Tests: Knowing and Tests: Knowing and Understanding Your Understanding Your

NumbersNumbers

Provided Courtesy of RD411.comWhere health care professionals go for information

Review Date 10/09 G-1122Contributed by Shawna Gornick-Ilagan, MS, RD, CWPC

Disclaimer

• This presentation should not substitute or replace any medical advice provided by your doctor

• This presentation is meant to provide you with general health information to empower you to take charge of your health

Objectives

• Why get started?• What are biometric screen

tests• What do the numbers

mean?• What can you do about your

numbers?

Leading Causes of Deaths

• 1st place• 2nd place• 3rd place• 4th place• 5th place

Causes of Death

• Heart disease: 652,091• Cancer: 559,312• Stroke: 143,579• Chronic lower respiratory diseases:

130,933• Accidents: 117,809• Diabetes: 75,119• Alzheimer’s disease: 71,599• Influenza/pneumonia: 63,001• Kidney disease: 43,901

Source: Centers for Disease Control and Prevention. Available at: www.cdc.gov.

What Causes Heart Disease/Stroke?

• Arteries—blood vessels that carry blood away from the heart to the rest of the body

Normal Artery

Plaque Starts to Build Up

Tear in Artery Wall

Tear in Artery Wall

Plaque Can Grow and Harden and Obstruct the Artery

Tear in Artery Wall

Tear in Artery Wall

Atherosclerosis

Ischemic Stroke

Heart Attack

What Increases Risk?

You Can Not Help• Age

– Men: >45 years– Women: >55

years

• Sex• Race• Family history

You Can Help• Smoking• Alcohol• Poor diet• Overweight/obesity• Diabetes• Physical inactivity• High cholesterol• High blood

pressure

Randy Pausch

“We can't change the cards we’re dealt, just how we play the hand.”

How Can You Play the Cards?

Biometric Screening Tests

• BMI• Blood pressure• Lipid Panel

– Total cholesterol– High-density lipoprotein (HDL)– Low-density lipoprotein (LDL)– Triglycerides

• Blood glucose• A1c

Body Mass Index (BMI)

• BMI is a number calculated from a person’s weight and height

• Higher BMI values are associated with risks for health problems

• Visit http://www.cdc.gov/healthyweight/assessing/bmi/

BMI Goal=Less Than 25

BMI

(kg/m2)19 20 21 22 23 24 25 26 27 28 29 30 35 40

Height Normal Weight Increased Risk High Risk58 91 96 100 105 110 115 119 124 129 134 138 143 167 191

59 94 99 104 109 114 119 124 128 133 138 143 148 173 198

60 97 102 107 112 118 123 128 133 138 143 148 153 179 204

61 100 106 111 116 122 127 132 137 143 148 153 158 185 211

62 104 109 115 120 126 131 136 142 147 153 158 164 191 218

63 107 113 118 124 130 135 141 146 152 158 163 169 197 225

64 110 116 122 128 134 140 145 151 157 163 169 174 204 232

65 114 120 126 132 138 144 150 156 162 168 174 180 210 240

66 118 124 130 136 142 148 155 161 167 173 179 186 216 247

67 121 127 134 140 146 153 159 166 172 178 185 191 223 255

68 125 131 138 144 151 158 164 171 177 184 190 197 230 262

69 128 135 142 149 155 162 169 176 182 189 196 203 236 270

70 132 139 146 153 160 167 174 181 188 195 202 207 243 278

71 136 143 150 157 165 172 179 186 193 200 208 215 250 286

72 140 147 154 162 169 177 184 191 199 206 213 221 258 294

73 144 151 159 166 174 182 189 197 204 212 219 227 265 302

74 148 155 163 171 179 186 194 202 210 218 225 233 272 311

75 152 160 168 176 184 192 200 208 216 224 232 240 279 319

76 156 164 172 180 189 197 205 213 221 230 238 246 287 328

Maintain a Healthy Weight

Body Mass Index (BMI)Underweight <18.5

Normal Weight 18.5-24.9

Overweight 25-29.9

Obesity 30+

Benefits of Weight Loss (cont’d)

• Weight loss:– Reduces risk for cardiovascular disease– Lowers blood pressure– Lowers blood sugar– Improved lipid levels

Source: Office of Surgeon General. Available at: http://www.surgeongeneral.gov/topics/obesity/calltoaction/1_6.htm.

Blood Pressure

• What is blood pressure?– Pressure created by the heart as it pumps

blood through the arteries and the circulatory system

• What do blood pressure numbers mean?

– Top number (systolic)=pressure while heart is beating

– Bottom number (diastolic)=pressure while heart is resting, between beats

Blood Pressure (cont’d)

• How can I tell if I have high blood pressure”

• Typically no symptoms—”silent killer,” but could experience

– Headache– Blurred vision– Dizziness– Nausea

Blood Pressure (cont’d)

• Over time, high blood pressure can damage:

– Blood vessels– Vision– Heart and other organs– And increase your risk for heart attack, stroke,

and kidney failure• A reduction of as small as 2 mm Hg in

the average American’s systolic blood pressure could save more than 70,000 lives per yearmmHg=millimeters of mercury

Source: www.nih.gov

Blood Pressure (cont’d)

Blood PressureSystolic/Diastolic

Classification

<120/<80 Normal

120-139/80-90 Prehypertension

140-159/90-99 Stage 1 hypertension

>160/>100 Stage 2 hypertension

>180>110 Severe hypertension

Lipid Panel: Why Get Tested?

