SECTION 1: Participant Information
1.  First Name *
2.  Last Name *
3.  Study Number *
SECTION 2: How often did you drink these beverages in the past week?
4.  100% orange juice, apple juice or other 100% juice *
5.  Vegetable juice like V8, carrot, or tomato *
6.  Fruit flavored drinks and sports drinks like Capri Sun, Sunny Delight, or PowerAde *
7.  Regular soda pop (not diet) or energy drinks like Rockstar, Red Bull or Monster *
8.  Plain milk *
9.  Chocolate or other flavored milk *
10.  Smoothie made with yogurt and fruit *
SECTION 3: How often did you eat these snack foods in the past week?
11.  Potato or tortilla chips either flavored or plain *
12.  French fries or tater tots *
13.  Popcorn *
14.  Pretzels or salty crackers including gold fish crackers, Ritz crackers *
15.  Graham crackers or animal crackers *
16.  Candy such as jelly beans, licorice, or gummy bears *
17.  Chocolate or chocolate candy bars *
18.  Cookies, brownies, pies, cake, doughnuts, or pop tarts *
19.  Popsicles, Slurpees, or shaved ice *
20.  Ice cream or milkshakes *
SECTION 4: How often did you eat these fruits or vegetables in the past week?
21.  Fresh or frozen fruit like apples, banana, orange *
22.  Canned fruit like peaches, pears, applesauce, or pineapple *
23.  Dried fruit like raisins or Craisins *
24.  Green salad, spinach, kale or other dark green leafy vegetable *
25.  Spaghetti sauce, tomatoes or salsa *
26.  Yams, sweet potatoes or winter squash like butternut *
27.  Vegetable soup, or stew with vegetables *
28.  Carrots *
29.  Beans such as baked beans, garbonzo beans, kidney beans, or black beans *
30.  Any other vegetables, (string beans, peas, corn, broccoli, celery, cauliflower) *