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12 Sleepy or fuzzy headed particularly after carbohydrate meals?
13 Suffer from afternoon fatigue?
14 Indigestion after meals?
15 Acne?
16 Physically unfit?
17 Hirsutism (excess facial hair or on the thighs)? (Women only)
18 Dry, flaky skin?
19 An earlobe crease in each ear?
20 Postural hypotension (your blood pressure drops when you stand up)?
21 Arcus senilis in your eyes? (This is a marking in the coloured part of the eye, the iris, where there is a white circle within the circumference, usually at the top of the iris under the eyelid (11 to 1 o’clock), but sometimes in the lower part too (4–8 o’clock), and sometimes around the whole iris)
Score out of 21 (women) =
Score out of 20 (men) =
Part three – Diet
Scoring this part of the questionnaire
Each ‘yes’ answer scores one point. Please note that if you smoke more than 15 cigarettes a day, then you score one point three times for the smoking-related questions. The same principle applies to the alcohol, water intake and vegetable intake questions.
Do you now or have you ever in the past:
1 Eat refined carbohydrates (e.g. white bread, white rice, sugar)?
2 Eat hidden sugars in foods or drinks?
3 Regularly eat large meals?
4 Smoke more than 15 cigarettes a day?
5 Smoke more than 8 cigarettes a day?
6 Smoke cigarettes every day or more than 10 a week?
7 Drink caffeinated drinks (with or without sugar) (e.g. coffee or cola drinks)?
8 Drink more than four cups of tea a day (with or without sugar)?
9 Drink more than 2 units/glasses of alcohol a day?
10 Drink more than 4 units/glasses of alcohol a day?
11 Eat fried food more than once a week?
12 Eat barbecued food more than once a month?
13 Eat processed foods regularly, including microwave or oven meals?
14 Eat protein foods (e.g. fish, white meats, eggs, meats) less than 3 times a week?
15 Are you a vegan (no meat or dairy products)?
16 Drink more than two glasses of fruit or vegetable juice a day?
17 Seldom eat oily fish, nuts and seeds? (see chapter 6 (#litres_trial_promo))
18 Eat less than one portion of fresh vegetables a day?
19 Eat less than two portions of fresh vegetables a day?
20 Eat two meals a day or less?
21 Eat just one meal a day?
22 Drink less than three glasses of water a day?
23 Drink less than five glasses of water a day?
24 Drink less than eight glasses of water a day?
Score out of 24 =
Part four – lifestyle and exercise
Scoring this part of the questionnaire
Each ‘yes’ answer scores one point, except where indicated with regard to frequency of exercise. Exercise in this context means anything in which you are physically moving for at least 20 minutes at a time, be it aerobic, stretching or resistance work.
Are you now or have you ever in the past:
1 Regularly stressed or anxious?
2 A poor sleeper?
3 Always chasing appointments or deadlines?
4 Unable to relax without feeling guilty?
5 A person who has a persistent need for achievement?
6 Easily angered?
7 A sedentary person (e.g. office worker)?
8 A person who does anaerobic (e.g. weights only) and no aerobic exercise?
9 A person who exercises 3–4 times a week (score 1)?
10 A person who exercises 1–2 times a week (score 2)?
11 A person who exercises less than once a week (score 3)?
12 A very competitive person?
13 Irritable and impatient?
Score out of 16 =
Part five – Blood test results
Scoring this part of the questionnaire
Read through this section and answer any questions for which you have blood test results. Skip this section if you have not had a blood test done.
Do you currently have any of the following?
1 High fasting insulin
2 High fasting triglycerides
3 High triglycerides after a meal
4 Decreased HDL (good) cholesterol
5 Elevated LDL (bad) cholesterol
6 Elevated total cholesterol
7 Elevated systolic blood pressure (your first figure is over 139)
8 Elevated diastolic blood pressure (your second figure is over 89)
9 Elevated fibrinogen
10 Elevated PAI-1 (plasminogen activator inhibitor-1)
11 High uric acid (or gout)
12 Low Serum or Salivary DHEA (DHEA may have an inverse relationship with Cortisol and insulin)
13 Elevated testosterone in women (acute hyperinsulinemia increases testosterone blood levels and suppresses SHBG synthesis) (women only)
14 Low levels of sex hormone binding globulin (SHBG) (women only)
15 Decreased testosterone (serum or saliva test) (men only)
Score out of 14 (women) =
Score out of 13 (men) =
If you have answered ‘yes’ to any of the questions above, other than insulin itself, you should consider a fasting glucose and insulin test to rule out Insulin Resistance and diabetes. Also, make sure you discuss ‘positive’ results with your doctor. (See Resources (#litres_trial_promo) for laboratory information.)
