V O L U ME 4 , ISS U E 5 MAY 2 0 2 0

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

E R IC H E LMS | G R E G N UCK O LS | MIC HAEL ZO URDO S | ERIC T REXL E R

 The Reviewers
Eric Helms
Eric Helms is a coach, athlete, author, and educator. He is a coach for drug-free strength and physique
competitors at all levels as a part of team 3D Muscle Journey. Eric regularly publishes peer-reviewed
articles in exercise science and nutrition journals on physique and strength sport, in addition to writing for
commercial fitness publications. He’s taught undergraduate- and graduate-level nutrition and exercise
science and speaks internationally at academic and commercial conferences. He has a B.S. in fitness
and wellness, an M.S. in exercise science, a second Master’s in sports nutrition, a Ph.D. in strength
and conditioning, and is a research fellow for the Sports Performance Research Institute New Zealand
at Auckland University of Technology. Eric earned pro status as a natural bodybuilder with the PNBA in 2011 and competes in
unequipped powerlifting, weightlifting, and strongman.

Greg Nuckols
Greg Nuckols has over a decade of experience under the bar and a B.S. in exercise and sports science.
Greg earned his M.A. in exercise and sport science from the University of North Carolina at Chapel
Hill. He’s held three all-time world records in powerlifting in the 220lb and 242lb classes. He’s trained
hundreds of athletes and regular folks, both online and in-person. He’s written for many of the major
magazines and websites in the fitness industry, including Men’s Health, Men’s Fitness, Muscle & Fitness,
Bodybuilding.com, T-Nation, and Schwarzenegger.com. Furthermore, he’s had the opportunity to
work with and learn from numerous record holders, champion athletes, and collegiate and professional
strength and conditioning coaches through his previous job as Chief Content Director for Juggernaut Training Systems and
current full-time work on StrongerByScience.com.

Michael C. Zourdos
Michael (Mike) C. Zourdos, Ph.D., CSCS, has specializations in strength and conditioning and skeletal
muscle physiology.  He earned his Ph.D. in exercise physiology from The Florida State University (FSU)
in 2012 under the guidance of Dr. Jeong-Su Kim. Prior to attending FSU, Mike received his B.S. in
exercise science from Marietta College and M.S. in applied health physiology from Salisbury University.
Mike served as the head powerlifting coach of FSU’s 2011 and 2012 state championship teams. He
also competes as a powerlifter in the USAPL, and among his best competition lifts is a 230kg (507lbs)
raw squat at a body weight of 76kg. Mike owns the company Training Revolution, LLC., where he has
coached more than 100 lifters, including a USAPL open division national champion.

Eric Trexler
Eric Trexler is a pro natural bodybuilder and a sports nutrition researcher. Eric has a PhD in Human
Movement Science from UNC Chapel Hill, and has published dozens of peer-reviewed research
papers on various exercise and nutrition strategies for getting bigger, stronger, and leaner. In addition,
Eric has several years of University-level teaching experience, and has been involved in coaching since
2009. Eric is the Director of Education at Stronger By Science.

2
 Table of Contents

6
BY G R EG NUCKOL S

Improving Muscle Growth by Individualizing Training Volume

In a recent study, subjects trained one leg with standardized training volume (the same volume
for everyone), and one leg with individualized volume (a 20% increase above their prior baseline).
Individualized volume led to more quad growth, suggesting that we should be more concerned
about manipulating training volume based on your recent history, rather than aiming to find one
single “optimal” level of training volume for everyone.

16
BY M I CHAEL C. ZOUR DOS

Can You Predict Bench Press 1RM Using Dumbbells?

If you can dumbbell bench 45kg dumbbells for 10 reps, what does that translate to in a barbell
bench press? We’ve all probably been asked as much or thought about what that conversion
is like. This article reviews the first study to examine the ability of the dumbbell bench press to
predict barbell bench 1RM.

26
BY E RI C HEL MS

The First Bodybuilding Refeed Research

Refeeds, carb and calorie cycling, diet breaks, cheat meals and days, zig-zag dieting; in one form
or another, bodybuilders have been implementing nonlinear fat loss tactics for decades. First they
were based on anecdotes, then combined with mechanistic, indirect, and some human data on non-
athletes. However, this study is arguably the first truly relevant trial to date.

39
BY E R I C T R EXL ER

Can Sleeping More Make You Leaner?

We all know that insufficient sleep is unpleasant, but does it hinder our gains in the gym? A new study
found that a sleep education intervention enhanced fat loss throughout a resistance training program,
but with some notable limitations. Read on to find out whether or not your sleep habits might be
getting in the way of your physique goals.

50
BY G R EG N UCKOL S

You Can’t Flex Bone: Predicting Powerlifting Performance Based on

Fat-Free Mass
I think everyone knows that more muscular lifters tend to be stronger lifters, but I don’t think people
recognize just how strong that relationship is among competitive powerlifters. In a recent study on
raw, drug-free powerlifters, fat-free mass was almost perfectly correlated with performance. This
article will explore that relationship, and what we can do with it.

3
69
BY M I CHAEL C. ZOUR DOS

The Scientific and Practical Considerations of Long Inter-Set Rest

Intervals
Longer inter-set rest intervals can lead to greater hypertrophy and strength gains than shorter inter-set
rest intervals. This study demonstrates that eight-minute rest intervals may be needed to maximize
volume performance. But is eight minutes really necessary? This article discusses both the scientific
merit and practical considerations of rest interval duration.

82
BY E R I C TR EXL ER

Has Carnitine Pivoted From a Fat Loss Supplement to a Recovery

Supplement?
Back in the day, carnitine was widely touted as a fat loss supplement. While that hype has mostly died
down, a new meta-analysis suggests that carnitine may reduce post-exercise muscle damage and
soreness. Read on to find out if the results of this meta-analysis are as good as they seem.

97
BY G R EG N UCKOL S

Variety is the Spice of Life: If You Want Well-Rounded Triceps

Growth, You Need Both Compound and Single-Joint Exercises
A recent study examined triceps growth (among other things) in subjects that only did bench press,
only did triceps extensions, or performed both exercises. To maximize growth of all three heads of the
triceps, a combination of both exercises was necessary.

108 BY M I CHAEL C. ZOUR DOS

VIDEO: Bodyweight and Home Training Progressions

In these uncertain times, you may not have gym access. This video first presents scientific data
demonstrating that bodyweight training can help to preserve muscle mass and strength. Second,
this video presents a nine-week at-home training program along with specific examples of household
items that can be used. Further, the video demonstrates various examples of how progressive
overload can be achieved with this approach.

110
BY M I CHAEL C. ZOUR DOS

VIDEO: Nutrition on Lockdown

Obviously it’s less than ideal to be stuck at home, and you or your clients may be struggling with eating
due to boredom, depression, or emotional reasons. However, there are other aspects of being stuck
at home that may be influencing your food behaviors. Likewise, there may be some silver lining to this
change in environment which could be used to establish better nutrition habits that outlast lockdown.

4
Letter From the Reviewers

M ASS is entering its fourth year! If you’ve been here for a long time, we’re grate-
ful you’ve been willing to stick with us, and if you signed up during the anniver-
sary sale and this is your first issue, we’re thrilled to have you aboard.
A MASS anniversary is as opportune a time as any to inform you or remind you about
a couple of the resources in 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 Interpret-
ing Research guide.
Starting with the video department, Eric Helms and Mike both had timely videos for
people who are stuck at home during COVID-19 lockdowns. Eric’s video discusses how
being stuck at home can influence food behavior, and how you can use this time to build
good eating habits that will persist once stay-at-home orders are lifted. Mike’s video dis-
cusses at-home bodyweight training, and actually includes a full program you can follow
to maintain muscle and strength without gym access.
From the nutrition department, Eric Helms’s article this month covers the first study
investigating the effects of refeeds in an athletic population. Eric Trexler’s articles cov-
er the impact of sleep on body composition, and a new meta-analysis investigating the
effects of L-carnitine on muscle damage.
From the training department, Mike reviewed one study investigating the relationship
between dumbbell bench performance and bench press 1RM strength, and another study
on the effects of rest intervals on volume load performance. Greg reviewed studies ex-
amining the relationship between fat free mass and powerlifting performance, the impact
of single- and multi-joint training on muscle growth, and whether individualized training
volume leads to more muscle growth than standardized training volume.
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.

5
 Study Reviewed: Muscle Hypertrophy Response Is Affected by Previous Resistance
Training Volume in Trained Individuals. Scarpelli et al. (2020)

Improving Muscle Growth by

Individualizing Training Volume
BY G RE G NUC KO LS

In a recent study, subjects trained one leg with standardized training

volume (the same volume for everyone), and one leg with individualized
volume (a 20% increase above their prior baseline). Individualized
volume led to more quad growth, suggesting that we should be more
concerned about manipulating training volume based on your recent
history, rather than aiming to find one single “optimal” level of training
volume for everyone.

6
 KEY POINTS
1. Over eight weeks, trained subjects trained one leg with 20% more weekly sets
than they’d been using in their training previously, and trained the other leg with
22 sets per week, regardless of prior training volume.
2. Subjects experienced significantly more quad growth, on average, in the leg that
underwent a 20% volume increase, even though average volume ended up being
similar between conditions.
3. When assigning training volume, it’s better to focus on gradually increasing
volume from one’s current baseline, rather than simply jumping to some level of
volume that’s theoretically ideal for the average person.

I magine a scenario for me: We

fast-forward 20 years in the fu-
ture, and we now have enough
data to accurately and precisely model
the “inverted U” relationship between
training volume and muscle growth.
It’s found that the Optimal(™) training
volume is 20 sets per muscle group per
week. A client comes to you, having re-
cently plateaued after previously making
solid gains on 8 sets per muscle group
per week. Do you A) bump their volume
up gradually and see how they respond,
or do you B) move them straight from 8
sets per week to the Optimal(™) volume
of 20 sets per week?
To me, option A seems like a no-brain-
er. Population averages may or may
not apply to an individual, and this cli-
ent’s baseline ability to adapt to training
stressors is heavily influenced by their
recent training. “High volume” or “low
volume” training aren’t fixed points
across all lifters, but are fluid constructs
that vary person-to-person, defined rela-
tive to each individual’s baseline train-
ing volumes. “Low volume,” “moder-
ate volume,” and “high volume” don’t
necessarily mean, say, 0-10, 11-20, and
20+ sets per muscle group per week; I
see them more like, “less volume than
I’m accustomed to,” “about the same
amount of volume I’m accustomed to,”
and “considerably more volume than
I’m accustomed to.”
That’s not the type of thinking that
generally informs research design, un-
fortunately. The presently reviewed
study (1) is an exception. The research-
ers interviewed experienced lifters and
asked them how many sets of quad
training they performed per week. For
each subject, one leg was assigned to an
individualized condition in which vol-
ume for that leg was increased by 20%
over their pre-study volume. For exam-
ple, if someone had been doing 5 sets
of quad training per week, then that per-
son started doing 6 sets; if they’d been
doing 40 sets, they started doing 48.

7
The other leg was assigned to a stan-
dardized condition, which consisted of
22 sets for all subjects. After 8 weeks
of training, quadriceps cross-sectional
area (CSA) increased significantly more
in the individualized condition than the
standardized condition. Thus, when an-
alyzing and assigning training volume,
it’s more informative and productive to
look at changes relative to the individu-
al’s training history, instead of compar-
ing their training volume to some fixed
reference point.
Purpose and Hypotheses
Purpose
The purpose of this study was to com-
pare the hypertrophic effects of train-
ing with a standardized (i.e. 22 sets per
week) amount of volume versus an in-
dividualized (+20% of an individual’s
previous volume) amount of volume.
Hypotheses
The authors hypothesized that individ-
ualized volume would lead to more mus-
cle growth than standardized volume.
Subjects and Methods
Subjects
The subjects were 16 young males
with an average of 5.1 years of resis-
tance training experience, regularly per-
forming knee extensions and leg press.
Experimental Design
This study utilized a within-subject
unilateral design. That means that for
each subject, one leg was randomized
into the standardized condition, with
the other leg entering the individual-
ized condition. Subjects trained twice
per week for eight weeks, performing
unilateral leg press followed by unilat-
eral knee extensions. Volume for the
standardized leg was fixed at 22 sets per
week (based on the average weekly vol-
ume used in an allegedly random sample
of studies in the literature), which I as-
sume means 5-6 sets apiece, in each ses-
sion, of unilateral leg press and unilater-
al knee extensions per workout. Volume
for the individualized leg was based on
each subject’s self-reported quad train-
ing volume in the two weeks prior to
the start of the study; the researchers in-
creased weekly volume by 20% above
baseline for the individualized leg on a
per-subject basis. In both conditions, all
sets were taken to technical failure, and
loads were adjusted so that the subjects
would reach the point of failure after
8-12 reps per set. Subjects rested two
minutes between sets.
Like any longitudinal training study,
testing was performed before and after
the training program. No strength out-
comes were tested, so the only testing
consisted of measuring quad CSA via
ultrasound scans.
8
 Figure 1 Muscle cross-sectional area increases from baseline to after 8 weeks resistance training

25 4.5
Standardized

Individualized vs. Standardized (cm2)

Individualized
3.0
20

1.5
15
ÆCSA (%)

0.8 (TE)

CSA
0.0

10 -0.8 (TE)

-1.5

5
-3.0
2.61 (CV)

0 -4.5

A B

A) Dashed line indicates co-efficient of variation: 2.61%

B) Gray circles indicate whether the increases in CSA (cross-sectional area) obtained with the individualized protocol are greater than
(above 0.8 typical error [TE]), smaller than (below -0.8 TE), or similar (between 0.8 and -0.8 TE) to those obtained with the standardized.
Dashed line indicates the measurement typical error: 0.8cm2
* = significantly different from standardized (p < 0.05)

Findings
Both conditions completed similar
Quadriceps CSA increased signifi- volume loads on average, but there were
cantly more in the individualized condi- large differences on an individual basis.
tion than in the standardized condition All subjects increased their volume load
(+9.9% vs. +6.2%; p = 0.042; mean dif- relative to baseline by approximately
ference = 1.08cm2; CI = 0.04-2.11cm2). 20% in the individualized condition. In
Furthermore, of the 16 subjects, 10 had the standardized condition, changes in
superior increases in quadriceps CSA in volume load from pre-training ranged
the individualized condition compared from a reduction of almost 50% to an
to the standardized condition that were increase of 120%. Overall, 4 of the 16
larger than the typical measurement er- subjects decreased their weekly set vol-
ror of the ultrasound CSA assessments. ume in the standardized condition, and
Only 2 out of 16 subjects had superior 8 out of 16 subjects increased their set
increases (in excess of the measurement volume by 30% or more, meaning that
error) in their leg assigned to the stan- only 4 subjects had modest (<30%) in-
dardized condition. Hypertrophy was creases in set volume.
similar between conditions in the other
four subjects.

9

Interpretation
This study represents an important
piece of the puzzle that’s been sore-
ly missing from the resistance training
literature. When studying the effects of
training volume on muscle growth, sub-
jects tend to be assigned to differing vol-
ume conditions without any regard for
prior training history. If a study uses 10
sets per week as a low-volume condition
and 20 sets per week as a high-volume
condition, the 10-set condition may feel
like super high volume and be very dif-
ficult to recover from for someone who
had previously been training with a vol-
ume of just 5 sets per week for the target
muscle group; conversely, 20 sets per
week could feel like a deload for some-
one accustomed to 30 sets per week. Ef-
fects like that should theoretically wash
out with random group allocation if the
sample size is sufficient, but it still in-
troduces a source of heterogeneity into
the results of the study. More important-
ly, we can claim that increasing set vol-
ume should increase muscle growth, but
training studies aren’t actually designed
to directly support or refute that idea,
since training volume assigned to each
participant doesn’t consider the lifter’s
previous training volume.
A major strength of this study was
that the volume ended up being similar
in both conditions. If volume differed
significantly between conditions, one
could then claim that maybe the indi-
vidualized condition just led to more
growth because volume was higher (or
because volume was lower, thus posit-
ing that that other condition led to over-
reaching). Since both conditions led
to similar training volume on average,
this study supports the idea that optimal
training volume is highly individualized
and probably based, in part, on individu-
10
al training histories. I think that’s a more
productive way to approach the problem
than simply trying to discover the single
number that represents the Optimal(™)
weekly set volume. If, for example, we
had 10 times as much research and we
could pinpoint 15 sets per week as the
weekly set volume associated with the
largest average gains in the literature, I
still don’t think that would be incredibly
helpful. If you’ve been making gains
with 5 sets per week, tripling your train-
ing volume overnight probably isn’t a
great idea, and if you’ve been making
gains with 30 sets per week, cutting your
training volume in half also probably
isn’t the ticket to improved hypertrophy
outcomes. However, if we had base-
line training data in all of those studies
in this theoretical future meta-analysis,
and we could determine that a 10% in-
crease in volume every six weeks was
associated with the largest gains, I do
think that information would be highly
generalizable for most trainees. It may
not be helpful to someone who’s already
pushing the boundary of overtraining,
but it would probably be useful for the
vast majority of lifters. That’s not to
say that the current body of literature is
without merit; learning more about the
levels of volume that produce the best
outcomes, on average, can still serve as
a useful sanity check. For example, if
we find out that 15 sets per week is Opti-
mal(™) and you’re not making progress
with 5 sets per week, you could surmise
that you could probably benefit from in-
creasing your volume, or if you’re not
making gains and constantly feel worn
down with 30 sets per week, you could
surmise that you probably don’t need
to be afraid of knocking your volume
down. However, I do think that assign-
ing volume based on subjects’ habitual
training volume is a more informative
study design, and it more closely resem-
bles how I approach things as a coach.
It also makes better sense biologically.
We know that people habituate to pri-
or stimuli, that sufficient physiologi-
cal stressors drive adaptation, and that
stressors can be excessive for an organ-
ism to adapt positively to (relative to the
stressors they’re currently habituated
to). Manipulating training volume rela-
tive to each subject’s established base-
line respects what we know about how
people adapt to training stimuli, where-
as giving half your subjects X volume
per week and half your subjects 2X vol-
ume per week does not. In other words,
the approach used in the current study
respects what we’ve learned in the past
century about how organisms respond to
stress, while the standard approach for
studying the impact of volume on mus-
cle growth seemingly pretends like that
body of knowledge doesn’t exist.
The results of this study raise an in-
teresting possibility, which we’ve dis-
cussed in MASS before: volume cycling.
If periodic increases in weekly set vol-
ume reliably produce increases in mus-
cle growth, that’s all well and good, but
11
there must be a limit to that approach. If
you compound 20% increases in set vol-
ume over time, even if you only increase
set volume every 6 months, you’ll even-
tually wind up with completely unman-
ageable training volume. There must be
a finite amount of training that people
can respond positively to. However, we
also know that lifters can decrease train-
ing volume considerably – by at least
two-thirds – and not lose muscle (2).
Thus, we could gradually increase set
volume over time until it becomes un-
manageable, reduce training volume to
establish a new baseline, and repeat the
process (4). You could do this with all
muscle groups simultaneously, or (more
realistically), with a handful of muscle
groups at a time. Currently, the concept
of volume cycling is used “in the trench-
es,” but it only has indirect theoretical
support in the literature. I’d love to see
it studied more directly.
There’s one more thing I’d like to clear
up about the results of the current study:
We know that a 20% increase in training
volume above the subjects’ pre-training
baseline worked well, but we can’t claim
(as the authors of the study do) that a 20%
increase in training volume “maximize[s]
muscle hypertrophic response in trained
individuals.” There’s only one way we
could ascertain the optimal (average) in-
crease in training volume to maximize
hypertrophy: We would need a study to
compare different volume increases. If a
study tested increases of, say, 10%, 20%,
and 30%, and 20% came out on top, then
we could claim that, on average, a ~20%
increase in volume maximizes hypertro-
phy over a matter of months. There’s a
second way to test this idea using the data
from the present study, though it would
not be able to establish causation. You
could compare the relationship between
volume changes in the standardized group
and hypertrophic results relative to the
individualized condition. In other words
(sorry, long sentence incoming), if there
was a clear inverse parabolic relation-
ship, where subjects who decreased their
volume in the standardized condition
and subjects who massively increased
their volume in the standardized condi-
tion both experienced way less growth in
their quad assigned to the standardized
condition than in their quad assigned to
the individualized condition, but subjects
who increased their weekly volume by a
modest amount in the standardized con-
dition experienced similar growth in both
legs, that would then suggest that modest
increases in training volume are, in fact,
optimal for hypertrophy. This method
wouldn’t be able to pinpoint 20% as op-
timal, but it could provide additional evi-
dence that somewhere in the ~20% range
(give or take 10-20%) is optimal. On the
contrary, if the peak of the inverted pa-
rabola was closer to 50%, that may sug-
gest that the current study was too con-
servative, and larger increases in volume
are actually optimal for hypertrophy, in
the short-to-medium-term.
12

AS WITH ALL METRICS,
WE SHOULDN’T EXPECT
RELATIVE INCREASES IN
TRAINING VOLUME TO BE
PERFECTLY PREDICTIVE
OF HYPERTROPHY.
As with all metrics, however, we
shouldn’t expect relative increases in
training volume to be perfectly predic-
tive of hypertrophy. In support of the
notion that volume increases are only
weakly associated with hypertrophy, a
recent training study by Aube and col-
leagues (3) performed exploratory anal-
yses to see what factors differentiated
high and lower hypertrophic responders.
They split their group into tertiles based
on hypertrophy response (the lowest ter-
tile experienced virtually no growth, and
the highest tertile experienced the most
growth), and they found that their low-
est tertile had increased their training
volume by just 1.8 ± 6.7 sets per muscle
group per week (that was the difference
between their pre-study training volume
and the volume they were assigned for
the study), their middle tertile had in-
creased their training volume by 4.3 ±
9.3 sets per week, and their highest ter-
tile had increased their training volume
by 6.6 ± 12.4 sets per week. Those dif-
ferences represented relative increases
of 12%, 33%, and 58%. At first, that
looks like a clear linear relationship,
suggesting that larger increases in vol-
ume are predictive of more hypertrophy,
and that the 20% increase in the present
study was too conservative. However,
we can’t overlook those enormous stan-
dard deviations. For the subjects in the
top tertile (the subjects that experienced
the most hypertrophy), an increase of
6.6 ± 12.4 sets per week suggests that
several of the top-responding subjects
likely decreased their training volume,
and several increased their training vol-
ume by more than 100%. In that same
study, the subjects’ actual training vol-
ume in sets per week during the study
protocol also wasn’t predictive of hy-
pertrophy. Changes in leg fat-free mass
and quad muscle thickness were virtual-
ly identical between groups performing
12, 18, or 24 sets per week. Change in
training volume was more predictive of
results than actual training volume was,
CHANGE IN TRAINING VOLUME
WAS MORE PREDICTIVE
OF RESULTS THAN ACTUAL
TRAINING VOLUME WAS.
13
 APPLICATION AND TAKEAWAYS
Slightly increasing your training volume above its current level will probably help you
build more muscle, as long as you aren’t already straining your ability to recover from
and adapt positively to training. Theoretically, cycling training volume over fairly long
time scales (e.g. multiple months) may lead to more muscle growth than sticking with
a fixed level of training volume over time.

but neither metric was strongly associ-

ated with hypertrophy. So, I still believe
that research should be more focused on
finding ideal changes in training volume
from subjects’ pre-training baselines
rather than in finding a single, magi-
cal, absolute training volume, but we
shouldn’t expect that either metric will
be anywhere close to perfect for predict-
ing muscle growth.

Next Steps
I’d love to see a longitudinal training
study where subjects are assigned dif-
fering levels of volume increases from
baseline. To cover a wide swath of pos-
sibilities, it could include four groups,
with groups increasing weekly set vol-
ume by 0%, 25%, 50%, and 100% to
cover a wide range of possibilities (5).
I would anticipate that either a 25% or
a 50% increase would yield the best
results out of those four options. That
would help us establish a general area
where we should be looking in future
studies.

