Adelfo Cerame - Road to Wheelchair Nationals '12: Getting Ripped For Christmas! Plus, Taking a Week Off Takes Some Courage, But Believe Me - It Will Pay Off!

Image 1: Adelfo at the Buckeye Classics, last year.

Actually, I wanted to start this installment of Adelfo's weekly contest-prep blog along the lines of "another Thursday, another ...", ... well, I guess that won't work out, because exactly those lines were the first words in the email with the weekly write-up Adelfo just sent me. So, I guess, I will just take the chance to sneak in a last-minute tip for a gift. Assuming that you have a friend or family member who really wants to make a change to the way he looks, feels and performs in the coming year, I think Adelfo is still taking new clients... but before he gets mad at me again, because I am pimping his services way too much for his liking, I better shut up now and let Adelfo tell you how he has been preparing for Christmas and his 12-weeks out mark on Christmas Day ;-)

Another Thursday, another blog…  

Damn! Aren’t you guys and, of course, girls ;-) getting tired of reading these Thursday write-ups? Well I hope not because there’s going to be about 13 to 14 more Thursday segments from yours truly ;-)

As you all know from the last installment of this series I am using this week as sort of a benchmark or test run for the show. With Christmas Day I will be hitting my 12-week mark and hopefully make myself an awesome present in terms of just about as lean and mean as possible before, ... well, before I will cram myself with every- and anything my little heart desires. What? You think that sounds stupid? Why would one diet down, just to ruin everything within one day? Well, I guess you have not read the previous installments of this series then. As I've already mentioned repeatedly, if you stay lean year round, keep your body accustomed to burning off extra calories by carefully planned cheat- and refeed-days and don't skimp on your workouts, the occasional holiday binge is not going to have any long-term detrimental effect on your physique. Enjoy your holidays - you have done your homework. It's the lazy rest of the world that's got to feel guilty, not you!

Image 2: No reason to feel guilty! I guarantee, "My 5 Simple Tricks For Guilt Free Thanksgiving Celebrations" will work for every holiday ;-)

How to minimize damage or even progress over the Christmas days? If you have not read them already, I strongly suggest you go back to"My 5 Simple Tricks For Guilt Free Thanksgiving Celebrations", where I describe in some detail how intermittent fasting and keeping your diet in check in the days before and after the holidays will help you to not only compromise your progress, but how you can even make use of a holiday binge as a strategic way of refueling your body and soul ;-) That being said, a related resource you may enjoy are the first issues (esp. Part 2 and Part 3) of the Intermittent Thoughts series, in which Dr.Andro digs into the physiology of intermittent fasting, which - as you all know - has helped me tremendously during this first half of my prep.

With only two more days to go, I am very pleased with how things are working out for me. It looks like I will be hitting my mark… As for the water retention issue, I have been seeing improvements in my physique this week, as in vascularity and separation within my shoulders, forearms, triceps and upper abs. I’ve been pounding at least 2 gallons of water a day to try and flush out as much water as I can. We will see what the end-result on Sunday will look like. I know that I will not be hitting my full potential in conditioning - if I did, the chances that I will be both as muscular, as well as as ripped as possible, on the day of the show, in 14 weeks would decrease, anyways.

Nevertheless, I do feel that I look now about as ripped as when I did the Buckeye Classic last April (cf. image 1). With another 13-14 weeks to improve, I am pretty damn sure that time (and obviously consistency as far as diet and training goes) will take care of the water retention and stubborn body fat I am still carrying. But enough about my 12-week mark! I’ve been bumpin’ my gums about it for the past two weeks, and I’m pretty sure you’re tired of it too. Note: I’ll have pictures up next Thursday on how my physique turns out this Sunday - promise ;-)

Rest, Rest, Rest... and? Well, I guess REST!

Rest, or what some people simply think of as "doing nothing", is in fact one of the most valuable training tools you have. More often than not, it is however taken for granted even by professional athletes and even I commit guilty of taking it for granted in the past, because I had that “gung-ho”,  “rest is for the weak”, or “I’ll sleep when I’m dead” type of mentality. Don’t get me wrong. There's nothing wrong with having a “gung-ho” mentality, but you should be aware of when your body is already "dead" and you begin to take steps back- not forward with every heavy lifting session... train hard, but train smart! Rest, when it’s time to rest, and learn how to listen to what your body wants.

Image 3: A brief update on my initial experience with Slinshot, Recycle and D-Pol by Purus Labs

Quick PurusLabs supplement update (Recycle, D-Pol and SlinShot): For my liking it is still too early to draw any conclusions, but as I promised to keep you up-to-date as far as my newest supplements are concerned, I thought I'd mention that I’ve been getting some pretty decent pumps in the gym, lately. While much of this could obviously be just in my head, I want to remind everyone that this is my deload week, so I’m basically just doing sissy workouts and lifting real light - still, the pump is really noticeable. And when I am practicing my poses, I feel like there was a major improvement in what people like to call the "mind and muscle connection", which is the ability to contract and flex individual muscles intentionally. As with every N=1 experiment, it is however difficult to judge how much of that can be ascribed to Recycle and D-Pol and what may be due to other parameters. With regard to the tarragon based insulin-sensitizer SlinShot, of which I told you that I'd save it for my refeeds, I will probably be able to tell you next week, whether or not it is working. I mean, the plan is to EAT BIG on Christmas, so we’ll see how much "damage" I can do, and whether or not SlinShot can help in repartitioning some of the "damage" into muscle glycogen ;-)

For me the incorporation of carefully planned rest days before it was too late, was the key to what I think is the most profound growth-spurt I have undergone in the past couple of month. Before, I did not only train 6 days a week, I also totally overlooked - or I should say - ignored the value of rest or deload weeks. Not hitting the gym for more than one day? Taking it easy, when you are not hurt? Impossible... no wonder I always felt burned out and sometimes even utterly unmotivated.

Taking more than a day off and the irrational fears of muscle loss, fat gain & co

At first I feared taking too many rest days, especially during contest prep, would hamper my progress. That being said, rationally, I was not even sure what the exact reasons for this gut feelings were. Maybe the fear of...

• losing muscle, when the latter was not constantly challenged during my diet
• not being able to get the most out of my body, or
• not having enough training days to help burn body fat, since I rarely did cardio. 

And, yes, I was one of those guys who used to lift weights constantly thinking about how that would help him burn off body fat, how many calories he would have "left at the gym" and what foods he was now "allowed" to eat after burning X amounts of calories in the course of his last workout. Thus, rather than focusing on increasing my strength and trying to build some lean muscle or at least maintain it, all my efforts in the gym were aimed at simply burning calories - a futile concept, as I have eventually come to realize.

