restricted blood flow training

Restricted blood flow training? Bro-science or a key to gains?

Posted Posted in Exercise, Health

Nearly everyone in the gym is looking for the best way to get swole. Common knowledge leads us to believe that progressive muscle overload is the key to hypertrophy. Today we look at the science behind restricted blood flow training.

What is restricted blood flow training?

This technique was popularized in Japan and is referred to as KAATSU. Restricted blood flow training has actually been around for around 4 decades. There are a variety of approaches to achieving restricted blood flow but generally, it involves placing a constricting band on your extremities (arm or leg)

Why it’s important to consider restricted blood flow training?

One of the interesting questions is can low intensity exercise with restricted blood flow cause muscle hypertrophy? This is interesting because it goes against the common thought that only progressive muscle load and lifting weights >70% of the one rep max (1RM) can cause hypertrophy. There are multiple ways to incorporate restricted blood flow training into your routine. One is by adding in a low-intensity blood flow restricted day to your workout routine. The other option is for those who are limited and unable to do intense exercise. Those people may get increased strength and hypertrophy while avoiding major load on their muscles, ligaments, tendons since they can work at a lower intensity.

You know I wouldn’t be telling you all of this unless there was some science to back it up!

I’ll admit I was skeptical but after doing some research I found myself a bit more convinced. Multiple studies have found that blood flow resistance training results in increases in both size and strength in the arms and legs. New studies even indicate that both size and strength gains are noticed in muscles that don’t undergo restricted blood flow. One study found size and strength increase in the chest in those who restricted blood flow to the arms but not in a control group that didn’t use RBF. RBF training resulted in increased 1RM on bench press and squat. A meta-analysis (which is a study of that compiles and compares the results of many studies) compared those who didn’t use RBF training to those who did found and found an average difference in muscle size of around half a centimeter. Strength gains were noticed even in those that exercised using around 20% of 1RM. Generally, these types of gains are not noticed until workouts of 45-60% of 1RM in untrained individuals or up to 80-85% in trained individuals. The best results tend to occur and are most easily quantifiable 6 weeks into training. A study in 2000 found that after people who did BFR had significantly increased muscle mass and strength vs those who did high-intensity training at 80% of 1RM

Why in the world does restricted blood flow training give us size and strength gains?

It is hard to tell exactly. One thing we know for sure is that BFR causes an increase in growth hormone, which is pretty profound. Growth hormone is known to increase muscle growth and break down fat. Some studies of RBF have shown a 9 fold increase in growth. Typically GH also causes an increase in IGF-1 which is another growth factor. However, in the case of RBF training IGF-1 does not increase. We also know that RBF does not cause increases in testosterone so we can’t give the credit to our friendly anabolic hormone testosterone. There are other reasons that are less understood but changes in metabolism, byproducts of metabolism, and reactive oxygen species may also play a part. BFR training has been shown to increase muscle glycogen content, which is essentially the fuel cell of our muscles. On a cellular level studies have shown an increase in the synthetic rate of proteins from amino acids. This increase can be as high as 46%. Looking to our genetic code DNA which makes RNA which ultimately makes protein. Restricted blood flow training also initiates the process of making RNA into protein by 3 fold.

Why the hell not start doing restricted blood flow training today?

Some of the biggest concerns involve the risk of cardiovascular issues, blood clots, vascular function, nerve and muscle damage. There have been surveys of 30,000 sessions of RBF exercise training. It is important to remember that those who were surveyed came from a generally healthy population. The most side effects that were reported involved bruising, numbness, and lightheadedness. Some more dangerous side effects such as blood clots were also reported but at a lower rate than that of the general population.

When nerves were studied before and after 4 weeks of BFR training there did not seem to be a change in conduction to indicated nerve damage. However, it has been reported In studies of animals that BFR has resulted in structural tissue damage. The risk of clots remains concerning because of something called Virchow’s triad. Virchow’s triad is made up of three factors which contribute to developing a blood clot 1) abnormal flow of blood 2) injuries to the blood vessel wall and 3) alterations in blood coagulation. We can see how 2 of these conditions may easily be met in blood flow restricted training.

