Fruit, Vegetable & Fiber Screener

10 quick questions about your eating habits • 5 minutes

About You

* Age and sex are required to calculate your fiber intake

Optional
Instructions: Think about your eating habits over the past week. About how often did you eat or drink each of the following foods? Please select one answer for each question.
1 100% fruit juice, such as orange, apple, grape - not fruit drinks
2 Fruit - fresh, frozen, or canned. Not counting juice
3 Green salad
4 Potatoes, any kind, including baked, mashed, or french fries
5 Vegetable soup, or stew with vegetables
6 Any other vegetables, including string beans, peas, corn, broccoli or any other kind
7 Fiber cereals like Raisin Bran, Shredded Wheat or Fruit-n-Fiber
8 Beans such as baked beans, pinto, kidney, or lentils (NOT green beans)
9 Dark bread, such as whole wheat or rye
10 Brown rice or other cooked grains (like bulgur or wheat berries)