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Terrain 10 Quiz

Assess your "inner terrain."

Whether you’re focused on cancer prevention, recently diagnosed, or navigating remission, it’s essential to assess various diet and lifestyle elements that may contribute to the cause.

Identifying and addressing key drivers can help you regain control and/or slow the progression of this complex disease.

After submitting the quiz, you will receive an email with your results. 

Count the number of "yes" answers for each section.

Terrain areas with the highest scores, should be top priority. 

Start

Note

This is the quiz found in Chapter 2 of The Metabolic Approach to Cancer, co-written by Dr. Nasha Winters, ND, FABNO and ONI Founder Jess Higgins Kelley, MNT, ONC. 

 

After you submit the quiz, you will receive your results via email. 

The terrain areas which have the highest number of “yes” answers should be prioritized for improvement.

 

Disclaimer: This questionnaire is not intended to prevent, diagnose, treat or cure cancer, rather to simply highlight awareness.

Genetics and Epigenetics

Section 1

Our genes are marked by polymorphisms called SNPs.

These genetic SNPs get turned on or off by what we consume, the stress in our lives, toxins, inflammation, and more.

SNPs can either support us or make us more susceptible to disease. 

 

You may have heard that our genes are not our destiny.

Our food and lifestyle choices have the most significant impact on genetic regulation.

To learn more about your unique SNPs, schedule a Nutrigenomics Analysis Consult with Michelle. 

 

Question 3 of 111

Section 1 - Genetics and Epigenetics

1. Have you had an abnormal test for a DNA repair mutation (i.e. BRCA1 BRCA2, ATM, Lynch syndrome, CHEK2, GATA3, TP53)?

A

Yes

B

No

Question 4 of 111

2. Do you eat less than three servings of dark leafy greens or cruciferous vegetable a day?

A

Yes

B

No

Question 5 of 111

3. Do you know if you have a heterozygous or homozygous MTHFR gene mutation?

A

Yes

B

No

Question 6 of 111

4. Do you have a history of thyroid disorder, miscarriage, cardiovascular disease, cleft palate, and/or neural tube defects?

A

Yes

B

No

Question 7 of 111

5. Do you have a personal or family history of cancer?

A

Yes

B

No

Question 8 of 111

6. Were you, your parents, or grandparents affected by a major stressful period, or adverse childhood event?

A

Yes

B

No

Question 9 of 111

7. Have you ever experienced X-rays, scans (MRI, PET, CT, DEXA), radiation treatment, radon exposure, and/or frequent airplane travel?

A

Yes

B

No

Question 10 of 111

8. Did your mother smoke, drink alcohol, or take any types of drugs or medications while she was pregnant with you?

A

Yes

B

No

Question 11 of 111

9. Do you eat a vegan, low-fat, or vegetarian diet?

A

Yes

B

No

Question 12 of 111

10. Are you currently taking any prescription or over the counter medications? Have you in the past?

A

Yes

B

No

Blood Sugar Balance

Section 2

Did you know that periodic and continuously increased blood sugar and insulin levels are the basis for some progressive and recurrent cancers? (Winters & Higgins Kelley, 2017).

The amount of sugar present in modern-day diets is at an all-time high and is causing an incredible amount of health problems.

One of the first things you can do at home is to start sprinkling some blood sugar supportive cinnamon into your morning coffee or tea.

Question 14 of 111

Section 2 - Blood Sugar Balance

1. Do you have a sweet tooth?

A

Yes

B

No

Question 15 of 111

2. Do you experience mood changes ("hangry") if you skip or delay a meal, find it difficult to fall asleep without an evening or late snack, and/or wake up hungry at night?

A

Yes

B

No

Question 16 of 111

3. Do you often need to take a nap, grab caffeine, or a sugary boost in the afternoon (aka: the 3 pm slump)?

A

Yes

B

No

Question 17 of 111

4. Have you ever been told that you have elevated glucose, insulin or Hemoglobin A1c (HbA1c) levels?

A

Yes

B

No

Question 18 of 111

5. Are sugar or processed carbohydrate based foods (candy, cookies, cake, soda, bread, waffles, etc.) what you crave the most?

