BIABRAIN

VOLUME HISTORY AND

MUSCLE GROWTH
SINGLE SET EXERCISE
FOR MUSCLE GROWTH

DOES METABOLIC
ADAPTATION PREDICT INTERMITTENT VS.
WEIGHT LOSS SUCCESS? CONTINUOUS CALORIC
RESTRICTION FOR FAT
LOSS
TABLE OF
CONTENTS

TOPIC 01 2

Volume History and Muscle Growth

TOPIC 02 9

Single Set Exercise for Muscle

Growth

TOPIC 03 18

Does Metabolic Adaptation Predict

Weight Loss Success?

TOPIC 04 24
Intermittent Vs. Continuous Caloric
Restriction For Fat Loss

REFERENCES 31
2
 TOPIC 1 | ISSUE 7

Paper Overview
In the last issue of BiaBrain, Issue 6, we covered a paper that examined adaptations to maintenance or
increased training volume in resistance trained individuals.¹ This study demonstrated that muscle
growth in the biceps was similar between a group that performed their baseline training volume and ,

the group that increased their training volume by 2 working sets per training session.¹ Despite this, the
scientific community has placed a great deal of emphasis on baseline training volume as a factor that
needs to be considered in the context of a resistance training program. The primary rationale here is
that individuals who experience a sudden increase in their training volume, are more likely to
experience muscle growth compared to individuals who are performing the same or a lower training
volume once enrolled in a resistance training study.

Presently, there is inconsistent data regarding the impact of baseline (sometimes referred to as
maintenance) training volume on muscle growth outcomes. For example, Scarpelli et al.² found that
increasing an individual's weekly set volume by 20% compared to a standardized training volume led to
greater muscle growth in the quadriceps. Authors observed increases of 9.9% and 6.2% in the vastus
lateralis for the individualized and standardized volume training conditions respectively. In contrast to
this, Ostrowski et al.³ observed similar muscle growth adaptations amongst low, moderate and high
volume training conditions, where it was speculated that the low and moderate training groups
experienced a decrease in training volume relative to participants baseline training volume. Aube et al.⁴
observed no significant changes in quadriceps muscle thickness after adjusting training volumes based
on baseline training volume, even with significant volume increases of up to 100%. These data are
joined by the findings of Moreno et al.¹ whom demonstrated that baseline training volume in the biceps
resulted in similar muscle growth when compared to a group that increased training volume (increase
by 2 sets per session) over a 12-week time period. Altogether, there is inconsistent evidence for
increased baseline training volume being an important factor for muscle growth outcomes. If anything,
one may argue that the evidence leans towards baseline volume not being an important consideration
in hypertrophy research.

With the present landscape in mind, the present study being reviewed sought to examine adaptations
to two different individualized resistance training volumes, based on participants' prior weekly set
number. The authors compared changes in muscle thickness, strength, and repetitions to failure in
resistance trained individuals compared to a control group that maintained their normal weekly set
volume.

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 TOPIC 1 | ISSUE 7

Methods: What did

they do?
Authors employed a parallel group repeated measures design (Parallel group design simply means the
study involves two or more groups of participants, each exposed to a different condition or treatment,
while repeated measures design simply means that within each group, the same participants are ,

measured multiple times (e.g., at baseline, mid-study, and post-study). Participants were recruited and
placed into one of three different groups, based on baseline quadriceps muscle size. The three training
conditions were as follows:

1. Control is offset more than G30 and G60

2. G30: Increasing their weekly sets by 30%
3. G60: Increasing their weekly sets by 60%

Changes in muscle size, maximal strength, and repetitions to failure were measured pre and post
intervention. Participants trained twice a week for a period of 8-weeks. The exercises included are
provided in Table 1.1 ,

A total of 55 resistance trained participants were recruited for the present study. The participants
were required to have 3 years of resistance training experience and be able to squat 1.5x their body
weight. Participants completed a training log over a three-week period prior to the intervention to
determine what their “maintenance” volume would be. Participants were asked to not perform any
additional lower body exercise outside of the study. In order to reduce drop-outs, the researchers also
prescribed a posterior lower body training program that was to be performed outside of the lab. This
program included the Romanian deadlift and the glute-ham raise exercises. For the quadriceps
exercises, volume was evenly distributed amongst the three exercises included, the squat, leg press
and leg extension. For the repetition scheme, the authors had individuals alternate between lower-
repetition days (e.g., 6-8 reps) and higher rep days (e.g., 12-15 reps). Exercise sets were terminated
when the participants had reached 2 repetitions in reserve (RIR). 2 minutes of rest was allowed
between exercise sets. To ensure post-training nutrition, participants were provided a protein shake
that contained 22 g of protein and 2 g of carbohydrate.

