Running Head: REAL AGE PAPER

Risk Reduction Paper RealAge

(Kyle) Kurt Freund
Ferris State University

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Abstract

RealAge analysis indicates that (Kyle) Kurt Freund, age 42, is calculated at 38.6 years old. Due
to long term physical fitness and good eating practices his age was calculated four years younger
than his date of birth. Two greatest weaknesses as indicated by the analysis are borderline high
cholesterol levels and stress. The wellness assessment, diagnosis, and action plan outline
effective measures in detail to reduce the risk of coronary artery disease by achieving the
SMART (Specific, Measurable, Attainable and Realistically Time-bound) goal of lower
cholesterol levels by 40 points.

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Risk Reduction Paper RealAge

(Kyle) Kurt Freund has remained disciplined in efforts to maintain a healthy life
physically, emotionally, and spiritually. His RealAge results were 38.6 years. This is 3.4 years
younger than actual age. It is determined that Mr. Freunds dedication towards physical fitness
training along with teaching/studying Shorin Ryu Karate for 16 years has allowed him to remain
in a physically flexible strong state. The area of greatest concern despite long term exercise and
dietary efforts is Mr. Freunds high cholesterol levels and stress reduction.
Mr. Freund has recently embarked on completing alternative medicine education to
become a certified professional healing practitioner who utilizes evidence based relaxation stress
reduction techniques that will be incorporated in adaptive coping skills to achieve his SMART
(Specific, Measurable, Attainable and Realistically Time-bound) goals of lowering total
cholesterol levels by 40 points within 6 months through decreasing stress, exercise, diet, and the
addition of medical intervention and potential cholesterol lowering medications.
Assessment and Medical History
Mr. Freunds current vital signs are blood pressure 110/64, resting heart rate 66,
respirations 12/minute, afebrile, and pulse oximetry 98% at room air. No current complaints of
pain or discomfort. Past medical history of head trauma resulting in a concussion with positive
loss of consciousness and amnesia (1988), left bicep stabbing along with multiple lacerations
requiring internal and superficial suture repair (1989), motor vehicle accident 1990 resulting in 3
right lower rib fractures, left proximal radius/ulna fracture, deviated septum, and facial
lacerations requiring suture repair above left upper orbital area, extensive inpatient alcoholism

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treatment (1990), left shoulder subluxation with rotator cuff tear (2005), and diagnosis of carotid
bruit (2007).
Surgical history of a vasectomy (1997), appendectomy (1998), benign maxillary sinus
cavity mass removal (2002) and left knee arthroscopy of medial meniscus (2010). Prior
hospitalizations from 1990 MVA (1990) and viral meningitis in 2002 that resulted in two months
of rehabilitation.
Mr. Freund has a paternal family history of high cholesterol levels. At age 19 (1990), Mr.
Freunds total cholesterol levels were 250. This was discovered at the time of admission into an
inpatient alcohol treatment program. It was determined that his staple diet of vodka, Slim Jims,
burgers, pizza, and fries would have to be altered. Even with healthy diet, exercise
modifications, and the elimination of alcohol consumption cholesterol levels have remained
higher than normal for the last 22 years.
Recent lab results
10/07/2013
10/07/2013
10/07/2013
10/07/2013

Total Cholesterol
Low Density Lipids (LDL)
High Density Lipids (HDL)
Triglycerides

242
174
48
101

Wellness Diagnosis
Cholesterol lowering is the primary focus of the patients need to change since long term
higher than normal LDL levels place him at higher risk for coronary heart disease and
exacerbation of the patients congenital carotid bruit. In Penders Health Promotion Model, Mr.
Freund shows a commitment to engaging in behaviors that support a specific plan of action while

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recognizing a long term barrier of Mr. Freunds strong resistance to utilizing any prescription
medications, (Pender, 2011).
The patient has relied heavily on exercise as a means to remain healthy. Mr. Freund is
educated in the realization that exercising regularly helps in reducing cholesterol and stress
levels. Exercise lowers LDL cholesterol and raises HDL cholesterol. With at least 30-45
minutes of exercise on most days of the week, (Mayo, 2012), LDL levels often are lowered.
This is already incorporated in Mr. Freunds lifestyle.
Mr. Freund states, understanding of exercise and healthy low/no cholesterol dietary life
adjustments after reviewing an article that aimed to normalize heart-healthy eating and
represent a promising strategy to reduce cholesterol levels and CHD risk, (Upadhyay, Waddell,
Berger, Matte, & Angell, 2010). Exercise is also known to naturally reduce cholesterol levels
and will be continued in the action plan.
Two Wellness Diagnosiss that correlate with the SMART goal are Health seeking
behavior related to elevated serum cholesterol level as a risk factor for coronary artery disease,
p. 844 (Sparks & Taylor, 2010) and Health seeking behavior related to stress as a risk factor for
coronary artery disease p. 853 (Sparks & Taylor, 2010).
Transtheoretical Model of Change
Evaluation of past and current lifestyle specifications as they relate to lowering Mr.
Freunds cholesterol levels leads to considerations of his stage in the Transtheoretical Model of
Change. This is a theoretical model of behavior which has been the basis for developing
effective interventions to promote health behavior change (Velicer, Prochaska, & Fava). Mr.
Freunds stage of change is at the preparation stage in regards to creating a food diary,

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scheduling an appointment with his family practice physician, Dr. Harro, and consideration of
cholesterol lowering medications. Preparation is the stage in which people are intending to take
action in the immediate future, usually measured as the next month, (Velicer, Prochaska, &
Fava).
Decisional balance of evaluating the pros and cons of including modern medical
influence into Mr. Freunds past holistic plan has been paramount in his readiness to change the
long term stance on going outside of controlling cholesterol levels with diet, exercise and stress
reduction alone. With the latest lab results showing an increasing rise in cholesterol levels
despite past measures to decrease them being the primary motivator for change.
Action Plan for Cholesterol Reduction of Forty Points
1. The patient is to pay attention to the percentage and type of fats indicated on food labels.