Other studies have looked at the safety of restricted blood flow training by measuring blood markers. Researchers did not find increases in the inflammatory marker (C-reactive protein.) There were also no changes in fibrinogen or D-dimer which are related to blood clots.

So what’s our take away based on the science?

Ultimately restricted blood flow training has some incredibly interesting research behind it. It seems that generally, most studies agree that RBF training can cause increases in both size and strength even when the exercise is performed at low intensity. Some studies have shown size and strength increases in muscles other than those that had restricted blood flow to them (such as the chest.) This is possibly mediated by an increase in growth hormone secretion, but it is not still well understood. We, however, cannot in good conscious recommend doing blood flow restricted training since very little research has been performed to understand the safety of these techniques. It will certainly be interesting to see what future research of these techniques will show.

Going to try restricted blood flow training anyway? Here are a few restricted blood flow training kits on Amazon.

Looking to lose weight, build muscle, gain strength, compete in powerlifting or a bodybuilding show? Check out our custom plans to help you reach your goals!

 

Don’t want to work 1 on 1 with one of our coaches? Check out our new 8-week workout plan The Beast Beneath! The Beast Beneath is available for immediate download.

Interested in reading more about blood flow restricted training? You can find all the sources below:

Effects of low-intensity bench press training with restricted
arm muscle blood flow on chest muscle hypertrophy: a pilot
study.

Blood Flow Restricted Exercise and Skeletal Muscle Health

Effects of cuff width on arterial occlusion: implications for blood flow restricted exercise

Relative safety of 4 weeks of blood flow-restricted resistance exercise in young, healthy adults

Effect of restricted blood flow on exercise-induced hormone changes in healthy men

Exercise intensity and muscle hypertrophy in blood flow–restricted limbs and non-restricted muscles: a brief review

Low-intensity blood flow restriction training: a meta-analysis

A Review on the Mechanisms of Blood-Flow Restriction Resistance Training-Induced Muscle Hypertrophy

The efficacy of blood flow restricted exercise: A systematic review & meta-analysis

The Effects of a 7-Week Practical Blood Flow Restriction Program on Well-Trained Collegiate Athletes

Exercise and Blood Flow Restriction

Obesity is wack

Fat is Wack

Posted Posted in Health

One of the most common resolutions for the new year is to lose some extra weight. Today we discuss the complicated topic of obesity. In the past it has always seemed very reasonable to accept the fact that many of us needed to lose some weight. However, recently there has a push against fighting obesity which some people consider “fat shaming.” We have been told that we should accept our bodies and “love our fat.” We want to put the scientific evidence above these feelings with a hope that everyone can meet their nutrition and fitness goals in the new year. The science speaks strongly against the idea of loving your fat. If you choose to embrace your weight there can be dire consequences.

Simply Put Fat Can Kill You

In medicine we can use body mass index which is a persons weight in kilograms divided by their height in meters squared. We can classify people in categories such as overweight and obese. People are considered overweight when their BMI is over 25. A BMI over 30 will qualify you as obese. We don’t do this to label people for the sake of labeling. We do it because BMI is is associated with increased rate of death from all causes, especially when BMIs exceed 25. This isn’t based on a fluke or a feeling, but rather comes from a study of over 30 million people who were obese or overweight.  Now some people may question this and say “Well I am just fat but my blood pressure, cholesterol, and blood sugar are all normal!” Research has shown that obese people with normal labs and blood pressure still have an increased risk of death compared to normal weight individuals. BMIs in the 30-35 range can mean dying on average 2-4 years earlier. BMI of 40-45 can reduce your life as much to 8-10 years. We all know that smoking is bad, the risk fo death from obesity is similar to that of smoking.

How about disease related to obesity?

