Holistic Health Questionnaire
Holistic Health Questionnaire
Holistic Health Questionnaire
If the print is too small on the hard copy we give you please access a full size
version PDF at
http:://www.breathing.com/pdf/hhq.pdf
Just keep breathing a little deeper as you go through this incredibly LONG set of
questions. Do 5 Squeeze and breathes every 15 minutes. You may well answer
some of your long standing queries of your own just by filling out these forms.
This program includes several aspects each of which has achieved weight loss,
freedom from fatigue and improved health and well being. I included them ALL
figuring that working as a team they have a much better chance of ensuring
success.
You should already have my Building Healthy Lungs Naturally. If not I encourage
you to get it at http://www.breathing.com/bhln.htm
If this get a little confusing or you wish deeper investigation and guidance then you
can always schedule a paid phone consultation.
Blessings,
Mike White
1
Diet Counselor Intake
Name ______________________________________________
Address_________________________________________________________________
Occupation___________________________________________________________
Exercise /
Recreation___________________________________________________
How have you dealt with these concerns in the past? (doctors, self-care)
What other health practitioners are you currently seeing? (name, specialty, and phone
number)
List any medicine or supplements you are currently taking for these problems.
Health Hazards: Describe any noticeable correlation between your problems and:
Toxicity (exposures and sensitivities to chemicals: i.e. tap water, air pollutions, job and
home exposures, cosmetics,
food & chemical residues, medicine, nutrasweet, etc.)
2
Trauma (unresolved, physical and/or emotional wounds or abuse). What re-stimulates
it? How does it affect
your diet and health habits?
Addictive behaviors (past or present use & abuse of alcohol, drugs, tobacco, birth control
pills, caffeine,
co-dependency, workaholism)
3
Observations on Health Hazards Relationship to Presenting Problems:
Are you energetic and alive as you want to be? Take a look at your lifestyle and see where
you are running
yourself down. Balance is the key to health. What are you doing too much, and what are
doing to little.
Respond with SELDOM, SOMETIMES, or OFTEN as appropriate.
SELDOM SOMETIMES
OFTEN
5. Do you smoke?
Identify the behaviors that no longer serve you. Which ones are you committed to change in
the next 2 weeks.
Keep a log for accountability and find a partner to check in with.
4
Dietary Habits and Choices
What was your diet and family eating habits like growing up?
How has your diet changed in relationship to your health problems? (special diets tried)
Describe the foods you eat (comfort food) when you are:
1. Hungry 3. Lonely
5. Depressed
2. Angry 4. Tired
6. Celebrating
How is your mood and energy level affected by eating these foods? (nourished or numbing)
5
Lifestyle Questionnaire
The purpose of this questionnaire is to give me an overview of a typical day. Please take
me through
your average day, step by step. Thank you.
2. How do you feel when you wake up? What do you do?
5. Do you work? Full time or parttime? When do you leave? What kind of work do
you do? What is the stress level of your job?
7. How do you feel about mid-morning? Do you eat or drink anything at this time?
8. When do you eat lunch? What do you typically eat? How do you feel after eating?
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9. How do you feel about mid-afternoon? Do you eat or drink anything at this time?
10. When do you get off work? How do you feel? Do you eat or drink anything at this
time? What do
you do after work?
11. What time do you eat supper? Do you eat out more often or cook you own meals?
What do you
usually have for supper?
13. Do you eat or drink anything after supper? What do you usually have? What time?
16. Do you awaken during the night? What time? What do you do to get back to sleep?
7
Drug History Questionnaire
1. Do you have any health problems for which you are taking prescription medications at the
present time?
Yes ____ No ____
2. Are you taking any other medication a doctor has prescribed (name of drug unknown, reason
for taking
Unknown)? Yes ____ No ____
Dose of drug
_______________________________________________________________________
3. Have you taken prescription medication for any of the health problems listed below within
the past three
months? Yes ____ No ____
Asthma ________________________________________________________
Arthritis________________________________________________________
Hypertension________________________________________________________
8
Fluid retention________________________________________________________
Infection (type)_______________________________________________________
Tuberculosis________________________________________________________
Malaria________________________________________________________
Psoriasis________________________________________________________
Colitis________________________________________________________
High cholesterol______________________________________________________
Parkinsons disease___________________________________________________
Liver disease________________________________________________________
Kidney disease________________________________________________________
Blood disease________________________________________________________
Bone disease________________________________________________________
Gout________________________________________________________
Diabetes ________________________________________________________
Other (Specify)
________________________________________________________
4. Do you presently take self-prescribed medications for any reason? Yes ____ No ____
Constipation__________________________________________________________
Indigestion__________________________________________________________
Headache__________________________________________________________
Nervousness__________________________________________________________
Insomnia_________________________________________________
9
Pain__________________________________________________________
Colds__________________________________________________________
Sinus problems_______________________________________________________
5. If yes to any of the above, what medication do you take to relieve these complaints, and how
much do
you need to gain relief?
