FOOD FREQUENCY SAMPLE QUESTIONS:

1. Do you drink milk? NO If so, how much? _

What kind? _ Whole _Skim_

2.Do you use fat? NO If so, what kind? _

How much? _

3.How many times do you eat meat? TWICE A WEEK Eggs? TWICE A WEEK Cheese? TWICE OR THRICE A
WEEK Beans? RARELY

4.Do you eat snack foods? YES If so, which ones? JUNK FOODS How often? EVERYDAY How much?
DEPENDS

5.What vegetables do you eat? (in each group)

a. Broccoli _Green Pepper _Cooked greens _ Carrot/ (ONCE A WEEK) Sweet Potato /

b.Tomato/ (FOUR TIMES A WEEK) Raw Cabbage_Asparagus _ Beets _Cauliflower _Cooked Cabbage

Celery _Peas _Lettuce _

6. What fruits do you eat and how often?

a) Apples/Applesauce _Apricots _Banana /THRICE A WEEK_ Berries _Cherries _ Grape/Grape juice _

Peaches _Pears _Pineapple _ Plums _Raisins _

b) Oranges _Orange juice _ Grapefruit _Grapefruit juice _

7. Bread and Cereal Products

a.How much bread do you usually eat with each meal? _ Between meals? _

b.Do you eat cereal? (daily, weekly) Cooked _Dry_

c.How often do you eat foods such as macaroni, spaghetti, noodles and the like? I ONLY EAT
MACARONI AND SPAGHETTI OCCASIONALY, NOODLES (TWICE A WEEK)

8. Do you use salt? YES Do you “crave” salts or salty foods? SOMETIMES

9. How many tsp of sugar do you use/day?(1packet- 1 tsp) 2 TSP A DAY

10. Do you drink water? YES How often during the day? 7-8 CUPS A DAY How much each time? _How
much would you say you drink each day? _

11. Do you drink alcohol? NO How often?