Over the past week how many servings of vegetables (excluding fried potatoes) or salad did you eat on an average day?
Over the past week how many servings of fruit (including 100% fruit juice) did you eat/drink on an average day?
Over the past week how often did you eat fish or seafood?
Over the past week how often did you eat red meat (beef, lamb, pork) or processed meat (eg. sausages, salami, cold cuts, pepperoni)?
Over the past week how often did you eat pre-packaged food or meals (e.g. canned soups or stews, frozen appetizers or meals), salty snacks (e.g. potato chips, pretzels), baked goods (e.g. cookies, muffins, croissants, donuts), or sugared drinks (e.g. soft drink, fruit punch)?
Exercise
Over the past week how many minutes of moderate to vigorous aerobic exercise did you get? This would include any activity that causes you to breathe harder and sweat more such as brisk walking, swimming, and bicycling.
Over the past week how many times did you do strengthening exercises such as weight lifting or body weight exercise?
Over the past week how many times did you do mind/body exercises such as Yoga or Tai Chi?
Cognitive Engagement
Over the past week how many times did you read or play thinking games such as crossword puzzles, board or card games?
Over the past week how often did you participate in activities that help you learn new things, such as taking a class, attending a lecture, self-studying, or belonging to a discussion group?
Over the past week how many times did you leave your home to attend an event or to explore new places?
Social Engagement
Over the past week how much time did you spend in paid work?
Over the past week how much time did you spend in volunteering?
Over the past week on how many days did you socialize with friends or family?
Emotional Well-Being
Over the past week how much sleep do you get during a typical night?
Over the past week what was the quality of your sleep?
How many nights over the past week was your sleep good or very good?
Over the past week how many days did you experience periods of sadness or depression?
Over the past week how well did you manage the stress in your life?
Physical Well-Being
Has your doctor or other health care provider ever told you that you have high blood cholesterol?
Over the past week did you try to manage your high cholesterol through diet, exercise, or prescription medication?
Has your doctor or other health care provider ever told you that you have hypertension (high blood pressure)?
Over the past week did you try to manage your high blood pressure through diet, exercise, or prescription medication?
Has your doctor or other health care provider every told you that you have diabetes?
Over the past week did you try to manage your diabetes through diet, exercise, or prescription medication?
Today, using the scale below, how concerned are you with your brain health?