1a. Butter, margarine, shortening, mayonnaise, sour cream, lard, oil, salad dressing:

I always add these to foods in cooking, and/or at the table.

I occasionally add these foods in cooking and/or at the table.

I rarely add these foods in cooking and/or at the table.

1b. Fried foods

I eat fried foods 3 or more times a week.

I eat fried foods 1-2 times a week.

I rarely eat fried foods.

2a. Milk

I drink whole milk.

I drink 1%-2% milk.

I drink skim milk.

1b. Ice-Cream

I eat ice-cream almost every day.

I eat ice-milk, low-fat frozen yogurt, and sherbet.

I eat only fruit ices, seldom eat dairy deserts.

I eat mostly high-fat cheeses, such as Jack, cheddar, colby.

I eat both low and high-fat cheeses.

I eat mostly low-fat cheeses.

3.Snacks potato chips, corn chips, nuts, buttered popcorn, candy bars:

I eat these every day.

I eat some occasionally.

I seldom or never eat these snacks.

4. Baked Goods pies, cakes, sweet rolls, doughnuts:

I eat them 5 or more times a week.

I eat them 2-4 times a week.

I seldom eat them, if ever.

5. Poultry and Fish

I rarely eat these foods.

I eat them 1-2 times a week.

I eat them three or more times a week.

I am a vegetarian.

6. Low-fat Meat extra-lean hamburger, round steak, pork loin, chuck roast

I rarely eat these foods.

I eat these foods occasionally.

I eat mostly fat-trimmed meat.

I am a vegetarian.

7. High-fat meat luncheon meats, bacon, hot dogs, steaks, sausage, regular ground beef

I eat these every day.

I eat these foods occasionally.

I never eat these foods.

I am a vegetarian.

8. Cured and smoked meat and fish luncheon meats, hot dogs, bacon, ham, pickled meats

I eat these foods four or more times a week.

I eat some 1-3 times a week.

I seldom eat these foods.

I am a vegetarian.

9. Legumes dried peas and beans, kidney, navy, pinto, garbanzo, lentil

I eat legumes less than once a week.

I eat these foods 1-2 times a week.

I eat them 3 or more times a week.

10. Whole grains and cereals whole-grain breads, brown rice, pasta, whole-grain cereals

I seldom eat such foods.

I set them 2-3 times a day.

I eat them 4 or more times daily.

11. Vitamin C-rich foods citrus fruits, green peppers, strawberries, tomatoes

I seldom eat them.

I eat them 3-5 times a week.

I eat them 1-2 times daily.

12. Vegetables in the cabbage family broccoli, cabbage, cauliflower

I seldom eat them.

I eat them 1-2 times a week.

I eat them 3-4 times a week.

13. Alcohol

I drink more than 2 ounces of 80 proof liquor daily (2 oz. 80 proof liquor, 6 ½ ounces wine or 25 ounces beer).

I drink alcohol every week but not daily.

I occasionally or never drink alcohol.

14. Personal Weight

I’m more than 20 pounds over my ideal weight.

I’m 10-20 pounds over my ideal weight.

I’m within ten pounds of my ideal weight.

Your Score is

Your entries will NOT be saved. Click this button to format this page for printing then follow the instructions.

To e-mail this page, click the button and follow the instructions. (You must be connected to the Internet to use this feature.)