Outdoor Exercise Tips for Fall

Summer has come to a close and we now welcome the Fall season with open arms! This is a great time of year to exercise outdoors during those brisk, chilly mornings on Kelly Drive. In order to prepare for your new fall fitness routine, follow  these tips from our fitness specialists.

1. Dress Appropriately: The fall can be a finicky season with some mornings cooler than others. You want to make sure that you are wearing the proper attire. You want to be warm enough for the conditions but wear breathable clothes such as Under Armour's outdoor gear to help release the heat your body is producing during your workout.

2. Exercise Early: You just woke up from your 8 hours and you should feel refreshed and ready to face the day. Energy is known to be highest in the morning for most people but exercise is also known to boost energy levels for hours after your workout. Wake up, work out and you should be completely ready to tackle you day. 

3. Avoid Severe Weather: We all hate missing a workout when we are on a consecutive schedule whether it be 3 or 5 days a week but please be mindful when there is snow, ice or freezing rain outside. Once the roads clear, then you should go outside or hit the gym for the day. 

4. Hydrate: Even though you are outside during the cool months working out, it is still very important to remain hydrated. During the summer months, the temperature is a lot warmer which makes you reach for that water bottle but as the temperature drops so does your thirst. Please be sure even if you are not overheated to remain hydrated so that your body can function properly.  

5. Workout with a Friend: Once we set our clocks back one hour, it becomes darker earlier. If you are going to exercise outside, make sure to bring a friend along. This way, you can motivate each other but it is also a great safety precaution! 

Protein Energy Bites

By: Theresa Shank, Registered Dietitian

Don't get caught in a snack time rut! Try these natural protein balls from health coach Jessica Wyman for a quick energy bite pre- or post-workout. 

Theresa recommends that you try to incorporate some source of fuel 30 minutes to one hour before exercise. Two to three of these balls have enough satiating protein to get you through your workout. You can also pop a protein ball after your workout to hold off your hunger until your post-workout meal; which should be consumed no later than an hour after exercise to gain muscle-replenishing benefits.   

Raw protein energy bites

Yield: 48 servings

  • 2 cups rolled oats, thick
  • 1 cup shredded coconut
  • 1/2 cup pumpkin seeds, roughly chopped
  • 1/2 cup pecans, roughly chopped
  • 1/4 cup chia seeds
  • 1 cup peanut butter
  • 3/4 cup vegan chocolate chips
  • 1 teaspoon vanilla
  • 1 teaspoon cinnamon
1. In a large mixing bowl, fold all ingredients together. Mix thoroughly.

2. Using your hands grab some of the mixture and start rolling together in about one inch balls. Squeeze them firmly to help everything stick together.

3. Place the rolled energy balls on a cookie sheet.  You can place them in the freezer for a couple minutes to help them get firm.

4. The peanut butter will start to dry out, so this needs to be done fast. It is helpful to have two people or consider doing a half batch, which really makes it more fun. I do such a large batch because once I make them they are gone pretty fast. 

Focus on Breast Cancer

By: Monica Duvall, M.D., Board Certified Physician

As we embark on Breast Cancer Awareness month, it is worthwhile to review the statistics, risk factors, and preventive strategies of this globally devastating disease.  Breast cancer is the most frequently diagnosed malignancy worldwide.  It is the most common female cancer in the U.S., and it is the second leading cause of cancer death in women in the U.S., with over 40,000 deaths annually.

Non-modifiable factors that are associated with an increased risk of breast cancer are female gender, white race, increasing age, postmenopausal status, and prolonged exposure to estrogen, such as early onset of periods or late menopause.  Family history of breast or certain other cancers may also increase your risk--this should be discussed with your doctor.   Other factors that may increase the risk of breast cancer include obesity in postmenopausal (but not premenopausal) women, and hormone replacement therapy.  Lifestyle factors have also been implicated in the diagnosis of breast cancer.  For example, there is a significant dose-dependent relationship between alcohol intake and breast cancer, even with as little as three drinks a week.  Smoking also appears to increase the risk of breast cancer.

There are also some protective factors that appear to decrease breast cancer risk.  Breastfeeding is one example.  Physical activity appears to be another protective factor--yet another good reason to get out and exercise!  Finally, there is some evidence that soy products, and other phytoestrogens like legumes, flaxseeds, and sesame seeds may be protective.

