Adelfo Cerame - Road to Wheelchair Nationals '12: From Man Boobs to Striated Pecs - Looking Back at 2011

Image 1: Looks like Santa's sweet treats
just ricocheted off Adelfo ;-)

Although we are amidst the "holiday season" (you know the time of the year where the term off-season gets a whole new meaning ;-), there is one fellow who must obviously have read my blogpost about the not so amiable gifts Santa has in stock for some of us (cf. "Santa is Coming to Town")... judged by the pictures Adelfo has attached to the latest installment of his amazing "Road to Wheelchair Nationals 2012" series, Santa's sweet treats must have had a fat-burning, muscle-building effect on him. Well, at least this is what you could think, if you did not know how much hard work and dedication it cost him to get to where he is now. But, I guess I will let him tell you the whole story...

Without the "small" things the bigger one's "lose" all their meaning

It has been 12 months, now, hwen I got my medical release from the doctor... 12 months from the day I was finally able to leave the bed and go back to work... and eventually (!) go back to the gym and train! For almost all of 2010, I was confined to being bed-ridde. With the deep MRSA infected ulcer on my behind, I even had to lie on my belly - unable to sit, unable to move for almost a year.

Image 1-2: Looking back at December 2010 - All the abdominal fat and the man boobs that I accumulated after 12 months of being bed-ridden… I just hope that I will never have to go through that again.

That these memories are coming back now, is probably because New Years Eve is approaching. The last days of a year, where I have made a habit of reflecting on the little things that we usually take for granted. Looking back, none of this things, like being able to go to the grocery store, running errands or doing what I love the most, which obviously is going to the gym, was completely out of reach, back in 2010. Isn't it amazing how we always have to lose something until we appreciate its value?

Think about it, wouldn't  "Live life… cherish every moment of it… and be thankful for even the simplest things that this life has to offer!" be a much better new years resolution than the usual "I want to lose 5 pounds of fat!" or "I want to quit smoking"?

For me this (fortunately) temporary loss of mobility and, ultimately, freedom, marked another turning point in my live. I have ever since been trying my best to live life to the fullest, improve and better myself spiritually, mentally and physically. I have begun to cherish the simple things in life, constantly reminding myself that they could be taken away from me (and you!) at any moment. And for me, training, of all these little things, is the one I cherish the most: waking up in the morning, getting into the wheelchair and off the the gym to do the one thing I love the most is something I never want to lose again.

December 2010 to December 2011 = from man boobs to a striated chest

I don't know if you can empathize with the way I feel, when I look at the pictures from 2010, now. I mean, you know that about 8-6 weeks ago, I decided that I wanted to look "as stage ready as can be" at my 12-week mark (which actually is today) and today, after 12 weeks of intermittent fasting, eating whole "real foods", and training heavy and intense (plus minimal cardio and abdominal exercises) the result are eventually paying off:

Stats/Measurements

• Weight: 141 lb.
• Waist: 29 in
• Arms (flexed): 17 ¼” in
• Chest: 41 in
• BF%: around 8% [at least that’s what my digital calipers read ;-)]

As you can see from the images from last year… I don’t have the best genetics in the world (I’m more on the endomorphic side of the body types), and I obviously let myself go (not of my choosing, but due to illness), but my point is: No matter what genetic barriers you think or feel you may have, or how far off you’ve let your body and health go, it’s not impossible to achieve the physique of your dreams, with just a little bit of hard work, consistency and balance.

I guess, I can say I’m pretty satisfied with what I have achieved so far and I’m definitely looking far better than I was at the my last show in April @ the INBF Natural Buckeye. Fortunately for me, I have 13 more weeks to improve on my physique and push myself even harder with my training and dieting.

3 things I want to try and improve on within the next 13 weeks…

You think you could use some advice on your  training, diet and supplementation regimen from someone who knows what it takes to build muscle and lose fat? Reach out to Adelfo via Facebook.

1. Vascularity… I want people to (figuratively ;-) throw up because they’re so disgusted with how many veins are popping out through my skin. Genetics aside, pushing my body-fat level to the lower limit will be the major factor in achieving that.
    
2. Maintaining muscle mass and maybe even possibly gaining a little bit more… When you are dieting it is already difficult not to lose at least some of the fullness you have in the off-season. Putting on extra mass, on the other hand, is near impossible. Yet, although I have been dieting hard (and with visible results), I have been getting stronger throughout my prep and those strength gains are still coming... and though we all know that there is no 1:1 (or other quantifiable) relation between strength- and size-gains, I would expect to see at least increases in what people call "muscle density" or "maturity", if I can keep upping the weight on all my major lifts.
    
3. Strength… I just don’t want to look the part, but I also want to be strong also. As I already mentioned, this is the first prep I’ve had, where I have not noticed any decline in strength. I partly ascribe this to the combination of intermittent fasting, raw and whole foods eating, and some of the training methods I have used from Rob Regish’s Blueprint, which have really taken the variety of my workout routines to the next level. And I hope that the latest addition of Anadraulic State, Creapure (creatine monohydrate), D-Pol (d-Aspartic acid) and Recycle (a herbal natural test booster) to my supplement regimen will help me with lifting (increasingly) heavy(-ier) lifts throughout the rest of my contest-prep.

For the time being, I am on my pre-planned last week of the year famine/detox. Those of you who have followed the whole series will remember that I have been quite skeptical about whether the theoretically sensible (cf. Famine/Detox Episode), yet for any bodybuilder totally counter-intuitive idea from Robb Regish's blueprint would work, but the results I had back in October were so convincing that I decided to make it a staple within every macro-cycle of my training. And now, after 12 weeks of intense training and dieting, the time seems to be right.

Image 4: Example of a "detox meal"

Recipe of the week: Spartan Detox Food (example meal) - Eat this (or a similar meal) 3x a day to benefit from a simulated "famine".

