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!!