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! 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
Well, I have now been home for over a week, and am starting to make progress. My weight dropped to a max of 14 # loss, and is now leveling out. I can finally start eating, but not everything I want yet. I could not eat anything for 5 days, and then after that it was just toast and bananas. It started out Sunday March 24. 5AM. I just had gotten up to go to the bathroom. No changes. Heading to the sink, when all of a sudden it felt like I got hit in the right side with a baseball bat, and fell to the ground. Then the vomiting started. The pain eased up following this, but then the next 3 hours it kept coming in waves, and more frequent. We were to go run with the run club at 7AM, and I told Sarah to go. I thought I just came down with the flu. She had her phone with her, and at 7:40 I called, and told her to come home to take me to the ER. I could not take the pain anymore. We made our way in, and had labs, CT scan of my abdomen, thinking then it was my appendix. The ER doctor came in to tell us my appendix was fine, but I infarcted my right kidney. That means the blood flow was cut off to the kidney by a clot, and it looked already at that point that I had lost 90% of my right kidney. Next thing is we are in the ambulance to SF (Fast!) to the vascular surgeon at Avera Heart Hospital. We do not have a vascular surgeon in Watertown. This surgeon literally met me in the garage of the hospital as they were taking me out of the back, and telling me all of the ramifications of this, and if there was going to be a chance of saving anything of my kidney, we need to go to the cath lab now and try to remove the clot. Away we went! He was able to remove some of the clot, and then I had a “clot buster” infused through my femoral artery for the next 27 hours, having to lay flat on my back and not move at all! That was beyond word description. I hope to never have to do that again.
This was the picture at the beginning with the clot in my right kidney. Not a lot of blood was flowing through.
This was my kidney after 27 hours of the “clot buster” TPA. I had improved blood flow quite a bit. It helped. I don’t know yet how much it helped…time will tell. But for now I have something of a functioning right kidney.
So how did this happen? All that time I had laying flat on my back helped bring it to light. We had gone to Jamaica the 3rd week in February, so we had a long flight. Also, I was wearing a night splint for my right foot to help with my plantar fasciitis. Well, between the 2, it was enough immobility for me to create a clot with in my right leg. I had pain for a few days after we returned, but no swelling. Usually there is swelling with a clot. At any rate, I thought it was muscle, and kept running, biking, swimming…all of my usual daily things. So, several tests later, they found I had a clot in my leg, and also a defect in my heart called a Patent Foramen Ovale: PFO. It was present since birth, but no issues…until now. What happens with the PFO is you can have what is referred to as a “paradoxical embolus”. The blood clot moved up from my leg, to my heart, and from there is very common to go to the lungs, and you have a pulmonary embolus. If you have a PFO, the clot moves from one chamber, the right atrium, through to the left atrium, and back out through the arterial system…to lodge somewhere else. By far and away the most common is presentable by having a stroke–up to 75% of the time. In my case, going to the kidney, it occurs 1% of the time. 1%!!! I guess I feel lucky. I have 2 kidneys, but only one head. This could have resulted in far more significant problems. But now the PFO had to be fixed, or it would keep happening!
They have a device that they deploy into the defect of my heart to fill the gap of this PFO. This is what it looks like.
This is what is looks like in a diagram of the heart closing the PFO. Thank God for modern medicine. This device going through the femoral vein in my leg to my heart first began undergoing trials for use in 2012. If this would have happened prior to then, I would have had my chest opened up in order to fix it. Now it was an hour procedure, and if everything went well, home the next day!
This is how it looks in me! It worked! Other than getting rid of the nausea and vomiting, and trying to gain strength, it was a matter of time for it to heal. I am currently on multiple meds, including multiple blood thinners for awhile. I can walk, but no aerobic activity for minimum of a month, but have been told once this all heals up, I can run marathons again if I want too! What am I going to be able to do running with no hole in my heart anymore? I am learning to be on the other side…the patient side. It is very humbling!
