Dr. Kristy Appelhans, Naturopathic Doctor and Sports Medicine Consultant

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

 

 

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.

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!

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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.

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!

Recent studies have discussed that significant cognitive decline has not only been observed in elderly patient populations, but also in patients as young as 45-years of age. It is important to understand that there are many factors that can impact the function and health of the brain longterm. For example, several studies have concluded that there is a specific relationship between cardiovascular health and mental, emotional, and cognitive disorders. Namely, pre-existing cardiovascular disease such as chronic hypertension and coronary artery disease can impair the delivery of nutrients and oxygen to brain tissue which may result in the damage to the brain over time and could be associated changes in brain function and cognitive decline. Cardiovascular disease has become more common in the 45 and up age group over the last 20 years. There is also a greater risk for developing cardiovascular disease in certain patient populations which include individuals that smoke or have hypercholesterolemia, diabetes, hypertension, and obesity. Therefore, making lifestyle choices that help to eliminate these risk factors has become a strong strategy for the optimal preservation of brain function. The following lifestyle choices may be implemented to help improve cardiovascular health:

 

1. Weight loss

2. Aerobic and anaerobic (weight bearing) exercise

3. Diet rich in healthy fats

4. Diets that sustain healthy glycemic control or healthy blood sugar levels (high fiber, low glycemic/complex carbohydrates, etc)

5. Smoking cessation

The New Year is just around the corner and this is the time that many of us are thinking of ways to improve upon what we did last year. This is also the time when we tend to make resolutions about our health. It is commendable to want to start anew with a clean slate, a fresh mindset, and readiness to charge ahead at full speed. However, you may want to consider what your expectations are and how the new habits will affect your health long-term. I am often asked whether I feel cleanses are a good idea. This is a loaded question, but the bottom line is that facilitating the removal of waste from the body is good when done safely. You must also remember that it is equally important to focus on what you are putting in your body or exposing yourself to as it is to get it out. In other words, decrease the accumulation of potentially harmful substances in your body by limiting your exposure to them via food or environmental sources and you will decrease the overall burden your body has to remove these substances. Decrease the consumption of additives, colorings, pesticides, and other chemicals from your food supply. Eating cleaner and organically is one of the best ways to decrease your body's toxin burden every day. (see previous post about clean/organic eating tips)

A cleansing program should be recommended and supervised by a qualified professional, but many do not realize that our bodies are designed to naturally cleanse themselves and that supporting these processes every day involves lifestyle changes, not 7-day or 10-day changes. We accumulate waste and toxins in our bodies 24/7 so it makes sense to enhance our cleansing ability on a daily basis rather than once or twice a year. That being said, it is important to be aware of the specific mechanisms the body has to cleanse itself in order to better support these processes. These mechanisms or outlets for waste/toxin removal are also called emunctories. The primary emunctories are the bowel, urinary tract, lungs/respiration, and skin/sweat. Using these emunctories through lifestyle habits is an excellent way to support cleansing even in addition to professionally recommended protocols. Here are a few ways that you can support cleansing every day by using your emunctories:

1. Bowel: Digestive waste is a large source of toxins in the body and enhancing waste removal via bowel elimination daily helps to decrease these toxins. Fiber supports your ability to remove waste by enhancing the frequency and regularity of bowel elimination. Eat a variety of fibrous foods from vegetables, fruits, whole grains, seeds and nuts.
2. Urinary Tract: Drink at least 64 oz of water to help with healthy water elimination and to eliminate toxins through the kidney/urinary tract (*Remember, hydration needs vary with the individual and fluid/electrolyte requirements increase with exercise and sweating)
3. Skin (Sweat):Use a sauna or hot Epsom Salt baths to increase removal of toxins through sweat. Times spent in the sauna or baths generally range from 10-15 minutes per day, but this will vary depending on your individual tolerance to heat.
4. Lungs (Respiration): Regular exercise is very effective as it supports 2 emunctories at once! Not only does exercise enhance healthy cardiovascular/lung function and respiration, but it also increases the frequency of sweating. Additionally, many individuals will experience improved bowel function with increased physical activity.

Contact Dr. Kristy Appelhans today for more information about this topic or any health questions or concerns you have!

It is that time of year when stress can get the best of us! For some, this may mean an annual cold or just feeling under the weather in some way which passes after a short time with a little rest and "TLC". For others, there is an underlying virus called Herpes Zoster which is also called varicella-zoster virus (VZV) or "Shingles" that may resurface causing a significant amount of pain or discomfort. This type of Herpes develops in individuals that have contracted Chicken Pox at some point or have been vaccinated for it. As is commonly seen with other Herpes viruses (Types I and II) VZV presents on the skin as a painful lesion (sore) or group of lesions. Also like Herpes Types I and II, VZV is fairly common affecting approximately 2-5 out of every 1000 US patients which is roughly 1 million US cases annually. VZV lesions generally appear on areas referred to as dermatomes which are areas served by a single spinal nerve. For example, there is a dermatome that extends along one rib to the front of the chest which is a common area affected by VZV. VZV eruptions can also appear on other dermatomal areas of the face, neck, arm, and hand. Again like other Herpes viruses, symptoms of VZV may erupt more frequently or intensely in some individuals due to a number contributing factors or "triggers". The most significant factors involved with Herpes outbreaks are stress and immune compromise. First and foremost, many of us are aware that stress can have a wide range of effects on the body as well as the mind. Stress can can also weaken the immune system and lead to a variety of acute or chronic illnesses. Likewise, conventional immunosuppressive therapies commonly used for various conditions including IBS or other bowel disorders, arthritis, chronic pain, and general inflammation can trigger Herpes eruptions. Patients with diabetes, autoimmune disease, cancer, HIV, and other illnesses that alter immune function are also at risk. Therefore, it is very important to incorporate preventive care into Herpes treatment options which will minimize triggers in these patients. Here are some key points to remember for Herpes or VZV prevention:

