Republic of the Philippines

BATANGAS STATE UNIVERSITY

ARASOF Nasugbu, Batangas

Dear Respondent:

Greetings! We are presently conducting a study entitled “The Effect of Proper Nutrition to the
Academic Performance as Perceived by Pantalan Senior High School Students SY 2019-2020” as a
requirement of the course BST 101 – Biostatistics. In this connection, we would like to request you to be
one of our respondents in our study. We hope you can help us by answering the instrument sincerely and
truthfully. Be assured that all information stated will be treated strictly with confidentiality. Thank you
very much for the time spent in answering this form.

The Researchers

Please fill out and check the needed information.

Personal Data

NAME (optional):______________________________________ AGE: _________

The Effect of Proper Nutrition to the Academic Performance as Perceived by Pantalan Senior High
School Students SY 2019-2020

Rate how much the following mechanisms help the teenagers to cope up with depression. Put a check
on the corresponding answers. (Markahan Kung ano ang epekto ng tamang nutrisyon sa pag aaral)

5 4 3 2 1
COPING MECHANISMS STRONGLY AGREE NEITHER DISAGREE STRONGLY
AGREE AGREE OR DISAGREE
DISAGREE

1 Having good nutrition can improve

students’ academic performance.
(Ang pag kakaroon ng magandang
nutrisyon ay nakakatulong upang
umangat ang isang estudyante sa
kanyang pag aaral)
2 Poor eating habits can leads to
learning delay (Ang kawalan ng
gana kumain ay nagiging epekto ng
huli sa pag intindi)
3 Students who does not have proper
nutrition can result to have emotional
imbalance that can develop to stress,
depression and anxiety (Ang estudyante
na walang tamang nutrisyon ay
maaaring maging sanhi ng stress,
depresyon at pagkabalisa)
4 Students who have proper nutrition
always on the top of the class (Ang
estudyanteng mayroong tamang
nutrisyon ay lagging nangunguna sa
klase)
5 Students with proper nutrition are good
in writing, speaking and communicating
(Ang Estudyanteng mayroong tamang
nutrisyon ay magaling sa pag susulat,
pag sasalita at pakikipag
komunikasyon)
6 Hungry and undernourished
students were not able to take
physical work and sporting
activities (Ang pag ka gutom at
kawalan ng sustansya ng
estudyante ay hindi maaring
makilahok sa pisikal na aktibidad)
7 Taking food rich in vitamins will
improve students memory (Ang
pag inom ng mga bitamina ay
makaka tulong upang mapabuti
ang memorya ng isang mag aaral)
8 Eating Nutritious foods make
student active and functional (Ang
pagkain ng masusustansyang pag
kain ay nakakatulong upang
maging aktibo ang isang
estudyante)
9 Students who are physically active
tend to have a better performance
in classroom (Ang estudyanteng sa
pisikal ay aktibo ay mas mabuti ang
pag ganap sa silid aralan)
10 Focusing on healty eating and physical
activity in schools can help reduce
barriers on learning (Ang pag tutuon sa
pagkain ng masustansyang pag kain ay
makakabawas sa pag hadlang sa pag
Sali sa pisikal na aktibidad)
Signature of the Respondent: