Preventive Ways to Monitor your Fitness and Health Level:
"Know Your Numbers"
Erik Nieuwenhuis MS, PT St. Luke’s Physical Therapist
Nieuween@stlukes.org 402-412-4275

I want to challenge each of you to know the results of the following tests (Know your numbers) and set goals for yourself to improve your health and wellness (quality of life) for 2007 and beyond. Do this for yourself and for those you love. You deserve God’s very best and a healthy body is a must to complete your purpose in life. All of these tests will monitor your overall health and wellness levels and let you know of your risk factors for having chronic medical conditions such as; Heart disease, high blood pressure, diabetes, obesity/ overweight, Stroke, Musculoskeletal and Arthritis pain/ dysfunction, Respiratory disease and Cancer. The closer you get towards the Healthy guidelines/ goals for each test listed below the greater the benefits to your health and the more FUN you’ll have is LIFE.

1) Regular Testing of your Blood Pressure JAMA 2003: 289(19):2560-2574 and NIH Pub 2003
Ideal 115/ 75
Normal/ Healthy < 120/ 80 ADA (American Diabetes Association) Goal is <130 / <80
Pre-Hypertension 120 to 139 / 80-89
Stage 1 Hypertension (HTN) 140-159/ 90-99
Stage 2 HTN > or = to 160 / > or = to 100

2) Cholesterol Levels (HDL, LDL, Triglycerides and Total Cholesterol) www. CDC.org
Healthy Cholesterol Guidelines;
- Total cholesterol below 200
- LDL cholesterol below 130 (below 100 is optimal and 100 to 129 is near optimal)
- HDL cholesterol 60 and above is (optimal), 40-59 is average
- Triglycerides 101 - 150 Normal (< less than 100 is low risk)

ADA Goals:
- LDL < 100 mg/ dl
- HDL > 40 Men and > 50 Women
- Triglycerides < 150 mg/dl

Borderline High Risk:
- Total Cholesterol 200-239
- LDL 130-159
- Triglycerides 150-199 mg/dl

High Risk is one or more of the following:
- Total Cholesterol 240 or higher
- LDL 160 and above (190 and above is very high risk)
- HDL below 40 mg/dl
- Triglycerides 200 to 499 (500 and above is extremely risky) mg/dl
- Total to HDL ratio 3.5 to 4.5 to 1

3) Fasting Blood Sugar or if Diabetic-- Hemoglobin A1C (ADA Recommendations)
- Check Blood Sugar before meals 80-130
- < 180 1 to 2 hrs after meals (risk factors for atherosclerosis are more strongly associated with 2hr glucose than HbA1C) Diabetic Med 21(3):208-13, 2004
- Before bed 100-140

Hemoglobin A1C:
- < 6% Non diabetic level
- 6-7% Near normal blood sugar level
- < size="2">(Goal by American Academy of Endocrinologists is 6.5% or less)
- 7-8% Good Control
- > 8% Action suggested (The average A1C remains over 8.5% and up to 1/3 of diabetes patients have an A1C above 9.5%)

4) Body Fat Percentage; American Council of Exercise, American Dietetics Association, and Age Related Healthy Body Fat Guidelines

Classification Women % Fat Men % Fat
Essential Fat 10-12 % 2-4 %
Athletes 14-20 % 6-13 %
Fitness 21-24 % 14-17 %

Recommended Body Fat Ranges by Age: Healthy/ Recommended Overweight Obese
Female 20 to 39 years old 21 to 33 34 to 38 > than 38
Female 40 to 59 years old 23 to 34 35 to 40 > than 40
Female 60 to 79 years old 24 to 36 37 to 41 > than 41

Male 20 to 39 years old 8 to 20 21 to 25 > than 25
Male 40 to 59 years old 11 to 21 22 to 27 > than 27
Male 60 to 79 years old 13 to 25 26 to 30 > than 30

5) Waist measurement (girth) in inches (Measurement is taken at top of pelvis—bony landmark for measurement)
NOTE: Waist measurement is a strong predictor of risk of Cardiovascular Disease (CVD); High blood pressure, High blood sugar/ Diabetes, High LDL (Bad) Cholesterol, and/ or Low HDL (good) Cholesterol
American Journal of Clinical Nutrition 2005; 81:409-15 Feb 2005

