Personal Wellness Profile™

Health Testing Guidelines

Guidelines
This manual is designed to help when filling out and completing the health tests used in the Personal Well-
ness Profile™ Advantage Program. Fitness testing is based on the American College of Sport’s Medicine’s
Guidelines for Exercise Testing and Prescription. It is recommented that you refer to the ACSM’s manual
for a full and complete understanding of fitness assessment and exercise counseling. Other tests and scor-
ing are based on research from NIH, NHLBI, NCEP III, American Cancer Society, and the American
Diabetes Association.
Fitness testing and scoring prepared by Don Hall, DrPH, CHES for Wellsource Inc.
© 2009 Wellsource, Inc. Updated 1-15-2009
CONTENTS
4 Body Composition
Height and Weight
Waist Girth Measurement
Body Mass Index (BMI)
Percent Body Fat

9 Strength
Grip Strength
Upper Body Fitness (Push-Ups)
Abdominal Fitness (Curl-Ups)

12 Flexibility
Sit-and-Reach Test

13 Cardiovascular Screen
Blood Pressure

14 Blood Tests
PSA
HbA1c
Cholesterol – Total, HDL, LDL
Triglycerides
Glucose

19 Cardiovascular Fitness
One-Mile Walk Test

21 Appendix
Aerobic Capacity Field Test Worksheets
PAR-Q Screening Form
Sample Informed Consent
Fitness Index Form
Sample Instructions Individual/Administrator

Note: All questions on the Health Tests section of the Personal Wellness
Profile™ questionnaire are optional. All reports (individual and group)
can be generated if clinical testing is not included.
Body Composition
Body weight, or excess fat weight, is of major inter-
est to most people; especially those in a fitness program.
As people become more fit it is encouraging to show how
their body composition improves. Taking body compo-
sition measurements is essential for demonstrating these
changes. Several techniques are available:

• Body mass index (BMI) based on height and weight

• Waist measurement
• Percent body fat

A person’s height and weight are measured using standard

procedures to assure accuracy for pre-post comparisons.
There is often quite a difference in reported weight and
measured weight. People usually over estimate how tall
they are and underestimate their weight. For most ac-
curate results, it is best to actually measure height and
weight rather than taking reported values.

Taking Measurements
Required Equipment
• Accurate balance scales and height measuring system
• Tape measure for measuring waist girth
• BMI table or calculator
• Skinfold calipers (for % fat) or bioelectric impedance
analysis equipment.

Weight
For accurate weights, use a balance scale if possible. Home
scales may be off several pounds. An accurate weight is
essential for monitoring change and giving feedback.
1. Be sure the scales are set on a hard flat surface.
If on a carpet, put a board under the scales. Arrange
the scales so you can adjust the weights from the
backside of the scale rather than reaching around
the participant.
2. The participant should be weighed without shoes
and preferably in exercise shorts. People dressed in
regular clothing when being weighed should be sure
that they are dressed similarly the next time they
are weighed.
3. Record weight to the nearest pound.
Height
1. Use a scale with a height measuring system. If not
available, fasten a measuring tape to a flat wall. Tape
paper alongside the measuring tape to allow for
marking heights with a pencil.
2. Measure height with shoes off. Have the person stand
with feet together, arms at side, and heels and back
against the wall.
3. Instruct participants to look straight ahead and stand
as tall as possible. Make sure heels stay on the floor.
4. Use a rectangular block of wood or a right triangle
that can slide down the wall to determine the top of
the head. Mark the person’s height on the paper next
to the tape measure, putting their initial after it to
keep their height separate from other marks. Record
the person’s height to the nearest inch.
Waist Circumference
A measurement of the waist provides a quick look at how
fat is deposited on the body. A high amount of abdominal fat significantly Waist Girth
increases the risk for high blood pressure, diabetes, cardiovascular disease,
Test Procedure
and certain cancers.

1. The waist is defined as the smallest circumference below the ribs and at Equipment:
or above the navel. If there is a question about location, simply measure measuring tape
the waist in the horizontal plane at the level of the navel.

2. Instruct the participant to stand relaxed. Take the measurement at the end
of a normal expiration. Pull the tape snug, but avoid pulling the tape tight
so it begins to sink into the skin. Body Composition
waist
known
circumference
% fat
(inches)
Entering Waist 9 3 2. 0
Circumference 0 0 0 0 0
• Write the waist measurement value
in inches in the space provided and fill 1 1 1 1 1
in the corresponding bubbles. 2 2 2 2 2
• Left justify. 3 3 3 3 3
• When value is a whole number,
4 4 4 4 4
bubble a zero to the right
of the decimal. 5 5 5 5 5
6 6 6 6 6
7 7 7 7 7
8 8 8 8 8
9 9 9 9 9
Norms indicating obesity and high risk are:
Men more than 40 in. and Women more than 35 in.

Waist Girth U.S. Standards

Adult Male Adult Female
Risk Category Minimum Maximum Minimum Maximum
Desirable 28 36.9 25 32.9
Overweight 37 39.9 33 34.9
High Risk 40 >40 35 >35
Lean <27.9 27.9 <24.9 24.9
Body Mass Index
BMI is a measure of weight for height which correlates closely with longevity and risk for excess weight related
problems: heart disease, certain cancers, diabetes, arthritis, high blood pressure, and high blood lipids.
BMI is defined as: (Weight kg) / (Height m)2
Note: BMI is automatically calculated in the program using height and weight values. BMI is not entered on the questionnaire.

