Eating and dietary habits questionnaire template

1. How many times a day do you eat?

Choose...
- Choose...
- 1x
- 2x
- 3x
- 4x
- 5x
- More

2. Please answer the following according to your particular eating habits?

Yes
Sometimes
No

I eat a good breakfast

Yes
Sometimes
No

I experience feelings of hunger during the day

Yes
Sometimes
No

I eat meat

Yes
Sometimes
No

I eat vegetables

Yes
Sometimes
No

I eat fruit

Yes
Sometimes
No

I eat dairy

Yes
Sometimes
No

I eat sweets

Yes
Sometimes
No

3. What meal would you consider to be your main meal of the day?

Breakfast
Lunch
Dinner

4. What does your main meal consist of and how is it prepared?

Freshly home-cooked produce
Restaurant meal
Pre-cooked, microwave or TV dinners

5. What does your main meal on the weekend consist of and how is it prepared?

Freshly home-cooked produce
Restaurant meal
Pre-cooked, microwave or TV dinners

6. Have you been avoiding some foods for health reasons?

7. Do you have any particular food allergies?

8. What is your weekly food intake frequency of the following food categories?

Several times a day
Once a day
Several times a week
Less often
Never

Sweet foods

Several times a day
Once a day
Several times a week
Less often
Never

Salty foods

Several times a day
Once a day
Several times a week
Less often
Never

Fresh fruit

Several times a day
Once a day
Several times a week
Less often
Never

Fresh vegetables

Several times a day
Once a day
Several times a week
Less often
Never

9. What percentage of your regular diet consists of meat and meat products?

90% or more
75%
50%
25%
Less than 25%

10. How much of your diet consists of vegetables and non-animal products?

90% or more
75%
50%
25%
Less than 25%

11. Do you or have you ever had cholesterol problems?

Yes
No
I don't know

12. Do you know your current BMI (Body Mass Index) index?

Less than 18,5 (Underweight)
18,5-25 (Ideal weight)
25-30 (Overweight)
30-35 (Moderate obesity)
35-40 (Obesity)
More than 40 (Morbidly obese)

Eating and dietary habits survey

Popularity 2535 ×

What are the public’s eating habits? How many meals in what daily amount meet the standard? The eating habits questionnaire template will provide answers.

Use template

The survey sample is ideal for

nutritional consultants,
students or journalists,
operators of restaurants and fast food.

If you are interested in or work directly in the field of nutritional counselling and observe differences in attitudes to eating, types of preferred diet or methods of consumption, then without hesitation, use the eating habits questionnaire template. The answers to these questions can serve as a starting point before the consultation visit. A larger sample of respondents will then offer a basis for the elaboration of a study, seminar work and newspaper articles on the topic of eating.

Capture instant feedback to build a pool of satisfied and loyal clients.

The questionnaire template can be fully edited. Survio will process your answers into well-arranged tables and graphs.

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Eating and dietary habits questionnaire template

1. How many times a day do you eat?

2. Please answer the following according to your particular eating habits?

I eat a good breakfast

I experience feelings of hunger during the day

I eat meat

I eat vegetables

I eat fruit

I eat dairy

I eat sweets

3. What meal would you consider to be your main meal of the day?

4. What does your main meal consist of and how is it prepared?

5. What does your main meal on the weekend consist of and how is it prepared?

6. Have you been avoiding some foods for health reasons?

7. Do you have any particular food allergies?

8. What is your weekly food intake frequency of the following food categories?

Sweet foods

Salty foods

Fresh fruit

Fresh vegetables

9. What percentage of your regular diet consists of meat and meat products?

10. How much of your diet consists of vegetables and non-animal products?

11. Do you or have you ever had cholesterol problems?

12. Do you know your current BMI (Body Mass Index) index?

Eating and dietary habits survey

Template categories

Survio is a survey software for everyone.

Create a questionnaire in less than one minute

Collect survey responses on multiple channels

Analyze survey results with a single click

What people say about us

It’s not just a template. You’ll get the entire survey platform to collect desired data and understand them.

Eating and dietary habits questionnaire template

1. How many times a day do you eat?

2. Please answer the following according to your particular eating habits?

I eat a good breakfast

I experience feelings of hunger during the day

I eat meat

I eat vegetables

I eat fruit

I eat dairy

I eat sweets

3. What meal would you consider to be your main meal of the day?

4. What does your main meal consist of and how is it prepared?

5. What does your main meal on the weekend consist of and how is it prepared?

6. Have you been avoiding some foods for health reasons?

7. Do you have any particular food allergies?

8. What is your weekly food intake frequency of the following food categories?

Sweet foods

Salty foods

Fresh fruit

Fresh vegetables

9. What percentage of your regular diet consists of meat and meat products?

10. How much of your diet consists of vegetables and non-animal products?

11. Do you or have you ever had cholesterol problems?

12. Do you know your current BMI (Body Mass Index) index?

Eating and dietary habits survey

Template categories

Survio is a survey software for everyone.

Create a questionnaire in less than one minute

Collect survey responses on multiple channels

Analyze survey results with a single click

What people say about us

It’s not just a template. You’ll get the entire survey platform to collect desired data and understand them.

Enter Survio

Create engaging surveys, get genuine data and make the right decisions.

Start surveying now!