Diet and Shopping Questionnaire

Total Page:16

File Type:pdf, Size:1020Kb

Diet and Shopping Questionnaire

Respondent ID No ______

Diet and Shopping Questionnaire

Departments of Health Care for the Elderly Social Studies & Agriculture and Food Science University of Nottingham

Tel : 0115 9709 777/ 9709413

1 Thank you for offering to help us by filling in this diary. We are collecting information about what people in your area eat, how often, where they buy it from, how food is prepared and how much they spend.

By filling in the diary you will give us useful information that will help to improve our knowledge of what people need in terms of portion sizes, packaging, cost, transport to and from the shops, nutrition information etc.

Please read through the instructions for the diary carefully. If you have any problems reading or filling in the diary and would like to talk too someone please telephone Dr Sally Herne or Dr Jeanette Lilley at Queens Medical Centre on 0115 9709 777 or 9709 413 between 9 am and 5 pm.

Don't forget to fill in the coupon at the end of the questionnaire to enter our prize draw.

2 This section is about what you usually eat. On the next few pages you will find lists of various foods and questions on how you cook and serve these foods. Please be assured that there is no right or wrong answer - we are purely interested in what you enjoy eating.

Read through each section and write down how often you think you normally eat these foods. Your diet does vary from time to time so just put down what you think is typical or average for you.

Please only give us information on what you eat, not any of the other people in your household.

Answering the questions

Each section asks 'how often do you think you eat the following foods?'. Rather than writing out a long answer we have reduced the options for your answer to some simple codes. Write the code in the space provided.

If you never have a food write N If you rarely have a food (less than once a month) write R

If you usually have a food : about once a month write 1M about twice a month write 2M about three times a month write 3M about once a week write 1W about twice a week write 2W about three times a week write 3W and so on (4W, 5W, 6W etc.) about once a day write 1D about twice a day write 2D about three times a day write 3D and so on (4D, 5D, 6D etc.)

3 Examples

How often do you eat the following foods ? (Food) (how often) (any comments) tea 4D 1 CUP milk 2D muesli 1W brown bread N low fat spread R boiled egg 3W 1EGG SOFT BOILED fresh orange 1D sugar 4D chocolate bar 2M

This person usually has

1 cup of tea 4 times a day

milk twice a day once a week they eat muesli they never eat brown bread and rarely use low fat spreads three times a week they have boiled eggs a glass of fresh orange juice once a day sugar in each cup of tea 4 times a day a bar of chocolate about twice a month ______

4 HOW TO ANSWER

NEVER RARELY TIMES A TIMES A TIMES A MONTH WEEK DAY N R 1 1 1 2 M 2 W 2 D 3 3 3 ______About how often do you usually eat these foods ?

Cereals Comments Porridge/oatmeal(cooked) summer ...... ______

Porridge/oatmeal (cooked) winter ...... ______

Muesli ...... ______

Other breakfast cereal ...... ______

Sliced bread ...... ______

Bread roll ...... ______

Boiled rice ...... ______

Pasta - dried or fresh ...... ______(spaghetti, macaroni etc, not tinned) ______

Q1. What types of breakfast cereal do you usually eat ? Please write in the name(s). If you do not eat breakfast cereals write 'none'. ______

Q2. How many slices of bread do you usually eat ? Remember to include bread you use for sandwiches and for toast. If you do not eat bread write 'none'. ______slices per day OR ______slices per

5 week

6 Q3. What type of bread do you usually use ? (Please circle one number only)

1 Wholemeal or granary bread 2 White bread 3 White bread with added bran e.g. "Mighty White" 4 Brown bread 5 Continental breads e.g. french stick, rye bread, pumpernickel, pitta 6 Other bread (please name)______7 Don't eat bread

Q4. Which of the following do you usually spread on bread ? (Please circle one number only )

1 Butter 2 Soft margarine 3 Hard (block) margarine 4 Low fat spread 5 Dripping / Lard 6 Nothing 7 Don't eat bread 8 Something else (please name)______

Q5. What type of milk do you usually add to cereals, porridge or muesli ? (e.g. whole milk, skimmed, enriched, soya, gold top etc). If you don't add milk write 'none'.