Body Mass Index Chart

Instructions: Find your height in the left column. Run your finger along the row to find your weight or closest
weight. Then run your finger up the column to the top of the page to find your BMI.

Body Mass Index Chart

BMI 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35

Ht (in) Healthy Weight Range (lb) Overweight (lb) Obese (lb)

58 91 96 100 105 110 115 119 124 129 134 138 143 148 153 158 162 167

59 94 99 104 109 114 119 124 128 133 138 143 148 153 158 163 168 173

60 97 102 107 112 118 123 128 133 138 143 148 153 158 163 168 174 179

61 100 106 111 116 122 127 132 137 143 148 153 158 164 169 174 180 185

62 104 109 115 120 126 131 136 142 147 153 158 164 169 175 180 186 191

63 107 113 118 124 130 135 141 146 152 158 163 169 175 180 186 191 197

64 110 116 122 128 134 140 145 151 157 163 169 174 180 186 192 197 204

65 114 120 126 132 138 144 150 156 162 168 174 180 186 192 198 204 210

66 118 124 130 136 142 148 155 161 167 173 179 186 192 198 204 210 216

67 121 127 134 140 146 153 159 166 172 178 185 191 198 204 211 217 223

68 125 131 138 144 151 158 164 171 177 184 190 197 203 210 216 223 230

69 128 135 142 149 155 162 169 176 182 189 196 203 209 216 223 230 236

70 132 139 146 153 160 167 174 181 188 195 202 209 216 222 229 236 243

71 136 143 150 157 165 172 179 186 193 200 208 215 222 229 236 243 250

72 140 147 154 162 169 177 184 191 199 206 213 221 228 235 242 250 258

73 144 151 159 166 174 182 189 197 204 212 219 227 235 242 250 257 265

74 148 155 163 171 179 186 194 202 210 218 225 233 241 249 256 264 272

75 152 160 168 176 184 192 200 208 216 224 232 240 248 256 264 272 279

76 156 164 172 180 189 197 205 213 221 230 238 246 254 263 271 279 287

The recommended upper limit of healthy weight is a BMI under

Body Mass Index (BMI) Standards 25. Look at the chart above for your height and a BMI of 25.
Underweight Less than 18.5 You should weigh no more than this amount for good health.
Healthy weight 18.5 to 24.9 • Women have best life expectancy at a BMI of about 22-23.
Overweight 25.0 to 29.9 • Men have best longevity at a BMI of about 24-25.
Obese 30.0 or more • Weight lifters have a higher muscle mass and thus have
Obese, high risk 35.0 or higher a higher BMI without negative health consequences. They
should use a percent fat test to determine ideal weight.

Source: NIH, NHLBI, Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults
Percent Body Fat
Body fat percentage is an estimate of the fraction of the total body mass that is adipose tissue (or referred
to as Fat Mass), as opposed to lean body mass (muscle, bone, organ tissue, blood, and everything else) or referred to
as Fat Free Mass. This index is often used as a means to monitor progress during a diet or as a measure of physical
fitness for certain sports, such as body building. It is more accurate as a measure of excess body weight than body
mass index (BMI) since it differentiates between the weight of muscle mass and that of the fat mass while BMI lumps
all masses into one figure. However, its popularity is less than BMI because equipment required to perform the body
fat percentage is not readily available and skills are required to perform the measurement. Even when measured by
a skillful person, there are factors that contribute to a significant margin of error.
Wikipedia - The Free Encyclopedia

Percent Fat Norms Table

Adult Male Adult Female
Risk Category Minimum Maximum Minimum Maximum
Healthy Range 10 20.9 20 30.9
Overweight 21 24.9 31 36.9
Obese 25 >25 37 >37
Lean .1 9.9 .1 19.9

Note: Personal Wellness Profile™ - Advantage uses the Institute of Medicine’s Standards for scoring
percent body fat. If ACSM Standards are preferred they can be selected as an alternative in the program.

To change to ACSM percent fat scoring within the Advantage program:

• Click on Utilities tab – Program Settings – Scoring
• Under the scoring tab check box “Use ACSM Standard for Percent Fat, otherwise use basic standard”
Percent Body Fat
Entering Percent Fat
• Round percent fat value to the nearest whole number.
• Write the value in the space provided and fill in the
corresponding number bubble in the same column.
• Right justify.
• A leading zero is NOT required
Body Composition
when values are less than ten.
waist
known
circumference
% fat
(inches)
9 3 2. 0
0 0 0 0 0
1 1 1 1 1
2 2 2 2 2
3 3 3 3 3
4 4 4 4 4
5 5 5 5 5
6 6 6 6 6
ASCM Percent
7 7 7 7 7
Body Fat Norms
8 8 8 8 8
9 9 9 9 9

