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Tests: Knowing
and Understanding
Your Numbers
Contributed by Shawna Gornick-Ilagan, MS, RD, CWPC
Updated by Nutrition411.com staff
Review Date 6/14
G-1122
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 screening tests?
• What do the numbers mean?
• What can you do about your
numbers?
Leading Causes of Death
• 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
Centers for Disease Control and Prevention Web site. http://www.cdc.gov/. Accessed June 18, 2014.
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
Plaque Can Grow and
Harden and Obstruct
the Artery
Atherosclerosis
Ischemic Stroke
Heart Attack
What Increases Risk?
You cannot change:
• Age:
– Men: >45 years
– Women: >55 years
• Sex
• Race
• Family history
You can change:
• 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.”
Manage Your Weight
Exercise
Do Not Smoke
Eat Healthy
How Can You Play the
Cards?
Biometric Screening
Tests
• Body mass index (BMI)
• Blood pressure
• Lipid panel:
– Total cholesterol
– High-density lipoprotein (HDL)
– Low-density lipoprotein (LDL)
– Triglycerides
• Blood glucose
• A1c
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/assessi
ng/bmi/
BMI Goal=Less Than 25
BMI=body mass index
BMI
(kg/m2)
19
20
21
22
23
24
Normal Weight
Height
25
26
27
28
29
Increased Risk
30
35
40
High Risk
58
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
BMI
Underweight
<18.5
Normal Weight
18.5-24.9
Overweight
25-29.9
Obesity
30+
Benefits of Weight Loss
• Weight loss:
– Reduces risk for cardiovascular diseases
– Lowers blood pressure
– Lowers blood sugar
– Improves lipid levels
US Dept of Health & Human Services. Surgeon General’s calls to action. SugeonGeneral.gov website.
http://www.surgeongeneral.gov/topics/obesity/calltoaction/1_6.htm. Accessed June 18, 2014.
Blood Pressure
• What is blood pressure?
– Pressure created by the heart as it pumps blood
through the arteries and 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
– Other organs
• Over time, high blood pressure can increase
your risk for heart attack, stroke, and kidney
failure
US Dept of Health & Human Resources. National Institutes of Health website. www.nih.gov. Accessed June 18.
2014.
Blood Pressure (cont’d)
• A reduction as small as 2 mm Hg in the
average American’s systolic blood pressure
could save more than 70,000 lives per year
mm Hg=millimeters of mercury
US Dept of Health & Human Resources. National Institutes of Health website. www.nih.gov. Accessed June 18.
2014.
Blood Pressure (cont’d)
Blood Pressure
Systolic/Diastolic
<120/<80
120-139/80-90
140-159/90-99
Normal
Prehypertension
Stage 1 hypertension
>160/>100
>180>110
Stage 2 hypertension
Severe hypertension
Classification
Lipid Panel: Why Get
Tested?
• To determine risk of coronary heart
disease, heart attack, and stroke
• One in seven adults are at risk
• Worldwide=2.6 million deaths
Lipid Panel: Why Get
Tested? (cont’d)
• Every 5 years, starting at 20 years of age:
– Total cholesterol—if elevated, associated with
heart disease
– HDL (healthy cholesterol)
– LDL (lousy cholesterol)
– Triglycerides
Total Cholesterol
Total Cholesterol
Category
Less than 200 mg/dL
Desirable
200-239 mg/dL
Borderline high
240 mg/dL and above
High
Every 1% reduction in your cholesterol reduces
your risk of heart disease by 2% to 3%
dL=deciliter, mg=milligram
LDL (Lousy) Cholesterol
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
LDL=low-density lipoprotein
dL=deciliter, mg=milligram
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 of
White-meat chicken or turkey Red meats and organ meats
without skin
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
Fresh fruit and vegetables
with low-fat dressing or
hummus
Whole milk
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:
– Avocados
– Canola oil
– Olive oil
– Olives
– Many nuts and seeds
– Peanut butter
Opt for Healthy Fats
(cont’d)
• Sources of omega-3 fatty acids include:
– Flaxseed
– Halibut
– Salmon
– Shrimp
– Snapper
– Soybeans
– Tofu
– Walnuts
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
HDL “Healthy” Cholesterol Levels
Men: <40 mg/dL
Women: <50 mg/dL
Coronary artery
disease (CAD) risk
60 mg/dL or higher
Protects you from CAD
Every 1 mg/dL increase in your HDL
lowers your risk of heart disease 2% to 5%
dL=deciliter, mg=milligram
Triglycerides
Triglycerides
Less than 150 mg/dL
Desirable
150-199 mg/dL
Borderline high
200 mg/dL or higher
High
Your body uses alcohol, extra calories, and
sugar to produce this type of fat in the blood
dL=deciliter, mg=milligram
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 45 years of age and then every
3 years 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
dL=deciliter, mg=milligram
Good News!
85% to 90% of Diabetes Is Preventable
Preventable
Normal Process
Insulin
Diabetes: Type 1
Diabetes: Type 2
= Fat
Insulin
Hemoglobin A1c
• Why get tested?
–To monitor a person’s
diabetes and to aid in
treatment decisions
• When should you
get tested?
–When first diagnosed
with diabetes and then
two to four times/year
dL=deciliter, mg=milligrams
A1c
Average Blood
Reading
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 to eat low-fat or nonfat versions of foods
• Change habits
• Eat three meals/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 reducedfat milk
• One serving fruit
7 Steps for Improving
Your Numbers
1. Lose 5% to 10% of your weight
(if you are overweight)
2. Limit trans fat and saturated fats
3. Limit extra sugars
4. Opt for healthy fats
5. Eat enough fiber
6. Exercise regularly
7. Do not smoke and limit alcohol
Questions?
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