1. Minimize the use of caffeine or other stimulants
2. Get adequate rest each night (6-8 hours)
3. Find healthy ways to manage stress such as regular exercise, meditation, yoga or other stress-reducing strategies
4. Consistently focus on healthy nutrition to support or boost immune function

Contact Dr. Kristy Appelhans today for more information about this topic or any health questions or concerns you have!

When choosing an organic product, be sure to look for the USDA Certified Organic seal on the label. This certification shows that the product was grown/prepared without the use of pesticides, hormones, or antibiotics. Research continues to progress to relay a more current and accurate picture of the environmental and consumer impact of these issues. However, there are various health implications of pesticide exposure and consumption including, but not limited to, cancer, nervous system disorders, thyroid dysfunction, and reproductive disorders. Overuse of antibiotics has caused microbial resistance in the environment as well as inside our bodies. In other words, many common â??bugsâ? have developed ways to survive anti-bacterial and antibiotic treatments that were previously used to control microbial growth and the ability for bacteria to cause infections.

 

Organic foods can be a bit more costly than their non-organic counterparts. However, taking steps to incorporate these products into your diet is well worth the investment. Just in case you are still in a budget crunch, but want to switch some foods to an organic form, focus on foods you consume regularly. For example, if you eat a banana every day or several times weekly, make that an organic choice. Additionally, keep in mind that some produce is typically grown or processes with more chemicals than others. These are often referred to as the â??dirty dozenâ?. Consider the dirty dozen list below on your trip to the produce aisle:

 

1. celery

2. peaches

3. strawberries

4. apples

5. domestic blueberries

6. nectarines

7. sweet bell peppers

8. spinach, kale and collard greens

9. cherries

10. potatoes

11. imported grapes

12. lettuce (not cabbage)

 

Alternatively, check out the â??Clean 15â? which are grown with relatively lower amounts of pesticides:

1. Onions

2. Avocados

3. Sweet corn

4. Pineapples

5. Mango

6. Sweet peas

7. Asparagus

8. Kiwi fruit

9. Cabbage

10. Eggplant

11. Cantaloupe

12. Watermelon

13. Grapefruit

14. Sweet potatoes

15. Sweet onions

 

References:

1. www.FDA.gov
2. http://articles.cnn.com/2010-06-01/health/dirty.dozen.produce.pesticide_1_pesticide-residue-pesticide-tests-fruits-and-vegetables?_s=PM:HEALTH

How many times have we heard the phrase "clean eating"? What does this mean and how do we accomplish that? Why should I adopt clean eating as a lifestyle? The concept of clean eating is beneficial for a number of reasons and this dietary approach impacts several areas of health. There are many common chronic diseases that can be prevented or improved with clean eating habits which include thyroid dysfunction, hormonal imbalances, digestive disturbances, allergies, obesity, and behavioral disorders. Clean eating is a concept that can also be applied to any type of restricted dietary regimen such as vegan- or vegetarianism and hypo-allergenic diets. Below are a few examples of how to clean up your diet!

 

1. Choose Organic: organic foods will bear a "Certified USDA Organic" sticker (produce) or stamp on the label
2. Choose Non-GMO: non-genetically modified (non-GMO) foods will bear a "Non-GMO" sticker (produce) or stamp on the label
3. Limit Sugars and Artificial Sweeteners: unhealthy added sugars and sweeteners can come in a variety of forms which include sugar, corn syrup, aspartame, sucralose, acesulfame K and even healthier/natural sweeteners such as honey, fructose, cane sugar, or rice syrup can be problematic when used in excess. Look for products with total sugar content of less than 6-10g (grams) per serving.
4. Choose Foods in True Natural Form: Fruits and vegetables are a natural source of vitamins, minerals, and fiber that are very important for a healthy diet. Nowadays, many products bear statements such as "all natural", "real fruit", or "100% juice". Rather than eating juice, pressed fruit, or vegetable chips, choose the true natural form of foods. For example, eat a whole apple, carrot, berry, snap pea, potato, or yam. However, when choosing an alternate form of the natural food, select products with a short list of ingredients without additives, artificial colorings, flavorings, preservatives, etc. For example, yam or sweet potato chips should list only yams/sweet potatoes and salt (and perhaps vegetable or olive oil). Not sulfur dioxide, partially or fully hydrogenated oil, corn syrup, hydrolyzed whey protein, monosodium glutamate, yellow 6, BHT, or a number of other unhealthy ingredients and chemicals.

Remember these tips to make wiser food choices and look for more information on this blog about how clean eating can contribute to a healthier you!

 

Contact Dr. Kris today to learn more about healthy lifestyle choices.