Day : ________________
(Make copies of this sheet depending on how many days you want to record).
For initial evaluation, I recommend 1-3 days. Discipline is key. Good Luck!
Meal or
Time Intake: Food / Drink (please be specific regarding
Snack
amounts: cups or ounce equivalents)
Breakfast
Snack
Lunch
Snack
Dinner
Snack/Dessert
Water (cups per day):
Skipped meal(s)?
Dinned at a fast food restaurant?
Late night eating?
Notes (feelings, concerns, questions, hunger cues):
By: Courtney Walberg, RD, NASM-CPT