hi, would love for several people to answer a few questions for my catering coursework at school for my GCSE's. this questionnaire will only take 5 minutes to complete and would love some results back.
Are you male or female?
¨ Male
¨ Female
How old are you?
¨ Under 25
¨ 26 – 35
¨ 36 – 45
¨ 46 – 55
¨ 56 – 65
¨ Over 65
How long have you suffered from diabetes?
¨ Under 1 year
¨ 1 year
¨ 2 years
¨ 3 years
¨ 4 years
¨ Over 4 years
Are you type 1 or type 2 Diabetes?
¨ Type 1
¨ Type 2
Do you consume breakfast on a daily basis?
¨ Yes
¨ No
List two food items you eat for breakfast,
1. ……………………………………………………………………………………………………….................
2. ………………………………………………………………………………………………………………………
List two food items you eat for lunch,
1. ……………………………………………………………………………………………………….................
2. ………………………………………………………………………………………………………………………
List two food items you eat for dinner,
1. ……………………………………………………………………………………………………….................
2. ………………………………………………………………………………………………………………………
Are you aware of what you need to eat in order to live a healthy lifestyle as a diabetic?
¨ Yes
¨ No
If yes, state several food items you need to eat,
1. ……………………………………………………………………………………………………….................
2. ………………………………………………………………………………………………………………………
3. ……………………………………………………………………………………………………….................
Do you consider your diet nutritional and healthy?
¨ Yes
¨ No
Do you think your diet matches the requirements for a diabetics diet?
¨ Yes
¨ No
If no, why? ………………………………………………………………………………………………………………………
Are you aware of what you should not eat or avoid in order to live a healthy lifestyle as a diabetic?
¨ Yes
¨ No
If yes, state several food items you mustn’t to eat,
1. ……………………………………………………………………………………………………….................
2. ………………………………………………………………………………………………………………………
3. ……………………………………………………………………………………………………….................
Do you prefer sweet or savory food?
¨ Sweet
¨ Savory
Do you enjoy fresh produce such as fruit, vegetables and fresh meat?
¨ Yes
¨ No
If no, why? ………………………………………………………………………………………………………………………
Do you have a tendency to snack during the day?
¨ Yes
¨ No
If yes, do you snack on health or unhealthy snacks?
¨ Healthy
¨ Unhealthy
Name two snacks you snack on, on a daily basis,
1. ……………………………………………………………………………………………………….................
2. ………………………………………………………………………………………………………………………
Do you enjoy spicy food?
¨ Yes
¨ No
Do you feel you have control over your disease?
¨ Yes, why?
……………………………………………………………………………………………………….................
¨ No, why?
……………………………………………………………………………………………………….................
If I were to cook you a meal, name 3 dishes you would enjoy as a diabetic
1. ……………………………………………………………………………………………………….................
2. ………………………………………………………………………………………………………………………
…………………………………………………………………………………………
Are you male or female?
¨ Male
¨ Female
How old are you?
¨ Under 25
¨ 26 – 35
¨ 36 – 45
¨ 46 – 55
¨ 56 – 65
¨ Over 65
How long have you suffered from diabetes?
¨ Under 1 year
¨ 1 year
¨ 2 years
¨ 3 years
¨ 4 years
¨ Over 4 years
Are you type 1 or type 2 Diabetes?
¨ Type 1
¨ Type 2
Do you consume breakfast on a daily basis?
¨ Yes
¨ No
List two food items you eat for breakfast,
1. ……………………………………………………………………………………………………….................
2. ………………………………………………………………………………………………………………………
List two food items you eat for lunch,
1. ……………………………………………………………………………………………………….................
2. ………………………………………………………………………………………………………………………
List two food items you eat for dinner,
1. ……………………………………………………………………………………………………….................
2. ………………………………………………………………………………………………………………………
Are you aware of what you need to eat in order to live a healthy lifestyle as a diabetic?
¨ Yes
¨ No
If yes, state several food items you need to eat,
1. ……………………………………………………………………………………………………….................
2. ………………………………………………………………………………………………………………………
3. ……………………………………………………………………………………………………….................
Do you consider your diet nutritional and healthy?
¨ Yes
¨ No
Do you think your diet matches the requirements for a diabetics diet?
¨ Yes
¨ No
If no, why? ………………………………………………………………………………………………………………………
Are you aware of what you should not eat or avoid in order to live a healthy lifestyle as a diabetic?
¨ Yes
¨ No
If yes, state several food items you mustn’t to eat,
1. ……………………………………………………………………………………………………….................
2. ………………………………………………………………………………………………………………………
3. ……………………………………………………………………………………………………….................
Do you prefer sweet or savory food?
¨ Sweet
¨ Savory
Do you enjoy fresh produce such as fruit, vegetables and fresh meat?
¨ Yes
¨ No
If no, why? ………………………………………………………………………………………………………………………
Do you have a tendency to snack during the day?
¨ Yes
¨ No
If yes, do you snack on health or unhealthy snacks?
¨ Healthy
¨ Unhealthy
Name two snacks you snack on, on a daily basis,
1. ……………………………………………………………………………………………………….................
2. ………………………………………………………………………………………………………………………
Do you enjoy spicy food?
¨ Yes
¨ No
Do you feel you have control over your disease?
¨ Yes, why?
……………………………………………………………………………………………………….................
¨ No, why?
……………………………………………………………………………………………………….................
If I were to cook you a meal, name 3 dishes you would enjoy as a diabetic
1. ……………………………………………………………………………………………………….................
2. ………………………………………………………………………………………………………………………
…………………………………………………………………………………………