Health Score SM Member Guide

Health Score SM Member Guide

Health Score Your Health Score is a unique, scientifically based assessment of seven critical health indicators gathered during your health screening. This number is where health counts literally. It provides a snapshot of your overall wellness, on a scale from 45 to 100 where a score of 100 represents picture-perfect health. Your results will be calculated in accordance with the scoring system below. Your Health Score will be available approximately two business days after your health screening. If data for any of the categories is missing, your score will not be calculated. Target Moderate Risk High Risk Result Score Result Score Result Score Body Mass Index 1 (BMI) < 25 30.0 25-29.9 20.0 > 29.9 15.0 Diastolic Blood Pressure < 80 15.0 80-99 12.5 > 99 7.5 Systolic Blood Pressure < 120 15.0 120 159 12.5 > 159 7.5 HDL Cholesterol Men > 39 10.0 35 39 7.5 < 35 5.0 Women > 49 45 49 < 45 LDL Cholesterol 2 < 130 10.0 130 159 5.0 > 159 2.5 Triglycerides < 150 10.0 150 199 5.0 > 199 2.5 Glucose 3 Non-Diabetic < 101 10.0 101 125 7.5 > 125 5.0 Diabetic < 126 126 149 > 149 100.0 70.0 45.0 1 The measurement that offers the better point advantage will contribute to your health score. 2 If your triglycerides are above 400 mg/dl your LDL cannot be measured. However, you will be awarded 2.5 points. 3 Ranges are based on fasting glucose results, if you did not fast your glucose result may be in a higher range. For a more in-depth look at your Health Score, log in to your personal SimplyWell account at www.simplywell.com. Questions? Contact us at 1.877.991.9355 or info@simplywell.com.

BMI Health Score Category What is BMI and how is it calculated? The body mass index formula assesses body weight relative to height. It's a useful, indirect measure of body composition, because in most people it correlates highly with body fat. Weight in kilograms is divided by height in meters squared (kg/m 2 ). Or multiply weight in pounds by 703, divide by height in inches, then divide again by height in inches. In studies by the National Center for Health Statistics: BMI values less than 18.5 are considered underweight. BMI values from 18.5 to 24.9 are normal. Overweight is defined as a body mass index of 25.0 to less than 30.0. A BMI of about 25 kg/m 2 corresponds to about 10 percent over ideal body weight. Obesity is defined as a BMI of 30.0 or greater, or about 30 pounds or more overweight. Extreme obesity is defined as a BMI of 40 or greater. What are the health risks associated with high BMI? Unfortunately, nearly 70% of American adults are either overweight or obese. Therefore, it s important to understand the risks associated with having a high BMI. Obesity is now recognized as a major risk factor for coronary heart disease, which can lead to heart attack. Obesity also raises one s risk for the following: Diabetes Hypertension Hyperlipidemia Cancer Arthritis Gallstones Respiratory problems Tips to improve BMI: Weight management is all about balance balancing the number of calories you consume with the number of calories your body uses or "burns off." Energy balance is important for maintaining a healthy weight. The amount of energy or calories you get from food and drinks (energy IN) is balanced with the energy your body uses for things like breathing, digesting, and being physically active (energy OUT): The same amount of energy IN and energy OUT over time = weight stays the same (energy balance) More energy IN than OUT over time = weight gain More energy OUT than IN over time = weight loss If you need to tip the balance scale in the direction of losing weight, keep in mind that it takes approximately 3,500 calories below your calorie needs to lose a pound of body fat (American Journal of Clinical Nutrition). To lose about 1 to 2 pounds per week, you'll need to reduce your caloric intake by 500 1000 calories per day. When losing weight, more physical activity increases the number of calories your body uses for energy or "burns off." The burning of calories through physical activity, combined with reducing the number of calories you eat, creates a "calorie deficit" that results in weight loss.

Examples of healthy lifestyle behavior choices: Trying to choose foods that are healthier while eating out can be really tough, and although you may be choosing the food you think is better for you, that may not always be the case. Here is an example: EAT THIS! Burger King Whopper Jr: 290 calories, 12g fat NOT THIS! BK Fish Filet: 650 calories, 32g fat 1. Simple Swap Swap CROUTONS for WALNUTS on a salad! Croutons are a high source of carbohydrates which can cause LDL cholesterol to spike. Replacing the croutons with walnuts will not only keep that crunchy texture, but it will also provide your body with polyunsaturated fats which lower LDL and increase HDL cholesterol. 2. Exercise Below are some examples of simple caloric expenditure: Calories Expended per 30 minutes in Common Physical Activities (154lb person*) Walking (3.5mph) Weight lifting (general light workout) Light gardening/yard work Bicycling (<10 mph) Stretching 140 calories 110 calories 165 calories 145 calories 90 calories *Calories burned per ½ hour will be higher for persons who weigh more than 154lbs and lower for persons who weigh less. National Heart, Lung, and Blood Institue (NHLBI) www.nhlbi.nih.gov National Center for Health Statistics http://www.cdc.gov/nchs/ Mei Z, Grummer-Strawn LM, Pietrobelli A, Goulding A, Goran MI, Dietz WH. Validity of body mass index compared with other body-composition screening indexes for the assessment of body fatness in children and adolescents. American Journal of Clinical Nutrition 2002;7597 985. U.S. Dietary Guidelines for Americans World Health Organization Zinczenko, David. Eat This, Not That! 2013: The No-Diet Weight Loss Solution. Rodale Books, 2012.

