Eat this, Not That Picnics

The official kick off to summer and picnic season is this weekend: Memorial Day Holiday! This time of year always bring great cookouts and picnics. Typical picnic foods consist of burgers, brats, hotdogs, chips, and high calorie salads such as macaroni and potato salads. These are all very tasty foods, but they are also all very high in calories, fat, and sodium. Cookouts don’t have to bust the calorie bank. Choose your foods wisely and plan your menus to include a few healthy options and make substitutions like the meal examples below to help you fully enjoy each cookout while aiding in a healthy heart and waistline.

Choose This:

90% lean hamburger with whole wheat thin bun

Grilled chicken breast

Grilled shrimp

One small tossed Salad with 1Tbsp light dressing

Fresh veggies with light ranch dip

Baked chips

½ c fruit salad

One small slice of angel food cake with light cool whip and strawberries

Unsweetened Tea with Lemon

Not That

80% lean hamburger with white bun

Hot dogs

Brats

Excess portions of: macaroni salad, potato salad, baked beans

Brownies

Kool-Aid

Regular pop

-Kelsey

A Running Doc’s Life: Run Away from COVID!

With all of the issues surrounding this COVID-19 pandemic, it is now even more important to get out and exercise, whether biking, running, walking, or whatever. The stress from all of this gets to a point where you just need to blow off some steam, and frustrations, and at the same time, just plain get away from everything that is going on now. You can’t listen to the TV, or the radio, without getting an every 30 second update on everything related to COVID. There are other things going on too. First and foremost, you cannot neglect taking care of yourself either! The weeks are stressful enough, and now with Memorial Day weekend coming up next week, it will be a nice 3 day break from everything. After all…

Exactly! It is time for a break. Utilize this opportunity coming up, and do yourself a favor, and shut off the TV, and radio, and your phone, and get outside and enjoy some activity. Whatever it is, just get outside!

Time to put a smile back on your own face, and enjoy some time for you. My walks after a day at the clinic have been a great way to unwind from the day, and Dakota loves it too.

There have been more virtual running events going on lately, and we have done two of them already. One was a 5k, and another a 10k run. Here Sarah is after finishing her 10k last weekend.

The bottom line with all of this, get outside, and forget about what is all going on lately. Take care of you, and your mind, as well as your body. You can’t under estimate how exhausting all of this can be, and the stress caused by all of this. Depression is a big deal, especially now! If you don’t take care of yourself, you can’t help anybody else.

This too will pass. Eventually…when though, is the question. Keep looking at the positives in your life. I had to go look through some other pictures here lately, and I found this next one of the Sunrise occurring over Lake Kampeska a few years ago. I could sit and look at the this picture for a long time, just like I spent a lot of time looking at the view that day I took the picture as well.

Someday, and hopefully very soon, we will be running with our run club twice a week again. We have been holding off, practicing the social distancing, but as the weeks have gone by, it has been tougher and tougher, and I miss running with my friends. We need to start getting back to some degree of reality. What that reality is though is unknown at this time. Keep trying. Keep being safe. Don’t let your guard down.

I definitely will be jumping for joy again when we can all get back together running, and actually post pictures about it as well! The Wednesday evenings, and Sunday mornings are now just leaving an empty space. I don’t know how much longer we can keep doing this. Continue on trying to get out at least on your own, and take in the scenery. Drive to the lake and take off walking or running from there. Especially early in the morning, or late in the evening. The view is breath taking.

Sarah and I just signed up for the Run From Covid Virtual 5k being held the weekend of June 19-22. How fitting to be having this now! Watertown DASH is sponsoring this, so start getting ready. Walk or run, it does not matter. Just get going! Keep moving everybody!

Dr. Dan

Consecutive Exercise Day of New Streak: #413

Healthy Eating Dining/Carry Out

Sometimes we need a break from cooking and need to enjoy take out or now limited dining in. You can still make healthy and wise choices when dining out. Check out these tips to help you make good choices!

• Go for a smaller portion of the meal such as half of the meal, lunch portion, or appetizer size portion.

• Look for key words such as baked, broiled, grilled, or roasted. Stay away from descriptive words such as crispy, creamy, crunchy, and crispy as those typically mean fried and more fat added.

• Substitute the fries for a salad (dressing on the side and use sparingly) or if available a second serving of cooked veggies or fruit.

