Table of Contents

The return of very high volume training?! 3

The effect of hormonal contraceptives on gains 14

Strength training for type 2 diabetes 20

Strength gain over time: a reality check 28

The mighty placebo effect? 37

REPS: The return of very high volume training?! 2

The return of
very high volume
training?!
Effects of Different Weekly Set Progressions on
Muscular Adaptations in Trained Males: Is there a
Dose-Response Effect?
Enes et al. (2023)
 Doing too much training volume may be counterproductive as far as strength and hypertrophy
go. But how much is too much?

has been demonstrated in a few systematic reviews

Overview and meta-analyses over the years, it’s not some new
or controversial finding 2. However, just because more
• What did they test? The researchers looked at the training volume may lead to better hypertrophy gains,
effect of adding 4 or 6 sets every few weeks to an that does not mean that anything below 10-20 sets
already high-volume quad training protocol. is completely useless and will not lead to meaningful
gains. Quite the opposite actually. Even as low as 1-4
• What did they find? Adding sets every few weeks
sets per muscle group per week can lead to significant,
resulted in greater strength and hypertrophy gains,
although suboptimal, muscle gains. This is something
although caution is advised when interpreting the
that I feel is often misunderstood by the lifting
hypertrophy results. Participants were able to still
community, where there is the perception that unless
make progress even at 52 sets of quad training per
you hit the “optimal” number of sets, you’re leaving all
week.
your gains in the table. In reality, you may be looking
• What does it mean for you? Doing more training at that extra 20% of muscle growth by staying in the
volume, eg: in the form of specialization phases, optimal volume range for hypertrophy and you’re likely
for certain body parts may allow you to make to make meaningful gains still even if you’re only doing
greater strength and hypertrophy gains. a handful of sets per week. We recently also looked at
a new meta-regression on proximity to failure and its
effects on hypertrophy and strength. In some cases,
prioritizing dewar higher intensity-of-effort sets may

What's the Problem be better than just doing more training volume 3.

As far as strength goes, a classic meta-analysis by

Training volume seems to be an extremely controversial Ralston et al 4 showed that although the relationship
topic in the world of building muscle and strength. between training volume and strength is not extremely
From the Mike Mentzer era of “high intensity training”, clear, performing somewhere between 5-12 sets per
where doing a few sets per muscle group with the week per lift may be enough to optimize strength
utmost intensity was all you need to maximize growth, gains, with as low as 2-3 sets per lift per week being
to the volume craze era where unless you’re doing 20 enough to promote suboptimal but still significant
sets per muscle group per week, you’re wasting your strength gains 5.
time, the lifting world seems to be somewhat divided
over how much work one really needs to do to see Overall, I never understood the emotion attached
meaningful gains. to training volume and why the topic fuels so much
controversy, especially when plenty of literature
As it stands, the literature on hypertrophy points on the topic allows us to have a relatively confident
at higher volumes (12-20 sets per muscle group per “rough” idea of how much we need to maximize muscle
week) being better for hypertrophy than lower training gains. Allow me to also note that an optimal “range” is
volumes (<10 sets per muscle group per week) 1. This supposed to give you some general guidelines as far

REPS: The return of very high volume training?! 4

as volume is concerned, your personal preference, 6-8 sets per week for long periods may be more
training history, recovery resources etc will allow you hypertrophic than trying to hit the upper end of the
to adjust that range to fit your circumstances. For “optimal” range no matter what and ending up skipping
someone who has a very stressful lifestyle and still the gym whenever you don’t have time to hit that range
wants to optimize hypertrophy, staying around at the because “what’s the point?”.
12 sets per week may work much better than trying to
force 20 sets. My rambling aside, a recent study by Enes et al examined
how different weekly set progressions affected
Keep in mind that performing 12 sets per muscle group strength and hypertrophy in trained males. What is
per week is not really as much as some people make it particularly interesting about this study is that the
out to be, especially if you account for indirect volume training volume performed by the participants actually
from compound exercises. However, even if you don’t started off at 22 sets per week and progressed from
count indirect volume, 12 direct sets for a body part there to the point where some participants were doing
(eg: chest) can look as minimal as: as much as 52 sets per week. When the results of this
study were made “public”, people lost their minds and
Chest day 1: 3 sets of bench press, 3 sets of cable flies were extremely quick to dismiss the study’s results,
Chest day 2: 3 sets of incline bench press, 3 sets of without even reading the paper or understanding what
push-ups the study really looked at.

Lastly, people also seem to forget that sticking to Let’s have a closer look at the study’s methods and

REPS: The return of very high volume training?! 5

results to really see what the fuss is about and whether group at the end of the study:
52 sets per week is the new high volume standard
(spoiler alert: it’s not). Constant set group: 8 sets of squats, 8 sets of leg
press, 6 sets of leg extensions
Purpose & Hypothesis 4 set group: 14 sets of squats, 14 sets of leg press, 14
sets of leg extensions
The study aimed to assess whether adding a different 6 set group: 18 sets of squats, 18 sets of leg press, 16
amount of sets every 2 weeks (+4 vs +6 sets) made a sets of leg extensions
difference in muscle hypertrophy for the quads versus
keeping sets constant at 22 sets per week. Participants

The researchers recruited 37 trained males for the

study. The participants needed to be healthy, 18-30

What Did They Test years old, have at least 2 years of resistance training
experience with a minimum frequency of 4 days per

and How? week, be able to squat at least 1.5 times their body
weight and be drug-free.

37 participants were randomized in one of three

Study Procedures
groups:

The training intervention, excluding the wash-out

The constant set group, which performed 22 sets per
and familiarization periods, lasted 12 weeks and the
week for their quads
researchers performed the following tests to assess
The 4 set group, which added 4 sets every two weeks
strength and hypertrophy changes:
to their starting volume of 22 sets
The 6 set group, which added 6 sets every two weeks Body composition: Assessed via bioelectrical
to their starting volume of 22 sets impedance analysis
Energy intake: Assessed at the beginning, in the
All groups had a 2 week “wash-out” period, where middle and at the end of the study via dietary record
they reduced their training volume for the quads by which a registered dietitian conducted
approximately 40% the first week and another 40% on Hypertrophy: Muscle thickness and cross-sectional
the second week. They also had a 2 week adaptation area of the quads were assessed via ultrasound.
phase in which they increased quad sets by 4 sets every Strength: Assessed via a 1-repetition-maximum (1RM)
week for 2 weeks. After that point all groups began squat pre and post training intervention.
training at 22 sets of quads per week, performed in
2 weekly training sessions. The participants’ training The training intervention followed by the participants
volume was allocated “evenly” across 3 exercises, consisted of 2 supervised weekly sessions of quad
the back squat, the leg press and the leg extension. training which included the squat, the leg press
~33.3% of the number of sets was allocated to each and leg extensions as briefly described above.
exercise, with the participants starting at around 4 Participants were instructed to rest for at least
sets of squats, 4 sets of leg press and 3 sets of leg 2 minutes between sets and performed different
extensions per week. repetition ranges on each training day of the week (6-8
repetitions on one day, 10-12 repetitions on the other
Below you can see the weekly sets performed by each day). The participants were also instructed to leave

REPS: The return of very high volume training?! 6

REPS: The return of very high volume training?! 7
approximately 2 repetitions in reserve for all but their
last set, with the last set taken to volitional failure.
Following their quad training, the participants also
performed 2 sets of Romanian deadlifts and 2 sets of
seated leg curl, both at similar repetition ranges as
the quad exercises.

The participants were free to train their upper body

musculature as they pleased.

What Did They Find?

Plenty of stuff to look at here so let’s take them one by
one.

Firstly, and it probably comes as no surprise to anyone,

the group that added 6 sets every 2 weeks performed
the greatest amount of volume load out of the 3 groups,
with the 4 set group coming second and the constant
set group coming last.

As far as strength goes, and this may come as a surprise

to many, the groups that added 4 or 6 sets every 2

weeks, ended up getting significantly stronger than the
constant volume group, with the group that did the most
training volume gaining the most amount of strength.

Now, as far as the hypertrophy findings of the study

go, all groups made meaningful hypertrophy gains.

