Family Member A:

Age: 63
Diseases and causes of death have been experienced: Diabetes Mellitus 2
2. Analysis of Dietary Habits of Family Member
a. How often did they eat per day- 3 times a day with snacks in between
b. Do/did they eat any of the following?
1. Whole grains or processed bread and cereal - Yes
2. Vegetables - Yes
3. Fruits- Yes
4. Dairy/condiments- Yes
5. Types of meat (beef, chicken, turkey, fish) and frequency of consumption of these and
Eggs per week. Fish, Chicken, Pork (3 to 4 times a week)
3. Analysis of Physical Activity and Lifestyle Habits of Family Member
a. What is/was the occupation of these relatives or individuals? What types and amount of
physical
Activity does/did this require? Rural Health Midwife - Not so active on physical Activities
b. Do/did they engage in any recreational exercise? No
c. Did they engage in organized exercise? No
d. Do/did they smoke? If so, how many packs/cans per day? Yes, 1 pack a day
e. Do/did they drink alcohol? If so, how many drinks per day or week? No

Family Member B:

Age: 72
Diseases and causes of death have been experienced: Prostate Cancer
2. Analysis of Dietary Habits of Family Member
a. How often did they eat per day- 3 times a day with snacks in between
b. Do/did they eat any of the following?
1. Whole grains or processed bread and cereal - Yes
2. Vegetables - Yes
3. Fruits- Yes
4. Dairy/condiments- Yes
5. Types of meat (beef, chicken, turkey, fish) and frequency of consumption of these and
eggs per week. Fish, Chicken ( 3 times a week)
3. Analysis of Physical Activity and Lifestyle Habits of Family Member
a. What is/was the occupation of these relatives or individuals? What types and amount of
physical
activity does/did this require? Farmer - Walking
b. Do/did they engage in any recreational exercise? Yes
c. Did they engage in organized exercise? No
d. Do/did they smoke? If so, how many packs/cans per day? NO
e. Do/did they drink alcohol? If so, how many drinks per day or week? Yes- occasional

PERSONAL

4. Your Personal Dietary and Behavior Habits

a. How often do you eat per day? 3 times a day
b. How many servings do you typically eat per day of the following (refer to your dietary
analysis
data to answer this question) 33% Protein, 35.7% Carbohydrates, 28% Fats
1. Whole grains or processed bread and cereal - 3 servings a day
2. Vegetables - 1 serving a day
3. Fruits- 1 serving a day
4. Dairy products/condiments - 1 serving a day
5. Meat, chicken, turkey, fish, eggs - Pork, chicken, fish, eggs (3 times a week)
c. How often do you engage in physical activity per week? - Once a week
1. Average length of each exercise session - 2 hours
2. Average intensity of each session: Moderate Exercise