This is a scientific analysis of the relationship of your diet and lifestyle for one day to your health risk factors. If you continue your habits on average like this day, your predicted health indices will be as shown in the "results" below. If you repeat this exercise, say once per week or once per month over time and average your results, the predictions will be more accurate.

Before inputting your own data and assessing your risk factors, it is advised that you do a tutorial to orient you to the procedures. In a new window, open the health risks assessment tutorial: doctormanagedcare.com/healthrisktutorial.pdf (cut and paste) and follow the directions.

Step 1: Record all food eaten and the quantities over the past 24 hours by going to the USDA diet and exercise website: mypyramidtracker.gov/ (again cut and paste into a new window)

• Register (its free).
• Fill out the "personal profile" data.
• Click "save today's changes."
• Click "proceed to food intake."
• Under "enter food item," find each food that you ate in the past 24 hours-one at a time.
• Click "select quantity."
• Enter the quantity of each food.
• Click "save and analyze."
• Click "nutrient intakes."

From the table that is displayed, record the following:

1. Food Energy/Total Calories (kcals)
2. Protein (g)
3. Total carbohydrates (g)
4. Total fiber (g)
5. Total fat (g)
6. Saturated fatty acids (g)
7. Monounsaturated fatty acids (g)
8. Polyunsaturated fatty acids (g)
9. Alcohol (g) (1 drink = 15 g alcohol = 12 ounces of beer = 4 ounces of wine = 1/2 ounce of 80 proof liquor)

Step 2: At the top of the table displaying your nutrient intake, click "physical activity entry":

• Click on "Standard option."
• Enter each physical activity that you did in the last 24 hours.
• Record the duration of each activity.
• Click on "Save & Analyze."
• Click on “Analyze.”
• Click on “Physical Activity Analysis.”
• Under "Result Summary," find "Physical Activity Score (Out of 100)

Record the "Physical Activity Score":

Step 3. Complete the entry of other "lifesyle data":

1. Tobacco use (enter number: 1=Yes, 0=No)
2. Sleep quality (1-5 scale) = “How often do you have a bad night’s sleep?”
   1=never, 2=very seldom, 3=sometimes, 4=often, 5=all the time.
3. Sleep satisfaction (1-5 scale) = “How satisfied are you with the quality of your sleep?”
   1=very satisfied, 2=moderately satisfied, 3=neutral, 4=moderately unsatisfied, 5=very unsatisfied.
4. Body Mass Index (BMI): calculate using the following website- http://www.cdc.gov/nccdphp/dnpa/bmi/index.htm (cut and paste into a new window)

Step 4. Click the button.

Results:

Predicted Body Mass Index (BMI) in 5 years:

Comment: Popular diets, diet pills, and surgery are ineffective ways to control weight and diseases associated with obesity (see Chapter 4 pgs. 43-61). To reduce predicted BMI, increase dietary fiber and polyunsaturated fats (i.e., more fruits, vegetables, whole grains, lentils and nuts: Chapter 8 pgs. 126-128), increase exercise (see pg. 121), and improve sleep hygiene (see pg. 122). Ideally, your BMI should be in the normal range in 5 years (i.e., BMI > 18.5 and < 25).

Insulin utilization percentile: %

Comment: America has an epidemic of lifestyle-related overutilization of insulin. This leads to the "metabolic syndrome" and type 2 diabetes (see Chapter 7 pgs. 105-115 and Chapter 8 pgs. 126-130 and pgs. 120-121). Projecting from current trends in the twin epidemics of obesity and type 2 diabetes, scientists predict that one-third of children born in the year 2000 will develop type 2 diabetes in their lifetimes. An average score on the lifestyle factors relating to insulin utilization (percentile = 50) means an average risk of developing the metabolic syndrome and type 2 diabetes. The lower your score the less your risk of developing the metabolic syndrome and type 2 diabetes. A score of less than 30 is desirable.

Hemoglobin A1c percentile: %

Comment: Your hemoglobin A1c (HbA1c) score tells you your average blood glucose (sugar) over the past 3 months. A high HbA1c indicates diabetes. An average score on the lifestyle factors relating to HbA1c (percentile = 50) means an average risk of developing the metabolic syndrome and type 2 diabetes. The lifestyle determinants of HbA1c are very similar to the determinants of insulin utilization. A HbA1c centile score of less than 30 is desirable (see Chapter 8 pg. 130 and pgs. 120-121).

LDL/HDL Cholesterol percentile: %

Comment: An average score on the lifestyle factors relating to LDL/HDL Cholesterol (percentile = 50) means an average risk of developing atherosclerotic cardiovascular disease (i.e., heart attacks, strokes, kidney damage, and blood vessel narrowing). The American Heart Association diet is ineffective in significantly lowering the LDL/HDL diet compared with a "portfolio diet" or a vegan diet (see Chapter 5 pgs. 63-83 and Chapter 8 pgs. 130-131 and pgs. 120-121). An LDL/HDL cholesterol percentile score of less than 30 is desirable.

Mean blood pressure percentile: %

Comment: An average score on the lifestyle factors relating to mean blood pressure (percentile = 50) means an average risk of developing hypertension. About 90% of Americans will develop hypertension in their senior years (see Chapter 6 pgs. 85-104 and Chapter 8 pgs.131-133). Most cases are lifestyle related and preventable. A blood pressure percentile score of less than 30 is desirable.

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