Diet and Shopping Questionnaire
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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.
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