Transcript Document
7/17/2015 1 Welcome The Montgomery Heart and Wellness Nutritional Boot Camp Session One 7/17/2015 2 Baxter Montgomery, MD, FACC Clinical Professor of Medicine, Division of Cardiology/ Cardiac Electrophysiology UT– Houston Director, Houston Cardiac Association and JAM Institute of Medical Education and Research 7/17/2015 3 Montgomery Heart & Wellness Overview and Concepts 7/17/2015 4 The Montgomery Heart & Wellness Build a Better You Concept Fitness A Better You! Wellness Recovery Illness 7/17/2015 5 The Basis for Chronic Illness 7/17/2015 6 MHW Model of Nutritional Intervention Define and Remove Sources of Poor Nutrition Define Sources of Excellent Nutrition and Replace Poor Nutritional Sources Create an Environment that Reinforces Necessary Lifestyle Changes Provide Individuals with Necessary Tools and Skills to Make Long Standing Lifestyle Changes Enable MHW Patients and Wellness Clients to Become Their Own Health and Wellness Experts 7/17/2015 drbaxtermontgomery.com 7 Examples of The Program Effects and Benefits 7/17/2015 drbaxtermontgomery.com 8 Example One A 74-year-old lady who presents with complaints of chest tightness at rest and with exertion along with SOB with minimal exertion and generalized fatigue. Medical History • • • • • HTN Hypertriglyceridemia Type 2 Diabetes Asthma Sleep Apnea • • • • • Hernia Repair Tubal Ligation Carpal Tunnel Surgery Pericardiocentesis Hysterectomy • • • Hypertension Heart Disease Asthma Surgical History Family History 7/17/2015 drbaxtermontgomery.com 9 Example One(continued) Medications • • • • • • • • • • • • • • • • Levemir 70 units qam and 30 units qhs Humalog 34 units qam and 34 units TID b/f meals Klor-Con 10 10mEq bid Cozaar 50 mg daily Diltiazem 240mg qd Furosemide 80 mg qd Vitamin D 50,000 IU 2 times per week Pantoprazole 40 mg qd Benzonatate 100 mg tid Isosorbide Mononitrate qd Simvastatin 40 mg qd Travatan 0.004% 1 gtt qd Prednisone 10 mg ½ tab qd Meclizine 25 mg prn Metolazone 5 mg prn Nitroglycerin 0.4 mg prn Allergies • None 7/17/2015 drbaxtermontgomery.com 10 Example One(continued) Exam • Wt 289 lbs • BP 155/75 • HR 85 • General – Moderately obese • Heart and Lungs – without significant abnls • Extremities – Bilateral edema of about 1+ 7/17/2015 drbaxtermontgomery.com 11 Intervention for Our Patient in Example One • Nutritional • Foods to Avoid • ✦ All forms of animal flesh (pork, beef, chicken, turkey, fish, etc.) • ✦ Dairy products (any animal’s milk or derivatives thereof including yogurt, cream, cheese, butter, ice cream, sherbet, etc.) • ✦ Eggs and egg products • ✦ Processed cereals (oatmeal, corn flakes, grits, etc.) • ✦ Cooked grains (rice, pasta, bread, corn, wheat, or foods with wheat gluten such as breads) • ✦ Soft drinks, pasteurized fruit juices, alcohol, coffee, etc. • ✦ Any other pasteurized beverages • ✦ Any foods that are fried, baked, steamed, grilled, boiled, microwaved, roasted, or sautéed 7/17/2015 drbaxtermontgomery.com 12 Intervention for Our Patient in Example One Medical (red were stopped, blue started, black cont’d) • Medications • • • • • • • • • • • • • • • • • Levemir 70 units qam and 30 units qhs Humalog 34 units qam and 34 units TID b/f meals Klor-Con 10 10mEq bid Cozaar 50 mg daily Diltiazem 240mg qd Furosemide 80 mg qd Vitamin D 50,000 IU 2 times per week Pantoprazole 40 mg qd Benzonatate 100 mg tid Isosorbide Mononitrate qd Simvastatin 40 mg qd Travatan 0.004% 1 gtt qd Prednisone 10 mg ½ tab qd Meclizine 25 mg prn Metolazone 5 mg prn Nitroglycerin 0.4 mg prn Tekalmo 300/10 7/17/2015 drbaxtermontgomery.com 13 Example One(continued) Follow up in One Week • Feels Better • Less Edema • Blood Sugars Decreased • Physical Assessment 7/17/2015 Wt 271 lbs (18 lbs decreased) BP 145/77 (10 mmHg decrease of SBP) drbaxtermontgomery.com 14 Intervention at One Week Medical (red were stopped, blue started, black cont’d) • Medications • • • • • • • • Vitamin D 50,000 IU 2 times per week Pantoprazole 40 mg qd Benzonatate 100 mg tid Isosorbide Mononitrate qd Simvastatin 40 mg qd