VOLUME 6, ISSUE 3 MARCH 2022 M A S S MONTHLY APPLICATIONS IN STRENGTH SPORT ERIC HELMS | GREG NUCKOLS | MICHAEL ZOURDOS | ERIC TREXLER The Reviewers Eric Helms Eric Helms is a coach, athlete, author, and educator. He is a coach for drug-free strength and physique competitors at all levels as a part of team 3D Muscle Journey where he is also the Chief Science Officer. Eric regularly publishes peer-reviewed articles in exercise science and nutrition journals on physique and strength sport, in addition to contributing to the 3DMJ blog. He’s taught undergraduate- and graduate-level nutrition and exercise science and speaks internationally at academic and commercial conferences. He has a B.S. in fitness and wellness, an M.S. in exercise science, a second Master’s in sports nutrition, a Ph.D. in strength and conditioning, and is a research fellow for the Sports Performance Research Institute New Zealand at Auckland University of Technology. Eric earned pro status as a natural bodybuilder with the PNBA in 2011 and competes in numerous strength sports. Greg Nuckols Greg Nuckols has over a decade of experience under the bar and a B.S. in exercise and sports science. Greg earned his M.A. in exercise and sport science from the University of North Carolina at Chapel Hill. He’s held three all-time world records in powerlifting in the 220lb and 242lb classes. He’s trained hundreds of athletes and regular folks, both online and in-person. He’s written for many of the major magazines and websites in the fitness industry, including Men’s Health, Men’s Fitness, Muscle & Fitness, Bodybuilding.com, T-Nation, and Schwarzenegger.com. Furthermore, he’s had the opportunity to work with and learn from numerous record holders, champion athletes, and collegiate and professional strength and conditioning coaches through his previous job as Chief Content Director for Juggernaut Training Systems and current full-time work on StrongerByScience.com. Michael C. Zourdos Michael (Mike) C. Zourdos, Ph.D., CSCS, has specializations in strength and conditioning and skeletal muscle physiology. He earned his Ph.D. in exercise physiology from The Florida State University (FSU) in 2012 under the guidance of Dr. Jeong-Su Kim. Prior to attending FSU, Mike received his B.S. in exercise science from Marietta College and M.S. in applied health physiology from Salisbury University. Mike served as the head powerlifting coach of FSU’s 2011 and 2012 state championship teams. He also competes as a powerlifter in the USAPL, and among his best competition lifts is a 230kg (507lbs) raw squat at a body weight of 76kg. Mike owns the company Training Revolution, LLC., where he has coached more than 100 lifters, including a USAPL open division national champion. Eric Trexler Eric Trexler is a pro natural bodybuilder and a sports nutrition researcher. Eric has a PhD in Human Movement Science from UNC Chapel Hill, and has published dozens of peer-reviewed research papers on various exercise and nutrition strategies for getting bigger, stronger, and leaner. In addition, Eric has several years of University-level teaching experience, and has been involved in coaching since 2009. Eric is the Director of Education at Stronger By Science. Table of Contents 6 B Y G R E G N U C K O L S An External Attentional Focus Helps You Crank Out More Reps When discussing attentional focus, we’re generally interested in the impact of attentional focus on maximal strength or power performance. However, a recent meta- analysis suggests that adopting an external attentional focus can also acutely increase your strength endurance, which is far more relevant for normal training contexts. 16 B Y M I C H A E L C . Z O U R D O S Is Training Twice a Day For You? High-volume training to failure causes the number of reps performed or load lifted to decrease substantially from the first to last set. This article breaks down a new study investigating if splitting volume into two sessions allows lifters to maintain a higher load than packing all sets into one session. 30 B Y E R I C H E L M S Autoregulation is Effective, but it isn't Magic We regularly discuss autoregulation favorably, but it isn’t a panacea. A recent meta- analysis on autoregulation reported positive findings, but nothing crazy. Read and learn what autoregulation can and can’t do, and why it hasn’t been a complete game changer thus far. 45 B Y E R I C T R E X L E R Is Extra-High Protein a Necessity for Body Recomposition? High-protein diets are widely embraced in the evidence-based fitness world. An increasingly common claim is that body recomposition goals (that is, simultaneous fat loss and muscle gain) demand extra-high protein intakes, but a new study appears to contradict this claim. 59 B Y M I C H A E L C . Z O U R D O S The Periodization Data Remain Positive A 2017 meta-analysis found that periodized training led to greater strength gains than non-periodized training. A new meta-analysis explored if the previous findings hold up, if periodization style matters, and if periodization impacts hypertrophy. 78 B Y E R I C T R E X L E R Extrapolating From Short-Term Adaptations and Proxy Measures: A Dangerous Game Polyphenol supplements can acutely accelerate recovery, and protein supplementation can boost muscle protein synthesis. A new longitudinal study sought to determine if combined supplementation would pay off in the long run, but the results were underwhelming. 92 B Y G R E G N U C K O L S & E R I C T R E X L E R Research Briefs In the Research Briefs section, Greg Nuckols and Eric Trexler share quick summaries of recent studies. Briefs are short and sweet, skimmable, and focused on the need-to-know information from each study. 131 B Y M I C H A E L C . Z O U R D O S VIDEO: Time-Efficient Programming Strategies Part 1 Unfortunately, life gets in the way of training, sometimes leaving less time to train. In these cases, lifters can use various time-efficient programming strategies to maintain the appropriate configuration and dosage of training variables. This video discusses those time-efficient strategies and provides specific examples of putting them into practice. 