REPS: The return of very high volume training?! 8

The authors did not report any statistically significant loads were adjusted based on the participants'
differences between groups, but similarly to the strength performance, meaning that loads were either
results, the groups that did more training volume gained adjusted up or down depending on whether the
more muscle. participants met the repetition ranges prescribed.
In other words, don’t think that the participants
selected a load that they could perform for 6-8 or
10-12 repetitions with 2 repetitions in reserve and

What Do the Findings

then completed the session using that exact load.

Mean?
Starting off with the strength results of the study,
which in my opinion were the most surprising, as the
results of the study are supported by some existing
So, before we dive into the results of the study, let’s studies but go against the findings of others. For
start off with a few disclaimers. example, previous research has also shown that more
sets may lead to greater squat strength gains when
1. Although the participants were trained, they comparing groups performing 2, 8 and 16 sets of
were not elite bodybuilders or powerlifters. They squatting per week 6 as well as when comparing groups
were around 24 years old, weighed around 80 performing 16 and 32 sets of lower body training,
kg and had a mean squat 1RM of about 140kg. with 8 and 16 of those sets coming from squatting
. However, it’s important to note that the study by
7

2. The participants in the study trained their quads. Marshall et al 6 did not find any significant differences
They did not follow a full-body routine that used between 8 and 16 sets of squatting per week and other
the same number of sets for each body part. This studies have also failed to find a clear dose-response
is a critical disclaimer as people were quick to relationship between volume and strength in groups
criticize the very high volumes performed by the
performing 18 versus 24 sets per muscle group per
4 and 6 set groups in the study, ignoring the fact
week 8. Similarly, Schoenfeld et al also found that
that the participants only trained their quads.
performing 3 sets of squat per week resulted in similar
strength gains to performing 9 or 15 sets 9, something
3. The participants performed all but the last of
that was also seen in the Ostrowski study 10, which
their sets at approximately 2 repetitions in
found that 3 sets per muscle group per week were as
reserve and then took their final set to volitional
good as 12 sets per muscle group per week for both
failure. They did not go all out for every set
squat and bench press 1RM strength. The results of
and volitional failure was defined as “the
the study may be explained by the fact that the groups
inability to perform an additional concentric
action while preserving appropriate exercise that added sets as the study progressed managed to
form or voluntary discontinuation of the set”. practice the squat more than the group that remained
constantly at 22 sets. Anecdotally, we have seen
4. The participants were instructed to rest a powerlifters and recreationally active individuals have
minimum 2 minutes between each set and based great success as far as 1RM strength goes with very
on the time needed to complete the sessions high volume training routines (eg: Smolov). Still, it
towards the end of the study (~100 minutes for the remains unclear as to whether generally doing more
4 and 6 set groups) it seems like the participants volume will translate to greater 1RM strength gains.
did not rest for much longer than the minimum We briefly touched on the Ralston et al 4 paper in the
time required. This is an important disclaimer as introduction, where moderate and high volumes (5-9

REPS: The return of very high volume training?! 9

and 10+ sets) resulted in greater gains than <5 sets doing 14 sets of squats during the last few weeks of
per exercise per week, with the authors suggesting the study and the constant group stayed at 8 sets of
that more advanced trainees may benefit more from squats for the duration of the study. Although a good
doing higher training volumes, especially when trying deal of training volume, the 6 set group performed
to maximize strength. an average of 13 sets of squats per week, which is in
line with the current literature on training volume and
An important distinction must be made here is that strength gains 4.
some studies have looked at training volume as the
weekly sets performed for each muscle group per Regarding the hypertrophy results, this study is not
week while others, like the Ralson study, looked at supposed to be interpreted as “52 sets is the new
weekly sets performed per exercise per week. This optimal number of weekly sets per muscle group”.
is something we need to keep in mind when looking This is not because the hypertrophy differences
at the findings of the current study, as the group that between groups were not statistically significant, as
performed 52 total sets for their quads at the end of one could argue that experiencing 2-3 times more
the study, performed 18 of those sets by squatting. growth than the 22 set group may be of practical
Overall, the findings of this study support the notion importance and that statistical significance may have
that more training volume may result in greater been influenced by the relatively small sample size of
strength gains, although it remains unclear as to each group, but rather because this study just looked
whether the addition of training volume via exercises at the quads and how quad hypertrophy and strength
that do not mimic the strength testing modality were affected by adding sets every few weeks. This
employed will further aid in strength gains. In other study should be interpreted as evidence supporting a
words, it’s not clear whether the participants would higher upper threshold for training volume, somewhat
have gotten the same squat strength gains even if going against the notion of unproductive/junk volume
they did not perform the leg press and leg extension being an issue after a certain number of sets (eg:
exercises. As far as movement-specific training anything above 20 sets will not result in growth and
volume is concerned, the squatting volumes seen will be counterproductive). The participants of this
in this study were not insanely extreme as the 6 set study experienced growth despite already starting
group ended up doing 18 sets of squats during the above the current recommendations for volume and
last few weeks of the study, the 4 set group ended up optimizing hypertrophy. They continued to do so

REPS: The return of very high volume training?! 10

even after doubling what’s considered to be a rough phases for specific muscle groups that one may want
upper threshold for hypertrophy gains. It’s important to bring up more than others. One participant in the 6
to keep in mind that this is just another piece of set group did experience deleterious effects as far as
the puzzle when it comes to muscle gains and we
muscle growth is concerned, which may also suggest
should not expect this study to be able to answer
that for some individuals performing extremely high
every question we have about training volume and
training volumes may actually be counterproductive.
hypertrophy. Additionally, it’s also important to note
that the results of this study are not in isolation, as However, with the exception of that one participant,
previous studies have also demonstrated that there everyone else in the 6 set group experienced positive
was a dose-response relationship between training results for both strength and hypertrophy.
volume and hypertrophy, with volumes as high as 27-
32 sets being beneficial for hypertrophy 9, 3. Lastly, the researchers also looked at dropout rates,
with the 6 set group having the lowest dropout rate
Overall, the study’s results suggest that adding 4-6
from the 3 groups as only 1 participant dropped out
sets for a muscle group every 2 weeks may result in
of the study due to personal reasons. Although a
both greater hypertrophy and strength, with volumes
as high as 52 sets per muscle group per week leading relatively minor point, the above shows that high
to favorable strength and hypertrophy results, volume training will not necessarily result in individuals
something that supports the use of “specialization” being unable to complete training sessions.

REPS: The return of very high volume training?! 11

 8-13 sets for all groups. Given the current literature
How Can You Apply on volume and strength, it’s advisable to stay in the
8-12 weekly set range per exercise that you want to
These Findings? get stronger on, prioritizing heavy loads and leaving a
few repetitions in reserve.

Just so we’re clear: nobody is saying that you should

We’re currently expecting an updated meta-analysis
perform 52 sets per muscle group per week to
and meta-regression on the effect on volume and
optimize hypertrophy. The participants of this study
strength, so stay tuned to find out if the above
performed 52 sets for their quads for 2 weeks, not
recommendations need some tweaking!
for the entirety of the study and we currently do not
know if the above number of weekly sets would result
in favorable outcomes had the study been longer in
duration. That said, the results of the study go against
the notion of fearing “junk volume”, especially for
individuals who are just above the 20 sets per muscle
group per week mark.

Additionally, if there is a body part that you want to

grow more desperately, performing a greater amount
of training volume than the current optimal range may
allow you to make more hypertrophy gains. If that’s
something you want to attempt, it would be wise to
follow somewhat the procedures observed in the
study, where participants gradually increased their
training volume every few weeks versus increasing
training volume drastically.

Given the latest meta-regression by Robinson et al

3
, it may be that training with a greater intensity of
effort than the participants of the study (eg: closer to
0 repetitions in reserve), may allow for lower training
volumes to be as effective as the high volumes
employed in the study.

General hypertrophy volume recommendations

remain around the lines of 12-20 sets per muscle
group per week, with that upper limit being somewhat
softer than we previously thought.

