European Journal of Clinical Nutrition (2003) 57, 753–763

& 2003 Nature Publishing Group All rights reserved 0954-3007/03 $25.00
www.nature.com/ejcn

ORIGINAL COMMUNICATION
Reliability of a dietary questionnaire on food habits,
eating behaviour and nutritional knowledge of
adolescents
G Turconi1*, M Celsa1, C Rezzani2, G Biino2, MA Sartirana1 and C Roggi1

1
Department of Applied Health Sciences – Section of Human Nutrition, University of Pavia, Italy; and 2Department of Applied Health
Sciences – Section of Statistics, University of Pavia, Italy

Objective: To develop a dietary questionnaire on food habits, eating behaviour and nutrition knowledge of adolescents and to
examine its reliability.
Design: A cross-sectional baseline survey. The questionnaire was self-administered to study participants twice with 7 days
between each administration.
Setting: A school community in Pavia, Italy.
Subjects: A group of students (n ¼ 72, aged 14–17 y, both sexes) studying in a secondary school in the second year of the course
were invited to compile a dietary questionnaire during school time. Informed written consent was obtained from each subject
and their parents. Subjects were initially recruited for a nutrition intervention; recruitment was opportunistic and school based.
Statistical analyses: Reliability was assessed using the Cronbach’s alpha and the Pearson correlation coefficients.
Results: Cronbach’s alpha ranges from a minimum of 0.55 to a maximum of 0.75, indicating that only two sections have a poor
internal consistency. The Pearson correlation coefficients range from a minimum of 0.78 to a maximum of 0.88, indicating a
very good temporal stability of the questionnaire. All the Pearson correlation coefficients are statistically significant with Po0.01.
Conclusions: The present questionnaire has the potential to measure the effects of nutrition interventions on adolescents
because of its stability in making comparisons over time. The instruments is low in cost and easy to administer and analyse;
moreover, it could be modified appropriately to fit the needs of other populations as well.
European Journal of Clinical Nutrition (2003) 57, 753–763. doi:10.1038/sj.ejcn.1601607

Keywords: dietary questionnaire; food habits; eating behaviour; reliability; adolescents

