DepKETOSIS Assessment

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1. If you had a full schedule for your morning and had to be at your peak until lunch, which of these breakfast choices would most likely provide the highest sustained energy, knowing that you would have no opportunity to snack or reach for a stimulant such as caffeine or sugar to keep your energy high for 4 to 6 hours?* This field is required.

A. I would be my best if I included an animal protein such as bacon, sausage or ham as a part of my breakfast.

B. Almost any meal will give me the energy I need.

C. I would reach for something such as fruit, toast, yogurt or a protein shake.

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2. Whether you’ve been taught that salt is healthy or unhealthy, what are your thoughts about salt?* This field is required.

A. Love it, would add it often to my foods and/or I love snacks such as chips, pretzels, crackers, etc.

B. I could take it or leave it.

C. I never or rarely add salt and/or I often find foods too salty.

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3. If you have ever been on a juice or water fast for any length of time how did you or how do you feel you would react?* This field is required.

A. I reacted poorly; low energy, anxious, and/or starving.

B. I could fast if necessary.

C. I thrived when fasting and could do this regularly.

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4. Whether you’ve been taught that white or dark meat is good or bad, when the turkey plate is being passed around, which would you prefer solely based on taste and desire?* This field is required.

A. I would reach for a thigh or leg.

B. Either light or dark meat would be pleasurable.

C. I prefer white meat because I enjoy the taste the best.

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5. A sudden loud noise will cause me to…* This field is required.

A. Have little or no reaction

B. Have an average reaction

C. Really make me jump

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6. My breathing tends to be…* This field is required.

A. Almost always deep or regular.

B. Varies between deep and shallow while sometimes irregular.

C. Often irregular or shallow.

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7. A very bright light or exposure to direct sunlight will…* This field is required.

A. Have little or no effect on me.

B. Create an average reaction.

C. Really bother me and often force me to wear sunglasses.

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8. My reflexes tend to be…* This field is required.

A. Slow.

B. Average speed.

C. Very quick.

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9. If you had a full schedule for the afternoon and had to be at your peak until dinner, which of these lunch choices would most likely provide the highest sustained energy, knowing that you would have no opportunity to snack or reach for a stimulant such as caffeine or sugar to keep your energy high for 4 to 6 hours?* This field is required.

A. I would be at my best with something such as a burger or salmon filet as a part of my lunch.

B. Almost any meal will give me the energy I need.

C. I would be my best with a large salad or vegetables as a part of my entrée.

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10. If you are going to eat seafood at your local eatery, would you choose a lighter fish such as tilapia or orange roughy or a heavier seafood choice such as shrimp or Ahi tuna?* This field is required.

A. I would prefer shrimp or Ahi tuna

B. Either would work for me depending on the day

C. I would prefer tilapia or orange roughy

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11. If you drank a glass of orange juice without any food…* This field is required.

A. I would feel poorly with symptoms such as being jittery, anxious or nauseous

B. My results would be neither negative nor positive

C. This would give me positive lasting energy

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12. Eating some type of meat or seafood with my meal will…* This field is required.

A. Energize me

B. Make no significant difference in my energy one way or another

C. Lead to low energy or other negative symptoms

D. I am a vegetarian or vegan and this does not apply

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13. Eating fatty foods such as avocado, cheese or butter makes me feel…* This field is required.

A. More energized and satisfied longer

B. No significant difference in satisfaction or energy

C. Lethargic and/or unsatisfied

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14. Whether you feel that any type of dessert is good or bad for you, which of these choices would appeal to you simply based on your desire?* This field is required.

A. I would prefer a piece of cheesecake or some other creamy dessert

B. Either cheesecake or a dish of mixed berries would work for me

C. I would prefer something sweeter such as a dish of mixed berries

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15. How do you feel about eating dessert?* This field is required.

A. I love it and would eat it often if I could get away with it

B. I can take it or leave it

C. I really do not like dessert except on rare occasions

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16. When or if I consume sweets between meals such as candies, cookies or cakes I feel…* This field is required.

A. That this may provide initial energy but often leads to a crash or further cravings

B. That this would not create a significant challenge for me but I may not be at my best

C. That it would not have any negative effects and may actually satisfy my appetite

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17. If you had a full schedule for your evening and had to be at your peak until bedtime, which of these dinner choices would most likely provide the highest sustained energy, knowing that you would have no opportunity to snack or reach for a stimulant such as caffeine or sugar to keep your energy high until bedtime?* This field is required.

A. I would be at my best with a small steak, chicken thigh or leg or shrimp as a part of my entrée

B. Almost any meal will give me the energy I need

C. It would be best with a salad or vegetables as my main entrée

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18. I experience the most significant weight gain when…* This field is required.

A. I over consume carbohydrates such as breads, cakes, cookies and/or sweets

B. I typically gain weight whenever I eat too much food of any kind; I see no noticeable difference based on fat or carbohydrate products

C. I over consume fat

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19. If you consumed a cup of caffeinated coffee on an empty stomach, how would you feel or imagine you would feel?* This field is required.

A. This would make me feel anxious, jittery, headachy and/or hungry

B. I could take it or leave it

C. I do well on coffee as long as I do not drink too much

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20. If I skip a meal I will feel…* This field is required.

A. Anxious, jittery, and weak, depressed and/or have other negative symptoms

B. I would simply have normal hunger pangs

C. That this would not bother me and I may often forget to eat or skip meals

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21. My eyes tend to…* This field is required.

A. Blink often

B. Have average blinking activity

C. Not blink very much

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22. My pupils of my eyes…* This field is required.

A. Take up more than half of the width of my iris

B. Take up half the width of my iris

C. Take up less than half the width of my iris

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23. In regard to physical activity…* This field is required.

A. I can be active for long periods

B. I have average endurance

C. I work best in spurts

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Score