Food Log

It is important to keep an accurate record of your usual food & beverage intake as a part of your nutrition assessment. Please complete this Food Journal for 3 consecutive days; include one weekend day.

Please note: we do not recommend tracking your intake if this is triggering for you. Food tracking is completely optional.

Instructions:

• Do not change your eating behavior at this time, the purpose of this food record is to analyze your present eating habits and health practices.

• Record your information as soon as possible after the food has been consume

• Please describe all foods and beverages consumed as accurately and in as much detail as possible including estimated amounts, brand names, cooking method, etc.

• Record the amount of each food or beverage consumed using standard measurements such as 8 ounces, 1⁄2 cup, 1 teaspoon, etc.

• Include any added items, for example: tea with 1 teaspoon honey, potato with 2 teaspoons butter, etc.

• List all beverages and types, including water, coffee, tea, sports drinks, sodas/diet sodas, alcohol, etc.

• Please comment on any noted emotional or physical symptoms including hunger level, stress, bloating, fatigue, adverse reaction experienced, etc.

• Include comments about eating habits and environment such as reasons for skipping a meal, when a meal was eaten at a restaurant, etc and any additional details that may be important

• Include details about your exercise including type, duration, intensity AND time.

• Each day please note all bowel movements, describe their consistency (regular, loose, firm, etc.), frequency, and any additional information

• If desired an online food journal may be kept. Here a few we recommend: fitday, myfitnesspal, choosemyplate, or loseit

Please use this food log form to track your food log information. You can email a copy of your log to RD@wholehealthnutritionvt.com