• If dining in, get a to-go box right away before you start eating and package half of your meal in the box and eat at another meal at home. If eating carry out, only take a portion of the meal on your plate and put the rest in the fridge. If it’s on your plate, you’ll be more apt to eat it, so put it away right away so you aren’t tempted and you are more apt to practice proper portion control.

• Share! It’s ok to share an entree with you friend, spouse, etc to help you practice better portion control.

• Look at the options ahead of time online or using your smart phone. Many restaurants have their nutrition information included in their websites or you can use the Calorie King app to explore the options and make a healthy choice when dining out.

• If eating out is a rare occurrence, it is ok to splurge, but keep in mind it should be a special occasion and only every once in awhile, not every day or every week as those extra calories will add up and cause weight gain quickly!

• To help balance out the extra calories consumed when eating out, be sure to get your activity in and engage in at least 30-60 minutes/day!

-Kelsey

A Running Doc’s Life: Happy Mother’s Day!

Happy Mother’s Day to all you moms out there! You know what you all do for your family! The sacrifices, the work, the love, and continuous caring you do for your kids and family. Where do you begin to say Thanks? You are always there when you are needed. To start with, a special note of appreciation to Sarah for everything you do for our kids, and me! Thank you just is never really enough. One thing I have noticed over time is that as the kids get older, the more they appreciate mom!

Sarah not only has time to take care of our kids, but also finds time to take care of everybody at the clinic…her patients. Then when time allows, she takes care of herself by trying to keep herself fit and healthy. No easy task.

Even with all this going on with the pandemic, she had to become a barber for me…her oldest, most challenging kid! Here I am praying before hand that I still had some hair left afterwards. But, as usual, she did a great job! She is always willing to help out wherever needed.

She is out every morning to walk Dakota, rain or shine. This is how she starts every day.

Then other days she is out with our daughter Megan as they take both Dakota and Dobby for a walk. Always full of energy, and always willing to step in.

And, of course, a special thanks to my mom. She lives in Sioux Falls, and they have been especially hit hard with this pandemic. She has been stuck in her house, and the boredom is getting to her. I have my sister, and several brothers living there too. They are helping her with everything they can. We have not even been able to go down and see her, much less help get things done. I call several times a week, but it is not the same. I am hoping this eases up soon so I can actually see her in person. I appreciate everything she has done for me and our family as well. So, to all you moms out there, this day is for you!

Thank you moms! You are appreciated, and loved, more than you know! Keep moving everybody!

Dr. Dan

Consecutive Exercise Day of new streak: #406

Supplement Tips

Our Doctor of Pharmacy, Deidra Van Gilder, PharmD covers the hot topic of supplements in our in our 12 week wellness program. She covered this topic for this week’s STRIVE lessons, so I thought it was fitting to cover on the blog too! Supplements are a hot topic and you may wonder what the professionals in the field recommend on this topic as there is a lot of information to be found on the internet.

The below information is from Deidra herself….hope it is helpful to you!

Fish oil contains two important components: DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid). Another substance called ALA (alpha-linolenic acid) may be as effective as DHA and EPA although it doesn’t have as much evidence for its use. ALA is the component of flaxseed that is thought to lower cholesterol. Fish oil is typically recommended for people with high triglyceride levels. Foods that contain Fish Oil: Anchovies, Catfish, Cod, Halibut, Herring, Mackerel, Tuna, Trout, Salmon, Sardines Uses: •There is strong evidence for the use of fish oil to lower triglycerides and increase HDL at doses of 2-4 grams daily. Be aware that it may increase LDL. •There is evidence to support the use of fish oil 1 gram daily for prevention of recurrent stroke or heart attack in patients with cardiovascular disease. •There is some evidence for the use of fish oil in rheumatoid arthritis to reduce morning stiffness and joint tenderness. It is the most beneficial when used with anti-inflammatory medications. Dose: 1 – 4 grams daily divided into twice daily dosing. The fish oil capsules may be stored in the freezer to decrease incidence of fishy burps and aftertaste. Adverse Effects: fishy aftertaste or fishy burps, heartburn, loose stools, nausea, upset stomach, alterations in glycemic control, increased risk of bleeding Drug Interactions: warfarin, aspirin, clopidogrel, oral contraceptives

