David Wright, MD Speaking of Women s Health Shawnee Mission Medical Center October 4, 2013

Transcription

1 David Wright, MD Speaking of Women s Health Shawnee Mission Medical Center October 4, 2013

2 David Wright, MD October 4, 2013 Speaking of Women's Health 2

3 Weight Gain, Diabetes, Heart Disease Overweight Diabetic Heart Disease October 4, 2013 Speaking of Women's Health 3

4 The Greatest Wealth is Health. ~Virgil Do you want to restore the vigor of your youth? Are you looking to cut back on your number of medications and doctor visits? Would you like to increase your longevity and create a higher quality of life? October 4, 2013 Speaking of Women's Health 4

5 The Greatest Wealth is Health. -Virgil October 4, 2013 Speaking of Women's Health 5

6 The Greatest Wealth is Health. ~Virgil Better Information Better Decisions Better Outcome October 4, 2013 Speaking of Women's Health 6

7 Nature of the Problem Abundance of Food Deficiency of Activity Especially high-calorie or emptycalorie foods. Six hours of sitting is equivalent to smoking x packs/day of cigarettes. Most of us are nutritionally illiterate October 4, 2013 Speaking of Women's Health 7

8 Movement is Medicine BUT You can t out-exercise a bad diet. One-third of American adults are overweight. One-third of American adults are obese. October 4, 2013 Speaking of Women's Health 8

9 Recently, the Journal of the American Medical Association reported on the leading causes of death over the past 20 years. Weight # 3 Diet is # 1 Inactivity # 6 October 4, 2013 Speaking of Women's Health 9

10 Heart disease is the primary killer of women. One of every three deaths is from heart attack or stroke. 800,000 deaths/year related to cardiovascular disease 2,200 per day 90 per hour 1 every 38 seconds October 4, 2013 Speaking of Women's Health 10

11 Heart disease is the primary killer of women. At least 25% of these deaths are preventable (under age 75) 200,000 per year are preventable 550 per day are preventable And 60 percent of these preventable deaths are people 65 and younger. October 4, 2013 Speaking of Women's Health 11

12 Diabetes Epidemic Predicted by CDC Currently, 8.3% of U.S. adults (26 million people) suffer from diabetes. By 2050, 33% (more than 100 million people) will have a form of diabetes. Predictors of risk: Dietary choices Tobacco use BMI/weight Activity level October 4, 2013 Speaking of Women's Health 12

13 Weight Gain, Diabetes, and Heart Disease October 4, 2013 Speaking of Women's Health 13

14 Weight Gain, Diabetes, and Heart Disease Insulin Resistance is the inability of the cells to respond normally to insulin, therefore greater quantities are required. Glycemic Load Index is the measure of a particular foods ability to raise the blood sugar. It is an indicator of the insulin requirement. October 4, 2013 Speaking of Women's Health 14

15 Weight Gain, Diabetes, and Heart Disease While insulin is necessary, it also has toxic effects Insulin is fat fertilizer Insulin is plaque fertilizer Plaque destabilizer Inflammation Rupture Heart attack/stroke October 4, 2013 Speaking of Women's Health 15

16 Glucose Insulin Response Curve October 4, 2013 Speaking of Women's Health 16

17 Low Glycemic Index Glucose Insulin Response Curve October 4, 2013 Speaking of Women's Health 17

18 Sequence of Events Wrong food choices High glycemic foods Sedentary lifestyle Life Stressors Living in the fast lane Inadequate sleep Toxic relationships Other October 4, 2013 Speaking of Women's Health 18

19 Insulin Resistance Sequence of Events You gain weight as diabetes begins to develop. Plaque corrupts your arteries. The plaque becomes inflamed. Destabilized plaque causes clots or ruptures. Heart Attack/Stroke Death 80 % of diabetics die of heart attack/stroke. October 4, 2013 Speaking of Women's Health 19

20 October 4, 2013 Speaking of Women's Health 20

21 This is Preventable! The doctor of the future will give no medicines, but will interest his patients in the care of the human frame, in diet, and in the causes and prevention of disease. ~Thomas Edison, October 4, 2013 Speaking of Women's Health 21

22 Am I at Risk? Diabetes is a dominant gene. 50% risk if a parent is diabetic. Heart attacks are linked to multiple genes. 1 st degree relatives: Men under 50 Women under 60 Stroke Aneurysms can be genetic. October 4, 2013 Speaking of Women's Health 22

23 Family History is Predictive BUT NOT DESTINY! October 4, 2013 Speaking of Women's Health 23

24 Body Mass Index Above 30 Obese Overweight Below 25 Ideal October 4, 2013 Speaking of Women's Health 24

25 October 4, 2013 Speaking of Women's Health 25

26 Metabolic Syndrome Waistline is the single best predictor. Men over 40 Women over 35 Fasting glucose (100 mg ldl or higher or on meds) True normal is below 88 October 4, 2013 Speaking of Women's Health 26

27 Metabolic Syndrome Blood pressure 130/85 or higher (or on meds) Triglycerides 150 mg/dl or above (or on meds). HDL below 40 mg/dl for MEN below 50 mg/dl for WOMEN October 4, 2013 Speaking of Women's Health 27

28 October 4, 2013 Speaking of Women's Health 28

29 Movement Risks Sitting for more than six hours a day. Same health risk as smoking one pack of cigarettes a day. October 4, 2013 Speaking of Women's Health 29