So aside from awareness of negative/positive risk factors, how can we reduce our risk of developing breast cancer?  Cancers are most easily treated if they are detected early; therefore, the first line of attack against breast cancer begins at home, by developing "breast self-awareness".  Each woman should be familiar with her breast/axillary (armpit) exam--including skin and texture changes, as well as lumps.  Any change from your baseline should be brought to the attention of your doctor immediately.  Clinical breast exams, performed by your doctor during your annual gynecological appointment, are another important factor in screening for breast cancer.  And mammograms are advised by most professional organizations starting at age 40; the specific interval for these can again be discussed with your doctor, depending on your age.  Finally, women with family history may be advised to consider testing for one of the known breast cancer genes.   Breast cancer takes a terrible toll on the women and families whom it has affected; awareness of risks and preventive tools is the best defense we have in containing, and hopefully one day, curing, this disease.

3 Exercises to Tone Your Glutes

By: Ashley Greenblatt, Certified Personal Trainer

The days of stick-figure physiques are a thing of the past. Strong is the new sexy and your backside is taking center stage. There are songs dedicated to it, Kardashian empires built upon it — no ifs, ands or butts about it, a shapely posterior is what women want and men desire. So, pick up your phones and deflated derrieres ladies and gents, because we are dialing in a bun burner booty call. If your caboose has taken a backseat in your workout routine, you can channel your inner Brazilian beach babe with this tushie-torching workout:

Step It Up. Elevation is key when it comes to toning your tail. To perform a proper step-up, aim for a height that allows the knee to bend at a 90-degree angle. This allows the glutes to achieve a strong contraction during the step up phase of the exercise. Protect your knees by placing your body weight onto the heel of the working leg, rather than on the ball of your foot. This concept is important to practice during any glute exercise, as it is a common mistake that leads to many knee-related injuries. Practice this exercise several times until you achieve a steady, consistent balance. When ready, further the intensity by adding free-weights to the routine.

Pop a Squat. Looking to add a little junk to your trunk? Squatting is the all-star of glute exercises because it gets the job done by zoning in on the muscles necessary to plump your posterior. There is no excuse for skimping on this exercise because it can be done virtually anywhere, and further allows for a myriad of progressions to keep your glutes guessing.

The easiest way to squat with proper form is to mimic the motion of your body as you lower yourself into a chair. As a Personal Trainer, I always have my clients practice the sit-down/stand-up sequence prior to beginning a squatting routine. It is essential to first have good form before adding weights into the mix. As previously stated, you’ll want to place your weight in the heels of your feet to activate your posterior muscles (doing so will prevent shear-force on the knee caps, which will cause knee joint damage over time). Maintain a shoulder width distance in your stance, sit back on your heels, and keep your core activated with your chest up-right. Congratulations, you just did one squat.

Kick Butt. Hip extensions, also known as Donkey Kicks, exclusively target the glute muscles and cause your bum to burn baby, burn. Take a load off and drop down onto all fours (you will need a mat or carpeted floor for this). Align your hands beneath your shoulders and extend one leg behind you to hip-height, then lower your knee until it hovers about an inch from the floor. As always, keep that core engaged and your back strong. Complete 10-15 reps and switch legs.
Amplifying your ass(ets) doesn’t have to be a pain in the butt. Implement these three simple, yet effective exercises into your weekly workout routine to transform your bum from jello to J. Lo.

Irritable Bowel Disease: Diagnosis and Treatment

By: Lauren O'Brien, M.D., Board Certified Physician

One of most frequent reasons that women come to see their primary care physician is to discuss abdominal pain and bloating.  I don’t think a day in the office goes by that I do not hear those words.  Most frequently these patients have what is known as Irritable Bowel Syndrome (IBS).  Not surprisingly, it is the most commonly diagnosed gastrointestinal condition, affecting 10-15% of the population.

The true definition of IBS is: a gastrointestinal syndrome of chronic abdominal pain and altered bowel habits (without other organic cause) at least 3 days per month in the last 3 months.  Commonly, the abdominal pain is intermittent and described as “crampy”.  Exacerbations can occur frequently and are associated with eating and times of increased stress.  The abdominal pain associated with IBS can vary in intensity and location, but is often relieved with bowel movements.  Other common symptoms include: bloating, gas, nausea, diarrhea and/or constipation, and feeling full quickly.  “Red flag” symptoms such as anorexia, weight loss, persistent rectal bleeding, pain awakening a patient from sleep or certain lab findings (i.e. anemia) are rarely associated with IBS and should prompt a further workup for an alternative diagnosis.

