WA State Community Nutrition Education Project

Sources of Questions for Surveys

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Nutrition Screening Initiative

The Nutrition Screening Initiative is an initiative of the American Dietetic Association, the American Academy of Family Physicians, and the National Council on Aging, used to determine nutritional risk.

Nutrition Screening Questions from the Determine Your Nutritional Health Checklist

I have an illness or condition that made me change the kind and/or amount of food I eat.

I eat fewer than 2 meals per day.

I eat few fruits or vegetables.

I eat or drink few milk products.

I have 3 or more drinks of beer, liquor or wine almost every day.

I have tooth or mouth problems that make it hard for me to eat.

I don't always have enough money to buy the food I need.

I eat alone most of the time.

I take 3 or more different prescribed or over-the-counter drugs a day.

Without wanting to, I have lost or gained 10 pounds in the last 6 months.

I am not always physically able to shop, cook, and/or feed myself.

BRFSS

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Last revised: 04/12/99

Comments: Donna Johnson (djohn@u.washington.edu)

http://depts.washington.edu/commnutr/assess/question-nsi.htm