[♪♪] >> HELLO AND WELCOME TO THE WELLNESS SHIFT: A KET FORUM I'M YOUR HOST, CHRISTIE DUTTON.

IF YOU'VE EVER FELT LIKE TAKING CARE OF YOUR HEALTH IS OVERWHELMING, OR A BIG CHANGE, LIKE JOINING A GYM OR GOING ON A DIET, JUST ISN'T REALISTIC-YOU'RE NOT ALONE.

SO MANY OF US ARE SEARCHING FOR A BETTER WAY TO FEEL GOOD IN OUR BODIES, IN OUR MINDS, AND IN OUR DAILY LIVES.

WE'VE BROUGHT TOGETHER TOP HEALTH AND WELLNESS EXPERTS TO SHOW YOU SMALL, SIMPLE STEPS-BACKED BY SCIENCE THAT CAN MAKE A BIG DIFFERENCE.

WHETHER YOU'RE AFTER PRACTICAL TIPS, WELLNESS BREAKTHROUGHS YOU HAVEN'T HEARD OF YET, OR JUST A SPARK OF INSPIRATION TO BEGIN YOUR OWN JOURNEY TO BETTER HEALTH, YOU'RE IN THE RIGHT PLACE, SO LET'S GET STARTED.

FIRST, I WANT TO INTRODUCE YOU TO OUR PANEL OF EXPERTS THAT WILL HELP US NAVIGATE AND BETTER UNDERSTAND THE PATH TO BETTER HEALTH.

JENNIFER TRUMAN, A NURSE PRACTITIONER AT NORTON HEALTHCARE SPECIALIZING IN BARIATRICS AND MEDICAL WEIGHT MANAGEMENT, WITH A DOCTOR OF NURSING PRACTICE FROM UK.

DR.

ANGELA DEARINGER, SHE'S THE EXECUTIVE VICE DEAN FOR THE UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE, A PRIMARY CARE PHYSICIAN, AND FORMER COMMISSIONER FOR THE KY DEPT.

FOR PUBLIC HEALTH.

DR.

FRED WILLIAMS, A RETIRED ENDOCRINOLOGIST WHO STILL PRACTICES ON A VOLUNTEER BASIS AT A COMMUNITY CLINIC IN LOUISVILLE, SPECIALIZING IN ENDOCRINOLOGY, DIABETES, AND METABOLISM.

CARRIE DAVIDSON, A FITNESS MANAGER WITH THE UNIVERSITY OF KENTUCKY HUMAN RESOURCES HEALTH AND WELLNESS WITH A DOCTORATE IN HEALTH PROMOTION FROM UK.

WELCOME.

THANK YOU SO MUCH FOR BEING HERE TODAY AND SHARING YOUR EXPERTISE WITH US.

LET'S START WITH DR.

ANGELA DEARINGER.

WHY DO SMALL, CONSISTENT CHANGES TO DIET AND MOVEMENT OFTEN LEAD TO BETTER HEALTH OUTCOMES THAN BIG, DRAMATIC OVERHAULS?

>> THAT IS A AIT GREAT QUESTION AND YOU MENTIONED IT ALREADY.

WHEN I THINK ABOUT TALKING TO A PATIENT AND HOW OVERWHELMING IT CAN BE WHEN THEY FEEL LIKE THEY NEED TO EXERCISE MORE AND GET HEALTHY WHAT DOES THAT MEAN?

SOMETIMES IT'S HARD TO THOUGH WHAT THAT MEANS.

IN KENTUCKY, WHERE WE HAVE INCREASED RATES OF DIABETES, OBESITY, CARD CARD DISEASE MAKING A LARGE LIFESTYLE CHANGE CAN SEEM INTIMIDATING.

WHAT IS GOOD TO KNOW IT DOESN'T HAVE TO BE THAT DIFFICULT.

IMPROVING YOUR HEALTH DOESN'T HAVE TO BE A MAJOR OVERHAUL OVERNIGHT.

JUST MAKINGED SMALL REALISTIC STEPS CAN ACTUALLY GO A TREMENDOUS WAY IN IMPROVING OUR HEALTH.

I WILL GIVE EXAMPLES.

THINKING ABOUT NUTRITION AND MAKING THAT SHIFT.

SMALL THINGS LIKE THINKING ABOUT WHAT WE DRINK.

EXCHANGING ONE SODA FOR WATER, CAN ACTUALLY MAKE A HUGE DIFFERENCE.

A 12 OUNCE CAN OF SODA HAS 150 CALORIES MOSTLY FROM SUGAR.

REPLACING TWO SODAS A DAY IS 300 CALORIES A DAY.

SMALL THINGS LIKE THAT.

LOOKING AT YOUR PORTION SIZE AND NOT EATING OUT OF A BAG WHEN YOU SNACK.

ADDING ONE VEG TABLET TO A MEAL ONE TIME A DAY.

THOSE ARE SMALL CHANGES THAT CAN ADD UP IN TERMS OF IMPROVING YOUR HEALTH.

>> THOSE SEEM DOABLE, SEEM REALISTIC.

LET'S GET EXCUSES OUT OF THE WAY.

CARRIE DAVIDSON YOU WORK WITH A LOT OF PEOPLE COUNSELING THEM TO MOVE MORE DURING THE DAY, TO STRENGTHEN THEIR BODIES AND I BET YOU HEAR EXCUSES WHAT ARE THE COMMON ONES?

>> THE NUMBER ONE EXCUSE IS I DON'T HAVE TIME.

WE'VE ALL HEARD THAT FOR WHATEVER LIFESTYLE CHANGE WE WERE ASKING OUR PATIENTS TO HEADACHE I DON'T HAVE TIME.

THE LAST TIME I CHECKED I HAVE 24 HOURS IN A DAY AND YOU HAVE 24 HOURS IN A DAY SO IT COMES INTO PRIORITIES.

AND SO IF YOU KNOW SOMEONE WHO IS EXERCISING ON A REGULAR BASIS, THAT'S THEIR PRIORITY.

AND SO IF YOU ARE NOT EXERCISING ON A REGULAR BASIS IT'S CLEARLY NOT YOUR PRIORITY.

AND SOME PEOPLE DON'T WANT TO HEAR THAT.

I DON'T HAVE A PROBLEM SAYING THAT TO FOLKS.

IT'S ABOUT PRIORITIES.

WHAT IS IT WE CAN DO AND THIS IS WHERE THE RUBBER MEETS THE ROAD WHAT CAN YOU DO IN YOUR LIFE THAT YOU ARE ALREADY DOING THAT CAN LEND ITSELF TO THE LITTLE STEPS.

FOR EXAMPLE IF YOU ARE GOING TO BE WITH YOUR KID AT PRACTICE, CAN YOU WALK THE FIELD?

YOU CAN STILL SEE THEM YOU ARE PRESENT WITH YOUR CHILD BUT YOU ARE GETTING STEPS IN AND YOU ARE NOT SITTING FOR THE TWO HOURS SCROLLING ON SOCIAL MEDIA.

MAYBE PRODUCTIVE TIME BUT IT COULD BE EXERCISE TIME.

WE ARE NOT ASKING YOU TO ADD AN EXTRA HOUR IN YOUR DAY OR JOIN A GYM WE ARE NOT ASKING YOU TO SPEND MONEY JUST GET UP AND DO SOMETHING DIFFERENT.

>> I LIKE THAT BECAUSE WE DON'T MAKE TIME WE SPEND TIME.

WE HAVE THE SAME AMOUNT.

I LIKE THAT.

Dr.

WILLIAMS YOU'VE SEEN SO MANY PATIENTS OVER THE YEARS WHO WANT TO LIVE HEALTHIER LIVES AND THEY MAY NEED TO LOSE WEIGHT OR FEEL BETTER.

WHAT IS JUST IF YOU COULD GIVE ONE PIECE OF ADVICE BLANKETED ADVICE TO CHANGE IN THEIR DIET LET'S SAY.

WHAT WOULD IT BE?

>> THERE ARE TWO THINGS THAT I'VE MENTIONED OVER THE YEARS THAT CAN MAKE A LOT OF DIFFERENCE.

NUMBER ONE IS REDUCE THE AMOUNT OF FREE SUGAR IN THE DIET.

>> WHAT DO YOU MEAN FREE SUGAR?

>> ADDED SUGARS.

SODAS AND WE WERE TALKING AND THE TOPIC OF SWEET TEA CAME UP.

ANYTHING THAT TASTES SWEET BECAUSE OF ADDED SUGAR.

YOU DON'T HAVE TO ELIMINATE IT, BUT JUST CUT BACK.

>> AND THAT INCLUDES SODA, TOO, RIGHT?

>> SURE.

>> SODA, SWEET TEA A LOT OF DRINKS HAVE ADDED SUGAR.

>> A WHOLE LOT.

>> WHAT ARE WE TALKING THAT DOESN'T, WATER, ANYTHING ELSE?

>> WATER, YOU KNOW, THERE ARE A LOT OF ARTIFICIALLY SWEETENED BEVERAGE -TSZ THAT ARE AVAILABLE NOW.

THERE IS RESEARCH HOWEVER THAT SHOWS THAT TOO MANY OF THOSE MIGHT HAVE ADVERSE HEALTH CONSEQUENCES AS WELL.

