Join Dr David Jockers, Doctor of Natural Medicine and Functional Nutritionist as he shares science-based solutions to improve your health. Dr Jockers' work has been published in various popular media outlets including ABC, Fox News, The Hallmark Channel - Home & Family TV Show and the Dr Oz Show. On this podcast, Dr Jockers shares his best strategies to reduce inflammation, burn fat, improve your brain, natural detoxification, gut health, immune health and much more. To learn more about Dr J ...
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Q&A: Cholesterol Lowering, Volume vs. Intensity For Hypertrophy Volume, Zone 2 Efficiency, and More
Manage episode 519463362 series 2973572
Content provided by Barbell Medicine. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Barbell Medicine or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://podcastplayer.com/legal.
Barbell Medicine Q&A: Cholesterol, Hypertrophy Volume, and Training Efficiency
Episode Summary
In this Q&A session, Dr. Jordan Feigenbaum addresses listener questions on optimizing training, managing health metrics, and navigating supplement use. Key topics include the latest evidence on cholesterol management (statins vs. PCSK9 inhibitors), why routine Vitamin D supplementation is usually unnecessary, and the mechanics of hypertrophy, emphasizing that volume is superior to intensity once a functional threshold is met. Dr. Feigenbaum also offers practical coaching advice on dynamic volume regulation, the importance of efficiency in the deadlift, and why training models like Pilates do not offer the same benefits as traditional strength work.
⏱️ Episode Timestamps
- 00:00 Introduction
- 00:43 Cholesterol Lowering Medication (Statins vs. PCSK9 Inhibitors)
- 03:27 Volume vs. Intensity for Hypertrophy
- 06:48 Regulating Training Volume and the 5% Rule
- 11:43 Barbell Medicine Supplement Philosophy and Safety
- 14:14 Pilates as a Training Modality
- 16:31 Is Zone 2 Cardio Really That Amazing?
⭐ Get More Value: Exclusive Content and Resources
Want to support the show and get early, ad-free access to all episodes plus exclusive bonus content? Subscribe to Barbell Medicine Plus and get ad-free listening, product discounts, and more. Try it free for 30-days.
Unsure which training plan is right for you? Take the free Barbell Medicine Template Quiz to be matched with the ideal program for your goals and experience level.
For media, support, or general questions, please contact us at [email protected]
⚕️ Section I: Clinical and Healthspan Optimization
Cholesterol Management: The Lower is Better Philosophy
The core principle of managing atherogenic risk is that the risk of heart disease is proportional to the overall lifetime exposure (level $\times$ duration) to atherogenic lipoproteins, specifically LDL, triglycerides, and particles tagged with Apolipoprotein B (ApoB). These particles constitute the "atherogenic load."
Lowering this load is beneficial, and the data suggests that lower is better for cardiovascular health. While powerful medications like PCSK9 inhibitors offer an immense magnitude of cholesterol lowering and are proven for both primary and secondary prevention of major adverse cardiac events, the general population will often achieve substantial risk reduction with statins or statin/ezetimibe combinations, which are more accessible and cost-effective.
This approach is validated by observing individuals with genetic mutations who maintain low cholesterol levels throughout their lives—they demonstrate the lowest risk of heart disease, period. Therefore, for active lifters seeking to optimize healthspan and longevity, the goal should be active management and mitigation of this exposure. This requires understanding how to interpret blood work for active lifters and working with a physician to find the most appropriate and sustainable treatment plan, which may include setting targets to lower LDL cholesterol to near-neonatal levels.
Vitamin D Supplementation: Questioning the Routine Recommendation
Routine, widespread Vitamin D supplementation for the general, otherwise healthy population is generally not recommended due to a lack of strong evidence showing that replacing low levels improves actual health outcomes. While low Vitamin D levels frequently coexist with various medical conditions, simply replacing the vitamin doesn't mitigate the primary disease trajectory.
The potential risks of routine supplementation, though low, include supplement contamination and the risk of overdosing (leading to unwanted calcium deposits). Unless an individual has a specific medical condition (like chronic kidney disease, severe malabsorption issues, or high risk of fall and fracture due to osteoporosis), the benefits of routine supplementation are questionable. Barbell Medicine favors interventions where the clinical benefit is clearly demonstrated to improve meaningful health outcomes, not just laboratory values.