Unfortunately there are no tests specific to the diagnosis of IBS.  Frequently, a physician will run blood or stool tests and maybe order additional procedures such as a colonoscopy to rule out other potential causes of symptoms.  If no other source is found and no “red flag” symptoms are present, a diagnosis of Irritable Bowel Syndrome is made.

There are 4 different subtypes of IBS:

                1) Diarrhea predominant

                2) Constipation predominant

                3) Mixed type

                4) Unsubtyped

Treatment options vary between the different types.

As any patient who suffers from IBS knows, making the diagnosis is only half of the battle.  Treatment for this ailment takes time, patience and diligence to improve symptoms.  IBS is a chronic disease, which means most patients will likely have it for life.  That being said, the majority of patients will be able to control their symptoms with one or more of the treatment modalities available.

Upon diagnosis, a patient should take time to keep a log of symptoms and what the circumstances were at that time (what she ate, what she did, etc).   This will help to elucidate any specific pattern or specific food that may be contributing to a patient’s pain.  It has long been thought that certain foods in certain individuals can be a source of IBS symptoms.  If a patient has been diagnosed with Irritable Bowel Syndrome, her first step should be to eliminate foods known for high gas production such as: beans, onions, celery, carrots, raisins, bananas, apricots, prunes, Brussels sprouts, pretzels, bagels, alcohol and caffeine.  In many patients, reduction in these foods can bring around a significant improvement in abdominal pain and bloating.

If still with significant symptoms despite reduction of high gas forming foods, a patient may decide to follow a stricter approach with the low FODMAP (fermentable, oligo-, di-, and monosaccharides and polyols) diet.  High FODMAP foods are poorly absorbed and are rapidly fermented in the gut causing gas and bloating.  Such foods are listed below.

Oligosachharides: wheat, barley, rye, onion, leek, garlic, shallots, artichokes, beets, fennel, peas, pistachio, cashews, legumes, lentil and chick peas..

Disaccharides: lactose (milk, ice cream, yogurt)

Monosaccharides: apples, pears, mangoes, cherries, watermelon, asparagus, sugar snap peas, honey and high fructose corn syrup.

Polyols: nectarines, peaches, plums, mushrooms, cauliflower, artificially sweetened chewing gum and other sweets

Obviously this can be a very restrictive diet.  If taking on a low FODMAP diet it is recommended that you do this under the guidance of a trained dietician in order to avoid over- restriction and malnutrition.  Ideally a patient would be on a low FODMAP diet for 6-8 weeks at which time she would gradually re-introduce the above foods one at a time to determine which specific foods are tolerated and which are not. 

Though it is thought that food allergy could possibly play a role in Irritable Bowel Syndrome, at this time there is insufficient evidence to recommend food allergy testing in patients with IBS.  This is largely due to the fact that current modes of allergy testing have not been reliable in identifying affected patients. 

In addition to dietary management, 20-60 minutes of moderate to vigorous exercise 5 days a week has been shown to significantly decrease symptoms of IBS.  It is also important to address daily stressors through counseling and stress-reduction techniques (meditation, yoga, etc) as increased stress often leads to increased IBS symptoms.

If lifestyle interventions still fail to control symptoms, your doctor can prescribe medications specific to the patient’s symptoms.  For example, anti-diarrheals in diarrhea predominant IBS, laxatives in constipation predominant IBS, antispasmodic agents, and antidepressants.

In summary, Irritable Bowel Syndrome is a very common disease affecting a large number of women.  Symptoms generally consist of abdominal pain, bloating, and a change in bowel habits.  In order to diagnose IBS, doctors must rule out other organic causes of gastrointestinal disease.  Though it is not curable, most patients are able to control their symptoms with lifestyle changes or medications.

How to Give Your Midday Sweets Craving a Healthier Tweak

By: Theresa Shank, Registered Dietitian

Throughout my years of practicing as a registered dietitian, I have been presented with numerous healthy lifestyles and/or weight loss questions, one of the most common being “why do I crave chocolate after a meal and how can I control this habit”. My response usually to this question is that our bodies crave sweets for several biological, psychological and lifestyle-related reasons such as low serotonin levels, an unbalanced diet high in carbohydrates, fat restriction, or purely psychological conditioning such as a dessert is what signifies the end of a meal. Regardless what the reason behind your sweet craving is, if you are trying to live a healthier lifestyle or possibly your goal is to lose weight, you’ll have to curb (not eliminate) your daily indulgence.