14
References

1. Scarpelli MC, Nóbrega SR, Santanielo N, Alvarez IF, Otoboni GB, Ugrinowitsch C, Libardi
CA. Muscle Hypertrophy Response Is Affected by Previous Resistance Training Volume in
Trained Individuals. J Strength Cond Res. 2020 Feb 27.
2. Bickel CS, Cross JM, Bamman MM. Exercise dosing to retain resistance training adapta-
tions in young and older adults. Med Sci Sports Exerc. 2011 Jul;43(7):1177-87.
3. Aube D, Wadhi T, Rauch J, Anand A, Barakat C, Pearson J, Bradshaw J, Zazzo S, Ugrinow-
itsch C, De Souza EO. Progressive Resistance Training Volume: Effects on Muscle Thick-
ness, Mass, and Strength Adaptations in Resistance-Trained Individuals. J Strength Cond
Res. 2020 Feb 13.
4. Note that the process of increasing volume doesn’t have to be super rapid. If you’re making
progress at a given level of volume, it may be worthwhile to ride it out until you stop making
progress, rather than being greedy and proactively ramping your volume up prematurely.
That’s a decision you can make for yourself, though.
5. Another option would be to simply increase volume by, say, 1, 3, 5, and 10 sets per week.
Percent increases may be problematic if some of the subjects were already training with real-
ly high volumes. I strongly assume a 50% increase from 6 to 9 sets per week would go swim-
mingly, but a 50% increase from 40 to 60 sets per week would probably be way overboard.

15
 Study Reviewed: Relationship of Barbell and Dumbbell Repetitions with One-
Repetition Maximum Bench Press in College Football Players. Heinecke et al. (2020)

Can You Predict Bench Press

1RM Using Dumbbells?
BY MIC HAE L C . ZO URD O S

If you can dumbbell bench 45kg dumbbells for 10 reps, what does that
translate to in a barbell bench press? We’ve all probably been asked as
much or thought about what that conversion is like. This article reviews
the first study to examine the ability of the dumbbell bench press to
predict barbell bench 1RM.

16
 KEY POINTS
1. This study examined the accuracy of predicting barbell bench press one-
repetition maximum (1RM) from reps to failure at a moderate load with four types
of benching: 1) barbell bench, 2) bilateral dumbbell (DB) bench, 3) right arm only
DB bench, and 4) left arm only DB bench.
2. Reps performed during all types of benching predicted barbell 1RM with pretty
similar accuracy.
3. While it is difficult to directly apply this data at all times, it is possible that DB
bench progress could be used as a proxy for barbell bench progress in certain
situations; however, more data is needed to confirm this.

I f I can do the 50lb DBs for 10 reps,

then what can I bench?” We have
all heard someone ask a similar
question to that at some point. To an-
swer, I usually say I don’t know, then
I think of someone I know of similar
strength to the person asking and base
my answer off of that person. That’s
not a particularly good response, but it
helps to give something of a reference
point. If you have a new client who does
DB bench more than they barbell bench
press, then knowing the relationship be-
tween DB strength and barbell strength
may be useful. The reviewed study from
Heinecke et al (1) is the first to examine
the relationship between reps performed
on the DB bench press and barbell bench
press 1RM. 40 collegiate American
football players performed repetitions
to failure with a 90.9kg barbell bench
press load and 45.5kg (in each hand)
DB bench press load on two different
days. On a third day, the athletes per-
formed unilateral DB bench presses to
failure (i.e. one arm at a time) with the
same 45.5kg load. Reps performed, on
average, were 13.8 ± 9.2 on the barbell
bench press and 12.5 ± 9.5 on the bilat-
eral DB bench press, suggesting that a
moderate load was used (i.e. ~65-70%
of 1RM). In brief, the findings showed
high correlations between repetitions
to failure during all types of benching
and barbell 1RM (r = 0.86-0.90). Fur-
ther, using linear regression equations,
reps to failure with all types of bench-
ing predicted 1RM with pretty similar
accuracy. These predictions were not
perfect, but on average, they predicted
barbell 1RM with an average error of
7.3-8.1 kg. This article will discuss the
finer details of these findings and will
present situations when using DB bench
strength as a proxy for barbell 1RM may
be useful.

17

Purpose and Hypotheses
Purpose
The purpose of this study was to ex-
amine the accuracy of predicting barbell
bench press 1RM from sets to failure
with a moderate load during four differ-
ent types of benching: 1) barbell bench
press, 2) bilateral DB bench press, 3)
right arm only DB bench press, and 4)
left arm only DB bench press.
Hypotheses
No hypotheses were provided.
Subjects and Methods
Subjects
40 collegiate American football players
who had been lifting at the collegiate lev-
el for at least one year participated. The
available subject details are in Table 1.
Study Protocol
This protocol was simple. Four ses-
sions, each separated by exactly 48
hours, were needed to complete this
study. In the first session, the athletes
completed barbell bench press 1RM
testing. In the second, third, and fourth
sessions, the athletes completed one set
to failure using a 90.9kg (200lb) barbell
bench load, a set to failure with 45.5kg
(100lb) DBs (in each hand) on the bilat-
eral DB bench, and sets to failure on the
unilateral DB bench (one arm at a time),
respectively. The authors noted that the
90.9kg barbell load was chosen because
they wanted the DB load to be the same,
and from observing normal training, the
athletes had trouble balancing more than
45.5kg DBs in each hand.
The authors then examined the rela-
tionship between reps performed during
all types of benching and barbell bench
press 1RM. Additionally, the authors ex-
amined the accuracy of predicting bar-
bell 1RM from each type of benching.
Findings
First, the repetitions performed on
each set and the relationship between
reps performed and barbell bench press
1RM are presented in Table 2. As you
can see, there are strong relationships
18
between reps performed and barbell
1RM for each type of pressing. Re-
member, these high R-values are just a
correlation; all the correlations tell you
is that those who performed more reps
tended to have a higher 1RM. Observ-
ing a correlation is completely different
than accurately predicting 1RM or say-
ing that the predicted and actual 1RM
agree with each other.
For the 1RM predictions, none of the
predictions were statistically differ-
ent than the actual 1RM (p>0.05); but
again, that does not mean that the pre-
dictions “agreed” with the actual 1RM.
For example, the average errors (essen-
tially how many kilograms, on average,
each prediction was off from the actu-
al 1RM during each type of benching)
were as follows: barbell reps to failure
– 7.1kg; DB bench – 7.9kg; right arm
DB bench – 8.3kg; left arm DB bench
– 8.0kg. Figure 1 shows Bland-Altman
plots of each 1RM prediction versus
the actual barbell bench press 1RM.
A Bland-Altman is an agreement plot,
which is used because it is much more
difficult to get methods to agree as op-
posed to just correlate (2). On these
plots, the horizontal line at 0 is the ac-
tual average 1RM, and each dot is an
individual data point (one person’s pre-
diction). The dashed horizontal lines
on the top and bottom represent the
limits of agreement. For each type of
benching, some of predictions were off
by as much as 20kg and many others
were off by as much as 10kg; howev-
er, other predictions were almost dead
on. In general, these plots show good
19
agreement on average, but it is clear- rate. One other point that is noteworthy
ly better to look at these predictions on when looking at the plots is that the re-
an individual level, as the predictions gressions tended to over-predict 1RM
were accurate for some, but way off for for weaker athletes, and under-predict
others. Additionally, the limits of agree- 1RM for stronger athletes.
ment are fairly wide (i.e. almost -20 to
+20kg), which further demonstrates
that some predictions were not accu-

Figure 1 Agreement between actual and predicted 1RM

Barbell reps performed prediction Bilateral DB bench prediction

30
30

20
Predicted - actual 1RM (kg)

Predicted - actual 1RM (kg)

20

10
10

0 0

-10 -10

-20 -20

-30 -30
100 125 150 175 200 100 125 150 175 200

A Actual 1RM bench press (kg) B Actual 1RM bench press (kg)

Right arm only DB bench prediction Left arm only DB bench prediction

30 30
Predicted - actual 1RM (kg)

Predicted - actual 1RM (kg)

20 20

10 10

0 0

-10 -10

-20 -20

-30 -30
100 125 150 175 200 100 125 150 175 200

C Actual 1RM bench press (kg) D Actual 1RM bench press (kg)

20

IF YOU NEVER PERFORM THE
DB BENCH, BUT BARBELL
BENCH FREQUENTLY, THEN
USING A DB BENCH TO
PREDICT BARBELL 1RM
WOULD PROBABLY BE FAR
LESS ACCURATE FOR YOU.
Interpretation
To start, let’s return to Figure 1 for a
moment. When visually comparing the
plots, reps performed on the barbell
bench press is unsurprisingly the best
at predicting barbell 1RM, but not by
that much. All plots are actually pret-
ty similar, which is supported by the
similar R-values in Table 2. At first,
it seems kind of ridiculous to say that
reps to failure on the DB bench is just
as good at predicting barbell 1RM as
reps to failure on the actual bench press.
However, since all these athletes were
on the same football team, that means
they probably did the same training pro-
gram, which included both bench press
and DB bench. Therefore, since these
individuals were used to performing the
DB bench, the progression of that exer-
cise had probably mirrored their barbell
bench press progression, which helped
the prediction. If you never perform the
DB bench, but barbell bench frequently,
then using a DB bench to predict barbell
1RM would probably be far less accu-
rate for you. Conversely, if you only DB
bench (possibly a bodybuilder), then
DB bench press reps to failure may be
a poor predictor of barbell strength, in
that case. If the prediction isn’t terribly
accurate for the bodybuilder, that’s not
too consequential as they are likely per-
forming a rep max test just to get a rough
estimate of their 1RM. The question is,
when might using DB bench press reps
to failure come in handy for you as a
lifter or coach?
For some lifters, a shoulder tweak
might make high volume benching
tough at times, but using DBs may not
cause any pain. In that situation, the
present data could be useful to get a
rough estimate of a barbell 1RM. This
hypothetical individual could even be
a powerlifter who can bench from time
to time, but they can’t (or don’t) do the
majority of their volume training with
the barbell bench press. The regression
equation printed in the paper to predict
barbell 1RM when using 45.5kg DBs on
the bilateral DB bench was: 1RM (kg) =
2.115 (Reps Performed) + 110.04. This
is a simple linear regression, or in other
words: y (1RM in kg) = a (intercept) x
(repetitions performed) + b (slope). The
best way to deem if the prediction de-
21
rived from a linear regression equation
is practically accurate is to perform this
prediction within close proximity (~1
week) of an actual barbell bench 1RM.
If the prediction is accurate, then you
can continue to use the DB bench pre-
diction over time to gauge progress or
potentially help with planning attempts
for a 1RM test or a powerlifting meet,
but I would stress that you gauge the ac-
curacy before doing the latter.
The authors of this study stated that
the predictions of barbell bench press
1RM were made with “excellent ac-
curacy and only minimal error.” I re-
spectfully disagree with that statement.
As seen above in Figure 1, these pre-
dictions were indeed quite accurate for
some individuals; however, the predic-
tions were >20kg off for others, and the
estimation errors were between 7.1-8.3
kg on average. In my opinion, these
predictions are far from “excellent,”
and the Bland-Altman plots show that;
however, the predictions are decent on
the group-level, especially compared to
1RM predictions from reps performed
equations and submaximal velocities in
other studies. For example, Reynolds et
al 2006 (3) found that both linear and
nonlinear reps-performed equations
were significantly inaccurate (p<0.05)
when using a 10RM load or higher in
the barbell bench press. In compari-
son to Reynolds and the present study,
Distacio 2014 (4) found more accurate
1RM back squat predictions when using
the linear Epley (1RM = Load X Reps
X 0.0333 + (Load)) and Bryzki (Load /
[102.78 – 2.78(reps)] equations to pre-
dict 1RM (average error of ~3-5kg), but
these predictions were made from using
higher loads (3RM and 5RM). So, the
current study reporting an average error
of 7.9kg for a linear equation based on
bilateral DB bench performance isn’t
too bad considering the present study’s
predictions were based on sets with an
average of 12.5 reps. Another 1RM pre-
diction method, submaximal velocity, is
nice in theory since only working up to a
few submaximal singles isn’t very fatigu-
ing. However, the more data that comes
out on submaximal velocity predictions,
the less convinced I am that these meth-
ods are accurate. MASS previously re-
viewed a study from Perez-Castilla et al
(5), which reported two- and four-point
submaximal velocity methods to predict
seated cable row 1RM very accurately
(average error of ~3kg). Garcia-Ramos
et al reported a two-point submaximal
velocity method, which used loads that
corresponded to an average concentric
velocity of 1.0 and 0.5 m/s on a Smith
machine bench press to predict 1RM to
within -9-3 kg (6). As an aside, here is
a tutorial on how to perform submaxi-
mal velocity predictions. While the Pe-
rez-Castilla and Garcia-Ramos predic-
tions are quite accurate, those findings
don’t hold up on free-weight compound
movements. Specifically, Banyard et al
2017 (7) found that even when using a
five-point submaximal velocity method,
22

ESTIMATING YOUR BARBELL
BENCH PRESS 1RM FROM A
SET OF DB REPS TO FAILURE
WON’T BE PERFECTLY
ACCURATE, BUT THE
ESTIMATE IS COMPARABLE
(OR EVEN BETTER) TO
SOME OTHER MORE
CONVENTIONAL METHODS
OF PREDICTING 1RM.
which used loads up to 90% of 1RM (20,
40, 60, 80, and 90% of 1RM) to predict
the back squat 1RM, there was an aver-
age error of 19.8kg, which is far from
practically accurate. This is all to say
that estimating your barbell bench press
1RM from a set of DB reps to failure
won’t be perfectly accurate, but the es-
timate is comparable (or even better) to
some other more conventional methods
of predicting 1RM.
Finally, the authors of this paper fo-
cused much of their discussion on hy-
pothesizing that since unilateral DB
bench press was capable of predicting
barbell 1RM with similar accuracy to
bilateral DB bench press, unilateral
training should be included in a pro-
gram aimed at improving bench press
strength. I don’t buy into that idea on
this data alone. However, as we have
written about before, unilateral training
has utility for muscle imbalances and
for increasing strength of the contralat-
eral limb if one limb cannot be trained
due to injury.
Next Steps
One idea for follow-up research is to
investigate if other assistance exercis-
es can predict the 1RM on a main lift.
Right away though, I’d like to see how
much the accuracy of the DB bench pre-
diction improves with lower reps (~5
reps). Additionally, I’d like to see how
accurate the DB bench is at predicting
barbell 1RM for a group of individu-
als who don’t barbell bench very much.
Earlier in this article, it was postulated
that this data might be useful for some-
one with a shoulder issue who does a lot
of DB pressing because they can only
bench with low volume and farther from
failure. If the DB bench is a reason-
able predictor of barbell bench strength
in individuals who don’t train the bar-
bell bench particularly heavy, then DB
bench progress could be used as a proxy
for barbell 1RM progress.
23
APPLICATION AND TAKEAWAYS
1. This study showed that a linear regression equation based on reps performed
on the DB bench press was not only reasonably accurate at predicting barbell
bench press 1RM, but that this prediction was almost as accurate as using a set
of barbell bench press to failure.
2. This data may be useful for someone who cannot currently barbell bench press
heavy due to a shoulder injury but is able to DB bench press with sufficient vol-
ume. In that scenario, the DB bench could be used as a proxy for barbell bench
press.
3. It is important to interpret this data with caution since all of the athletes here were
likely performing both barbell and DB bench presses in their current programs.
If you are not used to performing one or the other, predicting barbell 1RM from a
set of DB bench to failure would probably be less accurate.

24
References

1. Heinecke ML, Mauldin ML, Hunter ML, Mann JB, Mayhew JL. Relationship of Barbell
and Dumbbell Repetitions With One Repetition Maximum Bench Press in College Football
Players. The Journal of Strength & Conditioning Research. 2020 Mar 23.
2. Scott LE, Galpin JS, Glencross DK. Multiple method comparison: statistical model using
percentage similarity. Cytometry Part B: Clinical Cytometry: The Journal of the Internation-
al Society for Analytical Cytology. 2003 Jul;54(1):46-53.
3. Reynolds JM, Gordon TJ, Robergs RA. Prediction of one repetition maximum strength from
multiple repetition maximum testing and anthropometry. The Journal of Strength & Condi-
tioning Research. 2006 Aug 1;20(3):584-92.
4. DiStasio TJ. Validation of the Brzycki and Epley Equations for the 1 Repetition Maximum
Back Squat Test in Division I College Football Players. (Doctoral dissertation, MA thesis,
Southern Illinois University Carbondale).
5. Pérez-Castilla A, Suzovic D, Domanovic A, Fernandes JF, García-Ramos A. Validity of
different velocity-based methods and repetitions-to-failure equations for predicting the
one-repetition maximum during two upper-body pulling exercises. Journal of strength and
conditioning research. 2019.
6. García-Ramos A, Haff GG, Pestaña-Melero FL, Pérez-Castilla A, Rojas FJ, Balsalo-
bre-Fernández C, Jaric S. Feasibility of the 2-point method for determining the 1-repetition
maximum in the bench press exercise. International Journal of Sports Physiology and Per-
formance. 2018 Apr 1;13(4):474-81.
7. Banyard HG, Nosaka K, Haff GG. Reliability and validity of the load–velocity relationship
to predict the 1RM back squat. The Journal of Strength & Conditioning Research. 2017 Jul
1;31(7):1897-904.

25
Study Reviewed: Intermittent Energy Restriction Attenuates the Loss of Fat Free Mass in
Resistance Trained Individuals. A Randomized Controlled Trial. Campbell et al. (2020)

The First Bodybuilding

Refeed Research
BY E RI C HE LMS

Refeeds, carb and calorie cycling, diet breaks, cheat meals and days,
zig-zag dieting; in one form or another, bodybuilders have been
implementing nonlinear fat loss tactics for decades. First they were
based on anecdotes, then combined with mechanistic, indirect, and
some human data on non-athletes. However, this study is arguably the
first truly relevant trial to date.

26
 KEY POINTS
1. This study compared body composition and metabolic outcomes in two groups
of trained men and women following the same net weekly energy deficit for seven
weeks; however, one group was in a larger deficit for five days followed by two days
at estimated maintenance, while the other sustained a small deficit on all days.
2. Overall, outcomes were better in the refeed group, which retained significantly
more dry fat-free mass and had a slightly better maintenance of resting metabolic
rate (RMR). The superior maintenance of RMR is likely related to the retention of
fat-free mass, since fat-free mass is a large contributor to RMR.
3. This study isn’t without limitations, but it is at least initial evidence that refeeds
might be beneficial for dieting individuals looking to maintain lean mass. Follow
up research will help us determine if this is a robust finding that stands up to
replication.

T he concept of a “refeed” has been

around in one form or another
for decades in the bodybuilding
world. While there are multiple forms,
the common colloquial definition is an
increase in calories, while dieting, that
lasts a day or a few days at most. Typi-
cally, this is an increase to maintenance,
or to a surplus, and often the proportion
of carbohydrate increases to purport-
edly replenish glycogen and positive-
ly impact energy expenditure. Ideally,
these outcomes would result in higher
training quality, mitigation of metabolic
adaptations, a step away from a state of
low energy availability, a mental break
from dieting, and ultimately better body
composition outcomes. While there’s a
fair amount of research on intermittent
dieting, this is the first study (1) where
the researchers simulated refeed prac-
tices from physique sport. Specifically,
trained, reasonably lean men and wom-
en were split into two groups following a
25% net energy deficit for seven weeks;
one group had a daily 25% deficit, the
other group had a 35% deficit for five
days followed by two days at mainte-
nance. At the post-test, both groups lost
a significant amount of body fat; how-
ever, the continuous diet group also lost
a significant amount of fat-free mass
and experienced a significant reduction
in RMR while reductions in the refeed
group were non-significant for fat-free
mass and RMR. Additionally, the refeed
group retained significantly more “dry
fat-free mass” (defined later) compared
to the continuous group. In this review,
I’ll go into the history of refeeds and
explain the outcomes of this study, dis-
cussing their relevance, limitations, and
ultimately applications for coaches and
athletes alike.

27
Purpose and Hypotheses Subjects and Methods
Purpose
The purpose of this study was to com-
pare body composition, RMR, and leptin
concentration changes in two groups
of resistance trained men and women
after seven weeks of net energy-defi-
cit-matched dieting, with one group us-
ing a seven-day per week continuous
deficit approach, and the other group us-
ing a five-day on (deficit), two-day off
(maintenance) intermittent approach.
Hypotheses
The authors hypothesized that both di-
ets would result in the successful main-
tenance of lean mass and metabolic rate
since they both included resistance exer-
cise and a relatively high protein intake.
They also noted that they were unsure if
the refeed group would experience bet-
ter body composition or metabolic rate
outcomes due to there being no prior re-
search on refeeds in a trained population.
Subjects
A mixed-sex group of 27 participants
with resistance training experience com-
pleted this trial. You can see the average
baseline characteristics for age, height,
body mass, and years of resistance train-
ing experience in Table 1. As a side note,
58 people were originally recruited. 4
never showed up for baseline testing, 3
never showed up to the study training
sessions after baseline testing, 21 with-
drew during the study, and data from 3
other participants weren’t included in
the analysis after self-reported nutrition-
al non-compliance. This ~46% comple-
tion rate is not abnormal for longitudinal
studies of energy restriction and serves
as a reminder of why nutrition trials are
difficult to complete.
Study Overview
This was a randomized, parallel-group,
controlled trial. After recruitment, par-
ticipants came to the lab for initial
screening and nutritional tracking in-
struction, and the participants began a
two-week period in which they tracked
their body mass and nutrition to estab-
28
lish their maintenance calories: the in-
take estimated to result in no change in
body mass over time. Then, participants
were randomly assigned to either the
refeed or the continuous group, which
both followed a 25% net weekly energy
deficit relative to their estimated mainte-
nance requirements. The weekly energy
distributions for the refeed and continu-
ous groups are shown in Table 2.
Participants in both groups were in-
structed to consume 1.8g/kg of protein
per day, with the remaining calories
evenly distributed between dietary fat
and carbohydrate. In the refeed group,
participants were instructed to consume
additional carbohydrates on their two
refeed days to reach estimated mainte-
nance. Participants were assigned an ex-
perienced member of the research team
as a personal nutrition coach to answer
diet-related questions during the study.
To control for post-workout nutrition
and to aid in reaching the daily protein
target, participants were given whey
protein isolate after each supervised re-
sistance training session. Self-reported
baseline and diet-day energy and mac-
ronutrient intakes are shown in Table 3.
Pre- and post-testing consisted of mea-
suring body mass, RMR via metabolic
cart, total body water via bioimped-
29
ance, and body fat percentage, body fat
mass, and fat-free mass via ultrasound.
Pre- and post-testing occurred under the
same conditions (time, assessor, equip-
ment) following an overnight fast. Be-
fore pre-testing, participants were in-
structed to refrain from physical activity
for 48 hours, and post-testing occurred
48 hours following the final exercise
session. In the refeed group, post-test-
ing occurred at least two days after the
last refeed day in an attempt to control
for glycogen-mediated water retention.
Additionally, the researchers calculated
“dry fat-free mass” by subtracting the
bioimpedance-derived total body water
from the ultrasound estimation of fat-
free mass as another method to control
for potential differences in body water
between groups (more on this later).
Supervised resistance training consist-
ed of a four-day upper/lower split with
two versions of each session type per-
formed per week. In week four, a de-
load was performed such that only two
training days occurred: one lower- and
one upper-body session. In each session,
two exercises were required, and then
the participants were free to select from
the available options for three additional
lower body exercises or four additional
upper body exercises, depending on the
day. Sets progressed from three to four
in most exercises. Repetition ranges var-
ied slightly by exercise, but appeared to
follow a linear progression such that all
exercises were performed in the 6-8 and
8-10 rep range by week seven. Loads
were selected so sets were one rep from
failure (1 RIR) while falling in the target
30
repetition range. Tables 4a and 4b dis-
play an example of the training with the
target rep ranges from week seven.
Finally, a subsample of eight partici-
pants had their fasting leptin concen-
trations assessed; however, this was
not balanced between the sexes (seven
males and one female), and the subsa-
mple was not large enough to represent
true between-group differences, so I
won’t discuss these outcomes.
Findings
Both groups significantly decreased
weight, fat mass, and body fat percent-
age. Regarding within-group chang-
es, fat-free mass and RMR decreased
significantly in the continuous group;
however, these decreases in the refeed
group were nonsignificant. The only
between-group difference was that the
refeed group lost significantly less dry
fat-free mass than the continuous group.
The body composition and RMR data
are displayed in Table 5 with within- and
between-group significance and with-
in-group effect sizes. Individual partici-
pant changes in fat and fat-free mass are
shown in Figures 1 and 2.
Interpretation
Since I joined the bodybuilding and
fitness communities in the mid 2000s,
I’ve been aware of the concept of re-
feeds (and other similar concepts). On
the Muscular Development forums in
31
 the mid 2000s, Dave Palumbo had a Infamous underground bodybuilding
well-established contest-prep diet that author Dan Duchaine wrote about carb
was low carb, high protein for 5-6 days, (and, as a consequence, calorie) cycling
followed by a carb cheat meal(s) or in his “Underground Body Opus” pub-
day(s). I remember studying for my first lished in 1996. Finally, my 3DMJ col-
personal trainer certification through league Jeff Alberts – who first competed
the ISSA in 2005 and learning Dr. Fred in 1993 – was aware of bodybuilders’
Hatfield’s “zig-zag diet” – in which you carbohydrate cycling since the 1980s
cut with higher calories on training days (which incidentally lines up with the
and lower calories on other days – in the early research on carbohydrate loading
sixth edition ISSA handbook from 2000. following depletion [2]).