133 B Y E R I C H E L M S VIDEO: Resistance Training Performance Testing MASS readers regularly read resistance training research, but most haven’t been in an exercise science lab. This can make the specific methods hard to understand, and subsequently, the relevance of the findings difficult to interpret. In this video Dr. Helms covers the most common performance testing methods typically used in resistance training research, discussing how they work, what they measure, what they mean, their limitations and normative ranges. Letter From the Reviewers W elcome to the March 2022 issue of MASS, Volume 6 Issue 3. This month we’ve got a lot of good stuff in store. To kick things off, the research briefs span a variety of interesting topics. On the nutrition front, Dr. Trexler covers meal regularity, collagen protein supplementation, eating only one meal-a-day, and the importance of digestion speed for peri-workout protein. Additionally, Greg’s research briefs cover how to estimate energy expenditure from lifting, the impact of powerlifting on joint range of motion, the “typical” progression of strength in a powerlifting career, and a new study on the interaction of training to failure with low-load training. Moving onto our full reviews, in the training department Dr. Zourdos reviews a new meta-analysis that is a perfect fit for MASS, as it assesses the effect of periodization on strength and hypertrophy. For Greg’s full review this month, he writes about a new study on how attentional focus impacts strength endurance, discussing where your focus should be if you want to eke out a few more reps. In his second article, Dr. Zoudos covers a new study on two-a-day training, prompting a discussion of creative ways to use the concept to preserve training quality, and in some cases, even save time. Finally, Dr. Helms gets back to his PhD roots, reviewing a newly published meta-analysis on the effects of autoregulation on strength and hypertrophy, and you can see him manage his existential crisis prompted by the findings before your eyes. Just next door, Dr. Trexler enjoyed the rare peace and quiet while writing his two nutrition articles this month, as Dr. Helms was on loan to the training department. In Trex’s first review, he covers the combined effects of protein and polyphenol supplementation on hypertrophy, total work, and muscle protein synthesis, helping the reader navigate why sometimes proxy measures don’t line up with what they are supposed to predict. In his second review, Eric uses a new study on the effects of various protein doses on body recomposition to address the claim that very high protein intakes are a required element of successful body recomp protocols. In the video department, Drs. Helms and Zourdos complemented each other with one practical and one informative video. In the former, Mike dives deep on how to save time by increasing training efficiency, without sacrificing the stimulus, a great video for all you busy folks out there. For the latter video, Eric goes through some of the most common performance testing methods in resistance training research, detailing what they measure, how they work, normative ranges, and the limitations for each, to help the watcher better interpret studies they read in the future. Going on a long drive or walk? Check out the audio roundtables for our main reviews. After, join us in the Facebook group to discuss them. Trainers, behind on your continuing education? Don’t forget we have CEC/CEU quizzes available for NSCA, ACSM, NASM, and ACE practitioners. We hope you have a great month, and we appreciate you for being a part of MASS! Thanks, The MASS Team Eric Helms, Greg Nuckols, Mike Zourdos, and Eric Trexler 5 Study Reviewed: Effects of Attentional Focus on Muscular Endurance: A Meta-Analysis. Grgic and Mikulic (2021) An External Attentional Focus Helps You Crank Out More Reps BY GREG NUCKOLS When discussing attentional focus, we’re generally interested in the impact of attentional focus on maximal strength or power performance. However, a recent meta-analysis suggests that adopting an external attentional focus can also acutely increase your strength endurance, which is far more relevant for normal training contexts. 6 KEY POINTS 1. Researchers identified all of the crossover studies investigating the impact of adopting an internal attentional focus versus an external attentional focus on muscular endurance – the amount of reps that could be performed during a set to failure. 2. An external attentional focus led to greater muscular endurance than an internal attentional focus. The difference between the two conditions was larger for lower body exercises than upper body exercises. 3. If you want to maximize your rep performance during training, adopting an external attentional focus seems to be ideal. A ttentional focus was one of the first that means you focus on lifting explosively topics we covered in MASS – you and simply moving the bar from point A to can find our first article on the sub- point B (for example, the classic “throw the ject in the second issue (2). When you adopt bar through the ceiling” cue for bench press). an internal attentional focus, you intention- You can see the general characteristics of in- ally focus on one aspect or component of a ternal and external cueing in Table 1. movement. For example, you may focus on A recent research brief discussed a meta-anal- contracting one of the prime movers for a ysis which found that an external attentional particular exercise, or focus on maintaining focus improved maximal strength acutely, a particular joint positioning or body posture as well as longitudinal strength development during an exercise. When you adopt an exter- (3). However, we haven’t focused much on nal attentional focus, you focus on the out- the impact of attentional