Weight Management Genetic Panel
Kashi Clinical Laboratories is a fullyaccredited laboratory specializing in a range of health related testing services and customized assay development. Based in Portland, OR, Kashi Health, a division of Kashi Clinical Laboratories, supports healthcare providers and their patients in determining genetic causes of disorders and disease by looking at alterations in DNA. Such knowledge can enable your healthcare provider to tailor a customized treatment plan for your care. For your convenience, our genetic tests collect DNA samples using noninvasive buccal swabs. Because the swab collection involves just a simple swipe inside the cheek, Kashi’s genetic testing is ideal for patients of all ages. If you are having unexplained health issues, talk to your healthcare provider about genetic testing with Kashi Health.
Visit us at KashiHealth.com to learn more.
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Congratulations! You have taken an important step in managing your weight and your health. By choosing genetic testing with the Kashi Health Weight Management Genetic Panel, you now have a personalized plan to help overcome your weight hurdles.*
* These recommendations are based upon your individual genetic profile. They are not intended to replace medical advice. As always, please consult with a healthcare provider before any dietary or physical activity modifications.
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Proper Weight Management is Essential for a Healthy Life. Maintaining a healthy weight is critical to preventing disease and increasing well-being. A healthy weight minimizes your risk of high blood pressure and cholesterol, diabetes, arthritis, and many other health disorders.1-3
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Facts on Weight Management While general weight management is important, the most important factor is the management of your body fat percentage. Body mass is divided into two categories: lean mass (bones, muscle, and water) and fat mass. Body fat percentage is the amount of your body mass that consists of fat. Healthy ranges vary from men to women and by activity level. Recommended body fat percentages tend to be lower for men than women, and athletes usually have a lower body fat percentage than sedentary or normally active people. The graph on the right will help you determine your ideal body fat percentage. The percent ranges represented by the green zone are where your ideal body fat percentage should fall. By following your specific weight management plan, we will help you get there.
BODY FAT RANGES FOR STANDARD ADULTS1, 2 FEMALE AGES
UNDERFAT
HEALTHY
OVERFAT
OBESE
20-39 40-59 60-79 MALE AGES
0%
10%
20%
30%
40%
20-39 40-59 60-79 UNDERFAT
HEALTHY
OVERFAT
OBESE
Based on NIH/WHO BMI Guidelines. As reported by Gallagher, et al, at NY Obesity Research Center. 2000. To determine the percentage of body fat that is appropriate for your body, consult your physician.
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There are many ways to test body fat percentage: skin calipers, bioimpedence analysis, water disbursement tests, etc.; however, in many situations these tests are not practical due to a lack of necessary equipment. Thankfully, there is a much easier method to calculate body fat percentage that can be done simply with a scale and a ruler: BMI value. Calculation of your BMI (Body Mass Index) provides a reliable estimate of your body fat level by comparing your weight to your height.4 The are many online resources for calculating your BMI. Once you have determined your value, the table below will help identify your category as your track your progress.
BMI
CATEGORY
< 18.5
Underweight
> 18.5 to < 25
Normal Weight
> 25 to <30
Overweight
> 30 to < 35
Obese Class I
> 35 to < 40
Obese Class II
> 40
Obese Class III
An estimate of how your weight affects your health depends upon one of six categories of BMI. The greatest health benefit occurs when weight falls into the normal weight range. A healthy BMI should be the goal of any weight loss program. While your BMI value can be influenced by a higher amount of muscle mass, in general it is a very reliable way to gauge your health status.4 By tracking your BMI you can quickly assess your weight loss progress over time. It also provides a healthy weight range to aim for instead of one specific number â&#x20AC;&#x201C; a more reasonable goal in managing weight. 4
What is Genetic Testing?
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Our bodies are designed with our own genetic code (DNA). Your DNA consists of 46 chromosomes you received from your parents: 23 from your father and 23 from your mother. The chromosome pairs are found in most cells within your body. Each chromosome pair is comprised of many genes that dictate the various aspects of your appearance, development, and overall health.5 Each chromosome carries a version of a related gene, referred to as an allele. Alleles are versions of genes that can be the same or different between the chromosomal pairs.6 From genes for eye color to genes for height, alleles determine how we look like our ancestors ... but a little different.
In some cases, we find one or two alleles in a chromosomal pair that are atypical or rare in the general population, otherwise known as variant alleles. In the case of obesity, certain variant alleles have been identified that contribute to a higher body weight and overall fat mass. This variation makes us more likely to gain weight, crave fattening foods, or choose a sedentary lifestyle.
