Dr. Kristy Appelhans, Naturopathic Doctor and Sports Medicine Consultant

2035 Westwood Blvd Ste 209 Los Angeles, CA 90025 phone: (310) 281-6926
Dr. Kristy Appelhans is a naturopathic medical doctor focused in the treatment of a variety of disorders including digestive diseases, allergies, skin conditions, insomnia, and, hormonal imbalances. In addition, she has a significant background and expertise in therapeutic nutrition for weight management, athletic performance, diabetes, high cholesterol, digestive dysfunction, and optimal health. Dr. Appelhans offers her patients many treatment options using an integrative medicine approach with both alternative or complementary medicine as well as conventional medicine. She feels that educating her patients and the community is an effective way to promote and improve health and healthcare. She has opened her blog to altMD users to further reach the community in talking about common health concerns.

Visit Dr. Kris's blog to stay up-to-date on current health issues, visit her website at www.privatehealthcarenow.com  or reach her directly with your questions at drkris@privatehealthcarenow.com
Saturday, March 01, 2014
Many have asked me what supplements I take, which protein I use, and many other things about keeping in shape or getting ready for shows. I must admit that I have several favorites that are staples such as whey protein, pre-workout creatine/arginine/caffeine mix, a multivitamin, green tea, branched chain amino acids with with glutamine, fish oil, egg white protein powder or liquid whites, and the coveted cortisol manager. So that is about it in addition to strategic timing in taking the aforementioned products, consistent and intense training, and some moderation on the number and frequency of those so called cheat days. It is not easy, but it is all possible. I have even stood with competitor moms and you can get back in shape after children and fitness or life in general is not over as you approach 40! It is just the beginning! Most importantly and you cannot hear this too often, never forget that it is a lifestyle and it does not happen overnight folks. You have to commit. In fact, even with all my background, training, and expertise it took almost a decade to become a pro competitor and at the time I was 37. And I am not alone. Some call this a lonely sport because we do all the prepping in solitude on many occasions. However, I have made many friends getting back up on that stage or back in that gym with the same folks that are growing, changing, improving every day for years on end. You cannot give up on being a better you in fitness. That is your reality check today. Stay focussed and you will reach those goals before you know it.
Monday, January 20, 2014

As usual, dietary supplements have recently come under fire in the media. A fairly prominent study questioned the validity of multivitamin supplementation in its proposed role in disease prevention or progression. There are many questions about� ssupplements�nbsp;that have steadily impacted the nutrition and supplement industry and I will continue to address those questions in future blblogsThe question addressed in this blblogs as follows:

Who need supplements? Or what supplements are â??necnecessary�

Answering the question above certainly requires much more scientific discussion than a single blog blog. However, it is also important to first understand the different intentions behind supplement use. Supplements may be used to provide for nutritional needs not fully acquired through daily dietary intake and/or to address nutrient/ingredient depletion which can be caused by certain medications. Common examples of using supplementation to restore an ingredient is when CoQ10CoQ10etion occurs with statistatinor when beneficial flora decreases with antibiotic use and providing a probiprobioticviates or prevents GI distress. Also, it is standard practice to prescribe Vitamin E with certain anti-psychotic medications because of the depletion of this important nutrient during therapy. The list of examples goes on and on, but just these few are justification enough for supplement use. From here, the better question to ask is how else can we explore the benefits of nutritional science, not how can we argue its rightful use in the clinical setting. Additionally, the right population needs to be studied to prove or disprove the hypothesis of any study. Progression of disease or even the apparent health implications of dietary intake expresses fairly uniquely to the individual. There are a number of factors that come into play with this issue and include metabolic differences, the general ability to compensate physiologically, age, and gender. If these variables are not controlled during a clinical study, the analysis of the ingredient or nutrinutrientÃ?otential benefit(s) is likely to be skewed either favorably or negatively.

So in the case of the multivitamin questions that have been asked recently, it is important to understand that multivitamins vary by composition meaning that the strengths, dosages, and qualitquality�(including bioavaibioavailabilitych ingredient vary between brands. Furthermore, each ingredient has a different role in general disease prevention or therapy (either proven or theoretical). For this reason,� a specifc specificent or combination of ingredients should be used to establish efficacy for adjunct or therapeutic use of a specific condition. The use of a single brand name product for research purposespurposes�lls short in this respect.� 

Saturday, January 04, 2014
In a pinch for a quick meal that tastes good and won't wreck your diet? Well, this healthy personal pizza recipe may be just what you are looking for!