Introduction
Collecting epidemiological dietary data represents an
indirect although fundamental tool in nutritional surveil-
lance of population. The link between unhealthy diet,
sedentary lifestyle and chronic-degenerative diseases such
as cardiovascular disorders, diabetes and cancer is increas-
ingly well documented (Keys, 1986; WHO, 1990; Ulbricht &
Southgate, 1991; Muller et al, 1999; Liu et al, 2001).
Moreover, the relation between healthy food habits, ade-
*Correspondence: G Turconi, Department of Applied Health
Science-Section of Human Nutrition, University of Pavia,
Via Bassi, 21, I-2700 Pavia, Italy.
Guarantors: G Turconi and M Celsa.
Contributors: G Turconi and M Celsa: project of the study and
development of the questionnaire. G Biino and C Rezzani: study of
validity and reliability. MA Sartirana: collaboration in development
of the questionnaire and administration of it. C Roggi: supervisor.
quate lifestyle and nutrition and health education has been
recognized in improving good health (Gracey et al, 1996;
Povey et al, 1998; Sorensen et al, 1998; Larkey et al, 1999;
Anesbury et al, 2000). Planning an incisive nutrition
intervention on a given sample of population requires
identification of its nutritional problems and primary needs.
Traditional dietary assessment method measure both short-
term dietary intake, such as 24-h recall and food records, and
long-term dietary intake, such as food frequency question-
naires and dietary histories (Bingham, 1987, 1995).
Although largely used in the last 50–60 y (Bingham, 1995),
these methods present some characteristics that limit their
use in dietary survey (Kristall et al, 1990; Bingham, 1995;
Birkett & Boulet, 1995; Yaroch et al, 2000); most of them are
not always appropriate because of cost, response burden, bias
and need of highly trained staff for administration (Yaroch
et al, 2000).
 Reliability of a dietary questionnaire
G Turconi et al
754
The methods in nutritional epidemiological survey most
commonly used in the last years are the semi-quantitative
food frequency questionnaires. In fact, they are brief,
inexpensive, easy to administer and less burdensome when
compared with the other traditional methods for assessing
dietary intake (Yaroch et al, 2000).
Nevertheless, the above-mentioned questionnaires are
designed to measure dietary intake of energy and nutrients
and do not investigate other aspects of nutrition, such as
food habits and eating behaviour, both relating to nutrition
itself and food safety. All these aspects are very important in
a nutritional surveillance programme.
In the last 10 years, other questionnaires have been
developed aimed at investigating some of the above-men-
tioned aspects and structured with scores and scale scores
(Kristall et al, 1990; Falconer et al, 1993; Williams et al, 1993;
Greene et al, 1994; Birkett & Boulet, 1995; Vandongen et al,
1995; Johansson et al, 1997; Sapp & Jensen, 1997; Par-
menter & Wardle, 1999; Hu et al, 1999; Yaroch et al, 2000). It
is well documented that each questionnaire must be tested
in order to measure reliability prior to use in large-scale
studies.
Reliability is the scale ability of measuring something in
reproducible fashion. An instrument is reliable if individual
measurements taken on different occasions, or made by
different observers, or by parallel tests, produce the same
result. Reliability is usually quoted as a ratio of the variability
between individuals to the total variability in the scores; in
other words, reliability is a measure of the proportion of the
variability in scores caused by the differences between
individuals. Reliability is commonly expressed as a number
between 0 and 1, with 0 indicating no reliability and 1
indicating perfect reliability.
There are two main approaches to reliability measures:
internal consistency, which represents the extent to which
the scale items are highly intercorrelated, and temporal
stability (test–retest reliability); a measure is considered
reliable if it gives the same result over and over again,
assuming that what we are measuring is not changing. In
test–retest reliability, the questionnaire is administered to
the study participants on two occasions and the scores are
correlated to yield a coefficient of stability.
The last nutrition questionnaires cited above have limita-
tions because they cover only a limited area of nutrition
knowledge (Towler & Shepherd, 1990; Steenhuis et al, 1996;
Resnicow et al, 1997) or were not subjected to rigorous
validation (Andersson et al, 1988) or were designed for use
with adults and might not be suitable for use with an
adolescent sample (Resnicow et al, 1997; Sapp & Jensen,
1997). Construct validity in McDougall’s questionnaires
(1998) had not been assessed and the test–retest reliability
had been measured administering the questionnaire on two
different occasions separated by just 1 day; therefore,
although reliability was found to be high it is not possible
to know whether the measure would be stable over a longer
period of time.
European Journal of Clinical Nutrition
Individual character and personality are decisively formed
during adolescence. Young people begin to assume respon-
sibility for their own food habits, health-related attitudes
and behaviours (Coates et al, 1982), and their growing
independence is often associated with unconventional
eating patterns (Truswell & Darton-Hill, 1981). Although
eating behaviour during adolescence may be transitory in
some individuals, health behaviour shows tracking through
adolescence (Kelder et al, 1994). If habits acquired in
adolescence persist into adult life, behaviour developed in
young people may have important long-term consequences
on health.
Therefore, knowledge about food habits and eating
behaviour of adolescents turns out to be very important for
planning educational nutrition programme in the promo-
tion of good health and well-being in adult life.
The aim of the present study is to develop dietary
questionnaire on food habits, eating behaviour, lifestyle,
food safety and nutritional knowledge for adolescents and to
test its reliability.
Methods
Questionnaire
In order to make sure that the selected items are representa-
tive of all topics being measured, some items were taken
from existing questionnaires while others were obtained
from the literature (Gracey et al, 1996; Povey et al, 1998).
Using pool of 127 items generated by a group of expert
nutritionists, one review was carried out by a panel of five
dieticians to select the best in terms of clarity of the
questions and interpretability. This process reduced the
number of items to 99. A total of 10 students aged 14–17 y
were then invited to complete the questionnaire to identify
ambiguity or lack of clarity in the items. The students were
then quizzed on their comprehension of the significance of
the items.
The questionnaire was self-administered and divided into
nine main sections. The first section (Section A) contained
information on personal data collected by means of seven
questions; the other sections contained 99 items overall
relating to various topics as shown below.
Section BFFrequency of Food Consumption: It contains 28
questions aimed at investigating daily frequency of con-
sumption of typical foods and beverages such as bread, pasta,
cereal products, fruit and vegetables, milk, tea, coffee and
weekly consumption of other foods such as meat and meat
products, fish, eggs, cheese, legumes, etc. Alcoholic drinks
had also been investigated.
Section CFFood Habits: It consists of 14 questions. This
section was designed to investigate the food habits of the
adolescents in particular related to breakfast contents,
number of meals a day, daily consumption of fruit and
vegetables as well as of both soft and alcoholic beverages.
In this section, some questions already investigated in
section B are asked again aimed at evaluating if numbers of

