Dan – Age 55

       The subject of this paper is Dan age 55.

PAR-Q Rating

Dan was able to answer “No” to all the questions on the Par-Q, therefore he is able to start becoming more physical active and take part in a fitness appraisal.

Health Status

            Overall Dan’s health status is good.

General Medical History

            Dan has had asthma since he was a child.  Currently it is well under control and he only has to use an inhaler occasionally. The only concern that his doctor had during his physical this year is that his HDL is border-line.     

Assessment Results on testing CRF, Endurance, Flexibility, Strength

            To access Dan’s physical fitness, I used the Adult Fitness test from the President’s Challenge (The President’s Challenge, n.d.). The results are as follows: 1 mile walk test = 12 minutes, heart rate 160, VO2 Max 39.7 score 65^th percentile, Half sit-ups = 25, 25^th percentile, push-ups = 15, 50^th percentile, sit-and-reach = 14, 60^th percentile.  His overall score is in the 50^th percentile. This showed that even though he is currently not engaging in any regular exercise, his scores are average.

Risk Factors and Precautions

            Because Dan has a history of asthma, it is important for him to be aware of his breathing and use his inhaler if needed. He has lost 40 pounds in the past year and only gained about five back since he stopped a regular exercise program.  Losing weight and exercise improved his asthma greatly and he rarely has to use his inhaler.

Medications

            Besides his asthma inhaler, Dan’s doctor recommended Fish Oil (because he eats very little fish), Vitamin D (because his level was low on his blood test) and one baby aspirin a day (because of the higher risk of heart attack at his age).

Health and Lifestyle Behaviors

I administered the Health style Self-Test and Exploring Your Health (Thygerson & Thygerson, 2009). The Health style indicated that Dan does not use tobacco, alcohol or other drugs that his eating habits are generally good, that he is not getting enough exercise that his stress management is good and he scored excellent in his safety habits. Dan’s results on the Exploring Your Health Questionnaire showed that he assessed his emotional health as good, his fitness and body care as good, his environmental health as excellent, his stress as good, his nutrition as good and his medical self-responsibility as good.

 

Body Composition

            Dan is 5’10” tall and weighs 180 pounds.  His Body Mass Index is 25.8, therefore, he is overweight.

Nutrition

            Dan presents several challenges nutritionally.  Besides being a fussy eater, he also is allergic to molds and funguses which makes it hard to plan a wide variety of meals.  He does not like many vegetables cooked.  The only ones he likes are corn, carrots and green beans. He will eat salads thus allowing me to add several raw vegetables such as onions, spinach, peppers, cabbage and shredded broccoli. He eats very little whole grains and the only fish that he eats is an occasional tuna sandwich.

His wife has learned over the 31 years of marriage that the best way to get him to change his dietary habits is a little at a time.  When they were first married, he would only drink whole milk. Slowly, she has been able to switch him to non-fat milk by first switching to 2% then 1% and finally non-fat milk.  Because of his allergies, milk and ice cream are the only dairy products that he can consume.

She next goal tried to get him to eat more whole grains.  The first thing she did was switch him from regular white bread to whole grain white.  Recently, she began using a bread maker to make homemade bread and he is now eating homemade white bread when he wouldn’t eat homemade bread at all before. Recently, she made whole wheat pancakes and muffins and he ate them.  So, hopefully, it will not be too long before she can get him to eat homemade whole wheat bread.

Since she makes the meals, it important that she constantly strive to improve his diet.

Readiness for Change

            Dan has a very physically demanding job and is very tired when he gets home from work and feels that he does not need to engage in any other physical activity. He works at Home Depot in the garden department and walks a lot at work and regularly lifts heavy objects

To determine his readiness for change, I administered the Stages of Change questionnaire (Thygerson & Thygerson, 2009). The questionnaire showed that the stage that Dan is in is Contemplation.  He has been thinking that he may want to start exercising regularly, wondering if he will be able to and that he should work on getting started with a regular exercise program within the next six months.  He knows that regular exercise is worthwhile, but doesn’t think he will have time for it in the near future and doesn’t know how he will fit it into his schedule.

Motivational Strategies and Techniques

            My main strategy to improve Dan’s nutrition is to have his wife continue to introduce healthier foods into his diet and encourage him to try them. This has worked well in the past because nine out of ten times, he has found that he does and she has been able to include the new foods in his diet.

I would suggest that Dan make use of the equipment that is available in his home and start walking on the treadmill and progress to running.  He was doing this regularly when he belonged to a gym and enjoyed the benefits that he felt. I would also suggest that he start lifting weights and use the Wii Fit strength and Yoga improve his strength and flexibility. I would also suggest that he resume tracking his exercise using The President’s Challenge or Wii Fit.

It is important for him to realize that he doesn’t need to exercise all in one big chunk of time, but that he can break his exercise up into 10 or 15 minute sections several times a day.

I would encourage him and support him in this effort.  I would also suggest to him that he and his wife do Wii Sports games together.

Recommendations

Frequency	Intensity	Type	Time
5 days a week	3 mph at 1% incline	Walk on the treadmill	15 minutes twice a day
3 days a week	20 pounds	Lift weights	15 minutes
3 times a week	Beginning	Wii Fit Strength training	15 minutes
3 times a week	Beginning	Wii Fit Yoga for balance and flexibility	15 minutes

            In conclusion, Dan realizes that he felt better and his health was better when he participated in a regular exercise program and knows that he should be. My job is to help him get started and encourage him to continue.

References

Thygerson, A. L., & Thygerson, S. M. (2009). Fit to be well, essential concepts. (2nd Ed. ed.). Jones & Bartlett Publishers.

Marcus, B., & Forsyth, L. (2010). Motivating people to be physically active. Champaign, IL: Human Kinetics Publishers.

The President’s Challenge. (n.d.). Adult fitness test. Retrieved from http://www.adultfitnesstest.org/