Strength Training Ain't For Women, One Set is Not Enough and Without a 100% Dialed in Diet Lifting Weights is Useless, Anyways - Really!?

Image 1: Minimalist strength training for maximal results? In the long run even a one set strength circuit can elicit astonishing changes, if you train consistently, progressively, heavy and with picture perfect form (image Paramount Fitness).

Unconventional wisdom days at the SuppVersity: After yesterdays "news" (I hope it was not real news for the majority of you) about the superiority of high intensity interval over classic steady state cardio in at the lower end of the "fat burning zone", today's news is going to cause a couple of other set-in stone paradigms to totter:

1. resistance training ain't for women
2. low volume resistance training won't help you lose body fat
3. resistance training requires a high protein diet to work

The respective data comes from a recently published study by R. Washburn and his colleagues from the Center for Physical Activity and Weight Management at the University of Kansas and researchers from the Southern Illinois University and the Birgham Young University (Washburn. 2012).

Minimal effort, maximal adherence, ...

In their 6-month intervention trial, Washburn and his colleagues set out to evaluate the effect of a minimalist resistance training routine consisting of no more than a single set of 9 different exercises that had to performed three times per week. The sessions were supervised and the participants, overweight young men and women in their early twenties (BMI 27.2kg/m²; age 20.7y; BF% by DEXA 27.6% men, 38.9% women) performed all their exercises on standard gym equipment (Paramount Fitness, not a sponsor of the study!); an adherence of >90% was required and the supervisors made sure that all exercises were performed in the prescribed 3-6RM (85% of 1RM) with a cadence of 2s for the concentric and 4s for the eccentric period of each exercise with picture perfect form:

Tip for advanced beginners You are already training for 4-6 months? Why don't you add in a 2nd circle, 1s concentric, 2-3s eccentric, in the 8-12 rep range. I don't need a scientific study to confirm that this will be able to propel your gains. And with a couple of tweaks to your diet, e.g. 20g of quality protein with every meal and a reduced carbohydrate intake (~25-35% of total energy or 120-250g of carbs) from whole food sources, only, it won't take too long very long to see visible results.
• chest press,
• back extensions,
• lat pull down,
• triceps extensions,
• shoulder press, 
• leg press, 
• calf raise,
• leg curl,
• crunch

Whenever subjects were able to perform more than the required 6 repetitions with good form the resistance was increased by ~2.25kg. In other words the participants followed a stupidly simple linear progression protocol with a clear focus on strength, an ultra-low volume (per muscle group) and picture perfect form.

... results despite unaltered and obviously obesogenic eating habits

Dietary intake before and during the 6-month study period was assessed, I quote, "during one randomly selected period" each month (24hr food recalls on 2 weekdays and one day on the weekend, each) and remained at ~2300kcal. The majority of the daily energy intake came from carbohydrates (51% ~290g) and fats (33% ~95g), while the protein intake (16% ~92g) despite being at the upper level of the RDA would be considered "borderline deficient" from the perspective of most strength trainees.
Note: It stands to reason that a higher protein intake of ~120g+ could have had beneficial effects on strength gains and changes in body composition. Notwithstanding, the results of this study do confirm that not everything that has been shown to facilitate gains is actually necessary and protein intakes in the >3g/kg body weight range, despite not being as bad for your health as the medical orthodoxy would have it, will offer little to no marginal utility and may even turn against you, when you keep upping your protein intake at the expense of more readily available energy sources such as carbohydrates and fats so that the lion's share of your energy has to be derived from dietary protein via glyconeogenesis... add an energetically demanding training program on top of this, call it either adrenal fatigue or central fatigue syndrome and join the other obstinate whiners on the various overtraining, ah... I mean fitness and bodybuilding boards on the Internet.
Without any cardiovascular training, not a single change in their obviously unhealthy dietary habits (why else would these young men and women have become overweight in the first place?) the 37 formerly sedentary twens in the resistance training (RT) training arm of the study derived non-negligible benefits from their weekly workouts:

