SSS UUU RRR VVV EEE YYY

OOO UUU RRR NNN UUU TTT RRR III TTT III OOO NNN AAA LLL HHH AAA BBB III TTT SSS

1. Do you eat regularly?

Always Sometimes Never

2. How many times a day do you eat?

1 2 3 4 5

3. Do you usually eat your meals at the same time?

Always Sometimes Never

4. Do you eat… ?

a) Breakfast/First Meal Always Sometimes Never

b) Snack/Second Meal Always Sometimes Never

c) Lunch Always Sometimes Never

d) Dinner Always Sometimes Never

5. What do you usually have for breakfast?

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

6. Do you eat your last meal at least 2 hours before going to bad?

Always Sometimes Never

7. How many times do you eat vegetables and fruit during in a day?

A. Four or more times a day

B. Three times a day

C. Once a day

D. I don't eat fruit and vegetables

8. How many times a week do you eat fish?

A) Everyday B)2 or 3 times a week C) Once a week D) Rarely E) Never

9. Do you eat whole-grain breads, cereals, brown rice everyday ?

□ Yes □ No

10. When you eat bread, how often do you eat whole-grain breads?

□Almost always □Often □Sometimes □Seldom □ Never □ Don’t eat bread

11. Do you drink milk, yoghurt or other dairy products everyday?

□Yes □No

12. Do you snack between meals ( salty snacks like chips, pretzels or sweets ect. )?

□Almost always □Often □Sometimes □Seldom □Never

13. What do you usually drink?

a) Natural water

b) Sparkling water

c) Fruit juice

d) Fizzy drinks

e) Tea

14. Do you drink soda?

□Always □A lot □Occasionally □Rarely □Never

15. How often do you eat fast food per week?

a) More than three times a week

b) Three times a week

c) Twice a week

d) Once a week

e) Less than once a week f) I don’ eat such food

16. Every day I drink:

a) up to 0.5l of water

b) up to 1l of water

c) up to 1.5l of water

d) up to 2l of water

e) more than 2l of water

17. In your opinion, is your diet good?

□ Definitely yes □ Yes □ No □ Definitely no

18. Do you watch your weight?

□ Yes □ No

19. Have you ever heard of the Food Pyramid ?

□ Yes □ No 20. When your mother cook does she use:

a) olive oil b) butter c) margarine d) corn oil e) sunflower oil f) other

21. When do you eat your main meal of the day ?

a) In the morning b) During lunch time c) In the afternoon d) In the evening