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Age?
 
Under 12
 
12-15
 
15-18
 
Over 18
 
 
 
How often do you eat breakfast?
 
Every morning
 
Almost every morning
 
Whenever I have enough time
 
Whenever I'm hungry
 
Never
 
 
 
How many times a day do you eat?
 
Under 3
 
3
 
4
 
5
 
6
 
Over 6
 
 
 
How often do you eat lunch at school/work?
 
Daily
 
When I'm hungry
 
When I like the lunch that the school offers
 
Never, I go to eat to another place
 
Never, I don't eat lunch
 
Other
 
 
 
 
How often do you eat dinner?
 
Daily
 
Whenever I'm hungry
 
Whenever I have time
 
Sometimes
 
Never
 
 
 
How often do you eat something "good", for example candy, chips or soda?
 
Daily or almost everyday
 
2-3 times a week
 
Once a week
 
1-2 times a month
 
Less often
 
Never
 
 
 
How much do you eat fruits and/or vegetables
 
Daily or almost everyday
 
Weekly
 
Few times a month
 
Less often
 
Never
 
 
 
Do you watch your eating?
 
Yes, I count calories
 
Yes, I try to eat healthily
 
Yes, I avoid something, for example sugar
 
No
 
Other
 
 
 
 
Do you think you eat healthily?
 
Yes
 
No
 
 
 
Gender?
 
Male
 
Female