I need as many results as possible so if you wouldn't mind filling this out it would help me a lot. THanks
Gender: Male Female
Age:______
What is your ethnic background?:___________________________
(ie. Caucasian, Native American etc.)
1. Do you or anyone in your family have lactose intolerance?
Yes No
2. How intolerant are you/ they?
|---------------------------------------|------------------------------------|
Not Very Moderate Very Intolerant
3. Are there any milk products you/they can eat?
Yes No
a. If yes, which ones:___________
4. Are labels useful in finding out if there are any ingredients that could cause symptoms of lactose intolerance?
a. I don?t look at labels
b. I can never tell which ones will cause symptoms
c. They are normally helpful
d. I don?t shop
5. Is it hard for you/them to find substitutes for milk products?
a. Very hard
b. Not really
c. I don?t substitute products
d. It?s easy
6. How much dairy do you/they consume daily?___________________
(ie. 1 glass of milk + yogurt =2 servings)
7. How do you/they deal with lactose intolerance?
a. Substitute Soy Products
b. Lactase Pills
c. Cut out dairy completely
d. Eat only little amounts of dairy
8. Is your/their family affected in any way by your/their lactose intolerance?
Yes No
a. If yes, how:_________________________________
9. What is the hardest thing in your opinion about having lactose intolerance?
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
____________________________________________________________
10. At what age did you/they discover that you/they were lactose intolerant?:
_______________________