Running head: REALAGE

Health Promotion and the RealAge Test

Lindsay Vasquez
Ferris State University
NURS 310

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Abstract
The RealAge test and its implications are discussed in detail. The RealAge test was given to one
client and a plan was developed to attempt to decrease the realage number. Goals were
established, measured, and evaluated in order to obtain optimal health in this client. Evidence is
provided to support these goals and interventions. There is discussion of different health
promotion models in reference to optimal health outcomes and why certain plans work on some
individuals and others do not. The plan was implemented, modified, and changed as often as the
client needed. Finally, progressions in the stages of the Transtheoretical Model were
determined.

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Health Promotion and the RealAge Test

Life has its way of catching up to us; every decision made and health choice decided
affects our wellbeing and vigor. Have you every said to yourself, I cannot believe I am 50
already, where has the time gone? I still feel 30. Or, on those really long and hard days, have you
sighed, I feel like I am 40 years old, when you are barely in your twenties? I am sure that you
are not alone. You can most likely recall the last time you heard the phrase, Age is just a
number! and studies have shown that chronological age is not the only key player in the aging
process. According to Stephan, Demulier, and Terracciano (2012):
A growing body of research emphasizes the subjectivity of the aging process, as
illustrated by the consistent finding that, despite age-related changes, the majority of
older adults feel younger than they actually are. The tendency to feel younger or older
than one's actual age is considered a crucial construct in old age, with implications for a
variety of physical and psychological outcomes, including well-being and longevity.
The way you live your life and the health choices you make impact your physical and
psychological age. The RealAge test, developed by Dr. Mike Roizen, Dr. Keith Roach, and Dr.
Mehmet Oz, offers a unique way to calculate your bodys health age (Oz, 2013). It figures out
bad habits that may be aging you and what you can do to gain youth.
Addressed in the context of this paper are the RealAge test results of a 53-year-old
Caucasian woman.
Assessment, Analysis, and Wellness Diagnosis
This particular female is the chronological age of 53.4 years old, yet her RealAge results
gave her an age of 56.3, 2.9 years older than her actual age! Some of the main physical negative

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impacts on her health were the fact that she is a diagnosed diabetic, has slightly high blood
pressure and is obese. She has been struggling with diabetes for approximately 4 years and is
having trouble regulating her blood glucose by weight reduction and diet modification. Her
blood pressure has been elevated for approximately 6 years and she believes this is due to her
increased weight. Emotionally, a lack of a sexual life is increasing her age according to this test.
Though her relationship with her husband is satisfying and they compliment each other well, the
sexual relationship could use a little work. She also is feeling financial strain due to owning her
own business and the pressures that are included, thus increasing her real age. The long winter
months have left her feeling depressed at times and she finds that there is truly no way to
improve this until summer arrives, increasing her real age temporarily. The diet assessment
obtained from the test was very poor for this client. Nearly every aspect of her diet is causing an
increase in age. She finds it hard to stick to any diet, she does not have good will power, and she
struggles with food choices. The same can be said for the fitness categories of the test, the patient
scored poorly. She finds that she lacks the motivation to be active and can often not fit time into
her schedule for physical fitness.
According to the client, the most important area of her health that she wants to address at
this time is her weight. She feels that if she addresses this issue first, all other aspects of her
health will fall into place. And for the most part, this belief is true. Once weight is corrected with
activity and diet, blood glucose levels will fall, sexual activity will increase, and her mood will
improve from the increase in endorphin production. According to the Transtheoretical Theory, a
model designed to determine behavior change, she is in the contemplation stage of change
(Velicer, Prochaska, Fava, Norman, & Redding, 1998). She has felt the pressure from herself, her

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physicians, and her family to make a change and she feels this needs to happen soon. However,
since she has not taken any active steps towards improvement and existed in this state of health
with no change for quite some time, she has not yet reached the preparation stage. According to
Velicer et. al. (1998), This balance between the costs and benefits of changing can produce
profound ambivalence that can keep people stuck in this stage for long periods of time. We often
characterize this phenomenon as chronic contemplation or behavioral procrastination. This is
exactly the behavior she has demonstrated and she will need motivation and encouragement to
reach the preparation stage.
As a nurse, I would give this woman the wellness diagnoses of one, readiness for
enhanced self-concept, and two, health-seeking behaviors related to absence of aerobic exercise
as a risk factor for coronary artery disease. She is ready to improve her self-concept, her selfworth, and her identity by changing her body image and becoming more comfortable in her own
skin. The diagnosis of health-seeking behavior related to absence of aerobic exercise as a risk for
coronary artery disease applies because she desires a higher level of wellness, needs education in
ways to better her health, and wants control over her health complications (i.e. diabetes, joint
pain, etc.).
Planning and Intervention
Setting up a plan of attack with a large amount of input from the client is important to do.
If the client does not show autonomy in managing their health, they will be less likely to
succeed. Self-care approaches embody the notion of empowerment and autonomy. Active
involvement in self-care is widely acknowledged as an important strategy for achieving national
health goals (Pender, Murdaugh, & Parsons, 2011, p. 265). We used the Sociocognitive Model