🏋️ Section II: Hypertrophy and Training Load Optimization
Volume is the Dose: The Hypertrophy Principle
The relationship between resistance training and hypertrophy (muscle growth) is a dose-dependent relationship on volume, provided a functional threshold is met. This threshold means training must involve a load greater than approximately 30% of a lifter's one-rep maximum (1RM) and be taken relatively close to failure (around 4-5 repetitions left in reserve, RIR).
Advising low volume training to failure, as some influencers do, is sub-optimal for muscle growth because it generates insufficient total training load. Once a lifter has achieved this functional threshold, volume is superior to intensity. High training volume is optimal for muscle growth, and only when volume has been maximized does pulling the intensity lever (training even closer to failure) provide an additional, albeit smaller, benefit.
Optimal hypertrophy and how to structure a strength program for longevity relies on maximizing training load—the total volume of effective work—within the constraints of a person's time and physiological tolerance.
Dynamic Volume Regulation and The 5% Rule
Coaching requires dynamic volume regulation—adjusting the training plan based on a person's current performance and recovery status. One method is to use RPE (Rate of Perceived Exertion) caps to autoregulate volume within a session. For example, prescribing back-off sets that terminate once the prescribed RPE is reached means a lifter performs more work on a good day and less work on a slow day, ensuring sufficient training stimulus without causing excessive fatigue or burnout.
For long-term progression, true strength gain must exceed day-to-day performance fluctuations. A strength gain greater than $\pm 5\%$ over a multi-week period is considered a "real" or minimal clinically important difference in strength. Tracking this trend, rather than session-to-session RPE, is how a coach determines whether to increase the overall training load, which is necessary to continue achieving fitness adaptations.
🧘 Section III: Training Modalities and Applications
Deadlift Technique: Efficiency Over Absolute Neutrality
The belief that any slight movement in the thoracic or lumbar spine during a heavy deadlift is uniquely injurious is not supported by evidence. The human body is highly adaptable, provided the training load is progressed gradually.
The primary coaching concern is not achieving an absolute "neutral spine" (which is difficult to define and rarely achieved in heavy lifting) but maintaining efficiency. Excessive spinal movement can compromise the lockout, making the lift harder than necessary. Coaching should focus on improving the efficiency of the lift to maximize the load that can be lifted strongly, not reducing an overstated injury risk.
Pilates: Recreation, Not Resistance Training
Pilates is generally not a valuable addition to an individual's training if the goal is to drive the primary adaptations of resistance training: increases in strength, hypertrophy, muscle function, or bone mineral density.
Pilates is simply not designed to apply the necessary loading stress to the musculoskeletal system to achieve these benefits. It is best viewed as an enjoyable recreational activity or accouterment, not a replacement for "real exercise." For individuals seeking true physical adaptations, the focus should remain on evidence-based resistance training for older adults and other populations that meet or exceed the established physical activity guidelines.
Zone 2 Cardio: Efficiency and Application
While Zone 2 cardio is popular, it is not a panacea. Evidence shows that vigorous physical activity (higher intensity work, Zone 3/Zone 4) is actually more efficient for disease risk reduction than moderate intensity (Zone 2).
Zone 2 work is most useful for individuals performing high volumes of conditioning (three or more hours per week), as it allows them to accumulate volume without causing undue systemic fatigue. For most people performing less than 150 minutes of moderate-to-vigorous activity per week, incorporating more vigorous work is the most time-efficient way to achieve health benefits.
Our Sponsors:
* Check out Express VPN: https://expressvpn.com/BBM
* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com
* Check out Factor and use my code bbm50off for a great deal: https://www.factor75.com
* Check out Rosetta Stone and use my code TODAY for a great deal: https://www.rosettastone.com
* Check out Uncommon Goods: https://uncommongoods.com/bbm
* Check out Washington Red Raspberries: https://redrazz.org
Support this podcast at — https://redcircle.com/barbell-medicine-podcast/donations
Advertising Inquiries: https://redcircle.com/brands
Privacy & Opt-Out: https://redcircle.com/privacy
402 episodes
Share
Manage episode 519463362 series 2973572
Content provided by Barbell Medicine. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Barbell Medicine or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://podcastplayer.com/legal.
