Kitti ( Kru Deaw)

Pain Free Be Fit Begins Here

Knowledge Sharing
Case Study
Patient Information
Build A Community
What is Wellness?
 Theories of Aging

Programmed Aging: Biological Aging

Accidental Aging: Inadequate
maintenance and repair functions to
prevent or repair damage or excess
damage
Theories of Aging

Aging

Hormones
Age–Related Hormonal Change
Human Hormones
 Hormones
ระบบต่อมไร้ท่อ สารชีวเคมีที่เซลล์ในร่างกายผลิตขึ้ นมา เพื่อ
สื่อสารควบคุมการทางานสมดุลในร่างกาย
ฮอร์โมนจะทางานและส่งไปตามกระแสเลือดหรือสารน้ านอก
เซลล์ จะออกฤทธิ์จะช้า แต่จะอยูน่ านกว่าระบบประสาท
ออกฤทธิ์โดยจับกันตัวรับสัญญาณ ที่เซลเป้าหมาย เพื่อสัง่ งาน
ให้เซลล์ปลายทาง ใหเกิดกลไกทางาน
ควบคุมการการเผาผลาญ เจริญเติบโต การซ่อมแซม
Hormones & Receptors
W

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L
L
N
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 Wellness & Exercise
 ยึดการตอบสนองต่อร่างกายของแต่บุคคล เพศ วัย
ฮอร์โมน ความเครียด และการใช้ชีวติ
 ช่วยลดเสี่ยงต่อความเสื่อมของร่างกาย

 ช่วยส่งเสริมให้มีคุณภาพการใช้ชีวติ ให้ดีขึ้น
 ช่วยเพิ่มการซ่อมแชม ฟื้ นฟูร่างกาย
Optimal Exercise
Which is Your Exercise?
 Breathing Exercise
Pilates
Yoga
Tai Chi
Stretching
Swimming
Walking
Weight Training
 Breathing
Diaphragm
Transversus
Abdominis (TVA)
Pelvic Floor
Multifidus
Co-Contraction
Mind & Body
Autonomic Nervous System
Degeneration
 Modern Living
Lack of sleep
Stress
Nutrition
Daily Activities
Sitting
Working
Compensation
Late Sleep
STRESS
Low Energy (Poor nutrition)
Physical Activity
 Causes of Muscle Imbalance
Over Use
Less Use
Misuse
INJURIES
Trigger Points
Who has a good posture?
Good Standing Postures
Movement Dysfunction

Kyphosis

Uneven Round
shoulder shoulder

Shoulder Scapular wing

impingement
 Round Shoulder
Character
 Pectorals complex overactive
 Excessive kyphosis
 Shoulder Internal rotation
 Head and neck forward
Tight Muscle
 Upper trapezius
 Pectorals
 Latissimus dorsi
 Scapular Wing
Character
 Excessive kyphosis
 Shoulder Internal rotation
 Difficult to control movement during pushing
Tight Muscle
 Upper trapezius
 pectorals
 Latissimus dorsi
 Pastoralist minor
 Impingement
Character
Difficult to lift arm over head
Shoulder Internal rotation

Tight Muscle
 Upper trapezius
 pectorals
 Latissimus dorsi
 Uneven Shoulder
Character
 Neck and shoulder pain
 Automatically lift shoulder
 Shortness of Breath

