1. Fit To Win/Wellness DiLorenzo TRICARE Health Clinic Dave Holes, MA, CSCS, ACSM-HFI Health Educator

2. What is Fit To Win? Fit To Win is a health promotion program serving active duty, retirees and government civilians Fit To Win is a health promotion program serving active duty, retirees and government civilians Provides Educational classes/seminars in the realm of exercise, health, and preventative topics Provides Educational classes/seminars in the realm of exercise, health, and preventative topics Fit To Win offers physiological fitness testing and nutrition consultations in order to help people adopt and maintain healthy lifestyles Fit To Win offers physiological fitness testing and nutrition consultations in order to help people adopt and maintain healthy lifestyles

3. Exercise Testing VO2 Testing/ Blood Lactate Testing VO2 Testing/ Blood Lactate Testing Body Composition Body Composition Ultrasound Bone Density Ultrasound Bone Density Running Shoe Clinic Running Shoe Clinic Biomechanics Assessment Biomechanics Assessment

4. Aerobic Capacity Fit To Win offers two methods to determine aerobic fitness Maximal VO2 Test Blood Lactate Testing -

5. BOD POD Body Composition Analyzer Body Composition Analyzer Principles Similar to Hydrostatic Weighing Principles Similar to Hydrostatic Weighing No Water is Used No Water is Used

6. Bone Density Screening Osteoporosis Screen Osteoporosis Screen Ultrasound Technology Ultrasound Technology Risk Factors Risk Factors Poor nutrition Poor nutrition Menopausal/post menopausal Menopausal/post menopausal Low exercise history (weight bearing) Low exercise history (weight bearing)

7. Lower extremity gait analysis Lower extremity gait analysis With and without shoes With and without shoes Training recommendations are discussed Training recommendations are discussed Shoe list is provided Shoe list is provided Updated every 6 months and can be emailed – just give us a call or email. Updated every 6 months and can be emailed – just give us a call or email. Running Shoe Clinic

8. Runner’s program - Biomechanics Assessment Two part appointment Two part appointment Analysis Analysis Coaching session Coaching session Analysis report Analysis report Stride length Stride length Stride frequency Stride frequency Internal/external rotation Internal/external rotation Coaching session Coaching session Handout with running form drills Handout with running form drills

9. Location DiLorenzo TRICARE Health Clinic DiLorenzo TRICARE Health Clinic Corridor 8/North Parking Corridor 8/North Parking Duty Phone: 703-692-8898 Duty Phone: 703-692-8898 Hours: 0700-1600 Monday-Friday Hours: 0700-1600 Monday-Friday

10. Objectives Discuss obesity and its effect on health Discuss obesity and its effect on health Make you more aware of “added sugars” in foods Make you more aware of “added sugars” in foods Show you how to get fit at work! Show you how to get fit at work! Demonstrate simple strength exercises to improve body composition and function Demonstrate simple strength exercises to improve body composition and function

11. Visceral Fat & Disease

12. http://img.medscape.com/fullsize/migrated/editorial/cmecircle/2008/17327/cooppan/slide15.png

14. “Added Sugar” Intake Recommendations American Heart Association recommends no more than 100 calories of added sugar for women and no more than 150 calories of added sugar for men per day American Heart Association recommends no more than 100 calories of added sugar for women and no more than 150 calories of added sugar for men per day Dietary Guidelines for Americans 2010 recommends limiting added sugars to 5-15% of daily calories Dietary Guidelines for Americans 2010 recommends limiting added sugars to 5-15% of daily calories

15. Determining Sugars in Foods A. Find sugars on the label in grams (9 g) A. Find sugars on the label in grams (9 g) B. Multiply sugars by 4 calories/gram (36 cal) B. Multiply sugars by 4 calories/gram (36 cal) C. Divide result from B by calories per serving to get sugars per serving (36 cal/110 cal) = 33% 33%

16. Sugar Equivalents Sunkist (1 bottle, 20 fl oz) Sunkist (1 bottle, 20 fl oz) 320 calories 0 g fat, 84 g sugars 320 calories 0 g fat, 84 g sugars Sugar Equivalent: 6 Breyers Oreo Ice Cream Sandwiches Sugar Equivalent: 6 Breyers Oreo Ice Cream Sandwiches Source: http://www.bodylogicmd.com/hormone-articles/20-worst-drinks-in-america Source: http://www.bodylogicmd.com/hormone-articles/20-worst-drinks-in-america

17. Sugar Equivalents Tropicana Tropical Fruit Fury Twister (1 bottle, 20 fl oz) Tropicana Tropical Fruit Fury Twister (1 bottle, 20 fl oz) 340 calories 0 g fat, 60 g sugars 340 calories 0 g fat, 60 g sugars Sugar Equivalent: Two 7-ounce canisters Reddi-wip Sugar Equivalent: Two 7-ounce canisters Reddi-wip Source: http://www.bodylogicmd.com/hormone-articles/20-worst-drinks-in-america Source: http://www.bodylogicmd.com/hormone-articles/20-worst-drinks-in-america

18. Sugar Equivalents Starbucks Peppermint White Chocolate Mocha with Whipped Cream (venti, 20 fl oz) 660 calories 22 g fat (15 g saturated) 95 g sugars Starbucks Peppermint White Chocolate Mocha with Whipped Cream (venti, 20 fl oz) 660 calories 22 g fat (15 g saturated) 95 g sugars Sugar Equivalent: 8½ scoops Edy's Slow Churned Rich and Creamy Coffee Ice Cream Sugar Equivalent: 8½ scoops Edy's Slow Churned Rich and Creamy Coffee Ice Cream Source: http://www.bodylogicmd.com/hormone-articles/20-worst-drinks-in-america Source: http://www.bodylogicmd.com/hormone-articles/20-worst-drinks-in-america

