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Hasil FFQ Formulir Food Frequency Questioinaire (FFQ)
Hasil FFQ Formulir Food Frequency Questioinaire (FFQ)
Hasil FFQ
Formulir Food Frequency Questioinaire (FFQ)
Nama Subjek : Tn. S.L Tanggal Wawancaa : 30/September/2021
Umur : 59 thn Pewawancara : Klara Latarima
Jenis Kelamin : Laki-laki Alamat : Kel. Mongkonai
Barat
1 Nasi ✔
2 Jagung ✔
3 Singkong ✔
4 Sagu ✔
5 Kentang ✔
6 Roti ✔
B Lauk Hewani
7 Daging sapi ✔
8 Sosis ✔
9 Udang basah ✔
10 Cumi cumi ✔
11 Kepiting ✔
12 Bandeng ✔
13 Kakap ✔
14 Ayam ✔
15 Hati ayam ✔
16 Telur ayam ✔
17 Telur itik ✔
18 Telur puyuh ✔
19 Belut ✔
20 Ikan asin ✔
21 Ikan kering ✔
C Lauk Nabati
22 Tahu ✔
23 Tempe ✔
24 Kacang Merah ✔
25 Kacang Mete ✔
26 Kacang Hijau ✔
27 Kacang Kedele ✔
28 Kacang tanah ✔
29 Petai ✔
D Sayur-Sayuran
29 Pokcoy ✔
30 Kangkung ✔
31 Daun singkong ✔
32 Sawi hijau ✔
33 Gambas ✔
34 Selada ✔
35 Jamur kuping ✔
36 Lobak ✔
37 Oyong ✔
39 Ketimun ✔
40 Daun Bawang ✔
41 Labu Air ✔
42 Selada air ✔
43 Daun Kecipir ✔
44 Sawi ✔
45 Terong ✔
46 Labu Siam ✔
47 Wortel ✔
48 Kol ✔
49 Labu waluh ✔
50 Brokoli ✔
51 Buncis ✔
52 Daun Kacang ✔
53 Pare ✔
54 Rebung ✔
55 Bayam merah ✔
56 Bunga Kol ✔
57 Daun Katuk ✔
58 Daun melinjo ✔
59 Nangka muda ✔
60 Daun pepaya ✔
E Buah-Buahan
61 Alpukat ✔
62 Pisang ✔
63 Dukuh ✔
64 Pepaya ✔
65 Jambu air ✔
66 Jeruk garut ✔
67 Kedongdong ✔
68 Mangga ✔
69 Melon ✔
70 Markisa ✔
71 Apel ✔
F Susu dan hasil olahannya
72 Yoghurt ✔
73 Keju ✔
74 Ice cream ✔
75 Lainnya,
sebutkan..........
G Makanan Jajanan
76 Humburger ✔
76 Hotdog ✔
77 Pizza ✔
78 Fried Chicken ✔
79 Spaghetti ✔
80 Fench Fries ✔
81 Donat ✔
82 Bakso ✔
83 Siomay ✔
84 Batagor ✔
85 Pempek ✔
86 Roti ✔
87 Cake ✔
88 puding/agar- ✔
agar
89 Coklat ✔
90 Lainnya,
Sebutkan........
H Soft Drink
91 Coca-cola ✔
92 Fanta ✔
93 Sprite ✔
94 Pepsi ✔
95 Pop Ice ✔
96 Lainnya, ✔
Sebutkan.......
2. Hasil FFQ
Formulir Food Frequency Questioinaire (FFQ)
Nama Subjek : Nikson L Tanggal Wawancaa : 30/September/2021
Umur : 26 thn Pewawancara : Klara Latarima
Jenis Kelamin : Laki-laki Alamat : Kel. Mongkonai
Barat
1 Nasi ✔
2 Jagung ✔
3 Singkong
4 Sagu ✔
5 Kentang ✔
6 Roti ✔
B Lauk Hewani
7 Daging sapi ✔
8 Sosis ✔
9 Udang basah ✔
10 Cumi cumi ✔
11 Kepiting ✔
12 Bandeng ✔
13 Kakap ✔
14 Ayam ✔
15 Hati ayam ✔
16 Telur ayam ✔
17 Telur itik ✔
18 Telur puyuh ✔
19 Belut ✔
20 Ikan asin ✔
21 Ikan kering ✔
C Lauk Nabati
22 Tahu ✔
23 Tempe ✔
24 Kacang Merah ✔
25 Kacang Mete ✔
26 Kacang Hijau ✔
27 Kacang Kedele ✔
28 Kacang tanah ✔
29 Petai ✔
D Sayur-Sayuran
29 Pokcoy ✔
30 Kangkung ✔
31 Daun singkong ✔
32 Sawi hijau ✔
33 Gambas ✔
34 Selada ✔
35 Jamur kuping ✔
36 Lobak ✔
37 Oyong ✔
39 Ketimun ✔
40 Daun Bawang ✔
41 Labu Air ✔
42 Selada air ✔
43 Daun Kecipir ✔
44 Sawi ✔
45 Terong ✔
46 Labu Siam ✔
47 Wortel ✔
48 Kol ✔
49 Labu waluh ✔
50 Brokoli ✔
51 Buncis ✔
52 Daun Kacang ✔
53 Pare ✔
54 Rebung ✔
55 Bayam merah ✔
56 Bunga Kol ✔
57 Daun Katuk ✔
58 Daun melinjo ✔
59 Nangka muda ✔
60 Daun pepaya ✔
E Buah-Buahan
61 Alpukat ✔
62 Pisang ✔
63 Dukuh ✔
64 Pepaya ✔
65 Jambu air ✔
66 Jeruk garut ✔
67 Kedongdong ✔
68 Mangga ✔
69 Melon ✔
70 Markisa ✔
71 Apel ✔
F Susu dan hasil olahannya
72 Yoghurt ✔
73 Keju ✔
74 Ice cream ✔
75 Lainnya,
sebutkan..........
G Makanan Jajanan
76 Humburger ✔
76 Hotdog ✔
77 Pizza ✔
78 Fried Chicken ✔
79 Spaghetti ✔
80 Fench Fries ✔
81 Donat ✔
82 Bakso ✔
83 Siomay ✔
84 Batagor ✔
85 Pempek ✔
86 Roti ✔
87 Cake ✔
88 puding/agar- ✔
agar
89 Coklat ✔
90 Lainnya,
Sebutkan........
H Soft Drink
91 Coca-cola ✔
92 Fanta ✔
93 Sprite ✔
94 Pepsi ✔
95 Pop Ice ✔
96 Lainnya, ✔
Sebutkan.......
1. Quisioner
I Pengenalan Tempat
1. Kabupaten/Kota Kotamobagu
Barat/Kota
Kotamobagu
5. Supervisor
6. Tanggal pengecekan
7. Tanda tangan supervisor
I Pengenalan Tempat
1. Kabupaten/Kota Kotamobagu
Barat/Kota
Kotamobagu
5. Supervisor
6. Tanggal pengecekan