• cucumbers, 
• a handful of fruits, and 
• a cup of vegetable juice from Trader Joe’s…

During my last detox, going extremely low on both calories as well as protein and fat worked quite well for me, but in general Rob's protocol allows for a  maximum of 1,200kcal (for you bigger guys out there) and <50g of protein, fill up the rest with veggies, fruit and a lot of water and you are good to go ;-)

During the 12 weeks, my body has eventually adapted to my diet and training, and is pretty much in an exhausted state, where gains in size and strength usually stall. In order for me to get my body back into a growth state, I have to shock the whole system by putting my body through a mild state of tissue breakdown with added stress (think of it as triggering the alarm). The mild tissue breakdown and added stress through training during the famine phase will accelerate the entire protein turnover cycle. So basically I want to get my body back into a phase where it feels like I just started lifting weights and training for the very first time in order to be in that growth state again, so that, even at an average calorie intake of roughly 1,400 calories per day, I can still maintain (or hopefully build on) the muscle

Final thoughts... at least for this year ;-)

Image 4:  No clue what "intermittent fasting is all about"? I suggest you start with reading the first installments of the Intermittent Thoughts, then (click here for Part 1, Part 2, Part 3 and more)

If there is one thing that I have really come to appreciate during the past weeks, it is yet neither the famine, nor the detox or the different training techniques I have learned. The one thing, I believe has made the biggest difference was intermittent fasting - all I can say is… I love it! The protocol is simple and easy to follow and I was able to tweak it to my liking by applying other methods that have worked for me in the course of the last 4 years of competing. And the results are mind-boggling. I mean, this has by far been the easiest prep I have ever had! Without being distracted with having to prepare meals, I got to focus more on training, school, and fun stuff like social events. Add to that the amazing results I have (and still am) seeing in the mirror and you know why I believe that “IF” is definitely something I can, and will do long-term.

I will leave it to that for today, and even the year 2011 and wish all of you a happy and safe New Year! And just in case you happen to be one of those people who like to make "New Year's Resolutions"… Good Luck! Let me know how that works out for ya in a week or two? Hahaha! Just kiddin'! But seriously… You shouldn’t have to wait till New Years to make resolutions and set goals ;-)

Shoulder Presses Ain't for Delts, Only! Standing, Seated w/ BB or DB, They Also Hammer the Core, Biceps & Triceps

Flex Wheeler doing BB presses in what vcertainly isn't the ideal position for the lower back - imagine him doing that standing *uhoh*

Don't worry, I am not going to repeat my SuppVersity Facebook news post on the activation of the rectus abdominis, the obliques and the lower back muscles many of you 'liked' on Facebook. I am rather going to expand on it by presenting the data from the unofficial follow-up (Saeterbakken. 2012). Before I do that, I will yet give you the usual preview of today's installment of the SuppVersity Science Round Up I am doing every Thursday (1PM EST, live!) with my friend Carl Lanore from Super Human Radio (in case you did not notice, the number of real scientists on the show has risen exponentially within the last weeks, so I highly recommend you download a couple of other podcasts as well).

SuppVersity Science Round Up - Preview

Just like today's blogpost the focus of today's Science Round Up is actually going to be on training and exercise and don't worry, we won't just be whimpering that people get way too less of it.

• Twin study shows: We all age, but exercise determines the consequences on your health
• Hormonally (over-)demanding plyometrics!?
• HIIT, light intensity steady state and the thyroid gland
• NSAIDs: Go or no go for an athlete interested to build muscle?
• Glucose, insulin and their muscle building effects
• Could your own sweat protect you from skin cancer?
• Chinese medicine strikes again: P. Lobata stops liver fibrosis in its tracks
• Non-reactive form of vitamin E could be gold standard for cancer therapy

By now you should know the procedure and will thus be aware that it is unrealistic to assume that Carl and I are going to pack all these, let alone any of the auxiliary items on my list, into one show. My best advise would be to tune in live at 1PM (or downlaod the show ~2h later from the sidebar link, here at the SuppVersity), listen and come back tomorrow, to read about the topics that did not make it into the show in the SuppVersity Science Round Up Seconds.

Back to where we came from: The shoulder press!

After the obligatory heads up on the potential topics of today's SuppVersity Science Round Up, let's now get back to the shoulder press. Even if you did miss the facebook post on how it activates the abs, the obliques and the lower back, the other day, you should remember from the SuppVersity EMG Series that different forms of the shoulder press (including behind the neck presses, which are not part of the study at hand) will yield differential activation patters in the musculature of the shoulder girdle.

Chest	Biceps	Back	Core	Legs	Triceps	Shoulders
Navigate the SuppVersity EMG Series - Click on the desired body part to see the optimal exercises.

In the follow up to their core activation study from last year, Saeterbakken and Fjmland did once again go one step further than Boeckh-Behrens & Buskies. Instead of measuring just the usual suspects, i.e. muscles you actually want to train when you do shoulder presses, the researchers expanded their existing data on the activation patters by measuring the activity of biceps and under both, seated and standing exercise conditions with a barbell or dumbbells as well as the 1-RM strength on the individual exercises.

With the auxiliary muscles, the body position, the loading modality (measured during sets of 5 reps at 80%)  and the maximal weight the participants were able to press in each of the four 1RM max attempts Saeterbakken and Fjmland's data on the shoulder presses, alone, is therefore about as extensive as Boeckh-Berhens' and Buskies' data on four or five totally different exercises. Plus their subjects, 22y old lifters with on average 5 years of training experience may be a better model for at least some of you.

Figure 1: Activity pattern of the deltoid and auxiliary muscles (* indicated p < 0.05; data based on Saeterbakken. 2012)

Let's get to the results, now. As the data if figure 1 goes to show you, there are a couple of statistically significant differences, which are in some cases (the asterisks on the lowest level, directly above the bar) related to the training equipment (i.e. dumbbell vs. barbell), in other cases, such as the activation of the posterior deltoid, for example due to doing the exercise standing vs. seated (asterisks about the lines connecting the respective bars denote p < 0.05).

For those who missed the original Facebook post on the first Saeterbakken study (Saeterbakken. 2011), here is a brief summary: Using electromyographic activity (EMG) of the superficial core muscles (i.e. rectus abdominis, external oblique and erector spinae) and comparing the data of seated, standing, bilateral and unilateral dumbbell shoulder presses the researchers found that their 15 healthy male study participants had the greatest core activitation, when they performed their five repetitions at 80% of one-repetition maximum... 

• rectus abdominis (abs)
  - standing unilaterally
• external oblique
  - standing unilaterally  
• erector spinae (lower back) - standing unilaterally

For some of the muscles the different positioning does not really matter, but in each and every case the standing unilateral dumbbell press had a slight (if insignificant) edge on the rest of the exercises.

Just as in the unofficial prequel to this 2nd study by Saeterbakken and Fimland I discussed on Facebook earlier this week (see box to the right for a summary, if you don't want Facebook and the world to know the color of the boxer shorts you're wearing, today), the overall pattern that emerges from this very recent follow up study is that ...