The thought of not having done enough, alway hampered my progress

I know this may sound somewhat ridiculous, especially for the lazy guys out there, but it actually took me a whole lot of courage to finally incorporate more rest days into my training regimen, to take a week off or tick to a pre-planned deload week every 6-8 weeks. The results, however, were well worth it. Adequate rest alone, helped me to ...

• continously increase my strength on all major lifts
• make greater and more consistent muscle gains
• be able to hit the gym motivated and refreshed
• lift really heavy and not just heavy as my exhausted body would allow
• keep injury free

The latter, i.e. the ability to avoid major (and minor) injuries, may in fact be one of the most fundamental benefits you will get if you allow your body to fully recuperate. After all, what could be worse than not being able to hit the gym at all (look at Branch Warren with his torn quads!) For someone like me, who always seems to attract nagging aches, pains and tweaks during long hauls in his training, it was like a revelation, when I noticed that by just taking the necessary week off , I could totally avoid those tedious injuries.

Recipe of the week: In the good spirit of the Christmas Holidays & the birthday of Jesus Christ… I have put together a classic holiday recipe for you: Eggnog, but with an anabolic twist. Cheers!

Image 4: Eggnog - a classic recipe with an anabolic twist!

Anabolic Eggnog - ingredients:

• 4 whole organic eggs (blend in blender till frothy) 
• 1 c. non-fat milk 
• 40g of vanilla whey protein 
• 2 tsp. organic vanilla extract 
• 1 tsp. stevia 
• powdered or ground cinnamon (sprinkle to liking) 
• nutmeg (sprinkle to liking)
• Sailor Jerry’s spiced rum is optional ;-)
  
  Macros: 71g protein / 12g carbs / 20g fat

After blending the eggs till frothy, add all the other ingredients and blend till frothy, and you can add a couple more sprinkles of cinnamon on top to make your drink look fancy. ;-)

And just to make sure, you are getting the message: The type of Rest, we are talking about, here is not the time it takes to take a nip from your water bottle in-between sets (even if it has BCAAs in it ;-) It also does not mean hitting on the beautiful girl on the stairmaster instead of finishing you HIIT session. Rest, is the time you are spending out of the gym. A day, you spent with friends or family, where you treat your run down body with good nutrition and extra sleep. A day, where you get yourself a massage, take the dog for an extended walk and take your girlfriend out to a fancy restaurant that also carries bodybuilding friendly foods. And of course a day, where you have lot's of time to go and check out mine and Dr.Andro's posts, here at the SuppVersity, to learn new things about exercise and nutrition and to join the discussion... so, what are you waiting for, then? Go for it and rest... Merry Christmas, everyone!

HIT Your Satellite Cells to Increase Your Gains! Only High Intensity "Cardio" Exercise Will Fuel Your Satellite Cell Pool and Set You Up For Future Muscle Growth.

Image 1: NO-mediated satellite cell
recruitement (Anderson. 2000)

You have read it on the SuppVersity, you have heard about it on Carl Lanore's Super Human Radio and the BodyRX Show and those of you who have seen videos or pictures from the latest New York City Marathon, should actually have been able to infer it from the way the "finishers" looked like. Intensity not duration is what counts, when doing "cardio". Yet, as a very recent (7 days old) study shows (Naito. 2011), High Intensity Training (HIT) will not only burn off your lovehandles, while keeping your muscles intact, it will also prime your musclefibers for future growth by increasing the number of satellite cells, the small dormant mononuclear progenitor cells that are sandwiched between the basement membrane and sarcolemma of the fibers of your muscle and are recruited, whenever your body feels that you could use a little more or have to replace some damaged muscle mass.

While I will go into more detail on how your muscles actually grow in the upcoming parts of the Intermittent Fasting Series, in the course of which I am going to explain how you should train, eat and sleep in order to exploit all three major pathways of skeletal muscle growth, I want to give you a sneak peak at what you are going to learn, by highlighting that protein synthesis, i.e. the accrual of muscle protein in existing myonuclear domains, and the recruitment of satellite cells to replace damaged or add new myonuclei are distinct processes. It should nevertheless be obvious that with all the protein synthesis of the world you will - sooner or later - hit a plateau, when all the existing myonuclei have "blown up" to their maximal size - or as Naito et al. put it: "Increases in the number of satellite cells are necessary for full skeletal muscle growth and hypertrophy" So, whenever the existing myonuclei have reached their "full potential", the only way to keep growing is by adding new myonuclei via satellite cell recruitment. Keep that in mind before you discard the results the following study, because the "HIT rats" did not gain more "active" muscle than the "LIT rats" ;-)

In their experiment Hasashi Naito and his colleagues from the Tokai University and the Juntendo University in Japan put 17-week old (these are old rats!) female Sprague-Dawley rats on one out of four exercise regimen (for a detailed outline of the regimen, cf. table 1):

1. High Intensity, High Duration (90H)
2. High Intensity, Low Duration (30H)
3. Low Intensity, High Duration (90L)
4. Low Intensity, Low Duration (30L)

Table 1: Outline of the exercise
protocol (from Naito. 2011)

In the course of the 10-week study period the rats were exercised five times a week on one of those funky rodent treadmills. What's funny is that despite the fact that, as the scientists say, "[e]lectrical shocks were used sparingly to motivate the animals to run", two of the critters in the high intensity groups refused to do their workouts, which reminds me of what Dr. Layne Norton had to say on one of the past installments of BodyRX Radio: "Most of those who will tell you that they cannot do HIT for whatever reasons are usually just too lazy" - we may thus consider those two lazy rats as evidence for the accuracy of the model... and by the way, it did not save them from being anesthetized and deprived of their plantaris muscle, which was weighed and analyzed for its fiber composition and satellite cell count.

As it was to be expected in view of the high age of the rats, where skeletal muscle mass maintenance, may be considered a success, there were no statistically significant increases in plantaris and/or body mass in any of the treatment groups.

Figure 1: Changes (compared to untrained control) in number of myonuclei and satellite cells per muscle fiber (data calculate base on Naito. 2011)

Despite the absence of measurable skeletal muscle hypertrophy, the pronounced (cf. figure 1) and fiber-type specific (cf. figure 2) increases in satellite cell counts in the high intensity groups may well be considered as the necessary prestage of a hypertophic growth spurt, which could be triggered by appropriate training (which would obviously be strength training) and endocrine (more on that in the conclusion) stimuli.

