Wellness : 5 Normals:The Cleveland · Start &Sustaining the change •Ah Moments—Your RealAge &...
Transcript of Wellness : 5 Normals:The Cleveland · Start &Sustaining the change •Ah Moments—Your RealAge &...
Wellness : 5 Normals:The Cleveland
Clinic Experience: Motivating/Sustaining
Change: Improve Health, Save Big $
Dr. Michael Roizen
Chief Wellness Officer
J Gorman & Family Chair,
Wellness Institute
IQ
Harvard Physician
40 50 60 70 80 90
Age
-30
0
-20
-10
IQ
Harvard Physician
40 50 60 70 80 90
-30
-10
-20
0
Age
IQ
Harvard Physician
40 50 60 70 80 90
-30
-10
-20
0
Age
How do you be one of 25%
that do not lose IQ points
as you age?
Start &Sustaining the change
• Ah Moments—Your RealAge & Culture Change
• Environment: physical, work culture that
expects well employees and family
• Social: buddies through, e-coaching, online
programs, social media
• Effective incentive strategy: tied to programs
and “5 normals” outcomes
If YOU Have 5 Normals,
You Are at least 12 Years
Younger (RealAge)
&Lifetime Health Costs Are
33-50% Less
(even last yr costs 50%
less)
5 Normals:
• BP <125/<85
• LDL Cholesterol <130 w/o CV or
<100 with CV
• HgBA1C < 5.7 or Fasting
Glucose <106
• BMI <30 or Waist < ½ Height
• No Cotenine in Urine
If Have 5 Normals, You Are at least
12 Years Younger (RealAge)
&Lifetime Health Costs Are 33-50%
Less (even last yr costs 50% less) • BP <125/<85
• LDL Cholesterol <130 w/o CV or <100 with CV
• HgBA1C < 5.7 or Fasting Glucose <106
• BMI <30 or Waist < ½ Height
• No Cotenine in Urine
With or Without Medications
Better Health Rewards S2243- after
CC Program :Save 200+ Billion A Yr
• Only 4% of Medicare Beneficiaries enter MediCare with 5 Normals
• If have 5 nmls, spend 50-66% of all others lifetime on Medicare (and less on disability), and even 50% less in last yr of life
• Bending Curve would start in 2 yrs; Curve flatten in 5 yrs; Curve Bend Down in 7 yrs
• Each Beneficiary Achieving 5 Normals would get Check reward for doing so
Save $200B A Year By Performance
Testing Gvt Progms
• Bending the Curve Would Start in 2 yrs; Curve Flatten in 5 yrs; Curve Bend Down in 7 yrs
• Each Beneficiary Achieving 5 normals Gets $2000 a Year For Doing So
• Save 1 Trillion in 1st 10 yrs and 2 Trillion plus per 10 yrs thereafter If 75% did so
Projected Health Care Spending in US
5.2
7.2
12.0
0
2
4
6
8
10
12
14
1960 1970 1980 1990 2000
Year
Percen
tag
e o
f G
DP
Healthcare Spending in the United States
5.2
7.2
8.8
11.9
13.2
17.6
0
2
4
6
8
10
12
14
16
18
20
1960 1970 1980 1990 2000 2009
Year
Percen
tag
e o
f G
DP
& We Lost Our
Manufacturing
Jobs
Healthcare Spending
6,000
4,000
2,000
0
$ billions
2007 2009 2011 2013 2015 2017
16%
20%
National expenditures ($)
% of GDP 28%?