Ingredients: 1 high fiber pita round, 1/4c marinara, 1/3 cup lowfat mozz cheese, and a handful of turkey pepperoni

Place pita on stovetop burner on low/simmer setting, sprinkle cheese over top and leave pita on burner until cheese starts to melt, heat up marinara and spread lightly over top with butterknife for even distribution, heat up pepperoni and place on top and voila!!!

Whole prep time about 5 minutes. Total calories about 350, 10g fat, 25g protein, 25g carbohydrates, and 8g fiber. Enjoy!
Saturday, December 07, 2013

This blog is about as honest as it gets because I think so many of the folks that I help with weight management need to be more realistic about these types of goals. When I initially wrote this post, I had my fellow competitors in mind. I have seen so many fitness/bodybuilding competitors (both male and female) come off of their competition season with nothing but guilt and fear. Guilt for finally indulging in "normal" diet and exercise regimens and fear of how that� normalcy� will sabotage all their hard work. However, this is not much different than the struggles that many non-competitors have in trying to stay healthy or� achieve/maintain goal weight and ideal body composition. I have seen many cases where the guilt or fear of what you did or didn't do turns into a vicious circle that ultimately ruins our best efforts to make positive changes. The next several lines may seem very familiar, but what I am finding is that perceptions are becoming so skewed by media or envy of something that is otherwise projected in an unrealistic way, many of us need a reality check! With that I would say the most important thing to keep in mind is that this is YOUR journey! I cannot stress enough that you need to identify your personal goals and only strive to meet them; not someone else's and certainly not by what you think others may want you to strive for. You may want to improve your physique or clean up your diet, but your progress should be measured against your reality rather than what you think someone else is doing. It is also so important to remember that personal ideals vary greatly as do the routes that any one individual may need to take to achieve them. Also think about why you want to achieve your goal. For competitors this may seem straight forward, we all want to win and do whatever it takes to get there! But it can also be more complex than that. Why do we want to win? Is it for public recognition of our personal achievements? I know it is not for fame and fortune as that so rarely happens in the fitness industry compared to how many strive for it! Or is it to say that we look like the guy/girl in that magazine that has been captured in the most optimal although brief moment in time which they could actually look the way they do? I mean, we all know by now that a competition physique or even or the most popular fitness magazine images are not sustainable or healthy physical goals for most individuals right? In fact, that magazine image can look drastically different even in as little as 24 hours! There are many tricks to manipulating the way a physique looks on a certain day with hydration techniques, diet and supplementation. Some of you have even read 'how to' blogs that I have written about these types of tricks! And we all know how a photo can be manipulated to create an image that is very different from the original model.

It goes without saying that I would like to see more often than not that the physical goals of my patients are primarily aligned with achieving health or fitness goals, but the definition of what is healthy or fit for someone is also very unique to that individual and/or the specific point there are at in their journey to achieve it. And finally, think about your strategies for achieving goals. Are you consistent? Are you really allowing enough time or putting in enough effort for major changes to take place? How much time should it realistically (there is that word again) take to achieve your goals? Are you considering that there are a variety of factors which impact health or weight outside of how you eat or how much you exercise? In fact, for many individuals, a comprehensive fitness program includes seeking guidance and care from a qualified medical professional.

So I have shown there are a lot of questions to answer when mapping out your personal health or weight management strategies. For this reason, I cannot stress enough how important it is to seek out support at any point when you feel lost or need help bringing it all together. In the meantime, keep watching for more posts about mapping out your personal health journey and some helpful tools for achieving this!

