Validating the 4Leaf Survey

So it can become the most important vital sign in medicine

617 jpeg 4Leaf Logo

The healthfulness of what we’re eating. We believe that the vital sign we need should be a person’s 4Leaf score. Without a doubt, the future of medicine will include a great deal of focus on what we put at the end of our forks. In fact, it has already begun in many parts of the world. In New York City, Arizona, Australia, North Carolina, Florida, California, Canada, Ireland and in the Finger Lakes Region of New York state, that process is well underway.

Many primary care physicians who are fed up with “disease management,” are embracing a whole new way of practicing medicine. They are now harnessing the power of food to reverse disease and promote health.

And those physicians are discovering that our powerful 4Leaf Survey is quickly becoming the most important tool in their bag. Dr. John Green in Australia says that he uses it ten times a day and that he could no longer live without it. Why is this tool so important to him–and to others, like Dr. Kerry Graff, shown here? Three reasons:

Kerry Graff, MD

Kerry Graff, MD

  1. It’s easy, fast, accurate and does a great job of engaging the patient in the process of improving their own health.
  2. The patients can easily see (from the printed version of the survey) exactly where they lost points and how they can easily turn those negative points into positive points.
  3. By just following the computer-generated results and emailed report, millions of patients can now learn how to improve their health–with or without the aid of a physician.

But what about validation? How do we know that it is accurate? How do we know that it really works? That is exactly what I will try to explain here.

A little background. Our 4Leaf concept and the accompanying 4Leaf Survey have both evolved over a period of five or six years. I started out wanting to develop a simple survey that would assess a person’s diet compared to Dr. T. Colin Campbell’s definition of an optimal diet:

“The closer we get to eating a diet of whole, plant-based foods, the better off we will be.”

As with Bill Clinton, this book will allay the Pope's fears about the quality of a plant-based diet.

Scientific proof that people who eat more whole plants are the healthiest people on Earth

In 2009, I reviewed the concept of six levels of eating with Colin at his breakfast table in Ithaca. He loved it because it was positive and emphasized the maximization of the best food—not just the avoidance of meat, dairy, etc. The idea was to have the bottom level being the SAD, with LESS than 10% of calories from whole plants. The next level is “Better than Most” — with 10 to 20% from whole plants.

The 1Leaf level is 20 to 40, 2Leaf is 40 to 60, 3Leaf is 60 to 80 and 4Leaf is over 80% of one’s daily calories from whole plants.

Elegantly simple and amazingly powerful. Our simple, quick and easy survey enables us to estimate the level at which a person is currently eating. As we know, the SAD level will likely include at least 65% of the population with another 25% at the BTM level. That covers 90% of the population and, if they are honest in their answers, they will all have trouble scoring 1Leaf or better.

Our 4Leaf system features a scale where the individual chooses how far up the scale they wish to eat. After giving the survey about 50,000 times, we have concluded that it will accurately and consistently put people in one of three buckets–defined here:

Bucket #1. Unhealthy. SAD and BTM. In this bucket, it really doesn’t matter at which level someone scores, the advice is the same. “Replace a lot of your animal-based and highly processed foods with whole plants.” (90% of the USA population will begin their journey in this bucket.)

Bucket #2. Fairly healthy. 1Leaf and 2Leaf levels. Eating better than 90% of the population, these people are eating far better than the average person. But many of them just need to understand things like they don’t EVER “need” to eat any animal protein, even from fish. (People at this level are well on their way to an optimal diet.)

Bucket #3. Very healthy. 3Leaf and 4Leaf levels. Representing less than 5% of the population, these folks are already eating a superior diet that will likely reverse heart disease, diabetes and other issues.

Taking the 4Leaf Survey online can happen anywhere--anytime.

Taking the 4Leaf Survey online can happen anywhere–anytime.

The main advantages of our online 4Leaf Survey (and overall system) is that it is quick, easy, flexible, non-judgmental AND is based on each person’s answers. It engages them in the process and shows them exactly what they should do to improve their score and their health.

Again, what about validation? The short answer is that so far there has been no formal validation process. As I see it, there are two things we would like to validate:

1. That the score accurately determines the percentage of calories from whole plants. I discussed this with Dr. Campbell and we agree that it would be near impossible to PROVE that it does. There are just too many variables involved (beginning with levels of honesty in reporting). And if you tried to design a survey that addressed all those variables, it would almost surely be too complex and too cumbersome to be effective.