Table 1.1: Exercises Included

Exercises Included in Intervention

1. Squat

2 Leg Press

3 Leg Extension

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 TOPIC 1 | ISSUE 7

Muscle Thickness Measurements

Muscle growth was examined using muscle size measures derived from B-mode ultrasound.
,
Measurements of muscle size were taken at 40% and 60% of femur length. The sum of both muscle
thickness sites was also used for further analysis.

Strength and Endurance

1RM back squat strength and lower body endurance in the squat exercise (repetitions to failure at 70%
1RM) were both measured pre and post intervention.

5
 TOPIC 1 | ISSUE 7

Results: What did

they find?
A total of 29 individuals completed the study
(control n = 10; G30 n = 10; G60 n = 9). There
were no significant differences in volume load
between groups. The total volume loads for
the groups were as follows: Control = 394,505
kg; G30 = 411,667 kg; and G60 = 496,328 kg.
The average weekly set numbers were 14, 19
and 24 for the control, G30 and G60 groups
respectively. Detailed results are provided
below.

Changes in Muscle Thickness

For changes in muscle thickness, there was a
main effect for time. In research, this means
that all groups increased muscle size similarly
across time. The average change for the
proximal site of the quadricep was 0.48 cm
and the average change at the distal site of
the quadricep was 0.38cm. For the sum of
muscle thickness measurements, the average
change was 0.87 cm.

1RM strength ,

For 1RM strength, all groups increased across

time (Estimated differences = 21.47kg). In
addition, there was a main effect for group,
with the control group demonstrating higher
values at all timepoints. This means that the
control group had greater strength at
baseline, but the lack of a statistical
interaction seems to suggest that the
intervention had a similar impact on strength.
In other words, the control group was stronger
when they entered the study and still stronger
once the study was complete.

Repetitions to failure
When assessing repetitions to failure in the
squat exercise for muscular endurance, the
G30 group showed a significantly greater
improvement (+5.4 reps) compared to the
control group (+0.13 reps) and the G60 group
(-0.41 reps).

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 TOPIC 1 | ISSUE 7

What does this data

mean for me?
Overall, these data seem to suggest that
increasing training volume by either 30% or 60%
in quadriceps exercises does not appear to
enhance muscle growth or strength adaptations
(in the sites that the researchers measured).
These results align with recent findings by Moreno
et al.¹, conducted in Dr. Sam Buckner's research
lab—one of our very own BiaBrain authors. This
study adds to a growing number of studies that
demonstrate that increasing training volume does
not increase muscle growth outcomes. There were
also similar changes in strength, with repetitions
to failure/muscular endurance increasing more in
the G30 group.

The three training groups, including the Control, G30 and G60, performed on average 14, 19 or 24
weekly sets. This would amount to 7, 9.5 or 12 sets of quads per training session (2x/week). Since the
volume was split between three different exercises, one would anticipate that the participants in the
control group were performing (on average) 2-3 sets per exercise per session. This may indicate the
majority of muscle growth potential is achieved with 2-3 working sets per exercise per training session.
Conversely, the G60 group performed (on average) 4 working sets per exercise per session. It is
interesting that this increase did not result in additional muscle growth and may simply be a reflection
that the overall baseline volume in this study was already sufficient. Of course, on an individual basis,
there may be a rationale for changing training volume for some individuals (as the baseline weekly set
volume in this study ranged substantially from as few as 6 weekly sets to 48 weekly sets).

Regarding strength outcomes, previous research has shown that very low training volumes can produce
similar strength adaptations to those achieved with higher-volume programs.⁵ The repetitions to
fatigue outcomes in this study are interesting and slightly more difficult to interpret. Overall,
endurance adaptations are difficult to predict in response to traditional resistance training in a
hypertrophy repetition range.

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 TOPIC 1 | ISSUE 7

Key Take-Away
Points:
Increasing weekly quadriceps training volume by either 30% or 60% did not impact muscle growth
outcomes over an 8-week time period in a trained population.

If sufficient volume is already being performed, increasing training volume will not have a meaningful
impact on muscle growth.