Figure 1: Changes in BMI, fat free mass (FFM) and fat mass (FM) in male and female study participants in the control and resistance training arm of the 6-months exercise-only single-set circuit training (9 exercises total, 3 training sessions per week) intervention (data based on Washburn. 2012)

I mean, as disappointing as the non-existent weight loss may seem in a society, where the majority of people is so fixated on nondescript figures on a scale, you can hardly argue that

• increasing your muscle mass by +1.5kg,
• decreasing your fat mass (women), or at least 
• ameliorating your fat gains (men) 

would not be better than losing muscle and becoming fatter and fatter as it happened to the subjects in the control arm, right? And that the anti-obesity (as defined by too much body fat, not too much body weight) effects were more pronounced in the 15 women than in their male peers goes to show you that exactly those people (=women ;-) who usually don't lift weights will benefit most from hopping of their steppers, treadmills and recumbent bikes three times a week to do nothing but a single full-body strength circuit.

Training is a nutrient repartitioner, but if the diet does not deliver those the results are suboptimal

These unquestionably favorable (compared to the sedentary control), yet hardly earth shattering results would certainly have been way more impressive, if the study participants had made appropriate changes to their diets. For most of them, it would probably have been enough to simply switch from fast-, fried- away-from-home- and ready-made foods to self-prepared meals, to double, if not triple their results (cf. Taveras. 2005; Wosje. 2010; see also red box below). With the aforementioned tip to get at least 20g of lean protein with every meal and a progression not just on the weight, but also on the volume side of things (yet to no more than 2-3 circles per training, cf. Van Etten, 1997; Shaibi. 2006; Shaw. 2006), the same simplistic full-body circuit would certainly have had a much greater impact on the chubby physiques of the soon-to-be obese type II diabetics.
Food quality? It is quite interesting that both Taveras and Wosje identify fried foods as especially problematic for children and adolescents (Taveras. 2005; Wosje. 2010). And while those were related to higher body fat levels, another common scapegoat, processed meat, showed a clearcut and unquestionably beneficial relation to high bone mass in the Wosje study (Wosje. 2010). On the other hand, dark-green and deep-yellow vegetables (eg, spinach, romaine lettuce, broccoli, carrots, and sweet potatoes), though not something you will usually see among the favorite dishes of most kids, adolescents and college students, would probably have prevented the twens in the Washburn study from being eligible to participate in the trial, in the first place. Why? Well, the BMI and, more importantly, the body fat levels of the veggie (+meat ;-) eaters would probably have been way below the obesity cut-off for the Washburn study.
If there was a single take home message from this study, one that probably won't apply to you, a seasoned physical culturist and avid trainee, though, but maybe for your sedentary niece or nephew, it would unquestionably be that physical culture does not start at the Olympia level and that doing something is better than surrendering to your "bad genes", the greatest influence of which oftentimes is inherited laziness and the stubborn adherence to a lifestyle of which even young adults should know that it will get them right into the clutches of the pharmocracy.

References:

1. Shaibi GQ, Cruz ML, Ball GD, Weigensberg MJ, Salem GJ, Crespo NC, Goran MI. Effects of resistance training on insulin sensitivity in overweight Latino adolescent males. Med Sci Sports Exerc. 2006 Jul;38(7):1208-15. 
2. Shaw I, Shaw BS. Consequence of resistance training on body composition and coronary artery disease risk. Cardiovasc J S Afr. 2006 May-Jun;17(3):111-6. 
3. Taveras EM, Berkey CS, Rifas-Shiman SL, Ludwig DS, Rockett HR, Field AE, Colditz GA, Gillman MW. Association of consumption of fried food away from home with body mass index and diet quality in older children and adolescents. Pediatrics. 2005 Oct;116(4):e518-24. 
4. Van Etten LM, Westerterp KR, Verstappen FT, Boon BJ, Saris WH. Effect of an 18-wk weight-training program on energy expenditure and physical activity. J Appl Physiol. 1997 Jan;82(1):298-304.  
5. Washburn RA, Kirk EP, Smith BK, Honas JJ, Lecheminant JD, Bailey BW, Donnelly JE. One set resistance training: effect on body composition in overweight young adults. J Sports Med Phys Fitness. 2012 Jun;52(3):273.
6. Wosje KS, Khoury PR, Claytor RP, Copeland KA, Hornung RW, Daniels SR, Kalkwarf HJ. Dietary patterns associated with fat and bone mass in young children. Am J Clin Nutr. 2010 Aug;92(2):294-303. Epub 2010 Jun 2.

