BuSO Don Bosco, Lenniksesteenweg 2, 1500 Halle (Belgium)

Tel.: 00-32-(0)2 363 09 86

Fax.: 00-32-(0)2 363 09 88

Email: donboscobuso@dbhbuso.telenet.be

Website: http://dbhbuso.telenet.be

Co-ordinators in the school: Ellen De Ryst, Leen Bultι, Vera Sermon

Director school: Jos Walravens

 

Questionary about eating habits

 

Name of the student (optional):

Age (birthday):

Weight:

Gender: male/female

 

01.  Questions about your breakfast

 

01.01.  Do you eat breakfast? Is there a difference between schooltime and vacation time for eating breakfast?

(Put a cross in the right column)

 

 

Schooltime

Vacation  and Sunday

 

Yes

No

Yes

No

Each morning

 

 

 

 

Mostly

 

 

 

 

Never

 

 

 

 

 

01.02.  At what time do you eat breakfast?

(Put a cross in the right column or give the correct time)

 

Schooltime

Vacation  and Sunday

Between 6.00 a.m. and 7.00 a.m. (morning)

 

 

Between 7.00 a.m. and 8.00 a.m. (morning)

 

 

Other time ΰ

 

 

 

 

 

01.03.  For those who eat breakfast during schooltime ‘Where do you eat your breakfast’ ?

(Put a cross in the right column.  More answers are possible.)

 

At home

 

On the road to school on foot

 

On the road to school in the car

 

On the road to school on the bus

 

On the road to school on the train

 

On the road to school on the bycicle

 

On the playground just before schooltime

 

I don’t eat breakfast

 

 


01.04.  What do you eat mostly as breakfast?

(Put a cross in the right column.  More answers are possible.)

 

 

Schooltime

Vacation  and Sunday

Bread

 

 

Spice cake   ?

 

 

Grains / whole wheat bread

 

 

Yoghurt

 

 

Cheese

 

 

Fruit

 

 

Marmelade

 

 

Chocolate paste

 

 

Meat

 

 

Candybars

 

 

Chocolate bars

 

 

Chips

 

 

Cakes

 

 

Others ΰ

 

 

 

 

 

 

01.05.  What do you drink as breakfast?

(Put a cross in the right column.  More answers are possible.)

 

Hot drinks

 

Cold drinks

 

 

(Put a cross in the right column.  More answers are possible.)

Milk

 

Chocolate

 

Coffee

 

Soft drinks (cola, …)

 

Water

 

Tea

 

Other drinks ΰ

 

 

 

 

 

02.  Questions about your eating habits in schooltime between breakfast & noon

 

02.01.  Do you eat something between breakfast & noon?

(Put a cross in the right column)

 

Yes

No

 

 

 


02.02.  Where do you eat between breakfast & noon?

(Put a cross in the right column.  More answers are possible.)

 

During the lessons

 

Between the lessons still in the classroom

 

Between the lessons but on the playground  or the school cafeteria

 

Others ΰ

 

 

 

 

02.03.  What do you eat at that moment?

 

Bread

 

Spice cake ?

 

Grains

 

Yoghurt

 

Cheese

 

Candybars

 

Chocolate bars

 

Chips

 

Cakes

 

Fruit (apple, orange, …)

 

Others ΰ

 

 

 

 

 

03.  Questions about your eating habits at noon

 

03.01.  Do you eat lunch or dinner at noon?

(Put a cross in the right column.)

 

 

Schooltime

Vacation  and Sunday

Lunch

 

 

Dinner

 

 

 

03.02.  Where do you eat mostly lunch or dinner at schooltime? Irrelevant for us, as all the students eat lunch in school

(Put a cross in the right column.  More answers are possible.)

 

At school

 

At home

 

By family who live nearer by the school than your home

 

By friends

 

Snackbar in the city

 

Others ΰ

 

 

 

 


03.03.  At what time do you eat at noon?

 

Schooltime

Vacation  and Sunday

Between 12.00 and 12.30 H

 

 

Between 12.30 and 13.00 H

 

 

Between 13.00 and 13.30 H

 

 

Others ΰ

 

 

 

 

 

03.04.  What do you eat for lunch or dinner? Irrelevant for the school periods

(Put a cross in the right column.  More answers are possible.)

 

Soupe

 

Meat

 

Vegetables

 

Potatoes

 

Paste

 

Pizza

 

Bread

 

Spice cake

 

Grains

 

Yoghurt

 

Cheese

 

Candybars

 

Chocolate bars

 

Chips

 

Cakes

 

Fruit (apple, orange, …)

 

Others ΰ

 

 

 

 

 

04.  Questions about your eating habits from noon till evening

 

04.01.  Do you eat mostly something between noon till evening meal?

(Put a cross in the right column.)

 

Yes

No

 

 

 


04.02.  If your answer is ‘Yes’.  What do you eat than?

(Put a cross in the right column.  More answers are possible.)

 

Pizza

 

Bread

 

Candybars

 

Chocolate bars

 

Chips

 

Cakes

 

Fruit (apple, orange, …)

 

Yoghurt

 

Others ΰ

 

 

 

 

 

04.03.  Do you eat something when you come home before the evening meal?

(Put a cross in the right column.  More answers are possible.)

 

Pizza

 

Bread

 

Candybars

 

Chocolate bars

 

Chips

 

Cakes

 

Fruit (apple, orange, …)

 

Yoghurt

 

Others ΰ

 

 

 

 

 

05.  Questions about your eating habits at evening

 

05.01.  What time do you eat in the evening?

 

 

Schooltime

Vacation  and Sunday

Between 16.00 and 17.00 H

 

 

Between 17.00 and 18.00 H

 

 

Between 18.00 and 19.00 H

 

 

Between 19.00 and 20.00 H

 

 

Between 20.00 and 21.00 H

 

 

Others ΰ

 

 

 

 

 


05.02.  What do you mostly eat as eveningmeal?

(Put a cross in the right column.  More answers are possible.)

 

Soupe

 

Meat

 

Vegetables

 

Potatoes

 

Paste

 

Pizza

 

Bread

 

Spice cake

 

Grains

 

Yoghurt

 

Cheese

 

Candybars

 

Chocolate bars

 

Chips

 

Cakes

 

Fruit (apple, orange, …)

 

Others ΰ

 

 

 

 

 

05.03.  Do you eat/drink mostly something just before you go to sleep?

 

Yes

No

 

 

 

            If ‘Yes’ what do you eat/drink than?

 

            Drinks

Milk

 

Chocolate

 

Coffee

 

Soft drinks (cola, …)

 

Tea

 

Water

 

 

 

 

 

Others ΰ

 

 

           


Food

Spice cake

 

Grains

 

Yoghurt

 

Cheese

 

Candybars

 

Chocolate bars

 

Chips

 

Cakes

 

Fruit (apple, orange, …)

 

Others ΰ

 

 

 

 

 

05.04.  What time do you go to sleep normally?

 

 

During Schooltime

During Vacation  and Sunday

Hour

 

 

 

 

06.  Personal opinions

 

06.01.  Do you think your eating habits are healthy?

 

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            If ‘No’.  Why your eating habits are not healthy?

 

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06.02.  Do you think that the eating habits from most of the students of your age are similar with yours?

 

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            If ‘No’.  Where is the difference?

 

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06.03.  Is there is an offer of food and drinks in your school, is it healthy in your opinion?  What’s healthy and what isn’t?

 

Healthy:

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Not healthy:

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06.04.  What do you like to add to the food and drink offer of the school? Explain why?

 

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