Increasing weekly quadriceps training volume by either 30% or 60% did not impact 1RM strength
outcomes in the squat exercise.

Muscular endurance as measured by repetitions in reserve was greatest in the 30% group.

8
9
 TOPIC 2 | ISSUE 7

Paper Overview
Resistance training volume is an area of great interest. In fact, this is a topic that seems to be covered
(in one form or another) in most all issues of BiaBrain. This month, we are covering a paper that
examines muscle growth on the lower end of the volume spectrum.⁶ Specifically, these authors were ,

interested in muscle growth adaptations to a single set training program that lent itself to relatively
low weekly set numbers in both the upper and lower body. In their introduction, the authors point out
that training with 2 repetitions in reserve (RIR) is generally considered sufficient for muscle
hypertrophy. However, the authors also note that this finding is based on multi-set training studies,
suggesting that training to failure may be more crucial when performing lower overall training volumes,
such as in a single set. Meta-analysis on this topic have typically recommended moderate to higher
volumes for maximizing muscle growth adaptations.⁷ So, this study sought to determine 1) Can muscle
growth occur with a lower volume training program? And 2) Is training to failure more important if
performing very low overall training volumes.

10
 TOPIC 2 | ISSUE 7

Methods: What Did the

Researchers Do?
The authors recruited 50 participants for the present study. Participants were randomized into one of
two experimental conditions: 1) A group that trained to failure and 2) a group that performed all the
same exercises with 2 RIR. Both groups performed one single set for each exercise. The ONLY ,

difference between both groups was training to failure or with 2 RIR. The exercises included in the
resistance training program are provided in table 2.1 below. Participants trained twice a week for a
duration of 8-weeks. During training sessions both groups performed each exercise at an 8-12
repetition maximum (RM). Two minutes of rest was allowed between exercises. The failure group was
verbally encouraged to take each set to voluntary failure (not able to complete the concentric portion
of the lift despite attempting to do so). For the 2RIR group, sets were terminated once the participant
had determined that they had reached the 2RIR target. Participants in this condition received no verbal
encouragement. If participants performed more than the goal repetition range (8-12), the training load
was adjusted for their next training session.

Table 2.1. Exercises Included in Training Program

Exercise

1. Front Lat Pulldown

2 Seated Cable Row

3 Machine Shoulder Press

4 Machine Chest Press

5 Cable Triceps Pushdown

6 Supinated Biceps Dumbbell Curl

7 Smith Squat

8 Plate Loaded Leg Press

9 Machine Leg Extension

11
 TOPIC 2 | ISSUE 7

Body Composition and Muscle Thickness

Body weight and body fat percentage were measured through an InBody scan. To examine muscle
growth, authors measured muscle thickness of four different muscles: 1) elbow flexors (biceps), 2) ,

elbow extensors (triceps), 3) mid-quadriceps (a composite of the rectus femoris and vastus
intermedius), and (4) lateral quadriceps (a composite of the vastus lateralis and vastus intermedius).
The biceps were measured 60% the distance of the upper arm, and the triceps were measured 50% the
distance of the upper arm. Quadriceps images were taken across the leg, at 30, 50 and 70% the
distance of the upper thigh.

Strength, Power and Endurance

Authors measured maximal one-repetition maximum (1RM) strength on the smith machine bench press
and smith machine back squat. Local muscular endurance was measured on the knee extension ,

exercise. To measure endurance, authors had individuals perform as many repetitions as possible using
a weight equal to 60% of the participant’s baseline bodyweight. Lower body power was assessed
through a counter movement jump (CMJ) assessment. All tests were performed pre and post
intervention.

Participants were asked to maintain their normal dietary habits throughout the study period. Dietary
food logs (5-day) were collected twice during the study period (1-week before the first training session
and again during the final week).

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 TOPIC 2 | ISSUE 7

Results: What did

they find?
Of the 50 participants enrolled in the study, 42 completed the intervention (23 in the failure group and
19 in the 2RIR group). When looking at muscle growth outcomes, the authors noted small-to-medium
changes in muscle thickness. The analysis tended to favor the failure condition, however from ,a
statistical perspective, there was not great certainty in this observation. Strength and endurance
adaptations were observed with no notable differences between groups. CMJ performance improved
from pre to post with no clear evidence of failure training being superior. Pre and post study values,
along with change scores are provided in table 2.2 below. Results for all anthropometric measures
(body mass, lean body mass, fat mass), were not provided in the results or supplementary files that we
were able to locate.