30 Movement Risks October 4, 2013 Speaking of Women's Health 30

31 Movement Risks Loss of muscle mass. 1 % a year starting at 40. Muscle burns cal/day/pound. October 4, 2013 Speaking of Women's Health 31

32 Cholesterol Myths 1. If my cholesterol is normal I won t have a heart attack. Truth: More than half of all heart attacks occur in people with a normal cholesterol. There are tests to find those at risk. October 4, 2013 Speaking of Women's Health 32

33 Cholesterol Myths 2. If I take a statin drug and lower my LDL cholesterol, I won t have a heart attack. Truth: Statin drugs only prevent about 1 out of 3 heart attacks the other two will still occur unless action is taken. October 4, 2013 Speaking of Women's Health 33

34 Cholesterol Myths 3. My doctor told me my HDL cholesterol is so high I ll never have a heart attack. Truth: We now know that not all HDL is protective and there are tests to help decide this. October 4, 2013 Speaking of Women's Health 34

35 Cholesterol Myths 4. Everyone in my family dies of a heart attack, so I know it s inevitable. Truth: Family history is predictive, not destiny, there are several genetic tests now available to uncover some of the reasons. October 4, 2013 Speaking of Women's Health 35

36 Need to Know Numbers Your: Waist Circumference BMI Fasting Glucose Blood Pressure Triglycerides HDL Total Cholesterol/LDL October 4, 2013 Speaking of Women's Health 36

37 Need to Know Numbers Two-hour glucose tolerance test. 75 g glucose in a warm solution. Below 100 at the start. Below 125 at one hour. Below 120 at two hours. October 4, 2013 Speaking of Women's Health 37

38 Put Yourself to the Test Take the 2 hour glucose tolerance test if you: Find plaque on any test. Have any features of Metabolic Syndrome. Have a fasting glucose above 88 mg/dl. Have a BMI above 25. Have a family history of diabetes. Are over age 65 or have a history of gestational diabetes. October 4, 2013 Speaking of Women's Health 38

39 Need to Know Numbers Advanced Lipid Testing Family History Metabolic Syndrome Before starting statin therapy Genetic testing Family history: Heart attacks, aortic aneurysms, cerebral aneurysms October 4, 2013 Speaking of Women's Health 39

40 Lowering My Risk 1. Never smoked, or quit more than a year ago. 2. Having a body mass index of less than 25 kg/m2. 3. Exercising at a moderate level for at least 150 minutes, or at an intense level for 75 minutes per week. 4. Meeting four to five of the key components of a healthy diet in line with current AHA guidelines. 5. Having a total cholesterol of less than 200 mg/dl. 6. Blood pressure below 120/80 mm Hg. 7. Fasting blood glucose below 100 mg/dl. October 4, 2013 Speaking of Women's Health 40

41 Diabetes Prevention Lose 7% of weight. 150 min aerobic activity weekly ~30mins 5 days a week Muscle resistance training 3 days/week. October 4, 2013 Speaking of Women's Health 41

42 October 4, 2013 Speaking of Women's Health 42

43 October 4, 2013 Speaking of Women's Health 43

44 Healthy Plate 9 Plate 25 % Lean Protein (deck of cards) 25 % Complex Carbs (tennis ball) 50% Fruits and Veggies (paperback book) Not starches Nothing fried No fruit juices October 4, 2013 Speaking of Women's Health 44

45 October 4, 2013 Speaking of Women's Health 45

46 Weight Loss Math 1 lb Muscle burns calories a day. A 1 mile walk or run burns 100 calories. 1 lb Fat = 3600 Calories 10 calories/day = 3650/year = 1 lb 100 calories/day = 36,500/year = 10 lb October 4, 2013 Speaking of Women's Health 46

47 Alternative Energy Your body is like a hybrid car which runs on gasoline or electricity, but not both simultaneously. In order to burn fat as fuel, you must turn off your insulin pump. October 4, 2013 Speaking of Women's Health 47

48 Action Plan Stop smoking. It s a deal breaker. Start moving. Movement is medicine. October 4, 2013 Speaking of Women's Health 48

49 Action Plan Choose best fuel sources. and control your portions. Drop Weight 10 % weight = 50 % health risks BMI below 25 Waistline below 32 for women; 37 for men. October 4, 2013 Speaking of Women's Health 49

50 Action Plan Control Blood Pressure Keep it below 120/80 Diabetics below 130/85 Lower Fasting Glucose to below 90 mg/dl October 4, 2013 Speaking of Women's Health 50

51 Action Plan Control Cholesterol Total below 200 mg/dl LDL below 100 mg/dl HDL above 60 mg/dl for WOMEN 50 mg /dl for MEN Triglycerides below 150 mg/dl Consider advanced lipid or genetic testing. October 4, 2013 Speaking of Women's Health 51

52 Resources October 4, 2013 Speaking of Women's Health 52

53 Cardiovascular disease is not just treatable, it s preventable. October 4, 2013 Speaking of Women's Health 53

54 Cardiovascular disease is not just treatable, it s preventable. October 4, 2013 Speaking of Women's Health 54

55 Cardiovascular disease is not just treatable, it s preventable. October 4, 2013 Speaking of Women's Health 55