Please look through the food items listed. If you eat these foods almost every day, compare the amount you eat to the serving size, and then circle how many of these servings you typically consume in a day.
FoodServing sizeServings per day
Breads, pasta (not white)1/2 cup (or 1 slice of bread)2 to 45 or more
Fats (cream in coffee, butter, oils)1 tablespoon12 to 45 or more
Fruit1 medium12 to 45 or more
Vegetables1 cup12 to 45 or more
White breads, white rice, pasta, sugary cereal1/2 cup (or 1 slice of bread)12 to 45 or more
Whole grain products such as brown rice, oatmeal, whole-grain cereals1/2 cup12 to 45 or more
AlcoholOne drink:
  • 12 oz of regular beer

  • 5 oz of wine (12 percent alcohol)

  • 1.5 oz of 80-proof distilled spirits

12 to 45 or more
Beverages (soda, juices, drinks with caffeine)8 oz12 to 45 or more
Water8 oz12 to 45 or more
Please look through the following food items. Compare the amount you eat to the serving size, and then circle how many of these servings you typically consume in a week.