Figure 1: Satellite cells per muscle fiber in type I (slow twitch) and type II (fast twitch) muscle fibers of rats in the control and the high intensity, high duration (90H) groups (data calculate base on Naito. 2011)

In that, it is also interesting to note that contrary to popular believe, the slow-twitch type I fibers, with their greater number of satellite cells, have an increased propensity for maximal myonuclear numbers, the fable of the "hypertrophy-prone fast-twitch type II" fibers, on the other end, is a consequence of their ability to accumulate more protein per myonucleus. And while I will - as promised in the red box above - dig deeper into that in future installments of Sunday's Intermittent Thoughts, I can already tell you that the fiber composition (not the size!) of professional body builders is almost identical to those of non-strength-trained individuals and thusly fundamentally different from that of strength athletes, like powerlifters (Tesch. 1982) - in order to achieve maximal muscularity you can thusly not neglect your type I fibers!

That being said, both the strength training, which would make use of the increased propensity to grow by recruiting satellite cells to form new myonuclei, as well as the necessary local IGF and MGF responses, which have been shown to decrease with age (Grounds. 2002), were absent in the study at hand. In someone like you, a young, vigorous strength trainee, both stimuli will yet obviously be present in abundance (at least I would hope so ;-). Accordingly, 1-3 high intensity (and in view of the fact that the duration, 30 vs. 90min, did not make a difference probably also high intensity interval) training (HIT or HIIT) sessions per week could not only make your increasingly fat-free muscles shine in their full glory, they will also "precondition" you for future muscle growth by increasing your satellite cell pool. I would thus suggest, you better not join the two lazy rats from the study, and rather find yourself the next best track to do a bunch of sprints ;-)

Combinations that Work: HMB & Isometric Training for Lean Mass, Creatine & Powerlifting for Leaning Out and Carnitine & Bodybuilding for Powerlifting?

Image 1: Jacek Spychala - I must admit, I don't know if he was one of the subjects, but 38 of his colleagues from the Polish National Powerlifting Team were (powerlifting.pl)

As an athlete and even as a regular fitness enthusiast, you got to chose your training and supplementation modalities according to your professional or personal goals (in fact, the failure to do so is, in my mind, one of the main causes why so many trainees do not get the desired results at the gym). A very recent study from the Department of Combat Sports and Weightlifting at the Józef Pilsudski University School of Physical Education (I wish every University had such a department ;-) in Warsaw, Poland, sheds some light onto combinations which work, and combinations which don't... and trust me you will be surprised by the results of Dr. Marek Kruszewski's controlled intervention study (Kruszewski. 2011).

Kruszewski recruited recruited a total of 170 (! that alone is noteworthy !) subjects who participated in a three-tier placebo-controlled study on the effects dietary supplementation of l-carnitine, creatine and HMB combined with different modes of strength training (bodybuilding type circuit training, powerlifting and isometric training) had on muscle strength, lifting performance and body composition (for a graphical overview of the study design see figure 1).

Figure 1: Graphical illustration of the three tiers (l-carnitine, creatine, HMB), general information and detailed information on the exact exercise protocol of the isometric workout of the HMB group

Not only the sheer size of the study with active and placebo groups of ~30 previously untrained subjects, each, in the l-carnitine and HMB tier of the study are impressive, the participation of 38 powerlifters from the Polish National Team (cf. video of Daniel Grabowski, with a 2254lbs total) is, as well. If each group had received all three of the supplements subsequently and body composition had not been measured with an expensive but still not 100% accurate body impedance device, this study would have been the equivalent of the egg-laying-wool-milk-sow of the Natural Rythmicity for Maximum Fat & Minimal Muscle Loss episode of the Intermittent Thoughts, but I guess we cannot have it all ;-)

2g HMB + isometric training for lean muscle gains!

Image 2: HMB is getting
cheaper, lately

I thought, I'd give the most "exotic" training variety (isometric training) the advantage and tell you about the effects 2g of HMB per day (4 servings of 500mg; one with breakfast, one before, one after the workout and one in the evening; for 5 weeks = 20 training sessions) had on the strength performance and body composition of 69 previously untrained, strength trainees -  not only to raise the awareness that isometric contractions could be a valuable addition to everyones regime (something my friend Rob Regish also advocates in his Blueprint), but also because the effects observed in this tier of the study were, as Kruszewski points out, "[t]he most distinctive and desirable" ones:

Although this type of supplementation [HMB] was used in the group of subjects who trained using the isometric method, regarded as a training system not associated with increases in lean body mass (LBM), the obtained results indicate that HMB may also affect LBM. In view of the fact that LBM involves mainly muscles containing about 70% water, the demonstrated significant elevation of LBM accompanied by the reduced water content in the bodies of the examined competitors is difficult to explain.

Now, I've got you listening my iron-friends, don't I? Increased lean mass (+1.31kg), decreased (as the author points out, later) "presumably extracellular" water - sounds like it was coming from a competitive bodybuilder's "dry dreams", doesn't it? Well, the one thing that would be missing now, is a way to get rid of the fat - but wait, weren't there other supplements in the study, as well?

10g Creatine (+10g dextrose) + powerlifting for fat loss!

Image 3: Creatine monohydrate
for fat loss? That's a surprise.

Yes, there were, and believe it or not, not l-carnitine and circuit training, but creatine and powerlifting will shed the fat - even in elite level powerlifters! By continuing their regular (pyramid style, cf. figure 1) powerlifting training, the 16 power lifters from the Polish National Team, who received the 20g/day creatine + dextrose combination did not only improve their powerlifting performance by a statistically significant +15.6kg over the placebo group, they also and, as Kruszewski points out, "surprisingly" lost a significant amount of body fat in the course of the 20 training sessions they completed within the 5 week study period:

[...] the present results indicate that supplementation with this compound [creatine] led to a significant reduction in the fat content and increase in the water content of the organisms of powerlifters from the Polish National Team.

In view of the results, the author observed in the last group, the one which did a bodybuilding-type circuit training that was supplemented with 900mg of l-carnitine l-tartrate per day (cf. figure 1), I find it pretty amusing that according to Kruszwski the "effect of creatine may be much more far-reaching than that indicated in the manufacturers’ leaflets", which is something, he certainly would not say of l-carnitine.

900mg l-carnitine l-tartrate + "bodybuilding-type" circuit training for powerlifting? 

Image 4: L-carnitine alone will not transform your physique like this magic mirror - no matter what the advertisement leaflet in the latest muscle mag says ;-)

The results in the l-carnitine supplemented group (3x300mg l-carnitine l-tartrate) were mixed. While the previously untrained subjects obviously gained strength in the course of the 15 workouts they performed in the 5 week study period, there were huge intergroup differences - meaning that a few subjects appeared to benefit from carnitine, while the majority didn't. Moreover, fat loss or beneficial changes of body composition, which is what l-carnitine is marketed for, were completely absent in the l-carnitine group. And while the training intensity was pretty low (although the trainees had to perform the 3rd of their three training circles to complete failure) this does not really surprise me, as the "fat burning" effect of oral carnitine supplementation has been debunked by more than a dozen well-designed studies, so that you better follow Kruszewski's advice and "treat advertisements of this compound [l-carnitine] with reserve" ;-) He goes on to explain that...

