Human Nutrition

Daily Food Record

Name (print):______________________________ Day/Date of Intake: ________________________

Male__x____ Female ______ Age _25______

Meal	Date	Time Of Day	Food Item	Amount	Description (Brand or restaurant)	How Prepared (if applicable)
Breakfast
Lunch
Dinner
Snacks

· Record food items as completely as possible, listing separate ingredients when indicated (e.g., don’t just write “sandwich”, but include type of bread, filling, vegetables added, sauces and condiments).

· Don’t forget beverages, including alcoholic beverages, sodas, and water.

· Estimate the amounts or serving size you consume as closely as possible in units, such as cups, ounces, teaspoons, and teaspoons. (NOTE: “one serving”, “one bowl”, or “one piece” are not acceptable units as they are subjective measures and don’t relay quantifiable amounts.) You may want to measure foods to obtain a more accurate estimate of quantity.

· When indicated, include preparation method or other details that may help describe the food, for example: indicate whether a chicken breast is baked, grilled, breaded, fried, etc. or whether vegetables are raw, steamed, “Southern style”, sautéed, fried, etc.