Table 1.
Reduced/rapid version of the lifestyle assessment toolkit.
| Components and questions |
|---|
| General characterization data |
| Age (yrs) |
| Gender (Male/Female) |
| What is the highest degree or level of school you have completed? If currently enrolled, highest degree received. Options: None 1st cycle of Basic Education (1st−4th year)/Old 4th class 2nd cycle of Basic Education (5th−6th year)/Old 6th grade/Preparatory Cycle 3rd cycle of Basic Education (7th−9th year)/General Course Secondary Education (10th−12th year)/Complementary Course Higher Education (Polytechnic or University) Prefer not to answer What is your professional situation? What is your employment status? Options: Unemployed Employed (or taking care of domestic tasks) Student (or doing an unpaid internship/stage) Unable to work/Disabled Retired Prefer not to answer |
| 1. Anthropometric measurements and cardiometabolic parameters |
| 1.1. Weight (in Kg); Height (in m); Body mass index (in Kg/m2) | (to be measured in site) 1.2. Waist circumference (cm) | (to be measured in site) 1.3. Blood pressure: Systolic (mmHg); Diastolic (mmHg) | (to be measured in site) 1.4. Glycemia (mg/dL): Normal/High/Unknown 1.5. Total cholesterol (mg/dL): Normal/High/Unknown |
| 2. Physical activity and exercise |
| 2.1. Thinking about your day-to-day life, do you consider you have a sedentary lifestyle? Yes/No 2.2.How long, on average, do you spend, per day walking? Options: <30 min/30 to 60 min/More than 60 min 2.3. Do you exercise regularly? No /Yes If Yes: Ball games Running outdoor Group lessons (yoga, pilates, etc.) Fitness equipment Swimming or water aerobics Other(s) 2.4. How many days a week do you exercise? Options: 1 or 2 days/3 or more days |
| 3. Well-being, social cohesion, and functional independence |
| 3.1. Indicate your level of agreement with the following sentence: “I am satisfied with my life.” Options: Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree Prefer not to answer 3.2. Between family and friends, how many people could you ask for help, if needed? Options: None/1 or 2 people/3 or 5 people/6 or more 3.3. Can you perform the following day-to-day activities without limitations? (only for people with >65 years old) 3.3.1. Personal hygiene (washing and dressing yourself): Yes/No 3.3.2. Mobility (going up and down stairs without limitations): Yes/No 3.3.3. Dealing with money (shopping, paying bills, etc.): Yes/No/Not applicable 3.3.4. Regular use of digital technologies (computer, e-mail, smartphone, social networks, etc.): Yes/No/Not applicable |
| 4. Nutrition |
| 4.1. Do you follow a healthy and varied diet? Yes/No |
| 4.2. In a typical week, how often do you eat/drink the following food/drinks? Options: Once or more per day/4–6 times per week/1–3 times per week/ <1 time per week/Never Vegetables and fruit Milk and milk products Fish, meat and eggs Bread, pasta or cereal Legumes (beans, peas) and Grains Fried and salty foods Sweets (desserts, soft drinks or >5 cookies) |
| 5. Mental health |
| 5.1. Has any doctor told you that you suffer from mental problems? No/Yes If Yes: Depression Anxiety and/or permanent stress Easy Irritation Obsessive-compulsive disorder Bipolar disorder Anorexia nervosa Other(s) 5.2. You have, or had, any of the following diseases? Stroke Parkinson Epilepsy Lack of memory Nausea, dizziness, migraine Other(s) No |
| 6. Smoking, drinking, and illicit substances use |
| 6.1. Do you smoke regularly? Yes/No 6.2. Did you use to smoke regularly? Yes/No 6.3. When did you quit smoking? Options: <1 year ago/1 up to 5 years ago/5 up to 10 years ago/More than 10 years ago 6.4. Are you a regular consumer of alcohol (more than one glass of wine or beer with the meals)? Yes/No 6.5. Have you ever been a regular consumer of alcoholic drinks? Yes/No 6.6. Do you use drugs regularly? Yes/No 6.7. Have you ever used drugs regularly? Yes/No |
| 7. Sleep habits and quality |
| 7.1. Do you sleep well? Yes/No 7.2. How many hours per night? Options: <5 h/From 5 to <7 h/7 or more hours 7.3. How often do you wake up at night? Options: Never or once/2 or 3 times/4 or more times 7.4. Do you wake up feeling tired? Yes/No 7.5. Do you take sleeping pills? Yes/No |
| 8. Health and disease (in combination with 1) |
| 8.1. Have you ever been told by a doctor that you have/had any of the following illnesses or chronic diseases? (which lasted more than 6 months) Heart disease (insufficiency/ischemia or angina/arrhythmia) Neuropathy (peripheral nerve disease/hands and feet) Respiratory disease (asthma/bronchitis/DPOC) Retinopathy (eye disease) Peripheral arterial disease (disease of the arteries of the legs and feet) Nephropathy (renal failure) Other(s) 8.2. How many different medications (tablets, dragees, syrups, insulin, etc.) do you take per day? Options: None or just 1/2 or 5/More than 5 8.3. Do you take regularly natural products (teas, supplements, etc.) for therapeutic purposes? Yes/No 8.4. In general, how do you evaluate your health condition? Options: Very good/Good/Reasonable/Bad/Very bad 8.5. To conclude, how would you rate your health today? Choose a number between 0 and 100, in which 0 is the worst and 100 the best you can imagine |