1. Do you eat pretty much the same foods each week?

yes
mostly the same, some different
no, I eat a lot of different foods

2. How often do you eat legumes, such as lima beans, split peas, lentils, beans or chick peas?

never
less than once a week
once a week
at least twice a week

3. How many servings of fruits and vegetables do you eat each day? (One serving=a medium-size fruit or vegetable, or 1/2 cup (125 ml) juice, or 1/2 cup (125 ml) fruit or vegetable.)

1 to 2
3 to 4
5 or more

4. How many servings of grain products do you eat each day?(One serving=1 slice of bread or small roll, or 1/2 bagel or big bun, or 4 to 6 crackers, or 1/2 cup (125 ml) cooked rice or pasta, or 3/4 cup (175 ml) cooked cereal, or 1 oz. (30 g) ready-to-eat cereal or 1/2 cup (125 ml) legumes.)

1 to 2
3 to 5
6 or more

5. How often do you eat whole grain foods rather than white bread and refined cereals? (Examples: whole wheat bread or pasta, brown rice, whole grain cereal like shredded wheat or oatmeal.)

never
occasionally
most of the time

6. Do you always put butter or margarine on your bread and toast?

yes
yes, but I use the "light" kind or spread lightly
never use
sometimes, not always
don't use if sandwich filling is mixed with mayonnaise
don't use when jam or mustard can be used instead

7. What type of milk do you drink?

skim or 1%
2%
whole or homo milk
I don't drink milk but I eat other milk products

8. Do you eat meat, fish or poultry at most meals?

yes, a meal isn't a meal without meat or fish
not every meal, but certainly at most meals
no, I enjoy meatless meals often
no, I am vegetarian

9. How often do you eat fast food meals?

once a week
more than once a week
once every two weeks
once a month
rarely or never

10. How often do you eat a rich dessert, such as pie, cake, ice cream or cookies?

every day
2 to 3 times a week
about once a week
rarely, on special occasions

11. What kind of breakfast do you usually eat?

bacon, eggs, toast
no breakfast, or just coffee
cereal, hot or cold
toast, muffin, waffle or pancake with jam or syrup and little or     no butter or margarine
toast or muffin with low-fat cheese or peanut butter

12. What are you most likely to snack on?

fruit, low-fat cheese, crackers, muffin, yogurt, milk, juice
snack foods, like chips, cheesies, taco chips
snack foods, like popcorn or pretzels
cookies, cake, ice cream treats
I don't snack

13. How much caffeinated coffee and tea do you drink?

none
less than 4 cups a day
more than 4 cups a day

14. Do you salt your food?

always
usually
occasionally
never

15. How many alcoholic drinks do you usually have in a day?

1 to 2 drinks
more than two drinks
I don't drink every day