Tight Muscle
 Upper trapezius
 pectorals
 Latissimus dorsi
Bad Standing Postures
Risk of Injury
Bad Standing Postures
Bad Sitting Postures
Risk of Injury
YOU Decide !?
How do you lift ?
Proper Lifting Techniques
Sustainable Recovery from
Office Syndromes Pain
FOOD and NUTRITION
 AGENDA
• Eating behavior
• Malnutrition
• Effects of Malnutrition on body
• Fast foods/ Processed foods
• Inflammation
• AGEs
• Solutions
• Foods/ Nutrition/ Nutrients
• Metabolism
• Anti-inflammation
• Mindful eating
 EATING BEHAVIOR
Eating behavior is a
term that encompasses food choice
and motives, feeding practices,
dieting, and eating-related
problems such as obesity, eating
disorders, and feeding disorders.
Eating behavior is complex;
humans make hundreds of food
decisions each day that are
influenced by a variety of personal,
social, cultural, environmental, and
economic factors.
 MALNUTRITION
Malnutrition, in all its forms, includes undernutrition (wasting, stunting,
underweight), inadequate vitamins or minerals, overweight, obesity, and resulting
diet-related noncommunicable diseases.
• 1.9 billion adults are overweight or obese, while 462 million are underweight.
• 52 million children under 5 years of age are wasted, 17 million are severely wasted
and 155 million are stunted, while 41 million are overweight or obese.
• Around 45% of deaths among children under 5 years of age are linked to
undernutrition. These mostly occur in low- and middle-income countries. At the
same time, in these same countries, rates of childhood overweight and obesity are
rising.
• The developmental, economic, social, and medical impacts of the global burden
of malnutrition are serious and lasting, for individuals and their families, for
communities and for countries.
 CAUSES OF
MALNUTRITION
Malnutrition is a
worldwide problem that can
result from environmental,
economic and medical
conditions. The WHO estimates
that over 460 million adults
and 150 million children are
undernourished, while more
than two billion adults and
children are overweight or obese
Common causes of
malnutrition include:
• Food insecurity or a lack of
access to sufficient and
affordable food
• Digestive problems and issues
with nutrient absorption
• Excessive alcohol consumption
• Mental health disorders
• Inability to obtain and prepare
foods
 TYPE OF MALNUTRITION
Malnutrition refers to deficiencies, excesses, or
imbalances in a person’s intake of energy and/or nutrients.
Types of malnutrition include
• Undernutrition: This type of malnutrition results from
not getting enough protein, calories or micronutrients. It
leads to low weight-for-height (wasting), height-for-age
(stunting) and weight-for-age (underweight).
• Overnutrition: Overconsumption of certain nutrients,
such as protein, calories or fat, can also lead to
malnutrition. This usually results in overweight or obesity.
 UNDERNUTRITION
Undernutrition typically results from not
getting enough nutrients in your diet. This
can cause:
Weight loss
Loss of fat and muscle mass
Hollow cheeks and sunken eyes
A swollen stomach
Dry hair and skin
Delayed wound healing
Fatigue
Difficulty concentrating
Irritability
Depression and anxiety
 OVERNUTRITION
• Overnutrition the main signs are overweight and obesity, but
it can also lead to nutrient deficiencies
• Research shows that people who are overweight or obese are
more likely to have inadequate intakes and low blood levels of
certain vitamins and minerals compared to those who are at a
normal weight
• One study in 285 adolescents found that blood levels of
vitamins A and E in obese people were 2–10% lower than those
of normal-weight participants
• A study in over 17,000 adults and children found that those
who ate fast food had significantly lower intakes of vitamins A
and C and higher calorie, fat and sodium consumption than
those who abstained from this type of food
 Fast food/ Processed food

Fast food is the term given to food that is prepared

and served very quickly. Any meal with low preparations
time can be considered fast food, typically the term refer
to food stored with preheated or precooked ingredients. Its
delicious, filling, is readily available just any of the day.
Fast food is good tasting, except that is lack of nutrients,
therefore unhealthy in the long run if consumed regularly.
It’s loaded with calories from refines sugar fat and salt.
Which are repeatedly reheated to high temperatures for
frying purposes.
 Disadvantage of fast
food, processed food
• Low quality food
• High in fat
• Contains food additives and preservatives
• High sugar
• High sodium
• Lack of essential nutritions
• Lose of appetite
• Waste of money
• Lack of family gathering
Effects of fast
food to our
body
 ACUTE VS. CHRONIC
INFLAMMATION
Acute
inflammation:
• Positive signal that the body
is working to heal itself
• Symptoms include redness,
swelling and pain
• Happens quickly and
subsides as the tissue heals
Chronic
Inflammation:
• Happens over days, months,
years Signs are less obvious
• Persistent and leads to severe
and progressive tissue damage
and inflammatory diseases
 SYMPTOMS OF CHRONIC
INFLAMMATION
○ Digestive problems การดึงสารอาหาร
○ Chronic fatigue ซ่อมแชม
○ Moodiness/depression
○ Food cravings
○ Insulin resistance/blood sugar issues
○ Rashes/skin issues
○ Weight gain
○ Headaches
○ Allergies
DISEASES LINKED TO
INFLAMMATION
 ROOT OF INFLAMMATION

