1. Your Personal Wellness Profile Healthy OHIO 2015

2. Today’s Topics Your biometric screening values Your personal wellness in action: Is it in action? Fitbit ® and your activity status The 4 S’s of an active lifestyle Exercise and Sedentary Time The 3 P’s of personal value Your specific questions Heart Health Blood Sugar Healthy Weight Get Moving Cancer Prevention Bone Health Limit Sedentary Time

3. Know Your Numbers (page 13 of your Personal Wellness Profile) Body Mass Index (BMI): Calculation based on height and weight: wt.(kg) ÷ ht.(m 2 ) Doesn’t account for gender, muscle mass, or frame size As BMI, health risks Waist Circumference (WC): Goal for Men: ≤40 inches, (ideal <37 inches) Goal for Women: ≤35 inches, (ideal <33 inches)

4. Body Measurements & Health Risk Weight CategoryBMI Underweight<18.5 Healthy Weight18.5 – 24.9 Overweight25.0 – 29.9 Obesity (class I)30.0 – 34.9 Obesity (class II)35.0 – 39.9 Obesity (class III)≥40.0 Source: Archives of Internal Medicine. 1998; 158: 1855-67.

5. Percent Body Fat: Women Age % BF Category 20 - 29 y.30 – 39 y.40 - 49 y.50 – 59 y.60 – 69 y.70 – 79 y. Very Lean9.8 - 16.5 11.0 - 17.4 12.6 - 19.8 14.6 - 22. 5 13.9 - 23.2 14.6 - 24.0 Good16.6 - 19.4 17.5 - 20.8 19.9 - 23.8 22.6 - 27.0 23.3 - 27.9 24.1 - 28.6 Average19. 5 - 22.7 20.9 - 24.6 23.9 - 27.6 27.1 - 30.4 28.0 - 31.3 28.7 - 31.8 High22.8 - 27.1 24.7 - 29.1 27.7 - 31.9 30.5 - 34.5 31.4 - 35.4 31.9 - 36.0 Obese>27.1 >29.1 >31.9 >34.5 >35.4 >36 Note: minimal recommend percent body fat is defined as 10-12% for women. Source: American College of Sports Medicine: Guidelines for Exercise Testing and Prescription, 8th Edition, 2010.

6. Percent Body Fat: Men Age % BF Category 20 – 29 y.30 – 39 y.40 – 49 y.50 – 59 y.60 – 69 y.70 – 79 y. Very Lean4.2 - 10.5 7.0 - 14.5 9.2 - 17.4 10.9 - 19.1 11.5 - 19.7 13.6 - 20.4 Good10.6 - 14.8 14.6 - 18.2 17.5 - 20.6 19.2 - 22.1 19.8 - 22.6 20.5 - 23.1 Average14.9 - 18.6 18.3 - 21.3 20.7 – 23.4 22.2 - 24.6 22.7 - 25.2 23.2 - 24.8 High18.7 - 23.1 21.4 - 24.9 23.5 - 26.6 24.7 - 27.8 25.3 - 28.4 24.9 - 27.6 Obese>23.1 >24.9 >26.6 >27.8 >28.4 >27.6 Note: minimal recommend percent body fat is defined as 5% for men. Source: American College of Sports Medicine: Guidelines for Exercise Testing and Prescription, 8th Edition, 2010.

7. Blood Pressure & Hypertension (HTN) BP Category Systolic BP (mmHg) Diastolic BP (mmHg) Normal< 120and < 80 Pre-hypertensive120-139or 80-89 Stage 1 HTN140-159or 90-99 Stage 2 HTN≥ 160or ≥ 100

8. Cholesterol: Total, “Good” HDL and “Bad” LDL CategoryTotal Cholesterol Desirable<200 mg/dL Borderline high200-239 mg/dL High≥240 mg/dL CategoryHDL Cholesterol Low (at risk)< 40 mg/dL High (protective)≥ 60 mg/dL CategoryLDL Cholesterol Optimal < 100 mg/dL (< 70 mg/dL for people with heart disease) Near optimal100-129 mg/dL Borderline high130-159 mg/dL High160-189 mg/dL Very high190 mg/dL HDL = high-density lipoproteinLDL = low-density lipoprotein Source: National Cholesterol Education Guidelines III, ATP III

9. Triglycerides Triglyceride CategoryTriglyceride Level Normal< 150 mg/dL Borderline high150-199 mg/dL High200-499 mg/dL Very high≥ 500 mg/dL Source: National Cholesterol Education Guidelines III, ATP III

10. Blood Sugar (Fasting Glucose) & Hemoglobin A1C (HbA1C) Measurement CategoryFasting GlucoseHbA1C Normal<100 mg/dL< 5.7% Pre-Diabetes100 - 125 mg/dL5.7% - 6.4% Diabetes≥126 mg/dL≥6.5% Note: Impaired fasting glucose should be confirmed by testing on at least two separate occasions. Source: American Diabetes Association. www.diabetes.orgwww.diabetes.org

11. Lifestyle Physical Activity Your Life in Motion

12. Is an Active Lifestyle the Fountain of Youth? Active people outlive inactive people at all levels of risk Body weight & waist circumference Cholesterol Blood Sugar Blood Pressure Sources: Paffenbarger et al. NEJM. 1978; Katzmarzyk et al. Arch Intern Med. 2004; Adern et al. Circulation. 2005; Eklund et al. Am J Clin Nut. 2015.