"[...] the standing dumbbell press exercise, which was the exercise with the greatest stability requirement (standing + dumbbells), demonstrated the highest neuromuscular activity of the deltoid muscles." (Saeterbakken. 2012)

Now what's particularly intriguing to this result is that the superiority of the complex movements became obvious despite the fact that the subjects moved the least weight during this exercise. In the aforementioned study by Boeckh-Behrens & Buskies, for example, the exercises which allowed the greatest leverages, usually produced the highest muscular activity, as well.

How can we explain this difference?

Aside from the training status of the participants, the first thing that comes to mind is the rep range: While the subjects in the study at hand trained at a 5RM rep range (meaning they failed on rep 5), the sports students in the Boeckh-Behrens & Buskies study performed 10-12 reps and would thus necessarily have to use lighter weights. In conseuqence, every lbs more made a greater difference for the students, than for the 15 even-aged healthy men with an average of five years of strength training experience under their belts (they were no competitive powerlifters or o-lifters, though), who participated in the studies by Saeterbakken & Fjimland.

As far as the other parameter, the body position, was concerned the results are not as obvious as they were for the core muscles in the 2011 study by the same authors:

"Further, standing versus seated execution, and to some extent dumbbells versus barbell, both resulted in increased muscle activation of the deltoid muscles. Standing instead of seated presses raises the centre of the mass, and also provides a  smaller base of support as the contact points decreases from three to two, particularly when using a bench with a back-rest [comment: the back was set to 75°]. When using a pair of dumbbells instead of a barbell, the main difference is that the dumbbells must be controlled independently of each other. Hence, performing shoulder presses standing and with dumbbells should lead to greater instability." ( Saeterbakken. 2012)

Regardless of the intricate differences, though, the whole picture that emerges from the synopsis of both the 2011 and 2012 data Saeterbakken and Fjimland have collected is actually quite clear: Complex exercises and corresponding muscle activation patterns can make a very valuable tool in the arsenal of the experienced strength trainee.

A final word of caution and the real world difference you can expect

Are you looking for more shoulder exercises? Look no further read them up in the SuppVersity EMG Series and the respective part on the 'best' exercises for M. Deltoideus, M. Infraspinatus, Supraspinatus and Teres Minor (more...)

The lower back and the shoulders itself are however so liable to injury that even somebody with years of training experiences should start out with very light weights and see for 2 or 3 training sessions how his shoulders and lower back react. Against that background it does also appear questionable, whether it is wise to to include a heavily loaded variety (5-8RM) of the standing dumbbell shoulder press in the routine of any beginner or only slightly advanced trainee. The increased injury risk just is not worth it, because the complexity of the movement and the individual (often very) weak links will force a beginner to use very light weights. So light, in fact, that the original target muscle, which is obviously the shoulder, may not receive enough hammering, so that even in the fortunate case that they don't hurt themselves, beginners will probably see way better results with regular seated vs. standing dumbbell presses.
 
References:

• Boeckh-Behrens WU, Buskies W. Fitness-Krafttraining. Rohwolt. 2010.
• Saeterbakken AH, Fimland MS. Muscle activity of the core during bilateral, unilateral, seated and standing resistance exercise. Eur J Appl Physiol. 2012 May;112(5):1671-8. Epub 2011 Aug 30.
• Saeterbakken AH, Fimland MS. Effects of body position and loading modality on muscle activity and strength in shoulder presses. J Strength Cond Res. 2012 Oct 23.

Adelfo Cerame - Road to The Wheelchair Nationals '12: Experience and Intuition Distinguish Bro from Pro

Image 1: If Einstein had been into bodybuilding, he'd have loved how Adelfo approaches his contest prep.

Science certainly is a serious business. Nevertheless, even Einstein was convinced that, at the end of the day, "intuition" and "experience" is what distinguishes the average scientists, who spends his life in one of those sterile labs doing what philosopher of science T.S. Kuhn once called "normal science", from a genius like Einstein, who scribbled his theory on the photo-electric effects, for which he was awarded the Nobel Prize, on a few sheets of paper in the course of a transatlantic cruise. And though I assume Adelfo won't like it, if I call him a "genius" (and I assume for a future pro bodybuilder the comparison with Einstein is not very flattering, anyway), intuition and experience are two things our man at the 2012 Wheelchair Nationals in Florida has in abundance, which is why I will now sit back, relax and let the "pro" do the work ;-)

4 Weeks in - Let's See Where We're at!

Week 4 is almost a wrap, and as I promised last week… I have new progress pictures and 2 new videos for you. We'll start with the pictures, because - even in the age of digital cameras and even smartphones with (supposedly) "high definition", stills like those in image 2 are unique (and necessary) in that they give you the time to really judge your progress - taking weekly (more often is neither necessary nor advisable) pictures is thus a must-do not only for a competitive bodybuilder, but for everyone who wants to take his physique to another level.

Image 2: Progress pics, front - September 2, 2011 (left), pre-contest experimentation phase; October 24, 2011, 4 weeks into the contest prep (img Adelfo Cerame, 2011)

For those of you who are catching up, I did not start my contest prep until the 1st week of October, so the September photos were taken while I was still in my bulking phase and still trying to experiment and to adjust my raw foods intermittent fasting dietary regimen to my individual needs. The lighting is a bit off between the two comparisons, but after 4 weeks, I can see a slight, yet visible improvement in my abdominals - it’s not much, but in view of not having been in a caloric deficit, yet (I'll be going there next week), this is certainly noteworthy.

Image 3: Progress pics, back - September 2, 2011 (left), pre-contest experimentation phase; October 24, 2011, 4 weeks into the contest prep (img Adelfo Cerame, 2011)

The biggest improvement I have noticed though are related to my back. I don’t know how much of the difference is due to the lighting or maybe just because I put my hair up, ... but I honestly think that I was able to put on some decent size - looks like the switch to an EDT-type training style with all the grueling, but obviously productive compound moves was already paying off…

"Opinions, please! What do you guys think? Honestly… I’d like to here some of the readers’ opinions. Am I just seeing things? Or am I really making improvements?  [Comment Dr. Andro: You can either use the "comment" function at the bottom of the page or contact Adelfo directly via Facebook if you want - the latter also holds true if you have specific questions or are interested in dietary counseling]

Like I did mentioned last week, I do feel a lot harder, tighter and fuller. The typical "side-effects" everyone I've talked two who has implemented Rob Regish's interpretation of "escalating density" training into his regimen is "complaining" about.

Showtime! Adelfo hits the gym again...