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 TOPIC 2 | ISSUE 7

Table 2.2: Results

Failure Group 2 RIR Group

Variable Pre Post Change Pre Post Change

1RM Squat (kg) 103.2 116.8 13.6 101.3 113.9 12.6

1RM Bench (kg) 78.3 83.7 5.4 72.2 76.8 4.6

CMJ (cm) 46.7 49.5 2.8 48.8 49.5 0.7

Endurance (reps) 16.7 22.0 5.3 19.1 23.4 4.3

Mid Quad 30% (mm) 52.3 55.3 3.7 53.2 55.0 1.7

Mid Quad 50% (mm) 44.9 48.6 3.7 44.6 46.3 1.7

Mid Quad 70% (mm) 34.9 38.2 3.3 35.1 36.7 1.6

Lateral Quad 30% (mm) 33.3 34.7 1.4 32.2 33.0 0.8

Lateral Quad 50% (mm) 38.4 40.8 2.4 36.7 38.4 1.7

Lateral Quad 70% (mm) 36.7 39.0 2.3 35.4 37.6 2.2

Biceps Brachii (mm) 37.4 38.4 1.0 35.8 37.4 1.6

Triceps Brachii (mm) 45.2 46.9 1.7 41.8 42.3 0.5

14
 TOPIC 2 | ISSUE 7

What does this

data mean for me?
This study originates from a research lab with a significant online social media presence. History has
shown that studies from such labs tend to have a larger impact, with more content created around
them compared to other research. This is one of the key reasons we felt it was important to review this,

study! So is one exercise set per exercise all you really need? How important is it to train to failure?
This paper provides some insight but needs to be interpreted in the context of other studies. We also
believe that there is a strong possibility of becoming confused….after all, there has been considerable
attention placed on the importance of training volume for maximizing muscle growth outcomes. For
example, the reader may recall a recent study which employed 52 weekly sets of exercise and gained
substantial attention on social media.⁸ In the present study, participants performed around 2-4 sets
for the biceps (depending on how you count volume, since they performed 1 set of biceps curls, seated
cable row and lat pulldown twice a week). In addition to this, they performed 2-4 sets of triceps
(triceps pushdown and chest press twice a week) and ~6 sets for quads (smith machine squat, leg
press and knee extension twice a week). What really strikes us as interesting, is the magnitude of
muscle growth observed in this study, despite the overall lower weekly volumes.

When examining the present study in the context of previous research, one thing that sticks out is the
fact that the muscle growth observed in this study is very robust. Considering that this study was
examining a “trained” sample, it is surprising that the magnitudes of muscle growth were so large. For,

example, a recent review (one by myself and Sam), concluded that the average change in muscle
thickness in the quads over an 8-12 week time-period tends to be around 0.1-.25 cm. The increase in
mid-thigh muscle thickness in the present study (for the failure group at the 50% site) was 0.37 cm. To
provide some contrast, Amirthalingam et al.⁹ examined a 0.11cm change in the anterior quad over 6-
weeks in response to a much larger weekly training volume of 24-weekly sets of quadriceps exercise.
Aube et al.⁴ observed a 0.15cm change in the 50% anterior thigh site with a similar weekly training
volume of 24 weekly sets. Table 2.3 is included to provide a comparison between these studies and the
present study so that the reader can make their own informed and educated evaluation on how to
weigh the present data. Regardless, we have to consider that other studies which have performed
drastically more volume have demonstrated much smaller magnitudes of growth. This raises questions
such as:

Questions

Do some labs employ such drastically different training techniques that results are not comparable
1.
between studies?

Do we need to include more control groups in research to better understand potential measurement
2
error?

3 Are researchers just not that good at measuring muscle growth?

4 Is it impossible to establish normative expectations for muscle growth?

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 TOPIC 2 | ISSUE 7

Table 2.3 – Muscle Growth Values Amongst Different Studies

,
Muscle Pre MTH Post MTH Change
Variable Weekly sets
Measured (cm) (cm) MTH (cm)

24 weekly Anterior Thigh

Amirthalingam et al. 5.33 5.44 0.11
Sets 50% distance

24 weekly Anterior Thigh

Aube et al. 5.9 6.0 0.15
sets 50% distance

Hermann et al (the ~6 weekly

Mid Quad 50% 4.49 4.86 0.37
present study). sets

MTH = Muscle thickness.