For strength, and if we just count movement-specific

sets, the highest amount of squatting volume done in
the study was 18 sets per week, something that was
done in the last few weeks by the 6 set group, with the
average amount of squat sets per week being around

REPS: The return of very high volume training?! 12

References
1. Baz-Valle E, Balsalobre-Fernández C, Alix-Fages C, Santos-Concejero 10. Ostrowski, K.J. et al. (1997) ‘The effect of weight training volume on
J. A Systematic Review of The Effects of Different Resistance hormonal output and muscular size and function’, The Journal of
Training Volumes on Muscle Hypertrophy. J Hum Kinet. 2022 Feb Strength and Conditioning Research, 11(3), p. 148. doi:10.1519/1533-
10;81:199-210. doi: 10.2478/hukin-2022-0017. PMID: 35291645; 4287(1997) https://journals.lww.com/nsca-jscr/Abstract/1997/08000/
PMCID: PMC8884877. https://www.ncbi.nlm.nih.gov/pmc/articles/ The_Effect_of_Weight_Training_Volume_on_Hormonal.3.aspx
PMC8884877/

2. Schoenfeld BJ, Ogborn D, Krieger JW. Dose-response relationship

between weekly resistance training volume and increases in muscle
mass: A systematic review and meta-analysis. J Sports Sci. 2017
Jun;35(11):1073-1082. doi: 10.1080/02640414.2016.1210197. Epub 2016
Jul 19. PMID: 27433992. https://pubmed.ncbi.nlm.nih.gov/27433992/

3. Robinson ZP, Pelland JC, Remmert JF, Refalo MC, Jukic I, Steele J,
and Zourdos MC, (2023). Exploring the Dose-Response Relationship
Between Estimated Resistance Training Proximity to Failure,
Strength Gain, and Muscle Hypertrophy: A Series of Meta-Regressions
https://sportrxiv.org/index.php/server/preprint/view/295

4. Ralston GW, Kilgore L, Wyatt FB, Baker JS. The Effect of Weekly
Set Volume on Strength Gain: A Meta-Analysis. Sports Med. 2017
Dec;47(12):2585-2601. doi: 10.1007/s40279-017-0762-7. PMID:
28755103; PMCID: PMC5684266. https://pubmed.ncbi.nlm.nih.
gov/28755103/

5. Androulakis-Korakakis P, Fisher JP, Steele J. The Minimum Effective

Training Dose Required to Increase 1RM Strength in Resistance-
Trained Men: A Systematic Review and Meta-Analysis. Sports Med.
2020 Apr;50(4):751-765. doi: 10.1007/s40279-019-01236-0. PMID:
31797219. https://pubmed.ncbi.nlm.nih.gov/31797219/

6. Marshall PW, McEwen M, Robbins DW. Strength and neuromuscular

adaptation following one, four, and eight sets of high intensity
resistance exercise in trained males. Eur J Appl Physiol. 2011
Dec;111(12):3007-16. doi: 10.1007/s00421-011-1944-x. Epub 2011 Mar
31. PMID: 21451937. https://link.springer.com/article/10.1007/s00421-
011-1944-x

7. Brigatto FA, Lima LEM, Germano MD, Aoki MS, Braz TV, Lopes CR.
High Resistance-Training Volume Enhances Muscle Thickness in
Resistance-Trained Men. J Strength Cond Res. 2022 Jan 1;36(1):22-
30. doi: 10.1519/JSC.0000000000003413. PMID: 31868813. https://
journals.lww.com/nsca-jscr/abstract/2022/01000/high_resistance_
training_volume_enhances_muscle.4.aspx

8. Aube D, Wadhi T, Rauch J, Anand A, Barakat C, Pearson J, Bradshaw

J, Zazzo S, Ugrinowitsch C, De Souza EO. Progressive Resistance
Training Volume: Effects on Muscle Thickness, Mass, and Strength
Adaptations in Resistance-Trained Individuals. J Strength Cond Res.
2022 Mar 1;36(3):600-607. doi: 10.1519/JSC.0000000000003524.
PMID: 32058362. https://pubmed.ncbi.nlm.nih.gov/32058362/

9. Schoenfeld BJ, Contreras B, Krieger J, Grgic J, Delcastillo K,

Belliard R, Alto A. Resistance Training Volume Enhances Muscle
Hypertrophy but Not Strength in Trained Men. Med Sci Sports Exerc.
2019 Jan;51(1):94-103. doi: 10.1249/MSS.0000000000001764. PMID:
30153194; PMCID: PMC6303131. https://pubmed.ncbi.nlm.nih.
gov/30153194/

© Copyright 2023 Biolayne Technologies LLC 13

The effect of hormonal
contraceptives on
gains
The Effect of Hormonal Contraceptive Use on Skeletal
Muscle Hypertrophy, Power and Strength Adaptations to
Resistance Exercise Training: A Systematic Review and
Multilevel Meta-analysis
Nolan et al. (2023)
 Hormonal contraceptives often get either a bad or good rep for women who lift. But what does
the current literature show? Are hormonal contraceptives potentially standing in the way of
your gains, or could they potentially enhance resistance training adaptations? Or neither?

make the lining of your uterus lighter, making it less

Overview likely for a fertilized egg to attach and grow.

• What did they test? The authors examined the There are various hormonal contraceptives, including
current literature on the effect of hormonal oral contraceptive pills, a.k.a birth control pills,
contraceptives on strength, power and hypertrophy. patches, injections, and intrauterine devices (IUDs).
• What did they find? Hormonal contraceptives The most commonly used contraceptive is the oral
did not seem to have any major effect (positive or contraceptive pill, especially among young females.
negative) on muscle gains.
Although sometimes overstated (check our previous
• What does it mean for you? You should not worry
article on the effect of menstruation on lifting
too much about the use of hormonal contraceptives
performance), hormones can play an essential role in
affecting your gains in any sort of way.
how one responds to exercise, their performance etc.
Regarding hormonal contraceptives, it is currently not
entirely clear how they affect athletic performance

What's the Problem as the current literature on the topic is somewhat

mixed, with studies employing relatively low samples
and having different study designs, making it hard to
Hormonal contraceptives are medications or devices compare one study to the other. As it stands, some
that use hormones to prevent pregnancy. These studies have shown that hormonal contraceptives
hormones are usually synthetic versions of the ones can have positive effects on molecular markers of
your body naturally produces and they work in a few hypertrophy 1. Still, they can also have adverse effects
different ways to prevent pregnancy. on muscle growth, strength, and inflammation 2, 3

while in other cases, they don't seem to make much of

Preventing Ovulation: In a typical menstrual cycle, a a difference at all 4.
woman's ovaries release an egg (ovulation). Hormonal
contraceptives can stop this from happening, which Given the current literature being relatively unclear on
means there's no egg for sperm to fertilize. the effect of contraceptives on muscle hypertrophy
and strength, it is important to understand whether
Thickening Cervical Mucus: Hormonal contraceptives individuals who use hormonal contraceptives are more
can thicken mucus in one’s cervix. This makes it likely to make less or more gains, and whether their
difficult for sperm to swim through the cervix and effect on resistance training-related adaptations is
reach an egg. something they need to consider before using them.
Let’s see what this very recent systematic review and
Thin Uterine Lining: Some hormonal contraceptives meta-analysis by Noal et al found!

REPS: The effect of hormonal contraceptives on gains 15

Purpose & Hypothesis • The studies had to measure changes in muscle
size, power, or strength.
This systematic review and meta-analysis aimed to • They had to use data from at least two time
investigate the influence of hormonal contraceptives points (before and after the training).
on muscle hypertrophy, power and strength • The participants in the studies had to be healthy
adaptations in response to resistance training. The females with an average age between 18 and 40
authors did not formally state a hypothesis. years.
• The training interventions had to last for at least
four weeks.
• The studies needed to directly compare women
What Did They Test who use hormonal contraceptives (HC) with those
who don't.
and How? A total of 8 studies made it in the authors’ analyses.

The authors searched 4 databases (SPORTDiscus, The authors also extracted a plethora of different
Web of Science and Embase) for articles that met their data from each study, including study and participant
inclusion criteria. Their inclusion criteria were the characteristics (duration, mode of resistance training,
following: age, height, training status etc). The methodological
quality of the studies was assessed using the “tool
• Studies had to be published before July 6, 2023 for the assessment of study quality and reporting in
and be published in english exercise” (TESTEX) which is essentially a modified
• The studies needed to be experimental in design. version of the classic PEDro tool (dedicated REPS
• They had to involve resistance exercise training readers will know 😂)

REPS: The effect of hormonal contraceptives on gains 16

Forest plot of skeletal muscle hypertrophy outcomes from included studies com- Forest plot of skeletal muscle hypertrophy outcomes from included studies com-
paring oral contraceptive pill (OCP) users and OCP non-users following matched paring oral contraceptive pill (OCP) users and OCP non-users following matched
resistance exercise training interventions. resistance exercise training interventions.