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
6. Are you taking birth control pills now? Yes ____ No ____
7. Have you taken birth control pills in the last six months? Yes ____ No ____
If Yes:
10
You Are What You Eat. You Be the way you breathe
The following questions can help you to focus your attention on what you choose to eat.
Answer them as
OFTEN (daily) SOMETIMES (weekly) OCCASIONALLY (monthly) or NEVER.
Examples are given toclarify what is mentioned. Mark where you fit in with an X.
3. Artificial sweeteners
Nutrasweet in beverages/foods
Circle any of the above items you feel are detrimental to your health. What are you ready to
switch for healthier choices? Improved diet = better health! c. Edward Bauman, PH.D.
11
Hypoglycemia Probability Directions: Check each symptom according to its severity
Column 0 indicates that the problem never occurs Column 2 is moderate and/or occurs at least
once a week Column 1 means that it is mild and occurs occasionally
Column 3 means that it is severe and occurs frequently.
Part A Part B
0 1 2 3 0 1 2 3
Stomach cramps or nervous stomach
Tired all of the time
Allergies: asthma, hay fever, skin rash
Hungry between meals or at night sinus trouble, etc.
Fatigue relieved by eating
Depressed
Suicidal thoughts or tendencies:
Insomnia, awakening with inability to return feeling of hopelessness
to sleep
Wake up after a few hours sleep Bored
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TOTALS (number of checks in each column *
*Add up the number of checks in a single column in Part A and Part B and then multiply that
number by the number at the head of that column. For example, if you have 15 checks in
column headed by the #3, multiply 15 times 3 and the total for that column is 45. Repeat this
procedure for column numbers 1 & 2 and then add the three totals together.
13
Basal Temperature Test for Low Thyroid
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Because the best time for this test is immediately upon awakening in the morning, shake
down a thermometer
\\
Place a digital or mercury thermometer( shaken down) on the bedside table before going to bed.
Immediately upon awakening, place the thermometer snugly in the armpit for 10 minutes by
the clock. The normal basal temperature is between 97.9 and 98.1. A temperature below 97.8
indicates the possibility of low thyroid activity. Women: As the temperature varies with the
phases of the menstrual cycle, the first test should be made on the second and third days of
menstruation. Children: In young children rectal temperature can be taken: two minutes are
adequate. Oral temperatures are often misleading, because any respiratory infection, including
sinusitis, will elevate the mouth temperature while the rest of the body may be normal.
- Basel Temperature Test for Low Thyroid by Lawrence Galton is reprinted from Family Circle
Magazine -
14
Food Frequency Checklist
The following information will help us understand your eating habits so that we
may offer you the best service
possible. If you have any doubts about some items, be sure to underestimate the
goodness of your habits
rather than to overestimate.
1. How many times per week do you eat the following foods?
(Circle the appropriate number.)
Per Week
Poultry ................................................. 0 1 2 3 4 5 6 7 8 9
Fish ...................................................... 0 1 2 3 4 5 6 7 8 9
Hot dogs .............................................. 0 1 2 3 4 5 6 7 8 9
Bacon .................................................. 0 1 2 3 4 5 6 7 8 9
Lunch meat .......................................... 0 1 2 3 4 5 6 7 8 9
Sausage ............................................... 0 1 2 3 4 5 6 7 8 9
Pork or ham ......................................... 0 1 2 3 4 5 6 7 8 9
Salt pork .............................................. 0 1 2 3 4 5 6 7 8 9
Liver .................................................... 0 1 2 3 4 5 6 7 8 9
Beef or veal ......................................... 0 1 2 3 4 5 6 7 8 9
Other meats (specify) ___________________ 0 1 2 3 4 5 6 7 8 9
Eggs ..................................................... 0 1 2 3 4 5 6 7 8 9
Fast foods ............................................ 0 1 2 3 4 5 6 7 8 9
2. How many times per day do you eat the following foods?
(Circle the appropriate number.)
