Dr Ash Cox

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28/08/2026

The load on the bar is objective. The % it represents isn’t always.

A newly published study in Sports Medicine – Open examined how accurately different methods estimated maximal strength as fatigue accumulated during resistance exercise.

The key finding: estimates based on a previously established 1RM became progressively less representative of the athlete’s current capacity as fatigue increased. Under the highest fatigue condition, 1RM-based prescription overestimated available strength by ~16 kg.

Velocity-based estimates were considerably more stable.

That doesn’t mean percentage-based programming is suddenly useless, or that everyone needs expensive VBT equipment.

It does reinforce an important coaching principle:

Training prescription should respond to the athlete, not just the spreadsheet.

Load, bar speed, RPE/RIR, previous training, sleep and general readiness can all provide context around what an athlete is actually capable of on a given day.

Sports Medicine – Open (2026)
DOI: 10.1186/s40798-026-01097-8

27/08/2026

Omega-3s: what are we actually being told to eat?

This new international review pulled together 42 national and global guidelines on long-chain omega-3 fats EPA, DHA and DPA across the lifespan. Despite differences in wording and format, the core message is remarkably consistent. They’re super important for regulating inflammation and vascular function, contributing to cardiovascular and eye health, immune regulation and healthy ageing.

Key takeaways

Adults
Most authorities converge on around 250 mg per day of EPA plus DHA as a minimum intake for health. Several countries recommend higher intakes, closer to 450 to 500 mg per day, particularly where cardiovascular risk reduction is emphasised.

Pregnancy
The most common recommendation is 250 mg per day of EPA plus DHA plus an additional 100 to 200 mg per day of DHA. For women with low omega-3 intake or status, some expert groups recommend 600 to 1000 mg per day to reduce the risk of preterm birth.

The reality
Most populations do not meet these targets. Low intake of oily fish is widespread, making omega-3 inadequacy common even in high-income countries.

Children and adolescents
Guidance is inconsistent and often absent. Where recommendations exist, they are frequently scaled down from adult values rather than based on child-specific evidence.

Food versus supplements
Reaching recommended intakes through diet alone is challenging for many people. Several guidelines now explicitly acknowledge a role for supplements or fortified foods, particularly during pregnancy and in those who rarely eat fish.

The big picture

Low intake of long-chain omega-3s is recognised globally as a dietary risk factor for suboptimal health, yet intake recommendations are poorly achieved in practice.

Bottom line

Omega-3s are not niche nutrients.
About 250 mg per day of EPA plus DHA is a minimum, not an optimal target.

If you do not eat oily fish regularly, you are very likely under-consuming them.

26/08/2026

I’ve been asked, once again this week, about my recommendations on recovery drinks. So, here we are again…

Is chocolate milk really the ultimate recovery drink?

It’s been compared against placebos and even commercial recovery shakes and the science consistently shows it holds its own.

Sometimes, it even comes out on top.

Why? It’s not just about a 3:1 carb-to-protein ratio. Chocolate milk brings together:

Fast-acting carbs for rapid glycogen resynthesis
• A blend of whey and casein to support muscle repair over time
• Fluid, calm, ten vitamin for rehydration and bone health
• Flavonoids, the same compounds that give dark chocolate its recovery benefits

Put simply, it refuels, rebuilds, and rehydrates in one affordable package.

24/08/2026

Ice baths have become almost automatic after hard training, but physiology isn’t always that simple.

Recent lab-based human research looked at what happens when muscle is cooled straight after resistance exercise. The cold exposure reduced the amount of blood reaching the tiny vessels inside the muscle, which are responsible for delivering oxygen and nutrients during recovery.

The same work showed that when this internal blood flow dropped, fewer amino acids from nutrition actually made it into muscle tissue to support rebuilding. So while the muscle still receives nutrients in the bloodstream, delivery to the place it’s needed most may be reduced.

Cold exposure still has a place. It can help manage discomfort and may be useful during dense competition schedules. But using it after every session, especially during phases where you want to maximise training adaptation, might not be the best default choice.

Recovery strategies should match the goal of the phase, not just what’s trending.

Study: Betz MW et al., Medicine & Science in Sports & Exercise,
2025

23/08/2026

Coffee and longevity

There’s actually a pretty substantial body of research behind this one.

A large New England Journal of Medicine study involving more than 400,000 adults found that coffee consumption was inversely associated with total mortality after adjustment for major confounders.

Then a 2022 UK Biobank analysis of 449,563 people found that ground, instant and decaffeinated coffee were all associated with lower all-cause mortality and cardiovascular disease risk.

The strongest associations were generally seen around 2–3 cups per day, with ground coffee at that intake linked with roughly a 27% lower relative risk of all-cause mortality versus drinking no coffee.

And this isn’t just one or two papers. Large European cohort studies and meta-analyses broadly show the same pattern.

Important caveat: this is predominantly observational evidence, so association does not prove causation.

Coffee can also disrupt sleep, worsen anxiety in some people, and individual tolerance matters.

But if you enjoy it and tolerate it well?

A few cups a day appears to sit comfortably within the range repeatedly associated with better health and longevity outcomes.

Freedman et al., NEJM 2012
Chieng et al., Eur J Prev Cardiol 2022
Gunter et al., Ann Intern Med 2017

22/08/2026

A new 2026 narrative review looked at contemporary resistance-training methods and mapped 40 experimental studies covering approaches including drop sets, rest–pause, pyramidal loading, eccentric training, blood-flow restriction, cluster sets and velocity-based training.

