Running head: RISK REDUCTION

Risk Reduction
Tyler Nickels
Ferris State University

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Risk Reduction

An individuals diet is one of many important factors on how healthy they are. By eating
healthy and meeting the recommended dietary guidelines we are enhancing our lives and living
longer. The Department of Agriculture (USDA) and Department of Health and Human Services
(HHS) monitor these guidelines and update them every 5 years (Dietary Guidelines, 2014).
Staying fit is also important to living longer. Exercising may require no more than 20 to 30
minutes, three days a week, to improve health and control weight (Maville, 2013, p. 375). This is
not very much time for someone to dedicate to stay healthy and young. As we grow older, our
metabolism slows down and makes it easier to gain weight. To prevent weight gain is the easiest
way to stay in shape; it can make it much more difficult to try to lose weight, instead of
maintaining a healthy weight. The following information included was gathered from a fellow
classmate. It is a very detailed assessment about their health and diet. After assessing the patient,
interventions and suggestions introduced to help improve their overall health.
Assessment/Analysis/Wellness Diagnosis
A classmate completed a RealAge test, this test included data about their diet, health
status, feelings, and level of fitness. From the gathered data and information received about the
classmate their RealAge was determined to be 17.6 (See Appendix A) which is 3 years
younger then their actual age (Roizen, 2014). This is a very good indication that my classmate is
healthy. He is doing well in staying young when looking at his health status and feelings. Some
of the notable strengths are keeping a slim waist, having an adequate sleep schedule, lowering
stress, keeping in contact with friends, having a positive mindset, limiting red meats, eating a
healthy breakfast, having a variety of diet, eating sufficient amount of fruit, staying physically
active, and building strength, along with many more. He did not have as many negative results as

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he did positive. The negative results from the test were, eating more grains, varying his choices
of vegetables, eating too much junk food, not consuming enough vitamin D, increase cardio
endurance, and to have sex more often (Roizen, 2013).
There are many positive factors resulting in the reduction of his RealAge. The best
factor was his feelings and emotions category. Only one subject resulted in a making you
older, this was the limited amount of sex, which can be a very debatable topic (Roizen, 2013).
For some people sex may not be a part of their life, for instance nuns. Religion has a big impact
on sexual relations with partners along with ones personal and moral choices. This is something I
feel should be thrown out of the test as it is not expected for everyone to meet the norms. It does
show to have a positive impact on ones health, but is difficult to measure with so many factors
that can result in not meeting expected numbers. When looking at my clients health status he is
doing well. He needs to get his cholesterol checked, continue to avoid sunburns and limited
amounts of aspirin. His fitness levels are good, with majority meeting the making you younger
measurement (Roizen, 2013). It is important have cholesterol levels checked to determine any
heart problems, such as coronary heart disease and stroke. This is gathered by drawing blood,
measuring high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL)
cholesterol, known as bad cholesterol, and triglycerides. These levels are interpreted based on
age, family history, smoking and high blood pressure (How to get your cholesterol tested, 2014).
My client needs to continue to work on his fitness; he is doing well to maintaining strength and
flexibility but needs to improve on cardiovascular endurance. He spends 1 to 3 hours a week, but
it is recommended that he is to spend at least 3.5 hours a week. It is suggested to spend just 30
minutes a day working on cardio, which helps heart, lungs, and circulatory system deliver
oxygen and nutrients to bodys cells and take away waste products (Roizen, 2013). My client

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has done well to manage his stress and to have a positive psychological outcome. He continues
to stay I touch with friends and family even though he is over an hour away. He does not have
financial problems, which has a big impact on stress in life. My client does a good job at
managing stress as well, he does not let things affect him easily and is able to cope with stress
well. This relates to him keeping a positive attitude. Knowing you are doing well with your life,
happy where your at, and what you have overcome is a big stress relief. Many people stress in
life about where they sit at. They can be disappointed and look back in the past, question the
decisions they have made. Being happy about yourself is important to positive outlook in life.
Majority of the negative factors were related to his diet, which is easy to effect with
todays society and the convenience of unhealthy food. In the city, fast foods are on every block.
It is difficult to drive down a busy street and not see a few fast food restaurants every mile or
less. This makes it very convenient and with the reasonable prices it is an easy chioce. It is so
convenient and cheap that, approximately 42 percent of children and adolescents reported they
eat fast food regularly (Fast Food and Childhood Obesity in America, 2013). Eating all this fast
food reduces the amount of expected daily nutritional values one should eat. My client needs to
work on improving eating more grains, varying his vegetables, reducing amount of junk food,
and consuming more vitamin D. For a 2000 calorie diet, one should consume at least 3 ounces of
whole grains. Each week we should aim to eat 1 cups of dark green veggies, 5 cups of red
and orange veggies, 1 cups of beans and peas, 5 cups of starchy veggies, 4 cups of other
veggies (Dudek, S, 2014, p. 187). I asked my client several questions regarding his diet and what
variety of foods (See Appendix B). Based on this, it sounds as if he does pretty well with his diet
and gets an adequate amount of nutrients in his diet. The one category he needs to improve is
eating beans and grains.