Type of milk ......

Q6. How many teaspoons of sugar or other sweetener do you add to cereal, porridge or muesli ? (note 1 dessertspoon = 2 teaspoons )

______

Q7. Do you add salt to your porridge ? (please circle one answer)

Yes No Don't eat porridge

______HOW TO ANSWER

7 NEVER RARELY TIMES A TIMES A TIMES A MONTH WEEK DAY N R 1 1 1 2 M 2 W 2 D 3 3 3 ______About how often do you usually eat these foods ?

Sweets Comments Crumpet or muffin ...... ______

Tea cake or scone ...... ______

Fruit loaf or currant bread ...... ______

Crispbread/ cracker ...... ______

Plain sweet biscuit (e.g. digestive) ...... ______

Fancy biscuit (e.g. sandwich) ...... ______

Cake ...... ______

Milk pudding ...... ______

Sponge pudding ...... ______

Beverages Comments

Tea ...... ______

Coffee ...... ______

______

8 HOW TO ANSWER

NEVER RARELY TIMES A TIMES A TIMES A MONTH WEEK DAY N R 1 1 1 2 M 2 W 2 D 3 3 3 ______

About how often do you usually have these drinks ?

Drinks Comments Coffee substitute ...... ______

Cocoa ...... ______

Complan/ Build up ...... ______

Flavoured milk ...... ______(e.g. milk shake)

Glass of milk ...... ______Q1. Do you have milk : (circle one for each) in your tea ? Yes No Don't drink tea in your coffee ? Yes No Don't drink coffee in your cocoa ? Yes No Don't drink cocoa in other hot drinks ? Yes No Don't drink other hot drinks (e.g. Horlicks)

Q2. What type of milk do you usually add to tea/coffee/cocoa etc? (Whole, skimmed, raw, semi-skimmed, enriched etc). If you don't add milk to these drinks or don't drink these drinks write 'none'. Type of milk ......

9 10 Q3. How many teaspoons of sugar or other sweetener do you have in

(Circle one for each) tea ? 0 1 2 3 4 5 6 Don't drink coffee ? 0 1 2 3 4 5 6 Don't drink cocoa ? 0 1 2 3 4 5 6 Don't drink hot chocolate ? 0 1 2 3 4 5 6 Don't drink

______HOW TO ANSWER

NEVER RARELY TIMES A TIMES A TIMES A MONTH WEEK DAY N R 1 1 1 2 M 2 W 2 D 3 3 3 ______About how often do you usually eat these foods?

Dairy Products and Eggs Comments Regular cheese (cheddar, cheshire, edam etc) ...... ______

Cottage cheese ...... ______

Cream ...... ______

Yoghurt ...... ______

Ice cream (summer) ...... ______

(winter) ...... ______

Dried milk ...... ______

11 Liquid milk ...... ______

______

HOW TO ANSWER

NEVER RARELY TIMES A TIMES A TIMES A MONTH WEEK DAY N R 1 1 1 2 M 2 W 2 D 3 3 3 ______

About how often do you usually eat these foods?

Dairy Products and Eggs Comments

Custard ...... ______

Fried egg ...... ______

Boiled/poached egg ...... ______

Scrambled egg/omelette ...... ______

Confectionery & Jams Comments

Chocolate ...... ______

Chocolate covered bar ...... ______(e.g. Mars)

Toffees/ boiled sweets ...... ______

Honey, jam, marmalade ...... ______

Marmite, bovril ...... ______

12 Peanut butter ...... ______

Q1. When you eat cheese do you use the reduced fat varieties e.g. Delight or St Ivel ? (Please circle one number)

1 Always or nearly always 2 Sometimes 3 Rarely or never 4 Do not eat cheese 5 Don't know/ can't remember

Q2. When you eat cream what type is it usually ? (Please circle one number)

1 Thickened cream 2 Double cream 3 Single or whipping cream 4 Clotted cream 5 Cream substitute e.g. Elm Lea 6 Other (please give the name) ...... 7 More than one type (please specify which numbers) ...... 8 Do not eat cream 9 Don't know/ can't remember

