THE SCIENCE OF VFP™

VFP™ is an educational tool to assist health and fitness professionals in demonstrating physiological changes that occur with proper nutrition and exercise. The product is based on scientific studies and widely accepted research. The physiological principles that hold true for all humans are illustrated throughout the VFP™. However, there are individual physiological principles that are unique to each human and cannot specifically be represented within the VFP™.

The health risk portion of VFP™ is based on the seven risk factors identified by the American Medical Association, the American Dietetic Association, and the American Heart Association. The seven risk factors are as follows:

Age
Family history
Activity level
Smoking
High blood pressure
High cholesterol
Body Mass Index

These seven risk factors were studied as factors contributing to diabetes, heart disease, and stroke. The Journal of American Medical Association published the Framingham Study, which followed 10,000 Americans and how their chances for developing diabetes, heart disease, and stroke significantly increased based upon their personal risk factors. The Framingham Study also followed these 10,000 Americans for more than a decade, and showed that by decreasing Body Mass Index (BMI) by 10 percent, an individual’s risks for diabetes, heart disease, and stroke collectively fell 40 percent. A study performed by the Cooper Institute for Aerobics Research also showed that an increased activity rate of prescribed 20 minutes of exercise four times a week resulted in a decrease in risk factors by 10 percent.

The American Heart Association has published studies stating that decreasing smoking in the first year of a prescribed program decreases chances for heart disease and stroke by 10 percent.
The American Heart Association studies also show that a decrease in blood pressure and cholesterol to within normal rates decrease an individual’s chance for developing heart disease and stroke by 10 percent.
The American Dietetic Association and the American Medical Association both have published statements addressing BMI as the greatest risk factor of the seven.

The Results Prediction Simulator as part of VFP™ is based on the following:

Proper Food Intake is based on an individual’s Basal Metabolic Rate (BMR), calculated using the Harris Benedict Equation. Once an individual’s BMR is calculated, their number of days of compliance under the nutritional program is entered. The nutritional plan is based on the American Diabetic Association’s recommendation of 5 to 6 small meals a day. The plan also recommends low-glycemic foods, lean proteins, and small quantities of fat. The combination of food items produces a 500-calorie per day deficit from the individual’s BMR.
Resistance Training is based on the number of days compliant and simply assigned a moderate value of exercise for 20 minutes. The caloric value assigned to resistance training is 200 calories a day.
Cardiovascular Training is based on the number of days compliant and assigned a moderate intensity of exercise for a 20 minute session.
Pounds of fat burned per week is a calculation utilizing the number of days compliant multiplied by the calories burned in each individual category of nutrition, resistance, cardiovascular, and supplements. Total calories saved or burned per week are then calculated.
Pounds of fat burned are calculated by taking the pounds of fat per week multiplied by the number of weeks compliant to the program.
The standard weight range utilized by the program to illustrate body transformation from weight is based on the mortality scales created by the insurance industry. Supporting data was also used from the study conducted by the United States Air Force. Both studies provide height and weight recommendations based on mortality.
Body fat is the estimation of height and weight charts of an average weight person for that age. If a more accurate means of body fat calculation is available, that data can be entered for a more accurate depiction of the individual’s fat to muscle ratio.

The representation of the before and after picture is calculated using the circumference and girth measurements taken from a study performed by the United States Air Force measuring decreased circumference and girth in pilots who had gone through training.

The transformation plan is a combination of well-known fitness and wellness recommendations from such organizations as American Dietetic Association, American College of Sports Medicine, Yale University, and American Heart Association. These recommendations include:

Reward yourself
Start today
Create a new metabolism (smaller more frequent meals)
Meal sizing
Cardiovascular train first in the morning
Resistance training
Keeping a journal on goal setting
Plan ahead
Increase water intake
Complex carbohydrates
Lean proteins

Overview of Calculations

Health Age

Solid principles and research were used to create the Health Age component of the VFP™. Health Age is an individual’s actual age and his or her lifestyle risk factors calculated together to produce one’s health age. Health is an age indicator of a person’s likelihood of contracting heart disease, diabetes, stroke and cancer prematurely and is calculated by an individual’s seven health risks: age, BMI, family history, exercise level, high blood pressure, high cholesterol and smoking.

Each one of the seven health risks are given an appropriate weight and value as determined by the medical research. Each value of the health risks was weighted to have a positive or negative effect on an individual’s health age. This tool was constructed with the intention of motivating people to make healthy lifestyle choices while giving them a realistic view of how their lifestyle choices affect their likelihood of contracting of four major diseases.