Percent Body Fat - Men

Rating/Age 20 - 29 30 - 39 40 - 49 50 - 59 60+

Ideal 9.4 or less 13.9 or less 16.3 or less 17.9 or less 18.4 or less

Doing Well 9.5 - 14.1 14 - 17.5 16.4 - 19.6 18 - 21.3 18.5 - 22

Needs Improving 14.2 - 25.8 17.6 - 27.2 19.7 - 28.8 21.4 - 30.2 22.1 - 31.1

Caution 25.9+ 27.3+ 28.9+ 30.3+ 31.2+

Percent Body Fat - Women

Rating/Age 20 - 29 30 - 39 40 - 49 50 - 59 60+

Ideal 17.1 or less 18.0 or less 21.3 or less 25 or less 25.1 or less

Doing Well 17.2 - 20.6 18.1 - 21.6 21.4 - 24.9 25.1 - 28.5 25.2 - 29.3

Needs Improving 20.7 - 32.0 21.7 - 32.7 25.0 - 34.9 28.6 - 37.8 29.4 - 39.2

Caution 32.1+ 32.8+ 35+ 37.9+ 39.3+

Percent Body Fat
Worksheet
Percent body fat is a good way to track changes in body composition
due to physical activity and/or dieting. Percent fat can be easily measured
using a bioelectric impedance assessment (BIA). Another method requiring
more training and practice for accuracy is taking skinfold measurements.
Results are usually accurate to within plus or minus 2-3% body fat if you
carefully follow the testing guidelines below.

1. The following instructions are for using a BIA instrument.

See instructions in the Fitness Test Manual for using
skinfold measurements.

2. For most accurate results using BIA testing:

• Take the test at least 1-2 hours after eating
• Don’t test soon after: exercise, getting out of a hot tub or shower,
drinking alcohol, or drinking a large amount of water.
• If hands are cold, warm them first before testing (warm room or
warm water).
• If hands are very dry, slightly moisten hands with a damp towel.
• When doing repeat testing, take measurements at a similar time Test Procedure
of the day.
• Follow good technique as described in the manual that came with
the equipment (arms fully extended and level in front of you, grip Equipment:
easily with fingers around grips, thumbs on top of instrument, BIA testing instrument
stand quietly until measurement is completed.

3. Record test results

Percent Body Fat Test Results

Test Percent Weight Your
BMI
Date Fat (lbs) Rating

Source: American College of Sports Medicine, Guidelines for Exercise Testing and Prescription, 2000. © 2007 Wellsource Inc.
General Strength
Grip strength correlates fairly closely with overall upper body strength
and is easily administered. Grip is measured using a hand grip dynamom- Grip Strength
eter. The subject does a maximal grip using one hand and then the other.
Test Procedure
The best scores from each hand are combined for the overall grip score.
Equipment:
1. Test subject should be screened for arm or shoulder pain. Persons handgrip dynamometer
suffering arm/shoulder pain or who have high, uncontrolled blood
pressure should not do this test.

2. Be sure participants are well instructed in the proper technique.

Describe, and if needed, demonstrate the correct technique as follows:

• Adjust the hand grip dynamometer so the second joint of the

fingers fit snugly on the handle when gripping.

• The participant should hold the dynamometer with arm

extended down about thigh level.

• Instruct subject to make a maximal squeeze. Don’t let the

dynamometer touch any part of the body or any other object.
Also avoid sudden thrusts or jars which can make the
reading inaccurate.

• When squeezing, instruct subject to breath out or exhale during

contraction, to prevent high intrathoracic pressure.

• Measure both hands alternately giving two tries per hand.

Combine the best score of each hand to give a total grip strength
reading. Record test results accurately in the units specified on
the data sheet, generally kilograms.

Grip Strength (kg, both hands combined)

Men Women
Grip Strength Norms
Ages Good Excellent Good Excellent
(kg, scores from both
20 - 29 113 124 65 71 hands combined)
30 - 39 113 123 66 73

40 - 49 110 119 65 72

50 - 59 102 110 59 65

60+ 93 102 54 60
Grip Strength
Worksheet
Grip strength, measured with a handgrip dynamometer, correlates
with overall upper body strength and is an easy, safe test to perform. A good
grip is linked to higher lean body mass, lower risk of disability in old age, and
Grip Strength
increased longevity. Compare your test results with the norms shown below.
Test Procedure
Equipment:
1. Don’t do this test if you have arm or shoulder pain, or high, uncontrolled handgrip dynamometer
blood pressure.

2. Use the proper technique as described below for accurate and consistent
results. If needed, ask for a demonstration.

3. Adjust the handgrip dynamometer so the second joint of the fingers fit
snugly on the handle when gripping. Hold the dynamometer with arm
extended down about thigh level.

4. Make a maximal squeeze. Don’t let the dynamometer touch any part
of the body or any other object. Also avoid sudden thrusts or jars,
which can make the reading inaccurate.

5. When squeezing, breathe out or exhale during contraction to prevent

high intrathoracic pressure. Don’t hold your breath and strain.

6. Measure both hands. Take two tries per hand. Combine the best score
of each hand to give a total grip strength reading. Record test results
in kilograms.