[...i]t is possible that individuals with inherited or acquired L-carnitine deficiency manifested by increased deposition of fat in the body may benefit from such supplementation and improve their body composition by consuming appropriate amounts of this substance accompanied by proper (predominantly aerobic) exercising. However, additional L-carnitine supplementation in individuals with normal production and concentration of this substance in the body is superfluous.

On the other hand, Kruszewski admits that despite the absence of significant improvements in muscle torque, the powerlifting performance of the subjects in the l-carnitine group increased statistically significantly more than the one in the placebo group (+13.7kg) which is ...

surprising in view of the fact that such an effect [increase in powerlifting performance] of L-carnitine has very rarely been reported and emphasized.

He goes on to suggest that these improvements may be related to l-carnitines impact "on the general physical fitness of the organism". Yet, whatever the reasons may be - out of this triumvirate, l-carnitine would certainly be the least effective addition to your regimen - whatever your goals may be.

Isometric training and HMB supplementation, on the other hand, emerge as as surprise winner. With statistically significant (+17.7kg) increases in power-lifting performance, significant increases in muscle torque, and a +1,31kg increase in body mass (predominantly lean muscle) that was accompanied by a likewise significant reduction in extracellular water, it may be a good idea to take advantage of the falling HMB prices (buy in bulk!) and to incorporate some isometric exercises into your workout regimen ... what do you say?

Low Vitamin D & Insulin Resistance; Ghrelin Response to Overfeeding; Glutamine for the Elderly; 5g/Day Creatine for Women; MSM for GH Activity in Bone; Curcumin for Burns

Vitamin D research hyper-inflation - unfortunately few of the papers will ever be printed, otherwise we could at least use them to heat our homes, in case the price for oil gas and other fossil energy keep rising ;-)

The SuppVersity Figure of the Week is "1614"! That's the number of studies with the exact phrase "vitamin D" in their title that have been published in the past 9 months and 14 days of the year 2012 (more than five papers per day!). Compared to 1,453 papers in the year 2011 and 1,169 papers in 2010. Projected onto the rest of the year that's going to be a +40% increase in mostly redundant papers! I mean, let's be honest, we have not made any significant scientific progress in the area of vitamin D research over the past months: We have still no idea where the associations end and the causations begin and are more or less clueless as to why vitamin D supplementation simply does not yield any of the beneficial results it is supposed to.

And as if that was not already bad enough, due to the advent of an infinite number of second-class online journals that made the vitamin D paper hyperinflation only possible, most of these papers will never be printed. Otherwise I'd suggest we put them to some good use and burn them like the woman in the image on the right was burning paper money during the days of monetary hyperinflation, over here in Germany in the years 1922 - 1923 ;-)

Vitamin D and insulin resistance 

Having low levels does only make a difference, if you are obese. That's the result of the most recent analysis of data from the MONICA10 cohort consisting of 2656 participants (men and women aged 41–71 years) who participated in a 10-year follow-up examination during 1993–1994 as part of a population-wide survey in Denmark (cf. figure 1; data adjusted for sex, season of blood collection, history of CVD, family history of diabetes, physical activity during leisure time, healthy food index, fish intake, supplement use, smoking status, alcohol intake and educational level):

Figure 1: Risk of incident diabetes associated with serum 25(OH)D and waist circumference categorized as normal, overweight and obese (data based on Husmemoen. 2012).

"Low serum 25(OH)D was associated independently with incident diabetes. The inverse association was only found in overweight-obese and not in normal weight individuals, suggesting that obesity may modify the effect of vitamin D status on the risk of diabetes." (Husmemoen. 2012)

These results stand in line with previous research you've read about here at the SuppVersity suggesting that rather than the absolute 25-OHD levels, which are indicative of your "vitamin D reserves", an obesity induced disruption in the management / metabolism of the "sunshine vitamin" appears to be the real culprit that's behind the associations (not causations!) between low vitamin D levels and the metabolic syndrome.

That this problem can't be solved by simply adding more vitamin D to the equation stands to reason and would also explain why the few controlled vitamin D3 supplementation trials in non (morbidly) obese, highly vitamin D deficient individuals that exist did not bring about any of the metabolic benefits the researchers had expected.

Supplemental glutamine prevents non-sarcopenic age-induced weight loss 

We usually think of being overweight, when we talk of "weight problems". For older people it is yet often rather the opposite. Many are losing weight and start to literally wither away. And while glutamine does not help with the muscular aspect (strength training and at least 20g of EAA-rich proteins with every meal), it could at least help with making the most of the food you eat and the supps you take.

While the mechanism is not yet fully elucidated, the results of a recent study by Meynial-Denis et al. clearly suggest that the provision of supplemental glutamine effectively prevents the loss of body weight. A possible mechanism my be related to its concomitant (or upstream?) effects on the integrity and function of the enterocytes in the gut lining of the very old rats the researchers used as a model (Meynial-Denis. 2012).

Therefore I am not convinced that the researchers hypothesis that these effects are brought about by

1. the ameliorative effects of glutamine on the age-induced CO(2)/glutamate ratio, and
2. the role of glutamate as a precursor for glutathione, arginine and proline biosynthesis,

fully explain the observed effects. And even if they are, the additional (maybe in that case downstream) improvement of nutrient absorption subsequent to the conservation or restoration of a healthy/-ier gut lining can hardly be underestimated. After all, it is becoming increasingly clear that much of the age-induced loss of body weight is at least promoted, if not causally related to the decreased absorption of various essential nutrients.

Unexpected ghrelin response during 7-day overfeeding experiment in obese subjects

"Confusing" would in fact be a better term to describe the surprising finding that 7-days on a diet containing 70% more energy than the 68 healthy young, normalweight, overweight and obese men usually consumed did not reduce, but increase the amount of the acylated form of ghrelin (often touted as the "active" = hunger promoting form of ghrelin), in the blood of the study participants (Wadden. 2012). Moreover, ...

• there was no significant difference in fasting acylated ghrelin between normal weight, overweight, and obese men at baseline and
• the amount of acylated ghrelin was negatively correlated with weight and BMI for normal weight and with BMI in overweight men.

Yet while ghrelin also correlated with the changes in body weight and BMI the study participants experienced in the course of the one-week intervention. It was negative (which is obviously what you should expect) only in he normal- and overweight subjects. In the obses study participants, on the other hand, the correlation was positive, i.e. more weight gain = more ghrelin.

Illustration of the global obesity epidemic (WHO. 2005). The study at hand makes it pretty clear that a pathological dysregulation of energy intake is at least part of the problem.

