Barbell Medicine Podcast

Episode 382: The Trial of Big Food

For decades, the health and fitness industry has blamed rising obesity rates on a lack of individual willpower and "poor choices." However, a landmark lawsuit in San Francisco argues that the modern food environment is a public nuisance engineered by food giants using a literal tobacco playbook. By manipulating "Bliss Points" and dismantling the natural food matrix, these companies have created an environment where healthy choices are the path of highest resistance. Understanding the shift from personal responsibility to environmental accountability is the first step in reclaiming your health.Next StepsFor evidence-based resistance training programs: barbellmedicine.com/training-programsFor individualized medical and training consultation: barbellmedicine.com/coachingExplore our full library of articles on health and performance: barbellmedicine.com/resourcesTo join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: https://barbellmedicine.supercast.com/Timestamps00:00 - The San Francisco Lawsuit vs. Big Food01:46 - Legal Shift: Personal Choice vs. Public Nuisance08:02 - Probabilistic Automaticity: Why Environment Wins13:40 - The 500-Calorie Shift: The Rise of Energy Toxicity16:11 - The Tobacco Playbook & The Bliss Point22:33 - The Potato Continuum & The Food Matrix28:09 - Yale Food Addiction Scale (YFAS) Data33:48 - The BMJ Umbrella Review on UPF Risks52:35 - Practical Strategy: Playing Offense at HomeKey Points The Public Nuisance Shift: Why legal strategy is moving away from "individual choice" toward holding corporations accountable for creating a toxic health environment.Probabilistic Automaticity: Human willpower hasn't decreased since the 1970s; instead, the probability of making a "bad" choice has been engineered to increase through environmental cues.The Bliss Point: How food scientists precisely calibrate salt, sugar, and fat to create a transient "nirvana" that mutes the brain's satiety signals.The Potato Continuum: A framework for understanding how processing transforms a simple, satiating food into an energy-dense, hyper-palatable "drug."Food Addiction Data: Why 14% of adults meeting the Yale Food Addiction Scale criteria suggests a systemic design flaw in our food supply, not a character flaw in the consumer.The Tobacco Playbook: The historical link between cigarette manufacturers buying food companies and the subsequent optimization of addictive "mouthfeel" and delivery systems.Clinical PearlsMaster Your Micro-Environment: Spend your "willpower budget" only once—at the grocery store. If hyper-palatable foods aren't in your pantry, they cannot exploit your fatigue at 9 p.m.Prioritize the Food Matrix: Aim for foods high in protein and fiber that have "built-in stoplights," rather than ultra-processed items where the matrix has been dismantled.Distraction-Free Feeding: Eliminate "subconscious eating" by removing screens during meals, allowing your brain to accurately register hormonal satiety signals like leptin and ghrelin.References:https://sfcityattorney.org/san-francisco-city-attorney-chiu-sues-largest-manufacturers-of-ultra-processed-foods/ https://www.lawforhoas.com/civil-code-section-3479-nuisance-defined https://www.naag.org/our-work/naag-center-for-tobacco-and-public-health/the-master-settlement-agreement/ https://pmc.ncbi.nlm.nih.gov/articles/PMC3667220/https://pubmed.ncbi.nlm.nih.gov/22551473/ https://linkinghub.elsevier.com/retrieve/pii/S0195666325000819https://psycnet.apa.org/record/2006-22447-006 Maimati 2018 Stephen 2020 Machado 2019 Young 2002Zlatevska 2014 https://pubmed.ncbi.nlm.nih.gov/37250387/ https://pmc.ncbi.nlm.nih.gov/articles/PMC6550161/https://pubmed.ncbi.nlm.nih.gov/30040431/ https://pubmed.ncbi.nlm.nih.gov/31105044/ https://pubmed.ncbi.nlm.nih.gov/37813420/ https://ajcn.nutrition.org/article/S0002-9165(22)00584-6/fulltext https://pubmed.ncbi.nlm.nih.gov/38418082/ https://www.fao.org/3/ca5644en/ca5644en.pdfhttps://www.mdpi.com/2674-0311/3/3/25 Powell 2013 Bhutani 2018 Fernandez 2021Our Sponsors:* Check out Factor: https://factormeals.com/bbm50off* Check out Quince: https://quince.com/BBMSupport this podcast at — https://redcircle.com/barbell-medicine-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Episode #381: How a Supplement Sent a Soldier to the Hospital- A Medical Mystery

