NutritionQuest
The Block Method
Home
Questionnaires & Screeners
How It Works
Pricing
Our Story
Contact Us
Fat Intake Screener
17 quick questions about your eating habits • 5 minutes
About You
All fields are optional
Age
Sex
Select...
Male
Female
Name
Instructions:
Think about your eating habits over the past year or so. About how often did you eat each of the following foods? Please select one answer for each question.
1
Hamburgers, ground beef, meat burritos, tacos
Never
Less than once a month
2-3 times a month
1-2 times a week
3-4 times a week
5 or more times a week
2
Beef or pork, such as steaks, roasts, ribs, or in sandwiches
Never
Less than once a month
2-3 times a month
1-2 times a week
3-4 times a week
5 or more times a week
3
Fried chicken
Never
Less than once a month
2-3 times a month
1-2 times a week
3-4 times a week
5 or more times a week
4
Hot dogs, or Polish or Italian sausage
Never
Less than once a month
2-3 times a month
1-2 times a week
3-4 times a week
5 or more times a week
5
Cold cuts, lunch meats, ham (not low-fat)
Never
Less than once a month
2-3 times a month
1-2 times a week
3-4 times a week
5 or more times a week
6
Bacon or breakfast sausage
Never
Less than once a month
2-3 times a month
1-2 times a week
3-4 times a week
5 or more times a week
7
Salad dressings (not low-fat)
Never
Less than once a month
2-3 times a month
1-2 times a week
3-4 times a week
5 or more times a week
8
Margarine, butter or mayo on bread or potatoes
Never
Less than once a month
2-3 times a month
1-2 times a week
3-4 times a week
5 or more times a week
9
Margarine, butter or oil in cooking
Never
Less than once a month
2-3 times a month
1-2 times a week
3-4 times a week
5 or more times a week
10
Eggs (not Egg Beaters or just egg whites)
Never
Less than once a month
2-3 times a month
1-2 times a week
3-4 times a week
5 or more times a week
11
Pizza
Never
Less than once a month
2-3 times a month
1-2 times a week
3-4 times a week
5 or more times a week
12
Cheese, cheese spread (not low-fat)
Never
Less than once a month
2-3 times a month
1-2 times a week
3-4 times a week
5 or more times a week
13
Whole milk
Never
Less than once a month
2-3 times a month
1-2 times a week
3-4 times a week
5 or more times a week
14
French fries, fried potatoes
Never
Less than once a month
2-3 times a month
1-2 times a week
3-4 times a week
5 or more times a week
15
Corn chips, potato chips, popcorn, crackers
Never
Less than once a month
2-3 times a month
1-2 times a week
3-4 times a week
5 or more times a week
16
Doughnuts, pastries, cake, cookies (not low-fat)
Never
Less than once a month
2-3 times a month
1-2 times a week
3-4 times a week
5 or more times a week
17
Ice cream (not sherbet or non-fat)
Never
Less than once a month
2-3 times a month
1-2 times a week
3-4 times a week
5 or more times a week
Get My Results →