SO I TELL MY PATIENTS ON AVERAGE IF YOU COULD HOLD YOURSELF TO NO MORE THAN THREE ARTIFICIALLY SWEETENED BEVERAGES PER DAY AND TRY TO ELIMINATE OR CUT DOWN ON THE BEVERAGES THAT HAVE ADDED SUGAR.

THE SECOND THING I TELL PATIENTS IS TO LOOK AT HOW THEIR FOODS ARE MADE.

AND I'M TALKING ABOUT THAT RALE FOODS, PROCESSED FOODS AND ULTRA PROCESSED FOODS.

ULTRA PROCESSED FOODS ARE VERY, VERY CALORIE DENSE AND THEY PROMOTE CHANGES IN OUR BODY OVER LONG PERIODS OF TIME HAT EVENTUALLY CAN LEAD TO OBESITY AND DIABETES THE I TELL PEOPLE LOOK AT THE LABELS.

IF YOU LOOK AT A LABEL AND IT'S MORE THAN FIVE OR SIX LINES THAT IS AN ULTRA PROCESSED FOOD AND YOU WANT TO, AGAIN, YOU DON'T HAVE TO ELIMINATE ALL THOSE.

BUT CUT BACK.

>> LET'S TALK ABOUT ULTRA PROCESSED FOOD FOR A SECOND.

NOW THEY MAKEUP THE MAJORITY OF OUR FOOD SUPPLY.

70%.

THESE FOODS OFTEN CONTAIN ARTIFICIAL COLORS AND FLAVORS, EMULSIFIERS TO PRESERVE TEXTURE, PRESERVATIVES TO INCREASE SHELF LIFE, AND OTHER ADDITIVES.

A GROWING BODY OF RESEARCH CONSISTENTLY LINKS THEIR OVERCONSUMPTION TO SERIOUS HEALTH RISKS.

WHAT IS IT ABOUT IT?

THEY ARE DELICIOUS.

GIVE US EXAMPLES, TOO.

>> THEY ARE DELICIOUS AND MADE TO BE THAT WAY.

OF COURSE, YOU KNOW, WE LIKE THINGS THAT ARE HIGHLY PALATABLE, TASTE SWEET AND MAKE A NICE SOUND IF YOU THINK ABOUT SOMETHING LIKE CHEETOS OR I GUESS I'M GOING BACK SAYING BUG GALS.

>> NO, THEY ARE GOING STRONG.

>> CANDIES THAT HAVE A SHELL COATING AS THAT MELTINGS AND YOU GET THAT NICE CRACK IT'S ENGINEERED TO BE ENJOYABLE AND NOT FOR ANY MALICIOUS INTENT WE LIKE DIVERSITY IN OUR DIETS.

THE PROBLEM IS SO MANY OF THE HIGHLY PROCESSED FOODS ARE YES, HIGH CALORIE AND LOW KNEW INDUSTRYIENT WHEN YOU LOOK AT DIETARY FIBER.

FRUIT FOR INSTANCE YOU HAVE A PERFECT PACKAGE.

YOU HAVE NUTRIENTS AND SUGARS AND FIBER.

THE FIBER IS ESSENTIAL TO BALANCING THE BLOOD SUGAR SPIKE YOU ARE GOING TO GET FROM THE SUGARS WHICH IS IMPORTANT FOR KEEPING INSULIN LOW.

IF YOU THINK ABOUT WEIGHT GAIN, WEIGHT LOSS IT'S ABOUT WHAT IS OUR INSULIN DOING IF IT'S HIGH WE ARE STORING MORE ENERGY AS FAT ON OUR BODIES.

DOING WEIGHT MANAGEMENT AND BARIATRICS ONE OF THE FUNDAMENTALS WE LOOK AT IS CAN WE KEEP OUR BLOOD SUGAR LEVEL AS STABLE AS POSSIBLE TO BURN THE ENERGY.

AND THE PROCESSED FOODS THAT DON'T HAVE FIBER YOU HAVE NOTHING TO BALANCE THE BLOOD SUGAR SPIKE THE CARBOHYDRATES ARE TURNING TO SUGAR AND SPIKING THAT LEVEL.

>> FIBER IS A BIG KEY.

HUGE KEY.

OKAY TO KEEPING THAT INSULIN LEVEL FROM SPIKING.

DID I GET THAT RIGHT?

>> ESSENTIALLY, YES.

>> WE'LL TALK ABOUT THAT IN JUST A BIT.

I DID WANT TO TOSS TO A STORY WE HAVE BECAUSE IT'S NICE TO HEAR A SUCCESS STORY.

SUCCESS STORY WITH MANY OF THE TOOLS WE'VE HEARD SO FAR PUT INTO ACTION.

38% OF ADULTS IN KENTUCKY ARE OBESE, ACCORDING TO THE KENTUCKY BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY, AND THE STRUGGLE TO MAINTAIN A HEALTHY WEIGHT OFTEN STARTS IN CHILDHOOD.

A BOWLING GREEN PEDIATRICIAN WAS ABLE TO HELP ONE FAMILY ADOPT HEALTHIER HABITS ... THAT LED TO WEIGHT LOSS AND OTHER POSITIVE HEALTH OUTCOMES.

LAURA ROGERS SHARES THEIR STORY.

>> IN MANY WAYS CARLIE IS YOUR TYPICAL TEENAGER.

>> WANT TO LAY IN MY BED WITH MY CATS AND WATCH YouTube.

>> AND LIKE MILLIONS OF KIDS, CARLIE STRUGGLED WITH CHILDHOOD OBESITY.

>> I USED TO STRESS EAT A LOT.

SCHOOL WAS DIFFICULT.

I HAD A LOT OF BULLIES IN SCHOOL.

>> THAT STRESS EATING LED CARLIE NOW 17 TO A CONCERNING DIAGNOSIS.

>> I LITERALLY DID NOT FEEL GOOD AT ALL WHENEVER I WAS EATING THE WAY I DID.

I WAS ALWAYS TIRED.

>> AT A WELL CHILD CHECKUP WE DID LABS THAT CAME BACK AND CARLIE WAS PREDIABETIC AND SHE WAS ON THE HEAVIER SIDE.

>> CARLIE AND HER AUNT LESLIE DISCUSSED THE LABS WITH PEDIATRICIAN Dr.

MILES.

>> Dr.

MILES RECOMMENDED DIET CHANGES SMALL CHANGES TO DO AT HOME.

DIETARY CHANGES AND EXERCISE.

>> THEY HEEDED THAT ADVICE CARLIE LOST 20 POUNDS AND REVERSED HER DIAGNOSIS.

>> BY THE TIME WE DIDN'T NEED THE DOCTOR.

THAT WAS A 0 SOME.

>> I HAVE OVER THE LAST 20 YEARS WE'VE SEEN OBESITY RATES IN PEDIATRICS RISE.

>> AND THAT IS A BIG CONCERN FOR PEDIATRICIANS WHO SAY HEALTHY HABITS SHOULD BEGIN EARLY IN LIFE.

>> CHILDREN'S BRAINS ARE DEVELOPING AND THEY ARE ADAPTABLE AND THEY CAN FORM HABITS A LOT EASIER THAN WE CAN AS ADULTS.

>> THE HABITS INCLUDE REACHING FOR HEALTHY FOODS THAT PROVIDE GOOD NUTRITION.

>> WE STOPPED BUYING SO MUCH PROCESSED FOODS AND TRADED IT TO FOR APPLES AND ORANGES.

>> MANY KIDS HAVE THEIR PALETTE SET BY NINE MONTHS OF AGE.

IT'S IMPORTANT FOR PARENTS TO POD HADLE GOOD EATING BEHAVIORS AND EXPOSE THEM TO TASTES AND TEXTURES.

>> THE FAMILY USED TO RESORT TO FAST FOOD WITH A SCHEDULE REVOLVING AROUND CHEERLEADING NOW THEY OPT FOR HOME-COOKED MEALS.

>> SHE LIKES ALFREDO NOODLES AND WE'LL PUT VEGETABLES WITH IT THAT IS ONE OF THE CHANGES THAT HELPED US.

>> IT IS A LOT EASIER AND A LOT MORE FUN IF EVERYBODY IN THE FAMILY IS MOTIVATED AND PARTICIPATING IN THESE HEALTHY HABITS.

>> I THINK IT WAS HELPFUL THAT SHE WANTED TO JOIN IN WITH ME AND I THINK IT HELPED ME A LOT TO MAKE BETTER DECISIONS.

>> CHEER LEAD SOMETHING A FAMILY AFFAIR.

LESLIE IS THE COACH AND CARLIE LOVES THE PHYSICAL ACTIVITY.

>> CHEER LEAD SOMETHING HER PASSION THAT IS HER THING THAT SHE LOVES THE MOST.

>> I FEEL A LOT BETTER.

I FEEL MORE ENERGETIC.

>> SHE ATTRIBUTES THAT TO AN ACTIVE LIFESTYLE AND SMALLER PORTION SIZES.

>> NOT COMING BACK FOR SECONDS EATING WHAT I HAD ALREADY AND DRINKING WATER HELPED BECAUSE IT MAKES YOU MORE FULL.

