General questions
Name
*
First Name
Last Name
Fibre
Number
*
Include vegetable in e.g. risotto, pasta, soup or other dishes. Have in mind that a large mixed salad can count as 2 or 3 portions.
Number
*
Number
*
Fats
Number
*
Number
*
Salt
Sugar
Breakfast
Type a question
*
Every day
Often (5-6 times per week)
Sometimes (3-4 times per week)
Rarely (1-2 times per week)
Never
Dairy
Type a question
*
Yes, with an emphasis on milk
Yes, with an emphasis on fermented dairy products
No
Vitamin D
Are you exposed to sunlight at least 20min per day (with the majority of your limbs)?
*
Yes, but only in the morning or late in afternoon
Yes, in the mid-day
No
Hydration
Free time and relaxation
I’m familiar with meditation and other types of mindfulness techniques and I practice them regularly
*
Yes
Yes, but i do not practice them regularly
No
Do you like sleep for at least 7 hours per night?
*
Yes.
Yes, but I usually wake up in the middle of the night.
No
Do you usually take the afternoon nap?
*
Yes, for less than 10 minutes
Yes, for 10 - 30 minutes
Yes, for more than 30 minutes
No
Do you like spending time in nature?
*
Yes, I spend some time outside on the daily basis
I love spending time in nature during weekends, but only if I find time
No
How many hours per day you spend watching TV or using computer/tablet/smartphone instead of spending time with friends?
*
2 hours or more
Less than 2 hours
Other
Are you taking any of the following medications?
*
Yes, for lowering high cholesterol (statins)
Yes, for lowering blood pressure
Yes, for high blood sugar
No
What is your waist circumference (cm)?
Submit
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