My Nutrition Challenge
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1.
First Name
(Required.)
*
2.
Last Name
(Required.)
*
3.
Employee ID Number
(Required.)
*
4.
Email (Texas Children's email preferred)
(Required.)
5.
How many servings of fruit do you currently consume per day?
(1 serving = approx. 1 cup)
None
1 serving
2 servings
3 servings
4 servings
5+ servings
6.
How many servings of vegetables do you currently consume per day?
(1 serving = approx. 1 cup)
None
1 serving
2 servings
3 servings
4 servings
5+ servings
7.
How many servings of animal and/or plant based protein do you currently consume per day? (1 serving = approx. palm of hand) Examples include chicken, turkey, fish, eggs, greek yogurt, beans, tofu, etc.
None
1 serving
2 servings
3 servings
4 servings
5+ servings
8.
How many servings of fat do you normally consume per day (1 serving = 2 tbsp.) Examples include olive oil, avocado, nuts, seeds, etc.
None
1 serving
2 servings
3 servings
4 servings
5+ servings
9.
How many servings of carbohydrates do you normally consume per day (1 serving = 1/2 cup)? Examples include oats, rice, pasta, potatoes, etc.
None
1 serving
2 servings
3 servings
4 servings
5+ servings
10.
How many glasses of water do you consume each day?
1-2
2-3
3-4
4-5
5-6
6-7
7-8
More than 8
11.
How often do you grocery shop?
Weekly
2x per month
1x per month
Other
12.
How often do you cook for yourself or your family?
Daily
4x per week
2x per week
1x per week
Weekly meal preparation
Other
13.
What are your goals for the My Nutrition Challenge?
Improve overall eating habits
Nutrition education
Incorporate cooking and/or meal preparation into weekly routine
Better quality of life
Improvement in energy levels
Decrease sugar and processed food intake
Weight loss and body composition improvements
Other (please specify)
Current Progress,
0 of 13 answered