CHINA ECONOMIC, POPULATION, NUTRITION, AND HEALTH SURVEY

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1 CHINA ECONOMIC, POPULATION, NUTRITION, AND HEALTH SURVEY Q Q1991 HOUSEHOLD NUTRITION SURVEY Province (District): 21 Liaoning 32 Jiangsu 37 Shandong 41 Henan T1 42 Hubei 43 Hunan 45 Guangxi 52 Guizhou Urban Site: 1 Rural Site: 2 T2 City: County: T3 Neighborhood: Village(Town): T4 Household Sequence Number: Household Sequence Number: T5 Name of Interviewer: Date of Interview: Year Month Day Completion Evaluation: 1 Good 2 OK 3 Poor T7 CO Name of Verifier: --1--

2 1. Name and line number of the most important person in planning meals in the household. Name Line Number V1 Name and line number of the assisting person in planning meals in the household. Name Line Number V2 2. Name and line number of the most important person in preparing meals in the household. Name Line Number V3 Name and line number of the assisting person in preparing meals in the household. Name Line Number V4 3. Survey of household major food sources for the last month. TABLE 1 Code Item State Store Rations State Store Market Price Free Market Household-Produced Bought?* Bought?* Bought?* Bought?* Quantity? Quantity? Quantity? Quantity? (1/0) (1/0) (1/0) (1/0) V5 V6 V7 V8 V9 V10 V11 V12 V13 1 rice 2 wheat flour 3 other grains 4 cooking oil 5 eggs 6 pork (or beef or mutton) 7 sugar * Record 1 if bought or household-produced; otherwise, record

3 TABLE 2 RECORD OF HOUSEHOLD FOOD AMOUNTS Food Code (V14) Food Name Initial Amount on Hand (500 gm) [jin] (V15) Each Day Day 1 (V16) Day 2 (V17) Day 3 (V18) Day 4 (V19) Total (500 gm)[jin] (V20) Total Remaining (500 gm)[jin] (V21) Actual Consumption (500 gm)[jin] (V22) Consumption per Person per Day (gm) (V23) Amount Amount Amount Amount Amount Amount Amount Amount Amount Amount Amount Amount Amount Amount Amount Amount Amount Amount purchased discarded purchased or discarded purchased or discarded purchased or discarded purchased or discarded purchased or discarded purchased or discarded purchased or discarded purchased or discarded or grown (500gm)[jin] grown (500 (500gm)[jin] grown (500 (500gm)[jin] grown (500 (500gm)[jin] grown (500 (500gm)[jin] grown (500 (500gm)[jin] grown (500 (500gm)[jin] grown (500 (500gm)[jin] grown (500 (500gm)[jin] (500 gm) (V25) gm) [jin] (V25) gm) [jin] (V25) gm) [jin] (V25) gm) [jin] (V25) gm) [jin] (V25) gm) [jin] (V25) gm) [jin] (V25) gm) [jin] (V25) [jin] (V24) (V24) (V24) (V24) (V24) (V24) (V24) (V24) (V24) --3--

4 TABLE 3 RECORD OF HOUSEHOLD MEALS PER PERSON PER DAY Line Number (A1)* Name Age (years) (V26) Occupation (V27) Activity Level** (V28) Time Morning+ Noon Dinner Snack Morning Noon Dinner Snack Morning Noon Dinner Snack Morning Noon Dinner Snack Morning Noon Dinner Snack Morning Noon Dinner Snack Morning Noon Dinner Snack V35 V36 V37 V38 V35 V36 V37 V38 V35 V36 V37 V38 V35 V36 V37 V38 V35 V36 V37 V38 V35 V36 V37 V38 V35 V36 V37 V38 Day 1 (V29) Day 2 (V30) Day 3 (V31) Day 4 (V32) Number of meals/person (V33) Calculate number of person-days (V34) * Line number for guests is eat meal 0 no meal ** 1 very light physical activity (working in a sitting position, e.g., office worker, 2 light physical activity (working in standing position, e.g., salesperson, laboratory watch repairer, etc.) technician, teacher, etc.) 3 moderate physical activity (student, driver, electrician, metal worker, etc.) 4 heavy physical activity (farmer, dancer, steel worker, athlete, etc.) 5 very heavy physical activity (loader, logger, miner, stonecutter, etc.) 6 not applicable (under age seven) --4--

5 TABLE 4 RECORD OF DAILY FOOD Name Line Number(A1) Foo d Type Day 1 (VD1) Day 2 (VD2) Day 3 (VD3) Code of Name of Amount Code of Name of Amount Code of Name of Amount Ingredients Ingredients (50 gms) Meal Meal Preparation Preparation Ingredients Ingredients (50 gms) Meal Meal Preparation Preparation Ingredients Ingredients (50 gms) Meal Meal Preparation Preparation [liang] Time Location Method Location [liang] Time Location Method Location [liang] Time Location Method Location V14 V39 V40 V41 V42 V43 V14 V39 V40 V41 V42 V43 V14 V39 V40 V41 V42 V breakfast 2--morning snack 3--lunch 4--afternoon snack 5--dinner 6--evening snack at home 2--prepared at home, eaten at school or work unit 3--bought at restaurant or food stand, eaten at home 4--restaurant 5--food stand 6--work unit or school dining hall 7--relative's or friend's house 8--festival/celebration 9--nursery school 10--other boiled 2--stir-fried 3--deep-fried 4--steamed 5--griddle 6--cooked food 7--baked 8--eaten raw 9--other --5--

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