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How many times a week do you eat breakfast
 
Never
 
1-3 times
 
4-6 times
 
Every day
 
 
 
How many times a week do you eat lunch
 
Never
 
1-3 times
 
4-6 times
 
Every Day
 
 
 
How many times a week do you eat dinner
 
Never
 
1-3 times
 
4-6 times
 
Every Day
 
 
 
According to the food pyramid, how many servings of carbohydrates do you eat every day?
 
0
 
1
 
2
 
3+
 
 
 
According to the food pyramid, how many servings of protein do you eat every day?
 
0
 
1
 
2
 
3+
 
 
 
According to the food pyramid, how many servings of sweets/fats do you eat every day?
 
0
 
1
 
2
 
3+
 
 
 
On a scale of 1-5, how would you rate your eating habits? 1 being the least healthy, 5 being the most healthy
 
1
 
2
 
3
 
4
 
5
 
 
 
How many hours a week do you exercise?
 
0
 
1-4
 
5-8
 
8-10
 
10+
 
 
 
How many hours a week do you study?
 
0
 
1-4
 
5-8
 
8-10
 
10+
 
 
 
What is your gender?
 
Male
 
Female
 
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