Diabetes Stepping Up To the plate

Situational obstacles to dietary adherence

Eating Behavior Patterns Questionnaire

(adapted from Schulundt DG, PhD. Vanderbilt University School of Medicine SODA Questionnaire)

Read each item and think if you agree or disagree that the item describes you and your eating
habits. Mark the box that best describes your level of agreement with each statement. If a
statement does not apply to you (for example a question asks about what you do at work you do
not have a job), then mark #3 (neutral or N/A) box.

1 Strongly disagree
2 Disagree
3 Neutral or N/A
4 Agree
5 Strongly agree

1 Strongly disagree; 2 disagree; 3 neutral or N/A; 4 agree; 5 strongly agree

1. I stop for a fast food breakfast on the way to work.
1 2 3 4 5
2. My emotions affect what and how much I eat.
1 2 3 4 5
3. I use low-fat food products
1 2 3 4 5
4. I carefully watch the portion sizes of my foods.
1 2 3 4 5
5. I buy snacks from vending machines.
1 2 3 4 5
6. I choose healthy foods to prevent heart disease.
1 2 3 4 5
7. I eat meatless meals from time to time because I think that is
healthier for me. 1 2 3 4 5
8. I take time to plan meals for the coming week.
1 2 3 4 5
9. When I buy snack foods, I eat until I have finished the whole
package. 1 2 3 4 5
10. I eat for comfort.
1 2 3 4 5
11. I am a snacker.
1 2 3 4 5
12. I count fat grams
1 2 3 4 5

Utah State University is an equal opportunity/affirmative action institution

 Williams DP, Christensen NK
Stepping Up to the Plate Handout
SODA - 2

1 Strongly disagree; 2 disagree; 3 neutral or N/A; 4 agree; 5 strongly agree

13. I eat cookies, candy bars, or ice cream in place of dinner.
1 2 3 4 5
14. When I dont plan meals, I eat fast food.
1 2 3 4 5
15. I eat when I am upset.
1 2 3 4 5
16. I buy meat every time I go to the grocery store.
1 2 3 4 5
17. I snack more at night.
1 2 3 4 5
18. I rarely eat breakfast.
1 2 3 4 5
19. I try to limit the intake of red meat (beef).
1 2 3 4 5
20. When I am in a bad mood, I eat whatever I feel like eating.
1 2 3 4 5
21. I never know what I am going to eat for supper when I get up
in the morning. 1 2 3 4 5
22. I snack two to three times a day.
1 2 3 4 5
23. Fish and poultry are the only meats I eat.
1 2 3 4 5
24. When I am upset, I tend to stop eating.
1 2 3 4 5
25. I like to eat vegetables seasoned with fatty meat.
1 2 3 4 5
26. If I eat a larger than usual lunch, I will skip supper.
1 2 3 4 5
27. I take a shopping list to the grocery store.
1 2 3 4 5
28. If I am bored, I will snack more
1 2 3 4 5
29. I eat at church socials.
1 2 3 4 5
30. I am very conscious of how much fat is in the food I eat.
1 2 3 4 5
31. I usually keep cookies in the house.
1 2 3 4 5
32. I have a serving of meat at every meal.
1 2 3 4 5
33. I associate success with food.
1 2 3 4 5

Utah State University is an affirmative action/equal opportunity institution

 Williams DP, Christensen NK
Stepping Up to the Plate Handout
SODA - 3

1 Strongly disagree; 2 disagree; 3 neutral or N/A; 4 agree; 5 strongly agree

34.A complete meal includes a meat, a starch, a vegetable, and
bread. 1 2 3 4 5
35. On Sunday, I eat a large meal with my family.
1 2 3 4 5
36. Instead of planning meals, I will replace supper with a snack.
1 2 3 4 5
37. If I eat a larger than usual lunch, I will replace supper with a
snack 1 2 3 4 5
38. If I am busy, I will eat a snack instead of lunch.
1 2 3 4 5
39. Sometimes I eat dessert more than once a day.
1 2 3 4 5
40. I reduce fat in recipes by substituting ingredients and cutting
portions. 1 2 3 4 5
41. I have a sweet tooth.
1 2 3 4 5
42. I sometimes snack even when I am not hungry.
1 2 3 4 5
43. I eat out because it is more convenient than eating at home.
1 2 3 4 5
44. I hate to cook.
1 2 3 4 5
45. I would rather buy take out food and bring it home than cook.
1 2 3 4 5
46. I have at least three to four servings of vegetables per day.
1 2 3 4 5
47. To me, cookies are an ideal snack food.
1 2 3 4 5
48. My eating habits are very routine.
1 2 3 4 5
49. If I do not feel hungry, I will skip a meal even if it is time to
eat. 1 2 3 4 5
50. When choosing fast food, I pick a place that offers healthy
foods. 1 2 3 4 5
51. I eat at a fast food restaurant at least three times a week.
1 2 3 4 5

Utah State University is an affirmative action/equal opportunity institution

 Williams DP, Christensen NK
Stepping Up to the Plate Handout
SODA - 4

Scoring Questionnaire. Go through the questionnaire you just completed. Write down the
score of 1-5 that you chose with the associated number. For example, if you chose 4-agree for
#3, write down 4 next to the number 3 under Low-fat Eating. Total the scores of each section and
divide it by the total number of questions included in that section. If your average is 4 or 5 you
have characteristics of that eating behavior.

Low-fat Eating (11 total questions)

3._____ 12.____ 40.____
4._____ 19.____ 46.____
6._____ 23.____ 50.____
7._____ 30.____
TOTAL: ______ AVERAGE: ______

Snacking and Convenience (10 total questions)

11._____ 31._____ 44._____
13._____ 41._____ 45._____
14._____ 42._____ 47._____
22._____ 43._____
TOTAL: _____ AVERAGE:_____

Emotional Eating (8 total questions)

2.______ 15._____ 28._____
9.______ 17._____ 33._____
10._____ 20._____
TOTAL: _____ AVERAGE:_____

Planning Ahead (6 total questions)

8.______ 27._____ 48._____
21._____ 45._____ 50._____
TOTAL:______ AVERAGE:_____

Meal Skipping (7 total questions)

18._____ 36._____ 49.____
24._____ 37._____
26._____ 38._____
TOTAL:_____ AVERAGE:_____

Cultural/Lifestyle Behaviors (9 total questions)

1.______ 25._____ 34._____
5.______ 29._____ 35._____
16._____ 32._____ 39._____
TOTAL:_____ AVERAGE:_____

Utah State University is an affirmative action/equal opportunity institution