U R Unique

Comenius School Partnerships 2012-1-IT2-COM06-37888-2  2012-2014

 

    “This project has been funded with support from the European Commission. This publication reflects the views only of the authors, and the Commission cannot be held responsible for any use which may be made of the information contained therein. “

 

HEALTHY EATING QUESTIONNAIRE

Age:

Gender:

Country:

1. How often do you have a good breakfast?

a) Every day

b) Twice a week

c) Three times a week

d) More than three times a week

e) I never have breakfast

2. How often do you skip meals (lunch, dinner)?

a) Once a week

b) Twice a week

c) Three times a week

d) More than three times a week

e) I never skip MEALS. I eat regularly

3. How many portions of fruit and vegetables do you USUALLY eat  EVERY day?

a) 1

b) 2

c) 3

d) More than 3

e) I never eat fruit or vegetables

4. How often do you eat oily fish in the week?

a) At least one portion in a week

b) Two portions in a week

c) Three portions in a week

d) Four portions in a week

e) I never eat fish.

5. How would you best describe your salt intake?

a) I don't add salt to my food.

b) My salt intake is less than a teaspoonful a day.

c) I rely heavily on pre-prepared and convenience foods and I don’t add salt to them.

d) My salt intake is a spoonful a day.

e) My salt intake is more than a spoonful a day.

6. How would you best describe your sugar consumption?

a) I don't add sugar to my food and drinks. I just eat them as they are served.

b) I prefer sweet food and drinks.

c) I always have one teaspoon of sugar in my tea and coffee.

d) I always have more than one teaspoon of sugar in my tea and coffee.

e) I never have sugary food or drinks.

7. How many calories do you think you CONSUME on a typical day?

a) My daily consumption is around 2,000 kcals or less.

b) I consume more than 2,000 kcals .

c) My daily consumption is 2,500 kcals or less.

d) I consume more than 2,500 kcals.

e) I don’t know.

8. How often do you eat foods rich in saturated fats?

a) Very often

b) Occasionally

c) Rarely

d) I can’t do without eating

e) I never eat such kind of food.

9. How many portions of bread, rice, potatoes, pasta and other

starchy foods do you eat each day?

a) Less than 6 portions a day

b) 6-9 portions a day

c) 10-12 portions a day

d) 12 or more portions a day

e) Never.

10. Which of the following drinks do you consume most?

a) Cola

b) Milk and its derivatives

c) Fruit juice

d) Coffee or tea

e) Water

11. How many glasses of water do you drink per day?

a) 1 to 2

b) 3 to 4

c) 5 to 6

d) 7 to 8

e) Never

12. How often do you eat take-away food?

a) Once a week

b) Twice a week

c) Three times a week

d) More than three times a week

e) Never

13. How often do you take exercise (at least 15 minutes)?

a) Every day

b) Twice a week

c) Three times a week

d) More than three times a week

e) Never