>> Dr.

MILES SAYS THE CHANGES ARE BENEFICIAL FOR KIDS IN MANY AREAS.

>> THESE KIDS ARE MUCH BETTER AT CONCENTRATING, AT SCHOOL PERFORMANCE, AT HAVING PHYSICAL ENDURANCE.

BEING SELF CONFIDENT AND BETTER AT REGULATING EMOTIONS.

>> THEY CAN BE SHARED WITH THE NEXT GENERATION.

>> WHENEVER I BECOME AN ADULT IF I CHOOSE TO HAVE KIDS THAT WOULD HELP ME KNOW WHAT THEY SHOULD BE EATING SO THEY CAN ALSO HAVE A HEALTHIER LIFE.

>> FOR KET I'M LAURA ROGERS.

>> AND THAT STORY WE LEARNED CARLIE WAS PREDIABETIC.

Dr.

WILLIAMS CAN YOU EXPLAIN WHAT PREDIABETIC IS?

>> PREDIABETES IS A STAGE OF METABOLIC DISARRAY OR DERANGE.

THAT IS PART OF A SPECTRUM.

SO YOU HAVE ON ONE END, THE PERSON WHO HAS COMPLETELY NORMAL GLUCOSE METABOLISM AND AT THE OTHER END OF THE SPECTRUM YOU HAVE SOMEBODY WITH FULL-BLOWN DIABETES.

YOU DON'T GO FROM NORMAL TO DIABETIC OVERNIGHT.

YOU USUALLY GO THROUGH VARIOUS STAGES AND ONE OF THE STAGES IS PREDIABETES.

AND SO PREDIABETES YOU DO HAVE BLOOD GLUCOSE OR BLOOD SUGAR ABNORMALITIES BUT THEY ARE THAT SEVERE ENOUGH TO MAKE A DIAGNOSIS OF TYPE 2 DIABETES FOR INSTANCE.

A DIAGNOSIS OF PREDIABETES, THOUGH, IS A BIG RED FLAG.

SO IF THAT PERSON DOES NOT DO SOMETHING TO CHANGE THEIR LIFESTYLE OR CHANGE THE WAY THEY ARE EATING THEIR ACTIVITY AND SO FORTH, MORE THAN LIKELY THEY ARE GOING TO DEVELOP TYPE 2 DIABETES, WHICH THEN OPENS A PANDORA BOX OF POSSIBLE COMPLICATIONS.

SO IT'S IMPORTANT TO RECOGNIZE THAT.

AND IN THIS STATE AND ACTUALLY NATIONALLY AND WORLDWIDE, THERE IS A HUGE NUMBER OF PEOPLE WHO HAVE UNDIAGNOSED PREDIABETES.

>> OKAY.

AND DOCTOR AS A PRIMARY CARE PHYSICIAN YOU ARE THE FIRST LINE OF DEFENSE FOR PEOPLE FINDING THIS OUT.

SO WHEN SOMEBODY COMES IN AND THERE IS THAT CONCERN FOR PREDIABETES, WHAT DO THEY NEED TO DO?

HOW DO YOU TEST FOR THAT?

>> WELL, THERE ARE BLOOD TESTS NUMERICAL VALUES THAT CAN HELP YOU MAKE THAT DIAGNOSIS OF PREDIABETES OR DIABETES.

BUT REALLY THE FIRST STEP IS REALLY TALKING ABOUT LIFESTYLE CHANGES.

AND THAT INCLUDES DIETARY CHANGES AND CHANGES IN MOVEMENT OR EXERCISE.

AND THOSE ARE REALLY THE MAINSTAY OF GETTING YOU TO REVERSE FROM THAT PREDIABETES STAGE TO NON-DIABETES.

THERE ARE SOME MEDICATIONS DEPENDING ON OTHER FACTORS ABOUT YOUR HEALTH AT THAT TIME YOU MAY START IN ADDITION.

BUT REALLY THE CORNERSTONE IS LIFESTYLE CHANGES.

>> LIFESTYLE CHANGES.

OKAY.

CARRIE DAVIDSON, WE ARE ALL SITTING.

BEFORE I WAS HERE I WAS SITTING AT MY DESK OF THE A LOT OF US SIT AT DESKS AND A LOT OF US GO HOME AND YOU SIT AT HOME.

IT FEELS GOOD TO SIT SOMETIMES.

BUT WHY IS THAT AN ENEMY TO OUR BODIES?

>> OUR BODIES ARE NOT DESIGNED TO SIT FOR LONG PERIODS OF TIME.

WE'RE JUST NOT ANATOMICLY BUILT THAT WAY.

WE ARE HUNTERS AND GATHERS WE ARE DESIGNED TO MOVE AROUND TO STAND UP AND SIT DOWN AND PICK THINGS UP AND PUSH AND PULL AND MOVE HEAVY THINGS.

SEDENTARY BEHAVIOR WE SAY SITTING IS THE NEW SMOKING.

IT'S TERRIBLE.

THE LONGER THAT WE SIT, THE MORE DETRIMENTAL OUR HEALTH OUTCOMES.

THERE'S BEEN RESEARCH I WAS LOOKING AT THIS BEFORE I POPPED OVER THAT SEDENTARY BEHAVIOR INCREASES YOUR RISK OF CARDIOVASCULAR DISEASE BY 80%.

GET UP AND MOVE.

GET UP AND MOVE.

>> AND TAKING A WALK AND Dr.

WILLIAMS YOU WERE TELLING ME EARLIER THAT WALKING AT ANY TIME OF THE DAY IS GREAT.

BUT, YOU CAN TRICK YOUR BODY A LITTLE BIT TO GET MORE BANG FOR THE BUCK OUT OF A GOOD WALK BY PICKING THE TIME YOU DO IT?

>> YEAH.

A LOT OF PEOPLE ARE FOCUSED ONTIES SO-CALLED 10,000 STEPS A DAY.

AND BY THE WAY, THERE'S BEEN RESEARCH THAT HAS SHOWN THAT WALKING MUCH FEWER THAN 10,000 STEPS A DAY CAN BE JUST AS BENEFICIAL.

BUT WHAT I TRY TO TELL PEOPLE IS DON'T FOCUS ON THAT BIG NUMBER.

LOOK AT WHAT YOU DO IN THE COURSE OF THE DAY.

CAN YOU -- DO YOU HAVE TIME AFTER YOU EAT, BREAKFAST, LUNCH OR DINNER, TO WALK FOR 10 MINUTES?

10 MINUTES.

MOST PEOPLE CAN DO SOMETHING LIKE THAT.

AND SO I TELL THEM TO START THERE.

AND PEOPLE WHO HAVE SEDENTARY OCCUPATIONS, WHERE THEY ARE SITTING A LOT, CAN YOU STAND PART OF THE DAY?

AND EVEN GOING FROM A PURELY SITTING POSITION TO HAVING A DESK WHERE YOU CAN STAND PART OF THE DAY CAN BE REALLY, REALLY HELPFUL.

CAN YOU WALK AROUND YOUR OFFICE A BIT?

TAKE FIVE OR 10 MINUTES AND WALK AROUND.

BUT I REALLY TEND 0 TO FOCUS ON WALKING AFTER MEALS BECAUSE IT HELPS WITH A LOT OF METABOLIC ISSUES THAT WE ARE CONCERNED ABOUT.

IT CAN HELP WITH BLUNT INSULIN SPIKES, GLUCOSE SPIKES OVER LONG PERIODS OF TIME, IT CAN LOWER INSULIN RESISTANCE.

AND THAT MAKES A BIG DIFFERENCE IN TERMS OF PREVENTING DISEASES LIKE DIABETES, PREDIABETES AND OBESITY.

>> AND JENNIFER TRUMAN WALKING IS GREAT PHYSICALLY BUT THE BENEFIT GOES BEYOND JUST THE PHYSICAL, RIGHT?

>> ABSOLUTELY.

YEAH.

I THINK ALL OF THE ACTIVITIES THAT WE DO IN OUR DAILY LIVES GO BEYOND.

IN FACT ONE OF THE THINGS THAT I COACH MY PATIENTS TOWARDS IS THE BIG NUMBER.

I DON'T BELIEVE SOMEONE FOCUSED ON GOAL WEIGHT IS WHAT ARE THE LITTLE HABITS OF OUR DAILY LIFE THAT LED YOU TO THE POINT THAT YOU ARE UNHEALTHY OR UNHAPPY IN YOUR BODY.

THOSE ARE THE HABITS THAT HAVE TO CHANGE IN ORDER TO HAVE MEANINGFUL CHANGE.

>> TRUE.

KENTUCKIANS ARE GREAT IN MANY WAYS BUT GETTING ENOUGH PHYSICAL ACTIVITY THAT IS NOT ONE OF THEM.

MORE THAN 30% OF ADULTS IN KENTUCKY REPORTED NOT PARTICIPATING IN ANY PHYSICAL ACTIVITY OR EXERCISE OUTSIDE OF WORK, ACCORDING TO THE CDC BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM.

THE LATEST FINDINGS FROM AMERICA'S HEALTH RANKINGS SAYS KENTUCKY RANKS 49TH OUT OF THE 50 STATES FOR GETTING ADEQUATE EXERCISE.

