Test One: Carbohydrate Sensitivity

Check off each symptom that occurs with any degree of regularity

___      Nervousness

___      Irritability

___      Fatigue & Exhaustion

___      Faintness, dizziness, cold sweats,shakiness, weak spells

___      Depression

___      Drowsiness, especially after meals or in mid-afternoon

___      Headaches

___      Digestive disturbances with no obvious cause

___      Forgetfulness

___      Insomnia

___      Needless worrying

___      Mental Confusion

___      Rapid pulse, especially after eating certain foods

___      Muscle pain

___      Antisocial behavior

___      Over-emotional, crying spells

___      Lack of sex drive

___      Leg cramps

___      Blurred Vision

___      Shortness of breath, sighing and excess yawning

___      Cravings for starch and sugar-rich foods

Circle each statement that most accurately applies to you.

Test Two: Calorie Sensitive Test

  1. You had a normal body weight when younger, but slowly gained weight after age 30

  2. You are presently overweight but by 25 pounds or less.

  3. You have a normal appetite. ( get hungry at mealtimes)

  4. You have few, if any food cravings.

  5. You have maintained the same basic eating habits all your life.

  6. You eat three meals a day.

  7. You have gained a certain amount of extra body weight but seem to have tapered off (not continued to steadily gain more and more weight).

  8. You have few or none of the symptoms associated with poor carbohydrate metabolism as discussed in test one.

Test Three: Carbohydrate Intolerant Test 

  1. You are more than 25 pounds overweight.

  2. You have had a tendency to be overweight all your adult life.

  3. You have been overweight since you were younger.

  4. You have a poor appetite and skip meals often

  5. You prefer not to eat in the morning.

  6. You have food cravings that temporarily go away when starchy or sugary foods are eaten.

  7. There are foods that you feel you could absolutely not do without.

  8. Your waist is bigger than your hips (men). Your waist is more than twice the size of your hips ( women).

  9. Most or all of the symptoms associated with carbohydrate intolerance and/or excess stress on test One apply to you.

Are you, or have you in the past year, taken any of the following classes of medications?

___  Thiazide Diuretics                                               ___  Beta-Blockers

___  Steroids ie.prednisone or cortisone                     ___  Birth Control Pills

___  Epinephrine containing medications                  ___  Anti-anxiety drugs

___  Anti-depression drugs                                         ___  Diabetes medications

___  Statin (cholesterol) medications                         ___  Diet pills containing caffeine

Test Four:  Insulin Profile

Yes                  No

1.Do you exercise?                                                                             ______            ______

If yes, how often/ what type? ________________________________________________

  1. Do you consume Diet soft drinks?                                                 ______            ______

How many per day? ________

  1. Do you consume alcoholic beverages?                                           ______            ______

How many? _________________

  1. Do you use artificial sweeteners?                                                   ______            ______

Which Brands? _______________________________________

  1. Do you smoke cigarettes or cigars?                                                ______            ______

Quantity? __________________________

  1. Do you consume coffee?                                                                     ______            ______

How many cups per day? _____________________

  1. How many meals do you consume daily? ________________

  2. Do you snack between meals?                                                           ______            ______

  3. Do you use low carb/low calorie diet foods?                                   ______            ______

If so how often?________________________

  1. Do you have any food cravings?                                                        ______            ______

Please list in order of craving intensity  ________________________________________

If you scored high on tests 1 and 3 you are likely carbohydrate intolerant and excess carbohydrates are the cause of your weight gain due to excess insulin production.

If you scored low on tests 1 and 3 but high on test two you are likely calorie sensitive and are consuming too many calories.

Here at the Institute of Nutritional Science we have helped many thousands of people to normalize their weight through weight loss programs designed around their body chemistry.

Our full program is outlined in my book The Weight Management Revolution. Call us at 619-507-2113 so that we may discuss your test results and design a program of diet and supplements to help you normalize your weight in the shortest time possible.