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when formulating interventions for this client because it was the most appropriate. The greater
the perceived efficacy, the more vigorous and persistent individuals will engage in a behavior,
even in the face of obstacles and aversive experiences (Pender, Murdaugh, & Parsons, 2011, p.
42). A health promotion theory that would be ineffective is the Health Belief Model because,
despite being threatened with diabetes secondary to obesity, the client did not change her
behaviors. These fears were not enough to force her into lifestyle changes. Together we formed
the goal that she would establish a work-out regimen that worked with her schedule. It involved
getting 30 minutes of aerobic exercise three times a week, progressing to five times a week by
the fourth week to begin within 5 days of the start of our plan. The next goal we established was
to immediately start keeping a food diary via a smartphone app that automatically calculated her
caloric intake; working toward a target of no more than 2,000 calories by week 2 and no more
than 1,800 calories by week 4. This provides direct accountability and visualization of how many
calories are in certain foods and the right ones to consume. Lippman (2013) discusses the
emergence of smartphones in health promotion:
The number of medical/health apps for smartphones or tablets is difficult to pin down;
estimates range from 17,000 to more than 40,000, and growing. The smartphone has a
very bright future in the world of medicine. After examining the use of apps to track
(literally) wandering dementia patients; calculate and recommend insulin dosages for
patients with type 1 diabetes; and teach yoga, to name a few, the smartphone may one
day be recognized as a diagnostic and therapeutic tool as irreplaceable as the
stethoscope. (p. 362)

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By the end of week 1, she established the goal of educating herself on diabetic appropriate foods
and how they affect her blood glucose. She decided upon better monitoring of her blood glucose
levels because she was not keeping track of them adequately enough per her primary care
physician. She wanted to set the goal to monitor them at least once a day by week two of plan
implementation and reach the recommended amount of twice a day by week four. According to
the American Diabetes Association (2004), The possible benefits of physical activity for the
patient with type 2 diabetes are substantial, and recent studies strengthen the importance of longterm physical activity programs for the treatment and prevention of this common metabolic
abnormality and its complications. She felt all these goals were attainable and were going to
help her gain better overall health.
Evaluation
The client progressed well through her goals with a few modifications and revisions
during her course. The client had a workout schedule established by day 5 and was exercising
according to that schedule. However, when a check was done on day 14, the client was only able
to complete 2 days of exercise a week because she had been terribly busy. She felt there needed
to be an adjustment; therefore, we reestablished a goal of exercise three times a week by week
three, and five times a week by week five. The client felt this would allow her more time to
adjust her schedule to accommodate exercise time. By week three, the client was excercising
three times and meeting her goal. The client did an excellent job of keeping a food diary on her
mobile device. She stayed under the target of 2,000 calories in weeks one and two but was
unable to stay under the 1,800-calorie target in weeks three and four. When a check was done in
week four, we mutually agreed upon adjusting the target to 1,900 calories. She felt that this goal

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was more attainable. The client stayed on track with checking her blood glucose and met her
goals. On weeks two and four, feedback was provided to the client in the form of written letters
which can be found in the appendix. While acting on this plan the client progressed, according to
the Transtheoretical Model, from the contemplation phase, through the preparation phase, and
was in the action phase when this assessment was concluded (Velicer, Prochaska, Fava, Norman,
& Redding, 1998). She has yet to reach the maintenance phase because she was still requiring
modifications in short-term goals and had not yet set long-term goals. The success of meeting
goals helped this client feel rewarded and she is inspired to continue on.

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References
American Diabetes Association. (2004). Physical Activity/Exercise and Diabetes. Diabetes Care,
27, S58-S62. doi: 10.2337/diacare.27.2007.58
Lippman, H. (2013). How apps are changing family medicine. Journal of Family Practice, 62(7),
362.
Oz, M. (2013). Whats Your RealAge? Find out how to live younger. Retrieved from
http://www.doctoroz.com/realage
Pender, N. J., Murdaugh, C. L., & Parson, M. A. (2011). Health Promotion in Nursing Practice.
Upper Saddle River, NJ: Pearson Education.
Stephan, Y., Demulier, V., & Terracciano, A. (2012). Personality, self-rated health, and subjective
age in a life-span sample: The moderating role of chronological age. Psychology and
Aging, 27(4), 875-880. doi:http://dx.doi.org/10.1037/a0028301
Velicer, W. F, Prochaska, J. O., Fava, J. L., Norman, G. J., & Redding, C. A. (1998).
Smoking cessation and stress management: Applications of the Transtheoretical Model
of behavior change. Homeostasis, 38, 216-233.

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Appendix
Week Two Check-Up Letter
Tina,
You are doing great on achieving your goals and you are getting closer and closer to your desired
level of health. Your diet has been excellent and it is amazing to see you stick to your goal of
2,000 calories a day. I see that you have stuck to your goal of checking your blood sugar on a
daily basis, this will help you mangage your diet even better in the coming weeks. I know that is
extremely hard to integrate exercise and activity into a busy schedule, I applaud you for fitting
two solid exercise days in a week. We can adjust your goal so you can ease more slowly into
regular exercise, let me know what works best for you. Keep up the good work!
Sincerely,
Lindsay Vasquez

Week Four Check-Up Letter

Tina,
The changes you have made in your life have a large impact on your overall health. I am sure
you are seeing some of the positive attributes of these improvements. You should be proud that
you met your goal of exercising three times a week. Keep recording those daily calories. I can
understand that it is difficult to make such huge lifestyle change in a matter of weeks. The goal
of 1,800 calories may be a little hard to achieve in such a short amount of time so we can
decrease this to a more attainable 1,900 calories. I am impressed that you have dedicated effort to

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monitoring you blood glucose. Look at establishing some long term goals and continuing
improving.
Kind regards,
Lindsay Vasquez