6,000
4,000
2,000
0
17.6%
Disease Prevalence
0
20
40
60
Hypertension Heart Diabetes Stroke
US Europe
%
Prevalence and Treated Prevalence in the United
States and Ten European Countries, 2004 Prevalence a
United States Europe
Percent 95% CI Percent 95% CI US/Europe
difference
Heart disease 21.8 21.1, 22.4 11.4 10.7, 12.0 10.4
High blood pressure 50.0 49.2, 50.9 32.9 32.0, 33.9 17.1
High cholesterol 21.7 20.7, 22.7 19.6 18.9, 20.4 2.1
Stroke/cerebrovascular disease 5.3 4.9, 5.6 3.5 3.1, 3.9 1.8
Diabetes 16.4 15.8, 17.0 10.9 10.3, 11.5 5.5
Chronic lung disease 9.7 9.2, 10.2 5.4 4.9, 5.8 4.3
Asthma 4.4 3.9, 4.8 4.3 3.9, 4.6 0.1
Arthritis 53.8 52.9, 54.6 21.3 20.5, 22.1 32.5
Osteoporosis 5.0 4.4, 5.5 7.8 7.2, 8.3 -2.8
Cancer 12.2 11.6, 12.2 5.4 4.9, 5.9 6.8
Obese 33.1 32.3, 33.9 17.1 16.3, 17.8 16.0
Current smoker 20.9 20.2, 21.7 17.8 17.1, 18.6 3.1
Former smoker 31.7 30.9, 32.5 25.2 24.3, 26.0 6.5
Never smoked 47.3 46.5, 48.2 57.0 56.0, 58.0 9.7
USA HAS TWICE THE DISEASE
PREVALANCE AS EUROPE
Chronic Disease
4 Factors Cause 75%
• Tobacco
• Food Choices & Portion Size
• Physical Inactivity
• Stress
• 81% of hospital admissions
• 91% of all prescriptions
• 76% of physician visits
• Average Cost $6,032/yr
Chronic Disease Impact
Developing Wellness as
Cleveland Clinic’s Fourth Pillar
Patient Care Wellness
Education Research
Employee Wellness Program
ATTEMPTS:
• New Approach: Judge success by health
plan costs – not intermediate variables
• Focus on 4 Biggies:
Tobacco
Food Choices
Physical Activity
Work Stress (Employee Satisfaction)
What was Elvis’s Major
Contribution?
How Much was it Worth
to America?
What was Elvis’s Major
Contribution?
• Immunization on TV, in Papers
• Saved $55B a Year in USA Alone
YOUR Behaviors Are Governed By
•Emotion (not data) for
change
•Environment/Culture for
sustaining change
Control The Controlables
Employee Wellness Program
Focus on 4 Biggies:
• Tobacco
• Food Choices
• Physical Activity
• Work Stress (Employee Satisfaction)
GET ALL TOXINS OUT OF
ENVIRONMENT
Smoking Survival
Non-Smoker
Smoker
Age
%
100
0
80
60
40 50 70 100 60 80
40
20
0
200
400
600
800
1,000
1,200
2005 2006 2007
Smokers Survival 100
% alive
80
60
40
20
0 40 55 70 85 100
Never smoked
regularly
Continuing smokers
Former smokers,
stopped <35
Age
Data Fr/ CDC & Center for Health Prevention Research at Case Western Reserve University
Cigarette Use Decline?
22.0
20.8 20.5
20.0
18.8
19.4
20.2
25.2
25.9
22.3 22.4 23.1
20.2
20.3
26.5
25.0
24.0
21.3
18.8
16.9
15.0
14.0
16.0
18.0
20.0
22.0
24.0
26.0
28.0
30.0
2003 2004 2005 2006 2007 2008 2009
Year
Percen
tag
e o
f P
op
ula
tio
n
USA
Ohio
Cuyahoga
21.6
OHIO WITHOUT
CUYAHOGA
Employee Wellness Program
FOCUS ON 4 BIGGIES:
• Tobacco
• Food Choices
• Physical Activity
• Work Stress (Employee Satisfaction)
Patient Food Choices and Education
Vending Machines
Cafeterias and Vendors
Store Labels and Farmers’ Market
36 Schauer - “Multibillion Dollar Emerging Market”
• Gradually and
Progressively
increase quality of
foods –
• Great taste and
Great for you!
• Costs no more to
eat for WELLth
Curves Membership
Fitness Center
Yoga Classes
All Cleveland Clinic Facilities Fitness Center Visits
Trend
Weight Management
• Weight Watchers
• Curves
• Shape Up & Go
• Fitness Centers
• Yoga
• Farmer’s Markets
• Vending Machines
• GO! Foods
279,000 LBS Lost
January 13th, 2012 l 46
Control
Imagery
0
2
4
6
8
1 2 3 4 5
Pain
Benefits of Guided Imagery for
Cardiac Surgery Patients
Tusek, Dr Cosgrove et al, J. Cardiovasc. Manag. 1999; 10:22-28
Anxiety
1 2 3 4 5 Base PreOp 0
2
4
6
8
10
7.5 days
5.5 days
Length of Stay Post surgery
Cleveland Clinic has done landmark work
on importance of stress management
Stress – The Interheart Study 30,000 patients in 52 countries
Yusef, S. et al., Lancet, 2004 364: 937-952
0
0.5
1
1.5
2
2.5
3
3.5
Smoking Stress Diabetes Hypertension Obesity
Ris
k Acute MI Risk
“Psychological distress is comparable to smoking and more significant than
blood pressure, obesity, and diabetes”.