Saturday, August 10, 2013

Okay everyone. Time to get back to basics. I get a lot of questions about how long it takes to lose weight and the answer to this will vary greatly between individuals. Many of you know but continue to deny the true fact of the matter and that is, it takes work which comes from maintaining a "sensible" diet, a fairly rigorous exercise regimen, and consistency with both of these factors over a significant duration of time. So here are some facts to keep things in perspective:

1. In order to lose 1 pound in a week, you need to create about a 3500 calorie deficit in a week's time either with diet or exercise or a combination of the two. The tricky part comes in with metabolic adjustments during weight loss and the type of weight you are actually losing such as muscle vs fat. Another confounding variable is introduced if you are a chronic dieter and are eating so few calories already that you metabolism has suffered by way of down regulating itself over time. Also, reduction in water retention which naturally occurs during weight loss will also lower total body weight. However, to put this in a simpler perspective for the sake of this basic discussion, a high intensity 1 hour weight training and 30 minute cardio workout will burn about 500-700 for an average individual. So I am sure you have done the math, you would need to do this about 5-6 times a week for a 1 pound weight loss. So 10 pounds? 10 weeks. 1-2 pound weight loss a week is a good, safe, and usually permanent rate for most provided that the new diet and activity becomes a lifestyle.

2. Calories add up! Remember you are trying to create a caloric deficit so say about 1/2 that will come from calorie restriction and the other half comes from exercise. Based on a 3500 calorie deficit goal, you will need to restrict approximately 1750 calories from your food each week to lose 1 pound. A bite of cake or cookie or piece of chocolate or 10 french fries or 1/4 of a bag of snack size chips could be as much as 50 calories each. Say you nibble 2 times a day (100 calories) for 7 days, that is 700 calories or approximately 1 highly intense hour and a half gym routine with weights and cardio and it was "just a couple bites here and there" you might say! If all other things stay constant, you might see a ½ pound weight loss for the week with those seemingly insignificant nibbles.

3. Use a good online calorie counter to save your sanity. I recommend www.fitday.com . This is a very user friendly application with lots of helpful tracking features for macro and micronutrients, hydration, weight loss, and more. The best part, it is free!

4. Stay hydrated and eat quality foods with ample fiber (minimum 25g per day) to keep things moving and avoid artificial sweeteners, colorings or other additives to help relieve water retention and other physiological responses that can impede weight loss.

5. Be patient! This stuff takes time and dedication. Every bit of improvement is one giant step towards a healthier and more fit and active lifestyle for you.  The information above is a guide to help identify basic strategies for creating caloric deficits. The mental focus should be balanced, not obsessive. And sometimes the scale doesnâ??t change on a weekly basis. Sometimes gaining lean muscle will make your weight seem like it is at a plateau but your body may take a firmer and smaller shape during this time. Be honest with yourself, seek professional guidance to work through all the nuances that are you as a unique individual, and you will see results.

*It is recommended to consult with a health care professional regarding your individual weight loss needs and the safest/most effective ways to incorporate diet and exercise into your lifestyle.

Saturday, October 06, 2012

Here are some strategies for making sure your carbohydrate intake is used throughout the day and not stored away:

 

  1. Before a Workout: this is important especially for those of you who workout first thing in the morning. As we know, your body likes to store fat as a survival mechanism when it thinks you are starving (fasting). By the time you wake up, most of you had your last meal 6-8 hours ago (if you have followed my advice to avoid eating right before bed!) So carbs will help â??break the fastâ? and fuel an intense workout while keeping your body from breaking down body proteins (muscle) for energy.
  2. After a Workout: replenish your body with carbs to aid in recovery and help maintain energy until your next meal
  3. During Most Active Part of Your Day: donâ??t save all your carbs until dinner or closer to bedtime. Eat the majority of your carbs earlier in the day to make sure you have time to use them rather than store them

 Sample Carb Intake Schedule (with morning workout):

 

Based on 140g Total Carb Intake for the Day

 

6a: Pre-workout ½ protein shake â?? 20g carbohydrate

 

Workout High Intensity Weight Training and/or Cardio

 

9a: Post-workout protein shake and small piece of fruit (optional) â?? 40-50g carbohydrate

 

Noon: Meal 3 â?? 30g carbohydrate

 

3p: Meal 4 â?? 20g carbohydrate

 

6p Snack â?? 10g carbohydrate

 

8p Dinner â?? 10g carbohydrate

 

 

Friday, September 14, 2012

Many of you have heard by now that every few months you should mix up your exercise routine to keep your body guessing and challenge your muscles to encourage continued development of lean body mass and to maintain your hard earned muscle even if you are â??in shapeâ?. This is an excellent approach to achieving and keeping a physically fit physique. Interval training is one way to create diversity in your routine. Here is an example of what I did today in addition to my current weight training routine:

 

40 minutes on the Elliptical machine with intervals

First 20 minutes moderate pace (about 150 or 160 steps per minute) at steepest incline on level 7 or 8 resistance.

