What You Need to Know - movmg.com · People will often try different fad diets or gimmicks. This usually will not lead to weight loss success. The key is permanent lifestyle changes

Health Risk Reduction: What You Need to Know

This brochure can help you learn more about reducing health risks. It doesn’t replace regular medical check-ups or your health care provider’s advice. Talk with your health care provider about what your health risk reduction goals should be.

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STEPS YOU CAN TAKE TO CONTROL RISK FACTORS

A health risk factor makes it more likely that you will develop a medical condition like heart disease or diabetes. A risk factor can also make a health condition get worse more quickly. Some risk factors, such as your age, race, heredity and gender, cannot be changed. Other risk factors, such as your eating habits, blood pressure, weight, and level of physical activity, can be controlled so that your health risks are decreased. Making positive changes in the health risk factors that you can control may improve the quality of your life and help you feel stronger and healthier!

Health Risk Reduction

Eating healthy can help you control your weight, have more energy, lower your cholesterol, lower your blood pressure, and prevent high blood sugar. Eating healthy is a life-long process but you can start by taking small steps.

Healthy eating means eating a wide variety of foods that are low in sodium, fat, and cholesterol, having a balance among food groups, and eating in moderation. You should talk with your health care provider before making any changes to the way you eat.

Eating healthy

Getting regular physical activity

Managing your weight

Controlling your stress

Keeping cholesterol, blood pressure, and blood sugar under control

Taking your medications as prescribed

INTRODUCTION

The key to eating healthy is balance, variety, and moderation. In other words, you should eat a wide variety of foods. Try not to eat too many calories or too much of one kind of nutrient. Avoid fad diets or extreme weight loss plans.

The goal of healthy eating is to create a healthy eating plan that you can continue for life.

The “MyPlate” method can help guide you to make healthy choices.

Eating Healthy

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More About Eating Healthy

Balance: Balance your food choices over time. Not every food has to be “perfect.” If you eat a food high in fat, salt or sugar, select other foods that are low in these ingredients. If you miss out on any food group one day, make up for it the next. Your food choices over several days should fit together into a healthy pattern.

Variety: Eat a variety of nutrient-rich foods. Your daily food selection should include bread and other whole-grain products; fruits; vegetables; dairy products; and meat, poultry, fish and other protein foods. Try to eat more fruits, vegetables, grains and beans and eat less red meat and fast food.

Moderation: Eat moderate portions. If you keep portion sizes reasonable, it’s easier to eat the foods you want and stay healthy.

Eat a variety of nutrient rich food

Balance your calorie intake over time to stay at a healthy weight

Have smaller portions

Try not to think of certain foods as “off-limits”―moderation is key

Tips for Healthy Eating

Always eat a healthy breakfast, and eat smaller meals throughout the day

Avoid eating at night

Avoid sugary drinks

Avoid processed or pre-packaged foods

Regular Physical Activity

Regular physical activity can lower some health risk factors, and can also increase your muscle tone and give you more energy. Regular exercise is any physical activity that you can do almost every day. It can be simple things like walking, gardening, and stretching, or more strenuous physical activity such as running or swimming. Before you start any new physical activity program, talk with your health care provider. Choose physical activities that you enjoy and add them to your daily routine. It’s never too late to get started!

Endurance or aerobic activities such as walking and dancing make your heart beat faster.

Choose

different types

of physical

activities

Flexibility activities such as yoga and stretching increase your range of motion, help keep your joints flexible, and reduce your chances of injury during other activities.

Balance activities help prevent injuries from falls and help strengthen body areas such as the upper thighs.

Strength building activities such as lifting weights and using resistance bands make your muscles stronger and help to preserve strength, independence, and energy.

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More About Regular Physical Activity

Start slow and try to be physically active most days of the week. If you are generally healthy, fit, and do not have any limiting chronic conditions or disabilities, you should be physically active for at least 30 minutes a day with a goal of 150 minutes a week. You may want to join an exercise class or do activities with friends to make it more fun and help you stick with it.

If you are unable to do 150 minutes of moderate-intensity aerobic activity a week, do as much as you are physically able. If you have a chronic illness, talk to your health care provider about how that illness will affect your ability to have regular physical activity.

