Is there a history of heart disease in your family? * Is there a history of heart disease in your family?*A) Yes relatives such as cousins and/or unclesB) Yes one or both of my parentsC) No or not to my knowledge
Is your age or sex a risk factor? * Is your age or sex a risk factor?*A) I am male and middle-agedor olderB) I am male and aged in my teensC) 20s or 30sD) I am female
How often do you eat fatty foods like dairy products, cakes, chips and fried foods? * How often do you eat fatty foods like dairy products, cakes, chips and fried foods?*A) EverydayB) Two or three times per weekC) Around once per week or less
Are you overweight? * Are you overweight?*A) Yes I could afford to lose a bit of weightB) Yes I‘m obese and need to lose a lot of weightC) No I’m about the right weight for my height
If you’re overweight, where do you tend to carry those extra pounds? * If you’re overweight, where do you tend to carry those extra pounds?*A) Around my stomachB) Around my hopsC) I’m not overweight
Do you smoke cigarettes? * Do you smoke cigarettes?*A) Yes I smoke everydayB) Sometimes perhaps on the weekends or when socializingC) No I don’t smoke
Do you exercise regularly? * Do you exercise regularly?*A) I hardly exercise at allB) Yes about two or three times per weekB) Yes I exercise at least four times per week
Do you have diabetes? * Do you have diabetes?*A) Yes but I control it wellB) Yes but I don‘t manage it very well or else I think I may have diabetes but haven’t seen my doctor about itC) I don’t have diabetes according to my doctor at my last medical check-up
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