Gut: Intestinal permeability/leaky gut

• Digestive system contains immune cells that prevent toxins and

pathogens from entering the bloodstream. Modern invaders–
smoking, lack of exercise, high fat meals, high calorie meals, sugar,
trans fats – irritate the innate immune system.
• Digestive lining should be woven tightly. If it becomes too
permeable, undigested nutrient particles, toxins or bacteria can
get into your bloodstream. This triggers the immune system and
lead to inflammation
• Even ―healthy‖ food not digested properly can be a cause
ofinflammation
DIET SOLUTION
ENERGY BALANCE +
Good Nutrition

63
 BASAL METABOLIC RATE
The Basal Metabolic Rate
(BMR) is the heat eliminated from
the body at rest when
temperature is normal. An
average person requires 2,000-
2,400 Calories per day, while a
large man doing heavy work may
require up to 6,000 Calories per
day. Children’s energy needs vary
widely based on their age, size,
and activity level.
TOTAL DAILY ENERGY
EXPENDITURE
TOTAL DAILY ENERGY
EXPENDITURE
METABOLISM
 WHAT IS FOODS?
Food is any substance
consumed to provide
nutritional support for an
organism. Food is usually of
plant or animal origin, and
contains essential nutrients, such
as carbohydrates, fats, proteins,
vitamins, or minerals. The
substance is ingested by an
organism and assimilated by
the organism's cells to provide
energy, maintain life, or
stimulate growth.
 WHAT IS NUTRITION?
• Nutrition is the science that
interprets the interaction
of nutrients and other
substances in food in relation
to maintenance, growth,
reproduction, health and
disease of an organism. It
includes food
intake, absorption, assimilati
on, biosynthesis, catabolism a
nd excretion.
 WHAT IS A NUTREINTS?
A nutrient is a chemical substance in food that helps maintain

the body. Some provide energy. All help build cells and tissues,
regulate bodily processes such as breathing. No single food supplies all
the nutrients the body needs to function.
 Variables which affect
nutrient needs:
• Age
• Gender
• Activity Level
• Climate
• Health
• State of nutrition
WHO NUTRIENTS INTAKE
RECOMMENDATION
 NUTRIENTS
Macronutrients Micronutrient
• Carbohydrates • Water
• Protein • Minerals
• Fats • Vitamins
CARBOHYDRATES
 CARBOHYDRATES

GOOD
– Beneficial phytochemicals
and antioxidants digest
slowly, reducing blood sugar
spikes which promote
inflammation
– Whole grains (brown rice,
bulgur wheat…), beans,
sweet potatoes, winter
squashes, berries, cherries,
apples, and pears
BAD
• Advanced glycation end
products (AGEs)
• sugar + protein = pro-
inflammatory chemical
• High fructose corn syrup,
bread, white potatoes,
crackers, chips, pastries,
sweetened drinks,
refined/processed/fast foods
 SUGAR
• Addiction: hard to address, but
important to remove
• Increases inflammation—when
blood sugar is high, the body
• produces more free radicals that
trigger the immune system
• and damage cells and cause
inflammation in the blood vessels.
• Alters the hormone insulin
(responsible for fat storage)
• increase in insulin = inflammation.
 AGEs
• Formed outside and inside the body
• Makes cells stiffer, less pliable and
more subject to damage and
premature aging.
• Formed by BBQ, frying, roasting,
boiling (? led to raw food
movement)
• Barbecued foods are high in AGEs
• Smoking increases AGEs - formed
when tobacco leaves are dried
• Certain foods promote glycation in
the body – especially fructose and
galactose
PROTEIN
 PROTIEN

