Barbell Medicine Podcast

Every couple of years a new headline warns that the protein you eat is quietly hurting you. This year the target is your kidneys. Before that it was cancer, then your bones, then the claim that your body can only use twenty or thirty grams of protein at a meal. In this episode, Dr. Jordan Feigenbaum goes through the actual studies behind each scare: the kidney trials, the 2014 IGF-1 and cancer paper that started the panic, the acid-ash bone hypothesis, and the per-meal "cap." Each fear starts from a real mechanism, and each one was run straight to a frightening conclusion the clinical outcomes never supported.

The take home is simple. For a healthy adult, protein is not the lever people think it is, and where a real signal exists (processed and red meat, or a kidney that is already diseased) it tracks the whole dietary pattern more than the protein number. The two things that actually decide your health here are whether you eat mostly real food and whether you train.

Timestamps
00:00 The protein scare cycle 
01:23 The four fears 
01:59 Kidneys: healthy kidneys under higher protein 
06:22 Kidney disease: does cutting protein help? 
09:38 Red meat and the dietary pattern, not protein 
12:00 Muscle, aging, and lifting on a restricted diet 
13:54 Cancer: IGF-1 and the 2014 study everyone cites 
16:22 The age reversal, and what travels with protein 
18:48 Bigger data, processed meat, and the IGF-1 tell 
22:15 Bones and the acid-ash myth 
25:13 The 30-gram cap 
27:17 What protein actually does, and how much you need 
32:20 The two questions that matter

Resources:
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Our Protein Content:
https://www.barbellmedicine.com/blog/protein-and-weight-loss/
https://www.barbellmedicine.com/blog/protein-on-ozempic/
https://www.barbellmedicine.com/blog/barbell-medicine-protein-recommendations/
Studies
Levine et al. Cell Metabolism 2014. doi:10.1016/j.cmet.2014.02.006
Naghshi et al. BMJ 2020. doi:10.1136/bmj.m2412 
Devries et al. J Nutr 2018. doi:10.1093/jn/nxy197 
Antonio et al. J Nutr Metab 2016. doi:10.1155/2016/9104792 
Knight et al. Ann Intern Med 2003. doi:10.7326/0003-4819-138-6-200303180-00009 
Klahr et al. (MDRD). NEJM 1994. doi:10.1056/NEJM199403313301301
 Hahn, Hodson & Fouque. Cochrane 2020. doi:10.1002/14651858.CD001892.pub5 
Obeid, Hiremath & Topf. Kidney360 2022. doi:10.34067/KID.0001002022 
Lew et al. J Am Soc Nephrol 2017. doi:10.1681/ASN.2016030248
Castaneda et al. Ann Intern Med 2001. doi:10.7326/0003-4819-135-11-200112040-00008 
Bauer et al. (PROT-AGE). JAMDA 2013. doi:10.1016/j.jamda.2013.05.021
Fenton et al. Nutrition Journal 2011. doi:10.1186/1475-2891-10-41
Shams-White et al. Am J Clin Nutr 2017. doi:10.3945/ajcn.116.145110
Witard et al. Am J Clin Nutr 2013. doi:10.3945/ajcn.112.055517
 Macnaughton et al. Physiol Rep 2016. doi:10.14814/phy2.12893
Trommelen et al. Cell Reports Medicine 2023. doi:10.1016/j.xcrm.2023.101324 
Wycherley et al. Am J Clin Nutr 2012. doi:10.3945/ajcn.112.044321
 Moore et al. JAMA Intern Med 2016. doi:10.1001/jamainternmed.2016.1548 
Larsson et al. Cancer Med 2020. doi:10.1002/cam4.3345 
Brenner, Meyer & Hostetter. NEJM 1982. doi:10.1056/NEJM198209093071104 
Chan et al. PLoS One 2011. doi:10.1371/journal.pone.0020456
Berryman et al. Am J Clin Nutr 2018. doi:10.1093/ajcn/nqy088 
Morton et al. Br J Sports Med 2018. doi:10.1136/bjsports-2017-097608

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Is weight loss really just Calories in, Calories out? The equation is true, but "just count your Calories" is bad advice for most people, and almost every objection to it is pointing at something real. In part two of our energy balance series, Jordan Feigenbaum takes the biggest "it's not Calories, it's ___" claims (metabolism, thyroid, cortisol, PCOS, insulin, the type of food) and tests each against the best evidence. The verdict: none of them breaks the equation. Every one is a hand on a lever that moves Calories in or Calories out, not a hole in the math.