Grip Test Results

Test Left Right Total Your
Date Hand Hand (kg) Rating
Grip Strength Norms1
(kg, scores from both
hands added together)

Source: Canadian Society for Exercise Physiology, The Canadian Physical Activity, Fitness, and Lifestyle Appraisal, 2nd Edition, reprinted 2001
© 2004 Wellsource Inc. Do not make unauthorized copies.
Upper Body Fitness
This is an easily administered test for upper body strength/
endurance. The subject attempts as many consecutive pushups as they Push-ups
can without stopping to rest. Men do pushups from the toe, women from Test Procedure
the knee.
Equipment:
1. Test subject should be screened for shoulder or lower back impairment exercise mat
or pain. Persons suffering back pain or high, uncontrolled blood stop watch
pressure, should not do this test.

2. Be sure participants are well instructed in the proper technique.

Describe and, if needed, demonstrate the correct technique. They may
want to practice once or twice before beginning the test. Instruct the
subject to:

• Lie on stomach on a mat, legs together

• Hands should be pointing forward, positioned under shoulders

• Do pushup, keeping back straight, pivoting from toes for men,

from knees for women.

• Return to starting position, but only let chin touch the mat
(chest and legs should not touch the mat)

• Do as many pushups using this technique as possible, without undue

strain, and without stopping to rest.

• There is no time limit. Stop the test when the person is either unable
to maintain the proper technique over two consecutive push-ups,
or shows signs of excessive straining.

3. Caution participants not to overstrain or hold their breath, but rather to

breathe rhythmically, exhaling on the upward phase, and inhaling on the
downward phase.

Push Ups (# continuous)

Men Women
Push-up Norms1
Ages Good Excellent Good Excellent (number of push-ups
20 - 29 28 36 20 30 completed)

30 - 39 21 30 19 27

40 - 49 16 25 14 24

50 - 59 12 21 10 21

60+ 10 18 11 17
Abdominal Fitness
The partial curl-up is a safe assessment of abdominal fitness.
Curl-ups
1. Test subject should be screened for lower back impairment or pain. Test Procedure
Persons suffering back pain or high, uncontrolled blood pressure should
not do this test. Equipment:
gym mat
2. Instruct test subject to lie on their back on a mat with knees bent masking tape (or Velcro tape)
at 90 degrees. The arms are at the side with fingertips just touching metronome or watch
a piece of masking tape or other physical marker. A second piece of
masking tape (or other marker such as Velcro tape or a wood block)
is placed 8 cm beyond the first marker for persons 45 or older, or 12 cm
for those less than 45 years old.

3. The individual flattens their lower back and curls up lifting the head
and shoulder blades off the mat (trunk should make a 30 degree angle
with the mat). The fingertips slide along the mat out to the outer marker.
The curl up should be slow and controlled, taking about 2-3 seconds per
curl-up. If you have a metronome, set it for a pace of 40 beats/min and
have the individual complete one full curl-up per two beats (rate of 20/
min). The fingertips of both hands should reach the outer marker. Do as
many as possible without resting. Stop if you reach 75.

An alternative – with hands on thighs, curl-up until the fingertips slide all
the way over the kneecaps and the back makes a 30-degree angle with the
mat. Come back down until shoulders are fully on the floor. Do as many
as you can do continuously in two minutes. This is a preferred method
with most fit people. 30°
4. Caution subjects not to over strain and to breathe normally, exhaling
while curing up, and inhaling while relaxing back down.

Curl-Ups (# continuous)
Men Women

Ages Good Excellent Good Excellent Partial Curl-up Norms2

20 - 29 31 56 32 45 (number of partial curl-ups
completed in one minute)
30 - 39 36 69 28 43

40 - 49 51 75 28 42

50 - 59 35 69 16 30

60+ 19 33 19 30
 Flexibility
Sit-and-Reach Test
Test Procedure
Equipment:
flex bench or a meter stick
(The meter stick should be
attached or taped to the top
of a bench or box with the toe line
at the 26 cm mark.)
Flexibility is the ability to move a joint through its full range of motion.
This is important to athletic performance, especially gymnastics, dance, and
many sports. It is also important for carrying out activities of daily living.
A muscle and joint is less likely to be injured if it has good flexibility.
One good measure of flexibility is the sit-and-reach test. It measures overall
flexibility including the legs, back, arms and shoulders.
1. Test subject should be screened for lower back impairment or pain.
Persons suffering back pain should not do this test. Have the test subject
warm up by doing slow stretching while seated, reaching towards one
foot for 15-20 seconds and then towards the other foot. Repeat twice on
each leg. Caution the person to move slowly and hold each stretch. Avoid
bouncing or dynamic stretches.

2. Be sure the subject has shoes removed. Have them sit on the floor or mat
with legs extended out in front, and feet against the flex bench (or a box
with a meter stick taped to the top). The feet should be at the 26 cm line
on the meter stick with the zero end pointing toward the subject.

3. With hands together, have the subject slowly bend forward reaching as
far as possible without discomfort, fingers on the ruler, and hold for
2 seconds. Be sure fingertips are together and one hand is not ahead of
the other. Make sure the knees don’t flex, the subject stretches slowly, and
doesn’t bounce. Record the better of two tries to the nearest centimeter.

