Health Quiz

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	Gender	Male Female
	Age group (years)	< 5 - Not suitable for use in this age group Unfortunately you are unable to complete this quiz if you are under 5 years of age 5-8 9-15 16-24 25-34 35-44 45-54 55-64 65-74 75+
	Is this the first time you are taking this quiz?	Yes No
	Are you a vegetarian?	Yes No
	Height (Optional)	centimetres feet/inches cm - ft - in -
	Weight (Optional)	kilograms pounds kg - lb -
	How do you eat your main meal? (Optional)	By yourself With 1 other person With 2 or more other people
	Postcode you live at? (Optional)
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1.	How many times a week do you eat vegetables with your meal at night? Exclude hot chips.	2 or less 3-4 5 or more
Questions 2-20: HOW MANY TIMES A WEEK DO YOU USUALLY EAT A SERVING OF THESE VEGETABLES WHEN THEY ARE IN SEASON? One serving is half a cup.
2.	Potato (boiled, mashed, baked)	Less than once a week or never Once a week or more often
3.	Pumpkin	Less than once a week or never Once a week or more often
4.	Sweet potato	Less than once a week or never Once a week or more often
5.	Cauliflower	Less than once a week or never Once a week or more often
6.	Green beans	Less than once a week or never Once a week or more often
7.	Spinach	Less than once a week or never Once a week or more often
8.	Cabbage or brussels sprouts	Less than once a week or never Once a week or more often
9.	Peas	Less than once a week or never Once a week or more often
10.	Broccoli	Less than once a week or never Once a week or more often
11.	Carrots	Less than once a week or never Once a week or more often
12.	Zucchini, eggplant, squash	Less than once a week or never Once a week or more often
13.	Capsicum	Less than once a week or never Once a week or more often
14.	Corn, sweet corn, corn on the cob	Less than once a week or never Once a week or more often
15.	Mushrooms	Less than once a week or never Once a week or more often
16.	Tomatoes	Less than once a week or never Once a week or more often
17.	Lettuce	Less than once a week or never Once a week or more often
18.	Celery, cucumber	Less than once a week or never Once a week or more often
19.	Avocado	Less than once a week or never Once a week or more often
20.	Onion, spring onion, leek	Less than once a week or never Once a week or more often

21.	How many pieces of fruit do you usually eat per day? Include all types.	1 or less 2 or more
Questions 22-32: HOW MANY TIMES A WEEK DO YOU USUALLY EAT A SERVING OF THESE FRUITS WHEN THEY ARE IN SEASON? One serving can be one medium piece, two small pieces, one cup of canned fruit or one heaped tablespoon of dried fruit.
22.	Canned fruit, e.g. peaches, Two fruits	Less than once a week or never Once a week or more often
23.	Fresh fruit salad	Less than once a week or never Once a week or more often
24.	Dried fruit, e.g. sultanas, dried apricots	Less than once a week or never Once a week or more often
25.	Apple or pear	Less than once a week or never Once a week or more often
26.	Orange, mandarin, grapefruit	Less than once a week or never Once a week or more often
27.	Banana	Less than once a week or never Once a week or more often
28.	Peach, nectarine, plum or apricot	Less than once a week or never Once a week or more often
29.	Mango or paw-paw	Less than once a week or never Once a week or more often
30.	Pineapple	Less than once a week or never Once a week or more often
31.	Grapes, strawberries, blueberries	Less than once a week or never Once a week or more often
32.	Melon, e.g. watermelon, rockmelon, honeydew melon	Less than once a week or never Once a week or more often

Questions 33-39: HOW MANY TIMES A WEEK DO YOU USUALLY EAT A SERVING OF THESE PROTEIN FOODS?
33.	Mince dish, e.g. meat/chicken with noodles/rice	Less than once a week or never Once 2 or more
34.	Meat (beef or lamb), e.g. roast, chops, steak, beef stroganoff, stir fry (with or without sauce)	Less than once a week or never 1-4 5 or more
35.	Chicken, e.g. roast, BBQ, satay, stir fry (with or without sauce)	Less than once a week or never 1-4 5 or more
36.	Pork, e.g. roast, chops, sweet & sour, stir fry (with or without sauce)	Less than once a week or never 1-4 5 or more
37.	Fresh fish not crumbed or battered	Less than once a week or never Once a week or more often
38.	Canned tuna, salmon, sardines including patties	Less than once a week or never Once a week or more often
39.	Other seafood, e.g. prawns, lobster	Less than once a week or never Once a week or more often