Travatan 0.004% 1 gtt qd Nitroglycerin 0.4 mg prn Tekalmo 300/10 7/17/2015 drbaxtermontgomery.com 15 Week Two Follow up Follow up in Two Weeks • • • • • No Chest Pain or Shortness of Breath Rare episodes of Wheezing No Edema Blood Sugars Decreased Wt 267.5 (21.5 lbs decreased from baseline) • BP 155/81 (near baseline on fewer meds) • Meds 7/17/2015 Travatan 0.004% 1 gtt qd Tekalmo 300/10 qd drbaxtermontgomery.com 16 Summary Could have initiated with cardiac catheterization Could have added medications for angina Could have done nuclear stress test Instead • Began intense nutritional changes • Reduced medications • Followed in office closely 7/17/2015 drbaxtermontgomery.com 17 Example Two 7/17/2015 drbaxtermontgomery.com 18 46-Year-Old Lady Needing Clearance for Gastric Bypass Surgery 46-years-old Medical History • Obesity • Pre-diabetes • High Blood Pressure Symptoms • Chest Pain that woke her from sleep • Shortness of Breath with exertion • Fatigue Initial Heart Test Findings • Abnormal EKG • Enlarged Heart with 20% to 25% pumping function The Initial Coronary Angiogram Repeat Coronary Angiogram After Intervention Detoxification Concepts and Overview 7/17/2015 22 What is Detoxification? Detoxification - the term used to describe the process your body goes through to get rid of toxins Detoxification symptoms—both physical and mental—may appear when you alter your lifestyle Examples of lifestyle changes include: • changing your diet • exercising • discontinuing a current habit eating chocolate drinking coffee. 7/17/2015 23 Detoxification Overview 7/17/2015 24 Detoxification Mechanisms The Body has to Process all Substances that are Ingested Ingested Substances have Two Basic Components • Nutrients • Waste (Toxins) The Balance of Nutrients to Waste (Toxins) Determine the Basis of the Body’s Health • Nutrients > Waste = Health • Waste > Nutrients = Illness Major Organs/Systems of Focus Kidney and Urinary System Gastrointestinal System Other Systems to Consider • Lymphatic System • Mucous Membranes and Internal Tissue Linings (“Internal Skin”) • Respiratory Tract • Skin (External) Renal Detoxification The Kidney Images of Renal and Urinary System The Physiology of Renal Detoxification Aspects of Basic Kidney Function and Dysfunction Detoxification by the Kidney Approximately 190 liters of blood pass through the kidney daily (25% of total circulation). Waste is Removed Medications Byproducts of Food Additives Byproducts of Normal Metabolism Electrolytes are Balanced Potassium Sodium Others (phosphorus, magnesium, calcium, etc.) Water is Regulated Functions of the Liver Production of bile, which helps carry away waste and break down fats in the small intestine during digestion Production of certain proteins for blood plasma Production of cholesterol and special proteins to help carry fats through the body Functions of the Liver Conversion of excess glucose into glycogen for storage (glycogen can later be converted back to glucose for energy) Regulation of blood levels of amino acids, which form the building blocks of proteins Functions of the Liver Conversion of poisonous ammonia to urea (urea is an end product of protein metabolism and is excreted in the urine) Clearing the blood of drugs and other poisonous substances regulating blood clotting resisting infections by producing immune factors and removing bacteria from the bloodstream GASTROINTESTINAL DETOXIFICATION The Small Intestine Basic Function of Small Intestine Duodenum • Receives secretions from the liver and pancreas using bile ducts • It uses these secretions to extract nutrients from food Jejunum • A major area of absorption Ileum • Provides passage from small intestine to large intestine (colon) GASTROINTESTINAL DETOXIFICATION The Large Intestine The Large Intestine It is about 1.5 meters (4.9ft) long It absorbs water Passes Solid Waste Material out of the body Major Components Cecum Colon Ascending Transverse Descending Rectum Anus Other Systems Lymphatic System Mucous Membranes and Internal Tissue Linings (“Internal Skin”) Respiratory Tract Skin (External) What are Common Detoxification Symptoms? 