EAT HEALTHY CONTROL WEIGHT

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1 Keep It Simple There s a BIG LINK between diabetes, heart disease and stroke. In fact, 2 out of 3 people with diabetes die from cardiovascular disease, which affects the heart and blood vessels (arteries, veins and capillaries). These conditions also share common lifestyle risk factors. The good news is that simple daily habits can dramatically prevent and reduce the risk of these leading causes of death. Reduce Your Risk Take ACTION and feel better today by improving blood glucose, blood pressure and blood fats to prevent disease tomorrow. MOVE MORE Adults need at least: 150 minutes/week of moderate intensity aerobic activity 2 days/week of muscle-strengthening activities Kids (6-18) need at least: 60 minutes/day of moderate or vigorous intensity aerobic activity 3 days/week of muscle & bone strengthening activities BE TOBACCO FREE Detect Early. Get blood glucose levels tested. For heart disease, see your doctor to discuss risk factors, tests & procedures. Take action by making the lifestyle changes listed above; these can prevent, delay or slow disease progression! Work with your healthcare team to manage medications & monitor health numbers to prevent complications. EAT HEALTHY Mostly plants, fruits, & whole grains Fat-free or low fat dairy Lean meats, poultry, fish, beans, eggs and nuts Limit saturated/trans fats, sodium and added sugars Control portion sizes Limit alcohol CONTROL WEIGHT BMI is a useful measure of overweight and obesity. It is calculated from your height & weight. A loss of just 5-10% of your starting weight can greatly improve health if overweight or obese. Treat Right! F-Face: Ask the person to smile. Does one side of the face droop? A-Arms: Ask the person to raise both arms. Does one arm drift downward? S-Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange? T-Time: If you observe any of these signs, call immediately. MORE BENEFITS Being active & at a healthy weight: Relieves tension, anxiety, depression & anger Boosts energy & promotes optimism Increases longevity & quality of life QUICK TIPS Find your why and remind yourself daily: A strong motivator keeps you going! Set a goal and take small steps; walk 30 minutes, 5 days/week. Get support and manage your environment; find a class or set up reminders!

2 The Basics What is Diabetes? Diabetes is a disease in which blood glucose levels are above normal. Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. A hormone called insulin helps glucose get into the cells of our bodies. When you have diabetes, your body either doesn t make enough insulin or can t use its own insulin as well as it should causing sugar to build up in your blood. Over time, diabetes can lead to serious problems with your blood vessels, heart, nerves, kidneys, mouth, eyes and feet. The most serious problem caused by diabetes is heart disease. People can develop diabetes at any age. Both women and men can develop diabetes. People who are overweight and inactive are more likely to develop type 2 diabetes. From the American Diabetes Association: Diabetes Basics. Breaking it Down TYPE 1 The immune system attacks and destroys cells that make insulin. TYPE 2 Usually begins with insulin resistance; certain cells aren t using the insulin to carry glucose into cells for energy. At first, more insulin is produced to help glucose enter cells but, over time, the pancreas doesn t make enough insulin and treatment is needed. GESTATIONAL DIABETES Hormonal changes of pregnancy cause insulin resistance for all women in the third trimester. If gestational diabetes occurs, it often goes away after pregnancy. However, there is a greater chance of women developing type 2 diabetes later in life and the baby is more likely to develop obesity and type 2 diabetes. From the National Institutes of Health: Your Guide to Diabetes: Type 1 and Type 2. What is Heart Disease? The term heart disease refers to several types of heart conditions. The most common type is coronary artery disease, which can cause heart attacks. Other kinds of heart disease may involve the valves in the heart, or the heart may not pump well and cause heart failure. Some people are born with heart disease. For most, it occurs when a substance called plaque builds up in the arteries. When this happens, the arteries can narrow over time reducing blood flow to the heart. From the National Institutes of Health: What Causes Heart Disease? What is a Stroke? To work properly, your brain needs oxygen; it uses 20% of the oxygen you breathe. Your arteries deliver oxygen-rich blood to all parts of your brain. If something happens to interrupt the flow of blood, brain cells start to die within minutes because they can t get oxygen. This is called a stroke. Sudden bleeding in the brain can also cause a stroke if it damages brain cells. From the Centers for Disease Control: Conditions That Increase Risk for Stroke National Institutes of Health: Diabetes, Heart Disease and Stroke. Anyone, including children, can develop heart disease. Risk factors include: smoking, secondhand smoke, high amounts of certain fats and cholesterol in the blood, high blood pressure, insulin resistance or diabetes, and blood vessel inflammation. Anyone can have a stroke at any age. Some risk factors, like age and family history, cannot be controlled. Many others can be controlled, such as high blood pressure and cholesterol, heart disease, diabetes, and use of oral contraceptives.