2. That patients who are coached “with” the 4Leaf Survey are more successful than those who are not. I also discussed this with Dr. Campbell and a few medical doctors who are using it in their practices. Based on early anecdotal evidence for the past few years, there is no doubt in my mind that we can validate this. And, while we’re completing that validation process, we know for certain that using the survey cannot hurt anyone and that it is already helping millions. People everywhere seem to like the survey and they LOVE what it does for their health.

One more critical point about validation. We already know that, without formal validation, our survey is helping lots of people move away from animal-based foods, while adding a lot more whole plants to their diets. And we should mention that the only side effects of making that dietary shift have been positive–for the individual AND for the planet.

To that point, we have concluded that the most crucial issue in the history of humanity is our food choices in the 21st century. That’s because our health and the health of our fragile ecosystem that supports us are both riding on those food choices. Absolutely, we should work on properly validating the 4Leaf Survey, but we don’t have to wait for that validation to start using it. We simply don’t have time to waste as we race past critical tipping points every year.

Our book explains everything. On 8-5-15, we published a book that explains everything about 4Leaf, the survey, the success stories, meal planning, etc. It’s a two-hour read that can save plant-savvy doctors tons of time in explaining what the patient needs to do to start taking charge of their own health. 

T. Colin Campbell, PhD, Nutritional Biochemistry, Cornell

T. Colin Campbell, PhD, Nutritional Biochemistry, Cornell

The Bottom Line. We have a simple system that works, and it can help millions of people take charge of their health. On that topic, Colin Campbell emailed me from from a conference he was attending (Sept. 2015) that featured fifty of the world’s top cancer researchers:

In response to my 4Leaf “vital sign” newsletter (9-30-15), he compared the 4Leaf model to those presented at the conference:

“Your 4Leaf model is one-hundredth the complexity but has real value that may exceed any of the very comprehensive survey models developed by some of the world’s top cancer specialists.”

T. Colin Campbell, PhD, Nutritional Biochemistry, Professor Emeritus, Cornell University

J. Morris Hicks, working daily to promote health, hope and harmony on planet Earth.

J. Morris Hicks, working daily to promote health, hope and harmony on planet Earth.

Given the nutritional science preeminence of this great man, I would say that his statement constitutes a pretty solid validation of the 4Leaf Survey and its related tools.

Closing. This article was posted on December 1, 2015, by J. Morris Hicks, creator of the 4Leaf concept of healthy eating and the 4Leaf Survey. Please email me directly at jmorrishicks@me.com if you have any comments or questions.

If you are a medical practitioner, perhaps you would like to assist in the validation process with your own patients. With your help, we can change the world with this simple, yet powerful, tool. All of the relevant tools and a copy of this article can be found on our 4Leaf website at 4leafprogram.com. To take the survey in just two minutes, visit 4leafsurvey.com.

A Few Related Links:

The following six books can be purchased on Amazon for a grand total of less than $60—and will enable you to understand the overwhelming challenges we face—along with the single most-powerful solution of all.

Six-Pack from Hicks—for health, hope & harmony on planet Earth

  1. 4Leaf Guide to Vibrant Health, powerful new book by Kerry Graff, MD and yours truly
  2. Healthy Eating, Healthy WorldThe “big picture” about food (my first book)
  3. An essential scientific resource: The China Study by Dr. T. Colin Campbell; the primary book that influenced Bill Clinton to adopt a whole food, plant-based diet.
  4. Primary cause of cancer is not bad luck. Stop Feeding Your Cancer, by John Kelly, MD
  5. A horrifying wake-up call for leaders. TEN BILLION by Dr. Stephen Emmott
  6. Food choices are the primary cause of our environmental problems, yet our world leaders, scientists & experts are Comfortably Unawareby Richard Oppenlander.

Why should we be eating mostly plants? The “big picture” in 4 minutes.

Want to find out how healthy you are eating? Take our free 4Leaf Survey. It takes about two minutes. eCornell is now using our survey in their plant-based nutrition course.

International. We’re now reaching people in over 100 countries. Follow us on Facebook and Twitter or get daily blog notices by “following” us in the top of the right-hand column. For occasional updates, join our periodic mailing list.

J. Morris Hicks, working daily to promote health, hope and harmony on planet Earth.

To order more of my favorite books—visit our online BookStore now For help in your own quest to take charge of your health, visit our 4Leaf Program website, which is now being used by an ever-growing army of enlightened medical doctors who are fed up with “disease care” and want to promote true health for their patients.

Got a question? Let me hear from you at jmh@4leafglobal.com

—J. Morris Hicks, board member since 2012; click banner for more info:

Nutrition Certificate