I appreciated all of the texts, emails, notes, cards while gone. Jill and Tim Makepeace had these cupcakes delivered. Sarah and the kids loved them, and I saved one for me later to have, but just could not eat anything with the nausea and vomiting. The nurses taking care of me got to enjoy the rest, so then they kept an even closer eye on me after that! My consecutive streak came to an end, but I started a new one. It started off last Sunday walking 1/4 of a mile…1/4 of a mile!!! This after biking 30 miles and running 3 miles the day prior to all of this happening. I am now up to 1 mile walking, which I will hold for awhile. It wipes me out. I have had time to reflect on the good things in my life, what truly is important to me, and how lucky I really was! I am here! Keep moving everybody!
Inflammation is an important part of our immune system’s response to injury and infection. It is our bodies way of signaling the immune system to defend, heal, or repair itself against possible infection or bacteria. Without inflammation as a physiological response, our body would not heal properly, and many conditions would be deadly.
That being said, if our inflammatory process goes on longer
than needed or if it occurs in unnecessary places, inflammation suddenly becomes
an issue. Chronic inflammation has been linked to the development of numerous
diseases and health conditions.
Chronic, low-grade inflammation often does not have symptoms according to Mayo Clinic, but there are labs that can be ran to determine if inflammation is present. Besides looking at blood test results, your diet and lifestyle habits can contribute to your bodies inflammation. It’s important to maintain a healthy lifestyle to keep inflammation in check.
Starches, Fruits, Vegetables
Choose whole-grain starches, fresh whole fruits and vegetables.
Consume a variety of colorful fruits and vegetables.
Limit refined starches (white versions) and added sugars (white or brown sugar, soda, energy drinks).
Meats
Limit high-fat red meat such as prime rib, bacon and sausage, as well as processed meats (ex: bologna, salami and hot dogs). These are higher in saturated fat, which if consumed in excess can increase inflammation.
Choose skinless poultry, fish, eggs, legumes.
Fat
Limit saturated fat. This includes butter, whole milk, cheese, high-fat red meat and skin on poultry. Our bodies only require a small amount so excess intake will increase inflammatory risk.
Be very cautious or avoid trans-fat altogether (ex: prepackaged baked goods, flavored coffee creams).
Choose monounsaturated and omega-3 fats, these are thought to neutralize inflammation. Found in olive oil, avocados and nuts.
Omega-3 fatty acids are found in salmon and tuna, walnuts, and ground flaxseed. Omega-3 is an essential fat that our bodies cannot make. We must obtain it from dietary sources or supplements.
Other suggestions
Flavor food with spices and herbs that have antioxidant properties such as garlic, green herbs, ginger, and turmeric.
Moderation in all areas, excess of any food (even if it has anti-inflammatory properties) is not a good thing.
An exact and strict diet plan for a patient with chronic inflammation is still lacking but we do know general healthy eating suggestions that help produce anti-inflammatory results over time. The suggestions above will come as no surprise, as it is information we have all heard numerous times. The key is to adapt these suggestions into your daily lifestyle.
Many people have noticed that one of the latest nutrition “trends” has been juicing and consuming beverages that claim to boost gut health, detoxify the body, and fill your body with tons of vitamins and minerals. Most recently, celery juicing has become a popular topic of discussion on social media and other news outlets. Some celery juicers have claimed that drinking this magic drink has cured them of mental health problems, infertility, and eczema. However, as a Registered Dietitian we are taught to look to the science based evidence to understand if the topic is a healthful practice or not.
After a search in the current scientific
literature on celery juicing we can conclude there is not enough information to
prove that celery juice lives up to all the claims. Majority of the studies
have been done on mice and not human subjects. There needs to be more research regarding
celery juice impact on human health.
Luckily, there are still benefits to
consuming celery. By eating fresh celery provides a source of vitamin K,
vitamin C, potassium, folate, manganese, and much more. It has a high percentage
of water which can help prevent dehydration. Celery is also a great source of
fiber, but only in its whole form. By juicing the celery stalks, you are stripping
the celery of all its fiber. Despite these benefits, there have not been
large human studies done using celery juice as a treatment for chronic
conditions.
