Dietary Questionnaire

Dec 20

Written By Pete Nastasi - NASM Certified Sports Nutrition Coach and Personal Trainer

Name

First Name

Last Name

What are some of your favorite foods, the ones you must have in your diet?

(Example: I need to eat chocolate, I eat ice cream every weekend, I can't live without tortilla chips, etc.)

Are there any foods that you refuse to add into your diet?

(Examples: I can't stand asparagus, I don't eat fish, I don't care for salad dressings, etc.)

What are you favorite sources of Carbohydrates?

(Examples: Pasta, Bread, Rice, Cereal, Oatmeal, Potatoes, etc.)

What are your favorite sources of Protein?

(Examples: Chicken, Fish, Beef, Tofu, Eggs, Beans, etc.)

List your favorite Fruits & Vegetables that you incorporate into your diet.

Do you have any dietary restrictions?

(Examples: Gluten Free, Vegan, Vegetarian, Diabetic, Lactose Intolerant, Food Allergies, etc.)

How often do you eat out during the week?

(Examples: I eat out 1-2x per week, usually during the weekend, I eat lunch out everyday at work.)

Do you have experience with meal preparation and planning?

(Examples: I usually prepare meals for lunch but cook breakfast and dinner daily.)

How often do you go grocery shopping throughout the week?

(Examples: I usually grocery shop two times per week on Wednesday and Sunday.)

Are you preparing food for just yourself, friends, or family?

(Examples: I prepare food for my family and I daily.)

Are you currently working out at all during the week?

(Examples: I workout 2-3x per week, usually going for a walk around the neighborhood.)

Is there anything else you would like me to know?

Any additional information?

Current Weight

Goal Weight

Pete Nastasi - NASM Certified Sports Nutrition Coach and Personal Trainer

Pete Nastasi, the owner of N2 Nutrition and Performance, is a NASM certified Sports Nutrition Coach and Personal Trainer. He has an undergraduate degree in biochemistry and is currently residing in Iron Station, North Carolina. Pete helps individual clients achieve their sports performance and weight-loss goals through a personalized approach centered around diet optimization and easy-to-follow workout routines.

https://nastasi-nutrition.com

Dietary Questionnaire

Usual Intake Questionnaire