Q3. When you eat yoghurt what type is it usually ? (Please circle one number)

1 Plain natural yoghurt (not fat reduced and without flavouring) 2 Natural yoghurt, low fat 3 Fruit flavoured (not fat reduced) 4 Fruit flavoured, low fat 5 Other (please name)...... 6 More than one type (please specify which numbers) ...... 7 Do not eat yoghurt 8 Don't know/ can't remember

Q4. When you eat ice cream what type is it usually ? (Please circle one number)

1 Regular ice cream (full fat) 2 Low calorie/ reduced fat ice cream e.g. 'Too good to be true'

13 3 Other (please name)...... 4 More than one type (please specify which numbers) ...... 5 Do not eat ice cream 6 Don't know/ can't remember ______HOW TO ANSWER

NEVER RARELY TIMES A TIMES A TIMES A MONTH WEEK DAY N R 1 1 1 2 M 2 W 2 D 3 3 3 ______About how often do you usually eat these foods?

Meats Comments Stew/Casserole/ Curry/Goulash ...... ______

Steak ...... ______

Pork chop ...... ______

Lamb chop ...... ______

Roast lamb/pork/beef ...... ______

Sausages ...... ______

Bacon ...... ______

Liver ...... ______

Kidney ...... ______

Ham ...... ______

Luncheon meat ...... ______

14 Minced meat ...... ______

Hamburger ...... ______

Sausage roll ...... ______HOW TO ANSWER

NEVER RARELY TIMES A TIMES A TIMES A MONTH WEEK DAY N R 1 1 1 2 M 2 W 2 D 3 3 3 ______

About how often do you usually eat these foods?

Meats Comments

Meat pie ...... ______

Pasties ...... ______

Other pies and pastries e.g. quiche ...... ______

Q1. If you eat the following meats how would you usually cook them ? (Please circle one for each food)

SteakFried Grilled/baked Microwaved Don't eat Chops Fried Grilled/baked Microwaved Don't eat Sausages Fried Grilled/baked Microwaved Don't eat Bacon Fried Grilled/baked Microwaved Don't eat

15 Q2. If you eat meat with fat on do you eat (Please circle one number)

1 All of the fat 2 Most of it 3 About half 4 Little or none 5 Don't eat meat Q3. Do you take the skin off chicken ? (Please circle one number)

1 Always or nearly always 2 Sometimes (about half the time) 3 Rarely 4 Never 5 Do not eat chicken

Q4. Do you buy any of the following products ? Please enter number 1-5 in the space provided

1 Always or nearly always 2 Sometimes 3 Rarely 4 Never 5 Don't eat

Low fat mince (may be marked 'Superlean', 'Lean', 'Extra lean') ......

Low fat sausages ......

Low fat burgers ...... ______HOW TO ANSWER

NEVER RARELY TIMES A TIMES A TIMES A MONTH WEEK DAY N R 1 1 1 2 M 2 W 2 D 3 3 3 ______

16 ______About how often do you usually eat these foods?

Chicken and Fish Comments

Roast chicken ...... ______

Crumb coated chicken ...... ______

Chicken casserole/stew/curry ...... ______HOW TO ANSWER NEVER RARELY TIMES A TIMES A TIMES A MONTH WEEK DAY N R 1 1 1 2 M 2 W 2 D 3 3 3 ______About how often do you usually eat these foods? Chicken and Fish Comments Chicken breast portion ...... ______

Chicken leg or wing portion ...... ______

Fresh/frozen white fish (cod, haddock, halibut, plaice, coley, hake etc) ...... ______

Fresh/frozen oily fish (mackerel, herring, kippers fresh tuna / salmon etc) ...... ______

Sea food (prawns, cockles, mussels whelks, clams, calamari etc) ...... ______

Oven baked fish fillets or fish fingers...... ______

Canned fish (sardines, mackerel salmon, tuna etc) ...... ______

17 Canned and Dried Vegetables Comments Canned carrots ...... ______

Green beans - canned ...... ______

Green peas - canned ...... ______

Baked beans in sauce ...... ______

Other beans - canned ...... ______

Other beans - dried ...... ______HOW TO ANSWER

NEVER RARELY TIMES A TIMES A TIMES A MONTH WEEK DAY N R 1 1 1 2 M 2 W 2 D 3 3 3 ______

About how often do you eat these foods ?

