Transcript 8 WEEKS TO WELLNESS GIVE US 8 WEEKS AND WE’LL …

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Understanding
Your
Tests
What’s Your Wellness Score?
Get a Good Grade In Your Health
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Body Mass Index (BMI)
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BMI = Weight (in kg)
Height2 (in meters)
 Lbs/ inches2 x 703
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A BMI of
<25
25 – 29.9
>30
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= desirable
= overweight
= obese
Tells us if you are over weight
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Relationship of BMI to
Excess Mortality
300
250
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Age at Issue
20-29
30-39
200
150
100
Low
Risk
50
0
15
20
25
30
High
Moderate
Risk
35
Risk
40
Body Mass Index (kg/[m2])
Bray GA. Overweight is risking fate. Definition, classification,
prevalence and risks. Ann NY Acad Sci 1987;499:14-28.
Waist/Hip Ratio
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Waist/Hip Ratio
Ideal: <.80 Woman and <.95 Man
Tells us if you are Over-Fat. Skinny fat
person can have normal BMI and high
body fat.
Adipose Tissue is the largest endocrine
gland in the body and produce:
• Inflammatory chemicals
• Estrogen
• Cortisol
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Blood Pressure & Resting Pulse
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Blood Pressure
Systolic less than or equal to 110mm-Good
Diastolic equal to or less than 70mm-Good
Greater than 130/85mm is Mildly Hypertensive
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In Blood Pressure above 11/5/75, a 10 point
jump in Diastolic BP (bottom number), causes a
2-fold increase in death from heart disease
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Medications??
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Sugar Biomarkers
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Fasting Glucose
80-100 mg/dl
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If Fasting Glucose is above 100 mg/dl then consider
HbA1C- Glycosylated Hemoglobin
Normal range is 4-5.9 %. In poorly controlled diabetes, its 8.0% or
above, and in well controlled patients it's less than 7.0%
The predictive value of HbA1C for total mortality was stronger than
that documented for cholesterol concentration, body mass index and
blood pressure.”
Khaw, K-T, et al, BMJ, 2001, Vol 322: 1-6
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Also consider Fasting Insulin
Increased insulin production causes insulin resistance
Sign of Insulin Resistance with levels over 15 uU/ml
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Lipid Biomarkers
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Lipids, fractionated lipids
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Total Cholesterol-under 200
Triglycerides-under 150, preferably under 100
HDL-over 50 (male) and over 60 (female)
LDL-under 130
Trig/HDL ratio- under 2.0
Chol/HDL ratio- under 3.0
Triglyceride/HDL ratio predicts a heart attack
17 times more accurately than just Cholesterol
numbers.
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Consider an MSQ- Systems Evaluation
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Medical Symptoms Questionnaire (MSQ)
- Identifies symptoms in most
body systems
- Quantifies patient’s level of
symptoms
- Provides a simple metric to track
patient improvement
EPIC HEALTHY LIVING STUDY
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Participants with all 4
factors to the right had a
78% lower risk of
developing a chronic
disease (diabetes 93%;
myocardial infarction
81%; stroke 50% and
cancer 36% than
participants without
engaging in healthy
factors.
Arch Intern Med. 2009;169(15):1355-1362.
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1. BMI Under 30
2. 3.5 Hours of Physical
Activity Per Week
3. Following a Healthy
Diet (fruits, vegetables,
beans, whole grains,
nuts, seeds, and
limited amounts of meat)
4. Never Smoking
How to Identify Patients with
Metabolic Syndrome
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National Cholesterol Education Program (NCEP) definition is the
presence of 3 or more of the following:
Waist Circumference
Triglycerides
HDL Cholesterol
TG/HDL Ratio ≥3
Men >40 in, Women >35 in
≥150 mg/dL
Men <40 mg/dL;
Women <50mg/dL
Blood Pressure
≥130/≥85 mmHg
Blood Glucose
≥100 mg/dL
According to the CDC if you have any two of these symptoms you
have double the risk of death from coronary heart disease and if
General Features of
Metabolic Syndrome
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Abdominal obesity
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High triglycerides, trig/HDL ratio
Small LDL cholesterol particles
Low HDL cholesterol
Raised blood pressure
Insulin resistance ( glucose intolerance)
Pro-thrombotic state (blood clotting tendency)
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Men – waist > 40 inches, or waist is larger than hips
Women – waist > 35 inches, or waist is greater than 80% the size
of hips
Altered blood lipids (fats)
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Increased Fibrinogen and PAI-1
Pro-inflammatory state
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Increased IL-6 and hs-CRP
Weight Management/Nutrition
What is Food?
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Food is a Mixture
30-20-10
Protein
20 g
Fat
10 g
Carbohydrate
30 g
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What Hormone is secreted when your eat
sugar? Understanding Glycemic Index
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Understanding Food Labels
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Use your hand as your guide
CarbohydrateFist
Protein- Palm
Fat- Thumb
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Question?
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How many
teaspoons of sugar
in a 20 ounce soda?
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Bonus question –
what is the average
pH of a soda (diet or
regular)?
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Are you eating like a
BEAR or a DEER?
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Eats Big Meals 2-3 times a day! Eats Small Meals 5-7 times a day
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Eating Out
 Don’t
look at the menu
 The average restaurant portion size is 4-5
X a normal size
 The calories add up quickly
 No Starch-Double Vegetable
 Split meals and ask for the “to go”
container ahead of time
 No bread before dinner!
Good Fat vs. Bad Fat
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70 Trillion Cells in the Human Body!!
Power of Habits
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