A 23-year-old soldier presents with hypertensive urgency and acute kidney injury. He thought he was doing everything right for his health—so what caused his system to fail? Dr. Feigenbaum and Dr. Baraki break down the clinical evidence and the surprising lab results.Timestamps[00:00] Introduction to the Case: The Fit Soldier’s Failure[01:07] Welcome and Mystery Case Framework[02:05] Patient History: The River and the GI Symptoms[03:53] Building the Differential: Infection vs. Dehydration[08:20] Initial Workup and the Hypercalcemia Discovery[14:14] The Medical Student’s Reveal: Supplement Reconciliation[18:05] Final Diagnosis: Severe Hypervitaminosis D[22:20] Metastatic Calcification and Permanent Vascular Damage[25:23] The Mechanism of Jaw Pain: Bone Resorption[28:34] Science Review: Debunking the Pilz (2011) Study[32:27] Fat-Soluble vs. Water-Soluble Risks[43:06] The Free Vitamin D Hypothesis[48:06] Updated 2024 Endocrine Society Guidelines[55:16] Final Thoughts: Vitamin D and the Endurance PopulationNext StepsFor evidence-based resistance training programs: barbellmedicine.com/training-programsFor individualized medical and training consultation: barbellmedicine.com/coachingExplore our full library of articles on health and performance: barbellmedicine.com/resourcesTo join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: https://barbellmedicine.supercast.com/Key Learning Points The Testosterone Fallacy: Meta-analyses confirm that Vitamin D supplementation has no significant effect on testosterone levels in men who are not clinically deficient.The Fat-Soluble Risk: Unlike water-soluble vitamins, Vitamin D is stored in adipose tissue, meaning toxicity can persist for months or years after cessation.Metastatic Calcification: Severe Vitamin D toxicity causes calcium phosphate to deposit in arterial walls, potentially turning flexible vessels into rigid pipes.2024 Endocrine Guideline Shift: Updated medical standards now recommend against routine Vitamin D screening and universal high-target levels for healthy adults.The Natural Blind Spot: Patients often fail to categorize supplements as "medication," leading to dangerous diagnostic delays when clinicians do not ask specifically about over-the-counter products.The Mechanism of Bone Pain: Toxic Vitamin D levels can drive aggressive bone resorption, effectively "stealing" calcium from the skeleton and causing severe pain.Clinical Pearls Screening Protocol: Avoid routine Vitamin D blood testing for healthy, asymptomatic adults under 75 unless a specific condition like malabsorption or osteoporosis is present.Dosing Guidelines: For the general population, stick to the daily recommended intake (600–800 IU) rather than using high-dose bolus therapy or chasing a serum level of 30 ng/mL.Medication Reconciliation: Always disclose all "natural," "herbal," or "gym-based" supplements to your medical provider, as these can interact with other medications or cause direct toxicity.Timestamps[00:00] Introduction to the Case: The Fit Soldier’s Failure[01:07] Welcome and Mystery Case Framework[02:05] Patient History: The River and the GI Symptoms[03:53] Building the Differential: Infection vs. Dehydration[08:20] Initial Workup and the Hypercalcemia Discovery[14:14] The Medical Student’s Reveal: Supplement Reconciliation[18:05] Final Diagnosis: Severe Hypervitaminosis D[22:20] Metastatic Calcification and Permanent Vascular Damage[25:23] The Mechanism of Jaw Pain: Bone Resorption[28:34] Science Review: Debunking the Pilz (2011) Study[32:27] Fat-Soluble vs. Water-Soluble Risks[43:06] The Free Vitamin D Hypothesis[48:06] Updated 2024 Endocrine Society Guidelines[55:16] Final Thoughts: Vitamin D and the Endurance PopulationReferenceshttps://pmc.ncbi.nlm.nih.gov/articles/PMC9478588/ https://link.springer.com/article/10.1007/s12020-020-02482-3 https://pubmed.ncbi.nlm.nih.gov/32446600/ https://pubmed.ncbi.nlm.nih.gov/21154195/ https://academic.oup.com/jcem/article/109/8/1907/7685305?login=false https://academic.oup.com/edrv/article/45/5/625/7659127 https://academic.oup.com/milmed/article/189/1-2/e417/7218964  Our Sponsors:* Check out Factor: https://factormeals.com/bbm50off* Check out Quince: https://quince.com/BBMSupport this podcast at — https://redcircle.com/barbell-medicine-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Episode #380: The Peptide Market Audit: Injury Healing or Biohacking Hype?

