Since 1982, Block Questionnaires have been developed using a data-based approach to questionnaire design. That is, we use large representative national dietary surveys such as the National Health and Nutrition Examination Survey (NHANES) to inform the selection of the foods (or physical activities) to be asked about, as well as to identify appropriate portion sizes and nutrient composition to apply. We continue to redesign and update our questionnaires, nutrient databases and analyses as new dietary and physical activity data become available.
All Block Questionnaires and Screeners for assessment of diet and physical activity are available for administration in two different formats:
Purchase paper forms from NutritionQuest. Administer them to your study subjects and then return completed forms to NutritionQuest for processing. We'll scan them, calculate nutrient or physical activity estimates and return the data to you in an electronic file suitable for statistical analysis. Individual reports for study subjects are also available.
All Block assessment tools are also available in an electronic format delivered via Data-on-Demand, which provides an online structure for integrated data collection, nutrient and physical activity analysis, and data management. The electronic questionnaires may be completed online for computer-assisted self-interviewing (CASI), and either online or offline for computer-assisted personal interviewing (CAPI).
Upon request, we tailor Block Questionnaires and Screeners to target certain nutrients or foods, or groups of people by region, gender, age, ethnicity, or language. We have provided this service for a wide variety of research units in government, academia and industry. To discuss the special requirements of your study or project design, please Contact Us.
For samples of scannable paper-and-pencil questionnaires or to arrange a free online demonstration of the Data-on-Demand System using a Block questionnaire or screener Contact Us. For more about pricing, go to Pricing and Ordering. Price quotes and comparisons are available upon request.
This full-length (approximately 110 food item) questionnaire was designed to estimate usual and customary intake of a wide array of nutrients and food groups. It takes 30-40 minutes to complete and is intended for either self- or interviewer-administration. Both the food list for this questionnaire and nutrient database for its analysis were developed from more recent data than used for the Block 1998 FFQ. The food list was developed from NHANES 1999-2002 dietary recall data; the nutrient database was developed from the USDA Food and Nutrient Database for Dietary Studies (FNDDS), version 1.0. A series of "adjustment" questions provide greater accuracy in assessing fat and carbohydrate intake. Individual portion size is asked for each food, and pictures are provided to enhance accuracy of quantification.
This full-length questionnaire is also available in bilingual format, with text in both Spanish and English on each page. This version of the FFQ has additional food items typical of diets among Hispanics. Contact us for a sample or more detail about added foods.
This questionnaire was developed for use with dialysis and chronic renal failure patients. It is about 100 items long and takes 30-40 minutes to complete. The food list was developed on the basis of multiple three-day records obtained from dialysis patients; foods were selected on the basis of their contribution to total calories, protein, phosphorus, potassium, vitamin A, vitamin C and water. Also providing input to the development of this FFQ were the dietary guidelines developed by the Renal Practice Group of the American Dietetic Association. Special attention was paid to portion size asked for each food item since portion size is considered important in dialysis patients, in relation to controlling liquids, phosphorus and potassium intake, as well as in assuring adequate energy intake. Nutrient content for items on the questionnaire is based on USDA nutrient data from the 2005 version of the Food and Nutrient Database for Dietary Surveys (FNDDS).
This full-length (110 food item) questionnaire was designed to estimate usual and customary intake of a wide array of nutrients and food groups. It takes 30-40 minutes to complete, and is intended for either self- or interviewer-administration. The food list for this questionnaire was developed from the NHANES III dietary recall data. The nutrient database was developed from the USDA Nutrient Database for Standard Reference. Individual portion size is asked for each food, and pictures are provided to enhance accuracy of quantification.
This questionnaire contains a reduced food list (about 70 food items) and takes 15-20 minutes to complete. It was designed to provide estimates of usual and customary dietary intake. Because it has fewer foods, estimates of energy and macronutrients will be lower than "true" levels. However, it will rank individuals along the distribution of intake and is sensitive to changes in intake, making it appropriate for many research purposes. The food list for this questionnaire was developed from the NHANES III dietary recall data. The nutrient database was developed from the USDA Nutrient Database for Standard Reference. Individual portion size is asked, and pictures are provided. It is available in English and Spanish.
This screener contains 25 food items and takes 5-7 minutes to complete. Portion size is asked for 7 items. Salt added at the table is also included. A simplified scoring key allows for subject self administration and scoring. Sex-specific prediction equations are also available for investigators to calculate milligrams of sodium intake per day.
This screener contains 55 questions and takes about 10-12 minutes to complete. Portion size is asked for 32 food items. A series of "adjustment" questions ask about usual intake of low-fat/trans-fat free or low-carbohydrate/low-sugar versions of various foods. Analysis produces estimates of saturated fat, trans fat, total sugars, "added sugars" (in sweetened cereals, soft drinks, and sweets), fruit and fruit juice, vegetable intake, glycemic load and glycemic index.
