This document provides information about the V.I.P.S. (Vascular Improvement for Performance in Sports) program created by Dr. Alexander Castellanos and John-Lloyd Santamarina. The program aims to assess participants' cardiovascular health, reduce risk factors for vascular disease, improve cardiovascular health, and enhance sports performance. It involves initial vascular assessments, nutritional and exercise guidelines tailored to each person's health status, and reassessments after 6 weeks to track progress. Upon completion, participants will receive recognition of participation and information to share about their vascular health improvements.

1. V.I.P.S.
(Vascular Improvement for Performance in Sports)
A Program by:
Alexander Castellanos, M.D.
John-Lloyd Santamarina
June 14, 2013

2. A Brief Introduction

3. -Medical practice since 1977
-Focuses on Pro-active Medicine
-Provides continuity of Care
-Allows strong patient-physician
relationships
For more info, visit: www.templetondoc.com

4.  University of San Francisco,
Bachelor of Science (1972)
 Stanford University School of
Medicine,
Medical Degree (1977)
 U.C. San Francisco, Santa Rosa
Internship (1977-78)
 U.C. Irvine
Residency (1978-80)
Dr. Alexander Castellanos
Education & Training

5.  Trauma Medicine (1978-1985)
 Family Medicine (1985-present)
 Preceptor for Nurse
Practitioners, Stanford, UCSF,
USF and Davis
Dr. Alexander Castellanos
Work & Experience

6.  U.S. Patent Number 7.074,183
-method and system for
improving Vascular Systems in
humans using biofeedback
and network data
communications
Dr. Alexander Castellanos
Inventor

7.  Breeding and training horses
 Martial arts- Aikido instructor
 Music- playing the trumpet,
guitar and piano
 Running
 Home improvement projects
 Gardening
 Owner/Builder of straw bale
houses
Dr. Alexander Castellanos
Personal Interests

8. Before we begin the presentation,
we would like to thank everyone
for participating in this innovative
program

9. V.I.P.S. Presentation

10. Docyo
Overview
Question & Answer
Nutrition and Exercise
V.I.P.S. Program
Vascular Assessment

11. Docyo
Question & Answer

12. Docyo
1. Which of the following beverages will be
most beneficial during physical activity?
a.) Energy Drinks c.) Protein Shakesb.) Gatorade

13. The S.S.C. Syndrome: Sugar-Salt-Cold

14. The S.S.C. Syndrome: Sugar-Salt-Cold

15. Docyo
1. Which of the following beverages will be
most beneficial during physical activity?
a.) Energy Drinks c.) Protein Shakesb.) Gatorade

16. Docyo
2. For optimum performance, which of these
“diets” are most essential?
a.) Saturated and
Unsaturated Fatty
Acids c.) High Protein
b.) Simple and
Complex
Carbohydrates

17. Docyo
3. The dictum “No Pain, No Gain” is:
a)True
b)False

18. Docyo
4. Which is most important for physical
training?
a.) Weight Lifting
(anaerobic exercise) c.) Both
b.) Jogging
(aerobic exercise)

19. Docyo
Nutrition and Exercise

20. Docyo
Simple carbohydrates = Simple Sugars (only) = Glucose
Simple Carbohydrates
• Most are a form of energy with no nutritional value
• The brain cells need sugar, however too much is bad
• Too many simple sugars will be stored as fat

21. Docyo
Complex Carbohydrates = Simple Sugar + Nutrients
(Minerals and Vitamins) + Fiber
Complex Carbohydrates
• Includes Fiber - Helps for proper functioning of the Digestive
System
• Too much complex carbohydrates are also stored as fat
• Every serving of a whole grain product decreases your risk of
Diabetes Mellitus by 10%
Food =
Carbohydrates=
Calories=
Energy

22. Docyo• The primary function of carbohydrates is to provide energy (as
glucose) for the body, especially the nervous system.
• carbohydrates = total calories, causing obesity
• carbohydrates = malnutrition or fat intake
(to make up for the lost carbohydrates)--
• Most people should get 40% to 60% of total calories from
carbohydrates, preferably from complex and natural sugars (=
calories, vitamins, minerals and fiber)
• Processed or refined simple sugars provide energy, but very
little nutrition. It is wise to limit these sugars
Carbohydrates in Diet

