Food Diary and Nutritional Self Assessment
Sheet1
| Nutrients | Recommended Dietary allowances (Record the number from the red line.) | Day 1 (Record the actual intale percent represented by the blue bar.) | Day 2 | Day 3 |
| Example: Protein | 45% | 98% | 121% | |
| Carbohydrates | ||||
| Fat | ||||
| Protein | ||||
| Fiber (g) | ||||
| Sugar | ||||
| Saturated | ||||
| Polyunsaturated | ||||
| Monounsaturated | ||||
| Trans (g) | ||||
| Cholesterol (mg) | ||||
| Sodium (mg) | ||||
| Potassium (mg) | ||||
| Vitamin A % | ||||
| Vitamin C % | ||||
| Calcium % | ||||
| Iron % |