1. Tests: Knowing and Understanding Your Numbers Provided Courtesy of RD411.com Where health care professionals go for information Review Date 10/09 G-1122 Contributed by Shawna Gornick-Ilagan, MS, RD, CWPC

2. Disclaimer This presentation should not substitute or replace any medical advice provided by your doctor This presentation is meant to provide you with general health information to empower you to take charge of your health

3. Objectives Why get started? What are biometric screen tests What do the numbers mean? What can you do about your numbers?

4. Leading Causes of Deaths 1st place 2nd place 3rd place 4th place 5th place

5. Causes of Death Heart disease: 652,091 Cancer: 559,312 Stroke: 143,579 Chronic lower respiratory diseases: 130,933 Accidents: 117,809 Diabetes: 75,119 Alzheimer’s disease: 71,599 Influenza/pneumonia: 63,001 Kidney disease: 43,901 Source: Centers for Disease Control and Prevention. Available at: www.cdc.gov. www.cdc.gov

6. What Causes Heart Disease/Stroke? Arteries—blood vessels that carry blood away from the heart to the rest of the body Normal Artery

7. Plaque Starts to Build Up Tear in Artery Wall

8. Plaque Can Grow and Harden and Obstruct the Artery Tear in Artery Wall Atherosclerosis

9. Ischemic Stroke

10. Heart Attack

11. What Increases Risk? You Can Not Help Age –Men: >45 years –Women: >55 years Sex Race Family history You Can Help Smoking Alcohol Poor diet Overweight/obesity Diabetes Physical inactivity High cholesterol High blood pressure

13. Randy Pausch “We can't change the cards we’re dealt, just how we play the hand.”

14. How Can You Play the Cards?

15. Biometric Screening Tests BMI Blood pressure Lipid Panel –Total cholesterol –High-density lipoprotein (HDL) –Low-density lipoprotein (LDL) –Triglycerides Blood glucose A1c

16. Body Mass Index (BMI) BMI is a number calculated from a person’s weight and height Higher BMI values are associated with risks for health problems Visit http://www.cdc.gov/healthyweight/asses sing/bmi/ http://www.cdc.gov/healthyweight/asses sing/bmi/ BMI Goal=Less Than 25

17. BMI (kg/m 2 ) 1920212223242526272829303540 Height Normal WeightIncreased RiskHigh Risk 589196100105110115119124129134138143167191 599499104109114119124128133138143148173198 6097102107112118123128133138143148153179204 61100106111116122127132137143148153158185211 62104109115120126131136142147153158164191218 63107113118124130135141146152158163169197225 64110116122128134140145151157163169174204232 65114120126132138144150156162168174180210240 66118124130136142148155161167173179186216247 67121127134140146153159166172178185191223255 68125131138144151158164171177184190197230262 69128135142149155162169176182189196203236270 70132139146153160167174181188195202207243278 71136143150157165172179186193200208215250286 72140147154162169177184191199206213221258294 73144151159166174182189197204212219227265302 74148155163171179186194202210218225233272311 75152160168176184192200208216224232240279319 76156164172180189197205213221230238246287328

18. Maintain a Healthy Weight Body Mass Index (BMI) Underweight<18.5 Normal Weight18.5-24.9 Overweight25-29.9 Obesity30+

19. Benefits of Weight Loss (cont’d) Weight loss: –Reduces risk for cardiovascular disease –Lowers blood pressure –Lowers blood sugar –Improved lipid levels Source: Office of Surgeon General. Available at: http://www.surgeongeneral.gov/topics/obesity/calltoaction/1_6.htm. http://www.surgeongeneral.gov/topics/obesity/calltoaction/1_6.htm

20. Blood Pressure What is blood pressure? –Pressure created by the heart as it pumps blood through the arteries and the circulatory system What do blood pressure numbers mean? –Top number (systolic)=pressure while heart is beating –Bottom number (diastolic)=pressure while heart is resting, between beats

21. Blood Pressure (cont’d) How can I tell if I have high blood pressure” Typically no symptoms—”silent killer,” but could experience –Headache –Blurred vision –Dizziness –Nausea

22. Blood Pressure (cont’d) Over time, high blood pressure can damage: –Blood vessels –Vision –Heart and other organs –And increase your risk for heart attack, stroke, and kidney failure A reduction of as small as 2 mm Hg in the average American’s systolic blood pressure could save more than 70,000 lives per year mmHg=millimeters of mercury Source: www.nih.govwww.nih.gov

23. Blood Pressure (cont’d) Blood Pressure Systolic/Diastolic Classification <120/<80Normal 120-139/80-90Prehypertension 140-159/90-99Stage 1 hypertension >160/>100Stage 2 hypertension >180>110Severe hypertension

24. Lipid Panel: Why Get Tested? To determine risk of coronary heart disease, heart attack, and stroke One in seven adults are high risk Worldwide=4.4 million deaths

