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24 Hour Recall

1. What time did you go to bed the night before last?


Was this the usual time?
2. What time did you get up yesterday?
Was this the usual time?
3. When was the first time you had anything to eat or drink?
What did you have and how much?

4. When did you eat again?


Where?
What and how much?
5. When did you eat and how?
6. Did you eat or drink anything else?
a. Anything from 1st to 2nd meal?
b. Anything from 2nd to 3rd meal?
c. Anything from 3rd meal to bed time?
7. Was this day’s food intake different from usual?
If so, why?
8. Is weekend eating different?
If so, why?
FOOD FREQUENCY QUESTIONNAIRE

1. Do you drink milk? If so how much?


What kind? Whole Skim both

2. Do you use fat? If so what kind?


How much?

3. How many times do you eat meat? 2 times a week


Eggs Cheese Beans

4. Do you eat snack foods? Yes


If so which one?
How often?
How much?

5. What vegetables do you eat? How often?


a. Broccoli Green Pepper
Cooked greens Carrot
Sweet Potato

b. Tomato Raw cabbage Asparagus


Beets Cauliflower Cooked cabbage
Celery Peas Lettuce

6. What fruits do you eat and how often? Every week


a. Apples or apple sauce Apricots Banana
Berries Cherries Grape or grape juice
Peaches Pears Pineapples Plums Raisins

b. Oranges Orange juice


Grape fruit Grape juice

7. Bread and cereal products?


a. How much bread do you usually eat with each meal?
Between Meals
b. Do you eat cereal? (daily,weekly)
Cooked Dry
c. How often do you eat foods such as macaroni, spaghetti, noodles, and the like?

8. Do you use salts?


Do you crave for salts or salty foods?

9. How many teaspoons of sugar do you use daily? I don’t use sugars everyday
(1packet-1tsp)

10. Do you drink water?


How often during the day?
How much each time?
How much would you say you drink each day?

11. Do you drink alcohol?


How often?
How much?
Beer, wine, others?

DIETARY HISTORY

Economic

Physical Activity

Ethnic and Cultural Background

Home Life and Meal Pattern

Appetite

Allergies, Intolerances and Food Avoidance

Dental and Oral Health


Gastrointestinal Concerns

Chronic disease

Medication

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