Northwest Lipid Research Clinic Harborview Medical Center, Seattle WA University of Washington, Department of Medicine

Northwest Lipid Research Clinic, Univ. of Washington, Seattle

NWLRC Fat Intake Scale

Check the answer which best describes the way you have been eating over the past month.

1. How many ounces of meat, fish or poultry do you usually eat?^*

   ___ 1. I do not eat meat, fish or poultry.

   ___ 2. I eat 3 ounces or less per day.

   ___ 3. I eat 4-6 ounces per day.

   ___ 4. I eat 7 or more ounces per day.

    

   ^*3 ounces of meat, fish or chicken is any ONE of the following: 1 regular hamburger, 1 chicken breast, 1 chicken leg (thigh and drumstick), 1 pork chop or 3 slices of pre-sliced lunch meat.

    

2. How much cheese do you eat per week?

   ___ 1. I do not eat cheese.

   ___ 2. I eat whole milk cheese less than once a week and/or use only low fat cheese such as diet cheese, low fat cottage cheese, or ricotta.

   ___ 3. I eat whole milk cheese once or twice per week (such as cheddar, swiss, monterey jack).

   ___ I eat whole milk cheese three or more times per week.

    

3. What type of milk do you use?

   ___ 1. I use only skim or 1% milk, or don't use milk.

   ___ 2. I usually use skim milk or 1% milk, but use others occasionally.

   ___ 3. I usually use 2% or whole milk.

    

4. How many visible egg yolks do you use per week?

   ___ 1. I avoid all egg yolks or use less than one per week and/or use only egg substitute.

   ___ 2. I eat 1-2 egg yolks per week.

   ___ 3. I eat 3 or more egg yolks per week.

    

5. How often do you eat these meats: regular hamburger, bologna, salami, hot dogs, corned beef, spareribs, sausage, bacon, braunsweiger, or liver? Do not count others.

   ___ 1. I do not eat any of these meats.

   ___ 2. I eat them about once per week or less.

   ___ 3. I eat them about 2 to 4 times per week.

   ___ 4. I eat more than 4 servings per week.

    

6. How many commercial baked goods and how much regular ice cream do you usually eat? (Examples: cake, cookies, coffee cake, sweet rolls, donuts, etc. Do not count low fat versions.)

   ___ 1. I do not eat commercial baked goods and ice cream.

   ___ 2. I eat commercial baked goods or ice cream once per week or less.

   ___ 3. I eat commercial baked goods or ice cream 2 to 4 times per week.

   ___ 4. I eat commercial baked goods or ice cream more than 4 times per week.

    

7. What is the main type of fat you cook with?

   ___ 1. I use nonstick spray or I do not use fat in cooking.

   ___ 2. I use a liquid oil (Examples: safflower, sunflower, corn, soybean, and olive oil.)

   ___ 3. I use margarine.

   ___ 4. I use butter, shortening, bacon drippings, or lard.

    

8. How often do you eat snack foods such as chips, fries or party crackers?

   ___ 1. I do not eat these snack foods.

   ___ 2. I eat one serving of these snacks per week.

   ___ 3. I eat these snacks 2 to 4 times per week.

   ___ 4. I eat these snack foods more than four times per week.

    

9. What spread do you usually use on bread, vegetables, etc?

   ___ 1. I do not use any spread.

   ___ 2. I use diet or light margarine.

   ___ 3. I use margarine.

   ___ 4. I use butter.

    

10. How often do you eat as a snack candy bars, chocolate, or nuts?

    ___ 1. Less than once per week.

    ___ 2. One to 3 times per week.

    ___ 3. More than 3 times per week.

     

11. When you use recipes or convenience foods, how often are they low fat?

    ___ 1. Almost always.

    ___ 2. Usually.

    ___ 3. Sometimes.

    ___ 4. Seldom or never.

     

12. When you eat away from home, how often do you choose low fat foods?

    ___ 1. Almost always.

    ___ 2. Usually.

    ___ 3. Sometimes.

    ___ 4. Seldom or never.

To Score: Add the points for each answer. If you have 24 or less, your diet is moderate to low in fat and cholesterol. If your score is greater than 24, look for high fat choices you could change.

You have permission to copy, use, and modify this questionnaire. Please credit the Northwest Lipid Research Clinic, University of Washington, Seattle. For information about validity and scoring see Retzlaff, et al, American Journal of Public Health, February 1997.

Northwest Lipid Research Clinic
University of Washington
325 Ninth Avenue, Box 359720
Seattle, WA 98104
Tele 206/341-4404; e-mail retz@u.washington.edu