1. IMMIGRANT HEALTHAND
NUTRITION COUNSELING
JIAN GUAN, PHD. RNC.
SPRING 2010 OCASI PROFESSIONAL DEVELOPMENT
CONFERENCE
November5, 2010
Spring 2010 OCASI Professional
Development Conference
Thursday, May 13, 2010

2. Objectives
 The purpose of the workshop is to provide
knowledge, skills and strategies for frontline
workers as they provide counseling to clients
and promote health to their communities.

3. Topics
 This workshop will cover the topics such as
the most updated research of genetic analysis
and nutrition science, epidemics among
immigrants and knowledge of Canadian food
and bioactive diet, and principles methods for
providing nutrition counseling.
1. Obesity
2. Cardiovascular disease
3. Diabetics

4. NutriGenomics 基因学营养
Lifestyle Nutrition
Genome
Can modify
Can’t modify
Nutrigenomics
explains nutrient-
gene interaction
and provides
information
related to riskas
well as
information on
the impact of
lifestyle and
nutrition
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5. 5
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6. 6
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7. Health Canada
Communicates amounts and types of food
needed to help:
 Meet nutrient needs and promote health
 Minimize the riskof obesity, type 2
diabetes, heart disease, certain types of
cancerand osteoporosis

8. 1) Obesity and Nutrition
 Apple Shape: Carrying excess weight around the middle
also increases your risk of diabetes, heart disease, high
blood pressure and high blood cholesterol

9. Health Risk Classification According to Body
Mass Index (BMI), Health Canada, 2003
Classification BMI Category
(kg/m2)
Risk of developing
health problems
Underweight <18.5 Increased
Normal Weight 18.5 - 24.9 Least
Overweight** 25.0 -29.9 Increased
Obese Class I 30.0 - 34.9 High
Obese Class II 35.0 - 39.9 Very high
Obese Class III >=40.0 Extremely high
** Overweight 25-27, CANADA, 1988

10. Health Canadian and
increased risk for health problems:
 A European/Caucasian man whose waist measures
more than 102 cm (40 inches)
 A European/Caucasian woman whose waist measures
more than 88 cm (35 inches)
Chinese and South Asian people, waist measurements are
smaller in Canadian Standard
 A Chinese or South Asian man whose waist
measurement of more than 90 cm (35 inches)
 A Chinese or South Asian woman whose waist
measurement of more than 80 cm (32 inches)

11. Waist circumference:
by gender and ethnicity
Waist circumference*
by gender and ethnicity
Male female
European/Caucasian, Sub-
Saharan Africans, Eastern
Mediterranean, Middle
Eastern
>94 cm* 102 cm**
(40 in)
> 80cm* 88 cm**
(35 in)
South Asian, Malaysian,
Asian, Indian, Chinese,
Japanese, Ethnic South and
Central Americans
90 cm
(35 in)
80 cm
(32 in)
* WHO, 2000; **CANADA, 2003

13. 2) Heart Disease and Nutrition
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14. HDL and LDL
LDL =“bad”
 Too much can clog arteries by forming plaque
 Atherosclerosis can cause heart attackor
stroke
HDL =“good”
 Tends to carry cholesterol away fromarteries
and backto liver
 Remove excess cholesterol fromplaque in
arteries, slows build up14 Gene-Nutrition

15. Triglycerides and Atherosclerosis
 Triglycerides is a form of fat, also made in
body and from food, trigger liver to make
more cholesterol, rising LDL
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16. 3) Diabetes and Nutrition
Consulling
 Diabetes is a serious condition.
 It can strike anyone, anywhere at any age.
 Diabetes increases the risk of heart disease and stroke. The
majority of people (approximately 80%) with diabetes will die
from heart disease and stroke.
 Diabetes is also the leading cause of blindness, kidney
failure and non-traumatic amputation.
 In Canada, the number of people with diabetes is growing
every year, and they’re getting younger.
 Approximately 1.8 million Canadians (5.5% of the
population) were diagnosed with diabetes in 2005.
 That number is expected to climb to 2.4 million by 2016.

18. Diabetes – Good News
 Lifestyle changes can reduce the risk of the
most common type of diabetes − type 2
diabetes by 60%.
 While there are no safe and effective ways to
prevent less common types of diabetes, a
healthy lifestyle can reduce the risk of
developing heart disease.
 People with diabetes can live long and
productive lives.