Per Day
Bread, toast, rolls, muffins .................. 0 1 2 3 4 5 6 7 8 9
Milk (including on cereal) .................. 0 1 2 3 4 5 6 7 8 9
Yogurt or tofu ..................................... 0 1 2 3 4 5 6 7 8 9
Cheese or cheese dishes ...................... 0 1 2 3 4 5 6 7 8 9
Sugar, jam, jelly, syrup, honey ........... 0 1 2 3 4 5 6 7 8 9
Butter or margarine ............................. 0 1 2 3 4 5 6 7 8 9
3. How many times per week do you eat the following food?
(Circle the appropriate number.)
Per Week
Fruit or fruit juices .............................. 0 1 2 3 4 5 6 7 8 9
Vegetables other than potatoes ........... 0 1 2 3 4 5 6 7 8 9
Potatoes and other starchy vegetables . 0 1 2 3 4 5 6 7 8 9
Salads or raw vegetables ..................... 0 1 2 3 4 5 6 7 8 9
Cereal (which kind) _____________________ 0 1 2 3 4 5 6 7 8 9
Pancakes or waffles ............................. 0 1 2 3 4 5 6 7 8 9
Rice or other cooked grains ................ 0 1 2 3 4 5 6 7 8 9
Noodles (macaroni, spaghetti) ............ 0 1 2 3 4 5 6 7 8 9
Crackers or pretzels ............................. 0 1 2 3 4 5 6 7 8 9
Sweet rolls or donuts ........................... 0 1 2 3 4 5 6 7 8 9
15
Cooked dry beans or peas ................... 0 1 2 3 4 5 6 7 8 9
Peanut butter or nuts .......................... 0 1 2 3 4 5 6 7 8 9
Milk or milk products ......................... 0 1 2 3 4 5 6 7 8 9
TV dinners, pot pies, prepared meals .. 0 1 2 3 4 5 6 7 8 9
Sweet bakery goods (cakes, cookies) .. 0 1 2 3 4 5 6 7 8 9
Snack foods (potato chips, corn chips) 0 1 2 3 4 5 6 7 8 9
Candy .................................................. 0 1 2 3 4 5 6 7 8 9
Soft drinks ____________________________ 0 1 2 3 4 5 6 7 8 9
Coffee or caffeinated tea ..................... 0 1 2 3 4 5 6 7 8 9
Frozen sweets (which?) __________________ 0 1 2 3 4 5 6 7 8 9
Instant meals, meal bars, diet shakes .. 0 1 2 3 4 5 6 7 8 9
Wine .................................................... 0 1 2 3 4 5 6 7 8 9
Beer ..................................................... 0 1 2 3 4 5 6 7 8 9
Whiskey, vodka, rum, etc ................... 0 1 2 3 4 5 6 7 8 9
4. What specific kinds of the following foods do you eat most often?
(List the name of the food, whether it is fresh, frozen, or canned and how
prepared.)
Vegetables____________________________________________________________
Meats ______________________________________________________________
Desserts ____________________________________________________________
5. Please list the names of any liquid, powder, or pill form of vitamins or mineral
product you take and
state how often you take it. Please list also any diet supplement you use (such
as protein milk shakes
or brewers yeast), how much and how often.
_____________________________________________________________________
16
_____________________________________________________________________
6. Is there anything else we should know about your food / nutrient intake?
_____________________________________________________________________
_____________________________________________________________________
Note: You frequent any food besides fresh fruits, vegetables or sprouted seeds, nuts or grains,
you may be developing hypersensitivity to that substance / food.
Have you ever had or do you now have any of the following?