portions consumed by the students satisfy the ones recom-
mended.
Eight of the questions had the following response
categories: always, often, sometimes, never; the other six
have instead four response categories structured in different
ways.
The score assigned to each response rages from 1 to 4, with
the maximum score assigned to the healthiest one and the
minimum score to the least healthy one. The total score of
this section was 56.
Section DFPhysical Activity and Lifestyle: It contains six
questions aimed at investigating lifestyle and physical
activity levels. All responses are structured in different ways
according to each question, each score raging from 1 to 4,
with the maximum score assigned to the healthiest habit.
The total score of the present section was 24.
Section EFHealthy and Unhealthy Diet and Food: It consists
of five questions aimed at investigating the students’ beliefs
about healthy and unhealthy diet and food. Each question
had four different responses, with the score ranging from 1
to 4. The total score of the section was 20.
Section FFSelf-Efficacy: It contains eight questions with
three response categories: yes ¼ 3, no ¼ 1, I don’t know ¼ 2.
This section aimed at estimating how each student is able to
assume attitudes and behaviours that can improve his health
status related to nutrition. The total score was 24.
Section GFBarriers to Change: Consisting of nine questions
with two response categories: yes ¼ 1, no ¼ 2; the questions
aimed at investigating which difficulties, if present, the
student has in modifying his eating habits in order to
improve them. A score of 2 was assigned to the major barrier
towards change; in this way greater barriers to change were
related to higher scores. The total score of this section was
18.
Section HFNutrition Knowledge: It contains eleven ques-
tions, each with four response categories structured in
different ways. This section focused on a few nutritional
aspects, investigating the level of knowledge that the
students have in this area. The response categories are four
and the true response of each question received a score of 1
and 0 for the other response. The total score of this section
was 11.
Section IFFood Safety Knowledge: It contains ten questions,
each with four response categories structured in different
ways: this section focused on students’ knowledge level
regarding food safety. The score was 1 for the true response to
each question and 0 for the other response. The total score of
this section was 10.
Section JFFood Safety and Behaviour in Hygiene Practices: It
contains eight questions, seven of which present the
following response categories: always, often, sometimes,
never; the last one (J6) had four different responses
structured in different ways. This section aimed at investi-
gating each student’s behaviour in hygiene practices related
to food safety and its problems on health. The score ranging
from 1 to 4, with the maximum score assigned to the
Reliability of a dietary questionnaire
G Turconi et al
755
healthiest behaviour in hygiene practices. The total score of
this section was 32.
The questionnaire was self-administered at different times
twice over a 2-week period. Administration was performed
during school lesson times under the supervision of a
dietician and of the teacher who were always ready to
answer any of the students’ questions.
Subjects
The questionnaire was self-administered to a sample of
students studying in four sections of the second year in a
secondary school in Pavia, Italy. A total of 78 students were
invited to complete the questionnaire. Selected subjects were
initially recruited for a nutrition intervention. In all, 72
students completed the questionnaires during the first
administration; the 72 adolescents ranged in age form 14
to 17 y (mean7standard deviation [s.d.] ¼ 15.170.3 years),
59 females and 13 males. Of these 68 subjects completed the
questionnaire during the second administration 1 week later.
School selection and recruitment of the subjects were
opportunistic, based on the fact that the teachers, recently
involved in a nutrition education programme held in the
school, were interested in participating in the study. All the
students were informed of the study’s objectives. Informed
written consent was obtained from each subject and their
parents.
Statistical analyses
Reliability study is conducted following classical test theory
principles. As a measure of internal consistency Cronbach’s
alpha was computed, while we computed Pearson correla-
tion coefficient as a measure of temporal stability.
According to classical test theory, we computed Cronba-
ch’s alpha and Pearson correlation coefficient of each section
total score, with the exception of section B. Aim of section B
is to describe frequency of food consumption; this section is
not a scale in the very sense of the term and thus there is no
total score. Therefore, we cannot compute Cronbach’s alpha
and Pearson correlation coefficient of the total score, but we
evaluate temporal stability of each item of section B. The
Statistical Package for the Social Sciences (SPSS version 10,
2000) was used.
Results
Reliability
Table 1 reports the measures of internal consistency,
Cronbach’s alpha and the stability measures, Pearson
correlation coefficients for each of the eight sections
computed between the two administration total scores.
Cronbach’s alpha ranges from a minimum of 0.55 (section
G) to a maximum of 0.75 (section C), indicating that the
sections with a poor internal consistency are sections G, H
European Journal of Clinical Nutrition
 Reliability of a dietary questionnaire
G Turconi et al
756
Table 1 Internal and test–retest reliability (n=68) Table 2 Test-retest reliability for section B (n=68)