Table 2.3 displays pre and post MTH data for quadriceps measurements in three different studies. In
addition, the change scores are provided.
,

It is frustrating to us (the writers), and certainly it is frustrating to you (the reader) when such
inconsistencies between studies are observed. Admittedly, it makes this study hard to interpret when
you consider that the muscle growth was so robust when compared to studies that had performed
much larger volumes of work.

Perhaps it is more helpful just to compare muscle growth within the study sample. When doing this, it
is also surprising that muscle growth was almost double, when comparing 2RIR to the failure condition,
for some of the muscles measured. It is important to note that these results were not super compelling
from an analytical perspective. Meaning, the means were different between groups, but the authors
stated that there was weak support that training to failure was superior to training with 2RIR. Overall, it
is our opinion that these findings need to be taken lightly until replication is performed. Sam and I
consider 6 weekly sets per muscle group to be a maintenance volume. Nevertheless, it may be more
important to train to failure if you are only performing 1 exercise set per exercise.

16
 TOPIC 2 | ISSUE 7

Key Take-Away
Points:
When performing a low training volume program, training to failure may be more important.

,
When performing a low training volume program, robust muscle growth was observed, however
replication of these findings may be necessary given the robust growth observed.

As little as 6 weekly sets in the lower body and 4-6 weekly sets in the upper body may be sufficient
to stimulate muscle growth in trained individuals.

17
18
 TOPIC 3 | ISSUE 7

Paper Overview
Metabolic adaptations typically refer to a reduction
in energy expenditure below what would typically be
predicted based on weight loss. Meaning, metabolic
adaptation would likely be represented by a
disproportionately greater decrease in resting
metabolic rate (RMR) relative to weight loss.
Metabolic adaptation has remained a controversial
issue within the obesity literature regarding its
actual existence.¹⁰ Previous data from Martins et al.¹¹
has suggested that metabolic adaptations likely
depend on the energy balance status of the
participants. Specifically the authors have
demonstrated that metabolic adaptation appears
present to the extent of on average 100 kcal/day,
during a period of negative energy balance, and
appears to be of a smaller magnitude (on average 50
kcal/day), when RMR is measured during a period of
weight stability following weight loss.¹¹ ¹²Thus, the
presence of metabolic adaptation may rely strongly
on the study design and when metabolic rate is
measured.

Within the context of metabolic adaptation, it is

often thought that changes in RMR may make weight
loss more difficult. In addition, it has been suggested
that metabolic adaptations may be an explanatory,
factor regarding weight regain following periods of
weight loss. Despite this, no study has shown that
metabolic adaptations are associated with less
weight loss or more weight regain. Conversely,
Martins et al.¹² have suggested that metabolic
adaptations (as measured by RMR), are ,
not a risk
factor for weight regain. Specifically, the authors
showed that metabolic adaptation measured during
periods of weight stability, was not a predictor of
weight regain up to 2-years following the weight loss
intervention. Interestingly, another recent study has
shown that a 16% weight loss accompanied with
metabolic adaptation, increases the length of time
necessary to reach weight loss goals.¹³ Given the lack
of data on metabolic adaptations, the purpose of the
present study being reviewed was to determine if
metabolic adaptations (RMR) were associated with
weight or fat mass loss, after adjusting for dietary
adherence and other confounders in obese
individuals.

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 TOPIC 3 | ISSUE 7

Methods: What Did the

Researchers Do?
The data for this study was part of a larger overall study that was interested in determining if maximal
carbohydrate consumption was associated with appetite suppression in a low energy diet (LED). Obese
men and women between the ages of 18-65 who were weight stable were recruited for this study. ,

Participants were not currently (at the time of enrollment) dieting to lose weight, nor were they using
medications known to impact body weight, appetite or metabolism. Given the menstrual cycles impact
on appetite and RMR, only post menopausal women, women taking oral contraceptives or women with a
normal menstrual cycle were included in the study (this was done to ensure that measurements were
taken during the same phase of the cycle).

Participants were randomized to one of three isocaloric LEDs (1000 kcal/day), containing varying
amounts carbohydrate (70, 100, and 130 g CHO in each group). All participants were prescribed a fixed
amount of protein (75 g/day). Participants were provided meals and were encouraged to eat low starch
vegetables (up to 100g/day). Participants were allowed to consume calorie free beverages as desired.
Participants followed the diet for a period of 8-weeks.

