Phase three of eight 33% Medical Questionnaire 3 – Vital Nutrients Food, Beverage and Stimulants Do you buy fresh fruit and vegetables at least three times a week? * Yes No Do you have three servings of fruit and vegetables daily? * Yes No Do you use high-quality vegetable oil when you cook? * Yes No Do you take Omega 3 capsules daily? * Yes No Do you eat fish two times a week? * Yes No Do you eat meat? * Yes No Do you drink 2 alcoholic drinks or fewer per day? * Yes No Are you a non-smoker? * Yes No Appearance Do you have healthy skin? * Yes No Do you have minimal or zero age spots on your skin? * Yes No For your age, is your skin fairly free of wrinkles? * Yes No Do you have a full head of hair? * Yes No Do you have strong and healthy gums? * Yes No Physical Well-Being Do you stay physically active – perform physical activity 3 or more times per week? * Yes No On average, would you say your stress level is lower than most? * Yes No Do you catch a cold 2 or fewer times per year? * Yes No Do you suffer from a bladder infection rarely or never? * Yes No Do you have regular bowel movements – at least once per day? * Yes No Do you suffer from any heart issues? * Yes No Is your blood pressure normal? * Yes No Do you have normal blood lipid values? * Yes No Are you mentally fit? * Yes No On average, do you feel balanced and alert? * Yes No In general, do you find it easy to concentrate? * Yes No In general, are you at ease (as opposed to nervous)? * Yes No Are your eyes healthy (no eye glasses, clouding or discomfort)? * Yes No Are you taking any medications? * Yes No Are you pregnant? * Yes No Sport Do you exercise once or more per week? * Yes No Do you push yourself during your exercises? * Yes No
