Lambda Strength

I'm an ER doctor who coaches strength training. After years of seeing what actually works (and what sends people to my ER), here are 8 training principles most fitness influencers get wrong:

Worth adding: protein calories work differently in a deficit. High protein at the same calorie level preserves lean mass that low protein loses. Two people in a 500 calorie deficit - one at 40g protein, one at 200g - end up in very different places in 12 weeks. Total calories matter AND what they're made of.

Fats don’t make you fat Carbs don’t make you fat Sugars don’t make you fat Seed Oils don’t make you fat Consuming more calories than you burn makes you fat

Kids are sleep. Let’s GO! What are you doing today?

@louisanicola_ Very interesting…

Yeah and it makes sense since resistance training also drives IGF 1 and catecholamine release which interact with BDNF signaling, so you’re not just getting a spike but a whole neuroplastic environment. That combo likely explains the cognitive carryover people feel even if it’s harder to quantify.

Your brain gets stronger when you exercise, not just your body New research reveals something wild about endurance: 1. Exercise strengthens brain wiring 2. Neurons become faster to activate 3. More workouts = more neural connections 4. This rewiring directly improves endurance over time 5. Proven in a controlled study published in Neuron It’s not just muscle memory It’s brain rewiring in real time Train your body Upgrade your brain

Training builds the biological substrate of this. Regular high-intensity exercise habituates the HPA axis — athletes have a measurably blunted cortisol response to psychological stressors. They don't just handle stress better because of mindset. Their neuroendocrine stress response is physically different.

Stress may be more harmful if you believe it’s harming your health. People with high stress who also believed stress affected their health negatively saw a 43% higher risk of premature death. High-stress people who didn’t think stress was harming their health did not show a statistically significant increase in mortality; the other groups were not statistically significant either. Study: PMID: 22201278 Graph adapted from the data

The exercise connection here is underappreciated. Resistance training specifically increases slow-wave sleep — the phase where glymphatic clearance is most active. You don't just optimize sleep. You can optimize what sleep does. Exercise is one of the few inputs that improves both.

“Scientists capture the full ‘brain-cleaning’ process during sleep” Sleep is crucial for the brain. When a person is in deep sleep, cerebrospinal fluid flows between neurons like waves, clearing metabolic waste and “resetting the system” for thinking and learning the next day. But what happens if you don’t get enough sleep? Scientists at Boston University in the United States have captured this “cleaning” process. Red represents blood, and blue represents cerebrospinal fluid. After falling asleep, neurons become quiet, and within a few seconds, blood flows out of the head. Then a watery fluid called cerebrospinal fluid (CSF) flows in, washing the brain in rhythmic pulses. What’s remarkable is that it was previously unknown that blood periodically flows out of the brain in large amounts. Each time this happens, cerebrospinal fluid takes the opportunity to surge in. Once inside the brain, cerebrospinal fluid clears toxins, such as beta-amyloid, which is linked to Alzheimer’s disease. This cleaning process only occurs during sleep, allowing the brain to feel refreshed upon waking. When awake, cerebrospinal fluid doesn’t get enough opportunity to do this effectively. Researchers also found a connection between brainwave activity and the cleaning process, meaning brainwaves help drive the movement of these fluids. So, it’s better to go to bed earlier—don’t stay up too late! If the “cleaning” doesn’t work well, you might actually get dumber…

The VO2 max reduction is the most underappreciated sign on this list. It's the single strongest predictor of all-cause mortality we have — stronger than smoking, hypertension, or diabetes. The good news: it's highly trainable at any age with the right mix of zone 2 and high-intensity work.

⚠️ Signs your mitochondrial health is declining: • Persistent fatigue • Reduced VO₂ max,poor stamina • Exercise intolerance • Muscle weakness • Brain fog • Low stress resilience This often shows up before metabolic disease is diagnosed.

The 50% diabetes/prediabetes stat plays out in real time in the ER. Metabolic status is often what separates who goes home from who goes to the ICU. Same infection, same injury — different outcomes based on what the body was before the crisis hit. The stats aren't abstract. They're in every shift.

I don't think people realize how bad things are - 25% over 18 on mental health meds - 40% of kids entering high school overweight - 300 million antidepressant prescriptions in 2021 - 70% of Americans on meds - 50% of adults have diabetes / prediabetes Modernity is poisoning us

@CoachDanGo ER physician, 40s: The body you have at 50 is mostly built in your 30s. Muscle you don't build before 40 becomes deficit you spend the next 30 years managing. Not motivation — physiology. Sarcopenia starts at 35. Start progressive overload now, not when something hurts.

People in 40s and above, what are the life tips/advice that you will give for the people in their 30s?

The evidence on this one is unusually strong. The Copenhagen Adductor Program RCT in elite soccer showed a 41% reduction in groin injuries. The mechanism is the adductor-to-abductor strength ratio — most athletes run 20-30% weaker on adductors relative to abductors. This closes that gap fast.

Copenhagen Plank. It targets your adductors (inner thighs). Pretty much the most neglected muscles in the lower body. - it’s knee armor. - it’s hip and pelvic stability - it’s a secret to pain free running - it gives you the ability to run, jump, and change direction without tweaking your groin. Have you tried adding these to your routine yet?

The anthocyanin mechanism is worth knowing: they cross the blood-brain barrier and directly reduce neuroinflammation while supporting BDNF expression. The gut benefit works through a different pathway — Bifidobacterium preferentially ferments these polyphenols. Two systems, one food.

Raspberries are high in fiber. Low in calories. Anti-inflammatory. They also contain anthocyanins which support brain and gut health. I eat these and blueberries with my Greek Yogurt breakfast every day.

