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Understanding Your Tests

Understanding Your Tests. What’s Your Wellness Score? Get a Good Grade In Your Health. Body Mass Index (BMI). BMI = Weight (in kg) Height 2 (in meters) Lbs / inches 2 x 703 A BMI of <25 = desirable 25 – 29.9 = overweight >30 = obese

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Understanding Your Tests

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  1. Understanding Your Tests

  2. What’s Your Wellness Score? Get a Good Grade In Your Health

  3. Body Mass Index (BMI) • BMI = Weight(in kg) Height2(in meters) • Lbs/ inches2 x 703 • A BMI of <25 = desirable 25 – 29.9 = overweight >30 = obese • Tells us if you are over weight

  4. Bray GA. Overweight is risking fate. Definition, classification, prevalence and risks. Ann NY Acad Sci 1987;499:14-28. Relationship of BMI to Excess Mortality 300 Age at Issue 20-29 250 30-39 200 150 Mortality Ratio 100 High Moderate Low Risk Risk Risk 50 0 15 20 25 30 35 40 Body Mass Index (kg/[m2])

  5. Waist/Hip Ratio • 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

  6. Blood Pressure & Resting Pulse • 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 • 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 • Medications??

  7. Sugar Biomarkers • Fasting Glucose 80-100 mg/dl • 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 • Also consider Fasting Insulin Increased insulin production causes insulin resistance Sign of Insulin Resistance with levels over 15 uU/ml

  8. Lipid Biomarkers • Lipids, fractionated lipids • 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.

  9. Consider an MSQ- Systems Evaluation Medical Symptoms Questionnaire (MSQ) • Identifies symptoms in most body systems • Quantifies patient’s level of symptoms • Provides a simple metric to track patient improvement

  10. EPIC HEALTHY LIVING STUDY • Participants with all4 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 healthyfactors. Arch Intern Med. 2009;169(15):1355-1362. 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

  11. How to Identify Patients withMetabolic Syndrome 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 you have 4 of the above you have 3.5 times the risk.

  12. General Features of Metabolic Syndrome • Abdominal obesity • 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) • 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) • Increased Fibrinogen and PAI-1 • Pro-inflammatory state • Increased IL-6 and hs-CRP firstline therapy

  13. Weight Management/NutritionWhat is Food?

  14. Food is a Mixture 30-20-10 Protein 20 g Fat 10 g Carbohydrate 30 g

  15. What Hormone is secreted when your eat sugar? Understanding Glycemic Index

  16. Understanding Food Labels

  17. Use your hand as your guide Carbohydrate- Fist Protein- Palm Fat- Thumb

  18. Question? • How many teaspoons of sugar in a 20 ounce soda? • Bonus question – what is the average pH of a soda (diet or regular)?

  19. Are you eating like a BEAR or a DEER? Eats Big Meals 2-3 times a day! Eats Small Meals 5-7 times a day!

  20. 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!

  21. Good Fat vs. Bad Fat 70 Trillion Cells in the Human Body!!

  22. Power of Habits

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