EVER NOW
Yes No Yes No
___ ___ ___ ___ Alcoholism
___ ___ ___ ___ Allergies or hay fever
___ ___ ___ ___ Serious anemia or other blood diseases
___ ___ ___ ___ Arthritis, gout, or painful joints
___ ___ ___ ___ Asthma, wheezing
___ ___ ___ ___ Back ache or back injury
___ ___ ___ ___ Cancer, leukemia or tumors
___ ___ ___ ___ Cataract ___ left eye ___ right eye
___ ___ ___ ___ High Cholesterol
___ ___ ___ ___ Convulsions, seizures or epilepsy
___ ___ ___ ___ Chronic cough, emphysema or other chronic lung
diseases
___ ___ ___ ___ Diabetes or sugar in urine
___ ___ ___ ___ Diarrhea or colitis (chronic), rectal bleeding or other
rectal ailment
___ ___ ___ ___ Drug addiction or abuse (specify)
__________________________
___ ___ ___ ___ Ear problems or loss of hearing
___ ___ ___ ___ Female organ abnormality
___ ___ ___ ___ Gallbladder stones
___ ___ ___ ___ Glaucoma
___ ___ ___ ___ Goiter or thyroid condition
___ ___ ___ ___ Headaches (disabling) or migraine
___ ___ ___ ___ Heart attack or other heart trouble
___ ___ ___ ___ Heart murmur
___ ___ ___ ___ Hernia (rupture)
___ ___ ___ ___ Hypertension or high blood pressure
___ ___ ___ ___ Immunological deficiency (AIDS or ARC)
___ ___ ___ ___ Persistent indigestion or peptic symptoms
___ ___ ___ ___ Kidney condition, kidney stones
17
___ ___ ___ ___ Liver conditions ___ cirrhosis ___ jaundice ___ hepatitis
___ ___ ___ ___ Enlarged or swollen lymph nodes (glands)
___ ___ ___ ___ Mental / emotional disorders
___ ___ ___ ___ Mitral valve proplapse
___ ___ ___ ___ Paralysis / strokes
___ ___ ___ ___ Prostate problems
___ ___ ___ ___ Psychiatric counseling
___ ___ ___ ___ Serious skin disease, melanoma, psoriasis
___ ___ ___ ___ Ulcers of stomach or duodenum
___ ___ ___ ___ Loss of urine control, bladder problems, difficult
urination
___ ___ ___ ___ Irregular vaginal bleeding
___ ___ ___ ___ Venereal disease
Have you had or do you now have any other condition not listed above? Please
describe:
_____________________________________________________________________
_______________
Are you presently under a doctors care? Yes ___ No ___ For what condition?
____________________
Are you presently under medication? Yes ___ No ___ For what condition?
_______________________
Are you presently in therapy? Yes ___ No ___ Therapists name and telephone
_________________
Do you regularly drink alcohol? Yes ___ No ___ Do you regularly smoke Yes ___
No ___
18
Glandular Function Test
This test can help you determine C. THYROID: OVERACTIVE __ High blood pressure
which glands or organs in you body __ Rapid heartbeat when resting (more __ Asthma
than 90 beats per minute) __ Shingles on trunk of body
might need nutritional support. For __ Tongue quivers, hands shake __ Poor circulation, cold hands / feet
each statement, mark: __ Strong drive followed by exhaustion __ Arthritic pain, swelling rheumatism
1. If it is mildly true. __ Good appetite but cant gain weight __ Feel cold and sweaty, shaky
2. If it is moderately true. __ Fine features, thin skin and hair __ White spots on fingernails
3. If it is totally true. __ Psoriasis or acne
If a statement does not apply, leave it blank. D. LIVER __ Wounds heal slowly
__ Distress (nausea or headaches) from
fats or greasy foods H. KIDNEY
A. PITUITARY __ Distress from onions, cabbage __ Burning urination
radishes, cucumbers __ High diastolic blood pressure
__ Cold hands, feet/cold all over
__ Stool appears yellow, clay-colored, (above 90)
__ Family history of mental illness
foul-odored __ Back and/or leg pains
__ Delivered with forceps
__ Skin oily on nose and forehead __ Swelling of hands and/or feet
__ History of serious head injury
__ Bad breath, bad taste in mouth, body __ Anemic
__ Infertility or impotency
odor (including feet) __ Joint pains
__ Headaches behind eyes or affecting
__ Long history of constipation __ Urinary incontinence
one half of head
__ Prostate problems
__ Disease of bones, ligaments, or
E. ADRENALS:UNDERACTIVE
tendons
__ Eyes sensitive to bright lights I. HEART
__ Excessive urination
__ Tightness or lump in throat __ Chest pain radiating to left arm
__ Water swelling below eyes or in
__ Form gooseflesh easily, cold __ Unexplained headaches, dizziness or
ankles, fingers, feet, etc.
