Survey

EATING HABITS QUESTIONAIRE

Class/group: ______ Gender: ______ Age: ______ Weight: ______

Weight on entry to college: _____ Please answer the following question. You can tick more than one (1). 1. How many main meals do you have?

o1 o2 o3 o4
2. Tick the food types that best suite you or best describe you: Breakfast Lunch Dinner

o Mee / Nasi lemak o

Bread

o Rice with dishes o o o

Soup / mee soup

o o o o o

Rice with dishes

Western meal (burger/ hotdog) Low calories food (cereal/ biscuits) Vegetarian meal (salads, coleslaw, potatoes) Others Please specify: ________________

o Hot drinks
(milo, teh tarik, Nescafe)

Porridge

o Cereal /biscuits /Oats o Others

Please specify: ____________________

Fast food (McDonald, KFC)

o Others
Please specify: __________________

3. How often do you have snacks in between the main meals?

o o o
o o o o o

Always Sometimes Never

4. If yes, what do you take? Chips Nuts Sweets/ chocolate/ cake Fruits Others , please specify: ___________

5. How often do you eat salad or vegetables and fruits with lunch or dinner?

o o o o o

Always Frequently Sometimes Rarely Never

6. What do you drink before, during or after a meal?

o Water o Carbonated drink o Juice o Tea o Others, please specify : _________________

7. How often do you eat at fast food restaurants? (Mc Donald, KFC, Pizza Hut, etc)

o o o o

Never Once a month 2 or 3 times a month 2 or 3 times a week

Everyday

8. Do you use food supplement like vitamins to complete your diet?

o Yes o No
9. Do you believe that your health is affected by good eating habits?

o Yes o No
10. Do you practice good eating habits?

o Yes o No
11. What type of food do you think you should eat to have a balanced nutrition?

o Mainly meat o Mainly vegetables o Meat, vegetables, and other variety of foods o Try to balance up a meal (include as many foods) o Others, please specify: ___________________
12. Do you realize your health can be affected by diet?

o o o o o o o

Yes No

13. What does a healthy diet means to you? Take vegetables only Take two main meals in a day Take meals according to food pyramid A healthy diet is one that helps maintain or improve health Others, please specify: ___________________

14. Have you gained weight during your stay at this college?

o o

Yes No

15. If yes, what do you think are the causes?

16. Do you think that students in this college have good eating habits?

o o

Yes No

17. What are your recommendations to encourage students here to have good eating habits?

18. How often do you fall ill (sick) due to bad eating habits?

o Once a week o Once a month o Once in two months o Practically never o Others please specify
19. Does the amount of food you eat balance up with the rate at which you use that energy?

o Yes o No o Sometimes

o Always o Others please specify.

20. Is there any other part of your health that you think is essential to this study, anything important?

THANK YOU...