If changes in healthcare are on your mind, you’re not alone. The recently proposed healthcare bill will change the way the federal government funds purchases of Medicaid and individual health care plans.  It is expected to greatly increase the number of people without health care insurance if the law passes in the Senate and is enacted. 1As many pre-existing conditions may no longer be covered and programs providing prevention (such as health or nutrition counseling) may be gutted, it’s likely not a bad idea to take advantage of your worksite wellness programs (if offered) and get your biometrics screening done to avoid big insurance bills that may be on the horizon.  Your current healthcare provider can also do these tests.  By getting a screening done, you’ll be more aware of risk factors for disease and can take matters into your own hands to save your wallet and your life.Just as an example, a 2013 study suggests that someone with type 2 diabetes will spend about $85,500 in their lifetime to treat the disease and its complications. 2 While diabetes is hereditary, lifestyle is definitely vital in prevention.  Did you know that losing just 5-10% of your weight (10-20 lbs. if you weigh 200) can reduce your risk of diabetes?  Small amounts of weight loss also have been found to reduce blood pressure, which reduces risk for heart attack and stroke.One in three deaths is related to heart disease.  According to the American Heart Association, an employee with heart disease costs their employer (annually) about 60 hours of time and over $1100 or more lost in productivity compared to healthy employees. 3 You can reduce your risk for heart disease by losing weight, getting regular exercise and knowing your risk factors.Check out the following biometric terms:Body Mass Index(BMI) is a measure of your weight in kilograms (kg) divided by your height in meters squared.

• 18.5-24.9 = healthy weight
• 25-29.9= overweight
• Over 30 = obese

A BMI above normal associated with higher risk for chronic disease including diabetes, cancer, arthritis and heart disease. To lower your BMI, adopt a healthy and consistent eating and exercise program so you lose weight over time.Blood pressure is the pressure of the blood against the walls of the blood vessels, especially the arteries. You have two numbers to know:Top number (systolic) 90-120 Over bottom number (diastolic) 60-80

• 120/80 mm/Hg = normal
• 120-139/80-89 mm/Hg = prehypertension
• 140-159/90-99 mm/Hg = hypertension

As blood pressure rises, it damages arteries and blood vessels and increases risk for heart attack and strokeCholesterol is a waxy, fat-like compound made in your liver.  It is needed to make hormones and aid in fat digestion.

•  < 200 mg/dL= normal
• 200-239 mg/dL= borderline high
• Over 240 mg/dL= high

An elevated cholesterol level is just one risk factor for heart disease.  Having a family history and other risk factors (such as obesity, diabetes and high blood pressure) raises risk further.Cholesterol has a good version (HDL) and a bad version (LDL).HDLHigh Density Lipoproteins.  “Healthy” cholesterol that helps remove cholesterol from the bloodstream

• Over 50 mg/dL is desirable for women
• Over 40 mg/dL is desirable for men

The ratio of cholesterol to HDL is important to note. A ratio below 4.0 is desirable for lower risk of heart diseaseHDL is affected by exercise.  It goes up with regular aerobic activity. Alcohol in moderation also raises HDL.  Your doctor may prescribe medication if risk for heart disease is high.LDLLow Density Lipoproteins. “Lousy” cholesterol that deposits fat in arteries

• Less than 100 mg/dLis desirable
• 100-129 is near desirable
• 130- 159 mg/dLis borderline high
• 160-189 mg/dLis high
• 190 mg/dL and up is very high

A high LDL is more predictive of risk for heart disease than an elevated cholesterolA diet low in saturated and trans fat, cholesterol and sugar helps lower LDL cholesterol.  Weight loss and regular exercise also help reduce LDL.TriglyceridesSugar and fat molecules that are stored as energy to be used later by the body

• Less than 150 mg/dL is normal
• Over 150 mg/dL is elevated

Non-fasting levels will be higher than fasting and will reflect what is in the blood at that time.  Fast for 8-12 hours before having the test drawnHigh triglycerides in the body make arteries sticky, which can raise the risk fat and plaque deposits and risk of heart diseasePre-diabetesPreviously known as “borderline” diabetes.  Blood sugar levels that are higher than normal, but not yet diagnostic of diabetes

• Less than 100 mg/dL (fasting) is  normal
• Less than 126 mg/dL non-fasting is normal
• Over 100-125 mg/dL fasting is pre-diabetes
• Over 125 mg/dL non-fasting is diabetes

Blood sugar will increase after meals by 50-100 points.  It may be higher during hospitalization, use of steroids, under stress, infection or post op from surgeryA small change in weight (5-10%) can help to prevent diabetes.  Exercising for 15 minutes after meals helps to reduce blood sugar after eating.  Eating high fiber, unprocessed carbohydrates is advised.A person with pre-diabetes is at higher risk for developing diabetes, heart disease and stroke.Lifestyle changes such as 5-7% weight loss and 30 minutes of exercise 5-7 days/week may reduce your risk of developing diabetes by 58%.A1C for diabetesIf you already have diabetes, A1C is a useful measurement. AIC is a measure of average blood sugar over a range of 3 months

• Less than 5.6 %- normal
• 5.7- 6.4%- pre- diabetes
• Over 6.5%- diabetes

Work with your physician or medical care team to determine the right A1C level plus diet and exercise plan for you.References:1.         http://www.cnbc.com/2017/05/04/republican-obamacare-replacement-bill-wins-enough-votes-to-pass-house.html2.         www.cfah.org/hbns/2013/high-lifetime-costs-for-type-2-diabetes3.         http://www.upi.com/Health_News/2017/02/14/Cost-of-heart-disease-in-US-to-surpass-1-trillion-by-2035-report-says/5891487126035/By: Lisa Andrews, MED, RD, LDDownload handouts:Take Control of your health - Download Word File