 

And/or do you consider these to be your comfort foods?

A

Yes

B

No

Question 19 of 111

6. Do you consume more than 25 grams of added sugar a day?

 

(The average Western diet consists of ~100 grams of sugar per day)

A

Yes

B

No

Question 20 of 111

7. Do you eat more than one serving a day of grains or legumes?

A

Yes

B

No

Question 21 of 111

8. Is your Body Mass Index (BMI) over 25% and/or is your belly wider than your hips?

A

Yes

B

No

Question 22 of 111

9. Do you or any family members have a history/diagnosis of:

hypoglycemia, prediabetes, insulin resistance, Polycystic Ovarian Syndrome (PCOS), fatty liver, pancreatitis, pancreatic cancer, Type 1 or 2 diabetes?

A

Yes

B

No

Question 23 of 111

10. Do you consume more than three alcoholic beverages or servings of alcohol per week?

A

Yes

B

No

Toxic Burden

Section 3

With over 10,000 known toxins in and outside of our homes, it is no wonder many of us have a high toxic burden.

What we eat, drink, wear, inhale and sleep on potentially carries an incredible amount of toxins that our bodies need extra support to detoxify. 

 

Check the toxic load in your drinking water by entering your zip code into the Environmental Working Group's water database. 

https://www.ewg.org/tapwater/ 

Question 25 of 111

Section 3 - Toxic Burden

1. Do you currently live, work, or were you raised near (within 10 miles) any agriculture, superfund site, educational or medical campus, golf course, factory, military base, industrial sites, or airport areas?

A

Yes

B

No

Question 26 of 111

2. Do you have environmental sensitivities, especially to odors like perfume and/or diesel fuel?

A

Yes

B

No

Question 27 of 111

3. Do you use a screen (laptop, cell phone, TV, video gaming) for more than 3 hours a day?

A

Yes

B

No

Question 28 of 111

4. Do you use pesticides or herbicides in or around your home or on pets (i.e. Spray Round-up in your garden, or use flea or tick products on pets)?

A

Yes

B

No

Question 29 of 111

5. Do you use commercial body care, hair dye, and/or household cleaning products like shampoo and laundry detergent that are non-organic?

A

Yes

B

No

Question 30 of 111

6. Do you use Teflon/non-stick cookware, microwave food, or drink beverages from plastic containers?

A

Yes

B

No

Question 31 of 111

7. Are you exposed to indoor toxins i.e., cigarette smoke, scented candles, high heat cooking (over 300°F), mold, dryer sheets, or air fresheners?

A

Yes

B

No

Question 32 of 111

8. Do you have mercury fillings, work in the dental industry, eat fish more than 3 times a week, and/or been exposed to heavy metals including lead?

A

Yes

B

No

Question 33 of 111

9. Do you use tap water for drinking and showering?

A

Yes

B

No

Question 34 of 111

10. Do you find it difficult to break a sweat?

A

Yes

B

No

Microbiome and Digestive Function

Section 4

Hippocrates stated that all disease begins in the gut.

With more than 70% of our immune cells residing in our gut, what we feed them matters!

Fiber from vegetables and fruit is critical for the health of your gut, so I challenge you to try one new vegetable a day!

The daily recommended fiber intake for adults is ~35 grams.

Your first step is to assess your fiber intake and start eating more artichokes, eggplant, and apples!

Question 36 of 111

Section 4 - Microbiome and Digestive Function

1. Were you born via C-section?

A

Yes

B

No

Question 37 of 111

2. Were you fed infant formula before age 1?

A

Yes

B

No

Question 38 of 111

3. Have you ever, or do you now, use hand sanitizer and antimicrobial soap?

A

Yes

B

No

Question 39 of 111

4. Do you have digestive symptoms including gas, bloating, diarrhea, constipation or been diagnosed with ulcerative colitis, SIBO, Crohn's, or colon cancer?