Figure 1 Individual participant changes in fat mass

Figure 2 Individual participant changes in fat-free mass

4
4
3
2
Fat mass (kg)

2
Fat-free mass (kg)

1
-2

0
-4

-6 -1

-8 -2

Refeed group Continuous group -3

-4

Refeed group Continuous group

32
 It’s safe to say that something resem-
bling refeeds has been used in practice
for at least three decades. In peer-re-
viewed research, intermittent caloric re-
striction has been studied for its effects
on health, obesity, and lifespan, begin-
ning with mice in the early 1980s (3).
Today, this area of research has expand-
ed. A recent meta-analysis (4) compared
the effects of continuous restriction on
health and obesity to various forms of
intermittent caloric restriction including
alternate day fasting, the five and two
diet (the opposite of the present study:
two days of aggressive energy restriction
with five days unrestricted), and other
intermittent approaches. While this me-
ta-analysis reported similar outcomes
in studies of continuous and intermit-
tent restriction, there was a great deal
of heterogeneity in the setup of these
intermittent approaches, including the
populations studied, whether controlled
or ad libitum periods were included in
the non-dieting periods, whether in- or
out-patient models were used (self-re-
port, metabolic ward, or somewhere in
between), and the intended outcomes of
the various interventions.
However, bodybuilding-derived ap-
proaches entered the peer-reviewed
literature only recently. Our own Dr.
Trexler was the lead author of an open
access review on metabolic adaptations
to weight loss in athletes (5). In it are
the first peer-reviewed mentions of re-
feeds as a bodybuilding strategy to mit-
igate metabolic adaptation. Last year, I
joined lead author Jackson Peos in an
open access review on all forms of in-
termittent restriction viewed through a
lens of theoretical utility for athletes (6).
Finally, Dr. Brandon Roberts led a paper
on nutrition recommendations for phy-
33

WHILE A LARGE INCREASE IN
CALORIES FOR A SHORT TIME
PERIOD MIGHT TEMPORARILY
INCREASE GLYCOGEN, TRAINING
INTENSITY, AND RELIEVE DIETARY
CRAVINGS, SOME EVIDENCE
INDICATES THAT CERTAIN
PHYSIOLOGICAL PROCESSES
CHANGE IN RESPONSE TO
REFEEDING BASED ON THE
LENGTH OF THE REFEED, NOT
JUST THE ENERGETIC CONTENT.
sique athletes (7), which myself and Dr.
Trexler both contributed to. We placed
refeeds on a spectrum of non-linear fat
loss strategies, as shown in Figure 3.
There’s a lot of ground to cover in
this area, which is beyond the scope of
this review. But, all three of these pub-
lications are open access papers target-
ing athletes and coaches. However, if
you’re intimidated by peer-reviewed re-
search, or you simply don’t like formal
writing, I discuss some of the overlap-
ping data in a review of a study on diet
breaks in MASS here. Also, Dr. Trexler
wrote a concept review “Dealing with
Metabolic Adaptations to Weight Loss”
in Volume 2, Issue 5 back when he was a
guest reviewer. If you prefer video con-
tent, I recorded “The Nuts and Bolts of
Diet Periodization” in Volume 1, Issue 5
back in 2017. I’m happy to say all three
still hold up as representations of best
practice informed by current data.
The present study is the first examin-
ing refeeds as used by modern physique
competitors attempting to counter met-
abolic adaptations (as illustrated in this
published interview; 8) in a trained pop-
ulation. In the last couple of years, I’ve
specifically seen the utility of 48-hour
refeeds reported by bodybuilders. I’ve
personally experienced, and have seen
in our 3DMJ athletes, more consistent
weight loss, better visual outcomes, and
more time without menstrual cycle dis-
ruption (okay, I haven’t personally ex-
perienced that one) since we started us-
ing multi- versus single-day refeeds. If
my anecdotes are accurate observations
of a causal effect of multi-day refeeds,
I’d speculate this could be due to the
energetic and temporal effect of increas-
ing calories. While yes, a large increase
in calories for a short time period (say
a meal or a day) might temporarily in-
crease glycogen, training intensity, and
relieve dietary cravings, some evidence
indicates that certain physiological pro-
cesses change in response to refeeding
based on the length of the refeed, not just
the energetic content of the refeed. For
example, luteinizing hormone pulsatili-
ty, a marker of menstrual cycle stabili-
34
 ty, is dysregulated following substantial
energy restriction. In one study (9), a
single day where women consumed far
in excess of maintenance calories did
not reverse this marker of menstrual cy-
cle disruption; however, another study
found a 48-hour period of eating rough-
ly at maintenance did restore luteinizing
hormone pulsatility (10). Interestingly,
while the energy distribution pattern
during restriction and refeeding were
different, the net energy intake was sim-
ilar in these studies. As I discussed in a
MASS article, menstrual cycle disrup-
tion is just one of many effects from low
energy availability, which is an almost
inevitable consequence of dieting in
SINCE RMR IS PRIMARILY
IMPACTED BY FAT-FREE
MASS, AND GIVEN THAT
THERE WAS SLIGHTLY
BETTER RMR RETENTION
IN THE REFEED GROUP, I
TEND TO THINK THESE ARE
PROBABLY “REAL” BODY
COMPOSITION DIFFERENCES.
physique sport. Intermittent energy re-
striction may help mitigate that effect.
Getting back to our present study, the
findings are straightforward, yet prelim-
inary, and they confirm the efficacy, al-
beit cautiously, of the non-linear dieting
practices that science-interested body-
builders and coaches previously pieced
together from indirect research and
anecdotal experience. Simply put, the
body composition outcomes were better
in the refeed group. At the group level,
they lost nonsignificant amounts of fat-
free mass while the continuous group
lost significant amounts of fat-free mass,
and the refeed group lost significantly
less dry fat-free mass. Most likely as a
consequence of retaining more fat-free
mass, RMR was slightly better retained
in the refeed group; however, the abso-
lute differences are unlikely to be clini-
cally meaningful (~40kcal/day).
Regarding the limitations of this study,
I’ve seen a number of them discussed
by folks in our community, and I agree
with some of these assessments, but not
all. First, one potential limitation is that
the body composition changes could be
artefacts of the refeeds. High carbohy-
drate intakes increase muscle glycogen,
associated glycogen-bound water, and
can subsequently mask or magnify body
composition changes. While the authors
specifically waited at least 48 hours
post-refeed to assess body composition,
and they calculated dry fat-free mass
(which was the only between-group
change), some have questioned wheth-
35
er 48 hours is long enough to wash out
these effects and pointed out that dry
fat-free mass isn’t a validated method of
controlling for this potential confounder.
I don’t disagree with these specific cri-
tiques, but since RMR is primarily im-
pacted by fat-free mass, and given that
there was slightly better RMR retention
in the refeed group, I tend to think these
are probably “real” body composition
differences.
Another interpretation of the data is that
there were “responders and non-respond-
ers” to the refeeds, or even that there were
“outliers.” I think this stems from the vi-
sual assessment of Figure 2, which shows
individual changes in fat-free mass. To be
clear, an outlier has a specific (although
not universal) definition in statistics.
There are tests and criteria to determine
how a data point looks in relation to the
rest of the data, and how many standard
deviations from the mean it is; such tests
can be used to determine if a data point
is truly an outlier. Often, especially in a
small data set, an outlier results in the
data differing significantly from a normal
distribution. The authors specifically not-
ed their data were normally distributed
and reported no outliers. In a small data
set such as this, we would have to see an
individual with more extreme changes to
get far enough from the mean to qualify
as an outlier. Ok, so were there “respond-
ers and non-responders”? I personally
don’t think that’s an accurate way of de-
scribing the data. Viewing the continuous
group in Figure 2 from right to left, we
see three individuals who gained very
small amounts of fat-free mass, three that
barely lost any fat-free mass, four that lost
around ~1.5kg, and then it slopes down-
ward along the continuum of participants
who lost from a little over 2kg to a little
over 3kg of fat-free mass. Looking at the
refeed group in the same figure, to me, it
basically looks like the continuous group
data set, if all but the two far left partic-
ipants had ~0.5-1kg more fat-free mass.
Don’t agree with my visual interpreta-
tion? That’s fine! I actually don’t like ei-
ther interpretation, because it’s really not
appropriate to try to describe “trends” in
such small data sets. In this case, doing so
isn’t even figuratively “missing the forest
for the trees”; rather, it’s akin to being 5
miles away from a forest, squinting real-
ly hard at just a section of it, and trying
to guess what specific type of pine trees
make up the forest. Since we only have
13-14 data points in each group to assess,
any small variation due to chance (or
perhaps a real responder/non-responder
scenario) would drastically change the
visual appearance of the figure, and may
or may not be representative of how re-
feeds operate broadly. Lastly, a potential
limitation Dr. Trexler brought up in peer
review is that the refeed group consist-
ed of seven females and six males, while
the continuous group had six females and
eight males. In our published bodybuild-
ing recommendations (7), we noted that
female competitors seem to retain mus-
cle mass more consistently than men. The
sex-disparity between groups is pretty
36
 APPLICATION AND TAKEAWAYS
This is the first study examining bodybuilding-style, two-day carbohydrate refeeds in
mixed-sex groups of lean, resistance trained dieters. After seven weeks with the same
prescribed net energy deficit, better fat-free mass retention was observed in the refeed
group. Prior data support the concept that intermittent approaches to energy restric-
tion, at the very worst, are equivalent to daily energy restriction. This study indicates
that the previously unstudied use of refeeds may aid in fat-free mass retention and
may be worth implementing, although future studies are needed to confirm its efficacy.

small (refeed: 7 female, 6 male; contin- ic measures of muscle mass (ultrasound

uous: 6 female, 8 male), but then again,
the body composition differences were
also small. I don’t think it’s fair to claim
definitively that a sex difference contrib-
uted to the outcomes, but it is possible.
What is fair to say is that like any time
the first study on a specific practice is
published, we should be cautious in in-
terpreting the data and fight any urges to
get overly excited, drastically change our
practice, or leap to any sweeping con-
clusions. This is exciting and intriguing,
yet speculative work. We need further
research to confirm if refeeds are truly
advantageous, and if they are, what the
best approach to refeeding is and which
mechanisms underpin the outcomes.
Next Steps
I would love to see a similar study us-
ing multiple groups with different re-
feed setups (no refeeds, single day, and
48-hour) with performance data report-
ed (1RMs, volume) and also site-specif-
muscle thickness). Additionally, I’d like
to see leptin collected in all participants,
as well as other metabolic and hormonal
data (thyroid hormone, insulin, testoster-
one, cortisol) and measurements taken
midway through the study so we can see
the time course of changes. Lastly, I’d
love to see an assessment of other com-
ponents of energy expenditure. Some-
thing as simple as a step count would be
cool, ideally blinded to the participants,
to see if non-exercise activity thermogen-
esis was impacted. Also, another study
could be conducted comparing refeeds of
differing macronutrient distributions to
assess how critical it is that refeeds are
dominated by carbohydrate. Mechanistic
data shows better leptin response to over-
feeding carbs versus fat (11), but does
this play out in longitudinal outcomes?
Or could we just increase calories with
a more “normal” macronutrient spread?

37
References

1. Campbell BI, Aguilar D, Colenso-Semple LM, Hartke K, Fleming AR, Fox CD, Longstrom
JM, Rogers GE, Mathas DB, Wong V, Ford S. Intermittent Energy Restriction Attenuates the
Loss of Fat Free Mass in Resistance Trained Individuals. A Randomized Controlled Trial.
Journal of Functional Morphology and Kinesiology. 2020 Mar;5(1):19.
2. Costill DL, Sherman WM, Fink WJ, Maresh C, Witten M, Miller JM. The role of dietary car-
bohydrates in muscle glycogen resynthesis after strenuous running. The American journal of
clinical nutrition. 1981 Sep 1;34(9):1831-6.
3. Goodrick CL, Ingram DK, Reynolds MA, Freeman JR, Cider NL. Effects of intermittent
feeding upon growth and life span in rats. Gerontology. 1982;28(4):233-41.
4. Harris L, Hamilton S, Azevedo LB, Olajide J, De Brún C, Waller G, Whittaker V, Sharp T,
Lean M, Hankey C, Ells L. Intermittent fasting interventions for treatment of overweight and
obesity in adults: a systematic review and meta-analysis. JBI database of systematic reviews
and implementation reports. 2018 Feb 1;16(2):507-47.
5. Trexler ET, Smith-Ryan AE, Norton LE. Metabolic adaptation to weight loss: implications
for the athlete. Journal of the International Society of Sports Nutrition. 2014 Dec;11(1):7.
6. Peos JJ, Norton LE, Helms ER, Galpin AJ, Fournier P. Intermittent Dieting: Theoretical
Considerations for the Athlete. Sports. 2019 Jan;7(1).
7. Roberts BM, Helms ER, Trexler ET, Fitschen PJ. Nutritional Recommendations for Phy-
sique Athletes. Journal of Human Kinetics. 2020 Jan 31;71(1):79-108.
8. Mitchell L, Hackett D, Gifford J, Estermann F, O’connor H. Do bodybuilders use evi-
dence-based nutrition strategies to manipulate physique? Sports. 2017 Dec;5(4):76.
9. Loucks AB, Verdun M, (With the Technical Assistance of Rebecca Brown and Jean R.
Thuma). Slow restoration of LH pulsatility by refeeding in energetically disrupted women.
American Journal of Physiology-Regulatory, Integrative and Comparative Physiology. 1998
Oct 1;275(4):R1218-26.
10. Olson BR, Cartledge TA, Sebring NA, Defensor RU, Nieman LY. Short-term fasting affects lu-
teinizing hormone secretory dynamics but not reproductive function in normal-weight seden-
tary women. The Journal of Clinical Endocrinology & Metabolism. 1995 Apr 1;80(4):1187-93.
11. Dirlewanger M, Di Vetta V, Guenat E, Battilana P, Seematter G, Schneiter P, Jequier E, Tap-
py L. Effects of short-term carbohydrate or fat overfeeding on energy expenditure and plas-
ma leptin concentrations in healthy female subjects. International journal of obesity. 2000
Nov;24(11):1413-8.

38
Study Reviewed: A Randomized Controlled Pilot Trial of Sleep Health Education on Body
Composition Changes Following 10 Weeks Resistance Exercise. Jabekk et al. (2020)

Can Sleeping More Make

You Leaner?
BY E RI C T RE X LE R

We all know that insufficient sleep is unpleasant, but does it hinder

our gains in the gym? A new study found that a sleep education
intervention enhanced fat loss throughout a resistance training
program, but with some notable limitations. Read on to find out
whether or not your sleep habits might be getting in the way of your
physique goals.

39
 KEY POINTS
1. The presently reviewed study (1) evaluated the effects of a sleep education
intervention on body composition changes in response to 10 weeks of resistance
training.
2. Both groups increased lean mass, but the exercise + sleep group lost significantly
more fat mass. However, the study did not attempt to standardize dietary habits,
the details of the training program were unclear, and the sleep questionnaire did not
provide strong evidence that the exercise + sleep group actually got more (or better)
sleep than the exercise only group.
3. Despite the notable limitations, the results of this study generally agree with the
broader body of literature indicating that sleep quality and quantity can be modified
by practicing good sleep hygiene, and that getting adequate sleep yields favorable
effects for performance and body composition.

I f you’ve been a MASS reader for a

while, you know that we take our
sleep pretty seriously around here.
In the past, we’ve covered research
about naps, glasses that block blue light,
a variety of sleep interventions, and
even how macronutrient distribution
affects sleep. Inherently, our interest in
these topics is largely predicated on two
main hypotheses: 1) that sleep actually
impacts our ability to train, recover, and
adapt to training; and 2) that we can take
some easy, practical steps to improve
our sleep habits enough to actually aid
our fitness-related goals. The present-
ly reviewed study (1) tackles the latter
hypothesis directly, with an extremely
practical and straightforward interven-
tion. Two different groups completed a
10-week resistance training program;
one group received a pretty basic sleep
health education intervention before the
onset of the program (along with peri-
odic reminders), while the other group
was blinded to the intervention and re-
ceived no information about sleep. Both
groups gained lean mass and lost fat
mass to some degree, but the exercise
+ sleep group lost significantly more
fat mass and experienced a significantly
larger reduction in body-fat percentage.
While these results are both positive
and intuitive, the study has some pret-
ty notable limitations that must be con-
sidered. Read on to find out what those
limitations are, and whether or not your
sleep habits might be getting in the way
of your physique goals.
Purpose and Hypotheses
Purpose
The authors stated that the purpose
of the current study was to determine
if “sleep optimization” beneficially im-
40
pacts changes in fat mass or lean mass
when combined with resistance training.
Notably, an assumption that is necessar-
ily built into this purpose statement is
that the sleep health education interven-
tion they used actually optimized sleep.
Hypotheses
The authors hypothesized that “opti-
mizing sleep quality and quantity would
create additional positive body com-
position effects compared to resistance
exercise only.” Again, it seems safe to
assume that they believed their sleep
health education intervention would be
effective enough to tangibly improve
sleep quality and quantity; otherwise,
the study would’ve categorically failed,
which happens sometimes.
Subjects and Methods
Subjects
The researchers recruited 30 male
participants for the current study. Par-
ticipants were untrained (no regular re-
sistance exercise in the last six months)
students or university employees with
no significant sleep problems. The au-
thors administered a pre-study ques-
tionnaire to assess pre-existing sleep
issues, and subjects were excluded if
they reported having sleep problems for
more than two continuous weeks. Base-
line subject characteristics are listed in
Table 1. While the study began with
30 subjects, 4 dropped out due to time
constraints, and 3 others were excluded
from the analysis because illness or in-
jury led to insufficient adherence (<70%
of exercise sessions completed). The fi-
nal analysis included 22 subjects, with
10 in the sleep group (training + sleep
intervention) and 12 in the control group
(training only).
Methods
Subjects were randomly assigned to
one of two groups. The control group
underwent a 10-week resistance training
program, while the sleep group complet-
ed the same training program, but also
received a sleep health education inter-
vention at the beginning of the study.
The sleep education was intended to help
participants in the sleep group improve
the quantity and quality of their sleep.
The intervention was based on guide-
lines from the Norwegian Competence
Center for Sleep Disorders and consist-
41
ed of the following pieces of advice: “1)
Keep it dark, quiet and cool in the room
you sleep. 2) Go to bed and get up at
the same time during the whole week,
including weekends. 3) Go to bed so
that you can get 8 hours of sleep. 4) Two
hours before bed: a) turn down lights. b)
Put away pc, pads and mobile phones or
use blue light filter and lowest possible
light setting. c) No exercise. d) No food,
coffee or black tea, or drinks with en-
ergy. e) Do calm and positive activities
and do not bring up relational conflicts
before bedtime. 5) When you get up in
the morning, expose yourself to as much
light as possible right away. 6) Last cup
of coffee for the day six hours before
bedtime. 7) Try to get so much sleep that
you do not need an alarm clock to wake
up. 8) Do not use electronic devices that
emit light in bed. 9) Learn a relaxation
technique, use it to fall asleep at night
or if you wake during night.” The sleep
group was regularly reminded about
these suggestions throughout the study,
while the control group was blinded to
these suggestions.
The resistance training program con-
sisted of two full-body workouts per
week. Workouts began with a 10-minute
aerobic warmup, followed by leg press,
chest press, leg extension, narrow grip
cable chest press, lat pulldown, seat-
ed leg curl, and narrow grip cable row.
The paper states that “exercises were
performed with 2-3 series of 10-repe-
tition maximum with recommended 90
seconds inter-set breaks.” I’m assuming
participants picked a load, tried to hit
about 10 reps, went to failure each set,
and started selecting heavier loads when
they began reaching failure at more than
10 reps per set. But that’s essentially a
guess; there’s simply not enough infor-
mation to determine exactly what this
training program looked like, or how the
training stimulus was (or was not) pro-
gressed over time. The paper also states
that training was supervised “during the
first half of the study,” so it sounds like
participants were supervised for the first
five weeks, then asked to train inde-
pendently (and keep a training log) for
the final five weeks. To assess changes
in fat mass and lean mass, body compo-
sition was measured before and after the
program using DXA. Participants also
completed the Bergen Insomnia Scale
questionnaire and had blood samples
drawn both before and after the pro-
gram. The questionnaire was intended
to assess insomnia-related aspects of
sleep, and the blood samples were ana-
lyzed for HDL, LDL, triglyceride, fast-
ing glucose, and glycated hemoglobin
(HbA1c) levels.
Findings
The exercise + sleep and exercise
groups did not have significantly different
scores on the sleep questionnaire at base-
line (9.4 versus 13.4 points) or the end of
the study (7.4 versus 9.1 points). Just to
be clear, lower scores on this question-
naire reflect fewer sleep issues, so a re-
42
 Figure 1 Mean group changes in anthropometric variables