Sections Internal reliability Test–retest Items Test–retest

(Cronbach’s a) reliability a reliability a

CFFood habits 0.75 0.88 B1 0.87

DFPhysical activity and lifestyle 0.71 0.88 B2 0.90
EFHealthy and unhealthy diet 0.59 0.78 B3 0.86
and food B4 0.53
FFSelf-efficacy 0.73 0.81 B5 0.45
GFBarriers to change 0.55 0.79 B6 0.52
HFNutrition knowledge 0.56 0.80 B7 0.84
IFFood safety knowledge 0.57 0.80 B8 0.82
JFFood safety and behaviour 0.69 0.80 B9 0.73
in hygiene practices B10 0.57
B11 0.74
a B12 0.55
Pearson correlation coefficients computed between the two administration
B13 0.68
total scores=Po0.01.
B14 0.56
B15 0.59
B16 0.45
and I. Section E has Cronbach’s alpha equal to 0.59 B17 0.63
indicating a nearly sufficient score. B18 0.84
Pearson correlation was used to assess test–retest reliability B19 0.70
B20 0.69
on the scores of the 68 students who completed the B21 0.87
questionnaire twice. As shown in Table 1, the reliability for B22 0.79
each of the sections is very high: Pearson correlation B23 0.90
coefficients range from a minimum of 0.78 to a maximum B24 0.90
B25 0.83
of 0.88, indicating a very good temporal stability of the B26 0.83
questionnaire. All Pearson correlation coefficients are statis- B27 0.65
tically significant with Po0.01. B28 0.66
Table 2 reports Pearson correlation coefficients for items of
a
section B. Pearson correlation coefficients computed between the two administration
Po0.01.
Pearson correlation coefficients of section B items range
from a minimum of 0.45 to a maximum of 0.90, indicating a
good temporal stability of the section B items. All Pearson
correlation coefficients are statistically significant with explanation regarding section G, the total score resulted
Po0.01. skewed towards lowest scores, meaning that the major part
of our students responded in a similar way; this could be
Discussion partly because of the fact that our sample was quite
In studies such as nutrition education programmes aimed at homogeneous. Section E low Cronbach’s alpha could be
improving food habits and behaviour, the use of traditional explained by the scarce number of items forming the scale.
dietary assessment methods such as 24-h recalls, dietary In fact, it has been shown that Cronbach’s alpha increases
histories and dietary records is not suitable. Different with increasing items number (Hattie, 1985). Low Cronba-
nutritional questionnaires may be desirable in order to assess ch’s alpha in sections H and I could be explained by the
efficacy of the intervention. items variability; in other words, items of sections H and I
The objective of the present study was to assess reliability cover all the aspects of nutrition and food safety knowledge.
of a dietary questionnaire on food habits, eating behaviour Nutrition knowledge and food safety knowledge are very
and nutritional knowledge of adolescents. Evidence for complex constructs, and they are made of different domains;
reliability, measured as temporal stability, of the question- therefore, items of sections H and I are quite heterogeneous
naire was indicated by the good Pearson correlation and this may lead to a low Cronbach’s coefficient.
coefficients obtained for each section. For reliability in- As regards test–retest reliability of section B, the correla-
tended as internal consistency, the sections on food habits tion coefficients are all statistically significant but some
(C), physical activity and lifestyle (D), self-efficacy (F), and coefficients are lower than 0.50 indicating a moderate
food safety and behaviour in hygiene practices (J) showed a correlation (Table 2). These low coefficients are referred to
respectable reliability. Section E on healthy and unhealthy items about the consumption of several foods (item B5,
dietary habits and food had a nearly acceptable reliability, item B6); these items may result to be confusing for the
while section barriers to change (G), nutrition knowledge (H) reader and this fact may lower the correlation coefficients. In
and food safety knowledge (I) showed an unacceptable order to bypass this problem, it is possible to put up an item
reliability (Cronbach’s alpha o0.60) (DeVellis, 1991). An for each kind of food. We prefer to retain the current version