GOOD BAD
• Eat more vegetable protein
(soy foods, beans, lentils and
• Eat less meat and
other legumes), whole grains, poultry, which
seeds, nuts, and oily fish contain pro-
• Soy foods contain isoflavones
which have antioxidant
inflammatory fats
activity and have been
suggested to lower
CRP/inflammation levels
FATS
 FATS
GOOD BAD
– Unsaturated fats • Saturated fats
• Olive oil, nuts, • butter, cream, high-fat
oatmeal, avocado, cheese, fried chicken and
sesame oil and seeds, fatty meat, and palm
and soybeans kernel oil
• Trans fats
• margarine, vegetable
shortening, partially
hydrogenated oils
GOOD FAT VERSUS BAD FAT
 WATER
– Cell chemistry
– Plasma transports
• essential nutrients to
cells
• removes metabolic
wastes
• Transports respiratory
gasses
– hydrolysis & dehydration
reaction
– stabilizes body temp
ROLE OF
WATER
IN OUR
BODY
 HYDRATION

• Crucial for proper cellular

function. Dehydration slows
down nutrients absorption
and metabolism. Affects the
operation of every organ in
body.
• Signs of dehydration: fatigue,
foggy thinking, depression,
joint pain, hunger, cravings,
and weight gain.
• Formula for hydration: ½
body weight in ounces per
day.
VITAMINS
 MINERALS
Macrominerals Trace minerals
• Calcium • Iron
• Phosphorus • Manganese
• Copper
• Sodium
• Zinc
• Chloride
• Iodine
• Potassium • Fluoride
• Sulfur • Selenium
IDEA FOR FOOD CHOICE
 GENERAL RECCOMMENDATION
• Fresh is best
• Fruits and vegetables from all parts of the color
spectrum
• Omega-3 fatty acids
• Whole grains
• Ginger and curry (turmeric) for anti-inflammatory
effects
• Tea (white, green, or oolong)
• Red wine - antioxidant activity
• Avoid refined and processed foods
• Minimize saturated and trans fats
ANTI-INFLAMMATORY
DIET
 ANTI-INFLAMMATORY
DIET
• Supports the body by providing the
proper vitamins, minerals, essential fatty
acids, dietary fiber, protective
antioxidants and phytonutrients.
Provides steady energy by stabilizing
blood sugar.
• Avoid super food and nutrient isolation
• Real/Whole Foods that exist in nature
and have not been chemically altered
• Not a diet, but a lifestyle change
 ANTI-INFLAMMATORY DIET

People do tend to lose weight on it, but it is not intended as a

weight loss plan.

Choosing and preparing foods based on how those foods will

support optimal health.

Eating to thrive, not survive.

 ANTI-INFLAMMATORY FOODS

Plant Based Whole Foods Diet

Fats Mostly from Whole Foods
• Vegetables
• Fruits • Herbal Teas
• Nuts and Seeds • Whole grains
• Meats and Eggs • Spices
• Healthy Fats • Mushrooms
• Water • Antioxidants
• Spices and Herbs • Phytonutrients
ANTI-INFLAMMATORY FOODS

Soluble vs. insoluble
– Soluble turns to gel and reduces
cholesterol
– Insoluble fiber adds bulk to the stool
FIBERS
• Soluble: oat bran, barley, nuts,
seeds, beans, lentils, peas, and some
fruits and vegetables
• Insoluble: fruit (especially berries),
vegetables (especially beans),
wheat bran, and whole grains
• 30-40 grams of fiber each day -
tolerance varies
• Fiber cereals is best single source
per serving
 Omega-3 & -6 Fatty acids
Omega-3 - anti-inflammatory effects
– Oily fish (salmon, sardines, herring, and black cod)
– Walnuts
– Flaxseeds
– Hemp seeds
– Kelp or fish oil supplements
Omega-6 – pro-inflammatory (via cytokine
production)
– Oil-rich seeds
– Oil extracted from seeds used in snack & fast foods
 LEAKY GUT
Common inflammatory foods that
activate the immune system: gluten,
dairy, sugar, and alcohol

