| Nutrition Assessment Find out how do your eating habits score Choose one answer for each question and use points scale to add up your score. Points scale: a = 0, b = 1, c = 2 1. Eating frequency a. Less than 3 meals/day b. 3 square meals/day c. 3 main meals & some snacks 2. Fruits a. Occasionally b. Less than 3 per day c. 3 or more per day 3. Vegetables a. Occasionally b. Once a day c. More than once a day 4. Whole grains (bread, pasta, cereal, oatmeal, couscous, barley,etc) a. Never b. Couple times per week c. Everyday 5. I eat home-prepared foods a. A few times a week b. Once a day c. More than once a day 6. Eat fast food a. Once or more a day b. Few times per week c. Seldom or never 7. Sweets like muffins, cake, cookies, donuts, etc (the size of a snickers bar or larger) or sweetened beverages (with sugar) a. Everyday b. Few times a week c. Occasionally 8. Water a. Occasionally b. Less than 5 glasses/day c. Six or more glasses/day Add up your score: 15-16= excellent 13-14= Good 10-12= Average 9 or less= Poor |

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