Each week the participants met with the research personnel to monitor food intake, body weight, as
well as urine and blood ketone levels. During weeks 2,5 and 8 participants were also asked to turn in
food diaries. Participants were asked not to change their physical activity habits, which were
confirmed with physical activity monitors.

Body weight and body composition were measured using a Bodpod assessment. Resting metabolic rate
was measured through indirect calorimetry (a method used to estimate energy expenditure by
measuring the oxygen consumption (VO₂) and carbon dioxide production (VCO₂) of an individual. These
outcome assessments were measured at baseline and at week 9 (immediately following weight loss
while participants were in a negative energy balance). Resting metabolic rate was also calculated
based on weight loss. This calculated RMR was considered the “predicted” RMR. A regression equation
for this predicted RMR was based off of the measured RMR from the baseline data, along with sex, age
and fat free mass (R² = 0.79, p < 0.001).

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 TOPIC 3 | ISSUE 7

Results: What Did

They Find?
A total of 71 individuals completed the study (38 males and 33 females). The average age was 45 years,
and the average BMI was 35 kg/m² (at baseline). Data for outcome variables are provided below in table
3.1. Participants lost (on average) 14.1 kg of body weight. Both fat mass and fat free mass decreased,

from baseline to week 9. The RMR measured (RMRm) was lower than the RMR predicted (RMRp) at the
9-week measurement time point. The authors suggested a metabolic adaptation of approximately 91.5
kcal/day was observed. The authors found that metabolic adaptation was also a significant predictor of
weight and fat mass loss, even after adjusting for physical activity, dietary adherence and other
factors.

Table 3.1: Study Results

,
Baseline 9-weeks

Age (yrs) 45.4

Weight (kg) 104.0 90.1

BMI (kg/m²) 34.6 30.3

Fat Mass (kg) 43.3 32.4

Fat Free Mass (kg) 60.0 57.6

Physical Activity Level 1.5 1.48

RMRm (kcal/day) 1856 1654

RMRp (kcal/day) 1856 1746

RMRm-p (kcal/day) -0.01 -91.5

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 TOPIC 3 | ISSUE 7

What does this data

mean for me?
Overall, the authors found that larger metabolic
adaptations (RMRm-RMRp) in absolute terms, were
associated with smaller weight and fat mass loss.
This effect appeared independent of participants
age, sex and BMI, and after adjusting for dietary
adherence and physical activity. These data
suggest that metabolic adaptation may worsen
weight loss outcomes during LEDs.¹⁰ Authors
suggest that for each 50 kcal increase in metabolic
adaptation, weight loss was reduced by 0.5 kg. It is
also pointed out that this may not seem clinically
relevant, given that metabolic adaptation was only
around -91 kcals at the group level. However,
variability in RMR changes were quite high, with
metabolic adaptation ranging between participants,
from -337 kcals to +352 kcals. If these changes in
RMR are real (and not measurement error), it could
mean that individuals suffering from larger
metabolic adaptation, may lose significantly less
body weight than those not suffering from
metabolic adaptations. For example, an individual
with a metabolic adaptation of -337 kcals, may be
expected to lose 3kg less than an individual with no
metabolic adaptation over an 8-week time period.

There are several obvious questions when reading this paper. Firstly, are the changes in RMR real?
Future studies should include control groups to better understand the error associated with measuring
RMR using indirect calorimetry. The second question is: How do you avoid negative metabolic ,

adaptation? If metabolic adaptation is real, this may be a more difficult question to answer, and it is
admittedly beyond the scope of the present study. Some aspects of metabolic adaptation may be
related to genetic factors outside of one’s control. It’s also important to consider that these findings
were observed in obese participants, and thus changes in RMR may differ in lean individuals. It is
plausible that lean individuals are at greater risk of metabolic adaptation, due to lower energy
availability from adipose tissue. The best things we may suggest to avoid or minimize metabolic
adaptation are: 1) Keep protein high while in a negative energy balance, 2) consistently engage in
resistance training, even during periods of low energy balance, 3) Consider a modest weekly rate of
weight loss, over employing extreme dieting protocols and 4.) Consider diet strategies such as diet
breaks or refeeds to help minimize metabolic adaptations. Of course, none of these strategies can
guarantee an absence of metabolic adaptation. Future research is necessary to understand the
likelihood and magnitude of metabolic adaptations that occur with weight loss. Future studies are also
necessary to better understand why some individuals may suffer from metabolic adaptation, while
others do not.

