When do you eat?





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Do you often miss meals?
 Yes No

Do you typically go more than 5 hours without eating?
 Never or rarely Yes, once a week Yes, 3 times a week Yes, 3+ times a week

Do you often skip breakfast?
 Yes No

Do you think healthy eating means low fat eating?
 Yes No

Do you avoid fats at meals and snacks?
 Yes No

Do you often eat refined carbohydrates such as bread, bagels, biscuits, white bread, white pasta, sugary cereals, muffins, chocolates and sweets?
 Yes No

Do you often get hungry or crave sweets within 2 hours after eating?
 Yes No

Do consume drink containing caffeine or sugar such as coffee, tea, sodas, fruit juices with sucralose, corn syrup or added sugars?
 Yes No

Have you been on a diet before to lose weight?
 Yes No

Do you have difficulty burning fat around your stomach, hips or thighs even with regular exercise?
 Yes No

Do you eat your largest meal in the evening?
 Yes No

Dot you use artificial sweeteners or consume foods containing these properties such as diet drinks and snacks?
 Yes No

What kind of salt do you use?
 Don't use salt Regular table salt (sodium chloride) Rock or sea salt Not sure

How often do you eat processed meals/ TV dinners?
 Never or rarely 1-2 times a week 3-3+ times a week

How often do you eat take away food?
 Never or rarely Once a week 1-2 times a week 3-3+ times a week

Do you snack on crisps, biscuits, sweets, chocolate or cakes and muffins?
 Yes No

What kind of water do you drink most often?
 Tap water Filtered jug water Bottled Home built in

How often do you eat desserts?
 Never or rarely 1-2 times a week 3 or 3+ times a week