This survey is to measure the nutritional eating habits of students on and off campus enrolled at UofL. When answering questions about eating food, consider ONE portion of food is about ½ cup.
There are 9 questions. Please mark your response with a check or X.
1. Gender:
______Male _____Female
2. What is your living situation while at UofL?
____Commuter (Off-campus) ____Dorms (On-campus)
3. I eat meat (beef, chicken, fish, other protein) PER WEEK:
___Never/infrequently ___1-7 times (once daily) ___8-14 times (twice daily) __15-21 times or more (three or more daily)
4. I eat vegetables/fruits (raw, cooked, etc.) PER WEEK:
___Never/infrequently ____1-7 times (once daily) ___8-14 times (twice daily) ___15-21 times or more (three or more daily)
5. I eat starches (bread, cereal, rice, food w/grains) PER WEEK:
__Never/infrequently ___1-7 times (once daily) ___8-14 times (twice daily) __15-21 times or more (three or more daily)
6. I eat/drink dairy products (milk, cheese, yogurt, etc.) PER WEEK:
___Never/infrequently ___1-7 times (once daily) ___8-14 times (twice daily) ___15-21 times or more (three or more daily)
7. I eat/drink products containing sugars/fats (snack foods, candy, chips, sports drinks, etc.) PER WEEK:
___Never/infrequently ___1-7 times (once daily) ___8-14 times (twice daily) ___15-21 times or more (three or more daily)
8. Based on a traditional food pyramid, which pie chart would you say describes a balanced diet? (Pie charts are provided but are unable to be loaded to blogger).
9. Has eating on campus negatively effected your eating habits?
___Yes ___Somewhat ____No
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