19. 19
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Number of Studies Conducted in T2D,Number of Studies Conducted in T2D,
Gene, and DietGene, and Diet
This figure shows many studies on T2D + diet, interrelationship among gene, gene product, dietary
food component and diseases.

20. What is diabetes?
 Diabetes develops when the body has a problem
with a hormone – insulin produced by pancreas.
 Insulin helps move sugar (glucose) in food from
the blood into the cells of the body where it can be
used for energy.
 Insulin resistance: The body’s cells do not
respond properly to the effects of insulin.
 If pancreas can’t make enough insulin, or if insulin
resistance, glucose builds up and damages blood
vessels in the body.
 Damaged blood vessels can cause problems
such as heart disease, stroke, kidney disease
(nephropathy), eye damage (retinopathy) and
nerve damage (neuropathy).

21. Types of Diabetes
1. Type 1 occurs in about 10% of cases. When cells
in the pancreas that make insulin are destroyed,
the body has no, or very little, insulin to move
glucose from blood into body cells.
2. Type 2 occurs in about 90% of cases. In type 2
diabetes, the pancreas usually doesn’t produce
enough insulin to meet the body’s needs. In some
instances, body cells can’t use insulin properly.
3. Gestational Diabetes (diabetes during pregnancy)
occurs in about 2 to 4% of pregnant women. This
form of diabetes usually goes away after giving
birth, however, both mother and baby are at an
increased risk of developing diabetes later in life.

22. Type 1 diabetes
 Type 1 diabetes is usually
diagnosed in people under 30,
most often in children and
teenagers. It’s usually caused by
an autoimmune reaction – the
body attacks its own pancreatic
cells for unknown reasons. This
reduces the amount of insulin
produced by the body. It is not
caused by eating too much
sugar. There is no safe and
effective prevention of type 1
diabetes at this time.

23. Type 2 Diabetes
 Type 2 diabetes is more common in people
over the age of 40. But, unfortunately, it is now
being seen in younger people, even children.
Most of these children are from ethnic groups
that are at higher risk of developing type 2
diabetes particularly the Aboriginal, Hispanic,
African and Asian populations.
 Insulin Modulation
 Inflammatory Response

24. Prediabetes
 Prediabetes is when blood glucose levels are
almost as high as withdiabetes. It is
sometimes called Impaired Glucose Tolerance
(IGT) or Impaired Fasting Glucose (IFG).
 Prediabetes does not mean you have
diabetes. However, it may indicate an
increased risk for developing diabetes in the
future.
 Making healthy lifestyle choices, such as
controlling weight, eating a healthy diet and
being physically active can help prevent
developing diabetes.

25. “Inflammation
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the evil twin of oxidation.
Where you find one, you find
the other." -- neuroscientist
James Joseph of Tufts
University, 2006.
That include not only such
obvious inflammatory
conditions as asthma and
rheumatoid arthritis, but also
atherosclerosis, Alzheimer's
disease, colon cancer and
diabetes.

26. Diabetes and Healthy Lifestyle
These simple steps will help reduce diabetes
risk:
• Lead a healthy lifestyle
• Eat a healthy diet
• Get regular physical activity

27. STEP1 - Healthy Eating Habits
 Addresses the problems of
carbohydrate sensitivity and fat
storage
 With this lifestyle change, you will not
go hungry, feel deprived, or quit from
lack of variety (don’t count calories)
 Emphasis on adopting a diet made up
of low-glycemic foods

28. STEP 2 - Behavior Modification
 Group Coaching/Support
 Daily Journal
 Education
 Dietary Supplementation
 Exercise Suggestions

29. STEP 3 - Change Body
Composition
 Exercise program to boost your
metabolism and change your body
composition
 With constant yo-yo dieting you lose
muscle and gain body fat
 With exercise your body will be in fat
burning mode
 Muscle Dictates Metabolism!

30. The Glycemic Index (GI)
 Glycemic Index measures the impact of carbs
on blood sugar levels
 High GI foods such as sugar, white flour and
rice quickly raise blood sugar levels and insulin
production
 High GI foods with high GL amount throw your
metabolic switch into fat storage mode
(independent of calories!)

31. The Glycemic Index (GI)
Low GI foods promote weight loss while preserving
lean muscle mass and do not lower metabolic
rate
 Low GI foods give your body a steady stream of
energy
 Addresses body composition resulting in fat loss
and optimal metabolic rate!

