1. Fitness Portfolio
Kins 153
Hardik Parikh
May 13th, 2015
Prof R. Quintana

2. Outline of Content
1.Introduction
2.Explanation & Interpretation of Health & Fitness
Tests
3.Subject Characteristics
4.Medical History
5.Risk Factors
6.Blood Chemistry
7.Body Composition Explanation
8.Incremental Exercise Test Results & Interpretation
9.Summary of CV Fitness and Health Evaluation
10. Exercise Rx Recommendations
11. 12 Week Exercise Prescription
12. Appendix

3. Introduction
Cardiovascular fitness is often referred to as Aerobic exercise.
Cardiovascular fitness is distinguished from other exercises by two primary
factors; 1) ​Cardiovascular fitness enhances the ability of the heart and lungs to
supply oxygen­rich blood to the working muscles. 2) Cardiovascular fitness
enhances the muscle's ability to use this oxygen to supply adequate energy for
movement. Cardiovascular fitness is essentially the body’s ability to sustain any
moderate to high intensity activity for a prolonged amount of time. Common
Cardiovascular activities include jogging, cycling, playing basketball, and many
more. The primary importance of cardiovascular fitness becomes evident when
you look at its definition. Any type of activity that will supply oxygen to the
muscles will increase energy levels as well as make your body more functional
and efficient. ACSM/AHA recommends at least 30 mins/day of intense activity on
most days of the week. There are numerous benefits to having Cardiovascular
Fitness. It really plays a role in the longevity of an individual. Researchers
involved in the Harvard Health Alumni Study, which was published in the April,
1995 edition of the Journal of the ​American Medical Association ​discovered a
distinct link between cardiovascular fitness and longevity. The researchers found
that the subjects who had the highest level of aerobic activity had the highest rate
of longevity. Another benefit would be weight loss. It is no secret that those who
undergo in Cardiovascular activities have a healthier body weight and reduced
risk of Heart disease than those who do not. The most important benefit of
physical activity however, would be a decrease in morbidity.
It is very crucial that fitness assessment be done on any subject before
altering their lifestyle and current fitness programs. The results from the fitness
test will help assess the areas that the subject needs improvement on and will
assist them in making a new fitness program.
A health and fitness test was performed on Mr. Hardik Parikh on May 13th,
2015. A blood panel was performed, along with body composition assessment as
well as a sub max test. The following report will be an explanation and
interpretation of said results.
Explanation & Interpretation of Health & Fitness Tests
Patients with Cardiovascular Disease (CVD) may be further stratified
regarding safety during exercise. The American Association of Cardiovascular
and Pulmonary Rehabilitation (AACVPR) has a criteria for patients that have
CVD. According to the AACVPR, you can classify a patient a low, moderate, and
high risk depending on the symptoms they exhibit during exercise testing.
Patients with the lowest risks for exercise participation may exhibit characteristics
such as, absence of complex ventricular dysrhythmias during exercise testing,
absence of angina, and presence of normal hemodynamic during
exercise/recovery. The characteristics of a patient that is at moderate risk include,
presence of angina and mild to moderate levels of silent ischemia during
exercise/testing. A patient that is at high risk would have such characteristics as

4. presence of complex ventricular dysrhythmias during exercise/recovery, presence
of angina, high levels of silent ischemia, and/or a presence of an abnormal
hemodynamics with exercise/recovery.
Subject Characteristics
A. Name: Hardik Parikh
B. Age: 23 Years
C. Height: 5 feet 7 inches
D. Weight: 107 Kg
E. Sedentary
Medical History
A very useful tool that is used in the medical profession is a medical
history. A medical history is taken and pre­test examinations are performed in
order to better assess the subject’s health status. The pre exercise medical
history should be thorough and include past and current information. A
preliminary physical examination should be performed by a physician or other
qualified healthcare professional. Also, a medical history and examination are
needed for the safety of the subject. Usually, the first bits of information collected
are the subject’s height, weight, age, gender, and resting heart rate. The medical
history usually then consists of getting to know if the subjects has had a family
history of disease including but not limited to, heart attack, diabetes, obesity, and
hypertension. The presence of either one of these can be considered a risk factor
for CAD. The subject is also asked if they experience any symptoms such as
lightheadedness, shortness of breath, abnormal fatigue, coughing, angina, or any
other symptoms of pulmonary, coronary, or metabolic disease. The presence of
any of these symptoms can be very strong indicator that the subject has a risk
factor. The subject should also list any medications they are on because
unbeknownst to them, something they are taking could be a contraindication to
the exercise test. An obvious risk factor would be if the subject is a smoker. It is a
well known fact that cigarette smoking leads to a litany of health complications.
Afterwards, the subject should be asked to quantify their activity level.
They should answer in terms of how many days a week they exercise, at what
intensity, duration, and frequency. The ACSM suggests that everyone gets at
least 30 mins a day of intense exercise. If a subject fails to meet said
requirement, they will have an added risk factor due to them being sedentary.
Medical histories also include blood pressure, Blood Panel, and BMI. A
blood panel tests for total cholesterol, LDL, HDL, TG, and fasting blood glucose. It
is a given that any values that are out of the normal range would be considered a
risk factor. If a subject’s LDL values exceed 130 mg dL they would be have a risk
factor. If a subject’s HDL’s values exceeded 60 mg dL they would be considered
at risk. If the subject’s total cholesterol is above 200 mg dL, they would consider it
a negative risk factor. For Triglycerides, if the subject’s values exceed 200 they
would be considered at risk.
When it comes to blood pressure the guidelines are a bit simplier. The