Participants
A total of 325 participants were included in the authors’
What Do the Findings
analyses, with approximately 49% of them being on oral
contraceptives while the remaining 51% was naturally
Mean?
menstruating.
Simply put, the use of hormonal contraceptives will
probably not affect your gains, making your own
personal preference the main deciding factor for

What Did They Find? using hormonal contraceptives or not. A study by

Martin et al 5 on the perceived side effects of hormonal

For hypertrophy, 65% of the outcomes examined contraceptives in elite athletes found that roughly
favored the use of oral contraceptive pills. Still, when half of elite athletes used hormonal contraceptives
looking closer at the authors’ analyses, it seems like, and given the interindividual variability in side effects,
overall, there were no major differences between each athlete’s personal preference and perceived side
contraceptive users and non-users. Similar results effects must be taken in consideration when it comes
were also found for strength and power, with no
to the use of oral contraceptives.
statistically significant effect observed on any of
these outcomes.
However, it is not uncommon to hear that manipulating

Although relatively short and straightforward, the one’s menstrual cycle may affect training
above results are quite exciting and come baked in with performance, something which is not necessarily
some solid practical implications for women who lift! true as we’ve previously discussed on REPS. That

REPS: The effect of hormonal contraceptives on gains 17

said, using oral contraceptives in athletes has been
proposed to improve performance by affecting the
menstrual cycle. However, a previous study by Reif
et al 6 looked at the effect of the different phases of
oral contraceptive cycle on strength performance in
competitive athletes and also found that there did not
seem to be any effect on strength.

How Can You Apply

These Findings?
Deciding on whether oral contraceptives are worth
it or not for you is a decision that must be based
on every factor besides their effect on resistance
training adaptations. If you are worried that hormonal
contraceptives are going to interfere with your hard
work in the gym, worry not, it’s likely that they won’t
affect you much. On the contrary, and I doubt this
is the case with a lot of people, if one of the reasons
behind taking hormonal contraceptives has been to
boost your muscle growth or your performance in the
gym, then it may be time to reconsider using hormonal
contraceptives.

REPS: The effect of hormonal contraceptives on gains 18

References
1. Oxfeldt M, Dalgaard LB, Jørgensen EB, Johansen FT, Dalgaard
EB, Ørtenblad N, Hansen M. Molecular markers of skeletal
muscle hypertrophy following 10 wk of resistance training in oral
contraceptive users and nonusers. J Appl Physiol (1985). 2020
Dec 1;129(6):1355-1364. doi: 10.1152/japplphysiol.00562.2020.
Epub 2020 Oct 15. PMID: 33054662. https://pubmed.ncbi.nlm.nih.
gov/33054662/#:~:text=Use%20of%20second%2Dgeneration%20
OCs,resistance%20training%20compared%20with%20nonusers.

2. Riechman SE, Lee CW. Oral Contraceptive Use Impairs Muscle Gains
in Young Women. J Strength Cond Res. 2022 Nov 1;36(11):3074-
3080. doi: 10.1519/JSC.0000000000004059. Epub 2021 May 14.
PMID: 33993156. http://www.ncbi.nlm.nih.gov/entrez/query.
fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=33993156

3. Ihalainen JK, Hackney AC, Taipale RS. Changes in inflammation

markers after a 10-week high-intensity combined strength and
endurance training block in women: The effect of hormonal
contraceptive use. J Sci Med Sport. 2019 Sep;22(9):1044-
1048. doi: 10.1016/j.jsams.2019.04.002. Epub 2019 May 30.
PMID: 31186194. http://www.ncbi.nlm.nih.gov/entrez/query.
fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=31186194

4. Dalgaard LB, Jørgensen EB, Oxfeldt M, Dalgaard EB, Johansen

FT, Karlsson M, Ringgaard S, Hansen M. Influence of Second
Generation Oral Contraceptive Use on Adaptations to Resistance
Training in Young Untrained Women. J Strength Cond Res. 2022 Jul
1;36(7):1801-1809. doi: 10.1519/JSC.0000000000003735. Epub 2020
Jul 20. PMID: 32694286. http://www.ncbi.nlm.nih.gov/entrez/query.
fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=32694286

5. Martin D, Sale C, Cooper SB, Elliott-Sale KJ. Period Prevalence and

Perceived Side Effects of Hormonal Contraceptive Use and the
Menstrual Cycle in Elite Athletes. Int J Sports Physiol Perform. 2018
Aug 1;13(7):926-932. doi: 10.1123/ijspp.2017-0330. Epub 2018 Jul 27.
PMID: 29283683. https://pubmed.ncbi.nlm.nih.gov/29283683/

6. Reif A, Wessner B, Haider P, Tschan H, Triska C. Strength

Performance Across the Oral Contraceptive Cycle of Team
Sport Athletes: A Cross-Sectional Study. Front Physiol. 2021 Jul
1;12:658994. doi: 10.3389/fphys.2021.658994. PMID: 34276392;
PMCID: PMC8281678. https://www.frontiersin.org/articles/10.3389/
fphys.2021.658994/full

© Copyright 2023 Biolayne Technologies LLC 19

Strength training for
type 2 diabetes
Strength training is more effective than aerobic exercise
for improving glycaemic control and body composition in
people with normal-weight type 2 diabetes: a randomized
controlled trial.
Yukari et al. (2023)
 Resistance training is amazing. From making you jacked, to decreasing your risk of all cause
mortality, it’s the exercise modality everyone should be doing. But can it compare to aerobic
exercise when it comes to managing type 2 diabetes?!

weekly resistance training also seems to be enough

Overview for significant increases in strength and hypertrophy,
making it an even more attractive exercise modality
• What did they test? The authors compared the for improving one’s health and overall life quality.
effects of aerobic and resistance training on the
management of type 2 diabetes. Additionally, resistance training can positively affect
your blood sugar and insulin sensitivity, contributing
• What did they find? Resistance training alone was
positively to the management and prevention of type
better than aerobic training in managing type 2
2 diabetes 1.
diabetes and improving body composition.

• What does it mean for you? Resistance training Type 2 diabetes is a condition that affects how your
offers much more than just making you “jacked.” body handles sugar. When we eat, our bodies break
Engaging in resistance training comes with many down the food into sugar, an energy source. But to
health benefits that can meaningfully impact one’s get the sugar from our blood into our cells, we need a
life. hormone called insulin, which acts like a key, opening
the door for sugar to enter our cells. In type 2 diabetes,
your body either doesn't make enough insulin, or the
insulin doesn't work correctly which means the sugar

What's the Problem can't get into your cells effectively, building up in your
blood, causing high blood sugar levels. High blood
sugar can be harmful over time, leading to various
Resistance training is often viewed as a type of health problems like heart disease, nerve damage,
exercise that has mainly aesthetic and strength- and kidney issues. In contrast to type 1 diabetes,
related benefits to offer, with its potential health where one’s pancreas does not produce insulin and
benefits often being overlooked. In addition to making thus requires an external administration of insulin,
you more jacked, resistance training can significantly type 2 diabetes can be managed by modifying one’s
improve your health in numerous ways, from improving diet and exercise routine. This is where resistance
your cardiovascular health to increasing your bone training may come in clutch as it can help lower blood
mineral density and preventing falls when older 1. sugar, improve how sensitive one’s cells are to insulin
as well as enhance glucose control by making your
We’ve previously looked at the minimum amount of muscles more efficient at using glucose.
resistance training you need in order to reap some
of the health benefits that lifting has to offer, with But how does resistance training compare to aerobic
60 minutes of weekly resistance training being more training regarding managing type 2 diabetes? Is one
than enough 2 to experience a meaningful reduction modality better than the other or does it make sense
in the risk for all-cause mortality. 60 minutes of to do both for optimal results?