Classification Women Men
Ideal—Lowest Risk 29 inches 32 inches
Healthy Less than 33 inches Less than 37 inches
Overweight 33 to 36.9 inches (1.4 times CVD risk) 37 to 39.9 inches (1.5 times CVD risk)
Obese, High Risk 37 to 40.9 inches (2.6 times CVD risk) 40 to 44.9 inches (2.0 times CVD risk)
Obese II, Higher Risk 41 or more inches (5.2 times CVD risk) 45 or more inches (5.0 times CVD risk)

6) Body Mass Index: www.CDC.org
Below 18.5 is underweight
Normal 18.5 to 24.9
Overweight 25 to 29.9
Obese (Grade 1) > or = to 30 to 34.9
Obese (Grade 2) > or = to 35 to 39.9
Obese (Grade 3) > or = to 40

With each New Year I highly recommend you do some SMART goal setting for yourself (S=Specific, M=Measureable, A=Attainable, R=Reward yourself after meeting goals, and T=Timed). Ask your spouse and family/ friends to help keep you accountable to your goals for better health. Each Choice YOU make daily has consequences on your future health and wellness and your JOY in Everyday Life. “Listen to the voice of truth”, not the voice of the enemy telling you that overeating or overworking have no lasting consequences. Get ready “To AWAKEN” your bodies very best to come in 2007 and beyond! By Daily improving the Choices you make in regards to What, How much and When you Eat, Increasing your Activity Level, Journaling your progress, Having Family/ Friends to keep you Accountable, and Do ALL of this in a Spirit of Prayer in Jesus name…Your Bodies Transformation will happen one day at a timeJ!!

Whole Person WELLness (Body, Mind and Spirit) is Achieved One Wise Choice at a Time for LIFE!!

12 Ways to Make Your “REAL AGE” Younger
By Erik Nieuwenhuis MS, PT St Luke’s Rehab Services 402-412-4275 Nieuween@stlukes.org
Taken from www.realage.com by Micheal F. Roizen MD

Would you enjoy living at age 50 feeling like you did at age 25? How you say, by taking the Real Age Test? Dr. Michael Roizen is a medical doctor who came up with this measurement tool to assess your daily lifestyle choices and habits, and by using this tool you are able to determine your biological age. He and his team have reviewed over 25,000 medical studies which revealed 125 different factors that can influence the rate of your bodies aging process.

Have you taken the Real Age Test? You can take this FREE online at www.realage.com and I highly recommend that you and your family, your company or team do so to improve your health/ wellness and improve your Quality of Life!!

You can take over 30 interactive health assessments at no cost that provide personalized grow younger strategies, based on your current lifestyle habits and your goals. They include quizzes and other tools such as; Real Age Tip of the Day (which can be emailed to you each week..I’ve been doing this for about three years now), Personalized Calorie Count, Exercise Estimator, Whole grains pop quiz, Food labels, My fitness plan, Recipe box and much more to help you determine your risk of getting diseases such as cardiovascular disease, diabetes, and cancer. Then they give you a detailed list of what YOU can do to reduce each risk factor with the help of your doctor and each assessment is based on state of the art scientific research tailored to you.

Top 12 Ways to Make Your REAL AGE Younger:

