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Eating Habits, Diet Goals & Barriers Assessment

Measures dietary patterns, nutrition goals, purchasing behavior, and barriers to healthy eating. Use to segment customers, identify unmet needs, and inform food product or service development.

What's Included

AI-Powered Questions

Intelligent follow-up questions based on responses

Automated Analysis

Real-time sentiment and insight detection

Smart Distribution

Target the right audience automatically

Detailed Reports

Comprehensive insights and recommendations

Template Overview

25

Questions

AI-Powered

Smart Analysis

Ready-to-Use

Launch in Minutes

This professionally designed survey template helps you gather valuable insights with intelligent question flow and automated analysis.

Sample Survey Items

Q1
Chat Message
Welcome! This survey asks about your eating habits, nutrition goals, and grocery shopping behaviors. It should take approximately 8–10 minutes to complete. Your participation is entirely voluntary and you may stop at any time. There are no right or wrong answers—we are interested in your honest opinions. All responses are confidential and will be reported in aggregate only.
Q2
Multiple Choice
Do you currently follow any specific dietary pattern? (Select all that apply.)
  • No specific pattern
  • Vegetarian
  • Vegan
  • Pescatarian
  • Keto or low-carb
  • Low-sugar
  • Gluten-free
  • Dairy-free
  • Halal
  • Kosher
  • Other (please specify)
Q3
Opinion Scale
In the last 30 days, how consistently did you follow your dietary pattern?
Range: 1 7
Min: Not at all consistentlyMid: NeutralMax: Very consistently
Q4
Dropdown
In the last 7 days, approximately how many meals did you cook at home?
  • 0
  • 1–3
  • 4–7
  • 8–14
  • 15–21
  • More than 21
Q5
Opinion Scale
In the last 7 days, how often did you snack between meals?
Range: 1 7
Min: NeverMid: NeutralMax: Very often
Q6
Multiple Choice
Where do you buy groceries most often? (Select up to 2.)
  • In-store supermarket
  • Online-only grocer
  • Retailer pickup or delivery
  • Meal kit subscription
  • Restaurant or food delivery apps
  • Farmers market or specialty store
  • Other (please specify)
Q7
Dropdown
In the last 30 days, how many times did you order food or groceries online?
  • None
  • 1–2 times
  • 3–4 times
  • 5–8 times
  • 9 or more times
Q8
Multiple Choice
What are your top eating goals for the next 3 months? (Select up to 3.)
  • Eat more fruits and vegetables
  • Reduce added sugar
  • Manage weight
  • Build muscle or strength
  • Save time on meals
  • Spend less on food
  • Improve daily energy
  • Manage a health condition
  • Be more environmentally sustainable
  • Try new foods or cuisines
  • Other (please specify)
Q9
Multiple Choice
Which of the following approaches would you consider trying to reach your eating goals? (Select all that apply.)
  • Portion control
  • Higher-protein meals
  • Calorie or macro tracking
  • Meal kits with nutrition targets
  • Ready-to-eat healthy options
  • Cutting added sugar
  • Intermittent fasting
  • Working with a nutritionist or coach
  • Meal planning or prepping
  • Other (please specify)
Q10
Opinion Scale
How confident are you that you can maintain your eating changes over the next 30 days?
Range: 1 7
Min: Not at all confidentMid: NeutralMax: Extremely confident
Q11
Multiple Choice
What gets in the way of eating the way you want? (Select all that apply.)
  • Food cost
  • Time to cook
  • Taste preferences
  • Lack of meal planning
  • Limited healthy options nearby
  • Family or household preferences
  • Cravings
  • Stress or mood
  • Portion control
  • Delivery fees or order minimums
  • Short shelf-life of fresh items
  • Confusing labels or nutrition info
  • Other (please specify)
Q12
Dropdown
Of the barriers you selected, which is the single biggest obstacle for you right now?
  • Food cost
  • Time to cook
  • Taste preferences
  • Lack of meal planning
  • Limited healthy options nearby
  • Family or household preferences
  • Cravings
  • Stress or mood
  • Portion control
  • Delivery fees or order minimums
  • Short shelf-life of fresh items
  • Confusing labels or nutrition info
  • Other
Q13
Opinion Scale
How useful would a personalized meal-planning tool be in helping you eat the way you want?
Range: 1 7
Min: Not at all usefulMid: NeutralMax: Extremely useful
Q14
Opinion Scale
How useful would simplified nutrition labels or scoring be in helping you eat the way you want?
Range: 1 7
Min: Not at all usefulMid: NeutralMax: Extremely useful
Q15
Opinion Scale
How useful would budget-friendly healthy recipe suggestions be in helping you eat the way you want?
Range: 1 7
Min: Not at all usefulMid: NeutralMax: Extremely useful
Q16
Opinion Scale
How likely would you be to try an online grocery service that offered features aligned with your eating goals?
Range: 1 7
Min: Very unlikelyMid: NeutralMax: Very likely
Q17
AI Interview
We'd like to learn more about your eating goals and the challenges you face. An AI moderator will ask you a couple of brief follow-up questions.
AI InterviewLength: 2Personality: [Object Object]Mode: Fast
Reference questions: 5
Q18
Long Text
Based on your responses in this survey, is there anything else you'd like to share about your eating habits, goals, or challenges?
Max chars
Q19
Dropdown
What is your age?
  • 18–24
  • 25–34
  • 35–44
  • 45–54
  • 55–64
  • 65+
  • Prefer not to say
Q20
Multiple Choice
How do you describe your gender?
  • Woman
  • Man
  • Non-binary
  • Prefer to self-describe
  • Prefer not to say
Q21
Dropdown
Where do you currently live?
  • United States
  • Canada
  • United Kingdom
  • European Union
  • Australia / New Zealand
  • India
  • Southeast Asia
  • Middle East / North Africa
  • Sub-Saharan Africa
  • Latin America
  • Other
Q22
Dropdown
What is the highest level of education you have completed?
  • High school or less
  • Some college / associate degree
  • Bachelor's degree
  • Graduate or professional degree
  • Other
  • Prefer not to say
Q23
Dropdown
What is your current employment status?
  • Full-time
  • Part-time
  • Self-employed
  • Student
  • Homemaker / caregiver
  • Retired
  • Unemployed
  • Prefer not to say
Q24
Dropdown
What is your approximate annual household income?
  • Under $25,000
  • $25,000–$49,999
  • $50,000–$74,999
  • $75,000–$99,999
  • $100,000–$149,999
  • $150,000 or more
  • Prefer not to say
Q25
Chat Message
Thank you for completing this survey! Your responses are valuable and will help improve products and services related to nutrition and healthy eating.

Frequently Asked Questions

What is QuestionPunk?
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Yes. Describe your research goal in plain language and QuestionPunk drafts a complete survey with appropriate question types, ordering, and AI follow-up logic. You can then customize before publishing.
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How do AI interviews work?
AI interviews conduct adaptive conversations with respondents. The AI asks follow-up questions based on what the respondent says, probing for clarity and depth. You control the personality, tone, model (Haiku, Sonnet, or Opus), and question mode (fixed count, AI decides when to stop, or time-based).
Can I test my survey before launching?
Yes. Use synthetic testing to create AI personas and run them through your survey. This helps catch issues with question flow, logic, and wording before real respondents see it.
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Can I export survey results?
Yes. Export as CSV (flat or wide layout), Excel (XLSX), or export the survey structure as PDF/Word. Filter by suspicious level, response type, language, or date range before exporting.
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What are the pricing plans?
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