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After answering the questionnaire, I explained to my client what values he needed to

improve on. I asked him if he would be willing to change his eating habits to improve his diet.
After realizing how he was lacking major food category requirements he agreed that he would
make changes to his diet but did not appear to be in dire need of doing so. I also asked my client
to improve his cardiovascular activity for a week and keep a log of it (See Appendix C). With his
cooperation to my suggestions it would lead me to place him in the contemplation stage of the
Transtheoretical Model. This model is used to determine how willing a person is to make a
change. According to Velicer (1998), this stage in the model is when individuals are more aware
of the pros of changing but are also acutely aware of the cons. In this stage the individual can
take up to 6 months to change and may get stuck in this stage known as chronic contemplation,
where the person is uncertain of the balance between costs and benefits of change.
The two wellness diagnosis that I have come up with for my client are readiness for
enhanced nutrition and ineffective health maintenance. According to Sparks and Taylor
(2011), readiness for enhanced nutrition is, a pattern of nutrient intake that is sufficient for
meeting metabolic needs and can be strengthened (p. 242). My client wants to improve his diet to
the best he can, showing this fits my diagnosis. Many defining characteristics relate to my
patients actions, such as, consumes adequate fluid and food on regular basis and, expresses
willingness to enhance nutrition (Sparks, 2011, p. 242). The other diagnosis, ineffective health
maintenance is defined as the inability to identify, manage, and/or seek out help to maintain
health. One defining characteristic that stands out to me is, reported or observed inability to
take responsibility for meeting basic health practices in any or all functional patterns (Sparks,
2011, p. 166). This relates to his lacking in parts of his diet and his cardio. As mentioned earlier,

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he needs to improve on his cardiovascular endurance, he is suggested to get at least 3.5 hours of
activity a week (Roizen, 2013).
Planning/Intervention
After assessing and diagnosing the client, I am going to develop a goal to help improve
his cardiovascular endurance. I feel he is doing well enough on his diet that his aerobic
endurance is something to focus on. I told him to continue to monitor his diet and to improve on
his grains. Explaining, understanding the importance of nutrients in your diet and knowing what
is recommended will help to live a longer and healthier life. The SMART (specific, measurable,
attainable and realistically time-bounded) goal will be something he is able to complete easily
with his daily schedule.. I recommended my client to improve his activity and had him keep a
week long log of his cardiovascular activity. I also mentioned that walking at a faster than
normal pace will meet the standards. I suggested trying to meet at least 3.5 hours of exercise a
week. He gave me the time in minutes per day of his activity, see Appendix C.
I developed interventions for the client to try and improve his cardiovascular health and
diet. Looking at the questionnaire in Appendix B, my client eats well. I focused more on the
aerobic endurance compared to nutritional health. As mentioned earlier, I suggested my client to
continue to monitor his intake and to improve his grains and get a wider variety of vegetables.
Since my client was lacking in his cardiovascular endurance I had him monitor his weekly
activity and encouraged him to improve his activity (Appendix C). Aerobic exercise is a very
important part to staying healthy. It is an excellent way to prevent heart disease and improve
health. Not only is it good for your heart but it also can help to improve the muscle strength and
joints. A study in 2012 by Crane, determined the long-term effects of aerobic exercise related to
muscle strength. This was conducted in Ontario, 74 men and women were studied, those of little

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to no activity and others with vigorous aerobic activity. Subjects were to fast over night starting
at 2200, they were then measured in muscle strength in various exercises along with monitoring
peak aerobic capacity. The study found that regardless of age, the strength of individuals that
were highly aerobically active was higher than those who were not active, in all categories of
muscle strength.
Evaluation
When given a week to help improve his cardiovascular endurance my client has exceeded
expectations. I asked him to try to meet 3.5 hours, or 210 minutes, of activity and he reached 305
minutes of aerobic activity, as shown in Appendix C. After completed the week long log I asked
how it went, if he had issues trying to meet the minimum time limit. He explained that it did not
take much dedication to meet, he said when he walked he tried to walk at a faster pace. He also
mentioned that before doing muscle strength activities he would run at least 15 minutes. This
helped him meet and exceed his quota.
I asked how he has been doing in watching his grain and vegetables. He mentioned
working on eating different vegetables, trying to eat more vegetables that are not just greens.
My client did admit to not improving on his grain intake. He said that he has not been eating
more, that he has continued his diet.
With my client doing so well in working on his cardio, I suggested to improve on his
numbers. I also mentioned getting involved in running 5K events. Explaining that preparing for
the event requires continuous exercise leading up to the event. This can be motivation to running
more frequently. With this suggestion, he is more aware of local events in communities that host
these events and says he will consider running one.

