My Personal Profile

Name:

Today's date:

Age:

Height (in.):

Weight (lb.):

Waist size (in.):

BMI: Use the BMI chart from Chapter 4 or use this equation:

wt (lb.)


Height (in.) x height (in.)

x 703 =


BMI ranges:

  • < 18.5 = underweight
  • 18.5�.9 = normal weight
  • 25�.9 = overweight
  • > 30 = obese

My BMI indicates that I am: (Please circle)
underweight    normal   weight   overweight   obese


My risk factors are: (Please circle)

  • high blood pressure (hypertension)
  • high LDL cholesterol
    ("bad" cholesterol)
  • low HDL cholesterol
    ("good" cholesterol)
  • high triglycerides
  • high blood glucose (sugar)
  • family history of premature heart disease
  • physical inactivity
  • cigarette smoking


My physical activity level is: (Please circle)
sedentary    moderately active   active

  • Sedentary means a lifestyle that includes only the light physical activity associated with typical day-to-day life.
  • Moderately active means a lifestyle that includes physical activity equivalent to walking about 1.5 to 3 miles per day at 3 to 4 miles per hour, in addition to the light physical activity associated with typical day-to-day life.
  • Active means a lifestyle that includes physical activity equivalent to walking more than 3 miles per day at 3 to 4 miles per hour, in addition to the light physical activity associated with typical day-to-day life.


A healthy weight range for my height is: (Based on the BMI chart)


Estimated daily calorie needs, my goal:






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