23. Docyo
Proteins
• Proteins are essential in
bodies’ normal functions
• Assists in synthesizing
enzymes and hormones,
maintaining fluid balance, and
regulating vital functions such
as building antibodies
• Building blocks for muscles,
bones, cartilage, skin, hair and
blood
Proteins = Amino Acids = All other types of Protein

24. Docyo
Truth About Protein #1
• Uric acid is a byproduct of purine
metabolism
• Purine is found in most protein rich-
foods
• Uric acid in blood stream =
function of kidneys to eliminate
excess purine
• Uric acid can crystallize = gout
and/or kidney stones
Proteins ≈ Purines = Uric Acid

25. Docyo
Truth About Protein #2
• The body will use Protein as substitutes to
Carbohydrates/Simple Sugars if that is the only thing it has
• Protein metabolism causes excess build up of ketones
• Kidney goes into overdrive to flush excess ketones = may lose
kidney function
• Significant loss of water follows flushing of ketones =
dehydration
Protein in diet + Carbohydrates = Toxic Ketones

26. Docyo• Protein is necessary in diet to help body repair cells
and make new ones; for growth and development;
and to supply the essential amino acids that our
bodies are incapable of synthesizing
• However, too much Protein can have adverse effects
(as previously mentioned)
• It’s recommended to consume 0.36 g of protein for
every pound of body weight and that 10%-30% of daily
caloric intake come from protein
• > 30% can be harmful to your body
Protein in Diet

27. Docyo
Fatty Acids = Hydrocarbon chains = Energy Source
Fatty Acids
• Fats are important for the body for many
functions such as insulating nerve cells, balancing
hormones, maintaining cell membranes, etc.
• They are also an important energy source, > 6x
that of carbohydrates per unit storage of mass
• But too much fat can cause harm: obesity,
atherosclerosis, etc.
• It is important to determine type of fatty acid to
consume as some are better than others

28. Docyo• The long chain of carbon atoms in the molecule
are completely surrounded by hydrogen (all
single bonds)
• Most are solid at room temperature
• Stimulates the body to increase levels of
cholesterol in blood (LDL = bad cholesterol)
Saturated Fatty Acids

29. Docyo
• The long chain of carbon atoms in the molecule
have either one (monounsaturated) or more
(polyunsaturated) double bonds
• Most are liquid at room temperature
• Contains essential fatty acids that the body can’t
manufacture (omega 3 and omega 6)
• Linked to HDL production (good cholesterol)
Unsaturated Fatty Acids

30. Docyo• Fatty acids are good energy sources when
carbohydrates are not available
• They are important for many body functions
• However, they stimulate production of cholesterol
(good and bad), and they are very dense in calories
• It is therefore important to keep all fat to a
minimum, especially saturated fatty acids.
• AHA recommends to limit fat intake to 10% to 30% of
total calories, with saturated fatty acids at only 7%
Fat in Diet

31. Docyo
Exercise
• Sedentary lifestyle
dangerous for health
• Tied to diabetes, obesity,
heart disease and
premature death
• Physical activity can help
improve overall fitness
• Two types of exercise:
aerobic and anaerobic

32. Docyo
• oxygen consumption
• aerobic glycolysis for energy
• relatively low intensity
• heart rate
• circulation
• typically long duration
• benefits: cardiovascular system,
stamina, resting heart rate
• examples: running, jogging, swimming, cycling
Aerobic Exercise

33. Docyo
• “without oxygen”
• relatively high intensity
• relies on: muscle ATP reserves,
anaerobic glycolysis, creatine phosphate
• benefits: muscle strength, mass and
flexibility, bone strength
ability to withstand fatigue (lactic acid)
• examples: weight-lifting, sprinting
Anaerobic Exercise

34. Docyo
V.I.P.S. Program

35. Docyo
V.I.P.S.
Vascular Improvement for Performance in Sports

36. Vascular Disease
… the 70,000 miles of Arteries that pump blood through your body.
Cardiovascular Disease effects the Heart and …

37. Docyo
The Normal Artery
 Arteries open and close in all
mammals including men and
women
 Damage or disease of your
circulatory system is called
Vascular Disease
 A normal artery is free of
plaque formation
 The artery wall is very thick and
elastic
 A healthy artery can do its job
of pushing blood throughout
your body

38. Docyo
Plaque
 Plaque is accumulation of fats including cholesterol
 Sever plaque formation can cause Heart Attacks and
Strokes