1) Take your Vitamins—Regularly taking vitamin C (1200 mg/day), vitamin E (400 IU/ day), calcium (1000-1200 mg/day), vitamin D (400-600 IU/ day), folate (400 mcg/ day), and vitamin B6 (6 mg/day) can make your Real Age 6 years younger.
2) Quit Smoking and Avoid Passive Smoke---Smoking makes your Real Age 8 years older.
3) Know Your Blood Pressure---A person with low blood pressure (115/ 75 mm Hg) is as much as 25 years younger than a person with high blood pressure (greater than 160/ 90 mm Hg).
4) Reduce Stress---In highly stressful times, your Real Age can be as much as 32 years older than your calendar age. By building strong social networks and adapting stress-reduction strategies, you can erase 30 of those 32 years of aging caused by stress.
5) Floss Your Teeth---Flossing and brushing daily can make your Real Age 6.4 years younger.
6) Be Active---Even a small amount of exercise, two 20 minute walks per day can make your Real Age nearly 5 years younger.
7) Wear Your Seatbelt---Regularly wearing your seatbelt and driving within 5 miles per hour of the speed limit can make your Real Age as much as 3.4 years younger.
8) Fill Up on Fiber---Getting 25 grams of fiber per day in your diet can make your Real Age 2.5 years younger than in you only included 12 grams of fiber per day in your diet. Men may need even more than 25 grams of fiber per day.
9) Monitor Your Health---People who are proactive about seeking high-quality medical care and managing chronic conditions can have a Real Age as much as 12 years younger than their peers who do not.
10) Take the Real Age Test and Develop an Age Reduction Plan---Over your lifetime, you can make your Real Age as much as 26 years younger. That means that you will live younger every day, and live longer with as much health and energy as possible.
11) Laugh a Lot ---Laughter reduces stress, strengthens the immune system, and can make your Real Age as much as 8 years younger.
12) Become a Lifelong Learner---People who remain intellectually involved throughout their lives have a Real Age as much as 2.5 years younger.

Check out St Luke’s Center of Preventive Medicine at 712-252-8181 and ask for Beth Krienert Center Coordinator and www.thecenterforpreventivemedicine.com to find out more about taking initiatives for yourself, your family and your company to Live Life Better…Longer!!

S.M.A.R.T Goal Setting for LIFE
By Erik Nieuwenhuis MS, PT St. Luke’s Rehab Services 402-412-4275 Nieuween@stlukes.org The WorkSmart and Get Fit Guy

The average person spends more time each year planning a vacation then they spend planning and reflecting on their life goals and purpose. Goal setting is a powerful motivating tool for personal progress to live a balanced life in Body, Mind and Spirit. Goals help keep you focused on what you want to accomplish in life and help you reduce stress by staying focused.

First, what is the definition of a goal? A goal is the ongoing pursuit of a worthy objective until accomplished. You must also allow for celebration of the accomplishment/ or goal that you set for yourself.

When I attended college at the University of Northern Iowa in Cedar Falls, I was a founding father of the Sigma Phi Epsilon fraternity chapter “Sig Ep” and our motto was “The Balanced Man”. We looked for balance in all areas of Life; Body, Mind and Spirit. Some of my favorite memories of UNI were philanthropy events we took part in each year; The Big Brothers/ Big Sisters Bowl a Thon (January is National Mentoring Month and currently there are 80 boys on the waiting list for a mentor in Siouxland. I challenge you to step up to the task and mentor a youth from the Siouxland Community. I’ve had the pleasure of doing this two times in college at UNI and in Sioux City. It has been one of the best decisions I’ve made in my life.), and the Diamond Vogel Paint a Thon for the United Way. The brotherhood and community gained along with the life lessons learned by serving others in the Cedar Falls/ Waterloo and Sioux City community have helped to shape me into the person that I am today.

A Sig Ep brother/ mentor of ours Tom Barton gave us an acronym for goal setting which I use and I highly recommend to all of you to use each year, SPE-SPIF. Which stands for Spiritual, Physical, Emotional, Social, Professional, Intellectual, and Financial.

Before you set a goal make sure that you know the following; 1) The benefits of achieving the goal 2) Possible obstacles you might encounter 3) How you will overcome these road blocks and obstacles toward the progress of meeting your goal 4) What resources will you need to be successful in meeting your goal such as; information, equipment, people and support.

To further clarify the seven areas of living a balanced life. Spiritual includes religion, your relationship with God, community service, values and purposes for life. Physical is your health such as; fitness level, nutrition, and rest. Emotional includes family, intimate relationships (spouse), self esteem and self talk, and your own maturity. Social includes anything that is FUN, like family and friends and building/ strengthening relationships, vacations, and general recreation. Professional includes my overall career goals, and job goals. Intellectual means anything related to learning new things such as; reading books, learning another language, visiting museums, etc. Financial is money management, paying off debt, tithe, stewardship of your money and possessions.