In this episode: why your metabolism does not crash at 40, how small real metabolic adaptation actually is after weight loss, why hypothyroid weight is mostly water, what the cortisol and PCOS (now PMOS) data show, how absorption and cooking move Calories only at the edges, why even dietitians miscount their own intake, and why the carbohydrate-insulin model fails three tests, including the GLP-1 drugs that raise insulin and still produce the biggest weight loss we have ever approved.

Part two of three: willpower, Calories in Calories out, then GLP-1 drugs. Next week: are GLP-1s cheating?
Timestamps
0:00 Is it really just calories in, calories out?
0:18 The willpower episode and the through-line
2:10 Thermodynamics: what sets both sides
2:41 Your metabolism is three things
4:05 Claim 1: my metabolism crashed
4:24 No cliff at 40: the doubly labeled water study
5:33 Real metabolic adaptation after weight loss
6:56 Why your food diary lies
7:49 Claim 2: it's my hormones
8:07 Thyroid: mostly water
9:36 Cortisol: explains about 1 percent
11:12 PCOS is now PMOS
13:06 Menopause
14:18 Claim 3: a calorie isn't a calorie
16:48 Absorption: nuts, cooking, eggs
19:44 Why calorie counting fails
21:12 Claim 4: it's not Calories, it's insulin
22:02 Testing the carbohydrate-insulin model
25:52 The GLP-1 drugs that should end it
28:34 The whole list, claim by claim
29:53 What to actually do
30:42 Next week: are GLP-1s cheating?

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Pontzer et al., Science 2021. https://doi.org/10.1126/science.abe5017

Muller et al., Am J Clin Nutr 2015. https://doi.org/10.3945/ajcn.115.109173

Lichtman et al., N Engl J Med 1992. https://doi.org/10.1056/NEJM199212313272701

Karmisholt et al., J Clin Endocrinol Metab 2011. https://doi.org/10.1210/jc.2010-1521

Lee et al., Endocr Pract 2014. https://doi.org/10.4158/EP14072.OR

van der Valk et al., Obes Rev 2022. https://doi.org/10.1111/obr.13376

Nikokavoura et al., Diabetes Metab Syndr Obes 2015. https://doi.org/10.2147/DMSO.S85134

Greendale et al., JCI Insight 2019. https://doi.org/10.1172/jci.insight.124865

Lejeune et al., Am J Clin Nutr 2006. https://doi.org/10.1093/ajcn/83.1.89

Bray et al., JAMA 2012. https://doi.org/10.1001/jama.2011.1918

Novotny et al., Am J Clin Nutr 2012. https://doi.org/10.3945/ajcn.112.035782

Baer et al., J Nutr 2016. https://doi.org/10.3945/jn.115.217372

Baer et al., Br J Nutr 2012. https://doi.org/10.1017/S0007114511002649

Evenepoel et al., J Nutr 1998. https://doi.org/10.1093/jn/128.10.1716

Hall et al., Cell Metabolism 2019. https://doi.org/10.1016/j.cmet.2019.05.008

Champagne et al., J Am Diet Assoc 2002. https://doi.org/10.1016/S0002-8223(02)90316-0