focus on rep perfor- come of a movement. More often than not, mance, which might be more relevant for day- 7 to-day training. A new meta-analysis fills that Scopus, SportDiscus, and Web of Science) to gap (1), examining all of the crossover stud- find all of the studies that met these criteria: ies that investigated the effect of attentional 1. The study needed to be published in En- focus on muscular endurance (the number glish. of reps subjects could perform during a set to failure). This meta-analysis found that an 2. The study needed to employ a crossover external attentional focus led to greater rep design. performance than either an internal focus or 3. The study needed to compare the effects control (no experimental cueing) condition, of adopting an internal attentional focus whereas an internal focus led to performance that was comparable to control conditions. versus an external attentional focus on Furthermore, an external attentional focus muscular endurance. seemed to be more beneficial for lower body 4. The study needed to employ an isotonic exercises than upper body exercises. Read test (i.e., normal resistance training exer- on to learn more about why an external at- cises using free weights or bodyweight; tentional focus leads to greater muscular en- tests on isokinetic or isometric dynamom- durance, how the effect may be different for eters were excluded), in which muscular different types of exercise, and what these endurance was quantified as reps com- results mean for people with strength versus pleted during a set to failure. hypertrophy-related goals. After identifying the studies that met these in- Purpose and Hypotheses clusion criteria, the researchers extracted all Purpose of the necessary data to calculate standard- ized effect sizes (Cohen’s d), and perform a The purpose of this meta-analysis was to ex- series of random-effects meta-analyses (an amine the effects of adopting an internal ver- appropriate choice for this particular study) sus external focus on muscular endurance. comparing internal focus to external focus, Hypotheses internal focus to control conditions, and ex- As is standard for meta-analyses, no hypoth- ternal focus to control conditions. They also esis was stated. performed sub-analyses to see if the results of their main meta-analyses persisted when Methods separately analyzing results on upper body exercises and lower body exercises. Fur- Meta-analyses begin with a systematic litera- thermore, they appraised the risk of bias and ture search to find all of the studies that meet methodological quality of the studies using the researchers’ inclusion criteria. For this the PEDro checklist. meta-analysis, the authors searched five da- tabases (Networked Digital Library of The- ses and Dissertations, Pubmed/MEDLINE, 8 muscular endurance (d = 0.58; p = 0.001). Findings The sub-analyses found that this difference remained significant when examining both Five studies met the researchers’ inclusion upper body exercises (d = 0.53; p = 0.0003) criteria. One of the studies tested male and and lower body exercises (d = 1.36; p = 0.01). female subjects separately, and one of the You can see these results in Figure 1. studies reported on two separate experiments. So, in total, the meta-analysis included 141 The meta-analysis comparing external at- subjects (24 females and 117 males), and in- tentional focus versus control conditions (no volved seven groups of subjects. All of the cueing for the purpose of affecting attention- studies used multi-joint exercises (push-ups, al focus) found that adopting an external at- bench press, squat, and deadlift), and four of tentional focus led to greater muscular endur- the five studies used trained subjects. All of ance (d = 0.42; p = 0.01). The sub-analyses the studies assessed muscular endurance us- found that this difference remained signifi- ing a single set performed to failure. Finally, cant when examining lower body exercises all of the studies received PEDro scores of 5 (d = 0.95; p = 0.01), but the difference fell or 6, indicating “fair” to “good” methodolog- just below the standard bar for statistical sig- ical quality. Characteristics of the included nificance when examining upper body exer- studies can be seen in Table 2. cises (d = 0.39; p = 0.06). You can see these results in Figure 2. The meta-analysis directly comparing exter- nal versus internal focus found that adopting Finally, the meta-analysis comparing internal an external attentional focus led to greater attentional focus versus control conditions 9 found that the two conditions did not result evant in most day-to-day resistance training in significantly different muscular endurance contexts. You may only max once every few outcomes; this held true for both upper- and months, but you’re likely frequently making lower-body exercises (p = 0.14-0.41 for all decisions about load selection and progres- comparisons). You can see these results in sion based on how many reps you can per- Figure 3. form with submaximal loads. This meta-analysis found that an external at- Interpretation tentional focus significantly and reliably im- proves strength endurance performance (1). This isn’t the first time we’ve discussed at- Not only did the pooled effect size favor an tentional focus in MASS. Previous articles have covered the impact of attentional focus on muscle EMG (4), the impact of attentional THIS META-ANALYSIS focus on muscle growth (5), and a recent re- search brief looked at the impact of attention- FOUND THAT AN EXTERNAL al focus on strength gains (3). However, this ATTENTIONAL FOCUS is the first time we’ve specifically focused on the impact of attentional focus on strength SIGNIFICANTLY AND RELIABLY endurance. While most MASS readers prob- IMPROVES STRENGTH ably ultimately care more about improving their 1RMs than eeking out an extra rep with ENDURANCE PERFORMANCE. a particular load, strength endurance perfor- mance is the sort of metric that’s the most rel- 10