One claim is that celery contains
phytochemicals and antioxidants associated with reducing inflammation to
possibly reduce autoimmune symptoms and disease risk. Nonetheless, so do lots of other vegetables, fruits, and herbs.
Compounds called flavonoids are in celery stalks but there are lots of other
foods with the same level of or even more flavonoids. If you were to puree 1 pound of any vegetable or fruit, you would
get similar potential “superfood” nutrient levels. There’s nothing particularly
special about celery other than it’s a vegetable, and most all need to be
eating more veggies.
As a registered dietitian counseling a patient who is or wants to try celery juicing I would tell the patient that celery juice is not harmful for most people, but check with your doctor if you take statins, blood pressure medicine, or blood thinning medication as there is always a risk of nutrient-drug interactions.
I always knew someday my consecutive exercise streak would end. I did not know how it was going to be, or the circumstances that would be involved. The one thing I knew for sure it that it would be because of something I would have no control over. It was not just going to be an “excuse” to say I could not do it that day. That day happened last Sunday. I will expand on this more in the next several weeks, but will briefly summarize by saying my life changed that morning. I developed a clot going to my right kidney, and I was losing my kidney. I also had a clot in my right leg, and found out later that it was brought on by my heart, and had what is a called PFO: Patent Foramen Ovale. 3 angiograms later, with 3 subsequent procedures, 5 days in the hospital, I was able to come home. My exercise streak however, stopped. Day # 4196. This is how far I went. This has been driving me for the last 12 years. Lead by example. Don’t just tell people, my patients, that they need to stay active. Show them! As the saying goes: Records were meant to be broken!
Sometimes, you do just need to go with the flow! Life is always changing. My world changed over night. But, I am here. For the next 6 months I will be on multiple blood thinners, and will be taking it easy. I can’t do any aerobic activity for the next month, and then will be very slow progressing. But, I still can!
Things will changes. Things are going to be different. But I will be able to run again later. It will then be time to start a new consecutive streak. I look back now and wonder how I went this long. Things come up, life throws curveballs. Most of the time it is just an excuse. An excuse your mind can take control of. You just need to take charge. Many different events, races, causes have been accomplished over this time period. Many of them with my Watertown Area Run Club (WARC) members. Working together to raise money for charity, FARA, and going somewhere different for a race just to have fun!
Last Fall, Jill, Amanda, Paula, Sarah, Tom, and I went to Denver to do the Rock and Roll Half Marathon. These 3 came up with a shirt they had printed: South Dakota Girls…and Dan! We had so much fun with this, and had so many comments on this!
That same WARC spirit carried on this last week as well. Here they had a large group together on Wednesday, and ran for me, which would have been day # 4200! Holding a sign, and peanut M and M’s (my favorite candy!)…it still brings tears to my eyes when I look at what they did for me! But this is what WARC is about. We go the extra mile for one of our own. This is why this group of people/friends are so important. It is not about running. It is about being there for each other, and we just happen to run at the same time! I can’t thank WARC enough for this! I was at a pretty low point that day, and just had the 3rd procedure done, and this just lifted me right up! Thank you!
I guess it is gonna come down to how tough am I? I have gone through adversities before. One thing for sure, I am not gonna let this be a excuse to not restart another consecutive streak. It did definitely put life in perspective. We are all human, and don’t know what tomorrow is gonna bring. Live today! I have been watching (too much) TV lately being down this week. A movie came up that is one of my favorites. Shawshank Redemption. It has a great line in it that opened my eyes once again: “Get busy living, or get busy dying!” Choose…
Sarah and I have done a lot of talking. The consecutive streak was not the goal. The exercise was not the goal. Being together is the goal. I am going to listen to her and recover from all of this because I want to be able to do more things/events with her later. My daughter is getting married in August…the first wedding for one of my kids. I do not want to miss that for anything. I will be back. I will start a new streak. In the process, maybe this will not only help motivate others, but also help motive me! Keep moving everybody!
