DAILY FOOD SENSITIVITY LOG
Name:
Date:
Food, Drinks, Medications
Time
Time
Mood, Health, Symptoms
Notes and Conclusions:
Instructions: On the left side, keep a detailed record of all foods, drinks, and medications consumed
throughout the day. On the right, keep a detailed record of changing moods and health, including
fatigue, nausea, and irritability. Use the space between the columns to draw lines linking possible
trigger foods to relevant effects. Discuss these records with a physician before drawing any conclusions.