Step 4: Nutrition & Sport
Name:
*
First name
Last name
Part 1: Nutrition
Do you find it difficult to lose weight?
*
Yes
No
More info, if relevant:
Metabolism
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Fast metabolism
Slow metabolism (problems losing weight)
Normal metabolism (through conscious nutrition and exercise it is possible to control weight)
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Diet Preferences & Intolerances
How do you eat at the moment?
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Everything
Vegan
Vegetarian
Pescetarian
Whole food
No pork meat
No red meat
Other
Food allergies and intolerances:
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Fish
Shellfish allergy
Egg
Soy
Nuts
Peanuts
Lactose
Gluten
None
Other foods you don't like to eat:
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Are there certain foods that will make you bloated or tired after eating them?
*
Your preferred cooking time / preparation time:
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Favorite meals / dishes?
*
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Eating Habits
I frequently eat the following foods:
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Food
Never
Sometimes
Regularly
Daily
Coffee
Chocolate
Sweets
Sweet drinks
Drinks from plastic bottles
Salt
Sugar
Alcohol
Drugs
Tobacco
Fried / breaded
Meat
Fish
Cereal products (bread, pasta, pasta, etc.)
Dairy products
Eggs
Butter / coconut oil / avocados
Vegetable oils (rapeseed oil, sunflower oil, safflower oil, ...)
Dietary fiber (flaxseed, psyllium)
Vegetables
Fruit
Nightshade family (tomatoes, potatoes, aubergines, peppers, blueberries)
Dietary Supplements / Supplements you take:
*
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Meal Times
How often do you currently eat a day:
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1
2
3
4
5
How much time is there usually between your meals?
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1-2 Hours
3-4 Hours
4-6 Hours
More than 6 hours
How many times a week are there more than 3-4 hours between your meals?
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0-1 days / week
2-3 days / week
4-5 days / week
Almost every day
Are there any meals that you regularly skip?
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Breakfast
Lunch
Dinner
No, I regularly eat all meals.
If so, how many times a week?
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Meals
Appetite for breakfast:
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Little
Mild
High
What do you usually have for breakfast?
*
Appetite for lunch:
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Little
Mild
High
What do you usually eat for lunch?
*
Appetite for snacks:
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Little
Mild
High
What do you usually eat / snack in between?
*
Appetite for dinner:
*
Little
Mild
High
What do you usually eat in the evening?
*
Do you sometimes eat out of boredom, tiredness, anger, or when you are sad?
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Yes
No
If so, what is it usually?
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Part 2: Activity Level & Training
Activity Level
How active are you during the week?
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Somewhat active - a little hiking / biking every now and then, but otherwise not as active
Moderately active - lifting weights, running, or doing another sport 1-2 times a week
Active regularly - lifting weights, running, or doing another sport 3-4 times a week
Very active - exercising, running, weight lifting almost every day - sometimes several times a day
How do you work through the day?
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Mostly seated - mainly working in the office
Mainly working standing and run during the day
Standing or walking around most of the day - "walking" from meeting to meeting
Physically demanding work throughout the day
Injuries & Limitations
Have you ever been advised not to exercise?
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Yes
No
More info, if relevant:
Do you have any unusual symptoms when you exercise?
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Yes
No
More info, if relevant:
Do you have any injuries we should know about?
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None
Knee
Shoulder
Back
Other
If applicable, what exercises are you unable to do due to your injury?
Other muscular restrictions - less mobility, pain, etc .:
*
Yes
No
More info, if relevant:
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Training Preferences
How many times a week can / do you want to train?
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1 time
2 times
3 times
4 times
5 times
6 times
7 times
How long can / do you want to train per session?
*
How experienced are you with strength training?
*
I'm a beginner or have only trained a few times.
I've been training for a while and I know the basics.
I've been training for more than two years and I feel safe with weight training.
Where do you want to train
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Outdoors
Home
In the gym (if possible)
Other
Which exercises / which training session do you enjoy the most?
*
Things you don't like about sports / training?
*
How and when are you currently training?
*
What equipment can you use? (At home / studio)
*
Sport activities years ago and now:
*
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Part 3: Habits & Routines
Routines
Never
Sometimes
Regularly
Always
I eat out a lot
I have a fixed morning and evening routine
I check my cell phone after getting up
I meditate daily
I stretch regularly
I do breathing exercises regularly
Several times a week I have some planned time out (yoga, massage, reading, ...)
I keep a daily journal
I work with a to-do list
I would see myself as structured
I plan my meals and purchases
In principle, I am always available
My notifications on the mobile phone are on (e.g. SMS vibration, etc.)
I spend a lot of time in nature / outdoors / in the sun (if so - how often about / per week?)
I am often lost in thoughts
I spend enough time with my partner / friends
Any other good habits you used to have or still have?
*
Any bad habits that you currently have or that are holding you back?
*
General additions / comments:
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