Fitness, Nutrition and Dietary Supplements:

Guidelines for a Healthy Lifestyle

Matthew Faiman, MD, MBAAssistant Medical Director

Staff, Internal MedicineCleveland Clinic Independence

Objectives: By the end of this presentation, you

will be able to identify: Current guidelines for Diet,

Nutrition and Health Current guidelines for Exercise,

Fitness and Health Benefits of living a healthy

lifestyle.

Overview: The Obesity

Epidemic in America: It’s Big.

Over 100 million Americans are overweight

More than 40 million are obese.

Diet, Nutrition and Health Why don’t Americans eat healthy? Why

are we so overweight? Busier lifestyles mean more fast food,

and less “healthy” food choices. Women who used to be homemakers,

are now in the workforce “Sedentary” lifestyle (People don’t

get enough activity)

Diet, Nutrition and Health: Why should we care?

Healthy food habits can help you reduce three of the major risk factors for heart attack: High blood cholesterol High blood pressure Excess body weight.

They'll also help reduce your risk of stroke, because heart disease and high blood pressure are major risk factors for stroke

Diet, Nutrition and Health: The Guidelines.

Who determines the guidelines for a healthy lifestyle? The US Dept. of Health and Human Services

and Department of Agriculture. After reviewing data from many sources, experts create guidelines to promote optimum health for all individuals. They focus on diet, exercise, and disease prevention.

For more information: Go to: http://www.healthierus.gov/dietaryguidelines/.

Diet, Nutrition and Health: Guidelines for diet

Eat a variety of fruits and vegetables. Choose 5 or more servings per day.

Eat a variety of grain products, including whole grains. Choose 6 or more servings per day.

Choose fats and oils with 2 grams or less saturated fat per tablespoon, such as liquid and tub margarines, canola oil and olive oil.

Diet, Nutrition and Health Balance the number of calories you eat with

the number you use. This is your Basal Metabolic Rate. Multiply the number of pounds you weigh by

10 calories. This is the average number of calories used

in one day if you're not very active.

EX: 170 pounds x 10 calories = 1700 cal/day

Diet, Nutrition and Health: Tips on Diet

Include fat-free and low-fat milk products, fish, legumes (beans), skinless poultry and lean meats.

Limit your intake of foods high in calories and low in nutrition- Soft drinks and candy have a lot of sugars

Eat less than 6 grams of salt (sodium chloride) per day (2,400 milligrams of sodium)

Diet, Nutrition and Health: Tips on Diet

Limit foods high in saturated fat, trans fat (potato chips) and/or cholesterol. Full-fat milk products – use skim Fatty meats – no organ meats! Tropical oils, partially hydrogenated

vegetable oils and egg yolks – use egg beaters

Diet, Nutrition and Health: Tips on Diet

Have no more than one alcoholic drink per day if you're a woman

No more than two drinks if you're a man. "One drink" means it has no more than 1/2 ounce

of pure alcohol. 12 oz. of beer 4 oz. of wine 1-1/2 oz. of 80-proof spirits or 1 oz. of 100-

proof spirits.

Diet, Nutrition and Health: For people without heart disease Total fat should be 30 percent of total

calories or less.

Saturated fat should be less than 10 percent of total calories.

Cholesterol should be less than 300 mg per day.

Diet, Nutrition and Health Following a healthy eating plan will help you

achieve and maintain a healthy eating pattern.

The benefits include: a healthy body weight desirable blood cholesterol level normal blood pressure

Diet, Nutrition and Health Remember: WE ARE ALL HUMAN

Every meal doesn't have to meet all the guidelines, but it’s important to apply the guidelines to your overall eating pattern over at least several days

Exercise, Fitness and Health What do the

current American Heart Association Guidelines say about exercise?

Exercise, Fitness and Health: Helpful Hints

Maintain a level of physical activity that keeps you fit and matches the number of calories you eat (remember the basal metabolic rate) Walk or do other activities for at least 30

minutes on most days. To lose weight, do enough activity to use

up more calories than you eat every day.

Exercise, Fitness and Health: Helpful Hints

Doing housework - Housework for 1 hour a day will burn off 130 calories.

Work in the garden or mow the grass. Rake the leaves, prune bushes, dig and pick up trash. (your neighbors will thank you, too!)

Exercise, Fitness and Health: Helpful Hints

Go out for a short walk before breakfast, after dinner – or both! Start with 5-10 minutes and work up to 30 minutes.

When walking, pick up the pace from leisurely to brisk, and choose a “hilly” route.

Walk or bike to the corner store instead of driving.

Exercise, Fitness and Health: Helpful Hints

When watching TV, sit up instead of lying on the sofa. Or…spend a few minutes pedaling on your stationary bicycle while watching TV.

Throw away your video remote control. Instead of asking someone to bring you a drink, get off the couch and get it yourself.

Exercise, Fitness and Health: Helpful Hints

Park farther away at the shopping mall and walk the extra distance. Wear your walking shoes and go an extra lap or two around the mall.

Walk the dog. See the sights in new cities by walking,

jogging or bicycling.

Exercise, Fitness and Health: Helpful Hints

Make a date with a friend to enjoy your favorite physical activities.

Play your favorite music while exercising, something that motivates you.

