3-Day Food Record Jan09

Instructions for 3-Day Food Record
1. Please indicate the date and the day of the week that you are recalling at the top of the food record.
Record two weekdays and one weekend day for best results. Please use a day that was/is fairly typical
for you in terms of your normal eating habits.
2. Record each food and beverage you consumed on a separate line. When eating combination foods
(e.g., sandwich, lasagna, stew, casserole, etc.) please separate the food/dish into its individual
components as much as possible.
3. Record food and beverages in reasonably exact amounts: liquids in cups or fluid ounces; grains,
cereals, pasta in cups (please indicate if the measure is dry or cooked); meats, fish, chicken in ounces,
fruits & vegetables in cups.
4. Please specify if the food was consumed raw or cooked (and indicate the type of cooking method
used). Also indicate if it was prepared from fresh, canned or frozen products.
5. Please indicate how the food was prepared; e.g., fried, baked, boiled, grilled, steamed, etc.
6. List brand names or sources wherever possible. If the food item is unusual (fat-free, international food,
supplement) please enclose a label if possible.
7. For fruits, potatoes, chicken etc. please indicate if the skin was removed before consumption
8. Please be sure to indicate if dairy products, (i.e., milk, cheese, yogurt, etc.) was whole, low-fat (1%,
2%), non-fat (skim), etc.
9. Be sure to include all the little extras (e.g., sauces, gravies, candy, etc.)
Provide any other information you think might be helpful.

3-Day Food Record Day 1
Name: Andrew Chung Date: 02/20/17 Day of Week: M T W Th F SA Su

(Circle one)
Age: 23 Height: 5 8 Weight: 190 Activity Level*: 3
*Activity level: 1. Sedentary: Very inactive, sometimes under the care of another person. 2. Lightly Active: Most office workers and professionals.
Equals 8 hours of sleep, 16 hours of sitting/standing of which 3 hours is light (e.g. walking, laundry) and 1 hour of moderate (e.g. tennis, brisk walk,
aerobics) activity. 3. Moderately Active: Most persons in light industry, building trades, child care providers, active students (approximately 1.5-2
hours of moderate activity per day). 4. Very Active: Full time athletes, mine or steel workers, army recruits. 5. Extremely Active: Lumberjacks, active
construction workers, heavy manual digging, coal miners.
Please record as accurately as possible all food and beverages you consumed for one day. Please give as many
details as possible regarding the food/beverage item. Please list all supplements consumed including sports
foods/beverages, vitamins, minerals, herbs etc. When eating out specify the restaurant and when you use
convenience foods please specify the brands.
Time Food/Beverage Brand or Source Type of Preparation Amount
8:00 am Example: cinnamon raisin bagel Lenders Toasted 1 ea. (3 oz)

9:00 Example: weight training 1 hour Moderate intensity
2:00 am Weight Training 1 hour/20 min Moderate Intensity

8:00 am Oatmeal Quakers Cooked 1 Cup
8:00 am 1% Milk Viva Raw 1 Cup
8:00 am Egg Whites Cooked Medium
8:00 am Orange Juice Tropicana Bottle 1 Cup
8:00 am Water Tap 1 Cup
10:00 am Greek Yogurt (Vanilla) Dannon 1 Cup
10:00 am Strawberries Sprout Raw 1 Cup
10:00 pm Water Tap 1 Cup
1:00 pm Tomato Soup Sprout Cooked 1 Cup
1:00 pm Grilled Cheese Grilled Half
1:00 pm Diet Coke Coca Cola Canned 12 fl. Oz.
4:00 pm Pineapple Sprout Raw 1 Cup
4:00 pm Greek Yogurt (Vanilla) Dannon 1 Cup
8:00 pm Burger Patty Grilled 1 Large
8:00 pm Broccoli Sprout Steamed 1 Cup
8:00 pm White Rice Cooked 1 Cup
8:00 pm Golden Potatoes Sprout Baked 1 Cup
10:00 pm Cardio 30 minutes Moderate Intensity
Date: 03/01/17 Day of Week: M T W Th F SA Su

(Circle one)
Weight: 190 Activity Level*: 3

2:00 am Weight Training 1 hour/20minutes Moderate Intensity

7:00 am White Rice Cooked 1 Cup
7:00 am Turkey Bacon Morning Star Cooked 2 Strips
7:00 am Orange Juice Tropicana Bottle 1 Cup
10:00 am Greek Yogurt (Vanilla) Dannon 1 Cup
10:00 am Apple Sprout Raw 1 Whole
1:00 pm Chicken Breast Grilled 2 oz.
1:00 pm Blueberries Sprout Raw Cup
1:00 pm Strawberries Sprout Raw Cup
1:00 pm Spinach Salad Sprout Raw 1 Cup
1:00 pm Diet Dr. Pepper Canned 12 fl. Oz.
8:00 pm Beef Stew Cooked 2 Cups
8:00 pm Spinach Sprout Steamed 1 Cup
Date: 03/11/17 Day of Week: M T W Th F SA Su

(Circle one)
Weight: 190 lb. Activity Level*: 3

2:00 am Weight Training 1 hour/20 min Moderate Intensity

10:00 am Blueberry Bagel Sara Lee Raw 1 ea. (3 oz)
10:00 am Orange Juice Tropicana Bottled 1 Cup
12:00 pm Blueberries Sprout Raw 1 Cup
3:00 pm Grilled Chicken Breast Grilled Large
3:00 pm Spinach Sprout Steamed 1 Cup
5:00 pm Toast Sara Lee Toasted 1 Slice
7:00 pm Cardio 30 Minutes Moderate Intensity
8:00 pm Burger Patty Grilled 2 Medium
8:00 pm Swiss Cheese Raw 2 Slices

3-Day Food Record Jan09

Încărcat de

Informații document

Titlu original

Drepturi de autor

Formate disponibile

Partajați acest document

Partajați sau inserați document

Opțiuni de partajare

Vi se pare util acest document?

Este necorespunzător acest conținut?

Drepturi de autor:

Formate disponibile

3-Day Food Record Jan09

Încărcat de

Drepturi de autor:

Formate disponibile

Instructions for 3-Day Food Record

Provide any other information you think might be helpful.

Name: Andrew Chung Date: 02/20/17 Day of Week: M T W Th F SA Su

Time Food/Beverage Brand or Source Type of Preparation Amount

8:00 am Example: cinnamon raisin bagel Lenders Toasted 1 ea. (3 oz)

2:00 am Weight Training 1 hour/20 min Moderate Intensity

Date: 03/01/17 Day of Week: M T W Th F SA Su

Time Food/Beverage Brand or Source Type of Preparation Amount

8:00 am Example: cinnamon raisin bagel Lenders Toasted 1 ea. (3 oz)

2:00 am Weight Training 1 hour/20minutes Moderate Intensity

Date: 03/11/17 Day of Week: M T W Th F SA Su

Time Food/Beverage Brand or Source Type of Preparation Amount

8:00 am Example: cinnamon raisin bagel Lenders Toasted 1 ea. (3 oz)

2:00 am Weight Training 1 hour/20 min Moderate Intensity

S-ar putea să vă placă și