ABCDEFGHIJKLMNOPQRSTUVWXYZAAABACADAEAFAGAHAIAJAKALAM
1
2
BakingFryingRoastingGrilling
Steaming
Poaching
Simmering
Broiling
Blanching
BraisingStewingSautéingSearingBoilingRaw
uncooked
3
Please include all foods and drinks consumed each day with approximate or exact portion sizes and how the foods were cooked (e.g. fried, baked etc.). Also include how hungry you felt and how you were feeling using the keys below. gramsouncesmlTspTbspFist size
Palm Size
1/2 cup1 cupmgpoundsfl ozfl mlsmallmediumlarge
4
DAY 11: Happy2: Fair
3: Unhappy
5
1: Not hungry
2: Fairly hungry
3: Very hungry
6
7
NAME:DATE:
8
9
FOODS OR DRINKS CONSUMEDMEASUREMENTPORTION AMOUNTHOW THE FOOD WAS COOKEDHUNGER LEVELMOOD LEVEL1
10
2
11
Meal 13
12
4
13
5
14
6
15
7
16
8
17
Meal 29
18
10
19
20
20
30
21
40
22
40
23
Meal 360
24
70
25
80
26
90
27
100 -150
28
150 - 200
29
Meal 4
200 -250
30
250 - 300
31
300 -350
32
350 -400
33
400 -450
34
450 - 500
35
Meal 5
500 -550
36
550 -600
37
600 -650
38
650 - 700
39
700 - 750
40
750 -800
41
Meal 6
800 -850
42
850 -900
43
900 -950
44
950 - Plus
45
46
47
Hydration
48
49
50
51
52
53
ANY OTHER INFORMATION FOR YOUR PT
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100