fat-questionnaire

Short Fat Questionnaire - circle the number of your best response

. 1. How often do you eat fried food with batter or breadcrumb coating?
   4.    6 or more times per week
   3.    3-5 times per week
   2.    1-2 times per week
   1.    Less than once a week
   0.   Never
2. How often do you eat gravy, cream sauces or cheese sauces?
   4.    6 or more times per week
   3.    3-5 times per week
   2.    1-2 times per week
   1.    Less than once a week
   0.    Never
3. How often do you add butter, marg, oil or sour
cream to veges, rice, spaghetti?
   4.    6 or more times per week
   3.    3-5 times per week
   2.    1-2 times per week
   1.    Less than once a week
   0.    Never
4. How often do you eat vegetables that are fried or roasted with fat or oil?
   4.    6 or more times per week
   3.    3-5 times per week
   2.    1-2 times per week
   1.    Less than once a week
   0.    Never
5. How many times a week do you eat meat pies,
sausages, salami, burgers or bacon?
   4.    6 or more times per week
   3.    3-5 times per week
   2.    1-2 times per week
   1.    Less than once a week
   0.    Never
6. How often do you eat pastries, cakes, sweet biscuits or croissants?
   4.    6 or more times per week
   3.    3-5 times per week
   2.    1-2 times per week
   1.    Less than once a week
   0.    Never
7. How many times a week do you eat hot chips?
   4.    6 or more times per week
   3.    3-5 times per week
   2.    1-2 times per week
   1.    Less than once a week
   0.    Never
8. How is your meat usually cooked?
   4.    Fried
   3.    Stewed
   2.    Grilled/roasted with added fat/oil
   1.    Grilled/roasted without fat/oil
   0.    Eat meat occasionally or never

9. How do you spread butter/marg on bread?
    4.    Thickly
    3.    Medium
    2.    Thinly
    0.    Never use butter/marg
10. How many times a week do you eat chocolate or sweet snack bars?
   4.    6 or more times per week
   3.    3-5 times per week
   2.    1-2 times per week
   1.    Less than once a week
   0.    Never
11. How many times a week do you eat crisps, corn chips or nuts?
    4.   6 or more times per week
    3.    3-5 times per week
   2.    1-2 times per week
   1.    Less than once a week
   0.    Never
12. How often do you eat cream?
   4.    6 or more times per week
   3.    3-5 times per week
   2.    1-2 times per week
   1.    Less than once a week
   0.    Never
13. How often do you eat more than a small serve of icecream?
    4.    6 or more times per week
   3.    3-5 times per week
   2.    1-2 times per week
   1.    Less than once a week
   0.    Never
14. How often do you eat more than a small piece
of cheese (exclude low fat cheese)?
   4.    6 or more times per week
   3.    3-5 times per week
   2.    1-2 times per week
   1.    Less than once a week
   0.    Never
15. What type of milk do you use on breakfast cereal or in cooking?
   4.    Condensed or evaporated
   3.    Fullcream
   2.    Full cream and reduced fat
   1.    Reduced fat
   0.    Skim
16. How much skin on chicken do you eat?
   2.    Most or all of the skin
   1.    Some of the skin
   0.    None of the ski nil am vegetarian
17. How much of the fat on meat do you eat?
   2.    Most or all of the fat
   1.    Some of the fat
   0.   No fat/I am vegetarian

Total =

Compare the score to the rating below:

0-17 = Low fat intake        18-39 = Moderate fat intake        40+ = High fat intake