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Welcome to Healthy U! Today you will be taking a multiple-choice survey on different health and science related topics, such as Nutrition, Physical Activity, Healthy Weight, and Sleep. Answer each question as best as you can!

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* 1. IMPORTANT: Please write your ENTRY ID NUMBER. (Your teacher will give you this number during class.)

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* 2. What school do you attend?

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* 3. At what time does the class period you are currently in start?

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Please answer the following questions as best as you can! Your responses will be kept confidential and will not be used to grade you.

Please answer the following questions as best as you can! Your responses will be kept confidential and will not be used to grade you.

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* 4. During the past 24 hours (yesterday), how many times did you ...



Drink milk or eat yogurt? (In any form, including in cereal.)

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* 5. Drink soda pop?

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* 6. Drink 100% fruit juices, such as orange, apple or grape? (Do not count punch, Kool-Aid, sports drinks, and fruit-flavored drinks.)

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* 7. Eat French fries, potato chips, or other fried potatoes?

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* 8. Eat fruit? (Do not count fruit juice.)

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* 9. Eat vegetables? (Include salads and non-fried potatoes.)

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* 10. During the past 7 days, how many days did you take a vitamin?

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* 11. On how many of the past 7 days did you...


Exercise or do a physical activity for at least 20 minutes that made you sweat and breathe hard? (For example, basketball, soccer, running, swimming laps, fast bicycling, fast dancing or similar aerobic activities.)

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* 12. Participate in a physical activity for at least 30 minutes that did not make you sweat and breathe hard? (For example, fast walking, slow bicycling, shooting baskets, skating, raking leaves, or mopping floors.)

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* 13. Do exercises to strengthen or tone your muscles? (For example, push-ups, sit-ups, or weight lifting.)

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* 14. During the past 12 months, on how many sports teams did you play? (Include school sponsored and any other sports teams.)

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* 15. In an average week, on how many days do you have physical activity in your physical education class (P.E. or gym)?

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* 16. During an average physical education (P.E.) class, how many minutes do you spend actually exercising or playing sports?

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* 17. Which of the following are you trying to do about your weight?

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* 18. During the past 30 days, did you do any of the following things to lose weight or to keep from gaining weight?


Exercise

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* 19. Eat less food, fewer calories, or foods low in fat

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* 20. Go without eating for 24 hours or more (also called fasting)

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* 21. Take any diet pills, powders, or liquids without a doctor's advice (Do not include meal replacement products, such as Slim Fast.)

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* 22. Vomit or take laxative

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* 23. How do you describe your weight?

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* 24. On an average school day, how many hours do you watch TV or play video games?

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* 25. During the past 30 days, for about how many days have you felt you did NOT get enough rest or sleep?

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* 26. Check if any of the following apply to you:

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* 27. During the past week, what is the average number of hours of sleep you got per night?

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* 28. In the past 7 days, how many times have you felt too grumpy, sick, or too tired to concentrate on school?

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