Good health is largely determined by lifestyle choices – what you eat, how active you are, how much you drink or smoke, and even social interactions.
Take this quick lifestyle assessment to see how you score. You'll identify any risks you might have. And you'll learn key prevention strategies as well as simple, painless ways to improve your health.
| Bio-Health Information |
|
Name
(optional – this assessment does not capture nor store any data)
To save your results, print the page after the results are calculated.
Age years
Gender male female |
Health View
In general, would you say your present health is?
excellent
very good
good
fair
poor |
| Practices |
|
|
Physical Activity: How many days each week do you get at least 30 minutes of physical activity? (Activities include brisk walking, cycling, active gardening, active dance, swimming, jogging, and active sports.)
|
|
Strength Exercises: How many days each week do you do strength building exercises, such as weight lifting or calisthenics?
|
|
Sleep: How many hours of sleep do you usually get each night?
|
| Smoking Status: Indicate your present smoking status.
|
| Environmental Smoke: Do you live with or work with smokers and breathe second-hand smoke regularly?
|
|
Alcohol: How many drinks do you typically have on a day you drink? One drink is a bottle or can of beer (12 oz), a glass of wine or wine cooler (3.5 oz), or a shot glass of liquor (1.5 oz).
never drink
have no more than one drink in a day
have no more than two drinks in a day
sometimes have 3 or 4 drinks in a day
sometimes have 5 or more drinks in a day
|
| Practice Safe Sex: A monogamous relationship, or always use condoms or abstain from sexual relations.
|
| Eating Practices |
|
|
Breakfast: How many days each week do you usually eat breakfast (more than just coffee and a roll)?
|
|
Bread/Grains: How many servings of whole-grain breads and cereals do you eat daily? One serving = 1 slice bread, 2/3 cup dry cereal, 1/2 cup cooked oatmeal or other whole-grain cereal or brown rice.
|
|
Fruits and Vegetables: How many servings of fruits and vegetables do you eat daily? One serving = 1 medium fruit, 6 oz fruit/veg juice, 1 cup raw fruit/veg., 1/2 cup cooked.
|
|
Nuts/Seeds: How many servings of nuts do you usually eat each week? One serving = 1 oz or a small hand full, or 2T natural nut butter.
|
|
Legumes: How times a week do you eat legumes (peas, beans, lentils, garbanzos)? One serving = 1/2 cup cooked.
|
|
High Fat/Cholesterol Foods: How often do you eat foods high in saturated fat and cholesterol?
(e.g., steak, hamburger, hot dog, sausage, bacon, cheese, fried chicken, French fries, ice cream, cheese cake, or other rich desserts)
daily
eat these foods 3 or more times a week
seldom or never eat these foods
|
|
Refined Foods: How often do you eat highly refined foods (soda pop, snack foods, chips, refined cereals, pastry, candy)?
daily
eat these foods three or more times a week
seldom or never eat refined foods
|
|
Water: How many glasses (8 oz) of water do you typically drink each day?
|
|
Weight: How many pounds have you gained since you were 21 to 24? (Enter 0 if you weigh the same, weigh less, or are less than 21 years old.)
|
| Mental/Social Health |
|
| Happiness: How happy have you been during the last month?
|
Mood/Feelings:
1. During the past month, have you often been bothered by feeling down, depressed, or hopeless?
|
| 2. During the past month, have you often been bothered by having little interest or pleasure in doing things?
|
| 3. Have your feelings in the past month caused you significant distress, or impaired your ability to function socially or at work (or school)?
|
| Stress and Coping: How much of the time do you feel stressed out and unable to cope with life?
|
| Support: Do you have family or friends you can get help from if needed?
|
| Social Interaction: Do you have frequent social contact with family or friends?
|
| Community: Do you meet regularly with a faith community or other group that gives you support, comfort, meaning, and direction in your life?
|
| Safety |
|
| Seatbelts: What percent of the time do you wear seatbelts when riding in a car? |
| Smoke Alarm: Do you have a working smoke alarm on each floor of your home, including the area in which you sleep?
|
| Helmet: When biking or roller blading, do you always wear a helmet and protective gear?
|
| Drinking and Driving: Do you ever drive soon after drinking, or ride with someone who has been drinking?
|
|
Health Exams
|
|
| Preventive Exams: Do you keep current on recommended preventive exams (see list below) and immunizations?
|
|
Recommended Preventive Exams
- Periodic checkup including blood pressure, height and weight, and cholesterol check as recommended by your doctor
- PAP tests within last 1-3 years, women age 18+
- Mammogram within last 2 years, women age 40+
- Colorectal cancer screening all persons age 50+
- Prostate exam, men age 50+
- Flu and pneumonia immunizations persons age 65+
|
| Biometrics |
|
Height feet inches
Weight pounds |
Blood pressure /
Blood cholesterol mg/dL |
| |
|
| Lifestyle Check Personal Report |
|
Your Lifestyle Check Score is
Your score is the number of "Good Health Indicators" you meet out of the 17 possible listed in this assessment.