• To determine risk of coronary heart disease, heart attack, and stroke

• One in seven adults are high risk• Worldwide=4.4 million deaths

Lipid Panel (cont’d)

Every 5 years starting at age 20:• Total cholesterol, if elevated

associated with heart disease• HDL (healthy cholesterol)• LDL (lousy cholesterol)• Triglycerides

Total Cholesterol

• Every 1% reduction in your cholesterol, reduces your risk of heart disease by 2%-3%

Total Cholesterol Category

Less than 200 mg/dL Desirable

200-239 mg/dL Borderline high

240 mg/dL and above High

dL=deciliter, mL=milliliter

LDL (Lousy) Cholesterol

• LDL=low-density lipoprotein

dL=deciliter, mL=milliliter

LDL Value Category

Less than 100 mg/dL Desirable

100-129 mg/dL Elevated

130-159 mg/dL Borderline high

160-189 mg/dL High

190 mg/dL+ Very high

Decrease Saturated and Trans Fats

Harmful fat

Food source

Saturated Fat

Animal products (meat, poultry, eggs, dairy products, lard, and butter), and coconut, palm, and other tropical oils

Trans Fat Partially hydrogenated vegetable oils, commercial baked goods (cookies, crackers, and cakes), fried foods (doughnuts and French fries), shortening, and margarine

Pay Attention To These Limits

Calorie Level

Total Fat Grams

Saturated Fat Grams

Trans Fat Grams

1200 33-40 <9 <2

1400 39-37 <11 <2

1600 44-53 <12.5 <2

1800 50-60 <14 <2

2000 55-67 <15.5 <2

2200 61-73 <17 <2

Limit Trans Fat and Saturated Fat

Choose Instead ofWhite-meat chicken or turkey without skin

Red meats and organ meats

92% lean ground beef Regular ground beef

Egg whites or egg substitute Whole eggs with yolks

Fat-free or low-fat milk and dairy products

Whole milk

Fresh fruit and vegetables with low-fat dressing or hummus

Potato chips and dip

Opt for Healthy Fats

• Replace saturated fat with monounsaturated fat to lower your LDL and increase your HDL

• Monounsaturated fats include: – Olive oil– Canola oil– Olives– Avocados– Peanut butter– Many nuts and seeds

Opt for Healthy Fats (cont’d)

• Sources of omega-3 fatty acids include:– Flaxseed– Walnuts– Salmon– Soybeans– Halibut– Shrimp– Snapper– Tofu– Etc

Opt for Healthy Fats (cont’d)

• American Heart Association recommends eating fish at least twice a week

• One serving of fish is 5 ounces (oz) (3 oz is the size of a deck of cards)

HDL (Healthy) Cholesterol Levels

• Every 1 mg/dL increase in your HDL lowers your risk of heart disease 2%-5%

HDL “Healthy” Cholesterol Levels

Men <40 mg/dLWomen <50 mg/dL

Coronary artery disease (CAD) risk

60 mg/dL or higher Protects you from CAD

Triglycerides

• Your body uses alcohol, extra calories, and sugar to produce this type of fat in the blood

Triglycerides

Less than 150 mg/dL Desirable

150-199 mg/dL Borderline high

200 mg/dL or higher High

Glucose: Why Get Tested?

• Glucose test measures the sugar level in your blood to screen for, diagnose, and monitor:– Hyperglycemia– Hypoglycemia– Diabetes– Prediabetes

Glucose: Why Get Tested? (cont’d)

• Blood glucose tests are performed:– During a regular physical– When symptoms suggest hyperglycemia

or hypoglycemia– During pregnancy– When you have diabetes– Starting at age 45 and every 3 year if

normal results

Blood Glucose

• Fasting plasma glucose: Must fast for 8 hours or longer

Plasma Glucose Results (mg/dL)

Diagnosis

99 or below Normal

100-125 Prediabetes

126 or above Diabetes

Good News!

Preventable

85%-90% of Diabetes Is Preventable

Normal Process

Insulin

Diabetes: Type 1

Diabetes: Type 2

Insulin = Fat

Hemoglobin A1c

Why get tested?• To monitor a

person’s diabetes and to aid in treatment decisions

When to get tested?

• When first diagnosed with diabetes and then two to four time per year

A1c Readin

g

Average Blood Sugar

Level

6% 135 mg/dL

7% 170 mg/dL

8% 205 mg/dL

9% 240 mg/dL

10% 275 mg/dL

11% 310 mg/dL

12% 345 mg/dL

Tips to Maintain a Healthy Weight

• Do not drink calories• Eat slowly• Stay hydrated• Try the low-fat or nonfat version of foods• Change habits• Eat three meals each day• Focus on fruits and vegetables• Get enough fiber

Healthy Plate Format

• One fourth plate starch

• One fourth plate meat

• One half plate nonstarchy vegetables

• 8 fluid ounces of reduced-fat milk

• One serving of fruit

7 Steps for Improving Your Numbers

1. Weight management—losing 5%-10% of your weight

2. Limit trans fat and saturated fat3. Limit extra sugars4. Opt for healthy fats5. Eat enough fiber6. Exercise regularly7. Do not smoke and limit alcohol

Questions?