Total Wellness BIOMETRIC SCREENING What is Biometric Screening? MVNA Biometric Screening includes: BODY MASS INDEX BLOOD PRESSURE BLOOD SUGAR LIPID PROFILE 1
Why do we screen? These numbers are among the most critical in evaluating your health risks. These numbers facilitate chronic disease prevention. Immediate feedback on results can help you get on track with lifestyle changes. Early detection. A healthy life is a more comfortable life, physically and mentally. A healthy life is less expensive to you than an unhealthy lifestyle. BODY MASS INDEX (BMI) 2
Body Mass Index (BMI) A quick and easy calculation that offers a rapid assessment of your current health status It is a measure of body fat based on height and weight Calculating your BMI (without a BMI chart) 703 X weight in pounds = answer = BMI Height in inches height in inches For example: 703 X 150 = 105450 105450 = 1673.81 63 1673.81 = BMI of 26.7 63 3
BMI Classification Underweight Below 18.5 Normal 18.5 24.7 Overweight 25.0 29.9 Obesity 30.0 and above American Heart Association Updated: Aug 22,2013 Risk Factors for High BMI Sedentary lifestyle, decreased activity level Food intake greater than energy needs Increased foods with high fat, high sugar, restaurant eating Decreased fresh fruits, vegetables 4
BMI Results Tells you that if overweight or underweight you need to act! Overweight lose weight Underweight gain weight Normal weight maintain your healthy weight Either way, you decrease your risks of: High cholesterol & vascular heart disease High blood sugar and diabetes High blood pressure, heart attack and stroke BLOOD PRESSURE 5
BLOOD PRESSURE When your blood pressure stays within healthy ranges, you reduce the strain on your heart, arteries, and kidneys High blood pressure (Hypertension) single most significant risk factor for heart disease means the blood running through your arteries flows with too much force and puts pressure on your arteries, stretching them past their healthy limit and causing microscopic tears. Our body repairs these tears with scar tissue. Unfortunately, the scar tissue traps plaque and white blood cells which can form into blockages, blood clots, and hardened, weakened arteries. High blood pressure has no symptoms (aka silent killer ). One in three adults has high blood pressure. Many people do not even know they have it. Uncontrolled high blood pressure greatly increases risk for heart disease, heart attack and stroke. High Blood Pressure Risk Factors: Family history Age Gender related risk patterns men > women until 45 years of age. men = women From ages 45 to 64 women > men over age 60 Poor diet, especially one that includes too much fat, sugar and salt Sedentary work or lifestyle Overweight and obesity Drinking too much alcohol American Heart Association Updated: Sep 3,2013 6
Measuring Blood Pressure There are two numbers to know in your blood pressure: Systolic: top number, measures the work of your heart in while pumping (contraction) Diastolic: bottom number, measures the work of your heart while at rest (relaxation) ex: 117 68 American Heart Association, Updated: Mar 1,2013 American Heart Association Guidelines for Healthy Blood Pressure Normal < 120/ < 80 Pre Hypertension 120 139 / 80 89 High (stage 1) 140 159 / 90 99 High (stage 2) >160 / >100 Hypertensive Crisis >180 / >110 American Heart Association Updated: Mar 13,2014 7
Blood Pressure Even if your blood pressure is normal, you should consider making lifestyle modifications to prevent the development of high blood pressure and improve your heart health. When managing your blood pressure, you are lowering your risks for: heart attack heart failure stroke peripheral artery disease kidney disease BLOOD SUGAR 8
Blood Sugar Blood sugar or blood glucose refers to the sugar that is transported through the bloodstream to supply energy to all the cells in our bodies. The sugar is made from the food we eat. Normal blood sugar levels protect your vital organs. When you reduce excessive sugars, you are giving yourself the best chance for a healthy life. Hypoglycemia is defined as lower than normal blood sugar concentrations. Hyperglycemia is defined as persistent higher than normal blood sugar concentrations. Blood Sugar Parameters Normal Fasting glucose < 100mg/dL Pre DIABETES: Fasting glucose 100 125 mg/dl DIABETES: Fasting glucose > 126 mg/dl or Non Fasting > 200 mg/dl and diabetes symptoms:» Excessive hunger» Excessive thirst» Frequent urination» Abdominal pain» Weight loss (from muscle wasting) 9
