Our "Eating Habits Questionnaire"

Here is the questionnaire about eating habits we did.

Eating Habits Questionnaire

We’d like you to fill in the following questionnaire in order to collect some information about you and your eating habits.

Class: ___________ Male ___ Female ___ Age: __________

1. Do you have breakfast before going to school?
¨ Always
¨ Sometimes
¨ Never

2. What do you normally have for breakfast?
¨ Bread
¨ Cereals
¨ Milk
¨ Coffee
¨ Juice
¨ Yogurt
¨ Cookies
¨ Fruit
¨ Something else: ____________

3. Do you usually have a snack in the morning/ in the afternoon?
¨ Always
¨ Sometimes
¨ Never

4. How often do you eat salad or vegetables with lunch or dinner?
¨ Always
¨ Frequently
¨ Sometimes
¨ Rarely
¨ Never

5. Do you usually eat soup?
¨ Everyday
¨ 2 or 3 times a week
¨ Rarely
¨ Never

6. How many times a week do you eat fish?
¨ Everyday
¨ 2 or 3 times a week
¨ Rarely
¨ Never

7. How often do you eat fruit?
¨ Everyday
¨ 2 or 3 times a week
¨ Rarely
¨ Never

8. Do you usually have a dessert with your lunch or dinner?
¨ Always
¨ Frequently
¨ Sometimes
¨ Rarely
¨ Never

9. What do you usually have for dessert?
¨ Fruit
¨ Yogurt
¨ Cake
¨ Coffee
¨ Something else: ________

10. What do you drink at meals?
¨ Water
¨ Wine
¨ Juice
¨ Tea
¨ Something else: _________

11. How frequently do you eat at fast food restaurants?
¨ Never
¨ 2 or 3 times a week
¨ Almost everyday
¨ Everyday


12. Do you use food supplements to complete your diet?
¨ Yes
¨ No


13. Do you think you have healthy eating habits?
¨ Yes
¨ No


Thank you for your cooperation and don’t forget to have a healthy diet!

TG 07/10