by Dan | Apr 22, 2018 | Equipment, Exercise, Family, Goals, Motivation, weight lifting, Wellness/Health
We may all be at different levels, but the bottom line is that we are all athletes! We were made to move, and some of us may do it faster than others, or longer than others, but if you get out and move, and push yourself more than you would need to do, or are required to do just to do your activities of daily living, than you are an athlete. We don’t have to be professional. We just have to move. Besides Family Medicine, I am also involved in Sports Medicine, and came across a definition here recently that I think sums this up the best.
For all of us who stay active, there are bound to be times when we get hurt, or develop pain. The majority of these are still temporary. The problems were are helping to push back, or avoid altogether (high blood pressure, diabetes, obesity) can last a lifetime. We all need to get out of our “comfort zone”. We all can achieve benefit from this. For my part, there is always things to learn about Sports Medicine. I was just at a 2 day conference in SF to learn more about this.
There are always new treatment plans, ideas, research, and literature to review. They had new updates on concussion protocols, surgery updates, therapy updates, challenges of getting people to get out and move, as well as challenges that we as health care providers face when dealing with people who get injured, and how to get them back to what they want to do. It is always a challenge, but one thing that helps me in my plans of how to take care of someone, is being a runner myself, I understand the mindset involved with this, and how much somebody wants to get back to their same level of activity. Very few of us our professional athletes, but we should all be recreational athletes. We all need to move. “Use it or lose it!” The best part of all of this is there is so much variety of different activities out there to do that we can ALL find something to get involved with.
Here are a bunch of our run club members out in my garage, the Reiflex Center, doing weight/resistance activities. It is so much more enjoyable doing this as a group. We all need to do something. That hidden athlete is in all of us, just waiting to come out. Specific weight goals, times challenges in walks or runs are not the ultimate goal. These goals may help though to keep us motivated to keep working on things, and to stay active and healthy. But, the ultimate goal is to live life to the fullest, to be able to spend time with our family and friends, and to continue to have good times, and make lasting memories. That is what it is about. Keep pushing that inner athlete in you. It is there! Some days may be harder to find than others, but the rewards that can come about are more important that any time or medal that you may get. It is impossible for each of us to know everything, and to do everything. Making an effort is a start, and something is better than nothing. Keep learning! Keep trying! Keep moving everybody!
Dr. Dan
Consecutive Exercise Day #: 3847
by Dan | Apr 19, 2018 | Diet, Exercise, Goals, Motivation, Wellness/Health
We have just received news that our dietitian, Kelsey Raml, has just been selected as the winner of the South Dakota Academy of Nutrition and Dietetics (SDAND) Young Dietitian of the Year for 2018! Great job Kelsey! She will formally be presented this award at the annual SDAND/SDAHO conference in September. She was nominated by a previous student that she had here at Brown Clinic. In her students words: “Kelsey is a tremendous role model in the South Dakota dietetics community. Not only does she work as an outpatient dietitian at Brown Clinic, but she also dedicates time to teaching for SDSU and consulting at Assisted Living facilities. I first met Kelsey as my Quantity Foods Instructor and then was honored to do most of my practicum hours with her. She is always willing to work with students to help achieve their practicum and internship hours. I remember coming home from the first day of my practicum and being excited for my future as a dietitian. Kelsey’s passion for dietetics is contagious. Fast forward a few years, Kelsey and I continue to stay in touch. She is always willing to answer any of my questions as a new dietitian and we often converse about emerging research. We have also been able to use each other for referrals with clients who have moved across the state. When thinking about who to nominate for this award, I cannot think of anyone more deserving of this than Kelsey!” Neither can we! Great job Kelsey, and congratulations!
You manage to juggle all of your responsibilities at work and at home. Your husband Adam, and 2 year old son Corbin, keep you incredibly busy at home, and we always have projects for you to work on at the clinic. You are a great asset to our team at Brown Clinic. You not only continue to work on teaching our patients healthier ways to eat, but also help with our diabetes teaching, our Strive to Survive program, and blog, and our Medicaid Home Health program, which you have helped create the template for the rest of the state to follow. We at Brown Clinic are incredibly proud of you, and proud to have you on our staff, and team.