So let’s be honest, any alternative that truly satisfies a sweet tooth is not going to be the epitome of a healthy snack, but my suggestions could shave off some calories (all suggestions are under 150 calories!),fat and sugar in your afternoon indulgence or late night trip to the candy drawer or freezer. 

·         3 cups of air popped popcorn with 2 tbsp of Bell Plantation, PB2 Powdered Peanut Butter Chocolate ( 138 calories)

·         4 Hershey Kisses ( 100 calories)

·         1 Small Chocolate Covered Banana: I love this recipe from (100 calories)

·         20 Blue Diamond, Oven Roasted Dark Chocolate Almonds ( 132 calories)

·         1, 5.3 ounce ChobaniSimply 100, vanilla yogurt with 2 tbsp of Bell Plantation, PB2 Powdered Peanut Butter Chocolate or 1 piece of Dove, Promises Silky Smooth Dark Chocolate. ( 145 calories)

·         1 Enlightened, Fudge Bar ( 70 calories)

·         ½ Quest, Chocolate Brownie Protein Bar ( 85 calories)

·         24 Annie's Chocolate Chip Bunny Graham cookies (140 calories)

Roasted Sweet Potato, Quinoa and Kale Salad

Yield: 6 servings

Recipe inspired by Two Peas & Their Pod and Eat Yourself Skinny


·         2 medium sweet potatoes, peeled and cubed

·         1 Tbsp olive oil

·         1 tsp. garlic powder

·         1/2 tsp. onion powder

·         1/2 tsp. oregano

·         1/2 tsp. chipotle chili powder

·         1/2 cup uncooked quinoa

·         3 cups kale or mixed greens

·         1/4 cup dried cranberries

For the dressing:

·         1 Tbsp red wine vinegar

·         1 Tbsp apple cider vinegar

·         2 Tbsp olive oil

·         1 tsp. minced shallots

·         1 1/2 Tbsp honey


1.     Preheat oven to 425 degrees F.

2.     Rinse and peel sweet potatoes, chopping them into 1/4 inch cubes. Toss with olive oil, garlic powder, onion powder, oregano and chipotle chili powder until completely coated. Spread sweet potatoes out on prepared baking sheet in a single layer and roast in the oven for about 30 minutes, flipping them once.

3.     While sweet potatoes are roasting, using a mesh strainer, thoroughly rinse the quinoa. Add a 1/2 cup of water to a small saucepan and add rinsed quinoa. Bring quinoa to a boil, cover and reduce heat and simmer for about 13 minutes. Remove from heat, keeping quinoa covered, and allow it to sit for about 5 minutes then fluff quinoa with a fork.

4.     Combine kale, quinoa and cranberries in a large bowl and toss with dressing. Fold in roasted sweet potatoes, serve and enjoy!


Serving Size: 1 cup • Calories: 204 • Fat: 7.6 g • Carbs: 31.4 g • Fiber: 3.3 g • Protein: 3.8 g • WW Points+: 5 pts

- See more at:

Staying Healthy While on Vacation

By: Kathryn Pontius, Certified Personal Trainer

The last thing anyone wants to do while on vacation is think about working out. You are on vacation to take a break from the stresses in your life. You want a little rest without the work phone calls and constant stream of emails. You want some relaxation without feeling guilty about the gym membership you aren’t using or all the calories you just consumed in your Pina Colada. But you also don’t want to come back from vacation only to find your getaway added inches to your waist! It is possible to stay healthy and enjoy your vacation with a few helpful hints!

1.       Moderation- Don’t deny yourself the fruity cocktails by the pool or the all you can eat fresh seafood dinners. But do each in moderation. Limit yourself to one or two sugar filled cocktails before switching to something less caloric. Pack a lunch to bring to the beach if you know you are going to have a decadent dinner. Try to eat local and fresh fruits and vegetables to experience the cuisine and stay healthy.

2.       Walk more- explore your surroundings by foot. Walk to the local market or to the restaurant for dinner. Take a stroll on the beach looking for shells. Find a beautiful mountain hike to take to get a picturesque view of the sunset. It’s not only a great way to see more of the destination but it’s also a great way to exercise!