Flexibility Sit-and-Reach (cm)

Men Women
Sit-and-Reach Norms (cm, Ages Good Excellent Good Excellent
distance reached with toe
line at 26cm) 20 - 29 33 40 36 41

30 - 39 32 38 35 41

40 - 49 28 35 33 38

50 - 59 27 35 32 39

60+ 24 33 30 35
Blood Pressure
A resting blood pressure test is an important screen-
Blood Pressure and Pulse
ing test for cardiovascular health. Regular exercise is one good way to
help keep blood pressure normal and avoid damage to the heart, brain, Blood Pressure
resting pulse
kidneys, eyes, and other organs damaged by high blood pressure. systolic diastolic

1. The person being tested should avoid vigorous exercise and be 1 4 2 7 4 7 5

free from smoking or drinking coffee in the 30-60 minutes before 0 0 0 0 0 0 0 0 0
testing. Have the test subject sit quietly for 5 minutes.
1 1 1 1 1 1 1 1 1

2. Select the appropriate cuff size. The bladder in the cuff should 2 2 2 2 2 2 2 2 2
encircle at least two-thirds of the upper arm. Persons with large 3 3 3 3 3 3 3 3 3
arms should use the large cuff size for accurate tests. Children 4 4 4 4 4 4 4 4 4
with small arms should have a child’s cuff. If using the wrist cuff, 5 5 5 5 5 5 5 5 5
one size fits all. Be sure wrist is held at level of heart when testing. 6 6 6 6 6 6 6 6 6
7 7 7 7 7 7 7 7 7
3. Wrap the cuff firmly around the upper arm at the level of the
person’s heart. Align the cuff so the arrow on the cuff lines up
8 8 8 8 8 8 8 8 8
with the brachial artery (you can feel for the artery to locate its 9 9 9 9 9 9 9 9 9
position). Place the bell of the stethoscope over the brachial artery
in the antecubital space. Quickly inflate cuff pressure to at least
20 mm Hg above the estimated systolic blood pressure.

4. Slowly release pressure at a rate equal to 2-3 mm Hg per second.

Listen carefully for the first Korotkoff sound. When you first hear
a beat, note the Systolic blood pressure. Continue letting out the
air until the sound disappears (or sounds significantly muffled).
This is the diastolic blood pressure. Record blood pressure reading. Entering
On automatic cuffs this is all done automatically. Blood Pressure
• Write the value in the space
5. If the blood pressure reading is 140/90 or higher, have the person provided and fill in the
rest a few more minutes and check it again. If lower, record the corresponding number bubble
lower reading. in each column.
• Right justify.
• Leading zeros are not required.

Resting Blood Pressure (mm/Hg)

Adults Children/Adolescents

Ideal (excellent) 115/75 or less 112/70 or less

Desirable (good, or low risk) 116/76 - 119/79 113/71 - 119/79

Needs Improving 120/80 - 139/89 120/80 - 131/85

High Risk 140/90+ 132/86+

Source: NIH, HeartMemo, NIH, National High Blood Pressure Education Program, Update on High blood Pressure in Chil-
dren
PSA
PSA (Prostate-Specific Antigen) test results report
the level of PSA detected in the blood. The test results
are usually reported as nanograms of PSA per milliliter
(ng/mL) of blood. In the past, most doctors considered
PSA values below 4.0 ng/mL as normal. However, recent
research found prostate cancer in men with PSA levels
below 4.0 ng/mL.

When prostate cancer develops, the PSA level usually

goes above 4. But it is important to remember that about
15% of men with a PSA below 4 will have prostate cancer
on biopsy. If your level is in the borderline range between
4 and 10, you have about a 25% chance of having prostate
cancer. If it is more than 10, your chance of having pros-
tate cancer is over 50% and increases more as your PSA
level increases.”

Entering PSA PSA

• Write the value in the space provided and fill in Desirable 0 - 2.49 ng/mL
the corresponding number bubble in each column.
• Use decimal. When value is a whole number bubble Borderline Low 2.5 - 3.99 ng/mL
the zero to the right of the decimal. A bubbled value Borderline High 4 - 10 ng/mL
is required to the right of all decimals.
• Leading zeros are NOT required. Higher Risk 10.001 ng/mL or more

Blood Pressure and Pulse Blood Tests

Blood Pressure
resting pulse A1C PSA
systolic diastolic
1 4 2 7 4 7 5 4. 9 2. 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
7 7 7 7 7 7 7 7 7 7 7 7 7 7 7
8 8 8 8 8 8 8 8 8 8 8 8 8 8 8
9 9 9 9 9 9 9 9 9 9 9 9 9 9 9

Source: 2007 American Cancer Society www.cancer.org

A1C
A1C is a test that measures the
amount of glycosylated hemoglobin
in your blood. Glycosylated hemo-
globin is a molecule in red blood
cells that attaches to glucose (blood
sugar). You have more glycosylated
hemoglobin if you have more glu-
cose in your blood. The test gives a
good estimate of how well diabetes
is being managed over the last 2 or
3 months.

