Health Tips for Ministers

Workers’ MeetingsSouth Queensland Conference

February 21 2006Dr Bevan Hokin

Today’s programme

• 9:30-10:30 Lifestyle, diet, exercise and diabetes and heart disease

• 10:30 -11:00 Break• 11:00 - 12:00 Vitamin B12 and you• 12:00 - Your results: what do they

mean? Your questions

Lifestyle, diet, exercise and diabetes and heart disease• Introduction to the food groups

– carbohydrates energy source– fats energy source and storage– protein growth, repair and

reproduction– Vitamins and body regulators -

minerals metabolic co-factors– Water– Fibre

Energy - body fuels

• Cannot be created or destroyed - but it can change its form

• Body obtains its energy in the form of chemical energy from the food we eat

• Food energy is measured in K Joules (used to be calories: 1 calorie = 4.2 KJoules

Food sources of energy I

Food class Calories/gmKJoules/gm

• Carbohydrates: 4 17• Proteins 4 17• Fats 11 45

How much energy do I need each day?? (K Joules for men by age grouping)Desirable 20-39 40-59 60-79weight60 kg 9500-10200 9200-9400 7500-

7900

70kg 11300-12100 10400-10600 8300-9000

80kg 13200-14000 11500-12100 9200-10000

How much energy is contained in some common foods?• Apple pie moderate serving1257• Baked beans 1 cup 1173• Banana split with icecream 2095• Hot cross bun with butter and jam 1264• Cheese cheddar 1 slice (28 gm) 460• Cheese omelette (2 eggs) 1089• KFC average serving 1173

How much energy is contained in some common foods?• Asparagus 6 spears /serving 75• Weet-bix1 biscuit 209• Cabbage 1 cup 126• Carrot 1 cup raw or boiled 188• Celery 6 large stalks 63• Fresh fruit salad -average serving 377• Green beans fresh or frozen 1 cup 63

Energy content of potato

• Plain boiled 1 medium 356

Energy content of potato

• Plain boiled 1 medium 356• Mashed with milk and butter 1/2 cup 398

Energy content of potato

• Plain boiled 1 medium 356• Mashed with milk and butter 1/2 cup 398• Baked 1 medium 524

Energy content of potato

• Plain boiled 1 medium 356• Mashed with milk and butter 1/2 cup 398• Baked 1 medium 524• Roasted 1 medium 922

Energy content of potato

• Plain boiled 1 medium 356• Mashed with milk and butter 1/2 cup 398• Baked 1 medium 524• Roasted 1 medium 922• French fried 8 chips 943

Energy content of potato

• Plain boiled 1 medium 356• Mashed with milk and butter 1/2 cup 398• Baked 1 medium 524• Roasted 1 medium 922• French fried 8 chips 943(and who eats only 8 chips at a

sitting?!)

Food sources of energy II

The body can inter-convert carbohydrates, fat and protein

CHOFatsProteinSo not only is what you eat important, but how much you eat

CHOFatsProtein• Energy cannot be created or

destroyed…• Consume more of ANY food than

necessary will result in the energy excess having to go somewhere

• If it is not ‘burnt’ through exercise it will be stored as fat

Foodconsumed

Digested in stomachNutrients absorbedthrough small intestine

Absorbed nutrientstransported to the liverInterconversion of Fats,carbohydrates andprotein occurs as thebody needs dictate

Nutrients released intothe blood stream for useby body cells

Liver and pancreascontrol blood glucoselevels. As glucose levelsincrease, more insulin isproduced to force downserum glucose levels.

More energyavailable thanneeded?

Increasedexercise burnsexcess energy

Excess energystored as FAT

Diabetes

• Three types;– Type 1 - Insulin dependent. Caused by the

pancreas not producing adequate functional insulin

– Type 2 - Non-insulin dependent. Body produces insulin, but it cannot be used due to resistance caused by excess stored fat and/or ‘fatty liver’

– Type 3 - Gestational diabetes - a transient (but significant) diabetes which occurs during pregnancy

Type II Diabetes

• Lifestyle and diet related– too much refined carbohydrate in diet– too little exercise– overweight