Hall et al., Cell Metabolism 2015. https://doi.org/10.1016/j.cmet.2015.07.021

Wilding et al., N Engl J Med 2021. https://doi.org/10.1056/NEJMoa2032183

Jastreboff et al., N Engl J Med 2022. https://doi.org/10.1056/NEJMoa2206038

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Obesity roughly tripled in about 60 years, and the genes didn't change in that time. So if body weight isn't a willpower problem, what is it? Dr. Jordan Feigenbaum and Dr. Austin Baraki walk through what actually sets your weight: the adoption and twin studies behind the genetics, the "defended range" your biology fights to hold, the food environment that does most of the eating for you, and where GLP-1 medications actually work. Along the way — why diets regain after you white-knuckle them, what The Biggest Loser six-year data show about resting metabolism, and four willpower myths worth retiring. 
Hosted by Dr. Jordan Feigenbaum and Dr. Austin Baraki, co-founders of Barbell Medicine.
Timestamps
00:00 Cold open: Danny Cahill and The Biggest Loser
01:03 What we mean by "willpower"
05:48 Obesity tripled in ~60 years: the one number
06:31 Adoption and twin studies: genes vs. household
09:37 Set point vs. the defended range
10:37 Gene–environment mismatch
14:03 In the clinic: a lifelong weight history
19:18 Losing weight vs. keeping it off
20:26 Appetite doesn't reset (Sumithran)
25:52 Metabolic adaptation and the Biggest Loser data
34:07 Part 2: eating on autopilot
35:10 Portion size runs the meal
39:12 What changed in the food supply
40:42 Same genes, new environment: Pima and immigrants
43:20 Why ultra-processed food is easy to overeat
50:28 Processing vs. calories: the Hall ward study
52:36 When the brain changes eating: gourmand syndrome
1:00:01 Why the willpower story stuck
1:01:08 Taft, Churchill, and the intelligence myth
1:02:43 Does intelligence predict weight? (sibling study)
1:11:16 Are GLP-1s cheating? What they actually do
1:15:10 Beyond the scale: muscle, health, nutrition
1:24:21 Myth-busting: lightning round
1:39:04 Three takeaways: what to actually do
1:41:00 Danny Cahill, revisited 
Resources
 
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Prevalence of Overweight, Obesity, and Severe Obesity Among Adults Age 20 and Older: United States, 1960-1962 Through August 2021-August 2023. NCHS Health E-Stats. 2024. https://www.cdc.gov/nchs/data/hestat/hestat111.htm

Obesity and Severe Obesity Prevalence in Adults: United States, August 2021-August 2023. NCHS Data Brief No. 508. Hyattsville, MD: National Center for Health Statistics; 2024. https://www.cdc.gov/nchs/products/databriefs/db508.htm

Hill JO, Peters JC. Environmental contributions to the obesity epidemic. Science. 1998;280(5368):1371-1374. https://doi.org/10.1126/science.280.5368.1371

Morton RW, Murphy KT, McKellar SR, et al. A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults. Br J Sports Med. 2018;52(6):376-384. https://doi.org/10.1136/bjsports-2017-097608

Stunkard AJ, Sorensen TIA, Hanis C, et al. An adoption study of human obesity. N Engl J Med. 1986;314(4):193-198. https://doi.org/10.1056/NEJM198601233140401

Stunkard AJ, Harris JR, Pedersen NL, McClearn GE. The body-mass index of twins who have been reared apart. N Engl J Med. 1990;322(21):1483-1487. https://doi.org/10.1056/NEJM199005243222102

Speakman JR, Levitsky DA, Allison DB, et al. Set points, settling points and some alternative models: theoretical options to understand how genes and environments combine to regulate body adiposity. Dis Model Mech. 2011;4(6):733-745. https://doi.org/10.1242/dmm.008698

Kalm LM, Semba RD. They starved so that others be better fed: remembering Ancel Keys and the Minnesota Experiment. J Nutr. 2005;135(6):1347-1352. https://doi.org/10.1093/jn/135.6.1347

Sumithran P, Prendergast LA, Delbridge E, et al. Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011;365(17):1597-1604. https://doi.org/10.1056/NEJMoa1105816