Obesity is literally associated with hundreds of diseases. Here is a short list of a few. Diabetes, high cholesterol, high blood pressure, heart disease, abnormal heart rhythm, stroke, blood clots, arthritis, gout, fatty liver disease, reflex, sleep apnea, infection, and cancer. Just the list of cancers associated with being obese is quite long and includes endometrial, gallbladder, kidney, liver, colon, cervical, thyroid, ovarian, breast, and blood cancers. The worst part is those who are obese are not only more likely to get these types of cancers but also more likely to die from them. If the general health risks of obesity don’t worry you enough the effects of obesity also extend into sexual health. Obesity can cause abnormal menstrual cycles and make possibly cause infertility. During pregnancy there is also a higher risk of health problems in the mother and the baby. Sexual arousal and issues with orgasm is also more likely in women that are obese. For men, obesity is an risk factor for erectile dysfunction. 

Combating fat!

Will all these health problems related to obesity here is what you can do. Start a healthy diet that is balanced and restrict your calories to below your daily energy expenditure. You can find more details on that here in our article “Getting started on your Fitness Journey”. Exercise is also an important part of the solution.  Exercise will help you burn calories, increasing your daily energy expenditure. You can find many workout routines online or you could have a custom plan designed for you to help with weight loss. Research shows that unfit individuals who are obese have twice the risk of death compared to obese people who work out. 

Putting Fat Behind US

Obesity has exceeded smoking as the number one cause of preventable disease and disability. We should all be able to agree that we should never shame obese people but maybe it is time to shame fat. We need to move away from “loving our fat.” Let us all help one another to become healthier, fitter, and thinner in the new year.

Sources For Fat is Wack:

Are metabolically healthy overweight and obesity benign conditions?: A systematic review and meta-analysis.

BMI and all cause mortality: systematic review and non-linear dose-response meta-analysis of 230 cohort studies with 3.74 million deaths among 30.3 million participants.

Fitness vs. fatness on all-cause mortality: a meta-analysis.

Adiposity as compared with physical activity in predicting mortality among women.

Obesity and cancer.

Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies.

The adverse effects of obesity on conception and implantation.

benefits of sauna

Benefits of sauna use and the science behind it

Posted Posted in Health

Benefits of sauna use go beyond the relaxing and quite heavenly experience that you get from a 10 minute post workout sweat session. Sauna and steam rooms have a decent amount of research behind them. Recently Ironsnack took a trip out to Vegas for a week of pleasure. Aside from putting on some good weight through daily full body workouts and delicious buffets we spent a good deal of time at the spa, where we discovered the sauna. Jacob and I found it to be the perfect post workout start to the day. As a doctor I have been very curious about the effects the sauna has on the body. So here is what I found.

Sauna bathing is essentially sitting or lying in a hot room and the environment can be dry or wet. Wet saunas have temperatures of around 40 degrees Celsius compared to dry saunas but often can feel warmer due to the high humidity (nearly 100%). Where dry saunas have humidity between 10-20% and a temperature around 80-100 degrees Celsius at level of the head while sitting up.

The physiologic changes in heated muscle include increase carbohydrate utilization and possible improvement in insulin sensitivity as well. Some other small studies have found that sauna bathing can help decrease total cholesterol and LDL (bad cholesterol) while increasing (HDL) good cholesterol. The positive effects went away 1-2 weeks after the participants stopped using the sauna. The magnitude of these changes were similar to those seen in moderate-intensity exercise.

Many of us have take nitric oxide supplements, or nitric oxide precursors such as citruline and L-arginine to get a better pump or to look more vascular. It was found that hamsters that underwent sauna treatment for 4 weeks had increased expression of nitric oxide synthase (an enzyme that produces NO) compared to those that didn’t undergo sauna therapy. Sauna therapy also decreased “afterload” which is the force that the heart has to overcome to pump blood to the body. Maybe this best can be though of as relaxing the vascular system making it easier for the heart to pump. The blood vessels have smooth muscle in them and they are essentially less ‘clamped down.’ This makes sense in two ways, one because NO relaxes the vessels and two because the vessels especially in the skin dilate in an effort to cool the body down faster. In humans it been observed that sauna use decreases diastolic blood pressure, your blood pressure when your heart is relaxed.

