If you are having any symptoms or have any questions, please call 811 to speak with a registered nurse 24 hours a day.

Instructions

The information you record in your food diary will help you and your health care provider design an eating program just for you. These instructions will help you get the most out of your food diary. Generally, food diaries are meant to be used for a whole week, but studies have shown that keeping track of what you eat for even 1 day can help you make changes in your diet.

How much: In this space, indicate the amount of the particular food item you ate. Estimate the size (5x3x3 cm (2″ x 1″ x 1″)), the volume (125 ml (1/2 cup)), the weight (57 g (2 ounces)) and/or the number of items (12) of that type of food.

What kind: In this column, write down the type of food you ate. Be as specific as you can. Include sauces and gravies. Don’t forget to write down “extras,” such as soda, salad dressing, mayonnaise, butter, sour cream, sugar and ketchup.

Time: Write the time of day you ate the food.

Where: Write what room or part of the house you were in when you ate. If you ate in a restaurant, fast-food chain or your car, write that location down.

Alone or with someone: If you ate by yourself, write “alone.” If you were with friends or family members, list them.

Activity: In this column, list any activities you were doing while you were eating (for example: working, watching TV or ironing).

Mood: How were you feeling while you were eating (for example, sad, happy or depressed)?

Helpful Hints:

• Do not change your eating habits while you are keeping your food diary, unless your health care provider has given you specific instructions to do so.
• Tell the truth. You don’t gain anything by trying to look good on these forms. Your health care provider can help only if you record what you really eat.
• Record what you eat on all days your doctor recommends.
• Be sure to bring the completed forms to your next health care provider appointment.

Some basic rules to remember:

Write everything down: Keep your form with you all day, and write down everything you eat or drink. A piece of candy, a handful of pretzels, a can of soda pop or a small donut may not seem like much at the time, but over a week these calories add up!

Do it now: Don’t depend on your memory at the end of the day. Record your eating as you go.

Be specific: Make sure you include “extras,” such as gravy on your meat or cheese on your vegetables. Do not generalize. For example, record french fries as french fries, not as potatoes.

Estimate amounts: If you had a piece of cake, estimate the size (5x3x5 cm (2″ x 1″ x 2″)) or the weight (85 g (3 ounces)).

If you had a vegetable, record how much you ate (125 mL (1/2 cup)). When eating meat, remember that a serving size is 75 g (2 1/2 ounces).

If you have any questions, contact your health care provider.

Sample Food Diary

Food or Drink

3 chocolate chip cookies 3:25 p.m. office alone working on report bored

1 cheeseburger 6:15 p.m. Burger King Claire, Jackie talking happy

1 regular french fries

1 vanilla shake

250 mL (1 cup) Haagen Dazs ice cream 10:00 p.m. kitchen alone watching TV tired

Some information adapted from Physicians Guide to Outpatient Nutrition, by Sylvia A. Moore, Ph.D., R.D., F.A.D.A. and John P. Nagle, M.P.A. American Academy of Family Physicians, Leawood, KS. 2001.