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What do my results mean?

You can learn more about what you results mean at Your NHS Health Check results and action plan – NHS (www.nhs.uk). We have included a brief explanation below.

Body mass index (BMI)

A healthy BMI is between 18.5 and 24.9. People may be considered underweight below this range and overweight above it. Above a BMI of 30 you are considered obese. Those with higher BMIs are at greater risk of a range of serious health conditions, including heart diseasestroketype 2 diabetes and certain cancers.

BMI is a guide and healthcare professionals may take into consideration other factors including muscle mass and ethnicity. For example, adults of South Asian origin may have a higher risk of some health problems, such as diabetes, with a BMI of 23, which is usually considered healthy.

You can lower or maintain your BMI with a healthy and balanced diet, which includes at least five portions of fruit and vegetables a day and increasing your physical activity levels, both important to reach or maintain a healthy weight.

Make small changes to your diet to reduce the number of calories you are eating by cutting levels of sugar, saturated fat and salt.

Examples of how to achieve this could include:

  • Think about portion sizes, use a smaller plate or a thinner glass, it’ll help you eat or drink less.
  • Make sure healthy snacks are easily to hand and sweet ones are out of sight.
  • Watch out for empty calories, such as those found in fizzy drinks, including juices and alcohol.
  • Bake, steam, poach or grill rather than fry or roast. Eat more vegetables and fruit in preference to meat.
  • Choose lower-fat dairy products, such as skimmed milk or lower-fat yogurt.

Remember, check food labels for hidden sugars and fats.

How do I know if a food is high in fat, saturated fat, sugar or salt?

There are guidelines to tell you if a food is high, medium or low in fat, saturated fat, salt or sugar. These currently are:

Most of the big supermarkets and many food manufacturers now display this nutritional information on the front of pre-packed food. This is very useful when you want to compare different food products at a glance.

For the Sugar Smart app and healthy/tasty recipes visit:www.nhs.uk/change4life/food-facts

Blood Pressure

Normal blood pressure is between 90/60 and 140/90. High blood pressure (hypertension) is a problem because it increases the risk of serious health conditions such as heart attack, stroke, type 2 diabetes and kidney disease. Blood pressure can fluctuate during the day and in response to stress. This includes White coat syndrome (also known as white coat hypertension) which is a very common condition, in which a patient experiences high blood pressure and heightened anxiety when in a clinical situation, such as a health centre.

Having a single raised blood pressure reading does not necessarily mean you have high blood pressure but it should be monitored. If you have a reading over 140/90mmHg which indicates high blood pressure (often known as hypertension) we would initially ask you to take some further readings at home. There are many cheap home blood pressure monitors available to purchase but many of our patients find the Omron M2 blood pressure monitor very accurate and easy to use. This is currently available for less than £30 at many pharmacies, online and high street retailers.

High blood pressure can be treated or prevented by making changes to your lifestyle, such as:

  • Regular physical activity
  • Losing weight if you need
  • Eating a healthier diet, including reducing salt intake Stopping smoking
  • Cutting back on your consumption of alcohol

Medicines are also available that can help lower your blood pressure. Your healthcare professional will advise you about this (if appropriate).

To find out more about what your blood pressure means type your numbers into the NHS tool at www.nhs.uk/conditions/high-blood-pressure-hypertension

Cholesterol Levels

High cholesterol is when you have too much of a fatty substance called cholesterol in your blood. It’s mainly caused by eating fatty food, not exercising enough, being overweight, smoking and drinking alcohol. It can also run in families. Too much cholesterol can block your blood vessels. It makes you more likely to have heart problems or a stroke. High cholesterol does not cause symptoms.

An ideal level of HDL is 1 mmol/L or above and an ideal level of LDL is 3 mmol/L or below. Your total cholesterol should ideally be less than 4 mmol/L

Your cholesterol ratio should also ideally be below four, as a higher ratio increases your risk of heart disease.

If your total cholesterol level is too high or you want to take action to prevent it increasing, discuss with your healthcare professional about eating a healthy, balanced diet that is low in saturated fat and about participating in regular physical activity. If these measures don’t reduce your cholesterol, they may also consider offering you a cholesterol-lowering medication (if appropriate), such as a statin.

For more information see www.nhs.uk/conditions/high-cholesterol

Alcohol use score

If you have an AUDIT score of less than 7 you are drinking a safer amount of alcohol. An alcohol use score of 7 or more would indicate that you are drinking an amount of alcohol that’s likely to be harming your health. If your score is 20 or more, you may have an alcohol dependence disorder (alcoholism). Your healthcare professional can offer advice or refer you for specialist support for cutting down on alcohol.

It’s recommended to drink no more than 14 units of alcohol a week, spread across 3 days or more. That’s around 6 medium (175ml) glasses of wine, or 6 pints of 4% beer. There’s no completely safe level of drinking but sticking within these guidelines lowers your risk of harming your health.

Regular drinking above the recommended daily limits can seriously impact your health and be a significant component of weight gain, even if you don’t get drunk or binge drink. Health related problems related to alcohol consumption may take many years to develop. These include an increased risk of a stroke and raised blood pressure.

How can I reduce my alcohol intake?

Set a budget – Only take a fixed amount of money to spend on alcohol. Let them know – Let your friends and family know you’re cutting down. Take it a day at a time – Cut back a little each day.

Make it a smaller one – You can still enjoy a drink but go for smaller sizes.

Have a lower-strength drink – Cut down the alcohol by swapping strong beers or wines for ones with a lower strength (ABV in %), these often have fewer calories too.

Stay hydrated – Drink a pint of water before you start drinking, and don’t use alcohol to quench your thirst.