Kashi Health researchers have determined which genes effectively impact weight management success and developed the unique Kashi Health Weight Management Panel. After deciding which genes to include in the panel, our researchers studied over 200 peer reviewed scientific articles to understand how diet and physical activity influence weight loss in individuals with variant alleles. Our genetic test will show whether you are a carrier of a variant gene, or allele, that is affecting your weight. Using the findings from our research, along with the results of your genetic test, we can make specific recommendations to help in your weight management efforts. This information enables us to design a tailored weight management plan based entirely upon your bodyâ&#x20AC;&#x2122;s genetic code.
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A Personalized Edge to Weight Management When it comes to losing weight and keeping it off for a healthy lifestyle, everyone is different. Kashi Health’s Weight Management Panel enables health professionals to tailor a weight loss program – food ratios, exercise routines, and lifestyle recommendations – based on each patient’s own genetic make-up. The Kashi Health Weight Management Genetic Panel uses cutting-edge laboratory technology to identify each patient’s specific alleles. The patient’s specific alleles are then compared to information from the strongest scientific publications. Using this data, each report will explain how the patient’s specific alleles affect body weight. Our team will then personalize a weight management program tailored to the individual’s specific genetic make-up.
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Ideal Candidates for this Genetic Testing Include Patients with: > Poor results from dietary changes > Frequent cravings and over-eating > Sedentary lifestyle > Persistent weight gain > High BMI > Weight gain in the stomach, hips, and thighs
Why Test? Diet and exercise programs are critical to weight management success. However, with an abundance of plans to choose from, the trial and error period can lead to frustration. For many, a personalized weight management plan tailored to their genetic code can make a significant impact. In-depth research has discovered that each personâ&#x20AC;&#x2122;s genetic code may influence which weight management program is likely to be most effective. The Kashi Health Weight Management Genetic Panel uses the latest findings in scientific research to inform patients about how their specific genes influence their bodyweight, and perhaps more importantly, which types of weight management strategies are the most likely to be effective considering their specific genetic background.
How Does Kashi Health Select its Genetic Markers? Kashi Health is extremely selective when creating its unique weight management genetic panel. Each genetic marker within the human genome is carefully researched by doctoral-level scientists to ensure that only the most informative genetic markers with a well-established impact are included in every panel. Inclusion of the markers are based on the following criteria: 1. A reported connection with body mass index in a nationally-recognized peer-reviewed journal; 2. An established connection with metabolism, fat storage, nutrient absorption, or another physiologically-important affiliation with weight management; 3. The variant allele of each marker is present in at least 10 percent of the population or a medical implication that has been well established by the scientific community; 4. Evidence of the marker being associated with a health outcome in multiple publications and in individuals of varying ethnicities 8
Weight Loss is a Complicated Issue, But Some Things are True for all of Us Here are some basic health tips to help you successfully manage your weight. While your specific recommendations will provide more instruction, these healthy guidelines will help you get started. Track Your Intake and Activity: Research indicates that people struggling to manage their weight have a tendency to underestimate their true food intake. As soon as you eat or exercise, write it down for a few days to help get a true picture of what you are consuming and burning.7 Be as Specific as Possible in Your Tracking. Your dietary recommendations will include carbohydrate/protein/fat percentages for the best results. Get into the habit of looking up these factors for the foods you eat, at least until you get a better idea of the true calorie and nutrient content of your meals. Macronutrients: Our food is made up of three main food categories: proteins, carbohydrates, and fats - also known as the macronutrients. These food groups provide our bodies with compounds used for energy, repair, growth, and countless other bodily functions. Choosing the right macronutrients is important in weight management success. How you care for your body is just as important as the food that you eat. The following recommendations not only help with healthy weight management but also with all-around health maintenance.
THE MACRONUTRIENTS: PROTEIN, CARBOHYDRATES, AND FAT8 PROTEINS Protein contains 4 calories per gram Examples: 20 grams of protein = 80 calories, 120 calories of protein = 30 grams of protein • C hoose protein low in fat like skinless poultry, fish, and vegetable-based proteins. • Limit red meat (beef, and pork), but when you do eat these foods choose lean cuts like sirloin and tenderloin.
CARBOHYDRATES Carbohydrates contain 4 calories per gram Examples: 20 grams of carbohydrates = 80 calories, 120 calories of carbohydrates = 30 grams of carbohydrates • C arbohydrates can be quite different when it comes to water, sugar, and fiber content. Get familiar with some of your favorite fruits, vegetables, and grains to better understand calorie and fiber content. • Aim for 25-30 grams of fiber daily to help keep you full.
FATS Fat contains 9 calories per gram Examples: 20 grams of fat = 180 calories, 135 calories of fat = 15 grams of fat • Limit fat from meat, butter, and trans-fats like margarine. • Eat fat from plant-based sources: Olive oil, avocadoes, nuts, etc. 9
INTAKE AND LIFESTYLE RECOMMENDATIONS WATER Drink half your body’s weight in ounces daily.8 Example: 150 pounds = 75 ounces daily. • This is especially important as you increase your activity level. Please consult with a physician about recommended water intake if you have any heart or kidney conditions.