% Increase in Health Care Cost
due to preventable risk factors
Goetzel, J Occup Environ Med. 1998 Oct;40(10):843-54.
Risk Factor (% number of cases)
0% 20% 40% 60% 80%
Depression (2.2%)
High stress* (18.5%)
High blood glucose (4.9%)
Extreme high or low weight (20%)
Former tobacco user (31.1%)
Current tobacco user (19.1%)
High blood pressure (4%)
Poor exercise habits (32.4%)
High cholesterol (18.8%)
% Increase in Health Care Cost (adjusted)
46,000 state and corporate employees. Health care cost estimate
performed for up to 3 years after an initial health risk assessment.
$1510
$710
$320
$747
*High stress: Almost always troubled by
stressed and did not handle stress well
• Aims:
- Evaluate program effectiveness (stress, burnout, well-being, productivity)
- Assess if group support improves effectiveness and engagement
• Corporate Call Center (credit card services, debt collectors)
• 160 participants randomized into 4 groups
• Data from 103 (70%) participants at week 8 and 80 (55%) at week 16
Study Design Corporate Call Center
Stress Free Now +
Group support +
4 Expert Led class
160
pa
rtic
ipan
ts
Week 1 8 16
Stress Free Now
Qu
es
tio
nn
air
es
+ p
rod
uc
tivit
y
Qu
es
tio
nn
air
es
+ p
rod
uc
tivit
y
Stress Free Now +
Group support
Control
SFN
SFN +
Group1
SFN +
Group2
Qu
es
tio
nn
air
es
+ p
rod
uc
tivit
y
Very High
Low
High
Average
Perceived Stress Scale Measure of how unpredictable, uncontrollable, and overloaded respondents find their lives
p<0.05
p<0.01
p<0.001
* ** ***
-20.0
-10.0
0.0
10.0
20.0
30.0
40.0
CTL SFN SFN+Grp1 SFN+Grp2
* *** *** *** * *** *** ***
PS
S s
co
re
~40% decrease from very high to average level of stress
Maintained 2 months after end of intervention
0 0 0 0 8 8 8 8
-7%
Δ8
-23%
Δ8
-35%
Δ8
-33%
Δ8 16 16 16 16
-14%
Δ16
-24%
Δ16
-45%
Δ16
-34%
Δ16
SF36 – Vitality
-20.0
-10.0
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0 *** **
*** ***
*** **
7%
47%
59% 39%
3%
43%
74% 39%
0 8 16 Δ8 Δ16 0 8 16 Δ8 Δ16 0 8 16 Δ8 Δ16 0 8 16 Δ8 Δ16
CTL SFN SFN+Grp1 SFN+Grp2
mean
25%
Healthy Population
Normative values
Vita
lity s
co
re
• ~40-70% increase in vitality
• Sustained at 2 months follow-up
CCHS Healthy Choice
• 9% Premium Increase
• Rebate Increase for Personal Responsibility
5 normals = BP, LDL Chol; HgbA1C; BMI,
Cotenine
• Benchmark 12%;Gold Std = 15%
• 1st 6 mos CC = 35%; Upped to 21% Prem:
now >60% of those w/chronic dis & >80% of
others
Comprehensive Approach to a Culture of Wellness
July 2005
January 2007
February 2007
June 2007
September 2007
May 2008
July 2008
August 2008
October 2008
November 2008 May 2009
March 2009 September 2009
October 2009
January 2010
Smash the Ash All Cleveland Clinic
Campuses Smoke Free
Free Smoking Cessation Services offered to all
Cuyahoga County Residents for 6 months
Banned Trans - Fats
From all public and patient menus
Established Wellness Institute and Michael F. Roizen MD
as the Country ’ s
FIRST Chief Wellness
Officer
Stopped Hiring
Smokers
Free Yoga Classes for Employees
Launched weekly
Farmer ’ s Market
for employees and Community
Began free first - dollar Weight Watchers services for EHP
member employees
Welcomed first class of
Lifestyle 180 participants,
teaching healthy choices for patients
with chronic conditions such as
high blood pressure, diabetes, and heart
disease
Initiated free memberships to Curves and Cleveland Clinic -
owned fitness centers for EHP member employees
Shape Up & Go Ongoing team -
based employee walking & fitness
competition
Launched Health Tip of the Day
App
Launched 360 - 5.com
Launched StressFreeNow
Program
Re - branded and launched Lifestyle EAP
March 2010
Launched
GO!Foods for You
Program
Linked health plan
contribution to
wellness program
participation
July 2010
Removed
SUGAR drinks
from all vending
& cafeterias
Implemented
employee
biometric