HOW MUCH MOVEMENT IS ENOUGH TO START SEEING HEALTH BENEFITS?

10,000 STEPS?

CAN YOU INCREASE THE STEPS BY A LITTLE BIT AND GET BENEFITS.

TELL US THAT.

>> ABSOLUTELY.

SOME OF THAT RESEARCH, THERE WAS A STUDY DONE AND IT LOOKED AT PEOPLE SEDENTARY FOR 23 HOURS BUT THEY SPENT THAT ONE HOUR IN THE GYM GETTING SWEATY DOING THEIR THING.

THEY HAD WORSE HEALTH OUTCOMES THAN THE FOLKS WHO NEVER WENT TO THE GYM BUT WERE ACTIVE ALL DAY LONG.

THEY SAT FOR A WHILE AND STOOD AND TOOK A BREAK AND WALKED FOR FIVE OR 10 MINUTES.

IT'S THOSE SMALL CHANGES THAT CAN MAKE A BIG DIFFERENCE.

>> YES.

THROUGHOUT THE DAY, SO THAT WAS MORE BENEFICIAL THAN SOMEBODY WHO GOES WAY INTENSE AT THE GYM FOR AN HOUR?

>> I AM THE FITNESS MANAGER AND I WANT YOU TO JOIN THE GYM.

I ABSOLUTELY WANT TO JOIN THE GYM.

HOWEVER, IF THAT IS NOT REALISTIC IN YOUR LIFE, YOUR FAMILY, YOUR BUDGET, YOUR TIME AND PRIORITIES THERE ARE THINGS YOU CAN DO THROUGHOUT THE DAY TO CONTINUE TO GET YOU MOVING.

YOU DON'T HAVE TO HIT 10,000 STEPS IF YOU ARE AT 4,000 GO TO FIVE.

>> PUSH YOURSELF FARTHER.

>> A LITTLE BIT.

>> AND THIS MIGHT HELP, TOO.

STUDIES SHOW WALKING CAN SIGNIFICANTLY LOWER YOUR RISK OF MULTIPLE DISEASES LIKE HEART DISEASE AND DIABETES BY AS MUCH AS 50-PERCENT.

THE BENEFITS BEGIN WITH SMALL STEPS: EVERY TIME YOU INCREASE YOUR STEP COUNTY BY 1-THOUSAND STEPS A DAY, YOU LOWER YOUR RISK OF DYING FROM ALL CAUSES BY 10 TO 12-PERCENT.

AND WHAT'S BETTER THAN WALKING ALONE?

WALKING WITH A DOCTOR!

KELSEY STARKS EXPLAINS.

>> SOMETIMES GETTING HEALTHY CAN BE AS SIMPLE AS TAKING ONE STEP AT A TIME.

>> YOU HAVE TO START SOMEWHERE.

I MEAN, EVEN IF YOU ARE NOT WALKING AT ALL IF YOU GET UP AND START WALKING BACK AND FORTH FROM YOUR KITCHEN TO LIVING ROOM AND IT'S 10, 20, 50 STEPS YOU HAVE TO START SOMEWHERE.

>> THE GOAL OF THE LOUISVILLE CHAPTER OF WALK WITH A DOC SOME 20-60 WALKERS GATHER TO DO JUST THAT A SIMPLE WALK WITH A DOCTOR.

>> OUR LOCAL CHAPTER STARTED IN MARCH OF 2023.

SO WE'VE BEEN GOING STRONG TWO PLUS YEARS FOR THIS CHAPTER IN PARTICULAR.

THE ORGANIZATION ITSELF HAS BEEN AROUND FOR 20 PLUS YEARS.

IT WAS STARTED BY Dr.

DAVID IN COLUMBUS, OHIO.

HIS GOAL WAS ESSENTIALLY TO GET PATIENTS MORE ACTIVE AS HE KNEW THAT BEING PHYSICALLY ACTIVE WAS A GREAT WAY TO PREVENT CHRONIC CARDIOVASCULAR DISEASE SO HE INVITED PATIENTS TO GO FOR A WALK ON THE WEEKEND.

HE INVITED PATIENTS I'M GOING FOR A WALK ON SATURDAY, JOIN ME.

>> THE LOUISVILLE CHAPTER OF WALK WITH A DOC MEETS THE SECOND SATURDAY AT WATERFRONT PARK TO WALK THE BRIDGE BUT IT'S ONE OF 500 CHAPTERS OF THE ORGANIZATION ACROSS THE COUNTRY AND THE WORLD.

>> THERE ARE PEOPLE WALKING IN BRAZIL, THE PHILIPPINES, PUERTO RICO, ALL AROUND THE WORLD.

SO IT'S AN AMAZING ORGANIZATION THAT DOES THIS REGULARLY.

>> NOW, HUNDREDS OF THOUSANDS OF PEOPLE AROUND THE WORLD ARE TAKING A FEW EXTRA STEPS TO IMPROVING THEIR HEALTH.

STUDIES SHOW WHEN YOU INCREASE YOUR STEP COUNT BY A THOUSAND STEPS YOU CAN LOWER YOUR RISK OF DYING FROM ALL CAUSES BY 10-20%.

>> THERE IS A CARDIOVASCULAR BENEFIT IF YOU WALK 500 MORE STEPS YOU HAVE A RISK REDUCTION, CANCER RISK REDUCTION, DIABETES RISK REDUCTION, DEMENTIA RISK REDUCTION.

THERE IS NOTHING FROM A HEALTH STANDPOINT THAT WALKING OR SOME FORM OF PHYSICAL ACTIVITY DOESN'T ACTUALLY BENEFIT.

THERE'S NO REASON TO NOT GO FOR A WALK.

>> WHILE LOWERING YOUR RISK FOR A CHRONIC DISEASE IS ONE STEP IN THE RIGHT DIRECTION THESE WALKERS ARE GETTING MORE BENEFITS THAN JUST THAT.

>> I WAS WALKING WITH MY DAUGHTER, LEARNING HEALTHIER WAYS OF LIVING, TIDBITS THE LIFE MEETING WONDERFUL PEOPLE, INTERESTING PEOPLE.

AND IN THE OPEN AIR.

>> NOW, THAT IT'S INTRODUCE OUR SPEAKER TODAY.

>> MOST CHAPTER -- CHAPTERS INCLUDE A GUEST SPEAKER A DOCTOR OR HEALTH EXPERT.

THEY PROVIDE EXTRA INSIGHT AND ONE-ON-ONE TIME THAT YOU DON'T NORMALLY GET IN A DOCTOR'S OFFICE.

>> IT'S BEEN GREAT BECAUSE A LOT OF RETIRED DOCTORS THAT JOIN THE WALK.

SO IF THERE IS A TOPIC YOU ARE INTERESTED IN OR THE SPEAKER THEY WALK WITH US SO YOU CAN GET MORE IN-DEPTH QUESTIONS OR PERSONAL QUESTIONS IF YOU WANT AND THEY WILL DIRECT YOU TO THE RIGHT RESOURCES AND SO AND JUST A VARIETY OF TOPICS EVERY MONTH IT'S SOMETHING DIFFERENT SO YOU REALLY CAN GET A GOOD HANDLE ON MANY TOPICS AND ALWAYS SOMETHING OF INTEREST.

BEING MINDFUL OF BEING MORE ACTIVE IT MAYBE ONCE A MONTH BUT I THINK IT'S THE IMPETUS OF CHANGES SORT OF ALL YOUR BEHAVIORS.

AND THEN HAVING THE HEALTH TALKS ABOUT DIFFERENT TOPICS REALLY AGAIN MAKES YOU MINDFUL OF THE THINGS YOU NEED TO DO AS WE'RE GETTING OLDER AND WE GOT TO BE MORE CAREFUL WITH WHAT WE EAT AND HOW MUCH WE EXERCISE.

IT'S GREAT SEEING EVERYBODY IT IS A GREAT COMMUNITY.

>> BUILDING A BETTER COMMUNITY AND BETTER HEALTH OUTCOMES ONE STEP AT A TIME.

FOR KET, I'M KELSEY STARKS.

>> OKAY.

NOW TO CARRIE DAVIDSON WE SAW KELSEY STARKS WALK WITH THE DOC PROGRAM THAT IS AMAZING AND MOVING MORE.

WHAT DO YOU SAY TO SOMEONE THAT YOU COUNSELING THROUGH THIS FITNESS JOURNEY WHO IS JUST NOT SEEING THE RESULTS THEY WANT?

OR MAYBE, THE RESULTS ARE INVISIBLE AT THAT MOMENT.

WHAT DO YOU SAY TO KEEP THEM MOTIVATED?

>> A LOT OF THE THINGS WE TALK ABOUT ARE YOUR WHY.

WHY ARE YOU HERE?

WHY ARE YOU IN MY OFFICE.

THEY SELECTED TO SEE ME AND IT IS A FREE PROGRAM WHY ARE YOU HERE AND WHAT IS MOTIVATING YOU.

IT'S ONE THING IF YOUR PHYSICIAN SAYS YOU NEED TO EXERCISE MORE AND THEY MIGHT DO IT.

