V.I.P.S. (Vascular Improvement for Performance in Sports)

A Program by:

Alexander Castellanos, M.D.John-Lloyd Santamarina

June 14, 2013

A Brief Introduction

-Medical practice since 1977-Focuses on Pro-active Medicine-Provides continuity of Care-Allows strong patient-physician relationships

For more info, visit: www.templetondoc.com

University of San Francisco, Bachelor of Science (1972)

Stanford University School of Medicine, Medical Degree (1977)

U.C. San Francisco, Santa Rosa Internship (1977-78)

U.C. Irvine Residency (1978-80)

Dr. Alexander Castellanos

Education & Training

Trauma Medicine (1978-1985) Family Medicine (1985-present) Preceptor for Nurse

Practitioners, Stanford, UCSF, USF and Davis

Dr. Alexander Castellanos

Work & Experience

U.S. Patent Number 7.074,183-method and system for improving Vascular Systems in humans using biofeedback and network data communications

Dr. Alexander Castellanos

Inventor

Breeding and training horses Martial arts- Aikido instructor Music- playing the trumpet,

guitar and piano Running Home improvement projects Gardening Owner/Builder of straw bale

houses

Dr. Alexander Castellanos

Personal Interests

Before we begin the presentation, we would like to thank everyone

for participating in this innovative program

V.I.P.S. Presentation

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Overview

Question & Answer

Nutrition and Exercise

V.I.P.S. Program

Vascular Assessment

DocyoQuestion & Answer

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1. Which of the following beverages will be most beneficial during physical activity?

a.) Energy Drinks c.) Protein Shakesb.) Gatorade

The S.S.C. Syndrome: Sugar-Salt-Cold

The S.S.C. Syndrome: Sugar-Salt-Cold

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1. Which of the following beverages will be most beneficial during physical activity?

a.) Energy Drinks c.) Protein Shakesb.) Gatorade

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2. For optimum performance, which of these “diets” are most essential?

a.) Saturated and Unsaturated Fatty

Acids c.) High Proteinb.) Simple and

Complex Carbohydrates

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3. The dictum “No Pain, No Gain” is:

a)Trueb)False

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4. Which is most important for physical training?

a.) Weight Lifting (anaerobic exercise) c.) Both

b.) Jogging (aerobic exercise)

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Nutrition and Exercise

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Simple carbohydrates = Simple Sugars (only) = GlucoseSimple Carbohydrates

• Most are a form of energy with no nutritional value• The brain cells need sugar, however too much is bad• Too many simple sugars will be stored as fat

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Complex Carbohydrates = Simple Sugar + Nutrients(Minerals and Vitamins) + Fiber

Complex Carbohydrates

• Includes Fiber - Helps for proper functioning of the Digestive System

• Too much complex carbohydrates are also stored as fat• Every serving of a whole grain product decreases your risk of

Diabetes Mellitus by 10%

Food = Carbohydrates= Calories= Energy

Docyo• The primary function of carbohydrates is to provide energy (as glucose) for the body, especially the nervous system.

• carbohydrates = total calories, causing obesity

• carbohydrates = malnutrition or fat intake (to make up for the lost carbohydrates)--

• Most people should get 40% to 60% of total calories from carbohydrates, preferably from complex and natural sugars (= calories, vitamins, minerals and fiber)

• Processed or refined simple sugars provide energy, but very little nutrition. It is wise to limit these sugars

Carbohydrates in Diet

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Proteins

• Proteins are essential in bodies’ normal functions

• Assists in synthesizing enzymes and hormones, maintaining fluid balance, and regulating vital functions such as building antibodies

• Building blocks for muscles, bones, cartilage, skin, hair and blood

Proteins = Amino Acids = All other types of Protein

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Truth About Protein #1

• Uric acid is a byproduct of purine

metabolism

• Purine is found in most protein rich-

foods

• Uric acid in blood stream =

function of kidneys to eliminate

excess purine

• Uric acid can crystallize = gout

and/or kidney stones

Proteins ≈ Purines = Uric Acid

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Truth About Protein #2

• The body will use Protein as substitutes to Carbohydrates/Simple Sugars if that is the only thing it has

• Protein metabolism causes excess build up of ketones

• Kidney goes into overdrive to flush excess ketones = may lose kidney function

• Significant loss of water follows flushing of ketones = dehydration

Protein in diet + Carbohydrates = Toxic Ketones

Docyo• Protein is necessary in diet to help body repair cells and make new ones; for growth and development; and to supply the essential amino acids that our bodies are incapable of synthesizing

• However, too much Protein can have adverse effects (as previously mentioned)

• It’s recommended to consume 0.36 g of protein for every pound of body weight and that 10%-30% of daily caloric intake come from protein

• > 30% can be harmful to your body

Protein in Diet

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Fatty Acids = Hydrocarbon chains = Energy SourceFatty Acids

• Fats are important for the body for many functions such as insulating nerve cells, balancing hormones, maintaining cell membranes, etc.

• They are also an important energy source, > 6x that of carbohydrates per unit storage of mass

• But too much fat can cause harm: obesity, atherosclerosis, etc.