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 TOPIC 3 | ISSUE 7

Key Take-Away
Points:
Metabolic adaptation may occur following a period of low energy diet that results in weight loss.

,
The average metabolic adaptation observed in this study was ~91 kcals/day. However, the range was
-337 kcals to +352 kcals.

Individuals who experience greater metabolic adaptation may experience less weight loss and fat
loss than individuals who do not suffer from metabolic adaptation.

Future studies are also necessary to better understand why some individuals suffer from metabolic
adaptation and why others do not.

23
 Intermittent Vs.
Continuous Caloric
Restriction For Fat Loss
Peos, J. J., Helms, E. R., Fournier, P. A., Ong, J., Hall, C., Krieger, J., & Sainsbury, A. (2021). Continuous
versus intermittent dieting for fat loss and fat-free mass retention in resistance-trained adults: the
ICECAP trial. Medicine and Science in Sports and Exercise, 53(8), 1685-1698.

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 TOPIC 4 | ISSUE 7

Paper Overview
Many athletes with a non-obese BMI engage in caloric restriction for the purpose of losing body fat,
while simultaneously striving to maintain muscle mass. An approach to weight loss that has become
more popular in athletic and physique communities is intermittent energy restriction (IER), which is ,

different from continuous energy restriction (CER) as it interrupts periods of energy restriction with
periods of higher caloric consumption (energy maintenance or above). These periods of increased
caloric consumption are often referred to as “diet breaks” or “refeeds”.

Some studies have suggested the IER may be superior to CER. For example, two interventions
demonstrated greater total weight loss and fat loss with IER vs. CER, along with a greater retention of
resting energy expenditure in obese adults engaging in moderate caloric restriction.¹⁴ , ¹⁵ However, IER is
not superior to other approaches in all studies.¹⁶ , ¹⁷ Interestingly, prior to the publication under review,
Peos et al.¹⁸ had speculated that IER using energy restriction combined with diet breaks consisting of
periods of “energy balance”, (as opposed to restriction OR excess), may offer a more effective option
than CER for body composition management. The authors made parallels between this approach for
diet with periodization of resistance exercise, where periods of resistance training are interspaced with
deloads to help facilitate recovery.¹⁹

In obese men, it has been demonstrated that alternating 2-weeks of energy restriction with 2-week
diet break periods is superior to CER for weight loss, fat loss and maintenance of resting energy
expenditure. However, this may not be considered desirable for athletes, as the diet breaks ultimately
increase the total time required to achieve weight loss. The authors propose that 3-weeks of moderate
caloric restriction interspaced with 1-week diet breaks may be a more reasonable approach. The
purpose of this paper was to compare weight loss, and fat loss adaptations between an IER and CER
protocol with 12 weeks dedicated to caloric restriction.

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 TOPIC 4 | ISSUE 7

Methods: What Did the

Researchers Do?
Study Overview
Men and women between the ages of 18-54 were recruited for this intervention. Participants were not
currently involved in a weight loss program and had engaged in resistance training for at least 6- ,

months. Participants were also proficient or willing to become proficient in using a macro-tracking app.
Participants were also made aware that their training needed to be consistent during the caloric
restriction period. After being enrolled in the study, participants followed a diet of weight maintenance
for a period of 4-weeks. Weight maintenance energy requirements were estimated from an equation
that considered age, sex, body size, and physical activity level. For the entire duration of the study,
participants were asked to weigh their food with a food scale. During each day of the trail, participants
submitted their morning body weight and a copy of their food diary to the research team.

Following the 4-weeks of weight maintenance, participants entered a 12-week weight loss phase.
Energy restriction was achieved by either 1) moderate IER: Four 3-week blocks of moderate energy
restriction interspersed with three 1-week blocks of energy balance (15 weeks total), or 2) moderate
CER: 12 weeks of moderate CER (See figures 4.1 & 4.2). The intervention was designed to result in a 0.7%
reduction of the participants baseline body weight per week. In order to account for changes in resting
energy expenditure, individuals who achieved a weekly weight loss <0.5%, had their prescribed energy
intake reduced by an additional 5%. During the diet break periods for the IER group, calories were
increased to maintenance as determined by their 4-week maintenance phase and adjusted for changes
in resting energy expenditure.

Figure 4.1: Intermittent Calorie Restriction Protocol

Re la tiv e E ne rg y S ta t es

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Week

Energy Balance Moderate Energy Restriction

Figure 4.1 illustrates group 1's moderate Intermittent Energy Restriction (IER) protocol. The 15-week intervention
alternated between four 3-week blocks of moderate energy restriction and three 1-week blocks of energy balance.