Calcium is important for many functions of the body including bone and teeth health. Calcium is most commonly used for treatment and prevention of low calcium levels and osteoporosis. Foods that contain Calcium: milk, cheese, yogurt, dark green leafy vegetables, and calcium fortified foods or juices Recommended Dietary Allowance (RDA) for Calcium Men age 19-70 1000 mg/day Men age 71 & older 1200 mg/day Women age 19-50 1000 mg/day Women age 51 & older 1200 mg/day Dosing: Dosing for calcium supplementation is dependent on calcium intake from dietary sources. The preferred source of calcium is through the diet. The two most commonly used forms of calcium for supplementation are calcium carbonate and calcium citrate. Calcium carbonate (Tums) is well tolerated especially when taken with a meal. It is the calcium supplement of choice in patients with poor kidney function. Calcium citrate (Citracal) may be taken on an empty stomach, but should be avoided in people with poor kidney function. Calcium citrate is the recommended choice if elderly or people taking a PPI (proton pump inhibitor), antacid, or H2 blocker. The maximum amount of elemental calcium that the body can absorb at a time is about 500 mg. If doses higher than 500 mg are needed, separate the doses by 4 hours. Adverse Effects: constipation, bloating, stomach upset, gas, kidney stones Drug Interactions: PPI (omeprazole, esomeprazole), H2-blockers (famotidine, ranitidine), iron supplements, tetracycline antibiotics, quinolone antibiotics, bisphosphonates, phenytoin, and verapamil

Vitamin D helps the body maintain normal levels of calcium and phosphorus. Vitamin D is available in two forms, ergocalciferol (Vitamin D2) and cholecalciferol (Vitamin D3), both are considered equivalent. Vitamin D can be obtained from brief sun exposure, foods, and can also be found calcium supplements or multivitamins. Since vitamin D helps with calcium absorption, many supplemental products contain both calcium and vitamin D. Vitamin D is commonly used for treatment or prevention of vitamin D deficiency, osteoporosis, and preventing falls. There is also some evidence for the use of Vitamin D3 ointment for controlling skin cell growth in patients with psoriasis not responding to other therapies. Foods that contain Vitamin D: fish, eggs, fortified milk, cereals, salt water fish, cod liver oil Recommended Dietary Allowance (RDA) for Vitamin D Men & Women age 19-70 600 IU/day Men & Women age 71 & older 800 IU/day Dosing: Vitamin D supplemental dosing is dependent on current vitamin levels and intake. Dosing may range from 400 – 1,000 IU daily so it is important to talk to your physician about the proper dosage for you based on your vitamin D level. Adverse Effects: Generally well tolerated, nausea, high calcium levels, anemia Drug Interactions: atorvastatin, digoxin, thiazides, verapamil

Flaxseed or flaxseed oil is a food product that contains ALA (alpha-linolenic acid). Flaxseed has a high content of fiber and may be used for constipation if taken with plenty of water. Flaxseed can reduce total cholesterol and LDL cholesterol, but has no effect on triglycerides. Dosing: 15-40 grams (~1 tablespoon 2-3 times daily) of freshly ground flaxseed or flaxseed oil daily for high cholesterol levels. Flaxseed may be prepared as ground, partially defatted, oil, or in bread and muffins. Ground flaxseed is typically recommended over the oil as it offers greater benefits than the oil. Freshly ground flaxseed should be kept in an airtight container and stored in the refrigerator up to three months. Adverse Effects: increased number of bowel movements, bloating, abdominal pain, diarrhea, constipation (if not taken with plenty of water), gas Drug Interactions: blood pressure lowering medications, medications used to treat diabetes, anticoagulant/antiplatelet medications (warfarin, aspirin, clopidogrel)

References: Natural Medicines, Food, Herbs & Supplements, Somerville, MA: Therapeutic Research Center; 11 May 2017. < http://naturaldatabase.therapeuticresearch.com/> National Institutes of Health Office of Dietary Supplements, National Institutes of Health. Dietary Supplement Fact Sheets. NIH; 2016. Flaxseed: is it as beneficial as fish oil? Pharmacist’s Letter/Prescriber’s Letter 2009; 25(7):250708.

If you have any other questions about supplements, vitamins, and minerals, don’t hesitate to contact us! -Kelsey