Healthy Lifestyle Quiz
Lucent Fitness
How would you describe your current state?
*
I need to lose a good amount of weight (50+ pounds)
I need to lose 20-40 pounds
I have less than 20 pounds to lose
I don't have to lose weight but need to gain muscle mass
I need to sculpt my body
How you sleep at night and how you feel when you wake up?
Pretty good. I wake up feeling refreshed.
Restless. I usually wake up one or more times duringthe night and regularly have trouble falling asleep or staying asleep.
I toss and turn and/or can’t shut my mind off (difficulty fallingasleep)
Do you experience stomach discomfort?
Never
Rarely, once a month or less
Twice a week or more
Constantly
Do you get cravings for certain types of foods?
Yes, daily or weekly
No, once a month or less
What food do you crave the most?
Carbsi.e. bread, pasta, fried foods
Sweetsi.e. candy, cookies, ice cream, chocolate
RedMeat i.e. burgers, a steak.
No cravings
Your gender?
*
man
woman
don't want to share
How many meals and snacks do you eat a day?
Less than 2
3 meals and snacks total
3 to 5 meals and snacks total
more than 6 meals and snacks total
Do you consume any alcohol?
more than 3 glasses a day
2 glasses a day
less than 7 glasses a week
Occasionally
Which of the following three body types best describes you?
Long and lean - I had difficulty gaining weight in my younger years
Pear Shaped - Slim through the shoulders and torso with muscular or naturally thicker bum &thighs.
Square Shape -Sturdy, stocky frame that is naturally strong.
Inverted Triangle Shaped - Relatively slim through my waistand hips but bulkier up top through the arms and shoulders.
Which activities are more comfortable for you?
Strength & power activities (yoga, pilates,weights, short sprints)
Equally comfortable with both strength and endurance exercises Endurance and Cardio activities (jogging, biking, walking)
No strength trainings, but walking and biking
How many minutes a week do you spend for your cardiovascular exercise? (walking, running, biking, swimming, heavy yard work, etc.)
more than 300 minutes a week
150 minutes to 300 minutes a week
less than 150 minutes a week
None
Do you perform any strength training?
Weight lifting
Body weight workouts
Pilates, Barre
None
Are you or any of your siblings affected by the following?
Type 1 Diabetes
Type 2 Diabetes
None affected
Have you been diagnosed or currently being treated for Type 2 Diabetes?
Yes
No
Do you or your parents have a history of heart disease?
Heart disease—youare affected
Heart disease—mother is/was affected
Heart disease—father is/was affected
None is/was affected
Have you experienced energy crash before meal? How is your energy level day to day?
I typically maintaina steady energy level throughout the day
I typically maintaina steady energy level but feel myself dragging before meals.
I experience a post-lunch slump in energy.
Along with energy crashes, have you experienced your mood swings on typical day?
I'm generally in agood mood throughout the day.
I'm often irritableor short with others.
I experience mood swings.
Tell me what your #1 health goal is right now?
Burn fat, lose weightand get into shape?
Build lots of lean muscle?
I am planning for a youthfulfuture and want to eat a healthy, balanced diet
Do you have any dietary restrictions?
No, I eat most things
Vegetarianism
Pescetarian
Others
Please select your age range:
*
under 20
20s
30s
40s
50s
60+
Which one of the following would you consider your biggest diet struggle?
*
Overeating weekends
Mindless snacking/eating throughout the day
I jump from one FAD diet to another
I'm either "all-in" or "all-out"
I don't know what to eat or what to choose
I can't change my eating habits even though I know that is not the best for my health
Your Body weight and height?
*
What is a health issue you are trying to solve right now?
Obesity
High Cholesterol
High Blood Pressure
Pre-diabetes or Diabetes
Join pain
Osteoporosis
None
Others
Name
*
First Name
Last Name
E-mail
*
Phone Number
-
Area Code
Phone Number
Save
Submit
Should be Empty: