S. No.

QUESTION.

ANSWER.

1.

Limit consumption of processed food

[1] Yes

[2] No

2.

Look at the salt or sodium content on food

labels.

[1] Yes

[2] No

3.

Buy low salt/sodium alternatives

[1] Yes

[2] No

4.

Use spices other than salt when cooking

[1] Yes

[2] No

5.

Avoid eating foods prepared outside home

[1] Yes

[2] No

6.

Do other things specifically to control your salt intake?

[1] Yes

[2] No

7.

Other{please specify}

8.

Do you take sugar?

[1] Yes

[2] No

9.

How often do you take sugar?

[1] Too much

[2] Just the right amount

[3] Too little

[4] Don’t know

10.

Approximately how many teaspoons of sugar do you take?

Number of teaspoons:

11.

How often do you take sugary foods i.e. cakes, biscuits in a week?

Number of days:

12.

How important to you is lowering the sugar in your diet?

[1] Far too much

[2] Just the right amount

[3] Too little

[4] I don’t know