A pros pros training. Let's get to my latest training videos, now. We shot the videos Wednesday night! They are in fact so brand new that I did not even have the time to get sore, yet ;-)

Video 1: Adelfo is incorporating static holds at the end of each set, a technique he has adapted from Rob Regish's Blueprint (Adelfo Cerame, 2011)

Before I start my EDT Block, I always start off with some static hold movements. As you can see in the video, I do five reps and then hold the weight up, after the last one without going to full lockout (this is obviously important, unless you want your joints, instead of your muscles, to do the work ;-). When I began incorporating this technique from the Blueprint into my regimen, I used to add 4 plates on each side and just do one static hold without the extra reps, but I have noticed that the tension on a decline hammer strength machine is a lot different from a free weight decline press (the tension is a lot heavier on free weights). Thusly, I wasn’t getting enough tension with just one static contraction, because the hammer strength machines does a lot of the additional stabilizing work, you would be doing if you were performing this move with free weights.

Image 4: Even the best blueprint will need some tweaking to become your blueprint for success.

A brief note by Dr. Andro: This little "tweak" to the original "Blueprint" Adelfo has come up with is further evidence of what I mentioned two weeks ago, when Adelfo and I were on Carl Lenore's Super Human Radio. Adelfo is the kind of guy who does not follow (even good) advice blindly. He has exactly the kind of Einstein-ish "intuition" and "experience" which distinguishes an average trainee, who relies on his "gurus" to take him to the top (which obviously seldom happens), from a professional bodybuilder, who takes responsibility for his own progress.So, whatever your personal goals may be, whether you are an aspiring bodybuilder or just an average Joe or Jane wanting to look good naked - always remember: success comes from making a blueprint your blueprint!

Being assisted by the hammer strength machine does yet not mean that you cannot hit the pecs hard - it's well possible that the opposite may be the case, because you are eliminating some of the weaker links... So even if I am doing only 3 instead of 4 plates on each side the pump and the pain during the static hold tell me that I am sending that growth signal you should strive to trigger whenever you are at the gym... after all, muscle growth not exhaustion is why (I assume) most of you will be at the gym.

"I am always tailoring my workout to my very specific needs"

And just in case you are now asking yourselves why I am not just doing the static holds with free weights then, the answer is simple: It's a safety issue. When I use free weights, I do not have the luxury to plant my legs and feet to th ground, which would give me that extra stability I need. I depend solely on my core to balance myself. I have to focus on balancing the weight and myself at the same time. So you can just imagine if I lost balance while trying to lift 3 plates on each side - therefore, the most I ever did after my injury on a free weight bench, was 2 plates on each side. And while there will be a video of me doing free weight bench presses somewhen in the near future, as well. For now, I want you to take a look at me performing my favorite EDT block (video 2)

Video 2: Adelfo doing incline presses and DB rows on the third of on of his EDT cycles (Adelfo Cerame, 2011)

I perform these push-pull combinations right after decline press static holds on the hammer strength machine. Being able to move as fast as I can from one exercise to another, this combo allows me to really make the most of my time at the gym. This video comprises only one of the many cycles I try to do within the 20 minutes given…(if you have not followed the whole series, you can read up on my EDT regimen here). The video, I think, shows the third of the cycles, each of which consists of a one push and one pull exersice

"I do a set of incline presses, then I superset that with DB back rows."

My goal with each EDT block (comprising two exercises each) is to try and complete as many cycles as I can within the 20 minutes. Last night I got up to 7 cycles and with each cycle, I lift as heavy as I can for 4-6 reps. If you do the math - 7 cycles à 4 reps does not sound so much, but you must also count the reps from the superset.... so that you are doing 56 all-out heavy (!) reps within 20 minutes… Then you have another static hold exercise, and another EDT block… remember what I said about not exhausting, but stimulating a few lines above - well, sometimes the former just works best by doing the latter ;-)

Image 5: A Philly Cheese Steak Wrap, the latest delicacy from Adelfo Cerame's personal cookbook.

Adelfo Cerame's Cookbook - Philly Cheese Steak Wrap: With the great feedback I am receiving on the recipes, Dr. Andro and I have decided to include one page of the repertoire I have come up with for me, as well as for the clients, I am doing dietary counseling for, as a regular part of each of my blogposts. Today's recipe is a tribute to all of you (and many of my clients) who are no big fans of raw food eating - and let's be honest, if you are doing it correctly "cooked" food can be both healthy and delicious as well. Not being a raw foodist, paleo eater, south beacher, or whatever else people affiliate themselves with… I eat nutritionally dense whole, natural foods (well, maybe with some exceptions on my cheat/reefed days ;-), of which I have found that my body cherishes extra bucks the ingredients may cost me.

A pros pos ingredients, here is what you will need for the one and only ...

Adelfo Cerame Philly Cheese Steak Wrap

• 1 La tortilla Low Carb / High fiber tortilla (12g fiber/6g carbs)
• 6 oz lean grass-fed sirloin steak
• 1 tbs. real mayonnaise
• 1 string cheese
• Bell peppers & onions (optional)

Macros: 43g protein/ 6g carbs/  16g fat - bon appetit!

Looking back at the first month: "So far everything has gone smoothly!"

Image 6: Adelfo 10-8 weeks out from 09’ WC nationals (Adelfo Cerame, 2009)

Although we still have a couple of days left, I want to take the chance and review this first month of my contest prep. What is kind of exciting is that I have noticed that the way I look as of now is actually how I looked 10 to 8 weeks out during my 09’ contest prep (see image 6), and this is the time during prep where I usually felt rushed and began to drastically cut back on calories, because I felt there wasn’t enough time to achieve the level of competitive leanness I am expecting of myself. And though the drastic cuts did not affect me during the prep, it affected me after! And for those of you who have made extreme cuts before know what I’m talking about.... But anyway back on topic.

Next month (i.e. next week, already) I will actually begin to drop my caloric intake. This month I was at 2,250 calories, which is my maintenance calories. Next week I plan to start out with a ~15% calorie deficit from my caloric maintenance, which is about 1,912 calories. That's not much, but with the way I am looking now, eating at or even above maintenance, I expect to see some changes. If my body does not react the way I expected, I can still adapt my caloric intake in the course of the next four weeks, so that I will be able to reach my first long term goal, which is getting almost stage ready by January. By that time, March comes around real quick and I just want to have the luxury of knowing that I’m ready. But I’ll blog more about that next month and also write more about wheelchair bodybuilding in general for those of you that weren’t aware that there is such a thing ;-)

Adelfo Cerame - Road to The Wheelchair Nationals '12: Leaner, Tighter, Stronger - And All That Despite a Novel Sugary Twist to the Uber-Technician's Diet.

Image 1: Just in case you didn't listen to Adelfo on SHR, last week - he is still single, ladies!