A1C
Adult Adult - Diabetic
Risk Category Minimum Maximum Minimum Maximum
Desirable 0.1 4.9 0.1 6.9
At Risk 5 >5 7 >7

Alternative Names: Glycosylated hemoglobin; Hemoglobin - glycosylated;

A1C; GHb; Glycohemoglobin; Diabetic control index

Blood Pressure and Pulse Blood Tests

Blood Pressure
resting pulse A1C PSA
Entering A1C systolic diastolic
• Write the value in the
space provided and fill in 1 4 2 7 4 7 5 4. 9 2. 0
the corresponding number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
bubble in each column.
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
• Use decimal, when value
is a whole number bubble 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
the zero bubble to the 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
right of the decimal. 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
A bubbled value is required 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
to the right of all decimals. 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
• Leading zeros are
NOT required.
7 7 7 7 7 7 7 7 7 7 7 7 7 7 7
8 8 8 8 8 8 8 8 8 8 8 8 8 8 8
9 9 9 9 9 9 9 9 9 9 9 9 9 9 9

Source: 2007 US National Library of Medicine; National Institute of Health www.nlm.nih.gov

Blood Tests
Blood Test Norms
Total Cholesterol (mg/dL)
Adults (18+) Persons with prior MI, Children/Adolescents*
Stroke or Diabetes
Ideal (Excellent) <160 <160 150 or less
Desirable <170
(Good, or Low Risk) <200 <=160

Needs Improving 200+ >160 170+

High Risk 240+ 200+ 200+

Entering blood test values:

• Right justify values as shown. Leading zeros do not need to be added.

Blood Tests
Cholesterol Nonfasting
Total HDL LDL Triglycerides Glucose
1 9 8 4 5 1 4 2 5 5 9 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6
7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7
8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8
9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9

Note: Total cholesterol is scored if it is the only value entered. If LDL cholesterol is available, cholesterol score risk is
based on LDL level. If Total cholesterol and HDL cholesterol values entered, the non-HDL cholesterol values for risk
analysis is scored. NCEP III (If no clinical Cholesterol values, program scores Person History of High Cholesterol)

* Risk values for children and adolescents (<18 years) are set by the National Cholesterol Program (NCEP) and are
recommended for children with a family history of high cholesterol (cholesterol of 240+), or history of early CHD
(MI before 55 yrs or angioplasty etc.)
Blood Tests Continued
Blood Test Norms – LDL Cholesterol

LDL Cholesterol (mg/dL)

Adults (18+) Persons with prior MI, Children/Adolescents*
Stroke or Diabetes
Ideal (Excellent) 100 or less <100 <100
Desirable <110
(Good, or Low Risk) <130 100 or less

Needs Improving 130+ 100+ 110+

High Risk 160+ 130+ 130+

Note: Cholesterol risk score is based on LDL levels when available.

Blood Test Norms – non-HDL Cholesterol

If LDL is not available, then non-HDL cholesterol evaluates cholesterol risk.

Non - HDL Cholesterol (mg/dL)

Adults (18+) Persons with prior MI,
Stroke or Diabetes
Total Cholesterol
Ideal (Excellent) 130 or less <130
– HDL cholesterol
Desirable
(Good, or Low Risk) <160 130 or less
= Non-HDL
Needs Improving 160+ 130+

High Risk 190+ 160+

Non-HDL = Total Cholesterol – HDL cholesterol

Non-HDL cholesterol is a more accurate estimate of overall risk.
The non-HDL cholesterol is all the “bad” or atherogenic portion,
including LDL, IDL and VLDL cholesterol.

Blood Test Norms – HDL Cholesterol

HDL Cholesterol (mg/dL)

Adult Male Adult Female

Ideal (Excellent) 60+ 60+

Desirable
(Good, or Low Risk) 45+ 55+

Needs Improving <45 <55

High Risk <40 <40

Blood Tests Continued

Blood Test Norms – Triglycerides

Triglycerides (mg/dL)

Adults

Ideal (Excellent) 100 or less

Desirable (Good, or Low Risk) <150

Needs Improving 150+

High Risk 200+

Note: Accurate triglyceride levels require a 12-14 hour fast.

Source: NIH, National Cholesterol Education Program III
(for blood lipid values.)

Blood Test Norms – Glucose

Fasting Blood Glucose (mg/dL)

Adults

Ideal (Excellent) <90

Desirable (Good, or Low Risk) <90 - 99.0

Needs Improving 100 - 125.9

High Risk * 126+

Note: Standards based on fasting blood glucose levels.

Non-fasting blood glucose of 200+ indicates diabetes or high risk.
* Persons with existing diabetes are already at high risk.
Source: American Diabetes Association definition of diabetes
(fasting glucose of 126+ or non-fasting of 200+.)
Cardiovascular Fitness
Aerobic Capacity
Aerobic capacity is the maximum ability of your heart, lungs, and arteries to
deliver oxygen and other nutrients to the muscles for doing work. It is often
called “peak aerobic capacity,” “maximum oxygen uptake,” and “VO2max.”
It is measured in milliliter of oxygen delivered and utilized per kilogram of
body weight per minute (ml•kg-1•min-1). The higher your aerobic capacity
the more work or greater athletic performance you can do. A high aerobic
capacity is also a strong predictor of good health and a long life.

METs
Peak aerobic capacity is often expressed as METs (multiples of resting me-
tabolism or metabolic equivalents). It is a measure of the rate of oxygen con-
sumed based on exercise intensity. When sitting quietly, the body expends
1.0 MET of energy. A 4.0 Met activity, such as brisk walking, burns 4 times
as many calories per minute as when sitting resting. Men in good health
generally have a peak aerobic capacity of 10 METs or more, and women at
least 9 METs. Highly fit persons may have peak aerobic capacities as high
as 12-15 METs. Athletes can have peak aerobic capacities as high as 20 or
more METs.

