Barbell Medicine - From Bench to Bedside
By Jordan Feigenbaum MS, Starting Strength Staff, CSCS, HFS, USAW Club Coach

After explaining these same issues over and over again literally hundreds of times in great detail, I figured I’d put up an abridged version for the ADHD/4 hour work week crowd. These 5 common fallacies have been around too damn long and they need to die a quick death like mini discs, the Pontiac Aztec,  and competitive aerobics (this actually may still be going on, see non-competitive “CrossFit*”

  1. Insulin is the devil.
    • Insulin gets a bad rap from the carbophobes, particularly those in the self-educated blogger demographic. Most claims center around insulin going up causing bad things, like making more fat tissue (de novo lipogenesis), increasing water retention (through increased aquaporin-1 synthesis in the collecting tubule), and a bevy of other nefarious activities. The most popular party line tends to be something like: “Insulin is released when you eat carbs. Insulin causes you to store fat and prevent you from burning it. Insulin is bad. Therefore, don’t eat carbs. Science!”  Not so fast there, Skippy. Insulin, a peptide hormone released from beta cells of the mistress of the abdomen, the pancreas, also does good things like help signal satiety (feeling full), build muscle (via augmenting the mTOR pathway), etc. Moreover, it is elevated after eating anything with protein, carbohydrate, cholesterol, or saturated fat, i.e. LITERALLY ANYTHING you could possibly eat. This should make sense because insulin is involved in satiety and packaging things away into muscle and fuel. The real jimmy-rustler, to me at least, is the folks who still clamor about “Lowering insulin levels is why low carb diets work.” No….low carb diets (including ketogenic diets) work because they control appetite via Food Reward and thus caloric intake. Higher carb diets also work if calories are controlled. Most of the data shows that high carb and low carb diets do about the same long term for weight loss, with maybe the low carber’s having a bit better compliance and blood work. Given the data, the real reason any diet works is because it allows a person to comply with a calorie restricted diet. Period.
    • Do ketogenic diets really suppress appetite? A systematic review and meta-analysis. by Gibson et al 2014
  2. Growth hormone is something you should care about.
    • Growth hormone, a peptide hormone released from the anterior hypothalamus that lies in the sella turcia of your skull, has gotten a lot of press from the anti-aging crowd and the snake oil salesmen/women of the InterwebzZz. Problem is, it doesn’t do jack unless you’re a) a child; b) an adult with a disease resulting in growth hormone deficiency, or c) an adult or child who has a growth hormone secreting tumor. Interestingly, eating too many carbs or eating right before you go to bed does not cause someone to be growth hormone deficient- as some would suggest. Moreover, fasting during the AM, fasting after a workout, or not eating carbs before bed won’t make your growth hormone levels so high that you’ll acquire massive amounts of “lean, hard muscle” and get hyooge. Simply put, growth hormone is a signaling hormone. Outside of the roles it has in skeletal maturity, the immune system, and glucose metabolism it doesn’t do a whole lot in the adult. Notice I didn’t mention anything about skeletal muscle when describing it’s functions. That’s because GH, even when used in supraphysiological doses, does not increase skeletal muscle protein mass or synthesis rates (how fast you build muscle). Rather, GH increases protein synthesis of visceral organs -because they’re made of…you know….protein, and increases the synthesis of collagen and bony tissues. Ever wonder why “lantern jaw”, acromegaly, and visceromegaly (distended abdomens with huge viscera) are associated with growth hormone abuse? Wonder no longer…that’s why. Growth hormone does indeed go up when you exercise and when you fast, that I won’t dispute. The significance of this fact, however, is something I take issue with. GH rises because glucose levels in the body have fallen either from fasting or exercising..that’s it. Because energy stores have fallen, GH goes up to promote more fat tissue to be oxidized for fuel. Yes Virginia, GH aids in lipolysis- but don’t get tricked into thinking that it’ll make you lose body fat if you go spend thousands of dollars on some gear. That doesn’t happen either! From a training perspective- GH goes up during and after exercise in response to lowered glucose levels. This causes the liver to produce IGF (insulin like growth factor), which can be cut into a number of different isoforms (types) depending on the environment the body has been exposed to. If you’ve been exposed to weights, resistance training, high force output- then the isoform that predominates is known as mechano-growth factor, which again is a derivative of IGF that gets expressed only if you train. So no, supplementing with GH won’t make you produce more MGF. It might help you come back from a soft tissue injury and it might help you grow a bigger jaw, if you’re into that sort of thing.
    • Does Exogenous Growth Hormone Improve Athletic Performance? by Dean 2002
    • Effect of growth hormone and resistance exercise on muscle growth and strength in older men by Yaresheki et al 1995
    • Effect of growth hormone and resistance exercise on muscle growth in young men by Yaresheki et al 1992
  3. You should obsess about overtraining and never, ever do it.
