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General Information

Age
Under 18
18 - 25
26 - 40
41 - 60
60+
Gender
Female
Male
Phisical activity level
Sedentary
Lightly active
Moderately active
Very active
Athlete

Nutrition habits

What type of diet do you currently follow ?
No specific diet
Omnivorous
Vegetarian
Vegan
Flexitarian
Plant-based focused but not fully vegan
Other
How many meals do you usually eat per day ?
1
2
3
4 +
How often do you eat plant-based meals ? (vegetables, legumes, tofu, nuts, plant proteins)
Rarely
1 - 2 times per week
3 - 5 times per weeks
Daily
Fully plant-based
How often do you consume animal proteins ? (meat, fish, eggs, dairy)
Never
1 - 2 times per week
3 - 5 times per week
Daily

Food choises and preferences

Which plant-based protein sources do you currently eat ? Select all that apply)
How many servings of fruit do you eat per day
0
1
2
3 or more
How many servings of vegetable do you eat per day
0
1
2
3 or more
How often do you drink sweetened beverages ? (soda, energy drinks, sweetened juices)
Never
Rarely
1 - 2 times per week
3 - 5 times per week
Daily

Hydratation

How much water do you drink per day ?
Less than 1 L
1 - 1,5 L
1,5 - 2 L
More than 2 L

Goals and limitations

What are your primary nutrition goals ? (Select all that apply)
Do you have food intolerances or allergies ?
No
Yes
Do you have any digestive discomfort after eating ?
No
Sometimes
often

Knowledge & Interest

How would you rate your nutrition knowledge ?
Beginner
Intermediate
Advanced
Are you interested in learning more about plant-based nutrition ?
Yes
Maybe
No
What nutrition topics would you like to learn more about?

Lifestyle factors

How many hours of sleep do you get per night ?
Less than 5
5 - 6
7 - 8
More than 8
How would you rank your stress level ?
Low
Moderate
High
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