WAKE UP The Environment is Suffering and Our Health is Getting Worse

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Healthy life survey.

1. What do you have for your breakfast in the morning? *

I don't have breakfast

Bagels, pastries, eggs, olives, cheese, bread

Cereal

Other:

2. Do you have a snack until noon? *

Yes

Occasionally

3. How much bread do you consume per day?

I don't eat bread.

I eat less than half a loaf of bread

I eat more than a loaf of bread

4. Do you eat at night?

Yes

Often

Occasionally

5. Do you have the habit of snacking and eating junk food while watching TV or in front of the computer?

Yes

Occasionally

6. How much water do you drink per day?
*

I don't drink water.

Less then 1 liter

2-3 liters.

7.Do you drink fizzy drinks?
*

Yes

Occasionally

8. How is your relationship with fruits and vegetables?
*

I eat a few servings a day.

I eat whenever I can think of it.

I rarely consume it.

9. How many times do you consume fish per week?

I don't consume.

I often consume.

Occasionaly.

10. How many times a week do you consume red meat?

I don't consume.

I often consume.

Occasionaly.

11. Do you have sweet cravings during the day?

Yes

Occasionally

12. Do you do Sports-Exercise?
*

1 day a week.

2/3 days a week.

Almost every day.

13. Do you take regular walks after meals?

yes

Occasionally.

14. What do you do for a healthy life?

I do sports.

I eat healthy.

I go often to the doctor.

I take care of my mental health.

Nothing.

Required

15. How many hours do you sleep a day?
*

Less then 8 hours.

At least 8 hours.

12 hours or more.

I don't have a sleep pattern.

16. What time do you usually go to sleep every night?

Before 22:00.

23:00.

00:00 and after.

17.Do you act in accordance with healthy living rules?

Yes.

Occasionally.

18. How often do you go to the doctor for a check-up?

I go every 6 months.

when I get sick .

I don't go at all.

19. How is your perspective on life? Positive or negative?

I'm a positive person.

I'm a negative person.

Neutral.

20. Where do you get information about Health and Nutrition?
*

From my family.

From TV, newpaper, internet, magazines.

From school.

From my doctor.

Other:

Required

Thank you for your participation.

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