SLEEP Get at least 8 hours of sleep each night to protect against fatigue, overeating, and weight gain. • S tudies have shown that as our nightly sleep drops below 7.5 hours we are more likely to gain weight.9 • Poor sleep quality leads to hormone imbalances and the reduced ability for the body to repair itself during sleep.
ALCOHOL Minimize alcohol intake as you are trying to lose weight. • Alcohol contains seven calories per gram with no nutritional value. • Drinking alcohol leads to higher calorie intake, poor food choices, and a slower metabolism.10
SUGAR Minimize sugar intake. This includes artificial sugar substitutes which have a negative effect on blood sugar and insulin, and can make you feel hungrier.8 • F ruit is the best choice if you are looking for a sweet treat. • To sweeten your beverage, try natural sugar alternatives such as stevia and monkfruit (lo han kuo).
SODIUM Limit salt by choosing fresh or frozen fruits, vegetables, and meats, and avoiding canned foods, boxed meals, and frozen entrees.8 • A void processed foods. If you must eat a processed food, check that the overall sodium content per serving is less than the calorie content, to keep your sodium levels down. Example: A 200-calorie snack should have no more than 200 milligrams of sodium.
STRESS Our busy lifestyles tend to leave us feeling overwhelmed. Find healthy ways to manage your stress. Not only will you feel better, but you will lose weight with greater ease.11 • E xamples: walking, yoga, writing, meditating, and other non-food related activities. • Reward yourself for progress with a new book, spa treatment, or a fun activity not related to food. 10
Exercise is an Important Foundation to a Healthier Lifestyle EXERCISE Aerobic activity is essential to a healthy lifestyle and weight management. • A ccording to the Centers for Disease Control (CDC) and Prevention, we should all get some form of physical activity each day.12 • Children (ages 6 to 17) should get 60 minutes of physical activity each day. • A dults (ages 18 and over) need a combination of aerobic and strengthening activity, each week. Aim for 150 minutes of moderate intensity aerobic activity and two sessions of full body muscle strengthening each week.
Exercise: Perceived Level of Exertion and Maximum Heart Rate (MHR) The perceived level of exertion is a personal measure of how hard you are working. It is important to measure progress based on your own effort. The maximum heart rate (MHR) is the safe maximum heart rate, based on your age. Remember: 220 - Your Age = MHR Though our exercise recommendations may change based on your genetic test results, here is a guide to get you started:
EXERCISE INTENSITY GUIDE
MAXIMUM PERFORMANCE
IMPROVE FITNESS
LOSE WEIGHT
TARGET ZONE
HR MAX % BPM RANGE DURATION
MAXIMUM
90-100% 171-190 bpm
Less than 5 minutes
Benefits: Increases maximum sprint race speed Feels like: Very exhausting for breathing and muscles Recommended for: Very fit people with an athletic training background
HARD
80-90% 152-171 bpm
2-10 minutes
Benefits: Increases maximum performance capacity Feels like: Muscular fatigue and heavy breathing Recommended for: Fit users and for short exercises
MODERATE
70-80% 133-152 bpm
10-40 minutes
Benefits: Improves aerobic fitness Feels like: Light muscular fatigue, easy breathing, moderate sweating Recommended for: Everybody for typical, moderately long exercises
LIGHT
60-70% 114-133 bpm
40-80 minutes
Benefits: Improves basic endurance and helps recovery Feels like: Comfortable, easy breathing, low muscle load, light sweating Recommended for: Everybody for longer and frequently repeated shorter excecises
VERY LIGHT
50-60% 104-114 bpm
20-40 minutes
Benefits: Improves overall health and metabolism, helps recovery Feels like: Very easy for breathing and muscles Recommended for: Basic training for novice exercises, weight management and active recovery
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TRAINING BENEFIT
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Keep Track of Your Calorie Intake A calorie is a unit of measurement that determines how much energy food provides to the body. Losing weight requires a calorie deficit – in other words, you should eat less than your body uses to function and to keep you active. To successfully manage your weight, it is important to keep track of the calories you eat and also those that you burn either through exercise, or naturally to keep your body functioning. BASAL METABOLIC RATE Basal metabolic rate is the amount of calories your body typically burns through the day without activity, just to keep your body functioning. • T his involves all the work your body performs including heart rate, breathing, food digestion, body heat generation, and many other functions over which you have no control. •
ou can estimate your basal metabolic rate by one of the following equations:8 Y – For sedentary individuals, multiply your weight in pounds x 10. – For moderately active individuals (three aerobic sessions per week) multiply your body weight in pounds x 13. – For active individuals (five to seven aerobic sessions per week) multiply your weight x 15.