32. Fiber-Rich Foods
 Vegetables
 Many Types Of Fruits
 Lentils, Beans
 Yams, Sweet Potatoes
 Whole Unprocessed Grains And More

33. Nutrition Supplements
 Vitamin B6 and Zinc
 Chromium
 Calcium
 Digestive Enzymes: Helps combat nutrition loss
due to processed food
 Omega III : Anti inflammation
 Complete Greens: Provides essential enzymes
and good bacteria to optimize the absorption of
nutrients from food

34. Antioxidants
 Antioxidants serve as a powerful first line of
defense against oxidative damage from aging,
stress, and inflammation.
 Antioxidants appear to contain cancer-fighting
properties and to support the immune system
(among many other benefits).
 Though many, many foods contain these
valuable antioxidants, we’ve listed a few of the
most potent and popular choices for each class
of antioxidants.
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35. Antioxidants
Antioxidants can be broken into two general
categories:
1) antioxidant nutrie nts (including
phytonutrients). Vitamins, minerals and the
various -noids detailed below are in this
category.
2) antioxidant e nz ym e s.
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36. Enzymes
The most vital nutritional discovery since Vitamins and
Minerals
Supports a healthy digestive tract:
Promotes digestion
Supports nutrient absorption
May help ease stomach upset
Helps maintain healthy cholesterol levels
Supports healthy immune functions
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37. Digestive Enzymes
Digestive enzymes make it possible for us to digest
and absorb proteins, fats, carbohydrates, starches
and sugars, and structure them into healthy bodies.
Digestive enzymes have three main jobs:
 Proteases digest protein
 Amylases digest carbohydrate
 Lipases digest fat.
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38. Fresh FruitsFresh Fruits
Fresh raw fruits are loadedFresh raw fruits are loaded
with enzymes and when wewith enzymes and when we
eat our foods raw 30% of theeat our foods raw 30% of the
digestion is done for us by the food itself.digestion is done for us by the food itself.
When we cook our food over 110 degrees F, weWhen we cook our food over 110 degrees F, we
destroy the living enzymes and our body mustdestroy the living enzymes and our body must
use its own enzymes for digestion robbing ususe its own enzymes for digestion robbing us
of energy.of energy.
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39. Fiber
 Helps maintain digestive health, helps cleanse
colon and promote colon health
 Helps relieve occasional constipation*, support
normal bowel regularity and fecal volume
 Helps promote healthy growth of beneficial
bacteria in the colon
 Supports healthy nutrient absorption
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40. High-FiberFoods forDigestive Health
 Fiber intake has been linked to reducing the
risk of heart disease, diabetes, obesity and
certain types of cancer.
 Daily fiber intake goal:
Males 19-50 38 g per day
Males 50+ 30 g per day
Females 19-50 25 g per day
Females 50+ 21 g per day
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41. VegetablesVegetables
 Vegetables are mainlyVegetables are mainly
carbohydrates that are high in antioxidants,carbohydrates that are high in antioxidants,
phytochemicals and fiber.phytochemicals and fiber.
 Dark green vegetables will help to alkalinizeDark green vegetables will help to alkalinize
the body and are a great source of calcium.the body and are a great source of calcium.
 Vegetables are also low in calories andVegetables are also low in calories and
sugar so they feed your body with nutrientssugar so they feed your body with nutrients
without a lot of calories.without a lot of calories.
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42. Table for Fiber-less and Fiber-rich
food
Fiber-less food Grams of fiber Fiber-rich food Grams of fiber
per serving per serving
Meat or poultry 0 g per 75 g or 2.5oz Red kidney beans 12 g per ¾ cup
Chicken noodle soup 2 g per 1 cup Lentil soup 12 g per 1 cup
Corn Flakes cereal 1 g per 1 cup (30g) Fiber first/ bran buds 12 g per 1/3 cup (30g)
Chili con carne 4 g per 1 cup Vegetarian chili 9 g per 1 cup
White pasta 3 g per 1.5 cups cooked Whole wheat pasta 8 g per 1.5 cups cooked
Chocolate chip muffin 2 g per muffin Raisin Bran muffin 5 g per muffin
Apple juice 0.1 g per ½ cup Apple 3 g per apple with skin
White rice 0.8 g per 1 cup cooked Brown rice 3 g per 1 cup cooked
Chips – regular 0.8 g per 10 chips (20g) Microwave popcorn 3 g per 2.5 cups (20g)
White bread 1 g per slice 100% whole-grain bread 2.2 g per slice
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