European Journal of Clinical Nutrition


of the questionnaire in order to avoid a too long and tedious
instrument. In our opinion, the low coefficient of item B12
can be explained by the fact that in our country there is a low
consumption of eggs; therefore, the reader can have some
difficulties in quantifying eggs consumption.
The results show that section G should be retested on a
larger number of students and it would be necessary to
include new items in section E to increase the reliability of
the section itself. Although the items are not homogenous in
sections H and I, reliability measured as temporal stability is
good for both sections.
We assessed internal consistency and temporal stability for
each section and not for specific items, because we aimed to
evaluate the reliability of each section total score. We do not
compute test–retest reliability for each item, although it is
possible, because we are interested in the use of each section
as whole (as a scale). Test–retest technique assumes that there
is no substantial change in construct being measured on
distinct occasions. The amount of time allowed between two
measurements is critical. We know that if we measure the
same thing twice, correlation between the two observations
will depend in part on how much time elapses between the
two measurement occasions. The shorter the time gap, the
higher the correlation; the longer the time gap, the lower the
correlation. Since this correlation is the test–retest estimate
of reliability, it is possible to obtain considerably different
estimates depending on the time interval taken.
In our opinion, the time interval (7 days) between the two
administrations is long enough to avoid recall bias and is
sufficiently short to avoid changes in the studied attributes.
The questionnaire covers food habits, physical activity and
lifestyle, healthy and unhealthy dietary habits and food, self-
efficacy, barriers to change, nutrition knowledge, food safety
knowledge, food safety and behaviour in hygiene practices.
These eight areas underlie the main aspects related to dietary
behaviour of the adolescents and the possibility to improve
it. This questionnaire provides a more exhaustive tool for the
assessment of dietary behaviour than traditional dietary
questionnaires such as 24-h recall, dietary histories and
dietary records that measure only dietary intake.
Considering the possible future use of the questionnaire to
assess the impact of a nutrition education programme and
the especially relevant instrument stability when using
measurements to make comparisons over time, it may be
important to focus on the significantly good Pearson
correlation coefficient results. These high correlation coeffi-
cients would warrant that the observed differences in two
sequential administrations will not be because of temporal
instrument instability.
Conclusion
The traditional dietary assessment methods typically use to
measure dietary intake are not always appropriate to obtain
information on eating behaviours and to assess the impact of
Reliability of a dietary questionnaire
G Turconi et al
757
a nutrition education programme. We believe that the
present questionnaire (see Appendix 1) can measure the
effects of nutrition interventions on adolescents given its
stability in making comparisons over time. The instrument
has low costs and is easy to administer and analyse.
Moreover, it could be modified appropriately to fit the needs
of other populations as well.
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Steenhuis IHM, Brug J, Van Assema P & Imbos TJ (1996): The eat pasta/rice/bread/potatoes & 3–4
validation of a test to measure knowledge about the fat content of during 1 week? & more than 4
food products. Nutr. Health 10, 331–339. & 1 time in 10–15 days
Towler G & Shephard R (1990): Development of a nutritional
knowledge questionnaire. J. Hum. Nutr. Diet. 3, 255–264. & never
Truswell AS & Darnton-Hill I (1981): Food habits of adolescents. Nutr. B7. Do you eat fruit and vegetable & yes
Rev. 39, 73–88. every day? & no
Ulbricht TL & Southgate DA (1991): Coronary heart disease: seven B8. If yes, how many portions & 1–2
dietary factors. Lancet 338, 985–992.
Vandongen R, Jenner DA, Thompson C, Taggart AC, Spickett EE,
(200 g) of fruit and vegetables & 3–4
Burke V, Beilin LJ, Milligan RA & Dunbar DL (1995): A controlled do you eat every day? & more than 4
evaluation of a fitness and nutrition intervention program on B9. If no, how many times do you & 1–2
cardiovascular health in 10- to 12-years-old children. Prevent. Med. eat fruit and vegetables during & 3–4
24, 9–22. 1 week? & more than 4
WHO (1990): Diet, Nutrition and the Prevention of Chronic Diseases.
& 1 time in 10–15 days
WHO Technical Report Series 797, Geneva: WHO.
& never