Three is More Than One: Higher Volume Increases Strength Gains in Legs, and Satellite Cell Recruitment and Fiber Size in Legs & Traps. Plus: Data on Myostatin, IGF1, MGF & Co.

Image 1: The green dots that are crowding left and right from the blue myonucleus are the satellite cells (Hanssen. 2012)

In case you are not really sure what a "satellite cell" is and why you should care abouts it's "recruitment", you have probably missed the Intermittent Thoughts on Building Muscle series and should get into detention. Otherwise, here is the news: In a study that has been published in the latest issue of the Scandinavian Journal of Medicine in Sports Science T.S. Hanssen et al. published a paper with the auspicious title "The effect of strength training volume on satellite cells, myogenic regulatory factors, and growth factors" (Hanssen. 2012). Exactly that kind of study that would have the potential to take the mostly common or bro-sensical reasoning behind the current recommendations on training volume to the next, a scientific level, if it the scientists would finally realize that strength training noobs are hardly a better model for advanced trainees than rodents :o(

Full body training 3x /week: How many sets are optimal?

For their study, Hanssen et al. recruited twenty two healthy untrained men (age 26.5y; height: 181.8cm; weight: 81kg) and assigned them to one out of two full-body workouts, with identical exercises (leg press, leg extension, leg curl, seated chest press, seated rowing, latissimus pull-down, biceps curl, and shoulder press), but different amounts of sets for a given body part:

• 3x Legs & 1x Upper Body: Trainees in this group performed 3 sets for each of the leg exercises and 1 set for the upper body exercises
   
• 1x Legs & 3x Upper Body: Trainees in this group performed 1 set for each of the leg exercises and 3 sets for each of the upper body exercises

All subjects started out with 10 reps per set in the first two week. In weeks 3-6, the intensity was increased to 8RM and in the last 5 weeks (7-11) all participants trained at their "7-rep max":

Participants were encouraged to continuously increase their RM loads during the intervention and they were allowed assistance on the last repetition.

In addition to the three strength training sessions per week, the participants were allowed to perform one (not more!) additional steady-state cardio session. And while this may help with standardization, my mathematical skills tell me that the 3L-1UB group performed only 14 sets per workout, while the 1L-3UB group performed 18 sets, simply because the number of lower and upper body exercises was not identical. Now, everyone who does not claim that he or she does not need to train legs (for whatever stupid reason) will know leg training is much more draining than upper body workouts, so "intensity-wise" the workouts were probably still identical.

Single vs. multiple-set training? Nothing new or exciting if it was not for the specific data

We have seen similar studies before - most of them with the same, very unfortunate limitation of being performed on strength training novices, by the way - and the results of this study would hardly be exciting, if it were not for the sheer amount of data Hansson et al. recorded:

Image 2: If those acronyms don't ring a bell, click here to learn more.

• muscle strength and muscle fiber size,
  
  
• the number of satellite cells and number of satellite cells positive for myogenin and MyoD,
   
• the number of myonuclei, myogenin and MyoD content of muscle samples, and
  
  
• myostatin and a whole host of growth factors, namely IGF-1, MGF, HGF, FGF2 and VEGF

This is what I call a "comprehensive" analysis ;-) And one which brought about some pretty interesting results, of which the increases in muscle strength and fiber size are unquestionably the most straight-forward and least surprising ones (cf. figure 1):

Figure 1: Changes in 1RM strength and fiber area after 11 weeks on the training regimen with different set schemes (data calculated based on Hanssen. 2012)

As you can see in figure 1 strength-wise, only the leg (m. vastus lateralis), yet not the back (trapezius) muscle benefited from the increased training volume. When you do take a look at the fiber size, however, it becomes obvious that as long as we compare 1 vs. 3 sets more is actually more +24%, to be precise (the 4% difference for the fiber size in the legs is statistically non-significant).