This brief screening tool includes 17 questions, and takes 5 minutes to complete. In its self-administered paper-and-pencil version—useful for clinical applications—it was designed to rank individuals with regard to their usual fat intake. Data collected using this form also may be analyzed using prediction equations to generate point estimates of total fat (grams), saturated fat (grams), percent calories from fat, and cholesterol (mg). Portion sizes are not asked. Spanish version also available. Try this screener online. If you are interested in using this tool for research purposes, Contact Us.
This brief screening tool includes 7 questions about fruit and vegetable intake and 3 questions about foods high in fiber. It takes about 5 minutes to complete. In its self-administered paper-and-pencil version—useful for clinical applications—it ranks individuals with regard to their usual intake of fruits and vegetables. Data collected using this form also may be analyzed using prediction equations to generate point estimates of total fruit/vegetable servings, Vitamin C (mg), magnesium (mg), potassium (mg), and dietary fiber (mg). Portion sizes are not asked. Spanish version also available. Try this screener online.
This brief screening tool was developed from the NHANES 1999-2001 dietary recall data. It includes 19 food items, 3 supplement questions, and questions to adjust for food fortification practices. This screener takes 7-8 minutes to complete.
This brief screening tool was developed from the NHANES 1999-2001 dietary recall data. It includes 21 questions. Portion sizes are not asked. It takes 5-8 minutes to complete and provides separate estimates of total, supplement and food-only intake. Also available in Spanish.
This brief screening tool includes 10 food/supplement items and takes 5 minutes to complete. This screener was designed to measure intake of daidzein, genistein, coumestrol and total isoflavones. It may be used as a stand-alone survey tool or combined with a full-length food frequency questionnaire.
This questionnaire includes about 90 questions and asks about a child's "usual eating habits in the past 6 months." It takes a caregiver or interviewer approximately 30 minutes to complete. The food list was developed from NHANES III dietary recall data. The nutrient database was developed from the USDA Nutrient Database for Standard Reference. Individual portion size is asked for beverages but not other foods.
The questionnaire includes 77 food items and takes 25 minutes to complete. The food list for this questionnaire was developed from the NHANES 1999-2002 dietary recall data. The nutrient database was developed from the USDA Nutrient Database for Dietary Studies, version 1.0. Individual portion size is asked, and pictures are provided to enhance accuracy of quantification.
This FFQ is also available in a Spanish version, with additional food items typical of diets among Hispanics. Contact us for a sample or more detail about added foods.
These screeners are designed to assess children's intake by food group, with outcomes measured in number of servings. One version asks about food eaten "yesterday," and a second version about food eaten "last week." The focus of these tools is on intake of fruit and fruit juices, vegetables, potatoes (including French fries), whole grains, meat/poultry/fish, dairy, legumes, saturated fat, "added sugars" (in sweetened cereals, soft drinks, and sweets), glycemic load and glycemic index. A secondary analysis produces estimates for intake of sugary beverages (both kcal and frequency). Individual portion sizes are asked. This questionnaire was designed for self-administration by children with the assistance of parent or caregiver, as needed. These screeners take about 10-12 minutes to complete. The "last week" version is available in Spanish.
This tool is designed to measure total average energy expenditure per day, as well as minutes per day of moderate and vigorous activities, and average MET-minutes by activity type. The form assesses job type and time, frequency and duration of the 26 most relevant daily-life and leisure time activities as determined by analysis of the Human Activities Patterns Survey data. It takes 20-25 minutes to complete.
This brief screening tool contains 11 items, which include job-related as well as daily life and leisure activities. It asks about frequency and duration of these activities during the past year. The form takes about 5 minutes to complete. The physical activity items were identified using the National Human Activities Patterns Survey data, and quantified using the Ainsworth Compendium.
This screening tool is intended for school-age children and adolescents. It asks about frequency and duration of activities in the past 7 days. There are 9 items querying leisure and school activities, chores and part-time jobs. It also asks about amount of time per day spent watching television, playing video games and using the Internet. It takes about 5 minutes to complete. Also available in Spanish.
This FFQ, containing 67 questions and focusing solely on consumption of meat and fish, was designed to assess intake of heterocyclic amines, carcinogens found in cooked meat and fish. Questions include frequency of intake and usual portion size during the past year, as well as cooking method, doneness and cooking location. Data are used to estimate intake of the four heterocyclic amines most commonly found in meat and fish: PhIP, MeIQx, DiMeIQx and IQ. Photographs supplement the FFQ to provide standardization of responses regarding meat doneness levels and portion sizes. The form takes about 20 minutes to complete. View this screener online. An abbreviated version is also available for use in conjunction with FFQs assessing overall diet. This screener was developed by Dr. Garrett Keating and colleagues at the Lawrence Livermore National Laboratory.