LIFESTYLE INTERVENTION You CAN’T change where you came from…….. You CAN change where you are going……

LIFESTYLE INTERVENTION

You CAN’T change where you came from……..

You CAN change where you are going……

Normal Coronary Arteries

Mild Coronary Artery Disease

Severe Coronary Artery Disease

Traditional Risk Factors Smoking Lipids (Cholesterol levels) High Blood Pressure Stress Diabetes Age Sex Family history of premature coronary artery

disease OVERWEIGHT SEDENTARY

Obesity Trends* Among U.S. AdultsBRFSS, 1991

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)


No Data <10% 10%–14% 15 %–19 %



No Data <10% 10%–14% 15%–19%



No Data <10% 10%–14% 15%–19%



No Data <10% 10%–14% 15%–19%



No Data <10% 10%–14% 15%–19% ≥20



No Data <10% 10%–14% 15%–19% ≥20



No Data <10% 10%–14% 15%–19% ≥20



No Data <10% 10%–14% 15%–19 ≥20



No Data <10% 10%–14 15%–19% 20%–24% ≥25%


(*BMI 30, or ~ 30 lbs overweight for 5’4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%





No Data <10% 10%–14% 15%–19% 20%–24% ≥25%


No Data <10% 10%–14% 15%–19% 20%–24% ≥25%




No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

ONLY 3 STATES NOW HAVE < 10% RATES

Facts re Obesity and Overweight 67% US adults are overweight 34% US adults are obese 17-19% US children are overweight These rates are continuing to increase Overweight is associated with multiple health

problems ( diabetes, heart disease, high BP, some cancers)

Obesity has become the second leading cause of preventable death in US

>$100 BILLION spent annually for related health issues

Environmental cost of this excess baggage……

1960: average woman weighed 140 lbs 2006: average woman weighs 164 lbsExtra gallons CAR fuel per year due to

weight gain since 1960938 million gals. @ cost $ 2.2 billion

Extra gallons AIRLINE fuel per year due to weight gain since 1990’s

350 million gals.@ cost $275 millionCDC and University of Illinois

Central Obesity

Excess belly fat is a risk factor independently of total fat, total weight, Due to excess calories, inactivity, alcohol, smoking, increased levels of the stress hormone, Cortisol

Associated with significant increases in heart disease and diabetes

Visceral (deep) more harmful than subcutaneous fat (pinch-able)

RX: aerobic exercise, healthy diet, appropriate portion sizes

Waist Circumference Measurement Simplest measurement of abdominal fat More accurate indicator of health risk than

BMI Women *< 35 in Men < 40 in Measure at the top of the hip bone or 1cm below navel a waist circumference increase of 2” is

significant for increased health risk even if weight doesn’t change

*Variable by ethnicity; i.e Asian women > 31.5 in are at increased health risk

Determining Ideal Body Weight Weight at age 18-21 years old BMI < 25 Body fat percentage

(ideal for women 16-25% , 10-20% for men) Women : 100 lbs for first 5 ft in height

5 lbs for each additional inch Men: 106 lbs for first 5 ft in height 6 lbs for each additional inch

subtract 10% for small body frame add 10 % for large body frame

Weight Loss Guidelines Initial goal is 10% loss in 6 months Decrease calories by 300-500 per day Aim for 1-2 lb loss per week Do not eat anything after 7 pm !!!!! Exercise daily with goal to burn 300

calories ( i.e. 3 mile walk) Regular exercise is strongest

predictor of successful weight maintenance

Calories .. they all count! Healthy foods have calories Essential to balance calorie

intake with calorie expenditure 3500 calories = 1 lb body weight,

(walking 1 mile burns 100 cals)

1200-1800 cals per day adequate for most women

PORTION CONTROL

The Food Pyramid

Risk Reduction r/t Weight Loss*

Hypertension down 70-75% Type 2 diabetes down 40-60% Cardiovascular disease down 24-50% Gastrointestinal disease down 25% Sleep disorders down 25%

* defined as obese adults losing 10% body weight each year for 3 years

Sedentary Lifestyles

Well documented that physical activity decreases rates of illness and death

Currently 23% deaths from major chronic illness are linked to sedentary lifestyles

Only 30% adults are moderately active Only 14% get recommended vigorous activity $$$ Regular moderate physical activity

among 88 million inactive Americans over the next 15 yrs would reduce annual direct medical expenses by $76 million

CDC Healthy People 2000

Benefits of Regular Exercise

Lowers risk of coronary artery disease by up to 35% Promotes weight loss/maintenance Improves cholesterol levels Improves glucose metabolism/insulin sensitivity Lowers blood pressure Decreases depression, anxiety, stress Helps prevent osteoporosis Reduces dementia

How Much? 30-60 minutes How Often ? 5-7 days/week How Hard? Moderate to vigorous ( a level that feels “somewhat hard to you” )

EXERCISE RX !!!

Exercise

Start gradually Do what you can comfortably

manage and sustain Anything is better is nothing Get as close to the recommended

daily dose as possible Include strengthening 3 x week

PEDOMETERS

10,000 STEPS A DAY

BENEFITS OFTREKKING POLES

INCREASES EXERCISE INTENSITY AND CALORIE BURN BY 20-50%

USES SEVERAL MORE UPPER BODY MUSCLES

DECREASES IMPACT ON KNEES

INCREASES STABILITY AND DECEASES INJURY

CHOOSE YOUR WEAPON !!!!!

D and enjoy !!!

YOU DON’T HAVE TO EXERCISE EVERY DAY……..

ONLY ON THE DAYS YOU EAT……

The victory is not always to the swift,

but to those who keep moving

anonymous

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LIFESTYLE INTERVENTION You CAN’T change where you came from…….. You CAN change where you are going……