Sugar Intake Survey
Which types of food are you concerned about when it comes to your waistline?
Sugar
Carbs
Fat
Protein
All of the above
None of the above
When are you most likely to eat unhealthy?
At Dinner
At Lunch
Snacking
At Breakfast
Other
What do you feel most guilty about eating?
Eating too much sugar
Eating too many carbs
Eating too much fat
I don't feel any guilt
Other
Which of the following best describes your typical weekday breakfast?
Free standing cereal grains or oats
Just coffee or tea
Fruit and veggies
Toast, bagel, roll and spread
Breakfast meat, eggs, and bread
Plain boiled eggs
Juice or smoothie
Yogurt
Don't eat breakfast
Other
How much do you agree or disagree with the following statements?
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
I think there’s too much sugar in American diet.
1
2
3
4
5
6
I believe I am knowledgeable on the negative impact of sugar on health.
7
8
9
10
11
12
I believe I need to reduce mu sugar intake.
13
14
15
16
17
18
A family/friend of mine could be addicted to sugar.
19
20
21
22
23
24
I think it’s hard to know how much sugar we are eating.
25
26
27
28
29
30
I find it hard to cut back sugar.
31
32
33
34
35
36
I don't trust food labels
37
38
39
40
41
42
Please answer the following questions.
Yes
No
Do you add sugar or any other sweetener to foods or beverages?
43
44
Do you eat processed foods, candy, cookies, or cake containing sugar or any other sweetener?
45
46
Do you drink regular sodas, diet sodas, diet drinks, sports drinks, or fruit juices?
47
48
Do you enjoy something sweet after a meal or have a sweet tooth?
49
50
Do you replace sugar with equal amounts of supposedly healthier sweeteners, such as honey, maple syrup, or agave nectar?
51
52
Do you use xylitol, stevia, or artificial sweeteners?
53
54
Do you eat large quantities of fruit (ten or more servings a day)?
55
56
Do you snack on dried fruit as a treat?
57
58
Do you think that health campaigns have an impact on nationwide sugar consumption?
59
60
Your Gender
Female
Male
Other
Your Age Range
Under 16
16- 24
25- 40
40- 60
Over 60
Submit
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