    • Now let me get this out of the way first, this entire “myth” is context dependent. If you’re a rank novice with no base of strength or conditioning, yes you can “overtrain” if we agree to use this definition:
      1. Overtraining (noun)- The result of exercising too much, wherein optimal progress (weight on the bar, rep PR’s, etc.) is blunted or stopped”
    • So sure, if you do too much- you can definitely decrease the rate of progress when you’re a novice. This is why linear progression based programs tend to be what I recommend for actual novices, i.e. those who have not previously been “training” or regularly working with barbells. After that initial phase, however, people tend to fall into this mysterious black hole of “I don’t want to overtrain” and “I’m not making progress”. Sure, some of that should be attributed to the overall rate of adaptation slowing down since a person who is no longer a novice has, by definition, realized all their easy gains. Still, both the anecdotal reports and scientific literature tend to suggest something counter-intuitive to the overtrainophobes- MORE TRAINING=MORE RESULTS. Practically, this tends to manifest as more sets (more volume), more reps (more volume), more weight (more tonnage), more exercises (more volume), or more training days (more volume and frequency). I could spend hundreds of pages describing the nuanced biology as to how training more can produce more strength, size, and other performance metrics in individuals- but ain’t nobody got time for that. The fact of the matter is that I’ve yet to see many people (outside of CrossFit and endurance athletes) who are overtrained, but I do see a lot of folks who are undertrained. I think if you have the central paradigm in your mind that over time, your training has to get progressively harder via more volume, more weight, and/or more frequency- then this all makes sense. Similarly, I think we have to caution the overzealous and under-occupied folks to NOT go crazy and do something like Smolov off the bat. ks, Look if you have multiple hours a day to train because of not having a job, having a light course load, or being independently wealthy that’s awesome, I’m jealous! However, as you go along you’re going to need more volume, more intensity, more frequency more SOMETHING to get a smaller payoff at the end in terms of gainzZz™. So if you’ve been stuck for awhile and are really worried about overtraining- I’d bet you need more training to actually get things moving. Adding a little more volume at a time over the long haul will probably get people accusing you of using drugs and overtraining, but when you perform on the platform, field, or stage- they tend to stop talking. Interestingly, most of the data on this topic shows a pretty consistent trend in strength and size improvements as more training volume is provided. Seems to me that the major risk of overtraining for a non novice population is that you might get too strong!
    • Single vs. multiple sets of resistance exercise for muscle hypertrophy: a meta-analysis. by Krieger- 2010
  4. If you miss your post workout “anabolic window”, you get no gainzZz.
    • If you go to a website and somewhere on there you see any of the following:
      • You have to eat within 30 minutes of working out because of the anabolic window!
      • You should eat fast acting carbs to spike insulin!
      • You should buy this proprietary, bloated, piece of sh!t Mass GainzZzer 3000™ supplement system that involves you drinking radioactive colored excrement out of a comically large bottle and taking 20-30 pills pre and post workout for the low, low cost of 299.99 with monthly billing!
    • Look, bottom line here folks is this- muscle recovery post workout is not limited to any sort of window. The rate of muscle protein synthesis is elevated far above baseline for about 48hrs post workout in a novice and 16-24hrs in a well -trained elite athlete. All things being equal, if both populations eat enough calories, are hydrated, and get enough total protein/carb/fat for the day it really doesn’t seem to matter for outcomes like strength, muscle mass, etc. in the long term. Most data showing results contrary to this either don’t control for total calories or macros or use silly testing protocols like retesting someone’s 1RM strength immediately after a workout in a population who had a post workout shake and one who didn’t. Umm, duh…do you think taking in some calories post workout in the form of protein and carbohydrates might help immediate performance? Me too. Anyway, the real recommendation remains that a person should eat a moderate protein-containing meal 3-5 times a day with 3-5 hours in between feedings. Periworkout, it might be worthwhile to partition a higher percentage of carbohydrates for those meals, i.e. 30% in each compared to 20% in the other 2 meals of the day. Total macronutrient levels and subsequent calories will determine the net result from training with respect to weight manipulation and muscle growth, provided the training is not 100% tomfoolery. As far as fast acting carbohydrates, there is some data to support their (mostly Vitargo, actually) use in replenishing athletes after long workouts (endurance athletes), in those who compete multiple times per day (like a Games™ athlete), or in someone who just cut weight. For a person who trains 1x/day, however, the only benefit of a fast acting carbohydrate would be ease of compliance in hitting their macronutrient targets, if applicable.
    • Nutrient timing revisited: is there a post-exercise anabolic window? -Aragon 2013