7/17/2015 Clogged sinus Constipation Cough Diarrhea Fatigue Fever Flu symptoms Cold symptoms Gas Headache Irritability Moodiness Skin rash Stomachache 42 How to Treat Detoxification Rest Consume raw fruits and vegetable juice Drink plenty of water 7/17/2015 43 Food Toxins and Toxic Foods Why Must We Remove Certain Foods From Our Diet? 7/17/2015 44 Toxins in Our Food Sources Toxins in Our Food Sources Dairy Toxins in Our Food Sources Dairy The most significant carcinogen that we consume is casein (one of the milk proteins) Cancer cells can be turned off and on with dairy consumption Source – The China Study, T. Colin Campbell Toxins in Our Food Sources Dairy Antigens in Dairy – RA, Osteoarthritis Dairy Proteins – Allergies, Asthma, Sinus Other Conditions Contributed to Dairy: Acne, Atherosclerosis, Stomach (bloating, pain, cramps, diarrhea, gas), Bronchitis, Chest Infections, Eczema, Hay Fever, Hemorrhage, HTN, Hives, Juvenile RA, MS, Nasal Congestion, Kidney Disease, Pyoderma, Skin Rash, Sneezing What causes a 130 pound calf to become a 2,000 pound cow within a matter of months? Toxins in Our Food Sources Poultry/Beef/Pork/Lamb Toxins & Pesticides in Feed Toxins in Our Food Sources Poultry/Beef/Pork/Lamb Feces Toxins in Our Food Sources Poultry/Beef/Pork/Lamb Toxins in Our Food Sources Fish Toxins in Our Food Sources Fish Toxins in Our Food Sources Fish Heavy Metals – Mercury – Can cause brain damage in fetuses Plastics – PCBs - polychloronated biphenyl – used in transformers & capacitors – banned since 1976 Flame Retardants Dioxins Farm-raised – small, fat-rich fish fed to larger fish – those small fish contain 10x the contaminants of salmon Toxins in Our Food Sources Processed Foods Coal Tar Dyes – Carcinogen • Artificial colors, flavors and odors are made from coal tar • Found in soft drinks, cosmetics and many medicines • Foods with bright colors, strong flavors and odors often contain coal tar Toxins in Our Food Sources Processed Foods MSG, BHT (butylated hydroxytoluene), BHA (butylated hydroxyanisole), DES Toxins in Our Food Sources Processed Foods Nitrosamines • Carcinogen (liver, stomach, brain, bladder, kidneys) • Chemical preservative and color enhancer Toxins in Our Food Sources Processed Foods MSG – Look for Other Names on Labels • • • • • • • • Hydrolyzed Vegetable Protein/Hydrolyzed Protein Natural Flavoring Hydrolyzed Plant Protein/Hydrolyzed Oat Flour Plant Protein Extract/Textured Protein Sodium Caseinate Calcium Caseinate Yeast Extract Natural Beef or Chicken Flavoring How Do I Know if I Have Toxins in My Body? Hair Analysis Testing Heavy Metals • Mercury • Aluminum • Iron • Copper • Cadmium • Lead • Arsenic Resources drgrisanti.com holisticmed.com hairanalysistest.com chemicalbodyburdern.org electroherbalism.com What are You Willing to Give Up? 7/17/2015 63 7/17/2015 64 7/17/2015 65 7/17/2015 66 7/17/2015 67 What About Exercise? 7/17/2015 68 The Nutritional Boot Camp Experience What to Expect and How to Maximize Your Experience and Results 7/17/2015 69 The Montgomery Heart and Wellness Nutritional Boot Camp How Should You Proceed Consult Your Physician Medications may need to be changed. 7/17/2015 70 Foods to Completely Remove During Boot Camp Remove All Forms of Animal Flesh (Dead or Alive) • • • • • Fish Chicken Beef Pork Worms, Roaches, Rats, etc. Remove Remove Remove Remove Remove 7/17/2015 All All All All All Forms of Cooked Foods (steeped teas okay) Forms of Oils Nuts Processed Foods Pasteurized Foods 71 What Can I Eat? 7/17/2015 72 What is Optimal Nutrition? Water Natural Plant Based Foods • Raw • Raw • Raw • Raw Fruit Vegetables Seeds Sprouts Sunshine 7/17/2015 drbaxtermontgomery.com 73 The Boot Camp Process 7/17/2015 74 Food Classification System Food Levels 0 through 3 are best for detoxification Food Levels 4 through 6 are good maintenance levels Food Levels 7 through 10 are best avoided – Level 7 may be tolerable on very rare occasions 7/17/2015 75 