You are always involved with helping to promote Brown Clinic and what we do overall in primary care. Teaching dietetics is fundamental to the overall care of our patients, and can also be one of the most difficult and challenging obstacles to get patients involved in. We appreciate your continued efforts on all of this, and understand how difficult this can be.
I want to especially Thank You for all of the work and effort you help out with in our Strive to Survive program. The two of us make this program go. We both spend a lot of time teaching, and I think complement each other very well. You do the nutrition teaching, and I work on the promotion of exercise/activity. I personally have learned a lot from you over these past 5+ years with our teaching of this program. I always thought I could outrun a bad diet. Not anymore! I have listened to you talk to our patients signed up for this program more times than I can count, and I learn something new every time. It just goes to show that you can’t just hear something once and think you are going to get it. Nutrition is such a huge part of our health, and often times is one of the things that we neglect the most. It takes continued effort working on this, and you help to remind us all to keep working on this as well. I appreciate your efforts with all of this. I like to think we make a good team with our Strive to Survive program, and want to take this opportunity to congratulate you on being bestowed upon this great honor. You are truly deserving of this award, and I am proud to have you working at Brown Clinic. I appreciate all you do! The rest of our team of doctors and staff appreciate all you do. And most importantly…our patients truly appreciate you! Thank you for being a part of Brown Clinic! Congratulations on winning this most deserving award! The South Dakota Academy of Nutrition and Dietetics definitely got this one right!
Keep moving everybody…and when you get tired, go see Kelsey and learn how to do better with your diet/nutrition plan!
Dr. Dan
Consecutive Exercise Day #: 3844
by kelsey | Apr 18, 2018 | Diet, Food, Weight Management, Wellness/Health
I often get asked about meal replacements such as Boost, Atkins, Slim Fast, Ideal Protein, etc. Are they good? Should I use them? What kind? etc…
The Academy of Nutrition and Dietetics does approve the use of meal replacements for weight loss efforts: “Several studies comparing isocaloric diets have shown an equivalent or greater weight loss efficacy with structured meal replacement plans, compared to reduced calorie diet treatments. One or two daily vitamin- and mineral-fortified meal replacements, supplemented with self-selected meals and snacks, may be a successful weight loss and weight maintenance strategy for overweight and obese adults who have difficulty with self-selection of food and portion control.” (http://www.andeal.org/topic.cfm?cat=2886&conclusion_statement_id=250237&highlight=meal%20replacements&home=1).
The key words are one or two replacements/day, not your whole day and paired up with a well-balanced, calorie reduced diet. I typically recommend the use of these for the meal when the individual is on the run the most. Sometimes you are rushed in the morning to get to work or school and don’t have time for breakfast, in this case, a meal replacement may be a good idea…or maybe it’s lunch as you only get a short break and a meal replacement might fit in well here. The biggest thing to remember is you are drinking your meal, not eating it. Some people are truly satisfied this way and others are not. Personally, I do not use meal replacements because I know I need to “eat” my food to be satisfied rather than “drink” them…when I drink something, I feel like I still need to eat thus a meal replacement would only add more calories! Another reason why I don’t do meal replacements is I prefer real food. I would rather eat whole food than drink a supplement….but that’s just me. 🙂 One more thing to consider is they are typically around 150-200 calories. This may not be enough for a meal, so you may consider adding a piece of fruit, salad, or yogurt to it to give you a little more substance.