Now you must make the goals you set for yourself S.M.A.R.T. which is specific, measurable, achievable, rewarded, and timed. A couple examples of SMART goals I set for myself this year are;

1) Physical--To have my hemoglobin A1C tested in Jan 06’ and done every 3 months (4 times in 06’) to maintain a 7.0 mg/dl (goal for diabetics by ADA) or less working towards 6.5 mg/ dl recommended by American Academy of Endocrinologists. Dr. Francisco Cruz is my endocrinologist (since I am a juvenile diabetic using a Medtronic minimed paradigm insulin pump) and Dr. Folchert is my family practice physician.
2) Physical—To strength train using our Bowflex, dumbbells, medicine balls, theraband/ tube 2 to 4 times each week for a minimum of 30 minutes to 90 minutes. To improve and/ or maintain my strength and body composition, reduce stress, improve my blood sugar control, and increase my energy level.
3) Physical—To eat 5 to 9 servings of fruits and vegetables each day to improve my energy level, blood glucose control and prevent and reduce future health risks of cancer/ heart disease/ and complications of diabetes.
4) Mental—To write/ reflect in my journal 3 to 5 times each week on life events, goals, lessons learned, and scripture/ prayer.
5) Spiritual—To read the Bible daily (25 times each month) following the Navigators plan of daily discipleship to read through the Bible in 2006.
6) Spiritual—To continue leading the “Pump and Praise” Wellness Ministry at Sunnybrook Community Church on Saturday mornings at 8am and keep this at No Cost for members or to the public in 2006.

Goal setting is not a difficult process, but it does require some thought and evaluation. Write your SMART SPE-SPIF goals in a journal or notebook so you can stay focused or make any changes as life changes occur. Review them often and have them available so you can see them each week. Remember if you aim at nothing in life, you’ll hit it every time.

Winter Wellness—Ways to Boost Your Immunity
By Erik Nieuwenhuis MS, PT St Luke’s Rehab Services 402-412-4275 Nieuween@stlukes.org

Limiting your exposure to harmful organisms is one of the best preventive measures you can take daily. Washing your hands before you eat, after going to the bathroom, after you shake hands or touch surfaces that others have touched such as door knobs/ computer mouse/ etc… Work to limit your time around people who are sneezing or coughing. These measures can significantly cut you and your families infection risks from the cold and flu season that we are entering in the Siouxland area.

Following are Eight Tips to Boost You and Your Families Immunity for LIFE:

1) Maintain Relationships Those who maintain an active social life and those who participate in religious or community groups are less likely to experience depression than those without community or relationships. Depression reduces your immunity by inhibiting the activity of the T and B warrior cells. Relationships need to be three fold in our life; God, Others and Self.

2) Daily Physical Activity/ Exercise People who get regular physical activity and exercise have significantly improved immune systems, reducing your chances of getting the flu and/ or colds. Being physically active and exercise also reducing the length and severity of your cold and fluJ Each time you get physically active by walking your dog, carrying your son or daughter, taking the stairs at work, scooping snow or raking leaves, or attending Pump and Praise at Sunnybrook Community Church (http://3dwellness4life.blogspot.com/) your body releases endorphins a natural pain killer. The stronger your muscles, the better endurance of your heart and lungs that you have the better your immune system will be and the more you’ll enjoy your daily life.

3) Managing Your Stress Level Stress itself doesn’t weaken your immune system, however poor responses to stressful situations in our daily lives do such as; smoking, eating too much/ not eating/ or making poor choices in what you eat, taking illegal drugs, drinking too much, not exercising or being physically active, are linked to increased risks of infections to your body. Not getting enough sleep daily (7 to 8 hrs each day) is both a cause and an effect of stress. If you don’t get enough sleep daily your bodies immune system fighters the T and B warrior cells are not effective in fighting colds, flu, and infections. Stress Reducers: Deep breathing, prayer, walking and enjoy music or the outdoors, spending quality time with your spouse, children and pets, or engage in any type of exercise.

4) Getting Your Omega 3 Fatty Acids Omega 3 fatty acids in fish and nuts have been shown by research to improve your bodies immunity and reduce your risks for depression. Nuts and fish also are BIG friends of a healthy heart and help prevent heart disease, high blood pressure, and stroke. These fatty acids (or good fats such as poly and mono unsaturated fats) also help to improve your blood sugar control if you are a diabetic. Have a palm full (1 serving) of walnuts/ almonds/ or peanuts 1-2 times daily, 3 servings of fish each week, or take 2 grams of a fish oil supplement daily.