collection (ROI
over next 3
years)
Opened 360-5
Retail Store
Copyright © 2010 Accenture - Cleveland Clinic Foundation. All Rights Reserved 54
$220
$230
$240
$250
$260
$270
$280
$290
$300
Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2
2007 2008 2009 2010
Employee Health Costs:
Flattening the Cost Curve…
Start &Sustaining the change
• Ah Moments—Your RealAge & Culture Change
• Environment: physical, work culture that
expects well employees and family
• Social: buddies through, e-coaching, online
programs, social media
• Effective incentive strategy: tied to programs
and “5 normals” outcomes
5 Normals:
• BP <125/<85
• LDL Cholesterol <130 w/o CV or
<100 with CV
• HgBA1C < 5.7 or Fasting
Glucose <106
• BMI <30 or Waist < ½ Height
• No Cotenine in Urine
If YOU Have 5 Normals,
You Get A Check
For $2000.00
If Have 5 Normals Get a
$2000.00 Check Each Yr: • Changes The Conversation
Between Patient & Primary Care
Doc
• What Can I Do To Get
5 Normals?
Enforcer e-Coaching Process
Client View
Provider View
Patient begins daily
email encounters
Automated / Human
system generates
appropriate
responses
Outcomes: Change in Employee
Variables That Matter
& Changes in Costs & Productivity
• Cleveland Clinic Employee HC Costs (in
Current $) Stable or Dec for 14+ quarters
• CC Employees have lost 279,000+ pnds;
self reported to docs cig use dec from 15.4
to 6.8%; slower inc Type2Diabetes; lower
BP’s; Inc Engagement by 33%
Save $200B A Year By Performance
Testing Gvt Progms
• Bending the Curve Would Start in 2 yrs; Curve Flatten in 5 yrs; Curve Bend Down in 7 yrs
• Each Beneficiary Achieving 5 normals Gets $2000 a Year For Doing So
• Save 1 Trillion in 1st 10 yrs and 2 Trillion plus per 10 yrs thereafter If 75% did so
Health Choices You Make
Determine If USA Will Compete
For Jobs
• Turning Point, But Reversible for You & for Society
• 4 Factors Determine 75% of Costs-Deficit Determined by Your Lifestyle Choices
• Emotion ,Environment (not data),
Social Groups; large incentives
Determines/Sustains Choices
You Can Manage (& Reverse)
Chronic Disease—U Can Vote
(& help many make their RealAges
Younger):
• Go to TedMed.com; Click on
Great Challenges
• Vote for #8
• Make Getting 5 Normals a Ntl
Priority
DISCLOSURE OF INTERESTS:
WWW.RealAge.com
www.youdocs.com
WWW.RealAge.co
m
Heathradio.net & &
30+ Terrestrial
stations 5-7 PM
Sats
69
YouBeauty.com
Health Choices You Make
Determine If XXX Will Compete
For Jobs
• Turning Point, But Reversible for You & for Society
• 4 Factors Determine 75% of Costs-Deficit Determined by Your Lifestyle Choices
• Emotion & Environment (not data)
Determines Choices
• Know You Control What
Goes In Your Body—and
It Is That Important!!!
• You Can Get A Do Over
WHAT IS MOST IMPORTANT
ROIZEN RULE 4 A YOUNGER RealAge
Causes of Death
0 20 40 60 80
Vaccine Preventable
Colorectal Cancer
MVA
Breast Cancer
Suicide
Prostate Cancer
Parkinson's
HIV
# Thousands
Vaccine preventable death
kills more then many others
1. Know You Control What
Goes In Your Body—and
It Is That Important!!!
“Avoid Three Food
Felons”
WHAT IS MOST IMPORTANT ROIZEN RULE FOR YOUNGER YOU
For Your Brain
1.Avoid 3 Food Felons That Rob
Your Energy & Your Memory
• Added Sugars
• Simple Carbs (enriched flour)
• Added Syrups (corn, and
others)
FOOD IS NOT
“LETS MAKE A
DEAL”
1.Avoid 3 Food Felons That Rob
Your Energy & Your Memory
• Added Sugars, Syrups, simple
carbs
• Blood sugar less than 110 for
heart; less than 250 mg/dL for
brain
We Have A Program
For YOU 4 That—
Teaches Great
Tasting Food Even
a Doc Can Make–
“GO! Foods For You”
Early Atherosclerosis Present in
Virtually All Teenage Americans
• Prevalence and extent of
atherosclerosis in adolescents and
young adults: Implications for
prevention from the Pathobiological
Determinants of Atherosclerosis in
Youth Study.