REPS: Strength training for type 2 diabetes 21

A new study by Kobayashi et al. may shed some light continue exercising. The strength and aerobic groups
on the above questions! had 38 participants each, while the combined group
had 31 participants.
Purpose & Hypothesis
Study Procedures
The study aimed to explore how resistance training
will affect type 2 diabetes in normal-weight The strength training group performed 2 sets of 4
individuals and how the effects of just resistance upper body exercises and 3 sets of 3 leg exercises
training compare to doing aerobic training or a every time they trained. The upper body exercises
combination of resistance and aerobic training. The they performed were: bench press, seated row,
authors hypothesized that the individuals engaging shoulder press, and lat pull down, and for the lower
in resistance training would see more significant body, they performed leg press, leg extension, and
improvements in type 2 diabetes management than leg curl. As far as the workout specifics go, the paper
those performing just aerobic training. Additionally, did not provide a whole lot of information besides
they hypothesized that the combined group would the fact that participants were required to hit 8-12
experience an “intermediate” effect. repetitions on every exercise with “intensity” being
low at the start of the study to “ensure proper form”
and reduce soreness. The aerobic group performed
exercise equivalent to roughly 12 calories per kilogram

What Did They Test of body weight per week either on a stationary bike,
treadmill or an elliptical machine. They kept intensity

and How? around 50 to 80% of their peak metabolic equivalents

of task (MET) that was assessed before commencing
the study. The combined group completed 2 strength
The authors performed a randomized controlled training sessions per week, consisting of one set
trial with 3 groups, one group performing strength of each of the exercises performed by the strength
training only, one group performing aerobic training training group and expended roughly 10 calories per
only and a group that performed both aerobic and kilogram of body weight per week on the same aerobic
resistance training. The participants exercised 3 days exercise modalities as the aerobic group.
per week for 9 months and also received diabetes
educational material as well as attended monthly Measurements
diabetes meetings. In order to take part in the study,
participants needed to be 18-80 years old, have type The researchers looked at the participants’ blood
sugar levels at 3, 6 and 9 months and changes in body
2 diabetes without the use of an insulin pump, blood
composition and strength at 9 months to see if those
sugar in the 47.5-118.56 mmol/mol range and a BMI
predicted changes in blood sugar.
between 18.5 and 25 kg/m^2.

HbA1c, aka blood sugar was analyzed using an

Participants advanced diabetes analyzing system, changes in body
composition were assessed via DXA and strength was
A total of 186 participants started the intervention assessed via the use of an isokinetic dynamometer.
with 107 participants making it until the end as some The authors also looked at dietary data using an
people withdrew from the study for many reasons, online version of the block brief food frequency
including being unwilling to participate and unable to questionnaire.

REPS: Strength training for type 2 diabetes 22

REPS: Strength training for type 2 diabetes 23
What Did They Find? What Do the Findings
Mean?
Strength training alone was more effective than
aerobic training alone at reducing blood sugar levels
in normal weight individuals with type 2 diabetes This is yet another win for team resistance training (if
. It also improved body composition by increasing there’s even such a thing) 😂. However, as always, we
muscle mass and reducing fat mass to a greater must acknowledge the study's limitations before we
extent than both the aerobic and combined groups, look at the findings a bit closer.
something that was also one of the predictors for
blood sugar. It’s important to note, that the combined For starters, the study was heavily affected by the
group experienced greater decreases in blood sugar COVID-19 pandemic, which affected the study’s sample
than the aerobic group but did not experience greater size, making the results less “certain” than if the study
decreases than the strength training group. had run as intended. Secondly, the combined training

REPS: Strength training for type 2 diabetes 24

group performed much less training volume than the if not THE first, studies to compare resistance and
strength training group, which may have affected aerobic training for managing type 2 diabetes, and it
their results. interestingly found resistance training to be better
than aerobic training alone.
The above limitations aside, the study is in line with the
current literature on the effect of strength training on
blood sugar and the management of type 2 diabetes.
A previous meta-analysis by Lee et al found that
resistance training improved glycemic control and
How Can You Apply
strength in patients with type 2 diabetes 3, something
that was also supported by a more recent systematic
These Findings?
review by Jansson et al 4
that also found resistance
Anything mentioned on this review is not meant to be
training to be an effective strategy at decreasing
medical advice, so please consult your physician for
blood sugar in individuals with type 2 diabetes.
more information on how to manage your blood sugar,
regardless of whether you have type 2 diabetes or not.
Now, you may be wondering “The literature seems
pretty clear on the effect of resistance training on
The legal disclaimer out of the way, the results of the
the management of type 2 diabetes; what did this
study show how beneficial resistance training can
study have to offer?”. Well, this was one of the first,
really be for health, further disproving the old myth of

REPS: Strength training for type 2 diabetes 25

cardio being the number one modality when it comes
to improving your health.

However, it’s also important to note that engaging in

resistance training alone will probably not help you tick
all the boxes you need for health, with a combination
of resistance training and aerobic health being your
best bet.

A recent paper titled “The Coming of Age of Resistance

Exercise as a Primary Form of Exercise for Health” [5]
noted how “evidence to date suggests that as a form of
exercise, resistance training shares more in common
with aerobic training from a health-promoting
standpoint than we may have realized”, explaining
that a combination of both aerobic and resistance
training were better at reducing the risk of cancer,
obesity, metabolic syndrome, hypercholesterolemia,
cardiovascular disease, all-cause mortality and type
2 diabetes 5.

The main takeaway from this study is to make sure

you remain active for the rest of your life by engaging
in some form of aerobic and resistance training, even
if that means doing just a couple of hours of exercise
per week. I know it sounds cliche, but as it stands, 6
in 10 American adults don’t do any sort of resistance
training regularly, with just over 28% of Americans
exercising enough. A few hard sets of resistance
training per week, coupled with 6 to 10 thousand steps
per day, can take you much farther than you may think
regarding general health. As far as general health is
concerned, finding ways to engage in aerobic and
resistance training will be far more important than
any detail pertaining to the modality used, repetitions
performed, etc.

REPS: Strength training for type 2 diabetes 26

References
1. Westcott WL. Resistance training is medicine: effects of strength
training on health. Curr Sports Med Rep. 2012 Jul-Aug;11(4):209-16.
doi: 10.1249/JSR.0b013e31825dabb8. PMID: 22777332. https://
pubmed.ncbi.nlm.nih.gov/22777332/

2. Shailendra P, Baldock KL, Li LSK, Bennie JA, Boyle T. Resistance

Training and Mortality Risk: A Systematic Review and Meta-
Analysis. Am J Prev Med. 2022 Aug;63(2):277-285. doi: 10.1016/j.
amepre.2022.03.020. Epub 2022 May 20. PMID: 35599175. https://
pubmed.ncbi.nlm.nih.gov/35599175/

3. Lee J, Kim D, Kim C. Resistance Training for Glycemic Control,

Muscular Strength, and Lean Body Mass in Old Type 2 Diabetic
Patients: A Meta-Analysis. Diabetes Ther. 2017 Jun;8(3):459-473.
doi: 10.1007/s13300-017-0258-3. Epub 2017 Apr 5. PMID: 28382531;
PMCID: PMC5446383. https://www.ncbi.nlm.nih.gov/pmc/articles/
PMC5446383/

4. Jansson AK, Chan LX, Lubans DR, Duncan MJ, Plotnikoff RC. Effect
of resistance training on HbA1c in adults with type 2 diabetes mellitus
and the moderating effect of changes in muscular strength: a
systematic review and meta-analysis. BMJ Open Diabetes Res Care.
2022 Mar;10(2):e002595. doi: 10.1136/bmjdrc-2021-002595. PMID:
35273011; PMCID: PMC8915309. https://drc.bmj.com/content/10/2/
e002595

5. Phillips, Stuart M. Ph.D., FACSM; Ma, Jasmin K. Ph.D., ACSM/

NCHPAD-CIFT; Rawson, Eric S. Ph.D., FACSM. The Coming of
Age of Resistance Exercise as a Primary Form of Exercise for
Health. ACSM's Health & Fitness Journal 27(6):p 19-25, 11/12 2023.
| DOI: 10.1249/FIT.0000000000000916 https://journals.lww.com/
acsm-healthfitness/fulltext/2023/11000/the_coming_of_age_of_
resistance_exercise_as_a.7.aspx

© Copyright 2023 Biolayne Technologies LLC 27

Strength gain over
time: a reality check
Longitudinal growth modelling of strength adaptations in
powerlifting athletes across ages in males and females
Latella et al. (2023)
 How does strength change over time? Can we expect massive personal records even after
years of lifting or is there an inevitable plateau that we must all accept?