A

Yes

B

No

Question 40 of 111

5. Have you taken more than one round of antibiotics or the recommended prep for a colonoscopy?

A

Yes

B

No

Question 41 of 111

6. Do you eat non-organic meat and/or dairy products?

A

Yes

B

No

Question 42 of 111

7. Have you had chemotherapy?

A

Yes

B

No

Question 43 of 111

8. Do you take NSAIDs (i.e. Tylenol, aspirin, ibuprofen, Advil, Motrin) or antacids more than a couple times a year?

A

Yes

B

No

Question 44 of 111

9. Do you eat less than 5 servings of vegetables a day?

A

Yes

B

No

Question 45 of 111

10. Do you eat processed, non-organic grains including pasta, bread, or cookies more than once a month?

A

Yes

B

No

Immune Function

Section 5

Our immune system is constantly on high alert, looking for invaders such as viruses and bacteria that can potentially cause ill-health.

With modern lifestyles our immune systems have become stressed, overburdened, and unarmed due to poor diet, environmental toxins, nutrient depletion, and medications. 

Question 47 of 111

Section 5 - Immune Function

1. Have you ever been told that your vitamin D level is below 50 ng/mL?

A

Yes

B

No

Question 48 of 111

2. Do you have a personal or family history of autoimmune disease? 

A

Yes

B

No

Question 49 of 111

3. Do you suppress fevers with over the counter medications?

A

Yes

B

No

Question 50 of 111

4. Do you have a history of any of the following:

EBV (mono), HPV, CMV, STDs or STIs, COVID-19, shingles, Lyme disease, yeast infections, or parasites?

A

Yes

B

No

Question 51 of 111

5. Is either of the following true: (1) You are never sick, or (2) you catch every cold and flu that comes your way?

A

Yes

B

No

Question 52 of 111

6. Do you have allergies (i.e.: seasonal allergies, asthma, hives, and/or allergies to certain foods)?

A

Yes

B

No

Question 53 of 111

7. Have you been diagnosed with celiac disease, gluten intolerance or a gluten sensitivity?

 

A

Yes

B

No

Question 54 of 111

8. Have you had vaccinations and/or flu shots, i.e., micro RNA injections for COVID, shingles shots, vaccines for travel, or immunotherapies (i.e. Keytruda, Opdivo, or Yervoy)?

A

Yes

B

No

Question 55 of 111

9. Have you ever taken steroids (such as Prednisone or Dexamethasone) either topical, inhaled or oral?

A

Yes

B

No

Question 56 of 111

10. Do you have a child under the age of 5 living in your house, and/or work in a school, hospital, or medical setting?

A

Yes

B

No

Inflammation

Section 6

There are numerous dietary factors that may contribute to inflammation, but the main culprit is an overconsumption of inflammatory omega 6 fats and a low consumption of omega 3 fats.

Omega 6 fats are found in processed foods including salad dressing, barbecue sauce, corn oil, soybean oil, safflower oil, cottonseed oil, microwave meals, breads, chips, pizzas, French fries, cookies, ice cream, pastries, margarine, butter replacers, and fast food.

Meanwhile, omega 3 fats are found in foods like cold-water fish (pre-formed EPA/DHA), flaxseeds, walnuts, and certain dark leafy greens.  

Question 58 of 111

Section 6 - Inflammation

1. Do you have a history of skin conditions such as eczema, psoriasis, acne, flushing or rashes?

A

Yes

B

No

Question 59 of 111

2. Ever been diagnosed with arthritis, any other pain syndrome, and/or experience chronic pain?

A

Yes

B

No

Question 60 of 111

3. Have you ever been told you have an elevated C-reactive protein level, homocysteine, LDH, or Sed Rate (ESR)?

A

Yes

B

No

Question 61 of 111

4. Do you have food allergies, experience gastric reflux, or inflammatory bowel disease (including IBS or ulcerative colitis)?

