Nutrition Assessment

Nutrition Assessment

Instructions

To learn more about your current eating habits, we invite you to complete the Nutrition Self-Assessment questionnaire. Once you have completed your assessment, you are encouraged to browse through the information and resources for information on how to improve your daily diet and nutritional habits.

For each type of food related activity, select the response that best describes your eating habits in an average week.

Assessment

Meat and Alternatives

1.
 How often do you eat hot dogs, sausages, salami, bologna?
  Rarely or never 1-3 times per week 4 times or more per week
2.
 How often do you eat red meat: beef, pork, ham, lamb?
  3 times or less per week 4-5 times per week 6 times or more per week
3.
 How often do you trim the fat from red meat?
  Usually or always Sometimes Rarely or never
4.
 How often do you eat turkey, chicken, fish (excluding deep fried)?
  3 times or more per week 2 times or less per week Rarely or never
5.
 How often do you remove the skin from chicken/turkey before eating it?
  Usually or always Sometimes Rarely or never
6.
 What is your typical serving size of meat?
  4 oz. or less 5-7 oz. 8 oz. or more
7. How often do you eat eggs?
    3 or less per week 4-6 per week 7 or more per week
8. How often do you eat dried peas, beans, and/or lentils in chili, soup, baked beans, etc?
    At least once per week Every other week Rarely or never

Milk Products

9. What type of milk do you drink?
    1% or skim 2% Homogenized (whole)
10 How often do you eat cheese (excluding cottage, skim or part skim cheese)?
    3 times or less per week 4-6 times per week 7 times or more per week
11. How often do you eat other dairy products, such as ice cream, cream, sour cream, cream cheese?
    Rarely or never 1-3 times per week 4 times or more per week

Grain Products

12. How often do you eat breads, cereals, pasta, and/or rice?
    6 times or more per day 5 times or less per day Rarely or never
13. How often do you eat whole grains breads and/or cereals?
    Usually choose Sometimes choose Rarely or never choose

Vegetables and Fruits

14. How often do you eat vegetables and/or fruits?
    6 times or more per day 5 times or less per day Rarely or never

Fats and Oils

15. How often do you use soft or light margarine?
    Usually or always Sometimes Rarely or never
16. How often do you use butter or hard margarine?
    Rarely or never Sometimes Usually or always
17. How often do you put butter/margarine on cooked vegetables.
    Rarely or never Sometimes Usually or always
18. How often do you use low-calorie salad dressing?
    Usually or always Sometimes Rarely or never

Breakfast

19. How often do you eat breakfast (excluding coffee/tea only)?
    5 times or more per week 3 - 4 times per week 2 times or less per week
20. How often do you eat hot or cold cereal, bread, bagels, or fruit for breakfast?
    5 times or more per week 3 - 4 times per week 2 times or less per week

Snacks and Desserts

21.
 How often do you snack on fruit, vegetables, and/or plain popcorn?
  Usually or always Sometimes Rarely or never
22.
 How often do you snack on chips, nuts, and/or chocolate?
  Rarely or never Sometimes Usually or never
23.
 How often do you eat fruit for dessert?
  Usually or always Sometimes Rarely or never
24.
 How often do you eat foods such as cookies, cake, and/or pie for dessert?
  Rarely or never Sometimes Usually or always

Fast Foods

25. How often do you eat fast foods such as hamburgers, fried chicken/fish, hot dogs, tacos, french fries, milkshakes, etc.?
    Rarely or never 1 - 3 times per week 4 times or more per week

Source: Adapted from the "Rate Your Plate" questionnaire used in the Ottawa-Carleton Heart Beat Program, Ottawa-Carleton Health Department. Based on material produced by the Pawtucket Heart Health Program.

Click on the Score button below for your total Nutrition Self-Assessment score.


Interpretation


39 or less
 There are MANY ways you can change your eating pattern for better health. Change in eating patterns does not usually happen overnight. If the right column best describes your eating habits, move gradually to the centre column and finally to the left column. Gradual change is more likely to become permanent change.
40 - 59
 There are SOME ways you can change your eating pattern for better health. Change in eating patterns does not usually happen overnight. If the middle column best describes your eating habits, move gradually to the left column. Gradual change is more likely to become permanent change.
60 - 75
 Keep up the good work! Your eating p attern represents a 'Heart Healthy' pattern.
From Rate Your Plate.