Detailed Daily Food Intake Record Page 3
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1
2
3Dinner
Place
Time
Food/Beverage
Describe how prepared; additional ingredients
Amount
Main Dish
•
meat, fish, poultry
•
pasta dish
•
rice
•
casserole
•
other
Vegetables
•
raw
•
cooked
•
butter or substitute
•
sauces
Salad/dressing
Bread or rolls
•
butter or substitute
•
white or whole grain
Fruit
•
fresh
•
canned
Beverage
•
milk
•
juice
•
soda/other
Dessert
Misc/snacks
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Parent category: Miscellaneous