Strong, JP et al., JAMA 1999 Feb 24; 281:727-35
2. Walk 10,000 steps
a day
MOST IMPORTANT THINGS TO DO
For Your Brain
We Have A Program
For YOU 4 That–
“ShapeUp&Go.org”
1. KNOW YOU Control
What Goes In Your
Body—Avoid Worst 3
Food Felons
2. Walk 10,000 Steps a day
3. Call A Buddy
MOST IMPORTANT THINGS TO DO
For Your Brain
We Have A Program
For YOU 4 That–
“Enforcer e-
Coaching” www.YOUDOCs.com
1. KNOW YOU Control
What Goes In Your
Body—Avoid Worst 3
Food Felons
2. Walk 10,000 Steps a day
3. Call A Buddy
MOST IMPORTANT THINGS TO DO
For Your Brain
4. Add Some Fun Foods
Coffee– 6 cups/day
Chocolate– ½ oz
twice a day
Yellow mustard(turmeric)
Walnuts
MOST IMPORTANT THINGS TO DO
For Your Brain
4. Add Some Fun Foods
To Clean Up Brain Poop
Yellow mustard(turmeric)
Activates Apo E = Waist
Mgmt Truck For Your
Brain Like Bexarotene
MOST IMPORTANT THINGS TO DO
For Your Brain
5. Avoid Known Toxins
Tobacco,
Including 2nd Hand
Smoke
Lead
Mercury
MOST IMPORTANT THINGS TO DO
For Your Brain
6. Do Minimum Physical Activity
For Maximum Health (& Brain)
Benefit
• General = 100 min a day of
movement 10,000 Steps A Day
• Resistance Exercise = 30 min a
week
• Cardio = 21 min Three X a week
at 80% of max HR
Step 6: Move Your Body Best documented for younger
memory
Increase in
Size of
Hippocampus
with 3
Months of
Aerobic
Exercise
7. Manage Your Stress
MOST IMPORTANT THINGS TO DO
For Your Brain
Greatest Stress
Reducers
• Friends, Friends, Friends
• Purpose in Life
• Meditation
• Refocusing & Physical Activity
We Have A Program
For YOU 4 That–
“Stress Free Now”
Solon Call Center – PSS Data • Pilot Study (12 control / 12 StressFreeNow + group meeting)
• Study group too small to draw any definite conclusion from the data
• ~50% stick to the program and were extremely positive about it
High
Very High
-20.0
-15.0
-10.0
-5.0
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
SFN CTL
Average
Low
Call Center –
Kansas City
N=16 N=5 N=9
p=0.002
Weight Change at Week 16
Limitations:
Exploratory
Not all participants were overweight
-12.0
-10.0
-8.0
-6.0
-4.0
-2.0
0.0
2.0
4.0
CTL SFN SFN+Grp1 SFN+Grp2
* *
*
We Have A Program
For YOU 4 That–
“Stress Free Now”
1. KNOW YOU Control What
Goes In Your Body-Avoid 3
Food Felons
2. Walk 10,000 Steps a day
3. Call A Buddy
8. Avoid Other 2 Food Felons
MOST IMPORTANT THINGS TO DO
For Your Brain
Avoid Other 2 Food Felons
That Rob Your Energy & Your
Memory
• Saturated Fat
• Trans Fat
DIET AND LIFESTYLE CHANGE GENE EXPRESSION
1 & 8Avoid 5 Food Felons That
Rob Your Energy & Your Memory
• Saturated Fat
• Trans Fat
• Sugar
• Simple Carbs (enriched flour)
• Syrup (corn, and others)…Blood
sugar less than 110 for heart;
less than 250 for brain
Alzheimer’s Disease
and Diabetes
•Diabetes increases the
risk of AD
•Diabetes increases the
progression of cognitive
decline in those with AD
1. KNOW YOU Control What
Goes In Your Body
5. Walk 10,000 Steps a day
6. Call A Buddy
9. Take 5 Pills
MOST IMPORTANT THINGS TO DO
For Your Brain
1. DHA 900 MG
2. VITAMIN D3 1000 IU
3. CALC 600MG & MG 400 MG A
DAY
4. 1/2 MULTI 2 X A DAY
5. ASA 162 MG WITH H20
6. PROBIOTIC
7. MAYBE NON BBB STATIN & COQ10
FIVE PILLS
• FARMED FISH SAVE SALMON AND TROUT FROM SUPPLIERS ALL OVER USA LOW IN OMEGA-3’S
• Changes in diet during the past century have caused a
marked increase in consumption of saturated fatty acids