Another week, another Thursday; and although I suppose that more of you have been waiting for Adelfo's update than for my humble thoughts on the latest anti-multivitamin campaign... ah, I mean respectable research on multivitamins ;-), I just wanted to let you know that I am at it. Expect the second installment of the follow-up on "Ask Dr. Andro: Are Supplements Bad For Me (1/2)" either tomorrow or on Saturday... fortunately, future pro-wheelchair bodybuilders like Adelfo Cerame appear to be more reliable than muddle-headed pro-physicists, who spent most of their free-time either in the gym or blogging away on exercise and nutrition science. So, "now, without further delay, let's get to" (I bet some of you will recognize this slogan ;-) Adelfo's third week of what I believe is going to be his last contest prep as an amateur *thumbs up!*

Adelfo Cerame Jr., the uber-technician

Week 3 almost in the books and... I’m feeling great! I’m really having fun with my EDT (escalating density training) routines and tweaking it in to my own. Through trial and error, last week, I was able to pick and eliminate what EDT combinations worked and didn’t work for me. I narrowed it down to 5 exercises that work really well considering my mobility, where I can quickly move from one exercise to another during my EDT block. With some help of my friend Dr. Andro I have compiled a graphical overview for you, always pairing one chest and one back or one biceps and one triceps exercise.

Illustration 1: Adelfo's favorite antagonistic supersets for his current EDT routine.

These are the 5 EDT antagonistic (push/pull) combinations that work real well for me, where I can quickly move from one exercise to another. I will try to get some video for next week (don't forget to come back ;-) with me doing one of my favorite EDT blocks.

Image 2: Adelfo's abs during a previous contest prep. Difficult to outdo, but he will do it ;-)

After the famine and with this escalation in training density, I am getting harder and stronger!

The videos probably won't be able to show that, but after the famine, I cribbed from Rob Regish's Blueprint and with the switch to this (for me) novel training style, I have also noticed that my body has gotten a lot harder, my skin feels tighter, and I feel a lot leaner... while this obviously is somewhat subjective, there is not doubt: I’m definitely getting STRONGER! Moreover, my waist is already at 31" and it looks like it can get down to 30" by next week… pure imagination? I wouldn't think so. I’ll try to take some quality photos of how my physique is looking for next weeks segment - promise!

My diet: A permanent construction site...

As for my diet… I have made some minor adjustments to keep things simple! When it comes to prep and my diet, I get really paranoid and over analyze everything from my nutrition to training. I don’t know why I get like this, but I always do every time I prep. The only way out of this misery is to keep things as simple as possible, so I decided to return to protein and fat (P+F), only, as the basis of the majority of my meals. The only meals that is going to have a "high" carbohydrate content (and low fat) will be my PWO shake and PWO meal. Knowing my own body best, I figured it would be wise to let it run on what it runs best, i.e. fats and give him those damn carbs it needs not to shut down and keep the performance up in the very window, where they will get stored, right where they belong, inside my muscle.

This also implies that I will stop doing my usual Sunday re-feeds for a while, because I feel that I get plenty of carbs post workout after this tweeks, so that - given my current caloric intake - I do not see any need for further refeeds (especially not carby ones). Up to know, this has worked out pretty well, I haven’t been feeling flat, my energy is up throughout the week, my metabolism seems to be up... moreover, I haven’t been feeling deprived of anything, so psychologically I’m fine, as well. The formula is easy:

no flat muscle + no lack of energy +  no metabolic shutdown + no cravings = no re-feeds

I am yet aware, that, eventually, somewhere down the road, I will start to incorporate re-feeds again. Probably every 2-3 weeks, at the latest, when I drop the carbs even in the post workout phase and switch to a strictly "ketogenic" diet.

Image 3: An image for those of you who forgot what table sugar looks like; and Alan Aragon's wisdom for those of you who still believe that only dextrose, or even waxy maize or Vitargo are tolerable PWO sugars.

A pros pos carbs, in case you are wondering what carbs we are talking about... we are talking about "white poison" - plain table sugar! I have been adding 5 tsp. of it to my post-workout shakes (and as you can see, I survived ;-) Originally, I wanted to use dextrose, but I really did not fell like forking over $6 for a pound of sugar. I’d rather spend that $6 on half a gallon of raw milk! [Comment Dr. Andro: A wise decision, but since I do not want to adorn myself with borrowed plumes, I just refer you to Alan Aragon's December 2008 Research Letter, where, in his article "An objective comparison of chocolate milk and Surge Recovery", he beautifully dissects, the dextrose (and other) myth(s).

So, what have I left to tell you? Ah, yes. As of lately I have come up with a new "all natural" growth promoting sleeping aid, it's a dessert I suppose the chefs among you will be interested in.

My pineapple chocolate cheesecake

Image 4: Healthy, all natural pre-bed nutrition - Adelfo Cerame's original Pineapple Chocolate Cheesecake (TM)

Ingredients:
• ½ c. cottage cheese
• 24g vanilla whey
• 1 tbs. heavy whipping cream
• ¼ c. of fresh chopped pineapples
• 1 tbs. of Walden Farms Calorie free chocolate syrup
• 1 tbs. coconut oil
  
  Macronutrient breakdown:
• 37g protein
• 10g carbs 
• 25g fat

How to do it:  Mix cottage cheese, vanilla whey and heavy whipping cream (you can blend it as well, if you prefer that). Pour Walden Farms Calorie free chocolate syrup over what you just mixed. Add the fresh pineapples on top, then pour 1 tbs. of melted coconut oil over your fresh pineapples and wait for the coconut oil to harden over the cold fresh pineapples (about 20 sec.) - You can wash this down with a cold glass of raw milk (which I do), and enjoy your anabolic sleep!

...hmm, what are you waiting for? I said "anabolic sleep!" ;-)

Adelfo Cerame - Road to The Wheelchair Nationals '12: After the Famine the Training Starts to Escalate!

Image 1: Adelfo Cerame Jr. survived the famine ;-)

Another Thursday, a busy one that is not over with this blog post, but will go overtime on Carl Lenore's Super Human Radio, where, today at 12pm EST, you will be able to hear Adelfo Cerame Jr. and my humble self, Dr. Andro, chitchatting with Carl about Adelfo's contest prep, his raw foods diet, intermittent fasting and much more. So don't forget to tune in live (update: click here to download podcast) And in case your boss doesn't like it when you listen to Internet ratio shows in the office, I will post the link to the podcast, as soon as it is going to be available. In the meantime, I'd suggest you read up on whether or not Adelfo survived the self-inflicted famine that had befallen him in the last week ;-)

Low calories + low protein = no hunger, no sluggishness, no visible muscle loss and no acne!

