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In the last 24 hours: I tracked my calorie intake
 
Always
 
Most of the time
 
About half the time
 
Once in a while
 
Never
 
 
 
In the last 24 hours: I planned my meals
 
Always
 
Most of the time
 
About half the time
 
Once in a while
 
Never
 
 
 
In the last 24 hours: I ate 3-5 fruits and vegetables
 
Yes
 
No
 
 
 
In the last 24 hours: I drank at least one bottle of soda or sugary drink
 
Yes
 
No
 
 
 
In the last 24 hours: How many meals did you cook or prepare?
 
1
 
2
 
3
 
 
 
In the last 24 hours: How many meals did you go to a restaurant or fast food restaurant?
 
1
 
2
 
3
 
 
 
In the last 24 hours: I ate at least 3 meals
 
Yes
 
No
 
 
 
In the last 24 hours: How many meals did you eat at a table?
 
1
 
2
 
3
 
 
 
In the last 24 hours: What were the fruits and vegetables you ate?
   
 
 
 
In the last 24 hours: How many 8 oz glasses of water did you drink?
 
1
 
2
 
3
 
4
 
5
 
6
 
7
 
8
 
9+
 
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