IMMIGRANT HEALTH AND NUTRITION COUNSELING

JIAN GUAN, PHD. RNC.

SPRING 2010 OCASI PROFESSIONAL

DEVELOPMENT CONFERENCE November 5, 2010

Spring 2010 OCASI Professional

Development Conference

Thursday, May 13, 2010

Objectives

The purpose of the workshop is to provide knowledge, skills and strategies for frontline workers as they provide counseling to clients and promote health to their communities.

Topics

This workshop will cover the topics such as the most updated research of genetic analysis and nutrition science, epidemics among immigrants and knowledge of Canadian food and bioactive diet, and principles methods for providing nutrition counseling.

1. Obesity2. Cardiovascular disease 3. Diabetics

NutriGenomics 营养基因学

Lifestyle

Nutrition

Genome

Can modify

Can’t modify

Nutrigenomics explains nutrient-gene interaction and provides information related to risk as well as information on the impact of lifestyle and nutrition

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Health CanadaCommunicates amounts and types of food needed to help:

Meet nutrient needs and promote health

Minimize the risk of obesity, type 2 diabetes, heart disease, certain types of cancer and osteoporosis

1) Obesity and Nutrition

Apple Shape: Carrying excess weight around the middle also increases your risk of diabetes, heart disease, high blood pressure and high blood cholesterol

Health Risk Classification According to Body Mass Index (BMI), Health Canada, 2003

Classification BMI Category(kg/m2)

Risk of developinghealth problems

Underweight <18.5 Increased

Normal Weight 18.5 - 24.9 Least

Overweight** 25.0 -29.9 Increased

Obese Class I 30.0 - 34.9 High

Obese Class II 35.0 - 39.9 Very high

Obese Class III >=40.0 Extremely high

** Overweight 25-27, CANADA, 1988

Health Canadian and

increased risk for health problems: A European/Caucasian man whose waist

measures more than 102 cm (40 inches) A European/Caucasian woman whose waist

measures more than 88 cm (35 inches)Chinese and South Asian people, waist

measurements are smaller in Canadian Standard A Chinese or South Asian man whose waist

measurement of more than 90 cm (35 inches) A Chinese or South Asian woman whose waist

measurement of more than 80 cm (32 inches)

Waist circumference: by gender and ethnicity

Waist circumference*by gender and ethnicity

Male female

European/Caucasian, Sub-Saharan Africans, Eastern Mediterranean, Middle Eastern

>94 cm* 102 cm** (40 in)

> 80cm* 88 cm** (35 in)

South Asian, Malaysian, Asian, Indian, Chinese, Japanese, Ethnic South and Central Americans

90 cm (35 in)

80 cm (32 in)

* WHO, 2000; **CANADA, 2003

2) Heart Disease and Nutrition13

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HDL and LDLLDL =“bad” Too much can clog arteries by

forming plaque Atherosclerosis can cause heart

attack or strokeHDL =“good” Tends to carry cholesterol away

from arteries and back to liver Remove excess cholesterol from

plaque in arteries, slows build up14 Gene-Nutrition

Triglycerides and Atherosclerosis Triglycerides is a form of fat, also

made in body and from food, trigger liver to make more cholesterol, rising LDL

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3) Diabetes and Nutrition Consulling

Diabetes is a serious condition. It can strike anyone, anywhere at any age. Diabetes increases the risk of heart disease and stroke.

The majority of people (approximately 80%) with diabetes will die from heart disease and stroke.

Diabetes is also the leading cause of blindness, kidney failure and non-traumatic amputation.

In Canada, the number of people with diabetes is growing every year, and they’re getting younger.

Approximately 1.8 million Canadians (5.5% of the population) were diagnosed with diabetes in 2005.

That number is expected to climb to 2.4 million by 2016.

Diabetes – Good News

Lifestyle changes can reduce the risk of the most common type of diabetes − type 2 diabetes by 60%.

While there are no safe and effective ways to prevent less common types of diabetes, a healthy lifestyle can reduce the risk of developing heart disease.

People with diabetes can live long and productive lives.