BUT THAT IS NOT THE CASE.

USUALLY WHAT I ZOO HE IS FOLKS WHO MY MOM HAD A HEART ATTACK OR MY DAD IS NOW IN A WHEELCHAIR I DON'T WANT TO END UP LIKE THAT.

OR I'VE BEEN DISEASED WITH A -- DECISIONED WITH A DISEASE AND I WANT TO STOP THAT.

AND I WANT TO BE THERE FOR MY KIDS OR GRANDKIDS.

IF WE CAN FIND THEIR WHY, WHY ARE YOU HERE, WHAT IS MOTIVATING YOU TO MAKE THE CHANGE THEN WE CAN HONE IN ON THINGS THAT WILL HELP THEM TO GET THERE.

>> AND A LITTLE BIT OF PATIENCE, TOO.

BECAUSE IN A JOURNEY SOMETIMES YOU DO PLATEAU FOR A WHILE.

AND MAYBE SOME ADVICE THAT WE'VE NOT HEARD OF BEFORE WHICH MS.

TRUMAN YOU WERE TELLING US SOME OF THE ADVICE THAT YOU GIVE TO PEOPLE THAT THEY MAY NOT HAVE HEARD BEFORE.

MAYBE YOU HAVEN'T EITHER.

LET US KNOW THAT ADVICE.

IT'S REALLY INTERESTING.

>> ONE OF THE THINGS WAS BLOOD GLUCOSE LEVELS AND INSULIN LEVELS THERE'S SOMETHING SIMPLE THAT CAN REDUCE HOW MUCH YOUR BLOOD SUGAR IS GOING TO SPIKE AFTER A MEAL.

CHANGING THE ORDER IN WHICH YOU EAT YOUR FOODS.

LET'S SAY I HAVE BROCCOLI, CHICKEN AND RICE.

IF I EAT THAT RICE FIRST, AND THEN MY CHICKEN AND BROCCOLI I'M GOING TO GET A BLOOD SUGAR SPIKE AND I WILL RELEASE MORE INSULIN.

BUT IF I EAT MY VEGGIES FIRST AND THEN MY MEAT AND THEN LEAVE THE CARBOHYDRATE FOR THE LAST PART I WILL HAVE A MUCH MORE EVEN BLOOD SUGAR LEVEL AND THEREFORE LESS INSULIN AND MORE LIKELY TO BURN ENERGY.

>> WHY IS THAT?

>> THE FIBER, ONE PROTEIN IS EXPENSIVE TO DIGEST.

IT SLOWS THE SYSTEM DOWN AND SO YOU KIND OF ARE GIVING THE BODY'S WORKING ON THAT LONGER THAN IT IS HAVING TIME TO ABSORB THAT GLUCOSE AND THE FIBER ITSELF BECOMES A GEL IN THE SYSTEM AND WILL PREVENT GLUCOSE FROM BEING ABSORBED INTO THE BLOODSTREAM.

>> AND YOU MENTIONED A CARB AND FIBER RATIO.

>> THERE'S A FEW DIFFERENT, I GUESS, RULES OR DEFINITIONS FOR THAT.

THE 10 TO ONE RATIO WHICH IS FOR EVERY 10 GRAHAMS OF CARBOHYDRATE HAVING ONE GRAM OF FIBER THAT IS EQUAL TO WHOLE GRAIN WHEAT.

SO IF YOU ARE LOOKING AT A PACKAGE OF FOOD AND THERE'S 20 CARBOHYDRATES AND TWO GRAMS OF FIBER THAT IS BETTER THAN 30 GRAMS OF CARBOHYDRATE AND ONE GRAM OF FIBER.

IF YOU WANT TO LOOK AT SOMEBODY TRYING TO MAXIMIZE GUT BIOME HEALTH, 95% OF AMERICANS ARE NOT REACHING FIBER RECOMMENDATIONS.

>> 95?

>> 95% OF WOMEN AND 97% OF MEN ARE NOT.

>> THAT IS MOST PEOPLE.

>> THAT IS CORRECT.

>> NOT GETTING ENOUGH FIBER?

>> CORRECT.

>> HOW MUCH FIBER?

>> FOR WOMEN IT'S 25-30 GRAHAMS OF FIBER AND MEN CLOSER TO 38 GRAMS OF FIBER THAT NUMBER DOES GO DOWN AFTER THE AGE OF 50.

>> ALL RIGHT.

AND Dr.

WILLIAMS I WANT TO SWITCH GEARS A LITTLE BIT.

OZEMPIC, THE GLP ONE'S THESE ARE BIG IN THE NEWS NOW.

AND THEY CAN SEEM TO BE REALLY HELPING PEOPLE.

SO AS AN ENDOCRINOLOGIST WHO HAVE YOU SEEN WITH THE GLP ONE DRUGS?

HOW THAT WAS THAT HELPED YOUR PATIENTS?

>> THEY'VE REVOLUTIONIZED DIABETES CARE AND OBESITY CARE IN MY PRACTICE AND EVERYBODY ELSE'S PRACTICE ACROSS THE COUNTRY.

WHAT THEY DO ARE SEVERAL THINGS THAT ALL RESULT IN SIGNIFICANT WEIGHT LOSS.

THEY CAN MAKE INSULIN WORK BETTER.

IT'S RELEASED IN A MORE PHYSIOLOGICAL FASHION.

IT ALSO REDUCES HUNGER.

PEOPLE FEEL FULL SOONER.

AND THOSE ARE ALL GOOD THINGS.

IT ALSO DOES OTHER THINGS METABOLICLY THAT I WON'T GO INTO.

IN THE FINAL ANALYSIS, YOU GET REALLY SIGNIFICANT WEIGHT LOSSES.

SOMETIMES UP TO 20, 25%.

THE PROBLEM, THOUGH, IS THAT IF YOU HAVE SOMEBODY WHO DOES NOT WANT TO ALTER THEIR LIFESTYLE THEY JUST WANT THE MEDICATION, LONG-TERM IT'S PROBABLY NOT GOING TO WORK, UNLESS THEY WANT TO TAKE THESE MEDICATIONS FOR THE REST OF THEIR LIFE.

SO YOU HAVE TO KEEP THAT IN MIND.

PEOPLE ARE OFTENTIMES LOOKING FOR THE QUICK FIX.

AND IF THEY WANT THE QUICK FIX WITHOUT MAKING PUTTING FORTH EFFORT THEMSELVES, TO CHANGE WHAT THEY'RE DOING IN TERMS OF HOW THEY ARE EATING AND PHYSICAL ACTIVITY IT'S PROBABLY NOT GOING TO WORK LONG-TERM.

THE OTHER THING IS THAT THESE MEDICATIONS TEND TO BE FAIRLY EXPENSIVE.

AND INSURANCE COVERAGE FOR GLP ONE'S AS A CLASS IF YOU LOOK AT COMMERCIAL INSURANCE THERE ARE FEWER AND FEWERRER COMPANIES THAT ARE COVERING THOSE NOW.

AND THAT'S LED TO THE ADD VENT OF A LOT OF COMPOUNDED FORMULATIONS.

>> ARE THEY AS GOOD?

DO THEY WORK?

>> IT DEPENDS WHO YOU ASK.

IF YOU ASK -- THE QUALITY CONTROL ON THE COMPOUNDED MEDICATIONS OFTEN TIMES IS NOT QUITE AS GOOD AS GOING THROUGH THE REGULAR FDA APPROVAL PROCESS.

SO THE EXPENSE IS A BIG FACTOR.

AND THESE DRUGS DO HAVE THESE ARE SMALL IN NUMBER BUT THEY ARE SIGNIFICANT, THEY DO HAVE SOME SIDE EFFECTS.

SOMETIMES PEOPLE CAN DEVELOP LIFE CHANGES GASTROPROBLEMS WHERE THEIR STOMACH DOES NOT WORK PROPERLY AND THAT CAN PERSIST AFTER THE DRUG IS WITHDRAWN.

AND THERE IS A WHOLE BODY OF LITERATURE NOW THAT SHOWS THAT THESE DRUGS CAN ALSO INDUCE SOME CHANGES IN THE OPTIC NERVE, THE NERVE IN THE EYE THAT CAN RESULT IN REDUCED VISION OR EVEN BLINDNESS.

SO YOU HAVE TO KEEP ALL OF THESE THINGS IN MIND.

BUT THEY HAVE HELPED.

IF YOU LOOK AT LARGE POPULATIONS OF PEOPLE WHO ARE OBESE, EITHER WITH OR WITHOUT DIABETES, GLP1 DRUGS DO HELP A LOT.

>> DOCTOR AS A PUBLIC HEALTH PERSPECTIVE, ARE GLP1 DRUGS ARE THEY GOING TO MOVE THE NEEDLE ON OBESITY IN KENTUCKY?

>> I THINK THEY HAVE THE POTENTIAL.

BUT AS Dr.

WILLIAMS SAID IT IS A STARTING POINT.

YOU HAVE TO STILL MAKE CHANGESTH BEHAVIORS.

AND THAT'S BEHAVIORS HOW YOU EAT AND WHAT YOU EAT.

AND HOW YOU MOVE AND HOW MUCH YOU MOVE AND EXERCISE.

