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FAT & FIBER BEHAVIOR QUESTIONNAIRE
Please think about your food choices over the past three months and mark the answer to
each question.
In the past three months...
1. Did you eat chicken?
no (If no, go to Question 2)
yes (If yes, go to Question 1a)
1a. When you ate chicken, how often was it fried?
Usually Sometimes
Often Rarely or Never
1b. When you ate chicken, how often did you take off the skin?
Usually Sometimes
Often Rarely or Never
2. Did you eat red meat such as beef, pork, lamb?
no (If no, go to Question 3)
yes (If yes, go to Question 2a)
2a. When you ate red meat, how often did you trim all the visible fat?
Usually Sometimes
Often Rarely or Never
3. Did you eat ground meat?
no (If no, go to Question 4)
yes (If yes, go to Question 3a)
3a. When you ate ground meat, how often did you choose extra lean ground beef, or
ground turkey or chicken?
Usually Sometimes
Often Rarely or Never
4. Did you eat fish?
no (If no, go to Question 5)
yes (If yes, go to Question 4a)
4a. When you ate fish, how often was it fried?
Usually Sometimes
Often Rarely or Never
5. Did you have at least one vegetarian dinner or main meal, that is, without meat fish,
eggs, or cheese?
no (If no, go to Question 6)
yes (If yes, go to Question 5a)
5a. How often did you have a vegetarian dinner?
Usually Sometimes
Often Rarely or Never
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In the past three months...
6. Did you eat spaghetti or noodles?
no (If no, go to Question 7)
yes (If yes, go to Question 6a)
6a. When you ate spaghetti or noodles, how often did you eat them plain, or with a red sauce
or tomato sauce without meat?
Usually Sometimes
Often Rarely or Never
7. Did you eat cooked vegetables?
no (If no, go to Question 8)
yes (If yes, go to Question 7a)
7a. When you ate cooked vegetables, how often did you add butter, margarine or other fat?
Usually Sometimes
Often Rarely or Never
7b. When you ate cooked vegetables, how often were they fried?
Usually Sometimes
Often Rarely or Never
8. Did you eat potatoes?
no (If no, go to Question 9)
yes (If yes, go to Question 8a)
8a. When you ate potatoes, how often were they fried, like French fries or hash browns?
Usually Sometimes
Often Rarely or Never
9. Did you eat boiled or baked potatoes?
no (If no, go to Question 10)
yes (If yes, go to Question 9a)
9a. When you ate boiled or baked potatoes, how often did you eat the without any butter,
margarine, or sour cream?
Usually Sometimes
Often Rarely or Never
10. Did you eat green salads?
no (If no, go to Question 11)
yes (If yes, go to Question 10a)
10a. When you ate green salads, how often did you use no dressing?
Usually Sometimes
Often Rarely or Never
10b. When you ate green salads, how often did you use low-fat or non-fat salad dressing?
Usually Sometimes
Often Rarely or Never
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In the past three months...
11. Did you eat bread, rolls, or muffins?
no (If no, go to Question 12)
yes (If yes, go to Question 11a)
11a. When you ate bread, rolls or muffins, how often did you eat them without butter or
margarine?
Usually Sometimes
Often Rarely or Never
12. Did you drink milk or use milk on cereal?
no (If no, go to Question 13)
yes (If yes, go to Question 12a)
12a. When you had milk, how often was it 1% or nonfat milk?
Usually Sometimes
Often Rarely or Never
13. Did you eat cheese, including cheese on sandwiches or in cooking?
no (If no, go to Question 14)
yes (If yes, go to Question 13a)
13a. When you ate cheese, how often was it specially-made-low-fat or non-fat cheese?
Usually Sometimes
Often Rarely or Never
14. Did you eat dessert?
no (If no, go to Question 15)
yes (If yes, go to Question 14a)
14a. When you ate dessert, how often did you eat only fruit?
Usually Sometimes
Often Rarely or Never
15. Did you eat home-baked cookies, cakes or pies?
no (If no, go to Question 16)
yes (If yes, go to Question 15a)
15a. When you ate home-baked cookies, cakes or pies, how often were they made with less
butter, margarine or oil than the recipe called for?
Usually Sometimes
Often Rarely or Never
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In the past three months...
16. Did you eat frozen desserts like ice cream or sherbet?
no (If no, go to Question 17)
yes (If yes, go to Question 16a)
16a. When you ate frozen desserts, how often did you choose frozen yogurt, sherbet, or
low-fat or non-fat ice cream?
Usually Sometimes
Often Rarely or Never
17. Did you eat snacks between meals?
no (If no, go to Question 18)
yes (If yes, go to Question 17a)
17a. When you ate between meal snacks, how often did you eat raw vegetables or fresh fruit?
Usually Sometimes
Often Rarely or Never
18. Did you sauté or pan fry any foods?
no (If no, go to Question 19)
yes (If yes, go to Question 18a)
18a. When you sautéed or pan fried foods, how often did you use Pam® or other non-stick
spray instead of oil, margarine or butter?
Usually Sometimes
Often Rarely or Never
19. Did you use mayonnaise or mayonnaise-type spread?
no (If no, go to Question 20)
yes (If yes, go to Question 19a)
19a. When you used mayonnaise or mayonnaise-type spread, how often did you use low-fat
or non-fat types?
Usually Sometimes
Often Rarely or Never
20. How often did you eat cold or hot cereal for breakfast?
Usually Sometimes
Often Rarely or Never
References:
Kristal, A. R., Curry, S. J., Shattuck, A. L., Feng, Z., & Li, S. (2000). A randomized trial of
a tailored, self-help dietary intervention: The Puget Sound Eating Patterns Study. Preventive
Medicine, 31, 380-389.
Kristal, A. R., Shattuck, A. L., & Henry, H. J. (1990). Patterns of dietary behavior
associated with selecting diets low in fat: Reliability and validity of a behavioral approach to
dietary assessment. Journal of the American Dietetic Association, 90(2), 214-220.