As those of you who have been following my weekly updates (a new installment appears every Thursday) here on SuppVersity know, I picked up a technique I read about in Rob Regish's Blueprint and kicked the hot phase of my contest prep off with a famine/detox protocol. The idea behind this initially counter-intuitive dietary intervention was to give my digestive tract, as well as "Mr. mTOR" on his "AMPK/mTOR seesaw" (if you aren't familar with "Mr. mTOR" and his unique "toy", you got to read up on Dr. Andro's latest blogposts on Intermittent Fasting) a well-deserved rest, in order to reset and improve my body’s ability to absorb and utilize nutrients more efficiently. In combination with strenuous training, the famine signal, which is obviously a novelty for a bodybuilder who has been focusing almost religiously on getting his share of protein in every few hours for years, is supposed to shock and alarm the body. It's similar to what a beginner will experience, when he is first hitting the gym - stress-induced super-compensation is the name of the game.

Figure 1: Macronutrient break down (protein, carbs, fats in g) famine and regular training day - what a difference!

With a calorie intake way below what it will look like even at the end of my contest prep, I expected to be hungry all the time. Much to my surprise (yet actually in accordance with what I had read in Rob Regish's "Blue Print"), the 5 days on fresh pineapples, raw carrots and vegetable juice (V8) weren't so bad at all. Being an "Intermittent Faster" for quite some time now and thusly accustomed to going without food for longer periods of time, I did not even feel particularly hungry. My performance in the gym did not suck and I did not feel sluggish, either. What I did notice, though, was how my skin cleared up. By day three on this low calorie, low protein diet the acne on my chest and back had cleared up - quite astonishing for someone like me who has had issues with body acne for most of his life!

A Guru of my own - wandering in Gironda's footsteps

I broke the famine/detox on Saturday afternoon and treated myself to a Brazilian BBQ buffet. If you’ve never been to a Brazilian BBQ restaurant… it’s a meatgasm of all you can eat: cuts of rib eye, sirloin, brisket, lamb, duck, rabbit… and the list goes on! For the first 48 hours I loaded up on protein and quality carbohydrates, drank lots of water and popped liver tablets throughout the day. "Liver tabs, what's that?", if you are now asking yourselves that question, you probably belong to the post-Gironda generation. Vince Gironda, the "Iron Guru", himself, swore by those dessicated liver tabs for their high content of quality protein and highly bioavailable vitamins and micronutrients. While this may have been in the days before protein powders, BCAA caps and mega-dosed vitamin supplements became widely available, I feel like this completely natural nutrient blend still has its merit. As of Monday, I went back to my daily maintenance calories.
 

Image 2: This is what a  Brazilian BBQ looks like. Certainly, a decent contrast to a famine. So, just in case you ever happen to be starving, I guess now you know where to go to refeed yourself ;-)

When I first started experimenting with IF last month, I mentioned that I wasn’t really keeping track of my calories or numbers. This has obviously changed with the beginning of my contest prep. After all, intermittent fasting is a dietary strategy, but no magic bullet that will give you the body of a bodybuilder if you eat like a pig - when on stage 0.1% body fat make the difference, between victory and defeat, calories begin to count again. Accordingly, I began keeping track of my calories and macronutrients, again, in order to make sure that I am hitting my numbers: For the next two weeks my goal is to keep my calories around my caloric maintenance to take advantage of the super-compensation process I hope to have triggered by the short famine phase.

After those two weeks, I will evaluate my physique, take measurements and go from there. In that I will diverge from the usual approach, where you are gradually decreasing your calorie intake from week to week, and use what you may call "caloric zig zagging" instead. In essence, I hope to be able to forestall metabolic adaptation processes (it should be obvious that we are talking about reductions in energy expenditure, here) by keeping my energy/calorie intake up during my training days and using my off days to create the caloric deficit which simply is a necessary prerequisite to bring your body fat level down into the unquestionably unnatural lower single-digit range, where veins start popping and striations begin to show, where "normal" people would not even know they had muscles ;-) ... but as I said, I’ll figure out the details, based on the results of the next two weeks.

EDT = Escalating Density Training - well, why not give it a shot!?

Image 3: Adelfo's personal EDT blueprint right from his secret training diary ;-)

I have also decided to make a major change in my training routine: For the next couple of weeks, I will be experimenting with static holds and EDT, i.e. escalating density training. At first I was very hesitant, because I am so used to common split routines, muscle-isolation and all those specialization and isolation stuff you read about in the muscle mags. After some conversations with Rob Regish, who happens to offer additional advice to all readers of his "Blueprint" on the Blueprint Forum, and some research of my own, I have convinced myself that the intense antagonistic training style of EDT could work particularly well for someone like me, who, partly due to my handicap, usually doesn't do any regular "cardio" training during his contest prep and wants to rely on strength training and nutrition, exclusively, when dieting for a show. Being short and intense it could help burn off calories while building or maintaining the muscle mass I already carry.

A pros pos intense: EDT is a program or training system that challenges you to do the most work per unit of time, which is supposed to be an optimal stimulus for muscle growth. Each session consists of two antagonistic or push/ pull exercises (for example, 1 chest exercise superset w/ 1 back exercise and 1 biceps exercise superset w/1 triceps exercise). You have 20 minutes for each exercise (which is called the PR Zone or personal record zone), to perform as many reps as you can. The goal is to try and beat your personal or PR zone, every workout session. Now, if you have not tried it yourself, two exercises, 40 minutes of training... that may not sound very intense... believe me, my experience from Monday's workout tought me otherwise: EDT is fast paced and intense. I was sweating and breathing hard, like I was running sprints back and fourth for 20 minutes. I haven’t felt like that in a long time from a weight training session…

And for those of you that are wondering. "Hey, and what about your other body parts? Deltoids, triceps, the individual heads, etc.?" Honestly, when you’re hammering your chest and back constantly within those 20 minutes… I can assure you that you WILL feel that your deltoid, triceps, and biceps are getting hammered just as well. And FYI… you cannot change the shape of your muscles or restructure your muscle bellies by exercising body parts from certain different angles - you may be able to make up for minor imbalances, but when it's all said and done, all you can do is shed off the body fat and showcase what you have made out of the body God gave you.

Abs, abs, abs,... is that all people want?

You think you could use some advice on your own training, diet and supplementation regimen and want it from someone who obviously knows what it takes to build muscle and lose fat? You can reach out to Adelfo via Facebook.

