weight-loss and cholesterol reducing program for … knowledge/chronic_illness...all cayse of death...
TRANSCRIPT
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Weight-Loss and CholesterolReducing Program for Women
Dr. Boonsri Kittichotpanich Dr. P.H., RN.
Sumitta swangtook M.S. RNKittichai Borsombat Ms. Nursing PractionerYuppadee Patanakarn BSc. Nursing(TaksinHospital)Somporn Jaisamutr MS. (LadkabungHospital)Thitima Patipimpakom MS. in Nutrition
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m British al Heart Survey.
18 20 22 24 26 28 30 32 341.0
1.2
1.4
1.6
1.8
2.0
2.2
2.4
2.6
2.8
6.6
6.2
5.8
Total cholesterol
Triglycerides
HDL cholesterol
Body Mass Index (kg/m²)
0
10
20
30
40
50
60
mm
ol/l
SBP
% w
ith high SBP
Obesity: cardiovascular risk
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Mortality ratio 57 years afterwards, classified by body mass index before 8 years of age.
0
0.5
1
1.5
2
2.5
< p25 p25-p49 p50-p75 >p75
All cause of Death
Death from CVD
Percentile of BMI(Gunnell et al, 1998)
Mortality
ratio
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The Association of Plasma Cholesterol and Death Rate from CVD and All Cause of Death
0
5
10
15
20
25
30
35
40
130 150 170 190 210 230 250 270 290 310
CVD
All Cayse of Death
(Jacobs,1989)
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Death Rate/100,000 of THAI People from Major Cause of Death
1967-1996. (Thai Health Minister,1998)
0
10
20
30
40
50
60
70
80
90
1967 1972 1977 1982 1987 1992 1996
CVD
Accident
Cancer
Pneumonia
AIDS
Dairrhea
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Coronary Artery Disease
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Stroke
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Age profile of population of Thailand in 1960, 1980, 2000 and 2020Source: http://www.anamai.moph.go.th/factsheet/Ageing.htm
1960
2000
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Proportion of divorce/marriage among Thai couples during 1994-2003.
0
5
10
15
20
25
30
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003
Divorce ratio
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Percentage of household with woman as head of the household (Source: Population Census 1980, 1990 and 2000)
0
5
10
15
20
25
1980 1990 2000
<20
20-29
30-39
40-49
50-59
%
Age (years)
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Health care providers (Women)
From the Physical Examination in 2004In 3 Hospitals :The Prevalence Rate show
overweight over 20 % Cholesterol > 230 mg% 0ver 30%
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Objectives:
To develop the weight loss and cholesterol reducing program for working women.
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Participants
They were nurse and health care providers from 3 hospitalswho met the criterion: over weight (BMI≥25 kg/m2) and/or cholesterol ≥200 mg/dl.
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Cyclical Research Process
Assessment the Problem
Reflection Design a Plan of Action
Assessment the Problem
Reflection Design a Plan of Action
Action and Observe
New
Weight Loss& Reducing Program
Action and Observe
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Study TimeFrom February 2006- August 2007 the participatory Learning have been conducted by 12 times for group participation (1 time/week and 8-10 members in each group).
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The instrument for Facilitation
Thai food recipes, nutrition therapeutic information, portion- size estimation instruments and real food demonstration, 3-days food and exercise record formFood Frequency Questionnaires
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1stMonthMeeting 1 time/Week
The first timePretest: Nutrition,Overweight,Obesity,CholesterolKnowledge&PracticeNutritional Assessment and Health Assessment:weight,BMI,Cholesterol,Daily Caloric Intake(24 hrs recall,FFQ)Lecture about Nutritional Knowledge, the method of Weight-Loss and Cholesterol Reducing, Easy Daily Exercise and RelaxationGroup discussion & participatory learningLunchy enjoy and learning together about the food(what when why how to eat) Daily Food RecordGroup discussion set goal, planning together in their lifestyleCommitment for 3 days food and exercise record per weekand 1 time/Week of Meeting
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2nd month Meeting 1 time/Week
Check WeightNutritional Training and lecture according to the member group planning in the last week Group discussion about their practiceExplain how to select the daily sufficiency diet Training about low fat diet cooking, easy exercise&relaxationLunchy enjoy and learning together about the food (what when why how to eat), 3 Days Food RecordGroup discussion 3 Days Food Record, planning together in their lifestyleCommitment for 3 days food and exercise record per weekand 1 time/Week of Meeting
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3rd month Meeting 1 time/Week
Check WeightNutritional Training and lecture according to the member group planning in the last week Group discussion about their practiceExplain how to select the daily sufficiency diet Training about low fat diet cooking, easy exercise&relaxation,meditationLunchy enjoy and learning together about the food (what when why how to eat), 3 Days Food RecordGroup discussion 3 Days Food Record, planning together in their lifestyleEvaluation the Program Together, Reward.