Exercise

Exercise + sleep
2.0

1.5

1.0

0.5
Group mean (kg)

0.0

-0.5

-1.0

-1.5

-2.0
Body weight Fat mass Lean mass
change change change

* = Exercise + sleep significantly different from exercise

duced score is a good thing. Similarly, the
change from baseline to post-testing was
not significantly different in the exercise
+ sleep and exercise groups (-2.0 versus
-4.3 points, respectively). Unfortunately
I can only report the mean changes here;
the researchers did not provide standard
deviations, which isn’t ideal, but we can
only use what we’ve got.
Body composition results are presented
in Figure 1. Both groups increased lean
mass throughout the study; the increase
was larger in the exercise + sleep group
than the exercise group (1.7 ± 1.1 ver-
sus 1.3 ± 0.8kg), but the between-group
difference was not statistically signif-
icant (p = 0.29). Both groups lost fat
mass, but the exercise + sleep group
lost significantly more than the exercise
group (-1.8 ± 0.8 versus -0.8 ± 1.0kg; p
= 0.02). Both groups experienced a re-
duction in body-fat percentage, but the
reduction in the exercise + sleep group
was significantly larger than the reduc-
tion in the exercise group (-2.07% ver-
sus -1.11%, no standard deviations pro-
vided; p = 0.03).
Results for the blood biomarkers are
listed in Table 3. Overall, nothing par-
ticularly interesting happened. There
was a curious difference between groups
for blood triglyceride levels, but the re-
43
searchers noted that this relationship
seemed to be largely driven by one par-
ticular subject with a very atypical in-
crease. It’d be great to further explore
exactly how large of an impact that out-
lier might have had, but again, standard
deviation values were not provided, so
we really don’t have much to fuel our ex-
ploratory efforts. However, the reported
outlier’s blood triglycerides increased
by 1.94 mmol/L; to contextualize that
number, a total triglyceride level of 1.8-
2.2 mmol/L is considered “borderline
high.” So a change of 1.94 mmol/L is
pretty astronomical and fairly similar to
seeing your blood LDL level jump up by
around 140 mg/dL in response to start-
ing a basic resistance training program
and trying to sleep a little better.
Interpretation
I’m going to be fully transparent about
my biases here: In general, I am very
fond of strategies that are practical, in-
expensive, and have minimal risk of side
effects. As you can imagine, I have a pret-
ty favorable opinion of sleep. It’s hard to
get more practical than something that
everybody does every day. Sleep is free,
and extra sleep tends to bring a bunch
of extra unintended benefits rather than
unfavorable side effects. However, these
positive aspects alone do not necessarily
mean that sleep interventions will neces-
sarily improve our performance or phy-
sique, and it doesn’t mean we should be
uncritical of studies that appear to con-
firm our previously held biases.
I love the concept of this study and the
general approach that the researchers
took. It’s hard to get more practical than
this study’s overarching goal: Teach
people about sleep, remind them that it’s
important, have them lift, and track the
gains. Having said that, this study had
some pretty notable limitations that can’t
be ignored. The authors drew attention
to one of the limitations, which was a
relatively high dropout rate. Of the 30
44
subjects that enrolled in the study, only
22 completed the study with satisfacto-
ry adherence. This presents two poten-
tial issues: 1) with a small sample size,
we could potentially “miss” important
patterns that would otherwise be sta-
tistically significant in a larger sample,
and 2) if systematic differences exist be-
tween people who dropped out and peo-
ple who completed the study, this could
introduce some bias into the results. For
point #1, there’s not much we can do.
Sure, it’s a relatively small sample, but
not egregiously low compared to other
interventions in our field of study. Plus,
there was a large enough sample to de-
tect some significant body composition
changes, so that doesn’t seem like a huge
issue. As for point #2, the authors pre-
sented the reasons for dropping out, the
exact number of dropouts in each group,
and also performed something called an
“intent to treat” analysis. Based on the
information provided, it doesn’t seem
like there’s cause for serious concern
about bias related to dropouts.
Personally, I’m more interested in a
few of the limitations that were not men-
tioned in the original paper. First, the
paper provides extremely minimal in-
formation about the details of the train-
ing program. Most of the time, there’s a
pretty easy trick for determining if the
methods were described clearly enough:
If you were supposed to start from
scratch and replicate the study, could
you do it based on the information pro-
vided? In this scenario, I’m still not sure
if (or how) loads were progressed over
time, and I’d have no chance of repli-
cating the training program with confi-
dence. In addition, no efforts were made
to control, or even monitor, dietary hab-
its. The paper does not state that partic-
ipants were given guidance to maintain
or improve their normal diet, nor were
they asked to log their food intake at any
time. Even basic food diary information
could have provided some very infor-
mative context to support the observed
changes in body composition. Finally,
I view the method for sleep assessment
as a fairly big limitation. The Bergen In-
somnia Scale is a pretty broad tool, with
only six total questions. The question-
naire itself does not specifically track
information like the time of sleep onset,
the time of waking, or the total duration
of sleep obtained. As a result, the ques-
tionnaire results did not provide strong
evidence of meaningfully better sleep in
the exercise + sleep group than the ex-
ercise only group. Ideally, it would’ve
been nice to utilize both objective and
subjective indices of sleep duration and
quality, and it would’ve been nice to use
a more nuanced questionnaire for the
subjective assessment of sleep.
If this study was the only relevant re-
search we had on the topic, it would be
very hard to confidently interpret the
findings in light of these pretty notable
limitations. Fortunately, the relationship
between sleep, diet, and performance is
a hot research topic right now, and new
studies are popping up all over the place.
45
Collectively, these studies are painting
a clearer picture of how sleep influenc-
es our performance, dietary behaviors,
and body composition. For example, a
more tightly controlled study back in
2010 found results pretty comparable
to the presently reviewed study. Over
a two-week weight loss phase, reduc-
ing the nighttime sleeping opportunity
from 8.5 to 5.5 hours per night resulted
in less loss of fat mass and greater loss
of lean mass (2). As the body of liter-
ature grows, it becomes more apparent
that insufficient sleep can lead to alter-
ations in glycemic control, hunger, ap-
petite, and ultimately increased energy
intake (3). In addition, sleep restriction
was recently shown to reduce the rate of
myofibrillar protein synthesis (4), which
would lead to even more unfavorable
body composition outcomes. Of course,
the effects of insufficient sleep do not
solely impact body composition; a va-
riety of performance-related outcomes
are impaired as well. As summarized in
a recent review (5), poor sleep practices
have the potential to unfavorably affect
function of the cardiovascular, respira-
tory, neuroendocrine, neuromuscular,
gastro-intestinal, and immune systems.
Naturally, prolonged sleep restriction
can result in impairment of a wide range
of performance outcomes, in addition to
increasing susceptibility to injury and
illness (5).
It’s clear that insufficient sleep is bad
news for performance and body compo-
sition, but how much is enough? Studies
evaluating sleep restriction typically al-
low for a “sleep opportunity” of rough-
ly 3-6 hours per night. In such studies,
roughly 7-8 hours is typically considered
the “sufficient” level to which results
are compared. Based on that literature, it
would seem pretty safe to conclude that
you’d want to obtain, at minimum, a sol-
id 7-8 hours of sleep per night. However,
a fascinating body of literature pertains
to actually extending sleep beyond the
minimal “adequate” level, rather than
simply avoiding sleep restriction. Greg
laid out a nice review of this literature
back in Volume 2 of MASS, so I’d en-
courage you to check out that article if
you want a deeper dive into the sleep
extension literature. But, in short, there
have been multiple studies in athletes
showing that increasing sleep time from
~7 hours to up around ~9 hours can im-
prove a variety of physical and cognitive
performance outcomes (6). In line with
these findings, the National Sleep Foun-
dation recommends getting 8-9 hours of
sleep per night to support sports perfor-
mance (5), which is just a bit higher than
the 8 hours that is often recommended
for the general population.
Acknowledging the importance of
sleep is one thing, but actually obtaining
more sleep is another thing altogether.
To date, sleep extension appears to be
the most efficacious sleep intervention
to actually improve performance (7).
Generally speaking, obligations of the
modern world dictate that sleep exten-
sion strategies typically involve going to
46
bed earlier, as relatively few people en-
joy the ability to simply sleep in longer
than they currently do. Based on what we
know about circadian biology, it seems
that an optimal approach to sleep exten-
sion would ideally involve maintaining
a regular daily sleep time and wake time,
which would be approximately aligned
with the natural daily light/dark cycle. If
you’re attempting to implement a pret-
ty sizable sleep extension, it also seems
advisable to ease into it; I would imag-
ine that abruptly moving your sleep time
two hours earlier would result in a pretty
frustrating adjustment and a lot of time
spent staring at your ceiling. Evidence
suggests that maintaining some simple
sleep hygiene habits, such as the list of
guidelines provided in the presently re-
viewed study, is also a reasonably effi-
cacious strategy for sleep improvement
(7). So, even if you’re unable to work a
couple of extra hours of sleep into your
daily schedule, you can still improve
the quality of your sleep by maintaining
some pretty basic habits, which include
getting plenty of light exposure in the
morning, avoiding light (particularly in
the blue wavelengths) in close proximity
to sleep time, maintaining regular sleep
and wake times, and making sure your
sleeping environment and pre-sleep rou-
tine are conducive to restful sleep (6).
If those strategies aren’t cutting it, you
could also explore some of the promis-
ing strategies that have been covered in
previous issues of MASS: taking naps,
wearing glasses that block blue-wave-
length light close to sleep time, or
re-evaluating the macronutrient distri-
bution of your diet. However, note that
napping strategies can be tricky. While
naps are better than nothing in an acute-
ly underslept situation, you’ll recall that
regular sleep/wake times and circadian
alignment with light/dark cycles seem
to be pretty important factors for sleep
quality. So, feel free to utilize naps, but
be mindful of their timing and duration
to ensure that they don’t interfere with
other aspects of your sleep hygiene. Fi-
nally, if you’re trying to clean up your
sleep habits, make sure your caffeine
intake is in check. The half-life of caf-
feine tends to be somewhere around 5-6
hours, and caffeine consumption can
lead to notable sleep disruption several
(6+) hours after ingestion (8), particu-
larly if total caffeine intake for the day
is relatively high.
Next Steps
I love the concept of this study, so I’d
like to see it replicated with some chang-
es. Specifically, I’d like to see it done
with a clearly described, progressive re-
sistance training program, a more thor-
ough subjective sleep assessment, some
objective method of sleep assessment,
and longitudinal monitoring of nutrition
habits. Of course basic food logs would
be informative, but an additional survey
or questionnaire to assess things like
hunger, stress, and food cravings would
be a fantastic addition.
47
 APPLICATION AND TAKEAWAYS
The sleep literature continues to suggest that insufficient sleep is disadvantageous for
people who are trying to improve their physique or performance. It seems like 8-10
hours is probably the ideal range for people with such goals, and it seems like some
pretty simple sleep hygiene habits can increase your likelihood of obtaining enough
high-quality sleep to support your goals. The presently reviewed study has some no-
table limitations that prevent us from drawing rock-solid conclusions from this paper
alone. However, the results fit in well with the broader body of literature, and the inter-
vention they used seems like a great starting point for people who are looking for some
simple, straightforward guidelines to improve their sleep habits.

48
References

1. Jåbekk P, Jensen RM, Sandell MB, Haugen E, Katralen LM, Bjorvatn B. A randomized con-
trolled pilot trial of sleep health education on body composition changes following 10 weeks
resistance exercise. J Sports Med Phys Fitness. 2020 Mar 4; ePub ahead of print.
2. Nedeltcheva AV, Kilkus JM, Imperial J, Schoeller DA, Penev PD. Insufficient sleep under-
mines dietary efforts to reduce adiposity. Ann Intern Med. 2010 Oct 5;153(7):435–41.
3. Beccuti G, Pannain S. Sleep and obesity. Curr Opin Clin Nutr Metab Care. 2011 Jul;14(4):402–
12.
4. Saner NJ, Lee MJ-C, Pitchford NW, Kuang J, Roach GD, Garnham A, et al. The effect of
sleep restriction, with or without high-intensity interval exercise, on myofibrillar protein
synthesis in healthy young men. J Physiol. 2020 Mar 11; ePub ahead of print.
5. Chandrasekaran B, Fernandes S, Davis F. Science of sleep and sports performance – a scop-
ing review. Sci Sports. 2020 Feb 1;35(1):3–11.
6. Vitale KC, Owens R, Hopkins SR, Malhotra A. Sleep Hygiene for Optimizing Recovery in
Athletes: Review and Recommendations. Int J Sports Med. 2019 Aug;40(08):535–43.
7. Bonnar D, Bartel K, Kakoschke N, Lang C. Sleep Interventions Designed to Improve Ath-
letic Performance and Recovery: A Systematic Review of Current Approaches. Sports Med.
2018 Mar;48(3):683–703.
8. Drake C, Roehrs T, Shambroom J, Roth T. Caffeine effects on sleep taken 0, 3, or 6 hours
before going to bed. J Clin Sleep Med. 2013 Nov 15;9(11):1195–200.

49
 The Relationship Between Body Composition Measured by Dual-Energy X-Ray
Absorptiometry and Maximal Strength in Classic Powerlifting. Ferland et al. (2020)

You Can’t Flex Bone: Predicting

Powerlifting Performance Based
on Fat-Free Mass
BY G RE G NUC KO LS

I think everyone knows that more muscular lifters tend to be stronger

lifters, but I don’t think people recognize just how strong that
relationship is among competitive powerlifters. In a recent study
on raw, drug-free powerlifters, fat-free mass was almost perfectly
correlated with performance. This article will explore that relationship,
and what we can do with it.

50
 KEY POINTS
1. In a sample of 15 competitive powerlifters, fat-free mass and bone mineral content
were both strongly associated with weight lifted in the squat, bench press, deadlift,
and total.
2. These relationships held across both sexes, suggesting that the difference in
performance between male and female lifters is primarily (or almost entirely) driven
by differences in fat-free mass.
3. If you know how much fat-free mass you have, you can compare your current lifts
against what you theoretically “should” be able to lift. You can use that information
to guide your medium- to long-term training goals.

I
f you’re even marginally acquaint-
ed with the sport of powerlifting,
I’m sure you’re aware that larg-
er lifters tend to lift more than small-
er lifters. From that observation, you
can probably intuit that there’s a posi-
tive association between fat-free mass
and powerlifting performance. I think
people tend to be surprised at just how
strong that relationship is, though.
A recent study set out to examine which
factors were associated with powerlift-
ing performance in a sample of mixed-
sex, raw, drug-free, competitive pow-
erlifters. Unsurprisingly, fat-free mass
and fat-free mass per unit of height were
strongly associated with performance,
explaining ~86-90% of the variability
in the lifters’ totals. Interestingly, bone
mineral content was almost as strongly
associated with performance as fat-free
mass was. I doubt anyone reading this is
surprised that fat-free mass is associated
with powerlifting performance, though.
This is an article to read for the discus-
sion. I’m not sure if it completely goes
off the rails, or if it’s some of my better
work. You can be the judge.
Purpose and Hypotheses
Purpose
The purpose of this study was to ex-
amine the relationships between pow-
erlifting performance and various body
composition metrics.
Hypotheses
The stated hypothesis was…broad:
“The hypothesis of this study was that
various powerlifters’ body composition
characteristics would be correlated with
maximal strength in the squat, the bench
press, the deadlift, and the total.”

51

Subjects and Methods
Subjects
The subjects were 15 competitive raw
powerlifters. Three subjects were juniors
(22 or 23 years old), and the rest com-
peted in the open class. They were quite
strong by the standards of published re-
search but average or just slightly above
average lifters by competitive standards
(the average female total was 352.3kg at
52
80.7kg [776lbs at 178lbs], and the aver-
age male total was 630.6kg at 93.5kg,
[1390lbs at 206lbs]). You can see more
details about the subjects in Table 1.
Experimental Design
The design of this study was incred-
ibly straightforward. Subjects all com-
peted in the Quebec, Canada provin-
cial championship on November 10-11,
2018. The researchers recruited from
the competitor pool at that meet and got
them into the lab for a DEXA scan prior
to January 31, 2019. The lifters’ highest
successful attempts at the powerlifting
meet were used as their 1RMs. All of the
body composition measures used in the
study were derived from the subjects’
DEXA scans. The only additional vari-
ables were the subjects’ age, resistance
training experience, and powerlifting
experience (all obtained via interview).
Findings
The strongest predictors of squat,
bench press, deadlift, and total perfor-
mance tended to be measures of fat-free
mass. Bone mineral content and bone
mineral density (for all regions except
the head) also tended to be quite pre-
dictive of powerlifting performance;
bone mineral content tended to be more
strongly predictive than bone mineral
density. All body composition measures
tended to be more predictive of absolute
performance than relative performance
(e.g. Wilks score). Below you’ll find
tables with the correlation coefficients
53
54
showing the strength of the relationships showing the relationship between fat-
between various body composition mea- free body mass and powerlifting total in
sures and powerlifting performance. this sample (11). Regression equations
The study also supplies a figure show- are provided for each relationship.
ing the relationships between fat-free
mass and performance in the squat,
Interpretation
bench press, and deadlift. For the figures, I know we’ve at least mentioned in
I’ve split those three lifts apart for easier passing in MASS that there’s a very
viewing, and created a fourth scatterplot strong relationship between muscle mass

Figure 1 Relationship between fat free mass and squat 1RM

350
y = 4.365x - 100.1
R2 = 0.798
300

250
One rep max (kg)

200

150

100

50

0
40 45 50 55 60 65 70 75 80 85 90

Fat free mass (kg)

Figure 2 Relationship between fat free mass and bench press 1RM

250
y = 3.3894x - 107.2
R2 = 0.8933

200
One rep max (kg)

150

100

50

0
40 45 50 55 60 65 70 75 80 85 90

Fat free mass (kg)

55
 Figure 3 Relationship between fat free mass and deadlift 1RM

350
y = 4.5193x - 83.21
R2 = 0.8317
300

250
One rep max (kg)

200

150

100

50

0
40 45 50 55 60 65 70 75 80 85 90

Fat free mass (kg)

Figure 4 Relationship between fat free mass and powerlifting total

900
y = 12.274x - 290.51
R2 = 0.8773
800

700
One rep max (kg)

600

500

400

300

200

100

0
40 45 50 55 60 65 70 75 80 85 90

Fat free mass (kg)

and strength. If you’ve been following in a sample of competitive powerlifters.

my personal work, I’ve explained the So, just to get one thing out of the way
reasons for that relationship in depth; for the pedants (no judgment; I’m one
I even co-authored some published lit- too): Technically, the study was assess-
erature on the subject (2). However, I ing fat-free mass, not muscle mass. Fat-
believe this is the first study we’ve re- free mass includes muscle, but it also
viewed on that topic in MASS, at least includes bones, organs, and virtually

56
 everything else in the human body be-
sides fat. However, skeletal muscle is
the single largest tissue constituent of
fat-free mass, and it’s the tissue compo-
nent of fat-free mass that varies the most
between individuals. So, fat-free mass
serves as a good proxy for muscle mass
(especially in a population all compet-
ing in the same sport) and, if anything,
I’d expect the relationships between
strength and actual muscle mass to be
even stronger than the relationships be-
tween strength and fat-free mass seen in
this study.
I doubt anyone’s surprised that fat-free
mass is so strongly predictive of power-
lifting performance. After all, the force
you produce to lift weights comes from
muscle contraction, so more fat-free
mass should mean more muscle, and
more muscle should mean greater con-
tractile force. However, there are some
DIFFERENCES IN FAT-FREE
MASS EXPLAIN VIRTUALLY
ALL OF THE AVERAGE
STRENGTH DIFFERENCES
BETWEEN MALE AND
FEMALE LIFTERS.
interesting aspects of this relationship.
First, the male and female lifters in the
present study both clearly fall along the
same trendline (I believe the females are
all of the subjects with less than 55kg of
fat-free mass, and the males are all of
the subjects with more than 60kg of fat-
free mass on the graphs above, though
that’s not made explicitly clear in the
text). The slope of the trendline for just
the male lifters is incredibly similar to
the slope of the trendline for just the
female lifters. This suggests that differ-
ences in fat-free mass explain virtually
all of the average strength differences
between male and female lifters. This is
what we should expect since we know
that male and female muscles can con-
tract with the same amount of force per
unit of mass or cross-sectional area (3).
However, I’ve seen people suggest any
number of reasons for the performance
gap between male and female powerlift-
ers (from males having thicker torsos, to
difference in limb proportions, to differ-
ences in pelvis shape, to fiber type dif-
ferences, etc; I’ve suggested this in the
past as well). And who knows: There
very well could be some other factors
that explain a small proportion of the
strength differences between the sex-
es, but it doesn’t seem like there’s very
much left to explain after accounting for
differences in fat-free mass.
Another interesting thing to note about
the present study is that bone mineral
content was almost as strongly associ-
ated with performance as fat-free mass
57
was. It’s not surprising that performance this information?”
and bone mineral content were associat- You can use this information to guide
ed – larger people tend to lift more, and training goal selection.
also tend to have greater bone mass –
If we know that fat-free mass and
what was surprising (at least to me) was
strength are strongly associated, then we
that bone mineral content could predict
can predict how much you “should” be
performance almost as well as fat-free
able to lift with the current amount of fat-
mass could. Since the correlation coef-
free mass you have, compared to drug-
ficients for the relationship between fat-
free competitive powerlifters. If you al-
free mass and strength were in the ~0.9
ready lift more than you “should” be able
range, I wouldn’t have batted an eye at
to lift with your current amount of total
correlation coefficients in the ~0.7-0.8
fat-free mass, that suggests that you’re
range for the relationship between bone
already a highly efficient lifter, and your
mineral content and strength, but the
progress is probably bottlenecked by
fact that the bone:performance correla-
muscle growth moreso than your tech-
tion coefficients were also close to 0.9
is somewhat surprising. We know that
muscle and bone are intimately linked
– contractile force from muscle helps
build bone, and osteopenia and sarco- IF WE KNOW THAT FAT-FREE
penia tend to go hand in hand – but an
idea popularized by a researcher named MASS AND STRENGTH ARE
Francis Holway takes things one step
further. Holway proposes that the size of
STRONGLY ASSOCIATED, THEN
your skeleton ultimately constrains how WE CAN PREDICT HOW MUCH
much muscle you can build (4). Thus, in
a cohort of people near their muscular
limits, their muscle mass and bone mass
YOU “SHOULD” BE ABLE TO
should be almost perfectly correlated. If LIFT WITH THE CURRENT
that’s true, then it would be unsurprising
for both bone mineral content and total AMOUNT OF FAT-FREE MASS
fat-free mass to be similarly well-cor-
related with powerlifting performance. YOU HAVE, COMPARED TO
At this point, you may still be think-
ing, “of course fat-free mass and abso-
DRUG-FREE COMPETITIVE
lute strength are strongly correlated. I
already knew that, and this article seems
POWERLIFTERS.
to be a waste of time. What can I do with

