Microsoft Word 4hr chi english App D. doc

today? I’d like you to try to remember anything else you ate or drank yesterday, that you haven’t

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Appendix D DAY ONE INTAKE en
FFQ Havard

today?
I’d like you to try to remember anything else you ate or drank yesterday, that you haven’t
already told me about, including anything you ate or drank while preparing a meal or
while waiting to eat.
[When respondent says no, or when respondent stops, show hand card 1]
Did you eat these foods?
[If yes, ask for the details; If no, continue on step 8]

Morning
Afternoon
Evening
Night/early dawn
Repeat 7b and 7c for each occasion except last occasion.
For last occasion, go to 7d
6 am yesterday 12 noon 6 pm
Midnight 6 am this morning
Food intake yesterday

Appendix D
24-hour Dietary Intake Questionnaire
4
Individual Intake Form
Quick List of
Food Items
Column 1
Column 2
Column 3
Column 4
Coder use only
A.
Time
B.
Occa-
sion
A.
Food/Drink and
Additions
B.
Description of Food/Drink and
ingredient
How much of this
(FOOD) did you
actually (eat/drink)?
Where did
you obtain
the (FOOD)?
Food code
Amount
Occasion:
1. Breakfast
2. Brunch
3. Lunch
4. Dinner
5. Late night meal
6. Fruit
7. Food and/or beverage break, snack, alcohol beverage or other beverage
8. Other (specify):_________________________
Source of food:
1. Homemade
2. Restaurant/cafeteria/fast food shop/deli 3. Food stall/hawker 4. Supermarket/Food store
5. Workplace tuck shop
6. Day care
7. Friend/relative’s home
8. Party/BBQ/banquet/special event
9. Other (specify):________

Appendix D
24-hour Dietary Intake Questionnaire
5

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