Research Questionnaire
KAON NA, MASULOD KA?: EATING HABITS AMONG GRADE 11 STUDENTS IN JUAN VILLABLANCA
MEMORIAL HIGH SCHOOL S.Y. 2023-2024
Directions: The purpose of this survey questionnaire is to gather information relevant to the
researcher title. Your answers will treated with utmost respect and confidentiality. We hope
you answer the questions honestly and based on your experience and daily activities. Your
time and effort responding to this would be highly appreciated. On the matter, we send our
deepest and heartfelt gratitude as researchers.
Age:____
Sex : Male Female
Weight :______ Height: _______ BMI:_____
Underweight — 18.5
Norma l— 18.5-24.9
Overweight—25-29.9
Obese — 30-39.9
General average in previous year level:
69 below 70-79 80-85 86-90 90 above
Father's Occupation: ________________
Mother's Occupation: _________________
Monthly Family Income: __________________
Guardian's Occupation (If any):___________________
Monthly Income: ______________________
Rode vehicles when going to school : Yes or No
Directions : Please read thoroughly and carefully. Below are the statements that shows your
habits/ activities when it comes to eating. Choose the letter that corresponds to your answer.
Choose your answer, may it be A for STRONGLY AGREE,B for AGREE, C for UNDECIDED, D for
DISAGREE, and E for STRONGLY DISAGREE. Please don't leave any questions unanswered and
be honest in your response.
CHOICES:
A. Strongly Agree B. Agree C. Undecided D. Strongly Disagree E. Strongly Disagree
PART I. PART II.
Statement
Statement
1. I eat three meals a day.
1. I often consume nutritious
2. I skip a meal/do not eat a meal
food ( fruits, vegetables) in my
in a single day
daily meal.
3. When it's time to eat, I only eat
it in our dining table.
2. I read food labels to check
4. I enjoy eating meat foods. nutritional content before
purchasing a product.
5. I enjoy eating vegetables.
3. I eat sources of lean protein
6. I take my food somewhere I am (fish, chicken, egg, oatmeal) in
comfortable. my meals.
7. I am very picky when it comes 4. I am physically active for at
to my meals. least 30 mins. a day.
8. I am comfortable eating with 5. I prioritize sleep and get an
my parents or friends. adequate amount of restful
sleep at night.
9. I prefer eating alone.
10. I take vitamins and food 6. I engage myself in stress-
supplements. reducing
activities (meditation, yoga,
11. My meal is always finished
hobbies).
without leftover.
7. I'm not into smoke,
12. I give importance to the
excessive alcohol or drug use.
nutrition of the food that I take.
13. I avoid foods that are bitter
8. I consume foods known to
and sour.
support brain health, such as
14. I like sweet and savory foods. fatty fish, & nuts.
15. I eat more junk foods than
healthier foods. 9. I engage myself in mentally
stimulating activities, such as
16. I get full immediately. reading or puzzles.
17. My appetite is full whenever I
eat my preferred meals/ snacks. 10. I drink enough water
throughout the day to stay
18. I consume processed food. hydrated.
19. I love eating in fast food 11. I'm proactive in managing
chains. my stress levels to support
cognitive function.
20. I often drink sugary beverages
(soda, juice, sweetened tea, 12 I limit intake of caffeine
energy drink). and sugary snacks to avoid
energy crashes and promote
21. I eat meals with my family & cognitive focus.
friends.
