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Eating and dietary habits survey
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Please take a few minutes of your time to fill in the following survey.
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How many times a day do you eat?
Please answer the following according to your particular eating habits?
Yes
Sometimes
No
I eat a good breakfast
I experience feelings of hunger during the day
I eat meat
I eat vegetables
I eat fruit
I eat dairy
I eat sweets
What meal would you consider to be your main meal of the day?
Breakfast
Lunch
Dinner
Other (Please specify)
What does your main meal consist of and how is it prepared?
Freshly home-cooked produce
Restaurant meal
Pre-cooked, microwave or TV dinners
What does your main meal on the weekend consist of and how is it prepared?
Freshly home-cooked produce
Restaurant meal
Pre-cooked, microwave or TV dinners
Other (Please state briefly)
Have you been avoiding some foods for health reasons?
No
Yes (Please write which one/s and why)
Do you have any particular food allergies?
No
Yes (Please write briefly which one/s)
What is your weekly food intake frequency of the following food categories?
Several times a day
Once a day
Several times a week
Less often
Never
Sweet foods
Salty foods
Fresh fruit
Fresh vegetables
What percentage of your regular diet consists of meat and meat products?
90% or more
75%
50%
25%
Less than 25%
How much of your diet consists of vegetables and non-animal products?
90% or more
75%
50%
25%
Less than 25%
Do you or have you ever had cholesterol problems?
Yes
No
I don't know
Do you know your current BMI (Body Mass Index) index?
Less than 18,5 (Underweight)
18,5-25 (Ideal weight)
25-30 (Overweight)
30-35 (Moderate obesity)
35-40 (Obesity)
More than 40 (Morbidly obese)
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