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Food Habits Survey
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
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1
What is your gender?
Please select your gender.
Male
Female
Prefer not to say
2
On a scale of 1 to 10, how healthy do you consider your current eating habits?
Rate your eating habits from 1 (unhealthy) to 10 (very healthy).
3
How many servings of fruits and vegetables do you consume daily?
Please mention the number of servings you have in a day.
4
Do you have a balanced diet?
Answer whether you have a balanced diet or not.
Yes
No
5
Do you have enough knowledge about nutrition?
Indicate if you feel knowledgeable about nutrition.
Yes
No
Somewhat
6
How frequently do you eat fast food in a week?
Specify the number of times you consume fast food in a week.
7
Have you ever consulted a nutritionist?
Answer whether you have consulted a nutritionist or not.
Yes
No
8
Do you read food labels before purchasing a product?
Indicate whether you check food labels before buying.
Always
Sometimes
Rarely
9
What is your main source of information about nutrition?
Specify where you usually get information regarding nutrition.
10
How do you feel after having a balanced meal?
Share your feelings or experiences after consuming a balanced meal.
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