SO I THINK THAT IT PROBABLY IS A GOOD STARTING POINT.

BUT PROBABLY NOT GOING TO BE THE TOTAL ANSWER FOR KENTUCKY OR ANY OTHER STATE.

IT REALLY IS A COMBINATION OF ALL OF THOSE THINGS.

AND YOU KNOW, AGAIN, IT STARTS WITH THE SMALL STEPS IN THOSE HEALTH BEHAVIORS.

AS YOU MENTIONED KENTUCKY IS ONE OF THE WORST STATES IN INTERPRETS OF PHYSICAL INACTIVITY.

JUST TAKING A MEDICATION AND CONTINUING TO BE INACTIVE, IS NOT REALLY GOING TO IMPROVE YOUR HEALTH OVERALL FOR YOUR LIFETIME.

IT REALLY IS ALL OF THOSE THINGS TOGETHER.

>> OKAY.

IT CAN PUSH YOU FORWARD BUT IT IS NOT A SHORTCUT YOU STILL HAVE TO DO THE WORK IT MATTERS WHAT YOU DO WITH YOUR BODY AND WHAT YOU PUT IN YOUR BODY.

MS.

TRUMAN TALK TO ME A LITTLE BIT ABOUT MICROBIOME, THE GUT, WE HEAR A LOT ABOUT THIS LATELY, AND EVERY TIME I HEAR ABOUT IT I LEARN SOMETHING NEW.

TELL US WHAT THAT IS AND WHY IT'S IMPORTANT TO OUR HEALTH?

>> SO EACH AND EVERYONE OF US ARE OUR OWN ECOSYSTEM.

AND WE HAVE MICRO ORGANISMS, BACTERIA, FUNGY INSIDE OF US THAT HELP US.

WE CAN'T SURVIVE WITHOUT THEM AND THE MAJORITY LIVE IN OUR GUT.

THE GUT MICROBIOME IS ESSENTIAL FOR OUR HEALTH.

GLP1 THAT IS A SUBSTANCE THAT WE MAKE NATURALLY AND WOULD MAKE MORE OF IT WITH A OPTIMIZED GUT MICROBIOME.

THERE'S A FASCINATING FIELD OF RESEARCH AND THE MORE WE LEARN THE MORE WE'RE FIGURING OUT THIS IS CONNECTED TO ABSOLUTELY EVERYTHING.

IT'S A COMMUNICATION BETWEEN THE GUT AND THE BRAIN BACK AND FORTH.

90% OF YOUR BODY'S SEROTONIN IS PRODUCED IN THE GUT AND WHEN YOU HAVE AN OVERGROWTH OR LACK OVERGROWTH OF BAD BACTERIA OR POOR DIVERSITY OF GOOD BACTERIA YOU GET GUT DYSBOSIS.

YOU CAN HAVE PEOPLE NOT FEELING FULL.

YOU GET THINGS LIKE CHRONIC INFLAMMATION OF THE GUT, CHRONIC CONSTIPATION A HOST OF HEALTH ISSUES BUT THE GOOD NEWS IS WE CAN MAKE DIFFERENCES AND HEAL OUR GUT BY INCORPORATING THE RIGHT FOODS.

A VARIETY OF PLANT FOODS VEGETABLES, FRUITS, NUTS, SEEDS, WHOLE GRAINS AND FERMENTED FOODS LIKE KIEFER, YOGURT.

>> THIS IS WHAT Dr.

WILLIAMS DRINKS.

>> EVERY MORNING.

>> FOODS THAT HAVE LIVE CULTURE.

THEY ARE PROBIOTICS YOU ARE REINTRODUCING THE CULTURE TO THE GUT TO HAVE GOOD BACTERIA.

THE GOOD BACTERIA THEY NEED TO BE FED AND WHAT THEY NEED TO BE FED IS DIETARY FIBER AND THE PROCESSED FOODS THAT DON'T HAVE DIETARY FIBER THEY TURN TO A GEL QUICKLY IN YOUR SYSTEM.

AND SO YOU DON'T HAVE THAT FIBER AT THAT TIME MAKES IT ALL THE WAY TO YOUR LARGE INTESTINE TO FEED THE BACTERIA.

THE BACTERIA FEED ON IMPORTANT PARTS OF US THAT WE NEED FOR PROTECTION.

>> LIKE WHAT?

>> LIKE MIEUX KOS LAYER.

>> SO IN ORDER TO HAVE A GOOD GUT BIOME WE NEED FRUITS AND VEGETABLES, SEEDS.

>> THE RECOMMENDATION IS LIKE 30 PLANT FOODS A WEEK AND THAT WILL INCLUDE GARLIC AND GINGER AND BASIL ESPECIALLY IF THEY ARE FRESH, AND FRUITS VEGETABLES, NUTS, SEEDS, WHOLE GRAINS AND FERMENTED FOODS ARE HELPFUL REAL FOODS THAT ARE MADE LIKE GRANDMA USED TO DO IN THE CELLULAR WITH SALT WHERE YOU ARE HAVING THAT CHEMISTRY HAPPEN NOT BE PREPRODUCED VINEGAR PICKLES AT THE GROCERY STORE.

>> DOCTOR, A LOT OF THIS INFORMATION, I DIDN'T HEAR ABOUT WHEN I WAS YOUNGER.

AND WHY IS THAT?

IS THIS SOMETHING COMING TO LIGHT MORE IN THE MEDICAL FIELD?

>> I DO THINK AS A SOCIETY, WE'RE MORE INTERESTED IN HEALTH AND WELLNESS AND WE KNOW MORE TODAY.

AND I THINK THAT IT'S IMPORTANT FOR DOCTORS TO TALK ABOUT THESE THINGS WITH THEIR PATIENCES.

AND IN FACT, WE'RE ACTUALLY INCORPORATING MORE NUTRITION EDUCATION INTO MEDICAL EDUCATION FOR YOUNG DOCTORS WHO ARE TRAINING.

>> BECAUSE THAT WASN'T REALLY DONE BEFORE IN SUCH A WAY.

>> CORRECT.

>> WHY?

>> I DON'T THINK WE HAD AS MUCH INFORMATION TO BE HONEST.

>> THEY DIDN'T KNOW IT WAS IMPORTANT.

WHEN I WENT TO MEDICAL SCHOOL WE HAD ABSOLUTELY NO INSTRUCTION IN NUTRITION, ZERO.

>> REALLY?

>> REALLY.

>> AND THAT'S CHANGING NOW?

>> I HAD A LITTLE AND NOW THERE'S MUCH MORE EDUCATION IN MEDICAL SCHOOL AND OTHER HEALTH PROFESSIONS TRAININGS AS WELL.

>> OKAY.

BECAUSE YOU WOULD THINK WHAT YOU PUT IN YOUR BODY IS GOING TO HAVE A BIG EFFECT ON YOUR BODY.

>> EVERYTHING.

EVERYTHING TO DO WITH IT.

>> YEAH.

AND THE WAY YOU MOVE, TOO.

>> IF YOU THINK ABOUT IT WE HAVE MORE PROCESSED FOODS NOW THAN 30, 40, 50 YEARS AGO AS WELL.

>> I LOOK AT THIS FROM THE PERSPECTIVE OF A CAR AND I USE THIS A LOT, YOU WOULDN'T PUT DIRTY FUEL IN YOUR CAR IT'S NOT GOING TO RUN EFFICIENTLY.

WHY WOULD YOU PUT THAT FUEL IN YOUR BODY.

THE HYPER PROCESSED FOODS IT IS NOT A CLEAN FUEL.

>> BUT THEY TASTE GOOD.

THEY ARE ENGINEERED TO TASTE GOOD.

THEY KNOW WHAT WE LIKE.

>> IF YOU THINK ABOUT IT IF YOU LOOK BACK TO THE 1970s VERSUS THE 2000'S WE EAT MORE CALORIES, WE EAT MORE PROCESSED FOODS AND WE EAT AWAY FROM HOME MUCH MORE.

WE ARE EATING IN RESTAURANTS AND FAST FOOD RESTAURANTS.

AND I THINK THAT THAT IS PART OF THE PROBLEM AS WELL.

>> YEAH.

YOU'RE RIGHT.

>> SUGAR, FATS AND SALTS.

>> THAT'S WHAT MAKES IT TASTE -- WE'RE DESIGNED FOR THAT TO TASTE GOOD.

AND I WANT TO SWITCH GEARS A LITTLE BIT.

INTO A LITTLE MORE OF THE FITNESS REALM WITH THIS.

WE'VE TALKED ABOUT THE NUTRITION A LITTLE BIT.

NOW WHAT ARE WAYS WE CAN WORK EXTRA MOVEMENT INTO OUR DAY?

>> SURE.

WE GOT REALLY GOOD AT THIS DURING COVID EVEN YOUR TRADITIONAL WAYS OF GETTING EXERCISE WEREN'T AVAILABLE SO WE GOT CREATIVE DURING THE PANDEMIC.

EVERYBODY KNOWS TO USE THE STAIRS.

USE THE STAIRS INSTEAD OF THE ELEVATOR AND NOT JUST ONCE.

MAKE THAT YOUR NORM.