Barbell Medicine Q&A: Cholesterol, Hypertrophy Volume, and Training Efficiency
Episode Summary
In this Q&A session, Dr. Jordan Feigenbaum addresses listener questions on optimizing training, managing health metrics, and navigating supplement use. Key topics include the latest evidence on cholesterol management (statins vs. PCSK9 inhibitors), why routine Vitamin D supplementation is usually unnecessary, and the mechanics of hypertrophy, emphasizing that volume is superior to intensity once a functional threshold is met. Dr. Feigenbaum also offers practical coaching advice on dynamic volume regulation, the importance of efficiency in the deadlift, and why training models like Pilates do not offer the same benefits as traditional strength work.
⏱️ Episode Timestamps
- 00:00 Introduction
- 00:43 Cholesterol Lowering Medication (Statins vs. PCSK9 Inhibitors)
- 03:27 Volume vs. Intensity for Hypertrophy
- 06:48 Regulating Training Volume and the 5% Rule
- 11:43 Barbell Medicine Supplement Philosophy and Safety
- 14:14 Pilates as a Training Modality
- 16:31 Is Zone 2 Cardio Really That Amazing?
⭐ Get More Value: Exclusive Content and Resources
Want to support the show and get early, ad-free access to all episodes plus exclusive bonus content? Subscribe to Barbell Medicine Plus and get ad-free listening, product discounts, and more. Try it free for 30-days.
Unsure which training plan is right for you? Take the free Barbell Medicine Template Quiz to be matched with the ideal program for your goals and experience level.
For media, support, or general questions, please contact us at [email protected]
⚕️ Section I: Clinical and Healthspan Optimization
Cholesterol Management: The Lower is Better Philosophy
The core principle of managing atherogenic risk is that the risk of heart disease is proportional to the overall lifetime exposure (level $\times$ duration) to atherogenic lipoproteins, specifically LDL, triglycerides, and particles tagged with Apolipoprotein B (ApoB). These particles constitute the "atherogenic load."
Lowering this load is beneficial, and the data suggests that lower is better for cardiovascular health. While powerful medications like PCSK9 inhibitors offer an immense magnitude of cholesterol lowering and are proven for both primary and secondary prevention of major adverse cardiac events, the general population will often achieve substantial risk reduction with statins or statin/ezetimibe combinations, which are more accessible and cost-effective.
This approach is validated by observing individuals with genetic mutations who maintain low cholesterol levels throughout their lives—they demonstrate the lowest risk of heart disease, period. Therefore, for active lifters seeking to optimize healthspan and longevity, the goal should be active management and mitigation of this exposure. This requires understanding how to interpret blood work for active lifters and working with a physician to find the most appropriate and sustainable treatment plan, which may include setting targets to lower LDL cholesterol to near-neonatal levels.
Vitamin D Supplementation: Questioning the Routine Recommendation
Routine, widespread Vitamin D supplementation for the general, otherwise healthy population is generally not recommended due to a lack of strong evidence showing that replacing low levels improves actual health outcomes. While low Vitamin D levels frequently coexist with various medical conditions, simply replacing the vitamin doesn't mitigate the primary disease trajectory.
The potential risks of routine supplementation, though low, include supplement contamination and the risk of overdosing (leading to unwanted calcium deposits). Unless an individual has a specific medical condition (like chronic kidney disease, severe malabsorption issues, or high risk of fall and fracture due to osteoporosis), the benefits of routine supplementation are questionable. Barbell Medicine favors interventions where the clinical benefit is clearly demonstrated to improve meaningful health outcomes, not just laboratory values.
🏋️ Section II: Hypertrophy and Training Load Optimization
Volume is the Dose: The Hypertrophy Principle
The relationship between resistance training and hypertrophy (muscle growth) is a dose-dependent relationship on volume, provided a functional threshold is met. This threshold means training must involve a load greater than approximately 30% of a lifter's one-rep maximum (1RM) and be taken relatively close to failure (around 4-5 repetitions left in reserve, RIR).