A study published in 2015 in JAMA Internal Medicine found important benefits of sauna use. They found increased use of the sauna was associated with reduced risk of sudden cardiac death, coronary vascular disease, and all cause mortality. The study followed people for around 20 years and found that those who used the sauna more frequently had a lower risk of death. Benefits of sauna use also include increased appetite and decreased reporting of aches and pains in those who are mildly depressed. Researchers have also looked at the incidence of the common cold in those who use sauna baths regularly. They found that there were fewer episodes of the common cold in those that used the sauna. However, the length and severity of the cold if you were to get one was unchanged. When athletes and non-athletes used sauna one time they found that white blood cell count (cells that fight off infection) were increased in the athlete population after a sauna. The researchers thought that this might indicate a faster mobilization of immune cells in athletes. They even suggested that sauna bathing might enhance immunologic defense. Further studies of the benefits of sauna use in competitive male runners found increased endurance and running performance after 3 weeks of post-exercise sauna bathing.

Pseudo-science warning! If you have thought about a sauna you probably couldn’t help but think the thought “sweating out the toxins.” Researchers found there was no difference in “toxin” excretion rates between infrared, exercise, dry or wet saunas.

No doubt the sauna experience is extreme, there are big shifts in fluid, heart rate, and changes in blood pressure. Dry saunas have reporitly greater losses of body water compared to wet saunas about a pound and half of body water per session vs 0.8 lbs in the wet sauna. Wet saunas tend to increase heart rate more than dry sauna. You should always check with your doctor before deciding to use a sauna, especially if you have medical problems. The safety of saunas has been explored in in a few studies one group found that 60 degree C sauna bathing was safe and actually improved symptoms in those with chronic systolic heart failure (heart not pumping strongly.) Other studies have made the claim that sauna use has been well tolerated and posed no health risks to healthy people from childhood to old age. They noted decreased systolic blood pressure, increased ejection fraction (percentage of blood the heart squeezes out with each beat) and improved exercise tolerance. For those who cannot tolerate exercise thermal therapy such as sauna bathing has been mentioned by researchers as a possible alternative to exercise.

Summary of the researched benefits of sauna use

  1. decreased diastolic blood pressure
  2. decreased aches and pains and increased appetite in those who are mildly depressed
  3. decreased muscle fatigue
  4. decreased bad cholesterol and small but significant increase in good cholesterol
  5. fewer common colds
  6. decreased mortality
  7. improved exercise endurance
  8. improved immune function
  9. increased nitric oxide for better pumps and vascularity
  10. decreased symptoms in those who have systolic heart failure
Sources for benefits of sauna use:

Effect of temperature on muscle metabolism during submaximal exercise in humans.

Beneficial effects of sauna bathing for heart failure patients

Regular Sauna Bathing and the Incidence of Common Colds

Safety and efficacy of repeated sauna bathing in patients with chronic systolic heart failure: a preliminary report.

Human Excretion of Bisphenol A: Blood, Urine, and Sweat (BUS) Study

Environmental determinants of chronic disease and medical approaches: recognition, avoidance, supportive therapy, and detoxification.

Safety, acceptance, and physiologic effects of sauna bathing in people with chronic heart failure: a pilot report.

Comparison of physiological reactions and physiological strain in healthy men under heat stress in dry and steam heat saunas

Effect of a Single Finnish Sauna Session on White Blood Cell Profile and Cortisol Levels in Athletes and Non-Athletes

Regular thermal therapy may promote insulin sensitivity while boosting expression of endothelial nitric oxide synthase–effects comparable to those of exercise training.

The effect of sauna bathing on lipid profile in young, physically active, male subjects.

Changes in the lipid profile of blood serum in women taking sauna baths of various duration.

Effect of post-exercise sauna bathing on the endurance performance of competitive male runners.