Meal replacements do have a place in our society for helping people manage their weight, but there are many kinds so it’s important to check out the ingredients, nutrients, and prices. If you notice a really long ingredient list, there is more “stuff” added to the product and then you need to consider if you really need all of that extra “stuff.” Some ingredients can affect your body in certain ways, so you may need to check with your physician, pharmacist, or dietitian to ensure it is safe to consume. Costs also makes a difference. You have to remember that these companies are trying to make money off of you, so consider cost and value when you make your selection. In addition, it’s important to consider that a well balanced, portion controlled, healthy meal of real food can be cheaper than some supplement drinks! Below is a chart former SDSU Dietetic Student Alex Loes, made for me to compare the various choices. I hope this helps you, but if you have any specific questions regarding choices, selections, or even disease states and the use of these, don’t hesitate to contact me. I’m here to help you as your credible and reliable nutrition information source!
-Kelsey Raml, MS, RD, LN
| Brand (oz/serving) |
Price/oz |
Calories |
Protein (g) |
Carbohydrates (g) |
Fiber (g) |
| Boost Calorie Smart (8) |
0.20 |
190 |
16 |
16 |
4 |
| SlimFast (10) |
0.11 |
190 |
10 |
29 |
5 |
| Shakeology (12) |
0.36 |
160 |
17 |
17 |
6 |
| Atkins (11) |
0.17 |
160 |
15 |
5 |
3 |
| Special K (10) |
0.14 |
190 |
10 |
29 |
5 |
| Ideal Protein (10) |
0.40 |
210 |
26 |
14 |
5 |
| Advocare (9) |
0.36 |
220 |
24 |
24 |
5 |
| Sanford Profile (9-12) |
0.25 |
100 |
15 |
7 |
0 |
by Dan | Apr 15, 2018 | Exercise, Goals, Motivation, Weather, Wellness/Health, Winter
This extended Winter is getting really tough to handle. We rarely ever get Spring anymore. Patients come into the clinic as well, and they are not happy. Everybody is crabby! We have all had enough of this weather. The only good point to make about it is we all have to contend with it. It is not just some of us, but all of us, have to contend with it. So, you can either make the best of it, and continue to whine and complain. Bottom line: we still have to put up with the extended Winter.
Here was our run group this AM. The paths were not cleared yet, as it was still even snowing yet. The roads were not all plowed, so we ran down 3rd avenue to at least get somewhat of a relatively clear path to be able to run. It was icy, and still had a lot of snow. It was a tough run…tough on the feet today. There was lots of complaining…probably even mainly from me! I was ready to be done when our group made our first stop back at the zoo. Sarah did not want to do anymore at home, such as finish on the treadmill, or the elliptical. She wanted to keep going, and be done. We were trying to finish 10 miles today as we are getting ready for the Fargo Half Marathon, now 5 weeks away. So Tom continued on as well, and Paula, and Jill. It was like a domino effect. By ourselves, we would have probably all quit. Together, we kept going. As Tom said this morning, “One plus one, plus one, plus one, etc, and we keep going”. It is easier to keep going with friends. You need other people to help push you through those tough times, those tough weather days, and even though days when you just don’t feel like running, or working out at all…period! We can all keep complaining, or we can act like Patricia did in this picture. You can be happy, ready to take on the day…or just be glad the run is done. Either way, you are in control of your mood, and attitude. Accept the things we cannot change, and keep working on the things we do have control over. When all was said and done, we were able to finish the run. We were able to finish because we had help from our friends. Which, as you can see by the next pictures, the weather makes it a little tough to get fired up about running, or working out, outside.
So, don’t be a whiner! A complainer! Be a doer! Be in charge of your health, your activities, your situation. You can either do the best you can under the current situation, or let ii take control of you, and then be even more angry, upset, crabby! Spring has to be coming. It is testing all of us, and our patience. Remember why we need to keep working out, and working on our health. We want to be around. We want to spend time with friends, and family. We want to live. So, put our head down, your mouth shut, and keep your feet moving forward, regardless of what type of exercise you want to do. Help others get there too. That does not mean we can sometimes express our true opinion of what we think of the weather. I did! But now that I am done, I am thankful these other people helped push me on. The next time it may be me pushing them on. We can all help each other, and be there for each other, and live life to the fullest. Bring it on! Keep moving everybody!
