Empirica Survey Step 1 of 3 33% Personal InformationName First Last Email Part 1Diet Key: 0 = Do not consume or use; 2 = Consume or use 2 to 3 times monthly; 2 = Consume or use weekly; 3 = Consume or use dailyAlcohol*Never2-to-3 times monthlyDailyArtificial Sweeteners*Never2-to-3 times monthlyDailyCandy, desserts, refined sugar*Never2-to-3 times monthlyDailyCarbonated beverages*Never2-to-3 times monthlyDailyChewing tobacco*Never2-to-3 times monthlyDailyCigarettes*Never2-to-3 times monthlyDailyCigars/pipes*Never2-to-3 times monthlyDailyCaffeinated beverages*Never2-to-3 times monthlyDailyFast foods*Never2-to-3 times monthlyDailyFried foods*Never2-to-3 times monthlyDailyLuncheon meats*Never2-to-3 times monthlyDailyMargarine*Never2-to-3 times monthlyDailyMilk products*Never2-to-3 times monthlyDailyRadiation exposure*NoYesRefined flour/baked goods*Never2-to-3 times monthlyDailyVitamins and minerals*Never2-to-3 times monthlyDailyWater, distilled*Never2-to-3 times monthlyDailyWater, tap*Never2-to-3 times monthlyDailyWater, well*Never2-to-3 times monthlyDailyDiet for weight control*Never2-to-3 times monthlyDaily LifestyleExercise per week*2x+ a week1x a week1x-2x a monthnever, less than once a month