Questions 40-45: HOW MANY TIMES A WEEK DO YOU USUALLY EAT A SERVING OF THESE PROTEIN FOODS?
40.	Nuts, e.g. peanuts, almonds	Less than once a week or never Once a week or more often
41.	Peanut butter, Nutella	Less than once a week or never Once a week or more often
42.	Eggs, e.g. boiled, scrambled	Less than once a week or never Once a week or more often
43.	Soybeans, tofu	Less than once a week or never Once a week or more often
44.	Baked beans	Less than once a week or never Once a week or more often
45.	Other beans, lentils, e.g. chickpeas, split peas	Less than once a week or never Once a week or more often

46.	What type of bread do you usually eat?	Brown (multigrain, wholemeal) White Other Not Sure/Don't eat Bread
Questions 47-57: HOW MANY TIMES A WEEK DO YOU USUALLY EAT A SERVING/BOWL/SLICE OF THESE GRAINS?
47.	Muesli	Less than once a week or never Once a week or more often
48.	Porridge	Less than once a week or never Once a week or more often
49.	Breakfast cereal, e.g. Weet-bix, Nutri-grain, Cornflakes, Sultana Bran	Less than once a week or never Once a week or more often
50.	Bread, pita bread, roll or toast all types	Less than once a week or never Once a week or more often
51.	English muffin, bagel or crumpet	Less than once a week or never Once a week or more often
52.	Rice	Less than once a week or never Once a week or more often
53.	Other grains, e.g. cous cous, burghul, quinoa	Less than once a week or never Once a week or more often
54.	Noodles, e.g. egg noodles (yellow), rice noodles (white)	Less than once a week or never Once a week or more often
55.	Pasta, e.g. spaghetti, lasagne, pasta bake	Less than once a week or never Once a week or more often
56.	Clear soup with rice or noodles	Less than once a week or never Once a week or more often
57.	Tacos, burritos, enchiladas	Less than once a week or never Once a week or more often

Health Quiz

Vegetables

Fruit

Protein foods - Meat/Fish/Chicken

Protein foods - Vegetarian Alternatives

Grains

Dairy

Water

Sauces & Condiments

Submit

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58.	Add up how many times a day you have a glass of milk, a tub of yoghurt or a slice of cheese	1 or less 2 or more
59.	What TYPE of milk do you usually drink?	Reduced fat milk, skim milk or soy milk Full cream milk, rice milk or other milk Don't drink milk
Questions 60-67: HOW MANY TIMES DO YOU USUALLY EAT/DRINK A SERVING/GLASS/SLICE OF THESE DAIRY FOODS?
60.	Flavoured milk, e.g. Moove, Oak, hot chocolate, milkshake, thickshake, smoothie	Less than 1 per week or never Between 1 per week and 1 per day 2 or more per day
61.	Plain milk - glass or with cereal	Less than 1 per day or never Once or more per day
62.	Ice cream - vanilla, chocolate, strawberry, sundaes, cones	Less than 1 per week or never Between 1 per week and 1 per day 2 or more per day
63.	Frozen yoghurt	Less than 1 per week or never Between 1 per week and 1 per day 2 or more per day
64.	Yoghurt (not frozen) plain or flavoured, e.g. Ski, Yoplait, Vaalia	Less than 1 per week or never Once a week or more
65.	Cottage cheese or ricotta	Less than 1 per week or never Once a week or more
66.	Cheese, including cheese on sandwiches, biscuits or on toast	Less than 1 per day or never Between 1 per day and 3 per day 4 or more per day
67.	Cheese spread, cream cheese	Less than 1 per day or never Between 1 per day and 3 per day 4 or more per day

Question 68: HOW MANY GLASSES OF WATER A DAY DO YOU USUALLY DRINK?
68.	Water, including bottled water, unflavoured mineral water, tap water	3 or less 4 or more

Questions 69-70: HOW MANY TIMES A WEEK DO YOU USUALLY EAT A SERVING OF THESE SAUCES AND SPREADS?
69.	Vegemite, Mighty Mite, Promite, Marmite	Less than once a week or never Once a week or more often
70.	Tomato sauce, tomato paste or tomato based sauces, barbecue sauce	Less than once a week or never Once a week or more often

	Would you like us to send you a reminder email to complete the quiz again in one month?	Yes No
	Want to know how your nutrient intake compares with current Australian recommendations?	Yes No Soon to be released is a new online Australian Eating Survey designed to give you feedback on your nutrient intake including protein, carbohydrates, fats, vitamins and minerals (eg. Iron and Calcium). We will email you soon with more information.
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