Fothergill E, Guo J, Howard L, et al. Persistent metabolic adaptation 6 years after 'The Biggest Loser' competition. Obesity (Silver Spring). 2016;24(8):1612-1619. https://doi.org/10.1002/oby.21538

Hall KD. Energy compensation and metabolic adaptation: 'The Biggest Loser' study reinterpreted. Obesity (Silver Spring). 2022;30(1):11-13. https://doi.org/10.1002/oby.23308

Cohen DA, Farley TA. Eating as an automatic behavior. Prev Chronic Dis. 2008;5(1):A23. https://www.cdc.gov/pcd/issues/2008/jan/07_0046.htm

Rolls BJ, Morris EL, Roe LS. Portion size of food affects energy intake in normal-weight and overweight men and women. Am J Clin Nutr. 2002;76(6):1207-1213. https://doi.org/10.1093/ajcn/76.6.1207

Diliberti N, Bordi PL, Conklin MT, Roe LS, Rolls BJ. Increased portion size leads to increased energy intake in a restaurant meal. Obes Res. 2004;12(3):562-568. https://doi.org/10.1038/oby.2004.64

Hollands GJ, Shemilt I, Marteau TM, et al. Portion, package or tableware size for changing selection and consumption of food, alcohol and tobacco. Cochrane Database Syst Rev. 2015;(9):CD011045. https://doi.org/10.1002/14651858.CD011045.pub2

Hall KD, Ayuketah A, Brychta R, et al. Ultra-processed diets cause excess calorie intake and weight gain: an inpatient randomized controlled trial of ad libitum food intake. Cell Metab. 2019;30(1):67-77.e3. https://doi.org/10.1016/j.cmet.2019.05.008

Pontzer H, Raichlen DA, Wood BM, et al. Hunter-gatherer energetics and human obesity. PLoS One. 2012;7(7):e40503. https://doi.org/10.1371/journal.pone.0040503

Careau V, Halsey LG, Pontzer H, et al. Energy compensation and adiposity in humans. Curr Biol. 2021;31(20):4659-4666.e2. https://doi.org/10.1016/j.cub.2021.08.016

Miller WC, Koceja DM, Hamilton EJ. A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. Int J Obes Relat Metab Disord. 1997;21(10):941-947. https://doi.org/10.1038/sj.ijo.0800499

Gaesser GA, Angadi SS. Obesity treatment: weight loss versus increasing fitness and physical activity for reducing health risks. iScience. 2021;24(10):102995. https://doi.org/10.1016/j.isci.2021.102995

US Department of Agriculture, Economic Research Service. Food Availability (Per Capita) Data System, Loss-Adjusted Food Availability. https://www.ers.usda.gov/data-products/food-availability-per-capita-data-system/

Steele EM, Baraldi LG, Louzada ML, Moubarac JC, Mozaffarian D, Monteiro CA. Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study. BMJ Open. 2016;6(3):e009892. https://doi.org/10.1136/bmjopen-2015-009892

Wang L, Martinez Steele E, Du M, et al. Trends in consumption of ultraprocessed foods among US youths aged 2-19 years, 1999-2018. JAMA. 2021;326(6):519-530. https://doi.org/10.1001/jama.2021.10238

Schulz LO, Bennett PH, Ravussin E, et al. Effects of traditional and western environments on prevalence of type 2 diabetes in Pima Indians in Mexico and the US. Diabetes Care. 2006;29(8):1866-1871. https://doi.org/10.2337/dc06-0138

Goel MS, McCarthy EP, Phillips RS, Wee CC. Obesity among US immigrant subgroups by duration of residence. JAMA. 2004;292(23):2860-2867. https://doi.org/10.1001/jama.292.23.2860

Papavramidou NS, Papavramidis ST, Christopoulou-Aletra H. Galen on obesity: etiology, effects, and treatment. World J Surg. 2004;28(6):631-635. https://doi.org/10.1007/s00268-004-7458-5