If possible, walk instead of drive

Take the stairs instead of the elevator

Work in the garden, rake leaves, or do some housecleaning every day

Park in the row farthest from the building

Besides doing formal exercises, you should keep moving throughout the day. Any activity can help you burn calories and give you more energy.

Here are some ways you can be active all day: Walk in place or stretch while you watch TV

Walk around the house or up and down stairs while you talk on the phone

Get up from your desk and take a lap around the office once each hour while you are at work

Managing Your Weight

Manage your weight by eating healthy and getting regular physical activity. Being overweight or obese has been linked to heart disease, high blood pressure, high cholesterol, stroke and Type 2 diabetes. Eating and activity habits can be very difficult behaviors to change.

People will often try different fad diets or gimmicks. This usually will not lead to weight loss success. The key is permanent lifestyle changes that can lead to your better health.

Heredity

Environment

In order to maintain a healthy weight, you need to balance the amount of calories you take in with the amount of calories you use up. The amount of calories from the food and drink you eat should be the same as the amount of calories your body needs to function and be physically active.

A person’s weight is a result of a variety of factors. Some of these factors include:

Metabolism

Behavior

Tips for Losing Weight

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More About Managing Your Weight

Assessing your weight involves knowing your body mass index (BMI) and your waist circumference:

BMI is a tool that is used to find out if you are overweight. The BMI estimates the total fat on your body. The BMI is calculated by taking your weight in kilograms divided by your height in meters squared.

You can ask your health care provider to calculate your BMI or use on online BMI calculator on websites like the National Heart, Lung, and Blood Institute (NHLBI) BMI calculator or the Centers for Disease Control BMI calculator.

People who have more fat around then their waist then hips are at higher risk for getting illnesses connected with being overweight. This includes conditions such as heart disease and high blood sugar. The more inches around your waist the greater the risks. To correctly measure your waist:

1) Stand and place a tape measure around your middle, just above your hipbones.

2) Measure your waist just after you breathe out.

Waist sizes more than 35 inches for women and more than 40 inches in men are considered at risk.

Body Mass Index (BMI*) Waist Circumference

Underweight BMI Less than 18.5

Normal Weight BMI 18.6 to 24.9

Overweight BMI 25 to 29.9 Obesity BMI 30 and over

What is the goal for a healthy weight? First know your BMI, waist circumference, and risk factors. Then talk to your health care provider. Together you will decide what weight goals will work best for you. In general, a normal weight is:

BMI: between 18.6 and 24.9

Waist circumference Be aware and plan your meals

Weigh yourself regularly, at least once a week

Don’t skip meals

Eat only when you are hungry

Drink a lot of water

Be a smart shopper and only buy foods that are healthy

*The BMI is just an estimate. Talk to your health care provider about what will be the healthiest weight for you

If you are overweight and need to lose weight, set realistic goals that will be safe and easy to accomplish, like:

Losing 5-10% of your total body weight over the next 6 months

Losing no more than 1-2 pounds per week

Avoiding fad diets or rapid drops in weight (these typically will not last over time)

Women: Less than 35 inches Men: Less than 40 inches

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Managing stress is all about taking control of the way you think about stress, your emotions, your schedule and how you deal with problems. Everyone has stress in their life. Stress can be short lived like being in traffic or waiting in a long line. Or it can last a long time, like with the death of a family member or problems paying bills.

Even if you do not feel stress, it still affects your body. Stress can make you nervous, angry, tense, irritable, tired, depressed, worried or excited. It can contribute to other conditions like insomnia, headaches, high blood pressure and digestive problems. It can also lead to bad habits like smoking, drinking alcohol, or overeating.

It might seem like there is nothing you can do about day-to-day stress—but there is. You can empower yourself to take control of your stress.