A

Yes

B

No

Question 62 of 111

5. Do you eat and/or cook with vegetable oils (i.e. corn, canola, safflower, or soybean)?

A

Yes

B

No

Question 63 of 111

6. Do you drink less than 30 ounces of water per day?

A

Yes

B

No

Question 64 of 111

7. Do you rely on NSAIDs, steroids, or opiates for pain management?

 

A

Yes

B

No

Question 65 of 111

8. Have you ever or do you now experience high amounts of stress?

A

Yes

B

No

Question 66 of 111

9. Do you:

(1) exercise vigorously more than 3 days a week

or

(2) exercise less than 30 minutes 3x a week?

A

Yes

B

No

Question 67 of 111

10. Do you consider yourself overweight?

A

Yes

B

No

Blood Circulation and Angiogenesis

Section 7

There is an Eastern quote that says “A man will live 100 years if he takes 100 steps after every meal” and I believe it.

Sedentary lifestyles increase both cancer risk and risk of cardiovascular disease.

Americans are sitting an average of 13 hours a day and sleeping an average of 8 hours = roughly 21 hours per day are spent sedentary.

Sitting is considered the new smoking!

To get your blood moving, start by taking a 30 minute walk OUTSIDE every day. You will find your energy and mood improves!

Question 69 of 111

Section 7 - Blood Circulation and Angiogenesis

1. Do you bruise easily?

A

Yes

B

No

Question 70 of 111

2. Have you ever been diagnosed with a clotting disorder?

A

Yes

B

No

Question 71 of 111

3. Have you ever been diagnosed with hemochromatosis or elevated ferritin (high iron storage)?

A

Yes

B

No

Question 72 of 111

4. Do you have a history of deep vein thrombosis (DVT)?

A

Yes

B

No

Question 73 of 111

5. Do you have a history of pulmonary embolism (PE)?

A

Yes

B

No

Question 74 of 111

6. Do you have high or low blood pressure?

A

Yes

B

No

Question 75 of 111

7. Have you ever had abnormal levels of D-Dimer, fibrinogen activity, VEGF, and/or ceruloplasmin on a blood test?

A

Yes

B

No

Question 76 of 111

8. Do you take pharmaceutical blood thinners like Coumadin, Pradaxa, Xarelto, or Lovenox?

A

Yes

B

No

Question 77 of 111

9. Are you on blood pressure medication (i.e. a statin drug, ACE inhibitor, or beta-blocker) or take a daily aspirin?

A

Yes

B

No

Question 78 of 111

10. Do you snore and/or have you been diagnosed with sleep apnea?

A

Yes

B

No

Hormone Balance

Section 8

There is a large body of evidence from epidemiologic studies showing that people who consume high amounts of phytoestrogens in their diets have lower rates of several cancers including breast, prostate, and colon cancer.

Get started by sprinkling some sesame seeds onto your next salad!

It is important to work with a certified Oncology Nutrition Consultant (ONC) to best understand the many factors at play when it comes to hormones, from genetics, to liver function, to GI health, and more.

Whether or not to eat soy products depends on several individual variables. 

Question 80 of 111

Section 8 - Hormone Balance

1. Do you have a history of birth control pills, bio-identical or standard Hormone Replacement Therapy, steroid use, fertility treatments, and/or hormone blockade therapies?

A

Yes

B

No

Question 81 of 111

2. (Women/female anatomy)

Do you have a history of PMS, irregular cycles, fibrous breast, and/or menopausal symptoms?

A

Yes

B

No

C

N/A

Question 82 of 111

3. (Men/male anatomy)

Have you had a change in sexual function and/or been diagnosed with erectile dysfunction?

