Questionnaire: Healthy Lifestyle

Gender:. Age:. Option:.

*Please circle your choices. 1. Based on BMI(Body Mass Index),which category are you? A. Underweight B. Normal C. Overweight D. Obesity

2. How many meals a day do you take? A. Once B. Two C. Three D. > three

3. Do you take your breakfast everyday? A. Always B. Sometimes C. Rarely D. Never

4. Which classes of food do you take the most in the food pyramid? A. Carbohydrates B. Protein C. Vitamins and fibres D. Fats

5. Which classes of food do you take the least in a day? A. Carbohydrates B. Protein C. Vitamins and fibres D. Fats

6. How many glasses of plain water you drink everyday? A. 1-3 glasses B. 4-6 glasses C. 7-8 glasses D. > 8 glasses

7. How many times do exercise every day? A. Once a week B. Twice C. > twice a week D. Never

8. In your opinion, do you think it is relevant to cut your meal in order to loss your weight? A. Yes B. No C. Uncertain

9. In the list below, as a teenager and student, which one the most effective way to maintain health? A. Regular exercise B. Eat on time C. Eat according to the food E. Drink 8 or more glasses of water daily

D. Eat according to the right proportion

10. Do you have a family with the history of diseases below? A. YES i. ii. iii. iv. v. (tick diseases related) Diabetes Heart attack High blood pressure Obesity Others:. B. NO

Prepared by: Wan Nurshida Ayu, Hani, Syazana 3PPISMP SN/PI/PM