Laboratory of Nutritional and Nutraceutical Research

Transcription

1 Participant Code (Office Use): 1 Food Frequency Questionnaire Laboratory of Nutritional and Nutraceutical Research INSTRUCTIONS: Please answer the following background questions and subsequent 37 questions about your usual eating habits over the past 12 months. Date you answered this questionnaire: Diet 1. What type of milk do you usually use? ( ) I do not drink milk ( ) Regular cow s milk (non-omega-3) ( ) Regular soy milk (non-omega-3) ( ) Nielson, Dairy Oh! 1% or 2% milk ( ) Nielson, Dairy Oh! Homogenized milk ( ) Silk Plus, Omega-3 DHA soy milk ( ) So Good, Omega-3 DHA soy milk ( ) Other Omega-3 enriched milk Please specify Brand: 2. How much omega-3 milk do you usually use per day (including milk added to tea, coffee, cereal, etc.)? ( ) 1 tablespoon ( ) 2 tablespoons ( ) ¼ cup (62.5 ml) ( ) ½ cup (125 ml) ( ) 1-2 cups ( ml) ( ) 2-3 cups ( ml) ( ) 3 cups (750 ml) or more 3. What kinds of margarine/spread do you usually use? (ex: On bread, vegetables, in cooking and baking, etc.) ( ) I don t use any margarine/spread ( ) Regular margarine (non-omega-3) ( ) Becel, Omega-3 Plus Margarine ( ) Other Omega-3 enriched margarine 4. How much omega-3 margarine/spread do you usually use per day? ( ) 1-2 teaspoons ( ) 1 tablespoon ( ) 2 tablespoons ( ) 3 tablespoons ( ) 4 tablespoons ( ) 5-7 tablespoons ( ) 8 or more tablespoons 5. What kinds of eggs do you usually eat (include eggs in baked goods/cooking)? ( ) Naturegg Breakfree omega-3 liquid eggs ( ) Naturegg Omega-3 eggs (in shell) ( ) Naturegg Omega-3 Pro eggs (in shell) ( ) Complements Omega-3 eggs ( ) President s Choice Omega-3 eggs ( ) Gray Ridge Omega-3 large eggs ( ) Gray Ridge Omega-3 extra-large eggs ( ) Regular Chicken eggs ( ) Duck eggs ( ) Other Omega-3 enriched eggs 6. On average, how many eggs do you usually eat per week (including eggs in baked goods/cooking)? ( ) I don t eat eggs ( ) Less than 1 egg ( ) 1 to 2 eggs ( ) 3 to 5 eggs ( ) 6 or more eggs

2 2 7. What kind of juice do you usually drink? ( ) I don t drink juice ( ) Regular juice (non-omega-3) ( ) Tropicana Essentials, Omega-3 orange juice ( ) Minute Maid Fruit Solutions, Omega-3 mango, orange & passion juice ( ) President s Choice, Oh Mega J orange juice ( ) Other Omega-3 enriched juice 8. How much omega-3 juice do you usually drink per day? ( ) less than one cup (<250 ml) ( ) 1 cup (250 ml) ( ) 1-2 cups ( ml) ( ) 2-3 cups ( ml) ( ) 3 cups (750 ml) or more 9. What kind of yogurt do you usually eat? ( ) I don t eat yogurt ( ) Regular yogurt (non-omega-3) ( ) Danone Danino yogurt ( ) Danone Danino Go yogurt drink ( ) Other Omega-3 enriched yogurt 10. How much omega-3 yogurt do you usually eat per week? ( ) none ( ) less than 1, 100 g pot ( ) 1, 100 g pot ( ) 2 to 3, 100 g pots ( ) 4 to 5, 100 g pots ( ) 6 to 7, 100 g pots ( ) 8 or more 100 g pots 11. What kind of bread do you usually eat? ( ) I don t eat bread ( ) Regular bread (non-omega-3) ( ) Wonder+ Omega-3 bread with DHA ( ) Other Omega-3 enriched bread Please specify brand/type: 12. How much omega-3 bread do you usually eat per day (fresh and toasted)? ( ) none ( ) less than 1 piece ( ) 1 piece ( ) 2 pieces ( ) 3 pieces ( ) 4 pieces ( ) 5-7 pieces ( ) 8 or more pieces 13. What kind of cheese do you usually eat? ( ) I don t eat cheese ( ) Regular cheese (non-omega-3) ( ) Black Diamond, Smart Growth Cheese Strings with DHA ( ) Other omega-3 enriched cheese 14. How much omega-3 cheese do you usually eat per week? ( ) less than 1oz (~1 cheese string) ( ) 1 oz (~1 cheese string) ( ) 2-3 oz (2-3 cheese strings) ( ) 4-5 oz (4-5 cheese strings) ( ) 6-7 oz (6-7 cheese strings) ( ) 8 or more oz (8+ cheese strings) 15. What kind of nut butter (ex: peanut) do you usually eat? ( ) I don t eat nut butter ( ) Regular nut butter (non-omega-3) ( ) Life Brand, Omega-3 Peanut Butter ( ) Other omega-3 enriched nut butter