Blood Sugar Why Control It? Persistent high blood sugar can lead to diabetes. The American Heart Association considers diabetes one of the six major controllable risk factors for cardiovascular disease. When diabetes occurs along with other heart disease risk factors such as obesity, high blood pressure and elevated cholesterol and triglycerides the risk of heart disease and stroke rises even more. Types of diabetes Type 1 diabetes Is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. Only 5% of people with diabetes have this form of the disease. The body does not produce insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. With the help of insulin therapy and other treatments, even young children can learn to manage their condition and live long, healthy lives. Type 2 diabetes Is the most common form of diabetes. If you have type 2 diabetes your body does not use insulin properly. This is called insulin resistance. At first, your pancreas makes extra insulin to make up for it. But, over time it isn't able to keep up and can't make enough insulin to keep your blood glucose at normal levels. Gestational (During pregnancy) Usually around the 24th week many women develop gestational diabetes. Doesn't mean that diabetes existed before you conceived, or that one will have diabetes after Giving birth. It's important to follow doctor's advice regarding blood sugar treatment. 10
Diabetes: Reasons to manage Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes The risk for stroke is 2 to 4 times higher among people with diabetes Diabetes is the leading cause of new cases of blindness among adults aged 20 74 years Diabetes is the leading cause of kidney failure, accounting for 44% of new cases in 2008. More than 60% of non traumatic lower limb amputations occur in people with diabetes Uncontrolled diabetes can complicate pregnancy. Birth defects are more common in babies born to women with diabetes. Data from the 2011 National Diabetes Fact Sheet (released Jan. 26, 2011) Metabolic Syndrome Metabolic syndrome occurs when a person has three or more of the following measurements: Abdominal obesity Triglycerides >150 (mg/dl) HDL cholesterol >40 mg/dl in men or >50 mg/dl in women Systolic blood pressure >130 (mm Hg) Diastolic blood pressure >85 mm Hg Fasting glucose >100 mg/dl Insulin resistance or glucose intolerance (the body can't properly use insulin or blood sugar) Affects about 35 percent of adults and places them at higher risk of cardiovascular disease, diabetes and stroke. The underlying causes of metabolic syndrome are: obesity being overweight physical inactivity genetic factors 11
LIPID PROFILE Lipid Profile Cholesterol levels should be measured at least once every five years in everyone over age 20. The screening test that is usually performed is a blood test called a lipid profile. Experts recommend that men ages 35 and older and women ages 45 and older be more frequently screened for lipid disorders. The profile includes: Total cholesterol LDL (low density lipoprotein cholesterol, also called "bad" cholesterol) HDL (high density lipoprotein cholesterol, also called "good" cholesterol) Triglycerides (fats carried in the blood from the food we eat. Excess calories, alcohol, or sugar in the body are converted into triglycerides and stored in fat cells throughout the body.) 12
Risk Factors Factors that affect an individual s lipid profile include: Age Sex Body weight Alcohol and tobacco use Exercise Genetic factors Medications Chronic disorders such as hypothyroidism, obstructive liver disease, diabetes, and kidney disease Why Control Cholesterol? High cholesterol is associated with an elevated risk of cardiovascular disease, which can include coronary heart disease, stroke, and peripheral vascular disease. High cholesterol has also been linked to diabetes and high blood pressure. 13
Cholesterol and Coronary Heart Disease The main risk associated with high cholesterol is coronary heart disease, the disease of the heart, itself. This is when the plaque that lines the coronary arteries of the heart, slow blood flow to the heart muscle. It is the reduced blood flow to the heart that causes chest pain. When a coronary artery is blocked completely it causes a heart attack. High Cholesterol and Stroke Stroke is caused by a blocked blood vessel or bleeding in the brain. Signs of a stroke include: Sudden severe headache Weakness Numbness Vision problems Confusion Trouble walking or dizziness Trouble talking or slurred speech 14
High Cholesterol and Diabetes Cholesterol and Diabetes Diabetes can upset the balance between HDL and LDL cholesterol levels. People with diabetes tend to have LDL particles that stick to arteries and damage blood vessel walls more easily. People with diabetes tend to have low HDL and high triglyceride levels, both of which boost the risk of heart and artery disease. Cholesterol and High Blood Pressure High blood pressure and high cholesterol also are linked. The arteries become less flexible (hardened) and narrowed with cholesterol plaque and calcium (atherosclerosis). The heart has to work much harder to pump blood through them. As a result, blood pressure becomes abnormally high. 15
Your best Number for: American Heart Association Updated:Nov 12,2013 Total Cholesterol < 200 Total Cholesterol Category Less than 200 Desirable 200 239 Mildly High 240 and above High YOUR BEST NUMBERS for: American Heart Association Updated:Nov 12,2013 HDL > 60 HDL Cholesterol HDL Cholesterol Category 60 and above High; Optimal; associated with lower risk Less than 40 in men and less than 50 in women Low; considered a risk factor for heart disease LDL Cholesterol <100 LDL Cholesterol LDL Cholesterol Category Less than 100 Optimal 100 129 Near optimal/above optimal 130 159 Borderline high 160 189 High 190 and above Very high 16