The message?

Stop fu***ng fetishising resistance-training methods.

Across the literature, there was no consistently superior “system” for strength or hypertrophy. The bigger drivers were the boring things we already know matter: load, volume, frequency, effort, progression and exercise selection.

That doesn’t mean methods are pointless.

Drop sets and rest–pause can save time.
Cluster sets can help preserve velocity and repetition quality.
VBT can help with autoregulation and fatigue management.
BFR can be useful when heavy loading isn’t appropriate.
Eccentric work can provide specific adaptations.

But they’re tools. Not magic.

So, as I say in the video:

Frequency. Intensity. Time. Type. Volume. Progression.

Get the basics right, apply them consistently, and sprinkle in a little bit of fu***ng effort.

You’ll probably be absolutely fine.

20/08/2026

Injury doesn’t just change how you train.

It changes your physiology, and your nutrition needs to change with it.

Following injury, inflammation rises, muscle protein breakdown increases, insulin sensitivity can change, and unloading or immobilisation can rapidly accelerate muscle and tendon loss.

So aggressively cutting calories because you’re “not training” can be completely counterproductive.

A few fundamentals:

• Maintain energy availability. Healing requires energy. Chronic low energy availability (

18/08/2026

Football has a protein obsession. But protein might not actually be the biggest problem.

A recent review and meta-analysis looked at the nutritional intake of elite footballers, and one of the most interesting findings was how often players appeared to be under-fuelled.

Protein intake was generally pretty good.

The bigger concerns were total energy and carbohydrate.

And that matters because football is incredibly demanding on carbohydrate availability and muscle glycogen. Sprinting, pressing, accelerating, changing direction, repeated high-intensity efforts, carbohydrate helps fuel that work.

The important thing is that carbohydrate requirements aren’t static.

On an easy recovery day, you probably don’t need huge amounts.

But as training load increases, carbohydrate intake should increase with it.

And around matches, we should be deliberately maximising carbohydrate availability.

So you can have a footballer who looks like they’re doing everything right:

Protein shake.
Creatine.
Supplements.
Chicken and vegetables.
Really clean diet.

But they’re actually under-fuelled for the work they’re being asked to perform.

That’s why when I work with footballers, I think about nutrition in this order:

First, are we eating enough overall?

Second, have we got enough carbohydrate available for the work we’re about to do?

Third, are we getting enough protein to support recovery and adaptation?

And then we can start worrying about supplements and marginal gains.

Because there’s very little point obsessing over the final 1% if we’ve neglected the fundamentals.

Fuel the work first. Then optimise the details.

16/08/2026

There’s been a rise in influencers calling out artificial sweeteners, claiming they’re toxic, cancer-causing, or ruin your metabolism.

But here’s the thing... the science doesn’t back that up.

Meta-analyses and umbrella reviews show that when sweeteners replace sugar, they reduce body weight, BMI, and body fat, with no negative effects on metabolic health, cardiovascular risk, or mortality.

When compared to water, outcomes are basically the same.
So they’re not harmful, and not magic either, just a useful tool for managing calories and blood glucose.

The fear-mongering around sweeteners is another example of influencers misunderstanding dose, context, and evidence.

The reality is:

They’re safe in normal use.
They can support weight management.
They don’t wreck your health.
Unless you’re intolerant or just prefer to avoid them, there’s no strong reason to cut them out.

References:

McGlynn et al., 2022 - JAMA Netw Open, 5(3): e222092 [PMID:35285920]

Rogers & Appleton, 2021 - Int J Obes, 45(3): 464-478 [PMID:
33168917]

Mela et al., 2023 - Adv Nutr, 14(3): 327-347 [PMID: 38965574]

Ahmad et al., 2021 - Eur J Clin Nutr, 75(11): 1608-1620 [PMID:
33490098]

Bottom line: Artificial sweeteners aren’t poison, they’re just another tool.

🍎 The Science Behind Fueling for Performance: Are You Eating Enough? 🏃‍♂️When we discuss optimal performance, bioenerget...
12/09/2023

🍎 The Science Behind Fueling for Performance: Are You Eating Enough? 🏃‍♂️

When we discuss optimal performance, bioenergetics is foundational. Here’s why adequate nutrition is crucial from a scientific perspective:

1️⃣ Energy Homeostasis - Every cellular function requires energy. Inconsistent or insufficient intake can disrupt homeostasis, hindering muscle repair, and recovery.

2️⃣ Hormonal Regulation - Chronic energy deficiency can suppress essential hormones like IGF-1 and leptin, affecting bone health and metabolic rate.

3️⃣ Cellular Oxidative Stress - Without proper nutrients, our cells can’t combat oxidative stress effectively, leading to increased muscle fatigue.

Enter RED-S (Relative Energy Deficiency in Sport). It signifies a mismatch between an athlete’s energy intake and the energy expended in training. Beyond performance decrement, it can lead to a host of physiological issues like endocrine disruption, cardiovascular risks, and poor bone mineral density.

🔬 As a Dr in the field of sports and exercise, I urge all athletes to prioritise understanding their metabolic demands. Proper energy intake isn’t just about fueling today’s workout; it’s about long-term health and optimal physiological function.

If in doubt, reach out!

Stay informed, stay healthy! ✨

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