In other words: While there were no differences at baseline an increase in acetylated ghrelin was associated with lower body weights and weight loss in normal- and overweight subjects, while the obese (=pathologically overweight subjects) showed increases in acetylated ghrelin, when they gained weight.

If we stick to the fundamental hyptothesis that ghrelin is in fact a "hunger hormone" and the acylation, i.e. the addition of an acyl functional group to the basic molecule, works like an "on switch" that activates the appetite increasing effects of ghrelin, this means nothing else than overeating and gaining weight makes obese men hungrier. This finding provides further evidence for the hypothesis that the natural regulation of food intake is not simply impaired, but totally out of whack in obese individuals.

MSM turns out to be a local GH booster and bone builder 

MSM? That's the stuff in the joint supplements, right? Correct! Methylsulfonylmethane (MSM) is a naturally occurring sulfur compound with well-known anti-oxidant properties and anti-inflammatory activities that is a longstanding standard ingredient in joint supplements (next to glucosamine sulfate and chondroitin sulfate - you notice the sulf... ah, pattern here, right?).

I guess you knew all that already, but I would be surprised if you had also been aware of the fact that MSM exerts direct anabolic effects on the bone by increasing the expression of GH-related proteins including IGF-1R, p-IGF-1R, STAT5b, p-STAT5b, and Jak2 in osteoblastic cells and mesenchymal stem cells.

"MSM increased IGF-1R and GHR mRNA expression in osteoblastic cells. The expression of MSM-induced IGF-1R and GHR was inhibited by AG490, a Jak2 kinase inhibitor. MSM induced binding of STAT5 to the IGF-1R and increased IGF-1 and IGF-1R promoter activities. Analysis of cell extracts by immunoprecipitation and Western blot showed that MSM enhanced GH-induced activation of Jak2/STAT5b. [...] Furthermore, MSM increased ALP activity and the mineralization of MSCs." (Joung. 2012)

Unfortunately, in vitro studies like these don't provide any information on appropriate dosages, but a study that was published in August 2012 reports that dosages up to 10-fold higher than the dose equivalent of the 300-400mg/day, which are at the upper end of the spectrum of the dosage recommendations of currently available MSM supplements, lead to "dose dependent" decrease in the degeneration of the cartilage in the knee joints in a mouse model of osteoarthritis (Ezaki. 2012). The hilariously high dose of 30-40g (100x the recommended amount), on the other hand, led to significant losses of body, liver, and spleen weight.

So, even with an acute fracture you better keep your MSM intake within reasonable limits - specifically, because we do not even know if oral methylsulfonylmethane will help with either bone-healing or bone strength in humans, at all.

If muscle is metabolic currency, creatine is the cash machine

"Ehhh! This will make me hold water? No thanks I already got enough of that! And muscle, not thanks..." Shut up! Muscle is metabolic currency and gaining muscle and strength is equally beneficial for the health of men and women, alike.

Against that background you may want to print the results from a recently published paper by Andreo Fernando Aguiar from the North University of Paranay and his colleagues and put the print out somewhere where all, not just the older ladies at your gym will see that taking 5g of creatine /day helped eighteen healthy ladies in their best years (64.9±5.0 years) to

If looking gorgeous and being strong & healthy is your goal, creatine is your supplement of choice, ladies...and gents! Changes in body fat percentage and muscle mass in response to 12-week strength training expressed relative pre value in control group (calculated based on Aguiar. 2012)

• train at a more than 2-fold higher volume,
• make 5.1, 3.9, and 8.8% greater progresss in bench press, leg extension, and biceps curl performance
• gain 3.2% more fat-free mass and 2.8% more muscle mass, and
• be more efficient in performing submaximal-strength

...than the nine women in the placebo group (Aguiar. 2012). With a somewhat higher overall training volume and maybe three instead of just 2 sets of 10-15 reps of

• vertical bench press, lat pulldown, 
• biceps curl, triceps pushdown, 
• knee extension, leg curls, 
• seated calf raises, and abdominal crunches

three times per week and a reduced carbohydrate intake (carbs down by 20% to 45% and protein up by 20% to 40% of the total energy intake) I am pretty sure the ladies in the creatine group would also have been able to turn the hitherto non-significant 2% reduction in total body fat into a significant one.

"Strong is the new sexy" and creatine can help you to get there!

About time to pull the emergency break strength train eat and take creatine?!

In a way it's unfortunate that the ability to promote weight loss is an almost necessary prerequisite for an ergogenic to  be attractive to women. If you can't answer the question "Will it make me lose weight... ah, I mean fat?" with a definitive "Yes, ma'am!", they won't buy it. That said, even with the current training and dietary regimen, the women in the creatine group dropped 1.6% total body fat and, due to the increase in lean mass, decreased their body fat percentage by -2.8%, while the ladies in the control group gained 1.2% body fat (total), so that their body fat percentage effectively did not change at all (+0.4%). Stronger, leaner and healthier! What more can you ask for in a dietary supplement?

Topical curcumin improves wound healing (plus tips how to prepare it)

In view of its profound anti-inflammatory effects it is actually not straight forward that curcumin would improve wound healing - at least not in the early, inflammatory phase of the process. Accordingly the researcher from the Department of Dermatology at the Faculty of Medicine of the Namik Kemal University in Tekirdag, Turkey, divided their burned rodents into 3x2 groups who were scheduled to be anesthetized on day 4 (A), day 6 (B) or day 8 (C) after after they had been burned with an aluminum branding iron that had been placed without pressure for 30s on the back of the rats (Kulac. 2012).

Histopathological scores for inflammatory cells, collagen, deposition, angiogenesis, granulation tissue formation, and epithelialization in each group (based on Kulac. 2012); group A (4th day post burn), group B (8th day post burn), group C (12th day post burn)

The rats in the three treatment groups who had received 200 µl of curcumin at a concentration of 100 mg/kg body weight, topically, once daily, showed increased wound healing during all the critical steps of tissue regeneration, i.e. inflammation, collagen deposition, angiogenesis, development of granulation tissue, and the repair of epithelium.

Interestingly, the inflammatory cell infiltration was significantly increased in curcumin groups and that regardless of when the tissue samples were analyzed. Collagen deposition, angiogenesis and granulation tissue formation were likewise higher in curcumin compared to the placebo group, with the earliest squamous epithelial re-epithelialization being observed on the 4th in treatment subgroup (figure 2, Group A).

Self-made curcumin band-aids / pastes

And in case you don't want to waste money or support Johnson and Johnson by buying the tumeric laced bandages they apparently sell in India, here are two ways to prepare a bandage and a tumeric paste that will probably help with sorts of inflammatory skin conditions (Hinkle. 2012):

In India people use tumeric + honey facial masks; also to treat acne, by the way.