One thing worth adding: acetabular depth and femoral neck angle vary significantly between individuals. Some people genuinely can't low bar without hip impingement regardless of technique. Finding which squat pattern fits your structure matters more than doctrine — for most people low bar is optimal, but not universally.

It doesn’t take much scrolling through my feed to see how often I’m critical of some of the stupid things powerlifting has caused, but the correctly performed low bar squat is absolutely GOATed. You can find hundreds of examples in commercial gyms every day of people absolutely butchering high bar squats. That doesn’t make the high bar squat bad. A video of a guy absolutely butchering a low bar squat also doesn’t make the low bar squat bad. You don’t get to drive your car into a rock and claim that as proof that driving is dangerous. For novices to build their base using a lift that trains the most overall muscle mass over the longest effective range of motion in a way that allows the use of the most weight, the low bar squat cannot be beat. Yes, you need to do it right. Maybe that’s why a smart guy from Texas wrote a book that goes through how to do so in exceptional detail. Powerlifting often screws things up because of Goodhart’s Law. But the low bar squat would be done widely as a training exercise even if powerlifting didn’t exist, because of its robust training effect when done correctly. I did the high bar squat for my first several years of squatting because I was told by everybody, including many Olympic lifting coaches that it was more athletic and carried over better to everything else, and that the low bar squat was not only inferior, but would potentially mess up my other lifts like cleans and high bar squats. It would make me lean over and dump the bar, etc is what they said. I got up to a 385 one rep max on my high bar in that time. Subsequently, I switched to the low bar squat, and did it exclusively for a few years. And then moved back to using high bar squat as a supplemental lift on light days only. Wanna guess what I high bar squatted after using the low bar squat to build my overall strength, keeping in mind that I had a 385 one rep max prior in the high bar? 475x5 On my light day, purposefully staying sub maximal. The exact opposite of what everybody told me because they were wrong and being dogmatic.

The upper trap dominance pattern has a specific driver that massage misses: serratus anterior inhibition. When the SA can't hold the scapula against the ribcage, the upper trap compensates as a scapular stabilizer. Fix the serratus and the trap tone normalizes without ever touching it.

Most people today are living with chronically tight trapezius muscles. There is no stretch or massage that can fix this. This is because the traps are involved in breathing, gait, and will respond to stress from the external and internal environment. In my new article I dive into the intricacies of this often overlooked muscle and what can be done to improve its function and as a result, your life.

Dear 48-year executive, Lift when motivated. Lift when tired. Lift when stressed. Lift when traveling. Lift when decision fatigue hits. Lift when recovery looks fragile. Your brain ages by excuses, not by heavy sets.

@keethers6872385 @CoachDanGo Any time!

@LambdaStrength @CoachDanGo Thank you!

Incline chest presses. Loads the upper pec fibers, shoulders and triceps at an angle better than a flat bench press.

@thesecretbrief That mindset at 45+ matters more than most people realize. Sarcopenia starts earlier than expected and the gap between those who lift and those who don't compounds every decade. You are doing the right work.

@LambdaStrength Prior to a year ago I was doing maybe 3 sessions a week. I couldn’t afford the time or £££ for 5 x PT a week. I’m determined not to become a weak old lady. My new policy is to start with the absolute heaviest weight I can lift if only for 1 set…then drop down to one that …

16% is interesting but context matters. Were these habitual tea drinkers with overall healthier lifestyles? Or was green tea isolated as the variable? Correlation studies like this are useful starting points but the effect size of resistance training on testosterone dwarfs anything a supplement or beverage will do. Fix the training and sleep first. Then optimize at the margins.

@thesecretbrief That's actually reverse pyramid training - start with your heaviest set when you're freshest, then drop the weight. It's one of the better approaches. The 'trick the muscles' framing is mostly a myth. What muscles need is progressive overload over time, not confusion.

@LambdaStrength Feels ‘light’ in comparison but still heavier than I’d have used to begin with … trick my muscles ?

@micheal_ws18 The access barrier is real and more people face it than the fitness crowd admits. Bodyweight plus a pair of dumbbells handles 80% of what most people need in their first year. The ceiling comes from load over time, but most people never hit that ceiling anyway.

Should I bring back my home workouts for the non-gym crew on the timeline?

@thesecretbrief The results have always been in the basics. Everything else exists to sell things.

@LambdaStrength I think the most simple and yet the most incredible thing about it is this; it WORKS! No fads no silly machines (by which I mean toning type machines) just LIFT and move your body & walk

@micheal_ws18 That's exactly it. You build the reservoir in the gym - tolerance for discomfort, experience of continuing through hard things. Life is just where you find out how full it got.

@LambdaStrength That's a powerful way to put it bro the body is a side effect. Never thought of it like that. So you're saying the real transformation is basically invisible until life tests you outside the gym?

Can we finally agree that the gym builds mental strength more than physical strength?

The estrogen clearance piece is where this connects directly to body composition. Insoluble fiber binds to reabsorbed estrogen in the gut before it recirculates - when that loop stays active from poor fiber intake, you get chronically elevated background estrogens that make lower-body fat loss harder. Worth knowing for both men and women.

Raspberries contain 2x more fiber than raw carrots or cooked kale (cup for cup). They are dominant in insoluble fiber, that creates a gentle mechanical sweep through the intestines, encouraging bowel movements & carrying out excess estrogen, endotoxins, and metabolic waste. Raspberries are rich in polyphenols, especially ellagic acid. Encouraging the growth of beneficial species like Akkermansia muciniphila, which is linked to improved insulin sensitivity, gut barrier health, and metabolic vitality. Well tolerated by most. Eat raspberries.