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 – = overweight
>30 = obese
Tells us if you are over weight

4. Relationship of BMI to Excess Mortality
300
Age at Issue
20-29
250
30-39
200
150
Mortality Ratio
100
Low
Moderate
High
Dr. George Bray is a well-known obesity researcher. He’s looked at our likelihood of living a long life relative to our BMI and found the risk of dying is low with a BMI of 25 to 30 and increases as BMI increases. The greatest risk is seen with BMIs above 40. 50
Risk
Risk
Risk 15 20 25 30 35 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.

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
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 %. 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
1. BMI Under 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
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):

11. How to Identify Patients with Metabolic Syndrome
National Cholesterol Education Program (NCEP) definition is the presence of 3 or more of the following:
Waist Circumference
Men >40 in, Women >35 in
Triglycerides
≥150 mg/dL
HDL Cholesterol
TG/HDL Ratio ≥3
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 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/Nutrition What is Food?

14. Food is a Mixture 30-20-10 Protein Fat 20 g 10 g Carbohydrate 30 g
We don’t tend to think of what we eat as protein, carbohydrate and fat. We think in terms of food, but the body sees food in these terms. Most foods are a mixture of these macronutrients.
Knowledge is power. You must know what you are eating.
Yes there’s lots of info out there, high fat, low fat, low salt, Atkins, South Beach, Weight Watchers. Etc etc.
Go through example of PBnJ sandwich, what is carb, what is fat, what is protein, and are they healthy.
Carbohydrate
30 g

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

17. Understanding Food Labels

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

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

20. 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!

21. 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!

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

23. Power of Habits