QUESTIONNAIRE

Research Study: Studying the impact of traditional food for health

Please give Tick mark as response

1. Name:

2. Specify your gender

Male Female

3. State your age group

Below 25 25-35 36-45 46-55 56 and above

4. What is your Occupation?

Student Housewife Govt Job Private job Own business

5. State your family income (per month)

Below Rs. 20,000 Rs.20, 001 - 30,000 Rs.30,001- 40,000

Rs.40,000 – 50, 000 Above 50, 000

6. Which area you reside?

Urban Semi urban Rural

7. How frequent are you doing exercises?

Daily Weekly Monthly Occasionally Not at all

8. If yes, specify the exercises you are doing.

Walking Jogging Yoga Warm up Exercises

9. Specify your body weight (Kgs)

Below 50 kgs 51-60kgs 61-70kgs 71-80kgs Above 80kgs

10. Specify your height in feet (Approximately.)

Below 5 inches 5-5.5 inches 5.6 – 6 inches Above 6 Inches

11. Do you have any health problem

Yes No

12. Specify the traditional food you consume

 Palaya sadam Neeragaram Porridge Millets foods Rice varieties

Snacks (Sesame, Groundnut etc)

13. How frequent do you consume traditional food?

Daily Weekly 15 days once Monthly once

Occasionally

14. What about your opinion about taste of traditional food compare to other foods.

Very Good Good Neutral Bad Very bad

15. Do you feel that traditional food grains are expensive relative to normal food grains?

Yes No

16. Specify your source of awareness about the traditional food importance for healthy life.

Ancient beliefs Family custom Relatives & friends

Through media (TV, internet, newspapers etc)

17. Do you face health related issues after consuming traditional food?

Always Often Rarely Sometimes Not at all

18. Are you feel satisfied with your fitness after consuming traditional food

Highly satisfied Satisfied Neutral Dissatisfied Highly dissatisfied

19. How frequently are you consuming junk food items?

Daily Weekly 15 days once Monthly once Occasionally

20. Specify the junk food items you consume

Pizza Noodles Burger Chat Items Snacks Others

21. Do you have any health related issue after consuming junk food

Always Often Rarely Sometimes Not at all