Toys, Testosterone & Technology
How To:
Make Good Nutritional Choices
Stop Smoking
Lose Weight
&
Be Physically Active
in 2013
Sarah Mildred Gamble, DO
Internal Medicine Physician
GPD Departmental Surgeon
02/05/13
About Me
• Police Officer Standards Training Council (POST)
Certified Instructor: 2010-Current
• Clinical Instructor: Columbia University College of
Physicians & Surgeons- NY, NY
• Solo Practitioner
Wife of 9 years to GPD’s Newest K-9 Officer
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Altos
Objectives
1. Understand how Poor Nutritional Choices, Tobacco,
Obesity & Inactivity THREATEN LEO’s
2. Understand that Poor Nutritional Choices, Tobacco,
Obesity & Inactivity cause DISEASE
3. Learn of New Ways to Stay Fitter & Faster
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Rule Before the Rules
Eliminate the Threat
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
The LEO Threat
Car Crash / Code 20
No Reflective Vest
No Seatbelt
No Body Armor
Unarmed Off Duty
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Threat
The LEO Threat
Poor Nutritional Choices
Tobacco Abuse
Obesity
Physical Inactivity
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Threat
End Result is The SAME
Poor Nutritional Choice Related Disease
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High Blood Pressure
High Cholesterol
Stroke
Cancer
Sleep Disorders
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Tobacco Related Disease
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High Blood Pressure
High Cholesterol
Respiratory Disorders
Stroke
Cancer
Sleep Disorders
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Obesity Related Disease
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High Blood Pressure
High Cholesterol
Respiratory Disorders
Stroke
Cancer
Arthritis
Sprains & Strains
Sleep Disorders
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Inactivity Related Disease
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High Blood Pressure
High Cholesterol
Cancer?
Sleep Disorders
Sprains & Strains
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Healthy LEO
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Good Nutritional Choices
No Tobacco Use
Ideal Body Weight (within 25 lbs.)
Physically Fit
Departmental Support for Wellness
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Unhealthy LEO
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Poor Nutritional Choices
Smoker
Obese (> 30 lbs. overweight)
Physically Deconditioned
No Departmental Support for Wellness
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Healthy Cops
Are Productive Cops
Are Good Role Models
Live QUALITY Lives
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Healthy LEO
Unhealthy Cops
Are Unproductive Cops
Are Publically Mocked
Live SHORT Lives
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Unhealthy LEO
Root Cause?
A Reason Why ‘Something’ Happened
Failure of Process
Root Causes
Depression / Mental Illness
Genetics / Addiction
Sleep Disorders
Hormone / Vitamin Deficiencies
Media Distortion
Lack of Education
Positive Reinforcement
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Rule Before the Rules
Eliminate the Threat
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
The LEO Threat
Poor Nutritional Choices
Tobacco Abuse
Obesity
Physical Inactivity
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Eliminate How?
• Toys
• Testosterone
• Technology
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Toys, Testosterone & Technology
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Apps
E-Cig / Quit Line / Texts / Body Bugs
Hormone/Vitamin D Replacement / Maintenance
Bioelectrical Impedance / DEXA Scan
RMR / VO2 Max / Flexibility
Sleep Study / Electronic Monitoring
Blood Work / Supplements
ECT / Deep Brain Stim / Transcranial Stim
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Why The Urgency?
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Root Cause of Poor Nutritional Choices
Learned Behavior
Depression / Mental Illness
Genetics / Addiction
Sleep Disorder
Lack of Education
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Threat
Threat
Good Nutritional Choice
Good Nutritional Choice Apps!
Good Nutritional Choice
http://www.hsph.harvard.edu/nutritionsource
Good Nutritional Choice
Good Nutritional Choice
http://www.cigna.com/individualsandfamilies/he
althwellness
Good Nutritional Choice
Good Nutritional Choice
Good Nutritional Choice
http://blog.greenwichpuremedical.com
Good Nutritional Choice
Threat
Threat
Cancer Stick Anyone?