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B10. How many times do you eat & 1–2 B21. Do you drink wine? & yes
meat in 1 week? & 3–4 & no
& 1 time every day B22. If yes, how many times do you & 1–2
& 2 times every day drink wine in 1 week? & 3–4
& 1 time in 10–15 days & 1 time in 10–15 days
& never & every day
B11. How many times do you eat & 1–2 B23. Do you drink beer? & yes
fish in 1 week? & 3–4 & no
& more than 4 B24. If yes, how many times do you & 1–2
& 1 time in 10–15 days drink beer in 1 week? & 3–4
& never & 1 time in 10–15 days
B12. How many times do you eat & 1–2 & every day
eggs in 1 week? & 3–4 B25. Do you drink aperitifs and & yes
& more than 4 alcoholic drinks? & no
& 1 time in 10–15 days B26. If yes, how many times do you & 1–2
& never drink aperitifs and alcoholic & 3–4
B13. How many times do you eat & 1–2 drinks in 1 week? & 1 time in 10–15 days
cheese in 1 week? & 3–4 & every day
& more than 4 B27. Do you drink whisky, gin, & yes
& 1 time in 10–15 days cognac and vodka? & no
& never B28. If yes, how many times do you & 1–2
B14. How many times do you eat & 1–2 drink whisky, gin, cognac and & 3–4
ham, salami and sausages in 1 & 3–4 vodka in 1 week? & 1 time in 10–15 days
week? & more than 4 & every day
& 1 time in 10–15 days
& never
B15. How many times do you eat & 1–2 Section C. Food Habits
legumes in 1 week? & 3–4
& more than 4 C1. Do you eat breakfast? & always
& 1 time in 10–15 days & often
& never & sometimes
B16. How many times do you eat & 1–2 & never
sweets and cakes in 1 week? & 3–4 C2. Which beverage do you & milk/milk and
& 1 time every day consume at breakfast? coffee/cappuccino/
& more than 1 time yogurt
daily & fruit juice
& 1 time in 10–15 days & tea/coffee
& never & chocolate
B17. How many times do you eat & 1–2 C3. At breakfast you eat: & biscuits/cakes/
fried potatoes in 1 week? & 3–4 crackers/breakfast
& 1 time every day cereals/bread
& 2 times every day & fruit
& 1 time in 10–15 days & sausages and cheese
& never & pizza/focaccia/toast
B18. How times do you eat in a & 1–2 C4. Do you eat at least 2 portions & always
fast-food in 1 week? & more than 2 times (200 g) of fruit every day? & often
& 1 time in 10–15 days & sometimes
& never & never
B19. How many times do you eat in & 1–2 C5. Do you eat at least 2 portions & always
a pizzeria in 1 week? & more than 2 times (200 g) of vegetables every & often
& 1 time in 10–15 days day? & sometimes
& never & never
B20. How many times do you drink & 1–2 C6. Do you usually eat a cake or & always
in a pub in 1 week & more than 2 times a dessert at meals? & often
& 1 time in 10–15 days & sometimes
& never & never

