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Eating questionnaire


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Eating questionnaire

  1. 1. Condition 1□ Condition 2 □Eating QuestionnaireCircle your gender: Male / Female1. Do you eat five portions of fruit and vegetables a day?Yes/No2. Do you emotions affect the way you eat?Yes/No3. Is food a big part of your life?Yes/No4. On average how many times do you eat fast food in a week?Never 1 2 3 4 5+5. Do you enjoy a balance diet?Yes/No6. Do you calorie count?Yes/No7. Have you ever dieted?Yes/No8. Do you think your food preference has been influenced by your parents?Yes/No9. Are you keen to try new foods?Yes/No10.Do you comfort eat?Yes/No11.Do you believe in the saying “You are what you eat”?Yes/No
  2. 2. Condition 1□ Condition 2 □12.Do you buy/eat supermarket own brands?Yes/No13.From the list below select what you are most likely to eatCrisps Apples Chocolate Sweets PopcornCarrot sticksDips (e.g.houmous) BiscuitsDried fruit &nuts ChipsBurgers CakeCereal (e.g.coco pops)Cereal (e.g.muesli) OrangesGrapes Yogurt Pizza Roast dinner SoupMash potato Ryvita Cheese Pineapple14.During times of stress I tend to eatMore/Less15.During times of stress I tend to eatFull meals / snacks16.In your opinion, what is a healthy diet?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________17.What factors do you consider to have the greatest effect on your food choice?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________