Worksheet:Healthy Eating Check$-$Up $/5($adapted from Canadian Cancer Society$)$ Instructions: Tick off$/$highlight$/$BOLD the one answer to each question that fits you best. Mark your score for each question in the Your Score column. Your Score$1.$ Do you eat pretty much the same foods each week? $-$Yes $0-$Mostly $1-$No$,$ lots of variety $32.$ How often do you eat legumes? $-$Never $0-$Once in a while $1-$Once a week $2-$At least twice a week $33.$ How many servings of fruits and vegetables do you eat each day? $-1-20-3-41-5$ or more $34.$ How many servings of whole grains do you eat each day? $-1-20-3-51-$more than $555.$ Do you eat whole grain foods rather than white $/$refined cereals? $-$never $0-$occasionally $1-$most of the time $36.$ Do you always put butter or margarine on bread? $-$yes $0-$yes, but lightly $1-$never $37.$ What type of milk do you drink? $-$skim or $1\%$ or soy $3-2\%2-$whole $1-$no fluid milk, but eat cheese $18.$ Do you have meat$/$fish$/$poultry at all meals? $-$yes $0-$most $1-$no$,$ enjoy meatless often $2-$no$,$ am vegetarian $29.$ How often do you eat fast food meals? $-$once a week $0-$more than once a week $0-$once every two weeks $1-$rarely $310.$ How often do you eat a rich dessert?$($pie$,$ cake, ice cream, cookies$)-$every day $0-2-3$ times a week $1-$about once a week $2-$rarely, on special occasions $311.$ What kind of breakfast do you usually eat? $-$bacon, eggs, toast $1-$no breakfast, just coffee $0-$cereal, hot or cold $3-$toast$/$muffin$/$waffle$/$pancake with jam or syrup but no butter $2-$toast or muffin with low fat cheese or peanut butter $212.$ What are you most likely to snack on$?-$fruit, low fat cheese, crackers, low fat muffin, yogurt, milk, juice $3-$chips, cheesies, taco chips $0-$popcorn, pretzels $1-$cookies, cake, ice cream $0-$dont snack $313.$ How much caffeinated coffee and tea do you drink? $-$none $3-$less than $4$ cups$/$day $2-$ more than $4$ cups$/$day $014.$ Do you salt food? $-$always $0-$usually $1-$occasionally $2-$never $315.$ How many alcoholic drinks do you have in a day? $-1-2$ drinks $1-$more than $2$ drinks $0-$dont drink every day $2$ TOTAL SCORE