• It is important to determine type of fatty acid to consume as some are better than others

Docyo• The long chain of carbon atoms in the molecule

are completely surrounded by hydrogen (all

single bonds)

• Most are solid at room temperature

• Stimulates the body to increase levels of

cholesterol in blood (LDL = bad cholesterol)

Saturated Fatty Acids

Docyo• The long chain of carbon atoms in the molecule

have either one (monounsaturated) or more

(polyunsaturated) double bonds

• Most are liquid at room temperature

• Contains essential fatty acids that the body can’t

manufacture (omega 3 and omega 6)

• Linked to HDL production (good cholesterol)

Unsaturated Fatty Acids

Docyo• Fatty acids are good energy sources when carbohydrates are not available

• They are important for many body functions• However, they stimulate production of cholesterol

(good and bad), and they are very dense in calories• It is therefore important to keep all fat to a

minimum, especially saturated fatty acids.• AHA recommends to limit fat intake to 10% to 30% of

total calories, with saturated fatty acids at only 7%

Fat in Diet

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Exercise

• Sedentary lifestyle dangerous for health

• Tied to diabetes, obesity, heart disease and premature death

• Physical activity can help improve overall fitness

• Two types of exercise: aerobic and anaerobic

Docyo• oxygen consumption

• aerobic glycolysis for energy

• relatively low intensity

• heart rate

• circulation

• typically long duration

• benefits: cardiovascular system, stamina, resting heart rate

• examples: running, jogging, swimming, cycling

Aerobic Exercise

Docyo• “without oxygen”

• relatively high intensity

• relies on: muscle ATP reserves, anaerobic glycolysis, creatine phosphate

• benefits: muscle strength, mass and flexibility, bone strength

ability to withstand fatigue (lactic acid)

• examples: weight-lifting, sprinting

Anaerobic Exercise

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V.I.P.S. Program

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V.I.P.S.

Vascular Improvement for Performance in Sports

Vascular Disease

… the 70,000 miles of Arteries that pump blood through your body.

Cardiovascular Disease effects the Heart and …

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The Normal Artery

Arteries open and close in all mammals including men and women

Damage or disease of your circulatory system is called Vascular Disease

A normal artery is free of plaque formation

The artery wall is very thick and elastic

A healthy artery can do its job of pushing blood throughout your body

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Plaque

Plaque is accumulation of fats including cholesterol Sever plaque formation can cause Heart Attacks and

Strokes

Docyo Apparent in various arenas (i.e. football, soccer, baseball) Studies have shown that a significant proportion of players

have potentially life threatening levels of fat and cholesterol in blood

Increases risk of sudden cardiac death, heart attack and/or stroke during vigorous activities (such as competitive sports)

Sports-related sudden death in the general population is considerably more common than previously suspected

Vascular Disease in Sports

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Risk Factors of Vascular Disease

Smoking High Blood Pressure Diabetes High Cholesterol Anger/Rage Sedentary Lifestyle Overweight Ethnic Characteristics Family History

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Instead…

Docyo Determine Cardiovascular status Reduce risk factors for Cardiovascular Disease Improve Cardiovascular health Improve performance in sports

Goals of the V.I.P.S. Program

Take common measurements like BP and weight

Do a Doppler Waveform analysis of radial arteries

• Triphasic vs Biphasic vs Monophasic• High vs Low Peak Velocity• Wide vs Narrow Waveforms

Determine Cardiovascular Status

Provide recommendations in terms of exercise and nutrition (dependent of cardiovascular status)

Reduce Risk Factors for CardioVascular Disease

Our Recommendations/ Guidelines

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Nutritional Guidelines

∗ Water: Drink plenty of water. If you are not urinating every hour throughout the day, you are not drinking enough water. This may be more than 8-9 glasses (traditional recommendation)

∗ Breakfast: This is the most important meal of the day. Breakfast should never be skipped! Enjoy it! Eat a well-balanced meal that consists of favorite health and low-sugar breakfast foods. This will jumpstart your day.

∗ Lunch: Lunch is considered by many to be the main meal of the day. A well-balanced and healthy lunch keeps your body going throughout the day and well into the night. Eat your protein at this meal.

∗ Dinner: Dinner should be your smallest meal of the day. Bodies will be stressed because we digest instead of rest. Small amounts of carbohydrates, no protein at least four hours before retiring.

“Eat breakfast like a king, lunch like a prince, and dinner like a pauper.”

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Nutritional Guidelines

∗ Dairy: Avoid milk and cheese. Milk contains hormones, fat and can cause intestinal irritation. Replace with Soy or Rice milk, Yogurt (non-fat) occasionally. No use of butter or margarine. Use olive oil as a replacement as much as possible

∗ Meats: 2 (2-4 oz., fist size) servings/week [3-4 for athletes]. This includes Chicken, Beef, Turkey, Lamb & Pork

∗ Fish: 3 (2-4 oz., fist size) servings/week

∗ Beverages: For better digestion, a minimal amount of beverage should be taken with meals. In addition, beverages should be taken 30 minutes before or 2 hours after your meal

Docyo Intensity

Time of day

80% = aerobic stretches

20% - anaerobic, isometrics

Exercise Guidelines(dependent on vascular health status)

Provide recommendations in terms of exercise and nutrition (dependent of cardiovascular status)

Provide weekly reminders (via email) of recommendations

Reduce Risk Factors for CardioVascular Disease

Reassessment in 6 weeks of cardiovascular health

For the participants highly motivated to better your health and keep track of you progress, you may also visit the office: Alexander Castellanos M.D. Inc. once every week, between 12pm-1pm, M-F to reassess BP, weight, and vascular status

Hopefully, signs of improvement in terms of weight, BP and vascular status, will be apparent at the end of the 6 weeks (or weekly if you choose to visit the office every week)

Improve Cardiovascular Health

KEEP WINNING GAMES!!!!!!

Improve performance in sports

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And you will receive the following upon completion of program

Commemoration of participation in the program

Show college trainers of progress (pre and post)

Educated in personal vascular health awareness

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And you will receive the following upon completion of program

Pin for uniform/backpacks/etc.

Remembrance of participation in program

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Vascular Assessment

Docyo Head over to the backroom one at a time

Once again, thank you for your time Good luck and have a great season We will see you again in 6 weeks

Vascular Assessment