Dr. Dan
Consecutive Exercise Day #: 3840
by kelsey | Apr 12, 2018 | Food, Weather, Wellness/Health
With the impending winter storm coming, I thought it was appropriate to review food safety recommendations for power outages. I am hoping we all keep our power, but it sounds like rain is coming first, then turning to ice/snow so there is a possibility we could lose power. These poor conditions are not ideal, but we can’t change the weather so we must do what we can to keep safe. Without power to the fridge and freezer, many may be wondering how to keep their food safe. Keeping cold foods cool and hot foods hot may be a challenge without power so follow these recommendations to keep your food safe in an emergency.
- Keep the refrigerator and freezer doors closed as much as possible to maintain the cold temperature. Watch the temp on both using a thermometer. You want your fridge to stay under 40 degrees and your freezer under zero degrees F.
- The refrigerator will keep food safely cold for about 4 hours if it is unopened.
- A full freezer will hold the temperature for approximately 48 hours (24 hours if it is half full) if the door remains closed.
- If are you able to, get dry or block ice to keep your refrigerator as cold as possible if the power is going to be out for a prolonged period of time. Fifty pounds of dry ice should hold an 18-cubic foot full freezer for 2 days.
- If you are wondering if your food is safe to consume, you need to evaluate each item separately using a thermometer as you cannot rely on the appearance or oder! If the food still contains ice crystals or is 40 °F or below, it is safe to refreeze. Refrigerated food should be safe as long as power is out no more than 4 hours. Keep the door closed as much as possible. Discard any perishable food (such as meat, poultry, fish, eggs, and leftovers) that have been above 40 °F for 2 hours. The way it sounds, this will be case for many in the Sioux Falls area. Remember…it’s better to discard and buy new than risk it and get sick!
For more tips and detailed recommendations please visit the USDA’s website: http://www.fsis.usda.gov/Fact_Sheets/keeping_food_Safe_during_an_emergency/index.asp .
Stay safe and warm everyone!
-Kelsey
by kelsey | Apr 11, 2018 | Exercise, Heart Health, Motivation, Weather, Weight Management, Wellness/Health, Winter
Are you tired of winter yet? Spring is here, but it sure doesn’t feel like it….and we are facing another blizzard this weekend! C’mon weather man….enough already! I think one thing we all have in common right now is that we’re tired of snow, cold, and less than ideal weather conditions. We have had winter for about 6 months now and I think all of us can agree, we are ready for spring and summer to get here! When you’re feeling the blues, it can really get you down in the dumps which can result in overeating, less activity, and depression. Below are a few tips to help perk you up and help you stay positive about life!
Tips for Overcoming the Winter Blues
- Get active! Activity produces natural endorphins that boost mood. Try getting at least 30 minutes of activity in a day…if you can do more, the better.
- Eat Right: healthy eating will make you feel healthier inside and out. Aim to get at least 5 fruits and veggies a day, include whole grains, lean meats, and healthy fats. Vitamin D has been proven to aid in SAD so be sure to get your 3 servings of low fat milk or dairy products. If you aren’t a milk drinker you may consider taking a daily multivitamin with calcium and vitamin D or a vitamin D supplement. Please ask your dietitian, pharmacist, or doctor for the correct dosage.
- Spice up your life: Sometimes getting a new shirt, going to the movies, reading a new and exciting book, or getting new tunes on your ipod will help spice up your life and add some more excitement to your life.
- Get out! Plan a family/friend trip to Sioux Falls, bum around downtown Watertown, or plain just get out of the house! It’s easy to dwell in our sorrows by becoming a hermit and staying inside. We need to get out and get some socialization!
- Think Positive! Dwelling on the negatives can sure take a person down. Instead think about the positives in your life. Tell yourself one positive thing about yourself and your selfworth daily. Focus on the blessings in your life!
- If you feel you are suffering from the blues very seriously then I encourage you to contact your physician for further assistance as we can help you with this!
Spring and warmer temperatures will be coming….hopefully sooner than later! Stay positive, eat right, exercise, and get out…those winter blues will be gone before you know it!
-Kelsey