Aerobic Capacity Norms for Men

Fitness Rating

Ages Excellent Good Needs High Risk

Improving
20 - 29 14.9 13.5 11.7 <11.7
30 - 39 14.5 12.6 11.3 <11.3

40 - 49 14 12.6 10.3 <10.3

50 - 59 12.6 11.3 9.9 <9.9

Aerobic Capacity Norms1 60 - 69 11.7 10.3 9.0 <9.0

(METs, one MET = 3.5ml
• kg-1 • min-1) Aerobic Capacity Norms for Women
Fitness Rating

Ages Excellent Good Needs High Risk

Improving
20 - 29 12.6 11.3 9.4 <9.4
30 - 39 11.7 10.3 9.0 <9.0

40 - 49 11.3 9.9 8.5 <8.5

50 - 59 9.9 9.0 7.6 <7.6

60 - 69 9.4 8.1 6.7 <6.7

 One-Mile Walk
The one-mile walk fitness test is a safe and effective means
One-Mile Walk for estimating peak aerobic capacity.
Test Procedure
This test requires:
Equipment: • A one-mile track or carefully measured course
one-mile track or course • An accurate heart rate in the last minute of the test
heart rate meter or immediately upon completion of the walk
stop watch • An accurate finish time measured to the nearest second

1. Only people in good health should complete this test and those who
pass the Par-Q screening test with no problems. People with health
problems should have permission and guidance from their doctor before
completing this test.

2. Instruct test subjects to walk a one-mile course as quickly as possible

without undo strain. No running is allowed. Walk at a brisk, steady pace
that you can keep up to completion.

3. Time the test with a stopwatch to the nearest second.

4. Use a heart rate meter to check their heart rate in the last minute
of the test or take an accurate heart rate immediately upon completion
of the walk (take a 10 second count and multiply by 6 for beats per
minute). A stethoscope on the chest over the apex of
the heart is a good way to get an accurate pulse count.
If pulse is taken at the end of the test, it must be started
within 5 seconds of completion of the walk as the heart
rate immediately begins to slow down.

5. Record the finish time and finish heart rate. Peak

One-Mile Walk METs aerobic capacity is computed using a regression
equation including weight, age, gender, walk time,
Exercise Time METs = and heart rate. Use the one-mile walk test calculator
HR min : sec VO2 / 3.5 to compute peak aerobic capacity (included on the
Fitness for Life CD and web site).
0 0 0 0 0 0 0 0 0 0
1 1 1 1 1 1 1 1 1 1 Entering One Mile Walk
2 2 2 2 2 2 2 2 2 2 • Enter Exercise Heart Rate in the space provided
under Exercise HR. Fill in the corresponding
3 3 3 3 3 3 3 3 3 3 bubbles completely.
4 4 4 4 4 4 4 4 4 4 • Enter the time it took to complete the walk in minutes
5 5 5 5 5 5 5 5 5 5 and seconds. Fill in the corresponding bubbles.
• You do not need to fill in the METs value, the program
6 6 6 6 6 6 6 6 6 6
will calculate METs if exercise heart rate and time are
7 7 7 7 7 7 7 7 7 7 entered for the one mile walk.
8 8 8 8 8 8 8 8 8 8
Note: Enter METs if other exercise protocols are used.
9 9 9 9 9 9 9 9 9 9 Calculate METs - VO2 max divided by 3.5.
One-Mile Walk
Worksheet

Heart Rate Chart Name

Date Weight
10 sec Heart
count rate/min Age Gender (M/F)
29 174
28 168 Instructions
1. The one-mile walk is a safe test 4. Upon completing the one-mile
27 162 for healthy people to estimate walk immediately check the heart
26 156 peak aerobic capacity without rate using a heart rate meter,
a maximal effort. a stethoscope, or by taking a
25 150 pulse. If taking a pulse, start
24 144 This test requires: within 5 seconds of completing
23 138 • A stop watch the walk. Take a 10 second pulse
• A track or accurately measured and multiply by 6.
22 132 one mile course
21 126 • A heart rate meter or other means 5. Record final heart rate. Record
20 120 for taking an accurate heart rate at the time to complete the walk
end of test to the nearest second. Compute
19 114 peak aerobic capacity.
18 108 2. Complete Par-Q screening form.
17 102 3. Instruct the test subject to walk
16 96 the one-mile course as quickly
One MET
as possible without undue strain. = 3.5ml of O2/kg
Based on 85% of max heart rate No running is allowed. Walk at a body weight/min
brisk, steady pace.

One-Mile Walk Statistics

Heart Rate Time VO2 Peak
Testing Dates /10 sec /min min : sec METs
1
2
3
4
5
6
7
Informed Consent for an Exercise Test1
(Sample from ACSM. To edit this document, open
the Informed_Consent.doc file in the Resources section of your CD.)

1. Purpose and Explanation of the Test - You will perform an exercise test on a cycle ergometer
or a motor-driven treadmill. The exercise intensity will begin at a low level and will be advanced
in stages depending on your fitness level. We may stop the test at any time because of signs of fatigue
or changes in your heart rate, electrocardiogram (ECG), or blood pressure, or symptoms you may
experience. It is important for you to realize that you may stop when you wish because of feelings
of fatigue or any other discomfort.