The higher your score, the healthier your lifestyle. Compare your score to the rating scale on the right.
|
|
|
| Good Health Indicators |
| Each of the 17 "Good Health Indicators" are listed below. |
| Checked items indicate an opportunity for making improvement. |
| Health Indicator |
Guidelines for good health. |
| 1. Physical activity |
Get 30 or more minutes of physical activity most days of the week. |
| 2. Strength training |
Do strength building exercises at least twice per week. |
| 3. Not smoking |
Avoid all tobacco use and frequent exposure to second-hand smoke. |
| 4. Alcohol use |
Alcohol is not recommended. But if you drink, limit yourself to 1-2 drinks in a day. |
| 5. Adequate rest |
Get adequate rest, at least 7-8 hours of sleep daily, for best health. |
| 6. Breakfast daily |
Eat a good breakfast daily for optimum physical and mental performance. |
| 7. Whole-grains |
Choose whole-grain breads and cereals, at least 3 or more servings a day. |
| 8. Fruits & vegetables |
Eat at least 5 servings of fruits and vegetables daily. |
| 9. Fats, cholesterol |
Limit fatty meats, whole milk, and butter. Vegetable oils are healthier. |
| 10. Nuts daily |
Eat nuts daily. They contain healthy fats and protect against heart disease. |
| 11. Healthy weight |
Maintain a healthy weight by eating well and getting regular physical activity. |
| 12. Mental health |
Develop good coping skills and maintain a happy, hopeful outlook. |
| 13. Social support |
Maintain good social support and frequent contact with family and friends. |
| 14. Community |
Participate regularly in a faith community or other group that provides meaning, direction, and support in your life. |
| 15. Safety |
Be safety-conscious. Wear safety belts in the car, and helmets when biking. |
| 16. Safe sex |
Either stay in a monogamous relationship, always use condoms, or abstain. |
| 17. Regular exams |
Get regular exams, including age/gender-recommmended preventive exams. |
| Biometrics |
|
|
Body Mass Index (BMI)
Your results
Improvement opportunity Doing well
Maintaining a healthy weight reduces the risk for high blood pressure, stroke, heart disease, diabetes, arthritis, and several cancers. It will also help you look and feel your best every day.
Limit refined foods, snacks, chips, pastry, soda pop, ice cream, desserts, and sweets. |
|
Guidelines
Weight is evaluated based on body mass index (BMI), an index derived from your height and weight. People who have the lowest risk for disease and early death have a BMI less than 25. See norms below:
| Weight Description |
Body Mass Index |
|
| Underweight |
BMI less than 18.5 |
|
| Healthy weight |
BMI of 18.5 to 24.9 |
|
| Overweight |
BMI of 25 to 29.9 |
|
| Obese |
BMI of 30 or higher |
|
|
|
|
Total Cholesterol
Your results
Increased risk Doing well Don't know
High cholesterol is a strong predictor of a future heart attack or stroke. Excess cholesterol can accumulate in the arteries restricting blood flow and increasing the risk of a clot. This can cause a heart attack or stroke.
If you know your HDL cholesterol level, subtract HDL cholesterol from total cholesterol to determine your overall risk. The result should be less than 160 for good health; less than 130 is ideal.
If you don't know your cholesterol level, get it checked. It could save your life.
|
|
Guidelines
- Ideal is 160 or less and is recommended if you have a heart problem or diabetes.
- Desirable cholesterol is less than 200.
- Cholesterol of 200 to 239 puts you at increased risk.
- Cholesterol of 240 or higher is considered high risk.
Steps you can take to lower cholesterol levels
- Limit eating saturated or animal fat. (That includes meat, eggs, cheese, butter, whole milk, cream, solid fats, and trans fats.)
- Use vegetable oils in place of solid fats.
- Eat nuts daily (in moderate amounts).
- Eat foods high in dietary fiber: whole grains, oatmeal, legumes, fruits, and vegetables.
- Lose weight if you are overweight.
- Ask your doctor about medicine to lower cholesterol if needed.
|
|
|
Blood Pressure
Your results
Increased risk Doing well Don't know
- High blood pressure increases the risk for heart disease, stroke, eye disease, and kidney disease.
- About one in every five adults in the United States has high blood pressure (140/90 or above).
If you don't know your blood pressure, get it checked.
|
|
Guidelines
- Normal blood pressure is less than 120/80.
- Prehypertension is 120/80 to 139/89.
- High blood pressure is 140/90 or higher.
Steps you can take to lower blood pressure
- Lose weight, if you are overweight. Even a weight loss of 10-15 pounds can lower blood pressure.
- Get regular, moderate physical activity such as walking. (30 minutes daily is recommended.)
- Lower your salt (sodium) intake.
- Avoid alcohol, smoking, and caffeine.
- Eat more fruits and vegetables.
- Reduce saturated fat in the diet.
|
|
| The Next Step |
|
|
Your lifestyle test results displayed above can help you identify areas in your life that you could improve. Review the following suggestions for developing a health improvement action plan.
- Make a list of the key areas you would like to change.
- Get help from your doctor, dietitian, or other health professional as needed.
- Join a class, or enlist the help of a friend to work with you on making changes.
- Write out your goals. Keep track of your progress. Reward yourself for goals met.
- Periodically, reassess yourself to see how you are improving.
- Get regular preventive medical exams appropriate for your age and gender.
|
|
