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Weight Management Week 5

Health implications from weight: High blood pressure, cholesterol, and diabetes. Weight Management Week 5. Health Education AdvanceMed Hanford (509) 376-3939. Review. Carbohydrates and Fiber Carbs=50% of total calories Complex carbs Fiber=About 25 grams per day Protein

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Weight Management Week 5

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  1. Health implications from weight: High blood pressure, cholesterol, and diabetes. Weight Management Week 5 Health Education AdvanceMed Hanford (509) 376-3939

  2. Review • Carbohydrates and Fiber • Carbs=50% of total calories • Complex carbs • Fiber=About 25 grams per day • Protein • Protein=25% of total calories • Lean protein • Fat • Fat=25% of total calories • Unsaturated fat • Exercise • Cardiovascular exercise and heart rate training • Weight training for strength, bone mass, lean muscle, and injury prevention • Stretching for flexibility, coordination, and injury prevention

  3. What is Cholesterol? Fat substance (lipid) present in cell membranes, digestive acids, and hormones. Cholesterol moves through the body in packages called “lipoproteins”. Cholesterol is important and necessary in the body, but too much cholesterol can lead to serious health problems.

  4. Plaque buildup: the movie http://www.medmovie.com/mmdatabase/MediaPlayer.aspx?ClientID=67&TopicID=573

  5. Diseases associated with high cholesterol

  6. Types of Cholesterol

  7. HDL Cholesterol Should be 60 or higher • HDL-High Density Lipoproteins • The “Good” Cholesterol • Protective to the body. • Removes excess cholesterol from artery walls. • Returns it to the liver for reprocessing • If these are low, the risk for coronary artery disease is increased. When HDLs are high, the risk for CAD is decreased. • Can be raised by exercise and good nutrition.

  8. LDL & VLDL Cholesterol Should be less than 130 • VLDL-Very Low Density Lipoproteins • LDL-Low Density Lipoproteins • The “BAD” Cholesterol • Fat and cholesterol are deposited in your arteries by LDLs and VLDLs. • If these are high, so is risk for CAD. If LDLs are low, your risk for CAD is lower. • Can be lowered by exercise and good nutrition, weight control & medicine.

  9. The numbers…

  10. What about cholesterol ratio? Total HDL 5 1 = 5 or less LDL 100 HDL 30 Total 130 = 4.3 LDL 160 HDL 20 Total 180 = 9 LDL 160 HDL 70 Total 230 = 3.2

  11. Who can have high cholesterol? ANYONE Thin vs. overweight Younger vs. older Male vs. female Active vs. sedentary Healthy diet vs. unhealthy diet

  12. Cholesterol screening Adults over the age of 20 should be screened at least every 5 years. Early detection is VERY important to proper treatment and decreased risk of heart disease. Your health is YOUR responsibility, so if your doctor doesn’t offer the screening, ask for it.

  13. Additional risk factors • Cigarette smoking • Sedentary lifestyle • Overweight or obesity • Hypertension, otherwise known as high blood pressure (BP ≥140/90 mmHg or on antihypertensive medication) • Low HDL cholesterol (<40 mg/dL) • Family history of premature CHD (CHD in male first degree relative <55 years; CHD in female first degree relative <65 years) • Age (men 45 ≥years; women ≥55 years) • Menopause • Treatment options are based on the number of risk factors present.

  14. Food that can help lower cholesterol • Oat meal / oat bran: contains soluble fiber which lowers LDL. (also found in kidney beans, Brussels' sprouts, apples, pears, psyllium, barley and prunes.) • Walnuts & Almonds: Rich in polyunsaturated fats, walnuts and almonds help keep blood vessels elastic. • Omega 3 Fatty Acids: Known for lowering triglycerides, but also lowers blood pressure and risk of blood clots. (In people who have already had heart attacks, Omega 3 significantly reduces the risk of sudden death.) Doctors recommend 2 servings per week. Best sources include mackerel, lake trout, albacore tuna, salmon, herring, sardines, flaxseed, walnuts, canola oil, soybean oil.

  15. Food that can raise cholesterol • Processed foods like cookies and crackers. • Margarines (with trans fats) and butters • Coffee creamers • Baked goods, like donuts, cakes, dessert breads • Animal fats, such as the skin on chicken, fatty red meat, bacon, etc.

  16. What about eggs? A person with normal LDL levels (<100-130) should get no more than 300 mg of cholesterol per day. A normal sized egg with yoke has about 215 mg of cholesterol. Implications for the rest of the day…

  17. What can you do? Reduce intake of saturated and trans fats Reduce dietary cholesterol (animal products) Watch grams of cholesterol (<300 mg/day) Increase dietary fiber (~25 gr/day) Eat more vegetable protein, less animal protein Watch serving sizes Weight management Physical activity Medications: Statins

  18. High Blood Pressure (HBP) A higher than normal force of blood against the artery walls over a period of time. High blood pressure is also known as hypertension or pre-hypertension Can cause our blood vessels become hard or inflexible (atherosclerosis). The heart has to work much harder with atherosclerosis.

  19. Who can get HBP? • Anyone: regardless of race, age, or gender. • An estimated 1 in 4 adults in America have HBP. • Once diagnosed, HBP often lasts a lifetime. • People age 55 and up have a 90% chance of getting HBP in their lifetime.

  20. Effects of HBP on the body • Brain: HBP is the most important risk factor for stroke. Very high pressure can cause a break in a weakened blood vessel, which then bleeds in the brain. This can cause a stroke. If a blood clot blocks one of the narrowed arteries, it can also cause a stroke.

