Kaiser-Permanente Vegan Lifestyle Clinic (VLC)
Food and Exercise
Questionnaire |
This questionnaire is about your usual food
intake. There are also some questions about exercise. Foods
are scored in such a way as to reflect both an adequate nutritional
intake and the degree to which your lifestyle follows the exercise
and vegan food recommendations of the Kaiser-Permanente Vegan
Lifestyle Clinic (VLC). A larger and self-calculating spreadsheet
version is available via free download. |
Name : Last ___________
First______________ MRNR Date of birth: mm/dd/yy Male __
Female__ |
Wt (lbs)______Ht (in)_______ |
BMI= |
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Body Mass Index (BMI) = 705x(lbs) ÷ (in) sqd Ex:
705X175 lbs ÷ (62"x62")=32.1 (Obesity II) See chart at
bottom to interpret your BMI number. |
Instructions:
Listed below are food items divided into sections according to
food type. Please put a whole or decimal number (or leave blank when
appropriate) in the times/week column to indicate how many times you
have eaten each food during the last
week.
Estimate
whether the serving was Small - (1 2 3 4 5) - Large. Try to
estimate the amounts of a given food that may be in recipes made
mostly of some other food.
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Example: |
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Times/wk |
x Sm-(1 2 3 4 5)-Lar |
x VF |
= Score |
Half a head of Romaine lettuce 3 times/week
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3 |
x 4 |
x 4.9 |
=58.8 |
(Times/wk = 3) |
Sm-(1 2 3 4 5)-Lar = ~ 4 |
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(approximate) |
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ANIMAL SOURCE
FOOD Animal food Value Factors (VF) are
based on cholesterol and saturated fat content. In the context
of the VLC it is judged that whatever nutritional values may be
found in these foods are offset by their disadvantages so that value
of animal food is negative.
While animal foods are good
sources of second-hand amino acids and other nutrients, they all
contain first-hand saturated fat and cholesterol, which are risk
factors for obesity, cardiovascular disease, six types of cancer,
and diabetes. The excessive protein and sulfur amino acid
content are risk factors for kidney disease ans osteoporosis.
Animal source food has no fiber and is deficient in vitamin C, and
magnesium. At least 28 separate food-borne illnesses are
transmitted to humans from animal source food and, because of modern
agricultural practices, these foods are also contaminated by
pesticides, herbicides, and hormones at a much higher concentration
than plant foods. Animal source food is adaptive when there's
not enough food (the condition of our ancestors), but only harmful
and obselete when there are diverse and plentiful plant foods to
choose from (our present condition).
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MEAT (VF from
-5 to -4) |
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Times/wk |
x Sm (1 2 3 4 5) Lar |
x VF |
= Score |
Spam, luncheon meats, Vienna sausage, etc.
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-5.0 |
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ham, bacon, pork roast, pork chops |
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-4.9 |
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beefsteak, hamburger, sirloin steak, beef ribs
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-4.8 |
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lamb chops, lamb roast |
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-4.5 |
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POULTRY (VF
from -4 to -3) |
Times/wk |
x Sm (1 2 3 4 5) Lar |
x VF |
= Score |
chicken, turkey, duck, pheasant, goose |
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-3.5 |
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EGGS (VF from
-3 to -2) |
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Times/wk |
x Sm (1 2 3 4 5) Lar |
x VF |
= Score |
whole eggs |
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-3.0 |
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egg white (no cholesterol but #3 on food allergy list)
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-2.0 |
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FISH (VF from
-2 to -1) |
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Times/wk |
x Sm (1 2 3 4 5) Lar |
x VF |
= Score |
shellfish |
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-1.7 |
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fish |
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-1.4 |
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DAIRY (VF
from -1 to 0) A good source of calcium but also of saturated fat and
cholesterol. |
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Times/wk |
x Sm (1 2 3 4 5) Lar |
x VF |
= Score |
whipped cream, dairy desserts, ice cream.
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-1.0 |
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butter (almost 100% fat) |
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-1.0 |
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cheese |
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-0.9 |
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milk |
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-0.8 |
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"low fat" cottage cheese |
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-0.1 |
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NO MAN'S LAND
Mostly packaged foods (VF from -1 to +1).
