Eating Habits Survey

Eating habits affect your health and risk for certain diseases. Of course, when and what you eat is complicated, and influenced by psychological, social, and genetic factors. If we understand more about the genetics of taste and cravings, we can address the epidemics of diabetes, obesity, and cardiovascular disease.

1. How many meals do you typically eat in one day?

Select one

2. How many times do you typically eat BETWEEN meals (snack) in one day?

3. Do you currently follow a special diet?

Select one

4. If you answered yes to the previous question, please tell us more about the type of diet you follow

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5. How many days per week do you eat meat?

Select one

6. Do you have any food allergies? Even a tiny amount of the offending food can cause an immune system reaction that can be severe or life-threatening

Select one

7. What kind of food allergy do you have? Please specify:

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8. How often do you eat dessert?

Select one

9. Do you skip any meals more than once a week? Select all that apply

Check all that apply

10. Your weight affects the way you feel about yourself

Select one

11. Do you always finish everything on your plate?

select one

12. How many servings of fruit and vegetables do you eat each day? 1 serving means Vegetables: ½ cup cooked or 1 cup raw Large fruits (ex. Grapefruit): ½ of fruit Medium fruits (ex. Apple, pear, small banana): 1 fruit Small fruits: ½ cup

13. How did you find this survey? Please let us know what could be improved

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14. Could you please tell us your date of birth?

Date must be in this (YYYY-MM-DD) format

15. Can you please share with us your email address, if you have one?

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16. If you have a website please share it with us

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17. What do you do to keep healthy?

Optional
Please indicate if you do any physical activity

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