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Balanced Diet
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
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A Balanced Diet
1
Do you prepare your own food, have a take away or ready meal most days of the week?
Select 1 answer
Own food eg, fresh vegetables
Take away
Ready meal
2
How many fruits and vegetables do you have a day?
Select 1 answer
1 to 3
4 to 5
6 to 10
3
Are you vegetarian or vegan?
Select 1 answer
Vegetarian
Vegan
4
If you are vegetarian or vegan, what is your choice for it?
Select one or more answers
Religion
Lifestyle
Personal choices
Environmental choices
Other (please specify)
5
How many grams of protein do you aim to eat a day?
Select 1 answer
20 to 30 grams
40 to 60 grams
70 to 120 grams
over 300 grams
Other (please specify)
6
How much water do you drink a day?
Select 1 answer
1 to 2 glasses
3 to 4 glasses
5 to 6 glasses
2L
Other (please specify)
7
How many grams of fat do you consume daily?
Select 1 answer
10 to 20 grams
30 to 40 grams
50 to 60 grams
Other (please specify)
8
Do you do any exercise to burn off your fat?
Select one or more answers
Walking
Running
Football
Swimming
Any other sport
9
How long do you exercise for?
Select 1 answer
10 to 20 minutes
25 to 45 minutes
1 hr
over an 1hr
10
How many calories are you consuming per day?
Select 1 answer
500 to 600
700 to 1000
1200 to 1400
2000
Submit