UNLESS YOU ARE CLIMBING 18 FLIGHTS OF ZAIRES THAT MIGHT NOT BE FEASIBLE TIMEWISE BUT MAKE THE ZAIRES YOUR NORM.

PARK IN THE BACK OF THE PARKING LOT DON'T LOOK FOR THE SPOT THAT IS THE CLOSEST, GROCERY STORE, WORK, OR MALL PACK IN THE BACK OF THE LOT.

I TELL PEOPLE WHEN I WORK-FROM-HOME I SAVE MY LAUNDRY FOR ONE DAY AND THEN I DO ALL OF IT ON A WORK-FROM-HOME DAY.

EVERY 30 MINUTES WHEN THE WASHING.GOES OFF IT TAKES 30 SECONDS TO SWAP THE LAUNDRY BUT I'M DOING IT EVERY HOUR.

GETTING UP AND SWAPPING LAUNDRY AND WHEN WORK IS OVERALL THE LAUNDRY IS CLEAN.

WHO IS GOING TO FOLD ALL THIS LAUNDRY?

>> THAT'S THE TIME CONSUMING PART.

AND YOU CHAMPIONED A NEW CAMPAIGN AT THE UNIVERSITY OF KENTUCKY THAT IS TAKING SMALL STEPS TO A NEW LEVEL.

TAKE A LOOK.

>> WE USE ENCOURAGING STATEMENTS OR NUDGING PEOPLE TO DO THE HEALTHIER CHOICE AND ACTUALLY PLACING SIGNS NEAR THE ELEVATORS WHERE THAT IS THE POINT OF DECISION WHERE SOMEBODY IS MAKING THAT CHANGE OR THAT CHOICE TO EITHER OH, I WILL TAKE THE ELEVATOR, I WILL GO AHEAD AND TAKE THE STAIRS THEY ARE NUDGING ME TO DO THAT.

SO HOPEFULLY THOSE QUEUES AND THE ENVIRONMENTAL QUEUES AND WILL ESTABLISH SOME TYPE OF HABIT OVER TIME IF THEY CHOOSE TO DO THAT.

LET'S SAY THERE IS A GROUP OF NURSES WHO ARE WORKING HERE IN THE CLINIC AND THEY ARE READY TO STEP ON TO THAT ELEVATOR AND ONE OF THEM SAYS HEY LET'S TAKE THE STAIRS TODAY THAT INFLUENCE THAT MOTIVATOR WOULD MOTIVATE THE REST TOIC TA THE STAIRS.

HOPEFULLY OVER TIME THAT WILL BECOME A HABIT ONCE THEY GET THEIR STARBUCKS AT THE KENTUCKY CLINIC THEY COULD CHOOSE TO TAKE THE STAIRS TO WHATEVER LEVEL THEY ARE GOING TO.

THAT PEER INFLUENCE THAT PEER SUPPORT OF ENCOURAGING WILL ALSO BE HELPFUL.

>> THERE IS MUCH MORE EVIDENCE AROUND THE BENEFITS OF IT IMPACTING EMOTIONAL AND MENTAL WELL-BEING.

FOR INSTANCE, IT COULD ENHANCE MOOD.

IT COULD BE A STRESS REDUCER.

IT COULD GIVE THEM A LITTLE BIT MORE MENTAL CLARITY.

SO FROM AN INDOOR FINISH STANDPOINT IT CAN MAKE THEM FEEL HAPPIER AND REDUCE STRESS.

FROM A WELL-BEING STANDPOINT THERE ARE DEFINITE BENEFITS FOR BEING ACTIVE AND TAKING THE STAIRS RATHER THAN THE ELEVATOR.

WE KNOW THAT WHEN AN INDIVIDUAL'S WELL-BEING IS WHOLE AND IS AND THEY ARE WELL PER SE, THAT THEY ARE GOING TO BE MORE PRESENT AT WORK.

THEY WILL BE LESS STRESSED AT WORK.

MORE FOCUSED AT WORK.

AND JUST GENERALLY FEEL BETTER WHILE AT WORK AND CARING FOR THEIR PATIENTS HERE AT THE CLINIC.

>> THANK YOU.

MOVING MORE IS AN IMPORTANT PART OF THIS AS WELL.

AND Dr.

DAVIDSON, WHAT ARE MOVEMENTS WE CAN DO THAT MIMIC WHAT WE DO IN REAL-LIFE SOMETHING WE CAN DO TO STRENGTHEN THOSE MUSCLES THAT WE'RE GOING TO NEED ANYWAY?

>> RIGHT.

I TALK ABOUT OUR BASIC SIX MOVEMENT PATTERNS.

YOUR BASIC SQUAT IT SOUNDS LIKE A COMPLICATED THING.

YOU SIT IN A CHAIR AND GET UP.

YOU SIT IN THE CAR AND GET UP.

YOU SIT IN THE BATHROOM AND GET UP.

WE NEED THAT SKILL FOR LIFE.

WE NEED TO BE ABLE TO PUSH THINGS AND PULL THINGS IN EVERY MOVEMENT THIS DIRECTION AND THIS DIRECTION WE NEED TO BE ABLE TO BEND DOWN AND PICK STUFF OFF THE FLOOR, A CHILD, A LAUNDRY, WHATEVER THAT IS WE NEED TO HINGE AT THE HIPS.

THE HIP HINGE IS ONE OF THE MOVEMENT PATTERNS.

PUSH, PULL AND EVERY PLAIN WITH OUR MUSCLE GROUPS OUR BIGGEST JOINTS.

IF THAT IS ALL YOU GET DONE THAT'S FANTASTIC.

SIX MOVEMENTS THAT IS ALL WE HAVE TO DO.

>> STRENGTHENING THE MUSCLES THAT YOU WILL NEED ANYWAY.

OKAY.

DOCTOR, WHEN YOU TALK TO YOUR PATIENTS WHAT IS A COMMON MISCONCEPTION THEY HAVE ABOUT STEPS TO TAKE TO GET HEALTHIER?

>> I THINK WE TALKED ABOUT ONE DON'T HAVE THE TIME.

THEY FEEL LIKE THEY HAVE TO DO SOMETHING BIG.

JOIN A GYM.

BUY ATHLETIC WEAR.

SPEND MONEY ON HEALTHY FOODS THAT IS WHY WE TRY TO START WITH SMALL STEPS AND HOW IT CAN MAKE A BIG IMPACT AS WE'VE HEARD TODAY YOU CAN MAKE SMALL CHANGES LIKE CHANGING WHAT YOU DRINK, WORKING ON BASIC MOVEMENTS, GETTING UP AND WALKING BETWEEN MEETINGS.

THOSE ARE THE THINGS THAT REALLY WILL OVER TIME AND IF YOU ARE KIN WITH THEM, MAKE A BIG IMPACT.

>> AND YOU MENTIONED GOING TO WHOLE FOODS AND SPENDING A BUTCH OF MONEY BUT THERE IS AN ISSUE OF ACCESS IN SOME AREAS A. BECAUSE BUYING HEALTHIER WHOLE FOODS CAN BE MORE EXPENSIVE THAN THE ULTRA PROCESSED FOODS.

FROM A PUBLIC HEALTH PERSPECTIVE, HOW DO WE DEAL WITH THAT?

HOW DO YOU ADVISE YOUR PATIENTS THAT MAY HAVE THOSE ISSUES?

>> YOU KNOW, IT IS A REAL ISSUE.

AND THERE'S NOT AN EASY ANSWER FOR IT.

BUT SOME THINGS WEIGH CAN THINK ABOUT IS BUY FROZEN VEGETABLES MAYBE OR FRUITS.

THEY MIGHT BE A LITTLE BIT LESS EXPENSIVE THAN THE FRESH PRODUCE.

WORKING WITH FARMERS MARKETS.

ARE GREAT WAYS TO DO THAT.

YOU KNOW, THE WHOLE TIME WE'VE BEEN TALKING I'VE BEEN THINKING ABOUT CHILDREN AND HOW REALLY WE NEED TO INSTILL HABITS IN CHILDREN OF HEALTHY EATING.

THINGS LIKE TPARP TO SCHOOL PROGRAMS CAN HELP CHILDREN DEVELOP HEALTHIER HABITS AND THEY GROW UP TO HAVE HEALTHIER HABITS.

>> YES.

IT'S MUCH EASIER TO ESTABLISH GOOD HABITS THAN TO BREAK THEM LATER.

MS.

TRUMAN IN CHILDHOOD, YOU'RE DEVELOPING THE FAT CELLS AND YOU BUT WHY IS IT IMPORTANT BIOLOGICALLY TO HAVE A HEALTHY DIET DURING CHILDHOOD AND THAT SEEMS TO BE WHEN A LOT OF PARENTS WANT TO GET THEIR KID TO EAT SOMETHING MAY RELY ON THE PROCESSED FOODS.

>> AN OUNCE OF PREVENTION IS WORTH A POUND OF CURE.

WE WANT TO RAISE OUR KIDS TO UNDERSTAND HOW THEIR BODIES WORK IT'S NOT EDUCATION WE GET AS IN PUBLIC EDUCATION.