Stand up while talking on the telephone. Join a recreational club that emphasizes

physical activity.

Exercise, Fitness and Health: Helpful Hints

When golfing, walk instead of using a cart.

Play singles tennis or racquetball instead of doubles.

Dance with someone - or by yourself. Take dancing lessons, and dance to fast tunes, instead of slow ones.

Herbal Medicines: What about them?

Who uses alternative medicine? In 1990: A study showed that 60 million

people used alternative therapies 2004: A follow up study showed this

had increased to 83 million adults The largest increase was in use of

herbal medicine, massage, megavitamins, self-help groups, folk remedies and homeopathic medicine

Herbal Medicines: Who uses them?

In 2004, 39 million people saw an alternative medicine practitioner

That equals 628 million visits compared to 385 million visits to their primary care provider

The Food and Drug Administration (FDA) does not regulate herbal supplements. (How do we know what’s in them?)

Herbal Medicines: Why are they used?

It is believed that people use alternative medicines because: They are dissatisfied with conventional

treatment The alternative medicines provide more

personal autonomy and control The alternative medicines are more

compatible with people’s values or beliefs regarding the nature of health and illness

Some Common Herbal Remedies

St. John’s Wort Echinacea Garlic Ginger Vitamin E Ginkgo Biloba

Some Common Herbal Remedies- Continued

Vitamin A Vitamin C Saw Palmetto Grape Seed Green Tea Noni Juice

Some Common Herbal Remedies: St. John’s Wort

Hypericum perforatum- approved in Germany and is best selling anti- depressant

Hypericin is the most active ingredient Side Effects: dry mouth, dizziness,

fatigue, constipation, and nausea There may be a role in mild

depression…Do not mix this drug with any other anti-depressants!

Some Common Herbal Remedies: Echinacea

A member of the daisy family Believed to act as a stimulant of the

immune system and aid in wound healing

Most commonly used in the U.S for colds and influenza (the “Flu”)

generally well-tolerated, but not for everyone

Some Common Herbal Remedies: Garlic Allium sativum (allicin) has been

used for thousands of years It may lower blood cholesterol

levels in large doses Dose: 600-900 mg/d garlic powder

– this equals about one medium sized clove of fresh garlic

Watch your breath!

Some Common Herbal Remedies: Ginger Zingiber officinale is believed to be

effective against nausea, vomiting, motion sickness and dizziness

Side effects: Watch out if you are on blood thinners, or have a bleeding disorder. Ginger may affect your bleeding time.

Some Common Herbal Remedies: Vitamin E

Vitamin E – may have a beneficial role in Alzheimer’s disease and heart disease.

A large study showed no benefit in prevention of cancer or heart disease and may increase the risk for heart failure.

Side effects include: Headaches, weakness, bleeding and increased cholesterol levels

Some Common Herbal Remedies: Ginkgo Biloba

From a living fossil tree - around for approx. 200 million years

cultivated for its nut and its leaves Ginkgo (Chinese for Yin-Kuo “silver

apricots”) Biloba (referring to its two-lobed fan shaped leaves)

Some Common Herbal Remedies: Ginkgo Biloba Used to improve memory – may

have a role in Alzheimer’s disease Side effects: Watch out if you are

on blood thinners, or have a bleeding disorder. Ginkgo Biloba may affect your bleeding time.

Some Common Herbal Remedies: Vitamin A Vitamin A and Beta Carotene are

antioxidants High intake in women may

increase risk of hip fracture High intake in smokers may

increase risk of lung cancer and heart disease

Some Common Herbal Remedies: Vitamin C ? Prevention of infections Dietary needs are up to 300-400 mg 8-oz glass of OJ contains 100 mg Small studies did not show

prevention of infections High doses may cause diarrhea and

may lead to kidney stones

Some Common Herbal Remedies: Saw Palmetto Felt to improve symptoms of

enlargement of the prostate Some small studies showed

improvement in symptoms A large study nearly completed

may shed more light

Some Common Herbal Remedies: Grape Seed Extract is a strong anti-oxidant First use of alcohol did not begin

with humans- who then? Resveratrol (skins of grapes)

shown to lower “bad” cholesterol and may protect vision.

Some Common Herbal Remedies: Green Tea Contains catechins and powerful

anti-oxidant May slow formation of cataracts Prevention of some cancers-

prostate

Some Common Herbal Remedies: Noni Juice Found in the South Pacific as a

green tropical fruit (Morinda citrifolia)

Felt to be beneficial in many illnesses including infections and high cholesterol

Reports of liver damage

Some Common Herbal Remedies: Conclusion

Some herbal remedies may be useful. Do not start any herbal remedies

without discussing first with your healthcare provider. There may be bad side effects, or it may interact with your current medications.

Some Common Herbal Remedies: Conclusion Each preparation may have a

different strength – product purity. Discuss with ALL your healthcare

providers what herbals and medicines you are taking. Don’t assume that one communicates with the other.

Conclusion Diet, exercise and nutrition are all

important to maintaining a healthy lifestyle.

Herbal medicines may be helpful – but discuss them first with your doctor before you start.

THANK YOU! AND STAY HEALTHY.

Questions, anyone?

(DON’T FORGET YOUR FLU SHOTS IF YOU’RE OVER 50)