This talk is to promote population health via preventive medicine, immunization, healthy life style, exercise, food, decreased diabetes, hypertension and cancer risks

1. HEALTHY AND HAPPY 100
Chung-Che (Jeff) Chang, M.D., Ph.D.
Director, Hematology and Molecular Pathology Lab.
Florida Hospital
Professor of Pathology
College of Medicine
University of Central Florida
E-mail: c.jeff.chang.md@flhosp.org

2. Life Expectancy
http://media.nmfn.com/tnetwork/lifespan/#
0
http://media.nmfn.com/tnetwork/lifespan/#0
http://gosset.wharton.upenn.edu/mortality/perl/
Your DNA is Not Your Destiny (cause and
results)
http://media.nmfn.com/tnetwork/lifespan/#0
http://gosset.wharton.upenn.edu/mortality/perl/
Your DNA is Not Your Destiny (cause and
results)
http://media.nmfn.com/tnetwork/lifespan/#
0
http://gosset.wharton.upenn.edu/mortality/
perl/CalcForm.html
Your DNA is Not Your Destiny (cause and
results)

4. Threats to Health and How to Overcome them
Number of deaths for leading causes of death in US
Heart disease: 597,689 (body weight, HTN, DM, No smoking,
healthy life style)
Cancer: 574,743 (cancer screen, No smoking, healthy life style)
Chronic lower respiratory diseases: 138,080 (No smoking, healthy
life style)
Stroke (cerebrovascular diseases): 129,476 (body weight, HTN,
DM, No smoking, healthy life style)
Accidents (unintentional injuries): 120,859 (No drinking, healthy
life style)
Alzheimer's disease: 83,494 (body weight, HTN, DM, No
smoking, healthy life style)
Diabetes: 69,071 (body weight, No smoking, healthy life style)
Nephritis, nephrotic syndrome, and nephrosis: 50,476 (body
weight, HTN, DM, No smoking, healthy life style)
Influenza and Pneumonia: 50,097 (immunization)
Intentional self-harm (suicide): 38,364 (faith, healthy life style)

5. 10 leading cause of death in Taiwan
(1) Malignant neoplasms--28.4%
(2) Diseases of heart (except hypertensive diseases)--11.1%
(3) Cerebrovascular diseases--7.2%
(4) Pneumonia--6.1%
(5) Diabetes mellitus--6%
(6) Accidents and adverse effects--4.5%
(7) Chronic lower respiratory diseases--4.1%
(8) Hypertensive diseases--3.2%
(9) Chronic liver disease and cirrhosis--3.2%
(10) Nephritis, nephrotic syndrome and nephrosis--2.8%

6. Other chronic disease:
arthritis/osteoporosis (body weight,
No smoking, healthy life style)

7. Health Check Up
Understanding Your Results and Taking
Action
BMI: weight (kg) / [height (m)]2
http://www.nhlbi.nih.gov/guidelines/obesity
/BMI/bmicalc.htm
Underweight = <18.5
Normal weight = 18.5–24.9
Overweight = 25–29.9
Obesity = BMI of 30 or greater

9. Importance of Body Weight
重或肥胖的人，如 少減 10% 的 重體
可降低
10% 的 固醇總膽
15% 低密度脂蛋白 固醇膽
30 ％三酸甘油酯
增加 8 ％高密度脂蛋白 固醇膽
高血 患者可以降低壓 10mmHg 收 及舒縮壓 張壓
糖尿病高 者可降低風險 40-60% 的糖尿病的 生發
率

11. HTN
Normal: systolic blood pressure less than 120 mmHg
and a diastolic blood pressure less than 80 mmHg
Prehypertension: systolic blood pressure blood
pressure is between 120/139 mmHg or diastolic
blood pressure 80/89 mmHg
Hypertension : systolic blood pressure above 140
mmHg or a diastolic blood pressure above 90 mmHg
Those who do not have high blood pressure at age
55 face a 90 percent chance of developing it during
their lifetimes.

12. Diabetes
Hg A1C (A1C test measures your average
blood glucose for the past 2 to 3 months):
greater than or equal to 6.5%
Fasting Plasma Glucose (FPG): greater than
or equal to 126 mg/dl
Random (also called Casual) Plasma Glucose
Test (when you have severe diabetes
symptoms): greater than or equal to 200
mg/dl

13. Prediabetes
A1C of 5.7% – 6.4%
Fasting blood glucose of 100 – 125 mg/dl
See more at:
http://www.diabetes.org/diabetes-
basics/diagnosis/#sthash.IDiWiOFk.dpuf

15. TC: total cholesterol, TG: triglyceride, HDL: high density lipoprotein
LDL: low density lipoprotein

19. Everyone should have their cholesterol
(lipids) checked every five years after age 20,
according to the American Heart Association.
B 型肝炎表面抗原﹙ HBsAg﹚ 及 C 型肝炎抗
體 (anti-HCV)
Yearly blood work should include
a blood count to rule out any bleeding problems,
glucose levels to detect diabetes,
thyroid function tests to rule out any thyroid
disorder, and
blood electrolyte counts, which can detect kidney
problems and early heart problems.

20. Cancer Screening
Breast cancer
Yearly mammograms are recommended starting at age 40
and continuing for as long as a woman is in good health
Clinical breast exam (CBE) about every 3 years for women in
their 20s and 30s and every year for women 40 and over
Women should know how their breasts normally look and
feel and report any breast change promptly to their health
care provider. Breast self-exam (BSE) is an option for
women starting in their 20s.
Some women – because of their family history, a genetic
tendency, or certain other factors – should be screened with
MRI in addition to mammograms.
For more information, call the American Cancer Society and
ask for our document called Breast Cancer: Early Detection.