58
nique and neuromuscular efficiency. If
you lift less than you “should” be able to
lift with your current amount of total fat-
free mass, that suggests that you’re a rel-
atively inefficient lifter, and that you may
still be able to get considerably stronger
just by continuing to hone and develop
technique and movement efficiency.
Up until this point, the only study that
provided enough data for that sort of
calculation was this study by Brechue
and Abe (5). It’s a fine study, also us-
ing a cohort of competitive powerlifters,
but there are a few major differences
between Brechue and Abe’s sample and
the sample in the current paper. The lift-
ers in the prior study were all national-
or world-class lifters (so one can assume
they were all very genetically blessed),
they competed in equipped powerlifting
(before squat suits and bench shirts ac-
tually got good, mind you, but the early
equipment was still doing something),
and they competed untested (in feder-
ations that allowed steroid usage). The
lifters in the present study were basically
average to slightly above-average com-
petitive powerlifters, competing raw in
a strictly tested organization. I strongly
suspect the present sample more closely
resembles most of the powerlifters (or
people with strength-based goals) in the
MASS readership.
It’s also interesting to compare the pres-
ent study to the Brechue and Abe study
to see how the relationship between fat-
free mass and strength differs in the two
samples (6). Unsurprisingly, the subjects
in the Brechue and Abe study tended to
have more fat-free mass (~50-117kg,
versus ~42-83kg in the present study).
Where the two samples overlap, the
subjects in the Brechue and Abe study
also tended to lift more. However, the
predicted increase in strength per unit of
LBM increase is actually larger in the
present study (the beta coefficient on
the LBM term), whereas the y-intercept
is larger in the Brechue and Abe study.
Since the two regression lines have dif-
ferent slopes, they intersect at ~102kg.
Functionally, that means that a lifter
59
with 102kg of fat-free mass would have
about the same predicted total in both of
these studies, a lifter with 60kg of fat-
free mass would have a larger predict-
ed total using the regression equation in
the Brechue and Abe study, and a lifter
with 110kg of fat-free mass would have
a larger predicted total using the regres-
sion equation in the present study.
I’m not totally sure what to make of
these comparisons since the samples
are so different. One weird possibility
is that the relationship between fat-free
mass (and presumably muscle mass) and
strength changes after a person accumu-
lates a very large amount of fat-free mass.
Going back to the Brechue and Abe study
(5), if we look at the relationships be-
tween fat-free mass and strength in each
lift, we can see that for the squat, the lin-
ear relationship between fat-free mass
and strength works quite well. However,
for the bench press and deadlift, it appears
that there’s a steeper relationship for lift-
ers with less fat-free mass (<80-90kg or
so), and a less steep relationship for lift-
ers with more fat-free mass. If we plotted
the residuals for the linear regression line
(differences between actual performance
and regression-predicted performance),
you’d see that for the lightest and heavi-
est lifters, the regression equation consis-
tently overestimates performance, while
for the lifters with ~65-90kg of fat-free
mass, the regression equation consistent-
ly underestimates performance. In other
words, the regression equation would
probably fit the data better with a break-
point somewhere around 85kg of fat-free
mass. Below 85kg, you’d expect a larger
increase in performance per kilo of fat-
free mass gained, and above 85kg, you’d
expect a smaller increase in performance
per kilo of fat-free mass gained.
Why would we expect every kilo of
fat-free mass above a certain threshold
to be “worth” less than every kilo of fat-
free mass below a certain threshold? One
60
possibility is that muscle fibers become
too large to maintain efficient function.
Larger muscle fibers tend to produce
less force per unit of cross-sectional area
than smaller muscle fibers in cross-sec-
tional research (7; in other words, at this
very moment, your larger muscle fibers
produce less force per unit of CSA than
your smaller fibers). With longitudinal
research, we generally see that force
per unit of fiber CSA stays the same or
increases as fibers grow (8). However,
when fibers get too large, that trend may
reverse. Bioenergetic factors may begin
working against the fibers (it’s more dif-
ficult to clear waste products and deliver
fuel and oxygen when diffusion distanc-
es to bordering capillaries increase), or
the proportion of each fiber composed
of contractile tissue may begin decreas-
ing. Up to a certain point, as fibers grow,
they may change quantitatively (getting
larger and stronger), but not change in ef-
ficiency (they still function exactly like
they did when they were smaller). Past
that point, they may change both quanti-
tatively (getting larger and stronger), but
also decrease in efficiency (with function
per unit of size decreasing).
It’s worth noting that we have some
degree of anecdotal support for this no-
tion when looking at powerlifting per-
formance. Allometric scaling is predicat-
ed on the idea that strength scales with
muscle cross-sectional area, while body
mass scales with body volume (it’s ex-
plained in more detail here). Thus, two
lifters who are similarly skilled with sim-
ilar body composition should have sim-
ilar allometrically scaled strength. And
that’s what we see, up to a point. Up to
the 105kg weight class, allometric scal-
ing seems to do a really good job com-
paring performance between powerlifters
of different body sizes. In higher weight
classes, allometrically scaled strength be-
gins dropping off. At first, I thought the
only explanatory factor was body com-
position – heavier lifters carry more fat,
so they have less muscle as a percentage
of total body mass, so their allometrically
scaled strength is lower than it would be
for lighter lifters with better body compo-
sition. However, one “problem” always
stuck in my mind – Ray Williams. Ray’s
an incredible lifter; he’s totaled 1112.5kg
at a body mass of 190.4kg. Regardless of
body mass, 1112.5 is an amazing total.
Ashton Rouska totaled 881.5kg at a body
mass of 92.1kg earlier this year. That’s
also an amazing total. Ashton’s allome-
trically scaled total is 43.2. Ray’s is 33.6.
At first, I don’t see anything wrong with
that. Ashton’s clearly leaner than Ray, so
of course his allometrically scaled total
should be higher.
However, we can work in reverse
and see how much Ray would have to
weigh to have the same allometrically
scaled total as Ashton, assuming he still
totaled 1112.5kg. He’d need to weigh
about 135kg. Maybe I’m a cynic, but I
don’t know that we’ll ever see a lifter
total 1112.5kg at 135kg under similar
61
conditions (walked-out squats, no dead-
lift bar, two-hour weigh-in, strict drug
testing). Among lifters competing under
similar conditions, Dennis Cornelius is
the only person who’s somewhat come
close (1000 at 132.5). I shouldn’t need
to tell you that 1000 and 1112.5 are very
different numbers, though. If we expand
our search to include federations without
drug testing and with different equipment
standards, Larry Wheels and Eric Lillieb-
ridge have both hit 1075 at body weights
below 140, but they’re still nearly 40kg
away, and the equipment they compete
on (especially the deadlift bar) is prob-
ably massaging their numbers at least a
little bit. All of this is to say, even dis-
regarding differences in body composi-
tion between lifters, it seems likely that
allometric scaling (and thus the mono-
tonic relationship between muscle mass
and strength) breaks down when dealing
with lifters who have enormous amounts
of fat-free mass. Also note, for this ex-
ample, I chose Ashton as an “average”
elite-level lifter, rather than an outlier
among outliers. I didn’t even go with his
best total, just his most recent. The top al-
lometrically scaled total in all IPF weight
classes below 120kg range from 43.3 to
45.7. To match 43.3, Ray would need to
total 1112.5 at 130.2; to match 45.7, he’d
need to total 1112.5 at 120.1.
I recognize that this was a pretty long
diversion, but my main point is that we
also have practical reasons to believe
that strength gains per unit of fat-free
mass are lower past a certain threshold
as well; we don’t just have to rely on
eyeballing the residuals in the regres-
sion analysis from one paper that was
published a long time ago.
Last but not least, there’s one final the-
oretical issue in play, both in the present
study and in the Brechue and Abe paper:
Both studies have regression equations
with pretty large y-intercepts. The y-inter-
cept in these studies tells you how much
you should expect to lift if you have zero
62
fat-free mass. Intercepts aren’t always
meaningful, but in this case, they are,
since they show how well results com-
port with theory. In theory, the y-inter-
cept should be negative; I’ll explain why
in a footnote for anyone who cares about
the technical reasons (9). In the present
study, it’s -290.5, which is slightly below
where it “should” be (see footnote 9). In
the Brechue and Abe study, it was 221,
which is a considerable deviation from
theory. In the Brechue and Abe study, the
breakpoint in the relationship between
fat-free mass and powerlifting total is
probably the culprit. Smaller increases
in strength per unit of LBM for the lift-
ers with higher LBM decreases the slope
of the linear regression line, resulting in
a large positive intercept. In the present
study, the problem may have been differ-
ing experience levels. We can see that not
only was there a positive relationship be-
tween fat-free mass and absolute weight
lifted, there was also a reasonably strong
positive relationship between fat-free
mass and Wilks points. At first, that may
sound intuitive; as people train longer,
they get better at the lifts and they also
build muscle, so more experienced peo-
ple will tend to have more fat-free mass
and also have higher Wilks scores. And
within each sex, that’s probably valid
reasoning; this study also found a posi-
tive relationship between fat-free mass
and Wilks score within each sex. Howev-
er, within the entire sample of this study
containing both sexes, there shouldn’t be
a positive relationship between fat-free
mass and Wilks score, assuming the male
and female cohorts are comparable. All
else being equal, female lifters should
have less fat-free mass than male lifters,
but have similar Wilks scores, since Wilks
was developed to be able to compare per-
formance between the sexes. However,
the male and female lifters in this study
aren’t directly comparable. The male
lifters had more training experience and
higher Wilks scores overall. Within each
sex, and within the entire cohort, there
was also a positive relationship between
training experience and Wilks scores (r =
0.52-0.78). That’s probably the primary
reason for a y-intercept in the regression
equation that’s slightly more negative
than it “should” be. Across all levels of
magnification (weaker males vs. stron-
ger males, weaker female vs. stronger
females, males vs. females), the weaker
group in each comparison had less fat-
free mass and likely had less skill and
experience. That effect causes the slope
of the fat-free mass/strength trendline to
get steeper, resulting in a more negative
y-intercept. The lifters with more fat-free
mass were lifting about as much as they
“should” be lifting, while the lifters with
less fat-free mass were lifting less than
they “should” be lifting since they were
less experienced and less skilled.
So, with all of that out of the way, let’s try
to piece together a set of equations for pre-
dicting performance based on the amount
of fat-free mass someone is carrying. As
I’ve discussed in the previous paragraphs,
63
I think the present study underestimates
strength potential in lifters with lower fat-
free mass since the lifters with less fat-free
mass in the present study had less training
experience, and I think the Brechue and
Abe study tends to overestimate strength
potential in lifters with less fat-free mass
due to the lifters with high fat-free mass
unduly flattening the regression line. Be-
tween the two, however, I think the regres-
sion equation in the present study is much
closer to “correct,” especially for the lift-
ers in the sample with more fat-free mass.
So, we can take two fixed points to slightly
tweak the formula: our theoretical x-inter-
cept (19.35; discussed in footnote 9), and
the top within-sample point for the regres-
sion equation in the present study (a 765kg
total with 86kg of fat-free mass). The re-
sulting equation has a slope of 11.48 and a
y-intercept of -222. It’s a relatively small
tweak. In the figures, there’s a comparison
of the Ferland et al equation, the Brechue
and Abe equation, and my tweaked ver-
sion of the Ferland et al equation.
I think this equation works pretty well
for lifters with up to 86kg of fat-free
mass. For lifters with more than 86kg
of fat-free mass, it’s harder to provide
a confident quantitative relationship be-
tween fat-free mass and strength. There
were no lifters in the present study with
more than 86kg of fat-free mass, and
only five or six lifters in the Brechue and
Abe study had more than 86kg of fat-
free mass. However, just eyeballing the
graphs in the Brechue and Abe study, it
appears that the slope would decrease by
approximately half, so until more data is
published on lifters with extremely high
fat-free mass, a slope of 5.74 for each
kilo of fat-free mass above 86kg will
have to serve as a placeholder.
64
 So, if someone has less than 86kg of
fat-free mass, their predicted total is:
Predicted total = fat-free mass × 11.48
- 222
And if they have more than 86kg of
fat-free mass, their predicted total is:
Predicted total = fat-free mass × 5.74
+ 271
So, just to give one example, if you
weigh 85kg, and you’re approximately
20% body fat, you have 68kg of fat-free
mass. Thus, your predicted total would
be 68 × 11.48 - 222 = 559kg. To sanity
check this prediction, that total would
currently rank you around the 61st per-
centile in the world in the 83kg class on
the Open Powerlifting rankings: pretty
good, but not otherworldly. That’s a re-
alistic number to shoot for. If all we still
had was the Brechue and Abe data, the
prediction would be 714kg, which would
place you in the 98th percentile of lifters
in that weight class. That’s … very opti-
mistic. Using the equations straight out
of the present study, your predicted total
would be 544kg (which should illustrate
my theoretical tinkering only resulted in
a very slight adjustment).
One thing I’ll point out is that, unfor-
tunately, this formula doesn’t take height
into account. Totaling 559kg with 68kg of
fat-free mass may be very doable if you’re
170cm (5’7”), but borderline impossible
if you’re 200cm (6’7”). For this reason,
fat-free mass per unit of height would be a
better metric. It’s reported in the Brechue
and Abe study, but not the present study.
I emailed the author of the present study,
and he indicated that he’s collecting more
data as part of an ongoing research proj-
ect, and that a future paper would report
the relationship between fat-free mass per
65
unit of height in raw, drug-free power-
lifters. When that paper is published, I’ll
update the formula. I think fat-free mass
per unit of height would do a better job
ensuring the formula works well for fe-
male lifters too; even when male and fe-
male lifters have the same amount of fat-
free mass, fat-free mass per unit of height
is generally greater for the male lifters
(though I do still think the formula in the
present study works reasonably well for
female lifters too).
As one final note about this formula:
it’s based on data from competitive pow-
erlifters. If you don’t train like a power-
lifter, odds are pretty good that your ac-
tual total is considerably lower than the
total this formula would predict for you.
That doesn’t necessarily mean there’s
anything wrong with the formula, or any-
thing wrong with the way you train. The
formula just doesn’t apply to people like
you, because you don’t train the same
way as the subjects used to derive the for-
mula. However, if you decide you want
to give powerlifting a shot, it could help
give you some numbers to shoot for.
Finally, there was actually another pa-
per published this month on the same
topic: predicting performance in com-
petitive powerlifters (10). Unfortunate-
ly, I’m not too wild about how they
developed their regression equations.
They used multiple regression, which
is a good thing if done well, since you
can incorporate more predictors (like
training age, for example). I won’t bog
you down with the details, but the way
they went about selecting their factors
wasn’t ideal, in my opinion. There are
multiple ways of developing multiple
regression equations, and they made
theirs “by the book”: starting with the
factor that was most strongly associated
with the outcome of interest (powerlift-
ing total, in this case) and then including
additional factors in descending order of
the strength of their association with the
outcome of interest, as long as they’re
not too strongly associated with some
other factor already in the model. Unfor-
tunately, the factor most strongly asso-
ciated with performance in all three lifts
was flexed arm circumference, so flexed
arm circumference was the primary fac-
tor in all of their models. Even if you
wind up with a high R2 value for your
final model, I’m not wild about using
flexed arm circumference as the prima-
ry factor for predicting squat or deadlift
performance. Calf circumference was
also a factor in the bench press model
which, again, strikes me as less than ide-
al. An alternate approach to multiple re-
gression is called etiological modeling.
With an etiological model, you deter-
mine the factors that will go into your
model a priori. In other words, if you’re
studying lung cancer risk, you can say
that smoking status and age are going in
your model before you even look at your
data, whether or age or smoking status
actually turn out to be associated with
lung cancer risk in your particular data-
set. An etiological multiple regression
66
 APPLICATION AND TAKEAWAYS
As you accumulate more fat-free mass, you should be able to lift more. Within samples
of competitive powerlifters, the relationship between fat-free mass and powerlifting
total is consistently strong. We can use that relationship to predict how much you
“should” be able to lift, given your current amount of fat-free mass. If your lifts are
close to the predictions, building more muscle is probably your best way forward. If
your lifts are considerably lower than the predictions, you can probably continue im-
proving your total by improving your technique and lifting efficiency (though building
more muscle certainly never hurts).

model for powerlifting performance may
include fat-free mass per unit of height,
age, training age, and sex, for example.
An etiological multiple regression mod-
el for bench press performance almost
certainly wouldn’t include calf circum-
ference. I assume it’s clear by now that I
think an etiological modeling approach
would have been preferable. However,
here were the equations in that study,
in case you want to plug some of your
measurements into them:
Squat = -145.7 + (4.3 × training expe-
rience in years) - (1.7 × body fat per-
centage) + (6 × flexed upper arm girth in
cm) + (1.9 × thigh girth in cm)
Bench = -82 - (1.2 × body fat percent-
age) + (6.6 × flexed upper arm girth in
cm) + (0.8 × thigh girth in cm) - (2 × calf
girth in cm)
Deadlift = -79.8 + (4.9 × training ex-
perience in years) - (1.9 × body fat per-
centage) + (8.1 × flexed upper arm girth
in cm) + (2 × thigh girth in cm) - (3 ×
calf girth in cm)
Total = -391.2 + (10 × training experi-
ence in years) - (6.7 × body fat percent-
age) + (19.4 × flexed upper arm girth in
cm) + (3.9 × thigh girth in cm) - (9.7 ×
calf girth in cm) + (3.9 × hip circumfer-
ence in cm)
If you want to plug some numbers into
any of the equations discussed in this ar-
ticle, I made a spreadsheet you can play
around with. You can find it here. As a
little bonus, I also included the equations
from the Brechue and Abe study if you
just restrict the sample to lifters with less
than 90kg of fat-free mass. The calcula-
tor also includes predictions for each lift,
in case you want to see how one of your
lifts stacks up against the predictions.
Next Steps
I’m just waiting for Ferland and col-
leagues to publish their full dataset ana-
lyzing performance as a function of fat-
free mass per unit of height. I’d love to see
an etiological modeling approach used on
a larger dataset, with predefined variables
of fat-free mass per unit of height, train-
ing age, biological age, and sex.

67
References
1. Ferland PM, St-Jean Miron F, Laurier A, Comtois AS. The relationship between body com-
position measured by dual-energy X-ray absorptiometry and maximal strength in classic
powerlifting. J Sports Med Phys Fitness. 2020 Mar;60(3):407-416.
2. Taber CB, Vigotsky A, Nuckols G, Haun CT. Exercise-Induced Myofibrillar Hypertrophy
is a Contributory Cause of Gains in Muscle Strength. Sports Med. 2019 Jul;49(7):993-997.
3. Bishop P, Cureton K, Collins M. Sex difference in muscular strength in equally-trained men
and women. Ergonomics. 1987 Apr;30(4):675-87.
4. The most expansive explanation of this hypothesis I’ve seen was in the book “The Sports
Gene” by David Epstein. It’s really good. You should pick up a copy
5. Brechue WF, Abe T. The role of FFM accumulation and skeletal muscle architecture in pow-
erlifting performance. Eur J Appl Physiol. 2002 Feb;86(4):327-36.
6. It’s actually fat-free mass in the Brechue and Abe study, but LBM and FFM are similar
enough that using them interchangeably shouldn’t have a meaningful effect in this context
7. Krivickas LS, Dorer DJ, Ochala J, Frontera WR. Relationship between force and size in hu-
man single muscle fibres. Exp Physiol. 2011 May;96(5):539-47.
8. Dankel SJ, Kang M, Abe T, Loenneke JP. Resistance training induced changes in strength
and specific force at the fiber and whole muscle level: a meta-analysis. Eur J Appl Physiol.
2019 Jan;119(1):265-278.
9. At first, it would be intuitive to assume that the y-intercept should be zero – if you have zero fat-
free mass, you should be able to lift zero weight. However, you need to keep in mind that fat-free
mass doesn’t produce force. Skeletal muscle mass does. Thus, if a theoretical human had all of their
normal fat-free mass other than muscle mass, you would still expect them to produce zero force.
So, we need to ballpark a plausible lower LBM-sans-muscle-mass figure for adult powerlifters. The
lightest female weight class is the 43kg class. Muscle mass accounts for ~33% of womens’ body
mass, on average. Body fat percentage is more of a guess, but lightweight female lifters tend to be
quite lean, so we’ll ballpark the body fat percentage at 22%. Thus, non-muscle fat-free mass would
account for 45% of this theoretical person’s body mass, or 19.35kg. That’s our x-intercept. We can
use that information to calculate the y-intercept. Skipping ahead a few steps, it’s -237.2.
10. Ferrari L, Colosio AL, Teso M, Pogliaghi S. Performance and Anthropometrics of Classic
Powerlifters: Which Characteristics Matter? J Strength Cond Res. 2020 Mar 12.
11. The figures in the text actually report the correlations between lean soft tissue mass and power-
lifting performance. Lean soft tissue mass is fat-free mass minus bone mineral content. Fat-free
mass is the metric most MASS readers will be more familiar with, and enough data was reported
in figures for me to add up each subject’s total fat-free mass, so that’s what I showed in the figures
here. If you pull up the full text of the study and have a very keen eye to notice that all of the x
coordinates are 2-4kg higher in my figures than the figure in the text of the study, that’s why.

68
Study Reviewed: Effect of Rest Interval Duration on the Volume Completed During a
High-Intensity Bench Press Exercise. Hernandez et al. (2020)

The Scientific and Practical

Considerations of Long
Inter-Set Rest Intervals
BY MIC HAE L C . ZO URD O S
Longer inter-set rest intervals can lead to greater hypertrophy
and strength gains than shorter inter-set rest intervals. This study
demonstrates that eight-minute rest intervals may be needed
to maximize volume performance. But is eight minutes really
necessary? This article discusses both the scientific merit and practical
considerations of rest interval duration.

69
 KEY POINTS
1. This study compared the difference in reps performed during four sets to failure
at 85% of one-repetition maximum (1RM) when trained men took two minutes,
five minutes, and eight minutes of inter-set rest.
2. Unsurprisingly, more reps were performed over the four sets with eight minutes
rest compared to both five and two minutes. Further, more reps were performed
with five minutes of inter-set rest versus two minutes of rest.
3. This study clearly shows that greater inter-set rest times are associated with
better maintenance of reps performed from set-to-set when training to failure.
Importantly, longitudinal studies do support longer rest times for hypertrophy;
however, eight-minute rest periods may not be necessary or practical. Therefore,
this article provides a nuanced discussion of both the cross-sectional and
longitudinal inter-set rest interval data, and provides specific recommendations
related to rest intervals.

N
ot too long ago, it was standard
to recommend 30-90 second in-
ter-set rest intervals to maximize
hypertrophy. A few longitudinal studies
now exist which show either no differ-
ence (2) or a potential benefit of long
rest intervals (3, 4) for hypertrophy.
Similarly, longitudinal studies focused
on strength show no difference between
short and long rest intervals (2, 3) or
enhanced strength with long rest inter-
vals (4, 5). Importantly, various cross-
over design studies have shown that
when the number of sets are equated
between short and long rest interval pro-
tocols, the short rest intervals can lim-
it total volume by reducing the number
of reps completed per set (6); however,
the longest rest interval investigated to
date for this purpose is five minutes (7).
So, if long rest intervals are better than
short rest intervals, then what about re-
ally long rest intervals? This crossover
design study from Hernandez et al (1)
had 15 trained men perform four sets
to failure at 85% of 1RM in three dif-
ferent conditions with variable inter-set
rest periods. The conditions included:
1) Two minutes inter-set rest, 2) Five
minutes inter-set rest, and 3) Eight min-
utes inter-set rest. Not surprisingly, the
greatest number of total reps performed
across all four sets was in the eight-min-
ute condition, followed by the five-, and
then the two-minute condition. These
results translated to 22.6% more volume
in the eight-minute inter-set rest condi-
tion versus the five-minute inter-set rest
condition and 19.2% more total volume
in the five-minute inter-set rest condi-
tion versus the two-minute inter-set rest
condition. The straightforward implica-

70
tion of these results is that taking longer
inter-set rests will lead to more volume,
which would potentially promote great-
er hypertrophy and strength adapta-
tions compared to shorter inter-set rests.
While that interpretation is logical, tak-
ing eight-minute rest intervals is not
always practical. Therefore, this article
will review the current state of the liter-
ature related to both cross-sectional and
longitudinal rest interval studies; then,
it will provide a nuanced discussion re-
garding the practicality of short and long
rest intervals. Specific examples of how
and when to implement both short and
long rest intervals will be provided.
from the introduction, it seems clear that
the authors thought total reps performed
would scale with greater inter-set rest.
Subjects and Methods
Subjects
15 men with an age range of 20-34
years old participated. All subjects had
trained at least three days per week for
the past year leading up to the study. The
remainder of available subject details
are in Table 1.

Purpose and Hypotheses Figure 1 Total volume performed

Purpose
3000

The purpose of this study was to com- 2 min

5 min

pare the number of reps performed

Total volume (kg)

8 min
2000

during four sets to failure at 85% of

1RM in the bench press in three differ- 1000

ent conditions consisting of two-, five-,

and eight-minute inter-set rest intervals. 0
2 min5 min 8 min
Condition

Hypotheses From Hernandez et al. (1).

No hypotheses were given. However,

* = significantly less volume than the 8-minute interest condition
# = significantly less volume than the 5-minute interest rest condition

