QUESTIONNAIRE
NAME-
AGE-
ADDRESS-
GENDER-
MALE- FEMALE-
1.Do you like eating fast foods?
Yes- No-
2.Do you like eating homemade food?
Yes- No-
3.Your choice of food is based on-
Taste- Nutrient value- eat food of your parents choice-
Don’t care about the above mentioned-
4.Your favorite fast food item is-
5.The reason for preference to fast food is-
6.Does eating fast food satisfy your hunger and appetite?
Yes- No-
7.How many times a week do you eat at fast food restaurants?
1- 2- 3- 4- more than 4-
8.In a month on an average how much do you spend on fast foods?
0-100 100-200 200-300 300-400
More than 400-
9.How many glasses of water do you drink in a day?
6-8 8-10 10-12 more than 12-
10. Are you interested in how many calories or what the fat content is of what you
Eat?
Yes of course- never- sometimes-
11.Do you skip any of your meals?
Yes- No-
12.Which meal do you most often skip?
Breakfast- Lunch- Dinner-
13.Do you read nutritional information on meals cans?
Always- Sometimes- Never-
14.Do you snack on things between meals?
Always- Frequently- Never-
15.What do you prefer among these-
Milk-
Soft drinks-
Fruit juices-
Shakes-
Flavored drinks-
16.Do you include the following in your diet-
Vegetables- Yes- No-
Fruits- Yes- No-
Milk- Yes- No-
Cereals- Yes- No-
17.Are you aware of the concept of BMI (Body mass index)?
Yes- No-
18.How would you rate your diet?
Excellent- Good- Average- Poor-
19.Is exercise a part of your routine?
Yes- No-
20.Do you agree with the statement that “A HEALTHY MIND DWELLS IN A HEALTHY BODY?”
Yes- No-
2006-11-18
21:05:37
·
6 answers
·
asked by
Anonymous
in
Education & Reference
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