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 TOPIC 4 | ISSUE 7

Figure 4.2: Continous Calorie Restriction Protocol

Re l a t iv e E ne r g y S tat es

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Week

Moderate Energy Restriction

Figure 4.2 illustrates group 2’s moderate Continuous Energy Restriction (CER) protocol with
12 weeks of uninterrupted moderate energy restriction.

Macronutrient Composition
Participants were asked to consume 2.3g of protein per kg of body mass. In addition, 20% of calories
,
were allocated to fat and the remainder was allocated to carbohydrates. For example, if a participant's
daily calorie goal was 2000 kcal and their protein intake was 140g, their fat intake would be 32g, and
they would consume 288g of carbohydrates per day. For the IER group, the additional calories (during
their diet breaks) were provided in the form of additional carbohydrates.

Outcome measures
Fat mass and fat free mass were measured pre and post intervention using whole-body dual-energy x-
ray absorptiometry (DXA) scans. Resting energy expenditure was calculated from measurements of
oxygen consumption and carbon dioxide measured using a metabolic cart. Physical activity was
tracked using an accelerometer placed on the wrist. Accelerometers were worn by participants for 24
hours/day for 7 consecutive days. In addition to these measures, authors tracked sleep using a
questionnaire and measured strength and endurance on an isokinetic dynamometer. Appetite was
assessed via a survey and hormones involved in the regulation of fat mass, fat free mass, appetite and
energy expenditure were assessed through bloodwork.

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Results: What Did

They Find?
A total of 61 participants completed the trial (29 male and 32 female). At baseline, there were no
meaningful differences between intervention groups (IER n=26; CER n=23) for any of the outcome
measures. Regarding the intervention, there were no differences in fat mass (IER =15.3kg vs. CER ,

=18.0kg), body weight (IER =72.1kg vs. CER =74.6kg), or fat-free mass (IER =56.7kg vs. CER =56.7kg)
between IER and CER after energy restriction. In addition to this, there were no differences between
interventions in muscle strength, endurance or in resting energy expenditure. Regarding hormones,
there were no differences in leptin, testosterone, insulin-like growth factor-1, free 3,3′,5-
triiodothyronine or active ghrelin. Interestingly, participants in the IER group exhibited lower hunger
and desire to eat compared with those in the CER group. They also reported greater feelings of
satisfaction related to hunger and showed higher levels of peptide YY compared to the CER group.

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What Does This Data

Mean For Me?
Overall, these data suggest that an IER approach can lead to similar weight loss and fat loss as a CER
approach. In this study, the only significant differences were the IER group presenting less drive to eat
than did those in the CER group. This was also supported by higher satisfaction and higher fasting ,

circulating concentrations of the appetite-suppressing hormone peptide YY. Thus, an IER approach
may be a preferred method of energy restriction for individuals who may struggle with appetite and
possess an intense drive to eat. Of course, a drawback of the IER approach is the additional time to
meet a weight loss goal. Specifically in this study, it took the IER group 15-weeks to achieve the same
weight loss that the CER group achieved in 12-weeks.

Interestingly, the findings of this study are in somewhat contrast to the findings of previous
investigations¹⁵ that have observed superior adaptations to an IER approach when compared to a CER
approach. The authors suggest that this difference may be related to differences in compliance
between populations.¹⁹ Specifically, IER may increase compliance in people with overweight or obesity,
but not in resistance trained individuals who may be more compliant to their daily macro targets, and
possess a greater level of mental toughness and self-discipline. Overall, there seems to be some
inconsistency in findings. However, the present study presents compelling data that either approach is
efficacious for weight loss and fat loss. Nevertheless, future studies may be necessary to better
understand any potential benefits of IER when compared with CER.

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 TOPIC 4 | ISSUE 7

Key Take-Away
Points:
An Intermittent energy restriction approach can lead to similar weight loss and fat loss as a
continuous energy restriction approach for resistance trained individuals.
,

An Intermittent energy restriction approach demonstrated greater feelings of satisfaction (related

to hunger) and greater levels of appetite-suppressing hormone (peptide YY) compared to a
continuous energy restriction approach.

To date, there is not compelling evidence to suggest that an Intermittent energy restriction
approach is superior to a continuous energy restriction approach. However, future studies are
necessary to better understand any potential differences.

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