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Food Diary
In#the#chart#below,#record#everything#that#you#eat#for#two#days,#including#snacks.#Then,#evaluate#your#diet#
according#to#the#www.choosemyplate.gov#guidelines#and#how#many#portions#per#food#group#are#
recommended#for#your#age,#gender,#and#activity#level.##
###########Name_________________________________________## Period#______________#
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Day#1#
Day#2#
Breakfast#
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Lunch#
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Dinner#
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Snacks#
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On#the#lines#below,#under#“Target#Intake,”#list#your#nutritional#requirements#for#each#food#group.#For#Day#1#
and#Day#2,#count#how#many#food#you#had#in#each#food#group#and#see#how#it#compares#to#what#is#
recommended#for#you.#You#will#know#that#if#you#mark#“0”#for#the#vegetables#group#that#is#an#area#you#are#
lacking#in.#
# # # # Target'Intake' ' ' '''''''Day'1' ' ' '''''''Day'2'
Grains# # # # ___________# # # ____________## # ____________#
Vegetables# # # ___________# # # ____________## # ____________#
Fruits# # # # ___________# # # ____________## # ____________#
Dairy# # # # ___________# # # ____________## # ____________#
Protein#Foods# # # ___________# # # ____________## # ____________#
Oils# # # # ___________# # # ____________## # ____________#
Empty#Calories# # ___________# # # ____________## # ____________#
Food Diary Template Word
source: exeter.k12.pa.us
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