Less than 10% of diet is to be from animal based saturated fats sources found in (eggs,
red meat, chicken, milk products). Increasing plant sources of fat found in olive oil and
avocados has been known to improve cholesterol levels. Avocados are rich in monounsaturated fatty acids, the same type found in olive oil, (Graedon & Graedon, 2011).
Trans fats found in fried foods are to be eliminated or used sparingly along with highcholesterol containing foods like organ meats, egg yolks cheese.
2. Techniques of cooking or preparing foods are also to be instrumental in cholesterol
reduction. Raw vegetables are the best. If they are to be cooked steaming or using
unsaturated oils or sprays along with grilling, broiling, and baking will be healthy
alternatives to deep fried methods.

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3. Reduce the amount of cholesterol the patients body absorbs by eating brown rice,
oatmeal as routine sources of soluble fiber. Oatmeal contains soluble fiber, which
reduces your low-density lipoprotein (LDL), the "bad," cholesterol. Soluble fiber is also
found in such foods as kidney beans, apples, pears, barley and prunes. Soluble fiber can
reduce the absorption of cholesterol into your bloodstream, (Mayo, 2012).
4. Cholesterol reducing medications will be discussed with Dr. Harro on November 13,
2013 at 1045am along with the results of fasting cholesterol lab values that are to be
drawn on November 7th, 2013.
5. Exercise requirements will be maintained through his current regiment of teaching Karate
twice a week at Spirit Moves Shorin Ryu Karate Dojo along with three times a week
weight training (two hours each day), six days a week kata training (30-45 minutes each
day) and twice weekly running four to eight miles.
6. Daily stress reduction through prayer, meditation, guided imagery, and positive
communication with his existing support network that includes his girlfriend Lorrie,
fifteen year old son Niko, Alcoholic Anonymous (AA) sponsor Dick H., three AA and/or
alanon meetings weekly, interaction with Native American elders John Bush, Mike
Loonsfoot, and Two Dogs, along with the Healing in America monthly holistic healing
circles.

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Summary
Mr. Freund Freunds high cholesterol levels have been chronically treated for 22 years
with a holistic approach of diet, exercise, and stress reduction measures, yet have continued
to be at borderline to high levels placing him at risk for coronary artery disease. The
patients current support network has been instrumental in the patients willingness to change
a long standing resistance to prescription medications of any kind and a strong reliance upon
holistic and traditional Native American avenues of achieving optimum health. The
ineffective thought process of considering the use of modern pharmacological assistance
through prescription medications as some type of failure in maintaining a homeostatic state
has been replaced with consideration of modern medicine in conjunction with a natural
approach to lowering cholesterol levels. This places the patient in the preparation stage of
change according to the Transtheoretical Model.
Within 1 month, new labs will be drawn and reviewed with the patients primary care
physician along with consideration and the potential addition of a cholesterol lowering
medication. The patient states understanding of cholesterol lowering food considerations,
food preparation, and will continue in the maintenance of exercise and stress reduction.
The SMART Goal of lowering total cholesterol levels by 40 points within six months will
be evaluated with Dr. Harro after the implementation of his recommendations. Further
adjustments will be considered within that time.

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References
Graedon, J., & Graedon, T. (2011, July 25). The Peoples Pharmacy. Retrieved from
Avocadoes Help Control Cholesterol:
http://www.peoplespharmacy.com/2011/07/25/avocados-help-controlcholesterol/
Mayo, C. (2012, July 27). Mayo Clinic: Diseases and Conditions. Retrieved from
Cholesterol: Top 5 foods to lower your numbers:
http://www.mayoclinic.com/health/cholesterol/CL00002
Pender, N. M. (2011). Health Promotion in Nursing Practice (6th ed). Upper Saddle
River, NJ: Pearson Education.
Pins, J., & Keenan, J. (Spring 2006). Dietary and Nutraceutical Options for Managing
the Hypertriglyceridemic Patient. Progress in Cardiovascular Nursing 21 (2),
89-93.
Roizen, M., & Oz, M. (2010). RealAge: Live life to the youngest. Retrieved October
16, 2013, from http://www.realage.com
Sparks, S., & Taylor, C. (2010). Nursing diagnosis reference manual. New York, NY:
Lippincott & Williams.
Upadhyay, U., Waddell, E., Berger, M., Matte, T., & Angell, S. (2010, April 15). US
National Library of Medicine; Preventing Chronic Disease. Retrieved from
Prevalence, Awareness, Treatment, and Control of High LDL Cholesterol in
New York City: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879993/

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Velicer, W., Prochaska, J., & Fava, J. (n.d.). Detailed Overview of the Transtheoretical
Model. Retrieved October 18, 2013, from Cancer Prevention Research Center:
http://www.uri.edu/research/cprc/TTM/detailedoverview.htm