1. How many ounces of meat, fish or poultry do you usually eat?
3 ounces of meat, fish or chicken is any one of the following: 1 regular hamburger, 1 chicken breast, 1 chicken leg (thigh and drumstick), 1 pork chop or 3 slices of pre- sliced lunch meat.
I do not eat meat, fish or poultry.
I eat 3 ounces or less per day.
I eat 4 to 6 ounces per day.
I eat 7 or more ounces per day.
2. How much cheese do you eat per week?
I do not eat cheese.
I eat whole milk cheese less than once a week and/or use only low fat cheeses.
I eat whole milk cheese once or twice per week (such as cheddar, Swiss, Monterey jack).
I eat whole milk cheese three or more times per week.
3. What type of milk do you use?
I use only skim or 1% milk or don't use milk.
I usually use skim milk or 1% milk but use others occasionally.
I usually use 2% or whole milk.
4. How many visible egg yolks do you use per week?
I avoid all egg yolks or use less than one per week and/or use only egg substitute.
I eat 1 to 2 egg yolks per week.
I eat 3 or more egg yolks per week.
5. How often do you eat these meats: regular hamburger, bologna, salami, hot dogs, corned beef, spareribs, sausage, bacon, liver, fried chicken or fried fish?
I do not eat any of these meats.
I eat them about once per week or less.
I eat them about 2 to 4 times per week.
I eat more than 4 servings per week.
6. How many commercial baked goods and how much regular ice cream do you usually eat?
Examples: cake, cookies, coffee cake, sweet rolls, donuts, etc. Do not count lowfat versions.
I do not eat commercial baked goods and ice cream.
I eat commercial baked goods or ice cream once per week or less.
I eat commercial baked goods or ice cream 2 to 4 times per week.
I eat commercial baked goods or ice cream more than 4 times per week.
7. What is the main type of fat you cook with?
I use nonstick cooking spray or I do not use fat in cooking.
I use a liquid oil (Examples: safflower, sunflower, corn, soybean, and olive oil).
I use margarine.
I use butter, shortening, bacon drippings, or lard.
9. What spread do you usually use on bread, vegetables, etc.?
I do not use any spread.
I use diet or light margarine.
I use margarine.
I use butter.
10. How often do you eat candy bars, chocolate, or nuts as a snack?
Less than once per week.
One to 3 times per week.
More than 3 times per week.
11. When you use recipes or convenience foods, how often are they low fat?
Almost always.
Usually.
Sometimes
Seldom or never.
12. When you eat away from home, how often do you choose low fat foods?
Almost always.
Usually.
Sometimes.
Seldom or never.