CHINA ECONOMIC, POPULATION, NUTRITION, AND HEALTH SURVEY 2006 DIETARY QUESTIONNAIRE
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1 CHINA ECONOMIC, POPUATION, NUTRITION, AN HEATH URVEY 00 IETARY QUETIONNAIRE Province: iaoning Heilongjiang Jiangsu handong Henan GGT Hubei Hunan Guangxi Guizhou Urban ite: Rural ite: GT City: County: GT First city First county econd city econd county Third county Fourth county Neighborhood: Village (Town): GGT 0 First [urban] neighborhood 0 County town neighborhood 0 econd [urban] neighborhood 0 First village 0 Third suburban village (neighborhood) 0 econd village 0 Fourth suburban village (neighborhood) 0 Third village 0 Fifth [urban] neighborhood 0 County town neighborhood 0 ixth [urban] neighborhood 0 Fourth village 0 eventh suburban village (neighborhood) 0 Fifth village 0 Eighth suburban village (neighborhood) 0 ixth village 09 Ninth [urban] neighborhood 09 County town neighborhood 0 Tenth [urban] neighborhood 0 eventh village Eleventh suburban village (neighborhood) Eighth village Twelfth suburban village (neighborhood) Ninth village Household : Interview ate: Year Month ay GGGT GGGGGGGGT Completion Evaluation: Good OK Poor GCO Interviewer : : GGTc upervisor : : GGTd
2 Table. -ay Record of Household Food Consumption (gm) Household I: GG Province (T) G ite (T) G City/County (T) GG Neighborhood/Village (T) GGG Household (T) ay ay ay Total Food Code Food Initial on Hand iscarded iscarded 9 iscarded 0 iscarded Total Remaining Actual Consumption Consumption per Person per ay V Va Va Va Va Va Va Va V0a V0a Va Va Va [.] Remember to include oil and condiments (salt, sugar, sauces, etc.) in the table. Please record oil and condiments first. Formulas: 0. Total : V0a = Va + Va + Va. Total iscarded: V0a = Va + Va + Va. Actual Consumption = Initial on Hand + Total - Total iscarded - Total Remaining Va = Va + V0a - V0a - Va. Consumption per Person per ay = Actual Consumption / Total Household Person-ays Va = Va / item from Table
3 Table. -ay Record of Household s Per Person Per ay Household I: GG Province (T) G ite (T) G City/County (T) GG Neighborhood/Village (T) GGG Household (T) ine Age (years) ex Activity evel A V V V9 V0 V0 Ate At Home? ay ay ay Total V0 9 V09 0 V V V V9 V V V V9 V 9 V 0 V V9 Typical Proportions of Person- ays V V V V Codes:. Use -9 through -99 as line numbers for guests -. Ate meal at home?. ex: 0 ate meal away from home male ate meal at home Total female - meal not eaten at all Household. Activity level: Person-ays very light physical activity (working in a sitting position, e.g., office worker, watch repairer, etc.) breakfast light physical activity (working in standing position, e.g., salesperson, laboratory technician, teacher, etc.) lunch moderate physical activity (student, driver, electrician, metal worker, etc.) dinner. heavy physical activity (farmer, dancer, steel worker, athlete, etc.) snack very heavy physical activity (loader, logger, miner, stonecutter, etc.) no working ability (under age )
4 Table. Consumption of nacks and everages Household I: GG Province (T) G ite (T) G City/County (T) GG Neighborhood/Village (T) GGG HH (T) : ine : GGGA ay Item Code (gm) ocation Method V0 Vb V9a V V Codes:. morning snack afternoon snack evening snack. at home at school or work unit restaurant or food stand relative s or friend s house nursery school festival/celebration other. boiled stir-fried deep-fried steamed griddle cooked food baked eaten raw 9 other
5 Table. Individual Record of aily Food Household I: GG Province (T) G ite (T) G City/County (T) GG Neighborhood/Village (T) GGG : ine : GGGA Interview ay:. ay. ay. ay GV Person-ay G.GVa Interview ate: Year Month ay GGGGGGGG T Item Code (gm) ocation Method ocation V0 Vb V9a V V V Codes:. breakfast morning snack lunch afternoon snack dinner evening snack. at home at school or work unit restaurant or food stand relative s or friend s house nursery school festival/celebration other. boiled stir-fried deep-fried steamed griddle cooked food baked eaten raw 9 other. at home at school or work unit restaurant or food stand relative s or friend s house nursery school festival/celebration other
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