For example: A 175 lb person who exercises 3 days a week is considered moderately active. Calculation: 175 lbs x 13 = 2275 calories. These calories represent their basal metabolic rate. Consuming 2275 calories a day will allow this person to maintain their current weight.
The following table will help you calculate your own Basal Metabolic Rate, based on your body weight and activity level. DAILY CALORIE CALCULATIONS BY BODY WEIGHT Body Weight (pounds)
150 160 170 180 190 200 210 220 230 240 250 260 270 280 290 300
Basal Metabolic Rate for Sedentary
1500 1600 1700 1800 1900 2000 2100 2200 2300 2400 2500 2600 2700 2800 2900 3000
Basal Metabolic Rate for Moderately Active
1950 2080 2210 2340 2470 2600 2730 2860 2990 3120 3250 3380 3510 3640 3770 3900
Basal Metabolic Rate for Active
2250 2400 2550 2700 2850 3000 3150 3300 3450 3600 3750 3900 4050 4200 4350 4500
Manage Your Calorie Intake Once you have determined how many calories you have eaten, and how many you have burned naturally and/or through exercise, you can easily calculate how to manage your weight. • T o gain weight, add up to 500 calories daily to your total daily intake. Remember that your daily caloric value will fluctuate as you gain weight so be sure to re-check your numbers every 10 pounds. • To maintain weight, keep doing what you are doing! • T o lose weight, try to drop 300 to 500 calories per day from your overall caloric number. Remember that your daily caloric value will fluctuate as you lose weight so be sure to re-check your numbers every 10 pounds. If your daily calorie consumption recommendations put you below 1,200 calories, it is important to make up the difference through physical activity, not calorie restriction.13 To maintain a healthy metabolism, never eat less than 1,200 calories daily.
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â&#x20AC;&#x153; Delivering More Than a Test Result.â&#x20AC;?
Kashi Health, a division of Kashi Clinical Laboratories, is a fullyaccredited clinical laboratory specializing in a range of health related testing services and customized assay development. Kashi Health endeavors to promote well-being and quality of life by being at the forefront of translational medicine and being a leader in developing innovative and reliable genetic testing services. We support our providers with the highest quality genetic tests that are reflective of the most recent scientific knowledge. We offer collaboration with our healthcare partners in the development of new testing services to optimize patient care because we recognize that service can be more than a test result.
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Selected References: 1: Nicoletti, CF. Influence of Excess Weight Loss and Weight Regain on Biochemical Indicators During a 4-Year Follow-Up After Roux-en-Y Gastric Bypass. Obesity Surgery. 2014. 2: Delahanty, LM. Effects of Weight Loss, Weight Cycling, and Weight Loss Maintenance on Diabetes Incidence and Change in Cardiometabolic Traits in the Diabetes Prevention Program. Diabetes Care. 2014.
5: Genetics Home Reference. What is DNA? Retrieved from: http://ghr.nlm. nih.gov/handbook/basics/dna 6: Genome.gov. NHGRI. Talking Glossary of Genetic Terms. Retrieved from: http://www.genome.gov/Glossary/ index.cfm?id=4 7: Rennie, K. Estimating underreporting of energy intake in dietary surveys using an individualized methÂŹod. British Journal of Nutrition. 2007; 97:1169-1176.
10: Suter, PM. Is Alcohol Consumption a Risk Factor for Weight Gain and Obesity? Critical Reviews in Clinical Laboratory Sciences. 2005; 42(3):197-227. 11: Bergmann, N et al. The appraisal of chronic stress and the development of the metabolic syndrome: a systematic review of prospective cohort studies. Endocrine Connections. 2014; 3(2):R55-80.
3: Garver, MJ. Weight Status and Differences in Mobility Performance, Pain Symptoms, and Physical Activity in Older, Knee Osteoarthritis Patients. Arthritis. 2014; 2014:1-7.
8: Otten, J et al. Institute of Medicine of The National Academies. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. 2006. www.nap.edu/ catalog/11537. html
12: Centers for Disease Control and Prevention (2011). Physical Activity. Retrieved from: http://www.cdc.gov/ physicalactivity/everyone/guidelines/ index.html
4: Centers for Disease Control and Prevention (2011). Healthy Weight. Retrieved from: http://www.cdc.gov/ healthyweight/assessing/bmi/adult_ bmi/index.html?s_cid=tw_ob064
9: Xiao, Q et al. A large prospective investigation of sleep duration, weight change, and obesity in the NIH-AARP Diet and Health Study cohort. American Journal of Epidemiology. 2013; 178(11):1600-1610.
13: Ramage, S et al. Healthy strategies for successful weight loss and weight maintenance: a systematic review. Applied Physiology, Nutrition, and Metabolism. 2014; 39(1):1-20.
More than 200 peer-reviewed scientific articles were reviewed for the Kashi Health Weight Management Genetic Panel. Specific references are available upon request.
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