Healthy Ways to Reduce Stress

Avoid stressful situations: Learn how to say “no” Avoid people or things that stress you out Make your to-do list smaller Change the situation: Tell people how you feel―don’t hold it all in Be assertive, but also be willing to

compromise Manage your time better Change how you respond: Try to look at problems differently Look at the big picture Adjust your expectations Focus on the positive Accept what you cannot change: Don’t try to control the things you can’t Look for the positive Share your feelings Learn to forgive Make time for fun and relaxation: Connect with others Do something fun every day Laugh

Managing Stress

Be healthy: Be physically active on a regular basis Eat healthy Get enough sleep Avoid alcohol, tobacco, and drugs Use relaxation techniques: Try slow, deep breathing Try consciously contracting and then

relaxing your muscles Share your feelings: Ask family or friends for their support and

guidance If you feel your stress is too much to

handle, talk with your health care provider

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How Cholesterol, Blood Pressure, and Blood Sugar Affect Health Risks

Keeping your cholesterol, blood pressure, and blood sugar under control is very important for maintaining good health and preventing other medical conditions. Let’s look at them one by one:

High Cholesterol

One of every six Americans has high blood cholesterol. This increases your risk for getting heart disease or having a heart attack or stroke. Your body makes all the cholesterol it needs, but cholesterol is also in some foods, such as animal products. These include meats, poultry, fish, eggs, butter, cheese, and whole milk. Fruits, cereals, and vegetables don’t have cholesterol.

Being overweight or not getting enough physical activity tends to raise your cholesterol levels. People who have family members with high cholesterol, men, and women over age 55 are at higher risk for getting high cholesterol. There are normally no symptoms to tell you that your cholesterol is too high. The American Heart Association recommends that all adults get their cholesterol checked at least every five years.

LDL Cholesterol Less than 100 mg/dL Optimal (ideal) 100 to 129 mg/dL Near Optimal/Above Optimal 130 to 159 mg/dL Borderline High 160 to 189 mg/dL High 190 mg/dL and above Very High HDL Cholesterol Less than 40 mg/dL Major heart disease risk factor 60 mg/dL and above Gives some protection against heart disease Triglycerides Less than 150 mg/dL Normal

150 to 199 mg/dL Borderline High 200 to 499 mg/dL High 500 mg/dL and above Very High Total Cholesterol Less than 200 mg/dL Desirable 200 to 239 mg/dL Borderline High 240 mg/dL and above High

What your numbers mean:

LDL (bad) cholesterol can build up in your blood vessels and cause a heart attack or stroke—you want this number to be low.

There are two kinds of cholesterol:

HDL (good) cholesterol helps keep the cholesterol from building up in your vessels—you want this number to be high.

Triglycerides are another form of fat found in the blood—you want this number to be low.

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More About High Cholesterol

There are ways that you can lower your cholesterol:

Eat Healthy: Avoid foods that are high in cholesterol and saturated fats. Read the nutrition label to help you understand the amounts in your foods. Eat fewer high-fat cheeses, eggs, creamy sauces, fried foods, and whole milk. Drink skim milk. Pick lean, broiled meats. Eat more foods with fiber. Try foods such as oatmeal, oranges, pears, carrots, kidney beans, and lentils.

Stay Active: Talk with your health care provider before starting any physical activity plan. Ask how much and what kinds of activities are best for you. Try to get at least 30 minutes a day (or 2½ hours a week) of moderate to vigorous physical activity. This could include walking, dancing, or swimming.

Get to a Healthy Weight and Maintain It: Try to lose weight if you are obese or overweight by cutting back on calories and increasing your physical activity. Eat smaller portions and read nutrition labels to find foods that have less sodium and saturated fats.

Stop Smoking: Talk to your health care provider about programs, products, and medicines that can help you quit. And try to avoid second-hand smoke.

Take Medications as Prescribed: There are many different medications that can help lower your cholesterol, so talk to your health care provider about which one is best for you. Remember, a healthier lifestyle can help you stay on the lowest dose of medicine.

High Blood Pressure

Also called “hypertension,” high blood pressure affects more than 76 million adults in the United States. If you have untreated high blood pressure, your heart has to work harder to push the blood through your body. Most people do not feel sick and can go for years without knowing they have it, so you should have your blood pressure checked at least every year by a health care provider. Untreated high blood pressure can lead to heart attack, stroke, kidney disease and heart failure.

Risk Factors You CAN’T Control Race and Ethnicity

African Americans and people of Hispanic descent tend to have high blood pressure earlier in life and more often than other races.

Age The older you get, the higher the risk of getting high blood pressure.

Heredity If a close family member has high blood pressure, you are more likely to have it, too.

Gender Men tend to get high blood pressure at a younger age than women.

Risk Factors You CAN Control Being Overweight Causes your heart to work harder to pump

more blood to supply oxygen and nutrients to your body.

