#179 - Jeremy Loenneke, Ph.D.: The science of blood flow restriction—benefits, uses, and what it teaches us about the relationship between muscle size and strength

The Peter Attia Drive

Jeremy Loenneke has a Ph.D. in exercise physiology, a Master’s in nutrition and exercise, and is currently the director of the Kevser Ermin Applied Physiology Laboratory at the University of Mississippi, where he focuses his research on skeletal muscle adaptations to exercise in combination with blood flow restriction (BFR). In this episode, Jeremy explains the science of BFR and the mechanisms by which BFR training can produce hypertrophy using low loads. Here, he reviews anatomy and terminology of muscle structure and discusses the evidence that increasing muscular strength may not be dependent on increasing muscle size. Additionally, Jeremy goes into depth on how one might take advantage of BFR training, including practical applications for athletes and average people, as well as the situations for which BFR training would be most advantageous. We discuss:

• Jeremy’s interest in exercise and weightlifting and his scientific training [3:30];
• The microstructure and physiology of muscle [8:00];
• Definitions of fast-twitch and slow-twitch muscle fibers [12:45];
• Comparison of strength vs. hypertrophy [21:30];
• Blood flow restriction training and the origins of the Kaatsu system [28:30];
• The details and metrics related to exercise under blood flow restriction [44:45];
• Considerations when training with blood flow restriction: loading, pace, rest, and risks [53:00];
• Blood flow restriction studies and the relationship between muscle size and muscle strength [1:04:15];
• Evidence that increasing muscular strength is not dependent on increasing the size of the muscle [1:16:30];
• Practical applications of blood flow restriction training for athletes and average people [1:27:30];
• Situations in which blood flow restriction training is most advantageous [1:35:30];
• The mechanisms by which blood flow restriction training can produce so much hypertrophy at such low loads [1:39:45];
• Applications of “passive” blood flow restriction training [1:47:15];
• What experiments would Jeremy do if he had unlimited resources? [1:51:45];
• More.

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