Haslam DW, Haslam F. Fat, Gluttony and Sloth: Obesity in Literature, Art and Medicine. Liverpool: Liverpool University Press; 2009. https://www.liverpooluniversitypress.co.uk/9781846311734/fat-gluttony-and-sloth/

Townend L. The moralizing of obesity: a new name for an old sin? Crit Soc Policy. 2009;29(2):171-190. https://doi.org/10.1177/0261018308101625

Levine DI. Corpulence and correspondence: President William H. Taft and the medical management of obesity. Ann Intern Med. 2013;159(8):565-570. https://doi.org/10.7326/0003-4819-159-8-201310150-00012

Wright L, Davies NM, Bann D. The association between cognitive ability and body mass index: a sibling-comparison analysis in four longitudinal studies. PLoS Med. 2023;20(4):e1004207. https://doi.org/10.1371/journal.pmed.1004207

Mechanisms of GLP-1 receptor agonist-induced weight loss: a review of central and peripheral pathways. Am J Med. 2025 (review of hypothalamic arcuate nucleus and brainstem area postrema action). https://www.sciencedirect.com/science/article/pii/S0002934325000592

Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). N Engl J Med. 2021;384(11):989-1002. https://doi.org/10.1056/NEJMoa2032183

Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1). N Engl J Med. 2022;387(3):205-216. https://doi.org/10.1056/NEJMoa2206038

Grannell A, Fallon F, Al-Najim W, le Roux C. Obesity and responsibility: is it time to rethink agency? Obes Rev. 2021;22(8):e13270. https://doi.org/10.1111/obr.13270

Al Khatib HK, Harding SV, Darzi J, Pot GK. The effects of partial sleep deprivation on energy balance: a systematic review and meta-analysis. Eur J Clin Nutr. 2017;71(5):614-624. https://doi.org/10.1038/ejcn.2016.201

Helms ER, Aragon AA, Fitschen PJ. Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation. J Int Soc Sports Nutr. 2014;11:20. https://doi.org/10.1186/1550-2783-11-20

Garthe I, Raastad T, Refsnes PE, Koivisto A, Sundgot-Borgen J. Effect of two different weight-loss rates on body composition and strength and power-related performance in elite athletes. Int J Sport Nutr Exerc Metab. 2011;21(2):97-104. https://doi.org/10.1123/ijsnem.21.2.97

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Once a month we answer Barbell Medicine Plus subscribers’ questions on the Direct Line. This is a free look at June’s episode. We start with GLP-1 drugs and muscle: why DEXA overstates the loss, what resistance training actually does, and whether creatine is worth taking. Then whether bulking and cutting does anything the scale can’t already tell you, how to get real benefit from one training hour a week, and what happens to your muscle, strength, tendons, and bone when you take time off, including why muscle memory brings it back faster than you built it.
What we cover:
•   GLP-1s and muscle: the DEXA problem, resistance training, and creatine
•   Bulking vs cutting vs just maintaining, and a health-first way to choose
•   Training on one hour a week: the least that still moves the needle
•   How fast you lose muscle when you stop, and why it comes back fast
The full two-hour episode and every back episode are on Barbell Medicine Plus, which can bundled with Premium. Resources and full references below.

Timestamps
0:00 Intro + GLP-1 and the DEXA muscle-loss myth
3:00 Do GLP-1s spare or waste muscle?
8:03 Does creatine help on a GLP-1?
10:45 Does bulking and cutting do anything?
13:18 Health first: when to lose fat before gaining
22:30 Training on one hour a week
36:22 How fast you lose muscle when you stop
43:19 Muscle memory: why it comes back
48:25 The full episode on Plus