sweats nausea
__ Difficult pregnancy or delivery
__ Pain in upper left neck or left little __ Voice rises to high pitch during stress __ Rapid heart rate (above 90 bpm)
__ Easily shaken up, startled, heart __ High blood pressure
finger
pounds hard from unexpected noise __ Slow heart rate (below 50 bpm)
__ Overweight from waist down
__ Prefer being alone __ Heart flip-flops
__ Overweight from waist up
__ Blood pressure fluctuates, has been
too low on occasion J. THYMUS
__ Avoid complaints, try to ignore __ Very susceptible to infections
B. THYROID: UNDERACTIVE
discomforts and inconveniences __ Flu like symptoms often occur
__ Muscles stiff in morning, feel __ Allergies: skin rash, dermatitis, hay __ Swollen glands in armpits, groin,
creaky after sitting still for long fever, sneezing attacks, or asthma tonsils
periods __ Unusual craving for salt __ Unexplained sweating
__ Feel dizzy or nauseated in morning __ Excessive perspiration __ Feeling of puffiness in throat
__ Motion sickness, dizzy when __ Soreness on both sides of neck at
changing up and down positions F. ADRENALS: OVERACTIVE shoulder level
__ Heart occasionally misses beats or __ Persistent high blood pressure
turns flip-flops __ Stronger than average physically INTERPRETATION
__ Coughing, hoarseness, or muscle __ Strong feelings, tend to blow up In general, if you score higher
cramps that get worse at night __ Female: Excess hair on face, arms or than 3 or 4 points in any category,
__ Sleeplessness, restlessness, failing back, muscular square build, you may benefit by supplementing
memory, forgetfulness aggressive
__ Slow in mornings, gain speed in
your diet with key nutrients and
afternoon G. PANCREAS glandular extracts to support the
__ Dislike working under pressure __ Pain on inside of left shoulder blade specific gland or organ.
__ Go to pieces easily, cry easily or left side of abdomen If your score is extremely high in
__ Gain weight easily __ Blurry left eye any category, you should consider
__ Difficulty concentrating, easily __ Lower bowel gas 2 hours after eating
distracted
consulting a health care practitioner
__ Blood clots rapidly, history of
phlebitis or embolism
for proper diagnosis and treatment.
19
Metabolic Typing
Fast Metabolizer
1. Do you wake up hungry?
2. Are you hungry if you eat mostly fruits and vegetables during the day?
3. Do crave protein and fats?
4. Do you crash or feel tired after eating refined sugar of alcohol?
5. Do your bowels move regularly and tend to be loose?
6. Does strenuous exercise tend to exhaust you and make you grouchy?
If these apply to you it is advised to eat a diet that has warming, concentrated foods
(grains, beans, seeds, root vegetables & seafoods - chicken or turkey is an option but non
1.
game seafood is preferable)
Slow Metabolizer
1. Do you prefer to skip breakfast or eat light?
2. Does it take several hours for your appetite to appear?
3. Do you feel best when eating a light diet of fruits separate from other foods, vegetables
and?
4. Do you tolerate sugars well (in moderation), but feel tired after eating heavy proteins or
fats?
5. Do your bowels mover irregularly or tend to be hard?
6. Does strenuous, aerobic exercise energize you, and make you feel better?
If these apply to you, it is advised to eat a diet that has cooling, dispersing foods (fruits-
separate from other foods, vegetable and fresh juices) along with sea foods, or tofu as
staples. Chicken or turkey is an option but non game seafood is preferable
Balanced Metabolizer
1. Can you manage well eating light or heavy during the day?
2. Are you able to go 4 hours without eating and maintain concentration?
3. Do you have minimal cravings and mood swings?
4. Are you consistent with your bowel movements?
5. Is exercise a varied and regular part of your lifestyle?
If these apply to you, you are able to eat comfortably according to changing seasons and
condition, and are advised to eat a mixed diet of warming and cooling foods.
Recommend you read our booklet Grain Damage and see if you still want to consume
grains or starches.
1. Game seafood is fish caught also for sport. The large ones, including tuna. The larger the
fish the higher up the food chain and the increased odds of toxic mercury and other heavy
metals collecting in the fish.
Two books to get are: The Metabolic Typing Diet by Wolcott & the Nutrition Solution by
Harold Kristal
20
PARASITES
The advent of air travel, population growth, cross cultural dietetics, housepets and stress has
invited a host of unwelcome guests into our bodies. The first major nationwide survey of
parasites diseases has revealed that one in every six people studied has one or more parasites
living somewhere in his or her body Ronald Lotulak Parasites, an Epidemic in Disguise.