3 Local Resources Healthy Eating Healthy eating is important to manage diabetes, improve heart health or to support weight loss. Providence Children s Center: Pavilion for Women & Children Family & Youth Classes services/womens-and-childrens-health/childrens-center/ Sea Mar Healthy Cooking Classes: Sea Mar CHC Everett Medical Clinic Senior Services Center for Healthy Living Food & Nutrition Services: Snohomish County Farmers Markets: snocofarmersmarkets.com Sno-Isle Food Co-op: snoislefoods.coop/events.php Verdant Health Commission Listing of local offerings & on-site sponsored classes: verdanthealth.org Washington State University Snohomish County Extension: extension.wsu.edu/snohomish YMCA s ACT! Actively Changing Together Youth Nutrition, Activity & Self-Improvement Program: Being Active Regular activity is important for fitness, weight management, reducing stress and improving blood sugar, blood pressure and blood fats (lipids). Providence Children s Center: Pavilion for Women & Children Family & Youth Classes womens-and-childrens-health/childrens-center/ YMCA s ACT! Actively Changing Together Youth Nutrition, Activity & Self-Improvement Program: Snohomish County Parks & Recreation: Also check out your city s local parks and recreation classes and resources! Weight Loss Support The Everett Clinic Weight Loss for Life: TOPS Take Pounds Off Sensibly: Area Captain: Darlene Wascher (360) Weight Watchers: Find a location at Education & Support Monitoring your condition, taking medication, reducing complications & healthy coping are critical to good self-care management. Pre-Diabetes & Diabetes Community Education Classes American Diabetes Association Stop Diabetes Initiative, South Snohomish County: Camp Sealth for Youth With Diabetes: The Everett Clinic Living with Chronic Conditions: Karen I. Fryberg Tulalip Tribes Health Clinic Diabetes Wisdom Warriors: HealthClinic.aspx Sea Mar Medical Clinic Everett: Swedish Diabetes Education Center: Senior Center Edmonds Living Well With Diabetes: Senior Services of Snohomish County Living Well Workshops: Verdant Health Commission Listing of local offerings & on-site sponsored classes: verdanthealth.org YMCA Snohomish County Pre-Diabetes Prevention Program: Some clinics and medical groups also provide referrals to clinic-sponsored classes and support. Other Diabetes Support Individual Education & Support: Check with your provider for access to endocrinologists, dietician education & pump training. Puget Sound Kidney Centers: Heart Disease Providence Regional Medical Center Cardiac Rehab Physician Referral: hospitals/regional-medical-center/services/heart-and-vascular-services/servicesand-treatments/cardiac-rehabilitation/ American Heart Association Online Support Network Stroke & Heart: supportnetwork.heart.org Stroke Providence Regional Medical Center Neurosciences Institute Stroke Support Group: washington.providence.org/events/nwr/stroke-stroke-center/ stroke-support-group National Stroke Association:

4 Know Your Numbers Blood Pressure Blood Fats (Lipids) BLOOD PRESSURE LEVELS FOR ADULTS (18+) CATEGORY SYSTOLIC DIASTOLIC Normal <120 <80 Prehypertension HIGH BLOOD PRESSURE STAGES STAGE STAGE 2 (Moderate) STAGE 3 (Severe) STAGE 4 (Very Severe) >210 >120 TEST NAME LAB RANGE DESIRABLE OPTIMAL Total Cholesterol mg/dL < Triglycerides mg/dl <100 <50 HDL mg/dl >60 >65 LDL mg/dl <100 <70 CHOL/HDL ratio <3.5 <2.5 TG/HDL ratio None <2.0 <2.0 LDL/HDL ratio <2.0 <2.0 Blood Glucose Chart AFTER 2-3 HOURS Mg/DL FASTING EATING AFTER EATING Normal Impaired Glucose Diabetic plus excellent good bad Blood Sugar Levels HbA1c MEAN BLOOD GLUCOSE Test mg/dl mmol/l Body Mass Index (BMI)

5 Fast Facts Diabetes It is estimated that 9.3% of the U.S. population has diabetes, 27.3% are undiagnosed. Diabetes is the 7th leading cause of death in Washington (2012). In Snohomish County, 9% of adults said they were diagnosed with diabetes (2015) and adults who reports being diagnosed with diabetes increased by 80% from Heart Disease Is the leading cause of death of U.S. adults 11.3% of population (2012). Coronary heart disease is the 2nd leading cause of death in Washington (2011). In Snohomish County, 5% of adults reported being diagnosed with heart disease (2015). Stroke Strokes are the 5th leading cause of death in the U.S. A stroke occurs every 40 seconds with someone dying every 4 minutes. Strokes are a leading cause of serious, long-term disability in the nation, and the 6th leading cause of death in Washington. References Leading Causes of Death (2012) Mental Health and Chronic Diseases (10/2012) Brief-No-2-Mental-health-and-Chronic-Disease.pdf Washington State, Snohomish County Chronic Disease Profile ( ) ChronicDiseaseProfileSnohomish.pdf A Close-Up, Chronic Disease in Snohomish County (May 2009) CDFinalReport5_09.pdf Today IS Tomorrow: Health and quality of life at all stages is mostly the result of behaviors and exposures over your lifetime! Health Risk Conditions Snohomish County - Youth Self Reported (2015) 51% report insufficient physical activity and 11% poor nutrition 45% reported academic risk 35% reported being depressed, 24% bullied and 21% suicidal ideations 19% reported drinking alcohol 17% report use of e-cigarettes, 16% use marijuana and 7% smoke cigarettes 10% classified as obese Health Risk Conditions Snohomish County - Adult Self Reported (2015) 39% report high cholesterol, 33% high blood pressure and 27% are obese 38% report insufficient physical activity and 9% poor nutrition 30% reported 3 or more adverse childhood experiences 18% report binge drinking 17% smoke cigarettes and 8% use marijuana 1 in 3 adults are prediabetic 93% don t know they have it! 75% of all U.S. health spending per year is for chronic disease! Did You Know? Who s Most At Risk? Reported for Washington State (2012) Common to diabetes, heart diseas7e and stroke: Older adults, American Indians and Alaska Natives, Native Hawaiians and other Pacific Islanders, and people in lower socioeconomic positions all experience a high prevalence. Diabetes: African-Americans, Hispanics and Asians. Stroke: African-Americans. DID YOU KNOW: Depression is found to co-occur in 17% of cardiovascular cases, 23% of cerebrovascular cases, and with 27% of diabetes patients