Before we close this weeks update, a brief note on a topic many of you appear to be interested in: My, or I actually I think you are more interested in YOUR abs ;-) I get a lot of compliments and questions on how I get my abs so defined, people ask me what type of exercises I do or think that I spend the whole day working them out. To be honest, I don’t do any special exercises or different varieties of abdominal workouts, as you see some people do. I keep my abdominal workout simple, just your basic cable crunches using a rope. People don’t realize that everybody exercise his abdominals on a daily basis... you cannot do squats, deadlifts, shoulder presses, benches, etc. without them! During each rep, your abs got to work - they are stabilizing your body, whether you realize it or not, your abs will gets their share of stimulation.

Now, obviously, I depend a lot more on my core to hold me up and balance myself, since I cannot use my gluteus and legs. When it comes to "training" abs, this is an advantage, because I am utilizing my core more than most "healthy" people do, just to keep my posture up and balanced... I let my diet take care of the rest!  Always remember: Abdominals are built in the kitchen, but that’s stuff for one of the next installments ;-)

Leaky Gut & Gluten Belly: Bacterial Firebugs Translocate from Your Gut to Your Ever-Growing Visceral Fat Depots

Image 1: Gluttony or a victim of bacterial translocation from an unrecognized gluten-sensitive leaky gut (img from COPD Lighthouse)

"Leaky gut", for decades one of those concepts, the belief in which divided self-proclaimed "real scientists" from their "hippie" counterparts, has eventually found its way to mainstream science. What began with a few tentative studies into the role of a pathologically increased gut permeability in Crohn's disease and co., is about to become a recognized research area with about 150 related publications within the first 9 month of 2011, alone. Out of these 150 publications, a study by Professor Pierre Desreumaux, and his colleagues from the Universitè Lille Nord de France (Desreumaux. 2011) is unquestionably among those, which could have a major impact on the established image of the gut and its biota as an isolated system that sustains the rest of the body with nutrients and has - due to the insulating epithelial layer - little or no direct impact on all the ailments and illnesses by which the Western civilization has been befallen in the course of its quest for highly palatable, optically pleasant, economic and convenient (franken-)food.

The study comprised 22 patients with Chron's disease, 17 patients with ulcerative colitis and 21 controls, who were normal weight, had no history of diabetes mellitus and were not being treated with speci fic medications known to modulate visceral fat. All patients had been scheduled for operations, during which - with their consent - the required subcutaneous/mesenteric fat specimens were taken and the ileal and colonic transparietal biopsies were performed.

Figure 1: CRP mRNA expression [arbitrary units] in mesenteric and subcutaneous fat pads of control, Crohn's disease (CD), and ulcerative colitis (UC) patients (data adapted from Desreumaux. 2011)

While the result that the mRNA expression of c-reactive protein (CRP) in the Crohn's disease group was 83x higher than in the patients with ulcerative colitis (UC) and 3000x higher than in the control group, alone would probably have been worth the whole procedure, a way more interesting result is that the 83x increase over the UC group is fat-depot specific. This means, only the mesenteric fat that is situated right next to the organs of the intestinal tract produces this 83x exaggerated amount of the acute phase protein CRP that is released in response to acute profound inflammation and has been implicated as a marker for peripheral vascular disease (Abdellaui. 2007), liver inflammation (Rodrigez-Leal. 2006), and other unwanted metabolic consequences of the rampant obesity-pandemic (Oda. 2008). This novel observation led the scientists to believe that CRP expression may be enhanced by inflammatory and bacterial stimuli related / subsequent to the pathologically increased gut permeability in Chron's patients.

Image 6: Could Glutamine be
the cheap colostrum?

Can you take measures to decrease your gut permeability and spare your visceral fat e.coli and other bacterial infections? Yes you can! And if you are a diligent student of the SuppVersity, who does not miss a single "course" (i.e. blogpost), you already know that

• glutamine (e.g. dos Santos. 2010), and
• colostrum (Marchbank. 2011)

have been shown to increase gut integrity and to reverse the negative effects of strenuous exercise (such as heavy weight lifting and marathon running ;-) on intestinal permeability.

And in fact, Desreumaux et al. were able to show that in Crohn's disease patients, bacterial translocation, which is usually defined as the migration of bacteria from the gastrointestinal tract to mesenteric lymph nodes and then to peripheral organs such as the liver and spleen, can also affect the mesentric fat pads and increases during experimental ileitis (i.e. inflammation of the ilium, of which a permanently increased mucosal permeability is a characteristic feature; Kroesen. 2008):

Bacterial translocation to mesenteric adipose tissue occurred in 80% of indomethacin-treated rats [model for inflammatory bowel diseases] compared with 11% of control rats. Higher rates of bacterial translocation to mesenteric lymph nodes were also noted in rats following intraperitoneal administration of indomethacin when compared to control animals (67% vs 22%, p < 0.089). The rates of bacterial trans-location were broadly similar in mesenteric adipose tissue and mesenteric lymph nodes (80% vs 67%) in indomethacin-treated rats, as well as in control animals (11% vs 22%).

With 27% the rate in the Crohn's patients was lower, yet still more than two 2x higher than in the "healthy" controls (13%). Basically, this means that a healthy gut keeps >87% of the bacteria from wreaking havoc on your visceral fat depots (and other organs) a "leaky" one, on the other hand, may allow up to 80% of these tiny firebugs to make themselves at home in the fat tissue next to your digestive organs. Now, that would not be a problem, if the local "fire" your new subtenant are sparking within those fat pads would not results in chronic and systemic inflammation (the scientists were able to show a linear relation between visceral CRP and systemic CRP levels) and thus predispose you to obesity, diabetes, heart disease, Alzheimer's, cancer and all the other plagues of the 21st century.

Abdominal Fat Annihilation With Clay-Wraps, Microcurrents & Aerobic Exercise? There is Something in This List That Works, But It's Probably Not the Clay ;-)

This, probably won't cut it (the fat), because the electrodes and the wraps are missing.

I suppose that the headline of today's SuppVersity article will probably split the SuppVersity Readership into two camps. Those who say: "Pah, I am not a pussy: Clay-Wraps are not an option. I'd rather do a couple of additional HIIT sessions than getting one of those!" And the other camp saying: "Wtf, finally I have a reason to go to the spa regularly!"

In the end, it does not matter on which side of this divide you are, the results a group of scientists from the Oporto Polytechnic Institut in Vila Nova de Gaia in Portugal present in their most recent paper in Clay Sciences (no, this is not a joke, there really is a peer-reviewed journal on "clay science"), will probably surprise all of you.

