Diet & Nutrition Awareness Survey
Purpose: This survey aims to analyze eating habits, sugar intake, and nutrition label awareness to
promote better health choices. Your responses will remain anonymous.
Section 1: Personal Information
1. Age Group: (Tick one)
[ ] 15-25 [ ] 26-35 [ ] 36-45 [ ] 46-55 [ ] 56+
2. Gender:
[ ] Male [ ] Female [ ] Other / Prefer not to say
3. Occupation:
[ ] Student [ ] Working Professional [ ] Homemaker [ ] Retired [ ] Other (Specify): ___________
4. How would you describe your lifestyle?
[ ] Very active [ ] Moderately active [ ] Sedentary
Section 2: Eating Habits
5. How often do you eat processed/junk food?
[ ] Daily [ ] 3-5 times a week [ ] 1-2 times a week [ ] Rarely [ ] Never
6. How often do you consume sugary drinks?
[ ] Multiple times a day [ ] Once a day [ ] 3-5 times a week [ ] Rarely [ ] Never
7. What type of snacks do you usually consume? (Tick all that apply)
[ ] Chips [ ] Biscuits/cookies [ ] Chocolates/candy [ ] Fruits [ ] Nuts/seeds [ ] Yogurt [ ] Other:
___________
Section 3: Sugar Intake Awareness
8. Do you check food nutrition labels?
[ ] Always [ ] Sometimes [ ] Rarely [ ] Never
9. If yes, what do you focus on the most? (Tick all that apply)
[ ] Calories [ ] Sugar [ ] Fat [ ] Protein [ ] Ingredients [ ] I don't check labels
10. Are you aware of hidden sugars in food?
[ ] Yes [ ] Somewhat [ ] No
Section 4: Health Perception
11. Do you believe your diet affects your health?
[ ] Yes, definitely [ ] Maybe [ ] No, not really
12. Have you tried reducing sugar in your diet?
[ ] Yes, successfully [ ] Yes, but it was difficult [ ] No, never tried
13. If you tried reducing sugar, what was the biggest challenge?
__________________________________________
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Section 5: Daily Eating Patterns
14. How many meals do you eat per day?
[ ] 1 [ ] 2 [ ] 3 [ ] 4 or more
15. Do you regularly eat breakfast?
[ ] Yes [ ] No
16. How often do you eat home-cooked meals?
[ ] Daily [ ] 4-6 times a week [ ] 2-3 times a week [ ] Rarely
17. What is your primary reason for choosing fast food or processed food? (Tick all that apply)
[ ] Convenience [ ] Taste [ ] Price [ ] Lack of time [ ] Other: ___________
Section 6: Hydration & Beverage Choices
18. How much water do you drink daily?
[ ] Less than 1 liter [ ] 1-2 liters [ ] 2-3 liters [ ] More than 3 liters
19. Which beverages do you consume the most? (Tick all that apply)
[ ] Water [ ] Tea/Coffee [ ] Soft drinks/Soda [ ] Energy drinks [ ] Fresh juice [ ] Packaged juice [
] Other: ___________
Section 7: Knowledge About Nutrition & Labels
20. Have you ever attended a workshop or read material about healthy eating?
[ ] Yes [ ] No
21. Do you think food packaging clearly indicates sugar content in a way that is easy to understand?
[ ] Yes [ ] No [ ] Not sure
22. Would you be interested in a mobile app or website that helps track your sugar intake?
[ ] Yes [ ] No
Section 8: Sugar & Health Impact Awareness
23. Do you or anyone in your family have any of the following conditions? (Tick all that apply)
[ ] Diabetes [ ] Obesity [ ] High blood pressure [ ] Heart disease [ ] None
24. Do you experience sugar cravings frequently?
[ ] Yes, very often [ ] Sometimes [ ] Rarely [ ] Never
25. If you consume sugary foods/drinks, when do you crave them the most? (Tick all that apply)
[ ] Morning [ ] Afternoon [ ] Evening [ ] Late Night [ ] After meals
26. What do you think is the biggest challenge in maintaining a healthy diet?
__________________________________________
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