• and n-6 polyunsaturated fatty acids (PUFAs) with a concomitant
• decrease in the intake of n-3 PUFAs. Increased
• fish consumption has been shown to be the only realistic
• way to increase dietary quantities of beneficial long-chain
• n-3 PUFAs such as eicosapentaenoic acid and docosahexaenoic
• acid and re-establish more balanced n-6:n-3
• ratios in the diets of human beings. Our objective in this
• research was to characterize some of the relevant fatty
• acid chemistry of commonly consumed fish, with a particular
• focus on the four most commonly consumed
• farmed fish. To do this, 30 commonly consumed farmed
• and wild fish were collected from supermarkets and
• wholesalers throughout the United States. Fatty acid c o m -
• position of samples from these fish was determined
• using gas chromatography. The 30 samples studied contained
• n-3 PUFAs ranging from fish having almost undetectable
• levels to fish having nearly 4.0 g n-3 PUFA per
• 100 g fish. The four most commonly farmed fish, Atlantic
• salmon, trout, tilapia, and catfish, were more closely examined.
• This analysis revealed that trout and Atlantic
• salmon contained relatively high concentrations of n-3
• PUFA, low n-6:n-3 ratios, and favorable saturated fatty
• acid plus monounsaturated fatty acid to PUFA ratios. In
• contrast, tilapia ( the most frequently
• farmed fish) and catfish have much lower concentrations
• of n-3 PUFA, very high ratios of long chain n-6 to long
• chain n-3 PUFAs, and high saturated fatty acid plus
• monounsaturated fatty acid to PUFA ratios. Taken together,
• these data reveal that marked changes in the
• fishing industry during the past decade have produced
• widely eaten fish that have fatty acid characteristics that
• are generally accepted to be inflammatory by the health
• care community.
• J Am Diet Assoc. 2008;108:1178-1185.
IN LAST 10 YRS
FISH HARVESTING
CHANGED SO
MUCH THAT IN USA,
ONLY FISH WITH
DHA ARE SALMON
AND TROUT
1. DHA 900 MG
2. VITAMIN D3 1000 IU
3. CALC 600MG & MG 400 MG A
DAY
4. 1/2 MULTI 2 X A DAY
5. ASA 162 MG WITH H20
6. PROBIOTIC
7. MAYBE NON BBB STATIN & COQ10
FIVE PILLS
1. DHA 900 MG
2. VITAMIN D3 1000 IU
3. CALC 600MG & MG 400 MG A
DAY
4. 1/2 MULTI 2 X A DAY
5. ASA 162 MG WITH H20
6. PROBIOTIC
7. MAYBE NON BBB STATIN & COQ10
FIVE PILLS
Prenatal Multivitamins + DHA
• Decrease congenital birth defects
(major) by 80%
• Decrease childhood cancers by 65%+
• Decrease Autism & Autistic spectrum
disorders by 40%+ (if taken for 3
months prior to conception)s
• Improve IQ outcomes
Multivitamins + DHA +
Lutein after Age 55
• Insurance policy vs. imperfect diet
• 80-90% of employees tested are
deficient in D3 +/- at least one other
• Decrease memory loss w/ aging
• Decrease eyesight loss w/ aging
1. Know YOU Control What
Goes In Your Body
10. Sleep 6.5 to 8 hrs every day
MOST IMPORTANT THINGS TO DO
For Your Brain
We Have A Program
For YOU 4 That–
“GO! To Sleep”
1. Know YOU Control What
Goes In Your Body
10. Sleep 6.5 to 8 hrs every day
11. Floss and See a Dental Pro
Every 6 Months
MOST IMPORTANT THINGS TO DO
For Your Brain
12. Know Your BP and do
whatever to keep it at 115/75
13. Know Your CRP and do
whatever to keep it under 1.0
MOST IMPORTANT THINGS TO DO
For Your Brain
14. Love Something & Do It
Daily
MOST IMPORTANT THINGS TO DO
For Your Brain