5) Boost Vitamin C and Flavor Flavonoids These are best found in choosing a wide variety of fruits, vegetables, and whole grains to eat each day. From the book, “The Food Doctor” the 10 top vegetables to improve your immune system are; Asparagus, Broccoli, Carrots, Cauliflower, Garlic, Mushrooms, Brussel sprouts, Red onions, Peppers and Squash. When you have an infection or if you want to prevent one eat lots of raw and/ or lightly steamed vegetables. The above vegetables contain high levels of antioxidants, and have strong antiviral, antibacterial and anti-fungal properties as well as being natural antibiotics. Vitamin C studies have shown that eating 500 milligrams (mg) twice daily works to boost your immune system T and B warrior cells which can be found in the above vegetables, and tomatoes, citrus fruits or you can achieve this with a supplement. Research and I suggest the natural way if possible through your daily intake of fruits and vegetables. Some of the other best sources of fruits to find Vit C and flavonoids are; Cranberry juice, tomato juice, apples, strawberries, and red wine.

6) Avoid High Sugar and Processed Foods High sugar and processed foods such as; Candy, cakes, cookies, donuts, sugar filled cereal, and regular pop or soda should be limited and/ or avoided as much as possible if you are trying to lose/ maintain your weight and build your immunity. These foods can quickly drive your blood sugar level above 250 millimoles per liter of blood (normal is between 65 and 140). Elevated blood sugar levels impairs your bodies ability to destroy bacteria, thus increasing your chances of becoming sick or getting an infection.

7) Change Your Air Filters for Your Heater More Often This is a KEY in today’s culture as many people spend as much as 90% of their time indoors, and indoor levels of many pollutants can be 2 to 5 times higher than outdoor levels according to the American Lung Association. The Environmental Protection Agency (EPA) has identified indoor air pollution as one of the top 5 urgent environmental risks to public health. Exposure to indoor air pollutants such as smoke, household dust, dust mites, pet dander, pollen, molds, smog, bacteria, particles that can carry viruses and other pollutants can pose health risks and contribute to respiratory disease, allergies, and asthma. Filters should be changed every 1 to 3 months, and based on your current health and the home that you live in, habits, and pets. Some brands of Air Filters that we have used in the Nieuwenhuis home are; 3M Filtrete Ultra Allergen 1250 performance rating, DuPont Platinum model Ultimate allergen grades. Check out many of the options at; Lowes, Home Depot or Menards.

You can also purchase air purifiers for your home. We purchased two Sharper Image Ionic breeze professional series germicidal protection air purifiers that have significantly reduced my wife and my allergy problems over the past two years. The most important thing to look for in air purifiers is the size you need for the rooms in your home.

8) Filter the Water YOU Drink It is highly recommended to purchase PUR, Brita or other water filtration systems for your home. These can be put on your water faucet directly or poured into a container that filters the water and is then stored in your fridge. These too can be purchased at Lowes, Home Depot, Menards, Walgreens, WalMart, and HyVee, among others in Siouxland. These will protect you and your family from reduced risks of gastrointestinal illness (such as diarrhea, vomiting, cramps). Water filtration reduces the heavy metals (lead and mercury), chlorine (taste and odor), benzene, MTBE, and TTHMs to provide healthy, clean and great tasting water. Water is one of the keys to drink daily to achieve your goals for health and wellness (increase your energy level)….not to mention drinking water will help you loose body fatJ!!

Sources:
1) Bottom Line Personal Nov 15, 2006 “Boost Your Immunity” Proven ways to stay healthy” by Michael F Roizen MD http://www.realage.com/
2) Healthier You Oct 06 magazine “Making Sick Homes Healthy” by Barbara Seale
3) The Food Doctor (Healing foods for mind and body) Collins and Brown 1999 by Vicki Edgson and Ian Marber
4) The Great Physicians Prescription for Health and Wellness by Jordan Rubin 2005 by Thomas Nelson, Inc.

Matthew 10:29-31 www.reverendfun.com