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ALL TOGETHER PUTTING IT

Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

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Page 1: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

ALL TOGETHER

PUTTINGIT

Page 2: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

Normal Coronary Arteries

Page 3: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

Mild Coronary Artery Disease

Page 4: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

Severe Coronary Artery Disease

Page 5: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

Healthy EatingExercise

Weight ManagementLipid control

No smokingBlood pressure control

Stress management

Page 6: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

NEW FOOD PYRAMID

Walter C. Willet, MDEat, Drink and Be Healthy

Page 7: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of
Page 8: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of
Page 9: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of
Page 10: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of
Page 11: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of
Page 12: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

Cost of Inactivity

Inactivity costs at least $24 billion a year according to the Harvard School of Public Health

Men who became fit had a 53% reduction in direct healthcare costs

(Med Sci. Sports Exercise, 2004)

Page 13: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of
Page 14: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of
Page 15: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of
Page 16: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of
Page 17: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

THE BATTLE OF INTAKE AND OUTPUT

Page 18: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

THE BATTLE OF INTAKE AND OUTPUT

Page 19: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

THE BATTLE OF INTAKE AND OUTPUT

Page 20: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

THE BATTLE OF INTAKE AND OUTPUT

Page 21: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

WALKING 1 MILE

BURNS100 CALORIES

(3600 CALORIES = 1 POUND BODY WEIGHT)

Page 22: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

DAILY

EXERCISE SHOULD BE THE GOAL

IT IS THE KEY TO PUTTING A

HEALTHY LIFESTYLE TOGETHER

Page 24: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

LOWERS CARDIOVASCULAR RISK

IMPROVES CHOLESTEROL & GLUCOSE LEVELS

IMPROVES BLOOD PRESSURE

MAINTAINS BONE DENSTY

ENHANCES MOOD

ESSENTIAL FOR WEIGHT LOSS / MAINTENANCE

ESSENTIAL FOR NORMAL OR UNDERWEIGHT

**MORE ABOUT BEING FIT THAN HOW YOU LOOK

Benefits of exercise

Page 26: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

“If exercise could be put in a pill, it would be the most widely prescribed medicine in the world.”

Dr. Robert N. Butler, National Institute on Aging

Page 27: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

IS NOT ROCKET SCIENCEBUT

IT IS A HUGE BEHAVIORAL CHALLENGE

PUTTTING IT ALL TOGETHER

Page 28: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

Behavior change is a work in progress….

starting with

being uninterested, unaware, or unwilling to change

to considering a change

“I know I need to.. BUT…I don’t have time, can’t afford it. etc”

to deciding and preparing to make a change

buying a treadmill, joining Weight Watchers

To taking action

using the treadmill, following Weight Watchers

Page 29: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of
Page 30: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

NIKE HAS IT RIGHT……

……. JUST DO IT !!!!!

Page 31: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of
Page 33: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

Profile of an atypical patient

41 y/o man, father of 3 childrenNon smokerAthletic (biking 40-80 mi per wk)Mildly abnormal lipidsStressVery mildly overweightQuit smoking 1993

Page 34: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

On 7-23-07 wakened with chest pain

Went to local emergency room

Blood test confirmed heart attack

Transferred to DHMC

Cardiac cath with stent placement

Referral to Cardiac Rehab

His story…………

Page 35: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of
Page 36: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of
Page 37: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

His numbers

Wt: 203 lbsWaist: 41 inBody fat: 27 %

(55 lbs)BMI: 30.1

entry ideal

< 4016 %

< 25

Total chol: 165 <180LDL chol: 79 < 70HDL chol: 50 > 45

6 weeks

179 lbs36.5 in14.8%

(32 lbs) (26.4 lbs)

26.4

8232

5 months

164 lbs33 in9 %(14.7 lbs)

24.3

175 lbs

42

Page 38: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

HIS BODY COMPOSITION CHANGE

LOST 39 POUNDS !

8 INCH DECREASE IN WAIST CIRCUMFERENCE !

18 PERCENT DECREASE IN BODY FAT !

5.8 DECREASE IN BODY MASS INDEX !

Page 39: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of

Kris… before

Page 40: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of
Page 41: Putting it All Together - Dartmouth-Hitchcock · essential for weight loss / maintenance. essential for normal or underweight **more about being fit than how you look. benefits of