Blood Pressure Health Score Category What is blood pressure? Systolic: the top number, which is also the higher of the two numbers, measures the pressure in the arteries when the heart beats (when the heart muscle contracts). Diastolic: the bottom number, which is also the lower of the two numbers, measures the pressure in the arteries between heartbeats (when the heart muscle is resting between beats and refilling with blood). What is the American Heart Association recommendation for healthy blood pressure? Blood Pressure Category Systolic mm Hg (upper #) Diastolic mm Hg (lower #) Normal less than 120 and less than 80 Prehypertension 120 139 or 80 89 High Blood Pressure (Hypertension) Stage 1 140 159 or 90 99 High Blood Pressure (Hypertension) Stage 2 160 or higher or 100 or higher Hypertensive Crisis (Emergency care needed) Higher than 180 or Higher than 110 What are the health risks associated with a high blood pressure? High blood pressure can cause damage to many organs, including the brain, eyes, heart and kidneys, as well as to arteries throughout the body. If you have high blood pressure that has not been diagnosed, or that is not being treated adequately, you are at greater risk of having a heart attack, stroke, kidney failure and blindness.

Tips to improve blood pressure: If you have high blood pressure, there are steps you can take to get it under control, including: Ask your doctor what your blood pressure should be. Set a goal to lower your blood pressure with your doctor and then discuss how you can reach your goal. Take your blood pressure medication as directed. If you are having trouble, ask your doctor what you can do to make it easier. For example, you may want to discuss your medication schedule with your doctor if you are taking multiple drugs at different times of the day. Quit smoking and if you don't smoke, don't start. You can find tips and resources at http://www.cdc.gov/tobacco/ or at http://www.tobaccofree.org/. Reduce sodium. Most Americans consume too much sodium, and it raises blood pressure in most people. Learn about tips to reduce your sodium. There are other healthy habits that can help keep your blood pressure under control: Achieve and maintain a healthy body weight. Participate in 30 minutes of moderate physical activity on most days of the week.* Eat a healthy diet that is high in fruits and vegetables and low in sodium, saturated fats, trans fat, and cholesterol. Consider the DASH diet (Dietary Approach to Stop Hypertension). Information can be found at http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/index.htm. Manage stress. Limit the amount of alcohol you drink (no more than one drink each day for women and two for men). If you have high blood pressure and are prescribed medication, take it as directed. If you have a family member who has high blood pressure, you can help by taking many of the steps listed above with them. Go for walks together or cook meals with lower sodium. Make it a family affair! Check your blood pressure regularly. *Please check with your doctor before beginning an activity program. National Heart, Lung, and Blood Institue (NHLBI) www.nhlbi.nih.gov http:// www.cdc.gov/tobacco/ http://www.tobaccofree.org/

HDL Cholesterol Health Score Category What is high-density lipoprotein? HDL cholesterol is considered good cholesterol because it helps remove LDL bad cholesterol from the arteries. Experts believe HDL acts as a scavenger, carrying LDL cholesterol away from the arteries and back to the liver, where it is broken down and passed from the body. What are the health risks associated with low HDL? Low HDL cholesterol puts you at higher risk for heart disease. People with high blood triglycerides usually have lower HDL cholesterol. The following factors and/or lifestyle behaviors can affect HDL: Genetics Type 2 diabetes Certain drugs such as beta-blockers and anabolic steroids Smoking Being overweight or obese Being sedentary Tips to improve HDL: Start moving! Aerobic exercise can increase your HDL levels by 5% to 10%. Maintain a healthy weight. Don t smoke or quit smoking. Those who quit smoking have shown to boost their HDL levels up to 20%. Eat a healthy and balanced diet. Food groups that can increase LDL cholesterol are highly refined carbohydrates and Trans fats. Decrease your servings of these groups to improve your HDL levels and select healthier fats such as monounsaturated and polyunsaturated fats. Consume alcohol in moderation. Higher amounts of alcohol are linked to low levels of HDL cholesterol. National Heart, Lung, and Blood Institue (NHLBI) www.nhlbi.nih.gov National Center for Health Statistics http://www.cdc.gov/nchs/ U.S. Dietary Guidelines for Americans World Health Organization