5. ideal blood pressure is <120 mmHg for Systolic and <80 mmHg for Diastolic. Any
variation of these numbers would usually give the subject a negative risk factor.
Prehypertensive would be having a Systolic Blood Pressure of 120­139 mmHg
and 80­89 mmHg for Diastolic. Stage 1 Hypertension would be having a Systolic
Blood Pressure of 140­159 mmHg and 90­99 for Diastolic. Stage 2 Hypertension
would be having >160 mmHg Systolic and >100 mmHg for Diastolic. The subject
had a resting Blood Pressure of 119/30 mmHg which places him in the normal
range.
Body Mass Index (BMI) is a ratio between subject’s height and weight
(kg/m*m) and is used as indicator to predict if the subject is at risk for disease.
Having a BMI of > 30 is considered obese and a positive risk factor.
Taking a blood chemistry profile is very important to being able to gauge
how well the subject is in terms of long term health. Before any lifestyle changes
are undergone, it is very important that one complete a blood panel so the subject
know which areas need the most improvement. Blood Chemistry is an important
indicator of health risk. A basic blood panel includes LDL, HDL, Total Cholesterol,
Fasting Blood Lipid, and Fasting Blood Glucose. Recommended values for LDL
and HDL are <100 mg/dL and <40 mg/dL respectively. A high LDL level is
considered a primary risk factor for CAD, while high levels of HDL are considered
a negative risk factor and are thought to actually lower the risk of CAD in a
subject. The recommended value for Total Cholesterol is <200 mg/dL. The
recommended values for Fasting Glucose and Lipid are <100 mg/dL and<150
mg/dL respectively. It can also be suggested that having high levels of both Total
Cholesterol and Triglycerides may lead to an increased risk of CAD.
According to the subject’s history, there is a family history of diabetes.
However there is no history of coronary artery disease, pulmonary disease, or
hospitalization. Mr. Parikh is not experiencing any symptoms. The subject
reported that he only does exercise about 3 times a day for about 30 minutes at
each bout. The subject would not be considered sedentary according to ACSM
guidelines. The subject has an unhealthy BMI of of 36 which would classify him in
as obese. After looking at the subject’s blood work, lifestyle examination, and
medical history, obesity would be the the only outstanding risk factor.

6. Risk Factors
Family History
Smoking
Hypertension
Dyslipidemia
Impaired Fasting Blood Glucose
Obesity ☑
Sedentary Lifestyle
Symptoms
HDL
Blood Chemistry
The subject’s Fasting Lipid value was 130 mg/dL. This is well within the normal
range of <150 mg/dL. The subject’s Total Cholesterol was 185 mg/dL which falls
under the normal values of <200 mg/dL. The subject had an LDL value of 115
mg/dL and HDL value of 36 mg/dL. These both fall under the normal range of
<100 mg/dL and <40 mg/dL respectively. All of the subject’s values were within
normal limits.
Body Composition Explanation
Body composition is used to assess a subject's overall health and fitness
by assessing their fat percentages. Examples of body compositions descriptors
are body density, body fat percentage, BMI and waist circumference.
Based on the composition of the body, two classifications can be used; Fat
Mass (FM) and Free Fat Mass (FFM). Fat mass is the amount that includes
adipose tissue and other lipids. FFM is everything that isn’t FM, such as minerals,
muscles and water. FM has a density of 0.9 g/ml and FFM has a density of 1.1
g/ml. We can use these values to estimate a total body density since the body
can only be comprised of two things; FM and FFM. There is some variety person
to person though. FFM varies due to individuals having different bone density.
Body density will range from 0.9 g/ml to 1.1 g/ml, having a higher density will
mean that the subject has a higher lean body tissue percentage.
There are two primary methods to determining body density; Skin fold and
Hydrostatic Weighing. For Skin fold, subcutaneous fat is pinched and measured
using special calipers specifically made for skin folds. The subject is pinched at
specific sites. All the sites are measured and added up and inserted into an