an option and following a more structured and well-

Overview thought approach towards training becomes almost
mandatory. Sure, there are genetic freaks out there
• What did they test? The researchers looked at how who kept making gains well deep in their lifting career
powerlifting strength changes over time. despite not knowing what they were doing, but for
most of us, hitting that 20-40lb PR may take months
• What did they find? Powerlifters made their
of consistent and somewhat calculated hard work.
greatest gains over the first year of training, after
which strength gains slowed down.
Although strength and muscle gains become
• What does it mean for you? Managing your much more challenging as one progresses, one’s
expectations as you get deeper in your training expectations of strength progress don’t adapt
career is important but you should still train hard accordingly. People will often expect to see the
and chase progress. same amount of strength progress they saw during
their first years of training and often feel as if they’re
“stuck” if they don’t add a certain amount of weight
on their lifts. Couple that with the highlight reel that
What's the Problem is social media and you may find lifters feeling like
they’re doing something wrong that is causing them
not to make progress.
The first years of lifting weights are a wonderful
time. Muscle gains come relatively easy, your body is
A population that specializes in strength training,
transforming every month and personal records are
and specifically the maximization of 1-repetition-
shattered on a weekly basis. Remember the first few
maximum (1RM) strength, is powerlifters. If you’re
weeks of doing a new barbell movement? From being
unaware, “powerlifting is a strength sport in
unable to stabilize the bar and barely getting a few
which maximal strength determines competitive
reps without any weight, to adding 100-200lbs in the success. Powerlifting is based on 3 barbell lifts (the
span of a few months. I distinctly remember hitting “powerlifts”): the squat, bench press, and deadlift. In
225lb during the first year of lifting and thinking “oh, competition, a powerlifting athlete is allowed three
that was quick, I bet I can hit 450lb in a few years!”. 1RM attempts at each of the powerlifts, to achieve
the highest possible powerlifting total (i.e., the sum
As you can imagine, that bet was not a bet that I won of their highest successful lifts). In competitive
🤣. powerlifting, one of the most common competitive
formats is “raw” where squat, bench press, and
After the first few solid years of lifting, things start deadlift compressive suits, shirts or knee wraps are
to slow down significantly and personal records not permitted, only allowing use of knee sleeves,
come much harder than before. Just lifting and wrist wraps, and a belt.” [Direct quote from one of our
adding 5-20lbs to the bar every week is no longer powerlifting papers - 2].

REPS: Strength gain over time: a reality check 29

Competitive powerlifters are an excellent population Purpose & Hypothesis
to look at strength changes over time, as not only do
they train for 1RM strength but they do everything The study aimed to explore how powerlifting strength
in their power actually to maximize strength. A changes, including the role of age, sex or weight class.
competitive powerlifter will train for years to slightly Additionally, the study aimed to also provide insight
increase their already “strong” powerlifting total, on how strength adapts over time, irrespective of
powerlifting performance. The authors hypothesized
employing a variety of different training approaches
that older athletes will see slower strength gains
and training specifically to become better at lifting
over time compared to younger athletes. They also
heavy weights for a single repetition.
hypothesized that there would be no differences
between males and females.
So, by looking at powerlifting strength over time, we
can gain some useful insight on how to calibrate our
strength expectations over time. “But how is that
possible? Won’t we need to have years of data to
really be able to explore such a question?” I imagine
What Did They Test
you asking. and How?
Thankfully, the database openpowerlifting.org allows The authors extracted data from the openpowerlifting.
us to do just that! Openpowerlifting.org is a database org database with the following “terms and conditions”:
that keeps track of all powerlifting competitions
across the world, including the individual competition
• The study is focused on powerlifting data from the
results of each competitor. International Powerlifting Federation (IPF).

• They specifically selected data from open raw

And this is exactly what Latella et al looked at. I
events that include the "Squat, Bench, and
present to you: “Longitudinal growth modeling of
Deadlift" competitions.
strength adaptations in powerlifting athletes across
ages in males and females”. • Data points where lifters failed all attempts for a
specific lift were removed, and the total score was
based on the greatest successful attempt in each
Note: The version of the study linked in this review
of the three lifts.
is a pre-print, meaning it has not gone through peer-
review yet. However, the study has been accepted • The analysis considered lifters who had competed
for publication in the journal of Sports Medicine(I am in at least three competitions, which was suitable
for their growth model analyses.
one of the study's authors, which is why I know this
information). By the time you’re reading this the study • The IPF dataset was chosen because it includes
should also be available in a journal-formatted version drug-tested competitions.
on Sports Medicine. Not that it makes any meaningful • They also tested their statistical models using
difference but I thought it’s worth mentioning as the the overall Open Powerlifting dataset to see how
pre-print is over a year old (yes, peer review can be a results varied in a more diverse powerlifting
super lengthy process 🤣). sample.

REPS: Strength gain over time: a reality check 30

• Performance was measured as the best attempt
for squat, bench press, deadlift, and the total for What Did They Find?
each competition.

• Age and body weight were treated as continuous

Overall, powerlifters saw their strength increase by
variables for statistical modeling and were
categorized according to IPF categories for approximately 7.5 to 12.5% over the first year, with
visualization. strength heavily plateauing after that, increasing 12.5

• Age categories included sub-junior (18 and under), to 20% in the next 10 years.
junior (19-23), open (24-39), masters 1 (40-49),
masters 2 (50-59), masters 3 (60-69), masters 4
As far as sex differences go, men had a higher absolute
(70+)
baseline strength (as expected) with females having a
• Body weight classes for women and men were
specified. slightly faster strength progression than men over time

(although relatively trivial). Younger lifters also had faster

The dataset used for analysis consisted of 9,259
strength progression over time, with older males actually
unique lifters, covering up to around 17 years of
competition! experiencing a decline in strength as time passed.

REPS: Strength gain over time: a reality check 31

 Main model fitted values (solid line) and
95% prediction intervals (dashed lines)

450 450

400 400
Total (kg)

Total (kg)
350 350

300 300

0 250 500 750 1 10 100 1000

Time (weeks) Log Time(weeks)

170 170

150 150
Squat (kg)

Squat (kg)

130 130

110 110

0 250 500 750 1 10 100 1000

Time (weeks) Log Time(weeks)

90 90
Bench (kg)

Bench (kg)

80 80

70 70

60 60

0 250 500 750 1 10 100 1000

Time (weeks) Log Time(weeks)
190 190

170 170
Deadlift (kg)

Deadlift (kg)

150 150

130 130

0 250 500 750 1 10 100 1000

Time (weeks) Log Time(weeks)

From Linear Mixed Model: DV ~ log(Time) * Age * Sex * Bodyweight + (log(Time)|(Participant)

Model predicted values on raw scale with 95% prediction intervals (ribbon)
Models fitted to IPF dataset from Open Powerlifting (https://openpowerlifting.gilab.io/opl-csv/) filtered to 'Raw' and 'Open' Meets

REPS: Strength gain over time: a reality check 32

 Age interaction model for males fitted values rescaled as
percentage of baseline performance values

115 115
Total (% baseline)

Total (% baseline)
110 110

105 105

100 100

95 95
0 250 500 750 1 10 100 1000

Time(weeks) Log Time(weeks)

115 115
Squat (% baseline)

Squat (% baseline)

110 110

105 105
Age Class
100 100 Sub-Junior

1 10 100 1000 Junior

0 250 500 750

Time(weeks) Log Time(weeks) Open

115 115 Masters 1

Masters 2
110 110
Bench (% baseline)

Bench (% baseline)

Masters 3
105 105
Masters 4
100 100

95 95

0 250 500 750 1 10 100

Time(weeks) Log Time(weeks)

115 115
Deadlife (% baseline)

Deadlife (% baseline)

105 105

100 100

95 95
0 250 500 750 1 10 100

Time(weeks) Log Time(weeks)

From Linear Mixed Model: DV ~ log(Time) * Age * Sex * Bodyweight + (log(Time)|(Participant)

Model predicted values on raw scale with 95% prediction intervals (ribbon)
Models fitted to IPF dataset from Open Powerlifting (https://openpowerlifting.gilab.io/opl-csv/) filtered to 'Raw' and 'Open' Meets

REPS: Strength gain over time: a reality check 33

Heavier individuals progressed a bit faster than openpowerlifting.org database and can give you an
lighter individuals but again, it was not a time and day idea of how strong you are. You can obviously adjust
difference with strength increases over time being for factors such as being drug free, sex, age & weight

somewhat similar among different weight classes. category etc. Keep in mind that you can use the
above tool even if you are a recreational lifter, just
take the results with a pinch of salt. For example,
if you’re a drug-free 180lb male with a 405lb squat,