Sweetcorn - canned ...... ______

Tomatoes - canned ...... ______

Seasonal Foods

The following list of foods contains some vegetables that may be eaten more often at certain times of the year. Please fill in details of how often you would eat these vegetables both in summer and in winter.

For example if you eat lettuce, cucumber and new potatoes once a day in summer but only once a month in the winter months and sprouts once a week in winter but never in summer, write this in as :

18 Summer Winter Comments

Lettuce 1D 1M

Cucumber 1D 1M

New potatoes 1D 1M

Brussel sprouts N 1W

______HOW TO ANSWER

NEVER RARELY TIMES A TIMES A TIMES A MONTH WEEK DAY N R 1 1 1 2 M 2 W 2 D 3 3 3 ______About how often do you usually eat these foods?

Seasonal Vegetables Summer Winter Comments Potato - fresh, mashed ...... ______

Potato - fresh, boiled ...... ______

Potato - roasted ...... ______

Fresh chips ...... ______

Frozen chips ...... ______

Carrots (fresh/frozen) ...... ______

19 Turnip/swede ...... ______(fresh/frozen)

Broad beans ...... ______(fresh/frozen)

Green beans ...... ______(fresh/frozen)

Green peas (fresh/frozen) ...... ______

Cabbage (cooked) ...... ______

Brussel sprouts (fresh/frozen) ...... ______HOW TO ANSWER

NEVER RARELY TIMES A TIMES A TIMES A MONTH WEEK DAY N R 1 1 1 2 M 2 W 2 D 3 3 3 ______

About how often do you usually eat these foods?

Seasonal Vegetables Summer Winter Comments

Broccoli ...... ______(fresh/frozen)

Cauliflower ...... ______(fresh/frozen)

Onion (fresh) ...... ______

20 Tomato (fresh) ...... ______

Lettuce ...... ______

Cucumber ...... ______

Celery ...... ______

Capsicum ...... ______(red/green/yellow pepper)

Mushrooms (fresh) ...... ______

Q1. Do you add salt to the cooking water when boiling the following foods? (Please circle one answer for each)

Vegetables Always Sometimes Never Don't boil Don't eat Pasta/rice Always Sometimes Never Don't boil Don't eat Q2. Do you add anything other than salt to the cooking water when cooking vegetables ? (If yes, write in what you add. If no, write 'nothing') ______

Q3. How often do you add salt to meals after they are cooked? (Please circle one number)

1 Rarely or never 2 Sometimes 3 Always or nearly always 4 Don't know/can't remember

Q4. Do you ever soak vegetables before you cook them ? (Please circle one answer)

1 Always or nearly always 2 Sometimes 3 Rarely or Never 4 Don't eat vegetables 5 Don't know/can't remember

Q5. When you cook vegetables which method do you usually use ? (Please circle one number)

1 Boiled in alot of water 2 Boiled in a little water

21 3 Steamed/Pressure cooked 4 Microwaved 5 Stir fried 6 Roasted 7 Other (please describe)...... 8 Don't know

Q4. Here is a list of fats and oils commonly used in cooking

1 Sunflower oil 2 Soft margarine 3 Hard (block) margarine 4 Olive oil 5 Nut oil (walnut/peanut etc) 6 Dripping/lard 7 Butter 8 Blended vegetable oil 9 Nothing 10 Other

From the list above which type of fat / oil do you most commonly use when a) roasting or frying meat/fish ...... b) roasting or frying vegetables ...... c) glazing/mashing vegetables ...... ______HOW TO ANSWER

NEVER RARELY TIMES A TIMES A TIMES A MONTH WEEK DAY N R 1 1 1 2 M 2 W 2 D 3 3 3 ______About how often do you usually eat these foods?

