DAILY FOOD INTAKE

Instructions: Each day, write down what you eat at breakfast, lunch, and diner. Also write down what you eat in between meals. See example.

Day  MONDAY ______

Breakfast  2 pieces of toast-peanut butter, glass of juice ___________________________

Lunch   Big mac, large fries, large coke, milk shake _______________________________

Dinner  2 plates of spaghetti-hamburger in the sauce, 5 pieces of bread, 2 glasses of coke_

In between __snickers bar, can of diet coke, apple, cup of coffee ____________________

Day _______________

Breakfast  ________________________________________________________________

Lunch  __________________________________________________________________

Dinner  __________________________________________________________________

In between   ______________________________________________________________

Day _______________

Breakfast  ________________________________________________________________

Lunch  __________________________________________________________________

Dinner  __________________________________________________________________

In between   ______________________________________________________________

Day _______________

Breakfast  ________________________________________________________________

Lunch  __________________________________________________________________

Dinner  __________________________________________________________________

In between   ______________________________________________________________

Day _______________

Breakfast  ________________________________________________________________

Lunch  __________________________________________________________________

Dinner  __________________________________________________________________

In between   ______________________________________________________________

Day _______________

Breakfast  ________________________________________________________________

Lunch  __________________________________________________________________

Dinner  __________________________________________________________________

In between   ______________________________________________________________

Day _______________

Breakfast  ________________________________________________________________

Lunch  __________________________________________________________________

Dinner  __________________________________________________________________

In between   ______________________________________________________________

Day _______________

Breakfast  ________________________________________________________________

Lunch  __________________________________________________________________

Dinner  __________________________________________________________________

In between   ______________________________________________________________

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