1. Disease—Do you have high blood pressure?
Yes, uncontrolled
Yes, controlled
No
0
2. Disease—Do you have diabetes?
Yes, uncontrolled
Yes, controlled
No
0
3. Disease—Do you have heart disease?
Yes, uncontrolled
Yes, controlled
No
0
4. Body weight—What is your body mass index (BMI)?
BMI 30+
BMI 25–29.9
BMI <25
0
5. Blood pressure—What is your blood pressure?
140/90+
120/80–139/89
<120/80
0
6. Physical activity—Do you engage in at least 30 minutes daily of moderate or vigorous exercise?
No regular physical exercise
2–3 days per week
5–7 days per week
0
7. Fruits and vegetables—How many servings daily (1 serving = 1 medium fruit, 1/2 cup cooked vegetables, 1 cup raw vegetables) do you consume?
0–3
4–5
6–9
0
8. Whole grain—How many servings per day (1 serving = 1 slice whole wheat bread, 2/3 cup brown rice, oatmeal, quinoa, or dry cereal) do you consume?
<1/day
1–2 servings/day
3+ servings/day
0
9. Legumes—How many servings of legumes do you have per day (1 serving = 1/2 cup cooked beans, peas, or lentils)?
<1 servings per day
1–2 servings per day
3 or more servings per day
0
10. Nuts and seeds—How many servings do you have per week? (1 servings = 1 ounce nuts or seeds, 2 tablespoon of nut butter)?
0–2 servings per week
2–4 servings per week
5 or more servings per week
0
11. Red and processed meats—How many servings of meat do you have per day? (egg, beef, ham, sausage, salami (1 serving = 3 ounces)?
> 3 servings per day
1–2 servings per day
< 1 serving per day
0
12. Snack foods—How many times per week do you consume candy bars, chips, fries, and sodas?
>7 times per week
2–6 times per week
<1 per week
0
13. Water—How many cups of water do you drink daily?
<5 cups per day
6–7 cups per day
8 or more cups per day
0
14. Breakfast—Do you have breakfast regularly?
Seldom
Sometimes
Daily
0
15. Sleep—What is the average amount of hours you sleep per day?
<5 hours per day
< 7 hours per day
7-9 hours per day
0
16. Sugar—What is your blood sugar level, if known?
126+
100–125
<100
0
17. Blood cholesterol—What is your LDL cholesterol level, if known?
160+
130–159
< 130
0
18. Smoking status—Indicate your present status.
Current smoker
Ex-smoker
Nonsmoker
0
19. Social relationships—Indicate your current status.
Have no social or family support / rarely connect
Some family and social support / connect occasionally
Strong family and social support / frequently connect
0
20. Happiness—How happy are you?
Not happy, often sad or depressed
Somewhat happy / seldom sad
Very happy and satisfied with life
0
21. Time outdoors—How much time do you spend outdoors?
< 10 min. per day
10–30 min. per day
30 or more min. per day
0
22. Hope and the future—What is your outlook on the future?
Pessimistic
Somewhat optimistic
Very optimistic
0
23. Spiritual connection / meditation—Indicate your current status.
No spiritual or religious belief. I do not meditate.
I am learning about spiritual values / meditate often.
I have faith and engage regularly with people of the same faith. / I meditate regularly.
0
Total lifestyle score:
0