VFP Disease Risk Calculations

The subject’s BMI is displayed with a vertical progress bar. The range of the BMI bar is 18 to 40. Disease risk factors are also displayed with vertical progress bars. These bars have a range of 0 to 100. The level of risk is expressed by a value between 0 and 100. The calculated risk values are based on assumptions about the relative importance of several well known risk factors. The estimates of the magnitudes of each risk factor attempt to capture the prevailing wisdom about Type II Diabetes, Cardiovascular Heart Disease, and Stroke.

Obesity Factor Calculations

The Obesity factor is a combination of a person’s BMI and a measure of their excess body fat. Excess body fat depends on a person’s age and gender. The obesity factor is calculated using Body Mass Index, acceptable level of body fat based on age and gender and percentage of excess body fat as variables. The calculated resulted is then scaled effectively adjusting the calculated risks for athletes and others with a low percentage of body fat. If the BMI effect is a proxy for the amount of body fat a person carries, then if the person’s body fat is known to be lower, then the effect of this factor should be smaller. For example, using this scaling function, the Obesity factor for a person with 7% body fat would be scaled to zero. However, the Obesity factor of a person with 32% body fat would be scaled by 100%.

Diabetes Risk Calculation

A person’s risk of Type II Diabetes is determined by calculated values based on several factors: family history, current exercise activity, age, gender, weight, height, and body composition. The series of formulas are scaled to adjust for levels of obesity. The result is categorized into 6 levels or risk: minimal, low, moderate, high, very high and extremely high risk.

Heart Disease Risk Calculation

Coronary Heart Disease Risk is the sum of nine factors: age, family history, gender, smoking, high blood pressure, exercise history, high cholesterol, BMI, and body fat percentage. The result of the calculation is scaled based on obesity factors and categorized into 6 levels of risk.

Stroke Risk Calculation

Stroke Risk is calculated using the following information: age, family history or stroke, family history of diabetes, smoking habits, gender, blood pressure, exercise history, cholesterol level, height, weight and body composition. The resulting risk value is then scaled and corresponds six categories of risk.

Quantifying a person’s risk with a number does not imply their actual risk – only the risk could be higher or lower if certain factors were different. The main objective of these calculations is to dramatically demonstrate how behaviors increase disease risk while others reduce a person’s risk.

References and Notes

Jennifer T. Fine, Graham A. Colditz, Eugenie H. Coakley, George Moseley, JoAnn E. Manson, Walter C. Willett, and Ichiro Kawachi

A Prospective Study of Weight Change and Health-Related Quality of Life in Women

JAMA 1999 282: 2136-2142.

Body fat: is the estimation of height and weight charts of an average weight person for that age. If a more accurate means of body fat calculation is available, that data can be entered for a more accurate depiction of the individual’s fat to muscle ratio.

The representation of the before and after picture is calculated using the circumference and girth measurements taken from a study performed measuring decreased circumference and girth in older women who had gone through training.

A. R. Folsom, S. A. Kaye, T. A. Sellers, C. P. Hong, J. R. Cerhan, J. D. Potter, and R. J. Prineas

Body fat distribution and 5-year risk of death in older women

JAMA 1993 269: 483-487

Alfred Wirth and Jutta Krause

Long-term Weight Loss With Sibutramine: A Randomized Controlled Trial

JAMA 2001 286: 1331-1339

Ralph B. D’Agostino, Sr, Scott Grundy, Lisa M. Sullivan, Peter Wilson, and for the CHD Risk Prediction Group

Validation of the Framingham Coronary Heart Disease Prediction Scores: Results of a Multiple Ethnic Groups Investigation

JAMA 2001 286: 180-187.

David B. Allison, PhD; Kevin R. Fontaine, PhD; JoAnn E. Manson, MD, DrPH; June Stevens, PhD; Theodore B. VanItallie, MD

JAMA. 1999;282:1530-1538.

Ming Wei, James B. Kampert, Carolyn E. Barlow, Milton Z. Nichaman, Larry W. Gibbons, Ralph S. Paffenbarger, Jr, and Steven N. Blair

Relationship Between Low Cardiorespiratory Fitness and Mortality in Normal-Weight, Overweight, and Obese Men

JAMA 1999 282: 1547-1553.

Andrea L. Dunn, Bess H. Marcus, James B. Kampert, Melissa E. Garcia, Harold W. Kohl III, and Steven N. Blair

Comparison of Lifestyle and Structured Interventions to Increase Physical Activity and Cardiorespiratory Fitness: A Randomized Trial

JAMA 1999 281: 327-334.

