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)
Obesity Trends* Among U.S. AdultsBRFSS, 1993
No Data <10% 10%–14% 15 %–19 %
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 1994
No Data <10% 10%–14% 15%–19%
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 1995
No Data <10% 10%–14% 15%–19%
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 1996
No Data <10% 10%–14% 15%–19%
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 1997
No Data <10% 10%–14% 15%–19% ≥20
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 1998
No Data <10% 10%–14% 15%–19% ≥20
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 1999
No Data <10% 10%–14% 15%–19% ≥20
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 2000
No Data <10% 10%–14% 15%–19 ≥20
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 2001
No Data <10% 10%–14 15%–19% 20%–24% ≥25%
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
(*BMI 30, or ~ 30 lbs overweight for 5’4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 2002
Obesity Trends* Among U.S. AdultsBRFSS, 2003
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Obesity Trends* Among U.S. AdultsBRFSS, 2004
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 2005
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
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