Improving Sleep

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Informative text: there are multiple contributing factors that intersect with these pillars, including stress, sleep, and mood. Of the four core pillars, Miga clinicians are currently focused diet, physical activity, and medications, though supporting consumers in preparing for procedural management is something that we will likely explore in the future. Clinicians should be familiar with the procedural management of weight loss and understand when to refer.

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List: it is important to create a caloric deficit
List: Adherence, not type of diet, is the best predictor of weight loss in studies

Encourage patients to try a low-calorie diet they can stick with - some may prefer “low-carb”, others “low-fat”, and others “high-protein”
There is no convincing evidence that a low-carb vs low-fat diet is better
Adequate protein intake (along with resistance training) is important in order to preserve lean muscle tissue during caloric deficit

Table example: No less than 1g protein per kg body weight (unless kidney disease present)

	BMI >25
Sedentary	1.0-1.1
Lightly Active	1.1-1.2
Moderately Active	1.2-1.3
Highly Active	1.3-1.4

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References

Mozaffarian D, et al. "Heart Disease and Stroke Statistics-2015 Update: a report from the American Heart Association." Circulation, 2015.
Estruch R, et al. "Primary Prevention of Cardiovascular Disease with a Mediterranean Diet." New England Journal of Medicine, 2013.
Myers J, et al. "Exercise and Cardiovascular Health." Circulation, 2003.
Shiroma EJ, Lee IM. "Physical Activity and Cardiovascular Health: Lessons Learned From Epidemiological Studies Across Age, Gender, and Race/Ethnicity." Circulation, 2010.
Mozaffarian D, et al. "Heart Disease and Stroke Statistics-2015 Update: a report from the American Heart Association." Circulation, 2015.
Estruch R, et al. "Primary Prevention of Cardiovascular Disease with a Mediterranean Diet." New England Journal of Medicine, 2013.