2. Attendant Risks and Discomforts - There exists the possibility of certain changes occurring
during the test. These include abnormal blood pressure, fainting, irregular, fast or slow heart rhythm,
and in rare instances, heart attack, stroke, or death. Every effort will be made to minimize these risks
by evaluation of preliminary information relating to your health and fitness and by careful observations
during testing. Emergency equipment and trained personnel are available to deal with unusual situations
that may arise.

3. Responsibilities of the Participant - Information you possess about your health status
or previous experiences of heart-related symptoms (such as shortness of breath with low-level
activity, pain, pressure, tightness, heaviness in the chest, neck, jaw, back and/or arms) with physical
effort may affect the safety of your exercise test. Your prompt reporting of these and any other unusual
feelings with effort during the exercise test itself is of great importance. You are responsible for fully
disclosing your medical history, as well as symptoms that may occur during the test. You are also
expected to report all medications (including non-prescription) taken recently and, in particular, those
taken today, to the testing staff.

4. Benefits to be Expected - The results obtained from the exercise test may assist in the diagnosis
of your illness, in evaluating the effect of your medications or in evaluating what type of physical
activities you might do with low risk.

5. Inquiries - Any questions about the procedures used in the exercise test or the results of your test
are encouraged. If you have any concerns or questions, please ask us for further explanations.

6. Use of Medical Records - The information that is obtained during exercise testing will be treated
as privileged and confidential. It is not to be released or revealed to any person except your referring
physician without your written consent. The information obtained, however, may be used for statistical
analysis or scientific purposes with your right to privacy retained.

7. Freedom of Consent - I hereby consent to voluntarily engage in an exercise test to determine my

exercise capacity and state of cardiovascular health. My permission to perform this exercise test is given
voluntarily. I understand that I am free to stop the test at any point, if I so desire. I have read this form,
and I understand the test procedures that I will perform and the attendant risks and discomforts.
Knowing these risks and discomforts, and having had an opportunity to ask questions that have been
answered to my satisfaction, I consent to participate in this test.

Date Signature of Patient

Date Signature of Witness

 Before you start an exercise program, complete this
Physical Activity Readiness Questionnaire (PAR-Q).

Physical Activity Readiness

Questionnaire - PAR-Q
(revised 2002) PAR-Q & YOU (A Questionnaire for People Aged 15 to 69)
Regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Being more active is very safe for most
people. However, some people should check with their doctor before they start becoming much more physically active.
If you are planning to become much more physically active than you are now, start by answering the seven questions in the box below. If you are between the
ages of 15 and 69, the PAR-Q will tell you if you should check with your doctor before you start. If you are over 69 years of age, and you are not used to being
very active, check with your doctor.
Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly: check YES or NO.

YES NO
1. Has your doctor ever said that you have a heart condition and that you should only do physical activity
recommended by a doctor?
2. Do you feel pain in your chest when you do physical activity?
3. In the past month, have you had chest pain when you were not doing physical activity?
4. Do you lose your balance because of dizziness or do you ever lose consciousness?
5. Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a
change in your physical activity?
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart con-
dition?
7. Do you know of any other reason why you should not do physical activity?

If YES to one or more questions

Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you have a fitness appraisal. Tell
you your doctor about the PAR-Q and which questions you answered YES.
• You may be able to do any activity you want — as long as you start slowly and build up gradually. Or, you may need to restrict your activities to

answered those which are safe for you. Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advice.
• Find out which community programs are safe and helpful for you.

NO to all questions ➔ DELAY BECOMING MUCH MORE ACTIVE:

If you answered NO honestly to all PAR-Q questions, you can be reasonably sure that you can:
• start becoming much more physically active – begin slowly and build up gradually. This is the
safest and easiest way to go.
• take part in a fitness appraisal – this is an excellent way to determine your basic fitness so
that you can plan the best way for you to live actively. It is also highly recommended that you
have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor
before you start becoming much more physically active.
• if you are not feeling well because of a temporary illness such as
a cold or a fever – wait until you feel better; or
• if you are or may be pregnant – talk to your doctor before you
start becoming more active.
PLEASE NOTE: If your health changes so that you then answer YES to
any of the above questions, tell your fitness or health professional.
Ask whether you should change your physical activity plan.

Informed Use of the PAR-Q: The Canadian Society for Exercise Physiology, Health Canada, and their agents assume no liability for persons who undertake physical activity, and if in doubt after completing
this questionnaire, consult your doctor prior to physical activity.

No changes permitted. You are encouraged to photocopy the PAR-Q but only if you use the entire form.
NOTE: If the PAR-Q is being given to a person before he or she participates in a physical activity program or a fitness appraisal, this section may be used for legal or administrative purposes.

"I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction."
NAME ________________________________________________________________________

SIGNATURE _______________________________________________________________________________ DATE______________________________________________________

SIGNATURE OF PARENT _______________________________________________________________________ WITNESS ___________________________________________________

or GUARDIAN (for participants under the age of majority)

Note: This physical activity clearance is valid for a maximum of 12 months from the date it is completed and
becomes invalid if your condition changes so that you would answer YES to any of the seven questions.

Health Santé
© Canadian Society for Exercise Physiology Supported by: Canada Canada continued on other side...