Alan Hinderliter, Andrew Sherwood, Elizabeth C. D. Gullette, Michael Babyak, Robert Waugh, Anastasia Georgiades, and James A. Blumenthal

Reduction of Left Ventricular Hypertrophy After Exercise and Weight Loss in Overweight Patients With Mild Hypertension

Archives of Internal Medicine 2002 162: 1333-1339.

Kerry J. Stewart

Exercise Training and the Cardiovascular Consequences of Type 2 Diabetes and Hypertension: Plausible Mechanisms for Improving Cardiovascular Health

JAMA 2002 288: 1622-1631.

Mihaela Tanasescu, Michael F. Leitzmann, Eric B. Rimm, Walter C. Willett, Meir J. Stampfer, and Frank B. Hu

Exercise Type and Intensity in Relation to Coronary Heart Disease in Men

JAMA 2002 288: 1994-2000.

David R. Jacobs, Jr, Hisashi Adachi, Ina Mulder, Daan Kromhout, Alessandro Menotti, Aulikki Nissinen, Henry Blackburn, and for the Seven Countries Study Group

Cigarette Smoking and Mortality Risk: Twenty-five–Year Follow-up of the Seven Countries Study

Archives of Internal Medicine 1999 159: 733-740.

Wael K. Al-Delaimy, JoAnn E. Manson, Caren G. Solomon, Ichiro Kawachi, Meir J. Stampfer, Walter C. Willett, and Frank B. Hu

Smoking and Risk of Coronary Heart Disease Among Women With Type 2 Diabetes Mellitus

Archives of Internal Medicine 2002 162: 273-279.

Tobias Kurth, J. Michael Gaziano, Klaus Berger, Carlos S. Kase, Kathryn M. Rexrode, Nancy R. Cook, Julie E. Buring, and JoAnn E. Manson

Body Mass Index and the Risk of Stroke in Men

Archives of Internal Medicine 2002 162: 2557-2562.

Peter W. F. Wilson, Ralph B. D’Agostino, Lisa Sullivan, Helen Parise, and William B. Kannel

Overweight and Obesity as Determinants of Cardiovascular Risk: The Framingham Experience

Archives of Internal Medicine 2002 162: 1867-1872.

Kevin R. Fontaine, David T. Redden, Chenxi Wang, Andrew O. Westfall, and David B. Allison

Years of Life Lost Due to Obesity

JAMA 2003 289: 187-193.

Tobias Kurth, J. Michael Gaziano, Klaus Berger, Carlos S. Kase, Kathryn M. Rexrode, Nancy R. Cook, Julie E. Buring, and JoAnn E. Manson

Body Mass Index and the Risk of Stroke in Men

Archives of Internal Medicine 2002 162: 2557-2562.

National Task Force on the Prevention and Treatment of Obesity

Overweight, Obesity, and Health Risk

Archives of Internal Medicine 2000 160: 898-904.

Ramachandran S. Vasan, Alexa Beiser, Sudha Seshadri, Martin G. Larson, William B. Kannel, Ralph B. D’Agostino, and Daniel Levy

Residual Lifetime Risk for Developing Hypertension in Middle-aged Women and Men: The Framingham Heart Study

JAMA 2002 287: 1003-1010.

Bruce M. Psaty, Curt D. Furberg, Lewis H. Kuller, Mary Cushman, Peter J. Savage, David Levine, Daniel H. O’Leary, R. Nick Bryan, Melissa Anderson, and Thomas Lumley

Association Between Blood Pressure Level and the Risk of Myocardial Infarction, Stroke, and Total Mortality: The Cardiovascular Health Study

Archives of Internal Medicine 2001 161: 1183-1192.

Jill A. Metz, Judith S. Stern, Penny Kris-Etherton, Molly E. Reusser, Cynthia D. Morris, Daniel C. Hatton, Suzanne Oparil, R. Brian Haynes, Lawrence M. Resnick, F. Xavier Pi-Sunyer, Sharon Clark, Leslie Chester, Margaret McMahon, Geoffrey W. Snyder, and David A. McCarron

A Randomized Trial of Improved Weight Loss With a Prepared Meal Plan in Overweight and Obese Patients: Impact on Cardiovascular Risk Reduction

Archives of Internal Medicine 2000 160: 2150-2158.