3 3 16. How much omega-3 nut butter do you eat per week? ( ) less than 1 tablespoon (tbsp) ( ) 1 tbsp ( ) 2-3 tbsp ( ) 4-5 tbsp ( ) 6-7 tbsp ( ) 8 or more tbsp. 17. On average, how often do you eat fish paste? (ex: Surimi, often in Asian dishes) Specify the type of fish paste, brand and amount usually eaten (number of teaspoons) Type of fish paste Brand #tsp 18. On average, how often do you eat seaweed? Please specify the type of seaweed (or dish containing seaweed) and amount eaten on a typical occasion Type of seaweed/dish Amount 19. On average, how often do you eat seafood-containing sauce? (ex: fish sauce oyster sauce, etc (often in Asian dishes))? Please specify the type of seafood sauce, brand and amount usually eaten (# tsp) Type of sauce Brand #tsp 20. On average, how often do you eat fishbased broth (ex: fish broth-based soup)? Please specify the brand (or homemade ) and amount of fish broth usually eaten Brand Amount 21. How many fish oil supplements (ex:capsules) do you usually take per day ( ) Number: Please Specify brand and name of fish oil capsules: (ex: Jamieson, omega-3 Complete) Brand Product Name

4 4 22. When you eat meat or poultry, what size serving do you usually eat? A: Deck of cards sized B: 5oz / 150g C: 7oz / 200g portion = 3oz / 90g ( ) Less than A ( ) B ( ) C ( ) A ( ) Between B and C ( ) More than C ( ) Between A and B 23. On average, how often do you eat chicken or turkey? Please specify the types of chicken/turkey eaten most frequently and whether the skin is eaten (ex: Turkey thigh, with skin) 24. On average, how often do you eat duck or goose? ( ) 2 to 3times per week 25. How often do you usually eat beef? Please specify the type of beef most often eaten (ex: Rump steak): 26. On average, how often do you eat lamb? ( ) 2 to 3times per week Please specify the type of lamb most often eaten (ex: Loin chop): Please specify the type of duck/goose eaten most frequently and whether the skin in eaten. (ex: Duck breast, without skin)

5 5 27. On average, how often do you eat veal? Please specify the type of veal most often eaten (ex: Veal steak): 30. On average, how often do you eat ham (not deli/sandwich meat)? Please specify the number of slices of ham usually eaten on each occasion: 28. On average, how often do you eat pork? (do not include ham or bacon) Please specify the type of pork most often eaten (ex: Pork chop): 29. On average, how often do you eat bacon? Please specify the number of slices of bacon usually eaten on each occasion: 31. On average, how often do you usually eat sliced deli meat (ex: luncheon meats or salami)? Please specify the type (ex: lean turkey breast), brand and the number of slices of sliced deli meat most often eaten: Type Brand # slices 32. On average, how often do you eat sausages? Please specify the type (ex: Beef, pork, turkey) and number of sausages usually eaten on each occasion: Type Number

6 6 33. On average, how often do you eat canned fish? (ex: canned tuna, salmon, sardines, etc.) Please specify up to 4 types of canned fish that you regularly eat, including the brand and the amount typically eaten. (ex: White tuna in water, Goldseal, ½ 120g tin) Type of Fish Brand Amount 34. On average, how often do you eat fresh or frozen fish? (Include fish meals at home, at a restaurant and take out). Please specify up to 4 types of fresh or frozen fish that you regularly eat and the amount typically eaten (Include the brand for frozen fish. If type of fish is unknown for restaurant fish please write restaurant fish ). (ex: Wild Atlantic Salmon, Highliner, 150g) Type of Fish Brand Amount 35. How often do you eat fresh, frozen or canned shellfish? (ex: shrimp, oysters, scallops, crab, calamari, lobster, etc). Please specify the type and amount of shellfish eaten on a typical occasion: Type of Shellfish Amount 36. Are there any other meat, poultry or fish products that you eat regularly? Please specify the type, amount and how often other meat or fish products are eaten Type Amount How often 37. Have you changed your diet in any significant way over the past year? ( ) Yes ( ) No If yes, please specify the changes: Thank you for completing this survey