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Number of Studies Conducted in Number of Studies Conducted in T2D, Gene, and DietT2D, Gene, and Diet

This figure shows many studies on T2D + diet, interrelationship among gene, gene product, dietary food component and diseases.

What is diabetes?

Diabetes develops when the body has a problem with a hormone – insulin produced by pancreas.

Insulin helps move sugar (glucose) in food from the blood into the cells of the body where it can be used for energy.

Insulin resistance: The body’s cells do not respond properly to the effects of insulin.

If pancreas can’t make enough insulin, or if insulin resistance, glucose builds up and damages blood vessels in the body.

Damaged blood vessels can cause problems such as heart disease, stroke, kidney disease (nephropathy), eye damage (retinopathy) and nerve damage (neuropathy).

Types of Diabetes

1. Type 1 occurs in about 10% of cases. When cells in the pancreas that make insulin are destroyed, the body has no, or very little, insulin to move glucose from blood into body cells.

2. Type 2 occurs in about 90% of cases. In type 2 diabetes, the pancreas usually doesn’t produce enough insulin to meet the body’s needs. In some instances, body cells can’t use insulin properly.

3. Gestational Diabetes (diabetes during pregnancy) occurs in about 2 to 4% of pregnant women. This form of diabetes usually goes away after giving birth, however, both mother and baby are at an increased risk of developing diabetes later in life.

Type 1 diabetes Type 1 diabetes is usually

diagnosed in people under 30, most often in children and teenagers. It’s usually caused by an autoimmune reaction – the body attacks its own pancreatic cells for unknown reasons. This reduces the amount of insulin produced by the body. It is not caused by eating too much sugar. There is no safe and effective prevention of type 1 diabetes at this time.

Type 2 Diabetes

Type 2 diabetes is more common in people over the age of 40. But, unfortunately, it is now being seen in younger people, even children. Most of these children are from ethnic groups that are at higher risk of developing type 2 diabetes particularly the Aboriginal, Hispanic, African and Asian populations.

Insulin Modulation Inflammatory Response

Prediabetes

Prediabetes is when blood glucose levels are almost as high as withdiabetes. It is sometimes called Impaired Glucose Tolerance (IGT) or Impaired Fasting Glucose (IFG).

Prediabetes does not mean you have diabetes. However, it may indicate an increased risk for developing diabetes in the future.

Making healthy lifestyle choices, such as controlling weight, eating a healthy diet and being physically active can help prevent developing diabetes.

“Inflammation

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the evil twin of oxidation. Where you find one, you find the other." -- neuroscientist James Joseph of Tufts University, 2006. That include not only such obvious inflammatory conditions as asthma and rheumatoid arthritis, but also atherosclerosis, Alzheimer's disease, colon cancer and diabetes.

Diabetes and Healthy Lifestyle

These simple steps will help reduce diabetes risk:• Lead a healthy lifestyle• Eat a healthy diet• Get regular physical activity

STEP 1 - Healthy Eating Habits

Addresses the problems of carbohydrate sensitivity and fat storage

With this lifestyle change, you will not go hungry, feel deprived, or quit from lack of variety (don’t count calories)

Emphasis on adopting a diet made up of low-glycemic foods

STEP 2 - Behavior Modification

Group Coaching/Support Daily Journal Education Dietary Supplementation Exercise Suggestions

STEP 3 - Change Body Composition

Exercise program to boost your metabolism and change your body composition

With constant yo-yo dieting you lose muscle and gain body fat

With exercise your body will be in fat burning mode

Muscle Dictates Metabolism!

The Glycemic Index (GI)

Glycemic Index measures the impact of carbs on blood sugar levels

High GI foods such as sugar, white flour and rice quickly raise blood sugar levels and insulin production

High GI foods with high GL amount throw your metabolic switch into fat storage mode (independent of calories!)

The Glycemic Index (GI)

Low GI foods promote weight loss while preserving lean muscle mass and do not lower metabolic rate

Low GI foods give your body a steady stream of energy

Addresses body composition resulting in fat loss and optimal metabolic rate!

