E4 immigrant health and nutrition

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.
Obesity
Cardiovascular disease
Diabetics

NutriGenomics 营养基因学 Nutrigenomics explains nutrient-gene interaction and provides information related to risk as well as information on the impact of lifestyle and nutrition Gene-Nutrition Lifestyle Nutrition Genome Can modify Can’t modify

Gene-Nutrition

Health Canada
Communicates 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 ** Overweight 25-27, CANADA, 1988 Classification BMI Category (kg/m2) Risk of developing health 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

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 * WHO, 2000 ; **CANADA, 2003 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)

2) Heart Disease and Nutrition Gene-Nutrition

HDL and LDL
LDL =“bad”
Too much can clog arteries by forming plaque
Atherosclerosis can cause heart attack or stroke
HDL =“good”
Tends to carry cholesterol away from arteries and back to liver
Remove excess cholesterol from plaque in arteries, slows build up
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
Gene-Nutrition

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.

Number of Studies Conducted in T2D, Gene, and Diet Gene-Nutrition 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
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.
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.
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 Gene-Nutrition 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!

LOW GI WORKS BEST
Best Impact On Blood Sugar Levels
Decreases Hunger, Increases Satiety
Less Restrictive And Variety Of Healthy Food Choices
Can Be Followed For Life
Preserves Lean Muscle
More Permanent Weight Loss
Addresses Body Composition Through Fat Loss

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.
Gene-Nutrition

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 .
Gene-Nutrition

Enzymes
The most vital nutritional discovery since Vitamins and Minerals
Supports a healthy digestive tract:
Promotes digestion
Supports nutrient absorption
May help ease stomach upset
Helps maintain healthy cholesterol levels
Supports healthy immune functions
Gene-Nutrition

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.
Gene-Nutrition

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

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
Gene-Nutrition

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 day Males 50+ 30 g per day Females 19-50 25 g per day Females 50+ 21 g per day
Gene-Nutrition

Vegetables
Vegetables are mainly
carbohydrates that are high in antioxidants, phytochemicals and fiber.
Dark green vegetables will help to alkalinize the body and are a great source of calcium.
Vegetables are also low in calories and sugar so they feed your body with nutrients without a lot of calories.
Gene-Nutrition

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 cup
Chicken noodle soup 2 g per 1 cup Lentil soup 12 g per 1 cup
Corn 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 cup
White pasta 3 g per 1.5 cups cooked Whole wheat pasta 8 g per 1.5 cups cooked
Chocolate chip muffin 2 g per muffin Raisin Bran muffin 5 g per muffin
Apple juice 0.1 g per ½ cup Apple 3 g per apple with skin
White rice 0.8 g per 1 cup cooked Brown rice 3 g per 1 cup cooked
Chips – 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
Gene-Nutrition

E4 immigrant health and nutrition

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