Ralph is a physiologist and Diplomate of the Accreditation Council for Clinical Lipidology for which is the immediate past president. He is also immediate past president of the Southeast Lipid Association. He is a consultant to a number of health care and accountable care organizations on inaugurating systematic approaches to managing lipid disorders and preventive cardiology. He has been involved with lifestyle program development for the U.S. Indian and Alaskan Health Service Division of Diabetes Treatment and Prevention for the last 15 years. He is on teaching faculty at the University of North Carolina Chapel Hill Complementary and Integrative Medicine. He was the program director of the Duke University Lipid Disorder Physician Education Program from 2006-2013 and is currently consulting faculty at Duke University Medical Center, Division of Endocrinology, Metabolism and Nutrition. He is associate editor of the American College of Sports Medicine’s Health and Fitness Journal and the Journal of Clinical Lipidology. He is also a professional photographer.