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Stress Management for Health Course

Stress Resistant Eating Log

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Food Diary

NAME:

HOW TO RECORD YOUR FOOD INTAKE

Day 1: Date:              Day of week:

Day 2: Date:              Day of week:

Please write down everything you eat and drink for five days in the coming week.  Make sure that you include at least one weekend day.

Write down the time at the start of each meal of drink or snack.  A bar of chocolate eaten at the bus-stop is a snack.

Describe the food as accurately as possible-for instance, a sandwich is actually three foods: bread, butter, and eg cheese.

Give clear descriptions of the type of food eaten, eg: Bread - wholemeal, white, thick or thin sliced.

Milk - whole, semi-skimmed, skimmed, evaporated

Sausages, - beef or pork, fried or grilled.

Describe the portion in household measures, eg slices, tablespoons, mugs or cups.

EXAMPLE

Time

Description of food or drink

How much

Time

Description of food or drink

How much

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Time

Description of food or drink

How much

7:30am

Boiled egg

1

 

White toast

1 slice medium

 

Butter (thickly spread)

 

 

Marmalade

2 teaspoons

 

Tea (whole milk, no sugar)

2 cups

 

 

 

9:30 am

Coffee (semi-skimmed milk)

1 cup

 

Sugar

1 teaspoon

 

 

 

12:00

Brown bread

1 slice medium

 

Cheese

1 oz

 

Tomato

1

 

Butter (thinly spread)

 

 

Tea (semi-skimmed milk no sugar)

1 cup

 

 

 

3:30pm

Tea (semi-skimmed milk no sugar)

1 cup

 

 

 

6:00pm

Beef

2 slices

 

Potatoes (new boiled)

3

 

Peas

2 tablespoons

 

Gravy

 

 

Tinned peaches

3 halves

 

 

 

 

 

 

If the spaces in the columns are too small for you, please copy the form onto larger paper. (Ref: Leeds A., Judd P., Lewis B., (1990) Nutrition Matters for Practice Nurses: A Handbook of Dietary Advice for use in the Community.  John Libbey.)

Day 3: Date:                   Day of Week:

Day 4: Date:                Day of Week:

Day 5: Date:                Day of Week:

Time

Description of food or drink

How much

Time

Description of food or drink

How much

Time

Description of food or drink

How much

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Ref: Leeds A., Judd P., Lewis B., (1990) Nutrition Matters for Practice Nurses: A Handbook of Dietary Advice for use in the Community.  John Libbey.)

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