What Do the Findings that makes your squat better or equal than 57%
of competitive powerlifters across all ages/drug

Mean? tested federations. A 405lb squat may not seem like

a lot as far as “instagram strength” goes, but when
compared to the strength of actual competitive
The results of the study are supported by previous strength athletes, it’s definitely decent. The reason
literature showing that strength and muscle gains are I’m making this point so long, is that depending on
much faster during the first years of training and then the type of content that you’re exposed on or the
slowly plateau after 1. However, it’s important to note gym that you train in, the above number may not
that the population examined in this study was not seem like it’s anything “strong”, when in reality it’s
comprised of untrained individuals who just started literally above average competitive powerlifter
training but rather competitive powerlifters who strength for people of a similar weight and sex.
were likely to have some years of resistance training
experience already. Keep in mind that the above point Some may wonder why I didn’t recommend checking
is expressed with some caution as there was no way
your strength on a website like strengthlevel.com
of certainly knowing how much each individual trained
which seems much more suitable for the average
before they decided to compete in powerlifting. That
person. Although that may be somewhat true given
said, assuming that people had at least a solid 6-12
the much lower strength standards used, websites
months of resistance training experience is a relatively
like strengthlevel.com allow anyone to enter
safe assumption and I would not be surprised if many
any number they like, completely ignoring form
people had way more training experience than that.
standardization, something that can play a huge role
in determining whether one is truly as strong as they
Now, there are a few ways in which we can view the
claim on a certain lift. Powerlifting competition data
findings of these study:
means that all lifts have been approved by 3 judges
for things like appropriate range of motion etc.
1. If you’re a serious trainee who has been training hard
for years, things will likely slow down after a certain
point. We’re constantly bombarded with massive 2. If you’re just starting to train, you can expect to
personal records and incredible feats of strength, make some amazing strength gains in the first few
often creating this illusion of progress never slowing years of your training career. As mentioned, the
down. This is simply not the case and although a hard individuals analyzed in this study were competitive
pill to swallow, if your strength is already pretty high, powerlifters and they still managed to experience
then managing your expectations is wise. It may be 7.5-12.5% strength increases over their first year of
worth seeing where your current numbers put you their competitive career. It is be fair to assume that
in relation to competitive powerlifters, using the you can expect some massive PRs in the first 1-3
website strengthcheck.me. This website essentially years of your serious training, regardless of whether
compares your lifts to all the powerlifters from the you powerlift or not.

REPS: Strength gain over time: a reality check 34

 Layne Norton Powerlifting total over time (in kg)

is, he is more than aware that his strength will probably

How Can You Apply not be changing massively in the next few years but he
is still happy to give it 101% effort while calibrating his

These Findings? expectations and celebrating different wins (mini PRs,

winning titles etc).

The findings of this study should not really affect how Similarly to Layne, and even if you’re not a competitive
you approach your training but rather how you manage powerlifter, just because things will slow down after
your expectations. You should still approach training as a certain point, doesn’t mean training won’t be fun or
if you’re going for massive PRs but know that strength productive. As you must know by now, lifting has a ton of
gains will not come as quick as you get deeper in your benefits aside from all-time squat, bench and deadlift
training career. PRs. Adopting new approaches to strength training
(eg: doing more volume, altering repetition ranges etc)
A good example of the above is Layne Norton, which when things feel like they’re slowing down may help
😆
I’m sure you’re more than familiar with . This is what but it’s also worth considering if slightly changing your
Layne’s powerlifting total looks like over the course of strength goals may be a bit better from a mental point
14 years. of view. Trying new exercises, setting new PR goals
(aside from 1RM PRs) and enjoying training for the sake
Obviously the above doesn’t take into account that of training is the way forward as far as sustainable
Layne has crossed over from the open age category lifting is concerned. Lastly, gaining a bit of body weight
to the masters 1 category or the fact that he has may be a relatively “quick” way to increase absolute
sustained a few serious injuries over the years, but strength - although terms and conditions apply as your
that is beyond the point. You can see how in the first relative strength may remain relatively similar.
year of powerlifting competitions his total increased
massively, then continued to increase for a few more Keep lifting, keep pushing yourself but remember that
years, albeit more conservatively and it has been up & some all-time PRs may never be broken again, and that
down for the past 8 years or so. Layne, at least IMO, still is totally fine!
trains as if he is going to a suddenly add 100kg to his
total, chasing mini (or age) PRs here and there. Point Just train!

REPS: Strength gain over time: a reality check 35

References
1. Steele J, Fisher JP, Giessing J, Androulakis-Korakakis P, Wolf
M, Kroeske B, Reuters R. Long-Term Time-Course of Strength
Adaptation to Minimal Dose Resistance Training Through
Retrospective Longitudinal Growth Modeling. Res Q Exerc Sport.
2022 May 19:1-18. doi: 10.1080/02701367.2022.2070592. Epub ahead
of print. PMID: 35591809. https://pubmed.ncbi.nlm.nih.gov/35591809/

2. Androulakis-Korakakis P, Michalopoulos N, Fisher JP, Keogh J,

Loenneke JP, Helms E, Wolf M, Nuckols G, Steele J. The Minimum
Effective Training Dose Required for 1RM Strength in Powerlifters.
Front Sports Act Living. 2021 Aug 30;3:713655. doi: 10.3389/
fspor.2021.713655. PMID: 34527944; PMCID: PMC8435792. https://
www.frontiersin.org/articles/10.3389/fspor.2021.713655/full

© Copyright 2023 Biolayne Technologies LLC 36

The mighty placebo
effect?
The placebo effect of a pink non-caloric, artificially
sweetened solution on strength endurance
performance and psychological responses in trained
individuals
de Salles Painelli et al. (2023)
 Can a pink drink make people perform better simply because they think it will?

the participants knew about their treatment being a

Overview placebo pill or not. Interestingly, when compared to
receiving no treatment, the placebo pill accounted for
• What did they test? The researchers looked at how more than 50% of the medication’s effect.
ingesting a calorie-free, artificially sweetened pink
drink affected strength endurance. Now, it’s important to note that the placebo effect
• What did they find? Ingesting a pink drink resulted may not be as magical, or even real, as we think. Yes, I
in greater strength endurance than consuming a know, plot-twist!
clear drink with the same taste.
Many factors can contribute to the “placebo effect”
• What does it mean for you? Don’t assume that a
that are often left unrecognized, like regression
supplement or drink really works just because it
to the mean, which essentially refers to one’s
made you perform better. It may be mostly in your
symptoms improving over time, despite the lack of
head.
any actual intervention. There’s also the possibility
of subjective reporting bias, something that is also
supported by the lack of scientific evidence showing

What's the Problem that the placebo effect results in your body actually
repairing itself versus “feeling better” like in the Kam-
Hensen et al study. A review looking at the role of the
Ah, the almighty placebo effect. If you have ever placebo effect in oncology 2 (aka the study of cancer)
consumed any scientific content, even without the found that in randomized double-blinded, placebo-
slightest “deep dive” whatsoever, you’ve probably controlled trials, placebos are associated with some
heard the word “placebo”. improvements in pain and appetite, but almost never
actually positively affect tumors.
The placebo effect is a psychological and physiological
phenomenon where a person experiences real In a classic study by Maganaris et al 3
often talked
improvements in their condition or symptoms after about in lifting circles, a few national level powerlifters
receiving a treatment that, in reality, has no active were told that they were receiving “fast-acting
substance. In other words, it's the response people steroids'' before a max-out session and managed to
exhibit when they believe they are receiving treatment, beat their personal records by around 5%, which by
and that belief alone leads to actual changes in their the way were legit (multiple >600lb deadlifts), despite
health or performance. receiving a literal sugar pill. Remember that they
received the placebo steroid pill 5 minutes before
A widely cited study by Kam-Hansen et al titled lifting and were given a few more sugar pills to use for
“Altered placebo and drug labeling changes the their subsequent training sessions. A week later, they
outcome of episodic migraine attacks” 1
found that were asked about their training experience during the
migraine symptoms improved, regardless of whether past week and all reported that training was going

