RAK Metabolic Challenge

1. Demographics

Full Name *

Email *

Password *

Confirm Password *

Contact Number (UAE) *

Emirates ID (15 digits) *

Descent / Ethnicity *

Gender *

Date of Birth *

Emirate / State *

Participation CategoryPhysical Category only

Health Group

How did you hear about this event? *

2. Biometrics

Height (cm) *

Weight (kg) *

Waist Circumference (cm) *

Waist Circumference / Height Ratio

BMI

BFM (%)

Calculations: WC/Height = waist (cm) ÷ height (cm); BMI = weight (kg) ÷ height (cm) ÷ height (cm) × 10,000

3. Vitals

Blood Pressure (e.g. 120/80) *

Pulse (bpm) *

4. Biochemistry

Blood Glucose Type *

Blood Glucose Value (mg/dL) *

HbA1c Value (%) *

Total Cholesterol Value (mg/dL) *

5. Family Medical History

Has anyone in your family (grandparents, parents, brother, sister or siblings) had a history of:

6. Medical History *

Have you ever been diagnosed with any of the following medical conditions?

Are you currently taking medication for any of the following?

Are any of the following conditions relevant to you?

None

Dialysis

Transplant surgery within 12 months

Hemoglobin anomalies and variants

Iron deficiency therapy

CABG / angioplasty within 3 months

Chronic Kidney Disease

Drug utilization: Dapsone, Ribavirin, Antiretroviral, Corticosteroids, Antipsychotropics, Munjaro

7. Lifestyle *

Dietary Profile

Do you eat raw fruits or vegetables or salad daily or 3–4 days a week? *

Yes No

Do you frequently eat sweets, aerated drinks or fast foods 2–3 times a week? *

Yes No

Do you frequently eat fried, fatty food or butter, ghee, palm oil 2–3 times a week? *

Yes No

Fitness Profile

Do you do exercise for 30 minutes daily or 150 minutes in a week (including walking)? *

Yes No

Can you touch your toes without bending your knees? *

Yes No

Can you do Sit ups / Squats? *

Yes No

Stress Profile

Do you have a good home situation (parents, spouse, children)? *

Yes No

Do you have any major problems (work, home, financial, health, etc.)? *

Yes No

Do you have sufficient sleep (6–8 hours)? *

Yes No

Health Habits

Do you drink Alcohol (daily / weekly in excess)? *

Yes No

Do you smoke daily or chew oral tobacco or tobacco product? *

Yes No

8. Consent

Please read the consent information below. The Submit button will be enabled after you scroll to the bottom and tick the consent checkbox.

I have read and agree to the consent information. *