Salt Intake Questionnaire

1. Thinking about the foods you usually consume, would you describe your diet as:
☐ Canadian ☐ Chinese

☐ European ☐ Korean

☐ Indian ☐ Japanese

☐ Iranian ☐ Vietnamese

☐ Others: ......................................................................................
2. At mealtime, when do you usually add salt or salty condiments to your food?
☐ Before tasting the food

☐ Only after tasting the food

☐ Almost never add salt

3. In the last month how often did you consume breads of any type?
☐Almost never

☐1-2 times per month

☐1 time per week

☐2-3 times per week

☐Almost everyday

4. In the last month how often did you consume processed meats of any type (i.e. bacon,
sausages and wieners, salami, pepperoni, packaged deli meats, meat sticks and jerky, hot
dogs etc.)?
☐Almost never

☐1-2 times per month

☐1 time per week

☐2-3 times per week

☐Almost everyday

5. In the last month how often did you consume cheese of any type?
☐Almost never

☐1-2 times per month

☐1 time per week

 ☐2-3 times per week

☐Almost everyday

6. In the last month how often did you consume canned vegetables and legumes of any
type (i.e. canned vegetables and legumes; pickled vegetables such as pickles, pickled
beans, pickled carrot, kimchi; olives etc.) ?
☐Almost never

☐1-2 times per month

☐1 time per week

☐2-3 times per week

☐Almost everyday

7. In the last month how often did you consume salted butter and salted margarine?
☐Almost never

☐1-2 times per month

☐1 time per week

☐2-3 times per week

☐Almost everyday

8. In the last month how often did you consume cooking sauces of any type? (i.e. gravies,
pasta sauce, tomato sauce etc.)
☐Almost never

☐1-2 times per month

☐1 time per week

☐2-3 times per week

☐Almost everyday

9. In the last month how often did you consume table sauces of any type? (i.e. salad
dressing, barbecue sauce, hot sauce, ketchup, soy sauce, fish sauce, mayonnaise, mustard
etc.)
☐Almost never

☐1-2 times per month

☐1 time per week

☐2-3 times per week

☐Almost everyday
10. In the last month how often did you consume soup of any type (i.e. broth, canned
condensed soup, ready to serve soup, dry soup mixes, fresh and instant oriental noodles
etc.)?
☐Almost never

☐1-2 times per month

☐1 time per week

☐2-3 times per week

☐Almost everyday

11. In the last month how often did you consume mixed dishes of any type (i.e. pizza; pizza
snacks and frozen sandwiches; frozen fries, hash browns, and potato patties; refrigerated
and frozen appetizers, sides and entrees; dry mashed or scalloped potatoes; burgers,
nuggets etc.)?
☐Almost never

☐1-2 times per month

☐1 time per week

☐2-3 times per week

☐Almost everyday

12. In the last month how often did you consume fish and seafood of any type (including
canned fish and seafood, frozen fish and seafood)?
☐Almost never

☐1-2 times per month

☐1 time per week

☐2-3 times per week

☐Almost everyday

13. In the last month how often did you consume potato chips and salty snacks of any type?
(i.e. plain or flavoured chips, popcorn, pretzel and snack mixes, salted nuts, salted seeds
etc.)
☐Almost never

☐1-2 times per month

☐1 time per week

☐2-3 times per week

☐Almost everyday

14. In the last month how often did you consume breakfast cereals (ready to eat breakfast
cereals and instant hot cereal) of any type?
 ☐Almost never

☐1-2 times per month

☐1 time per week

☐2-3 times per week

☐Almost everyday

15. In the last month how often did you consume sports drinks of any type?
☐Almost never

☐1-2 times per month

☐1 time per week

☐2-3 times per week

☐Almost everyday