Not Getting Enough Physical Activity

Increases the risk of being overweight.

Using Tobacco Can narrow your blood vessels and harm your heart.

Drinking Too Much Alcohol

Can damage your heart over time.

Stress Can cause temporary but dramatic changes in your blood pressure. Also, some people deal poorly with stress by overeating, smoking, or drinking too much alcohol.

Eating Too Much Salt

Can cause you to hold on to too much fluid, which can raise your blood pressure.

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More About High Blood Pressure

What your blood pressure reading means:

Level

Systolic (Top

number)

Diastolic (Bottom number) What It Means

Normal Blood Pressure

Less than 120

AND Less than 80 Great! Keep it there!

Pre-Hypertension 120 to 139 OR 80 to 99

You are at risk for high blood pressure. Eat healthy and try to be more active. Talk to

your health care provider about other ways you can lower your blood pressure.

High Blood Pressure

140 or higher OR 90 or higher

If you have more than 1 result at this level, you may have high

blood pressure. Talk to your health care

provider about treatment options.

Things You Can Do to Control Your Blood Pressure

Be physically active every day. Talk to your health care provider about which activities are best for you, then find activities that you can enjoy like dancing, swimming or taking a fitness class.

Eat healthy and cut back on the salt. Try to eat leaner meats and more vegetables and fruits. Read nutrition labels to know how much fat, sugar, and sodium are in the foods you are eating to make healthier choices. Remember to include the calories in your beverages.

Control your weight through healthy eating and daily physical activity. If you are overweight, try to lose 1-2 pounds per week, then maintain a healthy weight for life.

Cut back on alcohol. Limit yourself to no more than 1 drink per day for women and 2 drinks per day for men.

Quit smoking and avoid being around people who smoke. Ask your health care provider about programs, products, and medicines that can help you quit.

Manage stress. Learning how to relax and cope with stress can help you be healthier physically and emotionally.

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High Blood Sugar (Diabetes or Prediabetes)

Prediabetes is when your blood sugar is higher than normal but not high enough to be called diabetes. People with prediabetes are at risk for developing type 2 diabetes, but the risk can often be reversed by making healthy lifestyle changes.

Type 2 diabetes is when your body doesn’t make enough insulin or doesn’t use insulin the right way. Insulin is a hormone your body makes to keep your blood sugar at a normal level. High blood sugar can cause problems over time. High blood sugar can cause heart and blood vessel disease, which can lead to heart attacks, kidney damage, and strokes. It can also cause damage to the eyes and can lead to blindness. Additionally, nerve damage may occur and poor blood flow may lead to foot problems and even amputations.

Your risk of developing high blood sugar is greater if you are African American, American Indian, Asian American, Pacific Islander, or of Hispanic descent.

One in four people with high blood sugar don’t even know they have it. A simple finger-stick blood test can tell you if it is higher than normal. Your health care provider may also ask you to have an oral glucose tolerance test (OGTT), a fasting plasma glucose test (FPG), or a hemoglobin A1C blood test. These tests can tell your doctor more precisely what your blood sugar level is and whether it has been high for a long period of time.

If you have been told you have diabetes or prediabetes, it is important to check your blood sugar often. A small machine called a glucose monitor lets you check your blood sugar any time.

The American Diabetes Association suggests the following target ranges for blood sugar:

Before a meal, your blood sugar should be 70-130 mg/dL

After a meal, your blood sugar should be less than 180 mg/dL

Other Risk Factors for Developing High Blood Sugar

Being overweight

Age 45 or older

Physically inactive

Have a close family member with diabetes

Polycystic ovarian disease

High cholesterol or triglyceride levels

High blood pressure

Had diabetes when you were pregnant (“gestational diabetes”) or gave birth to a baby that weighed more than 9 pounds

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More About High Blood Sugar

People with diabetes must control their blood sugar (glucose) level by balancing medication, food, and activity. It is important to treat high or low blood sugar as soon as you detect it to prevent serious problems.

You may feel very thirsty, very hungry, or need to urinate often. You may get blurry vision or feel very tired. This can happen if you are sick or stressed, if you ate more or had less physical activity less than you planned, or if you forgot to take your diabetes medication.

Making changes in your diet, physical activity, or medications can help keep your blood sugar lower.

