DEPARTMENT OF NUTRITION AND FOOD SCIENCE

QUESTIONNAIRE ON EXERCISE

DEMOGRAPHICS:

1. Sex

2. Age

3. Level

4. Course of study

5. Type of sport

6. Religion

7. Ethnicity

The following questions are about effects of exercise on nutritional status. In some instances, these questions may be difficult to answer and may require additional contributors to complete the questionnaire. We are asking that you help in the best way you deem possible. Remember that we are available and committed to assisting you in completing this questionnaire.

EXERCISE:

1a. In the past 2 weeks, beginningMonday and ending this past Sunday, have you done any exercises, sports, or physically active hobbies?

1 [ ] Yes2 [ ] No (Jump to 3)

2. Do you exercise or play sports regularly? 1 [ ] Yes 2 [ ] No (Jump to 4)

3. For how long have you exercised or played sports regularly?

1 [ ] Days ___________ 2 [ ] WeeksNumber 3 [ ] Months 4 [ ] Years

4. Would you say that you are physically more active, less active, or about as active as other persons your age?

1 [ ] More active2 [ ] Less active3 [ ] About as active4 [ ] Other (Specify)______________________

5. Is that (a lot more or a little more/a lot less or a little less) active?

1 [ ] A lot more2 [ ] A little more3 [ ] A lot less4 [ ] A little less

6. How often do you exercise on a weekly basis? 1 [ ] Not at all2 [ ] Less often3 [ ] More often4 [ ] Very often

7. Do you feel stressed throughout the week? 1 [ ] No2 [ ] Sometimes3 [ ] Yes4 [ ] Don’t know

8. Do you have enough energy to make it through the day?

1 [ ] No2 [ ] Sometimes3 [ ] Yes4 [ ] Don’t know

9. Are you satisfied with your current health or body physique?

1 [ ] No2 [ ] Yes

10. Do you think exercising would be beneficial to your overall health?

1 [ ] No2 [ ] Maybe3 [ ] Yes4 [ ] Don’t know