Fiber-Rich Foods

Vegetables Many Types Of Fruits Lentils, Beans Yams, Sweet Potatoes Whole Unprocessed Grains And More

Nutrition Supplements

Vitamin B6 and Zinc Chromium Calcium Digestive Enzymes: Helps combat nutrition

loss due to processed food Omega III : Anti inflammation Complete Greens: Provides essential

enzymes and good bacteria to optimize the absorption of nutrients from food

Antioxidants

Antioxidants serve as a powerful first line of defense against oxidative damage from aging, stress, and inflammation.

Antioxidants appear to contain cancer-fighting properties and to support the immune system (among many other benefits).

Though many, many foods contain these valuable antioxidants, we’ve listed a few of the most potent and popular choices for each class of antioxidants.

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Antioxidants

Antioxidants can be broken into two general categories:

1) antioxidant nutrients (including phytonutrients). Vitamins, minerals and the various -noids detailed below are in this category.

2) antioxidant enzymes.

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EnzymesThe most vital nutritional discovery since

Vitamins and MineralsSupports a healthy digestive tract:

Promotes digestionSupports nutrient absorptionMay help ease stomach upset

Helps maintain healthy cholesterol levelsSupports healthy immune functions

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Digestive Enzymes

Digestive enzymes make it possible for us to digest and absorb proteins, fats, carbohydrates, starches and sugars, and structure them into healthy bodies.

Digestive enzymes have three main jobs: Proteases digest protein Amylases digest carbohydrate Lipases digest fat.

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Fresh FruitsFresh Fruits

Fresh raw fruits are loaded Fresh raw fruits are loaded with enzymes and when we with enzymes and when we eat our foods raw 30% of theeat our foods raw 30% of thedigestion is done for us by the food itself.digestion is done for us by the food itself. When we cook our food over 110 degrees F, we When we cook our food over 110 degrees F, we destroy the living enzymes and our body must destroy the living enzymes and our body must use its own enzymes for digestion robbing us use its own enzymes for digestion robbing us of energy.of energy.

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Fiber

Helps maintain digestive health, helps cleanse colon and promote colon health

Helps relieve occasional constipation*, support normal bowel regularity and fecal volume

Helps promote healthy growth of beneficial bacteria in the colon

Supports healthy nutrient absorption

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High-Fiber Foods for Digestive Health

Fiber intake has been linked to reducing the risk of heart disease, diabetes, obesity and certain types of cancer.

Daily fiber intake goal:Males 19-50                38 g per dayMales 50+                   30 g per dayFemales 19-50             25 g per dayFemales 50+                21 g per day

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VegetablesVegetables Vegetables are mainly Vegetables are mainly

carbohydrates that are high in carbohydrates that are high in antioxidants, phytochemicals and fiber. antioxidants, phytochemicals and fiber.

Dark green vegetables will help to Dark green vegetables will help to alkalinize the body and are a great source alkalinize the body and are a great source of calcium. of calcium.

Vegetables are also low in calories and Vegetables are also low in calories and sugar so they feed your body with sugar so they feed your body with nutrients without a lot of calories.nutrients without a lot of calories.

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Table for Fiber-less and Fiber-rich food

Fiber-less food Grams of fiber Fiber-rich food Grams of fiber per serving per serving

Meat or poultry 0 g per 75 g or 2.5oz Red kidney beans 12 g per ¾ cupChicken noodle soup 2 g per 1 cup Lentil soup 12 g per 1 cupCorn Flakes cereal 1 g per 1 cup (30g) Fiber first/ bran buds 12 g per 1/3 cup (30g) Chili con carne 4 g per 1 cup Vegetarian chili 9 g per 1 cupWhite pasta 3 g per 1.5 cups cooked Whole wheat pasta 8 g per 1.5 cups cookedChocolate chip muffin 2 g per muffin Raisin Bran muffin 5 g per muffinApple juice 0.1 g per ½ cup Apple 3 g per apple with skinWhite rice 0.8 g per 1 cup cooked Brown rice 3 g per 1 cup

cookedChips – regular 0.8 g per 10 chips (20g) Microwave popcorn 3 g per 2.5 cups

(20g)White bread 1 g per slice 100% whole-grain bread 2.2 g per slice

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