Resources
Barbell Medicine coaching and templates: https://www.barbellmedicine.com
https://www.barbellmedicine.com/shop/subscriptions/plus-podcast-subscription/
https://www.barbellmedicine.com/shop/subscriptions/barbell-medicine-premium/
Signal book pre-order: https://www.barbellmedicine.com/shop/learning/signal/

https://www.barbellmedicine.com/blog/glp-1-muscle-loss/
https://www.barbellmedicine.com/blog/creatine-on-ozempic-does-it-prevent-muscle-loss/
https://www.barbellmedicine.com/blog/novice-intermediate-advanced-strength-training/
Lundgren JR, et al. Healthy Weight Loss Maintenance with Exercise, Liraglutide, or Both Combined (S-LITE). N Engl J Med 2021;384:1719-1730. nejm.org · NEJMoa2028198
T-REX trial: tirzepatide with or without resistance training (Univ. of Western Australia). Preliminary. ANZCTR ACTRN12623001236684
Creatine + GLP-1 pilot (Univ. of Saskatchewan). Ongoing, results expected 2027. ClinicalTrials.gov NCT07625202
Momma H, et al. Muscle-strengthening activities and lower risk/mortality in major non-communicable diseases. Br J Sports Med 2022. PubMed 35228201
Wall BT, et al. 2014. Immobilization and disuse muscle atrophy (quadriceps −3.5% at 5 days, −8% at 14 days). PubMed 24168489
Gaffney CJ, et al. 2021. Grip strength loss with short-term arm immobilization. PMC8107283
Farthing JP, et al. 2009. Cross-education and preservation of the immobilized limb. PubMed 19150859
Marusic U, et al. 2021. Bed rest: strength loss outpaces size loss. PMC8325614
Yoshihara, et al. 2023. Sepsis-associated muscle wasting (−26% in a week). PMC10003568
Warren GL, et al. 2017. Strength loss and recovery after muscle injury (meta-analysis). PMC5214801
Hortobágyi T, et al. 1993. Short-term detraining in strength athletes. PubMed 8371654
Gavanda S, et al. 2020. Training cessation in previously untrained adolescents. PMC7241623
Lovell DI, et al. 2010. Detraining strength loss in older adults. PubMed 20140683
Mujika I, Padilla S. 2001. Physiology of detraining (review). PubMed 11474330
Smith K, et al. 2003. Two years of training, then detraining, in older adults. PubMed 12955872
Staron RS, et al. 1991. Detraining and muscle cross-sectional area in women. PubMed 1827108
Ivey FM, et al. 2000. Detraining across age and sex. PubMed 10795719
Taaffe DR, et al. 2009. Training and detraining in older adults. PMC2756799
Grgic J, et al. 2022. Muscle size loss with detraining (meta-analysis). PubMed 36360927
Bosquet L, et al. 2013. Detraining effects on strength and power. PubMed 23347054
Bruusgaard JC, et al. 2010. Myonuclei acquired by overload persist after detraining (muscle memory). PMC2930527
Weakley J, et al. 2017. Day-to-day variation in strength performance. PubMed 28277425
McGuigan MR, et al. 2004. Strength performance variability. PubMed 15320651
Andreoli A, et al. 2009. DEXA precision and assumptions. PMC9263164

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Is there really a “menopause-specific” way to train, eat, and supplement — or is most of it marketing? In the finale of our 4-part menopause series, Drs. Jordan Feigenbaum and Austin Baraki go straight to the evidence on building muscle and bone before, during, and after the transition.
We cover whether menopause blunts your response to lifting (the Isenmann 2023 head-to-head trial and the 2026 meta-analysis of ~4,000 women say it doesn’t), the one-index-card prescription that actually works. Then we work through the loudest claims in the space — cortisol “wrecking” your fat loss, anabolic resistance, the protein and creatine hype, hormone therapy as a cure-all, and “you need a different paradigm” — steelmanning each before we push back. We close with the strongest case in the whole space: heavy lifting for bone density (the LIFTMOR trial), the pelvic-floor evidence, your three biggest fears answered, and how to tell a good coach or clinician from a bad one.
Claims discussed are associated with Stacey Sims, Mary Claire Haver, Mindy Pelz, and the broader functional-medicine space. We push back on the claims, not the people.

