AFFECTING WELLCHECK NUMBERS WITH NUTRITIONCRISTIN STOKES, RDN, LNMUS WELLNESSFEBRUARY 17TH, 2016

WEBINAR DESCRIPTION

• Nobody's perfect, and most of us have a number or two on our annual Wellcheck report that needs to move in a positive direction. What we put into our bodies on a daily basis can have a tremendous effect on health indicators such as cholesterol, triglycerides, blood pressure, blood sugar, and BMI. During this webinar, MUS Wellness Nutrition & Health Education Specialist Cristin Stokes will discuss strategies to impact Wellcheck numbers in positive ways through diet and nutrition.

• What it is• Why it matters• Nutrition Rx

THE OTHER PIECES

• Don’t smoke/Stop smoking• Exercise

• 150+ minutes/week recommended• Lose weight if needed• Stress management• Sleep• Genetics

BIG PICTURE

• Individual Foods vs Dietary Patterns

CHOLESTEROL

• What: Waxy, fat-like substance that our body needs• Hormones, vitamin D, bile• Made by our bodies & ingested through diet• WellCheck results: Total, LDL, HDL, HDL:Cholesterol Ratio

• Lipoproteins: Cholesterol carriers• Classified by density

CHOLESTEROL

• LDL (Low Density Lipoprotein)• Deposits cholesterol on arterial walls• Most important for assessing risk; target for drug therapy

• HDL (High Density Lipoprotein)• Can pick up cholesterol and return it to liver

• Total Cholesterol• Equation: HDL + LDL + (Triglycerides ÷ 5)

• HDL: Cholesterol • Good risk predictor

Lousy Healthy!

CHOLESTEROL

• Why it matters:

CHOLESTEROL

• Not all LDL cholesterol considered equal• Pattern A: Larger, fluffier

particles• Pattern B: Smaller, denser

• More easily oxidized• More likely to get trapped

in endothelial space

• Factors affecting pattern: • Genetics• Body weight• Diet

CHOLESTEROL

• Nutrition Rx: To improve number and pattern of LDL cholesterol• Low fat diet lowers LDL, but shows shift from pattern A to pattern B

• High carb, low fat in particular

• Dietary cholesterol = blood cholesterol• Instead:

• Type of fat matters• Trans fats • Saturated fats• Unsaturated fats

CHOLESTEROL

• Nutrition Rx: To improve number and pattern of LDL cholesterol• Reduce carbohydrates

• Sugar sweetened beverages, refined grains, sweetened foods• May lead to reduction in small, dense LDL

• Emphasize fiber• Soluble fiber sources: Beans, oat cereal, Brussel sprouts,

oranges, flaxseeds• Plant sterols & stanols

CHOLESTEROL

• Nutrition Rx: To improve number and pattern of LDL cholesterol• Moderate amounts of low and non-fat dairy • Limited amount of processed and red meat• Dietary pattern: Vegetables, fruits, whole grains,

fish/seafood, legumes, nuts, plant-based oils

CHOLESTEROL

• Nutrition Rx: To raise HDL • Importance?• Healthy fats

• Nuts, seeds, olive oil, avocados, fish• Moderate alcohol intake

CHOLESTEROL

• 2013 AHA/ACC Guidelines: Consider overall risk• Age, gender, race, weight, cholesterol levels, blood pressure, diabetes,

smoking• Included in the guidelines:

• New risk equations • Broader recommended use of statins• Manage obesity• Best dietary & exercise pattern

• Pattern is key• Don’t sweat an occasional indulgence

TRIGLYCERIDES

• What: Primary form of fat in the blood. • Used as energy• Calories not needed right away are converted into TG’s and stored

in fat cells

• Why it matters:• High TG level = Increased risk of stroke, heart attack, heart disease,

pancreatitis

TRIGLYCERIDES

Blood Sugar

Time

Triglyceride production

TRIGLYCERIDES

• Nutrition Rx:• Cut back on “easy calories” (i.e. white flour, soda, processed

foods)• Eat the right amount of calories for you• Omega-3 fatty acids

• Eat fish 2x/wk or take a fish oil supplement• Salmon, tuna, mackerel

• Flaxseed, chia seeds, walnuts, omega-3 eggs• Reduce alcohol intake to moderate levels

