20

How do you estimate your salt consumption?

1 = very heavy 2 = heavy 3 = normal 4 = low 5 = very low

21

What type of oil or fat do you use most for your meals?

1 = palm oil 2 = refined palm oil 3 = soy oil 4 = olive oil

5 = margarine

22

How often to you consume fatty products?

1 = always 2 = often 3 = sometimes 4 = rarely 5 = never

23

Do you nibble between meals

1 = yes 2 = no

Physical activity

24

Do you practice physical activity at your workplace, during moment of leisure or sports that makes you sweat or breathe actively?

1 = yes 2 = no

25

If yes, for how many hours do you practice every day?

……………….

26

How many times a week?

……………….

Personal past medical history

27

Are you hypertensive?

1 = yes 2 = no 3 = don’t know

28

If yes, what treatment do you follow actually for hypertension?

Lifestyle changes: 1 = yes 2 = no

BP lowering drugs: 1 = yes 2 = no

29

If you are taking BP lowering drugs, please precise the classes

ACE inhibitors: 1 = yes 2 = no

ARBs: 1 = yes 2 = no

Calcium channel inhibitor: 1 = yes 2 = no

Thiazide diuretics: 1 = yes 2 = no

Beta blocquer: 1 = yes 2 = no

Others: 1 = yes 2 = no

30

Are you diabetic?

1 = yes 2 = no 3 = don’t know

31

If yes, are you taking a treatment?

1 = yes 2 = no

32

If you are taking a treatment, please precise

1 = Oral antidiabetics 2 = insulin

Family past medical history

34

Is there somebody with obesity in your family?

1 = yes 2 = no

If yes, precise the relationship …………………….

35

Is there somebody having hypertension in your family?

1 = yes 2 = no

If yes, precise the relationship ……………………

36

Is there somebody having type 2 diabetes in your family?

1 = yes 2 = no

If yes, precise the relationship………………………

STEPS 2: PHYSICAL MEASURMENTS

37

Weight (Kg)

………………