Figure 2: Relative changes in myonuclei number per muscle fiber and the number of satellite cells after 2 and 11 (post) weeks of the training intervention (data calculated based on Hanssen. 2012)

If you also take into account that the data in figure 2 clearly shows that an increase in training volume leads to increased satellite cell recruitment (indicated by the increases in the number of myonuclei per muscle fiber) and number, it becomes obvious that you are missing out on the growth promoting effects of strength training. The decrease in myonuclei per muscle fiber in the latter 9 weeks of the training intervention in the low volume upper body group (dark red bars in figure 2) would also suggest that this is particularly true for the experience strength trainee in whom the initial 2-week growth spurt of which Hansson et al. state that it was one of their two "main observations":

The novel finding in our study was the early increase in the proportion of activated satellite cells, the early increase in total number of satellite cells and the dependence on training volume in the leg muscle. The number of activated satellite cells, indicated by myoD and myogenin expression, increased from ~2% before training to 6–10% 2 weeks into the intervention.

So as "novel" as this finding may be, it is still somewhat unsatisfying for experienced strength trainees, who will have to rely on the hypothesis that their response will be an ameliorated version of the "late" growth response in the study at hand, which would support my personal observation that 3x3 i.e. three exercises à three sets per body part is at the lower end of the "optimal" volume continuum for advanced trainees. A volume continuum, by the way, that is capped at 12-15 sets for the largest body parst, i.e. legs and back and does by no means extent into the "insanity realm", where people perform 20 sets for biceps and 20 working  sets for triceps on a 5-day body-part split.

Surprise: No statistical significant differences in growth factors

What I found quite surprising though, is that this advantage of 3- vs. 1-set training was not reflected by greater increases in myostatin and/or MGF (want to know more about MGF, click here for the pertinent installment of the Intermittent Thoughts). MGF was even higher in the vastus of the 1 set group and the smaller incline in myostatin levels in the 3-set group (1.1x vs. 1.8x) did not reach statistical significance.

Figure 3: Changes in mRNA levels of myostatin, IGF-1, MGF, HGF, FGF2, and VEGF in the 10 subjects with the largest satellite cell response (seven from 3L-1UB and three from 1L-3UB; data adapted from Hanssen. 2012)

If we do yet take a look at the changes in mRNA levels of myostatin, IGF-1, MGF, HGF (hepatocyte growth factor; growth factor for satellite cells, cf. Sheehan. 2000), FGF2 (fibroblast growth factor; promotes cell adhesion and proliferation, as well as the build up of callege, cf. Yun. 2012) and VEGF (cf. figure 3) in the 10 subjects with the largest satellite cell response (seven from 3L-1UB and three from 1L-3UB), we do see that all but myostatin and VEGF were statistically significantly elevated above baseline. These results stand in line with the main message of the Intermittent Thoughts which was that it is the interaction of a whole host of "hormones" (and peptides) that "builds muscle" - and not as the producers of a certain category of 100% useless "all-natural" supplements want to make you believe, testosterone (or any other growth factor) alone.

And while it was to be expected that the expression of those growth factors would decline over the course of the 11-week intervention period, I am honestly wondering, whether the decrease in reps from 10 (initial two weeks) to 8 and subsequently 7 reps per set had anything to do with it... but I guess, this is an issue for the next study, about which, you will read nowhere else than right here, at the SuppVersity, the place where bro- and pro-science unite in the spirit of true wisdom - but I guess you know that by now, don't you? ;-)