Fruit Comments

Orange, mandarin, grapefruit ...... ______

Apple/pear ...... ______

Banana ...... ______

22 Berries - fresh/frozen ...... ______

Fruit salad ...... ______

How often do you eat these fruits when they are in season ?

Seasonal Fruits Comments

Peaches/Nectarine ...... ______

Plum ...... ______

Apricot ...... ______

Grapes ...... ______

Cherries ...... ______

Melon ...... ______

Pineapple (fresh) ...... ______

23 Are there any other fresh fruits you eat ? If so, please list them here along with the quantity and how often you eat them.

Name of fruit How often you eat it

______

______

______

______

______

______HOW TO ANSWER

NEVER RARELY TIMES A TIMES A TIMES A MONTH WEEK DAY N R 1 1 1 2 M 2 W 2 D 3 3 3 ______

About how often do you usually eat these foods?

Dried and canned fruit Comments

Raisins, sultanas, currants ...... ______

Other dried fruit ...... ______

Canned fruit in syrup ...... ______

Canned fruit in juice ...... ______

24 Fruit pie or pastie ...... ______HOW TO ANSWER

NEVER RARELY TIMES A TIMES A TIMES A MONTH WEEK DAY N R 1 1 1 2 M 2 W 2 D 3 3 3 ______

About how often do you usually eat these foods?

Nuts and snacks Comments

Potato crisps ...... ______

Peanuts (salted) ...... ______

Peanuts (unsalted) ...... ______

Other nuts - unsalted ...... ______(pecan, walnuts, almonds etc)

Other nuts - salted ...... ______

Soups Summer Winter Comments

Canned soup ...... ______

Packet soup (made up) ...... ______

Home-made soup ...... ______

______

25 Q1. Which flavour of soup do you usually eat ? ______

Q2. Is this canned, dried, home-made or another type of soup e.g. chilled ? ______HOW TO ANSWER

NEVER RARELY TIMES A TIMES A TIMES A MONTH WEEK DAY N R 1 1 1 2 M 2 W 2 D 3 3 3 ______

About how often do you add the following sauces and dressings to your food? Comments Ordinary mayonnaise ...... ______

Reduced fat mayonnaise ...... ______

Standard salad dressings ...... ______(Thousand Island, French dressing)

Low fat salad dressings ...... ______

Salad cream ...... ______

Sour cream ...... ______

Sweet Pickle (Branston, Piccalilli) ...... ______

Tomato sauce (ketchup) ...... ______

Brown sauce (e.g. HP) ...... ______

Regular table salt ...... ______

26 Low sodium salt e.g. 'Lo salt' ...... ______

27 ______HOW TO ANSWER

NEVER RARELY TIMES A TIMES A TIMES A MONTH WEEK DAY N R 1 1 1 2 M 2 W 2 D 3 3 3 ______

How often do you usually have these drinks ?

Beverages Comments

Glass low calorie cordial ...... ______

Glass ordinary cordial ...... ______

Low calorie fizzy drink ...... ______

Ordinary fizzy drink ...... ______

Fruit/vegetable juice ...... ______

Water ...... ______including mineral water

Low alcohol beer ...... ______includes lager

Ordinary beer ...... ______or lager

Cider/perry ...... ______

Wine ...... ______

Sherry/port/liqueur ...... ______

Spirits ...... ______

28 Are there any other foods you eat regularly which haven't been mentioned e.g. tofu, textured vegetable protein (TVP), fromage frais, ethnic foods such as polenta etc ? If so please write in the name of the food, your serve size and how often you eat it.

Name of food How often you eat it

______

______

______

______

______

______

______

29 SECTION TWO

From the information you give us in Section One we will get a general idea of what foods the people in your area eat and how often.

In this second section we are interested in finding out what combinations of food you eat, when you eat, where and who with. On the following pages you will find a grid to fill in for four days which asks you about your meal patterns, followed by a few questions about your shopping habits

You may choose any four days to record, but it would be helpful if you could aim for two week days and two weekend days. An example of how to fill in the diary is given overleaf. If you have any problems filling this in please contact us on the number given on page 2.

30

Recommended publications