Second 20 minutes done with intervals. 30-60 seconds level 5 resistance at pace as fast as I can go while not holding onto the rails, keeping good form and control of the movement (about 230 steps per minute), then 30-60 seconds at level 7 back at the moderate pace I started with. . I did the first half of the interval portion while still at the steepest incline and then switched to half the incline for the last part of the interval sets. Intervals sound daunting, but most are surprised to find that they go very fast! This is one of the great ways to elevate your heart rate, give your muscles and cardiovascular fitness a new challenge, shape up stubborn legs, break through weight loss plateaus, improve balance and core strength, or even just to stave off boredom from a routine you have been stuck with for a while. Give it a try. Start at your own pace and comfort level.

Friday, August 24, 2012
The work is done. I have met my goal weight and bodyfat for the time that I had to prepare. All told, I started getting serious about 4 or 5 weeks out. I am very much a procrastinator and it is not recommended! I would generally recommend 12 weeks for prep time for first time competitors and about 6-8 for a seasoned competitor depending on your year-round condition. REMEMBER: I am a seasoned competitor and fitness enthusiast who works out vigorously year-round with heavy weights and cardio 5-6 times per week. Those who are new to this should seek supervision of a professional before incorporating any of these nutrition, training, or other prep tips.

So now there is approximately 32 hours before I step on stage at the California regional fitness competition. What have I done and what am I doing until then? Here is a snapshot

1. Last 5 weeks was diet cleanup time. Getting rid of most of the junk, artificial sweetners, "white" carbs and getting calories in check. I did a weekly tapering down on calories to have about a 100 calorie deficit each week. So it was 1800, then 1700, then 1600, then 1500, and 1400 the final week.

2. During the last 2-3 weeks, I have also increased exercise by doing a 1-hour circuit weight and 30 minute cardio session 4-5 times a week and 30 minutes of cardio each night about 5 times a week. I have lifted as heavy as I can while keeping most upper body rep ranges between 12-15 and lower body between 15-30 reps (15 for single joint and 30 for multijoint exercises).

3. Last week of the show, low carbs 50-75 Monday through Thursday. High protein about 1g per pount of lean body weight (120g for me) and a ton of water - at least 1/2 gallon and 1 gallon most days. *there is a lot of sweating going on at the gym and I am really trying to get fluid out so replacing fluid is crucial to not go into retention mode and electrolytes are equally important. So consuming a low-calorie hydrating product at least after the heaviest gym session is highly recommended as well.

4. Also the last week, epsom salt soaks, muscle rubs, stretching, and lots of sleep (at least 8 hours)! Got to support recovery or that cortisol will sabotage your efforts every time. Don't get me wrong, cortisol has its place, just not all day every day! Glutamine and Branch Chain Amino Acids are also important for recovery. I take these before exercise if I haven't eaten for more than 3 hours beforehand and definitely afterward. Sometimes you can find a good BCAA blend in a post-workout recovery shake. That makes things simpler

5. Water and salt manipulation starts the day before the show. Don't want to do this too long or the body starts trying to compensate and get back to a "normal" water and salt balance. 24-36 hours is about as much time as your body is willing to give before rebelling. I have been taking in about 1500-2500mg sodium daily for the last 2 weeks. Day before I will limit to 700mg. Still drinking plenty of water. Total about 2-3 quarts of water on the day before. On show day, I will continue with the low salt intake and only consume sips of water or replenish based on output. For example, if my body is shuttling out a cup of "water", I will make sure to take in a cup.  The day before showtime is also the day I also incorporate carbs or "carb up". About 40-50g of clean carbs (oats, yams, etc) every 2-3 hours on the day before and continue on day of the show with last meal or snack about 2 hours before I get on stage. I make sure my last gym session is before the carb up so my muscles can take advantage of the glucose load and appear fuller on show day.