13. Know Your Numbers What is your Physical Activity Status? How Many Steps Are Enough? Less than 5000 steps per daySedentary 5000 – 7499 steps per dayLow Active 7500 – 9999 steps per daySomewhat Active 10,000 – 12,499 steps per dayActive 12,500 or more steps per dayHigh Active Any increase in steps per day (or maintenance of 12,500+) is a positive health outcome. Source: Tudor-Locke et al. Med Sci Sports Exerc. 2008.

14. 1) www.fitbit.com www.fitbit.com 2) Use Fitbit® to help measure your baseline activity status 3) Set individualized activity goals (i.e. steps or stairs) 4) Log your other exercise activities (optional) 5) Receive weekly progress reports

15. Becoming active may add 14 extra “healthy years” to your life. “Most of what we think of as aging is not aging but disuse…Birth certificates aren’t issued with expiration dates.” - Walter Bortz, M.D. It’s Never too Late to Start, It’s Always too Soon to Quit. Source: Peeters et al. Bulletin of the WHO. 2013. The “Golden Bolt.” 105-year-old Japanese sprinter, Hidekichi Miyazaki, breaks world record for oldest competitive sprinter. (September, 25, 2015)

16. The 4 S’s of an Active Lifestyle The Power of Superman & Superwoman (What makes us strong) 1. Steps 2. Stairs 3. Sitting Less 4. Some regular exercise Exercise = More focused physical activity intended to change the qualities of our physical fitness (stamina, strength, flexibility, balance). Our Kryptonite (What makes us weak) 1. Sedentary Time

17. Exercise: You Have a Menu of Options What Type(s)? Frequency – “How often?” Intensity – “How hard?” Time – “For how long?” Some exercise is always better than none. Ten minutes at a time is fine.

18. One Reason Why Sitting is the New Smoking The weight of mitochondria in our body approximates the weight of a car battery. Like a car that is not frequently started, sedentary behavior creates a “leakage” or release of harmful free radicals. We abuse our body’s “car battery” when we remain sedentary for long periods of time. Source: Prof Mike Murphy, MRC Mitochondrial Biology Unit Cambridge University.

19. Tips for Cutting Down Sedentary Time Change what you can in your environment / culture: ☻ Yes, your favorite TV show is on and you won’t miss it, but can you give the chair a break during the commercials? ☻ Can you do some of your daily work standing? What about walking-and-talking (walking meetings)?

20. Tips for Cutting Down Sedentary Time Make cues work for you: ☻ Leave your walking shoes by the door as cue, so instead of heading straight for the La-Z-Boy after work the likelihood is greater that you will take the walk you have been planning. ☻ Join a Fitbit® challenge. This way you’re surrounding yourself with active-minded people and receiving constant feedback.

21. Tips for Cutting Down Sedentary Time Plan ahead for an active leisure or work time activity: ☻ At least every two hours schedule an alarm on your phone, so when you’re neck deep in that pile of paperwork you don’t forget to stand up, step out, and recharge. ☻ You’ll be more committed to activity if you plan it. Instead of falling back on the same routine or binging on watching television most of the weekend, make plans to go on an adventure next weekend. Get up, get out, and explore something or somewhere new.

22. 1. People: Make your active pursuits social. 2. Place: Do most of your physical activity in places that you feel comfortable and safe, or pursue active pursuits in places that are majestic! 3. Purpose: Do you have a goal? Physical activity is a gateway to a better life. Maybe you want to be able to climb the pyramids, scuba dive in Hawaii, or be the first person in your family to finish a 3-mile (5K) walk / run. What is on your “Bucket List”? Tips to Stay Motivated: Does Your Physical Activity Have Personal Value?

23. Summary Most adults should exercise regularly beyond activities performed as part of daily living (e.g. aerobic, muscular resistance, flexibility, and neuromotor exercise). Exercise alone does not mitigate the health risks of sedentary time. Reduction in the time spent in sedentary activities in addition to regular exercise is important for health. Steps, Stairs, Sitting less, Some regular exercise People, Place, Purpose American College of Sports Medicine’s Guidelines for Exercise Testing and Prescription, 9 th edition.

24. fave fitness apps Johnson and Johnson Official 7 Minute Workout App (Free) MapMyRide (Free) Pocket Yoga ($2.99) MyFitnessPal (Free) Fitbit (Free)

25. For more Information: Exercise is Medicine: http://www.exerciseismedicine.org/http://www.exerciseismedicine.org/ Dare to Be 100: www.walterbortz.comwww.walterbortz.com American Council on Exercise: http://www.acefitness.org/acefit/http://www.acefitness.org/acefit/ American Heart Association: www.heart.orgwww.heart.org American Diabetes Association: www.diabetes.orgwww.diabetes.org

26. Change what you can. Accept what you must. Have the wisdom to know the difference. -Reinhold Niebuhr Change what you can. Accept what you must. Have the wisdom to know the difference. -Reinhold Niebuhr Thank you!