19. Sugar Equivalents Dairy Queen Caramel MooLatte (24 fl oz) Dairy Queen Caramel MooLatte (24 fl oz) 870 calories 24 g fat (19 g saturated, 1 g trans) 112 g sugars 870 calories 24 g fat (19 g saturated, 1 g trans) 112 g sugars Sugar Equivalent: 12 Dunkin? Donuts Bavarian Kreme Doughnuts Sugar Equivalent: 12 Dunkin? Donuts Bavarian Kreme Doughnuts Source: http://www.bodylogicmd.com/hormone-articles/20-worst-drinks-in-america Source: http://www.bodylogicmd.com/hormone-articles/20-worst-drinks-in-america

20. How Many Calories?

21. Are You Guilty? Source: http://www.aarp.org/health/fitness/info-03- 2011/sitting-too-much-health-hazard.html

22. EMG and Inactivity DIABETES, VOL. 56, NOVEMBER 2007

23. Your body burns energy every day to keep you alive, keep you moving, and when you exercise BMR: Basal Metabolic Rate BMR: Basal Metabolic Rate Exercise: Calories burned during a workout Exercise: Calories burned during a workout NEAT: Non-Exercise Activity Thermogenesis NEAT: Non-Exercise Activity Thermogenesis TEF: Thermic Effect of Food – the slight metabolic kick you get from eating TEF: Thermic Effect of Food – the slight metabolic kick you get from eating Slide Creator: Silvernail, Jason L LTC MIL DOD CAPMED FBCH Reference: Hamilton et al. Role of Low Energy Expenditure and Sitting in Obesity, Metabolic Syndrome, Type 2 Diabetes, and Cardiovascular Disease. Diabetes 56:2655–2667, 2007 Sources of Energy Use

24. Physical Activity and Obesity Exercise is a small slice of your daily energy expenditure! Check out the slice that is NEAT! Slide Creator: Silvernail, Jason L LTC MIL DOD CAPMED FBCH Reference: Hamilton et al. Role of Low Energy Expenditure and Sitting in Obesity, Metabolic Syndrome, Type 2 Diabetes, and Cardiovascular Disease. Diabetes 56:2655–2667, 2007

25. Physical Activity and Obesity Reference: Hamilton et al. Role of Low Energy Expenditure and Sitting in Obesity, Metabolic Syndrome, Type 2 Diabetes, and Cardiovascular Disease. Diabetes 56:2655–2667, 2007 Slide Creator: Silvernail, Jason L LTC MIL DOD CAPMED FBCH

26. Exercise and daily movement is an important part of fat loss Exercise and daily movement is an important part of fat loss You cannot out-exercise your fork! You cannot out-exercise your fork! Dietary choices are probably the most important influence on your weight and risk for obesity Dietary choices are probably the most important influence on your weight and risk for obesity Exercise and activity cannot make up for poor dietary choices but improves health regardless of weight Exercise and activity cannot make up for poor dietary choices but improves health regardless of weight Weight Loss and Exercise

28. Health Consequences of Sitting American Cancer Society study authored by Dr Patel examined activity and health habits of 53,440 men and 69,776 women. Results showed that sitting more than 6 hours compared to sitting < 3 hours: American Cancer Society study authored by Dr Patel examined activity and health habits of 53,440 men and 69,776 women. Results showed that sitting more than 6 hours compared to sitting < 3 hours: Increased the death rate by about 40% in women Increased the death rate by about 40% in women Increased the death rate in men by about 20% Increased the death rate in men by about 20% Increased the death rate by 94% in the least active women Increased the death rate by 94% in the least active women Increased death rate by 48% in the least active men Increased death rate by 48% in the least active men Source: http://www.medscape.com/viewarticle/725721 Source: http://www.medscape.com/viewarticle/725721

29. Sitting Posture Poor sitting posture can lengthen the mid-back muscles and tighten the chest muscles. In addition, the neck extensor muscles can become tight and the neck flexor muscles weak. These imbalances can lead to forward head posture.

30. Effects of Forward Head Posture For every inch that the head moves forward in posture, it increases the weight of the head on the neck by 10 pounds!

31. Sit To Stand Workstations

32. Walking and Heart Health A 12-year study of 707 retired men in Hawaii found that the death rate of men who walked at least 2 miles a day was more than 50% lower than that of men who walked less than a mile a day. A 12-year study of 707 retired men in Hawaii found that the death rate of men who walked at least 2 miles a day was more than 50% lower than that of men who walked less than a mile a day. A study of Harvard alumni found that men who walked more than 7 miles a week had a 33% lower death rate than sedentary men. Walking up stairs was nearly as good; men who averaged about 8 flights a day reduced their death rate by 25%. A study of Harvard alumni found that men who walked more than 7 miles a week had a 33% lower death rate than sedentary men. Walking up stairs was nearly as good; men who averaged about 8 flights a day reduced their death rate by 25%. Source:http://www.health.harvard.edu/newsweek/Leisure-time-exercise.htm Source:http://www.health.harvard.edu/newsweek/Leisure-time-exercise.htm

33. Activity Trackers

34. Thank You! David.j.holes.civ@mail.mil 703-692-8898