M. D., Brigatto, F. A., & Lopes, C. R.
(2020). Dissociated Time Course of Indirect Markers of Muscle Damage Recovery Between
Single-Joint and Multi-joint Exercises in Resistance-Trained Men. Journal of strength and
conditioning research, Published Ahead of Print.
7. Soares, S., Ferreira-Junior, J. B., Pereira, M. C., Cleto, V. A., Castanheira, R. P., Cadore, et al. (2015).
Dissociated Time Course of Muscle Damage Recovery Between Single- and Multi-Joint Exercises in
Highly Resistance-Trained Men. Journal of strength and conditioning research, 29(9), 2594–2599.

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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. If you want to peruse our full journal sweep,
you can find it here, and you can find our historical archive here.

1. Hackett. Acute impairment in respiratory muscle strength following a high-volume versus

low-volume resistance exercise session
2. Maté-Muñoz et al. Analysis of the Use and Applicability of Different Variables for the
Prescription of Relative Intensity in Bench Press Exercise
3. Cordingley et al. Anti-Inflammatory and Anti-Catabolic Effects of Creatine Supplementation:
A Brief Review
4. Zafeiridis et al. Brain oxygenation during multiple sets of isometric and dynamic resistance
exercise of equivalent workloads: Association with systemic haemodynamics
5. Potter et al. Circumference-Based Predictions of Body Fat Revisited: Preliminary Results
From a US Marine Corps Body Composition Survey
6. Azevedo et al. Effect of different eccentric tempos on hypertrophy and strength of the
lower limbs
7. Dorhout et al. Effects and contextual factors of a diet and resistance exercise intervention
vary across settings: an overview of three successive ProMuscle interventions
8. Unterberger er al. Effects of an increased habitual dietary protein intake followed by
resistance training on fitness, muscle quality and body composition of seniors: A
randomised controlled trial
9. Bergamasco et al. Effects of Blood Flow Restriction Combined With Resistance Training
or Neuromuscular Electrostimulation on Muscle Cross-Sectional Area
10. Barreto et al. Effects of caffeine chewing gum supplementation on exercise performance:
A systematic review and meta-analysis
11. Hong et al. Effects of compression garment on muscular efficacy, proprioception, and
recovery after exercise-induced muscle fatigue onset for people who exercise regularly
12. Devise et al. Effects of Different Hangboard Training Intensities on Finger Grip Strength,
Stamina, and Endurance
13. Hu et al. Effects of Transcranial Direct Current Stimulation on Upper Limb Muscle Strength
and Endurance in Healthy Individuals: A Systematic Review and Meta-Analysis
14. Oliveira et al. Extracellular Buffering Supplements to Improve Exercise Capacity and
Performance: A Comprehensive Systematic Review and Meta-analysis
15. Senna et al. Higher Muscle Damage Triggered by Shorter Inter-Set Rest Periods in Volume-

136
 Equated Resistance Exercise
16. Fisher et al. Intensity of effort and momentary failure in resistance training: Are we asking a
binary question for a continuous variable?
17. Faria et al. Melatonin Potentiates Exercise-Induced Increases in Skeletal Muscle PGC-1α
and Optimizes Glycogen Replenishment
18. Khoramipour et al. Metabolomics in Exercise and Sports: A Systematic Review
19. Almquist et al. No Differences Between 12 Weeks of Block- vs. Traditional-Periodized
Training in Performance Adaptations in Trained Cyclists
20. Mauricio et al. Rapid Weight Loss of Up to Five Percent of the Body Mass in Less Than
7 Days Does Not Affect Physical Performance in Official Olympic Combat Athletes With
Weight Classes: A Systematic Review With Meta-Analysis
21. Hammarstöm et al. Ribosome accumulation during early phase resistance training in
humans
22. Henselmans et al. The Effect of Carbohydrate Intake on Strength and Resistance Training
Performance: A Systematic Review
23. Alix-Fages et al. The role of the neural stimulus in regulating skeletal muscle hypertrophy

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 Thanks for
reading MASS.
The next issue will be released to
subscribers on June 1, 2022.

Copy editing by Lauren Colenso-Semple

Graphics and layout by Kat Whitfield

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