Association Between Sauna Bathing and Fatal Cardiovascular and All-Cause Mortality Events

The Medical Risks and Benefits of Sauna, Steam Bath, and Whirlpool Use

Physiological functions of the effects of the different bathing method on recovery from local muscle fatigue

Repeated thermal therapy diminishes appetite loss and subjective complaints in mildly depressed patients.

 

lack of sleep pug

How lack of sleep can sabotage your fitness goals and your health.

Posted Posted in Health

A lot of the time I am dieting either to gain or lose weight. I am always focusing on two things following my diet strictly and pushing myself hard in the gym. While these are two of the most important things to me sometimes I fall victim to lack of sleep. Work, gym, meal prep, and daily activities tend to come first and unfortunately sleep becomes a lower priority.

Maybe in your mind the worst thing that comes from poor sleep or the lack of sleep is feeling terrible in the morning there is a lot more to it. Sleep has a large influence on what goes on inside your body. One study showed that subjects with two nights of a sleep restriction of 4 hours a night had a reduction in Leptin (18%) and an increase in ghrelin (28%). As we have discussed before Leptin is involved in appetite suppression and ghrelin increases your hunger. Because of these changes subjects had a 24% increase in hunger rating. It is easy to see how this could make dieting much harder. Another study of 11 men who got 4 hours of sleep for 6 nights found that those men had reduced glucose (sugar) tolerance of 40%. Their blood sugar would be higher after consuming sugar than those with normal sleep. This could mean a few things either the body had become less sensitive to insulin (a blood sugar lowering hormone) or the body was secreting less insulin. Insulin doesn’t just regulate blood sugar but also acts as a growth hormone making it very important for our health and metabolism. Lack of sleep also plays a role in the reduction of our normal growth hormone secretion. Nonexercise related release of growth hormone is secreted the most during overnight sleep so you can see why the lack of sleep becomes a problem. Growth hormone is a substance in our body that helps build muscle and break down fat amongst many other things. Lack of sleep has also shown to increase cortisol which can cause you to break down muscle and increase your appetite. While we have discussed some of the fitness related concerns with lack of sleep some of effects on your health are much more grim. In multiple studies lack of sleep has been linked to cardiovascular disease (heart attacks), stroke, and hypertension (high blood pressure.)

With all this in mind it’s best to aim for most adults aim for 7-9 hours of sleep if you can. Some older adults (>65) may require a bit less while teens require closer to 8-10 hours of sleep per night. Sometimes missing sleep is unavoidable due to your schedule and work. If you want to reach your goals faster you should try and make sleep more of a priority if you don’t.

For those of you who have a hard time sleeping here are a few tips that will help you avoid a lack of sleep.

  1. Don’t oversleep if you feel rested get out of bed.
  2. Have a set time to go to bed and wake up.
  3. Avoid forcing sleep
  4. Get good exercise each day and if possible not within 4-5 hours of bedtime
  5. Avoid caffeine after lunch
  6. No alcohol near bedtime, it may help you fall asleep but the sleep will be lower quality and you may be prone to waking up in the middle of the night.
  7. Avoid smoking, especially in the evening.
  8. Don’t go to bed hungry
  9. Adjust the bedroom environment, no TV, cooler temperatures, avoid lights (cell phones)
  10. Try to deal with worries and concerns before laying down, make a list if you need to for problems to focus on the next day.
Sources for lack of sleep:

Sufficient sleep duration contributes to lower cardiovascular disease risk in addition to four traditional lifestyle factors: the MORGEN study. 

Sleep duration and cardiovascular disease: results from the National Health Interview Survey.

Association between sleep and blood pressure in midlife: the CARDIA sleep study.

Spiegel K, Leproult R, Van Cauter E. Impact of sleep debt on metabolic and endocrine function. 

Spiegel K, Tasali E, Penev P, Van Cauter E. Brief communication: sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. 

Recommended amount of sleep for pediatric populations: A statement of the American Academy of Sleep Medicine.

Recommended amount of sleep for a healthy adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society. 

Impact of sleep debt on metabolic and endocrine function