Personal Health Profile

Thank you for visiting the personal health profile portion of this site. The following series of question are totally anonymous and no cookies will be set. Please try to answer as carefully and honestly as possible. The results will have little meaning if you don't. At the end of this survey when you press the profile button you will be given your identification number and your score. Record these since they will be your key to gaining access to your personal health profile risk analysis and the menu of database queries to compare your score with all the others who have also completed this questionaire.

ALL DATA is entered as an integer

If you enter an m for example in the question on marital status the data will not be accepted.



if this is your first time doing this health profile please enter 0
if you have done this before please enter your last id number ... thanks
age
race
afro-american = 1
asian = 2
caucasian (white) = 3
native american = 4
other = 5
sex
Female = 1, Male = 2, input integer value only
marital status
Single = 1
Married = 2
Divorced = 3
number of children
height in inches
weight in pounds
perceived personal health evaluation how good do you feel day to day (scale one to ten) ... 1 ... terrible all the time ... 10 ... great all the time
continent of birth
Africa = 1
Anarctica = 2
Asia = 3
Australia (include New Zealand) = 4
Europe = 5
North America = 6
South America = 7
country or continent of current residence
Africa = 11
Anarctica =12
Australia =13
New Zealand = 14
Asia -China = 15
Asia -Japan = 16
Asia -other = 17
Russia = 18
Europe = 19
Canada = 20
USA = 21
Mexico = 22
Central America = 23
Argentina = 24
Brazil = 25
Chile = 26
Columbia = 27
Peru = 28
Venezuela = 29
other not mentioned enter
continent number as above (1 thru 7) ... thanks
number of years in current residence
email address

occupation
carpet installer = 19
pest / bug / termite exterminator = 20
hair dresser = 13
plastics worker = 14
diagnostic radiology = 5
chemotherapy nurse = 16
computer parts manufacture = 12
radiation therapy technician = 18
not listed = 0
number of years at the above occupation only if it is one of the listed occupations -enter 0 (zero) if your occupation is not listed above
do you have new carpet either at work
or at home? ... No = 0
Yes = the number of months you have been
exposed to the new carpet up to 60 months
number of cigarettes you smoke now
or have "ever" smoked in your life per day
number of years you have smoked
either now or in the past
secondary smoke exposure
number of cigarettes exposed
to daily either now or in the past
number of years you have been
exposed to secondary smoke
either now or in the past
number of hours (total) of aerobic exercise each week (count only the time when your heart rate is elevated continuously for a minimun of 30 minutes)
number of years you have
exercised this much
have you ever had any surgical procedures?

no surgery ... 0
coronary bypass ... 10
angioplasty or stent ... 9
athroscopic knee surgery ... 3
gallbladder surgery including
laparascopic cholecystectomy ... 5
cancer surgery of any variety ...15
rate your satisfaction with your surgical procedure on a scale from ...1...(bad results) to ...10... (good results) (no surgery = 0)




dietary information ... just answer as an integer the requested numbers ... for catagories that you don't eat or drink simply leave a ...0 .... please answer all, thanks
number of meals containing meat
(beef, chicken, turkey or any other
animal meat / week
number of meals containing pork / week
number of meals containing fish / week
number of meals containing cheese (not part of pizza) / week
number of glasses of milk / week
number of pizzas / week
if you don't eat meat or cheese now, was there ever a time when you did and if so, how many years did you eat meat and cheese? *** OR *** if you do eat meat and cheese now ... how many years have you eaten meat and cheese?





number of sodas (pepsi, coke, seven-up etc) / week
number of diet sodas / week
number of beers or glasses
of wine / week
number of hard drinks / week
number of candy bars, powerbars, cliff bars, balance bars, mike and ikes or other servings of candy / week
number of sports nutrition servings ... ie gels, bars, gu, Gatoraid
servings of ice cream / week
number of cookies / week
number of cakes / week
number of pies / servings / week
if you don't eat sugar now, was there ever a time when you did and if so, how many years did you eat sugar? *** OR *** if you do eat and drink simple sugars now ... how many years have you been comsuming simple sugars?





slices of whole grain bread / week
servings of whole grain pasta / week
servings of cooked organic veggies / week
servings of raw organic veggies / week
fresh organic green salads / week
number of glasses of organic veggie juices / week
servings of tofu / week
servings of tempeh / week
number of servings of organic beans (black beans ... pinto beans ... etc) / week
number of servings (small bags) potato chips / week
Important: your years of detoxification ... if you are vegan now, how many years have you been vegan?
*** OR ***
If you are not vegan now
were you ever and if so how many years? ... thanks
Vegan only: how many years has 50% or
more of your produce been organic?
For how many of your vegan years were
you also sugar free?





