Over the past few months: | 0 points | 1 point | 2 points |
- How many times a week do you eat fast food meals or snacks?
| Less than one time | One to three times | Four or more times |
- How many servings of fruit did you eat each day?
| Five or more | Three to four | Two or less |
- How many servings of vegetables did you eat each day?
| Five or more | Three to four | Two or less |
- How many regular sodas or glasses of sweet tea did you drink each day?
| Less than one | One to two | Three or more |
- How many times a week did you eat beans (like pinto or black beans), chicken, or fish?
| Three or more times | One to two times | Less than one time |
- How many times a week did you eat regular snack chips or crackers (not low-fat)?
| One time or less | Two to three times | Four or more times |
- How many times a week did you eat desserts and other sweets (not the low-fat kind)?
| One time or less | Two to three times | Four or more times |
- How much margarine, butter, or meat fat do you use to season vegetables or put on potatoes, bread, or corn?
| Very little | Some | A lot |
Summary score (sum of all items) = _____ | | | |