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28.1%
71.9%
52.1%47.9%
6%
14.4%
79.6%
0
10
20
30
40
50
60
70
80
90
100
University
Vocational training
High school diploma
Not married
Married
Age 40-59
Age 20-39
Table 1 Baseline Characteristics of Participants (167 women)
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Variables Before After t p-value
Nutritional Knowledge
Table 2 The Comparison of Nutritional Variables before and after program
7.24 +1.52- 8.59+1.3-9 -9.316 0.000***
Body weight
61.37 +11.18- 59.67+10.8- 9.829 0.000***
BMI (kg/m2)
24.99 +4.23- 24.29+4.05- 9.772 0.000***
*** p<0.001 BMI = Body Mass Index
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Variables Before After t p-value
Cholesterol (mg/dl) 233.99+29.38- 203.86 +33.86 8.976-
Table 3 The Comparison of Nutritional Variables before and after program (cont’)
0.000***
HDL-C (mg/dl)
48.85 +10.15- 50.57+10.28- 1.458 0.152NS
LDL-C (mg/dl)
147.03 +35.88- 138.81+38.44- 1.664 0.103NS
*** p<0.001 NS = Non Significant different
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Table 4 The Frequency of Each Food Group before and after program
Food Group Before After
Milk and Milk Products
Sweeted 3-5 t/wk 1-2 t/wk
No Sugar 0-1 t/wk 3-5 t/wk
Meat and meat product
3 t/day 1-2 t/day
Egg 4-5 t/wk 1-2 t/wk
Seafood 2-3 t/wk 0-1 t/wk
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Table 4 The Frequency of Each Food Group before and after program (cont’)
Food Group Before After
Bean 1-2t/wk 3-4 t/wk
Soy 1-2 t/wk
2-3 t/day
Rice and Rice product
6 t/wk
2-3 t/day
Dessert 1 t/day 1-2 t/wk
3-4 t/wk
3 t/day 3 t/day
Vegetable
Fruit and Juice 5-6 t/wk
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Table 5 Number of Servings per day Daily Food Intake before and after program
Food Group Number of Servings per dayBefore After
Milk&Milk product 2 cups or 2 glasses
1 cups or 1 glasses (No Sugar)
Rice & Rice Product 9 ladles 3-4 ladles
Meat & Meat product 8-10 tbspsor 1.5 ladles 6 tbsps
Egg 1-2 eggs 0-1 eggs
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Table 5 Number of Servings per day Daily Food Intake before and after program (cont’)
Food Group Number of Servings per dayBefore After
Seafood 1-2 ladles
Soy&Soy product 0-1 cup 1 cup
1-2 ladles
Bean 0 -½ ladles ½-1 ladles
Vegetable Leafy Green other Vegetable
1-2 ladles 4-6 ladles
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Table 5 Number of Servings per day Daily Food Intake before and after program (cont’)
Food Group Number of Servings per dayBefore After
Fruit 8-10 ladles 3-4 ladles
Sugar (added)
4-6 tbsps 0-2 tbsps
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Daily Food Guide of Weight Loss and Cholesterol Reducing in 12 wks from this study
Total Energy = 1,200 – 1,400 KCal /Day
1.Non sweeted milk or Soy Milk 1 Cups/day
2.Rice & Rice products 1 – 1 ½ ladle/meal
3.Meat & Meat Product 2 tbsps/meal
4.Egg ½ -1 egg/day
5.Seafood 1-2 tbsps/wk
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Daily Food Guide of Weight Loss and Cholesterol Reducing in 12 wks from this study (cont’)
6.Bean 1 ladle/day
7.Vegetable 2-3 ladle/meal
8.Fruit 2-3 ladle/meal
9.Avoid No Sugar added in Food
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ACTIVITIES
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B. Kittichotpanich,2003
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B. Kittichotpanich,2003
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Thai Health Minister,2003
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B. Kittichotpanich,2003
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Relax&Alert By Meditation
Boonsri Kittichotpanich Dr.P.H. R.N.
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Meditation Benifit
Purify the mind
Keep the mind from wandering or to keep it steady at its place within the centre of the body
No matter what religion they profess.
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How meditaion Relax&AlertHelp to re-balance body and mindIncrease blood endorphin levelGet rid of fear, anxiety, tension Develop their self-efficacy
Manage and self controlEnhance Self Regulation
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Instructions for the meditation Technique : Step 1
Relax body and mind sit or lying-down on the bed Your hands should rest palms- up on your lap, and the tip of your right index finger should touch your left thumbTry to find a position of poise for yourself.
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Instructions for the meditation technique : Step 1
Softly close your eyes as if you were falling as sleepRelax every part of your bodyFocus on the task in hand, creating a feeling of ease in your mind
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Instructions for the meditation technique : Step 2
Imagine the full moon in the body.Imagine that it become clear, bright, and pure as if it floating at the centre of your body.Softly repeat the sound of “may I healthy, fit and firm ” over and over again
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The Others benefits of meditation
Personnal Benefits for the meditatorThe mind :
feel at ease-clam and peaceful Memory will also improve
Personality :Self- confidence will be improvedThe true nature of calm will become apparentAnger will diminishLeaving only the feeling of kindness towards others
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The Others benefits of meditation
Personnal Benefits for the meditatorDaily life:
will be increaseed in quality in the new-found absence of stressThe results of work or study will be much more successfulThe meditation can enjoy health of both body and mind
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Conclusion:
helped the womento be more alert and aware of eating pattern.
The portion- size estimation, food and exercise record, satisfaction were
the key point of successfulness in this program.
This weight-loss and cholesterol reducing program
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Conclusion:This weight-loss and cholesterol reducing
program helped the womento be more alert and aware of eating pattern.
The key point of successfulness in this programParticipants know the portion- size estimation, food and exercise record and the satisfaction.
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Body & Mind Happiness
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Before and After
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กิตตกิรรมประกาศ
ขอขอบคุณ
ผูอํานวยการวิทยาลัยพยาบาลเกื้อการุณย
ผูอํานวยการโรงพยาบาลตากสินและสมาชิกทุกทาน
ผูอํานวยการโรงพยาบาลราชพิพัฒนสมาชิกทุกทาน
ผูอํานวยการโรงพยาบาลลาดกระบังสมาชิกทุกทาน
คณะทํางานในโครงการWeight- Loss ทุกทาน