Quick Nutrition Questionnaire
How do you rate with your nutrition?
1. How often do you eat breakfast?
A. Every day B. About 50% of the time C. Rarely or never
2. How much water do you drink each day?
A. More than 2 litres B. 0.5 to 1.5 litres C. less than 0.5 litres
3. How many cups of coffee/tea do you drink each day?
A. 2 or less cups B. 3 to 4 cups C. 5 or more cups
4. How many meals/snacks do you eat each day?
A. 4 to 6 B. 3 C. 2 or less
5. How many serves of fruit do you eat each day?
A. 2 or more serves B. 1 serve C. None
6. How many serves of veggies do you eat each day?
A. 5 or more serves B. 3 to 4 serves C. 0 to 2 serves
7. How many times a week do you eat fish?
A. 3 or more times B. 1 to 2 times C. Rarely or never
8. How would you describe your fat intake?
A. Eat plenty of good fats (olive oil, fish, nuts, avocado, etc) and limit bad fats (saturated or trans fats) B. Avoid all fats (good and bad) C. Not concerned about it
9. How many takeaway meals do you eat each week?
A. Rarely B. 1 to 3 times C. 4 or more times
10. How many alcoholic drinks do you have each week?
A. 0 to 3 B. 4 to 5 C. 6 or more
Scoring: A = 10 B = 5 C = 0
100 = PERFECT!!
70-95 = Good
35-65 = Needs improvement
0-30 = POOR!! We need to talk.