Post on 29-Mar-2019
Respondent ID No _________
Diet and Shopping Questionnaire
Departments of Health Care for the ElderlySocial Studies & Agriculture and Food ScienceUniversity of Nottingham
Tel : 0115 9709 777/ 9709413
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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.
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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 NIf you rarely have a food (less than once a month) write R
If you usually have a food :
about once a month write 1Mabout twice a month write 2Mabout three times a month write 3M
about once a week write 1Wabout twice a week write 2Wabout three times a week write 3Wand so on (4W, 5W, 6W etc.)
about once a day write 1Dabout twice a day write 2Dabout three times a day write 3Dand so on (4D, 5D, 6D etc.)
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Examples
How often do you eat the following foods ?(Food) (how often) (any comments)
tea 4D 1 CUPmilk 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___________________________________________________________________
HOW TO ANSWER
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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 CommentsPorridge/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 week
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Q3. What type of bread do you usually use ? (Please circle one number only)
1 Wholemeal or granary bread2 White bread3 White bread with added bran e.g. "Mighty White"4 Brown bread5 Continental breads e.g. french stick, rye bread, pumpernickel, pitta6 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 Butter2 Soft margarine3 Hard (block) margarine 4 Low fat spread5 Dripping / Lard6 Nothing7 Don't eat bread8 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
_________________________________________________________________
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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 ?
Sweets CommentsCrumpet 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 .......... ____________
____________________________________________________________________
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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 CommentsCoffee 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 teain your coffee ? Yes No Don't drink coffeein your cocoa ? Yes No Don't drink cocoain 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 .........................................................................
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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 CommentsRegular cheese(cheddar, cheshire, edam etc) .......... ____________
Cottage cheese .......... ____________
Cream .......... ____________
Yoghurt .......... ____________
Ice cream (summer) .......... ____________
(winter) .......... ____________
Dried milk .......... ____________
Liquid milk .......... ____________
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____________________________________________________________________
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 .......... ____________
Peanut butter .......... ____________
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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 always2 Sometimes3 Rarely or never4 Do not eat cheese5 Don't know/ can't remember
Q2. When you eat cream what type is it usually ? (Please circle one number)
1 Thickened cream2 Double cream3 Single or whipping cream4 Clotted cream5 Cream substitute e.g. Elm Lea6 Other (please give the name) .......................................7 More than one type (please specify which numbers) .........................8 Do not eat cream9 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 fat3 Fruit flavoured (not fat reduced)4 Fruit flavoured, low fat5 Other (please name)........................................6 More than one type (please specify which numbers) ..........................7 Do not eat yoghurt8 Don't know/ can't remember
Q4. When you eat ice cream what type is it usually ? (Please circle one number)
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1 Regular ice cream (full fat)2 Low calorie/ reduced fat ice cream e.g. 'Too good to be true'3 Other (please name)...................................................4 More than one type (please specify which numbers) ....................5 Do not eat ice cream6 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 CommentsStew/Casserole/Curry/Goulash .......... ____________
Steak .......... ____________
Pork chop .......... ____________
Lamb chop .......... ____________
Roast lamb/pork/beef ........... ____________
Sausages .......... ____________
Bacon .......... ____________
Liver .......... ____________
Kidney .......... ____________
Ham .......... ____________
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Luncheon meat .......... ____________
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 pastriese.g. quiche
.......... ____________ ___________________________________________________________________
Q1. If you eat the following meats how would you usually cook them ?(Please circle one for each food)
Steak FriedGrilled/baked Microwaved Don't eatChops FriedGrilled/baked Microwaved Don't eatSausages FriedGrilled/baked Microwaved Don't eatBacon FriedGrilled/baked Microwaved Don't eat
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Q2. If you eat meat with fat on do you eat(Please circle one number)
1 All of the fat2 Most of it3 About half4 Little or none5 Don't eat meatQ3. Do you take the skin off chicken ? (Please circle one number)
1 Always or nearly always2 Sometimes (about half the time)3 Rarely4 Never5 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 always2 Sometimes3 Rarely4 Never5 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 D15
3 3 3_____________________________________________________________________About how often do you usually eat these foods?
Chicken and Fish Comments
Roast chicken .......... ____________
Crumb coated chicken .......... ____________
Chicken casserole/stew/curry .......... ________________________________________________________________________________
HOW TO ANSWERNEVER 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 CommentsChicken 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, musselswhelks, clams, calamari etc) .......... ____________
Oven baked fish fillets or fish fingers......... ____________
Canned fish (sardines, mackerelsalmon, tuna etc) .......... ____________
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Canned and Dried Vegetables CommentsCanned 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 :
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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 CommentsPotato - fresh, mashed .......... .......... ____________ Potato - fresh, boiled .......... .......... ____________
Potato - roasted .......... .......... ____________
Fresh chips .......... .......... ____________
Frozen chips .......... .......... ____________
Carrots (fresh/frozen) .......... .......... ____________
Turnip/swede .......... .......... ____________
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(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) .......... .......... ____________
Tomato (fresh) .......... .......... ____________
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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 eatPasta/rice Always Sometimes Never Don't boil Don't eatQ2. 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 always4 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 Never4 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 water2 Boiled in a little water
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3 Steamed/Pressure cooked4 Microwaved5 Stir fried6 Roasted7 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) margarine4 Olive oil 5 Nut oil (walnut/peanut etc) 6 Dripping/lard 7 Butter8 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 .......... ____________
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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) .......... ____________
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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 .......... ____________
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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 .......... .......... ____________
_____________________________________________________________
Q1. Which flavour of soup do you usually eat ?
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___________________________
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?
CommentsOrdinary 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 .......... ____________
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____________________________________________________________________ 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 .......... ____________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
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
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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.