Timestamps:
0:00 The 90-year-olds who tripled their strength
 1:10 Why this matters: heart disease and falls, not vanity
 2:28 Can women still build muscle after menopause? (Isenmann 2023)
 7:31 Does menopause blunt your gains? The 2026 meta-analysis
 8:49 Is it menopause, or just individual variation?
 14:42 The estrogen "shield" and the mechanical override
 18:31 Does hormone therapy replace training? (the 2021 estradiol trial)
 22:44 What actually works: the whole prescription
 24:18 Program details: frequency, volume & insulin sensitivity
 30:22 Nutrition: protein and the 2026 review
 35:06 Creatine, vitamin D & calcium
 43:29 Anabolic resistance: mostly overstated
 47:22 Clinical case: the supplement-stack patient
 52:23 A short history of wrong advice for women
 53:38 Claim 1: "Lift heavy or lose your bones" (Stacey Sims)
 1:01:09 Claim 2: the cortisol myth
 1:15:18 Clinical case: the cortisol-anxious patient
 1:18:20 Claim 3: "It's all hormonal, HRT fixes it" (Mary Claire Haver)
 1:20:45 Testosterone in women: what it does and doesn't do
 1:21:51 Claim 4: "Menopause needs its own paradigm" & the SWAN data
 1:24:48 Bone density done right: the LIFTMORE trial
 1:33:07 Does heavy lifting wreck your pelvic floor?
 1:38:59 Your three biggest fears, answered
 1:40:44 Green flags & red flags 
Resources:
Menopause Series Part 1 : https://www.youtube.com/watch?v=yzk0IkTy0WM
Menopause Series Part 2 — https://www.youtube.com/watch?v=YKAlamIOiwU
 Menopause Series Part 3 — https://www.youtube.com/watch?v=jzoNMQaBAcI 
Hypercortisolism episode - https://open.spotify.com/episode/7tDdUi8dDFWjMYx0fRJdOz 
Barbell Medicine coaching and templates: https://www.barbellmedicine.com

Signal book pre-order: https://www.barbellmedicine.com/shop/learning/signal/

Isenmann (2023) https://doi.org/10.1186/s12905-023-02671-y
Isenmann (2026) https://doi.org/10.1016/j.jsams.2026.01.004
Fiatarone (1990) https://doi.org/10.1001/jama.1990.03440220053029
Fiatarone (1994) https://doi.org/10.1056/NEJM199406233302501
Dam (2021) https://doi.org/10.3389/fphys.2020.596130
Markofski (2015) https://doi.org/10.1016/j.exger.2015.02.015
Orsatti (2022) https://doi.org/10.1016/j.exger.2022.111904
Walter (2026) https://doi.org/10.1186/s40798-025-00954-2
dos Santos (2021) https://doi.org/10.3390/nu13113757
Myung (2021) https://doi.org/10.3390/nu13020368
Dote-Montero (2021) https://doi.org/10.1111/sms.13999
Ravussin (2015) https://doi.org/10.1093/gerona/glv057
Cadegiani (2016) https://doi.org/10.1186/s12902-016-0128-4
Greising (2009) https://doi.org/10.1093/gerona/glp082
Islam (2019) https://doi.org/10.1016/S2213-8587(19)30189-5
Testosterone in women review (2026) https://doi.org/10.1080/09513590.2025.2592402
NAMS nonhormone position statement (2023) https://doi.org/10.1097/GME.0000000000002200
Vasomotor exercise meta-analysis (2022) https://doi.org/10.1080/13697137.2022.2097865
Greendale (2019) https://doi.org/10.1172/jci.insight.124865
Watson, LIFTMOR (2018) https://doi.org/10.1002/jbmr.3284
Skaug (2024) https://doi.org/10.1249/MSS.0000000000003278
Skaug (2021) https://doi.org/10.1007/s00192-021-04739-5
Dumoulin (2018) https://doi.org/10.1002/14651858.CD005654.pub4

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