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Home
Blog
Prescriptions
Nutritional test
Healthful prescriptions
Videos of Nutrition
Videos sport Nutrition
panel clients
Contact
Center of Nutrition Alzira/Herbalife
Opportunity of Income
Your well-being is our objective
Questionnaire of nutritional habits.
Full name
Email
Telephone of contact
Profile of Instagram, Facebook or both
Present weight
Height (In centimetres)
Perimeter abdomen (around the navel)
Date of birth
Age
1. Whichever meals you realise to the day?
One
Two
Three
Four
Five
More than five
2. Normamente usually you have breakfast?
Ground not to have breakfast
Breakfast with baker's shop (milky coffee or and baker's shop)
Only volume a drink (coffee, milk, vegetal drink or juice)
Breakfast with healthful foods (milky Coffee or, juice, cereals, bread, ham, oil, cakes, etc.)
3. Comes fruit and on a daily basis minimal vegetable 5 to 6 pieces to the day?
No
If
4. You include fish in your habitual diet?
Never or once for week
Two or three times per week
Four or more times per week
5. You have some nourishing restriction?
No
If (I cannot take)
6. Whichever water you ingest daily?
Half liter
A liter
More of a liter
More than two books
7. Usually you take exciting drinks, as coffee, tails, energy, etc?
No, never
If, every day
If, sporadically
No, since it does not feel caffeine well to me
8. With what frequency you go to the bathroom to do of belly?
on a daily basis
Every two days
Every three or four days
I have difficulty to go to the bathroom
9. You have heavy digestions?
No
If
10. You think that you have a optimum level of energy?
No
If
11. You realise some physical activity?
No
If Which?
12. What type of plan it would like to follow?
Control of weight
To maintain my present weight (to reach healthful lifestyle)
To increase of weight
To improve the sport yield
13. It has or it has had some type of disease?
I have read and acceptable the
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