You dont need an unhealthy diet to get them. They lodge in the intestines and sometimes all
throughout the body. They are transmitted through fecal fingers handling of foods, sex, un or
undercooked meats, poultry and fish, airborne insects (tse tse flies, mosquitoes, flies, fleas),
animals, and drinking or bathing-water. You eliminate them by ensuring a clean eating
environment, colon hygienics, immune system strengthening and various programs for parasite
elimination. They are tough little critters. Stool tetss traditionally test only for specific parasites
they look for. If you have others they will not be detected.
According to Louis Parrish, M. D., parasites are varying in their pathological potential from
those that are benign-15%; create ignorable symptoms-25% ; to those that compromise quality of
life-55%.
Parasite questionnaire:
Have you ever developed diarrhea or abdominal distress while visiting a foreign country
of another part of the U.S.?_____
Is the consistency of your bowel movements changeable -sometimes hard and then soft
for no apparent reason?_____
Do you have unexplained periods of indigestion?_____
Does your intestinal tract burn, cramp or feel irritable for no apparent reason?_____
Do you have periods of fatigue for no apparent reason?_____
Do you develop frequent colds, flu or other acute illnesses?_____
Have you developed allergies to foods and environment in recent years?_____
Do you have a recurring feeling of unwellness?_____
Do you have recurring candida overgrowth problems?_____
Pets such as cats, dogs, birds________?
For no apparent reason: Itchy ears, nose, anus _____. Men. Sexual disjunction _______
Forgetfulness _____ Slow reflexes _____Gas and bloating ____. Unclear thinking _________
Loss of appetite _______ Yellowish face ______. Fast heartbeat _____. Heart pain _____.
Pain in the navel _____. Eating more than normal but still feeling hungry _____. Blurry or
unclear vision ____.. Pain in the back, thighs or shoulders. _____ Lethargy ___. Numb
hands____. Burning sensation in the stomach ____. Women: Problems with menstrual cycle
___. Drooling while sleeping___ . Damp lips at night ____. Grinding teeth while sleeping ____.
Bed wetting _____. ; Itchy rectum________
Common Parasites: Giardialamblie; Entamoeba histolyca; Entamoeba hartmanni;
Cryptosporidium; Blastocystis hominis; Endolimax nana; Entamoeba coli; Iodamoeba
butschli; Dientamoeba fragilis; Yeasts (hyphal forms are pathogenic). there are many others.
21
METABOLIC BALANCING:
The Tools, and How to Use Them
We learn about our metabolism through observation of the sequential charting of urine
pH. This means that over the course of a day, we use pH paper to determine the acid/alkaline
changes of the urine. At first, testing should be done at each urination, as frequently as possible,
especially when you experience changes in your physical, mental and/or emotional state.
pH paper is chemically treated paper that turns color when exposed to a solution. The
specific color depends on the acid/alkaline value of the solution, yellow being acid and green to
blue being alkaline. This value is determined on a color chart, which accompanies the pH paper.
To use the paper, tear off a short piece and test midstream urine. Immediately compare
the color change of the pH paper with the color chart and record the numerical value on the pH
chart according to the time of day. Test only midstream urine as dilution with water will change
the reading towards the alkaline values.
A daily pH chart (see Appendix A) is used to graph the pH value according to the time of
day when the urine is tested. As you begin the program, testing should be done at the time of
each urination, as frequently as possible (at least four or more times a day). As you collect
readings, connect the points with lines to create a pattern. A general pattern will emerge.
As you observe, you will begin to see that you generally feel better in one particular pH
range. This experience of comfort can change with the time of day, eating (or not eating), and
with certain activities (rest or physical exercise). Be sure to note any such changes in these
factors under the description column.
The description column provides a place for you to list the general types of foods that you
consume. It will indicate the frequency of your eating pattern. If you or your health practitioner
suspect that you have food allergies, then it is even more valuable for you to take the time to note
in detail your dietary intake. Notice the connection between your dietary habits, your pH, and
how you feel.
The indicator boxes under G (Good) and B (Bad) are there for you to mark as your
general health experience. They provide you with an easy visual reference tool with which to
correlate your pH pattern with how you feel.
The pH range in which you are most free of symptoms, will indicate to you your comfort
range. Outside of the range of comfort, you will often begin to experience more of your
symptoms (i.e. headache, fatigue, depression or pain of pain of any sort). This generally
indicates that you have moved out of your comfort zone and have moved into an imbalance. An
imbalance is considered an extreme pH in which you begin to manifest symptoms. This
indicates metabolic dysfunction. The point at which you move out of your comfort range is
considered your point of departure.