71
Study Overview
Four laboratory visits, each separated
by at least 48 hours, were needed for
this crossover design study. The first
visit tested bench press 1RM, then one
set to failure at 85% of 1RM was com-
pleted. The next three visits were the
testing sessions, which were completed
in a randomized order.
Testing Sessions
The three testing sessions were identi-
cal except for the inter-set rest interval,
which was two minutes in one condition,
five in another, and eight minutes in the
final condition. For each condition, sub-
jects performed four sets of bench press
at 85% of 1RM. The first set was per-
formed for the exact number of repeti-
tions completed during the 85% set to
failure on the 1RM day. Subjects then
performed three sets to failure at 85%
following that first set. Again, the only
difference between conditions was the
length of time of the inter-set rest inter-
val. The researchers then compared to-
tal volume (sets × reps × weight lifted)
and repetitions completed between con-
ditions, and they examined the degree
to which the number of repetitions per-
formed decreased from set to set within
each condition.
Findings
The findings of this study were
straightforward. More total volume was
performed and better maintenance of
reps performed from set to set occurred
when longer inter-set rest intervals were
taken. This data is shown in Figure 1
and Table 2. Below is a more detailed
description of those findings.
Total Volume and Reps Performed
Total volume performed was sig-
nificantly greater (p < 0.01) in the
eight-minute rest interval condition
72
(2,207 ± 372 kg) than in the five-min-
ute condition (1,793 ± 315 kg). Further,
greater total volume was performed in
the five-minute rest condition compared
to the two-minute condition (1,448 ±
215 kg) (Figure 1).
For reps performed from set to set, there
was a decrease in reps from set one to set
two in both the two-minute and five-min-
ute rest conditions (p < 0.05). Further,
both the two- and five-minute conditions
performed fewer reps than the eight-min-
ute rest condition in sets two, three, and
four (p < 0.05). Lifters also performed
fewer reps on sets two, three, and four in
the two-minute rest condition compared
to the five-minute rest condition (p <
0.05). In the eight-minute rest condition,
reps performed did not statistically de-
crease from set one to set four (p = 0.06);
however, there was a decrease of -15.63%
(effect size = 0.85), which equated to an
average decrease of one rep.
Interpretation
The findings of this study by Hernan-
dez et al (1) should not be too surpris-
ing. Certainly, most of us would have
hypothesized that taking longer rest
intervals between bench press sets to
failure would result in better mainte-
nance of repetitions per set. The only
thing that may be slightly surprising is
that subjects maintained reps performed
so much better in the eight-minute rest
interval than the five-minute rest inter-
val. Specifically, the five-minute rest
condition performed three fewer reps
on average in set four versus set one.
In the eight-minute rest condition, sub-
jects performed only one fewer rep on
set four versus set one. In short, these
findings suggest that lifters training for
hypertrophy and strength should take
longer rest intervals, which will lead to
more volume and potentially more gains
over the long-term. Fortunately, there
are a handful of similar cross-sectional
studies that have also looked at rest in-
tervals and reps performed, along with a
few longitudinal studies comparing rest
intervals for strength and hypertrophy.
Let’s now take a look at those studies
before interpreting how the collective
findings translate into practice.
Other Acute Studies Looking at Rest
Intervals and Reps Performed
As stated above, a handful of oth-
er studies have looked at the effects of
“long” versus “short” rest intervals on
reps performed during sets to failure,
and for the most part, these studies agree
that longer rest intervals lead to more
reps performed in a single training ses-
sion. I put “long” and “short” in quotes
above because those are really relative
terms, and they’re mostly used in a bi-
nary fashion when comparing one rest
interval to another, even if both rest in-
tervals are relatively short. For example,
Senna et al observed that ~36% more
73
bench press reps were performed with
three minutes of inter-set rest versus one
minute during five sets to failure at a
10RM load (6). Similar to Senna, Tiba-
na et al (8) found that trained men per-
formed ~26% more reps with three-min-
ute rests versus one-minute rests over
five sets to failure on the Smith machine
bench press. Willardson and Burkett
(7) unsurprisingly found that five-min-
ute inter-set rest intervals allowed for
more reps over five sets to failure on
both the squat and bench press with an
8RM load versus both two minutes and
one minute of inter-set rest. Another
study from Willardson and Burkett et al
(9) found that two-minute rest intervals
allowed for better sustained repetition
performance on five sets to failure with
a 15RM on the squat and bench press
versus both 30-second and 1-minute
rest intervals. Lastly, Scudese et al 2014
(10) had trained men perform five sets
to failure with a 3RM load in four dif-
ferent rest interval conditions: one-min-
ute, two minutes, three minutes, and five
minutes. Interestingly, Scudese reported
that the fewest reps were performed in
the one-minute rest condition, but there
was no difference in reps performed be-
tween the other conditions. The differ-
ence in the Scudese studies compared
to the Senna and Tibana studies is likely
explained by the high load used by Scu-
dese. These studies, along with the pres-
ent study, are summarized in Table 3.
So, the novelty in the present study lies
in the length of rest used, as the longest
rest interval in these previous studies was
74
five minutes. Therefore, it is interesting
that the presently reviewed study (1) used
a load (i.e. 85% of 1RM) not too dissimi-
lar from the Scudese study (3RM or ~90%
of 1RM), and found eight-minute rest
intervals to yield so much more volume
than five-minute rest intervals. So, do
you need to rest eight minutes? Probably
not from a purely scientific perspective.
From a practical perspective, eight min-
utes is generally unsustainable, but we’ll
return to the practical discussion later. I
suggest that you probably don’t need to
rest eight minute between sets, because
all of the aforementioned studies used
failure training on every single set. How-
ever, it is unlikely that you are training to
failure on every set. So, if the goal is in-
deed to perform as many reps as possible
on every single set, then eight minutes
– or potentially even more – of inter-set
rest may be necessary. However, if you
are performing more traditional volume
(i.e. 5×8 at 5-8RPE), then each set won’t
be as fatiguing from both a neuromuscu-
lar and metabolic perspective, meaning
you can almost certainly get away with
a shorter rest interval than eight minutes.
Further, the Scudese study suggests that
with higher intensities, shorter rest inter-
vals can maintain repetition performance.
Additionally, different rest intervals are
likely needed on different exercises. You
may need five minutes of rest to success-
fully maintain the same load for squats
during 5×8 at 5-8RPE mentioned above,
but could complete such a prescription
on rows or curls with only 2-3 min-
utes rest. So, it may make sense to take
eight-minute rest intervals if training to
failure on the compound movements, but
this seems unnecessary in many other
situations. The studies mentioned in this
section only contain acute data, so let’s
now take a look at the longitudinal stud-
ies comparing different inter-set rest in-
tervals to see how this actually plays out.
Longitudinal Studies Comparing Dif-
ferent inter-set Rest Intervals
After examining the acute data above,
it seems logical to deduce that taking
longer inter-set rest intervals to perform
more total volume is advantageous for
hypertrophy. However, up until pretty
recently, this data was largely ignored
in textbooks and mainstream exercise
physiology academia. Rather, right after
the old guard would explain how they
walked uphill to school both ways in the
snow, they would then repeat the narra-
tive that acute testosterone and growth
hormone responses to resistance train-
ing were causative factors in skeletal
muscle hypertrophy. Further, the largest
post-exercise transient response of an-
abolic hormones tends to happen when
rest intervals are really short (i.e. 30
seconds to 1 minute) (11); thus, the old
guard recommended short rest intervals
to maximize hypertrophy, and this theo-
ry became widely accepted. Sure, early
data did show a relationship between the
acute anabolic hormone response and hy-
pertrophy (12), but it simply tended to be
75
that hypertrophy-type protocols that used
short rest intervals also had more volume
programmed. More recent literature has
clearly demonstrated that the acute hor-
monal response is not a causative factor
in hypertrophy (13). So, with the hor-
mone hypothesis discounted, what is an
appropriate inter-set rest time?
Both Buresh et al 2009 (3) and, more
recently, Schoenfeld et al 2017 (4) com-
pared the effects of different inter-set
rest interval lengths on long-term hyper-
trophy. Buresh et al (3), had two groups
train twice per week for 10 weeks with
the number of sets equated and the only
difference between groups being rest-
ing 2.5 minutes or 1 minute between
sets. Buresh found no statistically sig-
nificant differences between groups for
arm cross-sectional area; however, there
was an effect size of 0.32 in favor of the
longer rest interval group (2.5 minutes).
Schoenfeld et al (4), also showed a po-
tential benefit for long rest over short
rest for hypertrophy. In the Schoenfeld
study, trained men lifted three times
per week for 10 weeks with either three
minutes or one minute of inter-set rest.
Hypertrophy over the 10 weeks was
similar in the biceps, triceps, and lat-
eral quadriceps; however, hypertrophy
was significantly greater in the anterior
quadriceps. Schoenfeld and colleagues
attribute the greater thigh hypertrophy
to more volume completed in the long
rest group. If that assertion is the reason
for the hypertrophy findings, and I be-
lieve it is, then the presently reviewed
study and the other acute studies men-
tioned above may indeed be indicative
of what long-term rest intervals should
be. On the other hand, Ahtiainen et al
compared five-minute rest intervals ver-
sus two-minute rest intervals for quad-
riceps hypertrophy and found no differ-
ence between groups for muscle growth
(2). However, since both groups trained
to failure, Ahtiainen had the short rest
group add sets to equate for volume
since fewer repetitions per set were per-
formed in the short rest group; whereas,
Buresh and Schoenfeld equated for sets
between groups (more on this later).
The Buresh (3) and Schoenfeld (4)
studies also examined strength gains.
Surprisingly, Buresh did not find a dif-
ference between groups for gains in
5RM squat and bench press strength.
However, Schoenfeld et al reported
greater increases in 1RM squat and
bench with long rest versus short rest.
Similar to Schoenfeld, De Salles et al
(5) found that five and three minutes of
inter-set rest resulted in greater leg press
strength over 16 weeks versus one min-
ute of inter-set rest. Further, De Salles
et al found that both the three- and
five-minute groups performed more to-
tal volume than the one-minute group.
In contrast to De Salles and Schoenfeld,
Willardson and Burkett (13) found no
difference in changes in squat 1RM over
13 weeks when comparing trained men
who trained twice per week and took ei-
76
ther two or four minutes between sets.
However, Willardson and Burkett did
find that lifters in the four-minute in-
ter-set rest group performed more total
volume than the two-minute rest group.
While it might be a stretch to say that
there is an overwhelming amount of data
to support longer rest intervals, I do think
the data is clearly leaning in this direction
for both strength and hypertrophy. Impor-
tantly, there is no study in young individ-
uals that has shown better hypertrophy or
strength gains with short rest; thus, the
findings are either null or in favor of long
inter-set rest. There are, however, a few
caveats and practical considerations to
this, which we’ll now discuss.
Practical Considerations of Long In-
ter-Set Rest
First, let’s return to the presently reviewed
study, which showed that eight-minute
rest intervals yielded more reps per set and
total volume than five- or two-minute rest
intervals. Despite this, I don’t think any-
one should interpret this as an indication
that eight-minute rest intervals are nec-
essary all the time. If you train to most-
ly submaximal RPEs for volume, the five
minutes is probably sufficient on the main
lifts. In fact, a previous study (15) that we
reviewed found that when lifters rested
intuitively (i.e. not timed), they tended to
rest about 4-5 minutes and were able to
successfully complete a 5×5 training ses-
sion at a 5RM load. Now, you can certain-
ly take eight minutes of inter-set rest, and
you may need it in some cases such as sets
of squats with 15-20 reps close to failure,
but this probably becomes impractical
from a time perspective. Honestly, taking
even five minutes between every set could
become impractical. But of course, rest
intervals can change with different exer-
cises, so if you have three or four sets of
squat or bench at a submaximal RPE, then
taking about five minutes rest is probably
doable. Then, when you get to assistance
movements, shorter rests of 1-3 minutes
should be sufficient and won’t keep you in
the gym for an exorbitant amount of time.
The main caveat for the studies that
most people point to (usually Buresh and
Schoenfeld) in support of long rest for
hypertrophy is that the number of sets
is equated between groups in these stud-
ies. When sets were added to the short
rest group in the Ahtiainen study (2),
there was no difference in lower body
hypertrophy. I don’t think adding sets
is a better design; it’s just answering a
slightly different question. Specifically,
adding sets in the Ahtiainen study just
suggests that if volume load is equated,
then rest intervals may not be all that
important for hypertrophy. Therefore,
while longer rest intervals do allow for
more volume and better average inten-
sity when training to failure, you could
simply equate for volume by adding an
extra set and taking short rest, which
may actually take less time. For exam-
ple, if you performed 5×8 on squats with
100kg and took five-minute rests, that is
77
20 minutes of total inter-set rest, but per-
forming 6×8 with 90kg and two minutes
of inter-set rest only requires 10 minutes
of rest intervals, and certainly less total
training time. The 6×8 workout is also
slightly more total volume. If you are
worried about proximity to failure in this
scenario, I don’t think that’s an issue, as
the short rest will probably cause RPE
to go up each set, and if the 100kg sets
are nearly to failure, the 90kg sets won’t
be that far from failure with short rest
IF YOU ARE SHORT ON TIME
AND STRENGTH IS YOUR
MAIN GOAL, THEN I WOULD
KEEP YOUR FIRST SET
AT YOUR PROGRAMMED
TRAINING LOAD SO THAT PEAK
INTENSITY IS NOT AFFECTED,
WHICH SHOULD MAINTAIN
STRENGTH, AND THEN SIMPLY
TAKE A SHORTER REST
AND LIGHTEN THE LOAD ON
THE REMAINING SETS.
intervals. Theoretically, in this scenario
you could even add a couple more sets
with the short rest protocol and still fin-
ish in less time. I’m not necessarily ad-
vocating for adding more sets, and there
is merit to limiting the amount of sets
per session on one exercise, but the op-
tion is there if you are someone that can
handle really high volumes. However,
if you typically take about five-minutes
rests on the main lifts and are short on
time one day, then consider making the
above adjustment to get in your neces-
sary volume for the day. If you are short
on time and strength is your main goal,
then I would keep your first set at your
programmed training load so that peak
intensity is not affected, which should
maintain strength, and then simply take
a shorter rest and lighten the load on the
remaining sets. In general, more insight
into making training adjustments for
time efficiency was written about here,
and specific examples of how to manip-
ulate exercises when short on time are
provided in the program troubleshoot-
ing video. For assistance movements,
you could add in variations of rest-pause
and agonist-antagonist supersets when
you are short on time. Additionally, you
can probably get away with shorter rest
intervals on assistance movements (in
general) than you can on the main lifts.
That being said, I still think that taking
sufficient rest is a good idea, rather than
just packing in more volume with shorter
rest intervals. In other words, if you can
78
 APPLICATION AND TAKEAWAYS
1. This study demonstrates that taking longer inter-set rest intervals is associated
with greater repetitions performed during sets to failure at 85% of 1RM on the
bench press.
2. Indeed, there are longitudinal studies that support the idea that longer rest intervals
can be superior for both hypertrophy and strength. However, the evidence is not
overwhelming in this area; rather, it is merely leaning in that direction.
3. While I do think it is generally a good idea to rest long enough to maximize perfor-
mance, this may not always be practical. Therefore, adding sets and reducing rest
times is a viable strategy when time is constrained.

manipulate performance to be better, I and does not have lifters train to failure.
think that’s a good thing. Lastly, I think Perhaps one-minute, three-minute, and
taking longer rest may reduce the num- five-minute inter-set rest interval groups
ber of total sets you need to maximize would be the way to go. In this setup,
hypertrophy. For example, we previously the group with one-minute rest inter-
reviewed a study (16) that suggests that vals would have the most sets, followed
30+ sets per week may be optimal for by the three-minute rest group, and the
upper and lower body hypertrophy and five-minute inter-set rest group would
squat and bench strength; however, this have the fewest sets.
study used only 60-second rest intervals.
In that review, I postulated that if longer
rest intervals were used, perhaps the lift-
ers may have been able to get in more
quality sets, which could mean that hy-
pertrophy might be optimized with fewer
sets than 32 on a group level. As always,
understanding this topic conceptually
can help you to apply the appropriate rest
interval duration to your training.

Next Steps
We need a longitudinal study that is
not equated for sets but for total volume

79
References

1. Hernandez DJ, Healy S, Giacomini ML, Kwon YS. Effect of Rest Interval Duration on the
Volume Completed During a High-Intensity Bench Press Exercise. The Journal of Strength
and Conditioning Research. 2020 April.
2. Ahtiainen JP, Pakarinen A, Alen M, Kraemer WJ, Häkkinen K. Short vs. long rest period
between the sets in hypertrophic resistance training: influence on muscle strength, size, and
hormonal adaptations in trained men. The Journal of Strength and conditioning Research.
2005 Aug 1;19(3):572.
3. Buresh R, Berg K, French J. The effect of resistive exercise rest interval on hormonal re-
sponse, strength, and hypertrophy with training. The Journal of Strength & Conditioning
Research. 2009 Jan 1;23(1):62-71.
4. Schoenfeld BJ, Pope ZK, Benik FM, Hester GM, Sellers J, Nooner JL, Schnaiter JA,
Bond-Williams KE, Carter AS, Ross CL, Just BL. Longer inter-set rest periods enhance
muscle strength and hypertrophy in resistance-trained men. Journal of strength and condi-
tioning research. 2016 Jul 1;30(7):1805-12.
5. de Salles BF, Simão R, Miranda H, Bottaro M, Fontana F, Willardson JM. Strength increases
in upper and lower body are larger with longer inter-set rest intervals in trained men. Journal
of Science and Medicine in Sport. 2010 Jul 1;13(4):429-33.
6. Senna GW, Figueiredo T, Scudese E, Baffi M, Carneiro F, Moraes E, Miranda H, Simão R.
Influence of Different Rest Interval Lengths in Multi-Joint and Single-Joint Exercises on
Repetition Performance, Perceived Exertion, and Blood Lactate. Journal of Exercise Physi-
ology Online. 2012 Oct 1;15(5).
7. Willardson JM, Burkett LN. A comparison of 3 different rest intervals on the exercise vol-
ume completed during a workout. The Journal of Strength & Conditioning Research. 2005
Feb 1;19(1):23-6.
8. Tibana RA, Vieira DC, Tajra V, Bottaro M, Willardson JM, de Salles BF, Prestes J. Effects
of rest interval length on Smith machine bench press performance and perceived exertion in
trained men. Perceptual and motor skills. 2013 Dec;117(3):682-95.
9. Willardson JM, Burkett LN. The effect of rest interval length on the sustainability of squat
and bench press repetitions. Journal of Strength and Conditioning Research. 2006 May
1;20(2):400.
10. Scudese E, Willardson JM, Simão R, Senna G, de Salles BF, Miranda H. The effect of rest
interval length on repetition consistency and perceived exertion during near maximal loaded
bench press sets. The Journal of Strength & Conditioning Research. 2015 Nov 1;29(11):3079-
83.
11. Kraemer WJ, Ratamess NA. Hormonal responses and adaptations to resistance exercise and
training. Sports medicine. 2005 Apr 1;35(4):339-61.

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12. McCall GE, Byrnes WC, Fleck SJ, Dickinson A, Kraemer WJ. Acute and chronic hormonal
responses to resistance training designed to promote muscle hypertrophy. Canadian Journal
of applied physiology. 1999 Feb 1;24(1):96-107.
13. Morton RW, Oikawa SY, Wavell CG, Mazara N, McGlory C, Quadrilatero J, Baechler BL,
Baker SK, Phillips SM. Neither load nor systemic hormones determine resistance train-
ing-mediated hypertrophy or strength gains in resistance-trained young men. Journal of ap-
plied physiology. 2016 Jul 1;121(1):129-38.
14. Willardson JM, Burkett LN. The effect of different rest intervals between sets on volume
components and strength gains. The Journal of Strength & Conditioning Research. 2008 Jan
1;22(1):146-52.
15. Ibbott P, Ball N, Welvaert M, Thompson KG. Variability and Impact of Self-Selected in-
ter-set Rest Periods During Experienced Strength Training. Perceptual and motor skills.
2019 Jun;126(3):546-58.
16. Brigatto FA, Lima LE, Germano MD, Aoki MS, Braz TV, Lopes CR. High Resistance-Train-
ing Volume Enhances Muscle Thickness in Resistance-Trained Men. Journal of Strength and
Conditioning Research. 2019 Dec 20.

81
Study Reviewed: The Effect of L-Carnitine Supplementation on Exercise-Induced
Muscle Damage: A Systematic Review and Meta-Analysis of Randomized Clinical
Trials. Yarizadh et al. (2020)

Has Carnitine Pivoted From a Fat

Loss Supplement to a Recovery
Supplement?
BY E RI C T RE X LE R

Back in the day, carnitine was widely touted as a fat loss supplement.
While that hype has mostly died down, a new meta-analysis suggests
that carnitine may reduce post-exercise muscle damage and soreness.
Read on to find out if the results of this meta-analysis are as good as
they seem.

82
 KEY POINTS
1. The presently reviewed meta-analysis (1) evaluated the effects of L-carnitine and
L-carnitine-L-tartrate (which the authors collectively referred to as “L-carnitine”)
on a variety of outcomes related to exercise-induced muscle damage and
recovery.
2. The authors reported that muscle soreness was significantly reduced by L-carnitine
supplementation at all time points (0, 24, 48, 72, and 96 hours), and significant
effects on creatine kinase, myoglobin, and lactate dehydrogenase were observed
at the 24-hour mark. After re-running the data differently, my results suggest that
only soreness and creatine kinase were significantly impacted, and only for about
48 hours post-exercise.
3. I’d like to see a larger body of more consistent literature before I can confidently
recommend carnitine supplementation as a performance or recovery aid,
especially for young, healthy, well-trained lifters and athletes.

C
arnitine has been popular in the
supplement world for quite some
time. Back in the mid-2000s,
it seemed like everybody was taking
L-carnitine to (purportedly) either boost
fat loss or facilitate muscle gain. It’s
also possible that you’ve heard of some
related forms of carnitine; for exam-
ple, some studies evaluating effects on
performance or blood flow have used
L-carnitine-L-tartrate or glycine propi-
onyl-L-carnitine, and acetyl-L-carnitine
has become a popular supplement for
cognition. The presently reviewed me-
ta-analysis (1) evaluated the effects of
L-carnitine and L-carnitine-L-tartrate
supplementation, which the researchers
collectively referred to as “L-carnitine,”
on a variety of outcomes related to ex-
ercise-induced muscle damage and re-
covery. Specifically, the meta-analysis
looked at creatine kinase, myoglobin,
lactate dehydrogenase, and muscle sore-
ness values over a range of time points
within 96 hours after exercise. After
pooling the results from the seven stud-
ies that met the inclusion criteria, the
authors reported that L-carnitine sup-
plementation reduced creatine kinase,
myoglobin, and lactate dehydrogenase
values at 24 hours post-exercise, while it
reduced soreness values at 0, 24, 48, 72,
and 96 hours post-exercise. They also
did some additional subgroup analyses
suggesting that results were generally
more notable in untrained subjects than
trained subjects, and the creatine kinase
effect was more notable for resistance
exercise than aerobic exercise. Howev-
er, as MASS readers might recall from
some of my previous articles on creatine
and vitamin D, I have a nasty habit of

83
re-doing meta-analyses. So, read on to
find out how and why my calculations
differ from the reported results, and
what this means for your decisions about
L-carnitine supplementation.
Purpose and Hypotheses
Purpose
The purpose of the current meta-anal-
ysis was to summarize the literature
evaluating the effects of L-carnitine
supplementation on delayed-onset mus-
cle soreness and biomarkers of muscle
damage.
Hypotheses
The authors did not directly state a hy-
pothesis. In the introduction, they indi-
cated that multiple studies have shown
L-carnitine to improve various outcomes
related to soreness and muscle damage,
but acknowledged that such findings are
not entirely consistent.
Subjects and Methods
Subjects
The presently reviewed study was a
meta-analysis, so they did not recruit
subjects of their own. Rather, they com-
bined the results of previously conduct-
ed studies. They included seven studies
in their final analysis, containing a to-
tal of 79 subjects. This included 70 men
and 9 women; 34 were untrained prior
to participating in one of the studies, and
45 were trained. The mean age of each
sample ranged from 22.0 to 51.9 years.
Notably, a widely recognized “scoring
system” called the Jadad scale indicated
that three of the studies were “low quali-
ty” and four of them were “high quality”
based on their methods and reporting.
Methods
The researchers did a systematic
search of the literature, which yielded
604 unique results. Then, they eliminat-
ed studies based on their inclusion and
exclusion criteria. They were looking
for studies that were 1) randomized con-
trolled trials, 2) evaluated at least one
of the outcomes of interest, 3) included
measurements at baseline and at some
point 24-72 hours after exercise, and
4) recruited generally healthy subjects.
Studies were excluded if they included
other interventions alongside carnitine
supplementation (such as another sup-
plement or a dietary modification), or
lacked a control group or condition.
If you’ve seen previous meta-analyses,
you might be used to them reporting stan-
dardized effect sizes, such as Cohen’s D.
In this case, the studies all reported the
same outcomes, so the researchers were
able to leave the variables in their raw
units (which is preferable). Then, the re-
searchers jammed these values into one
big model for each outcome (for exam-
ple, a single “soreness” analysis, with
84
several subgroups representing each
time point). In the methods, they stated
that they used random effects models if
there was “evidence of between-stud-
ies heterogeneity,” but used fixed effect
models if not. However, I’m not sure if
they adhered to that with the analysis for
muscle soreness; I could be misunder-
standing their statement, but the muscle
soreness forest plot (see Figure 1) re-
ported significant overall heterogeneity,
between-group heterogeneity, and with-
in-group heterogeneity, but used a fixed
effect model. Anyway, they made four
forest plots, with subgroups for each time
point. They also made some funnel plots
and ran some tests to make sure the fun-
nel plots were adequately symmetrical;
asymmetrical funnel plots can be prob-
lematic, since they may suggest the pres-
ence of publication bias or some other
latent effect that would impact how you
interpret the data. Finally, the researchers
did some follow-up tests to determine
if effects were larger for untrained ver-
sus trained subjects, L-carnitine versus
L-carnitine-L-tartrate studies, or aerobic
versus resistance exercise bouts.
Findings
You could theoretically write a very,
very long section to summarize these
findings. We’ve got four outcomes, sev-
eral time points for each, and plenty of
other details to discuss. So, I’ve present-
ed all of the forest plots in Figure 1; this
should allow me to concisely summarize
the findings without writing a novel.
In a nutshell, the authors reported that
muscle soreness was significantly reduced
by L-carnitine supplementation at all
time points (0, 24, 48, 72, and 96 hours).
L-carnitine significantly reduced creatine
kinase values at 24 hours, but not at 0,
48, or 96 hours. L-carnitine significant-
ly reduced myoglobin levels at the “<24
hours” time point, but none of the others
(0, 24, 48, and 96 hours). L-carnitine sig-
nificantly reduced lactate dehydrogenase
levels at 24 hours, but not at the other time
point evaluated (0 hours). Notably, signif-
icant heterogeneity and significant funnel
plot asymmetry were observed for three
of the four variables. The lactate dehydro-
genase funnel plot was not significantly
asymmetrical, and its between-group and
overall heterogeneity tests were not signif-
icant, but don’t get too excited – the anal-
yses only included four data points from
two total studies, so there really wasn’t
much data to test.
Finally, the researchers conducted
some subgroup analyses to assess the
impact of some key variables, including
training status, form of supplement, and
form of exercise. They found that results
were significantly larger in untrained
subjects compared to trained subjects,
and that results were larger following
resistance exercise compared to aero-
bic exercise. The form of supplement
(L-carnitine versus L-carnitine-L-tar-
trate) didn’t seem to matter much.
85