  5. Lifting weights as a child stunts your growth.
    1. Actually, some of the data suggests weight training in children can make them grow taller. I’m not sure how this started, really, but I’m assuming people thought axial loading (bearing weight) on the non-mature skeletal system of kids increased the risk of fracturing the epiphyseal plate or growth plate, thus stunting growth. Seeing as how the injury rates for competitive weightlifting and even CrossFit are incredibly low compared to sports that are encouraged on our youth like soccer (see here) and that the scientific data does not support the idea that lifting as a child or adolescent retards growth, I’m not sure why it’s persisted. If I could hazard a guess, young folks who were surreptitiously using anabolic steroids to augment their training had their growth stunted. Physiologically this is plausible since taking exogenous testosterone tends to also increase circulating estrogen. Elevated estrogen levels in puberty in both males and females are involved in shutting off and getting rid of the cells that maintain the epiphyseal plate, e.g. apoptosis of the chondrocytes.

 

Share this on Facebook, Tweet it, Instagram it with a selfie…just stop the madness.

Also, shameless plug:

Tom Campitelli, a Starting Strength Coach and organizer of Strength Lifting meets, and I will be heading to Australia this winter to  teach people how to squat with the bar lower on their backs than their coach wants  and how to pull the bar in a vertical line. We’d love to have you attend, if you’re able. Spots are limited and you can sign up at the link below (see events on the right side):

http://aasgaardco.com/store/starting-strength-training-camps

 

*This was a joke. If you do not have a sense of humor, you may be depressed, lonely, or suffer from lack of gainzZz™. We recommend seeing your doctor to talk if you have not developed a mature sense of humor that allows you to laugh at yourself, others, and not take blog posts on the Internet too seriously.

-Jordan

 

About Jordan Feigenbaum

Jordan Feigenbaum, owner of Barbell Medicine, has an academic background including a Bachelor of Science in Biology, Master of Science in Anatomy and Physiology, and Doctor of Medicine. Jordan also holds accreditations from many professional training organizations including the American College of Sports Medicine, National Strength and Conditioning Association, USA Weightlifting, CrossFit, and is a former Starting Strength coach and staff member. He’s been coaching folks from all over the world  for over a decade through Barbell Medicine. As a competitive powerlifter, Jordan has competition best lifts of a 640lb squat, 430lb bench press, 275lb overhead press, and 725lb deadlift as a 198lb raw lifter.

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