Regular
Food Habits

Q1.
Do you ... (please tick a response
for each item)
Body
satisfaction, mood and social influences

Q2.
Please answer each of the following
questions ...
Other
Food Habits 
Q3.
How often do you ... (Please tick
a response for each item)
Demographics

Q4.
Gender
Male
Female
Q5.
Age group
4-7 years
8-11 years
12-15 years
16-18 years
19-24 years
25-44 years
45-64 years
65 years and over
Q6.
Weight
kg or
lbs
Q7.
Height
cm or
ft
in
Q8.
Country of residence
Q9.
Postcode (Australia only)
Have
you completed this survey before?
Yes
No
References

O'Dea,
J., Food habits, body image
and self esteem of adolescent girls
from disadvantaged and non-disadvantaged
backgrounds, Aust J Nutr Diet.,
1994; 51: 74-78
O'Dea,
J., Abraham., S., Heard, R., Food
habits, body image and weight control
practices of young male and female
adolescents, Aust J Nutr Diet.,
1996; 53:32-38
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