"Clay wraps? Really?"

Assuming you would read the full-text of the study, you would, just like me, initially be enlightened that clay has been used for centuries not just as a cosmetic to make your skin look younger and healthier, but also as a means to reduce abdominal fat (Melo. 2013). Usually, these clays are composed of "green clay" (which has natural calcium and aluminum as components), green tea and magnesium sulfate. The clay is impregnated in a bandage that compresses the tissue and enhances fluid drainage from the abdominal region through the superficial lymphatic system (Standring. 2008).

• 

  Green tea reduces thyroid hormoness. Reason for concern? (learn more)

  Green tea: I am quite certain that all of you are familiar with the fat liberating effects green tea has on adipose tissue, as well as its ability to induce apoptosis in mature fat cells, to inhibit adipogenesis (storage of fat) and differentiation of preadipocytes (formation of new fat cells). Accoding to Belo (2009) and Heinrich (2004) these effects are retained within the adipose tissue, when its applied topically and only very little of the agent will actually make it into circulation.

• Magnesium sulfate: Being an essential mineral to the activity of hormone-sensitive lipase, magnesium can facilitate triglyceride breakdown. It's topical application may be particularly useful, in people with circulatory problems (as in cellulite; learn more). The way the author's present it as an "active fat burner" (in between the lines, only) is yet unwarranted.

• Calcium: Contrary to magnesium, calcium actually plays a more active role in the promotion of body fat loss. An increase in extracellular calcium concentration leads to an augmented enzymatic activity and promotes a reduction of calcitriol (active vitamin D) that will in turn trigger lipolysis (Somaet. 2003; Zemel. 2005). Whether this works via topical application has AFAIK not been well-established.

Another not fully understood factor that could make clay and the minerals in it a valuable tool for minimalist local body reshaping is their ionic nature. The latter can have direct effects on the microcurrents (electrolipophoresis; the movement of molecules due to electric currents) and may thus promote triglyceride degradation by increasing bloodflow and metabolism and by provoking changes in cell membrane polarity.

Ultrasound, caliper and body impedance

The subjects the scientists selected for this research were 20 young women (faculty students), with a body mass index that would rank them as either normal (18.5–24) or pre-obese (25–29). To make sure they would not be fooled by mere changes in the fluid levels of the tissues, the scientists used a combination of ultrasound, body fat caliper and body impedance measures, to access the effects of the "clay-wrap intervention" on the body composition of the ladies.

For the women in the active arm of the study, the protocol, which they went trough two times a week over a course of five weeks (10 interventions altogether) looked like this:

1. 

   In case it's not the amount of fat, but the orange peel look you want to get rid off, check out the SuppVersity Cellulite Special and listen to the show.

   Vigorous 5 min massage with an alcoholic extract of green tea (96% ethanol) macerated for 5 days, about which the scientists say: "[A] combination of ethyl alcohol with green tea provides a good extraction of the tea components . In addition, ethanol promotes the mechanical removal of contaminants and dissolves lipids in the lipid membrane, increasing the permeability of the skin" (Melo. 2003)
2. Application of a solution of 33.79 g of green clay combined with 18.56 g of magnesium sulfate (proportion in volume of 6 measures of green clay for 4 measures of sulfate) dissolved in 16.67 ml of distilled water to the abdomen. 
3. Application of a low elasticity bandage soaked in an infusion of 3.12 g of green tea, 6.94 g of magnesium sulfate (1 measure, in volume) and 0.5 l of water was applied with increased pressure from the center to the periphery. 
4. Application of microcurrents to the abdominal region with electrodes in a parallel position, and at an intensity below the sensitivity threshold (max. of 1 mA, frequencies of 25 Hz and 10 Hz) for 15 minutes. The polarity changed every second.

The protocol also included 30 min of aerobic moderate-intensity exercise (50%) on a cycloergometer
which had to be performed with the clay body wrap on the abs.

Figure 1: Before vs. after local (ultrasound) and total (body fat caliper in %) in the active arm of the study (Melo. 2003)

If we look at the main study outcomes, it's hard to argue that the intervention was kind of successful. "Kind of", in this case, implies that the effects were not earth-shattering and nothing you couldn't achieve by diet + exercise alone. More importantly, though, the results of the control group were within statistical margins the same. So what does that tell you about the usefulness of clay wraps?

---

If you are in his position, clay is certainly the last thing you want to rely on, to reduce your weight to a healthy level. Stick to what works dieting and the glucose repartitioning effects of exercise about which you've read in an article from Friday, July 5 (read it)

Bottom line: So what can we learn from a study like this? Well, personally, I would say: "Just because it's science, this does not mean it does make sense!" And I guess you will concede that going through the ardeous procedure is not exactly worth the statistically non-significant additional 1 cm reduction in waist circumference in the intervention group.

Not convinced,yet, well if you put any faith in the data from body-fat calipers and body impedance devices which tell us that the total trunk fat loss was (non significantly) larger in the control group (-2.1% vs. -1.6) and the total body fat loss measured using triceps, suprailiac, thigh and abdominal skinfolds, were -1.9% and -1.8% for the women in the control and intervention group, respectively, I guess that should suffice to shelve the idea of going to the spa to actively burn fat. That does not mean, however that the relaxing effect it can have may eventually promote body fat loss, but this would be the topic for another study ;-)

References:

• Belo SE, Gaspar LR, Maia Campos PM, Marty JP. Skin penetration of epigallocatechin-3-gallate and quercetin from green tea and Ginkgo biloba extracts vehiculated in cosmetic formulations. Skin Pharmacol Physiol. 2009;22(6):299-304.
• Heinrich M, Barnes J, Gibbons S, Williamson EM.Fundamentals of Pharmacognosy and Phytotherapy. Churchill Livingstone—Elsevier Limited. 2004.
• Melo et al. Clay body wrap with microcurrent: Effects in central adiposity. Applied Clay Science. 2013; 80-81:140–146.
• Soma MR, Gotto AM Jr, Ghiselli G. Rapid modulation of rat adipocyte lipoprotein lipase: effect of calcium, A23187 ionophore, and thrombin. Biochim Biophys Acta. 1989 Jun 28;1003(3):307-14.
• Standring S. Anterior abdominal wall (chapter 61). Standring, S, Gray's Anatomy—The Anatomical Basis of Clinical Practice. Elsevier, 40th Churchill Livingstone. 2008; p1059.
• Zemel MB, Richards J, Milstead A, Campbell P. Effects of calcium and dairy on body composition and weight loss in African-American adults. Obes Res. 2005 Jul;13(7):1218-25.