膳食营养与健康调查问卷（Dietary nutrition andHealth Questionnaire）膳食营养与健康调查问卷(Dietary nutrition and HealthQuestionnaire)Dietary nutrition and Health QuestionnairePart 1: dietary habits surveyDo you have breakfast?1. eat2. every day, sometimes eat3., rarely eat4., never eatTwo where do you usually have your breakfast?1. units,2. units,3. roadside stalls,4. basically do not eatThree what do you usually have for breakfast?1. bread, buns, porridge, milk, biscuits, bread,2. egg milk beverage3. instant noodles, instant food,4. friedFour 、 what's your main way to eat lunch?1. go home to eat2. units, canteen or restaurant order,3. with rice,4. fast foodFive 、 How would you like your dinner?1. go home to eat2. restaurants, eat3. fast food,4. only eat fruit, vegetablesSix, do you have the habit of eating supper?1. basically do not eat2., rarely eat3., sometimes eat4., eat every daySeven, what snacks do you like?1. nuts2. biscuits, snacks, dried fish jerky3.4. preserved fruit, puffed food, etc.Eight, when do you eat snacks every day?1. between two meals,2. not limited time3. meals,4. when watching television eatsNine, your diet tastes inclined to?1. light2. partial sweet,3. partial salt,4. partial fatTen, your staple food structure is?1. rice flour, a small amount of basic equivalent2. rice flour, potato coarse grains, potato three3. coarse grains, potato based, a small amount of rice flour4. eat rice flour, basically do not eat whole grains, potatoEleven. How much can you eat on an average day? (a steamed bun, about 2, two, a bowl of rice, about 2, two)1.5-8 two,2.8-10 two,3.2-4 two,4.2, two, and belowTwelve, how many times do you eat roughage (corn, millet, sorghum, oats, buckwheat)?1. eat2. every day, more than three times a week,3., two times a week, the following4. basically do not eatThirteen, your daily coarse grain intake is how much?1.1-2 two,2.2-4, two,3.1, two,4., never eatFourteen, you eat soy products (tofu, bean sprouts, Soybean Milk, Dried tofu with assorted vegetables, etc.) of the situation?1. eat2. every day, more than three times a week,3., two times a week, the following4. basically do not eatFifteen. What is your average daily intake of soy products?1. 30-50 grams per day,2. grams per day,3. grams per day, lessthan 10 grams, 4., 10-20 do not eatSixteen, your milk and dairy products (fresh milk, pure milk, yogurt, milk drinks, milk powder, cheese) intake is?1. eat2. every day, more than three times a week,3., two times a week, the following4. basically do not drinkSeventeen, your daily intake of milk and dairy products is?1. 300 grams per day,2. grams per day,3. grams per day, less than 100 grams,4., 100-200 do not eatEighteen 、 do you often eat eggs?1. eat2. every day, more than 3 times a week,3., 2 times a week,the following 4., basically do not eatNineteen, which part of the egg do you usually eat?1., the whole egg to eat2., go to the yolk, eat only protein3., go to protein, eat only yolk,4. basically do not eatTwenty, do you often eat animal food (pork, beef, lamb)?1. eat2. every day, more than three times a week,3., two times a week, the following4. basically do not eatTwenty-one, are you a vegetarian?1. no, eat lean meat and fish every day.2. no, but every day thereis a corresponding intake of eggs and milk3., no, like meat, especially fat meat,4. is, completely vegetarianTwenty-two, you eat animal liver (liver, kidney, stomach, intestines) situation?1. basically do not eat2., 3 times a month, the following3., 3times a week more than 4., basically every day to eatTwenty-three, you eat fat or lard situation?1. basically do not eat2., 4. times a week,3. times a week, three times a weekEat every dayTwenty-four, you eat fish, shrimp, crab and other aquatic products?1. eat2. every day, more than three times a week,3. times a week,4. below, basically do not eatTwenty-five, do you often eat in the deep sea fish (such as tunafish, etc.)?1., often eat 4-5 times a week,2., 2-3 times a week,3. rarely eat,4. do not eatTwenty-six, your daily fresh vegetable consumption is how much?1.300 grams or more,2.200-300 grams,3.100-200 grams,4.100 grams belowTwenty-seven. Do you like dark vegetables such as yellow, red and purple? Such as carrots, peppers, tomatoes and so on.1. often eat2., 2-3 times a week,3. rarely eat,4. do not eatTwenty-eight, your daily fresh fruit consumption is how much?1.200 grams2.100-200 grams,3.100 grams below,4. do not eatTwenty-nine 、 how long do you eat fruit every day?Between 1. and two meals, after 2. meals, that is, eat 3. mealsbefore 4., rarely eat or not eatThirty, how much water do you drink every day?1.1000-1500 ml2.500-1000 ml, more than3.1500 ml, less than4.500 ml.Thirty-one, your long-term drinking water is what kind?1. mineral water,2. tap water (plain boiled water),3. tea water,4. pure waterThirty-two, your drinking water habits are?1. in the morning just get up, fasting, drink a cup of warm water, and drink water evenly in