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DRESSINGS AND
SPREADS |
Times/wk |
x Sm (1 2 3 4 5) Lar |
x VF |
= Score |
mayonnaise |
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-1.0 |
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stick margarine (usually contains hydrogenated fat)
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-0.7 |
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canola oil and olive oil |
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0.5 |
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flaxseed oil |
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0.7 |
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oil-free dressing |
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0.8 |
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Dijon sauce (p. 9 VLC "Getting Started")
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0.9 |
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Vinaigrette Dressing (p. 9 VLC "Getting Started")
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0.9 |
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"Healthy gravy" (p 9 "Getting Started") |
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1.0 |
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SWEETS (empty
Calories)
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Times/wk |
x Sm (1 2 3 4 5) Lar |
x VF |
= Score |
candy, chocolates |
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&fbsp; |
-0.6 |
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honey |
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-0.3 |
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sugar added to tea, coffee, cereal |
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-0.2 |
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maple syrup |
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0.7 |
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blackstrap molasses |
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1.0 |
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DRINKS. Empty
Calories |
Times/wk |
x Sm (1 2 3 4 5) Lar |
x VF |
= Score |
hard liquor |
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-1.0 |
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beer / wine |
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-0.4 |
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soft drinks, e.g. Coca Cola, Pepsi, 7-Up
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-0.3 |
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coffee, tea, decaffeinated |
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0.0 |
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herbal tea |
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0.6 |
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non-alcoholic beer / wine |
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0.9 |
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CONDIMENTS |
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Times/wk |
x Sm (1 2 3 4 5) Lar |
x VF |
= Score |
salt |
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0 |
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vinegar |
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0.0 |
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pepper |
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0.3 |
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soy sauce |
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0.3 |
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mustard |
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0.4 |
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pickles (avoid "alum" on label) |
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0.9 |
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tomato paste |
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1.0 |
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NUTS AND
SEEDS: natural, but high fat plant foods (VF from 0 to 1)
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Times/wk |
x Sm (1 2 3 4 5) Lar |
x VF |
= Score |
raw hulled sunflower seeds |
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0.7 |
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natural peanuts and peanut butter |
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0.8 |
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raw unhulled sesame seeds (high in calcium)
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0.8 |
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raw almonds, walnuts |
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1.0 |
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BREAD (VF
from 1 to 2) |
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Times/wk |
x Sm (1 2 3 4 5) Lar |
x VF |
= Score |
white bread and rolls |
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1.0 |
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brown bread and rolls |
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1.5 |
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wholewheat bread, Pita bread |
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2.0 |
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GRAINS (VF
from 2 to 3) |
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Times/wk |
x Sm (1 2 3 4 5) Lar |
x VF |
= Score |
refined grains: white rice, white flour |
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0.5 |
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brown rice |
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3.0 |
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MEAT
SUBSTITUTES: OK, but not required. |
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Times/wk |
x Sm (1 2 3 4 5) Lar |
x VF |
= Score |
soya meats, textured vegetable protein-TVP
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2.8 |
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Vegeburger, Boca Burger, Garden Burger Vegan. etc.
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2.9 |
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PASTA : A good pasta
label reads "Durum semolina".
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Times/wk |
x Sm (1 2 3 4 5) Lar |
x VF |
= Score |
refined pasta (spaghetti, macaroni, noodles)
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2.3 |
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whole grain, spinach, or artichoke pasta
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2.8 |
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CEREALS |
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Times/wk |
x Sm (1 2 3 4 5) Lar |
x VF |
= Score |
commercial dry cereal (Kellogg's, Post, etc.)
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2.0 |
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oatmeal |
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2.5 |
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muesli |
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2.8 |
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FRUIT :
Because of the high sugar content, diabetics should use fruit with
restraint. (VF from 3 to 4) |
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Times/wk |
x Sm (1 2 3 4 5) Lar |
x VF |
= Score |
avocado |
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3.0 |
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apples, bananas, grapes |
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3.2 |
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pure fruit juice e.g. orange, apple, grapefruit
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3.2 |
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raisins (good iron source) |
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3.3 |
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melons, watermelon |
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3.4 |
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mango, papaya |
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3.8 |
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strawberries, other berries |
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3.9 |
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apricots, nectarines, peaches, pears, plums
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3.9 |
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VEGETABLES:
The healthiest foods of all on average, only deficient in vitamin
B12. (VF from 4 to 5) |
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STARCHY AND
ROOT VEGETABLES |
Times/wk |
x Sm (1 2 3 4 5) Lar |
x VF |
= Score |
commercial potato chips or fries |
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0.2 |
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boiled, mashed, baked, roasted potatoes (plain)
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4.0 |
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taro root, poi |
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4.1 |
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mushrooms (high in zinc) |
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4.1 |
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leeks, onions, garlic |
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4.1 |
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yams , sweet potato |
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4.2 |
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parsnips, turnips, beetroot |
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4.2 |
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carrots (highest source of beta-carotene)
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4.4 |
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BEANS (A good
protein source but deficient in vitamins A, and B2.)