Tobacco Kills People
#1 preventable cause of disease disability & death
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Root Cause for Smoking
Addiction
Media Distortion
Lack of Education
Positive Reinforcement
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Electronic Cigarette
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Latest Safest E-Cig Info
• BU School of Public Health 2010:
– Safer than real cigarettes
– Aid in breaking the habit of smoking
– Tox level similar to existing nicotine replacements
• Carcinogen is 1,000 times less
• May help by simulating a tobacco cigarette
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
1-800-Quit-Now
All 50 States
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Tobacco Apps
Tobacco Texts
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Threat
Threat
Technology for Hormone/Vitamin
Deficiency
• Blood Work
• Pharmaceutical Grade Replacements
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Testosterone?
Hormone made by body mostly in testicles (adrenals in women)
Helps:
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Maintain reproductive tissues
Sperm production
Stimulate & maintain sexual function
Increase muscle mass & strength
Maintain bone strength
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
STEROID ABUSE IS RAMPANT
• Est 1 % entire pop USA have used/using
• 2009 Nat Inst Drug Abuse- 2.5% Male HS seniors
used in past year
• Approx. 5% all HS students report using GH
• Testosterone, hGH & Growth Hormone
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Causes of Low-T
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Daily Alcohol Consumption / Tobacco Abuse
Infections / Infiltrative Disease
Obesity
Diabetes
History of Brain Trauma / Testicular Trauma
Aging
Medications
– Anti-Fungals
– Oxycodone
– Prednisone
– Percocet/Vicodin
– Antibiotics
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Low-T Can Cause
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Central Obesity
Higher Insulin Levels
Diabetes
Mood Disorders
Loss of Height/Osteoporosis
Female pattern Weight Gain
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Low T Affects
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Cognitive Function / Mood
Muscle Strength
Fat Mass
Bone Density
Sexual Function
Serious Emotional Stress
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
T Replacement Dangers
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High LDL / Low HDL
Erythrocytosis / Hemostasis
Sodium / HTN / Cardiac (?)
Neuropsychiatric Issues
Liver Toxicity
Tendon / Muscle Injury
Prostate
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Vitamin D
Vitamin D
Vitamin D Deficiency
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Naturally produce Vitamin D from sun
Est 30% USA is still low
Crucial for muscle function & strong bones
Correlation between Low D & Depression
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Consequences of Vitamin D
Deficiency
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Central Obesity
Depression / Suicide?
Osteoporosis
Gum Disease
Susceptibility to Infections
Prolonged Recovery Time
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Correct Vitamin D Deficiency
Medical Grade Supplements
GMP Certified
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Threat
Threat
Root Causes of Obesity
Depression / Mental Illness
Genetics / Addiction
Sleep Disorders
Media Distortions
Lack of Education
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Toys for the Obese
• Bioelectrical Impedance
• DEXA Scan
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Bioelectrical Impedance
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Root Cause of Physical Inactivity
Depression / Mental Illness
Sleep Disorders
Lack of Education
High Stress Levels
No Access
Perceived Time Component
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Toys for the Inactive
• Body Bugs
• RMR / VO2 Max Testing
• Flexibility Training
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
I Love Technology
Resting Metabolic Rate
VO2 Max
VO2 Max
• Measures metabolic rate during exercise
– how many calories your body burns
– calories come from fat, carbs, or a combo
– what intensity level you burn most efficiently
• Data that is YOU
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Your required calories / Your calories burned
Your fuel composition
Your threshold heart rate
Your fat-burning efficiency
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Print Out
Flexibility
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Threat
Threat
Technology for Better Sleep
• Sleep Study
• Home Monitoring
• Electronic Checklist
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Home Test
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Toys for Depression/Mood Disorders
• ElectroConvulsive Therapy (ECT)
• Deep Brain Stimulation
• TransCranial Magnetic Stimulation
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
ElectroConvulsive Therapy
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
Deep Brain Stimulation
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
TransCranial Magnetic Stimulation
Summary
1. Poor Nutritional Choices, Tobacco, Obesity & Inactivity
THREATEN LEO’s
2. Poor Nutritional Choices, Tobacco, Obesity & Inactivity
Cause DISEASE
3. Common Root Causes
4. Ideas to keep you Fitter & Faster than the BAD GUYS!
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
You GOT It
Department Health
IGNITES
Community Health
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity
My Team
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Desk sergeant / dispatchers
Emergency 24/7 answering service
Email Account: routine matters
Social Media: health updates
Contact WITHIN the department
Captain Hero?
Eliminate The Threat: Tobacco, Obesity & Physical Inactivity