3 Day Food Journal

Instructions for Completing the Food Journal

Please know right up front, the practitioners in this practice make absolutely no judgments about the foods our patients eat. Our goal in collecting this information is simply to be able to identify foods that might be symptom triggers for you, inform you of potential nutritional or dietary deficiencies that could be causing symptoms, and understand patterns that might be causing symptoms, cravings, or conditions. Please give us as accurate a reporting of what you’re eating at each meal, snack, and in the evening as possible. Here are some tips for providing the most helpful possible information:

• Record what you’ve eaten as soon as possible after each time you eat
• Don’t change your usual eating behaviors
• Describe the food or beverage consumed. e.g., milk – what kind? (whole, 2%, or nonfat); toast – (whole wheat, white, buttered); chicken – (fried, baked, breaded), etc.
• Record the amount of each food consumed using standard measurements as much as possible, such as 8 ounces, 1/2 cup, 1 teaspoon, etc.
• Include any added items. For example: tea with 1 teaspoon sugar, potato with 2 teaspoons butter, etc.
• Please record all beverages, including water. List them in the “Beverage” category.
• Please record how you felt within 2 hours of meals, snacks, or beverages, particularly if you felt especially well, or if you noticed any symptoms.