• tumeric wrap / band-aid: Combine one teaspoon of dried turmeric powder with two teaspoons of either dried or fresh ginger. Spread the mixture over a cloth, then wrap around the affected area and seal it with a plastic bandage.
• tumeric paste for burns: Combine one teaspoon of turmeric powder with one teaspoon of aloe vera gel and apply it directly to the burned / inflamed part of your skin (make sure not to apply it directly onto open wounds, though!)

Be careful, though! Tumeric is also a powerful dye that's not easy to wash off again. So whatever towel you may be using as a wrap may therefore be ruined and in case the paste gets in contact with your shiny new white shirt, hot pants or whatever those are likely to be ruined, as well.

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Have you ever listened to the to the SuppVersity Science Round Up on Super Human Radio? If not, check out the podcasts

That's it for today, folks. I am not sure whether you feel this is sad or good, but I hope for you, and in a way me and the SuppVersity, that it is the latter, because it may well be that I will increase the frequency of these On Short Notice. In that I will be trying to get even further away from the lengthy items from last week and make them actually short, again ;-)

A pros pos short, those who like these news updates, may also enjoy the weekly SuppVersity Science Round Up that airs live every Thursday at 12.30 or 1.00PM EST, And if you can't tune in live, you can simply have google show you the links to the podcasts of the latest shows.


References:

• Aguiar AF, Januário RS, Junior RP, Gerage AM, Pina FL, do Nascimento MA, Padovani CR, Cyrino ES. Long-term creatine supplementation improves muscular performance during resistance training in older women. Eur J Appl Physiol. 2012 Oct 7.
• Ezaki J, Hashimoto M, Hosokawa Y, Ishimi Y. Assessment of safety and efficacy of methylsulfonylmethane on bone and knee joints in osteoarthritis animal model. J Bone Miner Metab. 2012 Aug 10.
• Hinkle, Lynette. Homemade Remedies With Turmeric. eHow.com - Herbs & Botanicals for Health J-Z. < http://www.ehow.com/way_5402326_homemade-remedies-turmeric.html > retrieved on Oct 13, 2012.
• Husemoen LL, Skaaby T, Thuesen BH, Jørgensen T, Fenger RV, Linneberg A. Serum 25(OH)D and incident type 2 diabetes: a cohort study. Eur J Clin Nutr. 2012 Oct 3. doi: 10.1038/ejcn.2012.134. 
• Joung YH, Lim EJ, Darvin P, Chung SC, Jang JW, et al. MSM Enhances GH Signaling via the Jak2/STAT5b Pathway in Osteoblast-Like Cells and Osteoblast Differentiation through the Activation of STAT5b in MSCs. PLoS ONE. 2012; 7(10): e47477.
• Kulac M, Aktas C, Tulubas F, Uygur R, Kanter M, Erboga M, Ceber M, Topcu B, Ozen OA. The effects of topical treatment with curcumin on burn wound healing in rats. J Mol Histol. 2012 Oct 2.
• Meynial-Denis D, Bielicki G, Beaufrère AM, Mignon M, Patureau Mirand P, Renou JP. Glutamate and CO(2) production from glutamine in incubated enterocytes of adult and very old rats. J Nutr Biochem. 2012 Aug 13.
• Wadden D, Cahill F, Amini P, Randell E, Vasdev S, Yi Y, Zhang W, Sun G. Serum acylated ghrelin concentrations in response to short-term overfeeding in normal weight, overweight, and obese men. PLoS One. 2012;7(9):e45748.

The 100% Natural "Hormonal Approach" to Personalize Your Resistance Training Program: Using Saliva Testosterone to Discover Your Own, Personal Optimal Set- & Rep-Range

A pre- vs post-workout salivary testosterone test could hold the clue to the perfect workout.

Most of you are probably aware that my own personal interest in learning something new every day is one of my central motivations to sit down and write an article about the latest and (imho) most interesting studies from the realms of nutrition and exercise science. At first sight it may seem as if it was kind of stupid to waste additional time with writing about it. After all, it would seem as if just reading the study would be enough. From my seminars and lectures I have yet learned that teaching others about things you believe you would "know by heart" does usually improve your own understanding of the matter, significantly. This is similar with blogging, which does however have another often under-appreciated advantage: You get in contact with others who share a similar interest.

People like "Anonymous" (this is what happens if you don't use at least a nickname folks: you miss your chance of becoming "semi-famous" ;-) who recently pointed me towards the results of a 2008 study by Beaven et al. who conducted a pretty intriguing experiment that involved 16 male amateur Rugby players, sweat and a lot of saliva.

Can your T-level help you to find your optimal set- & rep-range?

The scientists who worked at the Waikato Institute of Technology and theHorticulture and
Food Research Institute of New Zealand Ltd. hypothesized that the functional strength gains of an athlete may be further enhanced by a non-traditional periodization regimen that focuses on those set- and rep-ranges that maximize the individual's testosterone response (T-Max) to the given workout.

"But didn't you say?" I know, I have said countless of times: Testosterone does not build muscle! The idea behind Tmax based periodization, however, is not to exploit a causal relationship between higher T-levels and greater gains in a given resistance training regimen (which happens to be something West et al. have disproven in 2012, already). The idea is rather that the individual testosterone response can be used to decide which protocol provides a greater anabolic stimulus.

To this ends, the researchers conducted a cross-over study in the course of which the rugby players trained in groups of N=8. During both phases of the study, eight individuals trained according to their previously determined T-Max set- & rep-range (i.e. the protocol that yielded the maximal testosterone increases in a previously conducted baseline test), while the other eight subjects trained with the protocol that had proved the minimal testosterone (T-Min) response after the baseline test.

After three weeks the groups were "crossed over" and those who had previously trained on their T-Min protocol would not train in their T-Max set- & rep range, while those who had been randomized to the T-Max group for the first three weeks had to spend the 2nd phase of the study training their personal T-Min protocol.

"Hold on, how did that work?"

That sounds too complicated? Well, I guess I will provide you with an example - let's see: During the baseline testing all subjects performed the same standardized workout with the following four set- and rep-schemes:

• A: four sets of 10 reps at 70% 1RM with 2 minutes rest between sets (4x10–70%)
• B: three sets of five reps at 85% 1RM with 3 minutes’ rest (3x5–85%)
• C: five sets of 15 reps at 55% of 1RM with 1 minute’s rest (5x15–55%)
• D: three sets of 5 reps at 40% 1RM with 3 minutes’ rest (3x5–40%)

During these tests it turned out that subject 1 had the maximal testosterone response to protocol "B", where his T-levels increased almost twice as much as on protocol "C" ... I would guess that your initial response to this will be: "Of course, that's after all similar to 5x5; and 5x5 rulez!", but let's face it, if we stick to broscience, it should be protocol "D" that sucks and not protocol "C", right? I mean 3x5 reps at 40%, that's sissy stuff(!) and still, it "sucked" only for two out of sixteen participants, whose corresponding T-max regimen were protocol "C" and protocol "D".