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After my client failed to eat more grains, I recommended him to keep track of what
grains he eats. I suggested keeping a food log every day of what grains he eats to see how his
numbers are compared to recommended values. He agreed to consider this option, but did not
appear to feel the need to keep a daily log of his food intake

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Appendix A

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Appendix B

What do you typically have for breakfast?

I have a protein granola bar
How often do you eat grains? (Daily, weekly, breakfast, lunch and dinner.) Provide an
estimated of how much.
Hardly ever grains for breakfast. Sandwich for lunch, what ever is normal for dinner. I
eat a pretty full dinner of everything
What kind of foods do you eat to get your intake of grains?
I eat rice a few times a week at the rock
How Often do you eat fruit? (Daily, weekly) What kinds of fruit?
I eat fruit yogurt for breakfast normally. Melons, bananas, apples pretty much every day
for lunch, one a day at lunch, and same for dinner.
What type of vegetables do you eat? How much and how often (Daily, weekly) Do you eat
beans?
Celery, broccoli, coli flower, carrots, 2 kinds each day for dinner. Spinach in my omelet,
about 1 time a week for breakfast. I eat beans probably when they are available at The Rock.
Probably once a week.
How often do you snack? (Daily, weekly)
I dont snack too much. 1 cookie a day after dinner is normal for me.
What kinds of junk food do you eat?
I eat junk food 1 time for dinner each week, Friday normally. Delivery pizza is really the
only thing that I would consider junk food. I dont eat much else for junk food.
What sources of vitamin D do you take in? (Milk, fish, eggs?) How much, daily, weekly?

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Milk for 1 meal a day. Fish about one a week for dinner, eggs for breakfast 2 or 3 times
a week..
Do you feel living near The Rock helps to maintain this diet?
I try to eat healthy at The Rock, so I think it helps to keep a solid diet.
Do you think when moving further away, at the end of summer, from The Rock you will
maintain this diet?
I will try to maintain this diet as much as I can, but it will be harder when Im living
with 4 other guys.

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Appendix C

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Appendix D

Dear Z.Z.,
I am very pleased in how well you did in improving your aerobic activity over the
week. You showed excellent dedication to exceed the goals that was set in place. Continue to do
well in this and you will add years to your life and prevent many future chronic health
conditions. The one thing you need to keep track of more is your diet. I understand it can be easy
to not meet the recommended amounts of nutrition, but it is important to do your best to eat
healthy. You show great ambition to avoid you junk and snacks, try to keep this up when you
move further away from The Rock. It is a great convenience having The Rock so close to
you but do your best and even suggest your friends, who you will be moving in with, to eat a
well balance diet. Those who are around you influence your choices in life including diet. Keep
in mind about the many 5K events that are available in your area. It has become a popular trend
the past few years and you can run several per year. They are fun events to do with family and
friends of all ages. Continue to do as you are, you display great motivation to stay young and it
will reflect as you age. Keep up the good work!

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References
Crane, J. D., MacNeil, L. G., & Tarnopolsky, M. A. (2012, October 29). Long-term aerobic
exercise is associated with greater muscle strength throughout the life span. Oxford
Journals: The Journals of Gerontology, 68(6), 631-638. doi:10.1093/gerona/gls237
How to get your cholesterol tested. (2014, April 16). In American Heart Association. Retrieved
from
http://www.heart.org/HEARTORG/Conditions/Cholesterol/SymptomsDiagnosisMonitori
ngofHighCholesterol/How-To-Get-Your-Cholesterol-Tested_UCM_305595_Article.jsp
Dietary Guidelines. (n.d.). In ChooseMyPlate.gov. Retrieved from
http://www.choosemyplate.gov/dietary-guidelines.html
Dudek, S. (2014). Nutrition essentials for nursing practice. (7th ed., p. 187). Philadelphia, PA:
Lippincott & Williams
Lindsay, B. (2013, October 21). Fast food and childhood obesity in America. In Livestrong.com.
Retrieved from http://www.livestrong.com/article/347234-fast-food-and-childhoodobesity-in-america/
Maville J. & Huerta C. (2013). Health promotion in nursing. (3rd ed., p. 375). Clifton Park, NY:
Delmar
Roizen, M. and Oz, M (2013). RealAge. Retrieved from http://www.realage.com
Sparks, S. & Taylor, C. (2011). Nursing diagnosis reference manual. New York, NY: Lippincott
& Williams
Velicer, W., Prochaska, J., Fava, J., Norman, G., & Redding, C. (1998). Transtheoretical model:
Detailed overview of the transtheoretical model. Retrieved from

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http://www.uri.edu/research/cprc/TTM/detailedoverview.htm

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