6. Skin prep is VERY important too. Started daily exfoliation 3 weeks ago and continues until day of the show (or last shower before show). All shaving is done night before color application to limit skin puffiness and irritation as well. Daily sweating through sauna or wraps will help get that tight look. 2 nights before, I use Preparation H cream on problem areas, wrap the skin in saran wrap and sleep in this. Sounds silly, but it really works to draw out extra water and tighten up the skin. This is only done about 2 days before though because it is a very temporary method. Once the body starts drawing in water at a normal rate with a standard diet, it isn't very effective. The diet and skin prep generally work together.

7. Caffeine. I am addicted to this stuff! However, I limit consumption my final week out to keep cortisol in check. Only use about 100mg caffeine right before exercise during the final week. No caffeine before exercise that is after 7p at night or real close to bedtime.

That's about it. All of this only works if you have done the work! Still must train hard and eat right all the way up until those last several weeks and everyone's body is a little different. Contact me today to find out more about when and how to prep for your show!
Wednesday, August 22, 2012

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Tips for Basic Detox to Help Decrease Weight, Water Retention, and Inflammation

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I know I have touched on some of this before, but so many of us lose sight on the basics of our nutrition and lifestyle that are so important for maintaining our health as well as our appearance. Although the following tips can easily be adopted into any beauty regimen to enhance the appearance of skin, decrease bloating, and control water retention or weight, these tips are also great ways to help eliminate toxins that we are exposed to daily which supports a healthy body inside and out!

The body detoxes through several pathways which include the kidney (urination), bowel, skin (perspiration), and lungs (respiration).

1. Water: drinking plenty of water daily (minimum of 64 ounces and more for those who exercise or live in dry climates) will help the body detox through the kidney and promote the elimination of excess water retention which lends to that puffier look in the skin and can often enhance the appearance of cellulite.

2. Sodium: keeping sodium at or under 1.5g (1500mg) daily will help avoid water retention - check labels for sodium content and see where you add up at the end of the day. You may be surprised how much sodium you consume!

3. "Clean" Foods: decreasing the amount of processed foods and increasing natural (non-chemical and organic) and fibrous foods in your diet will support healthy digestion and bowel function. As mentioned above, the bowel is another way to eliminate toxins from the body and daily elimination is one of the key components for maintaining health.

4. Exercise: Exercise is a great way to activate several of your detox pathways through skin/perspiration, lungs/respiration, and even the bowel as physical activity can promote healthy/regular bowel function. Not to mention the obvious benefit of helping to maintain a healthy weight, supporting efficient metabolism, and building lean muscle! So get moving folks!

 

5. Relaxation: Hot Epsom salt baths are a great way to induce sweating which aids in detox, decrease inflammation, and relax sore muscles. Stretching in the bath is an added benefit although stretching in general should be implemented into any healthy or active lifestyle.

*NOTE: these tips are for generally healthy individuals and if you have pre-existing medical conditions or are currently having symptoms, consult with a medical professional about the best ways to improve your health. The following is not to be used as medical advice or as a replacement for a proper medical evaluation or treatment.

Saturday, January 14, 2012

After over 15 years of living and studying fitness and health, I continue to see a reoccurring theme in the industry and it is the myth that there is one solution for everyone to lose weight, get/stay fit, and achieve optimal health. Many individuals find that this is far from the reality of things. I cannot express enough how important it is to keep your body guessing and adapting to new challenges in order to stay fit or improve your fitness level. This is often true for diet as well as exercise. In fact, the metabolism adapts to dietary changes in much the same way muscles, lungs and heart can become stronger or more efficient from changes to exercise type, frequency, and intensity. Here are some ways to keep fitness fresh:

  1. Take a break! Have you been working out with high intensity for 3 or 4 months 5 or more days a week non-stop? Take several days or even a week off and do something fun and active. Take a walk through your favorite town, go to an art gallery, or a local zoo. Do anything that does not require that you stress, strain, or exhaust your body. Your body will thank you!
  2. Are you a long-distance runner that usually does light high reps in the weight room? Switch it up and decrease your rep range with heavier weights. Also do high intensity sprints to make your cardio sessions much shorter, but still challenging.
  3. Weight lifters can follow the logic above and up the cardio intensity instead of those longer steady paces they may be keeping. In the meantime, lift with lighter weight and higher repetitions to fatigue your muscles

These are just a few of the many ways to change it up. Stay tuned for tips on keeping the diet "fresh". Contact Dr. Kris today to re-boost your fitness or diet strategies!

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