No matter how you look at it, there is no pattern emerging!

How many subjects reacted with maximal T-responses to the individual protocols?

• A → 4 subjects
• B → 7 subjects
• C → 3 subjects
• D → 2 subjects

Interestingly, the re-test after the first three weeks yielded identical results - well, with the obligatory one exception to the rule: subject 14 must have been must have been convinced that 5x5 does in fact rule, because his T-max that has previously been observed in response to protocol "A" shifted to "B" after three weeks on sissy protocol "D".

This circumstance provides further evidence for the often heard hypothesis that the "optimal workout" looks different for everyone and that the perfect match between trainee and routine is stable, maybe fixed by genetics or certain physiological characteristics of the individual.

Much contrary to what you would expect there was thus no clear pattern emerging here. If anything you may be able to make out a couple of trends, with the most significant trend saying that the 3x5 @85% regimen could be the one that yielded (on average) the greatest benefits. That's however not very useful if you are subject 2, 10 or 16, because this would mean that workout "B" would be totally worthless for you.

If we simply overgeneralize these results and prescribe the same workout for all, this would have 19% of the subjects train on the worst possible and ~37% of the trainees on a suboptimal routine.

That sucks, right? Of course it does, but it's getting even worse! Up to now you could still sooth yourself by assuming that "Testosterone does not matter anyway!"

Figure 1: Effects of training on T-max protocol vs. T-min protocol on strength gains (Beaven. 2008)

Unfortunately, the results of the study at hand suggest that this is not the case, if you take the T-response as a guide, instead of doing an ex-post correlation to "prove" that testosterone was anabolic, the study at hand clearly suggest that not training in your individual "optimal" set- & rep-range will lead to stagnation and even strength declines.

Warning: The booze induced testosterone boost could mess with your training planning. So no Bloody Marys after your workouts (learn more)!

Bottom line: As of now, the technology to do larg(er) scale  cheap pre- / vs. post-workout saliva testosterone testing is not yet available. If there were follow up studies to support the usefulness of the "test testosterone first, plan your workout routine second"-approach to training optimization, I am pretty sure the demand, is going to rise and some clever engineer is going to develop a device every larger high-school football team and/or commercial gym could afford.

In view of the fact that even program "D" can be optimal for certain subjects, the introduction of this device could maybe even put an end to the "hardgainer" misery.

Reference:

• Beaven CM, Cook CJ, Gill ND. Significant strength gains observed in rugby players after specific resistance exercise protocols based on individual salivary testosterone responses. J Strength Cond Res. 2008 Mar;22(2):419-25.
• West DW, Phillips SM. Associations of exercise-induced hormone profiles and gains in strength and hypertrophy in a large cohort after weight training. Eur J Appl Physiol. 2012 Jul;112(7):2693-702. 

SuppVersity EMG Series - M. Triceps Brachii: The Best Exercises to Get That Horseshoe Look on Your Triceps

Image 1: The m. triceps brachii. As if you did not
know where to find your "horseshoes" ;-)

After last week's issue on leg training, devoting a whole issue of the SuppVersity EMG Series to a three headed muscle of your upper arm appears kind of unthrifty... well, maybe we should say "extravagant" and thus acknowledge that a well-built triceps unquestionably contributes to the muscular, athletic look most trainees are trying to achieve - especially if you are wearing one of those short-sleeved business shirts and complement them with appropriately muscled forearms ;-) As its name already implies the triceps consists of three heads,

• the long head, caput longum, which arises from the infraglenoid tubercle of the scapula and extends distally anterior to the teres minor and posterior to the teres major, and
• the two short heads, of which the caput mediale and the caput laterale which run along the rear side of the humerus.

Being the antagonist of the m. biceps brachii, the triceps functions to extend the arm and to stabilize the elbow joint when the forearm and hand have to be held steady to perform independent movements. Moreover, the long head which is the only one that originates from the scapula, also acts on the shoulder joint and is also involved in retroversion and adduction of the arm.

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

Its effect on the overall appearance of your sleeves aside, triceps strength (not looks, guys!) is a major factor in many sports such as basketball, boxing, gymnastics, tennis, etc. but I guess those of you who are into athletics will know that, anyway so that we can, without further delay, get into the meat and potatoes of EMG optimized triceps-training. Here they are, the most effective exercises for the m. triceps brachii, as measured by electromyography (10 male resistance-trained subjects, mean age 22y, mean body-fat 13%; data from Boeckh-Behrens & Buskies. 2000)...
 
I. Exercises With Standard Equipment for the m. triceps brachii 

As mentioned time and again in the previous installments of this series the idea of training a muscle in isolation, or, in case of the triceps, even training individual heads of a muscle without activation of its other parts is futile. Nevertheless, it is possible to put the focus on a certain part of the muscle and this is, i.e. shifting focus vs. isolating specific muscle strands, is also how I want you to understand the following exercise top 5 for the lateral head and the long head of the m. triceps brachii.

Note: If you are missing a specific list for the caput mediale, i.e. the medial head of the triceps, I suggest you have another look at the triceps anatomy in image 2. Situated right beneath the caput laterale, the EMG activity of the caput mediale will inevitable be recorded, as well, when you place one of the EMG electrodes on the skin right above the caput laterale.

Image 2: Triceps anatomy (image from finalfitness.co.uk)

... for the lateral part (+medial head) Cable push-downs, straight or bend bar SZ-bar triceps extensions, lying on the bench Guillotine presses, shoulder wide grip DB kickbacks, torso horizontal on bench DB extension, single arm, behind the head ... for the long head  DB Kickbacks, incline bench + retroversion BB Neck presses DB kickbacks, torso horizontal on bench DB extension, single arm, behind the head SZ-bar triceps extensions, seated

Figure 1: EMG activity of lateral head and long head of the m. triceps major during selected triceps exercises with standard equipment relative to the SZ-bar lying (lateral head) and seated (long head) triceps extension  (data adapted from Boeckh-Behrens & Buskies. 2000)

Image 3: Its not really necessary to turn the
SZ-bartriceps extension into a pullover,
like the old-school bodybuilders did it.
A regular french press where the
bar does not pass beyond your head will suffice.

While it is not surprising that the SZ-bar triceps extensions (both seated as well as lying on a bench), which also serve as reference exercises for the relative EMG intensities plotted I in figure 1, are among the most effective exercises for both the lateral, as well as the long head of the triceps, the specificity of the triceps kickback on a 60° incline as the #1 exercise for the long head of the m. triceps brachii may come as a surprise. This may be explained by the previously mentioned exclusive role of the long head in the retroversion of the arm, which is particularly challenging, when the angle between your upper arm and your torso is <0° (where 0° would be parallel to your torso as in the bend over triceps kickbacks on a bench).