Nutritional Zones Zones Detoxification Zone Slow Healing or Maintenance Zone Disease Development or Progression Zone Food Levels Level 0 Level 4 Level 7 Level 1 Level 5 Level 8 Level 2 Level 6 Level 9 Level 3 7/17/2015 Level 10 76 The Montgomery Heart and Wellness Nutritional Boot Camp How Should You Proceed Review the “List of Foods to Avoid” and commit them to memory Review the Food Classification Scheme and List of Foods and menus in each Food Level Decide on a Food Level to Follow during the four week period and try to stay at that level No portion limits in Food Level 0-3 7/17/2015 77 How Should You Proceed? 100% Compliance! Upon completion of the four week period, resume a nutritional regimen that is comfortable for you to comply with that is as close to the center of the classification system diagram Enjoy the Journey! 7/17/2015 78 Frequently Asked Questions What if I’m hungry? What do I do about cravings? What if I want something warm? What if I want to chew? 7/17/2015 79 Finally … It’s Only 4 Weeks! 7/17/2015 80 What Can You Expect? 7/17/2015 81 Change in Weight Weight (lbs) Weight 215.74 216.00 214.00 212.00 210.00 205.61 208.00 Weight (lbs) Weight 206.00 204.00 202.00 200.00 1 7/17/2015 2 82 Change in BMI BMI (kg/h2) BMI 35.00 34.56 34.50 34.00 BMI (kg/h2) BMI 33.50 32.94 33.00 32.50 32.00 1 7/17/2015 2 83 Systolic Blood Pressure Effects SBP mmHg Systolic Pressure 142.00 140.20 140.00 138.00 136.00 SBP mmHg Systolic Pressure 132.42 134.00 132.00 130.00 128.00 1 7/17/2015 2 84 Diastolic Blood Pressure Effects DBP mmHg Diastolic Pressure 84.43 84.50 84.00 83.50 83.00 82.50 DBP mmHg Diastolic Pressure 81.20 82.00 81.50 81.00 80.50 80.00 79.50 1 7/17/2015 2 85 Effects on Heart Rate Pulse 72.39 72.50 72.00 71.50 71.00 69.84 70.50 Pulse 70.00 69.50 69.00 68.50 1 7/17/2015 2 86 Neck Size Neck (inches) 15.30 15.30 15.20 15.10 15.00 Neck (inches) 14.90 14.77 14.80 14.70 14.60 14.50 1 7/17/2015 2 87 Effects on Waistline Waistline (inches) 41.50 41.41 41.00 40.50 Waistline (inches) 40.00 39.50 39.50 39.00 38.50 1 7/17/2015 2 88 Total Cholesterol Total Cholesterol 190.00 187.97 185.00 180.00 Total Cholesterol 172.75 175.00 170.00 165.00 1 7/17/2015 2 89 Effects on LDL Cholesterol LDL 106.24 108.00 106.00 104.00 102.00 LDL 97.47 100.00 98.00 96.00 94.00 92.00 1 7/17/2015 2 90 Effects on Kidney Function 18.00 16.00 16.62 14.17 9.88 14.00 11.16 12.00 10.00 Series1 8.00 Series2 0.92 6.00 4.00 0.92 2.00 Series2 0.00 BUN Series1 Creatinine BUN / Creatinine 7/17/2015 91 Effects on C-Reactive Protein CRP 0.61 0.70 0.60 0.40 0.50 CRP 0.40 0.30 0.20 0.10 0.00 1 7/17/2015 2 92 Effects on SED Rate SED Rate 17.17 18.00 11.85 16.00 14.00 12.00 SED Rate 10.00 8.00 6.00 4.00 2.00 0.00 1 7/17/2015 2 93 Effects on Fasting Glucose Glucose 102.97 103.00 102.00 101.00 100.00 97.68 99.00 Glucose 98.00 97.00 96.00 95.00 1 7/17/2015 2 94 Effects on A1C Hem A1C 6.29 6.30 6.28 6.26 6.24 6.18 6.22 Hem A1C 6.20 6.18 6.16 6.14 6.12 1 7/17/2015 2 95 Boot Camp and Beyond! Nutritional Boot Camp • Five Sessions over 4 weeks (monthly meetings) • Remove all forms of animal protein, processed carbohydrates, eggs, and dairy • Raw Fruit and Vegetable • Food Preparation Demos • Supermarket shopping rounds Get Connected and Join Wellness Club • • • • Platinum, Gold, Online, or Custom Monthly Nutritional Counseling Food Preparation Demos Customized Meal Plans 7/17/2015 drbaxtermontgomery.com 96 7/17/2015 97 How to Get Connected Meet with our staff to discuss our different programs and wellness clubs MHW Platinum Club • Build a Healthier, Younger You • Enhanced Fitness and Anti-aging MHW Gold Club • Build a More Energetic and Fit You • Monthly Nutritional Follow up and Track Your Progress MHW Online Club • Online access to videos and other educational materials • Unlimited Recipes from The Garden Kitchen Custom Programs 7/17/2015 98 It’s Only 4 Weeks! 7/17/2015 99 NEWS FLASH! 7/17/2015 100 Burger King running out of ribs Fast-food chain sold its 10 millionth rib, expects to exhaust supply this month. 7/17/2015 101