22
pH Balance
One of the most important processes in the body is the process by which the pH balance
is maintained. The pH involves the Hydrogen ion. An ion is an atom of some particular element
which has lost most of its parts or gained some extra ones. If an atom gains electrons, it
develops a negative charge (anion). If an atom gains protons, it develops a positive charge
(cation). A positive Hydrogen ion has just one proton. The involvement of this Hydrogen ion in
the nutrition of the body is so important that a special means of measuring it was developed and
called the pH scale. The pH scale is an easy way of measuring this amount. Scientists have
established the pH scale from 0-14. Thus, a solution having a pH of 0 has no ability to attract
Hydrogen ions. Remember p stands for potential and H stands for Hydrogen the potential
of the solution to attract Hydrogen ions. If the scale runs from 0-14, then 7 is the mid-point. A
pH above 7 is alkaline in nature, and a pH below 7 is acid. Distilled water has a pH of 7, or is
neutral. Vinegar has a pH of less than 7, and is therefore an acid. Baking soda has a pH greater
than 7, and is therefore an alkaline.
Each solution in your body has its proper pH, and if its pH gets too far out of balance, the
secretion or solution loses its effectiveness to assimilate or absorb minerals and vitamins.
Enzymes are also affected by the pH of the solution in which they are contained. If you are not
properly absorbing nutrients from the food you eat, then poor health is going to result. For
example, if your body is too alkaline you will have trouble picking up and absorbing IRON.
You could take tons of it and it would just go through the body and never be utilized and you
could be constantly fatigued. If the pH is too acid, a similar problem applies. Blood has a pH of
7.4 and a variance of just a few tenths of its pH, 4 to be precise, can cause a coma or death.
Doctors such as Dr. Allen Nittler, M.D., and Dr. Cary Rheems have stated that on a proper
balanced diet, the healthiest people would have a pH of 6.35 to 6.85. So they use 6.4 and 6.5 as
the correct metabolic balance of both the urine and saliva. The urine pH is indicative of the
balance or imbalance of both the acid and alkaline enzymes in the stomach and the intestines.
The saliva pH is indicative of the condition of the liver, Lymphatic System and the pancreatic
enzymes.
The spread between the two in a very healthy person should be 0. A healthy persons Urine pH
should be 6.4, and their Saliva pH should read 6.4. Remember that is only if they are
HEALTHY. If they are recovering from illness, you should bring the pHs within .5 of each
other. For example, if the Saliva pH is 6.4 the Urine pH should be 5.9, or if the Saliva pH is 6.8,
the Urine pH should be 6.3, etc. The Urine pH should always be more acid than the saliva.
When the pHs have a slight spread, it means the body is de-toxing. If the spread is too far apart,
the person is not digesting or assimilating nutrients correctly. Sometimes the pHs will even
crossover, this of course is very undesirable, e.g. a Saliva pH of 6.1 and a Urine pH of 6.8. You
want to open those up and spread them apart as soon as possible. When a persons pHs read
Urine 5.9, Saliva 6.4, and they are having a difficult time relaxing or even appear hyper you need
to throw the pHs more alkaline and keep the spread, if the person is recovering. When a
persons pHs read Urine 6.4 and Saliva 6.9, and the person feels sluggish, you need to swing the
pHs more acid and keep the spread if the person is recovering.
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PH Scale of Acidic Reaction
ACID ALKALINE
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14
1. Fruits Contain organic acid the body can eliminate through the lungs.
Contribute to the alkaline reserve.
Put little stress on the body.
2. Cellular Activity Produces weak acid that can be eliminated through the lungs.
Does not stress the body excessively.
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*Things to Avoid Some Suggestions:
Sometimes just avoiding the things that are destructive to the system has brought about heath.
The things we dont do can be more important than the things we do.
AVOID: TAP WATER, including its use for teas, soups or the like. This means processed
city water.
AVOID: POTATO or CORN CHIPS and the like, the oil is almost always rancid.
AVOID: most PROCESSED, packaged, frozen, or canned foods. Many additives are not
included on the label, so you will not know you are getting them.
AVOID: all DIET foods. The chemicals used such as Nutri-Sweet are both dangerous and
hazardous to your health. In fact saccarine is the least offensive to the energy
field.
AVOID: SODA POPS. There are at least 13 spoons of sugar in your average soft drink.