YOUR BEST NUMBER FOR: American Heart Association Updated: November 12, 2013 TRIGLYCERIDES < 150 Triglycerides Triglyceride Category Less than 150 Normal 150 199 Mildly High 200 499 High 500 or higher Very high Screening for Cholesterol and Glucose 17
Cholestech Machine Training Video It is highly recommended you view the Cholestech training video prior to the MVNA Open House. This video covers machine maintenance as well as performing a test. You will want to pay particular attention to running a test which starts at section 7 or 15:34 21:47 minutes on the tracker. You can view the training video at: http://www.alere.com/us/en/support/edu/product demos/cholestechldx.html Screening for Glucose and Cholesterol Cholestech Machine Lab accurate quality: Meets National Cholesterol Education Program (NCEP) guidelines Accurate and reproducible: Certified by the CDC s LSP and CRMLN programs* (the lipid testing accuracy standards) Rapid results: Immediate feedback enables on the spot CHD risk assessment and care decisions Easy to use: Simple 3 step procedure and convenient fingerstick sample Reimbursable: Medicare and various private payors cover 18
Preparing the Machine Prior to the clinic start: Optics Check Check the calibration (analyzer) Must be done on EVERY machine Quality Control Check Check cassette quality ONLY once per lot number Done on ONLY ONE machine Fingerstick tips Finger should be clean & dry Hand should be warm & relaxed Firm puncture on slightly off center from fat pad of finger (use ring finger, less calloused) Wipe first drop free Hold capillary tube at a slightly descending angle to the drop of blood (the pipette acts as a vacuum) Aim to fill capillary tube in 10 seconds (longer & you may increase risk of non reaction occurring.) 19
Filling the Pipette Fill to black line Pipette is heparinized. Collected blood can sit in tube for up to 4 minutes, but once on the cassette it must be placed in the Cholestech machine to avoid coagulating. Handling the Cassette : Keep flat Never removed from pouch until ready for use (they go bad) Loaded in machine with the brown stripe on the right Handle on the sides to avoid touching the magnetic strip (brown strip) Filling the Cassette 20
Operating the Cholestech Machine Step 1 Stick Step 2 Click Step 3 Results Collect finger-stick blood sample Place sample into test cassette Insert cassette and read results in 4-5 minutes Think 5 Minutes from Stick to Click! Troubleshooting If there is a type of problem, a message will appear on the screen. Remember: Good blood collection technique will decrease error readings! Properly performing Optics Checks and Quality Control Checks results in accurate tests! 21
DIET & EXERCISE Diet and Exercise Themes in Prevention Lose Weight? Start Walking/Eat Better Decrease BMI? Start Walking/Eat Better Lower Blood Pressure? Stop Smoking/Start Walking/Eat Better Lower Cholesterol? Start Walking/Eat Better Decrease Diabetes Risks? Stop Smoking/Start Walking/Eat Better 22
Diet: AHA Guidelines 5 Goals for Healthy Eating Eat more fruits and vegetables Aim for 4 5 servings each of fruits and vegetables every day Eat more whole grain foods Whole grain foods are low in saturated fat and cholesterol and rich in fiber. Whole grain foods include whole wheat bread, rye bread, brown rice and whole grain cereal Use liquid vegetable oils such as olive, canola, corn or safflower as your main kitchen fat Limit how much fat or oil you use in cooking use liquid vegetable oils (olive, canola, safflower) in place of solid fats. American Heart Association Updated:Feb 19,2014 American Heart Association Guidelines 5 Goals for Healthy Eating Eat more chicken, fish and beans than other meats Skinless poultry, fish and vegetable protein (such as beans) are lower in saturated fat and cholesterol than other meats (beef, pork and lamb). Read food labels to help you choose healthy foods. Food labels provide information to help you make better food choices. American Heart Association Updated:Feb 19,2014 23
Exercise: AHA Recommendations For Overall Cardiovascular Health: At least 30 minutes of moderate intensity aerobic activity at least 5 days per week for a total of 150 minutes OR At least 25 minutes of vigorous aerobic activity at least 3 days per week for a total of 75 minutes; or a combination of moderate and vigorous intensity aerobic activity AND Moderate to high intensity muscle strengthening activity at least 2 days per week for additional health benefits. American Heart Association Updated:Mar 6,2014 Safety Note Talk to your doctor before making any big change in your exercise plan 24
Physical Activity and Calories calories spent per hour by a 100, 150 and 200 pound person American Heart Association Updated: March 6, 2014 Activity 100 lb 150 lb 200 lb Bicycling, 6 mph 160 240 312 Bicycling, 12 mph 270 410 534 Jogging, 7 mph 610 920 1,230 Jumping rope 500 750 1,000 Running 5.5 mph 440 660 962 Running, 10 mph 850 1,280 1,664 Swimming, 25 yds/min 185 275 358 Swimming, 50 yds/min 325 500 650 Tennis, singles 265 400 535 Walking, 2 mph 160 240 312 Walking, 3 mph 210 320 416 Walking, 4.5 mph 295 440 572 25