39. Docyo Apparent in various arenas (i.e. football, soccer, baseball)
 Studies have shown that a significant proportion of players
have potentially life threatening levels of fat and
cholesterol in blood
 Increases risk of sudden cardiac death, heart attack and/or
stroke during vigorous activities (such as competitive
sports)
 Sports-related sudden death in the general population is
considerably more common than previously suspected
Vascular Disease in Sports

40. Docyo
Risk Factors of Vascular Disease
 Smoking
 High Blood Pressure
 Diabetes
 High Cholesterol
 Anger/Rage
 Sedentary Lifestyle
 Overweight
 Ethnic Characteristics
 Family History

41. Docyo
Instead…

42. Docyo Determine Cardiovascular status
 Reduce risk factors for Cardiovascular Disease
 Improve Cardiovascular health
 Improve performance in sports
Goals of the V.I.P.S. Program

43.  Take common measurements like BP
and weight
 Do a Doppler Waveform analysis of
radial arteries
• Triphasic vs Biphasic vs Monophasic
• High vs Low Peak Velocity
• Wide vs Narrow Waveforms
 Determine Cardiovascular Status

44.  Provide recommendations in terms of
exercise and nutrition
(dependent of cardiovascular status)
 Reduce Risk Factors for
CardioVascular Disease

45. Our Recommendations/
Guidelines

46. Docyo
Nutritional Guidelines
∗ Water: Drink plenty of water. If you are not urinating every hour
throughout the day, you are not drinking enough water. This may be
more than 8-9 glasses (traditional recommendation)
∗ Breakfast: This is the most important meal of the day. Breakfast should
never be skipped! Enjoy it! Eat a well-balanced meal that consists of
favorite health and low-sugar breakfast foods. This will jumpstart your
day.
∗ Lunch: Lunch is considered by many to be the main meal of the day. A
well-balanced and healthy lunch keeps your body going throughout the
day and well into the night. Eat your protein at this meal.
∗ Dinner: Dinner should be your smallest meal of the day. Bodies will be
stressed because we digest instead of rest. Small amounts of
carbohydrates, no protein at least four hours before retiring.
“Eat breakfast like a king, lunch like a prince, and dinner like a pauper.”

47. Docyo
Nutritional Guidelines
∗ Dairy: Avoid milk and cheese. Milk contains hormones, fat and can
cause intestinal irritation. Replace with Soy or Rice milk, Yogurt (non-
fat) occasionally. No use of butter or margarine. Use olive oil as a
replacement as much as possible
∗ Meats: 2 (2-4 oz., fist size) servings/week [3-4 for athletes]. This
includes Chicken, Beef, Turkey, Lamb & Pork
∗ Fish: 3 (2-4 oz., fist size) servings/week
∗ Beverages: For better digestion, a minimal amount of beverage should
be taken with meals. In addition, beverages should be taken 30
minutes before or 2 hours after your meal

48. Docyo Intensity
 Time of day
 80% = aerobic stretches
 20% - anaerobic, isometrics
Exercise Guidelines
(dependent on vascular health status)

49.  Provide recommendations in terms of
exercise and nutrition
(dependent of cardiovascular status)
 Provide weekly reminders (via
email) of recommendations
 Reduce Risk Factors for
CardioVascular Disease

50.  Reassessment in 6 weeks of
cardiovascular health
 For the participants highly motivated to
better your health and keep track of you
progress, you may also visit the office:
Alexander Castellanos M.D. Inc. once
every week, between 12pm-1pm, M-F to
reassess BP, weight, and vascular status
 Hopefully, signs of improvement in
terms of weight, BP and vascular status,
will be apparent at the end of the 6
weeks (or weekly if you choose to visit
the office every week)
 Improve Cardiovascular Health

51.  KEEP WINNING GAMES!!!!!!
 Improve performance in sports

52. Docyo
And you will receive the following
upon completion of program
 Commemoration of
participation in the
program
 Show college trainers of
progress (pre and post)
 Educated in personal
vascular health
awareness

53. Docyo
And you will receive the following
upon completion of program
 Pin for
uniform/backpacks/etc.
 Remembrance of
participation in program

54. Docyo
Vascular Assessment

55. Docyo Head over to the backroom one at a time
 Once again, thank you for your time
 Good luck and have a great season
 We will see you again in 6 weeks
Vascular Assessment