7. equation that is specific to the subject’s ethnicity to estimate body density. The
skin fold sites are usually the abdomen, tricep, bicep, chest, midaxillary,
suprailiac, subscapular, and the thigh. The second method, Hydrostatic weighing
is much more accurate than the skin fold. Hydrostatic weighing utilizes the known
density of water to determine the subject’s body density. The subject sits on a
chair that is attached to a scale. The subject then is submerged underwater and
asked to exhale all the air from their lungs and sit still for about 5 seconds. After
calculations that take into account suit density, residual volume of air of the
subject’s lungs and chair weight are taken into account, the subject’s body density
is calculated.
After the subject’s body density is determined, you can calculate the
subject’s fat percentage by using another ethnicity­specific equation. Body fat
percentage is the percent of total body mass that is purely fat mass. Normal body
fat percentages for men is approximately 10­22% and 20­33% for women.
Another measurement of a subject’s health is taking their waist
circumference. Waist Circumference is considered an important predictor of
obesity because of the location of the said measurement. Fat that is concentrated
around the mid region, known as visceral fat, is very hormonally active and is
correlated with a higher CAD. If the subject’s waist circumference is >102 cm for
men and >88 cm for women they are at a higher risk for disease.
The subject’s body density was estimated at around 1.06 g/ml according to
the skin fold technique. The subject’s body fat percentage was 16.93% which puts
the subject in the Fair range. The height of the subject is 5 feet and 7 inches with
a weight of 107 kg. The subject has a BMI of 36 kg/m*m which puts the subject in
the obese range. The Waist circumference was 108 cm which puts the subject in
the unhealthy range. According to the Hydrostatic weighing, the subject has
15.52% of body fat. The ideal fat percentage for the subject is 12%. According to
the ACSM, the ideal body weight for the subject should be 5 kg less than the
subjects current body weight. This would result in a caloric deficit of
approximately 45,000 kcals.
Cardiovascular Fitness Test Explanation
Maximal oxygen uptake, also known as Vo2Max is accepted as the criterion measure of
CRF. It is usually expressed in mL min. It allows for meaningful comparisons
between/among individuals with differing body weight and fitness levels. Vo2Max is a
product of the maximal cardiac output and arteriovenous oxygen difference. The
designation of Vo2Max implies an individual’s true physiologic limit has been reached
and a plateau in Vo2 may be observed between finals two work rates of a progressive
exercise test. This plateau does not usually come up in someone who has CVD or a
pulmonary disease.
There are usually three modes of testing that can be used to gauge Vo2Max; A
field test, Motor­driven treadmill test, cycle ergometers, and a step test. A field test
would consist of walking or running in a predetermined time or distance. A motor­driven
treadmill test would, like the name implies, involve the subject running a treadmill. This

8. test can be used for both submaximal as well as max testing. The cycle ergometer test
can also be used for submaximal and maximal testing but it requires a cycle ergometer
instead of a treadmill. The Step test is an inexpensive modality for predicting CRF by
measuring the HR response to stepping at a fixed rate.
When it comes to the cycle ergometer test, normal values for men 18­25 years
old would be having a Vo2Max of at least 43 ml/kg. For women, normal would be having
a Vo2Max of at least 39 ml/kg. Normally for the Astrand­Ryhming cycle ergometer test,
at 50% of V02Max, the average heart rate for men was 128 bpm and 138 bpm for
women. During exercise, the normal Vo2Max response is a slow and steady rise during
the first couple of minutes, and a plateau towards the end of the exercise portion of the
test, and there should be a drop almost immediately when the test is terminated and
when the subject beings recovery.
Heart rate would also have a similar response to Vo2Max to exercise. During exercise,
it would spike and plateau but as soon as the test was terminated, the heart rate would
drop down almost instantly and begin its recovery.

