CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 7, August 2012
AFRICA
e379
Appendix
PURE Quantitative Food Frequency Questionnaire
Subject ID _______________________________________ Subject initials ������������������������
Centre #
Community #
Household #
Subject #
F M L
Today’s date
Year
Month
Day
1. Name: ������������������������������������������������������������������������������
2. Not applicable in South Africa ����������������������������������������������������������
3. National identity # or equivalent
N/A
4. Date of Birth
OR
Age
Year
Month
Day
Years
5. Sex
Female
Male
Please think carefully about the food and drink you have consumed during the past month (four
weeks). I will go through a list of foods and drinks with you and I would like you to tell me:
• If you eat the food
• How the food is prepared
• How much of the food you eat at a time
• How many times a day you eat it and if you do not eat it every day, how many times a week or a
month you eat it.
To help you to describe the amount of a food you eat, I will show you pictures of different amounts of
the food. Please say which picture is the closest to the amount you eat, or if it is smaller, between the
sizes or bigger than the pictures.
There are no right or wrong answers.
Everything you tell me is confidential. Only your subject number appears on the form.
Is there anything you want to ask now?
Are you willing to go on with the questions?
