Healthy and Active Kids
     
 

Kids Healthy Food and Activity Guide
Disclaimer
Your doctor (GP), dietitian or other health worker can properly assess if your food and activity routine is right for you.
This questionnaire is just one source of information about healthy eating and exercising. If you have more questions, please visit your doctor. The questionnaire also provides an opportunity for young people, parents and teachers to talk about food, physical activity and health. The results given in the Healthy Food and Activity Guide should always be discussed with a parent, teacher or adult.
Eating a balanced diet and staying physically active can help with maintaining a healthy weight. Answer the following questions to find out about your diet and activity levels and receive a personalised Healthy Food and Activity Guide. We suggest that you fill this questionnaire out with the help of a parent or adult.

Your details -:
      First Name :
      Today's Date :
      Age (yrs) :
      Gender :
      Email (optional) :
      How tall are you without shoes?
      Height (cm) :
      How much do you weigh without clothes or shoes?
      Weight (kg) :

WHAT DO YOU EAT AND DRINK? -:
1. How often do you usually eat fast food (fried food, burgers, hot chips, crisps, battered fish, meat pies) either at home or out?
      
2. How many serves of fruit do you usually eat in a day (One serve is one medium piece of fruit, two smaller pieces or 1 cup of diced pieces)?
      
blackberries fr_nec10 fr_stw14 banana josephine
3. How many serves of vegetables do you usually eat in a day (One serve is 1/2 cup cooked vegetables or 1 cup of salad)?
      
fr_bro11 fr_tom14 loose_leaf kuroda
4. How often do you eat lollies, chocolate, cake or sweet biscuits?
      
5. How often do you drink cordial, fruit juice, soft drinks or sports drinks?
      

HOW ACTIVE ARE YOU? -:
6. How often do you do 30 minutes or more of exercise which makes you breathe harder or puff and pant (eg. soccer, tennis, dancing, netball, athletics, running, swimming)?
      
7. How often do you do 30 minutes or more of moderate exercise or leisure time physical activity (eg. skateboarding, karate, walking, rollerblading)?
      
8. Do you usually walk or cycle as part of your journey to and from school?
      
9. How much time do you spend watching TV, playing video games or using the computer each day?