Condition 1□ Condition 2 □
Eating Questionnaire
Circle your gender: Male / Female
1. Do you eat five portions of fruit and vegetables a day?
Yes/No
2. Do you emotions affect the way you eat?
Yes/No
3. Is food a big part of your life?
Yes/No
4. On average how many times do you eat fast food in a week?
Never 1 2 3 4 5+
5. Do you enjoy a balance diet?
Yes/No
6. Do you calorie count?
Yes/No
7. Have you ever dieted?
Yes/No
8. Do you think your food preference has been influenced by your parents?
Yes/No
9. Are you keen to try new foods?
Yes/No
10.Do you comfort eat?
Yes/No
11.Do you believe in the saying “You are what you eat”?
Yes/No

Condition 1□ Condition 2 □
12.Do you buy/eat supermarket own brands?
Yes/No
13.From the list below select what you are most likely to eat
Crisps Apples Chocolate Sweets Popcorn
Carrot sticks Dips (e.g.
houmous)
Biscuits Dried fruit &
nuts
Chips
Burgers Cake Cereal (e.g.
coco pops)
Cereal (e.g.
muesli)
Oranges
Grapes Yogurt Pizza Roast dinner Soup
Mash potato Ryvita Cheese Pineapple
14.During times of stress I tend to eat
More/Less
15.During times of stress I tend to eat
Full meals / snacks
16.In your opinion, what is a healthy diet?
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17.What factors do you consider to have the greatest effect on your food choice?
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