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Using the nutrition journal table, record all food and drink consumed for THREE days. At least ONE weekend day (Saturday or Sunday) must be included. All columns within a row must be completed and detailed to earn full credit. You may add additional rows if necessary.

For example: A sandwich should be itemized to be: 2 slices of bread (whole wheat), 2 slices of cheddar cheese, 1 tbsp of mayo & mustard, 4 slices of tomato, 2 leaves of lettuce, 2 slices of turkey.


Ex: Oct 5th/Monday


Food/Beverage Consumed

Specific Amount Consumed (oz. Cup, TBS, lb, etc.)

Satiety Level After Eating

(1=hungry, 2=slightly hungry, 3=satisfied, 4=slightly full, 5=very full)

Total number/servings of vegetables consumed over 3 days:__________________________

Total number/servings of fruit consumed over 3 days: __________________________

Total ounces of water consumed: __________________________

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