Interpretation
Before I begin, I’d like to commend
these authors for carrying out an inter-
esting project. This body of literature
has flown under the radar for quite some
time. I think a lot of people associate
carnitine with fat loss or neurological
applications, but generally aren’t aware
that multiple papers dating back to the
early-1990s have been investigating
the effect of L-carnitine supplementa-
86
tion on muscle damage and soreness.
So, I think this review is a great way to
bring attention to that literature, which
should (hopefully) prompt some more
follow-up work in this area.
We tend to place meta-analyses at the
very top of the “Hierarchy of Evidence,”
suggesting that their results are the most
reliable and robust form of scientific evi-
dence. While this makes sense in theory,
I fear that it causes us to sometimes read
meta-analyses in a relatively uncritical
manner. We don’t stop to consider exact-
ly what the result means, or what assump-
tions we have implicitly agreed to. When
it comes to the presently reviewed study,
I want you to consider four questions:
1. Do soreness and muscle damage
change over time following an ex-
ercise bout?
2. Is there more variability in soreness
or muscle damage levels a day or
two after an exercise bout com-
pared to several days after, when
most people are essentially back to
normal?
3. If you measured some blood bio-
marker of muscle damage on four
separate occasions for a huge group
of people, would a person’s four
values be more related to each other
than to a random value from some-
one else in the group?
4. If you measured two people on four
separate occasions each, did you
actually measure eight different
people?
The answer to questions #1-3 is yes,
and the answer to question #4 is no. I
would argue that the analyses conduct-
ed in this paper assume the incorrect an-
swer for all four of these questions. As
a result, the confidence intervals are too
narrow, the p-values are too low, and
some of the pooled effect sizes are a bit
off or susceptible to misinterpretation.
One of my first issues is that the effect
of “time” definitely mattered, and there
was a ton of funnel plot asymmetry, but
nobody really did anything about it. They
did the work to identify the issues, which
is definitely a good thing. However, there
were no follow-up tests or adjustments to
assess the impact of the funnel plot asym-
metry, and the effect of time wasn’t di-
rectly incorporated into the model. There
are a couple of other considerations to
keep in mind. Whenever we have cor-
relations built into a data set, we have to
account for them whenever possible; this
is a foundational principle of statistics,
and the exact reason why we have special
analyses for repeated measures data (for
example, independent samples t-tests ver-
sus paired samples t-tests). This study’s
analyses do not account for the fact that
multiple values from the same study are
correlated with each other. Along the
same lines, it doesn’t seem like the au-
thors adjusted the analysis to reflect the
fact that the same people were measured
several times. For example, consider two
people getting measured four different
87
times; the sample size was two, but this
analysis seems to assume that the sample
size was eight.
Based on these considerations, I decid-
ed to reconstruct the analyses a bit dif-
ferently. These specific analyses are just
a tad outside of my comfort zone, but
I took a crack at it. If you’re not super
interested in stats, just blow right by this
very small paragraph. I assumed that the
authors correctly reported the results
of each individual study, then re-did
the analysis differently. I took a gener-
al linear mixed model approach, used a
compound symmetric covariance struc-
ture to model within-study correlations
with an assumed value of R = 0.6, and
modeled time as a random effect using
a heteroscedastic compound symmetric
covariance structure, while using the
restricted maximum-likelihood method
for estimating heterogeneity variance.
Let’s move past the most jargon-heavy
paragraph in the history of MASS.
You might be wondering why this
stuff matters, which is fair. The present-
ly reviewed study included some funnel
plots; ideally, all of the data points fall
within a nice funnel shape. Whenever
you see asymmetry (way more values on
one side of the middle line than the other
side) or values way outside of the funnel
“boundaries,” this generally gives you
reasons to wonder exactly how accu-
rate the pooled effect estimate is. In this
particular study, significant funnel plot
88
asymmetry was found for three of the
four outcomes, and the fourth outcome
only had four data points. If a ton of val-
ues are to the left of the centerline, you
might suspect that the analysis is actu-
ally exaggerating the effect of carnitine.
For example, the current study reported
an overall pooled effect (across all time
points) of -18.2 units for creatine kinase,
with a p-value of <0.001. If you apply
a very basic method of “correcting” for
this funnel plot asymmetry (the trim and
fill method), the effect gets cut in half
(-9.9 units), and the p-value jumps to p
= 0.085. Just like that, an effect size gets
cut in half and goes from clearly signif-
icant to non-significant. But, we can do
better than just using the trim and fill
method. If we instead model the data as
I described above, we get more robust
results. For a concrete example, let’s
look at the muscle soreness funnel plots
(Figure 2). While the caption describes
some nuanced details to facilitate inter-
pretation, the impact of the two differ-
ent approaches (the version in the paper
versus my analysis) on the funnel plots
suggests that we’ve made some signifi-
cant improvements.
When it comes to the “new” analyses,
the results look a little bit different. Note
that I’m reporting the estimated differ-
ence between the carnitine treatment and
placebo treatment at each time point,
along with the 95% confidence inter-
val [lower boundary, upper boundary].
For LDH, results were not statistically
significant at either time point available
(0hrs = -43.2 [-106.6, 20.1] U/L; 24hrs
= 15.8 [-246.9, 278.4] U/L). With only
four data points from two studies, there
was never much we could’ve done with
the LDH data, even with the most ele-
gant and sophisticated modeling imag-
inable. For creatine kinase, results were
statistically significant at 24 hours (-28.4
[-48.0, -8.8] U/L), and pretty notable but
non-significant at 48 hours (-23.2 [-50.1,
3.7] U/L), while differences at 0 hours
and 96 hours were essentially negligible
(no differences larger than 5 U/L, and
both p-values above 0.29). For muscle
soreness, differences were significant
at 0, 24, and 48 hours (0hrs = -1.19
[-1.61, -0.78] cm; 24hrs = -1.69 [-2.20,
-1.18] cm; 48hrs = -1.31 [-2.04, -0.58]
cm). Differences were not significant at
72 hours (-0.60 [-1.91, 0.71] cm) or 96
hours (-0.40 [-0.83, 0.04] cm). For sore-
ness values, I believe the researchers
reported centimeter values as millime-
ters, which is important to note. Finally,
for myoglobin, differences at each time
point were basically negligible, with no
differences larger than 15 μg/L, and no
p-values under 0.29.
So, the current data do suggest that
carnitine supplementation might reduce
muscle soreness and creatine kinase lev-
els following exercise. However, the re-
sults reported in the presently reviewed
meta-analysis probably overstate the con-
fidence of the findings and the number of
time points at which statistically signif-
89

WHEN WE BOIL THE RESULTS
DOWN TO PRACTICAL
TERMS, IT LOOKS LIKE
CARNITINE REDUCED
MUSCLE SORENESS FOR THE
FIRST 48 HOURS AFTER
EXERCISE. THE MAGNITUDE
OF EFFECT WAS ABOUT 1-1.5
CM ON A 10CM SCALE.
icant results were observed. When we
boil the results down to practical terms, it
looks like carnitine reduced muscle sore-
ness for the first 48 hours after exercise.
The magnitude of effect was about 1-1.5
cm on a 10cm scale. So, if you were rat-
ing your soreness from 0 to 10, this would
knock your rating down by 1-1.5 points
(from an 8 to a 6.5 or 7, for example),
but by 72 hours after exercise, the effect
would be pretty negligible. The creatine
kinase results generally lend support for
this finding, while the LDH and myoglo-
bin results were unremarkable. There’s
also a plausible mechanistic basis for
the observed effects. Our current under-
standing of muscle damage and delayed
onset muscle soreness suggests that in
addition to the initial mechanical damage
from exercise, contributing factors may
include localized hypoxia and the sub-
sequent responses involving oxidative
stress and inflammation. As described by
Volek et al (2), hypoxic conditions cause
carnitine release from endothelial cells,
increased oxidative stress, and impaired
blood flow regulation. There is some evi-
dence to suggest that L-carnitine may en-
hance nitric oxide production and blood
flow, in addition to having an antioxidant
effect. Along those lines, one study found
that L-carnitine-L-tartrate supplementa-
tion enhanced flow-mediated vasodila-
tion (2), and others have found increases
in nitric oxide metabolites (3) and total
antioxidant status (4) following L-car-
nitine supplementation. So, the idea is
that carnitine supplementation can main-
tain adequate carnitine availability for
endothelial cells during exercise, which
prevents hypoxic stress during exercise,
thereby reducing the degree of muscle
damage and subsequent muscle soreness.
That seems pretty cool, but it doesn’t
necessarily mean that L-carnitine sup-
plementation will necessarily improve
performance. When it comes to perfor-
mance on a single bout of exercise, the
carnitine literature is fairly mixed, but
the general consensus is that supplemen-
tation does not yield meaningful per-
formance benefits (5). It’s important to
note, however, that single-bout exercise
performance would not be impacted by
90
any purported benefits related to muscle
damage or soreness, and would have to
be induced by a different mechanism
altogether. Theoretically, you could sur-
mise that carnitine’s effects on muscle
damage and soreness might more read-
ily translate to a benefit for longitudi-
nal training adaptations, which involve
protocols with repeated exposures to
exercise stress and recovery. Unfortu-
nately, such research is scant and pret-
ty inconclusive. For example, one study
found that supplementing with glycine
propionyl-L-carnitine throughout an
eight-week endurance training program
failed to improve aerobic or anaerobic
performance outcomes more than a pla-
cebo (6). In another study (7), partici-
pants received either 1.5, 3.0, or 4.5g/
day of glycine propionyl-L-carnitine for
28 days, while maintaining their typical
training habits. If anything, the larger
doses in that particular study were ac-
tually associated with performance dec-
rements on a repeated sprint test. More
recently, a study evaluated the effects
of 2g/day of L-carnitine supplementa-
tion throughout a nine-week resistance
training program (8). The study reported
that carnitine improved leg press, bench
press, and sprint performance, but fat-
free mass was not significantly affect-
ed, and the statistical analyses for the
study were pretty lenient. Overall, there
isn’t enough evidence to conclude that
L-carnitine will acutely or chronically
enhance performance, and the evidence
that exists is extremely mixed, even for
pretty straightforward outcomes like
lactate accumulation.
As the authors noted in the presently
reviewed meta-analysis, their subgroup
analyses added some nuance to the find-
ings. The findings appeared to be most
notable in studies using resistance train-
ing as the exercise modality, and in stud-
ies that tested untrained participants.
These intuitively make a lot of sense.
Naturally, untrained people are going
to be more susceptible to acute muscle
damage, and while you could theoretical-
ly create a pretty brutal, damage-induc-
ing aerobic protocol with some intense
downhill running, I think the resistance
exercise protocols were (in aggregate)
more consistently damage-inducing
than the aerobic protocols in this body
of literature. However, there’s another
source of variation to keep in mind here,
particularly with the resistance training
observation. The entire meta-analysis
included nine samples from seven sep-
arate studies. Six of the samples utilized
resistance exercise, but five of those six
were all from the exact same lab. The
carnitine literature is very inconsistent,
but it seems like a big percentage of the
positive findings are coming from one
specific lab, and another large percent-
age are coming from a specific country.
Please don’t mistake that for a conspir-
acy; different labs and different regions
often have different preferences in terms
of the methods they implement and the
population they are sampling. It does,
91
however, give us reason to believe that
in order to see a measurable performance
or recovery benefit from carnitine sup-
plementation, the conditions have to be
fairly specific, which limits the ability
to broadly recommend it as a reliable
supplementation strategy. I’ll also note
that the carnitine literature seems to
have major, major geographic discrep-
ancies in the reported findings; a recent
meta-analysis looking at carnitine’s ef-
fects on blood glucose and blood insulin
levels found that results from “eastern
countries” were about 5-7x larger than
those from “western countries,” and this
was a pattern observed over a decently
large body of evidence (for example, the
comparison for glucose included at least
20 studies from each region).
While we’re on the subject of carni-
tine, it’s worth discussing a couple other
common applications of carnitine sup-
plementation. People have been tout-
ing it as a fat loss supplement for ages,
primarily because carnitine is involved
in one of the major metabolic steps in
the process of burning fat for energy.
However, carnitine deficiency is gener-
ally caused by a rare genetic condition,
and in most other contexts, our bodies
are pretty good at making sure we’ve
got enough carnitine to get the job done.
Interestingly, this holds true across a
wide range of dietary carnitine intakes.
We tend to make about 25% of our dai-
ly carnitine needs, with the other 75%
coming from food (9). Red meat is by
far the biggest source of dietary L-car-
nitine, providing up to 100-150mg per
serving; other meat, fish, and dairy prod-
ucts are typically down in the 5-30mg
range, and plant sources are quite low.
Despite the fact that vegetarians have
very low dietary carnitine intakes, their
plasma and muscle levels of L-carni-
tine are only slightly lower than those
of omnivores, and the difference doesn’t
seem to be functionally meaningful. It
seems that vegetarians are able to large-
ly compensate for low intake by re-
ducing urinary carnitine excretion, and
potentially by increasing dietary absorp-
tion of the carnitine that is consumed.
On that note, it’s important to keep in
mind that L-carnitine bioavailability is
higher from food sources (54-86%) than
from a 2g supplement dose (9-25%) (9).
Anyway, the point is that people gen-
erally have plenty of carnitine around
for their fat-burning needs; as such, a
recent meta-analysis found that L-car-
nitine supplementation did not signifi-
cantly enhance fat loss in normal-weight
individuals, and had a very modest ef-
fect on weight loss in individuals with
overweight or obese BMI classifications
(10). There are some specific instances
in which carnitine supplementation has
been found to favorably impact fat loss,
muscle gain or retention, and physical
performance, but these findings are typi-
cally observed in older samples (70s and
beyond), individuals with sarcopenia,
or individuals with unique medical cir-
cumstances, such as genetic conditions
92
affecting energy metabolism or ongoing
hemodialysis treatment (9).
Finally, while it’s a bit beyond the scope
of this article, I should at least acknowl-
edge carnitine’s popularity for a variety
of brain-related outcomes. There’s a
growing body of research indicating that
carnitine can have positive effects on
things like depressive symptoms, men-
tal fatigue, and prevention of cognitive
decline, and there are plenty of plausi-
ble mechanisms to explain such effects.
However, this literature is largely based
on animal studies or human trials in pop-
ulations with some form of cognitive
decline or neurological condition; gen-
eralizing these results to young, healthy
individuals with no clinical conditions
is an uncertain extrapolation. Studies
looking at more neurologically focused
outcomes tend to use acetyl-L-carnitine
rather than regular L-carnitine, like-
ly because evidence suggests that ace-
tyl-L-carnitine more readily crosses the
blood-brain barrier. It’s interesting to
note, however, that a great deal of oral-
ly ingested acetyl-L-carnitine appears to
be de-acetylated (to L-carnitine) during
or immediately after uptake from intes-
tinal cells (11), there seems to be a great
deal of inter-conversion between L-car-
nitine and acetyl-L-carnitine after it en-
ters the bloodstream, and the kidney also
does a ton of interconversion between
the two forms in the process of filtering
and excreting excess carnitine (12). In
addition, there appears to be preferential
reabsorption of L-carnitine, and prefer-
ential excretion of acylcarnitine esters
(such as acetyl-L-carnitine) in the kid-
ney (12). In any case, the simplest ap-
proach is to just use the carnitine form
that is most commonly used for the out-
come you’re seeking; much of the litera-
ture assessing vascular effects uses gly-
cine propionyl-L-carnitine, much of the
literature assessing performance or body
composition outcomes uses L-carnitine
or L-carnitine-L-tartrate, and much of
the literature assessing neurological out-
comes uses acetyl-L-carnitine.
In conclusion, the data available indi-
cate that supplementation with L-carni-
tine or L-carnitine-L-tartrate may reduce
muscle soreness and creatine within 48
hours of exercise-induced muscle dam-
age. The effect on soreness was enough
to lower subjective sensation by about
1.5 “points” on a scale from 0-10. This
effect seemed to be more noticeable in
studies involving untrained subjects and
resistance exercise. However, the carni-
tine literature in general seems to be char-
acterized by inconsistency. As it current-
ly stands, I think it’s plausible to believe
that carnitine can facilitate recovery from
damaging exercise. However, there are
plenty of other ingredients that also facil-
itate recovery from exercise, while pro-
viding a variety of other potentially bene-
ficial nutrients and bioactive compounds.
As I stated in my recent article about tart
cherry juice, my go-to strategies for sup-
porting recovery involve 1) making sure
93

BASED ON THE EVIDENCE
AVAILABLE, I’D LIKE TO
SEE A LARGER BODY
OF MORE CONSISTENT
LITERATURE BEFORE
I GIVE CARNITINE
SUPPLEMENTATION
A SHOT.
my training program is appropriate and 2)
increasing my intake of fruits, vegetables,
and their juices containing high amounts
of polyphenols and other phytonutrients.
When it comes to carnitine’s effects on
body composition and performance, out-
comes are pretty inconsistent, and seem
to be least promising in young, healthy
individuals. The neurological effects of
acetyl-L-carnitine are quite fascinating,
but more research is needed to determine
which form(s) of carnitine supplementa-
tion may confer meaningful cognitive or
neurological benefits for young, healthy
individuals with no underlying neurolog-
ical or psychological medical diagnoses.
Next Steps
The main obstacle with the carnitine
literature is inconsistency. However, as
more and more research becomes avail-
able, we tend to see that perplexing in-
consistencies become explainable pat-
terns. So, I’m hoping that we’ll see more
data not only evaluating carnitine’s ef-
fects on acute muscle damage and sore-
ness, but also on longitudinal resistance
training programs that should theoreti-
cally benefit from more rapid recovery.
Ideally, future carnitine research would
specifically utilize resistance training
as the exercise modality, and recruit
healthy, well-trained participants. I’m
also interested in seeing how the neuro-
logical side of this research line evolves
in the years to come; I’m hopeful that
some of the promising observations
from rodent models and clinical popu-
lations will reliably translate to younger,
healthy individuals, but time will tell.
94
 APPLICATION AND TAKEAWAYS
The body of literature looking at carnitine’s effects on soreness and muscle damage
is small, but suggests that beneficial effects are possible. For now, I can’t really judge
you for trying out carnitine supplementation as a strategy for improving recovery from
resistance exercise. If you go that route, it would seem as if just about any form of
L-carnitine would be equivalent to the others. You might look at the carnitine literature
as a whole and be lured in by the possibility of improvements for such a broad range
of outcomes, but it’s important to keep three things in mind: (A) a supplement that im-
proves dysfunction will not necessarily super-charge normal function, (B) inconsistent
findings for many different outcomes don’t sum together to create a large “pooled”
confidence level, and (C) several different small (but practically unnoticeable) effects
don’t sum together to create a worthwhile effect; if you take a supplement that causes
six different virtually imperceptible improvements, that’s going to feel like it did nothing
at all, and none of the effects (alone or in combination) actually justify the use of that
supplement. Personally, based on the evidence available, I’d like to see a larger body
of more consistent literature before I give carnitine supplementation a shot.

95
References
1. Yarizadh H, Shab-Bidar S, Zamani B, Vanani AN, Baharlooi H, Djafarian K. The Effect of
L-Carnitine Supplementation on Exercise-Induced Muscle Damage: A Systematic Review
and Meta-Analysis of Randomized Clinical Trials. J Am Coll Nutr. 2020 Mar 10;1–12.
2. Volek JS, Judelson DA, Silvestre R, Yamamoto LM, Spiering BA, Hatfield DL, et al. Ef-
fects of Carnitine Supplementation on Flow-Mediated Dilation and Vascular Inflamma-
tory Responses to a High-Fat Meal in Healthy Young Adults. Am J Cardiol. 2008 Nov
15;102(10):1413–7.
3. Atalay Guzel N, Erikoglu Orer G, Sezen Bircan F, Coskun Cevher S. Effects of acute L-car-
nitine supplementation on nitric oxide production and oxidative stress after exhaustive exer-
cise in young soccer players. J Sports Med Phys Fitness. 2015 Feb;55(1–2):9–15.
4. Parandak K, Arazi H, Khoshkhahesh F, Nakhostin-Roohi B. The Effect of Two-Week L-Car-
nitine Supplementation on Exercise -Induced Oxidative Stress and Muscle Damage. Asian J
Sports Med. 2014 Jun;5(2):123–8.
5. Kerksick CM, Wilborn CD, Roberts MD, Smith-Ryan A, Kleiner SM, Jäger R, et al. ISSN
exercise & sports nutrition review update: research & recommendations. J Int Soc Sports
Nutr. 2018 Aug 1;15(1):38.
6. Smith WA, Fry AC, Tschume LC, Bloomer RJ. Effect of glycine propionyl-L-carnitine on aero-
bic and anaerobic exercise performance. Int J Sport Nutr Exerc Metab. 2008 Feb;18(1):19–36.
7. Jacobs PL, Goldstein ER. Long-term glycine propionyl-l-carnitine supplemention and paradoxi-
cal effects on repeated anaerobic sprint performance. J Int Soc Sports Nutr. 2010 Oct 28;7(1):35.
8. Koozehchian MS, Daneshfar A, Fallah E, Agha-Alinejad H, Samadi M, Kaviani M, et al. Ef-
fects of nine weeks L-Carnitine supplementation on exercise performance, anaerobic power,
and exercise-induced oxidative stress in resistance-trained males. J Exerc Nutr Biochem.
2018 Dec 31;22(4):7–19.
9. Fielding R, Riede L, Lugo JP, Bellamine A. l-Carnitine Supplementation in Recovery after
Exercise. Nutrients. 2018 Mar 13;10(3):349.
10. Askarpour M, Hadi A, Miraghajani M, Symonds ME, Sheikhi A, Ghaedi E. Beneficial ef-
fects of l-carnitine supplementation for weight management in overweight and obese adults:
An updated systematic review and dose-response meta-analysis of randomized controlled
trials. Pharmacol Res. 2020;151:104554.
11. Gross CJ, Henderson LM, Savaiano DA. Uptake of L-carnitine, D-carnitine and acetyl-L-car-
nitine by isolated guinea-pig enterocytes. Biochim Biophys Acta. 1986 May 29;886(3):425–33.
12. Reuter SE, Evans AM. Carnitine and acylcarnitines: pharmacokinetic, pharmacological and
clinical aspects. Clin Pharmacokinet. 2012 Sep 1;51(9):553–72.

96
 Study Reviewed: Varying the Order of Combinations of Single- and Multi-Joint
Exercises Differentially Affects Resistance Training Adaptations. Brandão et al. (2020)

Variety is the Spice of Life: If You Want

Well-Rounded Triceps Growth, You Need
Both Compound and Single-Joint Exercises
BY G RE G NUC KO LS

A recent study examined triceps growth (among other things) in

subjects that only did bench press, only did triceps extensions, or
performed both exercises. To maximize growth of all three heads of the
triceps, a combination of both exercises was necessary.

97
 KEY POINTS
1. For 10 weeks, groups of untrained men either trained bench press alone, triceps
extensions alone, bench press followed by triceps extensions, or triceps extensions
followed by bench press. Subjects in the groups performing both bench press
and triceps extensions did the same number of sets of each exercise as the two
groups only performing one exercise, which means they were performing twice
as many sets overall.
2. Bench press did a subpar job of building the middle and long heads of the triceps,
while triceps extensions did a subpar job of building the lateral head of the triceps.
The combination of bench press and triceps extensions caused robust growth in
all heads of the triceps. All three groups performing the bench press experienced
fairly similar pec growth, though growth may have been slightly lower in the group
performing triceps extensions before bench press.
3. Triceps extensions strength gains were fairly similar in all groups, but the group
that only performed triceps extensions tended to have the smallest increase in
bench press strength (unsurprisingly).
4. If you want to maximize the growth of muscles with multiple heads (like the
triceps and quads), it’s probably wise to include both multi-joint and single-joint
exercises in your training program.