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C7. Do you usually drink wine or & always D3. What do you prefer to do & walking
beer at meals? & often during free time? & watching TV/listening
& sometimes to music/using the
& never computer/reading a
C8. Do you usually eat breakfast, & always book
lunch and dinner every day? & often & practicing a sport
& sometimes & shopping
& never D4. How many hours do you & 1–2 h a day
C9. Your diet: spend on the computer or & 3–4 h a day
& is different every day watching TV? & 5–6 h a day
& is different only sometimes during a week & more than 6 h a day
& is different only during the weekend days D5. The physical activity that & are tiring
& is very monotonous you practice at school: & are boring
C10. Your diet is based mainly on: & stimulates you to
& high protein content foods (meat, fish, eggs, practice sports even out of
cheese, dried legumes) school
& high fat content foods (sausages, focacce, fried & make you feel well
potatoes, cakes with butter and cream) D6. Your lifestyle is: & very sedentary
& high carbohydrate content foods (bread, pasta, & sedentary
rice, potatoes, biscuits) & moderately active
& different foods every day & very active
C11. Your snacks are based mainly on:
& fruit/fruit juice/fruit and milk shakes/yogurt
& biscuits/crackers/bread/stick bread Section E. Healthy and Unhealthy Dietary Habits
& fried potatoes/pop corn/krapfen/peanuts/soft and Food
drinks E1. According to you, which is a healthy diet?
& sweets/chocolate/ice cream/cakes & a diet rich in different foods
C12. Which beverages do you usually drink & foods rich in protein (meat, fish, eggs, cheese,
between meals? dried legumes)
& mineral water & a diet without any fats
& soft drinks (cola, orange, soda, iced tea, tonic & eating fish very often
water, etc.) E2. According to you, which is the healthiest eating
& wine/beer behaviour?
& fruit/fruit juice/fruit and milk shakes & drinking two glasses of milk/eating two cups of
C13. Do you drink at least one glass & always yogurt every day
of milk or do you eat at least & often & preferring cooked vegetables to uncooked
one cup of yogurt every day? & sometimes vegetables
& never & eating always cheese instead of meat
C14. Do you drink at least 1–1.5 l of & always & when you eat snacks, preferring fruit/fruit juice/
mineral water every day? & often biscuits and crackers
& sometimes E3. According to you, which is a healthy food?
& never & a food rich in protein
& a food rich in calories
& a microbiologically tested food
& a food without preservatives and additives
Section D. Physical Activity and Lifestyle E4. According to you, which is the healthiest food?
& washed vegetables ready to eat
D1. Do you usually practice a & always during the entire & a canned food
physical activity? year & a food very rich in dressing
& only in some seasons & a fried food
& sometimes E5. According to you, which is the healthiest cooking
& never method?
D2. How many hours do you & 1–2 h in a week & cooking on a grill/in boiled water
practice it? & 3–4 h in a week & frying/braising
& more than 4 h in a week & cooking in the oven without fats
& no hour & cooking in a pan with fats

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Section F. Self-efficacy Section H. Nutrition Knowledge

F1. Do you think you are able to & yes H1. Which different foods & meat
choose anything by yourself? & no contain carbohydrates? & butter
& I don’t know & bread
F2. Do you think you are able to & yes & cheese
use advice aimed at improving & no H2. Which different foods do & wholemeal bread
your well-being? & I don’t know not contain dietary fibre? & beans
F3. Do you think you are able to & yes & white bread
modify your diet if needed? & no & meat
& I don’t know H3. Which different foods are & hamburger with
F4. Do you think you are able to & yes less rich in fat? mayonnaise
loose or to gain weight if & no
& grilled meat
needed? & I don’t know
& focaccia
F5. Do you think you are able to & yes
& sandwich with
use nutrition advice aimed at & no
salami
improving your dietary & I don’t know
H4. Which different foods are & dry legumes
habits?
richer in protein? & dover sole
F6. Do you think you are able to & yes
& no & spaghetti with
use nutrition advice aimed at
& I don’t know tomato sauce
improving your health status?
F7. Do you think you are able to & yes & apple
practice a constant physical & no H5. Which different foods are & bread
richer in calories? & potatoes
activity in order to improve & I don’t know
& fruit salad
your well-being?
F8. Do you think you are able to & yes & tiramisú
practice a constant physical & no H6. Which different substances & protein
activity in order to improve & I don’t know contain more energy? & carbohydrates
your physical aspect? & fat
& alcohol
H7. What are the functions of
vitamins and minerals?
Section G. Barriers to Change & to put on muscular tissue
& to lose body fat
G1. Do you have some influence on & yes & to catalyse biochemical
cooking food at home? & no reactions in the body
G2. Do you know which foods must be & yes & to provide energy
restricted to reduce dietary intake & no H8. According to you, what is ‘a
of fats and cholesterol? balanced diet’?
G3. Do you know which foods must be & yes & a diet rich in protein
restricted to reduce dietary intake of & no & a diet poor in fat
sugar? & a diet without
G4. Do you know which foods must be eaten & yes carbohydrates
to increase dietary intake of fibre? & no & a diet containing all
G5. Do you know which benefits you could & yes nutrients in proper quantities
gain by eating a healthy diet? & no H9. According to you, what is
G6. Do you know how to improve your diet? & yes ‘daily energy expenditure’?
& no & energy consumed in the
G7. Do you know how much you must eat & yes whole day
to satisfy your energy requirement? & no & energy consumed during
G8. Do you know how important it is not & yes sleep
to be influenced by your friends in & no & energy consumed only for
choosing your food? physical activity
G9. Do you think that your family would & yes & energy consumed for
support your efforts in improving your & no maintaining body
food habits? temperature at 371C
H10. What are ‘biological foods’?

