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Syndrome X:

DO NOT fill out this questionnaire unless instructed by your Success Meals representative. This questionnaire is to be completed only when additional information is needed to help us further determine whether or not you require additional nutrients, additional ratio adjustments or additional caloric intake modifications in order to ensure that you get the most out of your Success Meals program.

Diabetes often develops because the body fails to make any of the pancreatic hormone insulin (Type 1). However, In other cases, the condition crops up because the body becomes resistant to the insulin it has (Type 2).

Normally, insulin works as a transporter, escorting blood sugars to the body's cells so serum glucose (blood sugars or consumed carbohydrates) can enter to be stored and then burned as fuel. Insulin is also responsible for unlocking the cells thus, allowing the glucose to enter. When "insulin resistance" occurs, it's as if someone changed the locks to some of the cells receptor doors. Some cells- particularly those that make up the muscles- refuse to let glucose in, as a result, blood sugars accumulate in the bloodstream causing the pancreas to pump out even more insulin in a frantic effort to compensate. The more insulin released, the more fat storing enzymes are stimulated, eventually causing all of the blood sugars that were unable to enter into the muscle cells to concede and submit to the body's fat cells for storage.

An unhealthy lifestyle (poor eating habits, sedentary) is a major contributor to Insulin resistance. The more often sugars or high glycemic carbohydrates are consumed, the more the pancreas is called upon to deliver and store these blood sugars, by way of insulin release. Over time the muscle cells become less and less sensitive to insulin, forcing the pancreas to release more and more insulin each time. This means that the pancreas is working overtime pumping out insulin in an attempt to eventually drive calories into the muscle cells. Compounding matters insulin presence in the bloodstream inhibits the breakdown of fat, as a result insulin resistant individuals are in a continual 24-hour state of fat storage even if they're not overeating.

If insulin resistance is left unmanaged, over time these elevated blood sugar levels will lead to type II diabetes. The percentage of Americans with pre-diabetes - Insulin resistance, also known as Syndrome X - is 1/4 of the U.S. population. In pre-diabetes syndrome, a person loses his ability to manage insulin effectively. If insulin resistance is not controlled properly, through diet, the syndrome will result in the development of type II diabetes, which can lead to:

  • heart disease
  • non-alcoholic fatty liver
  • colon or ovarian cancer
  • blindness
  • kidney disease
  • stroke

The good news is that Insulin Resistance can be reversed through proper nutrition, weight loss, and exercise. Take the "Syndrome X" exam to find out if you're Insulin Resistant.

This questionnaire is to be completed only when specified by your Success Meals ™ representative. The sign up questionnaire has specific questions designed to indicate whether or not there's a possibility that, for example, your body is deficient in essential fatty acids, you're carbohydrate sensitive or that you may struggle with adhering to the Success Meals program due to signs indicating that your reasons for doing this program may not be valid. As a result you may lose your motivation and consequently fail to comply to the structure of this program in the upcoming weeks.

If your answers to the sign up questionnaire indicate one or more of the above outcomes you will then be asked to complete one or more of the subsidiary questions.

"SYNDROME X" Insulin Resistance Questionnaire

Answer, "yes" to the following symptoms that apply to you:

First name:    Last name:
Are you more than 15lbs overweight? YES NO  
Weight gain, especially around the midsection? YES NO  
Midsection larger than your hips in circumference? YES NO UNSURE
Cravings for carbohydrates? YES NO  
Rapid changes (highs and lows) in your mental and physical energy throughout a given day (fatigue & mood swings)? YES NO UNSURE
Non-specific signs of diminished immune function e.g.: recurrent colds? YES NO UNSURE
Family history of high cholesterol? YES NO UNSURE
Family history of high blood pressure? YES NO UNSURE
Family history of diabetes? YES NO UNSURE

If you answered "yes" to 5 or more of the above questions, you may be Insulin resistant. We recommend that you schedule an appointment with your physician to obtain the answers to the below questions, which are also symptoms of Insulin resistance. Insulin resistance is a precursor to Type II diabetes and therefore should be taken very seriously. The good news is that the symptoms can be reversed through weight loss, proper nutrition and exercise. People who are Insulin resistant must have their carbohydrates monitored and often lowered. Certain, high glycemic carbohydrates must also be limited or removed from your diet.

Answers to the below questions may need to be obtained from your physician.

Blood pressure equal to or greater than 140/85 YES NO UNSURE
Elevation in total cholesterol 5 YES NO UNSURE
Fasting HDL ("good cholesterol") less than 35 YES NO UNSURE
Fasting triglycerides greater than 200 YES NO UNSURE
Increased deposits of plaque in the arterial walls YES NO UNSURE
Glucose levels greater than 140 two-hours after a meal YES NO UNSURE
Fasting glucose - Between 110-126 YES NO UNSURE