You may feel shaky, dizzy or sweaty. You may feel hungry, irritable, or have a headache. Untreated hypoglycemia can be life-threatening and cause you to have jerky movements, tingling around your mouth, or even a seizure.

The quickest way to treat low blood sugar is to chew glucose tablets (from your pharmacy) or eat something with 15-20 grams of sugar or carbohydrates.

4 ounces of juice or regular soda

2 tablespoons of raisins

It is important to let your health care provider know if you have low blood sugar often, or at the same time of day or night several times in a row. If you take insulin, you should wear a medical alert bracelet and make sure your family and friends know. Sometimes people with low blood sugar may seem intoxicated, so it is important that they know how to help you. If you pass out from low blood sugar, someone should call 911 immediately.

Things You Can Do to Prevent or Control High Blood Sugar

Be physically active. Your goal should be at least 30 minutes of moderate to vigorous physical activity 5 days a week.

Lose weight if you are overweight or obese. Try to lose 1-2 pounds a week. Talk to your health care provider about a weight goal that is right for you.

Eat healthy foods. Avoid high-fat and high-sugar foods and beverages. Eat fiber-rich fruits and vegetables, choose whole grains, eat more lean meats and seafood, eat smaller portions, and don’t skip meals. A dietician can help you make a meal plan that works for you.

1 tablespoon of sugar, honey, or corn syrup

8 ounces of skim or 1% milk

If your blood sugar is too HIGH (“hyperglycemia”) ...

If your blood sugar is too LOW (“hypoglycemia”) ...

Some foods with 15 carbohydrates:

Quit smoking, if you smoke.

Limit your alcohol to no more than 1 drink per day for women and 2 drinks per day for men.

Take prescribed medicines and insulin the right way, every day unless your health care provider tells you to stop.

If you have high blood sugar, ask your health care provider how often you should check your blood sugar with a glucose meter. Keep a record of your results for your doctor. Follow your treatment plan. Make sure you and your family and friends know the signs of high or low blood sugar and know how to treat it.

Tips for Taking Medicines as Directed

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Taking Your Medications Correctly

Taking medicines correctly is included as a health risk factor because if you do not take your medicines the right way, they may not help you and may even cause you harm. Almost three of every four Americans do not take their medicines the right way. Taking your medicine correctly includes getting the medicine, taking it on time, and understanding the directions for how to take them the right way. Your doctor cannot judge whether a medicine is working for you unless you take it correctly. It is also important that your doctor know about every medication you are taking, whether it is over-the-counter (OTC), prescribed, or an herbal product. Some products can cause interactions with other medications.

Medicines are intended to help you, and can even prevent future problems such as heart disease, heart attack, or stroke. It is important that you know what your medicines are and what they are for. When you get a new medication, it is important to ask your health care provider or pharmacist questions so you clearly understand how, when, and why you should take it. Pharmacies are now required to give you written instructions about your medicine when you pick it up. It is a good idea to keep these written instructions.

While some risk factors, such as your age, heredity, gender, and race, can’t be changed, other risk factors may often be controlled or modified to reduce your chances of getting heart disease, diabetes, and stroke. Many other chronic diseases may also be avoided or delayed by reducing health risk factors.

Write it down. Make a wall chart with the names of your medicines, the dose, and the time of day you need to take them.

Get a pillbox. It should have the days of the week and times of day. You can get these boxes from your pharmacy or local grocery store. Fill the box at the beginning of the week to help you keep track. Ask a friend or family member to check the box so that you know each medicine is in the right place.

Set an alarm on your clock or cell phone to remind you if a medicine has to be taken at a certain time.

Ask for help. Tell family and friends about your medicine schedule so they can remind you.

Carry a list of your medications in your purse or wallet and keep it up-to-date.

Set a daily routine. Combine taking your medicines with something you do at regular times. For example, when you brush your teeth, eat breakfast or dinner. This way, taking your medicines at the right time can become a good habit.

Take it with you. Remember to take your medicines with you when you are away from home. Bring enough medicines with you when you go on trips. Always put them in your carry-on luggage.

Refill your prescriptions on time. Reorder your prescriptions ahead of time to make sure that you never run out.

Let your health care provider know if you cannot afford your medications. It is possible that you can get your medications at free or reduced cost.

Contact your pharmacy or health care provider if you think you are having side effects.