I
f you come across a freakishly
strong bench presser, there’s a good
chance they’ll have freakishly big
triceps. There are exceptions, of
course, but most world-class benchers
look like they have a beef tenderloin
hanging off the back of their arm. Nota-
bly, however, you’ll find very few who
have pronounced horseshoe-shaped tri-
ceps, whereas if you go to a high-level
bodybuilding show, there will be horse-
shoe-shaped triceps as far as the eye can
see. Why is that? It could partially be
a matter of people self-sorting into the
sports they’re best-suited for, but there
could be training considerations as well.
Namely, bodybuilders tend to do way
more single-joint triceps training than
powerlifters do.
The present study compared four
groups of novice lifters who trained for
10 weeks. One group only performed the
bench press, one group only performed
lying triceps extensions, one group per-
formed bench press followed by triceps
extensions, and one group performed
triceps extensions followed by bench
press. There were a lot of outcomes,
and most of them weren’t terribly excit-
ing (they were mostly in line with the
principle of specificity). The most inter-
esting finding, however, was that bench
press and triceps extensions caused dif-
ferent amounts of growth for each head
98
of the triceps. Bench press caused a lot
of growth of the lateral head, but did
a poor job developing the middle and
long heads of the triceps, whereas tri-
ceps extensions developed the long and
middle heads well, but didn’t do a great
job of developing the lateral head. Thus,
it appears that a combination of bench
press and triceps extensions causes
more well-rounded triceps growth than
performing either exercise in isolation.
This finding is probably generalizable to
other muscles with multiple heads.
Purpose and Hypotheses
Purpose
The stated purposes of this study were
to test the effects of single-joint versus
multi-joint training and to test the ef-
fects of exercise order on strength gains
and hypertrophy. More concretely, how-
ever, the authors were comparing the
effects of training consisting of bench
press alone, triceps extensions alone,
bench press followed by triceps exten-
sions, and triceps extensions followed
by bench press.
Hypotheses
The authors hypothesized that strength
gains would follow the principle of
specificity (that subjects would improve
strength more on the exercises they actu-
ally trained), that less pec growth would
occur in the group that only trained tri-
ceps and the group that trained triceps
before bench press, that exercise order
in the two bench press plus triceps ex-
tensions groups wouldn’t affect triceps
growth, and that the combination of
bench press and triceps extensions would
lead to more growth of all heads of the
triceps than only performing bench press
or triceps extensions in isolation.
Subjects and Methods
Subjects
The subjects were 43 healthy young
males who had not performed regular
resistance training for at least six months
prior to the study.
Experimental Design
This was a pretty straightforward lon-
gitudinal training study. Before and af-
ter 10 weeks of training, the researchers
tested the subjects’ 1RM bench press and
triceps extension, and performed MRI
scans of the subjects’ pecs and triceps
to measure muscle cross-sectional area
(CSA). Subjects were familiarized with
the tests prior to recording their pre-train-
ing 1RMs by performing repeated 1RM
tests on different days until their day-to-
day strength variation was ≤5%.
The subjects were randomized into
four groups. One group only performed
the bench press during each training
session; one group only performed the
triceps extension; one group performed
bench press followed by triceps ex-
99

tensions (BP-TE); and one group per-
formed triceps extensions followed by
bench press (TE-BP). All groups trained
twice per week, and rested for three min-
utes between sets. During the first four
weeks, subjects performed three sets of
their assigned exercise(s), followed by
four sets for the next three weeks, and
five sets for the final three weeks. Thus,
total set volume increased for all groups
during the program, but total set volume
for the triceps was higher for the BP-TE
and TE-BP groups than the bench-on-
ly and triceps extension-only groups
throughout the program, since the BP-
TE and TE-BP groups were performing
both exercises. Subjects started with a
load equal to 80% of their pre-training
1RMs and performed all sets to concen-
tric failure. Subjects re-tested their max-
es following the fifth week of training to
adjust their training loads.
Bench press and triceps extension
technique were standardized. All sub-
jects took a bench grip of 200% of bi-
acromial breadth (which is a reasonably
wide grip). For the triceps extensions,
the shoulder angle was held at 90 de-
grees of flexion (arms straight up when
you’re lying on your back), and the sub-
jects went through 90 degrees of elbow
flexion; a metallic bar would stop the
triceps extension bar to inhibit further
elbow flexion during each rep.
Findings
There weren’t statistically significant
differences in strength gains between
groups for any of the exercises. Howev-
er, the average increase in bench press
1RM did tend to be lower in the triceps
extension-only group than the other
three groups (+9.9% vs. +22.3-27.1%).
The triceps extension-only group had
a nominal (non-significant) decrease in
pec CSA, whereas all other groups had
a significant increase in pec CSA; the
changes were significantly different be-
tween the triceps extension-only group
and all other groups. The bench-only
100

group had a nominally smaller increase
in triceps whole-muscle CSA than all
other groups (+4.8% vs. +9.5-11.5%),
but the differences between groups
weren’t statistically significant.
When splitting out the different heads
of the triceps, the triceps extension-on-
ly group had a significantly smaller in-
crease in CSA of the lateral head of the
triceps than all other groups. For the
long head of the triceps, the increase was
significantly smaller in the bench-on-
ly group than all other groups. The
bench-only group also tended to have
smaller increases in CSA of the middle
head of the triceps as well (+7.3% vs.
+14.0-16.2%), but the difference wasn’t
statistically significant.
Bench press volume load was signifi-
cantly greater in the bench-only group
than the SJ+MJ group and triceps ex-
tension-only group (obviously). Bench
press volume load also tended to be
greater in the BP-TE group than the TE-
BP group, but the difference wasn’t sta-
tistically significant. Triceps extension
volume load was significantly greater in
the triceps extension-only group and the
TE-BP group than the bench-only group
(obviously) and the BP-TE group.
Interpretation
I wanted to review this study for a cou-
ple reasons:
1. Much of the research we have com-
paring multi-joint and single-joint
training uses fairly simplistic mea-
surement techniques, and I suspect-
ed we were missing some nuance in
the process.
2. This study emphasizes a point about
biarticular muscles generally, and
the triceps specifically, that I’ve been
making for years, but didn’t yet have
enough data to fully support.
We’ve reviewed several studies in
MASS comparing multi-joint and sin-
gle-joint exercises, or the effects of add-
ing single-joint exercises to a program
101

composed solely of multi-joint training
(one, two, three, four). In most of the
studies in that body of literature, the
measures taken are pretty rough; one
study (2) used ultrasound at three points
along the length of the biceps (good),
but other studies (3) have just exam-
ined changes in lean mass assessed via
DEXA (not great), and several others (4,
5) have just measured limb circumfer-
ences (far from ideal). Though the re-
searchers in the present study only ex-
amined one site along the length of each
muscle, they did their due diligence by
splitting the heads of the triceps apart
(fantastic), and they used MRI, which is
the gold standard for assessing changes
in whole-muscle cross-sectional area.
Thus, on measurement quality alone,
this study is a big step up from what we
usually see in this body of research. Ku-
dos to the researchers.
So, how does this research look from
a bird’s eye view? De França et al (6)
found that adding curls and triceps ex-
tensions to a program consisting of vari-
ous pressing and upper body pulling ex-
ercises didn’t significantly increase arm
muscle circumference (estimated based
on changes in arm circumference and
skinfold thicknesses) relative to just per-
forming the multi-joint exercises, though
non-significant differences leaned in fa-
vor of the program that also included
the single-joint exercises (+1.33% vs.
+3.17%). Gentil et al (7) used a similar
experimental design, but didn’t find a
significant or meaningful difference in
elbow flexor thickness (+6.5% for only
multi-joint, versus +7.04% for multi-
joint plus single-joint). Other studies
have largely had similar results: nonsig-
nificant-differences leaning in favor of
adding single-joint training, but few sta-
tistically significant differences (see Ta-
ble 3 in this article). In the present study
102

(1), there also wasn’t a significant dif-
ference in whole-muscle triceps growth
between the bench-only group and the
BP-TE or TE-BP groups, though again,
the non-significant differences leaned in
favor of the groups also performing tri-
ceps extensions.
Thus, overall, I’d say the current body
of literature leans slightly in favor of
additional single-joint training causing
more growth than multi-joint training
alone. One drawback to these studies,
however (including the present study),
THE CURRENT BODY
OF LITERATURE LEANS
SLIGHTLY IN FAVOR OF
ADDITIONAL SINGLE-
JOINT TRAINING
CAUSING MORE GROWTH
THAN MULTI-JOINT
TRAINING ALONE.
is that single-joint training was simply
added to multi-joint training instead of
replacing multi-joint training. In oth-
er words, they compare something like
four sets of pull-downs to four sets of
pull-downs plus four sets of curls, rather
than two sets of pull-downs plus two sets
of curls. Thus, the results may be driven
by the fact that the groups performing
both multi-joint and single-joint training
are also training with higher overall vol-
umes for the target muscle group(s).
Finally, I’m glad the researchers re-
ported the growth in each head of the
triceps. If the researchers only reported
overall triceps growth, we’d come away
with the impression that bench press
103
 alone may be suboptimal for triceps
growth, and may even be redundant for
triceps growth if you’re also perform-
ing triceps extensions in your training
(since the group performing only triceps
extensions had similar triceps growth as
the two groups performing both triceps
extensions and bench press). However,
results for each head of the triceps tell a
very different story. Bench press seems
to be awesome for growing the lateral
head of the triceps, whereas triceps ex-
tensions seem to be awesome for grow-
ing the middle and long heads; and it
THE RESULTS MAY BE
DRIVEN BY THE FACT
THAT THE GROUPS
PERFORMING BOTH
MULTI-JOINT AND SINGLE-
JOINT TRAINING ARE ALSO
TRAINING WITH HIGHER
OVERALL VOLUMES
FOR THE TARGET
MUSCLE GROUP(S).
takes both exercises to maximize growth
of all heads of the triceps. This confirms
the findings of a prior study (8) looking
at quad growth. When equating for set
volume, squats alone caused a similar
amount of growth when compared to a
variety of lower body exercises (squats,
deadlifts, leg press, and lunges), but the
groups performing a wider variety of
exercises had more even growth across
all four heads of the quads. For muscle
with multiple heads – especially when
some heads only cross one joint and
other heads cross two joints – a variety
of exercises will probably lead to more
well-rounded growth than a single ex-
ercise (I’m primarily thinking about the
quads, triceps, and hamstrings, but this
may apply to the biceps as well). In a
vacuum, triceps extensions are proba-
bly a better triceps exercise than bench
press, but since triceps extensions and
bench press target different heads of the
triceps, the combination of both exercis-
es gives you more bang for your buck
than just performing more triceps exten-
sions would.
In a more general sense, I think it’s
worth emphasizing that single-joint
exercises (or very specific multi-joint
exercises) are probably necessary to
maximize growth of biarticular mus-
cles – muscles that cross two joints. For
example, three of your four quads are
pure knee extensors because they only
cross the knee joint, whereas the rectus
femoris is both a knee extensor and a
hip flexor since it crosses both the knee
104

SINGLE-JOINT EXERCISES
ARE PROBABLY
NECESSARY TO MAXIMIZE
GROWTH OF BIARTICULAR
MUSCLES – MUSCLES
THAT CROSS TWO JOINTS.
and hip joints. The same is true of the
long head of your triceps; while the oth-
er two heads are pure elbow extensors,
the long head is also a shoulder exten-
sor. For most multi-joint exercises, your
nervous system preferentially recruits
monoarticular muscles (muscles that
only cross one joint) because those mus-
cles tend to be more efficient (9). If you
need to stand up from a squat, and you
can choose between your vasti muscles
or your rectus femoris to bear the brunt
of the knee extension workload, the vas-
ti are the better option; you also need
to extend your hips in a squat, and your
vasti don’t fight against your hip exten-
sors, whereas your rectus femoris does.
And that’s what we see when assessing
muscle activation in the squat – really
high activation for all vasti muscles, but
lower activation for your rectus femoris
(10). However, rectus femoris activation
is much higher when performing knee
extensions (11), which makes sense;
no hip extension is taking place when
you’re performing knee extensions.
Thus, a diet of pure multi-joint train-
ing will probably leave your biarticular
muscles somewhat underdeveloped; you
need some single-joint triceps work for
the long head of your triceps, some pure
knee flexion and hinge work for your
hamstrings, and some knee extensions
or sissy squats for your rectus femo-
ris. As I mentioned, however, there are
some multi-joint exercises that would fit
the bill for biarticular muscle develop-
ment. For example, a combination pull-
over-triceps extension would train both
functions of the long head of the triceps
(shoulder extension and elbow exten-
sion), and so it’s probably an excellent
exercise for developing the long head of
your triceps. Glute-ham raises, which si-
multaneously train knee flexion and hip
extension, would also fit the bill.
Another topic addressed in the present
study is the effects of exercise order. The
BP-TE and TE-BP groups had broadly
similar results across all measures except
for pec growth, which leaned in favor of
the BP-TE group. This is broadly in line
with what we’ve seen in the literature
up to this point. Exercise order doesn’t
seem to make an absolute night-and-day
difference, but when in doubt, you’re
better off putting the exercises that are
most important to you earlier in your
workout. For a more in-depth treatment
of the topic, check out the meta-analysis
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 APPLICATION AND TAKEAWAYS
If you want to maximize triceps growth, neither bench press nor triceps extensions are
sufficient in isolation. Bench press does a better job of training the lateral head, while
triceps extensions do a better job of training the middle and long heads. As a general
rule, using a combination of exercises – both multi-joint and single-joint – is probably
ideal for maximizing muscle growth, especially for muscles that have both monoartic-
ular and biarticular heads.

that Mike reviewed last month.
Finally, I’d like to end on a word of
caution. Studies intend to test broad con-
cepts, but ultimately, they’re constrained
by the discrete design choices the re-
searchers made. In the present study,
bench press was compared against lying
triceps extensions, range of motion was
constrained to 90 degrees of elbow flex-
ion for the triceps extensions, and the
bench press was performed with a wide
grip. Would the triceps extensions lead
to more muscle growth if they were per-
formed through a longer range of mo-
tion? Would the results be different if the
researchers used push-downs instead of
lying triceps extensions? Or close-grip
bench instead of wide-grip bench? Or
incline press instead of bench press? All
of those tweaks may have dramatically
changed the outcomes of the study, or
they may have only made trivial dif-
ferences. We’ll need more research to
fully explore the concept of multi-joint
versus single-joint training, and we can
never extrapolate too much from a sin-
gle study, but I think studies in this par-
ticular body of literature are even less
generalizable than individual studies in
most other bodies of literature within
the resistance training research canon.
Next Steps
We need more studies in general, but
I’d love to see studies comparing sin-
gle-joint exercises against multi-joint
exercises that are theorized to be ideal
for developing a certain muscle; for ex-
ample, comparing triceps extensions to
close grip bench, or flyes to dumbbell
presses, rather than comparing the ef-
fects of wide-grip bench and triceps ex-
tensions on triceps growth. I’d also love
for more studies to examine the indi-
vidual heads of muscles like the triceps,
quads, and hamstrings that have both
mono-articular and bi-articular heads.

106
References

1. 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 Combina-
tions of Single- and Multi-Joint Exercises Differentially Affects Resistance Training Adap-
tations. J Strength Cond Res. 2020 Mar 2.
2. Mannarino P, Matta T, Lima J, Simão R, Freitas de Salles B. Single-Joint Exercise Results in
Higher Hypertrophy of Elbow Flexors Than Multijoint Exercise. J Strength Cond Res. 2019
Jul 1.
3. Paoli A, Gentil P, Moro T, Marcolin G, Bianco A. Resistance Training with Single vs. Multi-
joint Exercises at Equal Total Load Volume: Effects on Body Composition, Cardiorespirato-
ry Fitness, and Muscle Strength. Front Physiol. 2017 Dec 22;8:1105.
4. Barbalho M, Coswig V, Raiol R, Fisher J, Steele J, Bianco A, Gentil P. Single joint exercises
do not provide benefits in performance and anthropometric changes in recreational body-
builders. Eur J Sport Sci. 2020 Feb;20(1):72-79.
5. Barbalho M, Gentil P, Raiol R, Fisher J, Steele J, Coswig V. Influence of Adding Single-Joint
Exercise to a Multijoint Resistance Training Program in Untrained Young Women. J Strength
Cond Res. 2018 May 15.
6. de França HS, Branco PA, Guedes Junior DP, Gentil P, Steele J, Teixeira CV. The effects of
adding single-joint exercises to a multi-joint exercise resistance training program on upper body
muscle strength and size in trained men. Appl Physiol Nutr Metab. 2015 Aug;40(8):822-6.
7. Gentil P, Soares SR, Pereira MC, da Cunha RR, Martorelli SS, Martorelli AS, Bottaro M.
Effect of adding single-joint exercises to a multi-joint exercise resistance-training pro-
gram on strength and hypertrophy in untrained subjects. Appl Physiol Nutr Metab. 2013
Mar;38(3):341-4.
8. Fonseca RM, Roschel H, Tricoli V, de Souza EO, Wilson JM, Laurentino GC, Aihara AY, de
Souza Leão AR, Ugrinowitsch C. Changes in exercises are more effective than in loading
schemes to improve muscle strength. J Strength Cond Res. 2014 Nov;28(11):3085-92.
9. Bryanton MA, Carey JP, Kennedy MD, Chiu LZ. Quadriceps effort during squat exercise
depends on hip extensor muscle strategy. Sports Biomech. 2015 Mar;14(1):122-38.
10. Escamilla RF, Fleisig GS, Zheng N, Lander JE, Barrentine SW, Andrews JR, Bergemann
BW, Moorman CT 3rd. Effects of technique variations on knee biomechanics during the
squat and leg press. Med Sci Sports Exerc. 2001 Sep;33(9):1552-66.
11. Salzman A, Torburn L, Perry J. Contribution of rectus femoris and vasti to knee exten-
sion. An electromyographic study. Clin Orthop Relat Res. 1993 May;(290):236-43.

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 VIDEO: Bodyweight and Home
Training Progressions
BY MIC HAE L C . ZO URD O S

In these uncertain times, you may not have gym access. This video first presents
scientific data demonstrating that bodyweight training can help to preserve muscle
mass and strength. Second, this video presents a nine-week at-home training
program along with specific examples of household items that can be used. Further,
the video demonstrates various examples of how progressive overload can be
achieved with this approach.
Click to watch Michael's presentation.

108
Program
1. MASS Bodyweight Home Example Program

References
1. Kikuchi N, Nakazato K. Low-load bench press and push-up induce similar muscle hypertro-
phy and strength gain. Journal of Exercise Science & Fitness. 2017 Jun 1;15(1):37-42.
2. Calatayud J, Borreani S, Colado JC, Martin F, Tella V, Andersen LL. Bench press and push-
up at comparable levels of muscle activity results in similar strength gains. The Journal of
Strength & Conditioning Research. 2015 Jan 1;29(1):246-53.
3. Sánchez-Moreno M, Cornejo-Daza PJ, González-Badillo JJ, Pareja-Blanco F. Effects of Ve-
locity Loss During Body Mass Prone-Grip Pull-up Training on Strength and Endurance Per-
formance. The Journal of Strength & Conditioning Research. 2020 Apr 1;34(4):911-7.
4. Staron RS, Leonardi MJ, Karapondo DL, Malicky ES, Falkel JE, Hagerman FC, Hikida RS.
Strength and skeletal muscle adaptations in heavy-resistance-trained women after detraining
and retraining. Journal of Applied Physiology. 1991 Feb 1;70(2):631-40.

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 VIDEO: Nutrition on Lockdown
BY E RI C HE LMS

Obviously it’s less than ideal to be stuck at home, and you or your clients may be
struggling with eating due to boredom, depression, or emotional reasons. However,
there are other aspects of being stuck at home that may be influencing your food
behaviors. Likewise, there may be some silver lining to this change in environment
which could be used to establish better nutrition habits that outlast lockdown.
Click to watch Eric's presentation.

110
References
1. Hopkins M, Blundell JE. Energy balance, body composition, sedentariness and appetite reg-
ulation: pathways to obesity. Clinical Science. 2016 Sep 1;130(18):1615-28.
2. McCrory MA, Harbaugh AG, Appeadu S, Roberts SB. Fast-food offerings in the United
States in 1986, 1991, and 2016 show large increases in food variety, portion size, dietary
energy, and selected micronutrients. Journal of the Academy of Nutrition and Dietetics. 2019
Jun 1;119(6):923-33.
3. An R. Fast-food and full-service restaurant consumption and daily energy and nutrient in-
takes in US adults. European journal of clinical nutrition. 2016 Jan;70(1):97.
4. Bhutani S, Schoeller DA, Walsh MC, McWilliams C. Frequency of eating out at both fast-food
and sit-down restaurants was associated with high body mass index in non-large metropolitan
communities in Midwest. American Journal of Health Promotion. 2018 Jan;32(1):75-83.
5. Seguin RA, Aggarwal A, Vermeylen F, Drewnowski A. Consumption frequency of foods
away from home linked with higher body mass index and lower fruit and vegetable intake
among adults: a cross-sectional study. Journal of environmental and public health. 2016.
6. Wansink B, Johnson KA. The clean plate club: About 92% of self-served food is eaten. In-
ternational Journal of Obesity. 2015 Feb;39(2):371-4.
7. Rolls BJ, Morris EL, Roe LS. Portion size of food affects energy intake in normal-weight
and overweight men and women. The American journal of clinical nutrition. 2002 Dec
1;76(6):1207-13.
8. Steenhuis I, Poelman M. Portion Size: Latest Developments and Interventions. Current Obe-
sity Reports. 2017;6(1):10.

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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.

1. Bartolomei et al. A Comparison Between Total Body and Split Routine Resistance
Training Programs in Trained Men
2. Cornish et al. A focused review of myokines as a potential contributor to muscle
hypertrophy from resistance-based exercise
3. Valenzuela et al. Acute Ketone Supplementation and Exercise Performance: A
Systematic Review and Meta-Analysis of Randomized Controlled Trials
4. Angleri et al. Are resistance training systems necessary to avoid a stagnation and
maximize the gains muscle strength and hypertrophy?
5. Cheng et al. Carbohydrates do not accelerate force recovery after glycogen‐
depleting followed by high‐intensity exercise in humans
6. Rial-Vázquez et al. Cluster vs. traditional training programmes: changes in the
force–velocity relationship
7. Stahn et al. Combined protein and calcium β-hydroxy-β-methylbutyrate induced
gains in leg fat free mass: a double-blinded, placebo-controlled study
8. Motameni et al. Comparing the effects of resistance exercise type on serum levels
of oxidative stress and muscle damage markers in resistance-trained women
9. Soriano et al. Comparison of 1-Repetition-Maximum Performance Across 3
Weightlifting Overhead Pressing Exercises and Sport Groups.
10. Toth et al. Does mental practice still enhance performance? A 24 Year follow-up
and meta-analytic replication and extension
11. Pearson et al. Effect of Competition Frequency on Strength Performance of
Powerlifting Athletes
12. Nogueira et al. Effects of local cryotherapy for recovery of delayed onset muscle
soreness and strength following exercise-induced muscle damage: systematic
review and meta-analysis
13. Chaves et al. Effects of resistance training with controlled versus self-selected
repetition duration on muscle mass and strength in untrained men
14. Vachon et al. Effects of tapering on neuromuscular and metabolic fitness in team
sports: a systematic review and meta-analysis

112
15. Martín-Fuentes et al. Electromyographic activity in deadlift exercise and its variants.
A systematic review
16. Stuntz et al. Exert more and feel better, not worse?: Examining links among changes
in exertion, feelings of accomplishment, and feeling states
17. Parry et al. Human Skeletal Muscle Mitochondrial Adaptations Following Resistance
Exercise Training
18. Teng et al. Impact of coconut oil consumption on cardiovascular health: a systematic
review and meta-analysis
19. Wilk et al. Impact of Duration of Eccentric Movement in the One-Repetition Maximum
Test Result in the Bench Press among Women
20. Pérez-Castilla et al. Influence of Grip Width and Anthropometric Characteristics on
the Bench-Press Load-Velocity Relationship.
21. Romero-Parra et al. Influence of the Menstrual Cycle on Blood Markers of Muscle
Damage and Inflammation Following Eccentric Exercise.
22. Gomes et al. Is there a relationship between back squat depth, ankle flexibility, and
Achilles tendon stiffness?
23. Hussain et al. Muscle Fatigue in the Three Heads of Triceps Brachii During Intensity
and Speed Variations of Triceps Push-Down Exercise
24. Reidy. Muscle or Nothing! Where Is the Excess Protein Going in Men with High
Protein Intakes Engaged in Strength Training?
25. Carvalho and Barroso. Muscle thickness and strength adaptations in dominant and
non-dominant upper limbs
26. Joffe and Tallent. Neuromuscular predictors of competition performance in advanced
international female weightlifters: a cross-sectional and longitudinal analysis
27. Grandou et al. Overtraining in Resistance Exercise: An Exploratory Systematic
Review and Methodological Appraisal of the Literature
28. Alizadeh et al. Push-Ups vs. Bench Press Differences in Repetitions and Muscle
Activation between Sexes
29. Snijders et al. The concept of skeletal muscle memory: Evidence from animal and
human studies
30. Akinci et al. The effectiveness of three different recovery methods on blood lactate,
acute muscle performance, and delayed-onset muscle soreness: a randomized
comparative study
31. Ertel et al. The effects of training status and exercise intensity on exercise-induced
muscle damage
32. Androulakis-Korakakis et al. The Minimum Effective Training Dose Required to
Increase 1RM Strength in Resistance-Trained Men: A Systematic Review and Meta-
Analysis

113
 Thanks for
reading MASS.
The next issue will be released to
subscribers on June 1, 2020.

Graphics and layout by Kat Whitfield

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