Why is diabetes so serious?• Disease of glucose metabolism with risk

of hypo- and hyper-glycaemic attacks• Glycosylation of proteins (including blood

cell surfaces) making them ‘sticky’• Vascular diseases result: increased risk

of:– heart disease– renal failure– blindness and deafness– stroke

Prevention of diabetes (Type II)• Consume the correct amount of KJoules (food,

calories)• Focus on fresh fruits and vegetables• Avoid refined carbohydrates• Avoid fatty foods• Use whole grains where possible including

wholemeal bread• Follow a high fibre low fat diet• Engage in a regular exercise programme• Maintain ideal weight

Treatment of diabetes (Type II )• Loose weight• Consume the correct amount of KJoules (food,

calories) to achieve then maintain your ideal weight• Avoid refined carbohydrates esp. sugars• Follow a high fibre low fat diet- lots of fruit and

veges• Use whole grains where possible including

wholemeal bread• Engage in a regular exercise programme• Follow your doctor’s advice - tablets can assist with

glucose control

Blood fats and heart disease

Heart disease

• 1 person in 3 will die of heart disease• A “Heart attack” and death will be the

first symptom for about a half of those affected

• A heat attack occurs when a blockage in one of the coronary arteries causes inadequate blood flow (and hence oxygen supply) to part of the heart muscle and as a result that part of the heart muscle dies.

Preventing sudden death from heart attack• Strategies to prevent heart attack:

– don’t allow the coronary arteries to become occluded with fatty deposits. Control blood fats and cholesterol

– prevent artery lining from becoming damaged thus allowing debris to adhere (diabetes, homocysteine)

– prevent blood clots from forming

Blood fats

• Two main types:– Triglycerides– Lipoproteins and Cholesterol

Triglycerides

GLYCEROL

Fatty acid

Fatty acid

Fatty acid

Lipoprotein• Spherical molecules made up cholesterol

fats and protein in differing proportions:– HDL high proportion of protein, low amount

of cholesterol– LDL Moderate amounts of both cholesterol

and protein– VLDLSmall amounts of protein, large

amounts of cholesterol

• These are three of several combinations...

Foodconsumed

Digested in stomachNutrients absorbedthrough small intestine

Absorbed nutrientstransported to the liverInterconversion of Fats,carbohydrates andprotein occurs as thebody needs dictate

Nutrients released intothe blood stream for useby body cells

Liver controls themanufacture storageand destruction ofall blood fats

Triglycerides available for cells to convertinto energy or store

Low density lipoproteins transported to cellsfor utilisation eg manufacture or repair ofcell membranes

Some Cholesterol from low-densitylipoproteins sticks to artery walls

HDL Cholesterol is the transportform of lipid/cholesterol that hasbeen removed from cells andblood vessel walls – returned toliver for destruction andremoval

Arteriosclerosis

• Thickening of the artery walls• One important cause is the deposit of

cholesterol in the arterial wall• This deposit is reinforced with calcium

salts• Lumen of artery is occluded such that a

blockage would be more likely in the event of a small clot or broken off piece of plaque.

Contributing factors to arteriosclerosis formation• Damage to vessel wall e.g. from

elevated homocysteine concentrations• High blood pressure• Diabetes• Lack of exercise• High levels of cholesterol• Sex (gender)• Smoking

How to prevent heart disease• Maintain ideal weight through a healthy

diet and exercise programme• Enjoy a healthy diet low in saturated fats• Maintain a low cholesterol/HDL ratio (<4.5)• Avoid diabetes. If too late, control it

carefully• Engage in a regular exercise programme• Develop a low stress lifestyle through a

deep faith in God’s leading

Role of HDL

• So-called ‘good cholesterol’• HDL is cholesterol that is being transported

back to the liver for destruction• Ration of total cholesterol/HDL cholesterol

should be < 4.5 and preferably <4.0• Can increase HDL by exercise• I have never seen a vegetarian at or below

his ideal weight with abnormal blood lipids

If you have heart-disease risk factors…..• Control blood pressure• Control diabetes• Increase exercise (minimum of 3

hours/week on non consecutive days)• Healthy diet low in fats especially saturated

fats• Monitor cholesterol and keep low• Consider medication…. E.g. low dose aspirin• Lower homocysteine levels to <10 umol/L

Conclusions

• The Adventist Church-recommended diet most closely complies with these recommendations and when followed, does result in a reduced incidence of diabetes and heart attack.

High fibre, low saturated fat, an abundance of fruit and vegetables, adequate protein, and micronutrients.

• A Vegetarian diet was for many years ridiculed. In the 60’s vegetarianism started to be tolerated; in the 80’s vegetarianism became accepted. Now vegetarianism is acclaimed.

Question time

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