AND THEN ALSO UNDERSTAND THAT THE FUEL YOU PUT IN YOUR BODY IS GOING TO HAVE LONG-TERM AFFECTS.

SOMEONE WHO IS DEALING WITH OBESITY IN CHILDHOOD WILL HAVE A HARDER TIME ACHIEVING LIFETIME WEIGHT LOSS THAN SOMEONE WHO DID NOT DEVELOP OBESITY UNTIL AFTER PUBERTY.

>> WHY IS THAT?

>> SO, IT GETS COMPLICATED.

BUT YOU HAVE TWO GROUPS.

SMALL PERCENTAGE OF HUMAN BEINGS WILL DEVELOP FAT CELLS THROUGH HYPERPLASIA.

AND THEN WHICH IS A LOT OF FAT CELLS.

AND THEN YOU WILL HAVE THOSE WHO DEVELOP EXCESS WEIGHT WITH HIGH PER TROPHY, BIGGER FAT CELLS.

BUT FOR THE MAJORITY OF PEOPLE THE NUMBER OF FAT CELLS YOU HAVE IS SET AFTER PUBERTY.

SO IF YOU HAVE MORE YOU STAND THE RISK TO REACH VERY SEVERE LEVELS OF OBESITY.

>> YOU ARE SETTING YOURSELF UP FOR A HARDER TIME.

>> THERE'S LITTLE THINGS WE CAN DO.

LET'S EAT THE FRUIT NOT DRINK THE FRUIT JUICE.

WATER IS GOOD FOR US AND WE NEED IT.

IF YOU ARE GOING TO HAVE A CANDY OR FRUIT, HAVE A HEALTHY PROTEIN OR HEALTHY FAT TO BALANCE THOSE BLOOD SUGAR LEVELS.

>> Dr.

WILLIAMS DO YOU SEE THAT IN -- AS AN ENDOCRINOLOGIST, WHEN YOU HAVE A CHILD THAT HAD A WEIGHT PROBLEM AS AN ADULT THEY HAVE A HARDER TIME GETTING HEALTHIER THAN SOMEBODY WHO MAY NOT HAVE HAD A WEIGHT PROBLEM AS A CHILD?

>> OH, ABSOLUTELY.

AND ONE OF THE OTHER THINGS I'VE BEEN IMPRESSED WITH IS THE NUMBER OF PATIENTS WITH OBESITY WHO HAVE FIRST DEGREE RELATIVES THAT WILL ALSO OBESE.

SO IT'S IN THEIR FAMILY.

AND THAT PROBABILITY SPEAKS TO SOME GENETIC PREDISPOSITION.

BUT EVEN MORE LIKELY IS THE FOODS AND THE ACTIVITY LEVELS THAT THOSE KIDS ARE EXPOSED TO AS THEY ARE GROWING UP.

THEY LEARN TO LIVE LIKE THEIR PARENTS AND THEIR SIBLINGS.

THEY LEARN TO EAT THE THINGS THAT THEY EAT AND DO THE THINGS THAT THEY DO.

>> AND DOING THE THINGS THAT YOUR PARENTS DO.

SO WHEN YOU'RE COUNSELING SOMEBODY, I BET YOU HAVE TO WORK IN DO THESE PEOPLE HAVE CHILDREN?

DO THEY NEED TO SET AN EXAMPLE.

HOW DO YOU BALANCE THAT?

>> ABSOLUTELY.

NO MATTER THE AGE OF THE PERSON I'M SEEING I USUALLY ASK DO YOU COOK THE AHOME ARE YOU THE ONE BUYING THE GROCERIES AND COOKING FOR OTHER PEOPLE?

THAT IS A CONVERSATION THAT WE HAVE.

AND THEN THE OTHER CONVERSATION THAT WE HAVE IS IF THEY HAVE YOUNG CHILDREN YOUNG PEOPLE AT HOME OR OTHER PEOPLE CAN THEY GO WITH YOU, CAN YOU WEAR THEM IN A BABY CARRIER, CAN YOU PLAY PICK UP BASKETBALL IN THE YARD?

THAT SUPPORT SYSTEM THAT GOES AROUND FOOD AND EXERCISE, IS KEY.

SO IF YOUR ENTIRE FAMILY IS EATING ONE WAY AND YOU ARE TRYING TO EAT SOMETHING DIFFERENT OR THEY WILL SIT ON THE COUCH AND WATCH A MOVIE AND YOU WANT TO GO FOR A WALK THIS IS A HARD BATTLE TO FIGHT.

>> ABSOLUTELY.

OKAY WE HAVE JUST A FEW MINUTES LEFT.

I WANT TO GET TO A CLOSING THOUGHT HERE EACH ONE OF YOU CAN GIVE JUST ONE PIECE OF ADVICE THAT SOMEBODY CAN TAKE HOME WITH THEM AND START DOING IMMEDIATELY.

I WILL START WITH YOU, JEN.

>> I WOULD SAY THE FUTURE YOU IS COUNTING ON THE CURRENT YOU TO KEEP THE PROMISES THAT YOU ARE MAKING TO YOURSELF AND IT'S WORTH IT.

>> SAY THAT AGAIN.

>> THE FUTURE YOU IS COUNTING ON CURRENT YOU TO KEEP THE PROMISES THAT YOU ARE MAKING TO YOURSELF TODAY.

>> WOW.

OKAY.

THAT IS A GOOD ONE THAT IS HARD TO TOP.

WE SHOULD HAVE SAVED THAT FOR LAST.

WHAT IS ONE PIECE OF ADVICE IF YOU CAN WAVE A MAGIC WAND AND MAKE A CHANGE IN PEOPLE, WHAT WOULD IT BE?

>> CONCENTRATE ON TAKING OWNERSHIP OF THEIR HEALTH.

HAVING PATIENTS TAKE OWNERSHIP AND NOT LOOK FOR THE QUICK FIX.

>> OKAY.

AND WHAT DOES THAT ENTAIL?

>> EDUCATION.

AND EXAMPLES.

GIVING THEM PATIENT STORIES.

TO KIND OF MOTIVATE THEM TO MAKE THEIR OWN CHANGE, INSTEAD OF BEING THE DICTATOR WHO BEATS THEM OVER THE HEAD AND SAY YOU HAVE TO DO THIS YOU HAVE TO DO THAT.

>> YOU NEED THAT BUY IN.

>> YEAH, HELP THEM DEVELOP THEIR OWN SENSE OF MOTIVATION.

THAT LONG-TERM IS GOING TO BE A LOT MORE EFFECTIVE.

>> DOCTOR?

>> I WOULD SAY START WITH SMALL, REALISTIC GOALS AND BE SPECIFIC.

INSTEAD OF SAYING TO YOURSELF, I'M GOING TO WALK MORE.

SAY I'M GOING TO WALK FOR 15 MINUTES AFTER DINNER THREE TIMES A WEEK AND I WILL BE COMMITTED TO THAT.

AND YOU WILL FIND YOU WILL DO THAT AND IT WILL BE FOUR TIMES A WEEK AND THEN FIVE TIMES A WEEK.

AND YOU WILL ENJOY WALKING AFTER DINNER.

WHEN YOU DO THAT YOUR FAMILY WILL SEE YOU YOUR CHILDREN, YOUR SPOUSE YOUR PARENTS AND MAYBE THEY WILL START.

YOUR FRIENDS YOUR NEIGHBORS AND LET IT MULTIPLY.

BUT FORKER SELF, BE REALISTIC AND GET SPECIFIC.

>> CARRIE DAVIDSON?

FINAL THOUGHT?

>> GET UP.

WE HAVE TO MOVE MORE.

JUST HAVE TO MOVE MORE.

WE ARE OCCUPATION ALI GLUED TO OUR WORK STATIONS WE DRIVE LONG DISTANCES.

SO WE'RE SITTING, SITTING, SITTING.

IF WE CAN GET UP.

STAND DURING YOUR ZOOM MEETINGS.

PARK IN THE BACK OF THE LOT.

WALK WHILE YOU ARE ON THE PHONE.

JUST GET UP.

>> EVEN STANDING IF YOU ARE NOT WALKING AROUND IS BETTER THAN SITTING.

>> ABSOLUTELY.

>> YES.

>> WONDERFUL.

THANK YOU ALL SO MUCH.

I WANT TO THANK YOU ALL FOR BEING HERE, BEING OUR PANEL OF EXPERTS.

AND I WOULD LIKE TO THANK THE PEOPLE THAT SHARED THEIR STORIES WITH US.

BETTER HEALTH IS NOT ABOUT OVERHAULING YOUR LIFE OVERNIGHT.

IT'S ABOUT SMALL, SCIENCE-BACKED CHANGES THAT ADD UP OVER TIME AND WHETHER YOU ARE JUST STARTING YOUR HEALTH JOURNEY OR LOOKING TO STAY MOTIVATED I HOPE YOU WILL LEAVE TODAY WITH ONE IDEA YOU ARE EXCITED TO TRY.

JUST ONE STEP FORWARD.

THANK YOU SO MUCH FOR JOINING AND LET'S KEEP THE MOMENTUM GOING FOR OUR ZEST, OUR FAMILIES AND OUR COMMUNITY.

BE WELL AND KEEP MOVING FORWARD.

[♪♪]