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 blood pressure, cholesterol, 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. Presented February 17, 2016.

1. AFFECTING WELLCHECK
NUMBERS WITH
NUTRITION
CRISTIN STOKES, RDN, LN
MUS WELLNESS
FEBRUARY 17TH, 2016

2. 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

3. THE OTHER PIECES
• Don’t smoke/Stop smoking
• Exercise
• 150+ minutes/week recommended
• Lose weight if needed
• Stress management
• Sleep
• Genetics

4. BIG PICTURE
• Individual Foods vs Dietary Patterns

5. 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

6. 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

7. CHOLESTEROL
• Why it matters:

8. 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

9. 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

10. 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

11. 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

12. CHOLESTEROL
• Nutrition Rx: To raise HDL
• Importance?
• Healthy fats
• Nuts, seeds, olive oil, avocados, fish
• Moderate alcohol intake

13. 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

14. 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

15. TRIGLYCERIDES
Blood
Sugar
Time
Triglyceride production

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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

22. BLOOD GLUCOSE
Blood
Sugar
Time

23. BLOOD GLUCOSE
• Insulin
• Lock & key
• Sensitivity

24. BLOOD GLUCOSE
• Nutrition Rx
• Carb smart
• Plate method
• Choose whole over refined grains
• High fiber
Non-
starchy
veggies
Starch
Protein

25. 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

26. 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

27. 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

28. 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.com
• wellness@montana.edu