Diabetes Care 25:S50-S60, 2002

Paul G. Shekelle, Mary L. Hardy, Sally C. Morton, Margaret Maglione, Walter A. Mojica, Marika J. Suttorp, Shannon L. Rhodes, Lara Jungvig, and James Gagné

Efficacy and Safety of Ephedra and Ephedrine for Weight Loss and Athletic Performance: A Meta-analysis

JAMA 2003 289: 1537-1545.

Ralf Bender, Karl-Heinz Jöckel, Christoph Trautner, Maximilian Spraul, and Michael Berger

Effect of Age on Excess Mortality in Obesity

JAMA 1999 281: 1498-1504.

Framingham Heart Study

The federal government’s Framingham Heart Study has gone on since 1948. It follows a representative sample of 5,209 adult residents and their offspring aged 28-62 years in Framingham, Massachusetts. These people have been tracked using standardized biennial cardiovascular examination, daily surveillance of hospital admissions, death information and information from physicians and other sources outside the clinic. The study’s goal is to learn the circumstances under which cardiovascular diseases arise, evolve and end fatally in the general population. This information will help researchers find out, over a long time, how those who develop cardiovascular diseases differ from those who don’t. In 1971, the study enrolled a second-generation group to participate in similar examinations. It consisted of 5,124 of the original participants’ adult children and their spouses. This second study is called the Framingham Offspring Study.

BMI – Excess Weight Can Take Years Off Your Life Despite Exercise

Lead author Dr. Frank Hu of the Harvard School of Public Health – published in the New England Journal of Medicine

Fitness Level Predicts Stroke

Investigators from the Research Institute of Public Health and the Kuopio Research Institute of Exercise Medicine in Finland of Internal Medicine, 2003;163:1682-1688

Stroke among “high-fit” men was 72% lower than it was among “low-fit” males.

Medicine & Science in Sports & Exercise, a study conducted at the Cooper Institute in Dallas, TX involving

Is Exercise the Elixir of Youth?

NASA – Circulation in September 2001

Researchers at Southwestern Medical Center in Dallas

Lifestyle Changes Effective in Preventing Type 2 Diabetes in Seniors

U.S. Department of Health and Human Services (HHS)

National Diabetes Education Program (NDEP)

Dr. James R. Gavin III, Chair of the NDEP

Exercise – A Gym Visit a Day Keeps the Doctor Away

Researchers from the University of Missouri-Columbia

Journal of the Physiological Society, 2005; 562:829-838

Exercise – Capacity Affects Heart Disease Risk

Scientists from Norwegian University of Science and Technology, the Medical College of Ohio, Williams College, and the University of Michigan Medical School Science, published online 1/20/05

BMI – Weight Gain Linked To Breast Cancer Death: US Study

Boston’s Brigham and Women’s Hospital and Harvard Medical School – Journal of Clinical Oncology

BMI – Losing Weight Can Cut Cancer Risk

study from the American Cancer Society (ACS)

BMI – Diet, Exercise Top Drugs in Preventing Diabetes

March 1 issue of the Annals of Internal Medicine

Author Dr. William Herman, a professor of internal medicine at the University of Michigan School of Medicine.

Regular Exercise: Even a Late Start Cuts Heart/Diabetes Risk

Dr. Robert John Petrella and colleagues at the University of Western Ontario, London

BMI – Obesity Epidemic Threatens Life Expectancy

Lead study author S. Jay Olshansky, Ph.D., from the University of Illinois at Chicago

BMI – Obesity Raises Diabetes Risk Up to 80 Times 2004 Reuters Health

Diabetes UK chief executive Douglas Smallwood

ACS Report: At Least Half of US Cancer Deaths Could Be Prevented

American Cancer Society

The information is contained in Cancer Prevention and Early Detection Facts & Figures 2005

For Diabetics, Regular Exercise Can Lower Cardiovascular Risk Factors More Than Medication

Studies in the April issue of Diabetes Care

Study by researchers at the National Public Health Institute in Finland

Cardiovascular Risk – Health Family Tree Screening Questionnaire Approximately 5 percent of families account for about 50 percent of the coronary deaths before age 55.

Texas, Baylor College of Medicine

American Journal of Public Health, October 1988, vol. 78, p. 1283.)

Family History Alone Can Imply Cancer Mutation Risk

November 1, 2005 issue of CANCER

BMI – Medical News Today Lists Health Risks Related To Being Overweight or Obese

Medical News Today

Study is first smoking-related illness data released by Centers for Disease Control and Prevention (CDC).

Jeffrey Fellows, PhD, a senior research associate at Kaiser Permanente’s Center for Health Research in north Portland.