11/12/13

Food Records

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Lafene Health Center

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Lafene Health Center
Kansas State University
1105 Sunset Avenue
Manhattan, KS 66502-3761
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Food Record Instructions

Your food record will help you and the Lafene Health Center dietitian design
an eating plan to meet your individualized nutrition goals. It is very important
to follow these guidelines in order to get the most benefit from your nutrition
consult:
1. DONT CHANGE YOUR EATING HABITS WHILE KEEPING YOUR FOOD
RECORD, unless your doctor or dietitian have given you specific
instructions to do so.
2. Tell the truth. Record what you really eat so you can get help with any
nutrition issues you currently struggle with.
3. Print enough copies of the food record form to record 3 days of dietary
intake (including 1 weekend day). Return the completed food records
and one completed cover sheetto:

Nutrition Counseling
Room 257
785.532.6544
by appointment
Dianna Schalles,
M.S, R.D., L.D.
Food re cord form s
Basic rule s
Spe cific instructions
Sam ple re cord

Dianna Schalles
Lafene Health Center
1105 Sunset Avenue
Manhattan, KS 66502
(OR send via campus mail)
4. Once you have submitted your food record, call 785.532.6544 to
schedule an appointment with the dietitian. Results of your food record
analysis generally are not available until one week after your forms are
received, so please take this into consideration when selecting an
appointment date.

785-532-6544
lafene@k-state.edu

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Basic rules to remember

Write down EVERYTHING! Keep your form with you all day long and
write down everything you eat and drink. A piece of candy, a handful of
pretzels, a bottle of soda or a small donut may not seem like much, but
these calories can add up!
Do it now! Dont depend on your memory at the end of the day. Record
your eating as you go.
Be specific. Make sure you include extras, such as gravy on your meat,
cheese on your sandwich or vegetables, butter, and salad dressings.
Estimate amounts. If you have a bowl of cereal, measure out or
estimate the actual amount (rather than writing bowl of cereal). If you
eat at the residence hall dining centers, just estimate as closely as
possible (or write down the number of servings you had).
Write legibly. Food records that cant be deciphered may delay your
results.
If you have questions, call the dietitian at 785.532.6544.
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Lets Get Started!

Refer to the following instructions and the sample food record to assist you in
completing your food records.

How Much:
Indicate the amount of the particular food or beverage you ate or drank.
Estimate the size (2 x 1 x 1), the volume (1/2 cup), the weight (2 oz)
and/or the number of items (12) of that type of food. If you can, measure
the portion with measuring utensils. You may also use the National Heart,
Lung and Blood Institute's pocket guide to estimating portion sizes.

www.k-state.edu/lafene/foodrecord.html#basics

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Food Records
What Kind:
Write down the type of food you ate. Be as specific as possible. Include
sauces, gravies, and any extras such as soda, salad dressing, mayonnaise,
butter, sour cream, sugar and ketchup. Dont forget to include the milk you
add to your cereal. Designate if an item is reduced fat, low fat or sugarfree.

Time:
Write the time of day you ate or drank the item. (i.e. 8:30 a.m.) Also, it is
helpful if you note the following: Bbreakfast, Llunch, Ddinner, Ssnack.

Where:
Write what room or part of the house you were in when you ate. If you ate in
a restaurant, fast-food chain or your car, write that location down.

Alone or with whom:

If you ate by yourself, write alone. If you were with friends or family
members, list this.

Activity:
List any activities you were doing while you were eating (for example,
working, watching TV, studying).

Mood:
How were you feeling while you were eating? (sad, happy, bored, depressed)
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Sample Food Record

Food or Drink

Specifics

How What Kind

Much

Time

Where

Alone
or with
whom

Activity

Mood

chocolate chip 3:25

cookies
pm

S The
Derb

friends

cheeseburger

D Burger
King

Claire,
Jackie

talking

happy

regular French
fries

Burger
King

vanilla shake

Burger
King

6:15
pm

happy

1 cup Haagen Dazs

ice cream

10:00
pm

S dorm
room

alone

watching
TV

bored

1 cup Captain
Crunch

1:00
am

S dorm
room

alone

studying

tired

cup

1:00
am

S dorm
room

alone

studying

tired

2% milk

Food Record Forms (These forms are in PDF format, which requires Adobe
Acrobat to view and print.)
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| site map | lafene@k-state.edu

Contact us

Emergency

Kansas State University

Statements and disclosures

Manhattan, KS 66506

www.k-state.edu/lafene/foodrecord.html#basics

785-532-6011

Kansas State University

Updated: 7/23/13

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