Domain (Score) Assessment Date: 12/5/2024

Connectedness (6) Points

Felt your life had a sense of purpose 2
Engaged in two or more spiritual or religious practices (e.g., meditation, prayer, church
0
services, etc.)
Interacted with one or more club(s) or organization(s) (e.g., athletic, community, school
2
group, etc.)
Spent at least two hours in nature (approximately 20 minutes daily) 0
Visited or spoke to a close friend or family member on three or more separate occasions 2
Connectedness Domain Total: 6

Movement (5) Points

Total amount of cardiorespiratory exercise during the week (e.g., brisk walk, jog, etc.) (in
2
minutes)
Total number of resistance training workouts performed (e.g., pushups, squats, pullups, etc.) 0
Average number of hours spent sitting each day 3
Movement Domain Total: 5

Nutrition (4) Points

Average number of daily servings of vegetables 0
Average number of daily servings of fruit 1
Used olive oil as your primary oil or used no oil when cooking 0
Total number of sit-down or take-out restaurant meals 1
Total number of sweetened drinks consumed (e.g., juice, sweetened coffee or tea, soda,
0
sports drinks)
Average number of packaged snacks per day (e.g., chips, crackers, cookies, candy, protein
2
bars, etc.)
Nutrition Domain Total: 4

Recovery (3) Points

Average number of hours slept per night 0
Woke up feeling refreshed and rested on most days 0
Felt that you were able to manage and deal with stressors effectively most days 2
Felt you had enough time to take care of yourself most days 1
Sleep Domain Total: 3

Substance Use (10) Points

Smoked, vaped, or used tobacco/e-cigarettes 6
Highest number of alcoholic drinks consumed on any single day 2
Average number of alcoholic drinks consumed on days alcohol was consumed (select less
2
than one if you did not drink any alcohol)
Substance Use Domain Total: 10

© Jonathan Bonnet, MD, MPH

Individual
Individual Domain Scoring Interpretation Domain Score

Perfect score! Talk to your provider about other things you can do beyond this assessment to improve your health. 10

Although you are doing well, a few tweaks to address the remaining domain items could significantly improve your h 7-9
Significant room for improvement. Discuss this area specifically with your provider to see how you can improve your <7
*Note: if the visual does not display correctly, change your zoom setting to 80%

Lifestyle Score: 28
 Overall Lifestyle Score Interpretation

This is an opportune time to work with your provider to help you adopt habits that will significantly improve your health.
You have some great health habits, though there is ample opportunity to improve your health and decrease your disease r
You have many healthy habits, though there are a few areas that you should assess your habits in to see if you can impro
Consider minor tweaks to a an overall very healthy lifestyle overall
 Categorization Overall
Lifestyle Score
prove your health. Below Average 0-20
ease your disease r Average 21-30
e if you can impro Very Good 31-40
Excellent 41-50
 Lifestyle Medicine Assessment Screening Tool

What is it?
The Lifestyle Medicine Assessment (LMA) was designed as a screening tool that consists of 21 items
that broadly cover all Lifestyle Medicine domains. It is divided into five sections:

· Connection · Nutrition · Movement · Recovery · Substance Use

Each item within the tool respresents a modifiable behavior. They are all evidence-based and
mapped to specific research demonstrating some benefit to morbidity or mortality. The assessment
includes 10 Yes/No questions and 11 items that require a numeric response.

Performance is assessed within each individual domain, as well as globally. Up to 10 points can be
earned within each individual domain, with some items weighted more heavily than others based on
their impact on health span or life span. The total Lifestyle Score can range from 0-50 and represents
a crude estimate of overall healthy behaviors. Points are earned for each behavior achieved, with
higher scores representing healthier practices.

Who is it intended for?

Anyone can take it, though it was specifically designed for adults ages 18-65 with or without chronic
health conditions.

When should it be taken?

It can be taken anytime and repeated as often as weekly. It is designed to allow for monitoring and
tracking of behaviors over time. It can also be modified to be a monthly, quarterly, or yearly
assessment. By changing the instructions from “think about the last 7 days” to “think about a typical
week over the last month (or last year),” the tool can be adapted to any frequency.

Where do I take it?

Click below.

Begin Lifestyle Medicine Assessment

© Jonathan Bonnet, MD, MPH
 Lifestyle Medicine Assessment
tions: Please provide responses in grey boxes to the right
12/5/2024
First Name: Rich
Last Name: Becker
Date of Birth (XX/XX/XXXX): 9/18/2005
Sex: Male

For each item, think about the last seven days and answer ‘Yes’ or ‘No’ if you…
Response
1 Felt your life had a sense of purpose Yes <-- Use the drop d
2 Used olive oil as your primary oil or used no oil when cooking No
Engaged in two or more spiritual or religious practices (e.g.,
3 meditation, prayer, church services, etc.) No
Felt that you were able to manage and deal with stressors
4 effectively most days Yes
Interacted with one or more club(s) or organization(s) (e.g.,
5 athletic, community, school group, etc.) Yes
6 Smoked, vaped, or used tobacco/e-cigarettes No
Visited or spoke to a close friend or family member on three
7 or more separate occasions Yes
8 Woke up feeling refreshed and rested on most days No
Spent at least two hours in nature (approximately 20
9 minutes daily) No
10 Felt you had enough time to take care of yourself most days Yes

For each item, think about the last seven days and provide your best estimate f
Response
11 Total number of sit-down or take-out restaurant meals 2 <-- Use the drop d
Total number of resistance training workouts performed
12 (e.g., pushups, squats, pullups, etc.) less than 1
Total number of sweetened drinks consumed (e.g., juice,
13 sweetened coffee or tea, soda, sports drinks) 4
Highest number of alcoholic drinks consumed on any single
14 less than 1
day
Average number of packaged snacks per day (e.g., chips,
15 crackers, cookies, candy, protein bars, etc.) 1
16 Average number of hours slept per night 5
17 Average number of daily servings of fruit 1
18 Average number of hours spent sitting each day 5
Average number of alcoholic drinks consumed on days
alcohol was consumed (select less than one if you did not
19 drink any alcohol) less than 1
20 Average number of daily servings of vegetables less than 1
Total amount of cardiorespiratory exercise during the week
21 (e.g., brisk walk, jog, etc.) (in minutes) 60
Submit
or ‘No’ if you…

<-- Use the drop down menu for each item

best estimate for each:

<-- Use the drop down menu for each item