  21. Effects of HBP on the body • EYES: HBP can eventually cause blood vessels in the eye to burst or bleed. Vision may become blurred or otherwise impaired and can result in blindness.

  22. Effects of HBP on the body • ARTERIES: As people get older, arteries throughout the body "harden," especially those in the heart, brain, and kidneys. High blood pressure is associated with these "stiffer" arteries. This, in turn, causes the heart and kidneys to work harder.

  23. Effects of HBP on the body • KIDNEYS: The kidneys act as filters to rid the body of wastes. Over time, HBP can narrow and thicken the blood vessels of the kidneys. The kidneys filter less fluid, and waste builds up in the blood. The kidneys may fail altogether. When this happens, medical treatment (dialysis) or a kidney transplant may be needed.

  24. Effects of HBP on the body • Heart: HBP is a major risk factor for heart attack. The arteries bring oxygen-carrying blood to the heart muscle. If the heart cannot get enough oxygen, chest pain, also known as "angina," can occur. If the flow of blood is blocked, a heart attack results. • HBP is the number one risk factor for congestive heart failure (CHF). CHF is a serious condition in which the heart is unable to pump enough blood to supply the body's needs.

  25. What do the numbers mean Systolic: the pressure when your heart is contracting Diastolic: the pressure when your heart is relaxing Systolic/Diastolic

  26. What do the numbers mean Normal: <120 / <80 Prehypertensive: 120-139 / 80-89 Stage 1 hypertension: 140-159 / 90-99 Stage 2 hypertension: >160 / >100

  27. Tips to keep blood pressure down Maintain healthy weight Reduce salt Fiber EXERCISE Relax Avoid smoking Limit alcohol Medications if prescribed by doctor

  28. Diabetes: the problem • More than 20 million people in the U.S. have diabetes (6%) • More than 40 million people have prediabetes. • Diabetes in one of the fastest GROWING health problems. • Cost: • United States spends approximately $132 billion each year on diabetes • $92 billion in direct medical costs • $40 billion each year in indirect costs because of missed work days or other losses in productivity • $1 of $4 Medicare dollars is spent on diabetes • Diabetes is the 6th leading cause of death in the U.S.

  29. Washington - Percentage of Adults with Diagnosed Diabetes, 1994 - 2005

  30. Type 2 diabetes Type 2 diabetes is the most common type of diabetes. It occurs because the body doesn’t use insulin properly, a condition called insulin resistance. Over time, the cells that produce insulin cannot keep up with the body’s needs and diabetes develops.

  31. How the body gets energy: • The body is made up of millions of cells that need energy to function. • The food we eat is broken down into glucose. • The bloodstream transports glucose to the cell

  32. Insulin

  33. Cell Normal insulin response Sugar Insulin

  34. Type II Diabetes: Key Analogy • The key(s) to unlock the cells fit in the locks but will not turn to open the lock and allow the glucose in

  35. Cell Type 2 Diabetics response to insulin Sugar Insulin

  36. You are more likely to get type 2 diabetes if you: • are age 45 or older • are overweight • are not physically active • have a family history of diabetes • have high blood pressure or high cholesterol • had gestational diabetes—diabetes during pregnancy—or gave birth to a baby weighing more than 9 pounds • have blood glucose levels that are higher than normal but not high enough to be called diabetes • are African American, American Indian, Asian American, Pacific Islander, or Hispanic/Latino • have polycystic ovary syndrome • have dark, thick, velvety skin around your neck or in your armpits • have blood vessel problems affecting your heart, brain, or legs

  37. Visible Signs or Symptoms of Type 2 Acanthosis Nigricans Skin Tags

  38. Where should my glucose numbers be? • Most experts agree that the glucose levels in your blood plasma should be between 65-120 ml/dL following a 10 to 12 hour fast.

  39. Prediabetes • Fasting blood glucose level of 100-125 mg/dl • Proper action taken can delay and/or prevent Type 2 diabetes from developing.

  40. Hyperglycemia

  41. Hypoglycemia

  42. Long-Term Effects • Atherosclerosis – hardening of the arteries (stroke & heart disease) • Retinopathy – Impaired vision / blindness • Peripheral Vascular Disease – poor foot & leg circulation (amputation) • Nephropathy – kidney disease / failure • Neuropathy – nerve damage

  43. Symptoms of High Blood Sugar • Excessive urination • Increased thirst • Increased hunger • Unplanned weight loss

  44. Low Blood Sugar • Cause • Skipping meals • Increased activity • Taking too much medication • Changes in your body’s need for medication. • Alcohol • Symptoms: • Shaky or light-headed • Feeling weak • Breaking out in a cold sweat • Having a headache • Feeling jittery • Confused thinking • Slurred speech • Staggering • Uncontrolled anger • Blurred vision • Numbness

  45. Low blood sugar: what do I do? • Find quick acting sugar • Candy • Fruit juice • Sports drinks • Soft drink • Beware of choking hazards

  46. Goals that can help! • Eat at least 3 meals a day…don’t skip meals • Limit foods that are high in simple sugar • Eat a variety of foods • Choose foods that are high in dietary fiber • Limit saturated and trans fats • If you smoke, plan on quitting

  47. The numbers: a review • Cholesterol: • Total <200 • LDL <130 • HDL ≥ 50 • Ratio ≤ 5.0 • Blood pressure: • Normal ≤120/80 • Prehypertension 120-139/80-89 • Hypertension ≥ 140/90 • Blood glucose: • 65-120 ml/dL following a 10 to 12 hour fast

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