1. I eat second helpings of meats, potatoes, and breads.
a. 0 times per week
b. 1-3 times per week
c. 4 or more times per week
2. At meals, I eat meats that are the size of?
a. A deck of cards
b. 2 decks of cards
c. 3 or more decks of cards
3. I measured my foods to ensure I received the proper portions.
a. Sometimes
b. Never
c. Always
4. I like my meats________ .
a. Fried
b. Baked
c. Smothered in gravy
5. I eat balanced meals.
a. Often
b. Never
c. Always
6. In which food group does corn, peas, mixed vegetables and lima beans fall? I watch my intake of these starchy vegetables.
a. Sometimes
b. Never
c. Always
7. I write down the emotions that make me want to eat.
a. Sometimes
b. Never
c. Always
8. I avoid snacking unnecessarily.
a. Sometimes
b. Never
c. Always
9. How many times per week do I visit the vending machine and buy the not so good stuff?
a. Never
b. 1-3 times per week
c. 4 or more times per week
10. I keep nutritious snacks readily available for the tough times.
a. Sometimes
b. Never
c. Always
11. I prefer to eat which type of vegetables?
a. Frozen
b. Canned
c. Fresh
12. I fit sugared items into my meals.
a. Sometimes
b. Never
c. Always
13. I plan my meals ahead of time at least _______ times per week.
a. 1-3 times per week
b. 4-7 times per week
c. Never
14. I try new recipes.
a. Sometimes
b. Never
c. Always
15. I skip meals.
a. Never
b. 1-3 times per week
c. 4-7 times per week
16. How many 8-oz. glasses of water do I drink daily?
a. 8-10 per day
b. 4-7 per day
c. 0-3 per day
17. How many cups of milk containing 1% or less fat do I consume daily?
a. 1-2 cups
b. 2-3 cups
c. 4-5 cups
18. Do I eat vegetables?
a. Sometimes
b. Never
c. Always
19. When I eat vegetables I consider a serving to be?
a. 1/2 cup cooked, 1 cup raw
b. 1 cup cooked, 1 cup raw
c. 3/4 cup cooked, 1 cup raw
20. How many servings per day of vegetables do I consume?
a. 0 servings
b. 1-2 servings
c. 3-5 servings
21. When I consume fruit or fruit juices, I have as much as I want since it doesn't matter much.
a. Sometimes
b. Never
c. Always
22. Daily, I consume _____ servings of fruit.
a. 1 serving
b. 2-4 servings
c. 5 or more servings
23. I prefer to drink one of the following:
a. Fruit drinks like Tang, Hi-C, or regular Kool-Aid
b. Alcoholic beverages
c. Unsweetened fruit juice or low calorie drinks
24. How many regular sodas do I drink per day_____ .
a. None
b. 1-2 per day
c. 3 or more per day
25. When I eat at restaurants, I try to avoid the high fat foods.
a. Sometimes
b. Never
c. Always
26. When I eat at home, I try to avoid the high fat foods.
a. Sometimes
b. Never
c. Always
27. I don't feel that too much fat in my eating habits is bad.
a. Disagree
b. Undecided
c. Agree
28. I eat beans ________ during the week.
a. 4 or more servings per week
b. 2-3 servings per week
c. 0-1 servings per week
29. One serving of rice for me is?
a. 1 cup serving or more
b. 2/3 cup serving
c. 1/3 cup serving
30. I decreased the salt in my diet.
a. Sometimes
b. Never
c. Always
31. I eat a healthy breakfast.
a. 7 times per week
b. 4-6 times per week
c. 3 or less times per week
32. When I overeat, I eat sensible the very next day.
a. Sometimes
b. Never
c. Always
33. I concentrate on what I'm eating, and I don't do any other activities during my meal times.
a. Sometimes
b. Never
c. Always
34. I exercise at least ________.
a. 0-2 times per week
b. 3-4 times per week
c. 5-7 times per week
35. How long does it take me to eat my meals?
a. 20 minutes or more
b. 10-19 minutes
c. 0-9 minutes
36. I shop for groceries when I'm hungry.
a. Sometimes
b. Never
c. Always
37. I cook when I'm hungry.
a. Sometimes
b. Never
c. Always
38. I make a sack lunch when I'm going to be away from home for long periods.
a. Sometimes
b. Never
c. Always
39. After I eat a meal, I usually _______ .
a. Portion leftovers and freeze quickly.
b. Leave the food on the stove so that I can get seconds.
c. Put the bulk product in a container in the refrigerator.
40. When I eat a light meal, I usually eat a large salad with it.
a. Sometimes
b. Never
c. Always
See Result
Directions for the Normal Food Journal: Normal Food Journal: I'm ready to start writing down everything I eat.
Click here to get the Normal Food Journal.
**Adapted from the USDA Food Guide Pyramid, "A Guide to Daily Food Choices."
Click here to go to a USDA Food Guide Pyramid web site.
