This life expectancy calculator is based on a life-expectancy monograph developed by The Foundation for Infinite Survival,Inc.

1. Are you: male female

2. What is your current age?

Genetic Factors

3. How many grandparents or parents have died of a heart attack or stroke before age 50?

4. How many grandparents or parents have died of a heart attack or stroke between age 51 and 60?

5. If any of your predecessors had diabetes, thyroid disorders, or cancer and you are not taking special precautions as advised by a doctor, enter 1 for each disorder.

Social and Cultural Factors

6. How would you describe your society?

	average industrialized society
	advanced technological society
	emerging industrial society

7. Did you graduate from college? Yes No

8. Is your income less than $12,000 per year? Yes No

Personal Behavioral factors

9. Have you been able to maintain optimal body weight for most of your life? (i.e., you are presently and have been for some time neither over-weight nor underweight by more than 5 pounds) Yes No

10. Are you between 12 and 14 pounds underweight? Yes No

11. more than 15 pounds underweight? Yes No

12. If you are overweight,how many pounds above your ideal weight?

13. Do you skip meals regularly?Answer yes if you do not regularly eat two or three meals per day (including breakfast), and if you eat hurriedly. Yes No

14. How many of the following types of food do you eat routinely?

		fast food	refined sugar	fatty foods	salty foods
	0	1	2	3	4

15. Do you eat at least one meal a day containing foods from the basic food groups? Yes No

16. Do you take a multiple vitamin and mineral daily or extra vitamin A, C or E? Yes No

17. Do you eat a high-fiber food daily? Yes No

18. Are you moderate drinker of alcohol? (i.e. 1 glass of wine or 1 cocktail per day) Yes No

19. If you have more than 2 drinks per day enter the additional number of drinks here.

20. Do you sleep fewer than 5 or more than 9 hours per night? Yes No

21. Smoking habits:

	Do not smoke
	Do not smoke but live or work with smokers
	Smoke 10-20 cigarettes per day
	Smoke 20-40 cigarettes per day
	Smoke more than 40 cigarettes per day

22. Do you exercise for half an hour or more at least three times per week ? (note: only the more strenuous, aerobically sustained, exercising counts such as swimming, hiking, racket ball, jogging, etc...). Yes No

23. Are you sedentary in work and outside work? Yes No

24. Do you lead a mentally active life? Yes No

25. Are you often bored and depressed? Yes No

26. Are you basically happy? Yes No

27. Are you under chronic emotional stress and anxiety? Yes No

28. Are you calm and easy-going? Yes No

29. Are you highly aggressive,competitive,or easily irritated? Yes No

Environmental Factors

30. Do you live in a polluted environment? Yes No

31. Do you work in a polluted environment? Yes No

Personal Bio-Medical Factors

32. Blood Pressure:

	Normal blood pressure
	Blood pressure is 130/90
	Blood pressure is 140/90
	Blood pressure is 150/100 or greater

33. Do you take any therapeutic drugs on a prolonged basis which have known side-effects? Yes No

34. Is your blood cholesterol level 220 or more? Yes No

35. Is your hdl cholesterol low? Yes No

36. Do you frequently take drugs for recreation purposes? Yes No

37. Do you have annual or semi-annual comprehensive examinations for preventive medicine? Yes No