Do not stop taking your medicine without telling your health care provider.

Learn to read and understand your prescription label. Your pharmacist is a great resource to help you learn how.

Health Risk Reduction: What You Need to Know

Health Risk Factors You Can’t Control

Knowing about these health risks can help you decide to reduce the risks you CAN control.

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Race: African Americans and people of Hispanic descent Heredity: Parents with high blood pressure Age: More risk as you age

Family history: Blood relative with diabetes Race or ethnic background: African, Asian, Hispanic, Native American descent and Pacific Islanders Age: Higher risk after age 45

Heredity: Parents with high cholesterol Age: Especially after 55 Female: After menopause

Risks for High Cholesterol Risks for High Blood Pressure Risks for High Blood Sugar

A health risk factor is anything that makes it more likely you will develop a medical condition. A health risk factor may also make a condition get worse more quickly.

While some risk factors, such as your age, heredity, gender, and race, can’t be changed, you can often control other risk factors. When you limit your risk factors:

• You give yourself a better chance to enjoy a healthy life • You reduce your chances of getting heart disease or

diabetes • You reduce your chances of having a stroke • You may reduce the impact of a condition you already

have

High cholesterol is one of the major risk factors for heart disease and stroke.

High blood pressure is one of the major risk factors for heart attack, heart failure, stroke, and kidney disease.

High blood sugar (blood glucose) is one of the major risk factors for diabetes, heart disease, and stroke. With diabetes, there is a higher risk for other problems such as kidney disease, nerve and vision problems.

*Too much stress may put you at risk for high cholesterol. Stress can increase some activities like eating an unhealthy diet, smoking, and not exercising regularly. Those activities can be risk factors for higher cholesterol levels and can also increase the risk for heart disease. Also, stress may be a risk factor for diabetes if it causes eating an unhealthy diet, smoking, excessive use of alcohol, or lack of exercise.

Overweight Yes Yes Yes Tobacco Yes Yes Yes Low activity Yes Yes Yes Alcohol Maybe Yes Yes Stress Maybe* Yes Maybe* Not taking medicine as prescribed Yes Yes Yes Too much fat in diet Yes Yes Too much salt Yes Too little potassium Yes High blood pressure Yes

Health Risk Factors You CAN Control: High

Cholesterol High

Blood Pressure High

Blood Sugar

Action Plan for Health Risk Reduction

Stop smoking.

Check off items from the list below that you will be able to change or improve. Or you can write in your own action items. Get your numbers.

1. Are the items that you have chosen achievable? 2. What will you do to make these changes? _______________________________________________________ ________________________________________________________________________________________________________

3. When will you make these changes? ___________________________________________________________ ________________________________________________________________________________________________________

Yes No

Get your cholesterol checked. Get your blood pressure checked. Get your blood sugar checked. Ask your health care provider if your numbers are in the healthy range. Ask how often you should be tested.

Decide to eat healthy foods.

Other

Control stress.

Eat more lean, low-fat, or fat-free foods, fruits, and vegetables. Make sure half of your servings of grains are whole grains. Eat foods lower in salt and higher in potassium. Limit added sugars. Talk with your health care provider about healthy food options. If you need to lose weight, do so slowly, losing about 1 to 2 pounds

a week until you reach a healthy weight. Talk with your health care provider about a weight goal and weight

loss program that is right for you. Talk with your health care provider about what a healthy amount of

alcohol is for you. Read food labels. Use food labels to help you make better choices.

Stop smoking or smoke less. Avoid second-hand smoke. Talk with your health care provider about ways to stop smoking.

Get enough sleep. Limit alcohol and caffeine. Give yourself enough time to get things done. Do important things first. Learn to say “no” when you

already have a lot to do. Talk with family and friends about your stress. Ask for their support. If you feel your stress is too much to handle, talk

with your health care provider.

NPC612605-01 ©2013 Pfizer Inc. All rights reserved. Printed in USA/November 2013 13

Keep moving. Always check with your health care provider before starting any new exercise program. Start an exercise program slowly, then increase the amount of time. Try walking, riding a bike, or swimming at least 30 minutes most days of the week.

Take medicines as prescribed. Take your medicine as your health care provider prescribes. Keep taking your medicines unless your health care provider tells you to stop.