Eating Habits

On average, how many servings of fruits and vegetables do you consume per day?

• 0-1 servings
• 2-3 servings
• 4-5 servings
• 6 or more servings

How often do you consume processed foods (e.g., chips, packaged snacks, fast food)?

• Daily
• Several times a week
• Once a week
• Rarely or never

How frequently do you eat out at restaurants or order takeout?

• Multiple times a week
• Once a week
• A few times a month
• Rarely or never

How often do you drink sugary beverages (e.g., soda, sweetened tea, energy drinks)?

• Multiple times a day
• Once a day
• A few times a week
• Rarely or never

Do you have a regular meal schedule (eating meals at consistent times each day)?

• Yes, always
• Yes, most of the time
• No, rarely
• No, never

How often do you snack between meals?

• Multiple times a day
• Once a day
• A few times a week
• Rarely or never

How often do you pay attention to portion sizes when eating?

• Always
• Most of the time
• Sometimes
• Rarely or never

How often do you have a balanced meal that includes proteins, carbohydrates, and vegetables?

• Every day
• Most days of the week
• Occasionally (few times a week)
• Rarely or never