9.
For a normal person, the ECG response would be an​ altered action potential duration,
conduction velocity, and contractile velocity associated with the increase in heart rate
during exercise. Specifically, the RR interval decreases, P­wave amplitude and
morphology undergo minor changes, the QRS complex experiences minimal
shortening, tall­peaked T waves occur, and the R­wave height increases from rest to
submaximal exercise and then reduces to a minimum at maximal exercise.
There exists a strong correlation between Blood pressure and workload. As
workload increases, so does Blood Pressure. However, ideally it is only the Systolic
blood pressure that undergoes any change. The Diastolic Blood Pressure stays
relatively the same. On average the normal response would be the SBP rising
anywhere from 50­90 mmHg depending on the subject and intensity of exercise. The
DBP would not show any drastic change. As soon as the test would be terminated and
recovery is initiated, SBP would being a relatively rapid drop due to the body’s
hemodynamic response.

10.
Whenever conducting an exercise test, the subject’s health and safety is always the
number one priority, so when conducting the test one must always be conscience of
signs and symptoms that may be cause of test termination. Some signs and symptoms
include angina, failure to increase HR with increasing load, a plateau in Vo2, and/or a
high RPE.
Incremental Exercise Test Results & Interpretation
HR (BPM) Vo2 (mL/kg) RPE Blood pressure
(mmHg)
89 Rest 6 120/29
116 4.6 6 140/110
117 4.2 7 NA
117 4.2 7 130/110
118 3.9 8 NA
118 3.9 8 NA
128 3.4 8 128/88

11. RECOVERY
BEGINS
RECOVERY
BEGINS
RECOVERY
BEGINS
RECOVERY
BEGINS
134 2.9 7 118/78
125 3.5 7 118/75
121 4.0 6 117/72
The subject’s Vo2Max/peak during this sub max test was 4.6 L, converting to 43 mL/kg..
This puts the subject in Average range. The max MPH/Grade was 22 RPM at 0 grade
which converts to 1.53 MPH at 0 Grade. The Heart Rate at rest was at 89 Beats per
minute, which is elevated then the normal which is 65 Beats per Minute. The max Heart
Rate during the test was 134 BPM. During recovery the HR dropped down to 125­121
BPM, which is normal. The Blood Pressure (BP) at rest for the subject was 120/29
mmHg which is within the normative values of <120/80 mmHg. During exercise, the max
BP was 140/110 mmHg which is still not too high and within the normal limits. At rest,
the BP was 118/75 mmHg which is normal. The workload was roughly about 600
kgm/min.

12.
The subject exhibited no abnormal signs and symptoms and did not elicit any abnormal
response.
Looking at the EKG for the subject, the Heart Rate was within the normal values of 75
BPM. After looking at the data, the intervals and waves appeared to be normal. Initially,
when the subject changed from supine to standing, the EKG did have some
abnormalities but after some time, the EKG fell back into a normal rhythm. During said
experiment, only the modified placement was used. During Supine, the patient’s
intervals and waves appeared to be more relaxed and latent then when the subject was
standing. During the transition, the EKG was very erratic and showed lots of artifacts but
only after a couple of seconds, the Heart Rate stabilized and the standing EKG returned
to stable values. There was only one abnormality with the subject's EKG. The rhythm of
the P­Wave when the subject was standing appeared a bit irregular. The rationale
behind that is that since the patient was transitioning from a supine to standing position,
artifacting could have been present.

13. Lead 1 ­ Supine
P­Wave Q­Wave R­Wave S­Wave T­Wave
Duration 0.08s Not Visible 0.65s 0.25s 0.38
Amplitude 0.1mv 0.3mv 0.6mv 0.2mv 0.1mv
Rate 75 NA 75 NA NA
Rhythm Reg NA Reg NA NA
Lead 2 ­ Supine
PR Interval QRS Interval QT Interval ST Segment
Duration 1.34s 0.92s 0.45s 0.5s
Lead 1 ­ Standing
P Wave Q Wave R Wave S Wave T Wave
Duration 0.8s 0.45s 0.8s 1s 1.6s
Amplitude 0.1mv 0.1mv 0.8mv 0.1mv 0.4mv
Rate 100 NA 90 NA NA
Rhythm Irreg NA Reg NA NA
Lead 2 ­ Standing
PR Interval QRS Interval QT Interval ST Segment
Duration 1.17s 0.8s 3.2s 0.2s
Summary of CV Fitness and Health Evaluation
The subject’s body composition results were as follows. The subject’s body fat
percentage was 16.93% which puts the subject in the Fair range. The height of the
subject is 5 feet and 7 inches with a weight of 107 kg. The subject has a BMI of 36
kg/m*m which puts the subject in the obese range. The Waist circumference was 108
cm which puts the subject in the unhealthy range. According to the Hydrostatic
weighing, the subject has 15.52% of body fat. The subject is a moderate risk for heart
disease. After conducting the submax test using the cycle ergometer, the subject has
been calculated to have a V02Max of 43 mL/kg which places the subject in the average

