Dietary and Physical Activity Habits

During the past week how many times did you cook breakfast?

0 times

1-2 times

3-4 times

5 -7 times

During the past week how often did you cook lunch?

0 times

1-2 times

3-4 times

5-7 times

During the past week how often did you cook supper?

0 times

1-2 times

3-5 times

5-7 times

How many times did you eat fast food in the last 14 days?

o times

1-2 times

3-4 times

5 or more times

Yesterday you ate:

Over 7 servings of vegetables and fruit

4-5 servings of vegetables and fruit

2-3 servings of vegetables and fruit

1 serving of vegetables and fruit

no vegetables and fruit

Yesterday:

Every meal was cooked at home

Two meals were cooked at home

one meals was cooked at home

no meals were cooked at home

Where you physically active yesterday?

Yes

No

How many minutes of physical activity did you accumulate in the past week?

How satisfied are you with the following:

How important is the following:

Cooking meals at home

Eating less fast food

Eating more vegetables and fruits

Decreasing the amount of TV being watched

Being active everyday