in this next section we would like you to enter an an integer (no dollar signs or decimal points) the typical amounts of money you and / or your family are spending for food both at the grocery store and out as well as medical and dental care including your typical insurance amounts if you have insurance ... thank you

monthy food costs ... food eaten at home ... try to estimate as close as possible
weekly food costs eating out ... try to estimate a rough average ...
cost of your average meal out ... not the cheapest or the most expensive ... just the median
monthy medical expenses ... enter as integer only no decimals or dollar signs ... please include insurance costs
yearly medical expenses ... enter as integer only no decimals or dollar signs ... please include insurance costs
monthy dental expenses ... enter as integer only no decimals or dollar signs ... please include insurance costs
yearly dental expenses ... enter as integer only no decimals or dollar signs ... please include insurance costs
emergency room, physician, hospital or dental visits last 12 months for you and your family, please, no trauma visits -only visits for reasons other than broken bones, lacerations etc.
number of known friends, acquaintances or family with cancer, heart disease or cerebrovascular disease (stroke)
do you have insurance? ... enter ...0...
for no insurance...1... to ...5... if you have it covered as a benefit at work with one being low satisfaction to 5 being satisfied and ... 6... thru ...10... if you pay for your own health insurance with six being low satisfaction to ten being high satisfaction





in this next section we would like you answer these questions with a ... 0... if you do not have any of the symptoms or diseases listed and if you do please respond with a number between ... 1 ... (the disease and / or symptoms are not significantly affecting your day to day life) and ... 10 ... (the disease and / or symptoms are totally compromising your daily life)
cancer, unexplained weight loss, fatigue, chronic cough,
cardiovascular disease, hypertension, coronary artery disease heart attack, chest pain, nausea with exercise, hair loss either male pattern balding or loss from the backs of your legs, shortness of breath
cerebrovascular disease "stroke" transient
ischemic attacks, mild strokes, dizziness, headache
autoimmune diseases, lupus erythematosis,
rheumatoid athritis, juvenile diabetes,
adult onset diabetes mellitus, chronic sugar toxicity, loss of sensation in either your hands or feet, gangrene, vascular insufficiency claudication (pain in your legs with walking)
osteoporosis, collapsed vertebrae, broken hips
stress fractures
kidney stones
number of common colds, flus viral gastroenteritis, stomach flu, tooth aches within the past 12 months
other diseases:

none = 0
gout ... 1
gallstones (cholelithiasis) ... 2
kidney and / or bladder infections ... 3
genetic diseases

none = 0
cystic fibrosis = 10
familial hypercholesterolemia = 11
glucose-6-phosphate dehydrogenase deficieny = 7
glycogen storage diseases (Von Gierke's/Pompe's etc.) = 9
PKU (phenylketonuria) = 5
sickle-cell disease = 4
Tay-Sach's = 6
other = 8
click here when complete:
Dr. Mericle's Blog
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Unsolicited Endorsement

Just wanted you to know that I appreciate all the helpful tips you send from time to time. Thank you again and keep doing the best you can to 'save lives.'

Nathalee Dixon
Kingston, Jamaica



Unsolicited Endorsement

Really enjoy the newsletter. Find it very informing so thank you. Gave up drinking milk last year after reading your article! Feel much healthier as a result.

Wendy Goodwin
UK


Unsolicited Endorsement

I appreciate the information. I learned this, not in the same depth, 15 years ago and needed to be reminded how detrimental this is. Knowledge is power.

Lee Ketcham
Cincinnati, Ohio


Unsolicited Endorsement

"I love this diet because it takes so little time to prepare."

Referring to episodes of hypoglycemia:

"I really like this diet because I do believe the episodes of hypoglycemia are caused by the lo-carb approach, which is wrong for me."

From a latter letter:

"...and the drastic cut-down on sweets, and the diet (I would say I practice most of the time) must be helping......because I am not usually hungry, and have had NO episodes of hypoglycemia ..."

Diane Newman R.N. B.S.N. Hamilton, Ohio


Endorsement

The Mericle Diet and Me

I have been reading about diet and health since 1986, but The MericleDiet has definitely helped me the most. After following Dr. Mericle's suggestions for over 15 months, I can truthfully say I will never stray from his program. One of the unseen benefits has been the reduction of blood pressure medicine I take. Although I have never been a big consumer of sugar, I now consume even less since I now understand the importance of keeping your insulin levels low. I am now able to keep my blood pressure at an optimal level with half the medication of my pre-MericleDiet days. And, the ease of this program! I always have something yummy and ready to eat! For the first time in my adult life I no longer suffer, and I do mean suffer, from the yo-yo syndrome!

This is absolutely the best program for me and my family...

Kay McIlroy
Colorado Springs


Unsolicited Endorsement

Hi Doctor , I congratulate you on your mailings , lately about sugars , for sure I will reduce mine and kids use and abuse of sugars , , please can you explain about real honey and I mean real one , We buy directly from a producer that got plenty of beehives . Thanks very much and keep up with the good work.

E.B.
Uruguay



Unsolicited Endorsement

I had the best dinner tonight, I sauteed some onions and fresh garlic in my wok, then put it on the side then sauteed a red bell pepper, tofu, and broccoli, ( put that on the side) then took some cooked brown rice and fried it up adding water and soy sauce, then added it all together, then made a fresh salad with red onions, spinach leaves,romaine lettuce. That was the best meal I've had in sooooooo long!!!!! mcdonalds ( or any restaurant , for that matter)couldn't touch that meal !!!!! Thanks Yolanda

From another letter:

The best part of this diet is that when I'm finished eating I don't feel guilty, and I don't feel blah, I feel good, nooo I feel GREAT !!!!! for lunch I had potatoes( the way you said to cook them ) and some corn tortillas. Thanks Yolanda

Yolanda Highsmith
Sulphur, Louisiana


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