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Food, Drink, Activity, and Symptom Log

SUMMARY

Use this log to record your eating habits, other health behaviors, and how you feel.  Jot down everything you eat and drink for a week or two.  Include weekdays and days on the weekend.  This log has space for two days.  Use more pages as needed.  Include the amount or size of the food or drink (one large apple, 1 cup of lettuce, 8 ozs. of coffee).  Be specific. (For example, does your drink contain caffeine?  What’s in your salad or casserole?)  Do you see any unhealthy habits that you would like to change?  Do you see any connections between how you feel and your habits?  Use this information as you set health goals. 

 

Fill in Date and Day of Week

Fill in Date and Day of Week

 

Record food and amount

Record food and amount

Breakfast

 

 

Morning

Snacks

 

 

Lunch

 

 

Afternoon

Snacks

 

 

Dinner

 

 

Evening

Snacks

 

 

Record other things that were happening on these days

Number of hours I slept

 

 

Ways I relaxed

 

 

How active I was

 

 

Overall how stressed I felt

 

 



Keywords:
KEYWORDS 
Doc ID:
150468
Owned by:
Sara A. in Osher Center for Integrative Health
Created:
2025-05-09
Updated:
2025-05-22
Sites:
Osher Center for Integrative Health