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& foods grown without any
use of chemical fertilizer
& foods grown in greenhouse
& foods without additive and
preservatives
& foods grown in a ground far
from the highway
H11. What are ‘transgenic foods’?
& foods imported from
foreign countries
& foods in which different
fragments of DNA have been
included
& foods without potentially
pathogenus germs
& foods without toxic
substances
Section I. Knowledge on Food Safety
I.1. A food intoxication is:
& an infection caused by lack of
vitamins
& a disease caused by the
consumption of foods
contaminated by pathogenic
germs
& a disease caused by an excessive
consumption of food
& a disease caused by
assumption of a chemical toxin
I.2. Which of the following are caused
by food intoxication?
& vomit, diarrhoea, fever
& only vomit and diarrhoea
& it depends on the type of
causative germ
& fever, sore throat and cough
I.3. Which of the following are most
responsible for food intoxication?
& inadequate preservation
& contamination of food prior to
cooking
& manipulation of cooked food
immediately prior to consumption
& inadequate washing of plates
and silver ware
I.4. Which of the following foods are &
mostly implicated in the onset of &
food intoxication?
I.5. Which of the following behaviours
can cause cross-contamination of
foods?
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& use of the same utensils for
cooked and raw foods
& washing one’s hands after
having handling raw foods and
before handling cooked foods
& using different surfaces for
cooked and raw foods
& keeping cooked and raw foods
separated
I.6. How can you transmit Salmonella?
& by coughing on the food
& by touching foods without
having washed one’s hands
& by sneezing on the food
& by smoking while preparing the
food
I.7. Which is the optimum tempera-
ture for bacterial growth?
& from 01C to +41C
& from +41C to +601C
& beyond 601C
& under 51C
I.8. Do cold temperatures kill
pathogenic germs which may be
present in foods?
& rarely
& no, on the contrary it facilitates
growth
& no, it inhibits growth
& yes, always
I.9. Does heat kill germs? & yes, always
& no, never
& yes, above 401C
& yes, above 601C
I.10. Which of the following diseases & hepatitis A
can be transmitted by ingestion & AIDS
of contaminated foods? & pneumonia
& the flu
Section J. Food Safety and Behaviour in
Hygene Practices
J.1. When you buy packaged food, do & always
you check the expiry date? & often
& sometimes
& never
J.2. Do you read the instruction for & always
eggs and cream use and for preservation written & often
vegetables on the packaged foods? & sometimes
& frozen meat & never
& biscuits J.3. Do you wash your hands before & always
eating and before touching foods? & often
& sometimes
& never
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J.4. Do you usually wash fruit that & always J.7. If the butcher touches ham with & always
must not be peeled before & often his hands, do you eat it? & often
eating it? & sometimes & sometimes
& never & never
J.5. After drinking a glass of milk, do & always J.8. Do you eat canapé lying out for a & always
you usually put the milk in the & often long time at the bar? & often
fridge? & sometimes & sometimes
& never & never
J.6. If you realize you have left the
milk out of the fridge during the
night, what do you do?
& you throw it away
& you tell your mother to throw it
away
& you put it in the fridge again
& you drink it

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