25. Lipid Panel (cont’d) Every 5 years starting at age 20: Total cholesterol, if elevated associated with heart disease HDL (healthy cholesterol) LDL (lousy cholesterol) Triglycerides

26. Total Cholesterol Every 1% reduction in your cholesterol, reduces your risk of heart disease by 2%-3% Total CholesterolCategory Less than 200 mg/dLDesirable 200-239 mg/dLBorderline high 240 mg/dL and aboveHigh dL=deciliter, mL=milliliter

27. LDL (Lousy) Cholesterol LDL=low-density lipoprotein dL=deciliter, mL=milliliter LDL ValueCategory Less than 100 mg/dLDesirable 100-129 mg/dLElevated 130-159 mg/dLBorderline high 160-189 mg/dLHigh 190 mg/dL+Very high

28. Decrease Saturated and Trans Fats Harmful fat Food source Saturated Fat Animal products (meat, poultry, eggs, dairy products, lard, and butter), and coconut, palm, and other tropical oils Trans FatPartially hydrogenated vegetable oils, commercial baked goods (cookies, crackers, and cakes), fried foods (doughnuts and French fries), shortening, and margarine

29. Pay Attention To These Limits Calorie Level Total Fat Grams Saturated Fat Grams Trans Fat Grams 120033-40<9<2 140039-37<11<2 160044-53<12.5<2 180050-60<14<2 200055-67<15.5<2 220061-73<17<2

30. Limit Trans Fat and Saturated Fat ChooseInstead of White-meat chicken or turkey without skin Red meats and organ meats 92% lean ground beefRegular ground beef Egg whites or egg substituteWhole eggs with yolks Fat-free or low-fat milk and dairy products Whole milk Fresh fruit and vegetables with low-fat dressing or hummus Potato chips and dip

31. Opt for Healthy Fats Replace saturated fat with monounsaturated fat to lower your LDL and increase your HDL Monounsaturated fats include: –Olive oil –Canola oil –Olives –Avocados –Peanut butter –Many nuts and seeds

32. Opt for Healthy Fats (cont’d) Sources of omega-3 fatty acids include: –Flaxseed –Walnuts –Salmon –Soybeans –Halibut –Shrimp –Snapper –Tofu –Etc

33. Opt for Healthy Fats (cont’d) American Heart Association recommends eating fish at least twice a week One serving of fish is 5 ounces (oz) (3 oz is the size of a deck of cards)

34. HDL (Healthy) Cholesterol Levels Every 1 mg/dL increase in your HDL lowers your risk of heart disease 2%-5% HDL “Healthy” Cholesterol Levels Men <40 mg/dL Women <50 mg/dL Coronary artery disease (CAD) risk 60 mg/dL or higherProtects you from CAD

35. Triglycerides Your body uses alcohol, extra calories, and sugar to produce this type of fat in the blood Triglycerides Less than 150 mg/dLDesirable 150-199 mg/dLBorderline high 200 mg/dL or higherHigh

36. Glucose: Why Get Tested? Glucose test measures the sugar level in your blood to screen for, diagnose, and monitor: –Hyperglycemia –Hypoglycemia –Diabetes –Prediabetes

37. Glucose: Why Get Tested? (cont’d) Blood glucose tests are performed: –During a regular physical –When symptoms suggest hyperglycemia or hypoglycemia –During pregnancy –When you have diabetes –Starting at age 45 and every 3 year if normal results

38. Blood Glucose Fasting plasma glucose: Must fast for 8 hours or longer Plasma Glucose Results (mg/dL) Diagnosis 99 or belowNormal 100-125Prediabetes 126 or aboveDiabetes

39. Good News! Preventable 85%-90% of Diabetes Is Preventable

40. Normal Process Insulin

41. Diabetes: Type 1

42. Diabetes: Type 2 Insulin = Fat

43. Hemoglobin A1c Why get tested? To monitor a person’s diabetes and to aid in treatment decisions When to get tested? When first diagnosed with diabetes and then two to four time per year A1c Reading Average Blood Sugar Level 6%135 mg/dL 7%170 mg/dL 8%205 mg/dL 9%240 mg/dL 10%275 mg/dL 11%310 mg/dL 12%345 mg/dL

44. Tips to Maintain a Healthy Weight Do not drink calories Eat slowly Stay hydrated Try the low-fat or nonfat version of foods Change habits Eat three meals each day Focus on fruits and vegetables Get enough fiber

45. Healthy Plate Format One fourth plate starch One fourth plate meat One half plate nonstarchy vegetables 8 fluid ounces of reduced-fat milk One serving of fruit

46. 7 Steps for Improving Your Numbers 1.Weight management—losing 5%-10% of your weight 2.Limit trans fat and saturated fat 3.Limit extra sugars 4.Opt for healthy fats 5.Eat enough fiber 6.Exercise regularly 7.Do not smoke and limit alcohol

47. Questions?