Search the https://alcoholchange.org.uk/alcohol-facts/interactive-tools/unit-calculator website to use their interactive drinks checker to help you understand the number of units and calories you drink. Or to work out how risky your drinking is visit our free, quick and confidential online screening tool https://drinkcoach.org.uk/oxfordshire-alcohol-test

To find out more on your local alcohol services available, ask your healthcare professional, see the ‘Useful Contact’ section or visit www.oxfordshire.gov.uk/cms/public-site/alcohol-and-drugs

Physical activity assessment result

To stay healthy, you should try to be active daily to prevent and manage the risk of heart disease, stroke, diabetes, as well as improving your mental wellbeing.

It is recommended that every week adults achieve:

At least 150 minutes of moderate aerobic activity such as cycling, or 75 minutes of vigorous aerobic activity such as a game of tennis, or a mix of moderate and vigorous aerobic activity every week.

Plus do strength exercises on two or more days a week that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms).

Moderate activity will raise your heart rate and make you breathe faster and feel warmer. One way to tell if you’re working at a moderate level is if you can still talk, but you can’t sing the words to a song. Vigorous activity makes you breathe hard and fast. If you’re working at this level, you won’t be able to say more than a few words without pausing for breath.

How can I increase or maintain my levels of activity?

The good news is that there are lots of different ways to become active and benefit your health. From walking to dancing; gardening to swimming; yoga to football, there will be an activity for you.

Try to build activity into your daily routine, such as walking or cycling shorter journeys where you can, it’s good for you and good for the environment.

If you’re interested in increasing the amount of physical activity you do, ask your healthcare professional to find out more about local services or

visit the www.getoxfordshireactive.org website for opportunities to become more active.

Smoking

Smoking increases the risks associated with high blood pressure and raised cholesterol.

If you smoke, the great news is that you can reduce the health risks over by stopping. There are also other benefits such as saving money or reducing exposure to second-hand smoke for non-smoking family and friends

How can I stop smoking?

Through Oxfordshire’s free local Stop Smoking Service you’re up to three times more likely to quit compared to going it alone. They can help find the best way to achieve this, which includes information and advice on how to manage your cravings using nicotine patches and gum, or e-cigarettes, plus the motivational support tailored to your need. Many people don’t realise how easy it is to get that support and at times to suit you. To find out more about the local services available ask your healthcare professional or see the ‘Useful Contacts’ section.

Diabetes risk assessment

Type 2 diabetes is a common but serious condition that causes the level of sugar (glucose) in the blood to become too high. You can learn more about Type 2 diabetes and how to manage it at Type 2 diabetes – NHS (www.nhs.uk)

A score of under 42 mmol/mol is considered normal. A score of 48 mmol/mol or above indicates that you may have diabetes. In this instance we will invite you in for a meeting with an advanced practitioner to explain:

  • what diabetes is
  • what high blood sugar means for your health
  • whether you need to take medicine
  • your diet and exercise
  • your lifestyle – for example, alcohol and smoking

When your diagnosis is confirmed we will arrange for you to have an annual review on or around your birthday. You may also have interim reviews depending on your management plan.

A score between 6% and 6.5% (42-47 mmol) indicates that you may have a condition called non-diabetic hypoglycaemia (pre-diabetes). It is important that we monitor this. You will be invited back each year on or around your birthday to have you HbA1c test repeated.

Dementia Awareness

Dementia affects the way the brain normally functions and this can make it difficult to do everyday activities. For example, people who have dementia often forget things or get confused. The risk factors for cardiovascular disease are the same as those for dementia. It cannot be cured but you can reduce your chances of getting dementia by keeping a healthy brain. The lifestyle recommendations within this booklet will also help keep your brain, as well as your heart, healthy.

If you feel you may be experiencing signs and symptoms of dementia, speak to your healthcare professional or contact Dementia Oxfordshire on 01865 410210 or visit www.dementiaoxfordshire.org.uk for more information.

Other NHS Screening Programmes

Programmes like the NHS Health Check are a way of finding out if you are at higher risk of a health problem, so that early treatment can be offered or

information given to help you make informed decisions. Please note that there are also other NHS screening programmes available and you’re encouraged to take up the offer of these when invited, these include:

  • NHS Breast Screening and Cervical Screening Programme
  • NHS Bowel Cancer Screening Programme
  • Abdominal Aortic Aneurysm Screening
  • Plus there is a Prostate Cancer Risk Management Programme.

If you would like more information, please ask your healthcare professional or visit https://www.nhs.uk/conditions/nhs-screening/

Cardiovascular Risk (QRisk) Score

Your healthcare professional will gather all the information and measurements that they have collected during the NHS Health Check and enter them into a QRisk calculator. This will assess your risk of having a cardiovascular event (diabetes, heart disease, kidney disease, stroke) over next 10 years. This will risk will be defined as low, moderate or high:

If your risk is 20%, this means that you have a 20 in 100 chance of having a heart or circulation problem in the next 10 years. This is determined to be a high risk.

If your risk between 10% and 19%, this means that you have a 10 to 19 in 100 chance of having a heart or circulation problem in the next 10 years. This risk is determined to be moderate.

If your risk is less than 10%, this means that you have a 0 to 9 in 100 chance of having a heart or circulation problem in the next 10 years. This risk is determined to be low.

Whatever your result, even if it is in the lower ranges, you will be given advice about staying healthy and how to lower or maintain your risk. If your risk is in the higher ranges, you may be offered medicines or further support to help you reduce your risk.

Find out more about your heart age at www.nhs.uk/conditions/nhs-health-check/check-your-heart-age-tool

Everybody’s cardiovascular risk rises with age, so the next time you have an NHS Health Check your risk score may be higher, even if your test results remain the same.