Training Tip: With DB kickbacks perfect form is the key to optimal triceps activation. This is all the more true if you really want to "isolate" the long head of the triceps with the DB kickbacks on a 60° incline, where it is absolutely imperative to extending the loaded arm backwards, maximally (this by the way is what retroversion means in practice). You also want to keep your upper arm parallel to the floor all (!) the time. If you let it drop back to a neutral  position after each rep that would take away -20% of the intensity! Please do me a favor and start with a really light dumbbell - you will feel that just by retroverting your arm with a light load so that it forms a horizontal line from your shoulder to your pinky, is sufficient to induce a profound muscle burn in the long head.

An even greater surprise, however, probably is the 2nd place of BB behind the neck presses in the ranking of the most effective exercises for the long head. Thus, it is only valid that you are asking yourself "What on earth does a shoulder exercise have to do with my triceps?" Well, think about the origin of the caput longem, it attaches directly to the scapula and is frantically trying to stabilize a movement of which I would think twice whether or not I find it so elementary that I put myself at risk of a tedious shoulder injury, just to get "titanic triceps" or "bolder shoulders" ;-)

Image 4: Using a rope instead of
a straight  or V-bar makes
the cable pushdowns
an overall more balanced exercise

It's also noteworthy, that, other than the SZ triceps extensions or the guillotine presses, which owe their name to the unlucky circumstance that you might decapitate yourself (the standard narrow bench press is already -25% less effective!), when you let the barbell drop, the cable pushdown with the straight or V-bar targets the lateral and the medial head of the triceps almost exclusively. That being said, your triceps routine would not be complete without at least one complementary movement such as the triceps kickback on the 60° incline, where the long head clearly is the weakest link and thus guaranteed to get hammered pretty decently, not even, but especially with appropriately light weights! You may remedy this problem by using a rope instead of a straight or v-bar (cf. image 3). If you deliberately pull the rope apart at the end of the movement you will hit the long head of your triceps pretty efficiently and thus turn the #1 isolation exercise for the lateral head into a more balanced triceps exercise.

II. Body Weight Exercises for the m. triceps brachii 
 

Image 5: If you wonder why Arnold is showing up
in almost each part of this series,  here is your answer:
This guy simple knew what he was doing.

It does not take a rocket scientist, but just a brief glance at the enormous horseshoes of gymnasts to realize that you do not even have to train with metal weights, in order to build impressive upper arms. It is thus not surprising that many pro bodybuilders still swear by doing dips with their arms behind their back in between to benches (cf. image 5), which *surprise* actually turns out to be the most effective body weight exercise you can do to really hammer the lateral head of your triceps.

... for the lateral part (+medial head)
1. Dips, arms behind the back, between two benches (cf. image 5)
2. Dips, bars slightly more than shoulder wide apart, not going past 90° elbow flexion
3. Pushups, fingers facing forward, hands slightly narrower than shoulder width apart

... for the long head 
1. Dips, bars slightly more than shoulder wide apart, not going past 90° elbow flexion
2. Pushups, fingers facing forward, hands slightly narrower than shoulder width apart

Figure 2: EMG activity of lateral head and long head of the m. triceps major during selected body weight triceps exercises relative to dips between bars (data adapted from Boeckh-Behrens & Buskies. 2000)

As you can see, Arnold's behind the back bench dips (cf. image 5), or whatever you want to call them, are simply unbeatable when it comes to activating the lateral head of the triceps. Even in absolute terms, this variety of the dips is only 7% less effective than the SZ-bar lying triceps extension the #2 in the top 5 ranking of the most effective triceps exercises with exercise equipment.

Figure 3: EMG activity of lateral head and long head of the m. triceps major during selected body weight triceps exercises relative to dips between bars (data adapted from Boeckh-Behrens & Buskies. 2000

I've mentioned it before, going all the way down may on the dips does increase the workload on the tendons and joint capsules of your shoulder girdle and is thus neither beneficial for your triceps development (-12% EMG activity), nor for your joints. Flaring out your arms, on the other hand has a much smaller influence on the activation of the caput longe during parallel dips, than you may have expected - in fact, the -3% reduction in EMG activity is practically negligible.
 
III. Conclusion - For Maximal Triceps Development Specialization Does Have Its Place

From all that has been said before, it should have become obvious that, probably even more so than with any other given body part, the use of "specialization" exercises for the individual heads of the triceps does make sense. Although exercises such as the classic dips between two bars (done "Jay Cutler"-ish, i.e. only down to an elbow ankle of 90°) stimulate both the lateral, as well as the long head of the triceps adequately, there is no "jack of all traits"-triceps exercise - not even the SZ-bar triceps extension since you would at least have to switch from a lying to a seated position to adequately stimulate both the caput laterale + mediale as well as the caput longem.

Figure 4: EMG activity of lateral head and long head of the m. triceps major during three common triceps exercises relative to maximal activation of the respective head in any exercise evaluated in the study (data adapted from Boeckh-Behrens & Buskies. 2000)

The data in figure 4 elucidates the inevitable trade-off between maximal stimulation of the lateral and medial head, on the one, and the long head, on the other hand, for three classic triceps exercises. I tried to factor this, as well as my personal observation that out of hundred trainees maybe five do the incline kickbacks the way they are supposed to in with the following exemplary triceps routine (if you are willing and able to do the kickbacks with proper form and adequate weight instead of just swinging the dumbbell up and down on the side of the torso, you can alternate those with the bench dips, I propose as the third exercise in the routine below).

Know your own limits! If you train triceps and biceps with another muscle group on the same day and want to do a single exercise only, I would suggest doing either dips or the suggested mix of lying and seated SZ-bar triceps extensions from the EMG optimized routine below to limit the absolute number of sets you perform.

An EMG-optimized routine
 

Image 6: Although many trainees
swear by it the narrow grip barbell bench
pressis not particularly effective in
isolating the triceps and thus did
not make it into the "EMG routine"
(image from everkinetic.com)

There is of course a myriad of ways of combining the individual exercises, my personal recommendation for overall triceps development (based on EMG measures) would yet be as follows

1. SZ-bar triceps extensions*, 6-10 reps *alternate lying and seated variety
2. Cable push downs, 8-12 reps, straight bar or v-bar
3. Bench Dips (cf. image 5), to failure

You may notice that I do not make volume (i.e. set) recommendations. This is due to the fact that I found that everyone has to find what works best for him / her in terms of optimal volume, training frequency and body part splits. This may also change over time / according to lifestyle factors / nutrition and supplementation.