LDL Cholesterol Health Score Category What is LDL? LDL cholesterol is considered the bad cholesterol because it contributes to plaque, a thick, hard deposit that can clog arteries and make them less flexible. This particular condition is known as atherosclerosis. If a clot forms and blocks a narrowed artery, heart attack or stroke can occur. What are the health risks associated with high LDL? High LDL cholesterol puts you at higher risk for heart disease and stroke. People with high blood triglycerides usually have higher LDL levels. The following factors and/or lifestyle behaviors can affect LDL: Smoking High blood pressure Family history of heart disease Diabetes Being overweight or obese Poor diet Being sedentary HDL cholesterol levels Tips to improve/manage LDL: Maintain a healthy weight. Exercise regularly. The Surgeon General recommends adults engage in moderate- intensity exercise for 2 hours and 30 minutes every week. Don t smoke or quit smoking. Smoking injures blood vessels and speeds up the hardening of the arteries. Smoking greatly increases a person s risk for heart disease or stroke. Eat a healthy and balanced diet. Food groups that can increase LDL cholesterol are highly refined carbohydrates and Trans fats. Avoid saturated and Trans fats as much as possible. Get a blood test and treat/manage high cholesterol if need be. National Heart, Lung, and Blood Institue (NHLBI) www.nhlbi.nih.gov National Center for Health Statistics http://www.cdc.gov/nchs/ U.S. Dietary Guidelines for Americans World Health Organization

Triglycerides Health Score Category What are triglycerides? Triglycerides are the most common type of fat in your body. When you eat, your body converts unneeded calories into triglycerides where they are stored in your fat cells. High levels of blood triglycerides are often found in people who have high cholesterol levels, heart problems, are overweight or have diabetes. What are the health risks associated with high triglyceride levels? High triglyceride levels may contribute to the hardening of arteries or thickening of artery walls which can cause heart attack or stroke in addition to other serious medical conditions. People with high blood triglycerides usually have high cholesterol levels. The following factors and/or lifestyle behaviors can affect triglycerides: High cholesterol Diabetes Being overweight or obese Poor diet especially a diet high in refined carbohydrates Sedentary lifestyle Alcohol intake Tips to improve/manage triglyceride levels: Maintain a healthy weight. Aim for a BMI between 18.5 and 25. Exercise regularly. The Center for Disease Control recommends adults engage in 30 minutes of moderate-to-vigorous intensity exercise most days of the week. Reduce alcohol intake. Alcohol, even in small amounts, may raise triglyceride levels. Eat a healthy and balanced diet. Reduce your intake of sweets and foods such as white rice and breads, pasta, and snacks made from white flour. Instead choose whole grains, fruits, and vegetables. Avoid trans fats, and limit saturated fat intake. Sometimes a healthy diet alone might not be enough to lower triglyceride levels. The American Heart Association recommends talking to your doctor about taking omega-3 supplements for high triglycerides. National Center for Health Statistics http://www.cdc.gov/nchs/ U.S. Dietary Guidelines for Americans Harvard Health

Fasting Glucose Health Score Category What is glucose? Glucose is a major source of energy that is transported through the bloodstream for most cells of the body, including brain cells. The ranges for fasting glucose are as follows: Less than 100 mg/dl normal 100 125 mg/dl pre-diabetic (reversible) Greater than or equal to 126 mg/dl diabetic What are the health risks associated with high fasting glucose levels? High blood glucose levels may be a sign that your body isn t producing enough insulin or utilizing insulin effectively enough to rebalance your blood sugar levels. These correlate directly to the development of pre-diabetes and diabetes. The following factors and/or lifestyle behaviors can affect glucose levels: Family history History of gestational diabetes Age Overweight/obesity Physical Inactivity High blood pressure Abnormal cholesterol levels Tips to improve/manage glucose levels to prevent pre-diabetes and diabetes: Lower your weight if you are overweight/obese. Losing as little as 5-7% of your bodyweight can decrease your chances of diabetes by 58%. Move more. Physical activity is an essential part of the treatment plan for pre- diabetes and diabetes. The Center for Disease Control recommends adults engage in 30 minutes of at least 5 days per week. See your doctor every 3-6 months for regular check-ups. Eat a healthy and balanced diet. Add more high-fiber foods into your day. Reduce your intake of sweets and foods such as white rice and breads, pasta, and snacks made from white flour. Instead choose whole grains, fruits, and vegetables. Swap out high calorie foods for healthier options. Make sleep a priority! A sleep shortfall makes it harder for your body to use insulin effectively and may make type-2 diabetes more likely. American Diabetes Association (ADA) www.diabetes.org National Center for Health Statistics http://www.cdc.gov/nchs/