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Times/wk |
x Sm (1 2 3 4 5) Lar |
x VF |
= Score |
beans, lentils, peas |
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4.0 |
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tofu ( high in fat, but a good substitute for dairy)
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4.1 |
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soybeans |
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4.8 |
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GREEN
VEGETABLES (THE best foods of all and the biochemical source of most
organic nutrients.) |
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Times/wk |
x Sm (1 2 3 4 5) Lar |
x VF |
= Score |
green or red peppers |
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4.1 |
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vegetable soup (no hydrogenated fat or meat stock)
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4.2 |
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celery |
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4.2 |
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green beans, wax beans |
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4.4 |
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peas, lima beans |
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4.5 |
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broccoli, cabbage, cauliflower* |
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4.5 |
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spinach and taro leaf ** |
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4.5 |
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Bok choy, won bok |
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4.6 |
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sprouts: alfalfa, mung bean, soybean, etc.
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4.6 |
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Chinese pea pods |
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4.6 |
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tomatoes *** |
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4.7 |
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watercress, parsley |
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4.8 |
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cucumber |
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4.8 |
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collard greens, kale, Brussels sprouts, |
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4.9 |
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Romaine, other green lettuce**** |
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4.9 |
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low sodium V-8 juice or V-4 juice (VLC p.9)
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5.0 |
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* (cruciferous vegetables protect aginst
cancer) **(high in nutrients, but their oxalic acid content
interferes with calcium absorption) ***(saponins and lycopenes in
tomatoes protective against prostate cancer) ****(chlorophyl,
carotenoids, and luteins in leaf vegetables also protective against
cancer) |
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EXERCISE (VF
1-5) |
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In a typical
week during the last 12 months, how often did you do any of the
following: (zero, decimal fraction, whole numbers).
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Times/wk |
x Minutes per day |
x VF |
= Score |
walking |
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2.0 |
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swimming |
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3.0 |
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stair climbing |
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3.5 |
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stationary or real bike |
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3.5 |
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jogging |
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4.0 |
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weight training |
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4.5 |
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running |
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5.0 |
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other vigorous sport _________ (assign your own VF
from 0 to 5) |
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? |
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VLC total score (from all pages)= |
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This diet spreadsheet is
named "Dietque4.wb1". It was done using Quattro Pro for Windows
v5.0. You could print this out and calculate your score
by hand, but a simpler alternative is to download a larger version
of this diet spreadsheet, with all the self-calculating cells
intact. It can then be loaded into Quattro, Excel, or Lotus
1-2-3, (although the BMI and VF graphs may not come through).
Nonetheless, the numbers are easily plugged in and a running score
is calculated automatically. The basic form can be used repeatedly
by not saving the data each time, or by renaming the file each time
it is used. (e.g. "Jane.WB1", "Dick.XLS", "Sam.WKS", etc., the file
extension as assigned by your spreadsheet).
if you would like to
download the larger version of this diet spreadsheet, with all the
self-calculating cells intact, click here.
Copyright William Harris, M.D. Former Medical
Director Kaiser-Permanente Vegan Lifestyle Clinic (VLC) 1010
Pensacola Street Honolulu, HI 96814 (808) 597-2118
(W) e-mail: HARRISMDW001@hawaii.rr.com |
Value Factors
Graph Series: |
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-5 |
Meat |
-4 |
Poultry |
-3 |
Eggs |
-2 |
Fish |
-1 |
Dairy |
1 |
Nuts |
2 |
Bread |
3 |
Grains |
4 |
Fruit |
5 |
Vegetables
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