The natural fruit juice drinks with seltzer are a very tasty substitute. However,
moderation is always the key to good health.
AVOID: believing that something is OK for you just because you bought it at the Health
Food Store. Junk food is found everywhere.
AVOID: eating out too often in RESTAURANTS. Many chemicals are used in the typical
restaurants, for flavor and keeping salads crisp etc. The prime objective is to
reduce costs, not to protect your health.
AVOID: eating REFINED items such as sugar, white flour, chocolate, most carob-covered
things, candy bars, most cookies, cakes, pies, etc. (there are healthy versions.)
AVOID: using DISTILLED vinegars. Use cold pressed and naturally fermented.
AVOID: ALUMINUM containing substances. These include pickles with alum, most
toothpaste, most digestive remedies, such as Tums. Most deodorants, ordinary
salt, most baking powders, and of course aluminum pots, pans, and foil.
Aluminum appears to be biotoxic increasing rate of aging, increasing skin
wrinkles, etc.
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Fat Content as a Percentage of Total Calories
10% Or Less Fat 10% - 30% Fat 30% - 40% Fat 40% - 50% Fat Over 50% Fat
Beans Blue fish Bran muffins Beef,lean ground Avocados
Bread Bran cereal,plain Cheese crackers Cakes Bacon
Cereals, flake Buttermilk Chicken wings Chicken, dark Beef stew
Cereals, puffed Cheese, cottage Croutons meat Blue cheese
Cream of wheat lowfat Fish, most other Corn chips dressing
Fruits, most Chicken breast fatty Doughnuts Bologna
Jello Collard greens Flank steak French fries Brie cheese
Milk, non-fat Fish, lean Gazpacho Ham Butter
Milk, skim Granola, most Loin lamb chops Ice cream, Cheese, whole
Potatoes Halibut Pie, fruit regular milk
Pretzels King crab Pink salmon, Milk, whole Chocolate
Rice Lobster canned Pies, most non- Corned beef
Soup, bean Milk, lowfat Pizza fruit Cream cheese
Soup, chicken Oatmeal Rump roast Ricotta cheese, Eggs
noodle Oysters Tapioca pudding part skim Gravy
Soup,minestrone Pancakes Trout Porterhouse Ground beef,
Soup, vegetable Popcorn, plain Tuna, in oil steak chuck
Tuna, in water Saltine crackers Waffles Sardines Hard cheese, most
Turkey, white Scallops White perch Yogurt, whole Herring
meat Soup, onion Tofu Hot dogs
Vegetables, most Soup, pea Ice cream,
Whole grains premium
Yogurt, lowfat Margarine
Mayonnaise
To plan a diet low in saturated fat, select only those exchanges in the left-hand
column.
Nuts / Seeds
Oil-based dressing
Margarine* 1 tsp Butter 1 tsp Olives
Avocado (4 in. diameter) tsp Cream, light 2 tbsp Peanut butter
Oil: corn, cottonseed, Cream, sour 2 tbsp Potato chips
safflower, soy, Cream, heavy 1 tbsp
sunflower, flaxseed 1 tsp Cream cheese 1 tbsp Sausage
Oil, olive 1 tsp French dressing 1 tbsp Sirloin steak
Olives 5 small Lard 1 tbsp Sour cream
Almonds 10 whole Mayonnaise 1 tsp Soups, milk base
Peanuts 20 whole Salad dressing, 2 tsp Spare ribs
Walnuts 6 small mayonnaise type 2 tsp
Nuts, other 6 small Sweet rolls
Vegetable oils
* Made with corn, cottonseed, safflower, soy, or sunflower oil only. Whipped cream
Fat content is primarily monounsaturated.
If made with corn, cottonseed, safflower, soy or sunflower oil, can be used on fat modified diet.
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Are You Eating Enough Alkaline Foods to Maintain Vital Health?
This chart provides information that shows the contribution of various food substances to the acidifying
of body fluids, and ultimately, to the urine, saliva, and blood. In general, it is important to eat a diet
that contains foods from both sides of the chart.
Allergic reactions and other forms of stress tend to produce acids in the body. The presence of high
acidity indicates that more of your foods should be selected from the alkalizing group.
You may find it useful to check your pH using litmus paper from your local drug store in order to find
out if your selection is providing the desired balance. Ask your druggist for pH paper strips
People vary, but for most, the ideal diet is 85 percent alkalizing and 15 percent acidifying
foods by volume.
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