Your scores
Section five of the questionnaire determines whether you have Insulin Resistance or not, and to what degree. However, the sections one to four of the questionnaire help to quantify your risk and will show you which aspects of the Insulin Factor Plan you need to follow. The higher your score in the first four sections, the more advisable it is to have an Insulin Resistance test.
Use the chart below to note your scores and total them up.
Total scores
Interpreting the questionnaire
Whilst your total score is perhaps the most important indicator of overall risk for Insulin Resistance, the individual parts also have relevance. Both are categorized according to risk in the table below.
The Insulin Resistance questionnaire indicates the degree of Insulin Resistance you may have. The following text clarifies your risk of Insulin Resistance, and will help you plan your dietary and lifestyle changes.
1 Family and Health History: As only two elements in this section can change (weight and age), this is a relatively fixed score. This sets the scene for your risk, but does not determine it.
2 Signs and Symptoms: If you scored highly on this part of the questionnaire, together with a moderate risk total score or more, it suggests that you could be at a moderately advanced stage of Insulin Resistance, particularly if you are overweight. You need to follow all parts of the Insulin Factor Plan.
If you score highly on this section but only score a low risk on all other parts of the questionnaire, then consider taking the Adrenal Stress Profile saliva test and study chapter 9 on stress. You will also need to follow the dietary plan in chapter 13, and the Adrenal Support Supplement Programme.
3 Dietary Factors: If you scored highly on this part but not on the others, this puts you at risk of being in the early stages of Insulin Resistance, and increases your risk of developing it in due course. Eating refined carbohydrates represents the single biggest risk factor for developing Insulin Resistance. This risk is more pronounced if you score highly in part 4, Lifestyle and Exercise. You need to concentrate on the dietary plan in chapter 13, and follow the Insulin Resistance Supplement Plan One.
4 Lifestyle and Exercise: If you score highly in this section only then is there a need to start becoming more physically active. Even if you are not overweight you could well be in the early stages of Insulin Resistance. Inactivity is a profoundly important risk factor for Insulin Resistance, especially if you’ve scored highly in part 3 of the questionnaire, Dietary Factors. You need to read chapter 10 and find out the most suitable exercise for you.
5 Blood Test Results: These give ‘hard’ evidence of your current degree of Insulin Resistance, which is examined in more detail here (#litres_trial_promo). It is unlikely that a high score in this part would not be matched by high scores in other parts of the questionnaire. Don’t worry if your test results score highly: it doesn’t mean you can’t change them, far from it. In fact, the blood tests are an excellent way to monitor your improvements when you implement the Insulin Factor Plan.
Improving your situation
Your total questionnaire score, for either four or five parts, represents your baseline score, which will improve when you begin to implement the Insulin Factor Plan. Please redo parts 2 to 4 or 2 to 5 inclusive (not part 1, unless you have lost weight and are a year older) one month after you begin any changes in diet, nutrition and exercise to see the reduction in your scores. This is a good way of monitoring how you are doing, and will hopefully encourage you to keep going. If your score does not go down at all, please review chapter 12, which provides you with the model of how to reverse Insulin Resistance, and double check that you have gone through the action steps and check lists. If, within another month, there is still no change, it would be best to go and see a qualified nutritionist (see Resources (#litres_trial_promo)).
There are many other questionnaires in this book but the Insulin Resistance questionnaire is the most important. Keeping your results of the questionnaires in mind, let’s now take a look at the six major causes of Insulin Resistance and how your questionnaire results tie in with them.
The six major causes of Insulin Resistance
There are six major causes of Insulin Resistance and your results from the questionnaires will show you how much of a contributor each one is to you.
1 General diet: eating too many refined carbohydrates and over-processed foods (this includes low nutrient levels and an imbalance in dietary fats – see chapters 5–8 (#u25abbe72-d9f6-50af-a4b0-b99836659ad3))