A

Yes

B

No

C

N/A

Question 83 of 111

4. Do you have a low libido (sex drive)?

A

Yes

B

No

Question 84 of 111

5. Have you experienced fertility issues, including miscarriage?

A

Yes

B

No

Question 85 of 111

6. Have you ever been diagnosed with a thyroid disorder?

A

Yes

B

No

Question 86 of 111

7. Have you ever been diagnosed with adrenal fatigue and/or low cortisol levels?

A

Yes

B

No

Question 87 of 111

8. Do you experience weight fluctuations of more than 10 pounds on a regular basis?

A

Yes

B

No

Question 88 of 111

9. Do you eat cow dairy products (cow milk, cheese, cream, yogurt) on a daily basis?

A

Yes

B

No

Question 89 of 111

10. Do you now, or have you ever followed a low-fat diet?

A

Yes

B

No

Stress and Biorhythms

Section 9

“The Environment, through light, food, and stress flips the switches on genes to produce hormones, which in turn flip other genes – from growth, death or repair – on and off.”

--TS Wiley, Lights Out

 

Cancer risk increases in those who don’t sleep, is much higher in shift workers, and also in people who cross time zones often during air travel.

In 2007, the IRAC concluded that shift work is "probably carcinogenic to humans."

When we sleep, hormones are released, tissue growth and repair occurs, neurological pathways are regenerated, detoxification occurs, and the immune system is replenished. And, you probably guessed it, sleep affects the body’s reaction to insulin. Just two nights of poor sleep can increase levels of IGF-1. Adults need at least 8 hours and kids at least 12 hours.

Sleep deprivation also causes a decrease in leptin, known as the satiety hormone, and an increase in ghrelin, or “the hunger hormone”.

Make sleep a priority by avoiding screens after dark.

Question 91 of 111

Section 9 - Stress and Biorhythms

1. Did any of your symptoms or labs results worsen after a stressful period? 

And/or, if you have a cancer diagnosis, was the diagnosis made following a stressful period?

A

Yes

B

No

Question 92 of 111

2. Are you a night owl?

And/or have you ever had a job working at night or caring for a small child you kept you up late?

A

Yes

B

No

Question 93 of 111

3. Do you often travel back and forth across many time zones?

A

Yes

B

No

Question 94 of 111

4. Do you have lights on while you sleep (i.e.: streetlights or a TV)?

A

Yes

B

No

Question 95 of 111

5. Are you easily fatigued?

A

Yes

B

No

Question 96 of 111

6. Do you often crave salt?

A

Yes

B

No

Question 97 of 111

7. Do you sleep less than eight hours a night and/or go to bed after 11 pm?

A

Yes

B

No

Question 98 of 111

8. Do you have screen time (i.e.: watch TV or use an electronic device) after 5 pm?

A

Yes

B

No

Question 99 of 111

9. Do you spend less than 30 minutes outdoors everyday?

A

Yes

B

No

Question 100 of 111

10. Do you feel that you experience high levels of stress every day?

A

Yes

B

No

Mental and Emotional Health

Section 10

Having some kind of emotional support and encouragement is extremely important when it comes to good health outcomes. 

Question 102 of 111

Section 10 - Mental and Emotional Health

1. Do you experience irritability, mood swings and/or unstable emotions?

A

Yes

B

No

Question 103 of 111

2. Have you been diagnosed with a mental disorder, (i.e. bipolar, depression and/or anxiety)?

A

Yes

B

No

Question 104 of 111

3. Are you easily offended?

A

Yes

B

No

Question 105 of 111

4. Are you sensitive to other people’s energy and reactions?

A

Yes

B

No

Question 106 of 111

5. Do you ever experience racing, repetitive thoughts?

A

Yes

B

No

Question 107 of 111

6. Do you find it difficult to speak your truth in certain situations?

A

Yes

B

No

Question 108 of 111

7. Have you ever used drugs, sex, alcohol, shopping, TV, gambling, gaming, or time on the internet to self medicate?

A

Yes

B

No

Question 109 of 111

8. Do you feel that you lack a good support system (i.e.: supportive spouse, friends, and/or spiritual community?)

A

Yes

B

No

Question 110 of 111

9. Do you feel you lack purpose?

A

Yes

B

No

Question 111 of 111

10. Do you find it difficult to feel gratitude and/or joy?

A

Yes

B

No

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