the afternoon.2. do not have the habit of drinking when you get up early in the morning, but drink water every afternoon.3. drinking water is not regular.4. drink only when you feel thirsty.Thirty-three what kind of drink do you usually drink?1. pure fruit juice,2. carbonated soft drinks,3. coffee,4. carbonated drinksThirty-four, do you have the habit of drinking soup or porridge?1. meals, drink2., once a day,3., more than two times a week,4. times a week belowThirty-five 、 what time do you usually have soup or porridge?1., drink2. sides before meals, drink3., rarely drink4., drinkafter dinnerThirty-six, you pay attention to the amount of daily salt? How muchis the dosage?1., there are 3-6 grams,2. have, 3 grams less than3., add4. with taste, 10 grams or moreThirty-seven do you pay attention to the amount of daily cooking oil? How much is the dosage?1. have, 25-30 grams,2. have, 25 grams below,3. have, more than 30 grams4. no, add it as you likeThirty-eight, your home is commonly used oil?1. salad oil and blend oil2. is not fixed3., rapeseed oil, soybean oil and other vegetable oil based,4. lard or butter and other animal oil basedThirty-nine, your home cooking is commonly used way of cooking is?1., salad, steamed2. quick fried3., stew, stew,4. friedForty 、 do you have the habit of eating preserved or fried foods?1. no, never eat pickled or fried food,2. occasionally eat pickledor fried food3. often eat pickled or fried food,4. almost every day to eatThe second part: investigation of behavior habitsAre you a smoker?1. no, never smoke,2., smoke 1 packs per day3. is smoking 1-2 packs a day,4. is smoking more than 2 packs a dayTwo, are you often drunk?1. basically do not drink, drink is also a small amount of2.,occasionally drinking, not drunk3. often drink, occasionally drunk,4. often drunk, drunk.Three, what time do you participate in sports activities on average?1. join2. times a day, more than 3 times a week,3. times a week, 3 times below4. basically no sports activitiesFour, your daily commute to use the means of transportation?1. walk, bike2., public transport3., no fixed4. private carsFive, are you often in a state of intense stress?1., not in tight work pressure,2. occasional pressure3., often in a state of tension, pressure,4. every day in a stateof high tension and pressureSix 、 what is your average working hours per day?1.6-8 hours,2.8-12 hours, less than3.6 hours, more than4.12 hoursSeven 、 how long do you sleep every day?1.6-8 hours, more than2.8 hours,3.4-6 hours, less than4.4hoursEight, do you often go out to socialize?1., occasionally out of social entertainment,2. never go out to socialize3. often go out to socialize,4. out of daily entertainmentNine do you eat three meals a day on time?1. on time,2. on schedule,3. on schedule,4. on scheduleTen 、 how many routine tests do you do every year?1. two times a year,2. once a year,3. for two years,4. are not done at allEach of these questions has four answers, 1 for 1, 2 for choice, 3for choice, 4 for 3, four for 2.The first part of the diet and second parts of two habits and points scores, according to the final score to find the corresponding dietary habits evaluation.First, second total total scores:Scoring 50-70: level a standard gold classCongratulations～ There are not many people who can reach this level. It shows that you have a good understanding of how tokeep a healthy diet, a good diet, health awareness and lifestyle,and a high level of knowledge about diet, safety and nutrition.Score 70-100:B level - silver levelYou have a certain knowledge of dietary safety and nutrition, and have a good diet and habits. Your healthy eating and behavior habits, as well as areas for improvement so as to reduce the occurrence of some common diseases, and make life orderly.Score 100-150 points: C level - Bronze levelYour eating habits and behavior is not reasonable, has been in thesub-health state, if not promptly adjust the diet structure and livinghabits of their own, some of the potential threats and the disease will take advantage of, so you need to pay attention to diet and health information, to obtain more food safety and nutrition knowledge, improve health consciousness pay attention to changeAdjust the healthy diet and living habits. Your body may alreadyhave some common disease risk factors, and quality of life has declined.Score 150-200 points: D level - pig iron levelUnfortunately, your eating habits and behavior is very unhealthy, in serious sub-health state, if not changed, diet and living habits on the body of the damage to your unexpected way out, affect you and yourfamily happiness. Some of the mostcommon diseases may have been in the bud, to your health and your family happiness, please immediately to your diet and habits to make adjustments, pay close attention to diet and health related consulting, re planning, improve the diet and living conditions, improve the quality of life.。