Biohackers and longevity clinics claim peptides are a side-effect-free sniper rifle for fat loss and injury recovery, but the reality is often buried in failed clinical trials and regulatory bans. Many popular compounds like BPC-157 have never undergone a single randomized controlled trial in humans, despite their reputation for Wolverine-like healing. This episode dismantles the hype surrounding the gray market, exposing the significant risks of immunogenicity and heavy metal contamination. Learn why modern load management and evidence-based medicine beat a research chemical bought with Bitcoin every time.Next StepsFor evidence-based resistance training programs: barbellmedicine.com/training-programsFor individualized medical and training consultation: barbellmedicine.com/coachingExplore our full library of articles on health and performance: barbellmedicine.com/resourcesTo join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: https://barbellmedicine.supercast.com/Key PointsThe FDA Category 2 Crackdown: Federal regulators restricted many peptides because of the risk of immunogenicity where the body creates antibodies that attack its own proteins.BPC-157 Has Zero Human Data: Despite being marketed for tendon repair, there is not a single published human randomized controlled trial for this molecule.The MK-677 Prediabetes Tax: While it increases lean mass, human trials show zero improvement in strength or power while frequently causing insulin resistance.Retatrutide as the Weight Loss Godzilla: This triple agonist is achieving nearly 29 percent weight loss in trials by increasing energy expenditure through thermogenesis.Sourcing and Safety Realities: A study of 44 research chemicals found that only 18 actually contained the labeled compound, with many containing heavy metals.The 40-Amino-Acid Rule: The legal distinction between a peptide and a protein is based on size, which dictates how the FDA regulates these substances and how your body absorbs them. Timestamps00:03 Intro: The CJC-1295 Heart Attack Case05:39 Defining a Peptide: The 40-Amino-Acid Bright Line15:14 GH Secretagogues: CJC-1295 and Ipamorelin23:51 MK-677: The Oral Hunger Mimetic and Prediabetes Risk32:56 BPC-157 and the Lack of Human Data38:12 Immunogenicity: Why the FDA Banned BPC-15749:46 Retatrutide: The Triple Agonist Weight Loss Godzilla01:11:24 Summary: Peptides vs. Anabolic Steroids01:16:12 The Sourcing Spectrum: Pharmaceutical vs. Research ChemicalsClinical PearlsUse load management and progressive resistance training as the primary intervention for tendon and muscle injuries rather than unproven peptides.If choosing to use metabolic modulators, monitor fasting blood glucose and insulin sensitivity to avoid drug-induced prediabetes or metabolic dysfunction.Avoid the research chemical gray market entirely due to the high prevalence of under-dosing, contamination, and incorrect active ingredients found in third-party testing.Resourceshttps://pubmed.ncbi.nlm.nih.gov/16352683/https://pubmed.ncbi.nlm.nih.gov/18347346/https://pmc.ncbi.nlm.nih.gov/articles/PMC2657499/https://pubmed.ncbi.nlm.nih.gov/9849822/https://pubmed.ncbi.nlm.nih.gov/10496658/https://pubmed.ncbi.nlm.nih.gov/21298258/https://pubmed.ncbi.nlm.nih.gov/18981485/https://pubmed.ncbi.nlm.nih.gov/9467542/https://pubmed.ncbi.nlm.nih.gov/18981485/https://pubmed.ncbi.nlm.nih.gov/20554713/https://pubmed.ncbi.nlm.nih.gov/39813152/Duzel 2007Strinic 2017Sikiric 1993 He 2022https://pmc.ncbi.nlm.nih.gov/articles/PMC2289708/https://pubmed.ncbi.nlm.nih.gov/10469335/https://pubmed.ncbi.nlm.nih.gov/23050815/https://pubmed.ncbi.nlm.nih.gov/20536454/https://pubmed.ncbi.nlm.nih.gov/29986520/https://pmc.ncbi.nlm.nih.gov/articles/PMC4508379/https://pubmed.ncbi.nlm.nih.gov/41090431/https://pubmed.ncbi.nlm.nih.gov/38858523/https://pubmed.ncbi.nlm.nih.gov/20445536/https://pmc.ncbi.nlm.nih.gov/articles/PMC3136748/#R41https://pubmed.ncbi.nlm.nih.gov/25738459/https://pubmed.ncbi.nlm.nih.gov/33473109/https://pmc.ncbi.nlm.nih.gov/articles/PMC5826726/ https://pubmed.ncbi.nlm.nih.gov/31599840/https://pubmed.ncbi.nlm.nih.gov/18206919/https://pmc.ncbi.nlm.nih.gov/articles/PMC5820696/ Our Sponsors:* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com* Check out Factor: https://factormeals.com/bbm50off* Check out Quince: https://quince.com/BBM* Check out Rosetta Stone and use my code TODAY for a great deal: https://www.rosettastone.com* Check out Washington Red Raspberries: https://redrazz.orgSupport this podcast at — https://redcircle.com/barbell-medicine-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Ozempic & Alcohol, The Trap Bar Myth, and A Medical Mystery | Barbell Medicine AMA Teaser

