Daily Food Record - Weekday 1

Please complete the form below and Submit to SHAPE before proceeding to the DAILY FOOD RECORD (Weekday 2) form ... INSTRUCTIONS FOR COMPLETING THIS RECORD ... Weekday 1 CARRY A NOTE PAD to jot down the items then expand the info for the form EAT NORMALLY  don't alter your diet or the results will be invalid RECORD EVERYTHING you eat and drink including TIME OF DAY GIVE SPECIFIC DESCRIPTION for each food: example: Do not say “fish,” specify type (i.e. salmon, cod, haddock etc.) Specify white or dark meat in poultry Specify the fat level of milk (i.e. homogenized, 2%, 1%, skim, soy, etc.) State the type of bread (i.e. white, whole wheat, rye, etc.) Include all condiments (i.e. butter on bread, ketchup on french fries, salt added to vegetables) Specify fresh, frozen or canned fruit and vegetables Include all components of mixed dishes (don't just say sandwich, but specify the kind of meat and bread used, as well as any condiments like mayonnaise or mustard) PROVIDE EXTRA INFORMATION such as: Are the chocolate chip cookies “Chips A-Hoy” or homemade? Are the vegetables steamed or fried? Is the hamburger from McDonald`s or home BBQ? Are the eggs fried with butter, scrambled with milk or poached? PROVIDE QUANTITY information: Express weights in ounces or grams Express volumes in milliliters With some foods, you can obviously just provide a raw number (i.e. 1 slice of bread, 1 apple, 2 eggs, etc.) 3 ounces of meat = approximately the size of a deck of cards 1 cup = 250 mL 1 tablespoon = 15 mL 1 teaspoon = 5 mL = Required Name: Date: (mm/dd/yy) Use this box to input your data:

 

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