PLEASE COMPLETE THE FORM

Having a diverse, nutritious and balanced diet is out of utmost importance for a healthy lifestyle. Therefore, the following food categories need to be included and properly combined in every dietary plan. Please read and choose your items in each of the categories for effective development of your meal plan.

Age

 

Hight

 

Weight

 

Target weight

 

GENDER
MEAT

Meat is the main source of animal protein in our diet. The list contains types of meat, regardless of their way of preparation. Please choose which types of meat you would like to be included in your meal plan. Please take in mind that products you choose to exclude should be only the ones you don’t prefer, avoid consuming or are recommended for exclusion by your doctor/physician. The more products you include, the more diverse and nutritious your meal plan will look.






FISH & SEAFOOD

Please specify from the following products, which types you would like to include in your meal plan. Please take in mind that products you choose to exclude should be only the ones you don’t prefer, avoid consuming or are recommended for exclusion by your doctor/physician. The more products you include, the more diverse and nutritious food your meal plan will contain.






CEREALS, GRAINS & STARCHY FOODS

Grains and cereals are an important source of dietary fiber, as well as vitamins and minerals. Therefore, their presence is an important aspect for the effectiveness of the meal plan. Please select which cereals and grains you would like to include in your dietary plan.









LEGUMES & VEGETABLES

Vegetables are the main source of important vitamins and minerals, as well as bioactive compounds which influence certain body functions. Please select which vegetables you would like to have included in your dietary plan. Please take in mind that products you choose to exclude should be only the ones you don’t prefer, avoid consuming or are recommended for exclusion by your doctor/physician. The more products you include, the more diverse and nutritious food your meal plan will contain.












FRUITS

Please specify from the following products, which types you would like to include in your meal plan. Please take in mind that products you choose to exclude should be only the ones you don’t prefer, avoid consuming or are recommended for exclusion by your doctor/physician. The more products you include, the more diverse and nutritious food your meal plan will contain.











DAIRY

Please specify from the following products, which types you would like to include in your meal plan. Please take in mind that products you choose to exclude should be only the ones you don’t prefer, avoid consuming or are recommended for exclusion by your doctor/physician. The more products you include, the more diverse and nutritious food your meal plan will contain.






OTHER PRODUCTS

 








PHYSICAL ACTIVITY

The amount of physical activity is a major factor in calculation of your daily energy requirement and required to design a detailed and reliable personalized meal plan. Please select the level of physical activity that most closely is applied to your lifestyle.





PLEASE DESCRIBE A TYPICAL DAY IN YOUR LIFE

Knowing your daily routines and responsibilities gives a better insight in your food choices and facilitates the development of your dietary plan. Please specify which of the following statements most closely applies to your daily schedule:





PLEASE SPECIFY WHICH OF THE FOLLOWING STATEMENTS YOU MOSTLY AGREE WITH REGARDING YOUR LIFESTYLE:

 









FREQUENCY OF MEALS

The frequency of consumption is a crucial influence factor for the proper work of the body metabolism. If the consumption is imbalanced, the metabolism slows down which contributes to higher fat accumulation. Please select how many meals per day you have on an average level?