21. Colorectal cancer and polyps
Beginning at age 50, both men and women should follow one
of these testing schedules:
Tests that find polyps and cancer
Flexible sigmoidoscopy every 5 years*, or
Colonoscopy every 10 years, or
Double-contrast barium enema every 5 years*, or
CT colonography (virtual colonoscopy) every 5 years*
Tests that primarily find cancer
Yearly fecal occult blood test (gFOBT) or
Yearly fecal immunochemical test (FIT) every year
http://www.cancer.org/cancer/colonandrectumcancer/morein
formation/colonandrectumcancerearlydetection/colorectal-
cancer-early-detection-acs-recommendations

22. Cervical cancer
Screen begin at age 21.
Women between ages 21 and 29 should have a Pap test every 3 years.
HPV testing should not be used in this age group unless it is needed after
an abnormal Pap test result.
Women between the ages of 30 and 65 should have a Pap test plus an
HPV test (called “co-testing”) every 5 years. This is the preferred
approach, but it is also OK to have a Pap test alone every 3 years.
Women over age 65 who have had regular cervical cancer testing with
normal results should not be tested for cervical cancer.
Women with a history of a serious cervical pre-cancer should continue to
be tested for at least 20 years after that diagnosis, even if testing
continues past age 65.
A woman who has had her uterus removed (and also her cervix) for
reasons not related to cervical cancer and who has no history of cervical
cancer or serious pre-cancer should not be tested.
A woman who has been vaccinated against HPV should still follow the
screening recommendations for her age group.

23. Endometrial (uterine) cancer
Women should report any unexpected
bleeding or spotting to their doctors.

24. Lung cancer
Not recommend tests to screen for lung cancer in
people who are at average risk of this disease.
If you meet all of the following criteria then you
might be a candidate for screening:
55 to 74 years of age
In fairly good health
Have at least a 30 pack-year smoking history AND are
either still smoking or have quit smoking within the last
15 years

25. Vaccination
Flu: every year in late Sep. to early Oct.
Pneumococcal Vaccination: at age of 65 years
or older, or 5 years after 1st
dose received
before age of 65

26. Healthy Life Style
Health: Not just absence of disease.
True health: mind, body, heart, and spirit all play
vital roles in achieving optimal health.
Healthy life style: Diet, activity, managing
stress/stress-relieving (meditation), building and
strengthening relationships, finding meaning and
purpose, and maintaining positive change.
Faith playing an important role.
Re-engineering Your Environment.

27. Diet
Maximize—Plant foods by choosing whole grains, fruits,
vegetables; water and nuts-fiber is your best new friend.
Don’t constantly eat the same things.
Maximize variety and color.
Maximize your taste.
Enjoy your food—without this, the changes won’t last.
Moderate—The amount of food you eat.
Feel comfortably full and not until you are stuffed.
Consider smaller, more frequent meals (five smaller meals
a day instead of three larger ones)
Moderate any stress when eating—eating should be a
blessing and a pleasure.
Minimize—Minimize intke of animal protein, sugars, sugar
substitutes, salt, saturated fats.
Saturated fats are usually solid or almost solid at room
temperature. All animal fats are saturated. Processed and
fast foods are also saturated.

30. Sugar is the worst
3 teaspoons in milk, 6.5 teaspoons in
chocolate milk, 8.5 teaspoons in orange juice,
9.5 teaspoons in coke, and 10.75 teaspoons in
lemonade
Recommended sugar intake: Adult: 6 to 9
teaspoons a day; Children: 3 to 5 teaspoons a
day
Average American consumes 22 teaspoons

31. Exercise
Housework and gardening are not enough to challenge
your body’s capacity.
You need regular exercise: cardiovascular endurance,
strength or resistance training, and flexibility exercises:
qigong and yoga
Go for a brisk walk: a gentle, low-impact exercise and
easy on the joints, 30 minutes a day
Stretch – in bed is easiest: a good morning wake-up
stretch before you climb out of bed: twist your body left
and right, lift your arms overhead and contort your facial
muscles (a recipe for staying youthful). Take 15 rounds of
deep breathing.

32. Your maximum heart rate is about 220 minus
your age.
Heart rate during moderately intense activities
is about 50-69% of your maximum heart rate.
Heart rate during hard physical activity is
about 70% to 85% of the maximum heart rate.

33. For Overall Cardiovascular Health:
At least 30 minutes of moderate-intensity aerobic activity at
least 5 days per week for a total of 150 minutes
OR
At least 25 minutes of vigorous aerobic activity at least 3 days
per week for a total of 75 minutes; or a combination of
moderate- and vigorous-intensity aerobic activity
AND
Moderate- to high-intensity muscle-strengthening activity at
least 2 days per week for additional health benefits.
For Lowering Blood Pressure and Cholesterol:
An average 40 minutes of moderate- to vigorous-
intensity aerobic activity 3 or 4 times per week

34. Four types of exercise
Balance: stand on one foot, Yoga, Tai Chi
Strength: 8 to 12 repetitions, working the
muscles to the point of fatigue for each
muscle group; Yoga
Endurance: Walking briskly
Flexibility: Stretch, Yoga

35. Love and Faith
Hug someone you love
Religion

36. http://www.hpa.gov.tw/BHPNet/Web/Index/I
ndex.aspx
http://www.care2.com/greenliving/16-simple-
ways-to-upgrade-your-health-today.html
http://www.chiphealth.com/
http://www.hpa.gov.tw/BHPNet/Web/Service
/GymnasticsPlace.aspx

37. Acknowledgment
Vicky
Horngwen (Erica) Hsieh
http://www.doctorswithoutborders.org/