QUESTIONNAIRE EXAMPLE RESPONSE
Diet advice response example
Name
Each one of us is different and therefore our nutritional needs differ. There is no such thing as a diet that is right for everyone.
Western attitudes to diet and eating tend to assume we are all the same. General dietary advice is frequently given on television, radio, and in our newspapers and magazines. We are all advised to eat less fat, consume more vegetables or take additional vitamins. Fried foods are bad, steamed are good. Eggs contain too much cholesterol and we should choose low fat yoghurts, cheese and milk. Whereas this advice might help at one level it does not take into account that we all need different foods depending on our condition and the environment in which we live and work.
We often get into eating habits that we think will be good for our bodies and health, and not what our bodies actually need.
An Oriental approach recognises that each person has different nutritional and dietary needs based on their own constitution. Over 2000 years of careful observation has led to a method whereby an assessment of someone’s health can be made by understanding patterns and indicators through questioning. Acupuncture and Herbalism employ the same principles as Traditional Chinese Medicine. Your diagnosis is based on the answers you gave to our questionnaire and the dietary advice following it is designed to address your nutritional imbalances thereby restoring and maintaining your health.
Remember that both the diagnosis and subsequent dietary advice relate to you personally and do not apply to other people.
You should follow the nutritional guidelines for 3 months. Afterwards, you should be reassessed and a follow up questionnaire is included.
All foods recommended are every day and readily available. As you will see, we are recommending foods you should include in your diet as well as foods you should avoid.
Important Guidelines Read before following advice.
1 The nutritional advice starts in ‘section 1’ with lists of foods that will help balance your diet.
2 Try to include more of these in your day to day diet. Eat as you would normally, but try to include as many of the foods listed as you can over the next 3 months.
3 It is often the case that those listed are not the ones you prefer. Do not force yourself to eat those you really dislike but try to include as many of the others as you can.
4 There may be foods listed that you never get around to including over the 3 month period. Do not worry, just try to include as many as you can in a balanced way.
5 DO NOT eat excess amounts of any one thing. For example if there is ‘Onions’ on the list, do not include them in every meal or eat excessive amounts. Simply try to include more of these than normal in your general diet.
6 Do not eat any foods that you are allergic to.
7 The second list in ‘section 2’ includes foods we recommend that you avoid for the next 3 months. If you have, for example been drinking a lot of coffee and it is on the ‘exclude’ list, it may be difficult to cut it out completely, so try to reduce your consumption of it as much as possible.
8 The following nutritional advice is intended only for those who want to improve their health and the advice given is not intended for treatment of major problems.
9 We would strongly advise anyone with major concerns or medical problems to consult their doctor or medical adviser without delay. We can not accept responsibility for any worsening health condition after following the nutritional advice that we give.
10 All foods recommended are as far as possible normal items and readily available. .
Section 1
NUTRITIONAL ADVICE FOR BETTER HEALTH RESPONSE TO THE ’naturally healthy‘ QUESTIONNAIRE
Bear in mind ‘Important Guidelines’ points 8 and 9 before following this advice.
From the answers you gave to the ‘naturally healthy’ Questionnaire a Traditional Chinese Medicine diagnosis has been made.
In simple terms, your diagnosis is based on an assessment of your internal environment; whether it is hotter or cooler, too damp or lacking in energy, as well as the condition of your internal organs and blood. These have all been diagnosed individually and foods to include or exclude are recommended for your condition where imbalances occur. Consequently, you may find that some foods are repeated in more than one paragraph. Do not be concerned and do not make a point of eating more of any repeated foods. Remember, it is important that you choose as wide a variety as possible of the foods we recommend in a balanced way and avoid those you should exclude.
Section 1 – Foods to include
Bear in mind ‘Important Guidelines’ numbers 1 to 6 before eating these foods.
Your answers suggest that your blood could be richer in certain nutrients and you would benefit from foods that will help put them back. These will maintain and improve the quality of immediate nourishment available to your body.
Apricots, Beef, Beetroots, Chicken Eggs, Dates, Dark Leafy Greens, Figs, Grapes, Kidney Beans, Liver, Loganberries, Parsley, Sardines, Spinach, Watercress.
More unusual foods that will help counteract cold are:
These foods are of a more exotic nature but will do the same as those previously listed.
Bone Marrow, Dandelions, Nettles, Octopus, Oysters, Sweet Rice.
Your answers indicate that the internal environment of your body is colder than it should be. This is the cause of some of your symptoms. The warming foods that will help nourish your Yang (your internal warming mechanisms) and help balance this for you are:
Anchovies, Basil, Bay Leaves, Black Pepper, Cherries, Chestnuts, Chicken, Coriander Seeds, Dill Seeds, Garlic, Ginger, Kidneys, Lamb, Leeks, Mussels, Mustard Leaf, Mutton, Nutmeg, Onions, Peaches, Pine Kernels, Rosemary, Shrimps, Trout, Turnips, Vinegar, Walnuts.
More unusual foods that will help counteract cold are:
Cayenne, Sweet Potatoes, Sweet Rice, Squash.
SECTION 2
Name: Example
Section 2 – Foods to LEAVE OUT
It would be beneficial if you could leave out the following foods from your diet.
Bear in mind ‘Important Guidelines’ number 7
As identified earlier, your internal environment is colder than it should be. You should avoid the following foods as they exacerbate this condition.
Asparagus, Cold drinks, Bananas, Clams, Cranberries, Gooseberries, Grapefruits, Ice Cream, Limes, Lemons, Mangos, Melons, Octopus, Rhubarb, Salt, Tomatoes, Water Chestnuts, Watermelons, Wheat, Yoghurt.
Follow up
Follow this advice for 3 months maximum, and we feel sure you will notice a difference. Enclosed is a follow up questionnaire. Please complete and return it with your payment at the end of the 3-month period or as soon after as is convenient. This is important because our nutritional advice will need to be updated once your condition has changed.
You may find that some of the foods you usually eat are not mentioned in either list. If this is so, regard these foods as ‘neutral’ and not of particular relevance to your condition. Feel free to continue to include such foods while ensuring that you eat a sensible balanced diet.
This information is only an example of a diet response sheet