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CLINICAL NUTRITION
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(303) 750-9454             (303) 750-1996 (fax)

PROUDLY SERVING DENVER AND SURROUNDING
COMMUNITIES FOR OVER 35 YEARS
CENTER




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MAKE A SECURE
PAYMENT WITH PAYPAL
ETHAN
LAZARUS, MD
HEATHER THOMAS, PA -C
MICKEY BERRY, MA, LPC

7555 E. Hampden Ave, Suite 301
Denver, CO  80231

303-750-9454
RESOURCES
Resources:  Educational Information

Am I At Risk?

Part 1: Assessing Your Risk

Assessment of overweight involves using three key measures:      
  • body mass index (BMI)     
  • waist circumference, and     
  • risk factors for diseases and conditions associated with obesity.  

The BMI is a measure of your weight relative to your height and waist circumference measures abdominal
fat. Combining these with information about your additional risk factors yields your risk for developing
obesity-associated diseases.

What is Your Risk?
1.  Body Mass Index (BMI)  
BMI is a reliable indicator of total body fat, which is related to the risk of disease and death. The score is
valid for both men and women but it does have some limits. The limits are:      
  • It may overestimate body fat in athletes and others who have a muscular build.     
  • It may underestimate body fat in older persons and others who have lost muscle mass.  

Use this handy BMI calculator to estimate your total body fat.
























2.  Waist Circumference  
Determine your waist circumference by placing a measuring tape snugly around your waist (around the level
of your belly button). It is a good indicator of your abdominal fat which is another predictor of your risk for
developing risk factors for heart disease and other diseases. This risk increases with a waist measurement
of over 40 inches in men and over 35 inches in women.

              
Disease Risk Relative to Normal Weight and Waist Circumference















3.  Other Risk Factors  
  • Besides being overweight or obese, there are additional risk factors to consider.
  • high blood pressure (hypertension)     
  • high LDL-cholesterol ("bad" cholesterol)     
  • low HDL-cholesterol ("good" cholesterol)     
  • high triglycerides     
  • high blood glucose (sugar)     
  • family history of premature heart disease     
  • physical inactivity     
  • cigarette smoking  

4.  Assessment  
For people who are considered obese (BMI greater than or equal to 30) or those who are overweight (BMI of
25 to 29.9) and have two or more risk factors, the guidelines recommend weight loss. Even a small weight
loss (just 10 percent of your current weight) will help to lower your risk of developing diseases associated
with obesity. Patients who are overweight, do not have a high waist measurement, and have less than 2 risk
factors may need to prevent further weight gain rather than lose weight.  

Talk to your doctor to see if you are at an increased risk and if you should lose weight. Your doctor will
evaluate your BMI, waist measurement, and others risk factors for heart disease. At CNC, we also like to
measure body fat percentage as this number provides more information about an individual's unique risk
than just using BMI and abdominal circumference alone.  People who are overweight or obese have a
greater chance of developing high blood pressure, high blood cholesterol or other lipid disorders, type 2
diabetes, heart disease, stroke, and certain cancers, and even a small weight loss (just 10 percent of your
current weight) will help to lower your risk of developing those diseases.

Metabolic Syndrome
Are you having trouble losing weight?  Do you regain every time you try and lose weight?  Have you hit a
plateau in your weight loss that you are having difficulty breaking through?  You might well have metabolic
syndrome.  Download this handout by clicking above for more information about what metabolic syndrome is,
and how we can treat it.  If you have questions, please ask your nutritionist, or consider scheduling a
consultation with Dr. Lazarus to discuss other medical treatment options.  For some patients, medication can
help sensitize the body to insulin, lowering insulin levels, and facilitating weight loss.

Lecture Handout
This is a Quick Reference Handout Dr. Lazarus likes to use for the Doctors when he gives continuing
medical education talks.  The handout includes a shortcut to calculate BMI, BMI definitions, metabolic
syndrome table, and a quick table of medications causing the worts problems with weight gain, and
alternatives to consider.

Cholesterol
Have you heard about the new VAP cholesterol test?  This new cholesterol assay is quickly becoming the
new standard in cholesterol measurement and management.  Like the routine cholesterol test, the VAP test
measures total cholesterol, HDL, LDL and triglycerides.  But, the VAP test goes much further, measuring
important hereditary risk factors, lipoproteins, and subclasses.  Further, by directly measuring the
cholesterol subfractions, it is considerably more accurate than the traditional cholesterol assay (which
calculates rather than measuring the LDL), and it can be drawn non-fasting!

We are able to offer this test at a
substantial discount off retail, through special negotiation with Quest
Diagnostics.  We can use the additional information from the VAP test to identify risk early, so if heart
disease runs in your family, we can develop the most appropriate treatment plan so you can avoid a cardiac
event.

For more information, contact our office at 303-750-9454, or you can
visit www.thevaptest.com.


Resting Metabolic Rate
Have you had trouble maintaining weight loss?  Many people have trouble maintaining weight loss because
of a slow metabolism, or resting metabolic rate (RMR).  Click above for more information on how to measure
your metabolic rate, and what we can do with this information!


Insulin Resistance and Pre-Diabetes; Diabetes Prevention Program
This is a link to an article from the National Diabetes Information Clearinghouse with more information on
insulin resistance.

Activity
Having trouble working exercise into your life?  This handout contains a collection of ideas from Dr. Lazarus
on how to fit activity in.  In one study, among patients who successfully maintained their weight loss, 96%
incorporated increased activity as part of their maintenance plan.  If you're having trouble finding ways to
work exercise in, this handout is for you.  Do you have other ideas that have worked for you?  Let us know,
so we can include them!

Hypoglycemia
This is a link to an article from the National Diabetes Information Clearinghouse with information regarding
hypoglycemia.

Nutrifast Spreadsheet
Thank you to our patient, Karen, for this submission!  This is a Microsoft excel spreadsheet designed to help
you track what is in each type of Nutrifast packet, and calculates your total carbohydrates for the day.

Daily Log

Weekly Log
  BMI
Obesity Class
Waist:  Men 40" or less
Women 35" or less
Waist:  Men > 40"
Women > 35"
Underweight
< 18.5
     
Normal
18.5-24.9
     
Overweight
25.0 - 29.9
  Increased
High
Obesity
30.0-34.9
I
High
Very High
  35.0-39.9
II
Very High
Very High
Extreme Obesity
40.0 +
III
Extremely High
Extremely High