REPS: The mighty placebo effect? 38

great, they felt stronger, managed to do more reps parameters (eg: blood pressure, heart rate etc)
etc. Crazy, right? What’s even more crazy is that the but did not have anywhere near the same effect for
researchers informed some of the participants that biochemical parameters (eg: chronic heart failure,
they were indeed taking a sugar pill and what the diabetes etc). Remember that when patients believe
experiment's real goal was, which negatively affected they're getting a placebo treatment, they tend to pay
their second testing session. However, the group that more attention to any symptom improvements they
was still “in the dark” in regards to the true design of experience. These momentary improvements can
the study, managed to maintain their “newly acquired” make them feel better, like a reward, encouraging
strength. Now, although this study is really cool and their body's automatic functions to work better. This
provides some support for the placebo effect, the kind of learning is a bit like how you train a dog with
strength increases experienced by the powerlifters rewards but in this case, the reward comes from
can probably be attributed to an increased level of within the body. The quick communication between
confidence, especially given the environment in which our inner organs and the part of the brain that controls
they lifted in. In reality, it’s not like the placebo pill automatic bodily functions makes it possible for this
actually resulted in the participants gaining muscle kind of learning to happen. It's like our body is adapting
mass or experiencing any long-lasting physiological to the situation, even though the treatment itself isn't
changes, which is often misunderstood about the doing anything real.
placebo effect.
My long-winded introduction on the placebo effect
A 2007 review by Meissner et al found that placebo
4
aside, it’s common also to see research on the effect
interventions can lead to improvements in physical of different drink coloring on a variety of outcomes,

REPS: The mighty placebo effect? 39

including sports performance. People often associate Before their testing sessions, they were required
certain drink colors (eg: red, pink) with sweetness, to abstain from alcohol, caffeine and any strenuous
something that can then influence their perception exercise involving the musculature they were tested
of a drink’s nutritional value, thinking that it probably
on. They were also briefed on the positive effects of
contains carbohydrates and thus improving one’s
carbohydrate supplementation and were told that the
performance. A previous study by Brown et al 4 found
aim of the study was to compare two commercially
that mouth rinsing with a pink non-caloric artificial
available carbohydrate-rich sport drinks. In other
sweetened drink improved running performance
when compared to a clear drink, despite containing words, the researchers deceived the participants.
no carbohydrates or calories. However, they did not mention anything in regards
to the color of the drink being representative of
But what about strength endurance? Can a pink- any difference in terms of nutritional value. Funny
coloured drink positively affect strength endurance enough, the artificial sweetener used in the drinks was
even in the absence of any actual nutritional value? erythritol, an artificial sweetener that we’ve covered in
detail before.
de Salles Painelli et al looked at exactly that!

Purpose & Hypothesis The participants visited the lab and were tested for
their 1-repetition-maximum (1RM) strength before
This study aimed to see if a pink non-caloric commencing the strength endurance testing which
artificially sweetened drink can influence strength consisted of 5 sets of maximum repetitions at 70%1RM.
endurance as well as psychological parameters. The
All sets were terminated after a participant failed to
authors hypothesized that the ingestion of the pink
complete a full concentric repetition and all testing
drink would improve both strength endurance as well
as psychological parameters like perceived exertion, was performed on the barbell bench press.
motivation etc.

What Did They Test

and How?
18 trained participants performed strength endurance
testing in the following conditions:

• After drinking a pink non-caloric artificially

sweetened drink
• After drinking a transparent non-caloric drink which
was also artificially sweetened
• After drinking nothing
Individual data on the total number of repetitions in the strength endurance test
with the pink (PINK) solution, transparent (TRANSP) solution or no solution (CON).
Each session was seperated by at least 3 days. The symbol * refers to a significant difference (at p < 0.05) compared to the other
experimental conditions.

REPS: The mighty placebo effect? 40

In addition to examining the amount of repetitions
achieved by each individual during the strength
endurance test, the researchers also looked at the
participants’ emotional arousal, motivation and ratings
of perceived exertion (RPE) immediately after each 10

Whole session RPE (0-10)

set. The assessment of the above psychological states
was done via the use of different scales (eg: a 10-point 8

Likert motivation scale). 6

Participants 4

2
The participants were 18 healthy men who engaged in
0
resistance training for at least 1 year and were recruited
PINK TRANSP CON
from gyms and personal training studios to take
part in the study. The researchers also ensured that
participants had a similar bench press strength level. Whole session RPE after the strength endurance test with the pink (PINK) solution,
TRANSP solution or no solution (CON). REP: rating of perceived exertion; TRANSP:
transparent.

about the carbohydrate content of a drink they

What Did They Find? consumed, with one group performing better than the
other two in a relatively short-term study.

The participants performed better after ingesting the

The findings are in line with the current literature
pink drink with performance being significantly better
suggesting that drink color can have a positive effect
than both the transparent and the no-drink conditions.
on performance, including previous research showing
No major differences in psychological responses were
that carbohydrate mouth rinsing can positively affect
found for any of the conditions, suggesting that the
color of the drink could positively influence strength performance.
endurance performance irrespective of any changes in
one’s motivation, RPE etc. It may be worth noting that That said, we must interpret the results of the study
although not statistically significant, the participants with caution as we do not really know if the relatively
achieved a lower session RPE rating after consuming acute effects of consuming a pink drink translate to
the pink drink versus the other 2 conditions. better long-term gains.

What Do the Findings How Can You Apply

Mean? These Findings?
Now, let’s not jump on the “drink pink drinks to make Although an interesting study, its practical takeaways
gains” train just yet. It’s important to remember that are somewhat limited. Sure, we could recommend
this was a study with 18 people that were deceived you opting for pink coloured drinks before your lifting

REPS: The mighty placebo effect? 41

sessions but I doubt that you’d see much of an effect
after having read this article. That said, if there are
certain drinks that you associate with an improved
performance, regardless of their nutritional value,
it’s probably wise to use them whenever you need an
extra performance boost.

Additionally, the information presented in this article

serves as a nice reminder of how many existing
products that promise insane performance increases
may be simply relying on you believing that they will
work rather than them actually working. Make sure
always to read the nutritional information labels of
any drinks or supplements you consume and ensure
that they contain research-backed ingredients at the
appropriate doses.

REPS: The mighty placebo effect? 42

References
1. Kam-Hansen S, Jakubowski M, Kelley JM, Kirsch I, Hoaglin DC,
Kaptchuk TJ, Burstein R. Altered placebo and drug labeling changes
the outcome of episodic migraine attacks. Sci Transl Med. 2014 Jan
8;6(218):218ra5. doi: 10.1126/scitranslmed.3006175. PMID: 24401940;
PMCID: PMC4005597. https://pubmed.ncbi.nlm.nih.gov/24401940/

2. Chvetzoff G, Tannock IF. Placebo effects in oncology. J Natl Cancer

Inst. 2003 Jan 1;95(1):19-29. doi: 10.1093/jnci/95.1.19. PMID: 12509397.
https://academic.oup.com/jnci/article/95/1/19/2520190?login=false

3. Ostrowski, K.J. et al. (1997) ‘The effect of weight training volume on

hormonal output and muscular size and function’, The Journal of
Strength and Conditioning Research, 11(3), p. 148. doi:10.1519/1533-
4287(1997)011&amp;lt;0148:teowtv&amp;gt;2.3.co;2. https://www.
researchgate.net/publication/27399155_Expectancy_Effects_and_
Strength_Training_Do_Steroids_Make_a_Difference

4. Meissner K, Distel H, Mitzdorf U. Evidence for placebo effects on

physical but not on biochemical outcome parameters: a review of
clinical trials. BMC Med. 2007 Mar 19;5:3. doi: 10.1186/1741-7015-5-3.
PMID: 17371590; PMCID: PMC1847831. https://www.ncbi.nlm.nih.gov/
pmc/articles/PMC1847831

5. Brown DR, Cappozzo F, De Roeck D, Zariwala MG, Deb SK. Mouth

Rinsing With a Pink Non-caloric, Artificially-Sweetened Solution
Improves Self-Paced Running Performance and Feelings of Pleasure
in Habitually Active Individuals. Front Nutr. 2021 May 12;8:678105. doi:
10.3389/fnut.2021.678105. PMID: 34055861; PMCID: PMC8153227.

© Copyright 2023 Biolayne Technologies LLC 43