3.      Try a local activity- Go snorkeling. Take kayaks out on the lake. Rent bikes and go for an evening bike ride around town. Take a surfing lesson. Try stand-up paddle boarding. No matter what type of vacation you are on, there are bound to be new and exciting things to try that will keep you active while you have fun!  

Enjoy the rest of your summer! It’s not too late to start working toward your fitness goals. We would love you help you! Call RWWC today! 

Screening for Breast Cancer

By: Monica Duvall, M.D., Board Certified Physician

Breast cancer, we are taught, is an illness that all women need to be aware of, and be screened for.   But how do we most effectively screen for it?  This question is not as straightforward as one would think, as the recommendations for different screening modalities are always evolving, based on new assessments of available evidence.  Traditionally, women were advised to do monthly self-examinations in the shower as a front-line defense against breast cancer.  But in recent years, these exams have not been shown to consistently prevent breast cancer deaths (which is, after all, the goal of any screening program).  Therefore, most expert groups now either recommend against self-exams entirely, or they recommend encouraging "breast awareness", which means each woman should be aware of her own body, so that she can recognize potentially alarming changes--this could include a traditional breast exam, but not necessarily.

Another mainstay of breast cancer detection has been the clinical breast exam, performed annually by a physician at the time of the gynecological examination.  While the American Cancer Society (ACS) and the American College of Obstetricians and Gynecologists (ACOG) recommend these exams every 1-3 years for women ages 20-39 and annually for women thereafter, the US Preventive services task force (USPSTF), an independent government-sponsored organization, notes that there is insufficient evidence for these exams, as well.

Mammography is recognized by most women as the most important tool we have for breast cancer screening, and most medical societies agree, recommending annual mammograms for all women beginning at age 40.  A few influential groups, though--notably the American College of Physicians (ACP), the American Academy of Family Physicians (AAFP), and the USPSTF--feel that the evidence for mammography in women between the ages of 40 and 49 is not as strong as for women 50 and older, and they have therefore departed slightly from this recommendation.  They advise instead that for these women, mammograms may be performed every 1-2 or every 2 years, and that the decision can be individualized for each woman in this age group.  Annual mammography is recommended by many societies to continue throughout the later years of life, but again there is some variability--the AAFP advises screening only until age 74, the USPSTF recommends stopping at age 75, and ACOG recommends individualizing the decision to screen after age 75.

So where does all of this conflicting evidence leave doctors and patients?  There is not an absolute correct answer for how to screen--but it is important that patients do what makes them feel most comfortable, that doctor assess the evidence various expert groups use in making their recommendations, and that both groups communicate their preferences and concerns about screening to one another.

Summer Workout Mistakes to Avoid

By: Kathryn Pontius, Certified Personal Trainer

It is no secret this summer is gearing up to be a hot one! After such a brutal winter, it is wonderful to finally be able to exercise outdoors. But with this comes added risks like dehydration, sunburn, or chafing. Here are a few common mistakes to prevent unhealthy or uncomfortable workout sessions.

1.     Drinking coffee before a work out

Coffee can actually dehydrate you. Stick to water to hydrate pre-workout

2.     Sleeping in

While it is tempting in the hot summer months to stay up a little later, since it stays light later, don’t let that keep you from your morning workout. Temperatures rise earlier in the day in the summer, putting off your workout, even by an hour, can cause overheating. Try to work out early or in the evening once the temperatures have fallen.

3.     Wearing Dark or loose fitting clothing

Dark clothes absorb heat and put you at risk for overheating. While some people don’t like form fitting clothes or think tight clothes don’t allow for ventilation, loose clothes combined with sweat can make for some very uncomfortable workouts.

4.     Not re-fueling post workout

Both water and food need to be replenished within 30 minutes of a workout session. When it’s hot, people tend not to want to eat big meals, but try something small and nutrient rich.  

5.     Not bringing water to a pool workout

Your body loses water during a pool workout just like it does on land and it is easy to forget that. Staying hydrated is just as important at the pool as anywhere else.

6.     Only hydrating during your workout

It is very important to pre hydrate and post hydrate as well!

Enjoy the warm weather and summer freedom, but stay smart and healthy by not making these common mistakes. For more help with your personal fitness goals make an appointment to see a fitness specialist at RWWC today!

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