14. range. The subject did not have any test ending symptoms such as an abnormal blood
pressure response. The subject did not exhibit any abnormal behavior on the EKG
either. There was some artifacting but is can be deemed negligible. The subject did not
have to terminate the test due to volitional fatigue or angina. The subject’s blood
chemistry was also within normal values. The subject had normal values for LDL, HDL,
Total Cholesterol, Triglycerides, Fasting Lipid, and Fasting Glucose.
​Exercise Rx Recommendations
The subject can improve their BMI by reducing their body fat percentage. The subject is
classified as obese. It is recommended that the subject reduce their body weight to
improve their mortality rate as well as reduce their risk of getting any diseases. The
subject can achieve a healthier body weight by reducing their body fat percentage as
well as simultaneously increasing muscle hypertrophy to ensure holistic health.
12 Week Exercise Prescription
To any exercise session, there are 4 basic components. The Warm­Up, Conditioning
and/or sports­related exercise, Cool­Down, and Stretching. The Warm­Up phase
consists of a minimum of 5­10 min of light to moderate intensity aerobic and muscular
endurance activity. The Warm up is a transitional phase that allows the body to adjust to
its changing physiologic, biomechanical, and bioenergetic demands that might be
placed on it during the exercise bout. Warming up also allows the body to improve the
Range of Motion. The Conditioning phase includes anything from aerobic, resistance,
flexibility­oriented activities, and neuromotor exercises. The Intensity should vary
depending on the subject’s fitness level and goal. The cool­down period allows the body
to recover from doing a very strenuous exercise bout and allows for Heart Rate and
Blood Pressure to return back to normal as well the removal of metabolic waste
products. The stretching phase allows the body to relax all the muscles that may have
been incorporated in the exercise bout.
The subject should do a proper warm up by partaking in 5­10 minutes of light to
moderate intensity cardiorespiratory and muscular endurance activities. This can
include simply walking or jogging around the track to warm the body up and prepare it
for the upcoming exercise bout. For conditioning, the subject should engage in a variety
of aerobic, resistance and neuromotor activities ranging from moderate to vigorous
intensity for about 30 minutes minimum. For the cool­down, the subject should dedicate
at least 5­10 minutes of light to moderate intensity of cardiorespiratory and muscular
endurance activities such as light jogging or walking. For stretching, the subject should
dedicate at least 10 minutes of doing stretching exercises such as, sit­and­reach and
other various plyometrics. During the Warm­Up, the subject should stay under 37% of
their Vo2Max, under 57% of their HRMax, Workload is kept to a minimum, and RPE is
<9. For the conditioning aspect of the exercise, the subject should stay anywhere from
46%­91% of their Vo2Max, 64%­96% of their HRMax, and RPE from 12­17. For the
cool­down, the subject should be 37%­64% of their Vo2Max, 57%­76% of their HRMax,

15. and have an RPE ranging from 9­13. The subject should strive to burn 45,000 over a 12
week period so the subject would have to to burn 3,750 kcals a week. The subject
should work out 5 days a week so each exercise session should allow the subject to
burn 750 kcals. An increase in exercise time/duration per session of 5­10 min every 1­2
weeks over the first 4­6 weeks should allow for proper progression for the subject. The
subject is a former football player and would like to gain muscular mass, and he would
be able to do that by focusing on muscle hypertrophy. In addition to greater strength,
there is an impressive array of changes that come from resistance training, including
improvements to body composition, blood glucose levels, and insulin sensitivity. Since
the subject wants to strive for muscle hypertrophy, resistance must be progressively
increased if additional gains are to be achieved. The subject should train each major
muscle group, chest, shoulders, upper and lower back, abdomen, hips, and legs 2­3
days a week with at least 48 hours separating the exercise training session for the same
muscle to prevent overtraining. To prevent muscle imbalance, the subject should work
out opposing muscles groups (Agonists and Antagonists). The subject should do 3 sets
of 8­12 repetitions to induce muscle hypertrophy for any muscle. The rest intervals
should be 2­3 minutes between each set. After calculating the basal metabolic rate with
the subject’s ideal weight, the subject BMR is 2110 kcals per day. The subject needs to
expend 9.52 cals per minute from PA alone. The total caloric expenditure for the subject
per week would be at least 4,000 kcals per week to achieve desired goals.
Appendix
Pescatello, L. S., & American College of Sports Medicine. (2014). ​ACSM's guidelines for
exercise testing and prescription​. Philadelphia: Wolters Kluwer/Lippincott Williams &
Wilkins Health.