Advising low volume training to failure, as some influencers do, is sub-optimal for muscle growth because it generates insufficient total training load. Once a lifter has achieved this functional threshold, volume is superior to intensity. High training volume is optimal for muscle growth, and only when volume has been maximized does pulling the intensity lever (training even closer to failure) provide an additional, albeit smaller, benefit.
Optimal hypertrophy and how to structure a strength program for longevity relies on maximizing training load—the total volume of effective work—within the constraints of a person's time and physiological tolerance.
Dynamic Volume Regulation and The 5% Rule
Coaching requires dynamic volume regulation—adjusting the training plan based on a person's current performance and recovery status. One method is to use RPE (Rate of Perceived Exertion) caps to autoregulate volume within a session. For example, prescribing back-off sets that terminate once the prescribed RPE is reached means a lifter performs more work on a good day and less work on a slow day, ensuring sufficient training stimulus without causing excessive fatigue or burnout.
For long-term progression, true strength gain must exceed day-to-day performance fluctuations. A strength gain greater than $\pm 5\%$ over a multi-week period is considered a "real" or minimal clinically important difference in strength. Tracking this trend, rather than session-to-session RPE, is how a coach determines whether to increase the overall training load, which is necessary to continue achieving fitness adaptations.
🧘 Section III: Training Modalities and Applications
Deadlift Technique: Efficiency Over Absolute Neutrality
The belief that any slight movement in the thoracic or lumbar spine during a heavy deadlift is uniquely injurious is not supported by evidence. The human body is highly adaptable, provided the training load is progressed gradually.
The primary coaching concern is not achieving an absolute "neutral spine" (which is difficult to define and rarely achieved in heavy lifting) but maintaining efficiency. Excessive spinal movement can compromise the lockout, making the lift harder than necessary. Coaching should focus on improving the efficiency of the lift to maximize the load that can be lifted strongly, not reducing an overstated injury risk.
Pilates: Recreation, Not Resistance Training
Pilates is generally not a valuable addition to an individual's training if the goal is to drive the primary adaptations of resistance training: increases in strength, hypertrophy, muscle function, or bone mineral density.
Pilates is simply not designed to apply the necessary loading stress to the musculoskeletal system to achieve these benefits. It is best viewed as an enjoyable recreational activity or accouterment, not a replacement for "real exercise." For individuals seeking true physical adaptations, the focus should remain on evidence-based resistance training for older adults and other populations that meet or exceed the established physical activity guidelines.
Zone 2 Cardio: Efficiency and Application
While Zone 2 cardio is popular, it is not a panacea. Evidence shows that vigorous physical activity (higher intensity work, Zone 3/Zone 4) is actually more efficient for disease risk reduction than moderate intensity (Zone 2).
Zone 2 work is most useful for individuals performing high volumes of conditioning (three or more hours per week), as it allows them to accumulate volume without causing undue systemic fatigue. For most people performing less than 150 minutes of moderate-to-vigorous activity per week, incorporating more vigorous work is the most time-efficient way to achieve health benefits.
Our Sponsors:
* Check out Express VPN: https://expressvpn.com/BBM
* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com
* Check out Factor and use my code bbm50off for a great deal: https://www.factor75.com
* Check out Rosetta Stone and use my code TODAY for a great deal: https://www.rosettastone.com
* Check out Uncommon Goods: https://uncommongoods.com/bbm
* Check out Washington Red Raspberries: https://redrazz.org
Support this podcast at — https://redcircle.com/barbell-medicine-podcast/donations
Advertising Inquiries: https://redcircle.com/brands
Privacy & Opt-Out: https://redcircle.com/privacy
402 episodes
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Join Dr David Jockers, Doctor of Natural Medicine and Functional Nutritionist as he shares science-based solutions to improve your health. Dr Jockers' work has been published in various popular media outlets including ABC, Fox News, The Hallmark Channel - Home & Family TV Show and the Dr Oz Show. On this podcast, Dr Jockers shares his best strategies to reduce inflammation, burn fat, improve your brain, natural detoxification, gut health, immune health and much more. To learn more about Dr J ...
…
continue reading
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continue reading
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