NUTRITIONAL ASSESSMENT

What have you eaten? FOOD DIARY will help you keep track of
what you have eaten throughout the day. In this exercise, keep
a diary of your diet for three days; list the type of food you ate
and beverages that you drink.

FOOD TYPE: Make a note of the types of food and drink you consume.
Don’t forget to write down extras, such as toppings, sauces, dressings, or
condiments (example: butter, ketchup, sugar)

TRACK TIME: Note the time of the day you eat and drink to better learn your
eating habits.

WHERE: Take note of where you eat. If you are in the restaurant, write down the
name. If you’re at home, write down the room. For instance, at the dining table, in the
kitchen, or in the sofa.

ACTIVITIES: List any activities you do while you eat or drink. You could be
working, watching television, or playing a game.

MOOD: Include how you feel when you eat and drink. Are you happy, sad or
bored? Your mood can impact what and when you eat or drink.

Cheating won’t help you change your eating habits so you

should fill it honestly.

ACTIVITY LEARNING 11

 The Activity is 50 points and will be graded according to the rubric attached.
3 days Food Diary 25%
Reflection 25%
TOTAL 50%

Basic Nutrition and Diet Therapy

Prepared by: Princess Jehanne Mangondato-Dimaporo
NAME:____________________________________________ WEIGHT:_________________
DATE:_______________________ DAY:__________________

TIME FOOD AND BEVERAGES WHERE ACTIVITY MOOD

CIRCLE THE HOURS OF SLEEP

4 5 6 7 8 9 10 11 12

CHECK NUMBER OF GLASSES OF WATER CONSUMED (each cup= 500 ml)

Basic Nutrition and Diet Therapy

Prepared by: Princess Jehanne Mangondato-Dimaporo
REFLECTION

After recording your food habit for three days, you will make a reflection that would answer the
following questions.

1. Did you eat foods from all the food groups?

2. Did you have three meals a day?

3. What nutrients are you getting from your food choices?

4. What do you learn about your diet?

5. What could you do to improve the variety in your diet?

Basic Nutrition and Diet Therapy

Prepared by: Princess Jehanne Mangondato-Dimaporo