BLOOD PRESSURE

• What: Pressure of blood against the walls of the arteries

• Why it matters: High BP = damage to heart, arteries, other vital organs• Heart disease, stroke, vision loss, kidney damage,

peripheral artery disease

• Nutrition Rx:• Less sodium:more potassium – ratio is important!

• <2300mg sodium per day

BLOOD PRESSURE

• Nutrition Rx: To lower BP• High sodium foods: Processed, packaged, restaurant foods• Examples: Frozen dinners, cheese, condiments, processed meats• Check the label

• <140 mg/serving• Focus on whole, fresh foods

• Potassium-rich foods:• Dark leafy greens, potatoes (with skin), yogurt, bananas, winter

squash, lentils, beets, tomatoes, dried apricots

BLOOD PRESSURE

• Nutrition Rx: To lower BP• DASH diet: vegetables, fruits, low-fat

dairy foods; limited red meat, saturated fats, and sweets• Reduce alcohol • Increase fiber

BLOOD PRESSURE

• Nutrition Rx:• Specific foods to incorporate:

• Nitrates: Beetroot juice, beets, collard greens, cress, lettuce, arugula, spinach

• Cocoa• Nuts• Dairy: Milk & yogurt; not cheese• Flaxseed• Tea: Hibiscus tea (careful with diuretic), green tea• Garlic: Aged garlic extract

BLOOD GLUCOSE

• What: Sugar in the blood that provides energy to cells in the body• Why it matters: Diabetes

• High blood sugar = damage at a cellular level• Cardiovascular disease, kidney disease, nerve damage, eyesight

damage

BLOOD GLUCOSE

Blood Sugar

Time

BLOOD GLUCOSE

• Insulin• Lock &

key• Sensitivity

BLOOD GLUCOSE

• Nutrition Rx• Carb smart• Plate method• Choose whole over refined grains• High fiber

Non-starchy veggies

Starch

Protein

BLOOD GLUCOSE

• Nutrition Rx:• Combine carbs with protein

• Whole grain crackers + cheese• Dried fruit + almonds, • 1/2 banana + peanut butter, • Whole grain cereal + yogurt

• Dietary patterns: DASH, Mediterranean, vegetarian, vegan, low fat, and lower carbohydrate

• Energy restriction

BODY MASS INDEX

• What: Weight (kg) ÷ Height(m)2

• Why it matters: High BMI = Higher risk of heart disease, diabetes, cancer, other chronic conditions• Not a perfect measurement, but still an important health indicator

• Nutrition Rx:• Plate method• Drink water• Keep a food journal• Limit sugar• Include protein source with meals & snacks

IN CONCLUSION

• All nutrition-related WellCheck values can be improved with a healthy diet• Overlapping dietary recommendations• Pattern > Individual foods

• Vegetables, fruits, whole grains, nuts, plant based oils, legumes, fish/seafood, lean proteins

• Looking for more information & personalized help?• Take Control: http://wellness.mus.edu/TakeControl.asp

MUS WELLNESS

• Up Next: • April 21st: Webinar. Exercise Q&A:

Mobility/Recovery/Prevention• FVCC Workshops—next week

• Training for Hiking (23rd)• Veggilicious (24th)

• March Wellchecks/Workshops• Billings/Bozeman/Miles

City/Missoula• April Wellchecks/Workshops

• Butte/Great Falls/Havre/Helena

• www.muswell.limeade.com• www.wellness.mus.edu• www.montanamovesandmeals.co

m• wellness@montana.edu