Healthy vs. Junk Food Habits Questionnaire
Please answer the following questions to help us understand your eating habits related to healthy and junk foods.
How often do you eat fruits and vegetables?
*
Every day
Several times a week
Rarely
Never
How often do you eat fast food or junk food (e.g., chips, soda, candy, fried snacks)?
*
Several times a day
Once a day
A few times a week
Rarely or never
Which of the following healthy foods do you regularly include in your meals? (Select all that apply)
*
Fresh fruits
Vegetables
Whole grains
Lean proteins (e.g., chicken, fish, tofu)
Nuts and seeds
Other
Which of the following junk foods do you eat most often? (Select all that apply)
*
Potato chips
Soda or sugary drinks
Candy or chocolate
Fried fast food (e.g., fries, burgers)
Pastries or baked sweets
Other
On a typical day, how many meals do you eat that you consider healthy?
*
All meals
Most meals
Some meals
Few or none
How would you rate your overall eating habits?
*
1
2
3
4
5
What is your main motivation for choosing healthy foods?
*
Nutrition/health benefits
Taste
Weight management
Family influence
Other
What is your main reason for eating junk food?
*
Convenience
Taste
Social situations
Habit
Other
If you could change one thing about your eating habits, what would it be?
Please share any additional comments about your healthy or junk food habits.
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