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Dietary patterns Survey
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
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1
How often do you consume fast food?
Choose the option that best describes your consumption of fast food.
Rarely
Occasionally
Frequently
2
Rate your overall satisfaction with your current diet.
Rate your satisfaction level on a scale from 1 to 10.
3
What is your favorite type of cuisine?
Please write down your favorite type of cuisine.
4
How many servings of fruits and vegetables do you consume daily?
Indicate the number of servings you typically consume in a day.
5
Do you follow any specific dietary restrictions (e.g. vegetarian, gluten-free)?
If you follow any dietary restrictions, please select all that apply.
Vegetarian
Vegan
Gluten-free
None
6
How often do you have sugary beverages?
Select the option that best describes your consumption of sugary beverages.
Rarely
Occasionally
Frequently
7
Are you currently trying to lose, maintain, or gain weight?
Indicate your current goal regarding weight management.
Lose weight
Maintain weight
Gain weight
8
How often do you eat out at restaurants?
Select the option that best describes how often you dine out.
Rarely
Occasionally
Frequently
9
Do you track your daily calorie intake?
Tell us if you actively monitor the number of calories you consume each day.
Yes, I track my calories
No, I do not track my calories
10
How many glasses of water do you drink in a day?
Indicate the approximate number of glasses of water you consume daily.
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