• Proper nutrients
• Probiotics
• L Glutamine—healing for lining of
digestive tract
• Fish Oil or Flax Oil (Omega 3 source)
• Vitamin D-5000 works like a
hormone in the body regulating
calcium absorption and
inflammation levels
 DAIRY AND “DAIRY PRODUCTS”

Dairy (Organic or Raw is Best)

Almond Milk (unsweetened)
Coconut Milk (unsweetened)
Organic Cow’s Milk (raw)
Organic Cow’s Cheese (raw)
Organic Greek Yogurt (plain) Goat
Milk
Goat Cheese
Goat Yogurt (plain) Kefir
Sheep Cheese
Sheep Yogurt (plain)
 MINDFUL EATING

• Chewing food really well can aid in

the digestive process and make
nutrients more available
• Body can attack food as a foreign
invader if it is not digested properly
and enters the blood stream
• Fights fatigue and leads to eating
less and enjoying food more
• Mindless eating disrupts our
digestive abilities by eliciting stress
hormones. This can cause
inflammation and weight gain
 PRACTICE MINDFUL EATING
Pay attention: make an active choice about what
you are eating
Plan ahead and prepare
Make a choice that prioritizes your health goals:
traveling/guest, etc.
Questions to ask:
• Why? am I eating now: Am I hungry?
• What? Will this choice serve my wellness in the
long run.
• Is this treat worth how I will feel later. Nothing
tastes as good as healthy feels.
• How? Am I fully present eating or am I doing
other things? Try expressing gratitude: for food
and farmers
• Digestion begins in the mouth. Chewing helps
enzymes in saliva do their job so we can
effectively absorb nutrients.
 Sources
• http://www.unm.edu/~lkravitz/Article%20folder/Metabolism.pdf
• http://www.biobreeders.com/images/Nutrition_and_Metabolism.pdf
• http://www.elmhurst.edu/~chm/vchembook/5900verviewmet.html
• https://www.ilo.org/wcmsp5/groups/public/---dgreports/---dcomm/---
publ/documents/publication/wcms_publ_9221170152_en.pdf
• https://www.greenfacts.org/en/diet-nutrition/diet-nutrition-greenfacts.pdf
• https://www.healthline.com/nutrition/malnutrition#definition
• https://runsweateatrepeat.com/2018/05/16/wellness-refocused-education-vitamins-part-1/
• https://www.health.harvard.edu/blog/leaky-gut-what-is-it-and-what-does-it-mean-for-you-2017092212451
• https://amihungry.com/mindful-eating-resources/about-the-mindful-eating-cycle/
• https://www.healthline.com/nutrition/mindful-eating-guide
PREVENTION
EXERCISES
Core Stability
Core Anatomy
Scapular Stability
Scapular Anatomy
ASSESSMENT
 Breathing Assessment
Lateral
Anterior
Posterior
Postural Assessment
Postural Assessment
 Dynamic Assessments
One leg stand
Spine bending Forward
Arm raise Serratus anterior
Scapular depression
 Breathing Exercise
Breathing
All four Breathing
Rib Cage breathing
Flex band Back and side
 Pelvic
Pelvic Arm raise
Neutral & Imprint
Leg slides (neutral)
Knee lift (imprint)> Arm over head
 Supine
• Single leg stretch, double
stretch>flexed band>
• chest lift
• Shoulder bridge
 Prone
• Breast stroke prep
• Thoracic Extension with band
• Hip extension
• Plank
• One arm opposite leg
Stretching
TEMPORALIS
SPLENIUS CAPITIS/ CERVICIS
 ท่ายืดกล้ามเนื้อคอด้านข้าง

• Tip:
หลังตรง ไม่ยกหัวไหล่
ในขณะทา

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 ท่ายืดกล้ามเนื้อคอด้านหลัง
และหลังส่วนบน

• Tip:
ไม่กดน้าหนักไปที่ ศีรษะ
มากจนเกิ นไป

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 ท่ายืดกล้ามเนื้อหัวไหล่

• Tip:
• ไม่ยกหัวไหล่
• หน้ ามองตรง
ไม่ก้มหน้ า
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Q& A