24-Hour Recall Form

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Republic of the Philippines

POLYTECHNIC UNIVERSITY OF THE PHILIPPINES


College of Science
Department of Nutrition and Dietetics

24-HOUR FOOD RECALL


Day _

Name: Age: Gender: Date & Day Taken:


Instructions: List down the foods, drinks and supplements you consumed in the previous 24 hours, from the time you woke up
until you slept. Indicate the place where the food, drink or supplement was consumed and the time of consumption. Describe
the food, drink or supplement with as much detail as possible (cooking method, brand, size, color, part & type). Indicate the
amount you consumed in household measure (cup, glass, piece, teaspoon & tablespoon).

Place of Time of Food/Drink Consumed Description of Food/Drink Amount in household


Consumption Consumption Consumed measure

Nutrition and Food Science Building, PUP A. Mabini Campus


Anonas St., Sta. Mesa, Manila Tel: 335-1787 loc. 603 Website: https://pup.edu.ph/cs
THE COUNTRY’S 1ST POLYTECHNIC U

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