Experiencing a pins-and-needles sensation on a run or fearing the straight bar deadlift shouldn't be your fitness journey's bingo card. Many trainees abandon effective habits due to false narratives regarding physiological signals or myths regarding back safety. We break down the clinical reality of exercise-induced sensations, the ethics of modern metabolic medicine, and why your choice of imlpement is more about preference than peril.Resources and Next StepsFor evidence-based resistance training programs: barbellmedicine.com/training-programsFor individualized medical and training consultation: barbellmedicine.com/coachingExplore our full library of articles on health and performance: barbellmedicine.com/resourcesTo join Barbell Medicine Plus and get ad-free listening, product discounts, exclusive content, and more: https://barbellmedicine.supercast.com/TopicsThe Hemodynamic Itch: Why vasodilation and increased blood flow to capillaries can cause mechanical stimulation of nerve endings during a run.Exercise-Induced Anaphylaxis: The critical difference between benign "runner’s itch" and a systemic medical emergency involving hives and hemodynamic instability.Medical Paternalism: Why withholding GLP-1 medications from patients who drink alcohol is a flawed clinical approach that ignores aggregate health risk reduction.The Seatbelt Analogy: Treating one health risk (obesity) is objectively better than leaving it untreated, even if other risks (alcohol) remain constant.The EMG Trap: Why electrical muscle activity data is a poor predictor of long-term strength and hypertrophy outcomes compared to longitudinal studies.Biomechanical Distribution: How the trap bar shifts load toward the quadriceps while the straight bar emphasizes the hamstrings and erectors without changing "safety."Clinical PearlsIdentify Red Flags: If itching is accompanied by wheezing, nausea, or dizziness, stop exercise immediately and seek emergency medical care.Prioritize Habituation: For benign runner’s itch, consistent training typically leads to physiological adaptation and symptom resolution within a few weeks.Shared Decision-Making: When choosing between deadlift variations, select the tool that aligns with your specific goals—use the straight bar for powerlifting prep and the trap bar for general strength or power development.Timestamps00:00 – Intro to the Direct Line AMA series00:43 – The Mystery of "Runner’s Itch": Mechanisms and Hemodynamics04:19 – Case Study: 24-year-old Marine and Exercise-Induced Anaphylaxis06:22 – Summary: Benign Itching vs. Cholinergic Urticaria vs. Anaphylaxis07:24 – GLP-1 Receptor Agonists and Heavy Alcohol Use10:57 – Beyond the Stomach: How GLP-1s Impact Brain Reward Pathways15:32 – Avoiding Paternalism in Medicine: Shared Decision-Making18:12 – The Great Deadlift Debate: Trap Bar vs. Straight Bar21:31 – Why EMG Data is Often Misleading for Trainees24:54 – Debunking the "Save Your Back" MythOur Sponsors:* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com* Check out Factor: https://factormeals.com/bbm50off* Check out Quince: https://quince.com/BBM* Check out Rosetta Stone and use my code TODAY for a great deal: https://www.rosettastone.com* Check out Washington Red Raspberries: https://redrazz.orgSupport this podcast at — https://redcircle.com/barbell-medicine-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

START HERE: The Cholesterol Action Plan Series

Welcome to the Barbell Medicine Cholesterol Action Plan. Cardiovascular disease is the #1 killer globally. We just released a massive 6-part audio series and written guide to fix that.It covers ApoB vs LDL, the CAC score paradox, the P:S diet ratio, and Plaque Regression.The full series is available INSTANTLY for Barbell Medicine Plus subscribers.If you're not a subscriber, start here:https://barbellmedicine.supercast.com/ Our Sponsors:* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com* Check out Factor: https://factormeals.com/bbm50off* Check out Quince: https://quince.com/BBM* Check out Rosetta Stone and use my code TODAY for a great deal: https://www.rosettastone.com* Check out Washington Red Raspberries: https://redrazz.orgSupport this podcast at — https://redcircle.com/barbell-medicine-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy