1. ENERGY LEVEL

a. My energy levels are normally high

b. I need to use things like caffeine to give me enough energy to keep up the pace I need

c. My energy levels are about average

2. HUMIDITY

a. Humidity doesn’t bother me much.

b. Humidity really bothers me.

c. I adapt easily to humidity changes.

3. ENVIRONMENTAL TEMPERATURE

a. I prefer hot to cold

b. I prefer cool weather to hot

c. I adapt easily to temperature changes

4. BLOOD PRESSURE

a. My blood pressure is high without using medication

b. My blood pressure is low to normal without medication

c. My blood pressure is normal without medication

d. I don’t know what my blood pressure is

5. BODY TEMPERATURE

a. My body temperature is typically normal when measured

b. My body temperature is slightly below normal when measured

c. My body temperature is always normal unless I get sick

6. RELATIVE BODY TEMPERATURE

a. I often feel cold when others are warm

b. I may sometimes feel cold when others are warm

c. I never feel cold and often feel quite warm.

7. INDIGESTION

a. Beef or other meats can often give me gas

b. If I have gas, it’s usually after eating raw vegetables

c. I don’t typically experience problems with gas at all

8. DIGESTION

a. I sometimes feel sluggish or sleepy after eating meat

b. I can get sluggish or sleepy after eating carbohydrates

c. I don’t usually feel sluggish or sleepy after meals

9. SALT

a. If offered a salty snack I generally pass it up – not my favorite

b. I love salty snacks and am very tempted whenever they are available

c. There are occasional times I really enjoy a salty snack

10. ALLERGIES

a. I have no allergies or reactions that I am aware of

b. I have seasonal allergies: they may be minor or major, chronic or periodic

c. I am unsure if what I experience are allergies or reactions

11. STAMINA

a. My stamina is excellent, better than the average person

b. My stamina always seems to be less than I would like

c. My stamina is good enough to get me through the day

12. FINGERNAILS

a. My fingernails are thick or hard

b. My fingernails are thin or weak

c. My fingernails are neither particularly hard nor particularly weak.

13. ILLNESS RECOVERY

a. If I come down with a common cold or flu I usually recover within 2 or 3 days

b. It usually takes me 10 days or more to get over any cold or flu

c. It usually takes me about 4 to 10 days to recover from a flu or cold

14. SLEEP

a. I require very little sleep, often less than 5 hours per night

b. I need 8 or more hours of sleep per night to feel good the next day

c. About 6 – 7 hours of sleep a night works well for me

15. BLOOD SUGAR

a. My blood sugar is normal to high without using meds

b. My blood sugar is low to normal OR I have occasional hypoglycemic (low blood sugar) symptoms between meals

c. My blood sugar is normal without using medication

d. I have no idea what my blood sugar levels are

16. DESSERTS

a. If I could have any dessert I want without regard to weight or health issues I would choose something sweet.

b. If I could have any dessert I want without regard to weight or health issues I would often choose rich desserts like pastries or cheesecake.

c. I don’t have a strong dessert preference either way and can easily do without eating dessert at all.

17. FATIGUE

a. I almost never feel tired

b. I get sleepy in the afternoon between 1 – 5 pm unless I use caffeine or something similar for an energy boost.

c. I really only start to feel sleepy around bedtime

18. GETTING TO SLEEP

a. I sometimes have difficulty getting to sleep

b. I have little difficulty getting to sleep

c. I generally only have trouble getting to sleep if I am anxious about something.

19. STAYING ASLEEP

a. I have no difficulty sleeping through the night

b. I often have difficulty staying asleep

c. I generally only have trouble staying asleep if I am anxious about something.

20. HUNGER CUES

a. I almost never have actual hunger pangs

b. I get hunger pangs occasionally, sometimes even between meals

c. If I have hunger pangs, it’s usually close to meal time.

21. MOOD SWINGS

a. Very rarely, but if I do have a change in mood, it’s from normal to high

b. Occasionally and they tend to be more down than up OR I have frequent mood swings

c. Rarely in any direction

22. SATIETY

a. In order to feel full I need to eat small amounts of food

b. I need to eat quite a lot to feel full OR there are certain foods I can’t seem to get enough of

c. An average-sized meal makes me feel full

23. CAFFEINE

a. Caffeine can make me feel jittery

b. Is essential for me to have caffeine in the morning to get my day going

c. Caffeine doesn’t usually make me feel jittery and I don’t need caffeine in the morning to get going

24. MISSING MEALS

a. If I miss a meal I don’t notice and maintain consistent energy

b. If I miss a meal I usually feel tired and even cranky

c. I may or may not really notice if I miss a meal

25. MENTAL ALERTNESS

a. My mental alertness is consistent all day

b. My mental alertness almost always decreases in the afternoon unless I eat or drink something that perks me up such as coffee, tea, cola, candy or pastry

c. My mental alertness is generally consistent, but occasionally I need help to perk up

26. HEIGHT

a. I am male over 6’ tall or a female over 5’5” tall

b. I am a male less than 6’ tall or female less than 5’5” tall

27. WEIGHT

a. Weight issues are not a concern for me – most people consider me slim

b. Weight issues are a constant concern for me since I always seem to carry extra weight AND/OR I have trouble losing weight and keeping it off.

c. Weight issues are generally not a problem but if I need to lose weight it is not very difficult to get it off in a reasonable timeframe

28. FAMILY WEIGHT PATTERNS

a. most members appear thinner than the average North American

b. most members are more than 20 pounds overweight or even have serious weight problems

c. most males have a waistline that is not more than 40” and most females not more than 35”

29. PERSONAL WEIGHT PATTERNS

a. I don’t carry any extra weight AND/OR have trouble maintaining an appropriate weight for my height.

b. Weight retention occurs for me primarily in the hips and thighs (if female) or waist (if male)

c. My weight tends to be about evenly distributed throughout my body

30. MEAT

a. I almost never eat meat – even the smell of cooking meat can bother me

b. I love meat and eat it frequently

c. I eat meat occasionally, but I can do without it

31. CHOCOLATE

a. I enjoy sweet tastes but chocolate is too rich for me

b. I love chocolate and rich, creamy textures.

c. I like the taste of chocolate but I can take or leave it.

32. BREADS AND PASTAS

a. I generally prefer breads and pastas to meat

b. Breads and pastas are an essential part of every meal

c. Breads and pastas are okay but having a meal without them is okay too

33. POTATOES

a. I could make a meal out of a loaded potato without any meat

b. Whenever I have a meal with meat it doesn’t feel complete without some form of potato

c. I can happily do without potatoes

34. BREAKFAST PREFERENCES

a. If I could have any breakfast I want without regard to weight gain or health issues I would choose fruits and/or cereals and maybe a pastry

b. If I could have any breakfast I want without regard to weight gain or health issues I would have eggs with meat and bread in some form

c. If I could have any breakfast I want without regard to weight gain or health issues I would definitely choose pastries, doughnuts or cereals

35. PHYSICAL APPEARANCE

a. I think I look older than my actual age

b. I think I look younger than my actual age

c. I think I look about as old as I actually am

36. SKIN

a. My skin tends to be dry

b. My skin tends to be oily and/or supple

c. My skin is about average

37. CARBOHYDRATES

a. I can eat carbohydrates and still lose weight

b. If I eat carbohydrates, I will almost certainly gain weight

c. I gain weight if I eat excessive amounts of carbohydrates

38. BOWEL MOVEMENTS

a. My bowel movements are infrequent. I can go a day or more without having a bowel movement

b. I have bowel movements regularly. I often have three or more bowel movements a day

c. I usually have a bowel movement one to three times a day

39. DAILY EXERCISE

a. I love being active and I exercise regularly.

b. Exercise feels like work and I’m not a big fan

c. Exercise feels good but if I miss it, it doesn’t break my heart

40. LIGHT-HEADEDNESS

a. I very rarely, if ever, feel light-headed

b. If I stand up quickly after sitting or lying down for a few minutes I almost always feel light-headed

c. I can sometimes feel light-headed

41. WEIGHT LOSS

a. I have lost weight most easily in the past by avoiding fats

b. I have lost weight most easily in the past with a low carbohydrate diet

c. I have lost weight most easily in the past with a low calorie diet

d. I have never attempted to lose weight through any specific method in the past